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2021 Vol. 51, No. 6 Published: 2021-06-25   431 The mechanism of fructo-oligosaccharides in the attenuation of coronary artery injury in mice with Kawasaki disease by regulating intestinal flora QIAN Fanyu, ZHANG Qihao, CEN Jianke, ZHOU Jinhui, LI Ruixin, YE Zi, WU Menghan, WANG Fangyan, CHU Maoping, ZHANG Chunxiang DOI: 10.3969/j.issn.2095-9400.2021.06.001 Objective: To investigate the underlying mechanism for fructo-oligosaccharide to attenuate coronary artery injury in mice with Kawasaki disease (KD) by regulating intestinal flora. Methods: Mice were given water-soluble components of Candida albicans cell wall (CAWS) to establish KD model and randomly assigned as normal control group (PBS), KD model group (CAWS), and FOS+KD group (FOS). After 28 days of modeling, feces and hearts were collected. The structural changes of coronary arteries and the infiltration degree of monocyte-macrophages were detected by HE and immunofluorescence with CD68 antibody, respectively. The differences in intestinal flora and metabolites of short-chain fatty acids (SCFAs) were analyzed by 16S rRNA sequencing and gas chromatography/mass spectrometry (GS-MS). Results: HE results showed that after KD modeling, many normal structures of coronary arteries disappeared. Wall edema and a large number of inflammatory cells were infiltrated. Immunofluorescence showed significant enhancement of CD68, the monocyte-macrophage markers, around coronary arteries. After FOS treatment, the above coronary artery injury and inflammation decreased significantly. 16S rRNA sequencing showed that intestinal flora in CAWS group was obviously disturbed, SCFAs producing flora and fecal SCFAs content decreased. However, intestinal flora composition and SCFAs recovered after FOS treatment. Conclusion: FOS alleviated coronary artery injury of KD mice through regulating intestinal flora disturbance to increase SCFAs production 2021 Vol. 51 (6): 431-436 [Abstract] ( 727 ) HTML (1 KB)  PDF (1740 KB)  ( 803 ) 437 Aggravation of macrophage-mediated inflammatory damage by knockdown of Nrf2 in a unilateral ureteral obstruction renal fibrosis model WU Cunzao, LU Hong, ZHU Hengyue, WENG Min, SHI Chenghao, LIN Zhouhao, BAI Yongheng DOI: 10.3969/j.issn.2095-9400.2021.06.002 Objective: To study the mechanism of Nrf2 gene knockout and its effect on inflammatory injury in unilateral ureteral obstruction (UUO) renal fibrosis model. Methods: The experimental mice were randomly divided into four groups, namely Nrf2 wild-type UUO group (Nrf2Wild-type UUO), Nrf2 knockout UUO group (Nrf2KO UUO), Nrf2 wild-type sham operation group ( Nrf2Wild-type Sham) and Nrf2 gene knockout sham operation group (Nrf2KO Sham), with 6 animals in each group. PAS and Masson staining was used to detect tissue damage and total collagen accumulation; immunohistochemical staining was used to detect the expression of macrophage marker CD68 and IRF5; ELISA was used to detect the level of iNOS; qRT-PCR was used to detect the mRNA expression of pro-inflammatory genes IL-1β, IL-6 and TNF-α. The protein expression of IRF5 was determined by Western blot. Results: PAS staining showed that Nrf2 gene knockout did not cause renal tissue damage, but after the UUO model was constructed, the renal tissue damage significantly increased. The results of Masson and immunochemical staining showed that Nrf2 gene knockout aggravated the degree of interstitial fibrosis in the UUO model, and promoted the infiltration of CD68-positive macrophages, accompanied with the enhancement of iNOS level. Further study found that compared with Nrf2Wild-type UUO group, the mRNA expression levels of IL-1β, IL-6, and TNF-α in the kidney tissues in the Nrf2KO UUO group were significantly increased (P<0.05). At the same time, Western blot and immunochemical staining results showed that Nrf2 gene knockout increased the expression of IRF5 protein (P<0.05). Conclusion: Nrf2 gene knockout aggravates the inflammatory damage in the UUO renal fibrosis model, and its mechanism may be related to the promotion of IRF5-mediated infiltration of inflammatory macrophages, thereby increasing the synthesis and release of inflammatory factors. 