15 August 2017, Volume 40 Issue 4

    

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  Expression and significance of TLR-4, TNF-α and IL-1 in acute lung injury

  WANG Weichen, SHI Lei, LIU Wei, CAI HongJing, XIA YongFu

  滨州医学院学报. 2017, 40(4): 241-244.

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  Objective To study the significance and expression change of Toll-like receptor 4 (TLR-4),tumor necrosis factor-α(TNF-α) and interleukin-1 (IL-1) in acute iung lnjury.Methods Forty wistar rats were randomly divided into control group and model group.Sterile laparotomy with cecum flipping was performed in the control group, while the cecum ligation perforation technique (CLP) was performed in the model group.Rats both in the control group and in the model group were killed after 6 hours or 12 hours.Enzyme-linked immuneo sorbent assay (ELISA) was used to detect the serum level of TNF-α and IL-1, and immunohistochemical technique was used to detect the expression and distribution of TLR-4 and TNF-α in lung tissue.Results The serum levels of TNF-α and IL-1 in two different time points of the model groups were higher than those of the control groups,and the difference was statistically significant (P＜0.01).The serum levels of TNF-α and IL-1 in the CLP group 12 hours after operation were significantly higher than those in the CLP group 6 hours after operation, and the difference was statistically significant (P＜0.01).Expressions of TLR-4 and TNF-αin lung tissue in two different time points of the model group enhanced,expression of TLR-4 mainly distributed in lung macrophages and endothelial cells,and expression of TNF-αmainly distributed in the airway epithelial cells and scavenger cells.Conclusion The levels of TLR-4,TNF-α and IL-1 could be used as indexes of early diagnosis of acute lung injury.
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  Comparison of protective effects of active perfusion and shunt perfusion on ischemic myocardial

  FENG Zanxiang, HOU Fang, LIU Baohui, LI Wei, WANG Feng, QIAN Zhaoyang, WANG Yujiu

  滨州医学院学报. 2017, 40(4): 244-248.

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  Objective To establish the porcine myocardial ischemia model, compare and estimate the protective effects of active perfusion and shunt perfusion on ischemic myocardial.Methods The acute myocardial ischemia was induced by suturing left anterior descending coronary artery at the proximal in 24 anesthetized,open-chest pigs. Thirty pigs were randomly divided into five groups:natural control group (N),shunt-55%coronary artery stenosis group (A1),shunt-75%coronary artery stenosis group (A2),active perfusion -55%coronary artery stenosis group (B1),and active perfusion -75% coronary artery stenosis group(B2).Aortic pressure(P₀),left anterior descending coronary pressure(P1), and the effective coronary artery pressure ratio (P₀/P₁) were measured 30mins after myocardial ischemia.The expression levels of TNF-α,cTnI,Mb,CK-MB,IL-6,and IL-10 were observed with Elisa,respectively.Results After operation, compared with those in the control group, left anterior descending coronary pressure(P₁),and the effective coronary artery pressure ratio (P₀/P₁) in other groups significantly decreased (P＜0.01) and TNF-α,cTnI,Mb,CK-MB,IL-6, and IL-10 in other groups significantly increased (P＜0.01).On the other hand, compared with those in group A,P₁ and P₁/P₀ in group B significantly increased (P＜0.01),and TNF-α,cTnI,Mb,CK-MB,IL-6,and IL-10 in group B significantly decreased (P＜0.01),showing that the degree of myocardial ischemia in B group was lower than that in group A.Conclusion Compared with shunt perfusion,active perfusion appears to have a more protective effect on ischemic myocardial.
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  Combined promoter hypermethylation of RASSF1A and FHIT gene in the diagnosis of non-small cell lung cancer

  XIE Zhen, LI Tianyue, LIU Hongjian, HUANG Bingtao, ZHANG Lianguo, ZHANG Qingguang

  滨州医学院学报. 2017, 40(4): 249-251.

