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Quick Search     Advanced Search   2023 Vol.  20 No.  5 Published: 2023-10-25 Basic Medicine Clinical Medicine Preventive Medicine Nursing Science Invited Review Pharmacy Invited Review 1 YANG Zhen, RENG Kaiqun, GU Feng Progress of therapy for mitochondrial diseases caused by mitochondrial genome mutations Mitochondrial diseases refer to a group of multi-system diseases caused by mitochondrial DNA（mtDNA）or nuclear DNA（nDNA）mutations that cause functional defects of mitochondrial metabolic enzymes,leading to adenosine triphosphate（ATP）synthesis disorders and insufficient energy production. It can involve nerves,muscles,eyes,ears,digestion,endocrine,cardiovascular,kidney and blood system alone or simultaneously. The genetic properties of mtDNA are very complex because there are multiple copies of mtDNA in each cell,and mtDNA mutations can be homogeneous（basically all mtDNA is a mutant）or heterogeneous（a mixture of mutated and wild-type mtDNA）. Dysfunction occurs only when the proportion of mutant mtDNA reaches a critical threshold. Not only can mitochondrial diseases occur at any age,but they can cause symptoms in any organ system. Therefore,it is of great significance to study gene therapy for mitochondrial diseases. The new generation of biotechnology has given birth to the treatment ideas and methods for mitochondrial diseases caused by mitochondrial genome mutations. In the present paper,we summarize the clinical application and the related exploratory research work in the research stage and highlight the bottlenecks for the treatments. It may pave a way for the development of novel therapeutic methods for mitochondrial diseases. 2023 Vol. 20 (5): 1-7 [Abstract] ( 608 ) [HTML 1KB] [PDF 2582KB] ( 2517 ) Basic Medicine 8 CHEN Hailin, Anniwaer · Maimaiti, ZHANG Xuan, WU Chunping Study on mechanism of HOTAIR/CSTF2/CD44 axis regulating invasion and metastasis of esophageal cancer Objective To explore the mechanism of HOTAIR/CSTF2/CD44 axis regulating invasion and metastasis of esophageal cancer. Methods EC tissue samples and adjacent normal tissues from 43 patients with nonspecific invasive EC from September 2020 to June 2022 were collected and divided into control group and EC group. EC cell lines KYSE150, EC109 and TE-1 and human normal esophageal epithelial cell line HEEC cells were cultured and divided into control, si-HOTAIR, CSTF2 mimics and si-HOTAIR+CSTF2 mimics. Real-time fluorescence quantitative PCR was used to detect the expression of HOTAIR, CD24 and CSTF2, CCK8 was used to measure cell viability, flow cytometry was used to detect apoptosis, and then cell migration and invasion were detected. Apoptotic proteins (Ki67, PCNA, lysed caspase 3 and caspase 9) and migration proteins (VEGF and MMP-9) were detected by western blotting. Mouse models were monitored for signs of tumor growth. Results The results showed that the expression of HOTAIR and CSTF2 in EC tissues was significantly higher than that in normal tissues. Compared with HEEC cells, the expressions of HOTAIR and CSTF2 were increased in EC cell lines EC109, KYSE150 and TE-1. Compared with control, HHOTAIR knockdown significantly reduced cell proliferation, migration and invasion, and accelerated cell apoptosis. Bioinformatics analysis of CSTF2 interaction showed that there was a potential binding domain in HOTAIR transcripts, and there was a strong correlation between HOTAIR and CSTF2 expression. HOTAIR knockdown resulting in CSTF2 downregulation significantly inhibited CD24 expression, and CSTF2 elevation significantly increased CD24 expression. In vivo studies have shown that HOTAIR knockdown can reduce the expression of CSTF and CD24, thus inhibiting the growth and invasion of tumor cells. Conclusion The results showed that the expression of HOTAIR and CSTF2 in EC cells and tissues increased significantly. In vitro and in vivo studies have shown that HOTAIR knockdown promotes apoptosis and inhibits cell proliferation and invasion. HOTAIR may bind CSTF2 and indirectly regulate the expression of CD24 in EC cells. 2023 Vol. 20 (5): 8-15 [Abstract] ( 482 ) [HTML 1KB] [PDF 3813KB] ( 2242 ) 16 CHEN Naxia, QI Miaomiao, LIN Hengxiu, HUANG Shan PCSK3 inhibits cell migration by regulating the inflammatory response of vascular smooth muscle cells and the expression of cell phenotype transformation markers Objective To investigate the effect of Recombinant Proprotein Convertase Subtilisin/Kexin Type 3(PCSK3) on the proliferation and migration of vascular smooth muscle cells. Methods First, the cell model was established by stimulating vascular smooth muscle cells (VSMCs) of mouse with 0, 25, 50, 100 mg/L ox-LDL, and the expression of PCSK3 mRNA was detected by RT-PCR. The atherosclerotic model cells stimulated by 100 mg/L ox-LDL were used as the model group, VSMCs were divided into NC group (0 mg/L ox-LDL stimulated VSMCs+scramble siRNA, SCR), ox-LDL group (model group+SCR), ox LDL+si-PCSK3 1 # group (model group+si-PCSK3 1 # plasmid) and ox-LDL+si-PCSK3 2 # group (model group+si-PCSK3 2 # plasmid). The proliferation activity of VSMCs in each group was detected by EdU method, and cell migration was observed by Transwell, ELISA kit for detecting IL-1 β, TNF α, IL-6, intercellular adhesion molecule-1(ICAM-1) content, RT-PCR was used to detect the changes of mRNA expression of type I and ⅲ collagen and smooth muscle actin (α-SMA) in SMC cells of each group. Results Under the concentration of 100 mg/L ox-LDL treatment, PCSK3 in VSMCs significantly increased, which can induce the proliferation of VSMCs. Interference with the endogenous expression of PCSK3 can inhibit the migration and proliferation ability of VSMCs stimulated by ox-LDL, reduce the secretion of IL-1 β, TNF α, IL-6, and ICAM-1 levels. Compared with the ox-LDL group, the expression of type I collagen and OPN mRNA was significantly downregulated in the si-PCSK3 treated cell group, while the expression of α-SMA mRNA was significantly upregulated. Conclusion Down-regulation of PCSK3 can attenuate the proliferation and migration of vascular smooth muscle cells, which may be related to the regulation of PCSK3 on intracellular inflammatory response and cell phenotype transformation. 2023 Vol. 20 (5): 16-22 [Abstract] ( 454 ) [HTML 1KB] [PDF 2863KB] ( 2244 ) 23 CHEN Yu, DONG Weiwei, ZHAO Yu, JIN He Exploring the Mechanism of Oral Mucosal Immune Homeostasis Based on the IL-37 Signaling Pathway Objective This study aims to elucidate the mechanism behind oral mucosal immune homeostasis by investigating the IL-37 signaling pathway. Methods An experimental model of oral inflammation was established in C57BL/6J mice through gingival nematode infection and induction of oral inflammation by human macrophages. The mice were categorized into control and rhIL-37b treatment groups. IL-37, inflammatory cytokines (IL-6, TNF-α, IL-10, IL-1β), and the NF-κB pathway were assessed using qPCR. Western blotting was employed to analyze the protein expression of IL-37 and the NF-κB pathway. Micro-computed tomography (microCT) imaging was utilized to quantify bone loss. Results Following gingival nematode infection, THP-1 cells exhibited elevated IL-37 mRNA expression. In human macrophages treated with rhIL-37b, production of IL-6, TNF-α, and IL-1β was reduced, accompanied by enhanced degradation of IκBα and diminished levels of phosphorylated p65 after gingival nematode infection, as compared to the control group. In the mouse periodontitis model, the rhIL-37b-treated group demonstrated a significant reduction in gingival inflammation and bone loss. Conclusion IL-37 plays a regulatory role in the inflammatory cytokine response of periodontitis by inhibiting the NF-κB signaling pathway. Consequently, IL-37 contributes to the mitigation of gingival tissue bone loss and cytokine expression. 