2021 Vol. 51 (6): 437-443 [Abstract] ( 692 ) HTML (1 KB)  PDF (1396 KB)  ( 733 ) 444 The neuroprotective effects of caffeine on the mice model of Parkinson’s disease: a transcriptomic analysis Zheng Yuyin, Feng Yijia, Ruan Qingqing, Tu Wenzhan DOI: 10.3969/j.issn.2095-9400.2021.06.003 Objective: To investigate by transcriptomics the possible molecular mechanism of the protective effect of caffeine in Parkinson’s disease, so as to provide new evidence for elucidating the neuroprotective effect of caffeine. Methods: The mice were injected with α-synuclein (α-Syn) fibril in the hippocampal region by stereotaxic injection, and were fed with caffeine. Three months later, the hippocampus tissues were isolated for transcriptome sequencing (RNA-seq). Results: α-synuclein was obviously aggregated in hippocampus and impaired the working memory in mice (P<0.05). Long-term drinking caffeine could effectively improve the cognitive impairment caused by α-Synuclein in mice (P<0.05). The transcriptome changes induced by α-Synuclein were mainly enriched in the pathways of microglial activation and chemokines signaling. Chronic caffeine consumption significantly improved the cell proliferation (P<0.05). Conclusion: Caffeine may repair the neuronal inflammatory damage caused by α-Syn via promoting cell proliferation. 2021 Vol. 51 (6): 444-448,453 [Abstract] ( 629 ) HTML (1 KB)  PDF (1642 KB)  ( 774 ) 449 Development of a nomogram to predict the mortality risk in elderly patients with acute lung injury CHEN Chan, LIANG Feiyu, ZHANG Jing, YANG Jingwen, SHI Xuan, DU Xiaohong, SU Huafang DOI: 10.3969/j.issn.2095-9400.2021.06.004 Objective: To explore the independent risk factors in the prognosis of elderly patients with acute lung injury (ALI) and to develop a nomogram to predict their mortality risk. Methods: Clinical data of 325 patients with acute lung injury from MIMIC-III database and 138 ALI cases in the First Affiliated Hospital of Wenzhou Medical University were collected. Univariate and multivariate logistic regression analyses were used to screen out the risk factors for death, and a nomogram model was constructed to predict short-term possible death. Results: Multivariate logistic regression analysis showed that the lowest systolic blood pressure, lactic acid and PT were risk factors for death in elderly patients with acute lung injury (P<0.05). The C index of nomogram model was 0.712 (95%CI=0.656-0.767), and the C index of external validation nomogram was 0.753 (95%CI=0.671-0.836), with the internal and external calibration curves close to the standard curve. Conclusion: This nomogram model can be used to evaluate the prognosis of elderly patients with acute lung injury, and has good accuracy and differentiation 2021 Vol. 51 (6): 449-453 [Abstract] ( 693 ) HTML (1 KB)  PDF (1457 KB)  ( 765 ) 454 Expression of PRKG1 and its role in prostate cancer RAO Dapang, XIANG Zhiyang, YU Haifeng DOI: 10.3969/j.issn.2095-9400.2021.06.005 Objective: To investigate the expression of PRKG1 in prostate cancer and its mechanism by knockout of prostate cancer cell line 22RV1. Methods: The expression of PRKG1 was detected by Western blot. The PRKG1 gene in prostate cancer cell line 22RV1 was knocked out by CRISPR/Cas9 and then its effect on proliferation, migration and invasion was observed and the related apoptotic protein was detected by Western blot. Results: The positive rate of PRKG1 in prostate cancer tissue was lower (42.7% vs. 13.3%, P<0.05), compared with normal prostate tissue. There was no significant difference between the two groups in clinical stage and Gleason score (P>0.05). Knockout of PRKG1 gene significantly enhanced the proliferation, migration and invasion of prostatic cacer cells (P<0.05). PRKG1 knockout significantly decreased the levels of Ezrin, MMP9, CDH-1 and Bax (P<0.05), but increased the levels of CDH-2 and Bcl-2 (P<0.05). Conclusion: PRKG1 can inhibit the development of prostate cancer through MMP9, CDH-2, Bax, Bcl-2 and CDH-1. 