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Preliminary study on the construction of national major science and technology infrastructure for translational medicine in China
LI Dong-liang, LAI Yu-chen, ZHANG Wei-wei, WANG Jian, LI Chun-hong, WANG Su-ping, SHI Qiong-yun, ZHANG Xing, TAO Ye-xuan
2020, 40 (06):  701-706.  doi: 10.3969/j.issn.1674-8115.2020.06.001
Abstract ( 11 )   PDF (9162KB) ( 3 )  
Objective · To explore the preliminary experience of the construction of national major science and technology infrastructure for translational medicine in China, and to provide reference for their future development. Methods · The current situation, experience and enlightenment of major science and technology infrastructure construction at home and abroad were sorted out by literature analysis, relevant recommendations were collected through expert interviews, and the preliminary experience of national major science and technology infrastructure construction for translational medicine in China was summarized. Results · The experience and enlightenment that can be used for reference from the construction of major science and technology infrastructure at home and abroad mainly included 7 aspects, i.e. high-quality team construction, device sharing, industry-academia-research collaboration, international cooperation, the cluster effect producing, talents cultivation and the scientific data sharing mechanism. In China, the construction of major science and technology infrastructure for translational medicine started late, and had a good try at the above first 5 aspects, but not so good at the last 2. At the same time, self-experience has been formed in taking full advantages of the supporting institutions and getting funds through multiple channels. Conclusion · The construction of national major science and technology infrastructure for translational medicine in China should learn from the development experience at home and abroad, combine our own characteristics, explore and innovate the system and mechanism, and seek new breakthroughs.
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Novel coronavirus article
Analysis and consideration of registration information of global coronavirus disease 2019 clinical study
QU Tian-tian1, 2*, FENG Tie-nan1, 2*, JIANG Jia-yuan1, 2, ZHANG Fan1, 2, QIAN Bi-yun1, 2
2020, 40 (06):  707-712.  doi: 10.3969/j.issn.1674-8115.2020.06.002
Abstract ( 7 )   PDF (7432KB) ( 1 )  
Objective · To analyze the registration characteristics of registered clinical research, and find the potential scientific and feasibility problems of clinical research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), providing reference for the good management of follow-up research registration. Methods · The key words of coronavirus disease 2019 (COVID-19) were identified and retrieved from Chinese Clinical Trial Registry and ClinicalTrials website. The registration characteristics of ethical status, number of recruits, total time, number of groups, intervention, study endpoint type, withdrawal, randomized controlled trial (RCT), stage, registration type, provinces distribution and patients' condition were summarized. IBM SPSS 22.0 software was used to analyze the above characteristics. Results · A total of 400 registered clinical studies were collected. Among them, 59 studies were not ethically approved, 15 studies were withdrawn, and stages of 303 studies were unclear. The differences of the three registration characteristics on the two official websites were statistically significant (all P<0.05). Fourteen studies recruited more than 1 000 people, the total time of 189 studies exceeded 6 months, and the number of groups in 22 studies exceeded 4 groups. There was no significant difference in the three registration characteristics on the two official websites. Only 15 studies were industry-sponsored trial. Most registered clinical studies were distributed in Hubei Province. Conclusion · The awareness of Chinese investigator initiating trial registration has increased. However, by collating and analyzing the registration information, it is found that the study design is not rigorous, so it is necessary to strengthen the registration quality management and study design methodological demonstration.
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Retrospective analysis of Chinese epidemic situation model based on elbow cluster analysis
LI Qiang1, 2, SUN Zhe2, QIAN Bi-yun2, 3, FENG Tie-nan2, 4
2020, 40 (06):  713-718.  doi: 10.3969/j.issn.1674-8115.2020.06.003
Abstract ( 12 )   PDF (5955KB) ( 1 )  
Objective · To explore the correlation patterns of the new coronavirus disease 2019 (COVID-19) epidemic in various provincial administrative regions in China at the early stage of the epidemic, and forecast the following development of epidemic situation. Methods · The data on the COVID-19 epidemic situation in various provincial administrative regions in China published by National Health Commission of People's Republic of China from Jan. 13 to Feb. 13, 2020, were retrospectively analyzed. The elbow cluster analysis method was used to cluster the provincial administrative regions. The SEIR (susceptible-exposed-infectious-recovered) model was used to calculate the basic infection number (R0) of different clusters, whose changing trends were also predicted. Results · According to the prevalence rates, the 34 provincial administrative regions were divided into four types of clusters: Cluster Ⅰ (22 provincial administrative regions) , Cluster Ⅱ (9 provincial administrative regions), Cluster Ⅲ (2 provincial administrative regions) and Cluster Ⅳ (Hubei). The prevalence rate of Hubei was higher than those of other clusters (P=0.000), but the differences in the cure rate and the case-fatality rate among the four clusters were not statistically significant; the R0 values based on the SEIR model of them were 2.764, 3.056, 3.899 and 3.984, respectively. By Feb. 13, 2020, except for Hubei, the cumulative prevalence curves of the other clusters tended to be stable and the cure rates increased. The prevalence rate and case-fatality rate of Hubei were still higher, and the cure rate was lower. Conclusion · From Jan. 13 to Feb. 13, 2020, 34 provincial administrative regions in China can be divided into four clusters according to the severity of the COVID-19 epidemic, and the prevalence rate of Cluster Ⅳ was significantly higher than those of other three clusters; by Feb. 13, 2020, the epidemic situations in the Cluster Ⅰ , Ⅱ and Ⅲ has been alleviated, and the epidemic situation in Cluster Ⅳ areas were still severe.
