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    Editorial
    Development of discipline of nutrition in China
    CAI Wei
    2010, 30 (1):  1. 
    Abstract ( 2536 )   PDF (4118KB) ( 1733 )  

    The discipline of nutrition has been developing quickly in the past 30 years in China, and a number of scientific progress has been achieved. Some new discoveries have been unveiled in terms of treatment and prevention of liver carcinoma, colon cancer, and breast cancer by certain nutrients. Besides, the application of nutrition in the prevention and treatments of metabolic diseases such as obesity, diabetes mellitus and congenital malformation has been studied. Furthermore, academic achievements in the treatment of tumor and metabolic diseases by integrating nutritional therapies has also been made. The establishment of relevant organizations and institutes as well as the prosperous performance of nutrition education contribute to the development of discipline of nutrition in China.

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    Monographic report (Nutrition research)
    Immunomodulatory effects of probiotics on rat models with ovalbumin induced food allergy
    TANG Wen-jing, HUANG Juan, ZHONG Yan, et al
    2010, 30 (1):  4. 
    Abstract ( 1984 )   PDF (5455KB) ( 1851 )  

    Objective To investigate the effects of probiotics on the occurrence of ovalbumin (OVA) induced food allergy and the regulatory effects on immune function of rat models. Methods Thirty female Brown-Norway rats aged 3 weeks were randomly divided into blank control group, food allergy group and probiotics intervention group (n=10). The levels of serum OVA-IgE and intestinal sIgA were measured by ELISA method. Splenic lymphocytes were isolated and cultured in vitro, and the Treg lymphocyte subgroups in the spleen were analyzed by flow cytometry. The levels of IFN-γ, IL-4 and IL-10 in the supernatant of cultured splenic lymphocytes were measured by ELISA method. Results The serum OVA-IgE level in food allergy group was significantly higher than that in blank control group (P<0.05), while that in probiotics intervention group was significantly lower than that in food allergy group (P<0.05). Compared with food allergy group and blank control group, the level of intestinal sIgA in probiotics intervention group was significantly higher (P<0.05). The percentage of CD4+CD25+T lymphocytes in food allergy group was significantly lower than that in blank control group (P<0.05), and that in probiotics intervention group had the increase tendency compared with food allergy group, with no significant difference between probiotics intervention group and food allergy group (P>0.05). The levels of IL-4 and IL-10 in food allergy group were significantly higher than those in blank control group (P<0.05). Probiotics intervention group had significantly lower levels of IL-4, IL-10 and IFN-γ than food allergy group (P<0.05). The ratio of IFN-γ/IL-4 in food allergy group was significantly lower than that in blank control group (P<0.05), while that in probiotics intervention group was significantly higher than that in food allergy group (P<0.05).ConclusionProbiotics intervention could prevent the occurrence of food allergy in animal models by modulating the Th1/Th2 cytokine balance.

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    Immunological relationship between food allergy induction and occurrence of asthma in mice
    GAO Xin, CHEN Bing, TANG Wen-jing, et al
    2010, 30 (1):  9. 
    Abstract ( 1993 )   PDF (5337KB) ( 1516 )  

    Objective To investigate immunological relationship between early induction of food allergy and occurrence of later asthma in mice, and explore the pathological changes in lung tissues. Methods Thirty-seven female BALB/c mice aged 6 weeks were randomly divided into blank control group (n=12), food allergy group (n=13) and asthma group (n=12). After being challenged by ovalbumin (OVA), the levels of serum IgE, IL-4 and INF-γ in bronchoalveolar lavage fluid (BALF) were detected. The numbers of inflammatory cells and eosinophils (EOS) in BALF were counted. Lung tissues were obtained for pathological sections, and thickness of bronchial wall and EOS infiltration were observed. Results The level of serum IgE and level of IL-4, ratio of IL-4/IFN-γ and number of EOS in BALF in food allergy group and asthma group were significantly higher than those in control group (P<0.05). The level of IL-4 and number of EOS in BALF in asthma group were significantly higher than those in food allergy group (P<0.05), while there was no significant difference in serum IgE level between these two groups (P>0.05), and levels of IFN-γ in BALF in both groups were significantly lower than that in blank control group (P<0.05). There were more EOS infiltration in lung tissues and thicker bronchial wall in food allergy group and asthma group than that in blank control group (P<0.05), and the number of EOS in asthma group was significantly higher than that in food allergy group (P<0.05). Conclusion IgE-mediated immune response is involved in both food allergy and asthma mouse models. Lung immune imbalance of Th1/Th2 and inflammatory cell infiltration caused by food allergy may participate in the occurrence of later asthma.