2021 Vol. 51 (6): 454-458 [Abstract] ( 745 ) HTML (1 KB)  PDF (1748 KB)  ( 797 ) 459 Theoretical study on the structures and properties of multidrug-resistant tuberculosis drug and potential drugs in oxazolidinone derivatives LI Zhenyue, WENG Yueyue, HUANG Luoyi, WANG Chaojie DOI: 10.3969/j.issn.2095-9400.2021.06.006 Objective: To compare the differences in the structures and properties of clinical drug and potential drugs for treatment multidrug-resistant tuberculosis (MDR-TB) so as to provide a reference for the development of new drugs. Methods: The pharmacophoric conformation, geometric and electronic structures, IR, UV-Vis and ECD spectra for Linezolid (Lin), the current treatment of MDR-TB and clinical trials of Sutezolid (Sut), Delpazolid (Del), TBI-223 (223), and the newly synthesized compound 19c in oxazolidinone derivatives were calculated and compared by using density functional theory M06-2X/6-311+G (2d, p). The molecular global reactivity index analysis was carried out with the aid of conceptual density functional theory, and the pharmacodynamic platform was used to calculate ADME/Tox and evaluate the druggability. Results: The data showed that the addition of a chiral center in 19c greatly reduced the pharmacophoric conformation. In different solvent environments, the geometric parameters of the pharmacophoric core in the five compounds were basically the same, and the calculated bond length values were in good agreement with the crystal parameters. Polar solvent environment caused maximum polarity change of Del. The calculated characteristics of infrared were in agreement with the experimental measurements. The theoretical maximum wavenumber of UV-Vis absorption of Lin was exactly the same as the experiment. Except that the UV-Vis absorption spectrum of Del transited from HOMO electron to LUMO, the others were HOMO→LUMO+2 transition, and all UV-Vis spectra were twin-peak curves. The ECD spectrum calculated of Sut coincided with the experiment. The electrostatic potential distribution of 19c, Sut and Lin were mainly concentrated at the oxazolidinone end, while the Del and 223 were negative at the other end. The reactivity index of the five compounds was close to each other. Drug evaluation showed that the distribution coefficient of Del was different from others, and the whole was similar to each other. Pharmacokinetic parameters of 5 compounds were consistent, but the parameters of clinical drug Lin were better. Conclusion: The new compound 19c has more advantages over clinical treatment drug and clinical trial drugs for MDR-TB, and has greater value for development. 2021 Vol. 51 (6): 459-467 [Abstract] ( 565 ) HTML (1 KB)  PDF (1998 KB)  ( 776 ) 468 Application of VTIQ in the assessment of masseter muscle elasticity in patients with temporomandibular joint disorder syndrome ZHAO Yuezi, SUN Xielu, DAI Miaolei, YE Haiyan, ZOU Chunpeng DOI: 10.3969/j.issn.2095-9400.2021.06.007 Objective: To investigate the changes in masseter muscle thickness and elasticity in healthy people and patients with temporomandibular joint disorder (TMD), using acoustic palpation tissue imaging and quantification technology (VTIQ). Methods: A total of 50 patients with TMD diagnosed in the Department of Otology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2019 to May 2020 were collected as the case group, and 50 healthy adults during the same period as the control group. All subjects underwent conventional ultrasound and VTIQ elastography to detect masseter muscle thickness and mid-range shear wave velocity (SWV) in closed and open bilateral masseter muscles. The differences in SWV and thickness of the left and right masseter muscle were compared between and within each group under closed and open state, and the correlation between thickness of the masseter muscle and SWV in the open and closed state was analyzed. Results: The thickness of the left masseter muscle and right masseter muscle of the control group, the healthy side masseter muscle and the affected side masseter muscle of the case group were greater in the open state than in the closed state, with statistical difference  (P<0.05). Whether the mouth was open or closed, the thickness of the masseter muscle on the affected side of the case group was greater than that of the left masseter muscle and the right masseter muscle of the control group as well as the contralateral masseter muscle of the case group, the difference being statistically significant (P<0.05); The thickness of the left masseter muscle and the right masseter muscle of the control group and the healthy side masseter muscle of the case group showed no significant difference (P>0.05). In the control group, the left masseter muscle, the right masseter muscle, the contralateral masseter muscle and the affected side masseter muscle of the case group had greater SWV in the open state than in the closed state, and the difference was statistically significant (P<0.05). In the closed state, the SWV of the masseter muscle on the affected side of