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Innovative research team achievement
Evaluation of physical and neurocognitive development of infants conceived from frozen embryo transfer
DONG Ze-han*, WU Yan-ting*, LIU Han, WANG Yin-yu, HUANG He-feng
2020, 40 (06):  719-727.  doi: 10.3969/j.issn.1674-8115.2020.06.004
Abstract ( 7 )   PDF (10977KB) ( 2 )  
Objective · To evaluate the physical and neurocognitive development of infants conceived from frozen embryo transfer (FET). Methods · Two hundred and forty-eight infants (1.5-4 years old) conceived from FET and natural conception (NC) were recruited as the follow-up cohort of FET offspring, and their physical and neurocognitive development were followed up and evaluated. Multiple Logistic regression analysis was used to assess the potential risk of cognitive retardation in FET offspring. Results · There was no significant difference in composition ratio of Z score for height, weight and body mass index between the FET group and the NC control group. Multiple Logistic regression analysis showed that compared with the NC control group, the risk of neurocognitive development abnormalities and retardation was higher in the FET group, especially in fine motor (OR=3.01, 95%CI 1.48-6.11) and social development domains (OR=3.76, 95%CI 1.63-8.69); and in the FET group, the social development risk of female infants was higher than that of male infants. Conclusion · FET may exert a negative impact on the early neurocognitive development of infants.
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Original article (Basic research)
Establishment and validation of OX40/FcγR-humanized mice for the study of agonistic anti-OX40 antibody
LIU Ming-dong*, LIU Xiao-bo*, ZHAO Ying-jie, ZHANG Yan, ZHANG Hui-hui, LI Fu-bin
2020, 40 (06):  728-735.  doi: 10.3969/j.issn.1674-8115.2020.06.005
Abstract ( 9 )   PDF (8565KB) ( 1 )  
Objective · To establish a rapid method to evaluate the activity of agonistic antibody using OX40 (tumor necrosis factor receptor superfamily member 4)/FcγR (Fcγ receptor)-humanized mice. Methods · Bone marrow cells from OX40-humanized mice and FcγR-humanized mice were collected and mixed with equal ratio. Then the mixed bone marrow cells were administrated into irradiated wild-type mice through the tail veins. The reconstruction efficiency of the immune system was confirmed by detecting the expression of hOX40 and hFcγR in the immune cells of chimera mice. After the chimera mice were generated successfully, they were used to evaluate the immunostimulatory activity of anti-hOX40 antibodies to CD4+ or CD8+ T cells. The results of flow cytometry were statistically analyzed. The unpaired t-test was used to compare the means between the two groups, and one-way ANOVA was used to compare the means between multiple groups. Results · Flow cytometry analysis showed that wild-type recipient mice were efficiently reconstituted with hFcγR expressing cells and hOX40 expressing cells to generate OX40/FcγR-humanized bone marrow chimera mice. In these mice, B cells and myeloid cells expressed hFcγRs (P<0.05), and T cells expressed hOX40 upon in vitro stimulation (P<0.05). When these mice were used to evaluate the immunostimulatory activity of anti-hOX40 antibody, significant expressions of IFN-γ and hOX40 were observed (P<0.05). Conclusion · OX40/FcγR-humanized bone marrow chimera mice are generated based on hFcγR expressing cells and hOX40 expressing cells, suggesting a rapid method to build a mouse model with both hFcγR and hOX40 expression. These mice are suitable for evaluating the immunostimulatory activity of agonistic human anti-hOX40 antibodies.
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Identification of differentially expressed genes and pathways in lipoprotein lipase gene heterozygous knockout mice through gene microarray analysis
CHEN Ning-xin, HAN Ting-ting, ZHENG Shuang, LIU Wei, HU Yao-min
2020, 40 (06):  736-743.  doi: 10.3969/j.issn.1674-8115.2020.06.006
Abstract ( 9 )   PDF (8566KB) ( 3 )  
Objective · To screen the differentially expressed genes (DEGs) and pathways in the islet tissues of lipoprotein lipase (Lpl) gene heterozygous knockout (Lpl+/-) mice and wild type (WT) mice, and explore the molecular mechanism of pathogenesis of type 2 diabetes mellitus (T2DM) mediated by lipotoxicity. Methods · The islets of Lpl+/- mice and WT mice were isolated and purified. DEGs were screened by gene microarray analysis. Gene Ontology (GO) function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of DEGs were performed. The expressions of key genes were verified by quantitative real-time PCR (qPCR). Results · A total of 187 DEGs were identified. GO functional analysis and KEGG pathway analysis showed that DEGs were mainly involved in the biological processes such as immune cell proliferation and differentiation, inflammatory signaling pathways and cell adhesion. Among the top 10 DEGs screened from Lpl+- mice and WT mice, gremlin 1 (Grem1) gene was closely related to the function of islet β cells, while the result of qPCR was consistent with that of gene microarray analysis. Conclusion · Multiple signaling pathways are involved in the process of T2DM mediated by lipotoxicity, which may lead to the dysfunction of islet β cells by inhibiting Grem1 expression.
