Table of Content

20 February 2019, Volume 19 Issue 01

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Research progress of botulinum toxin A as an adjunct to abdominal wall reconstruction for incisional hernia

TANG Fuxin， CHEN Shuang， LI Yingru， ZHOU Taicheng， JIANG Zhipeng

2019, 19(01):  1-5.  DOI: 10.3969/j.issn.1009?976X.2019.01.001

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Surgical managementof incisional ventral hernia has always been a bottle neck which is associated with considerable postoperative morbidity， risk of hernia recurrence. If there is no good preoperative preparation before the operation， the abdominal hypertension and abdominal hypertension syndrome （ACS） are very difficult to deal with. The treatment of giant incisional ventral hernia mainly relies on patch material to strengthen， and preoperative dilatation and reduction of abdominal wall tension serve as the adjuvant perioperative management. Despite advances in endoscopic techniques， materials and related basic research， giant incisional ventral hernia wall still faces high complications and recurrence rates.Botulinum toxin A （BTA） is a neurotoxic protein produced by Clostridium botulinum. Studies have shown that preoperative paralysis of the lateral abdominal muscles from intramuscular administration of BTA reduces the intraabdominal pressure， allowing closure of a hernia defect under less muscular tension. Ideally， temporary paralysis of the abdominal wall muscles with BTA prior to hernia repair may allow primary fascial closure without the need for component separation technique. The author has the experience of application of BTA in complex abdominal wall defect. This article reviews the progress of BTA in the incisional ventral hernia.

The relationship between marrow adipose tissue and disease and underlying mechanism

DAI Zhaojun1， ZHENG Guifen2， LI Yong1， CHEN Jianyu1

2019, 19(01):  6-10.  DOI: 10.3969/j.issn.1009?976X.2019.01.002

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［Abstract］ Bone strength is not only related to bone mineral density （BMD） and bone microarchitecture but also affected by the bone marrow microenvironment. Marrow adipose tissue （MAT） coexists with trabecular bonehematopoietic cells， nerve fibers and blood vessels in the medullary cavity， which plays an important role in bone remodeling， bone marrow hematopoiesis， and maintaining the stability of the bone marrow microenvironment. Recent studies have shown that MAT can participate in the development of various diseases such as metabolic diseases， hematological cancers and solid tumors by secreting cytokines such as adiponectin， providing new ideas for disease prevention， treatment and monitoring. Herein we review the biological characteristics and imaging methods of MAT， the correlation between MAT and disease and underlying mechanism.

Advance of the imaging diagnosis of radiation encephalopathy

LI Cheng1， BU Chao2， HUANG Suiqiao2

2019, 19(01):  11-18.  DOI: 10.3969/j.issn.1009?976X.2019.01.003

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［Abstract］ Radiotherapy is the most commonly used treatment for head and neck malignant tumors， especially nasopharyngeal cancer. In recent years， due to the improvement of radiotherapy technology， the incidence of complications after radiotherapy has decreased significantly， but it still can not be completely avoided. Radiation encephalopathy caused by radiotherapy has a far greater impact on the quality of life of patients than the tumor itself， and patients pay more and more attention to the quality of their life， so radiation encephalopathy is increasingly concerned， seeking for early detection， diagnosis and treatment. The diagnosis of radiation encephalopathy mainly depends on clinical manifestations and imaging examinations. This paper will review the pathogenesis and imaging diagnosis methods of radiation encephalopathy， including CT， MRI and molecular imaging techniques.

The function of long non?coding RNA THOR in cervical cancer cell C33A

YANG Haojie1，2， TAN Zicong1，2， LIN Junjie1，2， FU Ganglan1，2， CAO Minghui1，2

2019, 19(01):  19-22.  DOI: 10.3969/j.issn.1009?976X.2019.01.004

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［Abstract］ Objective To reveal the relationship between long non?coding RNA THOR and cervical cancer cell. Methods We confirmed the expression of LncRNA THOR in 15 pairs of cervical cancer tissues and adjacent normal tissues with qRT?PCR. And then we investigated the expression of LncRNA THOR in cervical cancer cell lines C33A， siHa and cervical squamous epithelium cell line H8 by using the same technique. After silencing lncRNA THOR in C33A cells， we conducted CCK?8 assay and colony formation assay to see the changes of proliferation. With flow cytometry， we tested cell cycle to support the previous results. Also， the changes of cyclin were assayed by western blot. Results According to the results of qRT?PCR， the expression of LncRNA THOR was significantly higher in 14 out of 15 cervical cancer tissues than the adjacent normal tissues， and the same phenomenon showed in cervical cancer cell lines C33A and siHa comparing with cervical squamous cell H8. Silencing LncRNA THOR in C33A cells， cell proliferation was suppressed as the CCK?8 assay showed， which corresponded with the less formation of cell colony in colony formation assay. Flow cytometry also showed the decrease of the G0/G1 cells. Following the silencing of LncRNA THOR， the cyclin D1 and cyclin E1 were down?regulated while the p27 was up?regulated according to the western blot. Conclusion LncRNA THOR exhibited high expression level in cervical cancer cells， and silencing LncRNA THOR suppressed the proliferation of it.

