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2020 Vol. 17, No. 17 Published: 2020-06-15

	4	Effects of Dantrolene on calcium handling of ventricular myocytes and cardiac function in rats with chronic heart failure
		HU Dongdong LIU Tao SHI Shaobo HUANG Yan LIANG Sa HU Dan
		Objective To discuss the effects of Dantrolene (DTL) on calcium handling of ventricular myocytes and cardiac function in rats with chronic heart failure (CHF). Methods According to the random number table method, 57 adult male SD rats were assigned to control group, CHF group and intervention group (n = 19), which were given normal saline, Isoproterenol (ISO), and ISO+DTL, for 2 weeks. Two-week later, the hemodynamic parameters and serum B-type natriuretic peptide (BNP) level were measured. The ventricular myocytes were isolated, then the cell contractility was automatically detected by the video edge-detector system. The calcium transient (CaT） and sarcoplasmic reticulum (SR) calcium content ([Ca2+]SR) were recorded by loading cardiomyocytes with Fura-2 AM. The protein levels of ryanodine receptor 2 (RyR2), SR Ca2+-ATPase (SERCA2a) and phospholamban (PLB) were detected by Western blot. Results Compared with control group, left ventricular end diastolic pressure (LVEDP), serum BNP level, diastolic intracellular Ca2+ level ([Ca2+]i) were significantly increased in CHF group (P < 0.01), decay time constant (tau) of CaT, time to peak (TP) of cell contraction, time to 50% cell relaxation (TR50) were significantly extended in CHF group (P < 0.01), while left ventricular end systolic pressure (LVESP), ±dP/dtmax, cell shortening percentage, CaT amplitude, [Ca2+]SR, the protein levels of RyR2 and SERCA2a were significantly decreased in CHF group (P < 0.01). Compared with CHF group, LVEDP, serum BNP level, [Ca2+]i, decay time constant of CaT were significantly decreased in intervention group (P < 0.01), decay time constant of CaT, TP of cell contraction, TR50 were significantly shortened in intervention group (P < 0.01), whereas, LVESP, ±dP/dtmax, cell shortening percentage, CaT amplitude, [Ca2+]SR, the protein level of RyR2 and SERCA2a were markedly increased in intervention group (P < 0.05 or P < 0.01). Conclusion DTL treatment can improve cardiac function in rats with CHF, which may be related to the repair of calcium handling of ventricular myocytes by DTL.
		2020 Vol. 17 (17): 4-8 [Abstract] ( 143 ) HTML (1 KB) PDF (1285 KB) ( 52 )

	9	Analysis of related literature based on CiteSpace leukoencephalopathy
		WEI Nina XU Manman PAN Juhua HUANG Shijing▲ WANG Yanyun
		Objective To explore the main research directions and hot pots of leukoencephalopathy by visual analysis of clinical neuroscience literature in the past 15 years. Methods The literature related to leukoencephalopathy in SCI-E from January 2004 to December 2018 in Web of Science was searched with the method of cis search. CiteSpaceV 5.4.R3 was applied to analyze the authors, research institutions, national cooperation relations, keywords co-occurrence analysis, and to visually analyze the co-citation of their literature and journals. Results A total of 3181 papers were obtained, with an average annual volume of nearly 212 papers. The number of published articles on the whole showed an upward trend, reaching the highest citation level in the past 15 years in 2017. The author with the highest amount of published articles was van der Knaap MS. The leading countries in this field were the United States, Germany and Italy, which produced more literature and cooperate closely. The Mayo clinic and the university of Munich were leading authorities in the field. The hot keywords were nachizumab, leukodystrophy, leukoencephalopathy, subcortical infarction, disappeared white matter, etc., which could form 8 clusters. The journal with the highest frequency of citation was Neurology. The most frequency of citation was the paper published by Bloomgren G et al., on the risk of progressive multiform leukoencephalopathy associated with natazumab. The highest ranking central literature was an literature by Gorelik L et al. published in Ann Neurol in 2010 on the effect of anti-JC virus antibodies on risk stratification of leukoencephalopathy. Conclusion The application of CiteSpace in the literature analysis of clinical neuroscience of leukoencephalopathy in the past 15 years shows the current countries and institutions of cooperation，reveals the hot spots and directions of research，and has important reference value for the in-depth study of leukoencephalopathy.
		2020 Vol. 17 (17): 9-14,20 [Abstract] ( 118 ) HTML (1 KB) PDF (1383 KB) ( 81 )

	15	Mechanism of Caulis Sinomenii on rheumatoid arthritis based on network pharmacology
		DING Wencong1，2 HAN Longyin2 QIAN Kai2 LIN Changsong1
		Objective To explore the pharmacological mechanism of Caulis Sinomenii in the treatment of rheumatoid arthritis (RA) through network pharmacology, and to provide theoretical basis for the clinical treatment of RA. Methods The retrieval time was from the establishment of the database to December 2018. Based on the TCMSP and TCMID database, the components and targets of Caulis Sinomenii were collected, and the component-target network was constructed through the software of Cytoscape. RA related targets were collected through TTD and Drug Bank data, and the target interaction (PPI) network was constructed in the STRING database. The common target of drugs and diseases was analyzed in Genomics database, and the signal pathway of common target was analyzed by using Cluego plugin in the software of Cytoscape. Finally, the component-target-pathway network diagram was constructed and analyzed. Results The therapeutic components of Caulis Sinomenii in the treatment of RA might be 16-epi-Isositsirikine, Stepholidine, Sinomenine, etc.; the therapeutic targets might include Jun proto-oncogene (Jun), Retinoid X receptor alpha (RXRA), peroxisome proliferative activated receptor gamma (PPARG), etc.; the key pathways included PPAR pathway, lipid metabolism regulation, PTEN gene transcription, nuclear cell receptor and transcription, etc.. Conclusion Caulis Sinomenii can relieve pain and inflammation and reduce bone destruction through multi components, multi targets and multiple pathways, which has a certain value for the treatment of RA.
		2020 Vol. 17 (17): 15-20 [Abstract] ( 240 ) HTML (1 KB) PDF (1687 KB) ( 140 )

	21	Effect of tetrahydroxystilbene glucoside of Polygonum multiflorum extract on early diabetic nephropathy rats based on TLR4/NF-κB signaling pathway
		CHEN Hua1 ZHOU Diyi2
		Objective To explore the effect of Polygonum multiflorum extract on unilateral nephrectomy combined with streptozotocin (STZ)-induced diabetic nephropathy (DN) rats. Methods A total of 60 SPF male Wistar rats were successfully modeled, while divided into control group, model group, irbesartan group, tetrahydroxystilbene glucoside (TSG) low, medium and high dose groups, with 10 rats in each group. Rats were given the corresponding dose of drugs daily, while the control and the model group were infused with a corresponding volume of distilled water. Indexes of rats in each group were recorded and analyzed. Results Compared with the control group, body weight and nuclear factor (NF)-κB inhibition(IκBα) protein expression were reduced in the model group, renal index, the level of serum creatinine (Scr), urea nitrogen (UN), 24 h urine protein content, the levels and mRNA expression of interleukin (IL) -1β, IL-6 and monocyte chemoattractant protein 1(MCP-1), and the protein expression of Toll-like receptor 4 (TLR4), NF-κB p65 and phosphorylated (p)-IκBα were significantly increased, while the glomerular damage was severe, and the differences were highly statistically significant (P ＜ 0.01). Compared with the model group, the weight of each experimental group was significantly increased, the levels of Scr, UN, 24 h urine protein content, IL-1β, IL-6, MCP-1, the protein expression of TLR4, NF-κB p65 and p-IκBα were significantly decreased, while the degree of glomerular damage was significantly improved, and the differences were highly statistically significant (P ＜ 0.01). Conclusion TSG may inhibit the formation of inflammatory factors by down-regulating TLR4/NF-κB signaling pathway to protect the kidney tissue of DN rats.
		2020 Vol. 17 (17): 21-25 [Abstract] ( 128 ) HTML (1 KB) PDF (1205 KB) ( 58 )

	26	Clinical characteristics and genetic analysis of a family of hereditary neuropathy with liability to pressure palsies
		GE Xiushan1 BAI Jinli2 JIAO Hui1 PENG Xiaoyin1▲
		Objective To analyze and summarize the clinical characteristics, and genetic analysis of peripheral myelination protein 22 (PMP22) gene in the proband and their family members of hereditary neuropathy with liability to pressure palsy (HNPP). Methods Child with HNPP who admitted to Department of Neurology, Children Hospital Affiliated to Capital Institute of Pediatric in May 2018 was selected as research object. The clinical manifestations of the proband and family members were analyzed and the electrophysiological examination was improved. The peripheral blood genomic DNA of the proband and their family members was extracted, and the second-generation sequencing technology based on target sequence acquisition was used to screen the mutations of single gene diseases of skeletal muscle nervous system. Multiplex ligation-dependent probe amplification (MLPA) was used to verify the absence of the proband and their parents and other family members. Results Paroxysmal, periodic and pressure-susceptible peripheral nerve palsy was the main characteristics for this patient. Electromyogram showed neurological damage and the symptoms disappeared between episodes. The results of the in-depth analysis of the second-generation sequencing technology indicated that the patient might have a large deletion about 1.38 Mb in the region of Chr17: 14095223-15477566 and this region mainly includes the PMP22 gene associated with HNPP. MLPA results verified that large fragments of heterozygosity were absent in the PMP22 gene and its adjacent regions (TEKT3 and COX10 gene). Parental verification analysis revealed that the defect originated from the mother of the child. Conclusion HNPP is a recurrent peripheral neuropathy with some clinical and genetic heterogeneity. On the basis of mastering the clinical characteristics of the children, the electrophysiological examination can provide diagnostic clues for them, while the genetic test as the basis of diagnosis is worthy of attention.
		2020 Vol. 17 (17): 26-29 [Abstract] ( 141 ) HTML (1 KB) PDF (651 KB) ( 73 )