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    Preventive effects of phytosterol on lipid metabolic disturbance of rats
    YANG Ke-feng, FANG Yue-hui, ZHANG Xiong, et al
    2010, 30 (1):  13. 
    Abstract ( 1693 )   PDF (3228KB) ( 1422 )  

    Objective To investigate the preventive effects of phytosterol on lipid metabolic disturbance of rats fed with high-fat diet. Methods Forty male SD rats were randomly divided into control group (fed with basic diet), high-fat model group (fed with high-fat diet), low phytosterol group(fed with high-fat diet and 100 mg/kg phytosterol) and high phytosterol group(fed with high-fat diet and 200 mg/kg phytosterol). Body weight, serum lipid, liver fat and body fat were measured at the end of experiment (6 weeks later). Results At the end of experiment, the body weight, contents of liver fat and body fat and serum TC, TG and LDL-C levels were significantly higher in high-fat model group, low phytosterol group and high phytosterol group than those in control group (P<0.05), while serum HDL-C levels in these three groups were significantly lower than that in control group (P<0.05). Compared with high-fat model group, the body weight gain and content of body fat of high phytosterol group were significantly lower (P<0.05). The contents of liver fat and serum TC, TG and LDL-C levels in low phytosterol group and high phytosterol group were significantly lower than those of high-fat model group (P<0.05). Conclusion Phytosterol could prevent lipid metabolic disturbance of rats fed with high-fat diet. High dose phytosterol has the potential to reduce the body weight gain and contents of body fat of rats fed with high-fat diet.

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    Distribution of HOMA-IR index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years
    WAN Yan-ping, XU Ren-ying, SHEN Wan-rong, et al
    2010, 30 (1):  16. 
    Abstract ( 2872 )   PDF (4170KB) ( 1538 )  

    Objective To investigate the distribution of homeostasis model assessment-insulin resistance (HOMA-IR) index and its relationship with metabolic syndrome and inflammatory cytokines in students aged 7 to 14 years. Methods The data of 366 students (n=163 for boys and n=203 for girls) aged 7 to 14 years were collected, including anthropometric parameters (height, body weight, body mass index, waist circumference, hip circumference and waist-hip ratio), blood pressure, total fat mass, fat proportion, fasting blood lipid, fasting blood glucose, fasting insulin and serum levels of inflammatory cytokines such as tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6), and insulin resistance was evaluated by HOMA-IR index. Results The 75th percentile of HOMA-IR index for boys and girls was 3.62 and 2.88, respectively. Body weight, height, body mass index, waist circumference, hip circumference, total fat mass and fat proportion were positively related to HOMA-IR index (P<0.01). When HOMA-IR index surpassed 75th percentile, age, anthropometric parameters, total fat mass, fat proportion and systolic blood pressure significantly increased in boy and girl students (P<0.05), no significant change occurred in diastolic blood pressure in boy and girl students, the levels of serum TNF-α and IL-6 significantly increased in boy students (P<0.05), while there was no significant change in level of CRP in boy students and levels of CRP, TNF-α and IL-6 in girl students. Conclusion The increase of HOMA-IR index leads to a dramatic increase of anthropometric parameters, total fat mass, fat proportion and serum TNF-α and IL-6 in boy students, while that results in the increase of anthropometric parameters, total fat mass and fat proportion in girl students, with no significant change in serum inflammatory cytokines.

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    Comprehensive nutritional assessment scale for hospitalized patients established with analytical hierarchy process
    WU Bei-wen, CAO Wei-xin
    2010, 30 (1):  20. 
    Abstract ( 1733 )   PDF (4127KB) ( 1419 )  

    Objective To establish a comprehensive nutritional assessment scale for hospitalized patients with objective and subjective nutritional assessment indicators. Methods The hierarchical structure model was established to evaluate the nutritional status of hospitalized patients by analytic hierarchy process, and the weight coefficients of various assessment indicators were worked out by Satty product method, then the comprehensive nutritional assessment scale for hospitalized patients was established. Results The newly established comprehensive nutritional assessment scale included 11 subjective and objective indicators, and the weight coefficients of indicators varied. The leading three important indicators for nutritional assessment were serum prealbumin (2.3), serum albumin (2.3) and degree of weight loss (1.6). Conclusion With both subjective and objective indicators, the new comprehensive nutritional assessment scale established with analytic hierarchy process transforms the qualitative indicator into the quantitative one. It is a new attempt to apply the mathematical theory into the area of clinical medicine.

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    Effect of community-based nutrition education program on diet quality of the elderly in Jinshan District of Shanghai
    MAO Xuan-xia, PAN Pan, CAI Mei-qin
    2010, 30 (1):  24. 
    Abstract ( 2019 )   PDF (3862KB) ( 1462 )  

    Objective To evaluate the effect of a community-based nutrition education program on the dietary quality of the elderly with diet balance index (DBI). Methods Eighty-three volunteers from Zhujing Town of Jinshan District of Shanghai with age ≥60 years were served as study objectives, and a total of 70 people completed the program. They were given nutritional guidance bimonthly in combination with measures such as community publications, panel discussions and individual interviews. Measurements of dietary intakes, which lasted for 3 d, were performed before intervention and 12 months after intervention, respectively. Diet quality was evaluated with DBI scoring system, and the parameters were compared before and after intervention. Results There were significant differences in DBI-Total Score (DBI-TS), DBI-Lower Bound Score (DBI-LBS) and DBI-Diet Quality Distance (DBI-DQD) before and after intervention for these 70 people (P<0.05). The proportion of subjects with adequate milk and soy product consumption increased from 7.1% before intervention to 20.0% after intervention, that with proper amount of salt intake from 22.9% to 51.5%, and that with diverse diet from 20.0% to 49.9%. The major DBI pattern changed from pattern B (47.1%) and pattern E (34.3%) to pattern B (34.3%) and pattern A (32.9%). Conclusion The community-based nutrition education program for the elderly can improve the diet quality of the elderly.