Expression and clinical significance of exosomal long non?coding RNA CCAT1 in pancreatic cancer

REN Xiaofan1， LI zhihua1

2019, 19(01):  23-27.  DOI: 10.3969/j.issn.1009?976X.2019.01.005

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［Abstract］ Objective To investigate the expression level and clinical significance of exosomal long non?coding RNA CCAT1 in pancreatic cancer. Methods The serums of 66 patients with pancreatic cancer before operation and 66 normal healthy people as control were collected and the exosomes were isolated by ultracentrifugation. The detection sensitivity and specificity of exosomal lncRNA CCAT1 were calculated by using the pathological diagnosis. The clinicopathological features were collected to analyze the clinical relationship between the exosomal lncRNA CCAT1 expression and clinicopathological features. Results The detection sensitivity， specificity and accuracy of lncRNA CCAT1 in pancreatic cancer were 89.4%，87.9% and 89.4%，respectively. Kaplan?Meier analysis showed that the expression levels of lncRNA CCAT1 was related to overall survival time of the patients of pancreatic cancer. Cox regression analysis showed that lncRNA CCAT1 expression was an independent risk factor of pancreatic cancer patients. Conclusion lncRNA CCAT1 was over?expressed in pancreatic cancer exosomes，and exosomal lncRNA CCAT1 deserved as an independent prognosis factor of pancreatic cancer.

LncRNA SNHG7 promote proliferation and metastasis of breast cancer through regulating β?catenin

ZHANG Ruihua， LAO Weisi， XU Ying， CAI Donghao， BI Zuofei， DUAN Chaohui.

2019, 19(01):  28-33.  DOI: 10.3969/j.issn.1009?976X.2019.01.006

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［Abstract］ Objective To explore the function and mechanism of long noncoding RNA SNHG7 in breast cancer. Methods qRT?PCR was to detect the expression of lncRNA SNHG7 in breast cancer in vitro. Cellular fractionation was to identify the subcellular localization of SNHG7 in MDA?MB?231.Si?SNHG7 was transfected into MDA?MB?231，and the effect of SNHG7 on the proliferation of breast cancer cell was measured by MTS assay and plate cloning assay. Wound healing and transwell assays were used to detect the effect of SNHG7 on the migratory and invasive ability of MDA?MB?231 cell. Expression changes of β?catenin and p?β?catenin protein after siSNHG7 intervention were measured by WB. Results SNHG7 over?expressed in breast cancer（P<0.05）. After the siSNHG7 transfection，breast cancer cells proliferation（P<0.05）， invasion and metastasis were inhibited（P<0.05）. Furthermore， after the siSNHG7 intervention， the expression of β?catenin，C?Myc and CyclinD1 decreased significantly and p?β?catenin increased significantly. Conclusion The expression of SNHG7 in breast cancer is significantly up?regulated. After the siSNHG7 intervention， SNHG7 could partly inhibit the proliferation， invasion and metastasis of breast cancer by regulating the expression of β?catenin and p?β?catenin.

Palmitic acid and LPS cooperatively promote MCP-1 expression in aortic smooth muscle cells

Zijiao1，2， LIU Shanying2， LIN Canxiang2，3， LI Yan1

2019, 19(01):  34-43.  DOI: 10.3969/j.issn.1009?976X.2019.01.007

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［Abstract］ Objective To investigate the effects of palmitic acid and lipopolysaccharide （LPS） on the expression of MCP?1， and to explore the involving underlying molecular mechanisms in rat thoracic aortic smooth muscle A7r5 cell line. Methods After the A7r5 cells were respectively incubated for 24 h with 0.2% BSA， palmitic acid （200 μM） ， LPS （1 μg/ml）+0.2% BSA and palmitic acid （200 μM ） +LPS （1 μg/ml）， MCP?1 was detected by the methods of RT?qPCR and ELISA and toll?like receptor 4 （TLR4 ） was determined by the methods of RT?qPCR and Western Blotting. Moreover， palmitic acid?induced MCP?1 was further detected after the pre?treatment with TAK?242， a toll?like receptor 4 inhibitor. Results Both palmitic acid and LPS had increase the mRNA and protein of MCP?1 in A7r5 cells， while the result of palmitic acid co?treatment with LPS showed MCP?1 was significantly enhanced when comparing with the single treatment. Palmitic acid and LPS upregulated TLR4 in the expression of protein， but not mRNA. Moreover， TAK?242 blocked the MCP?1 induced by LPS， which partially exerted the similar inhibiting effects on the palmitic acid?induced MCP?1. Conclusion Both palmitic acid and LPS can increase the production of MCP?1 via TLR4 and the synergy treatment of LPS with palmitic acid aggravated MCP?1 in thoracic aorta smooth muscle cells， which may play a potential role in the progression of atherosclerosis.

