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    Original article (Basic research)
    RNA-Seq based analysis on cSNP and gene expression level
    LI Shao-bo, FU Guo-hui
    2014, 34 (2):  129. 
    doi: 10.3969/j.issn.1674-8115.2014.02.001

    Abstract ( 1832 )   PDF (571KB) ( 1547 )  

    Objective To establish the analytical method for cSNP and gene expression difference based on transcriptome RNA-Seq data, and to screen SNP loci that may alter protein functions and gene expression difference among different cell phenotypes. Methods RNA-Seq was performed for normal cultured gastric cancer cell lines MKN28 and SGC7901. The sequencing data was then compared with the reference genome and the statistic analysis was conducted for the number of reads, sequenced genes, upregulated genes of MKN28 and SGC7901, and SNP and variable splicing patterns. Online software, database and computer programming were combined to screen and predict functions of SNP in transcriptome sequencing data of two gastric cancer cell lines, and to perform analysis and comparison for the GO clustering results of differentially expressed genes. Results The SNP of 709 genes belonging to 8 different gene terms were screened and predicted and 6 cSNPs that could cause protein functional alterations were identified. The expression of serine/threonine kinase in two cell lines were obtained by analyzing gene expression differences. Some of the analytical results were confirmed by the Western blotting and PCR. Conclusion An analytical method for cSNP data of transcriptome sequencing is established. This method can efficiently screen and analyze massive SNP data. A set of protein kinase genes with high expression in MKN28 and low expression in SGC7901 are obtained by clustering analysis and comparision. These results are basis for further experiments.

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    Effects of sub-chronically exposure to lead and benzo (α) pyrene (B [α]P) on calcium ion concentration and ATPase in mice hippocampus
    NI Jia-le, DUAN Li, ZHU Wei-jie, et al
    2014, 34 (2):  134. 
    doi: 10.3969/j.issn.1674-8115.2014.02.002

    Abstract ( 734 )   PDF (322KB) ( 823 )  

    Objective To observe the influence of sub-chronical exposure to lead and benzo (α) pyrene (B[α]P) on mouse behaviors, calcium ion concentration and ATPase of hippocampus, and to explore joint toxical effects on the possible mechanisms of neurobehavioral toxicity. Methods Eighty mice were randomly divided into five groups (n=16): the blank control group, solvent control group (vegetable oil), lead group (54 mg/L lead acetate), B[α]P group (5 mg/kg B[α]P), and lead+B[α]P group (54 mg/L lead acetate+5 mg/kg B[α]P). Lead acetate dissolved in drinking water was given every day, while B[α]P was administered intraperitoneally four times a week. After being exposed for eight weeks, the learning and memory functions of mice were measured by Morris water maze. The concentration of Ca2+ in hippocampus was detected by fluorescent labeling and the colorimetric technique was used to detect the activity of Na+,K+-ATPase and Ca2+,Mg2+-ATP in hippocampus. Results The results of morris water maze test showed that mice given lead or/and B[α]P exhibited a significant decrease in spacial learning and memory as compared to control groups (P<0.05). Lead+B[α]P group was decreased far more than lead group and B[α]P group (P<0.05). The levels of Na+,K+-ATPase and Ca2+,Mg2+-ATPase of the hippocampus in lead or/and B[α]P group were significantly decreased (P<0.05), while levels of Ca2+ were significantly increased as compared to control groups (P<0.05). The lead+B[α]P group had significantly lower activities of Na+,K+-ATPase and Ca2+,Mg2+-ATPase (P<0.05) and much higher concentration of Ca2+ than those of lead group and B[α]P group (P<0.05). Conclusion The combination of lead and B[α]P can impair the learning and memory functions of mice, and the possible mechanisms of behavioral deficits may be due to increased Ca2+ concentration and the decreased activities of Na+,K+-ATPase and Ca2+,Mg2+-ATPase in the hippocampus.

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    Suppressive effect of metabotropic glutamate receptor 4 on neuropathic pain by Rab5
    CHEN Rui, WANG Hua, JIANG Wei
    2014, 34 (2):  139. 
    doi: 10.3969/j.issn.1674-8115.2014.02.003

    Abstract ( 846 )   PDF (451KB) ( 973 )  

