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Quick Search     Advanced Search   2024 Vol.  21 No.  4 Published: 2024-08-25 Basic Medicine Clinical Medicine Nursing Science Pharmacy Basic Medicine 1 DENG Tingyun, LOU Lei, WANG Lianghou, ZHANG Jiansong, LI Xiang Decitabine inhibits migration and invasion of hepatocellular carcinoma cells by upregulating SOCS1 expression Objective This study was designed to investigate the effect of Decitabine (DAC) on hepatocellular carcinoma cell migration and invasion and to explore its molecular mechanisms. Methods MTT assay was used to detect the effect of different concentrations of DAC on the viability of hepatocellular carcinoma MHCC97H cells. The influence of different concentrations of DAC on the migratory and invasive abilities of hepatocellular carcinoma MHCC97H cells were determined by cell wound healing and transwell invasion assays. The impact of DAC on the protein expression of suppressor of cytokine signaling 1(SOCS1) in hepatocellular carcinoma MHCC97H and SK-Hep-1 cells was assessed by Western blot (WB). The siRNA transfection assay was performed to knock down the expression of SOCS1 in hepatocellular carcinoma MHCC97H cells, and changes in the migratory and invasive ability of cells were observed. Results DAC inhibited the viability of hepatocellular carcinoma MHCC97H cells in a concentration-dependent manner (IC50=5.0 μM) and had the inhibitory effect on cell migration and invasion. Knocking down the expression of SOCS1 enhanced the migration and invasion of hepatocellular carcinoma MHCC97H cells. DAC upregulated the expression of SOCS1 in hepatocellular carcinoma cells (MHCC97H and SK-Hep-1) in a concentration-dependent manner, and DAC reversed the promotion of migration and invasion of hepatocellular carcinoma MHCC97H cells by low expression of SOCS1. Conclusion DAC inhibits migration and invasion of hepatocellular carcinoma cells by upregulating SOCS1 expression. 2024 Vol. 21 (4): 1-6 [Abstract] ( 47 ) [HTML 1KB] [PDF 3632KB] ( 210 ) 7 FENG Chunhui, TIAN Yang, SUN Wenyang, HOU Yana, LIU Jingfang Study on the mechanism of dapagliflozin in improving vascular endothelial senescence by regulating TMEM16A mice with type 2 diabetes Objective To explore the possible mechanism of DAP in the treatment of diabetic vascular complications from the perspective of vascular endothelial senescence. Methods The experimental mice were randomly divided into three groups: blank group, model group and DAP group. To construct diabetic mouse model by intraperitoneal injection of STZ, and each group was administered in a different way. Observe the general state of mice and detect their physiological parameters; The histopathology of the common carotid artery in each group was evaluated by HE staining and Masson staining. The contents of nitric oxide (NO), reactive oxygen species (ROS) and inflammatory factors in the serum of mice were detected by ELISA. Expression levels of the common carotid artery osteopontin, phosphorylation/signal transducer and activator of transcription 3, smooth muscle 22α, transmembrane protein 16A, p53 and p21 protein were detected by Western-blot. Results In DAP group, the mental state, activity, diet and excretion of mice were effectively improved, and the blood glucose value was significantly reduced. The expression of collagen fibers and the thickness of the arterial membrane were decreased significantly. In addition, the DAP group reversed the decrease of NO and inhibited the production of ROS, and the protein contents of p21, p53, OPN, TMEM16A and p-SATA3 in the common carotid artery tissues of mice were significantly reduced, the protein content of SM22α was significantly reversed. Conclusion DAP can effectively improve endothelial cell senescence in diabetic mice, alleviate common carotid artery vascular fibrosis in diabetic mice, and play a protective role in vascular senescence. The mechanism may be related to its inhibition of TMEM16A expression, ROS production and IL-6/IL-6R/STAT3 signaling pathway. 2024 Vol. 21 (4): 7-11 [Abstract] ( 46 ) [HTML 1KB] [PDF 2508KB] ( 159 ) 12 MU Yilan, HAN Li, JIANG Pengcheng, WEI Siwen, LUO Huaiqing Effect of Dilong composite agentia on major depressive disorder in mice Objective To explore the effects of Dilong Composite Agentia (DCA) on mice with major depressive disorder (MDD). Methods The classical method-chronic unpredictable mild stress (CUMS) was used to construct MDD model. In the experiment, mice were evenly divided into control group, MDD group, MDD+ Paroxetine group and MDD + DCA group. We used the following techniques to indicate the results: sugar water preference experiments, tail suspension experiments, and forced swimming experiments for behavioral testing; HE staining to examine the pathological alterations in the hippocampal CA1 neurons of the mice; Immunohistochemical staining techniques to examine the expression of NF-κB in hippocampus. Using WB to detect the BDNF expression in hippocampal tissue and Elisa to detect the expression of TNF - α, IL-1β, and IL-6 in mouse brain tissue. Results The body weight of mice in the MDD+DCA group was apparently higher than that in the MDD group. The glucose preference rate of mice in the MDD+DCA group was significantly higher than that in the MDD group. The results of forced swimming and tail suspension experiments all showed that the stationary time of mice in the MDD+DCA group was significantly shorter than that in the MDD group. HE staining and immunohistochemical staining demonstrated that DCA significantly mitigated the pathological alterations in CA1 neurons of MDD mice induced by chronic unpredictable mild stress, along with a decrease in the expression of NF-κB. The expression of brain-derived neurotrophic factor (BDNF) protein of MDD+DCA group mice were obviously higher than that in the MDD group. The levels of TNF - α, IL-1 β, and IL-6 in the brain tissue of mice in the MDD+DCA group were apparently lower than in the MDD group. Conclusion Therefore, we conclude that DCA promotes neural repair and significantly improves depression behaviors through such mechanisms, which we propose with experimental evidence, that DCA increases BDNF expression in the hippocampal tissue and further reduces inflammation in the brain tissue of mice with depression. 2024 Vol. 21 (4): 12-17 [Abstract] ( 36 ) [HTML 1KB] [PDF 3775KB] ( 194 ) 18 TANG Ying, LI Pengfei, YU Jinjin Glycyrrhetinic acid improves inflammation and corneal injury induced by Pseudomonas aeruginosa by inhibiting GSDMD mediated atypical cell pyroptosis Objective To investigate how glycyrrhetinic acid improves inflammation and corneal injury induced by Pseudomonas aeruginosa by inhibiting Gasdermin-D (GSDMD) mediated atypical cell pyroptosis. Methods Prepare a rat model of Pseudomonas aeruginosa keratitis and randomly divide the rats into a control group, PA group, and GLY+PA group. Compare the keratitis index of each group; Enzyme linked immunosorbent assay (ELISA) was used to detect serum inflammatory factors; Hematoxylin eosin (HE) staining was used to detect pathological changes in corneal tissue; Immunofluorescence detection showed positive expression of caspase-11 and GSDMD in corneal tissue for cysteine; Protein blotting and qRT PCR were used to detect the expression of caspase-4, caspase-5, caspase-11, GSDMD protein, and mRNA in corneal tissue. Results The keratitis index and serum levels of interleukin-1β (IL-1 β) (78.54±8.03) and interleukin-18(IL-18) (26.31±2.74), inflammatory cell density, percentage of positive expression areas of caspase-11 and GSDMD, as well as the expression of caspase-4, caspase-5, caspase-11, GSDMD protein and mRNA in corneal tissue of rats in the PA group were significantly higher than those in the control group; Compared with the PA group, the GLY+PA group significantly reduced the keratitis index and serum levels of IL-1β (46.27±5.11) and IL-18(13.52±1.46), inflammatory cell density, percentage of positive expression areas of caspase-11 and GSDMD, as well as the expression of caspase-4, caspase-5, caspase-11, GSDMD protein and mRNA in corneal tissue. Conclusion Glycyrrhizic acid inhibits the corneal inflammatory response and tissue damage in rats with Pseudomonas aeruginosa keratitis, and its mechanism of action may be related to the inhibition of GSDMD-mediated activation of the atypical cellular pyroptosis pathway. 2024 Vol. 21 (4): 18-23 [Abstract] ( 32 ) [HTML 1KB] [PDF 5164KB] ( 184 ) 24 ZHANG Bao, CHEN Hongwei, ZENG Xiaochen, SHU Shengguang The Effect of HSP70 Gene on the Proliferation, Invasion and Migration of Cholangiocarcinoma Cells Objective To study the effect of HSP70 gene on proliferation, invasion and migration of bile duct cancer cells. Methods qPCR and Western blot were used to detect the difference of HSP70 gene expression in bile duct carcinoma and normal bile duct. RNA interference was used to silence and inhibit HSP70 gene expression in HUC-T1 human bile duct cancer cells, and then CCK-8 assay and Transwell assay were used to detect the effects of downregulation of HSP70 gene expression on the proliferation, invasion and migration ability of HUC-T1 cells. Results The expression of HSP70 gene is abnormally high in the tissues and cells of cholangiocarcinoma. After inhibiting HSP70 gene expression in HUC-T1 cells, the proliferation, invasion and migration ability of HUC-T1 cells were significantly decreased. Conclusion HSP70 plays important roles in promoting tumorigenesis and development in bile duct cancer cells, and it might be used as a therapeutic target of bile duct cancer in further study. 