Differential expression and function analysis of long non?coding RNA in aldosterone producing adenoma

XIANG Kexu， LI Shaohua， TANG Juying， ZHANG Xiaoyun， ZHANG Shaoling， GUO Ying

2019, 19(01):  38-43.  DOI: 10.3969/j.issn.1009?976X.2019.01.008

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［Abstract］ Objective To study the differentially expressed long non?coding RNA （lncRNA） in aldosterone producing adenoma（APA） and analyse the role of lncRNA in the genesis and growth of APA. Methods Using microarray to find out the differentially expressed lncRNAs between the tumor and peritumor tissue of APA.After that， to discover the target lncRNAs through analysis and validate their expression levels. Analyzing the functions of target lncRNAs. Results Two lncRNAs?NR_040090 and T065445 were selected through the microarray and analysis. They were validated to be up?regulated in the tumor，and the consequences were the same as the microarray?s. From the results of lncRNA and mRNA co?expression and conjoint analysis， we can conclude that NR_040090 may be related to aldosterone synthesis， T065445 may have influence on aldosterone synthesis and adrenocortical cell proliferation which is responsible for tumorgenesis. Conclusion lncRNAs?NR_040090 and T065445 were up?regulated in APA tumor， NR_040090 may have relationship with aldosterone synthesis， T065445 may be associated with both aldosterone synthesis and tumorgenesis.

Construction and verification of plasmid mediated LAPTM4B over expressing pancreatic cancer cell line PANC?1

ZHANG Guangtao1， LIANG Yue2， LI Minghua3

2019, 19(01):  44-47.  DOI: 10.3969/j.issn.1009?976X.2019.01.009

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［Abstract］ Objective To select low expression LAPTM4B?35 cell lines and construct and verify the stable PANC?1 cell line infected with LAPTM4B over?expressing plasmid. Methods Via RT?PCR and western?Blot， the expression of LAPTM4B in three kinds of pancreatic cancer cells was detected. The low expression LAPTM4B cell lines were screened. Overexpression of LAPTM4B?35 in PANC?1 cells by plasmid stable transfection was identified by RT?PCR and Western?blot. Results PcDNA3.0?AE plasmid was successfully amplified and transfected， and stable cell lines were screened. RT?PCR and western?blot showed that the overexpression of LAPTM4B?35 in stable strains was significantly higher than that of the blank control group. Conclusion The low expression cell line was successfully screened and the stable cell line PANC?1 overexpressing LAPTM4B?35 was established.

The clinical significance of immune regulatory factors in serum and plasma of urothelial cell carcinoma of the bladder

YANG Meihua， BI Junming， WANG Bo， HUANG Jian

2019, 19(01):  48-56.  DOI: 10.3969/j.issn.1009?976X.2019.01.010

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［Abstract］ Objective The purpose of this study was to analyze the expression of TGF?β1， IL?6 and IL?10 in the matched serum and plasma of patients with urologic diseases， and to investigate their clinical significance. Methods The serum and plasma samples were obtained from 42 patients diagnosed bladder cancer and 30 patients diagnosed urolithiasis from July 2015 to February 2016. The expression of TGF?β1， IL?6 and IL?10 in the serum and plasma were assessed by enzyme?linked immunosorbent assay （ELISA）. Nonparametric Wilcoxon analysis was used to evaluate the differences of cytokine expression in matched serum and plasma. Kruskal?Wallis analysis was applied to evaluate the clinical significance of TGF?β1 expression in matched serum and plasma collected from patients with bladder cancer. Result The concentration of TGF?β1 in serum is higher than it in the matched plasma （P<0.0001）. However， the concentrations of IL?6 and IL?10 had no statistical significance in the matched serum group and plasma group （P>0.05）. Compared to the Urolithiasis group， the level of TGF?β1 in tumor group was significantly elevated （P<0.01）. Moreover， the level of TGF?β1 in serum was positively associated with tumor stage and grade （P<0.05）. In contrast， the level of TGF?β1 in plasma group had no statistically significance （P>0.05）. Conclusion The expression of TGF?β1 in serum， but not plasma， was positively associated with tumor grade and stage， which suggested that the serum expression of TGF?β1 might be a potential biomarker for diagnosis and surveillance in urothelial cell carcinoma of the bladder.

A randomized controlled study of totally extraperitoneal laparoscopic herniorrhaphy on uinlateral inguinal hernia in elderly patients

ZHANG Shijie1，3， TIAN Peikai2， ZANG Shouge3， LIU Xiaoping1，3， OU Xi3， LIU Jikui3

2019, 19(01):  52-56.  DOI: 10.3969/j.issn.1009?976X.2019.01.011

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［Abstract］ Objective To observe the clinical effect of extraperitoneal laparoscopic herniorrhaphy on unilateral inguinal hernia in elderly patients. Methods 120 cases of unilateral inguinal hernia in Peking University Shenzhen Hospital from October 2015 to July 2017 were randomized into the control group and the observation group （60 cases each）. The control group was treated with tension free inguinal hernia repair under local anesthesia （open tension?free hernia repair under local anesthesia， OTFHULA）， and the observation group was treated with extraperitoneal laparoscopic herniorrhaphy on inguinal hernia repair （totally extraperitoneal prosthesis， TEP）. The operation time， intraoperative bleeding volume， total hospitalization cost， postoperative recovery time，the first day postoperative pain score （numeric rating scale， NRS）， the incidence of postoperative complications and postoperatively long term complications were compared in the patients with different surgical methods. Results The observation group of the operation time， intraoperative bleeding volume and the total hospitalization cost in the observation group were larger than those in the control group， and the observation group after the operation，postoperative NRS was less than the control group （P<0.05）. There was no significant difference in the first day the incidence of postoperative complications and postoperatively long term complications in the observa tion group. Conclusion For the elderly patients with unilateral inguinal hernia， group OPFHULA and group TEP have their own advantages and disadvantages， which can be rationally selected according to the actual situation of the patients and the skilled degree of the operation.