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  Objective To determine the value of combined detection of RASSF1A and FHIT gene methylation in predicting the diagnosis of non-small cell lung cancer (NSCLC).Methods Thirty patients with non-small cell lung cancer (NSCLC) diagnosed by WHO Histopathology Standard were enrolled in the case group,and 30 cases of healthy subjects were taken as the control group.The methylation rate of RASSF1A and FHIT gene was detected by real-time fluorescence quantitative methylation specific PCR (MSP).We analyzed the effects of age,sex,histopathological type, and clinical staging on methylation,and analyzed the sensitivity and specificity of the combined detection of two genes methylation in the diagnosis of non-small cell lung cancer.Results The methylation rate of RASSF1A gene was 66.67% (20/30) in patients with NSCLC,and FHIT gene methylation rate was 60% (18/30).There was no significant correlation between the clinicopathological features and the methylation of RASSF1A and FHIT genes (P＞0.05).RASSF1A and FHIT gene methylation were independent risk factors for NSCLC.Combined detection of RASSF1A and FHIT gene methylation can significantly improve the sensitivity and specificity of diagnosis, while the positive and negative predictions have no difference.Conclusion Combined detection of RASSF1A and FHIT gene methylation can significantly improve the diagnosis of NSCLC,but there is no obvious advantage for early diagnosis.
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  Application of 3D printing guide system in puncture of transforaminal percutaneous endoscopic lumbar discectomy

  LI Chenglong, LI Zefu, LI Meng, LIU Pengfei, SHAO Wei, LI Zhenzhu, HAN Xinyu

  滨州医学院学报. 2017, 40(4): 252-256.

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  Objective To study 3D printing guide system on puncture accuracy and fluoroscopic exposure as well as surgical efficiency of transforaminal percutaneous endoscopic lumbar discectomy (PELD).Methods Four patients with Lumbar disc herniaion, admitted to our hospital from October 2016 to February 2017 and aged from 45 to 78 years old (with the average age of 58.5),including 2 males and 2 females,were chosen as study objects.The 3-dimensional image was obtained with Mimics Medical 17.0 software.A perfectly personal navigation module included puncturing-guidance-channel was designed and printed by 3D-printing technology.The printing module was tested in surgery.The module was tightly attached to the puncturing area, and the puncturing was performed following the guide system during the surgery. The accuracy of the needle was observed with the C arm X-Ray machine.Results All the 4 patients successfully received surgery.Intraoperative fluoroscopy showed satisfied results which were classified based on accuracy: 2 highly accurate results, one qualified result and one acceptable result. No puncture failure and no injuries of important organs or blood vessels were found.Conclusion 3D printing guide system can significantly improve the puncture accuracy of PELD and reduce its fluoroscopy exposure as well as operation time, which indicates its great potential in the future clinical applications.
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  Diagnostic value of supersonic shear imaging evaluating the degree of liver fibrosis in chronic hepatitis B

  ZHANG Wenxiao, WANG Minmin, LI Baowei, WANG Minghui, WANG Kun

  滨州医学院学报. 2017, 40(4): 257-259.

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  Objective To explore the value of supersonic shear imaging evaluating the degree of liver fibrosis in chronic hepatitis B.Methods Data of 125 patients in a hospital from Jan.1,2015 to Dec.12,2016 were collected, and Pathological examination results from Liver biopsy were taken as the gold standard.SWE was used to test the elastic modulus and The elastic modulus was compared with pathological stages of hepatic fibrosis.Results There was significant differences in the elastic modulus of patients with different degrees of inflammation activity of liver tissue and of liver fibrosis.Conclusion SWE imaging was promising for clinical application and could be utilized as a noninvasive method for the quantitative evaluation of fibrosis staging in chronic hepatitis.
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  Effects of levosimendan on cardiac function, blood pressure and heart rate of patients with left ventricularfailure after acute myocardial infarction

  WANG Hongyun, ZHAO Yongjun, QIN Liang

  滨州医学院学报. 2017, 40(4): 259-262.