	30	Effects of evodotaxine on the proliferation of gallbladder carcinoma cells and the expression of HIF-1α and VEGF in anoxic microenvironment
		XU Zhi1 LIU Chunyan2 WEN Juan1 LIU Shaohua3
		Objective To investigate the effects of evodotaxine on the proliferation of gallbladder carcinoma cells (CBC-SD) and the expression of hypoxia-inducing factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF) in GBC-SD in anoxic microenvironment. Methods Using 3%O2 and 5%CO2 to simulate anoxic microenvironment, CBC-SD cells were divided into normal control group, hypoxic group and evodotaxine (100 μg/mL) + hypoxic group, they were cultured in normal and hypoxic microenvironments. MTT assay was used to detect the proliferation of 12, 24, 48, 72 and 96 h cells in each group. Annexin V-FITC/PI double staining flow method was used to detect apoptosis in each group. HIF-1α, VEGF protein expression was detected by Western blot. Results MTT results showed that there was no statistically significant difference in the optical density values between the three groups at 12 h (P ＞ 0.05). At 24, 48, 72 and 96 h, the optical density of the hypoxia group was lower than that of the normal control group, and the difference was statistically significant (P ＜ 0.05). At 24, 48, 72, and 96 h, the light density value of evodotaxine (100 μg/mL) + hypoxia group was lower than that of the hypoxia group, and the difference was statistically significant (P ＜ 0.05). Flow cytometry results showed that the apoptosis rate of hypoxia group was higher than that of normal control group (P ＜ 0.05). The apoptosis rate of evodotaxine (100 μg/mL) + hypoxia group was higher than that of normal control group and hypoxia group, and the difference was statistically significant (all P ＜ 0.05). The protein expression of the HIF-1α, VEGF in the cells of the evodotaxine (100 μg/mL) + anoxic group was lower than that of the normal control group and the hypoxic group, and the differences were statistically significant (all P ＜ 0.05). Conclusion Evodotaxine can inhibit the proliferation of GBC-SD cells in gallbladder cancer under hypoxic microenvironment and promote apoptosis, which may be related to evodotaxine′s inhibition of HIF-1α and VEGF expression in tumor cells.
		2020 Vol. 17 (17): 30-33 [Abstract] ( 128 ) HTML (1 KB) PDF (844 KB) ( 40 )

	34	Research progress on prevention and treatment of liver fibrosis by traditional Chinese medicine
		XIE Aize1 LYU Chao2 SHI Qinglan3 MAO Dewen3 BAI Wenjie2 CHEN Yueqiao3
		Liver fibrosis is a pathophysiological process of abnormal hyperplasia of intrahepatic connective tissue caused by a variety of causes. Its pathogenesis is complex, and there is no effective treatment to prevent or slow down the process of liver fibrosis. In recent years, studies have found that traditional Chinese medicine has a unique therapeutic effect on the process of liver fibrosis. Traditional Chinese medicine antagonizes liver fibrosis by inhibiting the activation of hepatic stellate cells, regulating adipocytokines, alleviating liver inflammatory response, improving oxidative stress, inhibiting the capillarization of sinusoidal endothelial cells, etc.; acupuncture and moxibustion can improve the immune function of the body, improve the state of liver function, and block liver fibrosis progress of liver fibrosis. This paper reviews the effects of traditional Chinese medicine on the pathogenesis of liver fibrosis.
		2020 Vol. 17 (17): 34-37 [Abstract] ( 155 ) HTML (1 KB) PDF (538 KB) ( 52 )

	38	Research progress of morning blood pressure at home and abroad
		HU Yue1 PENG Fang2 CAO Yudi1 LIU Kejia1 WEI Lijiao1 ZHANG Chunmei1 LIU Yanhui1
		In recent years, more and more studies have confirmed the importance of morning blood pressure for predicting cardiovascular risk. However, the research on morning blood pressure in China is still in its infancy, and there is still a high current situation of disability and death caused by the poor control of morning blood pressure. Therefore, the clinical efficacy of various intervention programs of traditional Chinese and Western medicine have become a hot topic for scholars to discuss. This study follows the process of morning blood pressure at home and abroad, cognitive rules and the current status of research on Chinese and Western medicine and non-drug intervention programs to sort out the relevant research of morning blood pressure at home and abroad, so as to provide reference for understanding the current research situation search in this field and carrying out futher in-depth discussion.
		2020 Vol. 17 (17): 38-40 [Abstract] ( 125 ) HTML (1 KB) PDF (572 KB) ( 197 )

	41	Research progress of traditional Chinese and Western medicine for idiopathic precocious puberty
		SONG Liancheng1 ZHANG Guiju2
		Idiopathic precocious puberty has a high incidence, it is a common endocrine disease in children. Its etiology and pathogenesis are not completely clear. In terms of treatment, Western medicine has a single treatment method, which uses gonadotropin-releasing hormone analogs or combined with growth hormone. Traditional Chinese medicine has obvious advantages in treating this disease. On the basis of dialectical treatment and classification, combined with external treatment of Chinese medicine, the clinical effect is remarkable. This paper reviews the progress in research and treatment of idiopathic precocious puberty in traditional Chinese and Western medicine, looking forward to help with the treatment of this disease.
		2020 Vol. 17 (17): 41-44,52 [Abstract] ( 140 ) HTML (1 KB) PDF (878 KB) ( 78 )

	45	Application of chromosome microarray analysis in thickening of transparent layer of fetal neck
		DING Xiaorui1 LIU Aiju2▲ YANG Xiaoyan2 ZHANG Junhui2
		Chromosomal microarray analysis (CMA) is a newly developed prenatal diagnosis technology, which has been widely used due to its huge advantages. Its advantages are Kb level resolution, high sensitivity and specificity, high degree of automation and high efficiency etc., it can not only detect chromosome number and unbalanced structural abnormalities, but also detect copy number variation (CNV) caused by unbalanced rearrangement at the level of chromosomal sub microstructure. Therefore, it has gained favor in clinical detection, become the tool of clinical genetic routine diagnosis, and has been introduced into prenatal fetal genetic disease detection. The measurement of nuchal translucency (NT) has been widely used as one of the routine screening items in early pregnancy. Many studies have found that NT thickening is a sensitive index of fetal chromosomal abnormalities. CMA has been used as a first-line diagnostic technique for prenatal genetic screening. In the detection rate of chromosomal abnormalities when NT abnormality is detected by ultrasound, CMA is significantly higher than that of conventional karyotype analysis. However, it is not clear whether CMA can be used as a first-line detection method for prenatal diagnosis. In application, it is necessary to pay special attention to the explanation and inheritance of gene CNV of clinical significance consultation. In this paper, we will review the application, advantages and challenges of microarray analysis in the thickening of NT.
		2020 Vol. 17 (17): 45-48,56 [Abstract] ( 109 ) HTML (1 KB) PDF (881 KB) ( 137 )

	49	The correlation between stigma and anxiety in elderly acquired immunodeficiency syndrome inpatients
		WU Xiaoli ZHAO Xia▲ LYU Chunrong WAN Bin ZHONG Yan LIU Chang HE Dingling HU Wen
		Objective To investigate the status of stigma and anxiety in elderly acquired immunodeficiency syndrome (AIDS) inpatients, and to understand the correlation between them. Methods From October 2018 to May 2019, a total of 130 elderly AIDS inpatients in the Public Health Clinical Center of Chengdu were investigated with social impact scale (SIS) and Hamilton anxiety scale (HAMA), and the correlation was analyzed with Pearson correlation analysis. Results A total of 111 effective questionnaires were collected, the effective recovery rate was 85.4%. Among 111 elderly AIDS hospitalized patients, the scores of stigma were 60-83 points, average (72.87±5.44) points; the anxiety scores were 0-29 points, average (10.78±6.15) points. Pearson correlation analysis showed that there was a positively correlation between stigma and anxiety in elderly AIDS inpatients（r = 0.330，P = 0.000). Conclusion Most of the elderly AIDS inpatients are prone to have stigma and anxiety, while there is a significant correlation between stigma and anxiety. We should pay attention to the care and respect of the elderly AIDS patients, help them to social integration and return.
		2020 Vol. 17 (17): 49-52 [Abstract] ( 155 ) HTML (1 KB) PDF (470 KB) ( 88 )

	53	Helicobacter pylori infection and the correlation with risk factors of atherosclerosis of 33 153 physical examinees in Nanchong
		LI Yun1 LIU Juhua2 TIAN Weike1 LEI Rong1 LIU Mi1
		Objective To analyze the prevalence of Helicobacter pylori (Hp) infection and the correlation with risk factors of atherosclerosis in physical examination population in Nanchong. Methods A total of 33 153 health examiners who underwent health examination from November 2015 to July 2019 in Health Management Center of Affiliated Hospital of North Sichuan Medical College were selected as the research subjects. According to the Hp infection, the examinees were divided into Hp positive group (13 948 cases) and Hp negative group (19 205 cases). The relationship between Hp infection and blood lipids, C-reactive protein, fasting plasma glucose, glycated hemoglobin, uric acid (UA), homocysteine (Hcy) were analyzed. Results There was no statistically significant difference in Hp infection rate among different age groups (P ＞ 0.05). Triacylglycerol (TG), very low density lipoprotein cholesterol (VLDL-C), UA and age of Hp positive group were higher than those of Hp negative group, high density lipoprotein cholesterol (HDL-C) was lower than that of Hp negative group, and the differences were highly statistically significant (P ＜ 0.01). Univariate logistic analysis showed that HDL-C and gender were protective factors for Hp infection (OR ＜ 1, P ＜ 0.01), while TG, VLDL-C, UA and age were risk factors for Hp infection (OR ＞ 1, P ＜ 0.01). Multivariate regression analysis showed that HDL-C was a protective factor for Hp infection (P ＜ 0.01). Conclusion Hp infection is associated with dyslipidemia. The higher the HDL-C value, the lower the possibility of Hp infection, which is a protective factor.
		2020 Vol. 17 (17): 53-56 [Abstract] ( 121 ) HTML (1 KB) PDF (484 KB) ( 75 )

