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25 March 2021, Volume 42 Issue 3

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MRI study of infarct volume and location in patients with acute cerebral infarction and crossed cerebellar diaschisis

MA Jian-hong, YAN Cheng-xin, ZHANG Yan-bo, ZHU Jian-zhong

2021, 42(3): 161-165. DOI: 10.3969/j.issn.1004-7115.2021.03.001

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Objective: To study the relationship between the occurrence of crossed cerebellar diaschisis (CCD) with acute cerebral infarction and the supratentorial infarction volume and position, and to explore the influence factors the occurrence of crossed cerebellar diaschisis after acute cerebral infarction. Methods: The imaging data of 100 patients with unilateral supratentorial acute cerebral infarction were collected. Cerebral blood flow (CBF) of bilateral cerebellar hemisphere was measured by arterial spin labeling (ASL) imaging technology. According to the asymmetry index of cerebral blood flow, the patients were divided into the CCD positive group and the CCD negative group. The relationship between the supratentorial infarction volume and position and CCD was analyzed. Results: Mann-Whitney Utest was used to compare the difference between the CCD-positive group and the CCD-negative group. It was found that the median volume of supratentorial infarction was 3.60 cm ³in the CCD-positive group and 1.90 cm ³in the CCD-negative group. There was no significant difference in the volume of supratentorial infarction between the two groups ( P=0.052). There was no significant difference in the occurrence of CCD in different position ( P=0.762). Conclusion: Acute cerebral infarction can lead to the occurrence of CCD. The incidence of CCD in the middle cerebral artery is the highest, followed by the watershed area, and there is no significant difference in the size of supratentorial infarction.

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Analysis of the relationship between sleep and control behaviors of sleep and blood pressure of hypertensive patients in some rural areas of Anhui

XIAO Zhi-min, LIU Rong, SHEN Xing-rong, JIANG Jian-jian, CHEN An-an, ZHU Ting, WANG De-bin

2021, 42(3): 166-171. DOI: 10.3969/j.issn.1004-7115.2021.03.002

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Objective: To study the sleep status of patients with hypertension and its influencing factors and the relationship between sleep and blood pressure control behavior and their influence on blood pressure. Methods: 275 patients with hypertension were interviewed face to face, and their sleep quality was evaluated by Pittsburgh Sleep Quality Index Scale. Results: The total PSQI of the subjects was (8.87±4.13).Gender, education level, age, regulating emotion and increasing exercise were the main influencing factors of patients' sleep.Patients with high score of hypnotics tended to improve sleep, patients with high score of sleep time tended to control diet, and subjective sleep quality affected patients' control of alcohol consumption and smoking. Conclusion: Sleep quality is different with different demographic characteristics and blood pressure control behaviors, and sleep quality may affect patients' blood pressure control behaviors.

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The value of heart rate variability and heart rate deceleration in predicting obstructive sleep apnea hypopnea syndrome

LIU Hong-man, XIANG Bing, GAO Lan, MENG Xiao-wu, DU Zhen-lan

2021, 42(3): 172-175. DOI: 10.3969/j.issn.1004-7115.2021.03.003

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Objective: To discuss the correlation between heart rate variability(HRV) and deceleration (DC) in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: The subjects of 101 patients with daytime somnolence or night sleep snoring in our hospital were included and were categorized into three groups according to apnea-hypopnea index (AHI): AHI＜5 as control group, 5≤AHI≤30 as mild-to-moderate OSAHS group, AHI＞30 as severe OSAHS group.Polysomnography (PSG) test and 24-hour dynamic electrocardiagraphic (DCG) monitoring in all patients were done and PSG parameters, HRV index and DC were recorded and analyzed. Results: Statistically significant differences were found in HRV index, such as SDNN, LF, LF and LF/HF and PSG parameters, such as AHI, ODI, T90 and SaO ₂min in between groups. SDANN, rMSSD and PNN50 results revealed significant difference between control group, mild-to-moderate OSAHS group and severe OSAHS group.In the OSAHS group, SDNN and LF/HF were positively linked to AHI, ODI and T90 while DC and AHI were negatively related. Conclusion: HRV index especially LF/HF and DC are important for assessing the prognosis and detecting OSAHS.