Hypoparathyroidism after total thyroidectomy： A retrospective analysis of 84 cases

WANG Donglai， HAN Bin， DAI Kangfu， ZHU Lizhang， CHENG Ran， WEI Wei

2019, 19(01):  57-60.  DOI: 10.3969/j.issn.1009?976X.2019.01.012

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［Abstract］ Objective To analyze the follow?up data of patients with temporary and permanent hypoparathyroidism after total thyroidectomy， and explore the relationship between the degree of postoperative PTH reduction and the normal time of PTH recovery， providing a theoretical basis for optimization of postoperative calcium supplementation in patients with total thyroidectomy. Methods A total of 84 patients with hypoparathyroidism （PTH<1.2 pmol/l， including both temporary and permanent） who underwent total thyroidectomy in the same therapeutic group of Peking University Shenzhen Hospital thyroid surgical department were retrospectively analyzed. Among them， 4 patients were loss to follow?up. The volunteers were divided into 3 groups according to the PTH level on the first postoperative day （Group A PTH≤0.3 pmol/l， Group B 0.3 pmol/l0.05）. There was a statistically significant difference between group A and group B. The medication rate in group A was higher than that in group B （P=0.014）； There was no statistical difference in medication between group A and group C， group B and group C （P=0.093 and 0.485）. Within 1 month and within 3 months after surgery， there was a significant difference between the proportion of patients with normal recovery of PTH in each group， until the 6 months after surgery， the recovery of PTH values among the groups had no statistically significant difference （P>0.05）. There was a statistically significant difference in the postoperative recovery rate of PTH among the three groups （P=0.017）. The rank sum test was performed in two groups. Compared group A with group B， group A with group C， there were statistically significant differences in the recovery rate of PTH values （P=0.025 and 0.033）. Group B and group C recovered faster than group A. Compared group B with group C， there was no significant difference in the recovery rate of PTH （P=0.936）. Conclusion Patients with hypoparathyroidism after total thyroidectomy should be treated with oral calcium to prevent hypocalcemia. The PTH level should be reviewed within one month； PTH≤0.3 pmol/l on the first postoperative day，the recovery period islonger than those PTH>0.3 pmol/l， and there is a higher chance of permanent hypoparathyroidism. Follow?up should be closely； by the 6th month after surgery， the PTH value of different degrees can be recovered to normal.

Efficacy of thalidomide combined with R?GEMOX regimen in the treatment of relapsed/refractor B?cell non?hodgkin′s lymphoma

ZHANG Cheng， SU Mingjun， RONG Tingjie

2019, 19(01):  61-66.  DOI: 10.3969/j.issn.1009?976X.2019.01.013

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［Abstract］ Objective To investigate the efficacy and toxicities of thalidomide （oral， starting dose 100 mg/d， increase 50 mg per week， up to 200 mg/d， QN， maintain） combined with R?GEMOX regimen （rituximab 375 mg/m2 d0， gemcitabine 1000 mg/m2， d1， d8， oxaliplatin 130 mg/m2 d1） in treatment of relapsed/refractor B?cell Non?Hodgkin′s lymphoma （NHL）. Methods Thirty?six patients with relapsed or refractor B?cell NHL after medication of traditional chemotherapy accepted thalidomide combined with R?GEMOX regimen，the efficacy toxicities was evaluated after two cycles of chemotherapy， the toxicities was evaluated after 1 cycles of chemotherapy. Results Of the 36 cases， 14 patients were in complete remission and 15 in partial remission， resulting in an overall response rate of 80%. Thirteen patients symptom disappeared， and one in 15 cases was alleviated of type B symptoms. The toxicities can be tolerated. Conclusion Thalidomide combined with R?GEMOX regimen was effect for recurrent or refractory B?cell NHL， and the toxicity was mild. This protocol was worthy of clinical application as salvage for relapsed or refractory B?cell NHL.

