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Quick Search     Adv Search 2022 Vol. 42, No. 3 Published: 2022-06-25 1 Influence of Pitavastatin Combined With Ticagrelor on Serum Monocyte Chemoattractant Protein 1 and Interleukin 10 Levels in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention Zhang Wenya DOI: 10.3969/j.issn.1001-8131.2022.03.001 Objective This study was conducted to investigate the effect of pitavastatin combined with ticagrelor on serum monocyte chemoattractant protein 1（MCP-1）and interleukin 10（IL-10）levels in patients with acute myocardial infarction（AMI）after percutaneous coronary intervention（PCI）.Methods 60 patients with AMI who underwent PCI were enrolled in this study and randomly assigned to receive ticagrelor（control group,29 cases）or pitavastatin combined with ticagrelor（observation group,31 cases）.Cardiac function indexes,coagulation states before and after PCI,clinical effects and inflammatory factor levels in the 2 groups were compared.Results Before PCI,no significant differences were found between the 2 groups in left ventricular diastolic function（E/A ratio）and ejection fraction（EF）（P>0.05）.After PCI,the E/A ratio and EF increased significantly in the 2 groups,which were significantly higher in the observation group than in the control group（P<0.05）.Before PCI,no significant differences were found between the 2 groups in fibrin（Fg）and D-dimer（DD）（P>0.05）.After PCI,Fg and D-D decreased significantly in the 2 groups,which were significantly lower in the observation group than in the control group（P<0.05）.The total response rate of the observation group was 93.55%,higher than 72.41% of the control group（P>0.05）.Before PCI,no significant differences were found between the 2 groups in IL-10,MCP-1 and high-sensitivity C-reactive protein（hs-CRP）（P>0.05）.After PCI,levels of IL-10,MCP-1 and hs-CRP in the 2 groups were higher than those before operation.Additionally,the observation group had IL-10 levels but lower MCP-1 and hs-CRP levels than the control group（P<0.05）.Conclusion After PCI,using pitavastatin combined with ticagrelor in the treatment of AMI can effectively help improve cardiac function and curative effect of PCI while reducing the occurrence of inflammatory reactions,increasing IL-10 level and lowering MCP-1 level. 2022 Vol. 42 (3): 1-3 [Abstract] ( 155 ) HTML (1 KB)  PDF (431 KB)  ( 178 ) 4 Distribution of Pathogens and Laboratory Analysis in Patients With Chronic Obstructive Pulmonary Disease Combined With Ventilator-Associated Pneumonia Li Ning DOI: 10.3969/j.issn.1001-8131.2022.03.002 Objective To investigate the distribution of pathogens and laboratory indicators in patients with chronic obstructive pulmonary disease（COPD）combined with ventilator-associated pneumonia（VAP）.Methods 118 patients with COPD and VAP,50 mechanically ventilated COPD patients without infection and 30 healthy physical examination patients were chosen in the study.All patients underwent bacterial culture and drug susceptibility testing and the analysis was implemented.Results There were 125 gram-negative bacteria,they were mainly on Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae;There were 31 gram-positive bacteria,they were mainly on Staphylococcus aureus;Among Gram-negative bacteria,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae showed high resistance to ceftriaxone,aztreonam,ciprofloxacin,levofloxacin,etc.No imipenem and meropenem resistant bacteria were detected in the three gram-negative bacteria.Among Gram-positive bacteria,Staphylococcus aureus has high resistance to ciprofloxacin,erythromycin and penicillin.The levels of serum C-reactive protein（CRP）,interleukin-6（IL-6）and tumor necrosis factor（TNF-α）in the COPD with VAP group were significantly higher than those in the COPD group and the control group,and the difference was statistically significant（P<0.05）.The area under the curve for the diagnosis of COPD with VAP by serum CRP,IL-6 and TNF-α levels is 0.645,0.712,0.689.Conclusion The infection of patients with COPD and VAP is mainly on Gram-negative infection.Drug resistance to various drugs of the pathogenic bacteria in patients with infection. 2022 Vol. 42 (3): 4-6 [Abstract] ( 127 ) HTML (1 KB)  PDF (434 KB)  ( 140 ) 7 Detection and Significance of Serum NT proBNP Level in Patients With Heart Failure Gao Ru DOI: 10.3969/j.issn.1001-8131.2022.03.003 Objective To investigate the detection and significance of serum N-terminal pro brain natriuretic peptide（NT proBNP）in patients with heart failure（HF）.Methods Forty two patients with acute heart failure（AHF） were selected as AHF group,and 42 patients with chronic heart failure（CHF）admitted to our hospital at the same time were selected as CHF group.The levels of serum NT proBNP,soluble ST2（sst2）and left ventricular ejection fraction（LVEF）were measured by echocardiography in both groups.The correlation between serum NT proBNP and sst2 and LVEF was analyzed.Results The levels of NT proBNP and sst2 in AHF group were higher than those in CHF group,while LVEF in AHF group was lower than that in CHF group（P<0.05）.The results of bivariate Pearson linear correlation test showed that serum NT proBNP was positively correlated with sst2（r=0.389,P<0.05）,and negatively correlated with LVEF（r=-0.253,P<0.05）.The ROC curve showed that the serum NT proBNP level predicted