Table of Content

20 December 2020, Volume 35 Issue 12

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Meta analysis of the relationship between vitamin D levels and tic disorder

Lin Xiaoxia, Ke Zhongling, Chen Yanhui, Chen Hui, Chen Xianrui

2020, 35(12):  1061-1066.  doi:10.3969/j.issn.1004583X.2020.12.001

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Objective  To evaluate and analyze the clinical relationship between tic disorder in children and Vitamin D(VitD) status. Methods  Relevant Chinese and English literature from CNKI,  Wanfang database,  VIP database,  Cochrane Library,  PubMed and EMbase were all searched from the establishment of the database to August 2020. Two researchers independently extracted the included literature data and evaluated the risk of literature bias. RevMan5.3 software was used for Metaanalysis. Results  Finally, four literatures were included for Meta analysis, with a total of 1  043 cases,  including 620 cases in TD group and 423 cases in healthy control group. This study showed that the average level of serum 25 hydroxyl VitD in the TD group was lower than that in the healthy control group（MD=-5.24，95%CI：-9.75-0.72，P<0.02）. Subgroup analysis showed that there was no statistically significant differences in serum VitD levels between TTD and CTD groups（MD=1.55，95%CI：-2.435.53，P<0.45）.There was no significant difference in serum VitD levels between CTD group and TS group（MD=1.06，95%CI：-0.082.21，P=0.07）.There was no significant difference in serum VitD between TTD group and TS group（MD=3.47，95%CI：-1.168.10，P=0.14）. Four literatures showed that there was no statistical difference in male children between TD group and healthy group (OR=1.36,  95%CI: 0.802.32,  P=0.25). There was no statistically significant difference in the age of children between TD group and healthy group(OR=0.03,  95%CI: -0.330.39,  P=0.86). Conclusion  This metaanalysis showed that the serum 25 hydroxyl VitD level of TD children was lower than that of healthy children, with no difference among the subgroups.

The factors influencing the prognosis of STsegment elevation myocardial infarction after coronary intervention A meta analysis

Luo Kaifeng, Feng Chuanjie

2020, 35(12):  1067-1077.  doi:10.3969/j.issn.1004583X.2020.12.002

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Objective  To systematically explore the risk factors for postoperative cardiovascular events in patients with acute STsegment elevation myocardial infarction (STEMI) undergoing coronary intervention.  Methods  The data of relevant casecontrol trials from 2010 to 2020 were collected. The Study quality evaluation with NewcastleOttawa Scale (NOS) scale. Metaanalysis on literatures was conducted by using RevMan 5.2 software. Results  Factors influencing adverse events after PCI in STEMI patients were advanced age, diabetes mellitus，Killip class ≥Ⅱ，EF values，maintenance of high systolic blood pressure, emergency PCI startup time, Gensini score，left main stem disease，multivessel disease≥2，hsCRP, NTproBNP，CKMB，intravenous tirofiban, TIMI flow grade（P<0.01）.Conclusion  Older age，history of diabetes mellitus, Killip class ≥Ⅱ，high Gensini score，multivessel disease≥2, increased hsCRP levels, increased NTproBNP levels, increased CKMB levels and TIMI flow grade≤2 are independent risk factors for patients after primary PCI , While high preoperative EF values, high preoperative systolic pressure and intravenous tirofiban are protective factors.

The influence of family stress on the quality of life and physical recovery of  male and female patients with acute coronary syndrome

Zhang Han, Shi Yunke, Zhang Min, Cai Hongyan, Li Jian,

2020, 35(12):  1078-1083.  doi:10.3969/j.issn.1004583X.2020.12.003

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Objective  To explore the influence of family stress on the prognosis of patients with  acute coronary syndrome  (ACS) in different gender,  so that providing evidences for different groups of people to develop appropriate rehabilitation and behavioral interventions. Methods  A total of 109 patients with acute coronary syndrome (ACS) for the first episode were enrolled in this study. Demographic and clinical data of patients were collected. The family stress,  burnout,  anxiety and depression at baseline were evaluated by Family Stress Scale (FSS),  General Burnout Subscale of Copenhagen Burnout Inventory,  and Hospital Anxiety and Depression Scale  respectively,  one day before their discharge. All patients were followed up one month after discharge. Their physical performance and quality of life were evaluated by Short Physical Performance Battery (SPPB) and 8item short form generic healthrelated qualityoflife questionnaire (SF8)  respectively. Then they were stratified according to different  gender. The effects of baseline family stress on physical performance (SPPB score),  SF8 physical health score and mental health score were analyzed. Results    The baseline family stress of the total sample was not related to the SPPB score,  but negatively related to the physical health score and mental health score,  one month after discharge. In female group,  baseline family stress was not correlated with SPPB,  physical health score and mental health score. While in male group,  baseline family stress was negatively correlated with SPPB score,  physical health score and mental health score. Multiple linear regression models were developed to control confounding factors in male group.  The effects of many confounding factors including age,  smoking,  drinking,  past medical history,  depression/burnout at baseline and so on,  were excluded. Then the results showed that baseline family stress of male had an impact on the SPPB score,  physical and mental health score one month after discharge. Conclusion  Male ACS patients with high family stress had poor physical strength and low quality of life one month after onset,  but there were no such effects in female patients,  suggesting that the impact of family stress on the prognosis of ACS patients may have gender differences.