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    Analysis of bone strength and influencing factors in adults
    SHI Yong-mei, LUO Xi, JIANG Yong-mei, et al
    2010, 30 (1):  28. 
    Abstract ( 2232 )   PDF (5657KB) ( 1603 )  

    Objective To investigate bone strength in adults, and explore its influencing factors. Methods One hundred and ninety-one adults undergoing health examinations were selected. The questionnaires about milk intake and exercise conditions were performed, the body weight, fat mass, body mass index (BMI) and calcaneal bone strength were measured, and the relationship between each parameter and bone strength was analysed. Results Bone strength decreased with age ncrease, and was higher in males than that in females. Bone strength of overweight to obese adults was higher than that with normal body weight (P<0.05). Bone strength of adults with high milk intake was higher than that of those with low milk intake (P<0.05). Multivariate analysis revealed that age was negatively related to bone strength, females were more susceptible to bone strength decrease, and BMI and milk intake were positively related to bone strength. Conclusion Gender, age, BMI and milk intake are main influencing factors for bone strength. Bone strength decreases with age increase, and increase of BMI and milk intake will benefit bone strength, especially for females.

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    Analysis of metabolic syndrome among obese children in clinics
    SHEN Wan-rong, WAN Yan-ping, XU Ren-ying, et al
    2010, 30 (1):  32. 
    Abstract ( 2139 )   PDF (4560KB) ( 1503 )  

    Objective To investigate the incidence of metabolic syndrome among obese children in clinics. Methods One hundred and thirteen obese children aged 7 to 14 years were selected from clinics of nutrition (case group), and another 366 healthy students aged 7 to 14 years were served as controls. Height, body weight, waist circumference, hip circumference, blood pressure and liver ultrasound were measured, related biochemical parameters such as fasting blood glucose, fasting insulin, serum total cholesterol, triglyceride (TG), high density lipoprotein and low density lipoprotein were detected, and the incidences of metabolic syndrome were obtained in two groups. Insulin resistance (IR) was evaluated by homeostasis model assessment (HOMA). Results There was no significant difference in age and gender between case group and control group (P>0.05). Body weight, body mass index (BMI), waist circumference, hip circumference, waist to hip ratio, systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, HOMA index and TG in case group were significantly higher than those in control group (P<0.01). The 75th percentile of HOMA index in control group was 3.28, and IR subgroup and non-IR subgroup were divided according to this cutpoint. In case group, body weight, BMI, waist circumference and TG in non-IR subgroup were significantly higher than those in IR subgroup (P<0.05). Metabolic syndrome occurred in 51 cases (45.1%) in case group. The incidence of metabolic syndrome was higher in IR subgroup than that in non-IR group (50.0% vs 21.1%) (P<0.05). Conclusion The prevalence of metabolic syndrome is higher in overweight and obese children. IR has a close relationship with metabolic syndrome.

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    Comparison of references for assessment of overweight and obesity in children of Shanghai
    CHEN Lei, TANG Qing-ya, RUAN Hui-juan, et al
    2010, 30 (1):  36. 
    Abstract ( 5641 )   PDF (3179KB) ( 1320 )  

    Objective To compare and analyse four references for assessment of obesity in Chinese children. Methods The height and weight of 2 347 children (1 175  boys and 1 172 girls) aged 7 to 8 years in Shanghai were measured, and their body mass indexes (BMI) were calculated. The prevalences of overweight and obesity were evaluated and compared among reference of Weight for Height 1985 (WFH 1985 reference), BMI reference of Working Group on Obesity in China (WGOC reference), BMI reference of Europe International Obesity Task Force (IOTF reference) and BMI reference of Centers for Disease Control and Prevention of American 2000 (CDC reference). Results The prevalence of overweight in boys evaluated by IOTF reference was significantly higher than those by the other three references (P<0.05), and the prevalence of overweight in girls evaluated by IOTF reference was significantly higher than those by WGOC and CDC references (P<0.05). The prevalence of obesity in boys evaluated by IOTF reference was significantly lower than those by the other three references (P<0.01), and the prevalence of obesity in girls evaluated by IOTF reference was significantly lower than those by WGOC and WFH 1985 references (P<0.01). There was no significant difference in the evaluation findings of obesity and overweight between WFH 1985 and WGOC references (P>0.05). Conclusion WFH 1985 and WGOC references are more suitable than IOTF and CDC references for assessment of overweight and obesity in Chinese children.

