Objective To study the effects of circumferential pulmonary vein isolation（CPVI） combined with linear ablation of left atrium roof on the success rate of ablation, cardiac function and complications in patients with atrial fibrillation. Methods A total of 103 patients with paroxysmal atrial fibrillation admitted from September 2018 to May 2021 were selected as the research subjects. According to different treatment methods, they were divided into the control group（n=49） and the observation group（n=54）. The control group was treated with CPVI, while the observation group was treated with CPVI combined with linear ablation of left atrium roof. Surgery-related parameters, ablation success rate, the maximum left atrial area（LAA）, the maximum left atrium volume（LAV）, peak velocity of mitral valve inflow（VA） based on mitral valve blood flow spectrum A peak, left atrial ejection force（LAF） and incidence of complications were compared between the two groups. Results The duration of operation and ablation time of the observation group were significantly longer than those of the control group（P＜0.05）. However, there was no significant difference in X-ray exposure time between the two groups（P＞0.05）. The ablation success rate of the observation group was significantly higher than that of the control group（P＜0.05）. After treatment, the levels of LAA and LAV in the two groups were decreased compared with those before treatment, while the levels of VA and LAF were increased. The levels of LAA and LAV in the observation group were lower than those in the control group, while the levels of VA and LAF in the observation group were higher than those in the control group（P＜0.05）. The total incidence of complications in the observation group was significantly lower than that in the control group（P＜0.05）. Conclusion CPVI combined with linear ablation of the left atrial roof in the treatment of patients with atrial fibrillation has a high ablation success rate, which can improve cardiac function and reduce the incidence of complications.
目的 讨论β2-微球蛋白(β2-MG)、成纤维细胞生长因子23(FGF 23)、血清肌酐(SCr)在慢性肾衰竭(CRF)中的水平及对预后的评估作用.方法 选取2018年6月—2020年8月收治的154例CRF作为观察组,另选取同期121名体检健康者作为对照组,比较2组β2-MG、FGF 23、SCr水平,不同分期CRF患者β2-MG、FGF 23、SCr水平,分析影响CRF患者预后不良的因素.结果 观察组β2-MG、FGF 23、SCr水平明显高于对照组(P<0.01).CKD 5期患者血清β2-MG、FGF 23、SCr水平均高于CKD 3、4期患者,CKD 4期患者血清β2-MG、FGF 23、SCr水平高于CKD 3期患者(P<0.05).经多因素Logistic回归分析可知,心血管疾病、β2-MG、FGF 23、SCr为CRF患者预后不良的独立危险因素(P<0.05,P<0.01).结论 CRF患者β2-MG、FGF 23、SCr水平升高,且随着病情发展三者水平呈上升趋势,三者检测有助于评估CRF患者预后情况.
IgA肾病( IgAN)于1968年由BERGER和HIN-GLAIS首次提出,并在随后的几十年中被认为是世界范围内最常见的原发性肾小球肾炎,主要临床表现为反复出现肉眼或显微镜下血尿,病理变化为肾小球系膜内大量IgA1沉积、系膜细胞增殖和基质扩张[1].IgAN不仅起病隐匿,且无明显临床症状,多数患者为尿检时发现血尿或血尿兼蛋白尿,确诊唯一金标准是肾活检.我国有61 . 7％ ～68 . 6％的肾活检标本最终被诊断为原发性肾小球肾炎,而IgAN占其中的45. 3％ ～54. 3％ [2] ,25％ ～50％的 IgAN患者在确诊后20年内发展为终末期肾病[3].