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Anti-inflammatory effects of liraglutide on innate lymphoid cells in mice with inflammatory bowel disease
LI Yue1, 2, SUN Han-xiao2, SHU Jie2, LI Yong-mei1#, SHENG Hui-ming2#
2020, 40 (06):  744-751.  doi: 10.3969/j.issn.1674-8115.2020.06.007
Abstract ( 8 )   PDF (9286KB) ( 1 )  
Objective · To investigate the role and mechanism of glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide in dextran sulfate sodium (DSS)-induced inflammatory bowel disease (IBD). Methods · The drinking water with DSS concentration of 3% was prepared by using DSS and sterile water, and the mice were free to drink for 7 days, to construct IBD model. The experimental mice were randomly divided into four groups with five mice in each group: the control group [drinking sterile water, intraperitoneal injection of phosphate buffered saline (PBS)], the liraglutide group (drinking sterile water, intraperitoneal injection of 0.6 mg/kg liraglutide), the model group (drinking DSS water solution, intraperitoneal injection of PBS) and the treatment group (drinking DSS water solution, intraperitoneal injection of 0.6 mg/kg liraglutide). During the experiment, the fecal morphology, body weight, and colon length were observed. And hematoxylin-eosin (H-E) staining was used to observe the degree of colitis in mice. Flow cytometry was used to detect the proportion of neutrophils and eosinophils, as well as the changes of the innate lymphoid cell (ILC) subsets and function in the colon. Results · Compared with the model group, the symptoms of loose stool and bloody stool were improved, and the shortened colon length was also improved (P=0.007) in the treatment group. H-E staining showed that the infiltration of inflammatory cells in the colon of the treatment group was significantly reduced. Flow cytometry analysis of the colonic lamina propria showed that the proportion of neutrophils in the colon of the treatment group was significantly reduced (P=0.004), and the proportion of eosinophils was also reduced (P=0.002); the proportion of ILC (ILC2) in group 2 decreased (P=0.032), but the proportion of ILC (ILC3) in group 3 increased (P=0.008); the cytokine interleukin-22 secreted by ILC3 was increased (P=0.008). Conclusion · Liraglutide may delay the development of IBD by affecting the proportion of ILC subsets and secretion function.
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Definition of macrophage subtypes based on the expression of CD169 in murine splenic red pulp macrophages
YANG Shi-qi*, LI Meng-yao*, LIU Si-ming, LIU Zhi-duo
2020, 40 (06):  752-760.  doi: 10.3969/j.issn.1674-8115.2020.06.008
Abstract ( 7 )   PDF (10983KB) ( 1 )  
Objective · To investigate the gene expression profiles of CD169+ and CD169- red pulp macrophages based on the expression of CD169 in murine splenic red pulp macrophages. Methods · The expression of CD169 in splenic red pulp macrophages in C57BL/6 wild-type (WT) mice was analyzed by flow cytometry and immunofluorescence. CD169 knockout (KO) mice were used as negative control. F4/80+ splenic red pulp macrophages were enriched and separated into CD169+ and CD169- subtypes. RNA-sequencing was performed on the two subtypes. DESeq2 was used to analyze differentially expressed genes at P<0.05 & |log2FC|≥1. Kyoto Encyclopedia of Genes (KEGG) enrichment analysis was used to classify the differentially expressed genes according to the pathways involved or functions they performed, and some differentially expressed genes were verified by quantitative real-time PCR (qPCR). Results · Expression of CD169 in some red pulp macrophages was confirmed by flow cytometry and immunofluorescence. There were 485 differentially expressed genes in CD169+ and CD169- subtypes. Some differentially expressed genes related to inflammation were highly expressed in the CD169- subtype. Conclusion · The CD169+ and CD169- red pulp macrophages have different transcriptional profiles, and CD169- red pulp macrophages have more features of M1 macrophages.