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    Parenteral nutrition related central venous catheter infection in elder patients with malignant tumors
    XU Ren-ying, SHAN Cheng-di, WAN Yan-ping, et al
    2010, 30 (1):  39. 
    Abstract ( 2220 )   PDF (3294KB) ( 1370 )  

    Objective To investigate the prevalence of parenteral nutrition related central venous catheter infection in elder patients with malignant tumors, and explore the risk factors. Methods The clinical data of 366 patients with malignant tumors who were managed with parenteral nutrition after operation were retrospectively analysed. The data of age, gender, body weight, diagnosis of primary disease, surgical approach, past history, volume of blood and albumin transfusion and time of fever (body temperature ≥38 ℃) were collected. Parenteral nutrition related parameters such as time of parenteral nutrition, total calorie, non-protein calorie, amount of fat, protein and glucose, calorie to nitrogen ratio and carbohydrate to fat ratio were also recorded. Results The mean age of 366 patients was (71.8±6.9) years, mean time of parenteral nutrition was (10.6±6.3) d, and total time of catheterization was 3 336 days. The prevalence of parenteral nutrition related central venous catheter infection was 2.5% (9/366). Logistic regression analysis demonstrated that the relative risks of plasma albumin level before parenteral nutrition and time of high fever to catheter infection were 1.257 and 2.518, respectively (P<0.01 for both). Conclusion Plasma albumin level before parenteral nutrition and time of fever were two risk factors for parenteral nutrition related catheter infection in elder patients with malignant tumors.

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    Energy metabolism and related mechanism in patients with malignant tumors
    HUANG Cui-hua
    2010, 30 (1):  42. 
    Abstract ( 1839 )   PDF (4149KB) ( 1308 )  

    Energy metabolism refers to the metabolism of three major nutrients associated with the process of energy production and usage. The metabolism in patients with tumors manifests specifically, as a result of tumor-bearing state, host's response to tumor and anti-neoplastic therapy. It is believed that resting energy expenditure increases in patients with newly diagnosed tumors, which is related to C-reactive protein and release of inflammatory cytokines. After effective therapy, resting energy expenditure decreases in some degree. In addition, the stage and differentiation of tumors also affect metabolism. However, there are some conflicts among research findings. The characteristics of energy metabolism and influential factors in patients with tumors are reviewed in this paper.

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    Application of fish oil in sepsis
    SHENG Hong
    2010, 30 (1):  46. 
    Abstract ( 1442 )   PDF (4352KB) ( 1265 )  

    Sepsis may result in a high mortality. Fish oil, which riches in ω-3 polyunsaturated fatty acids, has anti-inflammatory and immune regulatory functions. ω-3 fatty acids, which are special immune nutrient substrates, participate in the energy provision as well as improve organ function and regulate proinflammatory/anti-inflammatory cytokines. The ideal function of fish oil is associated with dosage, time of initiation and duration of application.

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    Original article (Basic research)
    Protective effect of active component of Eclipta on hepatic injury induced by ConA in mice
    XU Ru-ming, DENG Ke-min, LU Yang
    2010, 30 (1):  50. 
    Abstract ( 1828 )   PDF (6559KB) ( 1630 )  

    Objective To explore the protective effect of active component of Eclipta on hepatic injury induced by Concanavalin A (ConA) in mice. Methods Mouse hepatic injury models were established by injection of ConA (15 mg/kg) via tail vein. The effect of Eclipta extracts on serum alanine aminotransferase (ALT) and liver histology in both normal mice and hepatic injury mice was examined. A pure compound was obtained by means of bioactivity-guided isolation, and IR, 13C-NMR, 1H-NMR, 1H-13C HMBC and 1H-13C HMQC were used for structural identification. Results Eclipta extracts decreased serum ALT in hepatic injury mice induced by ConA, and demonstrated anti-apoptosis effect induced by ConA in hepatocytes. Wedelolactone, a coumarin, was isolated from Eclipta, and its structure was identified on the basis of spectroscopic analysis. Wedelolactone inhibited ConA-induced T cell proliferation selectively, and completely antagonized the effect of ConA at the concentration of 10 μg/mL. Conclusion Eclipta herb has hepatoprotective effect. Wedelolactone, the anti-inflammatory and anti-apoptosis active component of Eclipta, might serve as a lead compound for developing new antiinflammatory drugs.

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    Evaluation of mouse acute liver damage by breath test with domestically synthesized 13C-methacetin
    CHEN Su-yun, JIANG Lei, GUAN Liang, et al
    2010, 30 (1):  55. 
    Abstract ( 1903 )   PDF (5684KB) ( 1632 )  

    Objective To establish a convenient 13C-breath test system in live mice, and investigate the value of 13C-methacetin breath test (13C-MBT) in the diagnosis of acute liver damage of mice with domestically synthesized 13C-methacetin. Methods Domestically synthesized 13C-methacetin was prepared from acamol by methylation. Abdominal injection of CCl4 was adopted to duplicate acute liver damage of mice, then the mice were housed under normal laboratory condition for a whole month to gain recovery, which were indentified by hepatic pathological examinations and biochemical tests of liver function. After fasting, the mice were orally administered 13C-methacetin, and the expired air was collected at various time points. Infrared spectrometer was employed, and delta over baseline (DOB) curves of 13C-exhalation were drawn. Results Six to eight min after administration of 13C-methacetin, the rate of 13C-exhalation peaked in control group (51.9±2.04), and decreased thereafter. Sixteen min after administration of 13C-methacetin, the rate of 13C-exhalation peaked in model group (26.37±5.74), and decreased thereafter. There were significant differences between these two groups (P<0.05). There was no significant difference in peak value and time to reach the peak on DOB curves of 13C-methacetin breath test after the two groups of mice were housed under the same condition for a month (P>0.05). Conclusion 13C-MBT facilitates the collection and evaluation of 13CO2 in the expired air of live mice, and yields precise reflection of alterations of liver function in acute liver injury and functional recovery.