uNGAL for early evaluation of contrastinduced nephropathy in elderly patients with coronary heart disease

Shen Xinxin, Zhang Dahong, Wang Zhen, Han Wei, Liu Jun, Tan Huilian

2020, 35(12):  1084-1088.  doi:10.3969/j.issn.1004583X.2020.12.004

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Objective  To investigate the early diagnostic value of urinary neutrophil gelatinaseassociated lipocalin (uNGAL) in contrastinduced nephropathy (CIN) in elderly patients with coronary heart disease (CHD) after percutaneous coronary angiography and intervention.  Methods  A total of 348 CHD patients who underwent selective coronary angiography and percutaneous coronary intervention (PCI) in the First Hospital of Hebei Medical University from June 2017 to January 2019 were selected. The levels of uNGAL and serum creatinine (Scr) of patients were assessed before the surgery,  4 and 24 hours after the surgery. According to whether CIN occurred after the surgery,  the patients were divided into CIN group and nonCIN group,    and they were divided into the elderly group (≥60 years old) and the young and middleaged group (<60 years old). The changes of uNGAL and Scr of  the two groups were calculated. Results   The study included 348 patients,  and 58 had CIN. Compared with patients in nonCIN group,  those in CIN group were older,  had longer diabetes history,  higher Merhan score,  more implanted stents and higher doses of contrast agent. In the elderly patients,  the Scr levels of CIN group and nonCIN group 24 hours after the surgery  showed significant difference (P<0.05). And the levels of uNGAL in two groups 4 hours after the surgery  and  24 hours after the surgery were statistically significant (P<0.05). In the young and middleaged patients,  there was significant difference in uNGAL levels between CIN group and nonCIN group 24 hours after the surgery(P<0.05). The area under the curve of uNGAL in the diagnosis of CIN 4 hours after the surgery was 0.658,  and the cutoff value,  sensitivity and specificity were 47.50(ng/ml),  0.661 and 0.686,  respectively. Conclusion  The increase of uNGAL level in early stage of percutaneous coronary intervention has high sensitivity and specificity for the diagnosis of early CIN in elderly CHD patients,  and it can be used as a reference index for early diagnosis of the disease.

Difference between central arterial blood pressure and brachial blood pressure and influencing factors in patients with coronary artery disease

Luo Di, Wang Xiaofei, Wang Lei

2020, 35(12):  1089-1092.  doi:10.3969/j.issn.1004583X.2020.12.005

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Objective  To analyze the difference  between central arterial blood pressure and brachial blood pressure, and to evaluate the influencing factors of the difference between peripheral blood pressure and central arterial blood pressure in middleaged and elderly patients with coronary artery disease. Methods  Patients with cardiovascular disease and undergoing coronary arteriography were selected from May, 2018 to April, 2019.According to whether there were clinical symptoms of cardiac insufficiency, the patients were divided into experimental group (51 cases) and control group (66 cases). The data of patients in two groups were recorded, including gender, age, body mass index (BMI), LVEF,NTproBNP, creatinine, glycosylated hemoglobin and blood lipids. The cSBP, cDBP were recorded in the period of coronary arteriography, and SBP and DBP value of brachial were measured at the same time.    Genaini integral method was used to evaluate the degree of coronary artery lesions and range. Results  The LVEF value  in experimental group was lower than that in control group (P<0.05). There were significant differences in cSBP, cDBP, △SBP (△SBP =SBPcSBP),△DBP (△DBP= DBPcDBP) and Genaini integral between two groups(P＜0.05). Genaini integral was a risk factor of △ BP＜10(P＜0.01，OR=28.836). Conclusion   Monitoring of difference between central artery and brachial artery blood pressure may provide reference for evaluating the degree of coronary artery lesions.