2023 Vol. 20 (5): 23-28 [Abstract] ( 455 ) [HTML 1KB] [PDF 3616KB] ( 1976 ) 29 YAN Lin, LIAO Yuxiang, AN Zhihan, LIAO Xinbin, ZHANG Zhiping, XIAO Gelei Ascorbic acid alleviates hydrocephalus and protects blood-brain barrier via inhibiting oxidative stress in a rat model of intracerebral hemorrhage Objective To observe the effects of ascorbic acid (AA) on oxidative stress and blood-brain barrier (BBB) in rats with intracerebral hemorrhage (ICH), and on post-hemorrhagic hydrocephalus (PHH) formation in rats with ICH. Methods A rat model of PHH after ICH was developed through autologous blood infusion. To observe the effect of AA on the PHH condition of ICH rats, to observe the effect of AA on the nerve damage condition of ICH rats, to detect the expression of oxidative stress-related markers, and to detect the expression of BBB-related marker proteins. Results Compared with the ICH group, rats in the ICH-AA group had a smaller ventricular volume, a lesser degree of brain tissue damage, alleviated neuronal damage, lower brain water content, lower neurological function scores mNSS, decreased iNOS and MDA expression, increased SOD expression, up-regulated SVCT2 expression, decreased MMP-2 expression, and increased occludin, claudin-5, and ZO-1 expression. Compared with the PHH group, the ventricular volume of rats in the PHH-AA group was slightly reduced, the degree of brain tissue damage was basically the same, neuronal damage was not alleviated, but the brain water content was reduced, neurological function scores of mNSS were improved, iNOS and MDA expression was reduced, SOD expression was increased, SVCT2 expression was up-regulated, MMP-2 expression was reduced, and the expression of occludin, claudin-5, and ZO-1 expression was slightly increased. Conclusion AA inhibited the degree of oxidative stress and protected the BBB in ICH rats, alleviated the formation of PHH, and played a neuroprotective role in the early stage of ICH; whereas, after the formation of PHH, AA only partially inhibited the degree of oxidative stress but did not have any reparative effect on the BBB that had been damaged, and could not treat PHH, but could play a neuroprotective role. 2023 Vol. 20 (5): 29-37 [Abstract] ( 462 ) [HTML 1KB] [PDF 9096KB] ( 1956 ) 38 ZHANG Jiangchuan, WU Dan, JIANG Wei, ZHANG Chunmei Experimental study on the effect of midazolam on the proliferation and apoptosis of cervical cancer CaSki cells by down-regulating the expression of circ_0000285 Objective To explore the effect and possible mechanism of midazolam on the proliferation and apoptosis of cervical cancer CaSki cells. Methods CaSki cells were intervened with different doses（0,15,30,60 μg/mL）of midazolam,and the cell proliferation activity and apoptosis were measured by CCK-8 method and flow cytometry,respectively. The protein expressions of pro-caspase3 and cleaved-caspase3 were determined by western blotting,and the expression of circ_0000285 was determined by RT-qPCR. After CaSki cells that interfered with circ_0000285 expression or overexpressed circ_0000285 were constructed by transfecting circ_0000285 small interfering RNA or overexpression vector,they were intervened with 0 or 60 μg/mL midazolam,and then the same method sas above were used to measure cell proliferation activity,apoptosis and the expression of related proteins（Ki-67,pro-caspase3,cleaved-caspase3）. Results After CaSki cells were intervened by midazolam,the proliferation activity and the protein expressions of Ki-67 and pro-caspase3 were decreased,but the apoptosis rate and the protein expressions of cleaved-caspase3 were increased,and the expression of circ_0000285 in the cells was decreased. After interfering the expression of circ_0000285,the proliferation activity and the protein expressions of Ki-67 and pro-caspase3 in CaSki cells were decreased,but the apoptosis rate and the protein expressions of cleaved-caspase3 were increased. Overexpression of circ_0000285 reversed the effects of midazolam on the proliferation and apoptosis of CaSki cells. Conclusion Midazolam may inhibit the proliferation of cervical cancer CaSki cells and promote cell apoptosis by down-regulating circ_0000285. 2023 Vol. 20 (5): 38-43 [Abstract] ( 449 ) [HTML 1KB] [PDF 2564KB] ( 1746 ) 44 WEI chao, DONG Zihan, AN ning, YANG Qian, MA Yongping LncRNA MIR100HG Regulation of the miR-142-5p / SOX 5 axis on the proliferation and invasion ability of oral squamous carcinoma cells Objective To investigate the effect of the long non-coding RNA mir-100-let-7a-2-ir-125b-1 cluster host gene (LncRNA MIR100HG) regulating miR-14-2-5p / SRY related high mobility box protein 5(SOX 5) axis on the proliferation and invasion capacity of oral squamous cell carcinoma (OSCC) cells. Methods Quantitative real-time PCR and immunoblot were performed to detect the expression of LncRNA MIR100HG, miR-142-5p and SOX 5 in CAL 27, SAS, and SCC-25 in vitro cultured human oral epithelial cells and human OSCC-derived cells. When CAL 27 cells were cultured in vitro, They were randomly divided into control group, LncRNA MIR100HG knockdown group (transfection with LncRNA MIR100HG siRNA plasmid), miR-142-5p mimics group (transfected with miR-142-5p mimics), cotransfection negative control group (transfection with empty plasmid and miR-142-5p negative control), LncRNA MIR100HG knockdown + miR-142-5p inhibitor group (transfected with LncRNA MIR100HG The siRNA plasmid and miR-142-5p inhibitor), After the group-transfection, The expression of LncRNA MIR100HG, miR-142-5p and SOX 5 were analyzed by real-time PCR and immunoblotting; Using the method 3- (4, 5-dimethylthiazole-2) -2, 5-diphenyl tetrazolium bromine salt (MTT) method, 5-ethylene-2-2 ′ -deoxyuridine (Edu) staining and colony formation assay to detect cell proliferation in each group; CAL 27 cell invasion in each group was detected by Transwell invasion assay; Immunoblotting was used to detect protein expression associated with epithelial stromal transformation in each group of CAL 27 cells. OSCC tumor model was constructed in the area near the right armpit of the back of nude mice. The tumor volume and weight of nude mice were detected after 3 weeks of feeding. A dual luciferase reporter assay was used to detect the targeted regulation of miR-142-5p and SOX 5 by miR-142-5p. Results Compared with human oral epithelial cells, LncRNA MIR100HG, SOX 5 protein and mRNA were increased in CAL 27, SAS, SCC-25 and miR-142-5p decreased. In LncRNA MIR100HG knockdown, SOX 5 protein and mRNA expression, cell viability, proliferation rate, colony formation ratio, tumor volume and weight, invasion number, N-cadherin protein expression, miR-142-5p expression than control group. Downregulation of miR-142-5p can weaken the effect of LncRNA MIR100HG knockdown on various indicators of CAL27 cells. Targeted downregulation of miR-142-5p by LncRNA MIR100HG and miR-142-5p and SOX 5 in CAL 27 cells. Conclusion Knockdown of LncRNA MIR100HG can inhibit OSCC cells proliferation, epithelial stromal transformation and invasion by regulating the miR-142-5p/SOX5 axis, and can delay tumor growth in vivo. 2023 Vol. 20 (5): 44-50 [Abstract] ( 422 ) [HTML 1KB] [PDF 2883KB] ( 1977 ) Clinical Medicine 51 CHEN Ying, SHU Kongliang, LI Yuan, ZHOU Ying Effects of transcranial magnetic stimulation on dysfunction, pain degree and self-efficacy in patients with different types of chronic daily headache Objective To investigate the effects of transcranial magnetic stimulation on dysfunction, pain degree and self-efficacy in patients with different types of chronic daily headache. Method One hundred and sixty patients with chronic daily headache in our hospital from January 2021 to December 2022 were selected as the research objects. Randomized single-blind grouping: the control group (80 cases) received routine comprehensive treatment, while the research group (80 cases) received transcranial magnetic stimulation treatment on the basis of the control group. The functional classification, visual analog scale (VAS), headache frequency and general self-efficacy scale (GSES) scores before and after treatment were compared between the two groups and among different types of patients within the group. The clinical efficacy were statistically analyzed. Results 2, 3, 4 weeks after treatment, the dysfunction grade, VAS score and headache attack frequency of the study group were lower than those of the control group, while the GSES score was higher than that of the control group, there was no statistically significant difference between the two groups in functional impairment grade, VAS score, headache frequency and GSES score of different types of patients. The total effective rate of the study group was 95.00%, higher than 73.75% of the control group, there was no significant difference in total effective rate between different types of patients in the two groups. Conclusion Routine comprehensive treatment for patients with chronic daily headache combined with transcranial magnetic stimulation can alleviate dysfunction and pain, improve self-efficacy, and enhance efficacy, and the effects of different types of chronic daily headache patients are similar. 