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  Objective To observe the changes of cardiac function, blood pressure and heart rate of patients with left ventricular failure complicating acute myocardial infarction after the treatment with levosimendan.Methods Sixty-two patients with left ventricular failure after acute myocardial infarction and with need for inotropic agents were included and were randomly divided into the levosimendan group and the control group.The levosimendan group received intravenous levosimendan while dobutamine was given in the control group.Blood pressure,heart rate and other test indicators were monitored before and after the treatment.We observed the major adverse cardiac events of both groups within 1 week. We tested the blood,hepatorenal function,and blood electrolytes,and recorded adverse events related to drugs used.Results After treatment,the improvement rate of cardiac function in the levosimendan group was significantly higher than that in the control group (P＜0.05).Major adverse cardiac events of the levosimendan group was less than that in the control group during the observation period (P＜0.05).Blood pressure decreased slightly in the levosimendan group after treatment compared with baseline (P＜0.05).Conclusion Levosimendan can significantly improve cardiac function in patients with left ventricular failure after acute myocardial infarction, and can make systole blood pressure decrease slightly. Compared with the control group, levosimendan does not increase arrhythmias. Levosimendan is effective and safe for patients with with left ventricular failure after early acute myocardial infarction.
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  The application value of serum Cystatinc and Beta2-microglobulin for diagnosing early diabetic nephropathy

  LI Rui, NIU Xiaochun, WANG Qingfen

  滨州医学院学报. 2017, 40(4): 263-266.

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  Objective To investigate the diagnostic value of serum cystatinC(CysC) and β₂-microglobulin(β₂-MG) in early diabetic nephropathy.Methods Serum concentrations of cystatinC and β₂-microglo-bulin were measured in 106 diabetes mellitus patients and 30 healthy people(group N)using immune turbidimetry method,which were also compared with serum creatinine (Scr),endogenous creatinine clearance (Ccr) and other related indicators.Patients were divided according to the urine albumin excretion rate (UAER) into normal albuminuria (Group A),microalbuminuria (Group B), and macroalbuminuria (Group C).The sensitivity and correlation in diabetic neuropathy (DN) diagnosis between serum CysC、β₂-MG、Scr、Ccr concentrations were also respectively compared.Results 1.According to the UAER and compared with group N,CysC and β₂-MG in group A have begun to increase while the creatinine started to increase in group C.Ccr increased in group A, while it declined in group C,but no obvious change in group B.All changes were statistically significant. 2.The sensitivity of serum CysC,β₂-MG or Ccr were 53.77%,41.51%,31.13%;specificity of these three markers were 83.33%,66.67%,80.00%;and the accuracy were 60.29%,47.06% 41.91%.The sensitivity,specificity and accuracy of serum CysC are all higher than the other two.3.Serum CysC,β₂-MG or Ccr is well correlated with UAER(r=0.884、0.756、-0.700,respectively).Scr is middle correlated with it(r=0.421,respectively).CysC、β₂-MG is also correlated with Scr(r=0.470、0.458,respectively) and Ccr (r=-0.613、-0.559,respectively).CysC correlated more strongly with UAER (P＜0.01).4.Serum CysC,β₂-MG,Ccr or Scr is well correlated with the diabetic nephropathy (＞20 g/min, according to UAER diagnostic criteria) (r=0.814、0.785、-0.780、0.520,P＜0.01).Among them,cystatinC correlated more strongly with diabetic nephropathy (P＜0.01).Conclusion The cystatinC and β2-microglobulin are important biochemical markers of early kidney damage of the type 2 diabetes patients.They are more sensitive and accurate than serum creatinine and endogenous creatinine clearance.Of these two markers,cystatinC has better diagnostic value.
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  Effect of obesity on early outcome after total hip arthroplasty

  CAO Heng, LIU Mingting, SHI Hui, LI Jian, XU Chuang

  滨州医学院学报. 2017, 40(4): 267-270.

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  Objective To investigate the effect of obesity on the early outcome of total hip arthroplasty (THA) after total hip arthroplasty (THA).Methods From November 2014 to September 2016,300 patients who underwent total hip arthroplasty were divided into obese group (107 cases,BMI≥25)and non-obese group (193 cases,BMI＜25) according to the body mass index (BMI). The complications were compared between the two groups (intraoperative and postoperative bleeding volume,operation time and postoperative complications within 3 months) (prosthesis fracture, dislocation, Vein embolization). The Harris score of the hip joint was compared with that of the hip joint at 1 month, 2 months and 6 months postoperatively. The above data were analyzed statistically.Results Compared with the non-obese group, the total complication rate of the former group was higher than that of the non-obese group in the intraoperative and postoperative blood loss,operation time and postoperative 3 months (P＜0.05).The incidence of postoperative prosthesis dislocation,prosthesis fracture and deep vein thrombosis was higher in the obese group than in the nonobese group (P＜0.05),but the difference was not statistically significant (P＜0.05).The Harris score of the hip joint in the non-obese group was significantly higher than that in the obese group at 1 month,2 months and 6 months postoperatively (P＜0.05).Conclusion Obesity increases the difficulty of THA,increases the incidence of early complications after THA,and affects the early functional recovery of the hip.
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  The clinical observation of handling the early thickness soft tissue infection after post-operative fractureof lower limb with filling in PVA foam