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Effect of different test indicators and observation periods in contextual fear conditioning test on detection of behavioral efficacy of 5XFAD transgenic mice
ZHANG Tong, ZHANG Ying-lin, YAO Jun-yan
2020, 40 (06):  761-767.  doi: 10.3969/j.issn.1674-8115.2020.06.009
Abstract ( 3 )   PDF (10339KB) ( 1 )  
Objective · To explore whether different test indicators and observation periods in contextual fear conditioning test affect the detection effectiveness of learning and memory ability of 5XFAD transgenic mice. Methods · Twelve 4-month-old female 5XFAD transgenic progeny mice and 14 4-month-old female LM progeny mice were selected, which were produced by crossing male 5XFAD transgenic mice and female C57BL/6 mice, to conduct open field test and contextual fear conditioning test in succession. Total distance and velocity in open field test and average motion index in the first 60 s of training stage in contextual fear conditioning test of the two groups of mice were used to evaluate the difference of locomotor activity. Besides, the first 180 s, 181-360 s and the first 300 s of testing stage for observation were selected to evaluate the selection effects on percent freeze and activity suppression ratio. Then further investigation was launched to explore the effects of different observation periods on the detection effectiveness of percent freeze and activity suppression ratio. Results · The differences of total distance and total velocity of the two groups of mice in open field test were not statistically significant, however the average motion index in the first 60 s of training stage in contextual fear conditioning test of 5XFAD transgenic mice was significantly higher than that of LM mice (P=0.027). The comparison of percent freeze among the three groups of observation periods of LM mice had significant difference (both P<0.05), while there was no statistical significance in activity suppression ratio. The comparisons of percent freeze and activity suppression ratio among the three groups of observation periods of 5XFAD mice had no significant difference. The differences of percent freeze between 5XFAD mice and LM mice was not statistically significant during the three observation periods. However, the activity suppression ratio of 5XFAD mice was significantly higher than that of LM mice in the first 180 s (P=0.038), in the other two observation periods the difference of activity suppression ratio between the two groups of mice was not statistically significant. Conclusion · The average motion index detected in training stage in contextual fear conditioning test is more sensitive than total distance and total velocity detected in open field test for evaluating locomotor activity of 5XFAD mice. In contextual fear conditioning test, different observation periods have effects on the value of percent freeze provided by single strain of mice, while the value of activity suppression ratio remains unaffected. Activity suppression ratio is more precise than percent freeze to reflect the cognitive deficiency of 5XFAD mice. It is more accurate to select the first 180 s of testing stage for observation.
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Bioinformatics analysis of expression profiles of long noncoding RNA in endometrial cancer
JIAN Fang-fang1, CHE Xiao-xia2, FENG Wei-wei1
2020, 40 (06):  768-775.  doi: 10.3969/j.issn.1674-8115.2020.06.010
Abstract ( 0 )   PDF (7741KB) ( 0 )  
Objective · To analyze the differentially expressed profiles of long noncoding RNA (lncRNA) in endometrial cancer (EC) tissues and normal endometrial tissues. Methods · The RNA was extracted from 21 EC tissues and 5 normal endometrial tissues, respectively, and lncRNAs expression profiles were analyzed and screened by transcriptome sequencing technology. Gene Ontology (GO) function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were carried out for the differentially expressed lncRNAs, and their expression differences between the transcriptome sequencing and TCGA database were analyzed. Results · There were 3 060 differentially expressed lncRNAs, of which 2 046 were up-regulated and 1 014 were down-regulated. GO functional analysis showed that these lncRNAs were associated with cell adhesion, immune response, inflammatory response and cell proliferation. KEGG pathway analysis showed that these lncRNAs were mainly enriched on the pathways, such as PI3K-Akt signaling pathway, cell adhesion and cytokine-cytokine receptor interaction. Intersection analysis showed that 57 lncRNAs were up-regulated or down-regulated simultaneously in the sequencing results and TCGA database. Conclusion · The expression of lncRNAs in EC tissues and normal endometrial tissues are significantly different, suggesting that it may play an important role in the occurrence and development of EC.
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miR-214 promotes the progression of liver fibrosis by activating hepatic stellate cells
GONG Xu-hua1, ZHU Liang2, CHEN Chao3, QIAN Li-jun1
2020, 40 (06):  776-784.  doi: 10.3969/j.issn.1674-8115.2020.06.011
Abstract ( 0 )   PDF (9847KB) ( 0 )  
Objective · To explore the biological role of miR-214 in the activation of hepatic stellate cells (HSCs) and the procession of liver fibrosis and its possible mechanism. Methods · Quantitative real-time PCR (qPCR) was used to detect the expression of miR-214 in the activation of HSCs and the progression of liver fibrosis in rats induced by CCl4 (liver fibrosis model). HSC-T6 cells were treated with lentivirus infection and divided into miR-214 overexpression group, miR-214 knockout group and negative control lentivirus group (mock group). qPCR and Western blotting were used to detect the gene and protein expression levels of collagen type 1 (COL1) and α-smooth muscle actin (α-SMA) in the three groups, respectively. Transwell assay and flow cytometry were used to detect the migration and apoptosis of HSCs in the three groups, respectively. Double luciferase reporter gene assay was used to detect weather Hif1an was the target gene of miR-214, and then qPCR and Western blotting were used to detect the expression levels of HIF1AN in the three groups, the activation of HSCs and the liver fibrosis model. Results · miR-214 was upregulated during HSCs activation and the progression of liver fibrosis (both P<0.05). Compared with the mock group, the gene and protein expressions of COL1 and α-SMA in the miR-214 overexpression group were increased, and HSCs migration ability was increased and apoptosis rate was decreased (all P<0.05); the expressions of COL1 and α-SMA in the miR-214 knockdown group were decreased, and HSCs migration ability was decreased (all P<0.05). Double luciferase reporter gene assay showed that Hif1an was the target gene of miR-214. Compared with the mock group, the gene and protein expressions of HIF1AN in the miR-214 overexpression group were decreased (both P<0.05), and those in the miR-214 knockdown group were increased (both P<0.05). The expression of HIF1AN was decreased during HSCs activation and the progression of liver fibrosis (all P<0.05). Conclusion · miR-214 may promote the migration and activation of HSCs by targeting Hif1an, and then promote the progression of liver fibrosis, suggesting that miR-214 may be a new marker and potential target for the treatment of liver fibrosis.