	57	Effect of Yiqi Huoxue Lishui Prescription combined with Spironolactone in the treatment of heart failure and preserved ejection fraction in the elderly
		PENG Lang1,2 LU Xiaobin1,3 MEI Yingbing1,2 LIU Jinjin1,2 NI Wei1,4
		Objective To investigate the clinical effect of treating heart failure and preserved ejection fraction (HFpEF) in elderly patients with Yiqi Huoxue Lishui Prescription combined with aldosterone receptor antagonist. Methods A prospective, open and blank controlled clinical study was conducted to collect 120 cases of HFpEF patients in the outpatient and in-patient department of Hubei Provincial Hospital of Traditional Chinese Medicine from December 2017 to December 2018. According to the random number table method, they were divided into the traditional Chinese medicine group, the Spironolactone group, the combined group and the control group, each group with 30 cases. The control group was treated with western medicine basic treatment, the traditional Chinese medicine group was treated with Yiqi Huoxue Lishui Prescription, the Spironolactone group was treated with Spironolactone 20 mg/tablet/day, and the combined group received the same therapeutic intervention as the traditional Chinese medicine group and spironolactone group at the same time. Each group was treated continuously for 2 weeks. The results of N terminal pro B type natriuretic peptide (NT-proBNP) level, traditional Chinese medicine syndrome score and 6 min walking test were recorded and compared before and after treatment. Results Five cases were shed during the study, and 115 cases were actually completed. There were 30 cases in the control group, 28 cases in the traditional Chinese medicine group, 29 cases in the Spirolactone group and 28 cases in the combined group. There was no statistically significant difference in the level of NT-proBNP between the four groups before treatment (P ＞ 0.05). The level of NT-proBNP after treatment in the combined group, the traditional Chinese medicine group and the Spironolactone group was lower than that before treatment, and the differences were statistically significant (all P ＜ 0.05). Compared with the control group after treatment, the level of NT-proBNP in the combined group, the Spironolactone group and the traditional Chinese medicine group decreased, and the combined group was lower than the Spironolactone group, the differences were statistically significant (all P ＜ 0.05). There was no significant difference in traditional Chinese medicine syndrome score among the four groups before treatment (P ＞ 0.05). The traditional Chinese medicine syndrome scores of each group were lower after treatment than before treatment, and the differences were statistically significant (P ＜ 0.05). Compared with the control group after treatment, the traditional Chinese medicine syndrome scores of the combined group, the traditional Chinese medicine group and the Spironolactone group all decreased, and the traditional Chinese medicine syndrome scores of the combined group and the traditional Chinese medicine group were all lower than those of the Spironolactone group, with statistically significant differences (all P ＜ 0.05). There was no significant difference in traditional Chinese medicine syndrome scores between the combined group and the traditional Chinese medicine group (P ＞ 0.05). There was no statistically significant difference in 6 min walking distance among the four groups before treatment (P ＞ 0.05). The 6 min walking distance of each group after treatment was greater than that before treatment, and the differences were statistically significant (all P ＜ 0.05). After treatment, the 6 min walking distance of the combined group was greater than that of the Spirolactone group and the control group, and the differences were statistically significant (all P ＜ 0.05). There was no significant difference in 6 min walking distance between the combined group and the traditional Chinese medicine group (P > 0.05). Conclusion The advantage of the Yiqi Huoxue Lishui Prescription lies in the improvement of traditional Chinese medicine syndrome and activity endurance, and the advantage of Spironolactone lies in the reduction of NT-proBNP level. The combination of the two is an effective method for the treatment of HFpEF.
		2020 Vol. 17 (17): 57-61 [Abstract] ( 191 ) HTML (1 KB) PDF (566 KB) ( 33 )

	62	Comparative study of ventricular remodeling and cardiac function between immediate PCI after thrombolysis and primary PCI in STEMI patients
		WANG Changliang WANG Rongxin ZHAI Wenliang
		Objective To explore the effects of immediate percutaneous coronary intervention (PCI) after thrombolysis and primary PCI on postoperative ventricular remodeling and cardiac function in patients with acute ST segment elevation myocardial infarction (STEMI). Methods The clinical data of 123 patients with STEMI in Xuanwu Hospital, Capital Medical University from February 2017 to July 2019 were retrospectively analyzed, who were divided into immediate PCI group after thrombolysis (group A, n = 67) and primary PCI group (group B, n = 56) according to the surgical protocol. The indexes of ventricular remodeling and left ventricular function and the levels of serum biomarkers such as creatine kinase isoenzyme (CK-MB), matrix metalloproteinase-9 (MMP-9), N-terminal pro-brain natriuretic peptide (NT-proBNP) before and after 14 days of treatment were compared between the two groups. Results The left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI) of the two groups after 14 days of treatment were lower than those before treatment, and the left ventricular systolic function (LVSF) was higher than that before treatment, with statistically significant differences (all P ＜ 0.05). There were no significant differences in LVEDVI, LVESVI and LVSF between the two groups after 14 days of treatment (P ＞ 0.05). The left ventricular ejection fraction (LVEF), the left ventricular end-systolic dimension (LVESD), peak ejection rate (PER), peak firing rate (PFR) of two groups after 14 days of treatment were significantly higher than those before treatment，and left ventricular end-diastolic diameter (LVEDD) was lower than that before treatment, with statistically significant differences (all P ＜ 0.05). After 14 days of treatment, LVEF and LVESD in group A were higher than those in group B, and LVEDD was lower than that in group B, with statistically significant differences (all P ＜ 0.05). After 14 days of treatment, the levels of CK-MB, MMP-9 and NT-proBNP in the two groups were all lower than those before treatment, and the differences were statistically significant (all P ＜ 0.05). The levels of CK-MB, MMP-9 and NT-proBNP in group A after 14 days of treatment were all lower than those in group B, and the differences were statistically significant (all P ＜ 0.05). Conclusion Both immediate PCI after thrombolysis and primary PCI can improve ventricular remodeling and cardiac function in STEMI patients, but immediate PCI after thrombolysis can significantly improve cardiac function, which is especially worthy of clinical recommendation.
		2020 Vol. 17 (17): 62-66,83 [Abstract] ( 135 ) HTML (1 KB) PDF (914 KB) ( 63 )

	67	Changes and clinical significance of serum fibroblast growth factor 21 and nuclear peroxisome proliferator-activated receptor γ levels in patients with coronary heart disease
		LIN Puqing HONG Changjiang WU Shan HU Zhongzhi
		Objective To investigate the changes and clinical significance of serum fibroblast growth factor 21 (FGF21) and nuclear peroxisome proliferator-activated receptor γ (PPARγ) levels in patients with coronary heart disease (CHD). Methods A total of 129 patients with CHD confirmed by coronary angiography during hospitalization in Clifford Hospital of Guangzhou University of Chinese Medicine (hereinafter referred to as “our hospital”) from March 2018 to March 2019 were selected as the observation group, and 80 person who came to our hospital for physical examination during the same period were selected as the control group. The observation group was divided into mild group (n = 45), moderate group (n = 55) and severe group (n = 29) according to the degree of coronary artery disease. The observation group was divided into single-vessel lesion group (n = 48), double-vessel lesion group (n = 44) and multi-vessel lesion group (n = 37) according to the number of coronary artery lesion branches. Serum FGF21 and PPARγ levels in each group were determined by enzyme-linked immunosorbent assay, and the relationship between FGF21 and PPARγ levels and Gensini score and lesion count was analyzed. Results Serum FGF21 and PPARγ levels of patients in the observation group were significantly higher than those in the control group, and the differences were statistically significant (all P ＜ 0.05). Among the CHD patients with different degrees of coronary artery disease, the FGF21 and PPARγ levels in the moderate group were higher than those in the mild group, while those in the severe group were higher than those in the moderate group and the mild group, with statistically significant differences (all P ＜ 0.05). Among the CHD patients with varying degrees of coronary artery lesions, the FGF21 and PPARγ levels in the double-vessel lesion group were higher than those in the single-vessel lesion group, while those in the multiple-vessel lesion group were higher than those in the double-vessel lesion group and the single-vessel lesion group, with statistically significant differences (all P ＜ 0.05). Spearman correlation analysis found that FGF21 and PPARγ levels in CHD patients were positively correlated with lesion count and Gensini score (r ＞ 0，P ＜ 0.05), and FGF21 levels were positively correlated with PPARγ levels (r ＞ 0，P ＜ 0.05). Conclusion The levels of FGF21 and PPARγ are increased in CHD patients, and the levels of FGF21 and PPARγ are closely related to the stenosis degree and accumulation of coronary artery lesions.
		2020 Vol. 17 (17): 67-70 [Abstract] ( 176 ) HTML (1 KB) PDF (556 KB) ( 131 )

	71	Clinical effect of Shenfu Injection combined with mild hypothermia in the treatment of patients with cardiac arrest
		WANG Jun HE Yaping AN Pengpeng QIU Zhipeng LU Zhaoxin ZHANG Sen ZHANG Yi SONG Yongxin
		Objective To observe the clinical effect of Shenfu Injection combined with mild hypothermia in the treatment of patients with cardiac arrest (CA). Methods A total of 138 patients with CA who admitted to Qingdao Haici Medical Group, Shandong Province from January 2015 to December 2018 were selected as research objects, and they were randomly divided into control group and observation group according to the random number table method, with 69 patients in each group. The control group was treated with mild hypothermia (32 - 34℃), and the observation group was given 100 mL Shenfu Injection intravenously on the basis of the control group. Superoxide dismutase (SOD), nitric oxide (NO), malondialdehyde (MDA), neuron specific enolase (NSE), human S100B protein (S-100B) were detected by enzyme-linked immunoassay at 30 min, 2 h, 12 h and 24 h after cardiopulmonary resuscitation. Cerebral oxygen metabolism indexes of patients were detected at 12, 24, 48 and 72 h after CA respectively, including arteriovenous oxygen content difference (Ca-jvO2), jugular bulb blood oxygen saturation (SjvO2) and cerebral oxygen uptake rate (CERO2). The Glasgow coma scale (GCS) was used to assess the coma status of the patients. The recovery efficiency and case fatality rate were calculated. Results Compared with 30 min after resuscitation, the levels of SOD and NO significantly decreased and the level of MDA significantly increased in the control group at 2, 12 and 24 h after resuscitation, with statistically significant differences (all P ＜ 0.05). Compared with 30 min after resuscitation, the level of SOD significantly decreased and the levels of NO and MDA significantly increased in the observation group at 2, 12 and 24 h after resuscitation, with statistically significant differences (all P ＜ 0.05). Compared with 30 min after resuscitation, the levels of NSE and S-100B in the two groups were significantly increased at 2, 12 and 24 h after resuscitation, and the differences were statistically significant (all P ＜ 0.05). At 2, 12 and 24 h after resuscitation, the levels of SOD and NO in the observation group were significantly higher than those in the control group, while the levels of MDA, NSE and S-100B in the observation group were significantly lower than those in the control group, with statistically significant differences (all P ＜ 0.05). Compared with CA at 12 h, the level of SjvO2 and GCS score were significantly increased at 24, 48 and 72 h after CA, while the level of Ca-jvO2 were significantly decreased in both groups, with statistically significant differences (all P ＜ 0.05). The level of CERO2 at 24 h after CA was significantly higher than that at 12 h, and that at 48 and 72 h after CA was significantly lower than that at 12 h. with statistically significant differences (all P ＜ 0.05). The levels of Ca-jvO2, CERO2 and GCS score in the observation group at 48 and 78 h after CA were significantly higher than those in the control group, while the level of SjvO2 were significantly lower than those in the control group, with statistically significant differences (all P ＜ 0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group, while the case fatality rate was significantly lower than that in the control group, with statistically significant differences (all P ＜ 0.05). Conclusion Shenfu Injection combined with mild hypothermia has a significant protective effect on cardiopulmonary resuscitation myocardial tissue and brain tissue in patients with CA, and can significantly improve the prognosis.
		2020 Vol. 17 (17): 71-74 [Abstract] ( 116 ) HTML (1 KB) PDF (567 KB) ( 118 )