Objective To analyze the effect of conventional ultrasound combined with contrast-enhanced ultrasound（CEUS） in differentiating benign and malignant thyroid nodules（TNS）. Methods Retrospective analysis was performed on the clinical and ultrasonic data of 88 cases（106 nodules in total） of malignant TNS confirmed by pathology and 92 cases（112 nodules in total） of benign TNS confirmed by pathology from March 2018 to April 2022. The image characteristics of conventional ultrasound and CEUS were compared between benign and malignant TNS, and the diagnostic effect of conventional ultrasound combined with CEUS on benign and malignant TNS was analyzed. Results There were statistically significant differences between malignant and benign TNS in terms of internal components, solid part morphology, solid echo, microcalcification, blood flow signal, contrast enhancement degree, contrast uniformity, enhancement ring and boundary（P＜0.01）. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of conventional ultrasound combined with CEUS in the diagnosis of benign and malignant TNS were 93.52%, 95.45%, 94.50%, 95.28% and 93.75%, respectively, which were higher than those of conventional ultrasound（P＜0.05）. Conclusion Conventional ultrasound combined with CEUS has a certain value in differentiating benign and malignant TNS, and is of great significance in early diagnosis and treatment of TNS.
Objective To investigate the effect of Mirena combined with Mifepristone on menstrual volume, hemoglobin and sex hormones in patients with perimenopausal abnormal uterine bleeding（AUB） and mild to moderate anemia. Methods From December 2019 to December 2021, 100 patients with perimenopausal abnormal uterine bleeding combined with mild to moderate anemia were selected and divided into the combination group（n=54） and the Mirena group（n=46） according to different treatment schemes. The therapeutic effect, menstrual period, hemoglobin, sex hormone levels and adverse reactions of the two groups were compared before and after treatment. Results The total effective rate of the combination group was higher than that of the Mirena group（P＜0.05）. After treatment, the menstrual period, menstrual volume and endometrial thickness were significantly shortened or decreased in both groups（P＜0.05）. The menstruation period, menstrual volume and endometrial thickness in the combination group were shorter or less than those in the Mirena group（P＜0.05）. After treatment, the levels of hemoglobin, luteinizing hormone（LH）, estradiol（E 2 ） and follicle stimulating hormone（FSH） in the two groups were significantly improved; the levels of hemoglobin in the combination group were significantly higher than those in the Mirena group, while the levels of LH, E 2 and FSH were significantly lower than those in the Mirena group（P＜0.05）. There was no significant difference in the total incidence of adverse reactions between the two groups（P＞0.05）. Conclusion Mirena combined with mifepristone can reduce menstrual volume, improve hemoglobin and sex hormone levels in patients with perimenopausal AUB and mild to moderate anemia. It has better efficacy and safety than Mirena treatment alone.
Objective To explore the efficacy and safety of non-invasive ventilator ventilation combined with acetylcysteine solution inhalation in the treatment of elderly patients with respiratory failure complicated with hypercapnia. Methods A total of 98 elderly patients with respiratory failure complicated with hypercapnia who were admitted to the hospital from January 2020 to December 2021 were selected, and they were divided into control group（n=42） and observation group（n=56） according to different treatment regimens. The observation group was given non-invasive ventilator ventilation and inhalation of acetylcysteine solution, and the control group was given non-invasive ventilator ventilation combined with conventional treatments. The clinical efficacy, the pulmonary function indicators [forced expiratory volume in one second（FEV1）, forced expiratory volume in first second/forced vital capacity（FEV1/FVC）], blood gas indicators [oxygenation index（OI）, arterial partial pressure of oxygen（PaO 2 ）, arterial partial pressure of carbon dioxide（PaCO 2 ）] and inflammatory factors [procalcitonin（PCT）, C-reactive protein（CRP）] before and after treatment were compared in the two groups, and the total incidence rate of adverse reactions was recorded. Results The total effective rate of the observation group was 96.43%, which was higher than 83.33% of the control group（P＜0.05）. There were no significant differences in pulmonary function indicators, blood gas indicators and inflammatory factors between the two groups before treatment（P＞0.05）. After treatment, pulmonary function indicators, OI and PaCO 2 in both groups were higher than those before treatment, which were higher in the observation group than in the control group; PaCO 2 and inflammatory factors in both groups were lower than those before treatment, which were lower in the observation group than in the control group（P＜0.05）. The total incidence rate of adverse reactions was 7.14% in the observation group, which was lower than 23.81% in the control group（P＜0.05）. Conclusion Non-invasive ventilator ventilation combined with acetylcysteine solution inhalation has a significant clinical efficacy in the treatment of elderly patients with respiratory failure and hypercapnia. It can effectively improve the pulmonary function and blood gas indicators, and inhibit the occurrence of inflammatory reactions, and it is safe and reliable.
