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2019 Vol. 16, No. 29 Published: 2019-10-15

	7	Effect of naringin and naringenin on Clarithromycin metabolism in rat liver microsomes
		XIE Tangning SU Weiwei WANG Yonggang WU Hao PENG Wei LI Peibo
		Objective To investigate the effect of naringin and naringenin on Clarithromycin metabolism in rat liver microsomes. Methods The content of Clarithromycin in rat liver microsomes was determined by high performance liquid chromatography. The Michaelis constant (Km) for Clarithromycin was calculated according to Lineweaver-Burk equation. The effect of naringin and naringenin at concentrations of 0.11-180.00 μmol/L on Clarithromycin metabolism were evaluated in rat liver microsome by incubation in vitro. Results The chromatograms showed that Clarithromycin and inter standard were separated well and both were not disturbed by endogenesis substances, there was no interference of other endogenous substances in the warm incubation system. Vmax and Km were 0.59 nmol/(min·mg) and 77.57 μmol/L, respectively. Compared with the blank control group, naringin and naringenin in each dose group showed no statistically significant difference in Clarithromycin metabolism in rat liver microsomes (P > 0.05). Conclusion Naringin and naringenin did not affect the metabolism of Clarithromycin by liver microsomes.
		2019 Vol. 16 (29): 7-10,20 [Abstract] ( 164 ) HTML (1 KB) PDF (778 KB) ( 79 )

	11	Effect of triiodothyronine on abnormal calcium channel in ventricular myocytes of hypoxia/reoxygenation-induced lactating mice and its signaling pathway mechanism
		LIU Lei ZENG Bin LIAO Xiaoting
		Objective To observe the effect of triiodothyronine (T3) on abnormal calcium channels in ventricular myocytes of hypoxia/reoxygenation (H/R) lactating mice and the role of PI3K/Akt signaling pathway in it. Methods Isolation of ventricular myocytes from neonatal mice and establishment of cell H/R model were carried out. Normal control (Control) group, H/R group, T3+H/R group, T3+H/R+LY294002 (LY) group and H/R+LY group were set up. Patch clamp technique was used to observe the changes of L-type calcium channel current (ICaL) and Western blot was used to detect the expression of PI3K/Akt signaling pathway in cardiomyocytes. Results Compared with control group, the peak current of ICaL in H/R group decreased (P < 0.01) and I-V curve moved up. Compared with H/R group, ICaL peak current increased in T3+H/R group (P < 0.01), and decreased in H/R+LY group (P < 0.01). Compared with T3+H/R group, ICaL peak current decreased in T3+H/R+LY group (P < 0.01). Compared with control group, V1/2 in H/R group decreased significantly (P < 0.05), inactivation curve shifted to the right and inactivation slowed down. Compared with H/R group, V1/2 of T3+H/R group increased (P < 0.05), the inactivation curve moved left, and the inactivation accelerated. Compared with control group, V1/2 of H/R group increased (P < 0.05), the activation curve moved left, and the activation accelerated. Compared with H/R group, V1/2 of T3+H/R group decreased (P < 0.05), the activation curve moved right and the activation slowed down. Compared with control group, the expression of P-PI3K and P-Akt decreased in H/R group (P < 0.01). Compared with H/R group, the expression of P-PI3K and P-Akt in myocardial cells of T3+H/R group increased (P < 0.01), while the expression of P-PI3K and P-Akt in myocardial cells of H/R+LY group decreased (P < 0.01). Compared with T3+H/R group, the expression of P-PI3K and P-Akt in myocardial cells of T3+H/R+LY group decreased (P < 0.01). Conclusion ICaL current decreases when cardiomyocyte H/R, affecting excitation and contraction of cardiomyocyte. T3 can protect L-type calcium channel by activating PI3K/Akt signaling pathway and reduce the decrease of channel current, thus exerting its cardioprotective effect.
		2019 Vol. 16 (29): 11-15 [Abstract] ( 181 ) HTML (1 KB) PDF (913 KB) ( 66 )

	16	Effect of IL-4 and IFN-γ on the expression of HIF-1α and TGF-β1 in lung fibroblasts of COPD patients
		ZENG Cimei1 OU Zongxing1 HUANG Denggao2 SHEN Bing1 WANG Lei1 MA Ximiao3 CAO Hui2
		Objective To investigate the synergistic regulation of interleukin 4 (IL-4) and gamma interferon (IFN-γ) in airway remodeling in patients with chronic obstructive pulmonary disease (COPD). Methods From December 2017 to August 2018, lung tissue was collected from the Department of Thoracic Surgery, Central South University, Xiangya School of Medical, Affiliated Haikou Hospital. Lung tissue samples from 16 patients with lung cancer and 12 patients with lung cancer combined with COPD were surgically removed. Lung fibroblasts were isolated and identified from normal lung tissues and lung tissues of COPD patients, respectively, and the expression levels of hypoxia-induced factor 1α (HIF-1α) and transformed growth factor β1 (TGF-β1) were detected by qRT-PCR and Western blot, lung fibroblasts were stimulated with IL-4 and IFN-γ, respectively, and the expression levels of HIF-1α and TGF-β1 were subsequently detected to evaluate the effects of IL-4 and IFN-γ on lung fibroblasts HIF-1α/TGF-β1. Results Compared with normal lung fibroblasts, mRNA levels of HIF-1α and TGF-β1 in lung fibroblasts of COPD patients were significantly increased (P ＜ 0.01). IL-4 induced increased expression of HIF-1α and TGF-β1 in lung fibroblasts (P ＜ 0.05). The expression of HIF-1α and TGF-β1 was positively correlated with the duration of IL-4 action （R2 = 0.8736，P = 0.0018；R2 = 0.8637，P = 0.0223）. IFN-γ inhibits HIF-1α and TGF-β1 expression in lung fibroblasts (P ＜ 0.05), the expression of HIF-1α and TGF-β1 was negatively correlated with IFN-gamma duration （R2 = 0.8410，P = 0.0283；R2 = 0.8142，P = 0.0361）. Conclusion IL-4 promoted the expression of HIF-1α and TGF-β1 in pulmonary fibroblasts in COPD patients. Moreover, the expression of HIF-1α and TGF-β1 was positively correlated with the duration of IL-4 action. In contrast, IFN-γ inhibited the expression of HIF-1α and TGF-β1 in pulmonary fibroblasts in COPD patients, and the expression of HIF-1α and TGF-β1 was negatively correlated with the duration of IFN-γ action.
		2019 Vol. 16 (29): 16-20 [Abstract] ( 155 ) HTML (1 KB) PDF (1035 KB) ( 70 )

	21	Study on the antibacterial, anti-inflammatory, antipyretic and antitussive effects of total flavonoids of Viola thianschanica Maxim.
		WANG Xue SHI Yuzhu SI Lijun ZHAO Lijuan MA Xueping HUANG Hua
		Objective To investigate the antibacterial, anti-inflammatory, antipyretic and antitussive effects of total flavonoids of Viola thianschanica Maxim.. Methods The doubling dilution method in vitro and establishment of mice infection model of Staphylococcus aureus, Escherichia coli in vivo were used to investigate the antibacterial effect of total flavonoids of Viola thianschanica Maxim. in vivo and in vitro. The model mice with auricle swelling and model mice with increased peritoneal capillary permeability were used to investigate the anti-inflammatory effects. The model rats with fever induced by dry yeast were adopted to investigate the antipyretic effect. The model rats with cough induced by ammonia water were adopted to investigate the antitussive effect. Results The minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of total flavonoids of Viola thianschanica Maxim. against Staphylococcus aureus were 1.95, 3.90 mg/mL respectively, and the MIC and MBC values of total flavonoids of Viola thianschanica Maxim. against Escherichia coli were 0.49, 0.98 mg/mL respectively. The total flavonoids of Viola thianschanica Maxim. had a significant protective effect on the infection model of Staphylococcus aureus and Escherichia coli in mice at 0.32 g/kg, the protective rates were 30% and 40% respectively. The total flavonoids of Viola thianschanica Maxim. could significantly inhibit auricle swelling induced by xylene in mice at 0.16, 0.32 g/kg, and could significantly inhibit capillary inflammatory exudation induced by glacial acetic acid in mice at 0.08, 0.16, 0.32 g/kg. The total flavonoids of Viola thianschanica Maxim. had a good inhibitory effect on fever induced by dry yeast in rats at 0.14, 0.28 g/kg. The total flavonoids of Viola thianschanica Maxim. had a significant inhibitory effect on cough induced by ammonia water, the inhibitory rate was 57.7% at 0.32 g/kg. Conclusion The total flavonoids extract of Viola thianschanica Maxim. has good antibacterial, anti-inflammatory, antipyretic and antitussive pharmacological activities, its mechanisms remain to be futher studied.
		2019 Vol. 16 (29): 21-24 [Abstract] ( 176 ) HTML (1 KB) PDF (599 KB) ( 107 )