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Original article (Clinical research)
Mediating effect of obsessive-compulsive symptoms between attributional style and depressive symptoms in patients with obsessive-compulsive disorder
CHENG Jia-yue, LI Pu-yu, GU Qiu-meng, WANG Pei, CHEN Jue, LIU Qiang#, WANG Zhen#
2020, 40 (06):  785-790.  doi: 10.3969/j.issn.1674-8115.2020.06.012
Abstract ( 0 )   PDF (8036KB) ( 1 )  
Objective · To explore the relationship among depressive symptoms, attributional style and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder. Methods · Seventy patients with obsessive-compulsive disorder who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM- Ⅳ) were selected. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to evaluate the severity of obsessive-compulsive symptoms, the Beck Depression Inventor- Ⅱ (BDI- Ⅱ) was used to measure the depressive symptoms, and the Attributional Style Questionnaire (ASQ) was used to measure the attributional style. The correlations among obsessive-compulsive symptoms, depressive symptoms and attributional style as well as the mediating role of obsessive-compulsive symptoms between attributional style and depressive symptoms were analyzed. Results · The globality dimension of negative events in attributional style was positively correlated with obsessive-compulsive symptoms and depressive symptoms (both P<0.05), and obsessive-compulsive symptoms were also positively correlated with depressive symptoms (P=0.000). The mediating effect analysis showed that the mediating role of obsessive-compulsive symptoms between the globality dimension of negative events and depressive symptoms was 0.105 (95%CI 0.031-0.218), with an mediating effect ratio of 44.20%. Conclusion · Obsessive-compulsive symptoms in patients with obsessive-compulsive disorder may play a completely mediating effect between the globality dimension of negative events in attribution style and depressive symptoms.
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Clinical characteristics of the obsessive-compulsive disorder patients with hoarding symptoms
LÜ Na, YE Hui-ling, FAN Qing#, XIAO Ze-ping#
2020, 40 (06):  791-797.  doi: 10.3969/j.issn.1674-8115.2020.06.013
Abstract ( 0 )   PDF (9207KB) ( 1 )  
Objective · To explore the clinical characteristics of the obsessive-compulsive disorder (OCD) patients with hoarding symptoms and analyze the risk factors related to hoarding symptoms. Methods · A total of 247 OCD patients and 137 healthy controls (HC) were enrolled. The OCD patients were divided into hoarding group and non-hoarding group according to hoarding symptoms. Yale-Brown Obsessive-Compulsive Scale, Hamilton Depression Scale, Hamilton Anxiety Scale, Neuroticism Extraversion Openness Five-Factor Inventory and Obsessive Belief Questionnaire-44 were used to measure the severity of OCD, levels of depression and anxiety, personality characteristics and obsessive-compulsive beliefs of the three groups. The differences among the groups were compared, and Logistic regression was used to analyze the related factors of hoarding symptoms. Results · Regardless of hoarding symptoms, the scores of depression, anxiety, neuroticism and obsessive beliefs in the patients with OCD were significantly higher than those in the healthy controls (all P=0.000). Compared with OCD/non-hoarding group, OCD/hoarding group had a significantly lower level of extroversion (P=0.000), a significantly higher level of perfectionism/certainty (P=0.037), and higher scores in indecisiveness (P=0.003), pathological responsibility (P=0.006) and pathological slowness (P=0.000). There was statistical significance in age (OR=0.94), extraversion score (OR=0.89) and pathological retardation score (OR=2.50) in Logistic regression model (all P<0.05). Conclusion · The risk of hoarding symptoms in the OCD patients decreases with the increase of age and extroversion level, and increases with the increase of pathological retardation level.
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Relationship between stress-related negative feelings and shape concern of the patients with anorexia nervosa: mediating effect of depressive symptoms
GUO Lei1 , HU Yan-ran1, 2, KANG Qing1, WANG Yu-ping1, WANG Zhen1, CHEN Han1#, CHEN Jue1#
2020, 40 (06):  798-803.  doi: 10.3969/j.issn.1674-8115.2020.06.014
Abstract ( 1 )   PDF (8301KB) ( 1 )  
Objective · To investigate the interaction among stress-related negative feelings, depressive symptoms and shape concern of the patients with anorexia nervosa (AN), and the mediating effect of depressive symptoms between negative feelings and shape concern. Methods · A total of 110 AN patients who met the diagnostic criteria of the Diagnosis and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) were recruited and their stress-related negative feelings were measured with Perceived Stress Scale (PSS), depressive symptoms were measured with Beck Depression Inventory (BDI), and shape concern was measured with Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0). Pearson’s correlation test was used to examine the relation between the variables, and the Bootstrap method was used to test the mediating effect of depressive symptoms between negative feelings and shape concern. Results · Negative feelings of the AN patients were positively correlated with depressive symptoms and shape concern (r=0.537, r=0.729, both P=0.000), and depressive symptoms were positively correlated with shape concern (r=0.614, P=0.000). The mediating effect analysis showed that the mediating role of depressive symptoms between negative feelings and shape concern was 0.332 (95%CI 0.156-0.535), with the mediating effect ratio of 61.673%. Conclusion · The depressive symptoms of the AN patients may play a mediating effect between negative feelings and shape concern, and the mediating effect is greater than the direct effect.