the AUC of AHF>0.8,which had certain predictive value.Conclusion The high level of BNT Prof can be used to predict the clinical level of HF NT Prof. 2022 Vol. 42 (3): 7-9 [Abstract] ( 205 ) HTML (1 KB)  PDF (493 KB)  ( 155 ) 9 Analysis of the Factors Influencing the Prognosis of the Elderly Patients With Severe Pneumonia and Respiratory Failure Li Guozheng DOI: 10.3969/j.issn.1001-8131.2022.03.004 Objective To explore the prognosis of the elderly patients with severe pneumonia and respiratory failure,and analyze the influencing factors of prognosis.Methods Retrospective analysis was used to collect the clinical data of 98 elderly patients with severe pneumonia and respiratory failure.According to the standard of clinical disease diagnosis based on cure and improvement,the prognosis of the patients was divided into cure,improvement and death.The cure and improvement group was regarded as the good prognosis group（n=75）and the death group as the poor prognosis group（n=23）.Carefully read the patient's medical records,design the general situation questionnaire,and include the possible influencing factors.Through single factor and multi factor analysis,find out the influencing factors of the prognosis of the elderly patients with severe pneumonia and respiratory failure.Results All the possible influencing factors were included.The results of multiple non conditional logistic regression analysis showed that the history of mechanical ventilation,low immunity,low hemoglobin content and high Apache Ⅱ score were all the influencing factors for the prognosis of elderly patients with severe pneumonia and respiratory failure（or>1,P<0.05）.Conclusion History of mechanical ventilation,low immunity,low hemoglobin content and high Apache Ⅱ score may be the influencing factors for the prognosis of the elderly patients with severe pneumonia and respiratory failure.Clinical attention should be paid to and corresponding interventions should be given. 2022 Vol. 42 (3): 9-11 [Abstract] ( 94 ) HTML (1 KB)  PDF (433 KB)  ( 202 ) 12 Efficacy of Vacuum-Assisted Excision on Benign Phyllodes Tumors of Breast and Analysis of Related Factors of Local Recurrence Yao Lanya DOI: 10.3969/j.issn.1001-8131.2022.03.005 Objective To explore the efficacy of vacuum-assisted excision（VAE）in the treatment of benign phyllodes tumors of breast（PTB）and related factors of local recurrence.Methods The clinical data of 116 patients with benign phyllodes tumors of breast were retrospectively analyzed,and the patients were grouped according to the surgical methods.The patients who underwent vacuum-assisted excision were selected as observation group（n=74）,and the patients undergoing routine local resection were set as control group（n=42）.The differences in surgical indicators（surgical time,incision length,intraoperative blood loss）and postoperative complications were compared between the two groups.The two groups of patients were followed up and the patients were divided into recurrence group（n=12）and non-recurrence group（n=104）according to whether the patients had local recurrence. Univariate analysis was performed on the data of patients.Multivariate Logistic regression analysis was performed on indexes with significant differences in univariate analysis.Results The surgical time,incision length and intraoperative blood loss in observation group were lower than those in control group（all P<0.05）.The incidence rate of local subcutaneous ecchymosis in observation group was lower than that in control group（P<0.05）,and there were no significant differences in the incidence rates of local hematoma,incision infection and recurrence between the two groups（all P>0.05）.Results of univariate analysis showed that the tumor size,a history of fibroadenoma and surgical margin in recurrence group were significantly different from those in non-recurrence group（all P<0.05）,and there were no significant differences in the age,menstrual status and surgical methods between the two groups（all P>0.05）.Multivariate Logistic analysis showed that tumor size ≥ 2.5 cm（OR=1.571,P<0.001）,a history of fibroadenoma（OR=1.740,P<0.05）and positive surgical margin（OR=1.394,P<0.05）were risk factors for recurrence in patients with benign PTB.Conclusion VAE has better efficacy in treating patients with benign PTB than conventional local resection.Tumor size,a history of fibroadenoma and surgical margin are related factors affecting local recurrence. 2022 Vol. 42 (3): 12-14 [Abstract] ( 146 ) HTML (1 KB)  PDF (391 KB)  ( 131 ) 15 Effect of Intraperitoneal Hyperthermic Perfusion Chemotherapy Combined With DP Regimen in the Treatment of Advanced Ovarian Cancer Zhu Chun, Sun Liangqi, Qu Jia DOI: 10.3969/j.issn.1001-8131.2022.03.006 Objective To investigate the clinical effect of intraperitoneal hyperthermic chemotherapy（IHPC）combined with docetaxel and cisplatin（DP）in the treatment of advanced ovarian cancer.Methods According to the treatment method,80 patients with advanced ovarian cancer were divided into control group and observation group,40 cases in each group.The control group was treated with DP regimen,and the observation group was treated with IHPC.The clinical efficacy was compared between the two groups,and the serum tumor markers [carcinoembryonic antigen（CEA）,carbohydrate antigen 125（CA125）] were compared between the two groups before and after treatment.Results After 12 weeks of treatment,the clinical total effective rate of the observation group was higher than that of the control group（P<0.05）;after 12 weeks of treatment,the levels of CEA and CA125 in the two groups were lower than those before treatment,and the observation group was lower（P<0.05）.Conclusion IHPC combined with DP regimen can effectively improve the clinical efficacy and reduce serum tumor markers in patients with advanced ovarian cancer. 