	25	Research progress of the application of ubiquitin proteasome pathway
		DONG Huilin1 NIE Hongming1 MEI Zhaohe2 ZHAO Binbin2 JIANG Yuzi2 CHEN Jianjie1 WANG Lingtai1
		The ubiquitin proteasome pathway which is dependent on ATP has a highly specific and selective protein degradation pathway. UPP exists in eukaryotic cells widely, and plays an important role in cell cycle regulation, signal transduction, antigen presentation, immune response and other biological functions. Currently, it is known that this pathway is closely related to neurodegeneration, viral infection, tumor, cardiovascular and other aspects. Once UPP abnormal affects the function of α-synuclein and Parkin protein, it will lead to Parkinson′s disease. Skp2, E3 ubiquitin ligase c-cbl and ubiquitin ligase E2C in the SCF complex protein are all related to the development of tumors. Many viruses, such as the HCMV virus, can attack or use UPP to evade immune attacks. In addition, many diseases have also been reported to be related to UPP, but at present we know very little about the system, and the related research is far from enough, and more exploration is needed.
		2019 Vol. 16 (29): 25-30 [Abstract] ( 217 ) HTML (1 KB) PDF (622 KB) ( 180 )

	31	Research progress of leukotrienes associated with the atherosclerosis
		HUANG Jiaxin1 TIAN Ji1 NI Wei2 DU Wenwen3 HUANG Rongzeng1 SONG Chengwu1 XIE Yun1 JIN Shuna4
		Lukotrienes (LTs) are inflammatory mediators of eicosanoids in leukocytes, which are formed by arachidonic acid and eicosapentaenoic acid through the oxidation of arachidonic acid 5-lipoxygenase. This article gives a brief overview of physical and chemical properties of LTs, then details the significance of clinical monitoring between LTs and atherosclerosis through the lipoxygenase pathway metabolic processes and their products. Besides, the associations between LTs and atherosclerosis in the reported animal and human studies are assessed, which can provide suggestion for screening LTs-based disease biomarkers and be as the available reference of their new clinically targeted treatment options.
		2019 Vol. 16 (29): 31-36 [Abstract] ( 187 ) HTML (1 KB) PDF (1128 KB) ( 85 )

	37	Progress in research on ubiquitination in the field of reproduction
		YU Jiarui1 CONG Jing2 ZHANG Ming3 WU Xiaoke2
		Ubiquitin is a highly evolutionarily conserved small protein found in most eukaryotic cells. Ubiquitin can form a three-step cascade through ubiquitin-activating enzyme E1, ubiquitin-binding enzyme E2, and ubiquitin-binding enzyme E3, respectively, and bind to the target protein, ubiquitinates the target protein, then passes through the ubiquitin-proteasome degradation pathway. The ubiquitinated target protein is broken down into smaller polypeptides and amino acids. Ubiquitination can affect the transcriptional activity of estrogen and progesterone receptors and participate in processes in the reproductive field such as oocyte, spermatogenesis and embryonic development. This article reviews recent research in the field of ubiquitination and reproduction, explores the role of ubiquitination in reproduction is of great significance for further mastering the development of germ cells and early embryo development, and provides a theoretical basis for the treatment of infertility and perfecting the reproductive system.
		2019 Vol. 16 (29): 37-40 [Abstract] ( 169 ) HTML (1 KB) PDF (596 KB) ( 74 )

	41	Research progress on the differential diagnosis and functional relationship between AIDS enteropathy and inflammatory bowel disease
		LIU Huanyu RAN Yan MI Chen LI Yingchao
		Acquired immune deficiency syndrome (AIDS) patients often chronic diarrhea as a prominent clinical manifestations. The etiology of AIDS diarrhea in addition to the combination of intestinal opportunistic infection, combined with intestinal tumor, also includes human immunodeficiency virus (HIV) direct injury caused by HIV enteropathy or idiopathic AIDS enteropathy. In clinical practice, AIDS enteropathy is easy to be misdiagnosed as inflammatory bowel disease (IBD) due to patients′ concealed medical history and lack of specific signs of intestinal manifestations under endoscope. However, both HIV infection and IBD are immunologic inadequacy, and there is a close correlation between IBD and HIV infection. This paper reviews the clinical features of AIDS enteropathy, the differential diagnosis of IBD, and the relationship between HIV infection and IBD.
		2019 Vol. 16 (29): 41-44 [Abstract] ( 187 ) HTML (1 KB) PDF (596 KB) ( 98 )

	45	Advances in research on the relationship between serum uric acid and cardiovascular diseases
		LIU Zhencheng1，2 BIAN Yunfei2 LI Jiawei1，2 LI Xiaoxuan1，2
		Serum uric acid is a metabolite of purine. Due to the change of people′s dietary habits, the large use of some drugs, the aging of the population, the serum uric acid has increased trend. Higher levels of serum uric acid are associated with cardiovascular disease, such as coronary heart disease, hypertension, heart failure, atrial fibrillation, and so on. This paper summarizes the relationship between serum uric acid and cardiovascular diseases and their physiological mechanism, and provides a basis for the diagnosis and treatment of cardiovascular diseases.
		2019 Vol. 16 (29): 45-48 [Abstract] ( 161 ) HTML (1 KB) PDF (596 KB) ( 99 )

	49	Research progress of endometrial insulin resistance in polycystic ovary syndrome
		LI Mubai1 CHEN Jingxin2 WANG Tingting2 MA Hongli1
		Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age, most patients are accompanied by insulin resistance (IR), some PCOS patients have local endometrial IR, which leads to endometrium lesions. The specific effects of traditional Chinese and Western medicine on PCOS endometrial IR and its resulting endometrial lesions are mainly manifested in improving endometrial receptivity, inhibiting endometrial dysplasy, and reducing the incidence of endometrial polyps. At the same time, PCOS patients often have low pregnancy rate and high abortion rate, and treatment with traditional Chinese and Western medicine can also improve pregnancy rate and reduce abortion rate. Modern molecular biology analysis of the drug action mechanism is mainly through improving the intracellular phosphatidylinositol kinase/protein kinase B (PI3K/Akt) signaling pathway, glucose transporter 4 and insulin receptor substrate expression to improve the endometrium IR. In this paper, the current clinical application of PCOS endometrial IR and the research progress of the molecular mechanism of drug action are reviewed in order to provide more ideas for the diagnosis and treatment of clinicians.
		2019 Vol. 16 (29): 49-52 [Abstract] ( 233 ) HTML (1 KB) PDF (590 KB) ( 134 )

	53	Research and consideration on the integration of filial piety culture into medical students′ moral education
		YUAN Qian WANG Lan SU Yang QIN Xiangyu XIAO Qiujie
		Objective To investigate and analyze the medical students′ understanding of filial piety culture, the current situation of practice, the reasons for lack and their attitude towards filial piety culture education in Southwest Medical University. And to explore the feasibility way of integrating filial piety culture into traditional culture education of medical students. Methods A self-designed questionnaire was used to investigate and analyze undergraduates in Southwest Medical University from November 2018 to January 2019. Data was collated and analyzed by SPSS 17.0 statistical software and Excel. Results 64.9% of the medical students had a general understanding of filial piety culture. 41.6% of the students understood filial piety culture from family education. 56.4% of the medical students occasionally cared about their parents′ health according to their professional knowledge. 24.3% of the students thought that the reason for the lack of filial piety culture was busy study. 78.8% of the students thought it necessary to carry out filial piety culture education. 60.8% of the students thought that filial piety culture education was helpful to alleviate the contradiction between doctors and patients, 84.6% of the students expressed their willingness to participate in the filial piety culture course. Conclusion Contemporary medical students have a certain understanding of filial piety culture, and the current situation of practice is good, but there are still some students who do not understand filial piety culture at all. Most students think that filial piety culture education for medical students can improve the current tense doctor-patient relationship, improve the humanistic quality, and take a positive attitude towards the development of filial piety culture education in schools. In the future, medical colleges and universities can integrate filial piety culture into the moral education of medical students through various channels and forms.
		2019 Vol. 16 (29): 53-56 [Abstract] ( 188 ) HTML (1 KB) PDF (474 KB) ( 103 )

	57	Analysis of blood glucose achievement and related risk factors in rural diabetic patients in Changchun City
		ZHONG Chongli1 CHEN Yuanjuan2 WU Zhengjie3 CHEN Si4▲
		Objective To explore the blood glucose compliance status and related risk factors in rural diabetic patients in Changchun. Methods Eight hundred and eighty type 2 diabetes mellitus patients from May 2017 to December 2018 treated in the Second Hospital of Jilin University were selected as study objectives. According to the results of glycosylated hemoglobin test, the patients were divided into two groups: blood glucose standard group and blood glucose non-standard group. Univariate analysis was used to analyze the general data of patients. Unconditional Logistic multivariate regression analysis was carried out to investigate the risk factors of blood sugar failure and establish a prediction model. Results There were significant differences in age, education level, course of disease, regularity of administration, family income per capita, retirement, complications of diabetes, treatment, blood glucose meter and body mass index between two groups (P < 0.05). Logistic regression analysis showed that long course of disease (OR = 2.504, 95%CI: 1.074-5.840), irregular administration (OR = 11.045, 95%CI: 2.367-51.550), on-the-job (OR = 1.260, 95%CI: 1.118-1.420), combined treatment (OR = 2.977, 95%CI: 2.339-3.789), obesity (OR = 3.796, 95%CI: 2.113-6.821), diabetic complications (OR = 38.900, 95%CI: 3.695-409.509) had significant differences (P < 0.05). Conclusion Long course of disease, irregular administration, on-the-job, combined treatment, obesity and diabetic complications are risk factors for diabetic patients′ unsatisfactory blood sugar. This model is expected to be used to improve the control rate of blood sugar in diabetic patients.
		2019 Vol. 16 (29): 57-60 [Abstract] ( 162 ) HTML (1 KB) PDF (494 KB) ( 132 )