Effect of the consistency between preoperative needle biopsy and classification of surgical specimens on the treatment of early breast cancer

HE Jiangyao， WANG Jianwen， XIA Lili

2019, 19(01):  64-66.  DOI: 10.3969/j.issn.1009?976X.2019.01.014

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［Abstract］ Objective To investigate the effect of the consistency between preoperative needle biopsy and classification surgical specimens on the treatment of early breast cancer. Methods Forty?eight patients with breast tumors treated with surgical operation in our hospital were selected as the research subjects. Puncture biopsy and surgical resection biopsy were carried out on all the patients above. The immunohistochemical results of ER， PR， HER2 and Ki?67 in puncture tissues were analyzed according to the standard of surgical resection biopsy. Results Forty?two cases were positive and 6 cases were negative by surgical resection. The positive predictive values of ER， PR， HER2 and Ki?67 in puncture tissues were 97.44%， 93.75%， 89.65% and 92.59%， the negative predictive values were 55.56%， 25%， 15.79% and 19.05%， the sensitivity was 92.86%， 71.43%， 61.91% and 47.62% and the specificity was 75%， 33.33%， 27.27% and 21.43%. Conclusion The combined detection of ER， PR， HER2 and Ki?67 by immunohistochemistry in puncture biopsy can accurately reflect the histopathology of breast cancer and provide a reference for the treatment of breast cancer.

Comparison of the clinical efficacy of MIS?TLIF under the microscope and PLIF in the treatment of single level lumbar spondylolisthesis for Wiltse IV

LI Heng， LI Zhizhong

2019, 19(01):  67-70.  DOI: 10.3969/j.issn.1009?976X.2019.01.015

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［Abstract］ Objective To analyze and compare the outcomes in treatment of single level lumbar spondylolisthesis for Wiltse IV with MIS?TLIT （minimally invasive transforaminal lumbar interbody fusion， MIS?TLIT group） under a microscope and PLIF （posterior lumbar interbody fusion， PLIF group）. Methods This was a retrospective study and analyzed the clinical data of 128 cases of patients with single level lumbar spondylolisthesis for Wiltse IV. The perioperative indicators between the two groups （intraoperative blood loss， operative time， postoperative wound drainage for 48 hours after surgery） were recorded and compared. VAS score， JOA score and ODI score at preoperative levels， and in 2 weeks， 3， 6 and 24 months after surgery respectively were compared between MIS?TLIT group and PLIF group during the two years of follow?up. Results There was no significant difference between MIS?TLIT group and PLIF groups in operative time（P>0.05）. The intraoperative blood loss， postoperative wound drainage for 48 hours after surgery in MIS?TLIF were significantly lower than in PLIF group（P<0.05）. The significant differences were showed in VAS and ODI score between two groups and the patients in MIS?TLIF group were significantly lower than in PLIF group， but the JOA score of MIS?TLIF group was higher than that of PLIF group in 2 weeks after operation （P<0.05）. The differences of VAS， JOA score and ODI score between two groups were no significant differences in 3， 6， 24 months after operation（P<0.05）. Conclusion Compared with PLIF， microscopical MIS?TLIF treatment of single level lumbar spondylolisthesis for Wiltse IV has less trauma， less blood loss， significant short?term curative efficacy and similar long?term efficacy.

Effect of arthroscope combined with sodium glassate and glucosamine sulfate on osteoarthritis of knee

HUANG Sicong， LIU Xuedong， CHEN Yufang， WU Hua， LI Yuqun

2019, 19(01):  71-75.  DOI: 10.3969/j.issn.1009?976X.2019.01.016

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［Abstract］ Objective To investigate the curative effect of arthroscope combined with sodium glassate and Glucosamine sulfate in the treatment of knee osteoarthritis （KOA）. Methods Seventy?eight patients with knee osteoarthritis were included in this study from January 2017 to March 2018. They were randomized into experimental group and control group. The patients （n=39） in experimental group underwent the management of arthroscope combined with sodium glassate and glucosamine sulfate， and the controls （n=39） was treated with arthroscopic surgery alone. Both groups were guided to perform knee functional exercise after surgery. VAS pain quantification score， Lequesne index and arthritic effect scale （AIMS） score were recorded and compared between the two groups before treatment， 2 weeks and 8 weeks after treatment. The clinical efficacy in two groups was analyzed， and the adverse reactions during the treatment were observed and recorded. Results In the experimental group and control group， there were significant differences in VAS score， Lequesne index and AIMS score before and 2 week and 8 week after treatment （all P values <0.05）. And as compared with control group， VAS score， Lequesne index and AIMS score in the experimental group showed significant differences in each time point （all P values <0.05）. Conclusion The joint arthroscope combined with sodium glassate and Glucosamine sulfate has a good effect on KOA and is superior to the single arthroscopic operation.

Effects of different doses of bone cement PKP combined with estrogen on postmenopausal women with osteoporotic lumbar vertebral compression fracture

