BACKGROUND:Studies have shown that both Panax notoginseng saponins and concentrated growth factor can promote fracture healing,but there are few studies addressing their combined effects on fracture healing.Panax notoginseng saponins may accelerate fracture healing by promoting the release of concentrated growth factor-related factors over a certain period of time. OBJECTIVE:To study the effect of Panax notoginseng saponins on concentrated growth factor release and fracture healing in rats. METHODS:Eighteen 8-week-old Sprague-Dawley rats were numbered and randomly divided into three groups:Panax notoginseng saponins group,model control group and blank group.Panax notoginseng saponins group was fed with Panax notoginseng saponins for 2 weeks.Model control group was given 2 mL of normal saline for 2 weeks and blank group was fed normally.Concentrated growth factor was obtained by the centrifugation method both from the Panax notoginseng saponins group and model control group.After 1 week of normal feeding,all animals underwent modeling for femoral fracture.The Panax notoginseng saponins group and the model control group were implanted with autologous concentrated growth factor,and then the release concentration of growth factors at different time points(1 hour,1,3,5,7,9 and 11 days)were measured by ELISA.Fracture healing was assessed based on postoperative X-ray and hematoxylin-eosin staining of bone tissues. RESULTS AND CONCLUSION:Compared with the model control group,the Panax notoginseng saponins group had higher release concentrations of vascular endothelial growth factor A and transforming growth factor β at 7,9,and 11 days,Platelet-derived growth factor BB at 5,9,and 11 days,and basic fibroblast growth factor at 1-11 days(P<0.01).X-ray examinations indicated that fracture healing in the Panax notoginseng saponins group was better than that in the model control group,and fracture healing in these two groups was better than that in the blank group at 2 months after surgery.Hematoxylin-eosin staining results found that the constituent osteocyte density in the Panax notoginseng saponins group was greater than that in the model control group,and the constituent osteocyte density in these two groups was better than that in the blank group.These findings indicate that Panax notoginseng saponins can increase the concentration of concentrated growth factor-related factors.After intervention with Panax notoginseng saponins,concentrated growth factors are more advantageous in promoting fracture healing in rats.

Objective:To study the clinical effects of modified surgical method with H-uvulopalatopharyngoplasty(H-UPPP)and traditional surgical method in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)in children.Methods:The clini-cal data of 364 pediatric patients with OSAHS were retrospectively analyzed.The patients were divided into 2 groups and treated by low-temperature plasma knife radio frequency ablation for bilateral tonsil removal combined with H-UPPP(group A,n=204)and low-temperature plasma knife radio frequency ablation only(group B,n=160)respectively.The operative time,intraoperative bleed-ing,postoperative secondary bleeding,VAS of pain following operation,postoperative traumatic white film shedding time,OAH1,LSaO2,ESS scores and complications of the 2 groups were compared.Results:In group A the operative time,intraoperative bleed-ing,VAS,OAHI and ESS scores were lower than those in group B(P＜0.05),wile postoperative traumatic white film detachment time and LSaO2 were higher(P＜0.05).No statistically significant difference in terms of the number of cases of postoperative seconda-ry bleeding and complications was observed between the 2 groups(P＞0.05).Conclusion:The combination of low-temperature plas-ma radio frequency ablation and H-UPPP for the treatment of OSAHS may provide clear intraoperative view,and may improve the treatment effects.