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    Molecular mechanism of hyaluronan and CD44 on regulation of airway mucous hypersecretion
    YU Hong-mei, ZHOU Xiang-dong
    2010, 30 (1):  59. 
    Abstract ( 1841 )   PDF (4682KB) ( 1484 )  

    Objective To investigate the effects of hyaluronan (HA) and CD44 on airway mucous hypersecretion, and explore the molecular mechanism of activation of epidermal growth factor (EGF)/epidermal growth factor receptor (EGFR) signal transduction pathway by signal factors. Methods BEAS-2B airway epithelial cells were cultured in vitro, and were stimulated by neutrophil elastase (NE). Reactive oxygen species (ROS) scavenger (DMTU), hyaluronidase (Hase), CD44 antibody and tissue kallikrein (TK) inhibitor (PI) were served as interventional factors, and control group (serum free culture), NE stimulation group (50 nmol/L NE), DMTU+NE group (20 μmol/L DMTU+50 nmol/L NE), DMTU+Hase+NE group (20 μmol/L DMTU+10 μg/mL Hase+50 nmol/L NE), CD44Ab+NE group (5 μg/mL CD44Ab+50 nmol/L NE) and PI+NE group (100 μg/mL PI+50 nmol/L NE) were established. The expression of mucin (MUC) 5AC mRNA was detected by RT-PCR, the expression of MUC5AC and EGF protein was determined by ELISA, and the expression of phosphorylated epidermal growth factor receptor (p-EGFR) protein was analysed by Western blotting. Results The expression of MUC5AC, EGF and p-EGFR protein and MUC5AC mRNA in NE stimulation group was significantly higher than that in control group (P<0.01), the expression in DMTU+NE group was significantly lower than that in NE stimulation group (P<0.01), the expression in MTU+Hase+NE group was significantly higher than that in DMTU+NE group (P<0.05 for MUC5AC and p-EGFR protein and MUC5AC mRNA, and P<0.01 for EGF protein), the expression in CD44Ab+NE group and PI+NE group was significantly higher than that in NE stimulation group (P<0.05 for MUC5AC and p-EGFR protein and MUC5AC mRNA, and P<0.01 for EGF protein). Conclusion NE upregulates the expression of MUC5AC gene via OS/HA/CD44/TK/EGF/EGFR signal transduction pathway in airway epithelial cells.

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    Effects of nifedipine on proliferation of gingival fibroblasts in drug-induced gingival hyperplasia
    NI Jing, SHU Rong
    2010, 30 (1):  63. 
    Abstract ( 2323 )   PDF (3468KB) ( 1449 )  

    Objective To investigate the changes in proliferation index (PrI) of gingival fibroblasts in nifedipine-induced gingival hyperplasia (NIFr-HGF). Methods Gingival fibroblasts were derived from a patient with nifedipine-induced gingival hyperplasia. Cells were induced by 10 ng/mL and 1 000 ng/mL nifedipine (low- and high-concentration drug intervention groups), respectively. Cells were harvested 18 h and 30 h after intervention, cell cycles were detected by flow cytometry, and PrIs were calculated. NIFr-HGF without nifedipine induction were served as blank control. Results After induction for the same time, PrIs of NIFr-HGF cell cycle of low- and high-concentration drug intervention groups were significantly higher than those of blank control group (P<0.05), while there was no significant difference between low and high-concentration drug intervention groups (P>0.05). In low and high-concentration drug intervention groups, PrIs of NIFr-HGF cell cycle after intervention for 30 h were significantly higher than those after intervention for 18 h [(57.54±0.019)% vs (21.15±0.011)%, and (59.36±0.031)% vs (19.01±0.012)%, respectively] (P<0.05). Conclusion For patients with nifedipine-induced gingival hyperplasia, PrI of NIFr-HGF cell cycle increases with time of nifedipine intervention, while is not significantly related to drug concentration.

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    Accuracy of three dimensional facial measurement system based on structured light projection
    XIONG Yao-yang, CHEN Xiao-bo, SUN Jian, et al
    2010, 30 (1):  66. 
    Abstract ( 1665 )   PDF (6109KB) ( 1433 )  

    Objective To investigate the accuracy of three dimensional facial measurement system based on structured light projection, and explore the methods to reduce noise of the output images. Methods The known object for calibration was measured by the measurement system to correct the parameters of the system and enhance the measurement accuracy. The mechanism of noise was analysed, and the noise and sundry of the images were eliminated. Results The parameters of each assembly of system were obtained by calculation and calibrated, and the measurement accuracy (0.028 mm) of three dimensional facial measurement system based on structured light projection was increased. Application of image processing technology reduced the noise and sundry of output images. Conclusion The accuracy of three dimensional facial measurement system based on structured light projection is high. The image output is reliable, and can be clinically used in facial scanning and three dimensional reconstruction.