    Objective To explore the mechanism of neuropathic pain suppression by activating metabotropic glutamate receptor 4 (mGluR4). Methods Firstly, 24 SD rats were randomly divided into blank control group (n=6), shame operation group (n=6), and SNL group (n=12) after intrathecal catheterization. Rats in control group were only undergone the intrathecal catheterization. Values of 50%PWT were measured for other rats before surgery and 1~6 d after surgery. Then, rats in SNL group were randomly divided into SNL+saline group (n=6) and SNL+VU0155041 group (n=6) and received intrathecal injection of saline and VU0155041(500 nmol) 10 μL twice a day for seven days, respectively. Values of 50%PWT were measured before injection and 30 min after injection. Finally, left spinal dorsal horn of the spinal enlargement of control group, SNL+saline group and SNL+VU0155041group were obtained 1h after last injection and submitted for gene chip examination. The expression of mGluR4 and the subtypes of Rab5 were determined by Western blotting. Results During 1~6 d after surgery, values of 50%PWT of ipsilateral hindpaws in SNL group were significantly lower than those of the blank control group and shame operation group (P<0.01); the values of 50%PWT of the ipsilateral hindpaws in SNL+VU0155041 group were gradually higher than those of SNL+saline group from the forth day after injection (P<0.01); and the results of Agilent gene chip showed that Rab5 in SNL+saline group was higher than that of control group, while control group has no difference with SNL+VU0155041 group. The expression of mGluR4 in SNL+saline group was significantly lower than that of control group and SNL+VU0155041 group (P<0.05), but the expression of Rab5A and Rab5C were significantly higher than those of control group and SNL+VU0155041 group (P<0.05), and the differences of Rab5B expression among three groups were not statistically significant (P>0.05). Conclusion The activation of mGluR4 can affect neuropathic pain by regulating neurotransmitter release of synaptic vesicles through Rab5A and Ran5C.

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    Effect of curcumin on expression of VEGF in polycystic ovary syndrome rat models
    WANG Lian-lian, LI Cong, MENG Jiang-ping, et al
    2014, 34 (2):  144. 
    doi: 10.3969/j.issn.1674-8115.2014.02.004

    Abstract ( 1147 )   PDF (322KB) ( 1128 )  

    Objective To explore the effect of curcumin on the expression of VEGF in the polycystic ovary syndrome (PCOS) rat models. Methods Sixty immature female rats of 42 d old were selected. The PCOS rat model was established by injecting dehydroepiandrosterone and insulin. The rats were randomly divided into four groups, namely normal control group, model control group, lose-dose curcumin group, and high-dose curcumin group. The serum VEGF expression was measured by enzyme linked immunosorbent assay (ELISA); the expression of VEGF in the ovarian tissues was detected by immunohistochemical SP method; and protein level of VEGF was measured by Western blot. Results The results of ELISA showed that the expression level of VEGF in the serum of PCOS rats from the model group was significantly higher than that of the normal group (P<0.01). After curcumin was intraabdominally given, the expressions of VEGF in low- and high-dose curcumin groups were lower than that in the model group, and the expression of VEGF in high-dose group was lower than that in lose dose group (P<0.05). The results of immunohistochemical SP method and Western blotting showed that in ovarian tissues, the expression of VEGF protein in the model group was significantly higher than that in the normal group (P<0.01). After curcumin was given, the expressions of VEGF in high- and low-dose curcumin groups decreased, and the expression of VEGF in high-dose group was significantly lower than that in low-dose group (P<0.05). Conclusion Curcumin can lower the expression of VEGF in ovarian tissues of PCOS rats, and it may have certain therapeutic effect on PCOS.

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    Effects of low molecular weight heparin on proliferation of human hepatocacinoma cells and its mechanism
    YU Bei-kai, CHENG Long, ZHAI Wei-wei, et al
    2014, 34 (2):  149. 
    doi: 10.3969/j.issn.1674-8115.2014.02.005

    Abstract ( 692 )   PDF (618KB) ( 1102 )  

    Objective To investigate the effects of low molecular weight heparin (LMWH) on proliferation and cell cycle distribution of human hepatocacinoma cell line SMMC-7721 cultured in vitro,  and expressions of Skp2 and c-Myc relevant to cycle regulation. Methods SMMC-7721 cells were cultured in vitro then treated by LMWH of different concentrations for different periods of time. Then the cell survival and growth were determined by MTT assay. After cells of negative control group and LMWH treated groups (400 IU/mL and 800 IU/mL) were cultured for 36 h, the cell cycle distributions were analyzed by flow cytometry; alterations of Skp2 and c-Myc mRNA were examined by RT-PCR; and expression alterations of Skp2 and c-Myc proteins were investigated by Western blotting. Results Compared to negative control group, the cell proliferation of LMWH treated groups was inhibited and presented dose-dependent and time-dependent within a certain range. The cell cycle distributions altered and with the increasing of LMWH dose, the percent of cells in S phase decreased (P<0.05) and G0/G1 phase increased (P<0.05). In addition, the mRNA and protein expressions of Skp2 and c-Myc were dose-dependently reduced (P<0.05). Conclusion LMWH can inhibit the proliferation of SMMC-7721 cells. The mechanism may be relevant to reducing the expressions of Skp2 and c-Myc and arresting cell cycle at G0/G1 phase and consequently decreasing the cell proliferation index.