2022 Vol. 42 (3): 15-16 [Abstract] ( 179 ) HTML (1 KB)  PDF (325 KB)  ( 133 ) 17 Correlation Between Serum IL-18,IL-17 Levels and Pulmonary Function in Children With Mycoplasma Pneumonia Yue Wei DOI: 10.3969/j.issn.1001-8131.2022.03.007 Objective To investigate the correlation between serum IL-17,IL-18 levels and pulmonary function in children with mycoplasma pneumonia.Methods 70 children with mycoplasma pneumonia were selected as the research objects.According to whether there was wheezing sound in lung auscultation,they were divided into group A（wheezing,36 cases）and group B（no wheezing,34 cases）.30 cases of healthy children were selected as group C.The levels of IL-17,IL-18 and lung function indexes（forced pulmonary activity in the first second）were detected Volume（FEV1）,peak expiratory flow rate（PEF）,FEV1 to forced vital capacity ratio（FEV1 / FVC）].Results The levels of IL-17 and IL-18 in group A were higher than those in group B and group C,and the levels of IL-17 and IL-18 in group B were higher than those in group C（P<0.05）;the values of FEV1,PEF and FEV1 / FVC in group A were lower than those in group B and group C,and the values of FEV1,PEF and FEV1 / FVC in group B were lower than those in group C（P<0.05）.The bivariate Pearson correlation analysis showed that the serum levels of IL-17 and IL-18 were correlated with FEV1,PEF and FEV 1 / FVC was negatively correlated（r<0,P<0.05）.Conclusion The levels of serum IL-17 and IL-18 are negatively correlated with pulmonary function in children with mycoplasma pneumonia.Detection of IL-17 and IL-18 levels is helpful to evaluate the degree of lung function injury and provide guidance for clinical treatment. 2022 Vol. 42 (3): 17-18 [Abstract] ( 155 ) HTML (1 KB)  PDF (292 KB)  ( 173 ) 19 Comparison of the Efficacy of Dynamic External Fixator with two KirschnerWires and Mini Plate in the Treatment of Unstable Metacarpal and Phalangeal Fractures Mei Linjun, Liu Ganliang, Chen Mian, Yuan Kaiping, Xie Guangzhong, Tan Zhenlian, Lei Fangjin DOI: 10.3969/j.issn.1001-8131.2022.03.008 Objective To investigate the effect of dynamic external fixator with two Kirschner wires and mini plate in the treatment of unstable metacarpal and phalangeal fractures.Methods 60 cases of metacarpal and phalangeal unstable fractures were selected as the research objects.The micro plate group（30 cases）was treated with micro plate internal fixation,and the dynamic external fixator group（30 cases）was treated with two Kirschner wire dynamic external fixator.The clinical efficacy,hospitalization time,operation time and other related indicators of the two groups were compared and analyzed.Results The excellent and good rate of dynamic external fixator group（93.34%）was higher than that of mini plate group（73.33%）（P<0.05）.The operation time,hospital stay,fracture healing time and starting time of functional exercise in the dynamic external fixator group were lower than those in the mini plate group（P<0.05）.The complication rate of dynamic external fixator group（3.33%）was lower than that of mini plate group（20.00%）（P<0.05）.Conclusion The treatment of unstable metacarpal and phalangeal fractures with Kirschner wire dynamic external fixator has better effect and can achieve healing in a short time.It is a safe and valuable treatment scheme. 2022 Vol. 42 (3): 19-21 [Abstract] ( 171 ) HTML (1 KB)  PDF (464 KB)  ( 153 ) 21 Application of Serum Amyloid A in the Diagnosis of Rotavirus Enteritis in Children Zhao Xiafeng, Yang Xiaohua, Liu Qingfeng DOI: 10.3969/j.issn.1001-8131.2022.03.009 Objective To explore the application of serum amyloid A（SAA）in the diagnosis of rotavirus enteritis in children.Methods 120 children with enteritis who were positive for fecal rotavirus by colloidal gold method were selected for retrospective analysis.They were divided into observation group and 120 children with functional diarrhea caused by non infectious causes were selected as control group.The expression level and positive rate of serum SAA in the two groups were compared,The expression level and positive rate of SAA in children with rotavirus enteritis with different degrees of dehydration were analyzed.The corresponding specificity and sensitivity were obtained according to serum SAA.The ordinate was the sensitivity and the abscissa was the specificity.The receiver operating（ROC）curve was drawn to analyze the diagnostic value of SAA in children with rotavirus enteritis.Results There were significant differences in SAA expression and SAA positive rates between the observation group and the control group,and the observation group was significantly higher than the control group（P<0.05）;the SAA expression and SAA positive rates in children with rotavirus enteritis with different degrees of dehydration were significantly different ,And children with severe dehydration were significantly higher than those with mild to moderate dehydration and without dehydration（P<0.05）;the area under the curve of serum amyloid A was 78.89,and the best diagnostic limit was 12.52mg/L.Conclusion The expression level and positive rate of serum amyloid A in children with rotavirus enteritis were significantly higher than those in children with functional diarrhea,and SAA>12.52mg/L was the critical value for the diagnosis of rotavirus enteritis. 