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    Original article (Clinical research)
    Change of serum Nogo-A protein in patients with acute closed brain injury
    LIN Zai-kai, TIAN Heng-li, WU Bing-shan, et al
    2010, 30 (1):  70. 
    Abstract ( 2083 )   PDF (3079KB) ( 1423 )  

    Objective To investigate the change of serum Nogo-A protein in patients with acute closed brain injury, and explore its relationship with the severity of neuronal damage and prognosis. Methods Thirty-one patients with acute closed brain injury were enrolled. Venous blood samples (2 mL) were obtained 1, 3 and 5 d after injury. Serum concentrations of Nogo-A protein were determined by ELISA. Patients were divided into mild (n=7), moderate (n=10) and severe (n=14) injury groups according to Glasgow coma score (GCS), and were divided into favorable prognosis (n=23) and poor prognosis (n=8) groups according to Glasgow outcome score (GOS). Another 20 healthy adults were served as controls. Results The mass concentrations of serum Nogo-A protein in mild, moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in control group (P<0.01), and the mass concentrations of serum Nogo-A protein in moderate and severe injury groups 1, 3, 5 d after injury were significantly higher than those in mild injury group (P<0.05, P<0.01). The mass concentrations of serum Nogo-A protein 1, 3, 5 d after injury were significantly higher in poor prognosis group than those in favourable prognosis group (P<0.01). Conclusion Serum Nogo-A protein level significantly increases after brain injury, and is related to the degree of injury and prognosis.

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    Combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure
    SUN Ying, XU Wen-yin, HU Jie, et al
    2010, 30 (1):  73. 
    Abstract ( 2503 )   PDF (2739KB) ( 1648 )  

    Objective To investigate the combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure. Methods Ninety patients receiving sevoflurane for adenotonsillectomy procedure were randomly divided into control group (administration of 0.1 mL/kg normal saline 30 min before the end of operation), tramadol group (administration of 1 mg/kg tramadol 30 min before the end of operation) and tramadol+propofol group (administration of 1 mg/kg tramadol 30 min before the end of operation and 1 mg/kg propofol at the end of operation). Time of extubation and time stayed in postanesthetic care unit (PACU) after operation were recorded, scores of Pediatric Anesthesia Emergence Delirium (PAED) Scale, modified Aldrete scores and pain scores were obtained immediately after entrance into PACU, and the prevalences of post-operative nausea and vomiting were observed. Results There was no significant difference in time of extubation, time stayed in PACU and modified Aldrete Scores among groups (P>0.05). There were significant differences in scores of PAED Scale immediately after entrance into PACU, with control group> tramadol group> tramadol+propofol group (P<0.05). The pain scores of tramadol group and tramadol+propofol group were significantly lower than that of control group (P<0.05). The prevalence of nausea and vomiting was the highest in tramadol group, and the prevalence in tramadol+propofol group was significantly lower than that in tramadol group (P<0.05). Conclusion The combination use of tramadol and low dose propofol can decrease the severity of emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure, and reduce the prevalence of nausea and vomiting.

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    Evaluation of fluid balance and dry weight with BIA in patients with maintenance hemodialysis
    LU Wei, JI Gang, CHEN Shun-jie, et al
    2010, 30 (1):  76. 
    Abstract ( 2608 )   PDF (4442KB) ( 1611 )  

    Objective To evaluate the fluid balance and dry weight with whole body bioelectrical impedance analysis (BIA) in patients with maintenance hemodialysis (MHD). Methods Twenty patients in stable condition with MHD for more than one year were selected (MHD group). Extra-cellular water (ECW) and intra-cellular water (ICW) were measured by BIA before hemodialysis, after hemodialysis and at intervals of hemodialysis (24 h and 48 h after hemodialysis), and related parameters were calculated. Whether patients with MHD achieved dry weight at 0 h was analysed, and the effects of average daily urine volume on ECW and ICW were explored. Another 20 healthy volunteers were served as controls. Results Compared with control group, ECW retrieved by ideal body weight was significantly higher before hemodialysis in MHD group (P<0.05). In MHD group, ECW was significantly lower after hemodialysis than that before hemodialysis (P<0.05). ECW/total body water (TBW) was significantly lower and ICW/TBW was significantly higher after hemodialysis than those before hemodialysis and at intervals of hemodialysis(P<0.05). ICW and ECW at each time point were significantly related to body weight. ICW and ECW retrieved by ideal body weight at 0 h and 24 h of those who achieved dry weight were significantly higher than those who did not achieve dry weight (P<0.05). ECW and ICW before hemodialysis and 24 h after hemodialysis were significantly lower in those with urine volume <400 mL/d than those with urine volume ≥400 mL/d (P<0.05). Conclusion BIA analysis indicates that changes of fluid balance before hemodialysis, after hemodialysis and at intervals of hemodialysis in patients with MHD are characterized by ECW, and ECW/TBW is a more sensitive parameter. ICW and ECW retrieved by ideal body weight may be sensitive parameters to determine the dry weight in patients with MHD.