2023 Vol. 20 (5): 51-55 [Abstract] ( 445 ) [HTML 1KB] [PDF 1928KB] ( 1940 ) 56 DAI Hongying, GUO Jinjin, TANG Min Expression significance and correlation of TGF-β1, IFN-γ and Lund-Mackay score in CRSwNP patients Objective To investigate the relationship and significance of the expression of transforming growth factor β1(TGF-β1), interferon-γ (IFN-γ) and Lund-Mackay score in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Methods A total of 98 patients with CRSwNP in our hospital from January 2020 to October 2021 were selected as the research subjects. The expression of TGF-β1, IFN-γ and Lund-Mackay score in polyp tissues of patients with different stages were compared. The Pearson correlation coefficient was used to analyze the relationship between the expression of TGF-β1 and IFN-γ and the Lund-Mackay score. COX regression model was used to analyze the independent risk factors of CRSwNP recurrence. Receiver operating characteristic (ROC) curve was used to analyze the evaluation value of TGF-β1 and IFN-γ expression on postoperative recurrence, and decision curve analysis (DCA) was used to compare the clinical outcomes of TGF-β1 and IFN-γ alone and in combination. benefit situation. Results With the increase of patient stage, the expression of TGF-β1 decreased, the expression of IFN-γ and Lund-Mackay score increased (P<0.05). The expression of TGF-β1 was negatively correlated with the Lund-Mackay score, and the expression of IFN-γ was positively correlated with the Lund-Mackay score (P<0.05). The allergic rhinitis, combined asthma, postoperative infection, Lund-Mackay score, white blood cell count, eosinophils, TGF-β1 and IFN-γ in patients with postoperative recurrence were higher than those in patients without recurrence (P<0.05). After adjusting for allergic rhinitis, concurrent asthma, postoperative infection, white blood cell count, and eosinophils, TGF-β1 and IFN-γ were still independent influencing factors of postoperative recurrence in patients with CRSwNP (P<0.05). The combined AUC of TGF-β1 and IFN-γ to evaluate postoperative recurrence in CRSwNP patients was greater than the efficacy of independent evaluation (P<0.05). Within the threshold range of 0.18 to 0.82, the combined evaluation model of TGF-β1 and IFN-γ was better than the single test in evaluating the net benefit rate of postoperative recurrence in patients with CRSwNP. Conclusion The expression of TGF-β1 and IFN-γ in polyp tissue of CRSwNP patients is closely related to the disease condition. The risk of postoperative recurrence can be judged by detecting the levels of the two, and the benefit rate of patients is higher by the combined detection. 2023 Vol. 20 (5): 56-60 [Abstract] ( 470 ) [HTML 1KB] [PDF 2771KB] ( 2157 ) 61 FANG Min, YAN Lijie, ZHANG Qian, LI Zhenyu Risk factors and intervention measures of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia Objective To analyze the risk factors and intervention measures of hypothermia during laparoscopic hysterectomy under general anesthesia. Methods A total of 408 patients who underwent laparoscopic hysterectomy under general anesthesia in the First Affiliated Hospital of Nanjing Medical University from January 2022 to January 2023 were retrospectively included. According to whether there was hypothermia during the operation,they were divided into two groups：51 patients of the group with intraoperative hypothermia and 357 patients of the group without intraoperative hypothermia. The general data of patients were counted,and the single factor analysis of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia was carried out. The related factors affecting the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia were analyzed by multivariate Logistic regression. Results The results of univariate analysis showed that the age in the group with intraoperative hypothermia was higher than that in the group without intraoperative hypothermia,and the anesthesia time and operation time were longer than those in the group without intraoperative hypothermia,while the amount of fluid replacement,carbon dioxide consumption and bleeding volume were higher than those in the group without intraoperative hypothermia,with statistical significance. Multivariate Logistic analysis showed that anesthesia time ≥90 min,operation time ≥120 min,fluid infusion ≥2 000 mL,carbon dioxide dosage ≥150 L,and bleeding volume ≥100 mL were all risk factors for intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia. Conclusion Risk factors that affected the occurrence of intraoperative hypothermia in patients undergoing laparoscopic hysterectomy under general anesthesia included anesthesia time ≥90 min,operation time ≥120 min,fluid infusion≥2 000 mL,carbon dioxide dosage≥150 L,and bleeding volume≥100 mL. Therefore,targeted intervention measures could be taken for patients undergoing laparoscopic hysterectomy under general anesthesia to reduce the risk of intraoperative hypothermia. 2023 Vol. 20 (5): 61-64 [Abstract] ( 438 ) [HTML 1KB] [PDF 1809KB] ( 1990 ) 65 HE Qian, XU Ke, YANG Yalan, ZHOU Chunmei, LIU Jiakai, DU Zhenhong Application value of echocardiography in clinical diagnosis and prognosis evaluation of heart failure with preserved ejection fraction in elderly patients with hypertension Objective To evaluate the application value of echocardiography in clinical diagnosis and prognosis evaluation of heart failure with preserved ejection fraction（HFpEF）in elderly patients with hypertension. Methods A total of 96 elderly hypertension with HFpEF patients who were admitted to the hospital from January 2020 to April 2023 were selected as the study subjects. Among them,patients with HFpEF were included in the study group（n=96）and those without HFpEF were included in the control group（n=100）. The echocardiographic parameters of the two groups were compared,and the clinical value of echocardiography in diagnosing hypertension and HFpEF was analyzed using the receiver operating characteristic（ROC）curve. Patients in the study group were divided into the good prognosis group and the poor prognosis group according to the presence or absence of major adverse cardiovascular events（MACE）within 3 months after discharge. The prognostic factors were explored. Results IVSTD,LVDd,LVPWTD and LVMI in the study group were higher than those in the control group. ROC curve analysis found that the optimal cutoff values of IVSTD,LVDd,LVPWTD and LVMI for diagnosing hypertension and HFpEF were 0.985 mm,4.085 mm,0.965 mm and 114.175 g/m2,respectively. The AUC and sensitivity of the combined diagnosis of hypertension and HFpEF were higher than those of single diagnosis. Hb level and LVEF in the poor prognosis group were lower than those in the good prognosis group. The grade of cardiac function,LVMI and MEE were higher than those in the good prognosis group. Multivariate logistic regression analysis found that Hb,the grade of cardiac function,LVEF,and MEE were independent influencing factors for the prognosis of hypertension and HFpEF. Conclusion Compared with elderly hypertension patients without HFpEF,elderly hypertension with HFpEF patients have larger IVSTD,LVDd,LVPWTD and LVMI. The combination of these four indicators is of high application value in diagnosing hypertension with HFpEF. Hb,the grade of cardiac function,LVEF,and MEE are independent prognostic factors in hypertension with HFpEF patients,which deserves special attention in clinical practice. 