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Reliability and validity of self-rated Family Burden Scale in families of the patients with anorexia nervosa
PENG Yi-hua1, HUANG Ye2, NIE Lei-yan1, LIU Qiang1#, CHEN Jue1#
2020, 40 (06):  804-808.  doi: 10.3969/j.issn.1674-8115.2020.06.015
Abstract ( 0 )   PDF (7484KB) ( 1 )  
Objective · To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods · The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients’ BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results · The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion · Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.
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Response inhibition function in patients with drug-naive bulimia nervosa
HU Yan-ran1, 2, CHEN Han1#, YUE Ling1, XU Yi-xiang1, LIU Qiang1, KANG Qing1, GUO Lei1, RUAN Lie-min3, CHEN Jue 1#
2020, 40 (06):  809-813.  doi: 10.3969/j.issn.1674-8115.2020.06.016
Abstract ( 0 )   PDF (7669KB) ( 1 )  
Objective · To investigate the change of response inhibition function in patients with drug-naive bulimia nervosa (BN) and its relationship with eating disorders and self-reporting impulsiveness. Methods · Thirty-five drug-naive BN patients who accepted psychological counseling in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine between Aug. 2018 and Jun. 2019, and 23 healthy controls (HC) were recruited. The eating disorder and impulsiveness were compared between the two groups by using the Chinese version of Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) and Barrett Impulsiveness Scale-11 (BIS-11), respectively. The stop signal task (SST) was used to assess response inhibition function. The scale scores and SST results were compared between the two groups, and the correlation of stop signal reaction time (SSRT) with BIS-11 score, EDE-Q 6.0 score, the age of onset and the duration of illness was analyzed. Results · Compared with the HC group, the BN group demonstrated significantly longer SSRT in the SST (P=0.003), and had a higher total score of BIS-11 (P=0.004), attentional impulsiveness score (P=0.008) and non-planning impulsiveness score (P=0.002). SSRT was positively associated with the age of onset (r=0.503,P=0.006), negatively associated with the score of weight concern subscale (r=-0.337, P=0.048), and not correlated with the BIS-11 score and the duration of illness in drug-naive BN patients. Conclusion · Drug-naive BN patients have high impulsiveness, and their defects in response inhibition are associated with the age of onset and weight concern.
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Effect of citalopram on miRNA-16/serotonin transporter pathway in peripheral blood of patients with depression
QIAN Shi-xing, FANG Yuan#, SUN Lin, QIU Qi, LIN Zhi-guang, XIAO Shi-fu, LI Xia#
2020, 40 (06):  814-819.  doi: 10.3969/j.issn.1674-8115.2020.06.017
Abstract ( 0 )   PDF (8005KB) ( 1 )  
Objective · To discuss the effects of citalopram on miRNA-16/serotonin transporter (SERT) pathway in peripheral blood of the patients with depression. Methods · Forty-five patients with depression without medication (untreated group), 32 patients with depression treated with medicine(drug treated group) and 32 healthy people (control group) were enrolled in the study. Hamilton Depression Scale-17 items were used to evaluate the depressive symptoms. The expression level of plasma miRNA-16 was detected by fluorescence quantitative PCR, and the level of SERT protein in platelets was detected by Western blotting. Fourteen of the baseline patients who were treated with citalopram were followed up for 2 months. After the follow-up, the evaluation of HAMD-17, the detection of miRNA-16 and SERT protein were conducted. Results · There was no significant difference in the expression level of plasma miRNA-16 among the three groups (F=0.421, P=0.657). There was no significant difference of SERT protein expression in the platelets among the three groups (F=0.112, P=0.894). The follow-up study showed that the HAMD-17 score decreased after 2 months (Z=?3.187, P=0.001), the average expression level of plasma miRNA-16 increased (t=2.455, P=0.032), and the expression of SERT protein in the platelets did not change (t=?0.750, P=0.470) in 14 patients who were treated with citalopram. Conclusion · Citalopram, a serotonin reuptake inhibitor, can down-regulate the expression of plasma miRNA-16 in patients with depression, and the decrease of the platelet serotonin is not caused by the decrease of SERT protein on platelet membrane, but may be related to the decrease of the SERT function.