	61	Study on care burden and influencing factors of family caregivers of demented elderly
		SUN Ning ZHOU Ying YANG Shuang LI Laiyou JIA Rangcheng
		Objective To understand care burden of family caregivers of demented elderly in five communities of Nanyu Community, Dongyu Community, Fanyu Community, Shounan Community and Baihe Community in Ningbo City, and to analyze the influencing factors of caregiver burden. Methods A questionnaire survey was conducted among 100 family caregivers of mentally retarded elderly in five communities in Ningbo from April to July 2018 by using convenient sampling method. The survey included the demographic characteristics questionnaire of family caregivers, the demographic characteristics questionnaire of mentally retarded elderly and the burden questionnaire of caregivers. Results The top three nursing load scores of family caregivers of mentally retarded elderly were emotional load, social load and time-dependent load. There were significant differences in scores of caregivers of different ages, educational level, family income per capita, self-care ability of mentally retarded elderly, severity of illness and occurrence of accidents in the last year (P < 0.05). The incidence of accidents, the severity of illness and the monthly income per capita of the elderly with mental retardation in the last year were the influencing factors of the burden of care for family caregivers (P < 0.05). Conclusion Care load of family caregivers of community demented elderly is heavy, mainly reflected in emotional load, insufficient social support and continuous care time. At the same time, there are many influencing factors, mainly reflected in the occurrence of recent accidents, the severity of the disease and the family's economic income. Therefore, it is necessary to improve the social security and medical service system for dementia and alleviate the care burden of family caregivers.
		2019 Vol. 16 (29): 61-64 [Abstract] ( 176 ) HTML (1 KB) PDF (500 KB) ( 156 )

	65	Analysis on the related factors of post-operative cognitive dysfunction in elderly patients undergoing cardiac surgery under cardiopulmonary bypass
		YUE Qin WU Xiaochen WANG Jian DING Sheng XIN Mei ZHANG Jinbao
		Objective To explore the related factors of postoperative cognitive dysfunction (POCD) in elderly patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Methods Two hundred and six patients undergoing cardiac valve surgery under CPB in the Cardiac Surgery Department of Western Military General Hospital from March 2017 to March 2019 were enrolled. The patients were divided into POCD group (58 cases) and non-POCD group (148 cases), according to whether they had POCD or not, while the related factors of POCD were analyzed. Results Patients in the POCD group were older than that in the non-POCD group, while the education years, CPB time, aortic occlusion time, postoperative mechanical ventilation time, postoperative ICU hospitalization time of patients in POCD group were significantly longer than those in non-POCD group, and the differences were statistically significant (P ＜ 0.05). The related factors of the incidence of POCD in elderly patients undergoing cardiac surgery under CPB were age, the education years, CPB time and aortic occlusion time (P ＜ 0.05). Conclusion The occurrence of POCD in elderly patients undergoing cardiac surgery under CPB is related to the age, education years, CPB time and aortic occlusion time. Clinical doctors should pay a high degree of attention and take targeted preventive measures to reduce the risk of POCD.
		2019 Vol. 16 (29): 65-67 [Abstract] ( 197 ) HTML (1 KB) PDF (469 KB) ( 37 )

	68	Relationship between serum visfatin level and oxidative stress and carotid atherosclerosis in patients with coronary heart disease
		ZHONG Su1 YU Yan1 SU Xiaojuan2 WU Yongxin3
		Objective To study the relationship between serum visfatin level and oxidative stress and carotid atherosclerosis in patients with coronary heart disease. Methods Eighty patients with coronary heart disease admitted to Success Hospital Affiliated to Xiamen University (“our hospital” for short) from January 2017 to January 2018 were selected as the study group. According to Gensini scores, the patients were divided into mild atherosclerosis group (29 cases), moderate atherosclerosis group (25 cases) and severe atherosclerosis group (26 cases). While matching of sex, age, blood pressure, blood sugar and blood lipid, eighty patients with non-coronary heart disease admitted to our hospital during the same period were selected as the control group. The levels of biochemical indicators, serum visfatin, malondialdehyde (MDA) and superoxide dismutase (SOD) were compared between the two groups, respectively. And the relationship between SOD, MDA and the severity of carotid atherosclerosis and the level of serum visfatin were analyzed. Results There were no statistically significant differences in blood pressure, blood sugar and blood lipid between the two groups (P ＞ 0.05). The serum visfatin and MDA in the study group were significantly higher than those in the control group, while the serum SOD in the study group was significantly lower than that in the control group, and the differences were statistically significant (P ＞ 0.05). Serum visfatin and MDA levels in mild atherosclerosis group were higher than those in moderate atherosclerosis group, while SOD levels were lower than that in mild atherosclerosis group, and the differences were statistically significant (P ＜ 0.05). Serum visfatin and MDA levels in severe atherosclerosis group were statistically higher than those in mild and moderate atherosclerosis group, while SOD levels was lower than that in mild and moderate atherosclerosis group, and the differences were statistically significant (P ＜ 0.05). Serum visfatin levels were positively correlated with serum MDA levels and Gensini score (r = 0.587, 0.634, P < 0.05), while negatively correlated with SOD levels (r = -0.609， P ＜ 0.05). Conclusion The serum visfatin levels in patients with coronary heart disease are significantly higher and closely related to oxidative stress and carotid atherosclerosis. Serum visfatin level can be detected in clinical work, which is helpful to assess oxidative stress and severity of carotid atherosclerosis. It is worthy of clinical application.
		2019 Vol. 16 (29): 68-71 [Abstract] ( 187 ) HTML (1 KB) PDF (505 KB) ( 47 )

	72	Clinical application of continuous cardiac output monitoring with pulse index in the treatment of acute myocardial infarction complicated with cardiogenic shock
		WANG Yaqin1 YAO Huang2 HU Xiaocong1 LUAN Jin1 LI Tingyi3
		Objective To investigate the clinical application of pluse indicator continuous cardiac output (PICCO) monitoring in the treatment of patients with acute myocardial infarction (AMI) and cardiogenic shock (CS). Methods One hundred and seven patients with AMI and CS admitted to Xiaogan Central Hospital of Hubei Province from February 2015 to October 2018 were selected， while divided into non-PICCO group (53 cases) and PICCO group (54 cases) by random number table method. Non-PICCO group was given routine monitoring treatment, while PICCO group was treated under the guidance of PICCO. The clinical effects (including the use time of vasoactive drugs, hospitalization time, mechanical ventilation time and mortality) of the two groups were compared. The cardiac index (CI), extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI) and global end-diastolic volume index (GEDVI) were compared in PICCO group after 24, 48 and 72 hours. The changes of high sensitive troponin (hs-cTnI), N terminal pro B type natriuretic peptide (NT-proBNP) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores after 24, 48 hours of treatment were compared between the two groups. Results The use time of vasoactive drugs, hospitalization time and mechanical ventilation time in PICCO group were shorter than those in non-PICCO group, while the mortality rate in the PICCO group was significantly lower than that in the non-PICCO group, and the differences were statistically significant (P ＜ 0.05). After 48 and 72 hours of treatment, CI, EVLWI, ITBVI and GEDVI in PICCO group were significantly higher than those after 24 hours of treatment, and the differences were statistically significant (P ＜ 0.05). While after 72 hours of treatment, CI, EVLWI, ITBVI and GEDVI were significantly higher than those after 48 hours of treatment, and the differences were statistically significant (P ＜ 0.05). There was no significant difference in hs-cTnI, NT-proBNP and APACHE Ⅱ scores between after 48 hours and 24 hours of treatment in non-PICCO group (P ＞ 0.05). The scores of hs-cTnI, NT-proBNP and APACHE Ⅱ after 48 hours of treatment in the PICCO group were lower than those after 24 hours of treatment, while were lower than those in the non-PICCO group at the same time point, and the differences were statistically significant (P ＜ 0.05). Conclusion PICCO monitoring has a certain application effect in the treatment of patients with AMI and CS. It can improve tissue perfusion and reduce the mortality of patients with AMI and CS.
		2019 Vol. 16 (29): 72-75 [Abstract] ( 130 ) HTML (1 KB) PDF (475 KB) ( 97 )

	76	Study on cognitive function and fractional amplitude of low frequency fluctuation in patients with bipolar depression
		LYU Lanlan ZHANG Rongrong YAN Wei NI Longyan PENG Xiaohui XIE Shiping
		Objective To investigate the characteristics and correlation of cognitive function and the fractional amplitude of low frequency fluctuation (fALFF) in patients with bipolar depression. Methods From December 2017 to March 2019, 26 patients with bipolar depression who were treated in the Brain Hospital Affiliated to Nanjing Medical University were selected as the bipolar depression group, and 26 well-matched healthy people with gender, age and education level were recruited as the control group. All subjects were assessed for cognitive function and received MRI scans to collect resting state MRI data and obtain fALFF values. Correlation analysis were performed between fALFF values of significant brain regions and cognitive function in bipolar depression patients. Results Compared with the control group, the speed of processing, working memory, reasoning and problem solving, visual learning, attention/vigilance in the bipolar depression group performed poorly (all P < 0.05). The fALFF values of the bipolar depression group increased significantly in the left postcentral gyrus, the left precentral gyrus, the right postecentral gyrus, the left inferior parietal lobule, the right superior temporal gyrus, the right opercular part of inferior frontal gyrus and the right precuneus (all P < 0.005, TFCE corrected). The fALFF value of the left precentral gyrus in the bipolar depression group was positively correlated with category fluency (r = 0.73, TFCE corrected). Conclusion Cognitive dysfunction in most cognitive fields and abnormal neurological activity in multiple brain regions exist in the bipolar depression group, and abnormal neurological activity in specific brain regions is related to neurocognitive performance.
		2019 Vol. 16 (29): 76-79,91 [Abstract] ( 174 ) HTML (1 KB) PDF (780 KB) ( 37 )