2022 Vol. 42 (3): 21-23 [Abstract] ( 147 ) HTML (1 KB)  PDF (505 KB)  ( 166 ) 24 Effect of Different Doses of Gamma Globulin on White Blood Cells and Incidence of Coronary Artery Disease in Children With Kawasaki Disease Yuan Kelong, Liu Yusi, Liu Shie, Liu Liuyuan DOI: 10.3969/j.issn.1001-8131.2022.03.010 Objective To investigate the clinical effect of different doses of IVIG in the treatment of children with Kawasaki disease（KD）.Methods 40 children with KD were divided into two groups,20 cases in each group.The experimental group was treated with intravenous injection of 2g/kg IVIG,while the reference group was treated with intravenous injection of 1g/kg IVIG.Results The improvement time of fever,rash,lymphadenectasis,hand and foot swelling and mucosal congestion in the experimental group was less than that in the control group（P<0.05）;After treatment,WBC,PLT,CRP and ESR of the two groups were lower than those before treatment（P<0.05）;There was no significant difference in the incidence of WBC,PLT,CRP,ESR and CAL between the two groups after treatment（P>0.05）.Conclusion Daily use of 2g/kg IVIG in the treatment of children with KD can reduce fever in a short period of time,and has a positive effect on the disappearance of skin rash,improvement of mucosal congestion,and detumescence of hands and feet. 2022 Vol. 42 (3): 24-25 [Abstract] ( 197 ) HTML (1 KB)  PDF (311 KB)  ( 132 ) 26 To Explore the Application Value of Blood WBC、GRA%、CRP and PCT in Early Diagnosis of Neonatal Sepsis Wu Fujuan, Zhou Cheng, Zhang Lixia, Dai Yiheng, Gao Xiaoyan DOI: 10.3969/j.issn.1001-8131.2022.03.011 Objective To explore the application value of white blood cell（WBC）neutrophilic granulocyte（GRA%）,C - reactive protein（CRP）and procalcitonin（PCT）in early diagnosis of neonatal sepsis.Methods Retrospective and analysis of the clinical data of 99 cases full-term neonates treatedin our hospital ,45 children diagnosed with neonatal were sepsiswere served as the observation group ,while another 54 non-infectious children hospitalized during the same period were served as the control group.The levels of the blood WBC、GRA%、CRP、PCT were evaluated in each group,both of the levels of the blood WBC、GRA%、CRP、PCTwere evaluated in observation group before and after treatment for one week.Then analyze the application value of WBC、GRA%、CRP、PCT in early diagnosis ofneonatal sepsis by drawing the receiver operating characteristic curve（ROC curve）.Results The levels of the blood WBC、GRA%、CRP and PCT in the observation group were higher than those in the control group（P<0.05）.The levels of the blood WBC、GRA%、CRP and PCT in the observation group were reduced after treated one week（P<0.05）.The area diagnose neonatal sepsis under the ROC curve of WBC,GRA%,CRP and PCT were 0.722,0.887,0.908,0.964,respectively.Conclusion The dynamic monitoring of blood WBC,GRA%,CRP and PCT has a certain reference value for the treatment of neonatal sepsis.The blood WBC has the lowest diagnostic efficiency in diagnose neonatal sepsis ,the detection of the PCT,CRP,GRA% has a good diagnostic value for neonatal sepsis. 2022 Vol. 42 (3): 26-28 [Abstract] ( 146 ) HTML (1 KB)  PDF (504 KB)  ( 176 ) 29 Application of Bilateral Breast Molybdenum Targets in the Differential diagnosis of Breast Invasive Lobular Carcinoma and Invasive Ductal Carcinoma Du Junqing, Liang Lili DOI: 10.3969/j.issn.1001-8131.2022.03.012 Objective To explore the application of bilateral breast molybdenum targets in differential diagnosis of breast invasive lobular carcinoma（ILC）and invasive ductal carcinoma（IDC）.Methods 64 patients with invasive breast cancer were selected and divided into 33 cases of ILC and 31 cases of IDC according to the postoperative pathological results.The imaging features of mammography in patients with the two diseases were comparatively analyzed.Results In 33 patients with ILC,mammography showed 23 cases（69.70%）with disorganized and distorted structures and asymmetric dense shadows,10 cases（30.30%）having masses with burrs and marginal infiltration,and none cases having masses with calcification.In the 31 patients with IDC,there were 4 cases（12.90%）with nipple retraction,6 cases（19.35%）with skin and areola thickening,13 cases（41.94%）having masses with burrs and marginal infiltration,2 cases（6.45%）having masses with clear borders,4 cases（12.90%）having masses with calcification,1 case（3.23%）with simple calcification,and 1 case（3.23%）with asymmetric dense shadow.There was a statistically significant difference between ILC and IDC in lesion location（χ2=9.356,P<0.01）.Conclusion Bilateral mammography of mammography can improve the accuracy of the differential diagnosis of ILC and IDC,which is beneficial to the diagnosis and treatment of patients and is worthy of clinical promotion. 