目的 探讨急性淋巴细胞白血病(ALL)患儿儿童肿瘤协作组(CCCG)-ALL 2015方案化疗后早期微小残留病(MRD)检测及与预后的关系.方法 回顾性分析2017年6月—2019年12月收治的ALL患儿102例的临床资料,均采用CCCG-ALL 2015方案化疗,记录化疗后早期MRD发生情况,并探讨其与预后的关系.结果 随访3个月,3组在第15、33天MRD阴性率比较差异无统计学意义(P>0.05),但在第90天,3组间MRD阴性率比较差异有统计学意义(P<0.05).随访3年,102例3年总生存率为90.20％,3年无事件生存率为83.33％.经多因素Logistic回归分析发现,危险度分层高危、白细胞计数>50×109/L、33 d MRD≥1％、90 d MRD≥0.1％是影响ALL患儿3年OS及EFS的独立危险因素(P<0.05).结论 ALL患儿在应用CCCG-ALL2015方案化疗后对MRD进行动态监测十分关键,33 d及90 d MRD水平是提示预后的敏感指标.
Objective To investigate the expression of pyrroline-5-carboxylate reductase 2（PYCR2） protein in colorectal cancer（CRC） and its clinical significance. Methods From January 2016 to December 2020, 180 cases of CRC tissue surgically resected and 50 cases of normal colorectal mucosal tissue were collected. The expression levels of PYCR2 protein in CRC and normal colorectal mucosal tissues were detected, and the clinical characteristics and survival rates of different PYCR2 protein expression levels were compared. Results The high expression rate of PYCR2 protein in CRC tissues was higher than that in normal colorectal mucosa tissues（P＜0.01）. There were significant differences in the expression level of PYCR2 protein in CRC patients with different tumor diameters, depth of invasion, TNM stage and presence or absence of lymph node metastasis or distant metastasis（P＜0.05,P＜0.01）. The overall survival rate and progression-free survival rate of CRC patients with high PYCR2 protein expression were lower than those with low PYCR2 protein expression（P＜0.05, P＜0.01）. Conclusion The PYCR2 protein is highly expressed in CRC tissue, which is associated with occurrence and development of CRC. CRC patients with high expression of PYCR2 protein have a significantly lower survival rate than those with low expression.
Objective To explore the clinical effect of two kinds of skin flap transplantation in the treatment of finger skin defects. Methods The clinical data of 102 patients with finger skin defects admitted from January 2017 to December 2021 were analyzed retrospectively. According to the different surgical methods, they were divided into the control group（48 cases were transplanted with the conventional dorsal digital fascial pedicle island flap） and the observation group（54 cases were transplanted with he island flap pedicled with dorsal fascia of proximal phalanx anastomosed with cutaneous branch of digital artery）. The survival of skin flaps in the two groups were observed, and the perioperative indicators（duration of operation, wound healing time, two-point discrimination） and the level of peripheral blood inflammatory factors [tumor necrosis factor-α（TNF-α）, interleukin-10（IL-10）], hand function score, total range of motion（ROM） of the finger joint, and complications were compared between the two groups. Results At 7 d after operation, 42 flaps survived in the control group（87.50%） and 53 flaps survived in the observation group（98.15%）; the survival rate of skin flap in the observation group was higher than that in the control group（P＜0.05）. The duration of operation in the observation group was longer than that in the control group, while the wound healing time and two-point discrimination were shorter than those of the control group（P＜0.05）. At 3 d after operation, the levels of TNF-α and IL-10 in peripheral blood of the two groups were higher than those before operation（P＜0.05）. At 7 d after operation, the levels of TNF-α and IL-10 in peripheral blood of the two groups were lower than those before operation and at 3 d after operation, and lower in the observation group than in the control group（P＜0.05）. At 6 months after operation, the hand function score and the total ROM of the finger joint in both groups were higher than those before operation, and higher in the observation group than in the control group（P＜0.05）. After operation, there was no significant difference in the total complication rate between the two groups（P＞0.05）, but the incidence of dark purple skin flap in the observation group was lower than that in the control group（P＜0.05）. Conclusion The island flap pedicled with dorsal fascia of proximal phalanx anastomosed with cutaneous branch of digital artery can improve the survival rate of skin flap in patients with finger skin defect, accelerate wound healing, improve finger function, and reduce postoperative inflammatory reaction and complications.