Objective:To investigate the efficacy of primary closure versus T-tube drainage in patients with common bile duct stones after laparoscopic common bile duct exploration and stone extraction. Methods:Fifty-two patients with common bile duct stones who received treatment at The Second Affiliated Hospital of Guizhou Medical University between February 2021 and February 2023 were included in this study. All patients underwent laparoscopic common bile duct exploration and stone extraction and then were divided into two groups ( n = 26 per group) using a randomized controlled trial design with allocation based on a random number table. The control group received T-tube drainage postoperatively, whereas the observation group underwent primary suture treatment. Both groups were observed for 3 days postoperatively to compare various postoperative clinical indicators, including serum levels of cortisol, adrenaline, C-reactive protein, interleukin-6, direct bilirubin, total bile acid, alkaline phosphatase, and gamma-glutamyl transferase, and the occurrence of postoperative complications. Results:The operative time in the observation group was significantly shorter than that in the control group [(105.30 ± 5.89) minutes vs. (121.36 ± 5.86) minutes, t = 9.86, P < 0.001]. The intraoperative blood loss in the observation group was significantly less than that in the control group [(40.31 ± 4.53) mL vs. (45.20 ± 4.76) mL, t = 3.80, P < 0.001]. The length of hospital stay in the observation group was significantly shorter than that in the control group [(12.01 ± 2.86) days vs. (14.32 ± 2.73) days, t = 2.98, P = 0.005]. The gastrointestinal function recovery time in the observation group was shorter than that in the control group [(31.42 ± 2.59) days vs. (37.62 ± 2.63) days, t = 8.57, P < 0.001]. The bile drainage volume in the observation group was less than that in the control group [(168.69 ± 15.41) mL vs. (275.62 ± 15.32) mL, t = 25.09, P < 0.001]. The serum level of cortisol in the observation group was significantly higher than that in the control group [(469.63 ± 20.62) mmol/L vs. (359.65 ± 19.87) mmol/L, t = 19.58, P < 0.001]. The serum level of adrenaline in the observation group was significantly higher than that in the control group [(274.62 ± 20.21) ng/L vs. (198.64 ± 20.16) ng/L, t = 13.57, P < 0.001]. The serum level of C-reactive protein in the observation group was significantly higher than that in the control group [(3.42 ± 0.37) mg/L vs. (2.74 ± 0.25) mg/L, t = 7.77, P < 0.001]. The serum level of interleukin-6 in the observation group was significantly higher than that in the control group [(112.36 ± 8.94) μg/L vs. (87.62 ± 8.63) μg/L, t = 10.15, P < 0.001]. The serum level of direct bilirubin in the observation group was significantly lower than that in the control group [(24.52 ± 4.62) μmol/L vs. (35.62 ± 4.87) μmol/L, t = 8.43, P < 0.001]. The serum level of total bile acid in the observation group was significantly lower than that in the control group [(10.62 ± 4.21) U/L vs. (17.64 ± 4.16) U/L, t = 6.05, P < 0.001]. The serum level of alkaline phosphatase in the observation group was significantly lower than that in the control group [(100.21 ± 10.24) mg/L vs. (112.74 ± 11.25) mg/L, t = 4.20, P < 0.001]. The serum level of gamma-glutamyl transferase in the observation group was significantly lower than that in the control group [(122.36 ± 8.94) μg/L vs. (142.62 ± 5.63) μg/L, t = 9.78, P < 0.001]. The incidence of complications in the observation group was significantly lower than that in the control group [7.69% (2/26) vs. 30.77% (8/26), χ2 = 4.46, P = 0.035]. Conclusion:Compared with T-tube drainage, primary closure following laparoscopic common bile duct exploration and stone extraction can reduce patient stress responses, improve liver function, shorten postoperative recovery time, and result in a lower incidence of complications.

Objective To investigate the effects of different dosages of atorvastatin, rosuvastatin, and simvastatin in elderly patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods A total of 180 patients with STEMI undergoing PCI were prospectively selected as study subjects and divided into group A, group B, group C, group D, group E, and group F using a random number table method, with 30 patients in each group. The group A received low-dose simvastatin orally, the group B received high-dose simvastatin orally, the group C received low-dose atorvastatin orally, the group D received high-dose atorvastatin orally, the group E received low-dose rosuvastatin orally, and the group F received high-dose rosuvastatin orally. The levels of serum inflammatory factors[interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)], myocardial injury markers[creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP)], cardiac function indicators[left ventricular ejection fraction (LVEF), cardiac index (CI), cardiac output (CO)], as well as the ST-segment resolution, occurrence of adverse cardiovascular events, and adverse reactions were compared among the groups. Results At 1 day and 1 month postoperatively, the levels of IL-6, hs-CRP, and TNF-α decreased successively in groups A, B, C, D, E, and F(P < 0.05). At 1 day and 1 month postoperatively, the levels of cTnT, CK-MB, and NT-proBNP also decreased successively in the groups A, B, C, D, E, and F (P < 0.05). At 1 month postoperatively, the LVEF, CO, and CI increased successively in the groups A, B, C, D, E, and F (P < 0.05). The proportions of patients with ST-segment resolution successively increased in the groups A, B, C, D, E, and F (P < 0.05). There were no statistically significant differences in the total incidence of adverse cardiovascular events and adverse reactions among the groups (P>0.05). Conclusion Both low-dose and high-dose atorvastatin, rosuvastatin, and simvastatin can effectively relieve inflammation reactions, improve myocardial function, and promote ST-segment resolution in elderly patients with STEMI undergoing PCI, with high-dose rosuvastatin showing the best effect.