	76	Effect of shock index on the long-term survival of patients with acute myocardial infarction after PCI
		DONG Ningchao ZHANG Gong CHENG Guojie TONG Zichuan
		Objective To explore the effect of shock index (SI) on long-term survival after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction. Methods A total of 184 patients with acute myocardial infarction who were treated in Daxing District People′s Hospital of Beijing from December 2016 to December 2017 were selected as the research objects. According to the optimal threshold value of the working characteristic curve (0.49) of the patients, they were divided into the low SI group (≤0.49) and the high SI group (＞0.49), with 52 cases in the low SI group and 132 cases in the high SI group. Blood pressure and heart rate of patients were collected and SI was calculated. The optimal threshold value was determined by using the working characteristic curve of patients. Clinical data and causes of death were compared between the two groups. Results There were no statistically significant differences between the two groups in gender, age, course of disease, the proportion of paritients with hypertension, diabetes, history of smoking, hyperlipidemia, renal insufficiency, history of PCI surgery and history of peripheral vascular disease, PCI related characteristics, characteristics of drug therapy, and all-cause mortality (all P ＞ 0.05). The cardiogenic mortality in the high SI group was higher than that in the low SI group, and the difference was statistically significant (P ＜ 0.05). Conclusion SI can effectively predict the long-term survival status of patients with acute myocardial infarction. Clinicians should formulate treatment and rehabilitation plans in combination with patients′ SI to improve the prognosis of patients.
		2020 Vol. 17 (17): 76-78 [Abstract] ( 138 ) HTML (1 KB) PDF (545 KB) ( 37 )

	79	Effect of Edaravone in the hemorrhagic transformation after intravenous thrombolysis with rt-PA in patients with acute cerebral infarction
		XU Chunmei1 FAN Rong2 ZHANG Li3
		Objective To investigate the effect of Edaravone in the hemorrhagic transformation (HT) after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in patients with acute cerebral infarction. Methods From January 2017 to December 2018, a total of 98 patients with acute cerebral infarction who were treated with rt-PA thrombolysis in the Second People′s Hospital of Liangshan Yi Autonomous Prefecture were selected and divided into control group (50 cases) and study group (48 cases) according to different treatment methods. The control group was treated with rt-PA intravenous thrombolysis and routine treatment. The study group was combined with Edaravone on the basis of the control group. The serum indexes (Matrix metalloproteinase-9 [MMP-9], plasma glial fibrillary acidic protein [GFAP], plasma cellular fibronectin [c-Fn]), national institutes of health stroke scale (NIHSS) score and Barthel index of two groups were compared. Adverse reactions during treatment between the two groups were recorded. Results The levels of MMP-9, GFAP and c-Fn in the two groups on days 1 and 3 were higher than those before treatment, and the index levels on days 7 and 14 were lower than before treatment, while the time after treatment was longer, the index levels were lower, and the differences were statistically significant (P ＜ 0.05). The levels of MMP-9, GFAP, and c-Fn on the 3rd, 7th, and 14th days of treatment in the study group were lower than those in the control group, and the differences were statistically significant (P ＜ 0.05). In addition, the difference in the interaction of the indicators of the two groups was statistically significant (P ＜ 0.05). On the 14th day of treatment, the NIHSS score of the two groups were lower than before treatment, and the study group was lower than the control group; the Barthel index were higher than before treatment, and the study group was higher than the control group, the differences were statistically significant (P ＜ 0.05). The total incidence of HT in the study group was lower than that in the control group, and the difference was statistically significant (P ＜ 0.05). The incidence of adverse reactions between the two groups was not statistically significant (P > 0.05). Conclusion Edaravone can reduce the incidence of HT, improve the ability of self-care, reduce the damage of nerve function, and the safety of medication is better, which may be related to the down-regulation of MMP-9, GFAP, c-Fn and other factors.
		2020 Vol. 17 (17): 79-83 [Abstract] ( 130 ) HTML (1 KB) PDF (585 KB) ( 81 )

	84	Multiple regression analysis of the influencing factors of acute terminal neurological deficit in patients with cerebral infarction
		LI Huajian CHEN Haiyun HE Chaoming LIN Min PANG Mingwu GAO Weiyi
		Objective To analyze the influencing factors of patients with acute cerebral infarction and the degree of neurological deficits. Methods A retrospective analysis was performed on 68 patients with acute cerebral infarction admitted to the Department of Neurology, the Third People′s Hospital of Hainan from August 2015 to August 2016. The general data, intracranial pressure, cerebral perfusion pressure, infarct volume, laboratory index, previous history score and time from onset to admission of all patients were collected, and the correlation between each index and the neurological functional deficit scale (NFDS) score were analyzed. Results In patients with acute cerebral infarction, the levels of intracranial pressure, lesion volume, total cholesterol, triacylglycerol, fibrinogen, past history score, and time from onset to admission were positively correlated with NFDS score (rs ＞ 0, P ＜ 0.05). The size of the lesion, the time from onset to admission, and total cholesterol were influencing factors for the NFDS score (P ＜ 0.05). Conclusion Factors such as lesion volume, total cholesterol, and the time from onset to admission are related to the prognosis of patients with cerebral infarction at the end of the acute phase. Accurately grasping the relevant influencing factors and timely intervention are essential to improve the patients′ neurological deficit.
		2020 Vol. 17 (17): 84-86,90 [Abstract] ( 215 ) HTML (1 KB) PDF (589 KB) ( 84 )

	87	Family analysis and clinical research of Huntington disease
		ZENG Qian1 CAO Zhongwei2 SUN Junqing3
		Huntington′s disease (HD) is a typical autosomal dominant neurodegenerative disease. The disease is a genetic disease caused by a single gene HTT mutation. In the IT15 gene, cytosine-adenine-guanine (CAG) n repeats of the abnormal expansion of copies is the basis of HD in the family. The disease occurs, when the repeat sequence＞36 times. HD patients have accumulated variant protein and neuronal death pathological features, accompanied by behavioral, cognitive, and mental disorders. This article collects detailed clinical data of HD patients and some family members treated in the Department of Neurology of Inner Mongolia People′s Hospital from 2017 to 2019, discusses the genetic rules and clinical characteristics of HD families, draws a complete family tree, and tests the number of CAG trinucleotide repeats of IT15 gene in patients, using for genetic diagnosis and pre-symptomatic diagnosis of the disease. Three patients were diagnosed in both lines, and the causative CAG repeat copy number was≥40 times. In the analysis of the family, it was found that there was a premature phenomenon of paternal inheritance. The patients with advanced HD have more typical clinical manifestations, but the early symptoms are diverse and atypical, the clinical diagnosis is difficult, the behavior changes, and the imaging examination have important reference value. Genetic diagnosis can confirm the disease.
		2020 Vol. 17 (17): 87-90 [Abstract] ( 180 ) HTML (1 KB) PDF (628 KB) ( 35 )

	91	The effect of stem cell transplantation on functional remodeling after stroke : a network meta-analysis
		WANG Lulu GAO Run LIU Li
		Objective To review the effect of stem cell transplantation in the treatment of neurologic deficit and different methods of cell transplantationon functional remodeling after stroke. Methods Control trails about the effect of stem cell transplantation on after neurologic deficitstroke were searched and evaluated from PubMed, EMbase, Medline, the Cochrane library, CNKI and WanFang, VIP database. The retrieval time was from the database to May 2019. After screening and evaluating the literatures according to the inclusion criteria, the national institutes of health stroke scale (NIHSS) scores of each group were extracted for combined analysis. Results A total of 11 studies with 567 participants totally were included. The results of direct meta-analysis showed that the scores of NIHSS in the experinrental group(stem cell transplantation) was higher than the control group(normal saline or conventional treatment), the difference was statistically significant (MD = -2.37,95%CI：[-2.79，-1.97], P ＜ 0.05). The results of network meta-analysis showed the efficacy of different cell transplantation methods: arterial ＞ vein + other way ＞ non-venous transplantation ＞ vein and different period: acute ＞ chronic. Conclusion Stem cell transplantation is beneficial to improve the impaired function for stroke patients, andthedifferent way and time of cell transplantation can affect the recovery of nerve function.
		2020 Vol. 17 (17): 91-95 [Abstract] ( 109 ) HTML (1 KB) PDF (1221 KB) ( 125 )

	96	Detection of peripheral blood miR-146a and miR-146b levels in children with viral encephalitis and their clinical significance
		WEI Congzhen ZHAO Xiaojie LI Yanming CHAI Yue BIAN Ce ZHAO Shuai▲
		Objective To detect the peripheral blood miR-146a and miR-146b levels in children with viral encephalitis, and to explore their clinical significance. Methods Clinical data of 62 children with viral encephalitis admitted to the First Hospital of Hebei Medical University (“our hospital” for short) from June 2016 to June 2019 and the physical examination data of 43 healthy subjects during the same period in our hospital were retrospectively analyzed, and they were recored as study group and control group respectively. The study group was further divided into 5 subgroups according to the virus type: study group A (7 cases of herpes simplex virus), study group B (9 cases of herpes zoster virus), study group C (28 cases of enterovirus), study group D (6 cases of parotid virus), and study group E (12 cases of epidemic virus B). The levels of miR-146a and miR-146b between the study group, the control group and mild and severe cases of subgroups of study group were compared. The levels of T lymphocyte sub-population were compared between the study group and the control group. The correlations between the levels of miR-146a and miR-146b in peripheral blood and T lymphocyte sub-population levels in study group were analyzed. The levels of miR-146a and miR-146b in peripheral blood of different prognosis were compared. Results The levels of miR-146a and miR-146b in the study group and different sub-groups of the study group were higher than those in the control group (P < 0.05), of which the severe cases were higher than the mild cases (P < 0.05). The CD+3, CD+4 and CD+4/CD+8 in the study group and different sub-groups of the study group were lower than the control group (P < 0.05), while the CD+8 levels were higher than the control group (P < 0.05). The levels of miR-146a and miR-146b of the study group and different sub-groups of the study group were negatively correlated with CD+3, CD+4, and CD+4/CD+8 (P < 0.05), which were positively correlated with CD+8 (P < 0.05). The levels of miR-146a and miR-146b in children with good prognosis were significantly lower than those with poor prognosis (P < 0.05). Conclusion The levels of miR-146a and miR-146b in children with viral encephalitis increase, which can reflect the severity of the conditions and have correlations with the T lymphocyte sub-population, which can predict the prognosis.
		2020 Vol. 17 (17): 96-100 [Abstract] ( 169 ) HTML (1 KB) PDF (545 KB) ( 100 )