	80	Risk factors analysis and intervention strategies of asymptomatic intracranial artery stenosis patients for developing ischemic stroke
		ZHOU Xuejiao DENG Yongmei ZHANG Qian
		Objective To analyze the clinical characteristics of asymptomatic intracranial artery stenosis (AIAS) patients and identify the risk factors associated with stroke and propose intervention measures. Methods From January 2016 to December 2017, 122 patients who diagnosed with AIAS in Beijing Tiantan Hospital, Capital Medical University, were selected as study subjects, follow-up of 1-year. During this period, stroke patients were included in the positive group (n = 21) and patients without stroke were included in the negative group (n = 101). The clinical characteristics of two groups were compared, the risk factors of stroke in AIAS patients were analyzed. Results The propotion of hypertension, drinking and smoking in the positive group was higher than those in the negative group, the content of triacylglycerol (TG) was higher than that in the negative group, the relative expression of miRNA-223 was lower than that in the negative group, the differences were statistically significant (P < 0.05). There were no significant differences in body mass index, history of diabetes, albumin, homocysteine, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, degree of vascular stenosis and number of lesion vessels between the two groups (P > 0.05). Logistic regression analysis showed that smoking, drinking, TG ≥ 1.98 mmol/L and relative expression of miRNA-223 ≤ 0.56 were high risk factors for stroke in AIAS patients (P < 0.05). In the prediction of stroke in AIAS patients, the relative expression of miRNA-223 had higher prediction value than the content of TG. Conclusion Smoking, drinking, TG ≥1.98 mmol/L and relative expression of microRNA-223 ≤0.56 are high risk factors for AIAS patients to develop ischemic stroke. Health education, quitting smoking and alcohol, healthy diet, regularly checking relevant indicators, necessary drug treatment were required in AIAS patients.
		2019 Vol. 16 (29): 80-83 [Abstract] ( 192 ) HTML (1 KB) PDF (491 KB) ( 248 )

	84	Correlation between the serum levels of interleukin-17A and gene polymerphisms with cervical cancer
		LAI Ting ZHU Yan CHEN Lin
		Objective To investigate the correlation between the serum levels of interleukin-17 A(IL-17A) and gene polymorphisms with cervical cancer. Methods From March 2012 to March 2016, 185 patients with cervical cancer treated by surgery in Guiyang Maternal and Child Health Hospital ("our hospital" for short) were selected as the study group, and 185 healthy women who underwent physical examination in the outpatient department at the same time were selected as the control group. Enzyme-linked immunosorbent assay was used to detected the serum levels of IL-17A of both groups. The genotypes of IL-17A promoter rs2275913 (G/A) were analyzed by Taqman probe. The correlation between the IL-17A gene polymorphism with the clinicopathological characteristics and susceptibility cervical of cancer were analyzed. The correlation between the serum levels of IL-17A and gene polymorphisms with genetic susceptibility of cervical cancer were analyzed. Results The serum levels of IL-17A in the study group were significantly higher than those in the control group, the differences were highly statistically significant (P = 0.000). Genotype AG appeared more frequently in both groups, the frequency of genotype AA in the study group was higher than the genotype GG, while the control group did the opposite, the differences were highly statistically significant (P = 0.006). Compared with the control group, the occurrence frequency of allele A in the study group was higher than that of allele G, the difference was highly statistically significant (P = 0.007). Compared with genotype GG, genotype AA had a significantly higher risk of cervical cancer (P = 0.006, OR = 2.31, 95%CI: 1.27-4.20), but there was no significantly increased risk in genotype AG. Allele frequency of IL-17A were correlated with clinical stages (P = 0.001, OR = 0.48, 95%CI: 0.32-0.73）, degree of differentiation (P = 0.000, OR = 2.21, 95%CI: 1.46-3.36）, vascular invasion(P = 0.040, OR = 1.53, 95%CI: 1.01-2.31）and lymph node metastasis (P = 0.003, OR = 0.52, 95%CI: 0.34-0.80）. The mean serum IL-17A levels in two groups was 35 ng/L. People with serum IL-17A < 35 ng/L, the risk of cervical cancer in the genotype AA group was 1.995 times (95%CI: 0.880-4.520), but people with serum IL-17A ≥ 35 ng/L, the risk of cervical cancer in the genotype AA group increased to 2.500 times (P = 0.049, 95%CI: 1.000-6.230). Conclusion IL-17A and its gene polymorphism may be related to the genetic susceptibility of cervical cancer and the occurrence and development of cervical cancer.
		2019 Vol. 16 (29): 84-87,95 [Abstract] ( 164 ) HTML (1 KB) PDF (493 KB) ( 85 )

	88	Predictive value of endometriosis fertility index in the pregnancy modes of endometriosis patients after the laparoscopic surgery
		DING Yalan1 WU Weiwei2 JI Liwei1
		Objective To investigate the predictive value of endometriosis fertility index (EFI) in the pregnancy modes of endometriosis (EMT) patients after the laparoscopic surgery. Methods From January 2013 to December 2015, 98 endometriosis patients who underwent laparoscopic surgery in Suzhou Jiulong Hospital Affiliated to Medical College of Shanghai Jiaotong University were selected. According to the r-AFS staging standard, patients were divided into four stages and their natural pregnancy was observed within 3 years. EFI scoring system was used to evaluate the fertility of the patients, and their natural pregnancy was observed within 3 years in different groups. At the same time, the relationship between pregnancies after EMT with the r-AFS stage and EFI score was analyzed. The ROC curve was used to analyze the predictive value of EFI score for pregnant modes of EMT infertility patients after operation. Results In EMT infertility patients, the natural pregnancy rate decreased linearly with the increase of r-AFS stage (P < 0.05). The rate of natural pregnancy within 3 years after operation was positively correlated with EFI score (rs = 0.529, P < 0.01). Moreover, ROC curve analysis results showed that the area under the ROC curve of EFT score was 0.723. When the critical value of pregnancy predicted was 8.09 scores, the sensitivity was 68.26% and the specificity was 52.64%. Conclusion EFI score has a high predictive effect on the natural pregnancy after EMT infertility operation.
		2019 Vol. 16 (29): 88-91 [Abstract] ( 209 ) HTML (1 KB) PDF (503 KB) ( 113 )

	92	Clinical effect of Recombinant Human Interferon alpha 2b Vaginal Effervescent Capsules combined with Pidotimod in the treatment of cervical human papillomavirus infection
		WANG Jing1 FENG Tongfu1 DU Xin1 ZHENG Rong1 YAN Yuan1 WANG Yan1▲
		Objective To investigate the curative effect of Recombinant Human Interferon alpha 2b Vaginal Effervescent Capsules(Xinfuning) combined with Pidotimod in the treatment of cervical human papilloma virus (HPV) infection. Methods From January 2014 to December 2018, 100 patients with cervical HPV infection who diagnosed and treated in Materna and Child Health Hospital of Hubei Province were selected. According to the principle of random grouping, there were divided into group A and group B, 50 in each group. Group A was treated with Xinfuning alone and group B was treated with Xinfuning combined with Pidotimod. Reexamination after 6 months of treatment, the levels of plasma T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+) were detected. The therapeutic efficacy, recurrence rate and adverse reactions were analyzed. Results The effective rate of group B was higher than that of group A, the difference was statistically significant (P < 0.05). The levels of plasma T lymphocyte subsets (CD3+, CD4+, CD4+/CD8+) of group B were significantly higher than those of group A, the differences were statistically significant (P < 0.05). The recurrence rate of group B was significantly lower than that of group A, the difference was statistically significant (P < 0.05). The incidence of adverse reactions in group A and group B was basically the same, and there were no statistically significant differences (P > 0.05). Conclusion Xinfuning combined with Pidotimod can effectively improve the immune function of patients with HPV infection, the curative effect and safety, which is worthy of further clinical promotion.
		2019 Vol. 16 (29): 92-95 [Abstract] ( 199 ) HTML (1 KB) PDF (509 KB) ( 26 )