2024 Vol. 21 (4): 24-28 [Abstract] ( 36 ) [HTML 1KB] [PDF 2433KB] ( 150 ) Clinical Medicine 29 LI Yayuan, XING Fengjun The predictive value of miR-124-3p combined with SAA/hs-CRP ratio in the prognosis of children with influenza virus pneumonia Objective To analyze the predictive value of microRNA-124-3p (miR-124-3p) combined with serum amyloid A (SAA) /high-sensitivity C-reactive protein (hs-CRP) ratio for the prognosis of children with influenza virus pneumonia, so as to provide a certain guidance for improving the clinical efficacy and prognosis of children. Methods The clinical data of 121 children with influenza virus pneumonia who were diagnosed and treated in Changzhou Maternal and Child Health Hospital from August 2022 to February 2024 were retrospectively analyzed. miR-124-3p and SAA/hs-CRP were measured at admission. According to the efficacy, the patients were divided into poor prognosis group (26 cases) and good prognosis group (95 cases). The factors affecting the prognosis of children were analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to predict the prognosis of children with miR-124-3p combined with SAA/hs-CRP. Results miR-124-3p and age in the poor prognosis group were lower than those in the good prognosis group, and SAA/hs-CRP, the proportion of severe cases, and the proportion of complications were higher than those in the good prognosis group, and the differences were statistically significant. Logistic regression analysis showed that miR-124-3p level (OR=0.213, 95%CI 0.104-0.435) was an independent protective factor affecting the prognosis of patients, and SAA/hs-CRP level (OR=4.158, 95%CI 1.632-10.590) and disease severity (OR=2.249, 95%CI 1.217-4.153) were independent risk factors. ROC curve showed that the sensitivity of miR-124-3p, SAA/hs-CRP and their combination to predict the prognosis of children was 73.10%, 76.90%, 84.60%, respectively, and the specificity was 73.70%, 71.60%, 90.50%, respectively. The AUC were 0.808, 0.794 and 0.930, respectively. Conclusion The clinical value of combined measurement of miR-124-3p and SAA/hs-CRP levels in predicting the prognosis of children with influenza virus pneumonia is better than that of single measurement. 2024 Vol. 21 (4): 29-33 [Abstract] ( 41 ) [HTML 0KB] [PDF 2145KB] ( 106 ) 34 GAO Jinsong, YAO Feng, LI Jin, ZHANG Jianhui, Lei Mingsheng Imaging differences between drug-resistant and sensitive tuberculosis: A systematic review and meta-analysis Objective Meta-analysis was used to evaluate the imaging characteristics of drug-resistant and sensitive tuberculosis and to analyze the differences. Methods We searched PubMed, Web of Science, and China National Knowledge Infrastructure using the following search terms: “multidrug-resistant tuberculosis”“computed tomography”“drug-sensitive tuberculosis”, in which the time limited was from the establishment of databases to March 2024. The experimental group comprised patients with confirmed drug-resistant tuberculosis based on pathogen or molecular biology criteria, while the control group consisted of individuals with drug-sensitive tuberculosis. Data extraction from the included literature encompassed details such as first author, publication year, drug resistance status, sample size, imaging features, etc. Quality assessment of the included studies was performed using the NOS scale. Meta-analysis was carried out using Stata MP 18 software. Begg′s and Egger′s tests were employed to evaluate publication bias. Results Ultimately, eleven articles were included in our analysis, comprising 1352 patients with drug-resistant tuberculosis and 1852 patients with sensitive tuberculosis. The results of meta-analysis showed that in the experimental group, the incidence of cumulative lesions ≥3 lung lobes (RR=1.32, 95%CI 1.26-1.39), the incidence of damaged lung (RR=5.02, 95%CI 3.59-7.01), and the incidence of cavities (RR=1.55, 95%CI 1.47-1.69), lung consolidation rate (RR=1.35, 95%CI 1.24-1.46), incidence of atectasis (RR=1.36, 95%CI 1.16-1.60), was higher than that of control group, and lesion absorption after treatment (RR=0.63, 95%CI 0.57-0.71) was lower than that of control group , the incidence of pleural effusion (RR=1.01, 95% CI 0.87-1.16) and the incidence of mediastinal lymph node enlargement (RR=1.09, 95% CI 0.94-1.26) showed no significant difference between the two groups. The funnel plot results indicated publication bias in three effect indicators: lesion distribution, lung consolidation, and mediastinal lymph node enlargement. Conclusion Drug-resistant tuberculosis differs from sensitive tuberculosis in the distribution of lesions, lesion morphology, dynamic changes in the disease, and changes in the mediastinal lymph nodes, which can help in early diagnosis. 2024 Vol. 21 (4): 34-40 [Abstract] ( 42 ) [HTML 0KB] [PDF 2937KB] ( 96 ) 41 GAO Junjie, LI Runjun, ZHANG Lifang, TANG Xiuying Clinical efficacy and cardiac function of Sacubactril sodium valsartan combined with levosimendan in patients with valvular heart failure Objective To investigate the clinical efficacy and cardiac function of nohintal (sacubactril valsartan sodium) combined with levosimendan in patients with valvular heart failure. Methods 150 patients with valvular heart failure admitted to our hospital from October 2019 to October 2022 were selected as research objects, and were divided into observation group and control group by random number table method, with 75 cases in each group. The control group was treated with levosimendan, and the observation group was treated with nocinol combined with levosimendan. After 3 courses of treatment, the clinical efficacy, cardiac function, vascular endothelial function, myocardial injury markers and therapeutic safety of the two groups were evaluated. Results 1 case of voluntary withdrawal in the observation group, 2 cases of adjustment of treatment plan, 2 cases of voluntary withdrawal in the control group, and 1 case of missing observation index results were excluded from this study. The total effective rate of observation group was 91.67% (66/72), which was higher than that of control group 77.78% (56/72) (P<0.05). After treatment, left ventricular ejection fraction (LVEF) and cardiac output (CO) in observation group were higher than those in control group, but left ventricular end-diastolic diameter (LVEDD) and left ventricular end-diastolic volume (LVEDV) in observation group were lower than those in control group. After treatment, the levels of angioendothelin-1(ET-1) and angiotensin-II (Ang-II) in observation group were lower than those in control group, and the levels of nitric oxide (NO) were higher than those in control group. After treatment, the levels of cardiac fatty acid-binding protein (H-FABP), myoglobin (MYO) and extracellular matrix metalloproteinase-inducing factor (EMMPRIN) in observation group were lower than those in control group. The incidence of adverse reactions in the two groups was 11.11% (8/72) and 8.33% (6/72), respectively, and there was no significant difference between the two groups. Conclusion Nohintal combined with levosimendan has significant clinical efficacy in patients with valvular heart failure, which can improve the cardiac function and vascular endothelial function, reduce the level of myocardial cell injury markers, and has good therapeutic safety. 2024 Vol. 21 (4): 41-44 [Abstract] ( 41 ) [HTML 0KB] [PDF 2552KB] ( 90 ) 45 HU Conglong, HUANG Mingjun, YIN Liyi, ZHAN Jin, LIU Yiqun, CAO Yan, HAN Xiaotong Risk factors of death in ECPR patients with in-hospital cardiac arrest Objective To analyze the clinical characteristics of in-hospital cardiac arrest (IHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and explore the main risk factors leading to in-hospital mortality. Methods A retrospective analysis was conducted on the clinical data of 115 IHCA patients who received ECPR at the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022. Patients were divided into a survival discharge group and an in-hospital mortality group based on clinical outcomes. The differences in clinical data between the two groups were compared, and relevant risk factors for in-hospital mortality and poor prognosis were investigated. Cox multivariate regression analysis was used to explore the impact of various variables on in-hospital mortality. Results This study retrospectively analyzed 115 ECPR patients over the past three years, ultimately including 74 patients based on inclusion and exclusion criteria, with a survival discharge rate of 36.5%. Compared to the survival discharge group, the in-hospital mortality group had shorter ECMO run time and hospital stay, higher lactate levels at 24 hours post-ECMO stabilization, lower 24-hour lactate clearance rate, more CRRT treatments, more limb and cardiac complications, less return of spontaneous circulation before ECPR, higher SOFA and APACHE II scores, and lower SAVE scores, with statistically significant differences. ECMO cardiac complications, ECMO run time, and 24-hour lactate clearance rate post-ECMO were identified as risk factors for poor prognosis in ECPR patients. Conclusion ECMO cardiac complications, ECMO run time, and 24-hour lactate clearance rate post-ECMO are independent risk factors for in-hospital mortality in ECPR patients. 2024 Vol. 21 (4): 45-49 [Abstract] ( 50 ) [HTML 0KB] [PDF 2273KB] ( 90 ) 50 JIANG Yonghua, LUO Xiaoyi, SHI Weiwei Impact of herbal hot compress combined with problem-solving intervention on the rehabilitation of stroke patients with hemiplegia Objective To investigate the efficacy of combining traditional Chinese medicine Reyanbao therapy with a problem-solving intervention model on the rehabilitation outcomes of stroke patients with hemiplegia during the recovery period. Methods From January 2020 to October 2023, 124 stroke patients with hemiplegia admitted to our hospital were enrolled in this study. Participants were randomly allocated into two groups using a red and yellow ball selection method: an experimental group (red balls, n=62) and a control group (yellow balls, n=62). Both groups received standard rehabilitation measures. The control group additionally underwent problem-solving model intervention, while the experimental group received both problem-solving intervention and traditional Chinese medicine Reyanbao therapy. Traditional Chinese Medicine (TCM) syndrome scores were compared pre- and post-intervention. The National Institutes of Health Stroke Scale (NIHSS) was used to assess neurological deficits, and the Stroke-Specific Quality of Life Scale (SS-QOL) evaluated patients’ quality of life. Adverse events were also documented. Results Post-intervention, both groups showed significant improvements in TCM syndrome scores and neurological function compared to baseline, with the experimental group demonstrating more substantial reductions. Quality of life measurements across various dimensions improved markedly in both groups following the intervention, with the experimental group exhibiting significantly greater enhancements. No significant differences in complications were observed between the groups during the intervention period. Conclusion The combination of traditional Chinese medicine Reyanbao therapy and problem-solving intervention model during the recovery period of stroke patients with hemiplegia effectively accelerates clinical symptom relief, reduces the severity of neurological deficits, and significantly improves therapeutic outcomes and overall quality of life for patients. 