	101	Practical effect of mirror feedback therapy combined with task-oriented training in children with hemiplegic cerebral palsy
		ZHAO Xiuying1 QUE Lishuang1 LIAO Feng2 LIN Bin1 WU Zhanbo1 PAN Wenjiao1
		Objective To explore the practical effect of mirror feedback therapy combined with task-oriented training in children with hemiplegic cerebral palsy. Methods From June 2017 to June 2018, 170 children with hemiplegic cerebral palsy who were admitted to the Department of Children Rehabilitation of Hainan General Hospital for rehabilitation treatment were selected, according to the random number table method, they were divided into Group A (41 cases, conventional rehabilitation therapy), Group B (43 cases, conventional rehabilitation treatment + mirror feedback therapy), Group C (42 cases, conventional rehabilitation treatment + task-oriented training), and Group D (44 cases, conventional rehabilitation treatment + mirror feedback therapy combined with task-oriented training). Before and after treatment, balance function (Berg balance scale [BBS]), walking function status (step speed and step length), grip strength of affected limb, upper limb function (Carroll upper limb function assessment [UEFT]), Wee functional in dependence measure (WeeFIM) and rehabilitation efficacy of children were compared among the four groups. Results After treatment, the BBS score, step speed and step length of the four groups were all higher than those before treatment, and the differences were highly statistically significant (P < 0.01), and the BBS score, step speed and step length after treatment of Group D were larger than those among Group A, B and C, and Group B and Group C were larger than those of Group A, the differences were statistically significant (P < 0.05). After treatment, the grip strength, UEFT scores and WeeFIM scores of the affected limb were all improved in the four groups, and the differences were highly statistically significant (P < 0.01), the grip strength, UEFT scores and WeeFIM scores of the affected limb of Group D were larger than those among Group A, B and C, and Group B and Group C were larger than those of Group A, and the differences were statistically significant (P < 0.05). There were statistically significant differences in the curative effect and total effective rate among the four groups (P < 0.05), and the total effective rate of the Group D was higher than that of the Group A, and the difference was highly statistically significant (P < 0.01). Conclusion In children with hemiplegic cerebral palsy, mirror feedback therapy combined with task-based training can significantly improve balance function, limb motor function and independent ability, and enhance the rehabilitation effect.
		2020 Vol. 17 (17): 101-104,108 [Abstract] ( 151 ) HTML (1 KB) PDF (554 KB) ( 115 )

	105	Study on the new model of thyroid function screening before pregnancy
		DING Xufeng1* HU Yuqing2* MA Niandi1 MA Wei2 FAN Jun3
		Objective To explore the potentiality of a new thyroid function screening before pregnancy. Methods A total of 1026 females came from Maternal and Child Health Care Hospital of Yixing and prepared for pregnancy were enrolled. The concentrations of serum TPOAb and TgAb were detected by TRFIA in 719 cases whose TSH between 0.1-2.5 mU/L. Results of TRFIA were confirmed by Roche electrochemical luminescence, and the coincidence rate between TRFIA test and Roche electrochemical luminescence was observed. Results Among the 719 patients, TRFIA detected more TPOAb positive in 36 cases, accounting for 5.01%. TgAb positive in 31 cases, accounting for 4.31%. Of the 36 patients with positive TPOAb, 18 patients were confirmed by the project funds, 12 patients were confirmed by outpatient self-funded, and 6 patients refused to be reviewed. Among the 31 patients with positive TgAb, 15 patients were confirmed by the project funds, 13 patients were confirmed by outpatient self-funded, and 3 patients refused to be reviewed. Both of the project funds and the outpatient self-funded verification results showed that, the positive rate of thyroid antibody detected by TRFIA was highly consisted with that of Roche electrochemical luminescence method, the compliance rates of TRFIA and ECLIA on TPOAb were 94.44% and 91.67%, respectively, and those of TgAb were 93.33% and 84.62%, respectively. Conclusion The accuracy of TRFIA is relatively high. The new mode is conducive to the early discovery of TPOAb and TgAb in thyroid function screening of women before pregnancy, and it helps to promote bear and rear better children.
		2020 Vol. 17 (17): 105-108 [Abstract] ( 118 ) HTML (1 KB) PDF (536 KB) ( 78 )

	109	The value of serum 5′-nucleotidase and its combination with alanine aminotransferase in identifying bone metastases in cancer patients with elevated ALP
		CUI Chanjuan GAO Jia LI Jia YU Mengyao ZHANG Hao CUI Wei▲
		Objective To explore the value of serum 5′-nucleotidase (5′-NT) and its combination with alanine aminotransferase (ALT) in identifying bone metastases in cancer patients with elevated alkaline phosphatase (ALP). Methods A total of 176 cancer patients who enrolled from Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from December 2018 to August 2019 were selected. Among them, 88 cases with elevated ALP but without bone metastasis were named the liver cancer with elevated ALP group; other 88 cases with bone metastasis and elevated ALP but normal liver function were named the cancer with bone metastasis and elevated ALP group; 50 healthy volunteers were named the normal control group at the same time. The levels of serum 5′-NT and ALT were detected in three groups. Results The positive rate of 5′-NT in the liver cancer with elevated ALP group was higher than that in the cancer with bone metastasis and elevated ALP group (P < 0.01). The serum levels of 5′-NT in liver cancer with elevated ALP group were higher than those in the cancer with bone metastasis and elevated ALP group and the normal control group (P < 0.01). The increased serum 5′-NT or ALT levels were protective factors for bone metastases in cancer patients with elevated ALP. The area under the curve (AUC) of 5′-NT to judge the elevation of ALP to malignant tumor bone metastasis was 0.966, and the sensitivity was 90.91% and the specificity was 89.77% when the critical value was < 5.6 U/L. The AUC of 5′-NT combined with ALT was 0.980, and the specificity was increased to 96.49%. Conclusion The combined detection of 5′-NT and ALT has a certain clinical value in differentiating bone metastases of malignant tumors with elevated ALP.
		2020 Vol. 17 (17): 109-112 [Abstract] ( 129 ) HTML (1 KB) PDF (641 KB) ( 25 )

	113	Relationship between GSK-3β and prognosis in patients with glioma
		ZHAO Kai WANG Zhiwu YANG Junquan
		Objective To analyze the relationship between glycogen synthase kinase-3β (GSK-3β) expression and prognosis of glioma patients. Methods Tissue specimens and clinical pathological data of 148 cases who received surgical treatment for glioma in Tangshan People′s Hospital of Hebei Province from January 2010 to December 2014 were collected. According to the expression of GSK-3β, they were devided into GSK-3β high-expression group (85 cases) and GSK-3β low-expression group (63 cases). Age, gender, tumor length and diameter (<4 cm, ≥4 cm), tumor location (frontal lobe, temporal lobe, others), WHO grading data of two groups were collected. Immunohistochemical analysis of GSK-3β expression in tissues, Kaplan-Meier analysis and Cox regression analysis of the relationship between GSK-3β expression and the prognosis of glioma patients. Results GSK-3β expression level was significantly correlated with WHO grade (P < 0.05). The total survival time of GSK-3β high-expression group was shorter than that of GSK-3β low-expression group (HR=2.31, 95%CI: 1.87-4.15, P < 0.01). High GSK-3β expression and WHO grade were the factors affecting poor prognosis. Conclusion The high expression of GSK-3β is related to the poor prognosis of glioma patients, and it is an independent predictor of poor prognosis.
		2020 Vol. 17 (17): 113-116 [Abstract] ( 141 ) HTML (1 KB) PDF (499 KB) ( 56 )

	117	Relationship between coagulation parameters and tumor markers and venous thromboembolism in different stages of malignant tumors
		HE Lili CAO Guolei LUO Qin▲
		Objective To explore the relationship between coagulation parameters and tumor markers and venous thromboembolism (VTE) in different stages of malignant tumors. Methods A total of 233 patients with malignant tumors complicated with VTE who admitted to the Third Clinical Medical College of Xinjiang Medical University from May 2013 to January 2017 were selected as research objects. According to the malignant tumor TNM staging criteria, they were divided into group Ⅰ (17 cases), group Ⅱ (17 cases), group Ⅲ (54 cases), group Ⅳ (145 cases). D-dimer (D-D), prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen (Fbg), international normalized ration (INR) and Glycan 19-9 (CA19-9), CA125, Carcinoembryonic Antigen (CEA) were compared between four groups. Results D-D value in group Ⅲ was higher than that in groupⅠ-Ⅱ (P < 0.05); D-D value in group Ⅳ was higher than that in group Ⅰ-Ⅲ (P < 0.05); and there were no significant differences in PT, APTT, Fbg, INR levels between four groups (P > 0.05). CA19-9 levels in group Ⅲ were higher than those in group Ⅱ (P < 0.05); CA19-9, CA125 levels in group Ⅳ were higher than those in group Ⅰ-Ⅲ (P < 0.05); CEA levels in group Ⅲ-Ⅳ were higher than those in group Ⅰ-Ⅱ (P < 0.05). Conclusion Patients with late stage should pay more attention to D-D and CA19-9, CA125 and CEA levels, and the detection frequency can be appropriately increased to monitor their thrombus status.
		2020 Vol. 17 (17): 117-120 [Abstract] ( 195 ) HTML (1 KB) PDF (478 KB) ( 70 )

	121	Expression and clinical significance of miR-21 and C-met in colon cancer
		LIU Jie ZHANG Wentian DU Jinbo
		Objective To investigate the expression and clinical significance of microRNA(miR)-21 and hepatocyte growth factor receptor(C-met) in colon cancer tissues. Methods The pathological and clinical data of 95 cases with colon cancer who admitted to Cangzhou People′s Hospital of Hebei Province from February 2017 to May 2019 were analyzed retrospectively. Quantitative real-time PCR was used to quantitatively detect the expression levels of miR-21 and C-met in colon cancer tissues and adjacent normal tissues, and their correlation with clinicopathology were analyzed, and the correlation between miR-21 and C-met in cancer tissues was analyzed. Results The expressions of miR-21 and C-met in colon cancer tissues were higher than those in adjacent normal tissues (P < 0.05). The expressions of miR-21 and C-met in colon cancer tissues were related to TNM stage, lymph node metastasis and vascular cancer embolus (P < 0.05). There was a significant positive correlation between miR-21 expression and C-met expression in colon cancer tissues (r = 0.832, P = 0.000 ). Conclusion The expressions of C-met and miR-21 in colon cancer tissues are both up-regulated, and are associated with TNM stage, lymph node metastasis and vascular cancer embolus, which may be potential markers for assessing the severity of the disease and prognosis.
		2020 Vol. 17 (17): 121-124 [Abstract] ( 161 ) HTML (1 KB) PDF (496 KB) ( 54 )