2022 Vol. 42 (3): 29-31 [Abstract] ( 122 ) HTML (1 KB)  PDF (464 KB)  ( 152 ) 31 The Value of MSCT and MRI in Differential Diagnosis of Cirrhotic Nodules and Small Hepatocellular Carcinoma Li Dan DOI: 10.3969/j.issn.1001-8131.2022.03.013 Objective To investigate the differential diagnosis value of multi-slice spiral CT（MSCT）and magnetic resonance imaging（MRI）between cirrhotic nodules and small liver cancer.Methods The clinical data of 87 cases（109 lesions）with cirrhosis were retrospectively analyzed.All patients underwent MSCT and MRI examination,and the operative pathological Resultswere used as the gold standard.The diagnostic Resultsof MSCT and MRI were compared,and the sensitivity,specificity,accuracy,negative and positive predictive values of the two Methodswere compared.Results The specificity（94.03%）,accuracy（93.58%）and positive predictive value（90.70%）of MRI examination were higher than that of MSCT（94.03%,93.58%,73.91%）（P<0.05）.The sensitivity and negative predictive value（MRI：92.86%,95.45%）of the two examinations were higher than that of MSCT（94.03%,93.58%,73.91%）.MSCT：80.95%,87.30%）showed no significant difference（Pall>0.05）.Conclusion MRI has higher differential diagnostic value than MSCT in the diagnosis of cirrhosis nodules and small hepatocellular carcinoma. 2022 Vol. 42 (3): 31-33 [Abstract] ( 168 ) HTML (1 KB)  PDF (430 KB)  ( 162 ) 34 Correlation Analysis of Corneal High-Order Aberration and Refractivity and Eye Biological Parameters of High Myopia Patients Yang Cui, Li Changjin, Lu Qiang DOI: 10.3969/j.issn.1001-8131.2022.03.014 Objective To investigate the correlation between corneal high-order aberration and diopter and ocular biological parameters in patients with high myopia.Methods 53 patients with high myopia treated were selected as the research object,and their right eyes were taken.The corneal high-order aberrations（RMS total corneal aberrations,high-order aberrations RMS HOA,horizontal clover Z33,horizontal coma Z31,vertical coma z3-1,oblique axis clover z3-3,horizontal clover z44,X-direction secondary aberrations z42,spherical aberrations Z40,Y-direction secondary aberrations z4-2,vertical clover z4-4）and diopters（spherical,cylindrical,equivalent spherical se）and ocular biological parameters were analyzed.Results the total aberrations of RMS cornea were negatively correlated with the cylindricity and positively correlated with K2（r=-0.478,r=0.308,P=0.05）;Z33 was negatively correlated with the sphericity,Se and K1（r=-0.332,r=-0.320,r=-0.274,P=0.05）,but positively correlated with Al（r=0.347,P=0.011）;z3-3 was positively correlated with sphericity,K1 and km（r=0.273,r=0.301,r=0.291,P=0.05）,but negatively correlated with Al（r=-0.442,P=0.001）;z42 was negatively correlated with CCT,K1,K2 and km（r=-0.280,r=-0.321,r=-0.323,r=-0.332,P=0.05）;Z40 was positively correlated with IOP,CCT,K1,K2 and km（r=0.341,r=0.314,r=0.318,r=0.285,r=0.308,P=0.05）,but it was negatively correlated with Al（r=-0.297,P=0.031）;z4-2 was negatively correlated with Al（r=-0.288,P=0.037）.Conclusion the diopter and ocular biological parameters of patients with high myopia affect some components of higher-order corneal aberration in myopia.Among them,RMS corneal total aberration is affected by cylindrical lens and K2;Z33 is affected by spherical lens,Se,K1 and Al）;z3-3 is affected by spherical lens,K1,KM and Al;z42 is affected by CCT,K1,K2 and KM;Z40 is affected by IOP,CCT,K1,K2,KM and Al;z4-2 is affected by al. 2022 Vol. 42 (3): 34-36 [Abstract] ( 158 ) HTML (1 KB)  PDF (345 KB)  ( 192 ) 37 Application of Ropivacaine Combined With Sufentanil in Different Doses of Epidural Anesthesia in Full-Term Primiparas Undergoing Cesarean Section Wang Rang, Lin Shengnan, Gao Luoluo DOI: 10.3969/j.issn.1001-8131.2022.03.015 Objective To investigate the application effect of ropivacaine combined with sufentanil in different doses of epidural anesthesia in full-term primiparas undergoing cesarean section.Methods 126 cases of cesarean section women were randomly divided into three groups,42 cases in each group.0.2μg/ml sufentanil was used in the low-dose group,0.4μg/ml in the medium dose group,and 0.6μg/ml in the high-dose group,all of which were combined with 0.1% ropivacaine.Hemodynamics（SBP,DBP,HR）were compared among the three groups.Results SBP and DBP of the three groups were lower than those before anesthesia,while HR was higher than that before anesthesia SBP,DBP and HR were lower than those at skin incision,but SBP,DBP and HR in three groups were higher than those in 15 min after operation,and SBP and DBP at skin incision and at the end of operation in middle dose group were higher than those in low-dose group and high-dose group,while HR was lower than those in low-dose group and high-dose group.There were significant differences among three groups,time points and time points between groups（P<0.05）;sensory block occurred in middle dose group.Conclusion 0.1% ropivacaine combined with 0.4μg/ml sufentanil has little effect on hemodynamics of patients undergoing cesarean section,and the onset of sensory block is fast. 2022 Vol. 42 (3): 37-39 [Abstract] ( 136 ) HTML (1 KB)  PDF (464 KB)  ( 150 ) 39 Oral Polysaccharide Iron Complex Capsules Prevent Anemia For Improving Maternal and Child Health Levels Yang Chunxia, Zeng Xuefang, Song Li DOI: 10.3969/j.issn.1001-8131.2022.03.016 Objective To explore the clinical value of oral polysaccharide iron complex capsules to prevent anemia in pregnancy in