2024 Vol. 21 (4): 50-54 [Abstract] ( 43 ) [HTML 0KB] [PDF 2109KB] ( 88 ) 55 HAO Yuyu, LI Congsheng, WANG Yong Correlation analysis between serum HMGB1, α1-AT and AECOPD complicated with respiratory failure and the prognosis Objective To explore the correlation between serum high mobility group box 1(HMGB1), alpha-1 antitrypsin (alpha1-AT) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure (RF) and the prognosis. Methods A total of 80 patients with AECOPD and RF who were admitted to the hospital from July 2020 to July 2023 were selected as the observation group. Meanwhile, 50 patients with simple AECOPD were selected as the control group. Serum HMGB1 and alpha1-AT levels of the two groups were compared. Patients in the observation group were divided into good prognosis group and poor prognosis group. The prognostic factors in patients with AECOPD and RF were explored. The prognostic value of serum HMGB1 and alpha1-AT in patients with AECOPD and RF was analyzed using the receiver operating characteristic (ROC) curves. Results Serum HMGB1 and alpha1-AT levels in the observation group were higher than those in the control group. In this study, 22(27.50%) of 80 patients with AECOPD and RF had poor prognosis. Course of disease, CAT score, and serum HMGB1 and alpha1-AT levels in the poor prognosis group were higher than those in the good prognosis group. CAT score, serum HMGB1 and alpha1-AT levels were independent prognostic factors in patients with AECOPD and RF. Pearson correlation analysis results showed that CAT score of patients with AECOPD and RF was positively correlated with serum HMGB1 and alpha1-AT levels. ROC curves indicated that the optimal cutoff values of serum HMGB1 and alpha1-AT levels for predicting the prognosis of patients with AECOPD and RF were 179.925 μg/L and 14.710 mg/L, respectively. The AUC and specificity of combined prediction were 0.869 and 96.60%, both of which were higher than those of prediction using a single indicator. Conclusion Compared to patients with simple AECOPD, patients with AECOPD and RF have higher serum levels of HMGB1 and alpha1-AT. HMGB1 and alpha1-AT are independent prognostic factors in patients with AECOPD and RF, and HMGB1 combined with alpha1-AT is of high value in the prognosis of AECOPD with RF. 2024 Vol. 21 (4): 55-58 [Abstract] ( 38 ) [HTML 0KB] [PDF 2092KB] ( 92 ) 59 MA Feifei, REN Yajuan, XU Fang, MENG Tian Analysis of relationship between ultrasound image characteristics and clinicopathology and TCM syndrome type distribution in patients with granulomatous mastitis in mass stage Objective To explore the relationship between ultrasound image characteristics and clinicopathological staging and TCM syndrome type distribution in patients with granulomatous mastitis (GLM) in mass stage. Methods 56 patients with GLM in mass stage in the hospital were retrospectively selected from August 2022 to August 2023 and included in mass stage group. In addition, 30 patients with GLM in non-mass stage (abscess stage, post-ulcer stage) during the same time period were selected and enrolled as non-mass stage group. All patients underwent Doppler ultrasonography and were confirmed by pathology. The differences in ultrasound image characteristics (lesion size, shape, boundary, echo, calcification, catheter dilatation, blood flow signal) between the two groups were compared, and the relationship between ultrasound image characteristics and GLM in mass stage was analyzed by multivariate regression model. According to TCM syndrome types and tongue pulse conditions, the patients were divided into four syndromes: liver depression and phlegm coagulation syndrome, liver-stomach stagnation heat syndrome, phlegm-blood stasis blocking syndrome and yang deficiency and phlegm coagulation syndrome. The differences in ultrasound image characteristics were compared among patients with GLM in mass stage of different syndrome types. Results The proportions of lesions <6 cm, clear boundary, uniform echo, no calcification, no catheter dilatation and blood flow signal grade 0-I in mass stage group were significantly higher than those in non-mass stage group. Multivariate regression analysis showed that no catheter dilatation and blood flow signal grade 0-I were independent risk factors for GLM in mass stage. There was a statistically significant difference in the blood flow signal of ultrasound image among patients with different syndrome types of GLM in mass stage. The number of cases with blood flow signal grade 0-I in yang deficiency and phlegm coagulation syndrome (6 cases, 75.00%) was the highest, and the liver-stomach stagnation syndrome (2 cases, 12.50%) was the lowest. Conclusion The ultrasound image characteristics of lesion size, boundary, echo, calcification, catheter dilatation and blood flow signal in patients with different stages of GLM are different. Ultrasound images show that no catheter dilatation and blood flow signal grade 0-I are more likely to belong to GLM in mass stage. There are some differences in ultrasound blood flow signals under different TCM syndrome types of GLM in mass stage. Ultrasound blood flow signal can be used to assist the diagnosis of TCM syndrome differentiation of GLM in mass stage. 2024 Vol. 21 (4): 59-64 [Abstract] ( 40 ) [HTML 0KB] [PDF 2216KB] ( 84 ) 65 LI Huan, ZHANG Kun Changes and clinical significance of serum sFlt-1, E-cadherin and IFN-γ in patients with unexplained recurrent spontaneous abortion Objective To explore the changes and clinical significance of serum soluble vascular endothelial growth factor receptor-1 (sFlt-1) , E-cadherin and interferon γ (IFN-γ) in patients with unexplained recurrent spontaneous abortion (URSA). Methods A total of 146 patients with URSA and 80 normal pregnant women who underwent prenatal examination were enrolled as abortion group and control group between January 2021 and January 2023, respectively. The clinical data and changes of serum sFlt-1, E-cadherin and IFN-γ in the two groups were compared. The influencing factors of URSA were analyzed by multivariate Logistic regression analysis, and the predictive value of sFlt-1, E-cadherin and IFN-γ for URSA was analyzed. Results The levels of serum sFlt-1 and IFN-γ in abortion group were higher than those in control group, while E-cadherin level was lower than that in control group (t=8.520; t=4.254; t=6.643, P<0.05) . Pearson correlation analysis showed that serum sFlt-1 level in URSA patients was negatively correlated with E-cadherin, while positively correlated with IFN-γ (r=-0.286; r=0.392, P<0.05) . Serum E-cadherin in URSA was negatively correlated with IFN-γ (r=-0.272, P<0.05) . Binary Logistic regression analysis showed that age, sFlt-1, E-cadherin and IFN-γ were independent risk factors of URSA. ROC curves analysis showed that AUC of serum sFlt-1 combined with E-cadherin and IFN-γ for predicting URSA was 0.909, greater than that of single index (0.864, 0.666, 0.764, Z=2.892; Z=6.562; Z=4.089, P<0.05) . Conclusion The levels of serum sFlt-1 and IFN-γ are increased, while E-cadherin level is decreased in URSA patients, and all the three indexes have certain value in the prediction and diagnosis of URSA. 2024 Vol. 21 (4): 65-68 [Abstract] ( 39 ) [HTML 0KB] [PDF 2162KB] ( 89 ) 69 DENG Jianfeng, PENG Chengzhong, ZHOU Hai, ZENG Qinghu Analysis of the influence of bone cement dispersion range on the therapeutic effect during percutaneous vertebroplasty Objective To investigate the effect of bone cement dispersion distribution on the clinical efficacy and pain relief of percutaneous vertebroplasty (PVP) for the treatment of osteoporotic spinal fractures. Methods A retrospective analysis was conducted on 100 patients with osteoporotic vertebral compression fractures (OVCF) who underwent PVP treatment at the affiliated xiangdong Hospital of Hunan Normal University from January 2021 to January 2023. The degree of bone cement dispersion was evaluated based on postoperative X-ray films, and the patients were divided into a well dispersed group (n=57) and a poorly dispersed group (n=43). Comparing the general information, VAS score, anterior vertebral height ratio, and postoperative recovery rate of mid column height between two groups of patients. Results The VAS scores of the two groups on the 3rd day after the operation, the 3rd month after the operation and the 6th month after the operation were lower than the preoperative period. There was no statistical difference in the VAS score of the two groups at the same time before and after the operation; the anterior edge height ratio of the vertebral edge of the patients in the good dispersion group was significantly higher than that of the poor dispersion group, the degree of the vertebral collapse of the patients in the well dispersed group was significantly lower than that of the poorly dispersed group, and the postoperative middle column height recovery rate of the patients in the well dispersed group was significantly higher than that of the poorly dispersed group. Conclusion PVP surgery for OVCF can effectively alleviate pain, and the better the dispersion of bone cement, the more significant the supportive effect it plays. 