	125	Value analysis on the evaluation of severity and prognosis in patients with acute respiratory distress syndrome by severe ultrasound
		LIU Xing1 LI Xiaolei2 HUANG Zhongyi2 LI Jianqiu2
		Objective To analyze the value of severe ultrasound in the evaluation of severity and prognosis of patients with acute respiratory distress syndrome. Methods The clinical data of 50 (critical ultrasound score and care group) patients with acute respiratory distress syndrome (ARDS) who were monitored by ICU in Shenzhen Hospital Southern Medical University (hereinafter referred to as “our hospital”) from January 2017 to January 2019 were analyzed retrospectively. According to the prognosis, the patients were divided into death group (15 cases) and survival group (35 cases). According to the severity of the disease (oxygenation index ＞200-300 mmHg is mild, oxygenation index ＞200-300 mmHg is moderate, and oxygenation index≤100 mmHg is severe), they were divided into light group (13 cases), medium group (15 cases) and heavy group (22 cases). The correlation between severe ultrasonic score and acute physiology and chronic health status scoring system (APACHE Ⅱ), sequential organ failure score, and oxygenation index was observed. Another 50 patients with acute respiratory distress syndrome admitted to our hospital during the same period were selected (routine care group), the hospital stay, mechanical ventilation time, ICU time, fatality rate and failure of ventilator evacuation were compared under different monitoring methods. Results The final positive pressure of ventilator parameters was compared between the death group and the survival group, and the difference was statistically significant (P ＜ 0.05), the critical ultrasound score of patients in the death group was significantly higher than that in the survival group (P ＜ 0.05), severe set of APACHE Ⅱ, sequential organ failure score and severe ultrasonic score were higher than mild and moderate groups (P ＜ 0.05). The severe ultrasonic score was positively correlated with APACHE Ⅱ, sequential organ failure score positive correlation (r = 0.641, P ＜ 0.01; r = 0.523, P ＜ 0.01), while negatively correlated with oxygenation index (r = -0.715, P ＜ 0.01). Compared with the conventional monitoring group, the hospital stay was shorter, the ventilation time was shorter, the ICU time was shorter, and the fatality rate, withdrawal failure rate of ventilator vacuation and disability rate of critical ultrasound score care group were lower, the differences were statistically significant (P ＜ 0.05). Conclusion The use of severe ultrasound score in the clinical condition monitoring of patients with acute respiratory distress syndrome can effectively evaluate the severity of the patients′ condition, which has high application value.
		2020 Vol. 17 (17): 125-128,144 [Abstract] ( 198 ) HTML (1 KB) PDF (699 KB) ( 89 )

	129	Changes of plasma IL-10 and VEGF levels in patients with obstructive sleep apnea hypopnea syndrome and their clinical significance
		SHANG Jing1 HUAI De1 YING Min2 ZHANG Xilong3 CHENG Lei2 XU Min4 XIE Chenglan5
		Objective To investigate the changes and clinical significance of plasma interleukin-10 (IL-10) and vascular endothelial growth factor (VEGF) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods From March 2016 to March 2019, 219 patients with OSAHS admitted to Huai′an Hospital Affiliated to Xuzhou Medical University (hereinafter referred to as “our hospital”) were selected. All OSAHS patients were monitored by polysomnography diagnostic analysis system (PSG). According to the number of sleep apnea per hour (AHI), they were divided into light OSAHS group (AHI: 5-15 times/h, n = 69), moderate OSAHS group (AHI: 16-30 times/h, n = 73), severe OSAHS group (AHI: ＞30 times/h, n = 77). During the same period, 60 volunteers who underwent physical examination in our hospital were randomly selected as the control group. PSG monitoring indexes of each group were compared, plasma IL-10 and VEGF levels in each group were compared, the correlation of VEGF and IL-10 with general data and PSG monitoring indicators were analyzed by multiple stepwise regression. Results The proportion of AHI, oxygen saturation index (ODI) and blood oxygen saturation (SaO2) ≤90% in the light, medium and heavy OSAHS groups were higher than those in the control group, and increased in turn (P ＜ 0.05). The lowest SaO2 (LSaO2) of the OSAHS light, medium and heavy groups were lower than those of the control group and showed a downward trend in turn (P ＜ 0.05). VEGF in the light, medium and heavy OSAHS groups were higher than those in the control group, and showed an ascending trend (P ＜ 0.05), IL-10 in light, medium and heavy OSAHS groups were lower than those in the control group and showed a decreasing trend (P ＜ 0.05). The results of multiple stepstep regression analysis showed that VEGF was negatively correlated with LSaO2 (r = -0.386, P ＜ 0.05), positive correlation with Epworth sleepiness scale - score (r = 0.427, P ＜ 0.01); IL-10 was positively correlated with LSaO2 (r = 0.461, P ＜ 0.01), it was negatively correlated with age and AHI (r = -0.402, -0.452, P ＜ 0.05 or P ＜ 0.01). Conclusion Abnormal expression of plasma IL-10 and VEGF in OSAHS patients can lead to vascular dysplasia, inflammatory response activation, and accelerate the disease progression of OSAHS patients.
		2020 Vol. 17 (17): 129-132,148 [Abstract] ( 156 ) HTML (1 KB) PDF (667 KB) ( 72 )

	133	Effect of ligation of intersphincter fistula and incision and thread hanging of anal fistula in the treatment of complex anal fistula
		ZHANG Lei1 TIAN Ying1 YU Hongshun1 YIN Yi2 DONG Wanqing1 LI Shuju1 XUE Yaohan1 WU Yongfeng1
		Objective To analyze the effect of ligation of intersphincteric fistula tract (LIFT) technique and incision and thread drawing of anal fistula in treatment of complex anal fistula and its influence on anal function. Methods A total of 92 patients with complex anal fistula and who treated in Beijing Anorectal Hospital from July 2017 to November 2018 were selected, and the patients were divided into study group and control group by random number table method, with 46 cases in each group. The study group used LIFT surgery, and the control group used traditional incision and thread hanging surgery. The perioperative related indexes, surgical effect (cure rate, complication rate and recurrence rate after operation for 6 months) and the influence on anal function (anal function were determined by the pelvic floor electromyography and anorectal pressure and the degree of anal incontinence were determined by the Wexner score) were compared between the two groups. Results Perioperative indexes: the bleeding volume, wound area, visual analogue scale (VAS) 7 d after surgery and wound healing time in the study group were significantly shorter than those in the control group (P ＜ 0.05); there was no significant difference between the two groups in operating time (P ＞ 0.05). Surgical effect: the incidence of surgical complications in the study group was significantly lower than that in the control group (P ＜ 0.05). There was no significant difference in recurrence rate and cure rate between the two groups (P ＞ 0.05). Anal function: three months after operation, the time limit of action potential, anal resting pressure and maximum systolic pressure in the study group were significantly higher than those in the control group (P ＜ 0.05), and the Wexner score in the study group was significantly lower than that in the control group (P ＜ 0.05). Conclusion LIFT surgery and incision and thread hanging surgery have both advantages and disadvantages in the treatment of complex anal fistula. The former has little trauma, few complications and little influence on anal function, while the latter has a good surgical effect, but the recurrence rate is still high after the resection of complex anal fistula, which should be selected according to the specific situation in clinical practice.
		2020 Vol. 17 (17): 133-136 [Abstract] ( 138 ) HTML (1 KB) PDF (608 KB) ( 95 )

	137	Correlation analysis of cortisol, electroencephalogram characteristics and cognitive function in patients with first-episode depression
		QIU Zhengfa1 HUA Jiuzhou2 TIAN Haihua3
		Objective To observe the relationship between cortisol, electroencephalogram (EEG) and cognitive function in young patients with first-episode depression. Methods From January 2018 to June 2019, 46 patients with first-episode depression in the outpatient clinic of Ningbo Kangning Hospital (“our hospital” for short) were selected as the study subjects. According to the average cortisol level (557 nmol/L), they were divided into low cortisol group (18 cases, cortisol ≤557nmol/L) and high cortisol group (28 cases, cortisol ＞557 nmol/L). The general data, wechsler memory scale (WMS) score and EEG data of all patients were collected，and the difference at different cortisol levels were analyzed. The correlation between WMS score, abnormal EEG performance and cortisol levels were analyzed. Results There were no significant difference in general clinical data (age, sex, body fat ratio, education level) between low cortisol group and high cortisol group (P ＞ 0.05). The average score and classification of WMS in the low cortisol group were higher than those in the high cortisol group, and the differences were statistically significant (P ＜ 0.05). The incidence of abnormal EEG performance (θ wave, δ wave, frontotemporal spike wave, frontotemporal cusp wave, fast-slow combined wave, epileptiform discharge wave) in the low cortisol group was lower than that in the high cortisol group. Abnormalities in EEG were positively correlated with the cortisol level (r = 0.786, 0.627, 0.774, 0.784, 0.681, 0.735, P < 0.05). The WMS score was negatively correlated with the cortisol level (r = -0.816, P < 0.05). Conclusion There are changes in cognitive function in the first-onset young patients with depression. The main manifestations of EEG abnormalities are widespread slow wave, 14-20 HZ fast wave, and epileptiform discharge wave. Changes in cognitive function and the degree of EEG abnormalities are related to cortisol levels, which deserves clinical attention.
		2020 Vol. 17 (17): 137-140 [Abstract] ( 133 ) HTML (1 KB) PDF (605 KB) ( 106 )

	141	Relationship between plasma LP-PLA2 level and the risk stratification and the degree of atherosclerosis in hypertensive patients
		ZHANG Jun SUN Huifang LIU Xiaoli
		Objective To investigate the relationship between plasma lipoprotein related phospholipase A2 (LP-PLA2) level and the stratification and the degree of atherosclerosis (AS) in hypertensive patients. Methods A total of 100 cases of hypertension patients admitted to Minhang Branch of Shanghai Yueyang Integrated Traditional Chinese and Western Medicine Hospital (“our hospital” for short) from March 2016 to March 2019 were selected as the observation group, and another 100 cases of healthy personnel who received physical examination in our hospital during the same period were selected as the control group. The patients in the observation group were divided into low-risk group (16 cases), medium risk group (23 cases), high-risk group (21 cases) and extremely high-risk group (40 cases) according to the stratification standard of cardiovascular disease risk level. The basic data, blood lipid level, plasma LP-PLA2 and pulse wave velocity (PWV) levels were recorded. The correlation between plasma Lp-PLA2 and PWV in hypertension patients was analyzed. Results The levels of systolic blood pressure, diastolic blood pressure, low density lipoprotein and total cholesterol in the observation group were significantly higher than those in the control group, while the levels of triglyceride and high density lipoprotein were significantly lower than those in the control group ,and the difference was statistically significant (P ＜ 0.05). The levels of plasma LP-PLA2 and PWV in the observation group were significantly higher than those in the control group, and the difference was statistically significant (P ＜ 0.05). The levels of plasma LP-PLA2 and PWV of patients in the extremely high-risk group were significantly higher than the low-risk group, the medium-risk group and the high-risk group, and the difference was statistically significant (P ＜ 0.05). Pearson correlation analysis showed that plasma LP-PLA2 level was positively correlated with PWV level in hypertension patients (P ＜ 0.05). Conclusion The increase of plasma LP-PLA2 level in hypertension patients is closely related to the risk stratification and AS degree. The detection of plasma Lp-PLA2 level can guide the early treatment of patients.
		2020 Vol. 17 (17): 141-144 [Abstract] ( 170 ) HTML (1 KB) PDF (606 KB) ( 62 )