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Abnormal semantic and syntactic processing in patients with schizophrenia: an event-related potential study
YANG Qiao1, TANG Ying-ying2, QIAN Zhen-ying2, YANG Fu-zhong1, QIAO Yi1, SHENG Jian-hua1#, LU Guang-hua3#
2020, 40 (06):  820-827.  doi: 10.3969/j.issn.1674-8115.2020.06.018
Abstract ( 0 )   PDF (9851KB) ( 1 )  
Objective · To explore the differences of event-related potential components (N400 and P600) in response to language processing between schizophrenia (SZ) patients with formal thought disorder (FTD), SZ patients without FTD, genetic high-risk subjects and healthy controls (HC). Methods · Thirty SZ patients with FTD (SZ-FTD group) and 29 SZ patients without FTD (SZ-nFTD group), who were hospitalized in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 22 subjects at genetic high risk who were first degree relatives of SZ patients, and 31 healthy controls (HC) were recruited. Four different types of sentences (syntactically and semantically correct, syntactically correct but semantically incorrect, syntactically incorrect but semantically correct, and syntactically and semantically incorrect) were presented to the four groups respectively with electroencephalogram recording. Repeated measurement analysis of variance was used to compare the response accuracy of the four groups and to analyze the differences in the amplitude and latency of N400 and P600 components in response to each kind of sentence among the four groups. Results · SZ-FTD group showed a lower accuracy rate compared with the HC group (P=0.000). Compared with the HC group, N400 amplitude in SZ-FTD group was lower in statistically significance (P=0.003), while SZ-FTD group did not show a prominent N400 component. P600 component was well evoked in four groups, and there was an interaction between semantics, syntax and group (P=0.022). By further analysis, neither SZ-FTD nor SZ-nFTD group showed significant differences in P600 amplitudes evoked by syntactically correct and syntactically incorrect sentences. There was no significant difference in P600 amplitudes evoked by semantically correct and incorrect sentences in SZ-FTD group, whereas P600 amplitudes evoked by semantically correct sentences were greater than those evoked by semantically incorrect ones in the other three groups. Conclusion · Neural activity is impaired during semantic processing in SZ. In particular, SZ-FTD patients have impairments in both semantic and syntactic processing.
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Study on the clinical application of the intervention program of bowel dysfunction in patients with spinal cord injury
WEI Xiao-mei1, HU San-lian2, QIAN Hui-juan2, WEI Wei-ping1, WANG Fei-yan1
2020, 40 (06):  828-834.  doi: 10.3969/j.issn.1674-8115.2020.06.019
Abstract ( 1 )   PDF (8749KB) ( 2 )  
Objective · To verify the effectiveness of the intervention program of bowel dysfunction in patients with spinal cord injury (SCI). Methods · Eighty bowel dysfunction patients with SCI in a rehabilitation hospital in Shanghai from Jan. to Dec. 2018 were included. According to the time of admission, the patients were divided into intervention group and control group, with 40 cases in each group. The patients in the control group received the routine nursing, and the patients in the intervention group were provided with the intervention program constructed by this study. The bowel function indexes of the two groups were compared at the time of admission, 4 weeks after intervention and 1 month after discharge. The quality of life in the two groups was compared at the time of admission and 1 day before discharge. Results · After intervention, the defecation frequency, fecal character score, defecation time, abdominal distention, constipation rate and drug dependence rate of the intervention group were lower than those of the control group (all P<0.05), and their total scores of quality of life and the scores in various fields were higher than those of the control group (all P<0.05). The differences in the quality of life between the two groups of patients after intervention and at the time of admission were statistically significant except for the social field (all P<0.05). Conclusion · The intervention program for bowel dysfunction patients with SCI can effectively lead to the recovery of the bowel function, reduce the incidence of bowel complications, and improve the quality of their life.
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Three-dimensional measurement and analysis of nasolabial soft tissue changes following maxillary anterior movement by Le Fort Ⅰ osteotomy
XU Yu-ting*, YINGWANG Jun-zi*, WANG Shu-ze, LI Biao, WANG Xu-dong
2020, 40 (06):  835-840.  doi: 10.3969/j.issn.1674-8115.2020.06.020
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Objective · To evaluate nasolabial soft tissue changes of Chinese patients with malocclusion after maxillary anterior movement by Le FortⅠosteotomy with three-dimensional measurement. Methods · From Jan. to Dec. 2017, 37 patients with skeletal Class Ⅲ malocclusion from Department of Oral and Craniomaxillofacial Surgery of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, who underwent maxillary Le FortⅠosteotomy for anterior movement and bilateral sagittal split ramus osteotomy (bi-maxillary orthognathic surgery), were included. A full cranial spiral CT scan and three-dimensional facial soft tissue images were performed within 1 week before and 6 months after operation. Landmarks, relative distance and angle of nasolabial soft tissue were located and measured by 3dMD vultus software, and the differences before and after operation were compared. Results · After bi-maxillary orthognathic surgery, the alar width increased by an average of 0.82 mm, the subalar width increased by an average of 1.07 mm, the upper lip length increased by an average of 1.41 mm, the nasolabial angle increased by an average of 3.09?, and the pronasal angle decreased by an average of 1.51?(all P<0.05), while nasal height, nasal length and nasal frontal angle were basically stable. Conclusion · After the maxillary Le Fort I osteotomy for anterior movement, the face of patient with malocclusion is improved, and the nasolabial soft tissue is also changed.