Objective To investigate the feasibility of transumbilical laparoendoscopic single-site surgery（TU-LESS） in the treatment of ovarian cysts of different diameters and types. Methods The clinical data of 98 patients with ovarian cysts who underwent TU-LESS in the hospital from March 2018 to May 2021 were retrospectively collected. Diameters and types of cysts in all patients were calculated. Relevant indicators were compared between patients with different diameters and types of ovarian cysts. Results Among the 98 patients with ovarian cysts, there were 62 patients with cysts ＜10 cm, 36 patients with cysts ≥10 cm, 52 patients with cystadenoma, 26 patients with endometriosis cysts, and 20 patients with cystic teratoma. The intraoperative blood loss, postoperative anal exhaust time, length of postoperative hospital stay, postoperative Visual Analog Scale（VAS） score and postoperative levels of serum estrogen, anti-Müllerian hormone（AMH） and follicle-stimulating hormone（FSH） showed no statistically significant difference between the groups（P＞0.05）. The duration of operation of patients with cysts ＜10 cm was shorter than that of patients with cysts ≥10 cm（P＜0.01）. The above-mentioned indicators showed no significant differences in patients with different types of ovarian cysts（P＞0.05）. Conclusion TU-LESS is feasible for patients with ovarian cysts of different diameters and types.
Objective To investigate the effect of Metformin（MET） on articular chondrocytes of rats and its mechanism. Methods The articular chondrocytes of Wistar rats were treated with interleukin-1 β（IL-1 β） and different concentrations of MET（5, 10, 15 mmol/L）, and cell proliferation and differentiation activity was detected by CCK-8 method. The mRNA expressions of type Ⅱ collagen（Col Ⅱ） and matrix metalloproteinase-13（MMP-13）, the protein expressions of chondrocytes sterol regulatory element binding protein-2（SREBP-2） and 3-hydroxy-3-methylglutaryl-coenzyme A reductase（HMGCR）, and the contents of total cholesterol（TCH） in normal chondrocytes, osteoarthritic（OA） chondrocytes and OA chondrocytes after treatment with 10 mmol/L MET were detected and compared. Results In OA chondrocyte model, MET concentration of 10 mmol/L was associated with better cell proliferation activity. Compared with normal chondrocytes, the Col Ⅱ mRNA expression of OA chondrocytes decreased significantly, while MMP-13 mRNA, TCH, SREBP-2, and HMGCR protein increased significantly（P＜0.05,P＜0.01）. Compared with OA chondrocytes, the Col Ⅱ mRNA of OA chondrocytes increased significantly after treatment with 10 mmol/L MET, while MMP-13 mRNA, TCH, SREBP-2, and HMGCR protein decreased significantly（P＜0.05,P＜0.01）. Conclusion Metformin may protect articular cartilage by inhibiting cholesterol synthesis pathways in chondrocytes, reducing cholesterol accumulation in chondrocytes, and slowing down cartilage matrix degradation.