the case group was greater than that of the left masseter muscle and the right masseter muscle of the control group and the contralateral masseter muscle of the case group, with significant difference (P<0.05); The left masseter muscle, right masseter muscle of the control group and the contralateral masseter muscle SWV of the case group showed no significant difference (P>0.05). In the open state, the SWV of the masseter muscle on the affected side of the case group was greater than that of the left masseter muscle and the right masseter muscle of the control group as well as the contralateral masseter muscle of the case group, with significant difference (P<0.05); The SWV of the contralateral masseter muscle in the case group was greater than that of the left and right masseter muscles of the control group, the difference being statistically significant (P<0.05); There was no statistical difference in SWV between the left masseter muscle and the right masseter muscle of the control group (P>0.05). In the open and closed state, there was no significant correlation between the masseter muscle thickness and SWV of the affected side, the healthy side and the left and right sides of the control group. Conclusion: VTIQ can objectively evaluate the stiffness of the masseter muscle in patients with TMD, which provides quantitative information on the elasticity of the masseter muscle and an objective imaging basis for the clinic 2021 Vol. 51 (6): 468-472 [Abstract] ( 627 ) HTML (1 KB)  PDF (1435 KB)  ( 620 ) 473 The application of targeted axillary lymph node dissection in the evaluation of axillary lymph nodes after neoadjuvant chemotherapy LIU Pengpeng, ZHOU Yi, CAI Shibin, YU Kaijie, FENG Yaqin, WU Aifen, CHEN Shuzheng. DOI: 10.3969/j.issn.2095-9400.2021.06.008 Objective: To explore the application of targeted axillary lymph node resection in the assessment of residual axillary lymph node metastasis in breast cancer patients after neoadjuvant chemotherapy. Methods: Totally 57 patients who were admitted to the Breast Disease Diagnosis and Treatment Center of Lishui Central Hospital and underwent neoadjuvant chemotherapy from June 2015 to May 2020 were prospectively errolled in this study. In 31 patients undergoing neoadjuvant chemotherapy, the marker clip was implanted into the metastatic axillary lymph node, confirmed by fine needle aspiration under ultrasound guidance. After chemotherapy, the labeled lymph node was punctured and stained under ultrasound guidance and then sentinel lymph node biopsy was performed at the same time as the marker removal of axillary lymph nodes (TAD), and then axillary lymph node was dissected (for TAD group). The remaining 26 cases received neoadjuvant chemotherapy alone. After the chemotherapy was completed, sentinel lymph node biopsy was performed and then axillary lymph node was dissected (for the control group). Statistical analysis was made of the lymph node detection rate, accuracy, sensitivity and false negative rate of targeted axillary lymph node resection and sentinel lymph node biopsy. Results: Among 57 patients, at least one sentinel lymph node was detected in 53 cases. The detection rate of SLN was 92.98%. Among them, 31 cases were in the TAD group and 26 cases were in the control group. The detection rate of lymph nodes in the TAD group was 100.00% (31/31), with the average number of lymph nodes being 3.39 per case, the sensitivity 94.44% (17/18), the false negative rate 5.56% (1/18), and the accuracy rate 96.77%(30/31). The detection rate of lymph nodes in the control group was 84.62% (22/26), with the average number of lymph nodes detected being 3.38 per case, the sensitivity 62.50% (10/16), the false negative rate 37.50% (6/16), and the accuracy rate 72.73% (16/22). The detection rate, sensitivity and accuracy of lymph nodes in the TAD group were significantly higher than those of the control group, which showed statistical differences (P<0.05), and the false negative rate of the TAD group was significantly lower than that of the control group, with statistical differences (P<0.05). Conclusion: Targeted axillary lymph node dissection for breast cancer patients after neoadjuvant chemotherapy can actually reflect the axillary lymph node metastasis, compared with sentinel lymph node biopsy alone. 