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    Original article (Clinical research)
    Effect of anti-tuberculosis drug-induced hepatotoxicity on plasma microRNA expression
    YE Chang-gen, XIE Ping, LIU Liang-ming, et al
    2014, 34 (2):  154. 
    doi: 10.3969/j.issn.1674-8115.2014.02.006

    Abstract ( 892 )   PDF (547KB) ( 1186 )  

    Objective To investigate the effect of anti-tuberculosis drug-induced hepatotoxicity (ATDH) on the expression of miRNA in patients′ plasma. Methods The plasma from 3 patients with ATDH was collected and subjected to miRNA microarray analysis before anti-tuberculosis treatment and after liver injury during drug therapy. The differentially expressed miRNAs were verified using real-time quantitative PCR. The target genes of miRNAs were predicted by the Internet software, and the GO functional classification of target proteins were found by the PANTHER protein classification system. Results After ATDH had occurred, the microarray screened 22 differentially expressed miRNAs compared to those of pretreatment, among which 11 were up-regulated, and 11 were down-regulated. Real-time quantitative PCR results showed that after ATDH there were 5 up-regulated miRNAs, namely miR-378i, miR-125b-5p, miR-1224-5p, miR-194-5p and miR-34a-5p, and 3 down-regulated miRNAs, namely miR-1260a, miR-338-3p and miR-4286. Conclusion There are differentially expressed miRNAs in the plasma of patients after ATDH, and these miRNAs may be related to the incidence of ATDH.

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    The role of intraoperative transesophageal echocardiography in minimally invasive reoperative tricuspidal surgery by applying intraluminal occlusion for both caval veins
    JIANG Zhao-lei, MEI Ju, WU Shu-bin, et al
    2014, 34 (2):  161. 
    doi: 10.3969/j.issn.1674-8115.2014.02.007

    Abstract ( 1005 )   PDF (341KB) ( 1130 )  

    Objective To explore the value of intraoperative transesophageal echocardiography (TEE) in minimally invasive reoperative tricuspidal surgery by applying intraluminal occlusion for both caval veins. Methods From December 2002 to June 2012, 46 consecutive reoperative tricuspid valve operations were performed through a minimally invasive approach in the right fourth intercostal space without aortic cross-clamping, including 27 males and 19 females with ages between 13~67 years. TEE was used for monitoring and cooperation during the course of operations, estimating the degree of the TR, and guiding the occlusion of superior vena cava (SVC) and the inferior vena cava (IVC). Results All 46 patients underwent minimally invasive reoperative tricuspidal surgery successfully under the guidance of TEE. There were no cardiopulmonary bypass accidents during operations. The position and size of the balloons of two patients were readjusted to block caval veins completely under the guidance of TEE. The average time of operation was (161±52) min. The average time of building cardiopulmonary bypass (CPB) was (55±15) min and the average time of CPB was (58±23) min. TEE showed that all patients had no tricuspid incompetence during operations. Paravalvular leakage did not occur in tricuspid valve replacement (TVR).  All patients were successfully treated and discharged. Conclusion TEE can safely and reliably guide and monitor the operation when performing minimally invasive repeated isolated tricuspid valve surgery with vena cava intraluminal occlusion technique. Hence it has important application value.

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    Comparison of SinoSCORE and EuroSCORE in prediction of early mortality in off-pump coronary artery bypass surgery
    LIAN Feng, DAI Chen-yang, ZHANG Wen-tian, et al
    2014, 34 (2):  165. 
    doi: 10.3969/j.issn.1674-8115.2014.02.008

    Abstract ( 1481 )   PDF (257KB) ( 1173 )  