WEN Li， WANG Shengli， GE Zhanyong， ZHANG Xukun

2019, 19(01):  76-79.  DOI: 10.3969/j.issn.1009?976X.2019.01.017

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［Abstract］ Objective To investigate the effects of different doses of bone cement PKP combined with estrogen on postmenopausal women with osteoporotic lumbar vertebral compression fracture. Methods 120 elderly female patients with osteoporotic lumbar vertebral compression fractures admitted to our hospital from January 2015 to June 2018 were divided into three groups （group A 2~4 ml， group B 4~5 mL， group C 5~4 mL） according to the dosage of bone cement injected during PKP operation. All patients were followed up for one year and compared with the third group after operation. The VAS score， ODI score， the anterior height of injured vertebral body， the middle height of vertebral body and the incidence of complications were recorded. Results There was no significant difference in VAS score and ODI score between the three groups before treatment （P>0.05）； at the follow?up of three days and one year after operation， all the indexes of the three groups were significantly improved compared with those before treatment （P<0.05）， and there was no significant difference between the three groups （P>0.05）. There was no significant difference in the anterior and middle height of vertebral body before treatment （P>0.05）； the anterior and middle height of vertebral body increased significantly after three days and one year follow?up （P<0.05）. The anterior height of vertebral body in group C>group B>group A， and the intervertebral height in group C>group B were significantly higher than that before treatment （P<0.05）. The incidence of complications in group A （12.5%） was significantly lower than that in group B （30.0%） and group C （41.0%） （P<0.05）. Conclusion Intraoperative injection of low dose bone cement （2~4 ml） in PKP is effective and safe for the treatment of OVCFs in elderly women.

Clinical analysis of MRS and MRI in early traumatic cerebral infarction

CHEN Yunpeng1， LI Zaiyu2， YANG Zhengyue2， YAN Jiehao3

2019, 19(01):  80-82.  DOI: 10.3969/j.issn.1009?976X.2019.01.018

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［Abstract］ Objective To investigate the clinical guiding value of MRI and MRS in the early diagnosis， timely treatment and prognosis of traumatic cerebral infarction. Methods Imaging （MRI and MRS） examination fifty?one patients with traumatic cerebral infarction were divided into three groups for， and detected the content changes of some metabolites （such as NAA， Cho， Lac， etc.） in the area of traumatic cerebral infarction， and then analyzed the metabolites quantitatively. Results There were different degrees of abnormal signal changes in the infarct area and its surrounding area on MRI head plain scan and enhancement scan and DWI in the three groups of patients， suggesting that there were different degrees of edema and ischemia in the infarct area. MRS showed that in the central area of traumatic cerebral infarction， NAA decreased significantly， Cho increased significantly， Lac increased significantly， and Lac peak appeared. In the ischemic penumbra area around the center of cerebral infarction， NAA decreased slightly， Cho increased slightly， and Lac no significant increased. Conclusion MRI and MRS can provide effective value for the early clinical diagnosis of traumatic cerebral infarction and preliminarily determine the therapeutic prognosis.

Diagnostic value of cerebrospinal fluid procaicitonin and lactic acid level in intracranial infection after craniotomy

LU Xiaoju， RONG Yongzhang， FENG Jiaqiang， LI Xiaoxia

2019, 19(01):  83-85.  DOI: 10.3969/j.issn.1009?976X.2019.01.019

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［Abstract］ Objective To explore the diagnostic value of cerebrospinal fluid procalcitonin （PCT） and lactic acid level in intracranial infection after craniotomy. Methods Forty post?craniotomy patients with suspicious intracranial infection were chosen in our study； these patients were divided into infected group and disinfected group （n=20/each group）. PCT and lactic acid level in the serum and cerebrospinal fluid were detected and analyzed， respectively. Results Both PCT and lactic acid values in the cerebrospinal fluid and PCT in serum in the infected group were significantly higher than those in the disinfected group （P<0.05）. Both PCT and lactic acid in the CSF had good sensitivity and high specificity. Conclusion CSF PCT could be proposed as an effective diagnostic marker for intracranial infection and it is superior to CSF lactic acid， serum PCT and lactic acid count.

Recombinant human thrombopoietin for sepsis?associated thrombocytopenia clinical effect analysis

LONG Wenting1， ZHOU Qidi1， ZHANG Weixing， MA Liping2

2019, 19(01):  86-90.  DOI: 10.3969/j.issn.1009?976X.2019.01.020

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［Abstract］ Objective To investigate the clinical efficacy of recombinant human thrombopoietin （rhTPO） in the clinical treatment of patients with sepsis?associated thrombocytopenia. Methods Approved by the Peking University Shenzhen hospital and SUNYat?senMemorial Hospital， SUN Yat?sen Memorial Hospital University ethics committee， the study was conducted from August 2016 to July 2018. Sixty septic patients with thrombocytopenia from two hospitals were included in the study. Subjects were divided into two groups based on treatments they received： human recombinant platelet hormone （rhTPO） and ulinastatin group. The former received rhTPO treatments， with a dosage of 15000 U human recombinant platelet hormone （shenyang junior pharmaceutical co.， LTD.， S20050048， approved by the drug properties： Biological products， 15 000 units/1 mL/bottle） subcutaneously， 1 time/d， 1 week for a course of treatment. The latter received ulinastatin 300，000U/d （GuangdongTianpu biochemical pharmaceutical co.， LTD.， national drug approval word H19990134） intravenously for a course of 1 week. The platelet count， relevant other clinical and inflammatory indicators were compared and analyzed before and after treatment. Results The platelet count of the observation group before treatment and 3， 5 and 7 days after treatment were 50.54±20.58×109/L；64.20±10.18×109/L；72.61±18.56×109/L；105.60±20.19×109/L respectively， which were significantly higher than that of the control （all P values <0.05）. ALT in two group had not improved， but the levels of Cr， PT， RBC and WBC showed significantly improved， （all P values >0.05）. The indexes of inflammatory factors in the observation group were significantly lower than those in the control group （P<0.05）. Conclusion RhTPO has benefits for the improvement of platelet count among patients with sepsis?related thrombocytopenia and the safety profile is reassuring.