Objective:To investigate the relationship between parathyroid hormone（PTH） level and permanent hypoparathyroidism（PHPP） on the first day after radical papillary thyroidectomy, and its predictive value. Methods:A total of 80 patients with papillary thyroid cancer who underwent total thyroid resection and central lymph node dissection were collected and analyzed from January 2021 to January 2022. According to whether PHPP occurred after surgery, the patients were divided into hypoparathyroidism group and normal parathyroid function group, and univariate and binary logistics regression were used to analyze the correlation between PTH and serum calcium levels and PHPP on the first day after surgery in two groups. The dynamic changes of PTH at different time points after operation were analyzed. The area under the receiver operating characteristic was used to evaluate the predictive power of PTH on the development of PHPP after surgery. Results:Among the 80 patients with papillary thyroid cancer, 10 cases developed PHPP, with an incidence rate of 12.5%. Binary logistics regression analysis showed that PTH on the first postoperative day（OR=14.534, 95%CI: 2.377-88.858, P=0.004） was an independent predictive risk factor for postoperative PHPP. Taking PTH=8.75 ng/L on the first postoperative day as the cut-off value, the AUC of the area under the curve was 0.874（95%CI: 0.790-0.958, P<0.001）, the sensitivity was 71.4%, the specificity was 100%, and the Yoden index was 0.714. Conclusion:PTH level on the first day after total thyroid papillary carcinoma surgery is closely related to PHPP, and is an independent predictor of PHPP.
Humans ; Calcium ; Hypoparathyroidism/surgery* ; Parathyroid Glands ; Parathyroid Hormone ; Postoperative Complications/surgery* ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/complications* ; Thyroidectomy

Objectives To investigate the effects of low level of ambient NO₂ on the death of cardiovascular and cerebrovascular diseases in Enshi city and to identify sensitive population, so as to provide a scientific basis for formulating health policies. Methods The data of air pollutants, meteorological factors and death of cardiovascular and cerebrovascular diseases in Enshi city from 2015 to 2018 were collected. The generalized additive model based on Poisson distribution was used to analyze the effects of low ambient NO₂ level on the death risk of cardiovascular and cerebrovascular diseases in Enshi city. A subgroup analysis was performed on age, gender, and season. Results The average concentrations of major gaseous air pollutants in Enshi city from 2015 to 2018 were NO₂ (21.40 μg/m³), SO₂ (9.68 μg/m³), CO (0.88 mg/m³), and O₃ (61.21 μg/m³), respectively, all of which did not exceed the national secondary standard. The results of single pollutant model analysis showed that each 1 μg/m3 increase in NO₂ concentration in lag0 day was associated with a 0.33% increase (95% CI: 0.06 - 0.72) (P>0.05) in mortality risk of cardiovascular and cerebrovascular diseases. In the female population, each 1 μg/m3 increase in NO2 concentration in lag01 day was associated with a 0.92% increase (95% CI: 0.26 - 1.56) (P<0.05) in mortality risk of cardiovascular and cerebrovascular diseases. In the cold season, each 1 μg/m3 increase in NO₂ concentration in lag0 day was associated with a 0.62% increase (95% CI: 0.12 - 1.12) (P<0.05) in mortality risk of cardiovascular and cerebrovascular diseases. The results of the two-pollutant model showed that after controlling other gaseous pollutants (SO₂, CO or O₃), the effect of NO₂ on the mortality risk of cardiovascular and cerebrovascular diseases in women and the whole population in cold season still existed. Conclusion The low ambient level of NO₂ in Enshi city was significantly associated with increased mortality risk of cardiovascular and cerebrovascular diseases in female population as well as in cold seasons in the whole population. Attention should be paid to the health protection of special populations in areas with low ambient pollution level of NO₂ in special seasons.

Objective:To investigate and compare the value of cross-sectional area measurement and width measurement by high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia (CAH) in infants.Methods:The abdominal ultrasound images of 20 infants who were diagnosed as CAH in Tianjin Children′s Hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively. The maximum cross-sectional area of adrenal gland and the maximum width of single limb were measured respectively to assess the size of adrenal gland. Fifty normal full-term infants were selected as control group at the same period. The differences of maximum cross-sectional area of adrenal gland, the maximum width of single limb between CAH group and control group were compared. ROC curve was plotted to compare the diagnostic values of cross-sectional area measurement and width measurement.Results:①There was significant difference in maximum cross-sectional area of adrenal gland between infants with CAH and normal infants[(129.47±37.39)mm 2 vs (54.42±20.85)mm 2; t=10.004, P<0.001]. There was significant difference in maximum width of adrenal gland between infants with CAH and normal infants [(4.56±1.20)mm vs (3.25±0.66)mm; t=5.445, P<0.001]. ②The area under ROC curve(AUC) of cross-sectional area measurement was 0.966, the best cutoff value was 87.5 mm 2, the sensitivity was 95.0%, and the specificity was 92.5%. AUC of width measurement was 0.817, the best cutoff value was 5.25 mm, the sensitivity was 90.0%, and the specificity was 62.5%. The difference of AUC between cross-sectional area measurement and width measurement was 0.149, which was statistically significant ( Z=2.309, P=0.021). Conclusions:Both cross-sectional area measurement and width measurement by high frequency ultrasound have diagnostic values for CAH in infants, with the former more valuable than the latter.