	145	Analysis of risk factors of acquired immunodeficiency syndrome complicated with tuberculosis infection
		XU Yuping1,2 TIAN Qun2 WANG Jiye3
		Objective To explore the risk factors of acquired immunodeficiency syndrome (AIDS) complicated with tuberculosis infection. Methods A total of 3224 AIDS patients admitted to Guilin Third People′s Hospital of Cuangxi Zhuang Autonomous Region from January 2015 to November 2019 were selected as the subjects. According to the presence or absence of tuberculosis infection, they were divided into infection group (255 cases) and non infection group (2969 cases). The basic data and disease-related conditions were compared between the two groups. The risk factors of AIDS complicated with tuberculosis infection were analysed by multivariate related factors. Results The proportion of patients with smoking history, low family income, unemployment and intravenous drug use in the infection group were significantly higher than those in the non infection group (P ＜ 0.05), while the proportion of patients with BCG vaccination history were significantly lower than that in the non infection group (P ＜ 0.05). There were no significant differences between the two groups in age, gender, drinking history, education level, marital status, urban and rural distribution (P ＞ 0.05). Multivariate logistic regression analysis showed that smoking history, unemployment, intravenous drug use were the independent risk factors of AIDS complicated with tuberculosis infection (P ＜ 0.05), and BCG vaccination history was the protective factor of AIDS with tuberculosis infection (P ＜ 0.05). Conclusion Low family income, unemployment, intravenous drug use, smoking history are the independent risk factors of AIDS with tuberculosis infection, while BCG vaccination is the protective factor of AIDS with tuberculosis infection.
		2020 Vol. 17 (17): 145-148 [Abstract] ( 128 ) HTML (1 KB) PDF (607 KB) ( 88 )

	149	Development strategy and thinking of traditional Chinese medicine information standardization based on SWOT analysis
		ZHANG Yiran1 LI Qiang1 ZHU Jiaqing2 WANG Song3
		Standardization is the premise and foundation of traditional Chinese medicine (TCM) informatization. In recent years, TCM information standardization construction has achieved certain results, especially with the comprehensive start-up and implementation of State Administration of Traditional Chinese Medicine 2015 Central Finance Special Fund Project-101 TCM information standard research and formulation projects, which has initially established TCM information standard system integrated with health information standards. However, due to the late start of TCM information standardization construction and the relatively weak foundation, it is still unable to meet the actual needs of the construction of TCM information. This paper uses SWOT method to analyze the advantages, disadvantages, opportunities and threats of Chinese medicine information standardization development, and put forward the development strategy and thinking of TCM information standardization from the aspects of management system, top-level design and personnel training.
		2020 Vol. 17 (17): 149-152,157 [Abstract] ( 188 ) HTML (1 KB) PDF (715 KB) ( 464 )

	153	Clinical effect of Jiawei Buzhong Yiqi Decoction in the auxiliary treatment of chronic obstructive pulmonary disease with respiratory failure
		AN Huiming MIAO Dandan LYU Beibei QI Shubin
		Objective To analyze clinical effect of Jiawei Buzhong Yiqi Decoction in the auxiliary treatment of chronic obstructive pulmonary disease with respiratory failure. Methods Ninety-two patients of chronic obstructive pulmonary disease with respiratory failure treated in Xianxian Hospital of Traditional Chinese Medicine of Cangzhou City in Hebei Province from February 2018 to February 2019 were selected as study samples. They were divided into routine group and experimental group by random number table method, with 46 cases in each group. Routine group was treated with basic Western medicine, experimental group was treated with basic Western medicine and Jiawei Buzhong Yiqi Decoction for 4 weeks. Traditional Chinese medicine syndrome score, heart rate, respiration rate, oxygen partial pressure, carbon dioxide partial pressure, vital capacity, forced expiratory volume in the first second and peak expiratory velocity, St.George′s respiratory disease questionnaire score between two groups were compared before and after treatment. The therapeutic effect of two groups was observed. Results After treatment, the scores of traditional Chinese medicine syndromes in two groups were lower than those before treatment (P < 0.05), and the scores in experimental group were lower than those in routine group (P < 0.05). After treatment, the heart rate and respiration of two groups were slower than those before treatment, the level of carbon dioxide partial pressure was lower than that before treatment, the level of oxygen partial pressure was higher than that before treatment (P < 0.05), and the improvement of experimental group was better than that of routine group (P < 0.05). After treatment, the vital capacity, forced expiratory volume in the first second and peak expiratory velocity in two groups were higher than those before treatment (P < 0.05), and experimental group was higher than that in routine group (P < 0.05). Total effective rate of experimental group was higher than that of routine group (P < 0.05). After treatment, the scores of disease performance, disease influence and activity disorder in two groups were lower than those before treatment (P < 0.05), and the scores in experimental group were lower than those in routine group (P < 0.05). Conclusion The auxiliary treatment of Jiawei Buzhong Yiqi Decoction can improve the curative effect, clinical performance, lung function and life quality of patients with chronic obstructive pulmonary disease and respiratory failure. It has certain clinical application value.
		2020 Vol. 17 (17): 153-157 [Abstract] ( 138 ) HTML (1 KB) PDF (648 KB) ( 160 )

	158	Professor Gao Jining′s experience in treating chronic kidney disease of stage 2-3
		ZHANG Minji1 GAO Jining2 WANG Yang1
		Professor Gao Jining stressed that chronic kidney disease should be treated early, and the sooner the better. After years of clinical practice, he summed up the essence of “shoufang, yuanji, huofa”, and the idea of “diagnosis of the kidney, regulation of five zang viscera at the same time”. The article summarizes observing the pathogenesis, accurate differentiation and accurate treatment; paying attention to micro-treatment, paying equal attention to both Chinese and Western medicine; the multi-channel synergy of traditional Chinese medicine, combined with clinical cases, and sum up Professor Gao Jining′s clinical experience and academic ideas in treating chronic kidney disease of stage 2-3. The author hopes to establish a foothold in Chinese medicine, broaden thinking, and provide more experience and new research ideas.
		2020 Vol. 17 (17): 158-161 [Abstract] ( 189 ) HTML (1 KB) PDF (699 KB) ( 73 )

	162	Professor Zhou Shaohu′s experience in treating teratozoospermia with Yishen Huoxue Prescription
		WENG Haowei1 FENG Jiaming1 CHEN Qi1 WENG Zhiwei2 ZHOU Shaohu2
		Teratozoospermia is one of the common causes of male infertility. The etiology and pathogenesis of teratozoospermia are still uncertain, so there is still no clear treatment guideline. Professor Zhou Shaohu has been engaged in the research of male infertility for more than 30 years and has many valuable insights in treating teratozoospermia with Chinese medicine. Based on the theory of “yang transforming qi and yin shaping up body” and combination of disease differentiation and syndrome differentiation, he considers that the basic pathogenesis of this disease is kidney deficiency and blood stasis. Combining long-term clinical observation with modern lifestyle change of people, professor Zhou usually treats this disease with the method of invigorating kidney and filling essence, promoting blood circulation and removing blood stasis. He formulated the Yishen Huoxue Prescription, which has a significant curative effect. This paper briefly describes professor Zhou′s experience in treating teratozoospermia, with a case attached at the end of the article.
		2020 Vol. 17 (17): 162-164,168 [Abstract] ( 91 ) HTML (1 KB) PDF (654 KB) ( 95 )

	165	Clinical effect of modified Shenzhe Peiqi Decoction in treatment of esophageal low-grade intraepithelial neoplasia
		YANG Sishi JIANG Chao SHAO Yingxin
		Objective To observe clinical effect of modified Shenzhe Peiqi Decoction in the treatment of esophageal low grade intraepithelial neoplasia. Methods Fifty patients with esophageal low grade intraepithelial neoplasia from January 2017 to January 2018 in the Outpatient and Inpatient of Spleen and Stomach Department of Huanggang Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine were selected and divided into control group and treatment group by using random number table method, with 25 cases in each group. Control group was given Western medicine to inhibit acid and protect stomach. Treatment group was given modified Shenzhe Peiqi Decoction orally for 8 weeks. Before treatment and 1, 2, 4 and 8 weeks after treatment, total score of traditional Chinese medicine syndrome rating scale was used to determine the curative effect of traditional Chinese medicine syndrome. At the end of the course of treatment, 4 weeks after the drug was stopped, electronic gastroscopy was performed again. The endoscopic and histopathological manifestations were statistically analyzed, and the improvement degree of pathological manifestations and total scores were calculated. All patients were followed up for 24 weeks to find out whether there was any change of the condition. Results The effects of traditional Chinese medicine syndrome, endoscopic esophageal mucosa and histopathology in treatment group were better than those in control group, the differences were statistically significant (P < 0.05). Conclusion Modified Shenzhe Peiqi Decoction has an ideal effect in the treatment of esophageal low grade intraepithelial neoplasia, it can improve the reversal rate of esophageal low grade intraepithelial neoplasia, avoid excessive treatment of various minimally invasive therapies under endoscope, and effectively control the occurrence of esophageal cancer.
		2020 Vol. 17 (17): 165-168 [Abstract] ( 202 ) HTML (1 KB) PDF (703 KB) ( 69 )

	169	Retrospective analysis of adverse reactions of nervous system caused by antibiotics
		XU Bingfa1 QIN Kan1 SUN Jing1 REN Tingting2 SUN Wanlu3 TAI Hui4 WEN Gang5
		Objective To investigate the occurrence and risk factors of nervous system adverse reaction induced by antibiotics. Methods The adverse drug reaction (ADR) reported in the Third Affiliated Hospital of Anhui Medical University from January 2003 to June 2019 were analyzed, including 103 cases of neurological adverse reactions related to antibiotics. The gender, age, time of occurrence of ADR, dosage, dosage form, mode of administration and combination of drugs were analyzed. Results The rate of over 70 years old was the highest in 103 patients (33.0%). The most common antibiotics causing adverse reactions of nervous system were fluoroquinolones (49.1%), cephalosporins (14.2%), macrolides (9.4%), triazoles (8.5%), the incidence of Clindamycin, Voriconazole and Moxifloxacin was the highest among the single cultivars. ADR of nervous system mainly occurred within one day after administration (87.7%). Conclusion The ADR of nervous system caused by antibiotics should be paid enough attention. Careful selection of antibiotics, individualized administration and intensive drug monitoring are essential to reduce the adverse reactions of nervous system.
		2020 Vol. 17 (17): 169-172 [Abstract] ( 207 ) HTML (1 KB) PDF (349 KB) ( 128 )