Objective To analyze the risk factors of intraoperative and postoperative complications of laparoscopic cholecystectomy（LC） for acute cholecystitis in patients of different ages. Methods A total of 130 patients with acute cholecystitis who received emergency LC from January 2017 to January 2022 were selected and divided into group A（＜50 years, n=48）, group B（50-60 years, n=42）, and group C（60-70 years, n=23）, and group D（≥70 years, n=17） according to the age. The preoperative general data of patients of different ages were compared, and the risk factors of intraoperative and postoperative complications were analyzed. Results The proportion of patients with disease duration ＞48 h, comorbidities, Tokyo guideline standard（TG13/TG18） grade Ⅲ, and American Society of Anesthesiologists Physical Status Classification（ASA-PS） ≥grade Ⅲ increased with age, white blood cell count（WBC）, and the levels of fibrinogen（Fb）, creatinine（Cr）, and total bilirubin（TBIL） increased with age（P＜0.05）. The proportion of patients with disease duration ＞ 48 h and Fb ＞ 400 mg/dl in group B was higher than that in group A, and the risk of anesthesia surgery and disease severity in groups C and D were higher than those in group A（P＜0.05）. The postoperative drainage volume, incidence of complications and the rate of conversion to laparotomy in group B were higher than those in group A（P＜0.05）. The duration of operation, total length of hospital stay and postoperative hospital stay in groups C and D were longer than those in group A, and the postoperative drainage volume was higher than that in group A; the incidence of complications, the rate of conversion to laparotomy and laparotomy were higher than those in group A（P＜0.05）. Multivariate analysis showed that age ≥60 years, ASA-PS ≥grade Ⅲ, comorbidities, gangrenous cholecystitis, Fb＞400 mg/dl and TG13/TG18 grade Ⅲ were significantly correlated with postoperative complications（P＜0.05,P＜0.01）. Conclusion Postoperative complications in patients with acute cholecystitis increase with age. Age ≥60 years, ASA-PS ≥grade Ⅲ, comorbidities, gangrenous cholecystitis, Fb＞400 mg/dl and TG13/TG18 grade Ⅲ are risk factors for postoperative complications of acute cholecystitis after LC.
Objective To investigate the effect of nutritional guidance combined with personalized resistance exercise based on the Health Action Process Approach（HAPA） model on improving nutritional indicators and quality of life in patients with sarcopenia undergoing maintenance hemodialysis（MHD）. Methods The clinical data of 120 patients with sarcopenia undergoing MHD from June 2021 to March 2022 were selected, and they were divided into combination group（n=42, nutrition guidance combined with personalized resistance exercise based on HAPA model）, control group A（n=40, nutrition guidance） and control group B（n=38, personalized resistance exercise based on HAPA model） according to different intervention methods. The general data, the severity of sarcopenia [Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls（SARC-F）], serum nutritional indexes [hemoglobin（HGB）, prealbumin（PA）, transferrin（TRF）], limb function [Timed Up ＆ Go Test（TUGT）, 5-times-sit-to-stand test（FTSST）, grip strength test and Barthel index（BI）], quality of life [Kidney Disease Quality of Life Short Form（KDQOL-SF）] before intervention, and at 3 and 6 months after intervention were observed and compared in the three groups. Results At 6 months after intervention, the SARC-F scores of the three groups were lower than those before intervention, and lower in the combination group than in the control groups A and B（P＜0.05）. At 3 and 6 months after intervention, the serum levels of HGB, PA, TRF, limb function and KDQOL-SF score in the three groups were higher or better those before intervention（P＜0.05）. At 3 and 6 months after intervention, the serum levels of HGB, PA and TRF in the combination group were higher or better than those in the control groups A and B, and higher in the control group A than in the control group B（P＜0.05）; the TUGT and FTSST of the combination group were lower than those of the control groups A and B, and lower in the control group B than in the control group A（P＜0.05）; the grip strength and BI of the combination group were higher than those of the control groups A and B, and lower in the control group A than the control group B; the KDQOL-SF score of the combination group was higher than that of the control groups A and B（P＜0.05）. Conclusion Nutritional guidance combined with personalized resistance exercise based on HAPA model can effectively alleviate the condition of sarcopenia and improve the quality of life, which may be related to improvement of the nutritional status of patients and restoration of limb function.