improving maternal and child health.Methods 102 patients with pregnant anemia patients were selected as a research object,randomly divided into control group（N=51,giving sulfate treatment）and observation group（n=51,Given the polysaccharide complex treatment）,observing the hemoglobin（HB）,red blood cells（RBC）,red blood cell average hemoglobin concentration（MCHC）,red blood cell average volume（MCV）,red blood cell average volume（MCV）,blood cell distribution Width（RDW）level change,adverse reactions and clinical efficacy.Results ：HB,RBC,MCH,MCHC,and MCV levels were raised in two groups after treatment,and the observation group increased significantly higher than the control group（P<0.05）.The two sets of RDW decreased in two groups after treatment,and the observation group decreased More remarkable（P<0.05）.The incidence of adverse reactions in the observation group was significantly lower than that of the control group（P<0.05）,and the total effectiveness of the observation group was significantly higher than that of the control group（P<0.05）.Conclusion Polysaccharide Iron Refractory Capsule is obvious to prevent the clinical efficacy of anemia in pregnancy,can effectively improve the symptoms of anemia in pregnancy,high safety,have a significant effect on improving maternal and child health,there is a certain clinical reference value,worthy of promotion. 2022 Vol. 42 (3): 39-41 [Abstract] ( 172 ) HTML (1 KB)  PDF (429 KB)  ( 190 ) 42 Therapeutic Effects of Cortical Bone Screw Fixation and Suture Bone Anchor Repair in the Treatment of Supination and External Rotation Ankle Fractures With Distal Tibiofibular Syndesmosis Injury Deng Jianhai, Guo Xinli DOI: 10.3969/j.issn.1001-8131.2022.03.017 Objective To observe the clinical effects of cortical bone screw fixation and suture bone anchor repair in the treatment of supination and external rotation ankle fractures with distal tibiofibular syndesmosis injury.Methods 116 patients with supination and external rotation type III and IV ankle fractures and distal tibiofibular syndesmosis injury were selected as study subjects.According to the treatment method,they were divided into screw fixation group and bone anchor repair group with 58 cases in each group.The screw fixation group received cortical bone screw fixation,while the bone anchor repair group received suture bone anchor repair.The related intraoperative and postoperative indexes,the American orthopedic foot ankle society（AOFAS）scores,the gap distance and overlap distance of distal tibiofibular syndesmosis,and the occurrence of complications in the two groups were observed.Results There were no significant differences between the two groups in terms of operation time,intraoperative blood loss,hospital stay,and fracture healing time（P>0.05）.At 1 month and 3 months after operation,the bone anchor repair group had significantly higher AOFAS scores than the screw fixation group,and the differences were statistically significant（P<0.05）.At 6 months after operation,there was no significant difference in AOFAS scores between the two groups（P>0.05）.At 3 and 6 months after operation,there were no significant differences between the two groups in the gap distance and overlap distance of distal tibiofibular syndesmosis（P>0.05）.The total incidence of complications in the bone anchor repair group was significantly lower than that in the screw fixation group,and the difference was statistically significant（P<0.05）.Conclusion Cortical bone screw fixation and suture bone anchor repair have similar curative effects in half a year after operation.However,suture bone anchor repair can promote the recovery of ankle function in a short term,with few complications. 2022 Vol. 42 (3): 42-44 [Abstract] ( 140 ) HTML (1 KB)  PDF (445 KB)  ( 125 ) 44 Analysis of Clinical Features and Serum Indicators of Patients With Hepatocirrhosis Ascites Complicated With Spontaneous Bacterial Peritonitis Zhao Qiang DOI: 10.3969/j.issn.1001-8131.2022.03.018 Objective To analyze the clinical features and serum indicators of patients with hepatocirrhosis ascites complicated with spontaneous bacterial peritonitis（SBP）.Methods The clinical data of 91 cases of patients with hepatocirrhosis ascites and SBP treated were analyzed retrospectively.The clinical features,laboratory test results and etiological findings were analyzed.After receiving liver protection,diuresis and other treatments,the changes of serum indicators were observed.Results The clinical symptoms were mainly elevated body temperature,abdominal distension and abdominal pain,with a few cases of abdominal muscle tension and rebound pain.Peripheral blood examination showed 47 cases of white blood cell（WBC）increase and 66 cases of polymorphonuclear（PMN）increase.Ascites examination showed there were 70 cases of increased WBC in ascites and 68 cases of increased PMN.Etiological examination showed there were 36 cases of positive bacterial culture and a total of 38 pathogenic bacteria were detected,including 13 Gram-positive bacteria and 25 Gram-negative bacteria.After treatment,the levels of serum alanine aminotransferase（ALT）,total bile acid（TBA）,serum complement C3 and C4 were improved compared to before treatment（P<0.05）.Conclusion The main clinical manifestations of patients with hepatocirrhosis ascites complicated with SBP include elevated body temperature,abdominal distension and abdominal pain.The laboratory test shows that the WBC and PMN in peripheral blood and ascites are significantly increased,and the main infection flora is Gram-positive bacteria,and it can effectively improve the abnormal serum indicators after receiving relevant treatment. 