Effect of Wu Zhuyu hot pressing combined with acupuncture at Zusanli on FTS after gastric cancer operation

HUO Jingshan， HE You， HUANG Zijian， WU Minhan， TAO Shiming

2019, 19(01):  91-94.  DOI: 10.3969/j.issn.1009?976X.2019.01.021

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［Abstract］ Objective To explored the curative effect of integrated traditional Chinese and Western Medicine on postoperative fast?track surgery （FTS） of gastric cancer. Methods Fifty?five patients with radical gastrectomy in the Department of general Surgery of Foshan Chinese Medicine Hospital were included in the study， and were divided into two groups， A group （n=25， treated with FTS）， B group （n=30， treated with combined FTS and Chinese and Western medicine）. The postoperative anal deflation， removal of the gastric tube， start of eating time， length of hospital stay， hospitalization costs， postoperative complications， and C?reactive protein were evaluated. Results In the patients of B group， the first time of postoperative anal exhaustion， removal of gastric tube， start of eating time， hospitalization time， hospitalization cost and postoperative complications were significantly different with that in B group （all P values were less than 0.05）. Conclusion Intervention of traditional Chinese and Western medicine can promote the rehabilitation， reduce the length of hospital stay， reduce the hospitalization cost and postoperative complications for postoperative patients with gastric cancer.

Clinical observation of Apatinib combine with traditional Chinese medicine in treating advanced non?small?cell lung cancer

ZHANG Liping， DU Jiahao， SHEN LiMei， ZHANG Qizhou， JIN Jun

2019, 19(01):  95-100.  DOI: 10.3969/j.issn.1009?976X.2019.01.022

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［Abstract］ Objective To evaluate the efficacy and adverse reaction of the chemotherapy by apatinib or apatinib combined with traditional Chinese medicine in treating with advanced NSCLC. Methods This was a prospective study from Jan 2017 to Sep 2018， and 59 patients with a confirmed diagnosis of stageⅢb?ⅣNSCLC. Among them，31 patients receive treatment of Apatinib alone （control group）， 28 patients receive combined treatment of TCM and Apatinib （treatment group）. Results 1. Comparison of recent objective efficacy： The ORR （14.29%） and DCR （60.71%） of the treatment group were lower than the ORR （19.35%） and DCR （64.52%） of the control group， but there were no significant difference between the two group （P>0.05）. Comparison of the survival time： The mPFS was 3.33 months in treatment group and 3.0 in control group， and there was no significant difference between the groups （P>0.05）. The MST in the treatment group was 5.17 months， and the control group was 4.9 months （P>0.05 when compared between two group）. 2. Comparison of the side effect rate and safety： The rate of hypertension， proteinuria and bone marrow suppression in the treatment group was lower than that of the control group， and the difference of proteinuria between the groups was statistically significant （P<0.05）. Conclusion Compared with apatinib， Apatinib combine with TCM has the same efficacy in treatment of advanced non?small?cell lung cancer. Apatinib combine with TCM can antagonize the toxic and side effects caused by apatinib， improve the tolerance of patients and improve the quality of life of patients.

Pleural effusion caused by subclavian vein catheterization

LI Huachu, ZHOU Haibo, YANG Jingwen

2019, 19(01):  101-102.  DOI: 10.3969/j.issn.1009?976X.2019.01.023

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Preoperative CT and intraoperative neuromonitoring confirmed a case of right type I non?recurrent laryngeal nerve

ZHANG Long， LI Peng， LIANG Qingzhuang， WEI Wei

2019, 19(01):  103-105.  DOI: 10.3969/j.issn.1009?976X.2019.01.024

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［Abstract］ Non?recurrent laryngeal nerve （NRLN） is a rare anatomical variant. Because of the lateral shape of the vagus nerve after branching into the larynx， there is a higher risk of injury during thyroid surgery. Preoperative computed tomography （CT） examinations found the arteria lusoria can predict the possibility of the presence of right NRLN， so that the operation remains vigilant. Intraoperative neuromonitoring （IONM） confirms the presence of NRLN and helps protect the function of the recurrent laryngeal nerve.

Advances in the diagnosis and treatment of pancreatic cystic tumors by endoscopic ultrasonography

LI Zitao， MIAO Huilai

2019, 19(01):  106-109.  DOI: 10.3969/j.issn.1009?976X.2019.01.025

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［Abstract］ The detection rate of pancreatic cystic neoplasms was significantly increased with the improvement of recognition and the popularity of imaging diagnostic instruments.Due to the wide variety of pancreatic cystic neoplasms， biological behaviors can be not only benign， low?grade and malignant， but also dynamic changes in the growth process of tumors with the increase in volume.Accurate diagnosis of benign lesions is of particular importance in determining the need for monitoring surgical or endoscopic treatment， and in avoiding unnecessary surgery for non?potentially malignant cysts.In recent years， ultrasound endoscopy （EUS） has made great progress in the guidance evaluation and treatment of pancreatic cystic tumors. This paper summarizes the basic principles， main literature results， limitations and future prospects of each method.