2024 Vol. 21 (4): 69-72 [Abstract] ( 42 ) [HTML 0KB] [PDF 2624KB] ( 77 ) 73 LI Mengran, ZHANG Deyang, ZHOU Yibin, WANG Zhaoyi, NI Lei Correlation Analysis of Metal Exposure and Hashimoto's Thyroiditis based on NHANES Database Objective This study aimed to expore the potential relationship between heavy metals in urine and Hashimoto's thyroiditis （HT）,providing a basis for the prevention and control of heavy metal exposure in the general population and in those with HT. Methods Data included 5 011 cases with both urinary heavy metals （cadmium,cobalt,barium,lead,uranium）concentration indexes and thyroid peroxidase antibody （TPOAb）or thyroglobulin antibody （TgAb）from the 2007-2012 National Health and Nutrition Examination Survey （NHANES）（2007-2012）. Logistic regression models were used to explore the relationship between heavy metals in urine and HT,and restricted cubic spline models were used to examine possible nonlinear associations and to use restricted cubic spline models to visualize the dose-response relationship between different concentrations of cadmium,cobalt,and barium and HT. Furthermore,subgroup analyses were performed for gender. Results The urinary cadmium concentration in HT patinets （0.27 μg/L）was significantly higher than that in the normal population （0.24 μg/L）,while the concentrations of the other heavy metals showed no statistical difference in HT distribution. Multifactorial logistic regression showed that the risk of HT increased by 23.7 % for each quartile increase in urinary cadmium （OR=1.237,95 % CI 1.083-1.414）,and by 9.7% for each quartile increase in urinary cobalt （OR=1.097,95 % CI 1.021-1.177）. Compared to the group with the lowest urinary barium concentration （Q1）,the group with the highest urinary barium concentration （Q4）had a 48 % reduction of the risk of HT （OR=0.520,95 % CI 0.295-0.916）. However,the results of restricted cubic spline regression showed no dose-response relationship between the three and the prevalence of HT. Conclusion Exposure to heavy metals （cadmium,cobalt,barium）is associated with HT. Cadmium and cobalt may serve as potential risk factors for HT,while barium may have a protective effect against the disease. Cadmium and cobalt may be more pronounced in women. This provides the evidence for the development of intervention and health promotion guidelines,raising awareness of heavy metal exposure. 2024 Vol. 21 (4): 73-80 [Abstract] ( 37 ) [HTML 0KB] [PDF 2557KB] ( 87 ) 81 LIU Huimin, YAN Yimin, FENG Bin, ZHENG Mingzhi, REN Fangyuan The impact of trimodal prehabilitation strategy on functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy Objective To investigate the impact of trimodal prehabilitation strategy on perioperative functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy. Methods 100 cases of patients undergoing elective laparoscopic partial hepatectomy in our hospital from April 2022 to November 2023 were randomly divided into control group and prehabilitation group, each were 50 cases. The control group received conventional preparation for laparoscopic surgery, while the prehabilitation group received trimodal prehabilitation intervention strategy before surgery, about 2-4 weeks. All patients were followed up 30 days after discharge. The perioperative (at the baseline, 1 day before surgery, 7 days after surgery and 30 days after surgery) functional capability included: the validated six-minute walking distance (6MWD) was used to evaluate motor function, the hospital anxiety and depression scale (HADS) was used to evaluate the psychological status, and the nutritional indicators of prealbumin, albumin and total protein was used to evaluate the nutritional status. Short-term quality of life measured using SF-36 Health Survey Form (SF-36). The operation time, intraoperative blood loss, hospitalization time, abdominal drainage, postoperative complications and readmission within 30 days after discharge of two groups were compared. Results The operation time and intraoperative blood loss of two groups had no significant difference. Prehabilitation group had a significant reduction in abdominal drainage on the first day after surgery than control group. The hospitalization time of prehabilitation group was shorted than control group. At baseline, there was no statistically difference in 6MWD, HADS anxiety score, HADS depression score, prealbumin, albumin, total protein and SF-36 score between two groups.1 day before surgery, 7 days after surgery and 30 days after surgery, 6MWD, prealbumin, albumin and total protein of prehabilitation group were higher than control group.1 day before surgery and 7 days after surgery, HADS anxiety score, HADS depression score of prehabilitation group were decreased compared with the baseline and better than control group.30 days after surgery, HADS anxiety score and HADS depression score of two groups had no significant difference.30 days after surgery, the scores of BP, GH, MH, PF, RP, SF and VT in SF-36 of prehabilitation group were higher than control group. However, there was no significant difference in RE score. The incidence of postoperative complications of prehabilitation group were less than that in control group. There was no case of readmission within 30 days after discharge in both group. Conclusion Trimodal prehabilitation strategy can effectively improve the perioperative functional capability and short-term quality of life for patients undergoing laparoscopic partial hepatectomy. It can improve clinical outcomes and enhanced recovery after surgery. 2024 Vol. 21 (4): 81-86 [Abstract] ( 35 ) [HTML 0KB] [PDF 2144KB] ( 87 ) 87 LIU Xiaodong, REN Zhifei Relationship between systemic inflammatory immune index and blocking effect of tenofovir of hepatitis B from mother to child Objective To analyze the relationship between systemic immune inflammatory index (SII) and the blocking effect of tenofovir (TDF) on hepatitis B. Methods This was a retrospective, single-center study. From June 2019 to June 2023, 148 pregnant women infected with hepatitis B virus (HBV) were recruited from our hospital. The HBV DNA load, HBeAg positive cases, baseline neutrophils, baseline SII, and the number of CD4+T cells of neutrophils at delivery were detected. The HBsAg and anti -HBs results of infants born after tenofovir treatment were compared, and the blocking effect of systemic inflammatory immune index and tenofovir was judged. The failure of TDF to block MTCT was defined as HBsAg positive at 6 months old. Infant immune failure is defined as the level of anti-HBs antibody < 10 IU/L at 6 months old. Results Among 148 infants evaluated at 6 months, 6 infants were found to be HBsAg positive. Compared with the HBsAg negative infant group, the HBV DNA load, HBeAg positive cases, baseline neutrophils, baseline SII, neutrophils and SII at delivery in the HBsAg positive infant group increased significantly, and CD4+T cells decreased significantly at delivery. Both baseline SII and SII at delivery were positively correlated with HBV DNA load at delivery (r=0.320 and 0.201, both P< 0.05), and the baseline SII was negatively correlated with baseline CD4+T cells (r=-0.183, P=0.026). Binary logistic regression analysis showed that baseline SII (OR=1.003, 95%CI 1.000-1.007) was an independent influencing factor of HBV infection in infants (P=0.044).132 cases (88%) of 6-month-old infants had anti-HBs antibody titers ≥ 10 IU/L. Compared with the successful infant immunization group, the baseline SII of the failed infant immunization group increased significantly. Conclusion The use of TDF in pregnant women infected with HBV can effectively block MTCT, and the increase of baseline SII level in pregnant women may be an important factor leading to the failure of TDF blocking. 2024 Vol. 21 (4): 87-92 [Abstract] ( 38 ) [HTML 0KB] [PDF 2323KB] ( 91 ) 93 LU Lin, QU Rui, DAI Yuanyuan The clinical effect of lamotrigine combined with high-dose diazepam in the treatment of benign epilepsy in children with central temporal spikes and epileptic electrical persistence during sleep Objective To evaluate the clinical efficacy of lamotrigine combined with high-dose diazepam in the treatment of benign epilepsy in children with central temporal spike wave (BECT) and status epilepticus during sleep (ESES) . Methods Clinical data of 80 children with BECT combined with ESES admitted to Xuzhou Medical University Affiliated Hospital from January 2019 to February 2023 were selected. They were randomly divided into a control group (treated with lamotrigine) and an observation group (treated with lamotrigine combined with high-dose diazepam) using a random number table method, with 40 cases in each group. Both groups were treated for 3 months. Compare the clinical efficacy, frequency and duration of seizures, discharge index, EEG activity, PIQ, VIQ, FIQ scores, serum biomarker levels, and incidence of adverse reactions between two groups. Results The total effective rate of the observation group was higher than that of the control group; The frequency of epileptic seizures in the observation group was lower than that in the control group, and the duration was shorter than that in the control group. The number of epileptiform discharges and the number of involved leads were both lower than those in the control group, and the difference was statistically significant; The scores of VIQ, PIQ, and FIQ, as well as the EEG, improved in both groups compared to before treatment. The PIQ, PIQ, FIQ, and serum biomarker levels in the observation group were higher than those in the control group; The difference was statistically significant; There was no statistically significant difference in the incidence of adverse reactions between the two groups. Conclusion The combination of lamotrigine and high-dose diazepam can improve the efficacy and safety of BECT combined with ESES in children. 2024 Vol. 21 (4): 93-96 [Abstract] ( 37 ) [HTML 0KB] [PDF 2590KB] ( 106 ) 97 HAO Limei, REN Wenqing, QIN Lin, LI Huihui, WANG Yixuan Transcriptome and Multivariate Mendelian Randomized Interpretation: Relationship Between Type 2 Diabetes and Fractures Objective Using bioinformatics and Mendelian randomization analysis combined, we identified the risk factors contributing to increased fracture risk in patients with type 2 diabetes. This establishes the theoretical foundation for developing subsequent clinical prediction models. Methods Utilizing the Gene Expression Omnibus (GEO) databases GSE38642 for type 2 diabetes and GSE30159 for fractures, we conducted differential analysis and selected key genes. Subsequently, we employed Genecards to construct a Sankey diagram illustrating the interplay between these genes and associated diseases. Within the realm of transcriptomics, we identified significant risk factors as exposure variables and type 2 diabetes along with fractures as outcome variables for Mendelian randomization analysis. We employed the inverse variance-weighted (IVW) method as the primary approach and evaluated horizontal pleiotropy using the intercept term in MR-Egger regression, while Cochran's Q statistic assessed heterogeneity (Cochran Q P<0.05 indicates heterogeneity). Additionally, we validated overall effects through leave-one-out analysis. Finally, we performed multivariable Mendelian randomization analysis on risk factors displaying causal effects in MR. Results In transcriptomics, a total of 14 risk factors associated with fractures in patients with type 2 diabetes were identified. These factors include height, citrate levels, alanine levels, glycated hemoglobin levels, glomerular filtration rate status, IL-1R2 levels, blood protein levels, resting heart rate, heart rate, pulse pressure status, atrial fibrillation, chronic obstructive pulmonary disease, acute myeloid leukemia, and systolic blood pressure. Following Mendelian randomization and multivariable analysis, glycated hemoglobin levels and height were determined to be risk factors for fractures in patients with type 2 diabetes. Conclusion sIn patients with type 2 diabetes, an elevation in glycated hemoglobin levels triggers alterations in bone metabolism-related functions, thereby increasing the risk of osteoporosis. This, in turn, leads to a decrease in patient height, ultimately culminating in fractures among individuals with type 2 diabetes. 