	96	mRNA expression of VEGF-C and Bcl-xl in prostatic carcinoma tissues and their correlation with clinical pathological characteristics and prognosis
		HAN Yuefu CHEN Dong PENG Lian HUANG Hongcai
		Objective To study the expression of vascular endothelial growth factor C (VEGF-C) mRNA and B cell lymphoma/leukemia-xl (Bcl-xl) mRNA in prostatic carcinoma (PCa) tissues and analyze the correlation between their expressions and clinical pathological characteristics and prognosis of PCa patients. Methods One hundred and thirty-two cases of PCa and forty cases of benign prostatic hyperplasia (BPH) tissue obtained by surgery in Yuebei People′s Hospital Guangdong Province from January 2014 to June 2016 were collected. Real-time quantitative PCR was used to detect the expressions of VEGF-C mRNA and Bcl-xl mRNA in PCa and BPH tissues, and the relationship between their expressions and clinical pathological characteristics was analyzed. Kaplan-meier survival analysis was used to explore the difference in prognosis of patients with different VEGF-C mRNA and Bcl-xl mRNA expressions. Results The relative expressions of VEGF-C mRNA and Bcl-xl mRNA in PCa tissues were significantly higher than those in BPH tissues (all P ＜ 0.05). The expression of VEGF-C mRNA was positively correlated with the expression of Bcl-xl mRNA (r = 0.637，P ＜ 0.05). There was no significant difference in the expression of VEGF-C mRNA and Bcl-xl mRNA in PCa tissues of patients with different age, Gleason score and admission to PSA (all P ＞ 0.05). The expression of VEGF-C mRNA and Bcl-xl mRNA in PCa tissues of patients with different TNM stages and with or without distant metastasis was statistically significant (all P ＜ 0.05). The 3-year overall survival rate of patients with high expression of VEGF-C mRNA and Bcl-xl mRNA was significantly lower than that of patients with low expression of VEGF-C mRNA and Bcl-xl mRNA (all P ＜ 0.05). Conclusion The increased expression of VEGF-C mRNA and Bcl-xl mRNA in PCa tissue is related to the TNM stage of tumor and whether it is accompanied by distant metastasis. VEGF-C mRNA and Bcl-xl mRNA may become new biological targets for PCa diagnosis and treatment.
		2019 Vol. 16 (29): 96-99,103 [Abstract] ( 221 ) HTML (1 KB) PDF (545 KB) ( 138 )

	100	Expression and correlation of CD44V4 and nm23 in triple negative breast cancer
		LI Jun1 LI Chunying2
		Objective To explore the expression of CD44V4 and nm23 in triple negative breast cancer (TNBC) and their correlation in clinical prognosis. Methods Seventy TNBC patients admitted to Department of General Surgery, Liuzhou Municipal Liutie Central Hospital Guangxi Zhuang Autonomous Region (hereinafter referred to as "our hospital") from January 2010 to March 2015 were selected as the study group, and 70 non-TNBC patients in the same period in our hospital were selected as the control group. Immunohistochemistry was used to detect the expression of CD44V4 and nm23 in the cancer tissues of patients of two groups, and their correlation in the poor prognosis of TNBC was analyzed. Results The positive expression rate of CD44V4 in the study group was significantly higher than that in the control group, and the positive expression rate of nm23 in the study group was significantly lower than that in the control group. The differences were statistically significant (all P ＜ 0.05). The positive expression of CD44V4 in TNBC patients was correlated with vascular infiltration and lymph node metastasis (P < 0.05). The positive expression of nm23 was associated with lymph node metastasis (P ＜ 0.05). There was no significant correlation between CD44V4 and nm23 expression in TNBC cancer tissues (rs = -0.166, P ＞ 0.05). Conclusion The positive expression of CD44V4 in TNBC was up-regulated, while the positive expression of nm23 was down-regulated. The detection of the relationship between CD44V4, nm23 in TNBC and invasion, metastasis is of great value, and may become a new biomarker to judge the prognosis of TNBC.
		2019 Vol. 16 (29): 100-103 [Abstract] ( 196 ) HTML (1 KB) PDF (484 KB) ( 59 )

	104	Expression and clinical significance of STAT3 and HMGB1 in cervical cancer tissue
		ZHENG Wei ZHANG Hanxue CAO Rong
		Objective To study the expression of signal transduction and activator of transcription 3 (STAT3) and high mobility group protein B1 (HMGB1) in cervical cancer tissues and their clinical significance. Methods Clinical data of 65 patients undergoing radical cervical cancer surgery in Liaoning Cancer Hospital and Institute from January 2015 to December 2018 were collected. Meanwhile, 26 patients undergoing total hysterectomy due to uterine fibroids were selected as a comparison. Immunohistochemistry was used to detect the expression of STAT3 and HMGB1 in 65 cervical cancer tissues and 26 normal cervical tissues. The correlation between STAT3 and HMGB1 in cancer tissues and their relationship with the clinical pathological characteristics of cervical cancer patients were analyzed. Results The positive expression rates of STAT3 and HMGB1 in cervical cancer tissues were higher than those in normal cervical tissues (P ＜ 0.05). The expression of STAT3 was related to pelvic lymph node metastasis condition, international federation of gynecology and obstetrics (FIGO) stage and depth of myometrial tumor invasion (P ＜ 0.05), while the expression of HMGB1 was related to age of patients, pelvic lymph node metastasis and depth of myometrial tumor invasion (P ＜ 0.05). There was a positive correlation between the expression of STAT3 and HMGB1 in cervical cancer tissues (rs = 0.371, P ＜ 0.05). Conclusion STAT3 and HMGB1 are highly expressed in cervical cancer tissues and have certain correlation, and are also correlated with the clinical pathological characteristics such as tumor stage and invasion degree.
		2019 Vol. 16 (29): 104-107 [Abstract] ( 189 ) HTML (1 KB) PDF (483 KB) ( 63 )

	108	Clinical study of preservation of left colic artery during laparoscopic assisted anterior resection of low rectal cancer in elderly patients
		WANG Xian1 ZHEN Ya′nan2 WANG Chunxi3 SONG Zhou3 WANG Lingdi3 XU Zhongfa2
		Objective To evaluate the clinical effect and application value of preserving left colic artery during laparoscopic anterior resection of low rectal cancer in elderly patients. Methods Clinical data of 79 patients who underwent laparoscopic radical resection of low rectal cancer in Department of General Surgery, Chinese PLA General Hospital from January 2016 to January 2018 were retrospectively analyzed. The patients who retained the left colic artery during the operation were regarded as the observation group (32 cases), and the patients who did not retain the left colic artery were regarded as the control group (47 cases). The intraoperative, postoperative, recurrence and metastasis were compared between the two groups. Results There were no statistically differences between the two groups in operative time, intraoperative blood loss, number of lymph node dissection, number of lymph node dissection at root of inferior mesenteric artery, incision infection, intestinal obstruction, recurrence rate and metastasis rate (all P ＞ 0.05). There were statistical differences in the incidence of anastomotic bleeding, anastomotic fistula and free splenic curvature between the two groups (all P ＜ 0.05). Conclusion During laparoscopic anterior resection of low rectal cancer in elderly patients,preserving the left colonic artery will not increase the operation time and operation risk, but may reduce the incidence of anastomotic bleeding, anastomotic fistula and free splenic curvature, which is worthy of clinical application.
		2019 Vol. 16 (29): 108-111 [Abstract] ( 151 ) HTML (1 KB) PDF (484 KB) ( 109 )

	112	Effect of Sugammadex on postoperative nausea and vomiting：a meta-analysis
		GAO Wenli YUAN Ruixia XING Yanmei RUAN Shanshan ZHU Yi LIN Miao DAI Zhongliang
		Objective To evaluate the effect of Sugammadex on postoperative nausea and vomiting. Methods The randomized controlled trials related to Sugammadex and postoperative nausea and vomiting were collected from PubMed, Embase, The Cochrane Library, CNKI and Wanfang databases. This meta-analysis was performed by Stata 15 software. Results Finally 21 RCT with 2248 patients were included. The meta-analysis showed that Sugammadex was better than Neostigmine in reducing the incidence of postoperative nausea and vomiting (RR = 0.69, 95%CI: 0.57-0.85, P ＜ 0.001), and 2 mg/kg group could lower the incidence of postoperative nausea and vomiting (RR = 0.69, 95%CI: 0.54-0.87, P ＜ 0.01), but 4 mg/kg could not lower the incidence of postoperative nausea and vomiting (RR = 0.71, 95%CI: 0.50-1.02, P ＞ 0.05). Conclusion Sugammadex is better than Neostigmine in reducing the incidence of postoperative nausea and vomiting.
		2019 Vol. 16 (29): 112-117 [Abstract] ( 164 ) HTML (1 KB) PDF (1423 KB) ( 125 )