2021 Vol. 51 (6): 473-477 [Abstract] ( 752 ) HTML (1 KB)  PDF (1458 KB)  ( 767 ) 478 The effect of antagomir-30d on osteogenic differentiation of bone mesenchymal stem cells WANG Yan, JIN Qiong, CHEN Wei, HUANG Hui DOI: 10.3969/j.issn.2095-9400.2021.06.009 Objective: To verify the upregulating effect of antagomir-30d (miR-30d) on osteogenic differentiation of bone mesenchymal stem cells (BMSCs) and to confirm the optimum transfection concentration. Methods: Antagomir-30d of different concentrations was divided into antagomir-30d (antagomir-30d group), negative control (NC group) and untransfected BMSCs (blank group). Transfecting different concentrations of antagomir-30d/NC/blank to BMSCs, gene expression of osteoblast marker genes (ALP, OC and RUNX2) was analyzed using RT-PCR and then optimum transfection concentration and transfection efficiency were confirmed. The role of antagomir-30d in regulating osteogenesis was verified by ALP staining. Results: The results of RT-PCR showed that antagomir-30d enhanced osteogenic differentiation of BMSCs in vitro. The transfection effect changed according to transfection concentration. When transfected with 150 nmol/L, the expression of ALP, OC and RUNX2 in the antagomir-30d group was significantly higher than the other groups. Meanwhile, there was no significant change in the proliferation and apoptosis of BMSCs when transfected with 150 nmol/L. Therefore, 150 nmol/L proved to be optimum ALP staining showed ALP activity of antagomir-30d group was significantly upregulated. Conclusion: The antagonist of miR-30d (antagomir-30d) promotes osteogenic differentiation of BMSCs in vitro and 150 nmol/L is the optimum transfected concentration. 2021 Vol. 51 (6): 478-482 [Abstract] ( 575 ) HTML (1 KB)  PDF (1540 KB)  ( 605 ) 483 The clinical characteristics of patients with tuberculosis-destroyed lung and in-situ pulmonary artery thrombosis CHI Qiong, ZNENG Jiyang, DAI Xinjian, ZHANG Baoyi, HUANG Yang. DOI: 10.3969/j.issn.2095-9400.2021.06.010 Objective: To summarize and analyze the clinical characteristics and prognosis of patients with tuberculosis-destroyed lung (TDL) and in-situ pulmonary artery thrombosis (PAT). Methods: Patients with TDL who were hospitalized in Wenzhou Central Hospital from June 2015 to May 2020 were analyzed retrospectively. They were divided as TDL with PAT group and TDL group, according to whether they were complicated with PAT. Data on demographic characteristics, tuberculosis history, imaging information, systolic pulmonary artery pressure (SPAP) and blood gas analysis were collected. Results: Compared with TDL group, patients complicated with PAT had more damaged lobe lesions (P<0.05). ABG showed higher alveolar-arterial oxygen partial pressure difference. The rate of SPAP > 50 mmHg (moderate and severe pulmonary hypertension) in patients complicated with PAT was 100% (6/6), which was significantly higher (P<0.05) than TDL group19% (4/21). One patient died in TDL with PAT group, wihile none died in TDL group. Conclusion: Patients with TDL who have multiple lobes damaged and moderate to severe pulmonary hypertension should be alert to be complicated with PAT. 2021 Vol. 51 (6): 483-486,490 [Abstract] ( 594 ) HTML (1 KB)  PDF (1549 KB)  ( 596 ) 487 The study of methylene blue combined with intraoperative ultrasound exploration in sentinel lymph node biopsy of breast cancer YANG Qing, XIANG Yingying, SHEN Yanyan, ZHENG Jinying, ZHAO Yaxin DOI: 10.3969/j.issn.2095-9400.2021.06.011 Objective: To investigate the clinical practicability and advantages of methylene blue staining combined with intraoperative ultrasound exploration in improving the removal rate and positive detection rate of sentinel lymph node (SLN) during breast cancer surgery. Methods: From Jan. 2020 to Dec. 2020, 145 consecutive cases with clinical axillary lymph node-negative early breast cancer were enrolled. All patients underwent sentinel lymph node biopsy (SLNB) through methylene blue staining combined with intraoperative ultrasound detection. Intraoperative frozen and postoperative paraffin pathological examinations were performed to SLN, with respectively calculation of the blue-stained SLN and the suspicious SLN detected by ultrasound as well as the number of metastatic lymph nodes contained in each. Results: All 145 patients were blue stained and successfully underwent SLNB. The detection rate of positive SLN by methylene blue staining was 21.7% (114/526), and the detection rate of positive SLN combined with intraoperative