2024 Vol. 21 (4): 97-105 [Abstract] ( 40 ) [HTML 0KB] [PDF 3470KB] ( 102 ) 106 ZHOU Qinhua, HE Kaiyin, LIU Le, SU Chao, LU Defu Effect of auricular point pressing therapy combined with psychological and behavioral guidance on compliance, adverse reactions, and psychological states of children with Mycoplasma pneumoniae pneumonia treated with erythromycin Objective To investigate the effect of auricular point pressing therapy combined with psychological and behavioral guidance on compliance, adverse reactions, and psychological states of children with Mycoplasma pneumoniae pneumonia treated with erythromycin. Methods A total of 86 children with Mycoplasma pneumoniae pneumonia treated in the hospital between September 1, 2022 and October 31, 2023 were selected. Using the random number table method, children enrolled were assigned to the combination group and the control group, with 43 cases in each group. The control group was given psychological and behavioral guidance on the basis of erythromycin treatment. The combination group was given auricular point pressing therapy on the basis of the control group. Then, the two groups were compared on compliance with erythromycin treatment, psychological states, disease outcomes, and incidence of adverse reactions. Results After intervention, the compliance rate of erythromycin treatment in the combination group (95.35%) was higher than that in the control group (81.40%). The scores for general health issues and behavioral issues, and total scores of both groups decreased. Compared with the control group, the combination group had lower scores. The relief time for fever, cough and length of hospital stay in the combination group were shorter than those in the control group. The total incidence of adverse reactions in the combination group (6.98%) was lower than that in the control group (23.26%). The nausea and vomiting grading in the observation group was better than that in the control group, and the proportion of grade 0 was higher than that in the control group. Conclusion Auricular point pressing therapy combined with psychological and behavioral guidance is conducive to improving compliance with erythromycin treatment among children with Mycoplasma pneumoniae pneumonia, improving their psychological and behavioral problems, promoting recovery, and reducing the risk of adverse reactions. 2024 Vol. 21 (4): 106-109 [Abstract] ( 41 ) [HTML 0KB] [PDF 2536KB] ( 89 ) 110 ZHENG Yipeng, GU Tongtong, LIU Kang, WANG Qian, WANG Yanfeng Clinical efficacy analysis of single-balloon unilateral trans-midline expansion with modified PKP for OVCF Objective To investigate the efficacy of single balloon unilateral transmedial dilatation modified percutaneous balloon dilatation vertebral kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods A total of 115 patients with OVCF in our hospital from August 2021 to June 2022 were selected and grouped according to different surgical methods. Among them, 58 patients were treated with unilateral transmidline dilated PKP with single balloon as the study group, and 57 patients were treated with bilateral pedicle PKP as the control group. The surgical conditions, traumatic stress indexes [prostaglandin E2(PGE2), noadrenaline (NE), Substance P (SP) ] before and after surgery, spinal and pelvic sagittal balance parameters [loss rate of injured vertebra height, Cobb Angle, sagittal deviation (SVA), thoracic kyphosis Angle (TK), lumbar lordosis Angle (LL), pelvic incidence Angle (PI), Pelvic inclination Angle (PT), sacral inclination Angle (SS) ], lumbar function (ODI score, JOA score), pain degree (VAS score), bone turnover markers [type Ⅰ collagen cross-linked carboxy-terminal peptide (CTx), β-collagen degradation products (β-CTx), type Ⅰ procollagen amino terminal propeptide (PINP) ], incidence of postoperative adverse events. Results The surgery time and intraoperative fluoroscopy frequency in the study group were less than those in the control group, and the amount of bone cement injection was higher than that in the control group; The serum levels of PGE2, NE, and SP in the study group were lower than those in the control group on the 1st, 3rd, and 7th day after surgery; There was no significant difference in the loss rate of vertebral height, Cobb angle, SVA, TK, LL, PI, PT, SS between the study group and the control group at 3 and 6 months after surgery; There was no significant difference in ODI, JOA, and VAS scores between the study group and the control group at 3 and 6 months after surgery; The incidence of postoperative residual back pain in the study group was lower than that in the control group. Conclusion sBoth single-balloon unilateral transmedial expansion modified PKP and conventional bilateral arch puncture PKP for OVCF can correct the spinal pelvic architecture, restore lumbar function and relieve patient pain, while the former can further optimise the procedure, reduce the number of intraoperative fluoroscopies, reduce tissue damage and lower the risk of residual postoperative back pain, but increase the amount of bone cement used. 2024 Vol. 21 (4): 110-115 [Abstract] ( 42 ) [HTML 0KB] [PDF 2386KB] ( 95 ) 116 ZHANG Aiping, FAN Jing, HUANG Zhi, WANG Jinlian, TAN Xia, LI Weifang, SU Xian, WANG Tuanmei The epidemic characteristics of low birth weight and its influencing factors in Changsha from 2018 to 2021 Objective To analyze the incidence and influencing factors of the low birth weight in Changsha from 2018 to 2021, which provide evidences for making precision intervention measures. Methods 17506 live births who delivered in Changsha maternal and child health hospital from 2018 to 2021 were selected as the participants. The multivariate logistic regression analysis was used to explore the influencing factors of the low birth weight. Results The incidence of low birth weight of newborns in Changsha was 4.08 % from 2018 to 2021. The results of multivariate logistic regression analysis showed that pregnant woman with risk factors during initial diagnosis, neonatal growth restriction, preterm birth, multiple births, cesarean section and hip midwifery, birth defects for infants were the risk factors for low birth weight. Preterm birth (OR=75.67, 95%CI 60.38-94.82) , multiple births (OR=14.91, 95%CI 10.46-21.24) , and neonatal growth restriction (OR=11.33, 95%CI 5.09-25.20) were the main the risk factors of low birth weight. Moreover, the parity of mother was twice, the height of mother was higher than 155cm, and the weight of mother before delivery was higher than 60 kg were the protective factor for low birth weight. Conclusion There was a high level incidence of low birth weight in Changsha, which is affected by many factors. It is necessary to strengthen the management of pregnancy care for elderly parturient women and multiple pregnancies, and prevent the high risk factors of fetal growth restriction. 2024 Vol. 21 (4): 116-122 [Abstract] ( 47 ) [HTML 0KB] [PDF 2615KB] ( 82 ) 123 XIA Weitao, QU Zhaozhen, HE Haiyan, YAN Guanmei, LU Zhiwei, ZHU Yanna Observation on the therapeutic effect of acupoint electrical stimulation combined with behavioral analysis therapy on children with autism spectrum disorders Objective To investigate the efficacy of acupoint electrical stimulation combined with behavioral analysis therapy (ABA) on autism spectrum disorder (ASD). Methods 109 children with ASD admitted to our outpatient clinic from July 2021 to December 2022 were selected for the study. The children were divided into observation group (n=54) and control group (n=55) according to different treatment methods. The control group was given ABA, and the observation group received acupuncture point electrical stimulation combined with ABA treatment. The clinical efficacy, CARS score, C-PEP-3 score, ATEC score, ABC scale score and serum cytokine were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group; After treatment, the CARS score, ATEC score, and ABC score of the observation group were significantly lower than those of the control group, while the C-PEP-3 score was significantly higher than that of the control group; The levels of 25(OH) D, folate, and BDNF in the observation group were significantly higher than those in the control group. Conclusion Acupoint acupoint stimulation combined with ABA can significantly improve the treatment effect of children with ASD, improve the clinical symptoms of children, conducive to the recovery of social life ability, and have high clinical value. 