    Objective To compare the prediction value of the Chinese System for Coronary Operative Risk Evaluation (SinoSCORE) and the European System for Cardiac Operative Risk Evaluation (EuroSCORE) for patients undergoing off-pump coronary artery bypass (OPCAB) surgeries in China, and to confirm the fitness of SinoSCORE for predicting OPCAB. Methods The data of patients who underwent OPCAB between July 2004 and July 2013 in Department of Cardiovascular Surgery of Renji Hospital, Shanghai Jiao Tong University School of Medicine, was collected.SinoSCORE and EuroSCORE were used separately to predict the mortality which was then compared with the observed mortality.The end point of the study was postoperative in-hospital death. Hosmer-Lemeshow goodness-of-fit test was adopted to evaluate calibration.The area under the receiver operating characteristic (ROC) curve was used to assess the discrimination. Results Among 1 530 patients, 23 died in hospital and the observed mortality was 1.50%. The predicted mortalities of SinoSCORE and EuroSCORE were 2.69% and 4.73%, respectively. Hosmer-Lemeshow test for SinoSCORE was non-significant (P=0.612) and the area under ROC curve (AUC) was 0.796.For EuroSCORE, the Hosmer-Lemeshow test was significant (P=0.013) and the area under ROC curve was 0.782.Both SinoSCORE and EuroSCORE showed good discrimination, but the calibration and prediction of SinoSCORE were better than EuroSCORE. Conclusion SinoSCORE is more suitable than EuroSCORE for predicting postoperative in-hospital mortality of OPCAB patients in China. Moreover, SinoSCORE is an appropriate assessment system for in-hospital mortality prediction for patients undergoing OPCAB in China.

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    Correlation between erectile function and serum testosterone in old and middle-aged males
    LIANG Guo-qing, YU Xiao-hua, WU Min, et al
    2014, 34 (2):  169. 
    doi: 10.3969/j.issn.1674-8115.2014.02.009

    Abstract ( 1090 )   PDF (274KB) ( 1016 )  

    Objective To study the relationship of erectile function (EF) and serum total testosterone (TT), free testosterone (FT), and bioavailable testosterone (Bio-T) of old and middle-aged males. Methods The International Index of Erectile Function questionnaires was used to evaluate 236 people with normal EF, 369 patients with mild erectile dysfunction (ED), and 390 patients with moderate and severe ED. The serum total testosterone (TT) and sex hormone-binding globulin (SHBG) were measured by chemilum inescentenzyme immunoassay (CLIA) method, and free testosterone (FT) and bioavailable testosterone (Bio-T) levels were calculated. Results The incidence of ED was 76.28% among old and middle-aged males and increased significantly with the age. The TT levels of ED patients were slightly lower than those of people with normal EF (P>0.05). While FT and Bio-T values were significantly lower than those of people with normal EF (P<0.01). The variations of TT among ED patients with different IIEF scores are not regular, while FT and Bio-T decreased significantly with decreasing of IIEF score. Pearson regression analysis revealed that TT was not related to IIEF score, while FT and Bio-T were significantly related to IIEF score (P<0.01). Conclusion The incidence of ED among old and middle-aged males increases significantly with the age. The TT level is not significantly related to ED, but FT and Bio-T are significantly related to ED. The endocrine diagnostic value of FT and Bio-T is better than TT and can reflect the serum testosterone level of ED patients more accurately.

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    Evaluation of the influence of keratinized mucosa width on peri-implant soft and hard tissue health
    ZHANG Yun-xin, SHU Rong, XIE Yu-feng
    2014, 34 (2):  173. 
    doi: 10.3969/j.issn.1674-8115.2014.02.010

    Abstract ( 2831 )   PDF (260KB) ( 1184 )  

    Objective To investigate the influence of peri-implant keratinized mucosa width on the health of peri-implant soft and hard tissues after restoration for 12 months. Methods Forty Straumanns' implants were planted in 25 patients. After the final prostheses were restored, the keratinized mucosa width (KMW) was measured in the middle buccal of the implants. Implants were divided into two groups: KMW≥2 mm and KMW<2 mm (n=20). Radiographs for bone loss were taken and bleeding on probing (BOP), plaque index (PLI), gingival index (GI), probing depth (PD) and mucosal recession were measured at the restoration day (baseline), 6 and 12 months after restorations. Results After restoration for 12 months, PLI and BOP scores of both groups were significantly higher than those of baseline (P<0.05), and plaque index values of KMW<2 mm group were significantly higher than those of KMW≥2 mm group (P<0.05). The mucosal recession around implants of KMW<2 mm group was obvious. The differences of PD and marginal bone loss around implants of two groups were not statistically significant (P>0.05). Conclusion The keratinized mucosa may have positive effects on plaque control and mucosal recession around dental implants, but the exact effect needs further study and longterm observation.