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Preoperative MRI features of elderly patients with lumbar intervertebral disc herniation and their correlation with the efficacy of PELD

Gu Qian-jiang

2021, 42(3): 176-180. DOI: 10.3969/j.issn.1004-7115.2021.03.004

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Objective: To observe the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation (LDH) in the elderly, and to analyze the correlation between preoperative MRI features and surgical outcomes. Methods: Forty-one elderly LDH patients were treated with PELD from March 2017 to May 2018. The thickness of ligamentum flavum, ratio of disc herniation, size of lateral recess, anterior and posterior diameters of intervertebral foramen, upper and lower diameters of intervertebral foramen and height of intervertebral space were measured before and after operation. The VAS score of pain and ODI index of dysfunction were evaluated after 1 year follow-up. Improvement. Spearman correlation analysis was used to investigate the correlation between the above-mentioned MRI features and surgical outcomes. Results: The average VAS score and ODI index of all patients one year after operation were significantly lower than those before operation ( P< 0.05); Spearman correlation analysis showed that there was no significant correlation between the thickness of ligamentum flavum and the ratio of lumbar disc herniation and the VAS score and ODI index one year after PELD operation (|r|<0.3, P>0.05). Size of lateral recess, anterior and posterior diameter of intervertebral foramen, upper and lower diameter and height of intervertebral space were negatively correlated with VAS score and ODI index (all |r|>0.3, P<0.05). Conclusion: PELD can achieve good results in the treatment of elderly LDH patients. The bigger the lateral recess was, anterior and posterior diameter of intervertebral foramen, upper and lower diameter of intervertebral foramen and height of intervertebral space before operation are, the better the effect of PELD is .

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Replantation of amputated limbs in 21 cases

GUAN Shu

2021, 42(3): 181-184. DOI: 10.3969/j.issn.1004-7115.2021.03.005

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Objective: To analyze the key points and summarize the key techniques of successful replantation of severed limbs. Methods: From January 2010 to August 2020, 21 patients with limb disfigurement were treated, including 1 case of forearm disfigurement, 2 cases of severed palm, 1 case of severed palm combined with amputated finger and 17 cases of amputated fingers. Scientific design of surgery and division of labor were carried out to improve the efficiency of surgery and the implementation of surgery. Results: Iischemic necrosis occurred in one case of small finger injury, and all the rest were replanted successfully, which significantly shortened the operation time, reduced the operation risk, increased the success rate of replantation and reduced the complications of the patients. Conclusion: The reasonable and scientific design of the operation plan combined with superb microsurgical technique can improve the efficiency of replantation of damaged and severed limbs.

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Clinical significance of the combined EGFR/TGF-α/P-AKT/PTEN detection to non-small cell lung cancer and their correlations

YUAN Li, LI Su-xia, WANG Wei-hua

2021, 42(3): 185-189. DOI: 10.3969/j.issn.1004-7115.2021.03.006

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Objective: To probe into the expression of EGFR, TGF-α, P-AKT proteins and PTEN gene in non-small cell lung carcinoma (NSCLC) and their correlations with clinico-pathological characteristics. Methods: Immunohistochemical methods were adopted to detect the expression of EGFR, TGF-α and P-AKT proteins in NSCLC and in situ hybrid technology was used to detect the expression of PTEN gene in NSCLC and normal lung tissues. Analysis was made of correlations between various factors and their relations with clinico-pathological characteristics. Results: In NSCLC and normal lung tissues, the positive rates of EGFR were 68.5%(50/73)and 30.0%(3/10)respectively; the positive rates of P-AKT were 76.7%(56/73)and 30.0%(3/10); the positive rates of TGF-α were 72.6%(53/73)and 20.0%(2/10); the positive rates of PTEN were 30.1%(22/73)and 80.0%(8/10). There was statistically significant difference ( P＜0.05). The expressions of EGFR, TGF-α, P-AKT proteins and PTEN gene were respectively related to lymphatic metastasis, distant metastasis and differentiation degree. There was statistically significant difference ( P＜0.05). EGFR, TGF-α and P-AKT were positively correlated; however, they were negatively correlated with PTEN gene. The difference was statistically significant( P＜0.05). Conclusion: The overexpression of EGFR, TGF-α and P-AKT and the PTEN gene deletion play a significant role in the growth, proliferation and metastasis of NSCLC. The research findings can serve as a research orientation for NSCLC detection and prognostic indictor as well as for targeted therapeutic drugs.