2023 Vol. 20 (5): 65-69 [Abstract] ( 426 ) [HTML 1KB] [PDF 2242KB] ( 2147 ) 70 SHA Ou, YU Yang Association study between Metabolic Insulin Resistance Score and New-Onset Stroke in middle-aged and elderly Chinese population Objective Stroke is a major cause of cardiovascular mortality and may have a correlative relationship with insulin resistance. To investigate the relationship between the metabolic score for insulin resistance (METS-IR) and new-onset stroke in middle-aged and elderly people based on a large cohort study. Methods Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2018. Regression models were developed to explore the association between METS-IR and new-onset stroke, while restricted cubic spline models were used to examine possible nonlinear associations and subgroup analyses were used to explore possible potential moderating variables. Results A total of 6706 study subjects were included in the study, including 381 with new-onset stroke. The regression model results found a 67.3% increase in the risk of new-onset stroke for each quartile increase in the METS-IR (OR=1.673, 95% CI: 1.440-1.944). A linear relationship between the METS-IR and the prevalence of new-onset stroke was shown using restricted three-sample regression analysis, and stratified analysis revealed that the relationship between METS-IR and new-onset stroke was consistent across subgroups. Conclusion The METS-IR is strongly associated with the prevalence of new-onset stroke, and people with high METS-IR need to be more alert to the risk of stroke. 2023 Vol. 20 (5): 70-74 [Abstract] ( 486 ) [HTML 1KB] [PDF 1905KB] ( 2164 ) 75 SUN Hui, MA Tengfei, HUANG Shanshan, XU Wenhua Repair effect of self-etching adhesive combined with composite resin on deciduous tooth caries and its influences on tooth sensitivity and marginal fitness Objective To explore the repair effect of self-etching adhesive combined with composite resin on deciduous tooth caries and its influences on tooth sensitivity and marginal fitness. Methods A total of 84 children with deciduous tooth caries admitted to the hospital were enrolled between April 2019 and April 2022. According to random number table method, they were divided into experimental group (n=42) and control group (n=42). On basis of composite resin, control group was treated with full-etching adhesive, while experimental group was treated with self-etching adhesive. The curative effect after treatment, grading of tooth retention and marginal fitness, incidence of complications, tooth sensitivity [tactile value of tooth sensitivity, schiff cold air sensitivity scale, visual analogue scale (VAS) ] and gingival index in the two groups were observed before and after treatment. Results The total response rate of treatment was higher in experimental group than control group. After treatment, Tactile value was greater in experimental group than control group, while VAS and Schiff scores were lower in experimental group. The grading of tooth retention and marginal fitness were better in experimental group than control group. Immediately after treatment, at 1 month and 3 months after treatment, gingival index was lower in experimental group than control group. The incidence of complications was lower in experimental group than control group. Conclusion The repair effect of self-etching adhesive combined with composite resin is good on deciduous tooth caries, which can effectively improve tooth retention, marginal fitness, tooth sensitivity and gingival index, and reduce the incidence of complications. 2023 Vol. 20 (5): 75-78 [Abstract] ( 466 ) [HTML 1KB] [PDF 1778KB] ( 2054 ) 79 TANG Rongning, TANG Wenlin The expression levels of plasma NO and cGMP in children with left-to-right shunt congenital heart disease and their relationship with prognosis Objective To investigate the expression levels of plasma nitric oxide（NO）and cyclic guanosine phosphate（cGMP）in children with left-to-right shunt congenital heart disease and their relationship with prognosis. Methods A total of 114 children with left-right shunt congenital heart disease in our hospital from January 2018 to May 2021 were retrospectively selected,all of whom received surgical treatment,and were divided into good prognosis group（92 cases）and poor prognosis group（22 cases）according to the prognosis 6 months after surgery. The clinical data,plasma NO and cGMP levels of the two groups were compared,the correlation between plasma NO and cGMP and the disease was analyzed,and the influence and predictive value of plasma NO and cGMP on the prognosis was evaluated. Results The heart function grade,postoperative severity score and the proportion of pulmonary hypertension in the poor prognosis group were higher than those in the good prognosis group. Plasma levels of NO and cGMP in poor prognosis group were lower than those in good prognosis group. The levels of plasma NO and cGMP in grade Ⅳ children were lower than those in grade Ⅲ children than those in grade Ⅱ children;The plasma levels of NO and cGMP in children with higher severity were lower than those in children with lower severity. The plasma levels of NO and cGMP in children with pulmonary hypertension were lower than those in children without pulmonary hypertension. Plasma NO and cGMP levels were negatively correlated with cardiac function grade,postoperative severity and pulmonary hypertension. Low levels of plasma NO and cGMP significantly increased the risk of poor prognosis in children with left-to-right shunt congenital heart disease. The OR values were 2.563 and 1.921,respectively,and 95%CI were 1.840-3.570 and 1.372-2.691,respectively. Combined plasma NO and cGMP levels predicted poor prognosis of children with left-right shunt congenital heart disease with AUC of 0.929（95%CI：0.865~0.969）and Yoden index of 0.811,which were greater than those predicted by the two alone. Conclusion Plasma NO and cGMP are down-regulated in children with left-to-right shunt congenital heart disease,which is closely related to the disease and will increase the risk of poor prognosis,and the combined prediction of poor prognosis is reliable. 2023 Vol. 20 (5): 79-83 [Abstract] ( 441 ) [HTML 1KB] [PDF 2857KB] ( 2210 ) 84 ZHAO Wenjiao, LIU Fang, YAN Qiongqiong Differential expression of MicroRNA in cervical cancer and precancerous lesions Objective To investigate the expression of miRNAs in the blood of patients with squamous cell carcinoma (SCC) and high-grade squamous intraepithelial lesion (HSIL) of the cervix and to determine the impact of these miRNAs in the clinical course of cervical cancer development. Methods Between January 2020 and January 2022, a total of 35 patients with HSIL and 35 patients with cervical SCC and 30 healthy controls were enrolled in the study. Blood specimens from patients were collected and the relative miRNA expression levels of miR-409, miR-32, miR-454, miR-17, miR-520 and miR-373 in serum were analyzed by qRT-PCR. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic potential of differentially expressed miRNAs. Results Compared with healthy controls, miR-409 was found to be significantly down-regulated, and miR-32, miR-454, and miR-17 were significantly up-regulated in HSIL and cervical SCC tissues. In addition, miR-409 was significantly downregulated, and miR-32, miR-454, and miR-17 were significantly upregulated in the cervical SCC group compared with the HSIL group. roC analysis showed that miR-409(AUC=0.972), miR-32(AUC=0.942), and miR-454(AUC=0.905), and miR-17(AUC=0.969) had high specificity and sensitivity in distinguishing the control and SCC groups. miR-409(AUC=0.921) and miR-17(AUC=0.851) had high specificity and sensitivity in distinguishing the HSIL and SCC groups. In addition, miR-32 and miR-454 were less sensitive in distinguishing HSIL group from SCC group. Conclusion In this study, four miRNAs (miR-409, miR-32, miR-454, miR-17) differentially expressed in the sera of normal controls, HSIL and SCC patients are identified, and these miRNAs show good sensitivity and specificity in distinguishing normal from SCC. Among them, miR-409 and miR-17 could also be used as potential markers to distinguish HSIL from SCC. 2023 Vol. 20 (5): 84-89 [Abstract] ( 438 ) [HTML 1KB] [PDF 2347KB] ( 2012 ) 90 ZHONG Wanmei, YE Zeming, YANG Shideng, OU Wei, HE Lilong Comparison of acute normovolemic hemodilution in patients undergoing lobectomy under controlled low central venous pressure Objective To explore the value of acute isovolume hemodilution in patients with hepatic lobectomy under controlled low central venous pressure. Methods Thirty patients with selective hepatectomy who were admitted to Wuzhou People’s Hospital from August 2020 to August 2022 were selected and divided into the test group（using acute normovolemic hemodilution combined with controlled low central venous pressure）and the control group（using controlled low central venous pressure）with 15 patients each using