	118	Clinical application value of urinary trace proteins combined detection in the diagnosis of early renal injury in chronic kidney diseases
		CHEN Peng1 WANG Xiaoqin2 WANG Lan2,3 WU Wenjing2,3 LONG Sijie1
		Objective To investigate the clinical application value of urinary trace proteins combined detection in the diagnosis of early renal injury in chronic kidney diseases. Methods According to calculated estimated glomerular filtration rate（eGFR）and staging criteria, 521 patients with clinically diagnosed chronic kidney diseases were enrolled and divided into five groups including phase Ⅰ(222 cases), phase Ⅱ（130 cases）, phase Ⅲ（105 cases）, phase Ⅳ（39 cases）, phase Ⅴ（25 cases） in Hubei Provincial Hospital of Traditional Chinese Medicine （“our hospital” for short） from August 2015 to August 2018, while another 86 healthy subjects of our hospital were selected as normal control group. Six urinary trace proteins [Urine retinol binding protein (URBP), urine microalbumin (UmAlb), urine beta 2-microglobulin (Uβ2M), urine transferrin (UTRF), urine immunoglobulin (UIgG) and urine N-acetyl-beta-D glucosamine (UNAG)] and serum creatinine were detected respectively. The results of each group were compared, while analysed the relevance and diagnostic efficiency of urinary trace proteins, and their correlation and consistency with the stages of chronic kidney diseases. The clinical application value of single and combined detection of these markers in the diagnosis of early renal injury in chronic kidney diseases were evaluated. Results The levels of six urinary trace proteins in chronic kidney disease group were higher than those in normal control group, while increased significantly with the progression of disease, and the differences were highly statistically significant (P ＜ 0.01). The relevance of URBP and Uβ2MG as well as UTRF and UmAlb (rp = 0.789, 0.940) was high. Moreover, urinary trace protein UmAlb, UTRF and UIgG reflecting glomerular injury were well interrelated (all rp ＞ 0.6). Grade correlation analysis showed that Uβ2MG and URBP were significantly correlated with eGFR and stages of nephropathy, while other proteins were moderately correlated. However, UNAG was the worst. The correlation between six urinary trace proteins and the stages of chronic kidney diseases was ordinary, and the consistency was general (all Kappa ＜ 0.4). The diagnostic efficiency of urinary trace proteins combined detection was not only superior to that of single index (AUC ＞ 0.958), but also superior to that of serial mode in terms of correlation and consistency with the stages of chronic kidney diseases. Conclusion Urinary trace proteins have their own biological characteristics, and each of them has its own advantages in evaluating early renal injury in chronic kidney diseases. The combined detection of urinary trace proteins has high diagnostic performance and can significantly improve the diagnostic efficiency. It has high clinical application value for early diagnosis, pathological classification, staging monitoring and prognosis evaluation of renal injury in chronic kidney diseases.
		2019 Vol. 16 (29): 118-123 [Abstract] ( 390 ) HTML (1 KB) PDF (720 KB) ( 153 )

	124	Relationship between clinical features of different phenotypes of refractory asthma and peripheral blood cells
		CONG Li1 ZENG Yun2 CHEN Liping1▲ WU Chao1
		Objective To explore and analyze the correlation between different phenotypes of refractory asthma and peripheral blood cells. Methods Eighty-eight patients with refractory asthma admitted to Xinjiang Uygur Autonomous Region People′s Hospital from May 2016 to May 2018 were selected as subjects, while they were enrolled in the sputum cytology. According to different airway inflammation phenotypes, the patients were classified in acidic granulocyte type, neutrophil type, mixed cell type and oligocytic type. The lung function indexes and the peripheral blood counts of patients with different airway inflammation phenotypes were compared. Results Forced expiratory volume in one second (FEV1), FEV1/forced vital capacity(FVC), fractional exhaled nitirc oxide(FeNO) in acidic granulocyte type and mixed cell type patients were significantly higher than those in neutrophil type, and the differences were statistically significant (P ＜ 0.05). FEV1、FEV1/FVC in oligocytic type patients were significantly higher than those in neutrophil type, while FeNo was lower than that in neutrophil type, and the differences were statistically significant (P ＜ 0.05). Neutrophils in acidic granulocyte type and mix cell type patients were significantly lower than those in neutrophil type, while eosinophils were significantly higher than those in neutrophil type, and the differences were statistically significant (P ＜ 0.05). Neutrophils in oligocytic type patients were lower than that in neutrophil type, while lymphocytes were significantly higher than those in neutrophil type, and the differences were statistically significant (P ＜ 0.05). Conclusion There are four phenotypes of airway inflammation in refractory asthma. Among them, the pulmonary function of neutrophil type is poor, and the levels of eosinophils and neutrophils in peripheral blood cells are correlated in assessing the inflammatory phenotype of asthma.
		2019 Vol. 16 (29): 124-127 [Abstract] ( 160 ) HTML (1 KB) PDF (695 KB) ( 76 )

	128	Diagnostic efficacy of serum NGAL, KIM-1 and Cys-C for acute kidney injury in sepsis patients
		LIU Ruiqing1 MENG Zhiyun1 CHU Hongguang2 LI Zhaochun1
		Objective To explore the diagnostic value of serum neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and cystatin C (Cys-C) for acute kidney injury (AKI) in sepsis patients. Methods A total of eithty-nine patients with sepsis admitted to ICU of Weifang Traditional Chinese Medicine Hospital of Shondong Province were observed continuously for 48 hours, who were divided into AKI group (42 cases) and non-AKI group (47 cases) according to the presence of AKI. Serum NGAL, KIM-1 levels were measured by double antibody sandwich enzyme-labeled immunoassay at 0, 6, 12, 24, 48 hous after admission, while serum Cys-C level was detected by immunoturbidimetry. Results Serum NGAL, KIM-1, and Cys-C levels were compared between the two groups at different time points, and the differences were statistically significant (P ＜ 0.05). The serum levels of NGAL, KIM-1 and Cys-C in AKI group were higher than those in non-AKI group at the same time, and the differences were statistically significant (P ＜ 0.05). Serum NGAL was positively associated with KIM-1 and Cys-C in AKI group, while serum KIM-1 was positively associated with Cys-C (P ＜ 0.05). Serum NGAL, KIM-1 and Cys-C have high predictive value for AKI in sepsis patients at 6 hours after admission, and the area under ROC curve was 0.891 (95%CI: 0.869-0.972), the sensitivity and specificity were 0.93 and 0.87, respectively, while the accuracy was 0.91. Conclusion Combined detection of serum NGAL, KIM-1 and Cys-C can predict early AKI in sepsis patients, which has certain clinical reference significance.
		2019 Vol. 16 (29): 128-131 [Abstract] ( 195 ) HTML (1 KB) PDF (727 KB) ( 76 )

	132	The relationship between serum 25-hydroxyvitamin D, leptin levels and bone mineral density in postmenopausal women with type 2 diabetes mellitus
		HUANG Liang LU Bangchao
		Objective To analyze the relationship between serum 25-hydroxyvitamin D [25(OH)D], leptin levels and bone metabolism in postmenopausal women with type 2 diabetes mellitus. Methods The clinical data of 80 patients with postmenopausal type 2 diabetes mellitus treated in Nanjing Gulou Hospital from June 2014 to November 2018 was retrospectively analyzed. According to the bone mineral density level, the patients were divided into osteoporosis group (28 cases), osteopenia group (27 cases) and normal bone mass group (25 cases). The serum 25 (OH)D, leptin levels and serum bone metabolic indexes in each group were measured. The relationship between serum 25 (OH)D, leptin levels and bone metabolism in postmenopausal women with type 2 diabetes mellitus was analyzed. Results Compared with the normal bone mass group, the serum 25 (OH)D levels in osteoporosis group and osteopenia group decreased (P ＜ 0.05), and the serum 25 (OH)D level in osteoporosis group was lower than that in osteopenia group (P ＜ 0.05). The serum leptin levels in osteoporosis group and osteopenia group were higher than those in normal bone mass group (P ＜ 0.05), which in osteoporosis group was higher than that in osteopenia group (P ＜ 0.05). There were no significant differences of serum Ca and P levels among the three groups (P ＞ 0.05). The levels of serum beta C-terminal cross-linked telopeptides of typeⅠcollagen (β-CTX), bone gla protein (BGP) and procollagen typeⅠamino-terminal propeptide (PINP) in osteoporosis group and osteopenia group were higher than those in normal bone mass group (P ＜ 0.05), and the levels of serum indicators in osteoporosis group were higher than those in osteopenia group, the differences were statistically signiigfcicant (P ＜ 0.05). Spearman correlation analysis showed that bone mineral density was positively correlated with serum 25 (OH)D (r = 0.142, P = 0.036), negatively correlated with serum leptin (r = -0.325, P = 0.000), β-CTX (r = -0.135, P = 0.001), BGP (r = -0.183, P = 0.000), PINP (r = -0.106, P = 0.002). Conclusion Bone mineral density is positively correlated with serum 25 (OH)D level and negatively correlated with serum leptin in postmenopausal patients with type 2 diabetes mellitus.
		2019 Vol. 16 (29): 132-135 [Abstract] ( 174 ) HTML (1 KB) PDF (704 KB) ( 118 )

	136	Clinical study of Shenmai Injection combined with enteral nutrition in the treatment of hyperlipidemic severe acute pancreatitis
		WANG Jian′gang1 WANG Yubo2 KONG Na1
		Objective To investigate the efficacy and safety of Shenmai Injection combined with enteral nutrition in the treatment of hyper lipidemic severe acute pancreatitis (HLSAP). Methods Ninety-three patients with HLSAP admitted to the Third People′s Hospital of Yunnan from January 2016 to June 2018 were selected. According to the random number table method, the patients were divided into observation group (47 cases) and control group (46 cases). The control group was treated with enteral nutrition, the observation group was treated with Shenmai Injection combined with enteral nutrition. Both groups were treated continuously for 14 days. The clinical effect of the two groups was compared. The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and Balthazar CT score were evaluated and compared between the two groups before and after treatment. The levels of serum prealbumin (PAB), albumin (ALB), triacylglycerol (TG), C-reactive protein (CRP), immunoglobulin A (IgA), immunoglobulin M (IgM) and immunoglobulin G (IgG) were detected and compared between the two groups before and after treatment. The occurrence of adverse reactions during the treatment was recorded. Results The total clinical effective rate of the observation group was 97.87% (46/47), which was significantly higher than 78.26% (36/46) of the control group, the difference was statistically significant (χ2 = 8.573, P = 0.003). After treatment, APACHEⅡ and Balthazar CT scores of the two groups were significantly lower than those before treatment (P ＜ 0.05), which of the observation group were lower than the control group (P ＜ 0.05). After treatment, the serum levels of PAB, ALB, IgA, IgM and IgG in the two groups were significantly higher than those before treatment (P ＜ 0.05), the serum levels of TG and CRP were significantly lower than those before treatment (P ＜ 0.05), and the improvement of serum levels of PAB, ALB, TG, CRP, IgA, IgM and IgG in the observation group was significantly better than those in the control group (P ＜ 0.05). No serious adverse reactions were found during the treatment in both groups. Conclusion Shenmai Injection combined with enteral nutrition in the treatment of HLSAP has significant clinical efficacy, which can significantly improve the nutritional status, reduce inflammatory reaction, enhance immune function, and has good security.
		2019 Vol. 16 (29): 136-140 [Abstract] ( 155 ) HTML (1 KB) PDF (715 KB) ( 77 )