Objective: To monitor the WT1 mRNA level and its dynamic changes in patients with myelodysplastic syndromes (MDS) after hypomethylating agents (HMA) , as well as to assess the significance of WT1 mRNA levels and its dynamic changes in evaluating the efficacy of HMA and distinguishing the disease status of heterogeneous patients with stable disease (SD) . Methods: Bone marrow or peripheral blood samples of 56 patients with MDS who underwent hypomethylating agents (≥4 cycles) from November 2009 to March 2018 were tested by real-time quantitative polymerase chain reaction (PCR) to detect the expression of WT1 mRNA, and to observe the correlation between the dynamic changes of WT1 mRNA expression and clinical efficacy and prognosis of patients. Results: WT1 mRNA expression levels of MDS patients decreased significantly after 3 cycles of hypomethylating agent treatment. Besides, the WT1 mRNA expression levels of patients increased significantly after diseases progression. According to the dynamic changes of WT1 mRNA expression levels during SD, 45 cases could be further divided into increased group and non-increased group. In those SD patients with increased WT1 mRNA expression level, the ratio of suffering disease progression or transformation to AML was 95.65% (22/23) , whereas the ratio turned to be 9.09% (2/22) for the non-increased group (χ²=33.852, P<0.001) . Compared with those SD patients reporting no increase in WT1 mRNA expression level, the overall survival[17 (95%CI 11-23) months vs not reached, P<0.001] and progression-free survival [13 (95%CI 8-18) months vs not reached, P<0.001] of those SD patients reporting increase in WT1 mRNA expression level were significantly shorter. Conclusion WT1 mRNA expression level is a useful indicator to assess the efficacy of hypomethylating agents in MDS patients. Especially in patients with SD, detection of the changes in WT1 mRNA expression level is able to predict disease progression and help to make clinical decision.

To disscuss the role of cross‐sectional area measurement under high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia ( CA H ) in infants . Methods T he abdominal ultrasound images of 20 infants with CA H w hich were admitted to our hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively . T he size of adrenal glands were evaluated by measuring the maximum cross‐sectional area .Fifty normal full‐term infants were selected as control group synchronism . T he size of adrenal glands between infants with CA H and normal infants were compared . T he area under the curve ( AUC ) and best cutoff value were obtained by drawing ROC curve .Sensitivity and specificity were also obtained . Results T here was significant difference in maximum cross‐sectional area of adrenal gland between CA H group and control group[ ( 129 .70 ± 37 .34) mm2 vs ( 54 .41 ± 20 .84) mm2 , t ＝10 .004 , P ＝0 .001] . T he AUC of cross‐sectional area measurement was 0 .966 ,and best cutoff value was 87 .5 mm2 . T he sensitivity and specificity were 95 .0% and 92 .5% . Conclusions High‐frequency ultrasound is convenient and accurate in measuring the maximum cross‐sectional area of adrenal gland in infants . Cross‐sectional area measurement has high sensitivity and specificity to the diagnosis of CA H . T he presence of CA H is highly suspected w hen the area of adrenal gland reached 87 .5 mm2 .

Objective To investigate the interventional therapy effect of combination application of thrombus aspiration and intracoronary injection of tirofiban for treating heavy thrombosis burden of infarction related vessel in the patients with acute anterior myocardial infarction.Methods The patients with acute anterior myocardial infarction undergone direct primary percutaneous coronary intervention in the hospital were retrospectively analyzed.The group A received simple thrombus aspiration during transcutaneous PCI and the group B received the combination treatment of thrombus aspiration and intracoronary injection of tirofiban in direct PCI.Results The patients with myocardial perfusion grade less than 3 during thrombolysis during myocardial infarction(TIMI) in the group B were significantly less than those in the group A(P＜0.05).The cardiac magnetic resonance imaging(MRI) results indicated that the area of myocardial infarction in the group B was smaller than that in the group A(P＜0.05).The color echocardiography results showed that the left ventricular diastolic volume(LVDV) and left ventricular ejection fraction(LVEF) in the group B were significantly better than those in the group A(P＜0.05).Conclnsion The combination application of thrombus aspiration and intracoronary injection of tirofiban is safe and effective in direct PCI.