2022 Vol. 42 (3): 44-46 [Abstract] ( 140 ) HTML (1 KB)  PDF (439 KB)  ( 190 ) 47 Correlation Analysis of Immunoglobulin Level and Diabetic Nephropathy Li Haibo DOI: 10.3969/j.issn.1001-8131.2022.03.019 Objective To study the relationship between the level of immunoglobulin and diabetic nephropathy.Methods 121 cases of diabetic patients were selected.All patients underwent glomerular filtration rate（EGFR）,and EGFR>90ml/（min·1.73m2）were included in the normal renal function group（n=28）,patients with 60ml /（min·1.73m2）<EGFR≤90ml /（min·1.73m2）were included in the mild abnormal renal function group（n=32）,and 30ml /（min·1.73m2）<EGFR Patients with EGFR≤30ml /（min·1.73m2）were included in moderate abnormal renal function group（n=31）,and patients with EGFR≤30ml/（min·1.73m2）were included in severe abnormal renal function group（n=30）.The levels of serum immunoglobulin A（IGA）,immunoglobulin M（IgM）and immunoglobulin G（IgG）were detected in all patients.The levels of serum IgA,IgM and IgG in the four groups were compared.The correlation between serum immunoglobulin levels and diabetic nephropathy was analyzed by bivariate Pearson correlation analysis.Results The levels of IgA,IgM and IgG in severe abnormal renal function group were the highest,followed by moderate abnormal renal function group and mild abnormal renal function group,and the lowest in normal renal function group（P<0.05）;by bivariate Pearson correlation test,serum IgA,IgM,IgG levels were positively correlated with EGFR levels（r>0,P<0.05）.Conclusion Serum IgA,IgM and IgG levels are closely related to diabetic nephropathy,which can be used as sensitive indicators for clinical prediction of diabetic nephropathy. 2022 Vol. 42 (3): 47-49 [Abstract] ( 172 ) HTML (1 KB)  PDF (434 KB)  ( 198 ) 49 Effect of Hemodialysis Combined With Hemodialysis on Renal Fibrosis and Inflammatory Factors in Patients With Chronic Renal Failure Zhou Xuan DOI: 10.3969/j.issn.1001-8131.2022.03.020 Objective To investigate the effect of hemodialysis（HDF）combined with HD on renal fibrosis and inflammatory factors in patients with chronic renal failure（CRF）.Methods A total of 93 GRF patients were selected as the study subjects.According to the random number table method,they were divided into the control group（46 cases）and the observation group（47 cases）.Control group treated with HD,the observation group based on the joint HDF treatment,compared the two groups after treatment of renal fibrosis [link protein fiber（Fn）,hyaluronic acid（HA）,collagen type Ⅲ before（PC-Ⅲ）and collagen type Ⅳ]（C-Ⅳ）levels,inflammatory factor levels [serum c-reactive protein（CRP）and interleukin 6（IL-6）,interleukin cells-10（IL-10）].Results After treatment,two groups of FN were rising,C-Ⅳ,HA,PC-Ⅲ decreased,but the observation group of FN is higher than the control group,the C-Ⅳ,HA,PC-Ⅲ is lower than the control group,the difference was statistically significant（P<0.05）;After treatment,CRP and IL-6 were reduced in both groups,and IL-10 levels were increased in both groups.However,CRP and IL-6 in the observation group were lower than those in the control group,and IL-10 was higher than that in the control group,with statistically significant differences（P<0.05）.Conclusion HD combined with HDF in the treatment of CRF patients can reduce the level of inflammatory factors,improve renal fibrosis,reduce renal injury. 2022 Vol. 42 (3): 49-51 [Abstract] ( 142 ) HTML (1 KB)  PDF (410 KB)  ( 258 ) 87 The Application Value of Real-Time Myocardial Contrast Echocardiography Combined With 4D-SI Technology in the Diagnosis of Coronary Heart Disease Song Hongwei, Wang Shengming DOI: 10.3969/j.issn.1001-8131.2022.03.039 Objective To explore the application value of real-time myocardial contrast echocardiography（MCE）combined with four-dimensional strain technology（4D-SI）in the diagnosis of coronary heart disease（CHD）.Methods 80 patients with highly suspected CHD admitted to our hospital were selected as the subjects of theresearch group（71 patients were finally diagnosed,and were divided into 27 mild cases,25 moderate cases and 19 severe cases）.And 30 healthy volunteers during the same period were selected as the control group.All personnel underwent MCE and 4D-SI examinations to evaluate the diagnostic efficacy.Compare the myocardial blood supply and the peak strain of myocardial systole between the groups.Results The diagnostic sensitivity of MCE combined with 4D-SI was 91.55%,the specificity was 66.66%,and the accuracy was 88.75%,which was higher than that of MCE combined with automatic imaging technology（78.87%,44.44%,and 75.00%）.Among them,the difference in sensitivity and accuracy was statistically significant（P<0.05）.Compared with the control group,4D-GLPS,4D-GCPS,4D-GAPS and 4D-GRPS were significantly reduced.In patients with mild stenosis,only 4D-GLPS and 4D-GAPS were significantly reduced（P<0.05）.Conclusion MCE combined with 4D-SI can more accurately and intuitively understand the myocardial function of CHD patients,assist clinical evaluation,and have a higher diagnostic efficiency.Among them,4D-GLPS and 4D-GAPS can also reflect the early pathological changes of CHD,which is conducive to its early diagnosis. 