Research progress in the treatment of diversion colitis

LIAO Tianyou1，2， OUYANG Manzhao

2019, 19(01):  110-114.  DOI: 10.3969/j.issn.1009?976X.2019.01.026

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［Abstract］ Diversion colitis （DC） is a non?specific inflammation of the mucosa in the defunctioned part of the colon after colostomy or enterostomy. Although the majority of patients with intestinal stoma are asymptomatic， almost all patients with diverted stools could develop DC. The clinical symptoms of DC mainly include abdominal pain， tenesmus， colorectal bleeding， and discharge of mucus. Inflammation of mucosa could be aggravated with the prolonged of colon disused， which could affects the quality of life for these patients in different degrees. However， there were a few researches on DC and a lack of knowledge about it in China， so it has not attracted enough attention from clinicians. Given this， in this paper， the researches and advances in the clinical features， treatment， and patient management of DC were reviewed to improve the clinical understanding of DC and help doctors make better treatment decisions and management in the future.

Advantages and limitations of minimally invasive endoscopy in the treatment of lumbar disc herniation

ZHANG Daijie， FANG Qingmin

2019, 19(01):  115-121.  DOI: 10.3969/j.issn.1009?976X.2019.01.027

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［Abstract］ Lumbar disc herniation（LDH） is one of the most common diseases in spine surgery and also a common cause of chronic lumbago and leg pain. With the development of medical science and technology， minimally invasive technology has become a major development direction for the treatment of lumbar disc herniation besides the classical open decompression surgery. In the current stage of clinical application， minimally invasive endoscopic surgery is mainly used for the treatment of the disease， include microendoscopic discectomy （MED） and percutaneous transforaminal endoscopic discectomy （PTED）. Compared with the traditional open operation， there is no doubt that the application of endoscopy has a series of obvious advantages such as light tissue destruction， less bleeding in the operation， and rapid recovery after operation. However， Spinal endoscopy is also limited， such as narrow scope of application and strict operation. Although minimally invasive endoscopy is the same， the principles and indications of MED and PTED are different. The purpose of this paper is to make a detailed comparison and summary of the two technologies.

Knowledge and practice of ICU nurses on endotracheal suctioning for intubated patients： a cross?sectional study

ZHANG Chunqiong1， YE Hua2， LI Zhuohui1， RONG Zhimin1

2019, 19(01):  118-121.  DOI: 10.3969/j.issn.1009?976X.2019.01.028

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［Abstract］ Objective To investigate the knowledge and practice on endotracheal suctioning of the intubated patients among intensive care nurses. Methods From August 2017 to April 2018， 87 nurses from ICU and EICU were selected to receive the investigation in intensive care units of two hospitals. All participants were surveyed with questionnaires， and 33 nurses of 87 were assessed for on?site ETS operation. Results Most ICU nurses get higher questionnaire scores， but the scores of on?site assessment are lower， which was comparable to the results of knowledge questionnaire， and had relationship with their academic qualifications and working hours. Only 10 nurses （30.3%） had chest auscultation before ETS. Unsatisfactory aseptic operation， frequent sputum suction and no observation of blood pressure after ETS were the main problems. Conclusion Continuing education should be strengthened to suit the practical clinical skills required. These factors may require further supervision and management to prevent them.

Effect of trans?theoretical health education on health behaviors of elderly patients with complex renal calculi

ZENG Fanying， ZHOU Xiumei

2019, 19(01):  122-124.  DOI: 10.3969/j.issn.1009?976X.2019.01.029

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［Abstract］ Objective To explore the effect of trans?theoretical health education on health behaviors of elderly patients with complex renal calculi. Methods From January 2016 to June 2017， 93 elderly patients with complex renal calculi were randomly divided into the observation group （46 cases） and the control group （47 cases）. The control group received routine continuing health education， while the observation group received health education guided by trans?theoretical model. Their dietary status at one week and 12 months after discharge， status of behavioral change at one week and three months after discharge， relapse within 12 months after discharge were observed. Results The differences of dietary status at one week after discharge between two groups were not statistically significant （P>0.05）. At 12 months after discharge， daily drinking amount in the observation group was significantly more， the take of animal protein food and oxalate rich food in the observation group was significantly less， the differences were statistically significant （P<0.05）. The differences of status of behavioral change at one week after discharge between two groups were not statistically significant （P>0.05）. At 12 months after discharge， status of behavioral change in the observation group was significantly better， the difference was statistically significant （P<0.05）. The relapse rate in the observation group was significantly lower than that in the control group （P<0.05）. Conclusion Trans?theoretical model can promote the implementation of healthy behavior in elderly patients with complex renal calculi， which is helpful to reduce recurrence.