Expression and function analysis of miR-16 in the serum of patients with coronary heart disease

Jin Xing, Li Wenyi, Ma Rong

2020, 35(12):  1093-1096.  doi:10.3969/j.issn.1004583X.2020.12.006

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Objective  To explore the relationship between plasma miR16 and coronary heart disease(CHD), and to clarify the regulation of miR16 on the proliferation phenotype of vascular smooth muscle cells. Methods  Fortythree patients with coronary heart disease and 49 healthy volunteers were randomly selected. The expression intensity of plasma miR16 was detected by realtime fluorescent quantitative polymerase chain reaction (PCR). miR16 analogues were transfected into human vascular smooth muscle cells, and the proliferation activity of the cells was detected by CCK8 experiment. The expression of cyclin D1, D2 and E1 were detected by western blot. Results  The expression of plasma miR16 in CHD patients was significantly lower than that in  control group(P<0.05). Overexpression of miR16 significantly inhibited the proliferation of vascular smooth muscle cells and downregulated the expression of cyclin D1, D2 and E1. Conclusion  miR16 expression was decreased in plasma of patients with CHD. This miR may inhibit the proliferation of vascular smooth muscle cells through targeting the expression of cyclin D1, D2 and E1.

Randomized controlled trial of Tianma Gouteng Decoction and  irbesartan in treatment of essential hypertension

Liang Yuling, Li Wenxi, Gu Xuewen

2020, 35(12):  1097-1100.  doi:10.3969/j.issn.1004583X.2020.12.007

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Objective  To investigate the clinical efficacy of Tianma Gouteng Decoction combined with irbesartan  in the treatment of essential hypertension. Methods  A total of 136 patients with essential hypertension admitted to our hospital from January 2018 to January 2020 were selected. They were randomly divided into observation group (68 cases) and control group (68 cases). The control group was treated with irbesartan tablets, and the observation group was treated with Tianma Gouteng Decoction combined with irbesartan tablets. Both groups were continuously treated for four weeks. The clinical efficacy and TCM symptom scores of two groups were analyzed, and the blood pressure, oxidative stress indicators and vascular endothelial injury marker levels of  two groups were compared before and after treatment. Results  After treatment, the TCM symptom scores of  observation group were significantly lower than those of  control group (P<0.01). The total clinical effective rate in observation group was higher than that in control group (P<0.05). After the treatment,  both systolic blood pressure and diastolic blood pressure in observation group were lower than those in control group (P<0.05). Compared with control group, observation group had lower serum AOPP and MDA, and higher serum SOD (P<0.05). And serum ET1, ICAM1 and vWF were significantly higher in observation group than those in control group, while serum NO in observation group was lower than that in control group(P<0.05). Conclusion   Tianma Gouteng Decoction combined with irbesartan  tablets in the treatment of essential hypertension is definitely effective, which can reduce vascular endothelial damage and help improve oxidative stress.

Influencing factors and screening effect of depression in  convalescent patients after stroke

Hong Wanting, Sun Xiuli, Bao Lanjun, Yang Nanhua, Chen Su, Guan Xiaobo, Shi Min

2020, 35(12):  1101-1105.  doi:10.3969/j.issn.1004583X.2020.12.008

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Objective  To investigate the distribution and influencing factors of depression in convalescent patients after stroke and the screening effect of selfrating depression scale(SDS) on depressive disorder.Methods  A total of 43 patients in convalescence after stroke were included. The results of demography, heart rate, hypertension, BMI, glycosylated hemoglobin, blood cholesterol, blood triglyceride and coagulation factor activity were collected. Anxiety, depression and sleep quality were measured by Selfrating Anxiety Scale (SAS), Selfrating Depression Scale (SDS) and Pittsburgh Sleep Quality Index (PSQI). A regression model was established to observe the influence of the included variables on the SDS scores. Results  Of the 43 cases, 14 cases (32.6%) had a score of depression. The regression analysis showed that HbA1c（β=4.01, P<0.01） and  PSQI（β=0.83, P<0.05）  had significant influence on SDS score, and the regression coefficient of HbA1c was relatively large. ROC curve diagnosis revealed that the area under the ROC curve(AUC) was 0.841（95%CI：0.7130.969，P<0.01）,the best cutoff value was determined as 40.5, Youden index was 0.592, with a sensitivity of 69.2% and a specificity of 90%.Conclusion  Clinically, patients with high blood sugar and poor sleep quality after stroke should be screened and intervened in time. SDS scale can effectively screen for depressive disorder in patients.