2024 Vol. 21 (4): 123-127 [Abstract] ( 43 ) [HTML 0KB] [PDF 2119KB] ( 83 ) 128 GAO Ling, LU Tianhui, LIU Shuhua, SHI Jingfa, NI Na, LONG Yufen Application of midwife-led standardized pain nursing combined with free position technique in vaginal delivery of primiparas Objective To explore the application effect of midwife-led standardized pain nursing combined with free position technique in vaginal delivery of primiparas. Methods According to random number table method, 186 primiparas undergoing delivery in Hefei Maternal and Child Health Hospital were divided into control group (93 cases) and study group (93 cases) between January 2022 and December 2023. On basis of routine perinatal nursing, control group was given routine pain management, while study group was given midwife-led standardized pain nursing combined with free position technique. The differences in delivery pain [visual analogue scale (VAS) ], psychological state, perinatal indexes, incidence of adverse delivery outcomes and intraspinal adverse reactions, and satisfaction rate between the two groups were compared. Results Before delivery, there was no significant difference in VAS scores between the two groups. VAS scores in study group were lower than those in control group during different stages of labor and after delivery. After intervention, scores of childbirth attitudes questionnaires (CAQ) and pregnancy-related anxiety questionnaire (PAQ) were decreased, and scores of labor agentry scale (LAS) were increased in both groups, and the improvement was better in study group than control group. The first, second and total stages of labor, vaginal midwifery rate, transfer to cesarean section rate, usage rate of oxytocin, oxytocin dose and blood loss at 2h after delivery in study group were lower than those in control group, while vaginal delivery rate and neonatal 1min Apgar score were higher than those in control group, but difference in the third stage of labor between the two groups was not statistically significant. The difference in incidence of adverse delivery outcomes and intraspinal adverse reactions between the two groups was not statistically significant. The satisfaction rate in study group was higher than that in control group. Conclusion The intervention effect of midwife-led standardized pain nursing combined with free position technique is significant in vaginal delivery of primiparas, which can effectively relieve negative psychology, improve perinatal indexes and satisfaction, with significant analgesic effect and high safety. 2024 Vol. 21 (4): 128-133 [Abstract] ( 45 ) [HTML 0KB] [PDF 2170KB] ( 98 ) 134 DENG Yuxiong, LIU Huanhao, HUANG Libing, WU Yan The influencing factors of immature autologous arteriovenous fistula and the clinical effect of ultrasound guided PTA treatment Objective To explore the influencing factors of poor maturation of autologous arteriovenous fistula and the clinical effect of percutaneous transluminal angioplasty (PTA) treatment under ultrasound. Methods 124 patients with autologous arteriovenous fistula who were planned to undergo autologous arteriovenous fistula treatment in our hospital from August 2022 to July 2023 were selected to observe the occurrence of immature autologous arteriovenous fistula and analyze the clinical data differences between mature and immature patients. Patients with immature autologous arteriovenous fistula were given ultrasound guided PTA treatment to observe the treatment effect. Results Out of 124 patients, 32 had immature autologous arteriovenous fistula, incidence rate was 25.81%. The proportion of hypertension, diabetes and cardiovascular and cerebrovascular diseases in patients with immature autogenous arteriovenous fistula was 56.25%, 40.63% and 46.88%, respectively, which was significantly higher than that in patients with mature autogenous arteriovenous fistula. The diameter of the cephalic vein, the diameter of the posterior cephalic vein, and the diameter of the radial artery in patients with immature autologous arteriovenous fistula were (2.79±0.43) mm, (2.49±0.56) mm, and (3.37±0.61) mm, respectively, which were significantly smaller than those in mature autologous arteriovenous fistula patients, while the total cholesterol (TC) was (4.82±0.91) mmol/L, which was significantly higher than those in mature autologous arteriovenous fistula patients. Logistic regression analysis showed that hypertension, diabetes, the diameter of cephalic vein and radial artery were the influencing factors for the immature autogenous arteriovenous fistula, The model predicts that the area under the ROC curve for immature autologous arteriovenous fistula was 0.836(95% CI: 0.755-0.917), with predictive sensitivity and specificity was 81.30% and 76.30%, respectively, Patients with immature autologous arteriovenous fistulas were successfully treated with ultrasound guided PTA, with a maturation rate of 87.50% (28/32) at 1 monthaftersurgery. The blood flow, fistula vein diameter, and vascular wall thickness at 1months after surgery were (803.32±52.03) ml/min, (6.15±0.90) mm, and (0.73±0.18) mm, respectively, which were significantly increased compared to before surgery. Conclusion The immaturity of autogenous arteriovenous fistula is affected by hypertension, diabetes, the diameter of cephalic vein and radial artery. PTA under ultrasound has a good clinical effect on the immaturity of autogenous arteriovenous fistula, which is worthy of clinical use. 2024 Vol. 21 (4): 134-138 [Abstract] ( 42 ) [HTML 0KB] [PDF 2981KB] ( 88 ) 139 FENG Ni, LI Yufeng, LI Yuehong, YU Xiang Investigation and analysis of deciduous tooth caries in preschool children in Yuelu district of Changsha City Objective To investigate the caries status of deciduous teeth in 3~5 years old children in Yuelu District of Changsha, Hunan province, and to provide data support for oral health care and related research . Methods According to the requirements of the fourth national Oral health Epidemiological survey, A total of 1 762 permanent preschool children (35 240 teeth) aged 3, 4 and 5 years old were randomly selected from Yuelu District, Changsha City, Hunan Province during the period of 2021 to 2022. The caries status of all deciduous teeth was examined, and the caries prevalence rate, average caries and filling rate were calculated. Results The caries prevalence rates of 3 to 5 years old children were 37.96%, 53.70% and 59.79%, respectively in Yuelu District, Changsha City, Hunan Province. ; The mean dmft were 1.12、2.22、3.05 respectively; the filled rates were 2.57%、7.84%、11.80% respectively. The prevalence of caries in the 3-year group was significantly lower than that in the 4-year and 5-year groups. Similar to the prevalence of caries, the mean dmft increased with age. The mean dmft of children in different age groups were statistically significant . There was no significant difference in the mean dmft between public and private kindergartens . The filled rate of the 3-year-old group was significantly lower than that of the 4-year-old group and the 5-year-old group, and the filled rate of the 4-year-old group was significantly lower than that of the 5-year-old group . There was no statistical significance in the filled rate of dental caries between public and private kindergartens . The number of caries in 1 762 preschoolers (35 240 teeth) was 3 813, and they were most common in maxillary deciduous central incisor. Conclusion Children aged 3-5 years old in Yuelu District of Changsha City have a serious decidary tooth caries. It is necessary to strengthen the publicity and education of children caries and improve the oral health awareness of parents and children. 2024 Vol. 21 (4): 139-144 [Abstract] ( 44 ) [HTML 0KB] [PDF 2338KB] ( 92 ) 145 NING Zhi, ZHOU Dai, DAI Xingjun, WANG Dan, WU Minghui, PENG Yue, LI Cuiying Clinical Study on the Prevention and Treatment of Negative Effect after mFOLFOX6 Chemotherapy Protocol using a Combination of Xiangsha Liujunzi Paste and Ondansetron Objective This study was designed to evaluate the clinical efficacy and toxic side effect of Xiangsha Liujunzi paste applied to the Shenque acupoint in combination with Ondansetron in preventing and treating nausea, vomiting, and appetite loss caused by the mFOLFOX6 chemotherapy regimen. The goal of this study was to provide scientific evidence for the integration of traditional Chinese and Western medicine in treating vomiting induced by gastric cancer chemotherapy. Methods A prospective randomized controlled trial design was employed in this study. Sixty patients who underwent radical surgery for gastric cancer with the mFOLFOX6 chemotherapy regimen were selected as subjects and randomly assigned to the control group and the treatment group. The control group received Ondansetron (8mg Q12h intravenously) on days 1, 2, and 3 of chemotherapy, while the treatment group underwent additional Shenque acupoint application treatment daily from day 1 to day 7 of chemotherapy, lasting 24 hours. Observation indicators included the incidence of nausea, acute vomiting, appetite loss during the first three days of two chemotherapy cycles, delayed vomiting on day four of chemotherapy, and Karnofsky performance scores before and after two cycles. Results The treatment group showed a higher incidence of mild (grade 0-I) nausea on days 1, 2, and 3 after the first and second cycles of chemotherapy compared to the control group, with a statistically significant difference. The effectiveness of acute vomiting treatment was also significantly higher in the treatment group. In terms of the delayed vomiting, the incidence was significantly lower in the treatment group, with a statistically significant difference. Additionally, the treatment group demonstrated a higher effectiveness in treating appetite loss compared to the control group, with a statistically significant difference. Regarding Karnofsky performance scores, both groups experienced declines, but the difference before and after chemotherapy in the treatment group was not significant, whereas it was significant in the control group; the difference between the two groups after treatment was also significant. Conclusion The combination of Xiangsha Liujunzi paste application and Ondansetron can effectively prevent and treat negative symptoms of nausea, vomiting, and appetite loss induced by the mFOLFOX6 chemotherapy regimen, and it also improves the quality of life for patients with gastric cancer. These findings provide new insights and strategies for integrating traditional Chinese and Western medicine in treating chemotherapy-related side effect. 