ultrasound detection was 26.2% (155/591), with significant difference (P<0.05); the detection rate of macrometastasis SLN by methylene blue staining was 7.0% (8/114), and the detection rate of macrometastasis SLN combined with intraoperative ultrasound exploration was 18.7% (29/155), with significant difference (P<0.05). Conclusion: The use of methylene blue staining has a certain rate of missed diagnosis in breast cancer SLNB. However, combined with intraoperative ultrasound exploration, it is of clinical significance by remarkably increasing the SLN resection rate and positive detection rate. 2021 Vol. 51 (6): 487-490 [Abstract] ( 651 ) HTML (1 KB)  PDF (1386 KB)  ( 579 ) 491 Application effect of regional nerve block anesthesia in the operation of intertrochanteric fracture ZHENG Junju, CHEN Jiaru, LIN Zhou, LIN Fan, ZHOU Guang, HAN Xiaodong DOI: 10.3969/j.issn.2095-9400.2021.06.012 Objective: To investigate the effect of regional nerve block anesthesia in the operation of intertrochanteric fracture. Methods: Clinical data of 75 patients with intertrochanteric fracture who underwent operation from Mar. 2020 to Dec. 2020 in Wenzhou Central Hospital were retrospective analyzed. They were divided into two groups:the regional nerve block anesthesia group (n=34) that underwent combined block anesthesia of lumbar plexus nerve, femoral nerve or lateral femoral cutaneous nerve, and the control group (n=41) that underwent spinal anesthesia. A comparison was made between the two groups in intraoperative and 2, 4, 8 h postoperative VAS scores, albumin level, the incidence of postoperative complications (hypotension, delirium, uroschesis), ADL scores, hospitalization time and the cost of hospitalization. Results: Intraoperative and 2, 4, 8 h postoperative VAS scores and the decrease of albumin [(4.47±2.36)g/L vs. (6.52±2.34)g/L] in regional nerve block anesthesia group were significantly lower than those in the control group (P<0.05). The arterial pressure of the two groups has no significance before anesthesia [(101.6±8.1)mmHg vs. (104.2±9.1)mmHg], but during the operaiton of skin incision, 20 min and 40 min, it decreased slightly [(103.2±9.1)mmHg vs. (93.8±8.2)mmHg, (100.9±8.3)mmHg vs. (91.9±7.1)mmHg, (97.9±7.2)mmHg vs. (91.8±5.8)mmHg, P<0.05]. Compared with control group, lower incidence of postoperative hypotension (5.88% vs. 26.83%) was found, but there was no significant difference in the incidence of postoperative delirium (5.88% vs. 12.20%) and postoperative uroschesis (8.82% vs. 19.51%) between the two groups. ADL scores were higher in regional nerve block anesthesia group than those in control group [(26.9±4.4) vs. (21.3±2.5), P<0.05]. Hospitalization time [(11.1±3.7)d vs. (14.8±9.4)d] and the cost of hospitalization [(27 142.5±5 676.0)yuan vs. (31 828.7±9 065.4)yuan] were better in regional nerve block anesthesia group (P<0.05). Conclusion: Regional nerve block anesthesia in the operation of intertrochanteric fracture has better analgesic effect in that it reduces the negative nitrogen balance, hospitalization time and the cost of hospitalization, and also accelerates postoperative recovery. 2021 Vol. 51 (6): 491-494 [Abstract] ( 717 ) HTML (1 KB)  PDF (1364 KB)  ( 566 ) 495 Surgical treatment of cervical esophageal carcinoma: larynx-preserving esophagectomy via tracheal transection approach WU Peng, YE Fan, LIN Renyu, ZOU Changlin, LIN Xiaoming, LI He DOI: 10.3969/j.issn.2095-9400.2021.06.013 Objective: To study the results of larynx-preserving esophagectomy via tracheal transection approach for cervical esophageal carcinoma. Methods: A total of 5 patients with cervical esophageal carcinoma undergoing larynx-preserving esophagectomy in our hospital from 2017 to 2019 were selected. Results: All patients underwent combined thoracic and laparoscopic larynx-preserving esophagectomy via tracheal transection approach. Only one patient developed unilateral vocal cord paralysis after surgery. Two patients developed left pleural effusion and atelectasis after surgery. Gastric acid reflux was observed in all patients, which was significantly improved after drug treatment. No patients had major complications and no deaths during their stay in the hospital. After surgery, 4 patients received radiotherapy or chemotherapy, and 1 patient refused chemoradiotherapy for personal reason. The follow-up time was 2-36 months. Only 1 patient died of tumor recurrence 