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    Long-term quetiapine therapy on the cognitive function in patients with Alzheimer′s disease
    SHEN Li-li, XIE Fan, YAO Pei-fen, et al
    2014, 34 (2):  177. 
    doi: 10.3969/j.issn.1674-8115.2014.02.011

    Abstract ( 1582 )   PDF (258KB) ( 1011 )  

    Objective To investigate the effect of long-term administration of quetiapine on the cognitive function of patients with Alzheimer′s disease (AD). MethodsFifty-one AD outpatients with psychological and behavioral symptoms were randomly divided into treatment group (taking quetiapine, n=26) and control group (n=25). Cognitive Abilities Screening Instrument (CASI) and Alzheimer′s Disease Assessment Scale (ADAS-cog) were used to assess the cognitive function of two groups before treatment (baseline), and three months, six months after treatment. Results The baseline scores of CASI and ADAS-cog of two groups were not statistically significant (P>0.05). Three months after treatment, the scores of CASI and ADAS-cog increased but were not statistically significant (P>0.05). Six months after treatment, the scores of CASI and ADAS-cog further increased. The scores of treatment group were obviously higher than those of the control group and statistically significant (P<0.05). Conclusion Long-term administration of quetiapine may cause an adverse impact on the cognitive function of AD patients.

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    Related factors of the recurrence of Ureaplasma urealyticum infection in genital tract
    FAN Yu-ping, HU Ye, PAN Jia-ping, et al
    2014, 34 (2):  181. 
    doi: 10.3969/j.issn.1674-8115.2014.02.012

    Abstract ( 2512 )   PDF (193KB) ( 1144 )  

    Objective To analyze relevant factors of recurrences of Ureaplasma urealyticum (Uu) infections after treatment. Methods Eighty-nine male cases of Uu infection were followed up for more than two weeks after being treated and cured by antibiotics. Questionnaire surveys were conducted among them with respect to National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), living habits such as smoking, drinking, sitting for long time, eating peppery foods, and riding bicycles, satisfactory level of sexual activities, sexual frequency, and Uu infections of sexual partners. Results All 89 cases were followed up for (1.62±0.89) months and 13 of cases recurred after being cured for more than two weeks. The recurrence rate was 14.61%. Recurrences of Uu infections after being cured were positively correlated with long time sitting, eating peppery foods, and Uu infections of sexual partners, and negatively correlated with sexual frequency. Conclusion During the treatments of Uu infections, avoiding living habits that may induce chronic prostatitis and cross infections of sexual partners are helpful for preventing recurrences after being cured.

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    Therapeutic effect of vacuum sealing drainage to severe burn combined with systemic inflammatory response syndrome
    SU Wei-guo, WANG Ping-li, WEI Ying, et al
    2014, 34 (2):  184. 
    doi: 10.3969/j.issn.1674-8115.2014.02.013

    Abstract ( 943 )   PDF (492KB) ( 1114 )  

    Objective To observe the therapeutic effect of vacuum sealing drainage in severe burns with the systemic inflammatory response syndrome (SIRS). Methods A total of 36 cases of severe burn combined with SIRS were divided into treatment group (n=18) and control group (n=18). Vacuum sealing drainage was used for treatment group while the sulfadiazine silver was used for the control group. The incidence of complications, exudation of 1% total body surface area (TBSA), cost of hospitalization, use of human serum albumin and red blood cell of each group were compared within 7 d after surgery. The leucocyte count, percentage of neutrophile granulocyte, C reactive protein (CRP) and procalcitonin (PCT) were compared between two groups before surgery and at 24, 72, and 120 h after surgery. Results The incidence of complications of treatment group was less than the control group after surgery (P<0.05). The cost of 1% TBSA hospitalization, consumption of red blood cell and human serum albumin, and exudation within 7 d after surgery were all significantly lower than those of control group, the difference was statistically significant (P<0.05). The leucocyte count, percentage of neutrophile granulocyte, CRP, and PCT after surgery being performed 24 h were all significantly lower than those of control group, the difference was statistically significant (P<0.05). Conclusion Vacuum sealing drainage is an efficient method to treat severe burn combined with SIRS. It can reduce the incidence rate of sepsis and other complications and cost of hospitalization.

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    Effects of diabetes on laparoscopic cholecystectomy in elderly patients
    HU Feng, SHAO Chong-fei, ZHANG Zhong-qi
    2014, 34 (2):  189. 
    doi: 10.3969/j.issn.1674-8115.2014.02.014

    Abstract ( 909 )   PDF (258KB) ( 931 )  