2024 Vol. 21 (4): 145-149 [Abstract] ( 39 ) [HTML 0KB] [PDF 2109KB] ( 80 ) 150 ZHANG Lan, WANG Liyuan Predictive value of anti-M-phospholipase A2 receptor antibody for disease remission in patients with primary membranous nephropathy Objective To explore the predictive value of anti-M-phospholipase A2 receptor (PLA2R) antibody in the remission of primary membranous nephropathy (PMN) patients one year after treatment. Methods One hundred and six patients with PMN treated in our hospital from January 2020 to January 2023 were divided into remission group (72 cases) and non-remission group (34 cases) according to whether the disease was relieved one year after treatment. The clinical data of the two groups were compared, and the correlation between anti-PLA2R antibody and non-remission of PMN patients after treatment was analyzed. Logistic regression analysis was used to identify the independent influencing factors of non-remission of PMN patients after treatment, and the ROC curve of subjects was drawn to analyze the predictive value of anti-PLA2R antibody for non-remission of PMN patients after treatment. The independent influencing factors obtained were incorporated into the nomogram prediction model, and the effectiveness of the nomogram model was evaluated by C index, ROC curve and calibration curve in R software. Results Compared with the clinical data of the two groups, the age, 24hUP and anti-PLA2R antibody in remission group were lower than those in non-remission group, while eGFR and ALB in remission group were higher than those in non-remission group, with statistical significance. There was no difference in other clinical data. After one year’s treatment of PMN patients, Chi-square test and Kendall’s tau-b correlation analysis showed that anti-PLA2R antibody was positively correlated with 24-hour UP and negatively correlated with eGFR and ALB. Logistic regression analysis showed that high level of 24-hour UP and anti-PLA2R antibody and low level of ALB were independent risk factors for PMN patients who were not relieved after one year of treatment. The ROC curve was drawn, and the result showed that the AUC value of anti-PLA2R antibody level was 0.957, which indicated that anti-PLA2R antibody had a good predictive value for the remission of PMN patients after one year of treatment. A nomogram model was constructed to predict the unresponsiveness of PMN patients after one year of treatment. The verified results showed that the C-index value of the calibration curve was 0.950, the AUC of the ROC curve modeling group was 0.950, and the AUC of the verification group was 0.969, which indicated that the nomogram model had good predictive energy efficiency and discriminating ability. Conclusion The level of anti-PLA2R antibody is related to 24-hour UP and ALB. Anti-PLA2R antibody is an independent factor that affects the remission of PMN patients after treatment. The higher the level of anti-PLA2R antibody, the worse the prognosis of PMN patients. 2024 Vol. 21 (4): 150-155 [Abstract] ( 35 ) [HTML 0KB] [PDF 2448KB] ( 96 ) 156 YANG Xiaofang, SHA Sha, ZHENG Xuebin The impact factors of standardized training and effectiveness of anticoagulation in primary care doctors with atrial fibrillation under the model of general practice training combined with close medical association Objective To explore the intervention effect of the combination of general practice training and close medical alliances on anticoagulation therapy for atrial fibrillation (AF) among grassroots doctors, in order to improve their knowledge of anticoagulation in the community. Methods A total of 100 medical staff from three hospitals, including Changsha Guanshaling Community Hospital, Wangyuehu Community Hospital, and Xihu Community Hospital, were included as intervention subjects. The knowledge mastery rate, anticoagulation prescription rate, and training acceptance level of primary care doctors before and after the training were compared, and the influencing factors of the training satisfaction were analyzed. Results After intervention, the mastery rate of atrial fibrillation anticoagulation knowledge and the prescription rate of anticoagulants among community grassroots doctors were significantly improved compared to before intervention (P<0.05); 70 grassroots doctors (70.0%) expressed a good acceptance of the intervention plan; The results of chi square test and binary logistic regression analysis showed that age, highest education level, professional title, years of work experience, and department were the influencing factors of the intervention satisfaction of anticoagulation therapy for atrial fibrillation among grassroots doctors trained in general practice and closely affiliated with medical consortia. Conclusion The implementation of the comprehensive training and close medical alliance model for primary care doctors in AF anticoagulation treatment is beneficial for improving the community's primary care doctors' mastery of atrial fibrillation anticoagulation knowledge and prescription rates, and has a good acceptance rate; Multiple factors affect the effectiveness of standardized anticoagulation training for atrial fibrillation 2024 Vol. 21 (4): 156-160 [Abstract] ( 42 ) [HTML 0KB] [PDF 2513KB] ( 75 ) Pharmacy 161 WANG Yan, LI Huilong, JIAO Aijun Investigating the synergistic effects of Tripterygium glycosides and methotrexate in the management of rheumatoid arthritis through the utilization of network pharmacology and bioinformatics. Objective This study aims to explore how Tripterygium glycosides and methotrexate work together to treat rheumatoid arthritis using network pharmacology and machine learning, focusing on their synergistic effects and underlying molecular mechanisms. Methods This study used the CTD database to identify target genes of methotrexate and triptolide, and analyzed rheumatoid arthritis datasets from the GEO database to find differentially expressed genes. Shared genes between the drugs and the disease were identified using Venn diagrams. Machine learning algorithms screened core shared genes, which were then validated with clinical samples. This approach integrates network pharmacology with machine learning. Results Using systematic analysis and machine learning, we've identified IGFBP4 and CASP7 as potential targets for rheumatoid arthritis treatment with tripterygium glycosides and methotrexate. Clinical trials show that after 24 weeks, the dysregulated IGFBP4 and CASP7 levels improve, and the DAS28 score significantly decreases, suggesting that this combination therapy may alleviate rheumatoid arthritis by regulating these proteins. Conclusion This study uses systematic analysis and machine learning to uncover the molecular mechanisms of tripterygium glycosides and methotrexate in treating rheumatoid arthritis, identifying new therapeutic targets. It offers a scientific basis for personalized treatments with significant clinical value. 2024 Vol. 21 (4): 161-168 [Abstract] ( 39 ) [HTML 0KB] [PDF 2901KB] ( 82 ) 169 XU Han, PENG Lin, ZHANG Siwei, WANG Bijun, ZHAO Rong, YANG Zehua Study on the current situation and problems of joint supervision of drug registration, research and production in Hunan Province Objective To analyze the results of the joint inspection of drug registration, research and production in Hunan Province in 2023, and explore the methods to improve the quality and safety of products in local enterprises under the joint supervision mode of drug registration, research and production in Hunan Province. Methods Through on-site questionnaire surveys, on-site inspections and data collection were conducted on drugs registered within Hunan Province in 2023 to analyze the overall situation and existing problems of drug development and production in Hunan Province. Results A total of 14 drugs in Hunan Province were inspected in 2023, and the results showed that all met the basic conditions for national verification, with 56 defect free items, accounting for 33.3% (56/168); 108 general defects, accounting for 64.3% (108/168); There are 4 main defects, accounting for 2.4% (4/168) of the total inspection items; There are 0 serious defects. Among them, the defects and their causes mainly involve issues with document management, quality control and assurance, equipment problems, and dedicated inspectors. Conclusion The results of the joint supervision of drug registration, research and production in Hunan Province in 2023 are still acceptable, but the regulatory authorities still need to accelerate the training of full-time inspectors for provincial drug quality management standards in the verification center, strengthen the promotion of laws and regulations to enhance the awareness of corporate responsibility, and standardize the management of drug data in enterprises to strengthen on-site verification of drug registration joint inspections. 2024 Vol. 21 (4): 169-174 [Abstract] ( 37 ) [HTML 0KB] [PDF 2251KB] ( 91 ) 175 ZHANG Yan, LI Man, LU Xinyan Impact of Pharmacovigilance Based on PCNE Classification System on Treatment Outcomes, DRPs in Patients with Diabetic Nephropathy Objective To observe the effects of pharmaceutical care based on the Pharmaceutical Care Network Europe (PCNE) classification system on the treatment outcomes and drug-related problems (DRPs) of patients with diabetic nephropathy (DN). Methods A total of 120 patients with DN admitted to the hospital from May 2021 to May 2022 were selected and divided into control group and intervention group with 60 cases each by random serial numbers generated by Excel. The control group received medication according to the doctor’s orders, without pharmaceutical care, and the intervention group received pharmaceutical care through the PCNE system. The clinical indicators and medication adherence were compared. The treatment outcomes and DRPs of the two groups were compared. Results After the intervention, the fasting blood glucose (FBG), systolic blood pressure, diastolic blood pressure, triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), serum uric acid (SUA), and 24 h urine protein quantification of the two groups were decreased, and which of the intervention group were lower than those of the control group. The high-density lipoprotein (HDL-C) and Morisky Medication Adherence Scale (MMAS-8) scores of the two groups were increased, and which of the intervention group were higher than those of the control group. The distribution of treatment outcome levels and the total effective rate of the intervention group were higher than those of the control group, but the incidence of DRPs was lower. Conclusion Pharmaceutical care based on the PCNE classification system can improve the treatment outcomes of DN patients, increase their medication adherence, and reduce DRPs. 2024 Vol. 21 (4): 175-179 [Abstract] ( 32 ) [HTML 0KB] [PDF 2153KB] ( 99 ) Nursing Science 180 LIU Feiyan, TIAN Dandan, HE Pingping, HU Qiongyan, OU Zhengbin, CAO Jixia, ZHANG Yingyi Current status and influencing