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Changes of new urinary biomarkers in children with Henoch-Schonlein purpura nephritis
MA Yi-fei, LI Yu-feng, GUO Gui-mei, ZHU Ya-ju, GONG Ying-liang, DONG Yu
2020, 40 (06):  841-846.  doi: 10.3969/j.issn.1674-8115.2020.06.021
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Objective · To evaluate the changes of urinary angiotensinogen (UAGT), fibroblast-specific protein-1 (FSP-1) and thrombin in the children with Henoch-Schonlein purpura nephritis (HSPN). Methods · Fourteen children with HSPN (HSPN group), 28 children with Henoch-Schonlein purpura (HSP) but without renal injury (HSP group) and 23 children with normal urinalysis (control group) were included in the study. Ten HSPN children before treatment (untreated group), 9 HSPN children after glucocorticoid (GC) pulse therapy (GC group) and 8 HSPN children after GC and cyclophosphamide (CTX) double pulse therapy (GC+CTX group) were also selected in the study. Clinical information and fresh morning urine samples were collected from all the children. UAGT, FSP-1 and thrombin in urine were measured by kits. Urine creatinine (Ucr) was also measured for correction. Results · UAGT/Ucr and FSP-1 in HSPN group were significantly higher than those in HSP group and control group (P<0.05). Thrombin in HSPN group had no significant difference, compared with HSP group (P>0.05), but thrombin levels in HSPN group and HSP group were both significantly higher than that in control group (P<0.05). UAGT/Ucr in HSPN untreated group had no significant difference, compared with GC group, while it was significantly higher than that in GC+CTX group (P=0.000). FSP-1 in untreated group was significantly higher than that in GC group, but had no significant difference, compared with GC+CTX group. There was no significant difference in thrombin among the 3 HSPN groups. Conclusion · UAGT/Ucr, FSP-1 and thrombin all increase in the urine of HSPN children, and UAGT/Ucr and FSP-1 may reflect the treatment effect to some extent.
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Analysis of Tim-3/Gal-9 expression and T cell infiltration in adenocarcinoma of the esophagogastric junction
WANG Yang-yang1, ZHENG Xiao2, ZHU Chun-chao1, LIU Qiang3, ZHANG Zi-zhen1, ZHAO En-hao1
2020, 40 (06):  847-855.  doi: 10.3969/j.issn.1674-8115.2020.06.022
Abstract ( 1 )   PDF (8938KB) ( 1 )  
Objective · To detect T cell immunoglobulin mucin 3 (Tim-3) and galectin 9 (Gal-9) expression as well as CD3+ T cells and CD8+ T cells infiltration in the tumor tissues of adenocarcinoma of the esophagogastric junction (AEG), and analyze their correlations with the patients’ clinical characteristics and survival prognosis. Methods · A retrospective case study was used to collect clinical data and follow-up data of 116 AEG patients who were admitted to Renji Hospital, Shanghai Jiao Tong University School of Medicine from Dec. 2005 to Dec. 2013. Tim-3, Gal-9, CD3, and CD8 protein expressions were detected by immunohistochemistry in the tumor tissues, and the clinical characteristics and prognosis were compared among the patients with different levels of protein expression and T cells infiltration. Results · The results of immunohistochemistry showed that Tim-3 mainly expressed in the infiltrating immune cells, and Gal-9 mainly expressed in the tumor cells. The analysis on the clinical characteristics revealed that Tim-3 expression level was related to the Siewert classification (P=0.030) and CD8+ T cells infiltration level was related to the tumor TNM stage (P=0.042). The results of survival analysis showed that the patients with high level of CD8+ T cells infiltration had a better survival prognosis (P=0.047). However, there was no difference in the prognosis among the patients with different Tim-3 and/or Gal-9 expression levels or with different CD3+ T cell infiltration levels. Conclusion · AEG patients with high level of CD8+ T cells infiltration usually have earlier TNM stages and better prognosis. There is no significant difference in the prognosis of AEG patients with different Tim-3/Gal-9 expression levels.
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Original article (Public health)
Current status of self-perceived burden and related factors in the patients with non-Hodgkin's lymphoma
NI Xue-ping1, 2, LI Xian-hua2, XIN Xiao2, WU Sheng-jia1, 2, SONG Ting1, HE Yang2, ZHENG Xin2
2020, 40 (06):  856-862.  doi: 10.3969/j.issn.1674-8115.2020.06.023
Abstract ( 2 )   PDF (8442KB) ( 0 )  
Objective · To investigate the current status of self-perceived burden of the patients with non-Hodgkin's lymphoma (NHL) and analyze the related factors. Methods · A total of 169 NHL patients who were hospitalized in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. to Oct., 2019, and their caregivers were enrolled by convenience sampling method. The general information questionnaire, Social Support Rating Scale (SSRS), Self-rating Depression Scale (SDS), Zarit Caregiver Burden Interview (ZBI) and Self-perceived Burden Scale (SPBS) were used to investigate, and the factors related to the score of SPBS were analyzed. Results · The average score of SPBS was 28.95±11.27, while the score of economic burden was the highest (3.13±1.37). Multiple regression analysis suggested that the family income per month per person (P=0.001), Karnofsky performance status (KPS) (P=0.027), SDS score (P=0.006) and ZBI score (P=0.000) were associated with the SPBS score in the NHL patients. Conclusion · The overall self-perceived burden in the patients with NHL is mild-to-moderate, but the economic burden is not neglectable. Low monthly income, poor ability of self-care, depressive symptoms and heavy burden of caregivers can aggravate the self-perceived burden of the patients with NHL.
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