    Objective To explore the effect of diabetes on post-operative complications in elderly patients with laparoscopic cholecystectomy (LC). Methods Clinical data of 145 patients underwent LC (age≥60 years) were retrospectively analyzed. The incidences of complications were compared between diabetic and non-diabetic patients. Results There were 52 cases in the diabetic patient group, among which there were 5 ruptured gallbladder cases, 4 bile leakage cases, 4 wound infection cases, 3 abdominal infection cases, 4 pulmonary infection cases, 1 duodenal injury case, 1 umbilical hernia case, 3 intra-abdominal hemorrhage case, 1 bile duct injury case, and 3 residual bile duct stones cases. The post-operative complication rate was 19.2%. There were 93 cases in the non-diabetic patient group, among which there were 1 ruptured gallbladder case, 1 pulmonary infection case, 3 bile duct injury cases, 2 subcutaneous emphysema cases, and 3 residual bile duct stones cases. The post-operative complication rate was 8.6%. Six cases of diabetic patient group were undergone convertion laparotomy, while only two cases of nondiabetic patient group were undergone convertion laparotomy. The rates of convertion laparotomy were 11.5% and 2.2%, respectively. The difference was statistically significant (P<0.05). The rates of intraoperative rupture of the gallbladder, bile leakage and wound infection of diabetic patient group were significantly higher than those of non-diabetic patient group (P<0.05). The hospital days of diabetic patient group were also significantly longer than those of non-diabetic patient group (P<0.05). Conclusion Diabetes is one of the risk factors of operative complications after laparoscopic cholecystectomy and to which attention should be paid. The blood glucose of elderly diabetic patients should be regularly monitored during the peri-operative management. Intensive insulin therapy may performed to reduce the incidence of complications if necessary.

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    Study on antagonistic effects of zinc supplementation during pregnancy on mother-infant mercury toxicity and its anti-oxidative damage mechanism
    ZHU Hong, YANG Zu-jing, HUI Ning, et al
    2014, 34 (2):  193. 
    doi: 10.3969/j.issn.1674-8115.2014.02.015

    Abstract ( 805 )   PDF (327KB) ( 997 )  
    Objective To investigate the antagonism of zinc to mercury caused toxicity in mothers and fetuses and its anti-oxidation mechanism. Methods According to the levels of maternal blood mercury at middle and late pregnancy, 90 pregnant women were divided equally into the case group, the treatment group, and the control group. The levels of maternal blood mercury and zinc, and neonatal growth and development indexes of three groups were compared. The levels of glutathione peroxidase (GSH-PX), superoxidase dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) in placenta were detected by lipid peroxidation kit. Results The level of maternal blood mercury at late pregnancy of the treatment group was lower than that of the case group, while the level of zinc was higher than that of the case group and the difference was statistically significant (P<0.05). The level of maternal blood mercury of the treatment group at late pregnancy was lower than that
    at middle pregnancy, while the level of zinc was higher than that at middle pregnancy and the difference was also statistically significant (P<0.05). The head circumference, crown-heel length, and birth weight of neonates of the case group were significantly lower than those of the treatment group in which the data were better (P<0.05). The levels of GSH-PX, SOD, and CAT in placenta of the treatment group were higher than those of the case group, but lower than those of the control group. The level of MDA in placenta of the treatment group was lower than that of the case group, but higher than that of the control group, and the differences were statistically significant (P<0.05). Conclusion Zinc supplement during pregnancy can antagonize mercury caused toxicity in mothers and fetuses. Antioxidant effect of zinc may be one of the important mechanisms.
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    Analysis of thyroid function in pregnant women of different stages of gestation and ages
    LU Yong-xia, LI Qi-fu, SHU Xiao-yu, et al
    2014, 34 (2):  197. 
    doi: 10.3969/j.issn.1674-8115.2014.02.016

    Abstract ( 924 )   PDF (256KB) ( 985 )  
    Objective To discuss the levels of thyroid related hormones and incidence of hypothyroidism at different gestational ages and in different stages of gestation. Methods The 734 pregnant women without thyroid related medical history were selected for the study and 108 healthy non-pregnant women were selected as the control group. All these gravidas were divided into different groups by age (group A: <28 years, group B: 28-34 years, and group C: 35-43 years) and by the duration of pregnancy (group T1: 0-13+6 weeks, group T2: 14-27+6 weeks, and group T3: 28 weeks-delivery). The free triiodothyronire (FT3), free thyroxine (FT4), and thyroid stimulating hormore (TSH) levels were measured by chemiluminescent method. Results The differences of thyroid related hormone (FT3, FT4, and TSH) levels of
    pregnant women in each stages of gestation and women in the control group were statistically significant (P<0.01). For T2 and T3 groups, the levels of FT3 and FT4 were lower than those of T1 group, while the level of TSH was higher than that of T1 group, and the incidence of hypothyroidism of FT3 and FT4 groups were obviously higher than that of T1 group. All these differences were statistically significant (P<0.05). But the differences of incidence of subclinical hypothyroidism among each stages of gestation were not statistically significant (P>0.05). For group C, the levels of FT3 and FT4 were lower than those of group A, while the level of TSH was higher than that of group A, and the differences were statistically significant (P<0.05). TSH increased with age. But the differences of incidence of hypothyroidism and subclinical hypothyroidism among gestational age groups were not statistically significant (P>0.05). Conclusion The thyroid related hormone levels are closely related to gestational ages and stages of gestation. Detection of gestational thyroid hormone levels plays an important role in screening and intervention of hypothyroidism.
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    Original article (Preventive medicine)
    Exposure to household insecticides and risk of childhood acute leukemia
    CHEN Di-di, ZHANG Yan, SHI Rong, et al
    2014, 34 (2):  201. 
    doi: 10.3969/j.issn.1674-8115.2014.02.017