目的 探讨心肌声学造影(MCE)评估心肌灌注状态在急性心肌梗死(AMI)患者诊断及经皮冠状动脉介入(PCI)术后疗效评估中的应用价值.方法 选取2020年1月—2021年1月收治的拟行PCI术的AMI102例作为研究组,另选取同期冠状动脉造影正常者60例作为对照组.比较2组MCE参数[平台期峰值强度(A)、曲线斜率(β)、心肌血流量(A·β)、灌注计分指数(PSI)],以及研究组PCI术前、术后1个月、术后3个月MCE参数和心功能指标[左室短轴缩短率(LVFS)、左室射血分数(LVEF)];采用受试者工作特征(ROC)曲线分析MCE参数对AMI的诊断价值;采用Pearson相关性分析探讨AMI患者MCE参数与心功能指标的相关性.结果 研究组A、β 和A·β 均低于对照组,PSI高于对照组(P<0.01).ROC曲线分析结果显示,A、β、A·β及PSI联合诊断AMI的曲线下面积高于单独诊断(P<0.05).PCI术后1个月和3个月,研究组A、β、A·β及LVFS、LVEF均高于PCI术前,PSI低于PCI术前(P<0.05).Pearson相关性分析结果显示,AMI患者A、β和A·β均与LVFS、LVEF呈正相关,PSI与LVFS、LVEF呈负相关(P<0.01).结论 MCE参数能评估AMI患者心肌灌注状态,与AMI患者心功能指标存在相关性,可用于AMI诊断及PCI术后疗效评估.
Objective To investigate the distribution and drug resistance of pathogens detected from blood culture in our hospital, so as to provide a basis for rational use of antibiotics in clinical practice. Methods Retrospective analysis was conducted on the main pathogens, distribution in different departments and drug resistance characteristics of blood culture detected from blood culture in our hospital from January 2016 to December 2020. The MA120 automatic microbial identification/drug sensitivity analysis system was used to identify and test the drug sensitivity of the isolated strains, and the Whonet 5.6 and SPSS 20.0 software were used for statistical analysis. Results In total, 932 strains of non-repetitive pathogens were isolated in 5 years, of which 56.87% were gram-negative bacteria, 39.70% were gram-positive bacteria, and 3.43% were fungi. The top five pathogens were Escherichia coli, coagulase negative staphylococcus, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. The top 5 departments with pathogenic bacteria were Neonatal Ward, Pediatric Ward, Intensive Care Unit, Hematology Department and Digestive Department. The detection rate of extended spectrum β-Lactamase-producing Escherichia coli and extended spectrum β-Lactamase-producing Klebsiella pneumoniae were 43.55% and 16.98%, respectively. The detection rates of carbapenem resistant Klebsiella pneumoniae, carbapenem resistant Pseudomonas aeruginosa and carbapenem resistant Escherichia coli were 30.19%, 12.50% and 2.15%, respectively. The detection rates of Methicillin resistant coagulase-negative Staphylococci（MRCNS）, methicillin-resistant Staphylococcus aureus and high-level Aminoglycoside-resistant enterococci were 58.56%, 51.22% and 52.27%, respectively. The total detection rate of MRCNS increased year by year in the past 5 years（P＜0.01）. No Staphylococci resistant to vancomycin, teicoplanin, daptomycin, linezolid and enterococcus faecium resistant to vancomycin, daptomycin and linezolid were detected. Conclusion The pathogens detected from blood culture in our hospital are mainly gram-negative bacteria, among which Escherichia coli and Klebsiella pneumoniae are the most common pathogens. It is of great significance to strengthen the monitoring of blood culture pathogens for the rational use of antibiotics and the prevention and control of drug resistance.