factors of barriers to physical activity in elderly patients with coronary artery disease and diabetes mellitus Objective To investigate the status quo of physical activity disorder in elderly patients with coronary heart disease (CHD) complicated with diabetes mellitus (DM), and to explore its influencing factors, so as to provide evidence for secondary prevention and intervention strategies in elderly patients with CHD complicated with DM. Methods A total of 261 elderly patients with coronary heart disease and diabetes mellitus were selected from 3 Grade A hospitals in Changsha and Hengyang of Hunan Province from September 2023 to November 2023 by convenience sampling method. General situation questionnaire, perceptive Social support Scale, Chinese version of the Fear of exercise scale for Heart disease, Patient Health questionnaire Depression Scale, Chinese version of the physical activity disorder scale for patients with coronary heart disease were used to investigate the questionnaire. Results The score of physical activity disorder scale in elderly patients with coronary heart disease combined with diabetes was (38.96±11.41). The results of multiple linear regression analysis showed that the family per capita monthly income, the number of readmitted hospital in the past year, perceived social support, fear of exercise and depression were all influencing factors of physical activity disorder in elderly patients with CHD and diabetes. Conclusion The physical activity disorder of elderly patients with coronary heart disease and diabetes mellitus is at a moderate level. The lower the family per capita monthly income and the more readmitted times in the past year, the higher the level of physical activity disorder in elderly patients with CHD and diabetes. Improving social support, exercise fear and depression is conducive to reducing the level of physical activity disorder in elderly patients with CHD and diabetes. 2024 Vol. 21 (4): 180-186 [Abstract] ( 44 ) [HTML 0KB] [PDF 2190KB] ( 101 ) 187 LI Chuan, LIU Zhiying, JIANG Xiaojian, DAI Jinjun, YANG Hongxiu, FAN Fangxiu Study on the Quality of Life and Influencing Factors of Family Caregivers of Patients with Recurrent Schizophrenia Objective To explore the quality of life of family caregivers of patients with recurrent schizophrenia and its related influencing factors, so as to providing new reference for rehabilitation strategies for schizophrenia patients. Method A cluster sampling method was used to conduct a questionnaire survey on the primary caregivers of 300 patients with recurrent schizophrenia in Hunan Province from July 2023 to January 2024, using general information questionnaire, Family Care Burden Interview Scale (FBIS), and World Health Organization Quality of Life-BREF (WHOQOL-BREF), in depth research was conducted on 18 factors including gender and age to analyze the impact of these factors on the quality of life of family of their quality of life. Conclusion:The quality of life of family caregivers of patients with caregivers of recurrent schizophrenia patients. Results The WHOQOL-BREF score of family caregivers of patients with recurrent schizophrenia was (59.60±9.20), with the lowest score in psychological field (49.32±10.73) and the highest score in social relationship field (56.49±9.17). The logistics regression analysis results showed that, the place of residence (OR=1.868, 95%CI 1.098-3.177), family relationship with patients (OR=12.697, 95%CI 1.582-101.885) and care burden (OR=0.205, 95%CI 0.122-0.342) were the influencing factors recurrent schizophrenia is poor, with the lowest score in the psychological field. Residential area, family relationship with patients, and caregiving burden are factors that affect the quality of life of family caregivers of patients with recurrent schizophrenia. 2024 Vol. 21 (4): 187-192 [Abstract] ( 53 ) [HTML 0KB] [PDF 2163KB] ( 125 ) 193 OUYANG Bicong, LI Lezhi, HU Xiangxiang, DAI Jinjun, LI Meizhi, ZHU E Survey and Analysis of Mental Health Knowledge and Attitudes Among Non-Psychiatric Nurses in Multiple Regions of Hospitals in Changsha City Objective To assess the knowledge level of non-psychiatric nurses regarding mental health and their attitudes towards patients with mental illnesses in multiple regions of hospitals in Changsha, and to investigate the influencing factors. Method A systematic data collection and analysis were conducted on 569 non psychiatric nurses using general information questionnaires, mental health knowledge questionnaires, and discrimination assessment scales for mental illness patients. The Pearson method was used to analyze the correlation between mental health knowledge scores and discrimination among non psychiatric nurses, as well as their three dimensional scores. Multivariate logistic regression was used to analyze the influencing factors of mental health knowledge and discrimination attitudes among non psychiatric nurses. Results Among 569 non-psychiatric nurses, the overall accuracy rate for mental health knowledge was 84.6%, with an average score of (16.9±2.5). The non-psychiatric nurses’ total score for discrimination against psychiatric patients was (61.2±10.6), with scores of (31.9±5.1) in the isolation dimension and (11.3±2.2) in the ability dimension. Factors influencing the mental health knowledge scores of non-psychiatric nurses included the occurrence of escape incidents (OR=1.632, 95% CI: 1.086-2.451), regular supervisory reviews of patients' mental states by managers (OR=2.153, 95% CI: 1.317-5.681), formal personnel status (OR=2.671, 95% CI: 1.341-5.319), and employment system (OR=2.747, 95% CI: 1.351-5.590) (P<0.05). Factors influencing the mental health discrimination scores of non-psychiatric nurses included gender (OR=1.118, 95% CI: 1.118-5.760), years of service (OR=1.484, 95% CI: 1.065-2.069), history of vandalism incidents (OR=0.611, 95% CI: 0.430-0.870), and mental health knowledge scores (OR=0.518, 95% CI: 0.368-0.727). Conclusion The awareness rate (i. e. accuracy rate) of non-psychiatric nurses in multiple regions of hospitals in Changsha City regarding mental health knowledge meets policy requirements, Non-psychiatric nurses exhibit discriminatory attitudes towards mental patients and lack the necessary empathy and supportive attitude. 2024 Vol. 21 (4): 193-199 [Abstract] ( 33 ) [HTML 0KB] [PDF 2164KB] ( 103 ) 200 WENG Jinhua, CHEN Zhuomin, PAN Jie, TU Lili, CHEN Wei, ZHANG Xiaoling Relationship between mindfulness level, disease uncertainty and fear of cancer recurrence in patients after cervical cancer surgery Objective To analyze the relationship between mindfulness level, disease uncertainty and fear of cancer recurrence (FCR) in patients after cervical cancer surgery. Methods A retrospective analysis was performed on the clinical data of 193 patients who underwent cervical cancer surgery in 908th Hospital of PLA Joint Logistic Support Force and Jiangxi Cancer Hospital between January 2020 and June 2023. According to presence or absence of FCR, they were divided into FCR group (n=103) and non-FCR group (n=90). The postoperative mindfulness level and disease uncertainty were compared between the two groups. The relationship between mindfulness level, disease uncertainty and FCR was analyzed. The risk factors of FCR were analyzed by Logisitic regression analysis. Results The mindfulness level in FCR group was lower than that in non-FCR group, and scores of disease uncertainty were higher than those in non-FCR group. The mindfulness level was negatively correlated with FCR, while disease uncertainty was positively correlated with FCR. Logisitic regression analysis showed that age, marital relationship, education level, medical payment type, economic income, cancer staging, disease uncertainty and mindfulness level were risk factors of FCR in patients with cervical cancer. Conclusion FCR is positively correlated with disease uncertainty, while negatively correlated with mindfulness level in patients undergoing cervical cancer surgery. The disease uncertainty and mindfulness level are risk factors of FCR. 2024 Vol. 21 (4): 200-203 [Abstract] ( 45 ) [HTML 0KB] [PDF 2515KB] ( 107 ) 204 YU Shuimei, XU Qian, LI Shuping, ZHANG Jun, WAN Qin, ZHAO Shoucai Influence of knowledge-society-psychology integrated care model on psychological status and physiological functional recovery in elderly patients with cerebral infarction Objective To observe the influence of knowledge-society-psychology integrated care model on the psychological status and physiological functional recovery in elderly patients with cerebral infarction. Methods 84 elderly patients with cerebral infarction in wuhu integrated traditional chinese and western medicine hospital were enrolled in the study from January 2022 to June 2023. They were divided into control group (n=42) and observation group (n=42) by complete randomization method of random number table method. The control group implemented routine care model, while the observation group carried out knowledge-society-psychology integrated care model. The psychological status [Mental Status Scale in Non-psychiatric Settings (MSSNS) ], physiological functional recovery status [Functional Independence Measure (FIM) ] and self-management ability (self-management ability scale of stroke patients) were compared before intervention and after 1 month of intervention. The quality of life [Stroke Specific Quality of Life Scale (SS-QOL) ] after intervention were compared between the two groups of patients. Results After 1 month of intervention, the scores of MSSNS scale in the two groups were reduced than those before intervention, and the scores in observation group were lower. The scores of FIM scale and self-management ability scale of stroke scale were enhanced in the two groups compared with those before intervention, and the observation group scores of FIM scale, self-management ability scale of stroke scale and SS-QOL scale had higher scores. Conclusion Compared with routine care model, knowledge-society-psychology integrated care model can effectively improve the psychological status, promote the physiological functional recovery, and enhance the self-management ability and quality of life in elderly patients with cerebral infarction. 2024 Vol. 21 (4): 204-208 [Abstract] ( 43 ) [HTML 0KB] [PDF 2083KB] ( 89 )

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