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    Influence of nebulized Pulmicort respules inhalation after endoscopic sinus surgery on expression of ENaC protein
    JIANG Yi-ming, JIANG Xu-cheng, LI Ji-ping, et al
    2010, 30 (1):  80. 
    Abstract ( 2071 )   PDF (5416KB) ( 1440 )  

    Objective To investigate the influence of nebulized Pulmicort respules inhalation after endoscopic sinus surgery (ESS) on the expression of epithelial Na+ channel (ENaC) protein in nasal mucosa. Methods Forty-four patients with nasal polyps undergoing ESS were randomly divided into Pulmicort respules treatment group (n=21, nebulized Pulmicort respules inhalation for 10 d after ESS) and Rhinocort control group (n=23, Rhinocort aqueous nasal spray for 10 d after ESS). All the patients were performed biopsy of membrane on the residual middle turbinate 14 d after ESS, eosinophils (Eos) and neutrophils (Neu) per hundred inflammation cells were counted under microscope during ESS and after ESS, and the expression of ENaC protein was detected by immunofluorescence assay. Results The percentages of Eos and Neu decreased in two groups after treatment, and the percentage of Neu in Pulmicort respules treatment group was significantly lower than that in Rhinocort control group (P<0.05). The expression of ENaC protein after treatment in Pulmicort respules treatment group was significantly lower than that in Rhinocort control group (P<0.01). Conclusion Application of pulmicort respules after ESS can decrease Neu infiltration and inhibit expression of ENaC protein, which can relieve acute inflammation and edema of nasal mucosa.

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    Minimally invasive fixation of complex proximal tibial fractures by uniaxial and polyaxial locking plates
    LIU Jian-xing, YIN Xiao-fan, XU Jun
    2010, 30 (1):  84. 
    Abstract ( 1666 )   PDF (5294KB) ( 1498 )  

    Objective To investigate the clinical application of minimally invasive fixation of complex proximal tibia fractures by uniaxial and polyaxial locking plates. Methods The clinical data of 38 patients with minimally invasive fixation of complex proximal tibia fractures by uniaxial (n=21) and polyaxial (n=17) locking plates from January 2008 to June 2009 were retrospectively analysed, and the union rates and function recovery were compared between groups. Results All patients were followed up for 3 to 20 months, with an average of 12 months. All patients had bone union. The time of fracture union for fixation by uniaxial locking plates was 10 to 20 weeks, with an average of 14 weeks; and that for fixation by polyaxial locking plates was 11 to 18 weeks, with an average of 13 weeks. Evaluated by Johner-Wruhs method, there were 14 “excellent” cases, 5 “better” cases, 2 “good” cases and 0 “poor” case for fixation by uniaxial locking plates (rate of “excellent and better”, 90.4%), and there were 11 “excellent” cases, 5 “better” cases, 1 “good” case and 0 “poor” case for fixation by polyaxial locking plates (rate of “excellent and better”, 94.1%). Conclusion Minimally invasive fixation of complex proximal tibia fractures by uniaxial and polyaxial locking plates is stable, has less effects on bone blood supply, high bone union rate and favourable function recovery, and is an effective way in the treatment of complex proximal tibia fractures. Fixation by uniaxial locking plate has a better mechanical intensity, while fixation by polyaxial locking plate can adjust the screw angle according to fracture situation, which can be clinically applied accordingly.

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    Diagnosis and treatment of pediatric and hebetic adrenocorticotropic hormone secreting pituitary microadenoma
    ZHAO Jian-xiang, HE Hua, ZHAO Kai-jun, et al
    2010, 30 (1):  88. 
    Abstract ( 2856 )   PDF (3176KB) ( 1517 )  

    Objective To investigate the methods of diagnosis and treatment of pediatric and hebetic adrenocorticotropic hormone (ACTH) secreting pituitary microadenoma. Methods The data of 10 patients with ACTH secreting pituitary microadenoma were retrospectively analysed. ACTH secreting pituitary microadenoma was diagnosed by clinical manifes-tations, biochemical and imaging findings, and 5 patients underwent bilateral inferior petrosal sinus sampling (BIPSS). Transsphenoidal surgery was performed on all the patients under microscope, and the tumor specimens were detected by immunohistochemistry. Results Immunohistochemical examination revealed that ACTH was positive in 8 cases and negative in 2 cases. Patients were followed up for 12 to 63 months, 7 cases (70%) were cured, one (10%) achieved remission, and the other two (20%) experienced recurrence. Conclusion BIPSS is helpful in the diagnosis and localization of pediatric and hebetic ACTH pituitary microadenoma, and transsphenoidal surgery is the optimal choice of treatment.