  TIAN Xiue, CHENG Shuai, REN Qiang, WANG Jianming

  滨州医学院学报. 2017, 40(4): 271-274.

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  Objective To investigate the clinical observation of handling the early full thickness soft tissue infection after fracture of lower limb after open reduction and internal fixation with filling in medical PVA foam with the anatomic level layered.Methods 52 cases in patients of early full thickness soft tissue infections after fracture of lower limb after open reduction and internal fixation with stage I were all treatment for stratified filling tube with medical PVA foam pouring out negative pressure closed drainage, after sealing the infusion,deep intermittent perfusion,shallow the negative pressure drainage,later from deep to shallow,withdrawal the medical PVA foam with tube layer by layer,the final closure of the wound.Results Most of the patients with sepsis rapidly control,visible fresh granulation tissue to grow in 6-7 days,14~21 days to destroy deep dead space,granulation tissue covering the bone sections,21-28 days of shallow soft tissues closed wound.During the 2-3 years of follow-up,51patients were cured the infection,fracture healing,1 cases of patients with late infection delayed healing,be cured after removing the implants with bone transport.Conclusions Layered filling medical PVA foam with tube filling vacuum sealing drainage treatment of early full thickness soft tissue infection post-operative fracture of lower limb with good effect.For each layer of tissue,less tamponade,less destructive,sinus formation is reduced, shorten the course of treatment, can deal with the early full thickness soft tissue infection after steel plate screw internal fixation of femoral fracture, avoid osteomyelitis or even amputation.
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  The application of flexible management in outpatient nursing management

  JI Xiangqin, SU Tingting, SONG Qiong

  滨州医学院学报. 2017, 40(4): 274-276.

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  Objective To discuss the application of flexible management in the outpatient nursing management.Methods The flexible management was carried out in the outpatient nursing management from January 2015 to date.We compared the improvement of nursing quality,patient satisfaction and nurse satisfaction before and after the implementation of flexible management, and conducted statistical analysis.Results After the implementation of flexible management, the nurse work requirement,the clinic order,patient health education and hospital infection management were improved significantly (P＜0.05);the patients' satisfaction with the nurses' appearance,the treatment order,the service attitude and the nursing safety were improved significantly (P＜0.05);the nurses' satisfaction with scheduling,training and humanistic management were improved significantly (P＜0.05).Conclusion The flexible management can improve effectively the outpatient nursing quality,the patient satisfaction and the nurse satisfaction.
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  Peanut Skin Procyanidins reduce the expression of survivin and induce the apoptosis of pancreaticcancer cells through Wnt/ beta-catenin signaling pathway

  MI Wei, LIU Jinhui, GUO Mengzhu, LIU Chengjuan, TIAN Cheng, LI Changzhen, TANG Jinshuo

  滨州医学院学报. 2017, 40(4): 276-281.

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  Objective The present work was undertaken to explore the molecular mechanism for the apoptosis of pancreatic cancer cells induced by PSP through down regulating the expression of survivin via the Wnt/β-catenin signal pathway.Methods Pancreatic cancer cells were nurtured routinely at PSP concentrations of 100,200,300,400,500 and 600μg/mL.The cell counting kit-8(CCK-8) assay was used to detect and calculate the inhibitory rate of pancreatic cancer cells after 72 hours of culturing.The IC50 of 450μg/mL was chosen as the experimental group. Western blotting was adopted to detect the degree of GSK-3β and β-catenin phosphorylation and the protein expression levels of survivin, caspase-3 and caspase-7.RT-PCR was used to evaluate the expression level of survivin mRNA.Annexin V-FITC/PI was used to test inhibitory rate of pancreatic cancer cells after 24, 48 and 72 hours.Results The degree of GSK-3β and β-catenin phosphorylation reached the highest (P＜0.01) after 12h in the experiment group.The expression of survivin mRNA in the experiment group was significantly lower (P＜0.01) compared to that in the control group.Under the action of PSP,the expression of survivin protein was the lowest (P＜0.01) after 72 hours while the expression of caspase-3 and caspase-7 protein were the highest(P＜0.01)after 72 hours.The apoptosis rate of pancreatic cancer cells increased as the culture period was prolonged,which reached 51.59% (P<0.01) after 72 hours of culture.Conclusion PSP can exert a pro-apoptotic effect on pancreatic cancer cells by reducing the expression level of survivin through the Wnt/β-catenin signal pathway.
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  Analysis on the demand and influence factors of the unemployment insurance of medical students