Objective To explore the value of multi-slice spiral CT（MSCT） combined with MRI in the diagnosis of bone contusion and occult fracture in the elderly. Methods A total of 120 elderly patients with suspected bone contusion and occult fracture treated from June 2021 to June 2022 were selected and underwent MSCT and MRI examination. With the results of surgery or arthroscopy as the "gold standard", the value of MSCT and MRI alone and in combination in the diagnosis of bone contusion and occult fracture in the elderly was statistically analyzed. Results The results of surgical or arthroscopic examination showed that 95 cases had bone contusion and occult fractures, and 25 cases had no bone contusions and occult fractures. The sensitivity, specificity and accuracy of MSCT combined with MRI in the diagnosis of bone contusion and occult fracture in the elderly were all 100.00%, and the sensitivity and accuracy of MSCT combined with MRI in the diagnosis were higher than that of MSCT alone（P＜0.01）. Two experienced radiologists used MSCT combined with MRI to diagnose bone contusion and occult fracture in the elderly, and the intragroup correlation value was 0.946（95% CI: 0.857, 0.976）, showing high consistency. The accuracy of MSCT combined with MRI in the diagnosis of bone contusion and occult fracture of different types in the elderly was 100.00%, which was higher than that of MSCT alone（P＜0.01）. Conclusion MSCT combined with MRI has high accuracy and repeatability in the diagnosis of bone contusion and occult fracture in the elderly, and has high clinical application value.
Objective To investigate the effect of combined Kaiqiao Tongluo acupuncture therapy on nerve injury factors and consciousness of patients with craniocerebral injury after large bone flap decompression. Methods In total, 100 patients with craniocerebral injury admitted from April 2019 to March 2022 were selected and divided into the combination group and the control group according to different treatment methods. Both groups were treated with large bone flap decompression and other conventional comprehensive treatment. On this basis, the combination group was supplemented with Kaiqiao Tongluo acupuncture. The consciousness status of the two groups [time of regaining consciousness, and Glasgow Coma Scale（GCS） scores before and after treatment, at 3, 5 and 12 d after treatment], the levels of nerve injury factors [neuron specific enolase（NSE）, S-100 B] before and at 3, 5, and 12 d after treatment, oxidative stress indexes [serum malondialdehyde（MDA）, superoxide dismutase（SOD）, glutathione peroxidase（GSH-Px）, advanced oxidation protein products（AOPPs）] levels, intracranial pressure and cerebral perfusion pressure were compared between the two groups. Results The time of regaining consciousness in the combination group was earlier than that of the control group, and the GCS score of the combination group was higher than that of the control group at 3, 5 and 12 d after treatment（P＜0.01）. The levels of NSE, S-100 B, MDA, AOPPs and intracranial pressure in both groups were lower than those before treatment at 3, 5 and 12 d after treatment（P＜0.05）, which showed a decreasing trend with time（P＜0.01）. The levels of NSE, S-100 B, MDA, AOPPs and intracranial pressure in the combination group were lower than those in the control group at 3, 5 and 12 d after treatment（P＜0.05）. The levels of SOD, GSH-Px and cerebral perfusion pressure in both groups were higher than those before treatment at 3, 5 and 12 d after treatment（P＜0.05）, showing an increasing trend with time（P＜0.01）. The levels of SOD, GSH-Px and cerebral perfusion pressure in the combination group were higher than those in the control group at 3, 5 and 12 d after treatment（P＜0.05）. Conclusion The combined treatment with Kaiqiao Tongluo acupuncture can improve the condition of nerve injury and oxidative stress, reduce intracranial pressure, increase cerebral perfusion pressure, promote the recovery of patients and improve the consciousness of patients with brain injury after large bone flap decompression.