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    Original article (Public health administration)
    Empirical analysis of economies of scale in public hospitals of Zhejiang Province
    ZHAO Ming, MA Jin
    2010, 30 (1):  91. 
    Abstract ( 1789 )   PDF (3439KB) ( 1358 )  

    Objective To analyse the economies of scale in public hospitals in Zhejiang Province. Methods One hundred and twenty-five public hospitals in Zhejiang Province with qualification no less than class two level two were selected as sample hospitals. Douglas production function was employed to analyse the relationship between investment and output in sample hospitals between 2004 to 2006, with two types of production models established by medical service and incomes in hospitals as dependent variables. Results From 2004 to 2006, the medical service and incomes of sample hospitals were in line with economies of scale. The production increase rate was higher than investment increase rate. The medical service, incomes, total assets and number of staff in class three hospitals were higher than those in class two hospitals (P=0.000). Conclusion Economies of scale is the ultimate incentive to continuous outstretch for hospitals. Hospitals should rationally control the scale so as to avoid problems in medical service caused by overstretch.

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    Review
    Research progress of role of innate immunity in infection of leptospira
    DENG Cong
    2010, 30 (1):  94. 
    Abstract ( 1751 )   PDF (4372KB) ( 1384 )  

    Leptospirosis is an important zoonosis with worldwide distribution. As the first procedure in immunity system, the role and significance of innate immunity in controlling infection at the early stage of the disease have gradually been emphasized. Macrophages can phagocytize and kill leptospira, while the pathogenic leptospira can evade the killing by macrophages. In addition, neutrophils, complement system and cytokines also contribute to the defence of leptospira infection.

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    Research progress of mechanisms of Acinetobacter baumannii resistance to β-lactam antibiotics
    HOU Pan-fei
    2010, 30 (1):  98. 
    Abstract ( 2047 )   PDF (6814KB) ( 1879 )  

    Acinetobacter baumannii, a glucose-nonfermentative gram-negative coccobacillus, is an important pathogen isolated in nosocomial infections, and the clinical detection rate has been increasing in recent years. Acinetobacter baumannii attracts widespread attention due to strong viability, broad resistance spectrum and high rate of drug resistance. The resistance mechanisms include the production of β-lactamases, alterations in penicillin-binding proteins, decreased outer membrane permeability and overexpression of active efflux pumps. The mechanisms of Acinetobacter baumannii resistance to β-lactam antibiotics, especially those of the outer membrane porin and active efflux system are reviewed in this paper.

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    Research advances in peroxisome proliferator activated receptor-gamma and renal fibrosis
    LU Ying
    2010, 30 (1):  104. 
    Abstract ( 1684 )   PDF (4477KB) ( 1278 )  

    The end stage of chronic renal diseases is characterized by glomerular sclerosis and interstitial fibrosis. Studies have revealed that effective amelioration of renal fibrosis can significantly delay the progression of chronic renal diseases. Peroxisome proliferator activated receptors (PPARs) are ligand-activated nuclear transcriptional factors of the nuclear hormone receptor superfamily, and PPAR-γ is one of the phenotypes of PPARs. The effect of PPAR-γ on inhibiting renal fibrosis has become a hot spot. In this article the research advances of PPAR-γ in amelioration of renal fibrosis are reviewed.

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    Research on cortical stimulation for treatment of stroke
    GUAN Hong-xin, XIAO Yun-shi
    2010, 30 (1):  108. 
    Abstract ( 1683 )   PDF (4438KB) ( 1293 )  

    Stroke is characterized by a group of acute cerebral vascular diseases which attack acutely with focal neurological deficits. Residual motor deficits often sojourn after stroke. Cortical stimulation, which is a technique developed many decades ago, has recently re-emerged as a promising method for researchers in their quest to causally probe cortical representations of sensorimotor and cognitive functions and to facilitate the treatment of various neuropsychiatric disorders. The article summarizes the research progress of cortical stimulation in the promotion of motor function recovery after stroke, the method of operation, the possible mechanisms and the prospect.

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    Technique and method
    Computer-aided surgical simulation and navigation in reconstruction of old maxillofacial fractures
    LIN Yan-ping, CHEN Xiao-jun, ZHANG Shi-lei, et al
    2010, 30 (1):  112. 
    Abstract ( 1952 )   PDF (6013KB) ( 1690 )  

    Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the healthy side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.

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    Case report
    One case report of successful treatment of severe myocarditis mimicking acute myocardial infarction by intra-aortic balloon counterpulsation
    YIN Gui-zhi, ZHANG Da-dong, HU Wei, et al
    2010, 30 (1):  116. 
    Abstract ( 1799 )   PDF (2270KB) ( 1122 )  

    An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECG, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers (significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.

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    Four cases report of functional visual loss
    HUANG Zhu, XIN Dan-li, GU Yang-shun
    2010, 30 (1):  118. 
    Abstract ( 1808 )   PDF (3106KB) ( 1272 )  

    Functional visual loss is caused by the functional disturbance of visual cortical area, which is induced by strong emotion impact. With the characteristics of diverse clinic symptoms, functional visual loss is usually hard to be identified and diagnosed. Four cases of functional visual loss are reported in this article. The patients were diagnosed by the query of medical history, observation of behavior and some examinations such as foggy test. The patients received suggestibility treatment, and achieved favourable therapeutic effect.

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