  CONG Jianni, ZHAO Yongjun, HUANG Xiaomin

  滨州医学院学报. 2017, 40(4): 281-283.

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  Objective to understand the demand and influence factors of the unemployment insurance of medical students.Methods Self-designed questionnaire and cluster stratified sampling were used to investigate 209 medical students from a university.Results 53.59% of the investigated students thought it necessary to take part in the unemployment insurance for university students;5.26% thought it unnecessary to attend unemployed insurance.46.5% males would like to buy unemployment insurance,while 69.4% females were willing to buy unemployment insurance,and the difference was statistically significant (P＜0.05).There was no statistical significance in the willingness to buy unemployment insurance of the medical students with different household registration and household income (P＞0.05).Conclusion The willingness to buy unemployment insurance of medical students was not strong,so the university should strengthen the propaganda and education,especially for males, so as to change their willingness and improve the insurance rate.
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  Effect of costal perichondrium on reconstruction of mandibular condyle with Costochondral grafts

  DONG Pengfei, LI Guohua, WANG Fang, WANG Yuliang

  滨州医学院学报. 2017, 40(4): 283-286.

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  Objective To explore the mechanism about costal perichondrium regulating reconstruction of Costal Cartilage by observing the histological expressions and expressions of BMP-2 of the Costal Cartilage.Methods Rabbits were devided randomly into the experiment group and the control group.For the experiment group,costal perichondrium was protected in the operation of Costochondral reconstruction of mandibular condyles, while for the control group, costal perichondrium was removed.Histological observation and immunohistochemics were used to detect the histological changes and expressions of BMP-2 during different stages.Results Histological observation showed that the proliferation of the chondrocytes in the experiment group happened earlyer than that in the control group.The expressions of BMP-2 of the Costal Cartilage showed that there was more positive results in the experiment group,with statistical significance.Conclusion Costal perichondrium has a beneficial function in regulating proliferation and reconstructing Cartilage.
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  Aesthetic evaluation of immediate single implant restoration in the maxillary anterior aesthetic zone

  LI Jinyuan, LIU Hongye, HOU Xiaoqing, SONG Yu, ZHANG Yu, HOU Yudong

  滨州医学院学报. 2017, 40(4): 287-290.

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  Objective To evaluate the aesthetic outcome of immediate single implant restoration in the maxillary anterior aesthetic zone.Methods Forty-three patients with anterior aesthetic zone dentition defects were received immediate single implant restoration.After a mean follow-up period 12 months, the professional esthetic treatment outcome was also evaluated using pink esthetic score (PES) and white esthetic score (WES).A visual analog scale (VAS) was used to assess the extent of patients satisfaction regarding the esthetic outcome. The correlations between the PES value and WES value,VAS value and PES value,VAS value and WES value were calculated.Results The mean±SD values of PES and WES were 8.00±0.60 and 7.81±0.82.The Spearman correlation analysis revealed significant positive correlations between the PES and WES value (r=0.528,P＜0.01).The VAS value was 97.67%.The Spearman correlation analysis revealed significant positive correlations between the VAS and PES value,VAS and WES value (r=0.561,P＜0.01;r=0.423,P＜0.01) respectively.Conclusion Immediate single implant restoration in the maxillary anterior aesthetic zone can obtain better aesthetic effects and subjective satisfaction. A strong correlation was observed between the PES and WES,VAS and PES value, VAS and WES scoring systems.