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Relationship between serum 25-(OH)D and bone mineral density in type 2 diabetic nephropathy

XU Juan, GAO Yun, LIU Wen

2021, 42(3): 190-192. DOI: 10.3969/j.issn.1004-7115.2021.03.007

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Objective: To analyze serum 25-(OH)D and to explore the relationship between 25-(OH)D and bone mineral density(BMD) in type 2 diabetic nephropathy. Methods: Sixty type 2 diabetic patients with nephropathy (24 h urinary protein＞30 mg,GFR≥45)were selected. According to BMD values,subjects were divided into normal bone mass group and abnormal bone mass group(including low bone mass and osteoporosis). Serum 25-(OH)D were detected to analyze its relationship with BMD. Results: 25-(OH)D levels were decreased significantly in abnormal bone mass group, and positively correlated with BMD values (P＜0.05). Conclusion: Decrease of BMD and osteoporosis in type 2 diabetic nephropathy is associated with the decrease of 25-(OH)D.

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Determination of paeonol in Mudanpi and different paeonol ointments by HPLC

ZHANG Zuo-hua, PAN De-li, LI Ke

2021, 42(3): 193-196. DOI: 10.3969/j.issn.1004-7115.2021.03.008

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Objective: To establish a HPLC method for the determination of paeonol in cortex moutan and paeonol ointment of different markets. Methods: HPLC method was adopted,the HPLC column was hypersil C ₁₈(250 mm× 4.6 mm, 5 μ m), the mobile phase was methanol water (64︰36), the flow rate was 1.0 mL·min ^-1, the injection volume was 20 μL, the column temperature was room temperature (22-25℃), and the detection wavelength was 277 nm. Results: The linear relationship between the concentration of Paeonol and the peak area was good in the range of 5～150 μg·mL ^-1 (r= 0.999 6); the recovery of paeonol was 95.37%, 96.22% and 101.07% respectively, and the RSD of low, medium and high concentrations were 0.84%, 0.76% and 0.75%. Conclusion: The method is simple, accurate, accurate and reproducible. It can be used for the determination of paeonol in cortex moutan and different paeonol ointment.

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Meta-analysis of intensive pain nursing for trauma patients in emergency department of orthopedics

XIAO Yun-jiu, XIAO Hong-ling, ZHANG Yi-ting, WANG Qian, CHEN Mei-ling

2021, 42(3): 197-202. DOI: 10.3969/j.issn.1004-7115.2021.03.009

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Objective: To explore the impact of intensive pain care on emergency orthopedic trauma patients through Meta-analysis, and to provide evidence-based evidence for the pain care of emergency orthopedic trauma patients. Methods: The computer search was made of Chinese and English databases such as CBM, CNKI, VIP Database and Wanfang Database, PubMed, Web of Science, Embased, Cochrane Library, and manual retrieval and citation retrieval was carried out to assist in finding relevant literature on the pain effect and sleep quality of intensive pain care for emergency trauma patients. Two researchers conducted a quality evaluation and data extraction on the research that met the inclusion criteria, and Revman 5.3 software was used for statistics Analysis; the retrieval time was from the establishment of the database to June 2020. Results: A total of 15 randomized controlled trials were included, with a total of 1386 patients. Meta-analysis results showed that after the implementation of intensive pain care intervention, the pain score (VAS) of the experimental group was higher than that of the control group, the sleep quality score (PSQI) score of the experimental group was higher than that of the control group, the pain control satisfaction and pain education satisfaction scores of the experimental group were higher than those of the control group, the nursing satisfaction of the experimental group was higher than the control group, and the difference was statistically significant ( P<0.05). Conclusion: The enhanced pain nursing model can effectively relieve the pain of emergency trauma orthopedic patients, improve the patient's sleep quality, clinical nursing satisfaction and nursing quality.