	173	Clinical effect of Linagliptin combined with Insulin in the treatment of type 2 diabetes mellitus with nephropathy
		LI Li1 ZHANG Chaoyun2 LU Shan1 PAN Dan1 SHI Rui1 SU Weiwei3 LI Lu4 ZHAO Kexin1
		Objective To analyze the clinical efficacy and safety of Linagliptin combined with Insulin in patients with type 2 diabetes mellitus (T2DM) and concurrent nephropathy. Methods From June 2017 to December 2018 in Hebei Petrochina Central Hospital, 96 patients with early diabetic nephropathy inpatient and outpatient were selected as the subjects. They were divided into treatment group 48 cases (Insulin + Linagliptin), control group 48 cases (insulin) by random number table method. Patients in both groups were treated with Valsartan Capsules 80 mg orally to reduce urinary protein on the basis of hypoglycemic therapy for 16 weeks. The changes of each index before and after treatment were compared between the two groups, indicators including fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 HPG), glycosylated hemoglobin (HbA1c), serum creatinine (CR), 24 h urine trace albumin urinary inhibition (M-A1b), cystatin (Cys-C), the steady-state model of insulin resistance index (HOMA-IR) and islet β cell function index (HOMA-β), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), three acyl glycerin (TG), body mass index (BMI) and insulin dosage. Results Compared with before treatment, FPG, 2hPG and HbA1c indexes of the two groups decreased after treatment (P ＜ 0.05). The LDL-C and TG indexes in the treatment group were reduced, and the difference was statistically significant (P < 0.05), while the differences in LDL-C and TG between before and after treatment of the control group was not statistically significant (P ＞ 0.05), and the difference in the treatment group was lower than that in the control group (P ＜ 0.05). BMI in the two groups, the difference was not statistically significant (P ＞ 0.05). HOMA-IR was reduced in the two groups, and the treatment group was lower than the control group (P ＜ 0.05). HOMA-β increased in the two groups, and the treatment group was higher than the control group (P ＜ 0.05). The amount of insulin in the control group increased, and the amount of insulin in the treatment group decreased, and the treatment group was lower than that in the control group (P ＜ 0.05). The increase of CR and Cys-C between the two groups before and after treatment was not statistically significant (P ＞ 0.05). The M-A1b in the two groups was decreased(P ＜ 0.05), but the difference between two groups was not statistically significant (P ＞ 0.05). Conclusion The combination of Linagliptin and Insulin in the treatment of T2DM patients can effectively reduce the blood glucose, reduce the amount of insulin and regulate the blood lipid，and help reduce the urine protein in patients with diabetic nephropathy.
		2020 Vol. 17 (17): 173-176 [Abstract] ( 178 ) HTML (1 KB) PDF (344 KB) ( 63 )

	177	Application of PBL combined with situational simulation teaching method in the first aid skill training of psychiatric nurses
		WEI Shaojun LI Qiuju
		Objective To explore the application effect of PBL combined with situational simulation teaching method in the first aid skills training of psychiatric nurses. Methods A total of 124 psychiatric nurses working in the Brain Hospital of Guangxi Zhuang Autonomous Region from May 2018 to March 2019 were studied. According to the random number table method, they were divided into the control group and the observation group, with 61 in the control group and 63 in the observation group. The control group adopted situational simulation teaching method, and the observation group adopted PBL combined situational simulation teaching method, the first-aid skill training was carried out for 10 months, The theoretical knowledge, skill operation and simulated scenario drills of the two groups were evaluted and compared, the teaching effect was evaluted. Results After the training, the scores of first aid theoretical knowledge, skill operation and simulated scenario exercise in the two groups were significantly higher than before the training (P ＜ 0.01). The score and value added of the observation group were higher than those of the control group (P ＜ 0.05). The observation group was also higher than the control group in terms of disease judgment, risk assessment, emergency response process and emergency response capacity (P ＜ 0.05). The total score of training satisfaction and learning enthusiasm, independent thinking ability, consolidation and flexible application of knowledge in the observation group were higher than those in the control group (P ＜ 0.05). Conclusion The application of the PBL method in the training of first aid skills for psychiatric nurses can obviously improve the students′ learning enthusiasm and strain ability, and it has a good effect and is worthy of promotion.
		2020 Vol. 17 (17): 177-180,184 [Abstract] ( 164 ) HTML (1 KB) PDF (509 KB) ( 47 )

	181	Application effect of traditional Chinese medicine characteristic nursing in dysmenorrhea treatment
		MA Chunhua1 LIU Haiyong1 ZHANG Jin1 CHEN Haixia2 LUO Dongming2 MI Na2
		Objective To explore the application effect of traditional Chinese medicine characteristic nursing in the treatment of dysmenorrhea. Methods From September 2018 to October 2019, 90 patients with dysmenorrhea from Sanhe Hospital in Hebei Province were selected as the research object. The patients were randomly divided into observation group and control group, with 45 patients in each group. The control group received the basic nursing intervention for dysmenorrhea, arranged a relatively comfortable and quiet treatment environment for the patients, ensured the patients to get a full rest, informed the patients of matters needing attention during dysmenorrhea treatment, and communicated with the patients more. In the observation group, on the basis of the control group, patients were given finger point massage and moxibustion with traditional Chinese medicine special nursing treatment once a day, starting from the 1st day of menstrual period and ending from the first menstrual period for a course of treatment. After observation of 3 courses of treatment, the curative effect of dysmenorrhea nursing was evaluated, including TCM symptom score, visual analogue scale (VAS), TCM curative effect standard before and after treatment, and the data of the two groups were statistically analyzed. Results Before treatment, there was no statistically significant difference in general indicators between the two groups (P ＞ 0.05). After treatment, TCM symptom scores of patients in both groups were lower than before treatment, and the observation group was lower than the control group (P ＜ 0.05). VAS scores of both groups were lower than before, and the observation group was lower than the control group (P ＜ 0.05); the total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P ＜ 0.05). Conclusion The characteristic nursing method of traditional Chinese medicine has obvious curative effect in the treatment of dysmenorrhea patients, which has its application value and significance, and the effect is better than the ordinary nursing method.
		2020 Vol. 17 (17): 181-184 [Abstract] ( 172 ) HTML (1 KB) PDF (489 KB) ( 173 )

	185	Clinical analysis of two pediatric patients with sodium taurocholate cotransporting polypeptide deficiency
		SUN Wenjun YU fei▲
		Sodium taurocholate cotransporting polypeptide (NTCP) deficiency is a newlydiscovered hereditary bile acid metabolic disorder in recent years. The aim of this research is to improve the understanding of NTCP deficiency． Two cases who presented with failure to thriveand jaundice in Department of Endocrine Genetic Metabolism in Children，Maternal and Child Hospital of Hubei Province, Tongji Medical College Huazhong University of Science and Technology were selected. Although the clinical manifestations were different, refractory hyperbile acidemia was found in all patients, and accompanied by a decrease in 25-hydroxy vitamin D. Genetic analysis revealed SLC10A1 mutation, which was clinically diagnosed as NTCP deficiency. After positive symptomatic treatment, the clinical symptoms were relieved and the prognosis was good. This study suggests that NTCP deficiency should be considered in neonates and children with significant and persistent hyperbile acidemia. Pediatric patients with NTCP deficiency may suffer from stunted growth and development in the long term and growth hormone may improve the lifetime height of patients with NTCP deficiency.
		2020 Vol. 17 (17): 185-188 [Abstract] ( 182 ) HTML (1 KB) PDF (452 KB) ( 40 )

	189	Assessment of regional allocation of medical and health resources in traditional Chinese medicine by cluster analysis and rank sum ratio method
		ZHENG Xin1 DAI Lihui1 LIU Shuo2 WANG Miyuan1 GUO He1
		Objective To analyze the equity of health resource allocation of traditional Chinese medicine medical institutions in 30 provinces (autonomous regions, municipalities directly under the central government) in 2017 by cluster analysis and rank sum ratio (RSR) method. Methods China Health Statistics Yearbook 2018 was used to obtain the relevant data, using cluster analysis in 2017 30 provinces and cities of Chinese medicine health resources was used for Q-cluster, and the RSR method was used to determine the effect of clustering results. Results The national medical and health resources of traditional Chinese medicine can be divided into three grades, and the difference of RSR value among the grades was statistically significant (P < 0.05); Sichuan, Gansu, Chongqing and Xinjiang were the first grade, with the mean and standard deviation of RSR being (0.81±0.13), and all of them belong to the northwest region; 17 provinces (cities) such as Beijing and Anhui were the second grade (better), with the mean and standard deviation of RSR being (0.53±0.19); 9 provinces (cities) such as Shanghai and Tianjin were the third grade (general), with the mean and standard deviation of RSR being (0.37±0.10). Conclusion The allocation of medical and health resources of traditional Chinese medicine varies greatly among regions in China, and has no definite relationship with regional economic development. We should increase the input of human and material resources to improve the efficiency of allocation of medical and health resources of traditional Chinese medicine, and make a reasonable regional development plan of traditional Chinese medicine according to local conditions.
		2020 Vol. 17 (17): 189-192,196 [Abstract] ( 139 ) HTML (1 KB) PDF (460 KB) ( 149 )

	193	Relationship between resistance rate of Klebsiella pneumoniae and the intensity of commonly used antibiotics
		LIU Dongling SHI Lei
		Objective To investigate the relationship between the resistance rate of Klebsiella pneumoniae and the intensity of commonly used antibiotics. Methods The strains isolated from 120 patients in Liaocheng People′s Hospital from February 2018 to February 2019 were isolated and cultured. Automatic microbial identification system and drug sensitivity test were used to isolate, culture and identify. The drug resistance rate of Klebsiella pneumoniae and the use intensity of antibiotics were calculated. Results The resistance of Klebsiella pneumoniae to Ceftriaxin, Ceftriaxone, Gentamycin, Penicillin and Ampicillin Sulbactam was high. The use intensity of third generation cephalosporins, compound preparations containing β lactamase inhibitors, quinolones and penicillins were high, and the use intensity of the first, second generation cephalosporins and aminoglycosides were lower. The drug resistance of Klebsiella pneumoniae was positively correlated with quinolones (r = 0.674, P = 0.021), penicillins (r = 0.682, P = 0.019), third-generation cephalosporins (r = 0.525, P = 0.033), compound preparations containing β lactamase inhibitors (r = 0.558, P = 0.029), and negatively correlated with fourth generation cephalosporins （r = -0.524, P = 0.036). There was no correlation with the first generation cephalosporins (r = 0.146, P = 0.101), the second generation cephalosporins (r = 0.104, P = 0.142), carbapenem (r = 0.123, P = 0.124) and aminoglycosides (r = 0.173, P = 0.092). Conclusion There is a certain correlation between Klebsiella pneumoniae and the intensity of commonly used antibiotics. Antibiotics should be selected reasonably in clinical use to prevent the abuse of antibiotics.
		2020 Vol. 17 (17): 193-196 [Abstract] ( 207 ) HTML (1 KB) PDF (445 KB) ( 130 )

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