a random number table. Compare the hemodynamic indexes,cerebral oxygen metabolism indexes,coagulation function indexes,quality of awakening period Incidence of adverse reaction of anesthesia. Results The central venous pressure（CVP）,mean arterial pressure（MAP）,and heart rate（HR）of patients were compared between the test group and the control group at four different time points：before blood dilution,before hepatic portal occlusion,during hepatectomy,and upon completion of the surgery. There was no significant difference between the two groups;The Hct values of patients in the test group were significantly lower than those in the control group before hepatic portal occlusion and at the time of hepatectomy;There was no significant difference between the two groups in the measured values of Da jvO2 and SjvO2 at each time point;The measured value of CERO2 in the test group was significantly lower than that in the control group before hepatic portal occlusion,and the measured value of VADL in the test group before hepatic portal occlusion and during hepatectomy was significantly lower than that in the control group;Before hemodilution,the measured values of PT,APTT,Fib and TT in the two groups showed no significant difference;The measured values of PT and APTT in the test group were significantly lower than those in the control group after operation;There was no significant difference between the test group and the control group in the time of opening eyes,extubation and leaving the recovery room;The incidence of anesthesia related adverse reactions in the test group was 26.67%,compared with 60.00% in the control group,and there was no significant difference. Conclusion The application of acute normovolemic hemodilution combined with controlled low central venous pressure in hepatectomy under general anesthesia is conducive to stabilizing the hemodynamic indexes of patients,maintaining the balance between cerebral oxygen supply and demand,and reducing the impact of surgery on the coagulation function of patients. 2023 Vol. 20 (5): 90-94 [Abstract] ( 430 ) [HTML 1KB] [PDF 1862KB] ( 1785 ) 95 ZHU Yaofeng, DU Chun, SONG Huan, HE Zezhen, ZUO Lingyan, GONG Ling, ZHANG Yunyun Correlation between serum Sortilin level with glucose and lipid metabolism and insulin resistance in patients with gestational diabetes mellitus and diagnostic value analysis Objective To investigate the diagnostic value of serum Sortilin level in gestational diabetes mellitus (GDM) and analyze its correlation with glucose and lipid metabolism and insulin resistance. Methods 911 pregnant women admitted to the obstetrical clinic of our hospital from February 2019 to February 2022 were selected as the study subjects, including 162 pregnant women with GDM (GDM group) and 749 pregnant women with normal glucose tolerance (control group). Serum Sortilin level were detected at gestation week 12, and week 20, 28 , glucose and lipid metabolism and insulin resistance were detected. The correlation between Sortilin and glucose and lipid metabolism, insulin resistance and the diagnostic value of Sortilin in GDM were analyzed. Results Age, pre-pregnancy body mass index, pregnancy body weight gain, serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo-B), fasting blood glucose (FPG), fasting insulin (FINS) level and insulin resistance index (HOMA-I) in GDM group were higher than that of control group. The serum Sortilin level of GDM group increased gradually from week 12 to week 28 of gestation, but had no significant change in the control group. The serum Sortilin level of GDM group at week 12, week 20 and week 28 of gestation was higher than that of the control group. Serum Sortilin level at gestation week 12, and week 20, 28 was positively correlated with TC, TG, LDL-C, APO-B, FPG, FINS, HOMA-IR. High pregnancy body weight gain, Sortilin at gestation week 20 and week 28 and HOMA-IR were risk factors for GDM. The area under the curve of Sortilin at gestation week 12 and week 20 in diagnosing GDM was 0.754(95%CI: 0.725-0.782), 0.807(95%CI: 0.779―0.832), with sensitivity of 77.78% and 80.86%, specificity of 69.83% and 79.97%. Conclusion Serum Sortilin level in GDM patients increases in the first trimester of pregnancy, which is related to glucose and lipid metabolism disorders and insulin resistance. Serum Sortilin level in the first trimester of pregnancy can be used as a predictive marker of GDM. 2023 Vol. 20 (5): 95-98 [Abstract] ( 418 ) [HTML 1KB] [PDF 1972KB] ( 2162 ) 99 LEI Xiaomei, YANG Hua, WANG Ying, MENG Weihua Prognostic value of Th17 / Treg related cytokines in peripheral blood in ovarian cancer Objective To investigate the prognostic value of peripheral blood helper T cell 17（Th17）/ regulatory T cell（Treg）- related cytokines in ovarian cancer. Methods A total of 80 patients with ovarian cancer admitted to the Second Affiliated Hospital of Guangxi Guilin Medical College from July 2019 to June 2021 were selected as the ovarian cancer group，and 50 healthy patients in the same period were selected as the healthy group. The prognosis of ovarian cancer patients during 3 years follow-up was analyzed. Recurrence and death were poor prognosis，while no recurrence and survivors were good prognosis. The percentage of Th17，Treg cells，interleukin-17（IL-17）and IL-10 in peripheral blood of each group were detected，and Th17/Treg was calculated. The above indexes were compared between ovarian cancer group，healthy group and ovarian cancer patients with different clinical stages. Cox regression analysis was used to identify related risk factors，and ROC curves were drawn to verify the prognostic efficacy of Th17/Treg，IL-17 and IL-10 in ovarian cancer. Results The proportion of Th17 and Treg cells，Th17/Treg and IL-17 and IL-10 levels in peripheral blood of patients with ovarian cancer group were higher than those in healthy group. The proportion of Th17 and Treg cells，Th17/Treg and IL-17 and IL-10 levels in peripheral blood of patients with stage Ⅰ to Ⅱ were lower than those of patients with stage Ⅲ to Ⅳ. There were statistically significant differences in age，clinical stage，residual lesion size，number of chemotherapy courses，Th17，Treg，Th17/Treg，IL-17 and IL-10 between patients with poor prognosis and those with good prognosis. Multivariate Cox regression analysis showed that clinical stage，residual lesion size，number of chemotherapy courses，Th17，Treg ratio in peripheral blood，Th17/Treg，IL-17 and IL-10 levels were independent prognostic factors of ovarian cancer patients. ROC curve results showed that the area under ROC curve（AUC）of Th17/Treg，IL-17，IL-10 and the three combinations were 0.789，0.845，0.839 and 0.960，respectively. Conclusion The changes of Th17 / Treg and its related cytokines，such as IL-17 and IL-10，may participate in the occurrence and development of ovarian cancer，and are closely related to the prognosis of patients，which has a certain predictive value for prognosis. 2023 Vol. 20 (5): 99-102 [Abstract] ( 421 ) [HTML 1KB] [PDF 1891KB] ( 2306 ) 103 JIANG Beile, WEI Xiaoshuang, ZHAO Fengmao, WANG Zixia, CHANG Hongyun, GONG Liqin The effect of Diedazhuifeng wine dipping combined with TDP infrared therapeutic apparatus irradiation on the maturation of autologous arteriovenous fistula Objective To observe the effect of Diedazhuifeng wine dipping combined with TDP infrared therapy device irradiation on the maturation of autologous arteriovenous fistula. Methods From January 2018 to February 2022, 120 patients with renal failure in outpatient or inpatient treatment at Guilin Hospital of Traditional Chinese Medicine were divided into the control group (60 cases) and the observation group (60 cases) by random number table method. Both groups of patients were treated with autologous arteriovenous fistula. The control group was treated with polysulfonic acid mucopolysaccharide cream + TDP infrared therapeutic apparatus after treatment, while the observation group was treated with Diedazhuifeng wine dipping + TDP infrared therapeutic apparatus after treatment. Irradiation intervention. The differences in high-sensitivity-C-reactive protein (hs-CRP), monocyte chemoattractant protein-1(MCP-1), cephalic vein diameter, blood flow, internal fistula wall thickness, and arterial resistance index were compared. First puncture success rate and complication rate. Results The hs-CRP