	141	Current status of protein-energy wasting and its impact on quality of life in the maintenance hemodialysis patients
		Paredanmu·Tuohuti1,2 LI Yufang2 ZHANG Li2 ZHANG Shaohua2 Zinati·Sawuti2 YAN Ping1
		Objective To investigate the status and incidence of protein-energy wasting (PEW) in maintenance hemodialysis patients and describe the impact of PEW status on quality of life in the maintenance hemodialysis (MHD) patients. Methods A total of 170 MHD patients admitted to the Blood Purification Center of the First Affiliated Hospital of Xinjiang Medical University from June to December 2018 were enrolled in this study. They were divided into PEW group and non-PEW group according to PEW diagnostic criteria by convenience sampling method. PEW status was assessed by physical measurements and the quality of life was assessed by questionnaire. The differences in the quality of life were compared between MHD patients with PEW group and non-PEW group. Results A total of 50 cases met at least 3 indicators of PEW diagnostic criteria in MHD patients, the prevalence of PEW in MHD patients was 29.40%. The demographic characteristics of the patients in the PEW group and the non-PEW group were statistically significant in terms of age, physique index and occupation (P ＜ 0.05). In the quality of life assessment of patients with PEW and non-PEW groups, there were statistically significant differences in vitality, social function, social affection, burden of kidney disease, symptomatic effects and total scores (P ＜ 0.05). Conclusion The prevalence of PEW in MHD patients tends to a medium level. The PEW status has an impact on the quality of life in MHD patients， suggesting that nursing staff should pay more attention to the quality of life in PEW patients and provide a theoretical basis for further intervention.
		2019 Vol. 16 (29): 141-144 [Abstract] ( 221 ) HTML (1 KB) PDF (700 KB) ( 125 )

	145	The value of Cervista high risk HPV and CK8/18， P120ctn expression in predicting the progress and outcome of low grade squamous intraepithelial lesion
		QIN Yan1 CHEN Ying1 LIU Xiaoyan1 PENG Ming2 ZHOU Donghua1
		Objective To investigate Cervista high risk HPV(HR-HPV) typing and the value of CK8/18 and P120ctn in predicting the progression and prognosis of low-grade squamous intraepithelial lesions (LSIL). Methods Atotal of 119 patients with LSIL admitted to Foshan Women and Children Hospital Affiliated to Southern Medical University from December 2012 to December 2016 were selected as the subjects. There were progressive group (28 cases), persistent group (41 cases) and regression group (50 cases). In addition, 20 patients in the HSIL\squamous cell carcinoma(SCC) control group and 15 patients in the normal cervical were collected as normal control group. The HR-HPV genotypes were detected by Cervista and then the expression of CK8/18 and P120ctn were detected by Ventana full automatic immunohistochemical. Results The positive rates of A9 in the progressive group were higher than those of A7 and A5/A6. The positive rates of A9 in progressive group were higher than persistent group and regression group. It was significant difference in HR-HPV typing among LSIL groups（P ＜ 0.05）.The positive expression rate of CK8/18 was 67.9% in the progressive group, was 41.5% in the persistent group and was 20.0% in the regressive group. The positive expression rate of CK8/18 in the LSIL group was significantly higher than that in the HSIL\SCC control group and normal control groups（P ＜ 0.05）.The positive expression rate of P120ctn was 82.1% in the progressive group, was 90.2% in the persistent group and was 100.0% in the regressive group. The positive expression rate of P120ctn in LSIL group was lower than that in the normal control group, the LSIL group was higher than the HSIL\SCC control group, the differences were statistically significant (all P ＜ 0.05). Conclusion Simultaneous testing Cervista HR-HPV typing and expression of CK8/18 and P120ctn may be useful in predicting the progression and prognosis of LSIL.
		2019 Vol. 16 (29): 145-148 [Abstract] ( 179 ) HTML (1 KB) PDF (713 KB) ( 116 )

	149	Application of bone turnover markers in detecting type 2 diabetes mellitus patients with osteoporosis
		LIU Hongli1 ZHANG Fan1 HONG Xiaoyu1 LU Donghui1 HAN Lingchuan1 DAI Yali1 LAN Wei2 PENG Weiqun1
		Objective To explore the significance of bone conversion markers in the screening of type 2 diabetic osteoporosis. Methods Sixty-six patients with type 2 diabetes (T2DM) and osteoporosis (DOP group) and fifty-four patients with type 2 diabetes mellitus with no osteoporosis (T2DM group) admitted to Peking University Shenzhen Hospital (“our hospital” for short) from July 2016 to December 2017 were selected as research subjects. And sixty healthy subjects who underwent health examination in our hospital were selected as HP group. Bone mineral density, biochemical markers of bone conversion were measured, and the relationship between biochemical markers of bone conversion and disease course was analyzed. Results Compared with HP group, the bone mineral density in the DOP group and T2DM group was decreased, the serum levels of P1NP in the DOP group and T2DM group increased (P < 0.05). It showed that P1NP was negatively correlated with bone mineral density at left femoral neck proximal femur (r = -0.415, -0.377, P < 0.05), β-CTx was negatively correlated with bone mineral density at proximal femur(r = 0.303, P < 0.05). In addition, there was a positive correlation between patients′ blood sugar control and whether there were other diseases with the levels of P1NP and β-CTx, the differences were statistically significant (P ＜ 0.05). Conclusion The detection of bone conversion markers is helpful for the screening of T2DM with osteoporosis.
		2019 Vol. 16 (29): 149-152 [Abstract] ( 188 ) HTML (1 KB) PDF (700 KB) ( 69 )

	153	Meta-analysis of efficacy and safety of Xingxiong Sodium Chloride Injection in the treatment of ischemic stroke
		YU Zecheng1 LUO Xiaodong2 CAI Qiaodi1 ZHENG Chunye2
		Objective To systematically evaluate the efficacy and safety of Xingxiong Sodium Chloride Injection in the treatment of ischemic stroke. Methods Systematic search of PubMed, CNKI, Wanfang database, Vip, SinoMed and other databases was conducted to collect randomized controlled trials (RCT) of Xingxiong Sodium Chloride Injection in the treatment of ischemic stroke. The retrieval time was from the establishment of the database to December 2018. Data was extracted by two professionals and merged and analyzed by RevMan 5.3 software. The quality of the included literature were evaluated using the risk assessment form provided by the collaborative network. Results There were 9 RCTs and 1511 patients, including 756 in experimental group and 755 in control group. Results of Meta-analysis: total effective rate of drug treatment in experimental group was higher than that in control group [RR = 1.11, 95%CI (1.01, 1.22), P = 0.04]. The improvement of neurological deficit in experimental group was better than that in control group [MD = -4.16, 95%CI (-7.23, -1.10), P = 0.008]. There was no significant difference in Barthel index score between two groups [MD = -0.39, 95%CI (-17.29, 16.50), P = 0.96]. The level of hs-CRP in experimental group was lower than that in control group [MD = -1.94, 95%CI (-3.38, -0.51), P = 0.008]. Conclusion Xingxiong Sodium Chloride Injection is effective and safe in the treatment of ischemic stroke. However, there is still a lack of more reliable clinical trials to provide clinical evidence.
		2019 Vol. 16 (29): 153-157 [Abstract] ( 169 ) HTML (1 KB) PDF (1107 KB) ( 119 )