    Abstract ( 788 )   PDF (314KB) ( 1236 )  
    Objective To investigate the relationship between household insecticides exposure and the incidence of childhood acute leukemia (AL) for different development periods of children. Methods We interviewed parents/guardians of children from case group and control group which matched the case group with respect to gender, age, and location of residence. Information on normal sociodemographic characteristics of subjects and household insecticides usage during their different development periods was collected. The results of investigation were processed by conditional logistic regression analysis and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results The rate of household insecticides usage of case group was higher than that of the control group. Mainly used insecticides were mosquito repellent and cockroach killer. The incidence of childhood AL may increase when household insecticides were used (OR=6.3, 95%CI: 1.4-28.7) and cockroach killer was used (OR=7.8, 95%CI: 1.6-37.7) during the period of 0-3 years old, and mosquito repellent was used (OR=3.3, 95%CI: 1.1-10.2) during the most resent year. Besides, the incidence of childhood AL might also increase when the usage frequency of mosquito repellent (OR=5.8, 95%CI: 1.1, 30.1) and cockroach killer (OR=8.9, 95%CI: 1.5, 52.2) increased. Conclusion Household insecticides exposure during the period of 0-3 years old
    and the most resent year may increase the risk of childhood AL.
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    Status of oral health service needs, demands, and utilization of Shanghai residents
    LI Cun-rong, WANG Yan
    2014, 34 (2):  206. 
    doi: 10.3969/j.issn.1674-8115.2014.02.018

    Abstract ( 938 )   PDF (300KB) ( 1019 )  
    Objective To understand Shanghai residents′ needs, demands, and utilization of oral health services, and to provide references for making and regulating oral health policies. Methods The data of Shanghai residents′ needs, demands, and utilization of oral health services from the third national oral health epidemiological sampling survey was statistically analyzed. Results Caries prevalence rates of 4 age groups was between 34.6%-99.2%. Gingival bleeding and calculus detection rate of the 35-44 years of age group was nearly 90%. Periodontal pocket detection rate of the 65-74 years of age group was as high as 66.1%, and the edentulous jaw rate of the 65-74 years of age group was 10.8%. The hospital visit rate within 6 months was 10%-20.4%. And 60.4% of the 5 years of age group had never visited dentists. Most residents would choose stomatological hospitals above count level, health centers, community centers, and district dental centers. For medical fees, 63.9% of the 35-44 years of age group had no medical insurances, while 65.5% of the 65-74 years of age group had medical insurances. Conclusion Shanghai residents′ oral health service needs are huge. Oral health demands and needs do not match. Oral health service utilization rate is low. It is necessary to strengthen the construction of district dental centers and Shanghai oral health service network and system, and extensively carry out oral health education.
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    Original article (Public health administration)
    Cognition on general practice curriculum structure of clinical teachers in Shanghai communities and policy suggestion
    WANG Su-ping, YANG Tao, GONG Rui-jie, et al
    2014, 34 (2):  211. 
    doi: 10.3969/j.issn.1674-8115.2014.02.019

    Abstract ( 1052 )   PDF (234KB) ( 925 )  

    Objective To understand the practice cognition on general practice courses of teachers tutoring five-year program medical students from community health service centers (CHS) in Shanghai, and to propose relevant advises. Methods Questionnaire survey method and case interviews were conducted among 300 teachers of 13 CHSs. Results Tutorial doctors believed that early general trainings were essential and should be taken before practice, and practicing general trainings at CHS were also very important and students were more interested in these trainings. Conclusion In order to improve the general medical trainings, we should provide adequate early general training, perfect the training system, extend practice time at CHS, enrich training contents, adopt the same evaluation standard of tutorial teachers, and improve the incentive mechanism.