2022 Vol. 42 (3): 87-88 [Abstract] ( 128 ) HTML (1 KB)  PDF (509 KB)  ( 157 ) 107 Influence of Pitavastatin Combined With Ticagrelor on Serum Monocyte Chemoattractant Protein 1 and Interleukin 10 Levels in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention Zhang Wenya DOI: 10.3969/j.issn.1001-8131.2022.03.049 Objective This study was conducted to investigate the effect of pitavastatin combined with ticagrelor on serum monocyte chemoattractant protein 1（MCP-1）and interleukin 10（IL-10）levels in patients with acute myocardial infarction（AMI）after percutaneous coronary intervention（PCI）.Methods 60 patients with AMI who underwent PCI were enrolled in this study and randomly assigned to receive ticagrelor（control group,29 cases）or pitavastatin combined with ticagrelor（observation group,31 cases）.Cardiac function indexes,coagulation states before and after PCI,clinical effects and inflammatory factor levels in the 2 groups were compared.Results Before PCI,no significant differences were found between the 2 groups in left ventricular diastolic function（E/A ratio）and ejection fraction（EF）（P>0.05）.After PCI,the E/A ratio and EF increased significantly in the 2 groups,which were significantly higher in the observation group than in the control group（P<0.05）.Before PCI,no significant differences were found between the 2 groups in fibrin（Fg）and D-dimer（DD）（P>0.05）.After PCI,Fg and D-D decreased significantly in the 2 groups,which were significantly lower in the observation group than in the control group（P<0.05）.The total response rate of the observation group was 93.55%,higher than 72.41% of the control group（P>0.05）.Before PCI,no significant differences were found between the 2 groups in IL-10,MCP-1 and high-sensitivity C-reactive protein（hs-CRP）（P>0.05）.After PCI,levels of IL-10,MCP-1 and hs-CRP in the 2 groups were higher than those before operation.Additionally,the observation group had IL-10 levels but lower MCP-1 and hs-CRP levels than the control group（P<0.05）.Conclusion After PCI,using pitavastatin combined with ticagrelor in the treatment of AMI can effectively help improve cardiac function and curative effect of PCI while reducing the occurrence of inflammatory reactions,increasing IL-10 level and lowering MCP-1 level. 2022 Vol. 42 (3): 107-108 [Abstract] ( 179 ) HTML (1 KB)  PDF (315 KB)  ( 173 ) 123 Clinical Effect of QishenHuanwu Capsule on Drainage Treatment of Hemorrhagic Apoplexy and Improvement of Nerve Function Defect in Patients Sun Baoshan, Wu Peng, Tian Lili, Yang Yun, Li Jing, Ma Jie, He Lihua, Xia Qingyou DOI: 10.3969/j.issn.1001-8131.2022.03.057 Objective To investigate the clinical efficacy of QishenHuanwu capsule combined with stereotactic drainage in the treatment of hemorrhagic apoplexy and its effect on the improvement of neurological defects in patients.Methods Sixty-six eligible hemorrhagic stroke patients were selected and randomly divided into control group and study group,with 33 patients in each group.The control group was treated with stereotactic drainage,and the research group was treated with QishenHuanwu capsule Decoction on the basis of the control group.The clinical efficacy of the two groups was compared.Results After treatment,the total clinical effective rate of the study group was significantly higher than that of the control group（96.97% vs.81.81%）,and the difference between the two groups was statistically significant（P<0.05）.Before treatment,there was no significant difference in GCS and NIHSS scores between the two groups（P> 0.05）.After treatment,the GCS score of the study group was significantly higher than that of the control group,while the NIHSS score was significantly lower than that of the control group,with statistical significance（P<0.05）.Before treatment,there was no significant difference in the levels of MATRIX metalloproteinase-9 and hypersensitive C-reactive protein between the two groups（P>0.05）.After treatment,the levels of matrix metalloproteinase-9 and hypersensitive C-reactive protein in the study group were significantly lower than those in the control group,with statistical significance（P<0.05）.Conclusion QishenHuanwu capsule combined with stereotactic drainage has a high clinical efficiency in the treatment of hemorrhagic apoplexy,which can better improve the patients' consciousness disorder,neurological function defect and serum index level. 2022 Vol. 42 (3): 123-125 [Abstract] ( 197 ) HTML (1 KB)  PDF (514 KB)  ( 172 ) 140 The Development Status of Standardized Training and Teaching Mode for General Medical Residents Deng Cuixuan, Ren lijie DOI: 10.3969/j.issn.1001-8131.2022.03.065 At present,the teaching mode of standardized training of general medical residents in China shows diversified development,The change and development of teaching mode complement the quality of teaching.This article summarizes the current different teaching models,summarizes and analyzes their advantages and disadvantages,To present relevant views and opinions,Explore the teaching mode of the training center to improve the teaching quality. 2022 Vol. 42 (3): 140-142 [Abstract] ( 160 ) HTML (1 KB)  PDF (441 KB)  ( 151 )

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