Objective To analyze the application value of Adler grading, C-TIRADS grading and blood flow morphology grading in the diagnosis of benign and malignant thyroid nodules. Methods The clinical data of 165 patients with thyroid nodules（179 nodules） treated in the hospital between March 2019 and March 2022 were collected. There were 61 malignant nodules and 118 benign nodules confirmed by needle biopsy or surgical pathological examination. The differences in ultrasound image features, Chinese Thyroid Imaging Reporting and Data System（C-TIRADS） grading, blood flow Adler grading and blood flow morphology grading were compared between malignant nodules and benign nodules, and the diagnostic value of the above three grading modes and their combination was evaluated. Results The features of blurred boundary, aspect ratio≥1, microcalcification and hypoecho of malignant nodules were significantly more than those of benign nodules, while the feature of cystic changes was less than that of benign nodules（P＜0.05）. Malignant nodules had higher C-TIRADS grading, blood flow Adler grading and blood flow morphology grading than benign nodules（P＜0.01）. Taking C-TIRADS grade 4 C to 5, blood flow Adler grade 2 to 3 and blood flow morphology grade Ⅲ to Ⅳ as the diagnostic criteria for malignant thyroid nodules, Kappa consistency test showed that the diagnostic value of one indicator was not high, but the diagnostic value of combined detection of the three indicators was high, with the Kappa coefficient of 0.492. Conclusion Color Doppler flow Adler grading combined with blood flow morphology grading and C-TIRADS grading has high application value in identifying benign and malignant thyroid nodules.
Objective To investigate the effect of Paeoniflorin（PF） on oxidative stress and inflammation of vascular endothelial cells in Kawasaki disease（KD） induced by tumor necrosis factor-α（TNF-α） and its mechanism. Methods Human coronary endothelial cells（HCAECs） were cultured in vitro, and the cells were randomly divided into Control group, PF group, KD group, and PF+KD group. Control group was not given any treatment, PF group and PF+KD group were given 25 μg/ml PF pretreatment for 24 h, and KD group and PF+KD group were given 50 ng/ml TNF-α treatment for 6 h. The proliferation activity of cells in each group was detected by CCK-8 method, and the level of reactive oxygen species（ROS） was detected by DCFH-DA method. The activity of superoxide dismutase（SOD） was detected by WST-1 method, and the total antioxidant capacity（T-AOC） was detected by ABTS. qRT-PCR method was used to detect interleukin-6（IL-6）, interleukin-8（IL-8）, interleukin-1β（IL-1β）, intercellular adhesion factor-1（ICAM-1）, vascular cell adhesion factor-1（VCAM-1）, and E-selectin mRNA expression levels. Western Blot was used to detect the protein expressions of IL-1β, IL-6, nuclear factor erythroid 2-related factor 2（Nrf2）, heme oxidase-1（HO-1）, phosphorylated nuclear factor-κB（p-NF-κB）, Keap1 and zonule occlusive protein-1（ZO-1）. Results Compared with the Control group, there was no significant difference in each index in the PF group（P＞0.05）. The proliferation activity, SOD activity, T-AOC and Nrf2, HO-1, ZO-1 protein expression levels in the KD group were significantly decreased, while ROS fluorescence intensity, IL-1β, IL-6, IL-8, ICAM-1, VCAM-1, E-selectin mRNA and IL-1β, IL-6, Keap1, p-NF-κB protein expression were increased significantly（P＜0.05）. Compared with KD group, SOD activity, T-AOC and protein expression of Nrf2, HO-1 and ZO-1 in PF+KD group were significantly increased, while ROS fluorescence intensity, IL-1β, IL-6, IL-8 and ICAM-1, VCAM-1, E-selectin mRNA and IL-1β, IL-6, Keap1, p-NF-κB protein expressions were significantly decreased（P＜0.05）. Conclusion PF can reduce the injury of vascular endothelial cells in KD by inhibiting oxidative stress and inflammation.
脊髓损伤( SCI)是一种严重的、高度致残的、致命的一种疾病,多由意外事故引起[1].在SCI中,初始机械作用引起的原发性损伤存在不可逆的神经细胞死亡,继而在炎症、局部缺血、脂质过氧化和细胞凋亡等多种因素作用下导致继发性损伤,最终造成轴突束断裂,引起运动或感觉功能障碍[2-3].