1 year after surgery. The other 4 cases were all alive, with good recovery of speech and swallowing function. With tracheostomy tube removed, they had no choke, no anastomotic fistula or aspiration pneumonia. Conclusion: The larynx-preserving esophagectomy for cervical esophageal carcinoma via tracheal transection approach, combined with adjuvant chemotherapy or radiotherapy, can obtain safe perioperative recovery 2021 Vol. 51 (6): 495-498 [Abstract] ( 525 ) HTML (1 KB)  PDF (1474 KB)  ( 698 ) 499 Comparison of fingerstick glucose values between healthy and paralyzed side in hemiplegic patients after stroke SUN Haiqiu, DU Xudong, HONG Xianchai, YOU Junli, CHEN Gangmei, LU Zhongqiu DOI: 10.3969/j.issn.2095-9400.2021.06.014 Objective: To compare and analyze the difference of blood glucose values between the healthy side and the paralyzed side in hemiplegia patients complicated with diabetes mellitus. Methods: Totally 75 hemiplegia patients complicated with diabetes mellitus from the First Affiliated Hospital of Wenzhou Medical University were enrolled in the study. The peripheral blood glucose levels of the healthy and the paralyzed sides of the ring finger were monitored by Johnson & Johnson one touch blood glucose meter. The paired t-test was used to find whether there was difference between the healthy side and the paralyzed side; at the same time, the univariate analysis method was used to analyze the influence of the patient’s characteristics (disease type, gender, age) on the difference of blood glucose value between the healthy side and the paralyzed side. On the basis of single factor analysis, multiple linear regression was used to analyze the influence of the above factors on the difference of blood glucose value between the healthy side and the paralyzed side. Results: Of 75 patients, 54 male and 21 female, with an average age of 70.67 years, 20 cases of hemiplegia were caused by cerebral hemorrhage, 43 by cerebral infarction, and 12 by cerebral hemorrhage combined with cerebral infarction. The results of paired t-test analysis showed that there was no significant difference in blood glucose values between the healthy side and paralyzed side; univariate and multiple linear analysis showed that disease type (cerebral hemorrhage, cerebral infarction, cerebral hemorrhage combined with cerebral infarction), gender and age had no significant influence on blood glucose values between the healthy side and paralyzed side. Conclusion: There is no significant difference in blood glucose values between the healthy side and the paralyzed side in diabetic patients with hemiplegia. Disease type (cerebral hemorrhage, cerebral infarction, cerebral hemorrhage combined with cerebral infarction), gender and age have no significant influence on blood glucose values between the healthy side and the paralyzed side 2021 Vol. 51 (6): 499-501,505 [Abstract] ( 618 ) HTML (1 KB)  PDF (1412 KB)  ( 660 ) 502 A comparison between two scales in risk assessment of stress injury in elderly patients with cerebrovascular accident CHEN Xiufang, ZHOU Aimei, LU Sujuan, YANG Suili, HONG Xianchai DOI: 10.3969/j.issn.2095-9400.2021.06.015 Objective: To compare the effect of Braden scale and Waterlow scale in the risk assessment of stress injury in elderly patients with cerebrovascular accident. Methods: Totally 244 elderly inpatients with cerebrovascular accident were selected and evaluated by Braden scale and Waterlow scale. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, AUC (area under the ROC curve) of each scale were calculated. Results: The best critical value of Braden scale was 17 points, and the sensitivity, specificity, positive predictive value and negative predictive value of Braden scale was 93.33%, 62.00%, 13.86% and 99.30%, respectively. In contrast, the best critical value of Waterlow scale was 15 points, and the sensitivity, specificity, positive predictive value and negative predictive value of Waterlow scale was 93.33%, 81.67%, 25.00% and 99.47%, respectively. AUC of Waterlow scale (0.94) was significantly higher than that of Braden scale (0.87) (P<0.05). Conclusion: The application of Waterlow scale in stress injury risk assessment of elderly patients with cerebrovascular accident is more valuable than Braden scale. 2021 Vol. 51 (6): 502-505 [Abstract] ( 613 ) HTML (1 KB)  PDF (1376 KB)  ( 731 )

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