and MCP-1 in the control group were significantly higher than those before treatment 7 days after treatment, but there was no difference in hs-CRP and MCP-1 in the observation group compared with those before treatment. hs-CRP and MCP-1 were lower than the control group, with statistical significance. The cephalic vein diameter and blood flow in the two groups after 15d and 30d after treatment were significantly higher than those before treatment. There was no difference in the thickness of internal fistula vessel wall and arterial resistance index between the two groups at 15d after treatment. On the 30th day, the thickness of the internal fistula vessel wall in the two groups and the arterial resistance index in the observation group were significantly lower than those before treatment, and the diameter and blood flow of the cephalic vein in the observation group at the same time point after the treatment were higher than those in the control group. The thickness and arterial resistance index were lower than those of the control group, with statistical significance. The success rate of the first puncture in the observation group was 93.33% (56/60), which was higher than 80.00% (48/60) in the control group, while the incidence of complications was 1.67% (1/60), which was not statistically significant compared to 8.33% (5/60) in the control group. Conclusion Treatment of Diedazhuifeng wine dipping combined with TDP infrared device irradiation can promote the maturation of autologous arteriovenous fistula and improve the success rate of first puncture, which may be related to reducing postoperative inflammatory response and improving the vascular condition of the internal fistula. 2023 Vol. 20 (5): 103-106 [Abstract] ( 423 ) [HTML 1KB] [PDF 1810KB] ( 1900 ) 107 LIAO Yilin, Qin Wenyi, LAN Ying, WEI Zhaokai Application of Low Molecular Weight Heparin Combined with Urokinase or Oral Indobufen in the Sealing of Central Venous Catheter in Hemodialysis Patients Objective This study aimed to investigate the effect of low molecular weight heparin combined with urokinase or low molecular weight heparin combined with oral Indobufen in the sealing of central venous catheter in hemodialysis patients. Methods A total of 42 hemodialysis patients with central venous catheterization were divided into the control group (low molecular weight heparin, n=14), research group A (low molecular weight heparin combined with urokinase, n=14), and research group B (low molecular weight heparin combined with oral Indobufen, n=14). The catheter permeability, coagulation index, and the incidence of catheter adverse events were compared between the control group and research group A/B. Results Compared with the control group, the research group A was present with higher blood flow, urea clearance index, PT, APTT, and INR, and lower venous pressure and FIB. Compared with the control group, the research group B was present with higher blood flow, urea clearance index, PT, APTT, and INR, and lower venous pressure and FIB. There is a significant difference in the incidence of adverse events between the control group and study group A or between the control group and study group B. Conclusion The strategy of low molecular weight heparin combined with urokinase or low molecular weight heparin combined with oral Indobufen was effective in the sealing of central venous catheter in hemodialysis patients. 2023 Vol. 20 (5): 107-110 [Abstract] ( 450 ) [HTML 1KB] [PDF 1816KB] ( 2387 ) 111 LIU Huimin, FU Weidong, LUO Liu, ZHENG Mingzhi Effect of subanesthetic dose of esketamine combined with propofol on the recovery quality and pro-inflammatory factors in elderly patients with outpatient colonoscopy Objective To investigate the effect of subanesthetic dose of esketamine combined with propofol on the recovery quality and pro-inflammatory factors in elderly patients with outpatient colonoscopy. Methods 200 cases of elderly patients with outpatient colonoscopy in our endoscopic center were randomly divided into control group (propofol group) and observation group (subanesthetic dose of esketamine combined with propofol), each were 100 cases. The bispectral index (BIS) was used as an monitoring index of individualized anesthesia depth. The hemodynamic index (HR、RR、MAP、SpO2) and BIS value of two groups were compared at the time of entering the examine-room (T0), immediately before inserting (T1), the colonoscope has passed the splenic flexion (T2), the colonoscope has passed the liver flexion (T3), colonoscopy end-point (T4) and after procedure (T5). The dosage of propofol, eye-opening time, completion time of commanded action, leaving PACU time, colonoscopy time, 40-item questionnaire (QoR-40) score and adverse reactions of two groups were recorded. The pro-inflammatory factors (IL-1β、IL-6, TNF-α) were compared before and after colonoscopy. Results There were no significant difference in HR, RR, MAP and SpO2 between two groups at T0. Compared with T0, MAP, SpO2 and HR of two groups decreased at T1-T4. MAP and SpO2 in observation group were higher than control group at T1-T4. There was no significant difference in BIS value between two groups at T0-T5. The dosage of propofol of observation group was less than control group. The eye-opening time, completion time of commanded action, leaving PACU time and colonoscopy time had no significant difference between two groups. At T5, the QoR-40 score of physical comfort, pain, emotional state, psychological support and total score of observation group were higher than control group, and the level of IL-1β、IL-6, TNF-αof observation group were lower than control group. The incidence of adverse reactions such as hypotension, respiratory depression, somatic reaction and propofol injection pain of observation group were lower than control group. Conclusion Subanesthetic dose of esketamine combined with propofol can provide effective sedation and analgesia for elderly patients with outpatient colonoscopy. The hemodynamics was stable. It can effectively reduce the level of inflammation, improve quality of early awakening with lower respiratory depression. 2023 Vol. 20 (5): 111-116 [Abstract] ( 446 ) [HTML 1KB] [PDF 4061KB] ( 2357 ) 117 REN Jing, LIANG Jiali, XU Fengyi Analysis of Pathogens, Drug Resistance and Risk Factors of Puerperal Infection Objective To analyze the pathogens, drug resistance and risk factors of puerperal infection. Methods The clinical data of 124 parturients who delivered in our hospital from July 2020 to December 2021 were analyzed retrospectively. The infection rate, pathogenic bacteria and drug resistance were counted, and the risk factors of infection were analyzed. Results The infection rate was 7.26% in 9 parturients. The main infection sites were perineum incision (33.33%) and genital tract (22.22%). A total of 36 pathogens were detected, including 19 gram-negative bacteria (52.78%), 14 gram-positive bacteria (38.89%) and 3 fungi (8.33%). The resistance rate of gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) to rifampicin, vancomycin and meropenem was low. Gram-positive bacteria (Staphylococcus aureus, Enterococcus faecalis) had low resistance rates to vancomycin and imipenem. Multivariate logistic regression analysis showed that pregnancy complications, prenatal anemia, postpartum hemorrhage, labor process time ≥ 8 h, rupture time ≥ 12 h, and soft birth canal injury were independent risk factors of puerperal infection. Conclusion Gram-negative bacteria and positive bacteria were the main pathogens of puerperal infection, and the antibiotics with high sensitivity should be selected according to the drug resistance. There are many factors influencing puerperal infection, and corresponding preventive measures can be taken according to relevant risk factors. 2023 Vol. 20 (5): 117-120 [Abstract] ( 438 ) [HTML 1KB] [PDF 1770KB] ( 2023 ) 121 CHEN Rao, PENG Jinfeng, SHEN Ting Occurrence of depression in patients with acute ischemic stroke after intravenous thrombolysis and construction of prediction model Objective To analyze the occurrence of depression in patients with acute ischemic stroke (AIS) after intravenous thrombolysis, and construct a prediction model. Methods A total of 243 patients with AIS who underwent intravenous thrombolysis in the Third Hospital of Mianyang from January 2020 to December 2021 were selected as the study subjects. According to the presence or absence of depression after intravenous thrombolysis, the patients were divided into depression group (n=78) and non-depression group (n=165). Baseline data of the two groups were compared. Logistic regression analysis was conducted to identify the influencing factors of depression after intravenous thrombolysis for AIS, and a prediction model was constructed. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Univariate analysis showed that there were statistically significant differences between the two groups in terms of age, BMI, accompanying mode, recent occurrence of negative life events, NIHSS score at admission and complications after thrombolysis. Logistic regression analysis found that age ≥ 60 years old, BMI ≥ 28 kg/m2, accompanied by nursing workers, negative life events occurring recently, the NIHSS score higher than 5 at admission, hemorrhage and ischemia-reperfusion injury after thrombolysis were risk factors for depression in patients with AIS after intravenous thrombolysis. A prediction model was constructed based on above-mentioned factors, and internal verification by Bootstrap method showed that the prediction curve was in good agreement with the standard model curve. ROC curve analysis showed that the sensitivity and specificity of the indicator Prob were 86.00% and 70.50%. Conclusion Age, BMI, accompanying mode, presence or absence of negative life events recently, the NIHSS score at admission and complications after thrombolysis are influencing factors of depression in patients with AIS after intravenous thrombolysis. The prediction model constructed based on above factors provides certain reference for predicting depression in AIS after intravenous thrombolysis. 2023 Vol. 20 (5): 121-124 [Abstract] ( 427 ) [HTML 1KB] [PDF 1873KB] ( 2054 ) Pharmacy 125 HE Siyuan, PENG Chuang Mechanism of Tao-Hong-Si-Wu Decoction in Treating Chronic Cholecystitis Based on Network Pharmacology and Molecular Docking Objective To explore the mechanism of Tao-Hong-Si-Wu Decoction (THSWD) in treating chronic cholecystitis based on network pharmacology and molecular docking, so as to save the cost for the research and development of new drugs and make the experiment more targeted. Methods The effective components of drugs were searched by TCMSP database, and their corresponding targets were predicted in wiss Target Prediction. Then the target of chronic cholecystitis is predicted by GeneCards database. After establishing the target database of drugs and diseases, PPI network diagram, drug composition-target diagram and G0 and KEGG enrichment analysis were drawn. According to the degree value, the target of the core component was screened out, and then the combination of the two was verified by molecular docking. Finally, LPS stimulated human gallbladder epithelial cells to induce inflammation, and Elisa kit was used to detect the concentration of inflammatory mediators in supernatant. Western blot was used to detect the expression of AKT and p-AKT after treatment with different concentrations of THSWD. Results 3,262 potential targets of 49 active components of THSWD were screened, and 665 potential targets were obtained after weight removal. There are 681 disease targets, and Go enrichment analysis shows that the target proteins are mainly involved in smooth muscle cell proliferation, MAPK cascade reaction, inflammatory reaction, protein kinase B signal regulation and so on. KEGG enrichment analysis found that the target was involved in 140 pathways, mainly involving AGE-RAGE signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and so on. The core targets screened according to the degree value are AKT1, TNF, TP53, VEGFA and IL-1B, and the core components are kaempferol, luteolin and quercetin. AKT1 with the highest degree was selected for molecular docking with kaempferol, and the results were visualized. CCK-8 experimental results showed that THSWD of 12.5ug/ml and 25ug/ml had no obvious toxic effect on gallbladder epithelial cells. The results of Elisa showed that the level of IL-6 increased significantly after lipopolysaccharide stimulation, but decreased significantly after THSWD treatment. Western blot showed that the expression of p-AKT increased in LPS-induced group and decreased in THSWD-treated group. Conclusion Based on the network pharmacology, molecular docking and cell experiments, it is found for the first time that THSWD is effective in the treatment of chronic cholecystitis, and AKT1 and Kaempferol may be its target and one of its effective components respectively. 2023 Vol. 20 (5): 125-131 [Abstract] ( 447 ) [HTML 1KB] [PDF 4831KB] ( 2254 ) 132 PENG Min, PAN Yong, DAI Yingchun, CHEN Li, YAN Xiao, LI Wei, Deng Yinhua Analysis of the use and influencing factors of cephalosporins after the routine skin test was cancelled in a tertiary hospital Objective A questionnaire survey was used to evaluate the knowledge of medical staff in a certain hospital on cephalosporin skin test, to determine the impact of the policy of “phasing out cephalosporin skin test “ on the use of inpatient cephalosporins, and to provide reference for the sustainable advancement of this work. Methods Statistics and analysis of cephalosporin use in June-September 2020 and June-September 2021. A quesionnaire was distributed to each clinical department by the clinical pharmacy department in the hospital to investigate the attitudes of doctors, nurses and pharmacists to cancel the routine skin test of cephalosporin and the corresponding countermeasures. Results After the skin test was cancelled, the amount of cephalosporins was significantly decreased, and the proportion of total defined daily doses (DDDs) decreased (25.24%vs 24.41%). A total of 328 medical workers were surveyed, and doctors, nurses and pharmacists accounted for 26.83%, 63.72%, and 9.45%, respectively. Only 41.46% knew that the hospital implemented the policy of “phasing out cephalosporin skin test”, and 51.23% of the respondents supported “phasing out cephalosporin skin test”. The main reason for disapproval (53.96%) is that “skin test is an effective screening method to assess whether patients are allergic to cephalosporins”. The univariate chi-square test showed that there was no significant difference in each factor (including gender, age, highest education, department, and working years) for “after canceling the routine skin test, will the patient still be given a skin test?”.81.71% thought that the most common description of the history of cephalosporin allergy was a positive skin test, and 80.49% would avoid the use of cephalosporin because of a positive skin test in the past. Nurses' correct interpretation of the configuration, operation method and results of the cephalosporin skin test solution accounted for 35.58%, 3.37%, and 75.00%, respectively, and the univariate chi-square test showed that there were significant differences between departments. The main influencing factors for the correct “method of preparing cephalosporin skin test solution”. Conclusion There are still many misunderstandings about the knowledge of cephalosporin skin test among medical workers in this hospital, and after the cancellation of routine cephalosporin skin test, routine skin test is still performed or the use of cephalosporin antibiotics is reduced. Clinical pharmacists should actively respond to national policies, strengthen communication and training with clinical clinics, and eliminate the concerns of medical workers. With the assistance of clinical medical care and information systems, we will jointly promote the implementation and promotion of policies. 