Application value of diffusionweighted magnetic resonance imaging combined with spectral imaging in evaluating glioma grade

Zhang Zhaoming, Yu Xiangfeng, Song Jihui

2020, 35(12):  1106-1110.  doi:10.3969/j.issn.1004583X.2020.12.009

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Objective  To explore the clinical value of diffusionweighted imaging (DWI) in the assessment of glioma grade combined with magnetic resonance spectroscopy(MRS).Methods  The clinical data of 103 patients with glioma who visited Xinhua Hospital affiliated to Dalian University from January 2017 to August 2020 were retrospectively analyzed. According to the World Health Organization (WHO) classification of central nervous system tumors,  the patients were divided into two groups: lowgrade glioma(LGG) group (54 cases) and highgrade glioma(HGG) group (49 cases). The results of the diffusion coefficient (ADC),  relative apparent diffusion coefficient (rADC),  choline (Cho),  Creatine (Cr) and Nethanol tianmendong (NAA) in each group were comparatively assessed. Results  The ADC value were in LGG and HGG group were (1.51±0.47)×10-3 mm2/s and (1.37±0.29)×10-3 mm2/s(P<0.01) respectively; The rADC value  in LGG and HGG group were (1.87±0.49)×10-3 mm2/s and (1.66±0.37)×10-3 mm2/s(P<0.01) respectively; the ratio of Cho/Cr in LGG and HGG group were 2.21±0.46 and 4.02±0.48(P<0.01) respectively; The ratio of Cho/NAA in LGG and HGG group were 2.19±0.41 and 4.21±0.58(P<0.01) respectively; the ratios of NAA/Cr in LGG and HGG group were 0.81±0.22 and 0.47±0.11(P<0.01) respectively. The results of receiver operating characteristic  (ROC) curve showed that the area under the curve of ADC,  rADC,  Cho/Cr,  Cho/NAA and NAA/Cr were 0.750, 0.842, 0.766, 0.801 and 0.751，respectively,  which were all statistically significant. Conclusion  DWI and MRS have high application value in preoperative assessment of glioma grade, which complement the deficiency of conventional MRI sequence and play a guiding role in the formulation of clinical doctors' diagnosis and treatment plan.

Shortterm clinical efficacy of Kinesio Taping on walking ability of patients with knee osteoarthritis

Shi Bohan, Huang Chunmeng, Zhu Yan, Chen Zhu, Li Kunpeng, Luo Yun, Xiao Zhongxin, Tang Yanfu, Xu Qian, Xu Yan

2020, 35(12):  1111-1115.  doi:10.3969/j.issn.1004583X.2020.12.010

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Objective  To investigate the shortterm clinical efficacy of Kinesio Taping on walking ability of patients with knee osteoarthritis.  Methods  A total of 42 patients with knee osteoarthritis were randomly divided into  treatment group (group A) and  placebo group (group B), with 21 cases in each group. The health education was carried out among patients. Group A was treated with  Kinesio Taping, while group B was treated with placebo taping. All patients were treated for seven days.  After 3 days and 7 days of treatment,  Visual  Analogue  Scale (VAS), 10meter walking test (10MWT), Timed Up & Go Test (TUG) and the peak torque (PT) of quadriceps'  centripetal contractions (by isokinetic muscle strength measurement) were evaluated and compared between two groups.  The walking ability, pain and knee extensor strength of patients were also evaluated and the clinical efficacy was calculated. Results   In terms of VAS(walking state), 10MWT, TUG, and PT of quadriceps' centripetal contractions by isokinetic muscle strength measurement showed significant differences between two groups(P<0.05)．Compared with group  B, group  A  had more obvious differences and better improvement(P<0.05). In addition, the scores of VAS (walking state)  were significantly higher than those in the resting state. The VAS scores (walking state) after treatment in group A were significantly improved than before. Conclusion   Kinesio Taping can effectively relieve joint pain in walking state, enhance knee extension muscle strength and improve walking ability of patients with knee osteoarthritis.

One case report and literature review of SSCNS

Hu Yatinga, Liang Zhipingb, Zhang Junchen, Xu Wuhuaa

2020, 35(12):  1116-1119.  doi:10.3969/j.issn.1004583X.2020.12.011

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Superficial siderosis of the central nervous system (SSCNS) is a rare disease with impaired cerebellum and brain stem as main clinical manifestations,  and with iron depositions on the surfaces of central nervous system tissues as MR neuroimaging characteristics. This paper reported the clinical diagnosis and MR features of one SSCNS female who had recurrent headaches,  progressive sensorineural hearing loss,  cerebellar ataxia,  slight pyramidal signs and no history of cerebral hemorrhage. Combined with literatures review,  its possible pathological mechanisms and comprehensive methods for early diagnosis and treatment will be explored.