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The effect of fiberoptic bronchoscope suction and lavage treatment on patients with severe pneumonia and the effect of inflammation markers

ZHANG Xiao, GAO Yun, LI Xue-hua, TIAN Hong

2021, 42(3): 203-206. DOI: 10.3969/j.issn.1004-7115.2021.03.010

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Objective: To study the clinical effect of auxiliary treatment by means of sputum suction with fiberoptic bronchoscope in patients with severe pneumonia. Methods: Forty-two patients with severe pneumonia in our hospital were randomly divided into control group and treatment group, with an average of 21 cases in each group. The control group received conventional anti infection and symptomatic treatment; the treatment group received auxiliary treatment by fiberoptic bronchoscope sputum suction on the basis of conventional anti infection and symptomatic treatment, and was given once a day or every other day according to the needs of the state of the illness,lasting for 1 week.And the levels of inflammatory markers (procalcitonin PCT, C-reactive protein CRP), the total effective rate of disease control and the total length of hospital stay were compared between the two groups before and after treatment. Results: The improvement of inflammatory markers in the treatment group was greater than that in the control group after the treatment. The total effective rate of disease control was 90.5%, which was higher than 71.4%,the rate of the control group; the total hospitalization time was (9.16± 1.02) d, which was lower than (13.62± 2.45) d in the control group, and the difference between the two groups was statistically significant( P＜0.001). Conclusion: In patients with severe pneumonia, auxiliary treatment by means of sputum aspiration with fiberoptic bronchoscope can significantly improve the level of inflammatory markers, shorten the total length of hospital treatment, and improve the total effective rate of disease treatment.

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Correlation between serum CA125, HE4 levels and lymph node metastasis in patients with endometrial carcinoma

ZHAI Su-ping, SUN Hui, MA Xin-wei

2021, 42(3): 207-209. DOI: 10.3969/j.issn.1004-7115.2021.03.011

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Objective: To investigate the correlation between serum carbohydrate antigen 125 (CA125), human epididymal protein 4 (HE4) levels and lymph node metastasis in patients with endometrial carcinoma. Methods: Sixty-eight patients with endometrial carcinoma in our hospital from February 2018 to July 2020 were retrospectively analyzed, all patients underwent MRI examination, the condition of lymph node metastasis was measured, their serum CA125 and HE4 levels were detected, and the correlation between serum CA125, HE4 levels and lymph node metastasis in patients with endometrial carcinoma was analyzed. Results: The result of MRI examination showed that, among 68 cases of patients with endometrial carcinoma, lymph node metastasis occurred in 9 cases, accounting for 13.24%; lymph node metastasis didn't occur in 59 cases, accounting for 86.76%; lymph node metastasis in patients with endometrial carcinoma was not associated with age, body mass index, endometrial thickness and menopause, and the difference was not significant statistically ( P>0.05); the levels of CA125 and HE4 were correlated with lymph node metastasis in patients with endometrial carcinoma, and the difference was significant statistically (P<0.05); the results of Logistic regression analysis showed that increasing serum CA125 and HE4 levels were risk factors for lymph node metastasis in patients with endometrial carcinoma (OR>1, P<0.05); the ROC curve was drawn, and the results showed that serum CA125 and HE4 levels predicted the AUC of lymph node metastasis in patients with endometrial carcinoma were 0.825 and 0.835 respectively, which had certain predictive value. Conclusion: Serum CA125 and HE4 levels are closely related to lymph node metastasis in patients with endometrial carcinoma, the increase of their levels is an important factor in the occurrence of lymph node metastasis in patients with this disease, serum CA125 and HE4 levels can be monitored clinically to provide a reliable basis for the prevention and treatment of lymph node metastasis in patients with this disease.