2023 Vol. 20 (5): 132-138 [Abstract] ( 425 ) [HTML 1KB] [PDF 2391KB] ( 1897 ) Preventive Medicine 139 MA Rongfei, SONG Tianyu, WANG Shumin, TANG Zhiru Research on Structural Changes and Optimization Paths of Total Health Costs Based on the Degree of Structural Changes Objective To analyze the total amount and structural changes of health financing and institutional flow, find out its changing rules and characteristics, and provide reference for the rational allocation of medical and health resources in Anhui Province. Methods Using the method of structural change degree, the changes of financing and flow direction of health expenditure in Anhui Province from 2006 to 2021 were analyzed from two aspects of total amount and structure. Results From 2006 to 2021, the total health expenditure in Anhui Province maintained an increasing trend. In the financing structure, the change value of government health expenditure and social health expenditure is positive, and the change value of personal cash health expenditure is negative. The structural change value of urban hospitals, health centers and public health institutions in the flow structure is negative, and the structural change value of county hospitals and community health centers is positive. Conclusion From 2006 to 2021, the scale of total health expenditure in Anhui Province showed an increasing trend, the financing structure was gradually optimized, and the personal medical burden was further reduced. The resource allocation of public health institutions and primary health care institutions is insufficient. 2023 Vol. 20 (5): 139-144 [Abstract] ( 423 ) [HTML 1KB] [PDF 2480KB] ( 1914 ) 145 WANG Zhenru, DU Bairu Effect of group psychological intervention on disease cognition and stress response in elderly patients undergoing laryngeal cancer surgery Objective To explore the effect of group psychological intervention on disease cognition and stress response in elderly patients undergoing laryngeal cancer surgery. Methods 102 elderly patients with laryngeal cancer surgery who were hospitalized in department of otolaryngology of the hospital were selected between January 2023 and March 2023 and were randomly divided into control group and treatment group. The disease cognition degree, psychological resilience, self-perceived burden, social support and coping styles were compared between the two groups. Results The disease cognition degree in treatment group after intervention was higher than that in control group. After intervention, the scores of psychological resilience scale were higher in treatment group than those in control group. After intervention, the score of self-perceived burden scale in treatment group was lower compared with that in control group. The scores of perceived social support scale after intervention in treatment group were higher compared with those in control group. After intervention, the facing score of Medical Coping Modes Questionnaire in treatment group was higher while the scores of yielding and avoidance were lower than those in control group. Conclusion Group psychological intervention can improve the disease cognition degree, enhance the psychological resilience, reduce the self-perceived burden, strengthen the social support degree, and enhance the confidence of facing positively of elderly patients with laryngeal cancer surgery. 2023 Vol. 20 (5): 145-148 [Abstract] ( 427 ) [HTML 1KB] [PDF 1804KB] ( 2058 ) Nursing Science 149 WU Wenya, HE Caiyun, LI Liu, ZHANG Ping The Mediating effect of self-efficacy on self-perceived burden and health literacy in patients with thyroid cancer Objective To explore the mediating effect of self-efficacy on self-perceived burden and health literacy in patients with thyroid cancer. Methods A convenience sampling method was used to select patients with thyroid cancer from a tertiary Grade-A hospital in Changsha,Hunan Province from October 2022 to April 2023. A general data questionnaire,electronic health literacy scale,self-perceived burden scale,and general self-efficacy scale were used to investigate them. Results The total score of health literacy,self-perceived burden and self-efficacy were（26.14±5.62）,（22.83±8.45）and（23.54±6.69）,respectively. Health literacy was negatively correlated with self-perceived burden,health literacy was positively correlated with self-efficacy,and self-perceived burden was negatively correlated with self-efficacy. Linear regression analyses showed that self-efficacy played a fully mediating effect in the influence of health literacy on self-perceived burden in thyroid cancer patients. Conclusion Self-perceived burden of illness needs to be reduced in thyroid cancer patients,and health literacy can influence the level of self-perceived burden of illness through the mediating role of self-efficacy. 2023 Vol. 20 (5): 149-153 [Abstract] ( 461 ) [HTML 1KB] [PDF 1877KB] ( 2305 ) 154 ZHENG Mingxiang, LIU Fang, LI Xihong, LIU Jun, DAI Ling, ZHOU Jianwei Status and influencing factors of health information literacy in hospitalized patients with coronary heart disease Objective To understand the status and influencing factors of health information literacy in hospitalized patients with coronary heart disease. Methods From October to November 2022, 401 in-patients with coronary heart disease (CHD) who met the admission criteria in 2 top-three hospitals in Yueyang City and Changsha City were selected as the investigation objects by convenient sampling. General data questionnaire, concise health Measurement Scale and CHD health information literacy questionnaire were used for field investigation. Results The total score of health information literacy of inpatients with CHD was (65.11±10.13), among which the score rate of health information literacy was the highest and the score rate of health information evaluation ability was the lowest. Correlation analysis showed that the total score of health information literacy in CHD patients was significantly positively correlated with quality of life. Ordered logistic regression analysis showed that mental health, PCI times, education level, whether to receive CHD related health education were the main influencing factors of health information literacy level of patients. Conclusion Nursing staff should focus on patients with low education level, first-time PCI, and no CHD education, develop personalized nursing plans for patients, provide targeted health education and psychological guidance, help patients overcome obstacles, improve their health information literacy, and improve the health management and rehabilitation of hospitalized CHD patients. 2023 Vol. 20 (5): 154-160 [Abstract] ( 452 ) [HTML 1KB] [PDF 1911KB] ( 2171 ) 161 ZHOU Yan, ZENG-FAN Hua, ZHANG Chan, XU Lili, LI Piaopiao, QI Mingming The effect of comprehensive health management on delivery outcome of pregnant women with Gestational diabetes mellitus in Zhuzhou area Objective To investigate the effects of comprehensive health management on delivery outcome of pregnant women with Gestational diabetes mellitus in Zhuzhou area. Methods A total of 100 pregnant women who were diagnosed as gestational diabetes mellitus by 75g oral glucose tolerance test during week 24-28 of gestation were enrolled in the study. There were 50 cases in Experimental group who voluntarily undergo integrated health management and 50 cases in control group who except voluntary general nursing intervention. The self-management and pregnancy outcome of the two groups were observed. Results The self-management efficacy scores of the experimental group were significantly higher than those of the control group, and the scores of diet control, regular exercise and blood glucose monitoring were higher than those of the control group, There was no significant difference in foot care, blood glucose treatment and compliance with medical drugs. The qualified rate of body quality control in the experimental group was higher than that in the control group, the number of people using insulin was less than that in the control group, and the postprandial blood glucose in the experimental group was lower than that in the control group, the difference was statistically significant. There was no significant difference in HBA1c and fasting blood glucose between the two groups. The incidence of pregnancy-induced hypertension, cesarean section, postpartum hemorrhage, neonatal asphyxia, neonatal hypoglycemia and macrosomia in the experimental group was lower than that in the control group, and the difference was statistically significant. Conclusion The comprehensive health management model is beneficial to improve the compliance of pregnant women with gestational diabetes mellitus, effectively reduce the occurrence of cesarean section, neonatal hypoglycemia, asphyxia and huge fever, improve the pregnancy outcome, and has good clinical promotion value. 2023 Vol. 20 (5): 161-164 [Abstract] ( 434 ) [HTML 1KB] [PDF 1786KB] ( 2069 )

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