	162	Effect of new team support exercise group on cardiopulmonary function and recovery after lung cancer surgery
		ZHANG Dan1 GU Yingjia1 WANG Chenyu2 LIN Shan1 WU Qiong1
		Objective To explore and analyze the influence of the new team supporting exercise group on the postoperative cardiopulmonary function and rehabilitation of patients with lung cancer. Methods From May 2016 to May 2018, 78 patients with lung cancer admitted to the First Affiliated Hospital of Harbin Medical University were selected. A random number table method was used to divide the patients into the control group and the observation group, with 39 cases in each group. The control group was given only regular exercise. The observation group was given the new group support exercise on the basis of the control group, both interventions lasted 2 months. The postoperative pulmonary function indexes, functional exercise compliance, quality of life questionar core (peripheral neuritis, chest pain, dysphagia, mucositis, cough, hemoptysis, dyspnea, hair loss, shoulder and back pain and other pain scores) of patients were compared between the two groups. Results Compared with preoperative, postoperative vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), 6 min walktime (6 MWT) of two groups were elevated and exercise intensity on own initiative scoring scale was reduced; compared with control group, postoperative VC, FVC, FEV1, 6 MWT of observation group elevated and exercise intensity on own initiative scoring scale was redaced, differences were statistically significant (all P ＜ 0.05). The exercise compliance rate in the observation group was higher than that in the control group, with statistically significant difference (P ＜ 0.05). Compared with the two groups before surgery, peripheral neuritis, chest pain, dysphagia, mucositis, cough, hemoptysis, dyspnea, hair loss, shoulder and back pain and pain in other parts of the two groups after surgery were all decreased, and the scores of the above indicators were all decreased in the observation group, compared with the control group after surgery, with statistically significant differences (all P ＜ 0.05). Conclusion On the basis of routine intervention, the application of the new team exercise group can effectively improve the preoperative cardiopulmonary function of patients, improve the postoperative lung function, improve the rehabilitation compliance and quality of life of patients.
		2019 Vol. 16 (29): 162-166 [Abstract] ( 241 ) HTML (1 KB) PDF (538 KB) ( 90 )

	167	Influence of social support combined with family support for acute myocardial infarction patients
		ZOU Xin SUN Lei LIU Ling
		Objective To approach influence of social support combined with family support for acute myocardial infarction patients. Methods From January 2016 to January 2018, 300 patients with acute myocardial infarction admitted to Dalian Municipal Central Hospital Affiliated of Dalian Medical University were selected as the study subjects. Patients were divided into routine nursing intervention group (n = 149) and double-item support group (n = 151) according to the random number table method. The routine nursing intervention group adopted the general nursing intervention measures, social support combined with family support was used in the double-item support group. Before and after intervention, psychological resilience scale, general self-efficacy scale, social support scale, family function scale and coping style scale were evaluated, cardiac output, left ventricular ejection fraction, cardiac index and stroke output were measured, and treatment compliance and satisfaction were observed. Results There were no significant differences in mental resilience scale score and general self-efficacy score between the two groups before and after the implementation of nursing measures (all P ＞ 0.05). Before intervention, there were no statistically significant differences in social support score, family function score, coping style score, cardiac output, left ventricular ejection fraction, cardiac index and stroke output between the two groups (all P ＞ 0.05). Compared with before intervention, after the intervention of the above indicators of the two groups were significantly increased, compared with routine nursing intervention group after the intervention, the function of social support score, family function score, coping style score, cardiac output, left ventricular ejection fraction, cardiac index and stroke volume of the double-item support group were significantly elevated, the differences were statistically significant (all P ＜ 0.05). Treatment compliance and satisfaction of patients in the double-item support group were significantly higher than those in the routine nursing intervention group, and the differences were statistically significant (P ＜ 0.05). Conclusion Social support combined with family support for patients with acute myocardial infarction can improve their social support, family function and coping ability, and improve cardiac output, left ventricular ejection fraction, cardiac index and output per stroke, which is worthy of clinical promotion and application.
		2019 Vol. 16 (29): 167-171 [Abstract] ( 179 ) HTML (1 KB) PDF (536 KB) ( 123 )

	172	Analysis of one case of misdiagnosed eosinophilic gastroenteritis
		LI Xiaohong1 GONG Yucheng2 LIU Yuyue3 ZHAO Xingjie1 WANG Zhibin1
		Eosinophilic gastroenteritis (EG) is a rare intestinal inflammatory disease in clinic. Because of its lack of specificity in clinical manifestations, the misdiagnosis rate of EG is very high. This paper reports a case of EG in Outpatient Department of Hepatobiliary and Gastroenterology of Dongfang Hospital in Beijing University of Traditional Chinese Medicine （hereinafter referred to as "our hospital"） in 2017. Because of abdominal pain and purulent stool, combined with colonoscopic edema, congestion and ulcer, the patient is considered as ulcerative colitis in the early stage. However, the therapeutic effect is not good. The patient′s symptoms are alleviated after re-examination of colonoscopy and pathological examination in our hospital and re-diagnosis of EG. In order to improve the understanding of EG, the relevant literature is reviewed and the differential points between two diseases are analyzed. Colonoscopy and pathological examination are particularly important in the diagnosis and differential diagnosis of the two diseases.
		2019 Vol. 16 (29): 172-174 [Abstract] ( 199 ) HTML (1 KB) PDF (371 KB) ( 105 )

	175	The information management of medical archives and the protection of patients′ privacy right under the background of big data
		YANG Jianmin1 SU Xiulan2▲
		Under the background of big data, informatization construction of medical archives greatly improve the work efficiency of medical staff and hospital service quality. However, in the process of patients′ medical treatment, patients′ personal information and protected personal space disclosed to medical workers, namely patients′ privacy right, will be violated to a certain extent due to the neglect of medical workers and the loopholes in the storage, use and sharing of information-based medical archives. How to maintain the patients′ privacy right reasonably and legally hinders the management of informationized medical archives to a certain extent, which is in urgent need of solution. This article deeply analyzes the solution to the benign development of the information management of medical archives and protection of patients′ privacy right. This paper proposes to strengthen the protection of patients′ privacy right in the rapid and efficient construction of medical archives informatization from the aspects of strengthening medical ethics education in daily work of hospitals, supervision and responsibility system, as well as encryption in the process of uploading, managing and sharing information medical archives, so as to lay a foundation for building a harmonious doctor-patient relationship.
		2019 Vol. 16 (29): 175-178 [Abstract] ( 182 ) HTML (1 KB) PDF (504 KB) ( 152 )

	179	Study on the implementation effect of medical service price reform from the perspective of patients
		ZHANG Ying1 DUAN Lizhong2 ZHOU Yujin2 ZHANG Chongxu2 LU Qi3
		Objective To explore the effect of medical service price reform and the factors that affect the patients′ evaluation of medical expenses. Methods From September 2017 to February 2018, one public hospital was selected from the five regions of Beijing, Tianjin, Hebei, Shandong and Liaoning respectively, patients of five outpatients and inpatients were investigated. Literature analysis method and expert interview method were used to design questionnaires on the formation mechanism of dynamic adjustment of medical service prices. The reform effect of was analyzed based on the three dimensions such as characteristics of individuals, the status quo of the current medical service price policy and the implementation effect of the current medical service price policy. Results The total price of medical services in the five regions of Beijing, Tianjin, Hebei, Shandong and Liaoning was 3.861 points. Patients rated the cost of surgery and examination higher, they scored 4.097 and 4.011 respectively. Multiple linear regression analysis showed that age and whether the patient had commercial medical insurance affected the patient′s evaluation of comprehensive medical expenses (P ＜ 0.05). Patients′ evaluation of the comprehensive effect after the reform was affected by the level of the medical institutions they visited recently and whether they still had commercial medical insurance (P ＜ 0.05). The different gender and age paid attention to the distribution of medical policy, and the difference was statistically significant (P ＜ 0.05). At different gender levels, there was a statistically significant difference in the distribution of access to medical service price reform policies for respondents of different age groups (P ＜ 0.05). Conclusion The implementation effect of medical service price reform is good, but it still needs to expand the publicity of medical service price reform policy, optimize the price structure of medical service items, and increase the coverage of commercial medical insurance to relieve the medical burden of patients.
		2019 Vol. 16 (29): 179-184,188 [Abstract] ( 191 ) HTML (1 KB) PDF (547 KB) ( 176 )

	185	Construction of key indicators of medical quality based on patient experience
		HUANG Xiantao1 TANG Xueqin2 WANG Chenyu1 PAN Limin1 XUE Jun1
		Objective To establish the evaluation system of key indicators of medical quality based on patients′ medical experience as the main evaluation criterion. Methods In this study, the key indicators of the evaluation system were preliminarily constructed by consulting the literature of related research fields at home and abroad from 2010 to 2018 using China National Knowledge Infrastructure. Delphi method was adopted to establish a medical quality evaluation model based on patients′ medical treatment experience. Through two rounds of consultation and discussion with experts, key indicators of medical quality based on patients′ experience were finally determined. Two third-level hospitals and three second-level hospitals in Hebei Province were selected to carry out patient experience survey among 400 inpatients, and the results of the survey were distinguished, analyzed and evaluated to evaluate the improvement effect of the evaluation system of key indicators of medical quality. Results In this study, five first-level indicators were designed, included objective hospital environment, treatment process, attitude of medical staff, quality of medical service and protection of patients′ rights and interests. According to their own professional experience, experts in various research fields carried out the first-level indicators effectively, formed 28 second-level indicators that can be directly investigated and visited. Each indicator can be directly used as a problem, and the patients were graded by 1-5 points. The 400 patients surveyed scored higher on the attitude of medical staff, the quality of medical service and the importance of protecting patients′ rights and interests. Conclusion The evaluation system of key indicators of medical quality based on patient experience has strong practicability, which lays a good foundation for the establishment of a complete scale for evaluating patients′ medical experience. Relevant results can be applied to improve the medical service level of the third-class hospitals in Zhangjiakou city, and it is of great significance to formulate medical service strategies in the future.
		2019 Vol. 16 (29): 185-188 [Abstract] ( 189 ) HTML (1 KB) PDF (508 KB) ( 107 )

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