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    Evaluation of commonweal policy of free anti-hypertensive drugs for patients with hypertension in rural community
    XU Yu-ping, CHEN Xiao-wen, BO Yan-qing, et al
    2014, 34 (2):  215. 
    doi: 10.3969/j.issn.1674-8115.2014.02.020

    Abstract ( 871 )   PDF (279KB) ( 954 )  

    Objective To evaluate the policy of free anti-hypertensive drugs, which has been implemented in the Waigang Community of Jiading district. Methods Questionnaire survey was conducted among people benefited from the free drug policy and group interviews were performed with relevant health workers. Results A total of 3 032 questionnaires were issued and 2 990 valid questionnaires were returned. Nine local rural doctors and 25 administrative staff were interviewed. The analysis showed that 77% of policy implementation cost was from the government funding and 97% of people benefited from the policy were satisfied. Conclusion The policy implementation cost is mainly from the government funding. Most people are satisfied with the policy which meets the commonweal requirements of primary health service. But it is necessary to consider the benefit level of health workers of primary health clinics in order to ensure the sustainable development of the policy.

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    Comparison of hospitalization medical costs of different payment between urban and rural children and analysis of its influencing factors
    XIAO Yong-hong, XIAO Qian, JI A-dan, et al
    2014, 34 (2):  219. 
    doi: 10.3969/j.issn.1674-8115.2014.02.021

    Abstract ( 857 )   PDF (346KB) ( 946 )  

    Objective To compare hospitalization medical costs for children with urban resident medical insurance and new rural cooperative medical care, and to analyze the influence factors of different payments for medical costs so as to provide references for perfecting the medical security system of both urban and rural residents. Methods The hospitalization children of 0~14 years old with urban resident medical insurance (n=387) and new rural cooperative medical care (n=3 134) were chosen in 2011 in Luan County of Tangshan City. Their hospitalization medical costs and the influence factors of different payments for medical costs were analyzed by the univariate analysis and multivariate regression method. Results The average hospitalization medical cost for children with urban resident medical insurance was 1 632.12 Yuan, which was significantly higher than children with new rural cooperative medical care (932.84 Yuan). The difference was statistically significant (P<0.05). For children with urban resident medical insurance and new rural cooperative medical care, the drug costs accounted for 57.5% and 59.8% of the hospitalization medical costs, of which the fund payments were 61.6% and 59.5%, while individual payments were 38.4% and 40.5% respectively. Both personal factors (age, hospitalization days, and conditions of entering hospital) and social factors (hospital grade, income level, and medical insurance type) were influencing factors, which affected the hospitalization medical costs and different payments for children with urban resident medical insurances and new rural cooperative medical care. Conclusion Reducing medical costs should be achieved mainly by controlling the social factors and gradually improve the proportion of fund payments in different grade hospitals to establish the consolidated medical insurances in urban and rural areas.

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    Empirical research of quality of graduates′ educational service based on satisfaction
    CHEN Li, FU Ji-feng, YUAN Hui, et al
    2014, 34 (2):  224. 
    doi: 10.3969/j.issn.1674-8115.2014.02.022

    Abstract ( 731 )   PDF (343KB) ( 1115 )  

    Objective To investigate the satisfaction level of graduate education quality and analyze its influence factors. Methods The satisfaction level survey was conducted among 500 graduates enrolled in 2010 from three comprehensive universities in Shanghai by random sampling method. The questionnaires covered sex, discipline, hometown, and family annual income of subjects and satisfaction level survey table covered 36 items of 5 categories, including education and research conditions, campus life, service facilities, concerns about individuals, and charges and subsidizations. Descriptive analysis, t-test, ANOVA, and multiple linear regression analysis were adopted to study the satisfaction level of the graduates and its influence factors. Results The overall satisfaction level of graduates was scored 5.44, which could be classified as relatively satisfied. Among five categories, the most satisfied category was the charges and subsidizations, the score of satisfaction level was 5.62±1.20; the least satisfied one was the concerns about individuals, the score was 5.32±1.16. The difference between the expectation of service quality and actual service quality was statistically significant (P<0.05). Scores of different disciplines (medicine, engineering, science, management, and law) and graduates from different income families were statistically significant (P<0.01 and P<0.05). The influential factors of the overall satisfaction level of graduates were disciplines (t=-4.292, P=0.000) and annual household income (t=3.221, P=0.001). Conclusion The graduates are basically satisfied with the overall quality of education services. Less satisfied aspects are interaction between teachers and students, contents of elective courses, activities organized by the school, and concerns about students. Factors such as disciplines and annual household income. can affect the graduates′ judgments on the quality of higher education services. Large space still exits for improving and upgrading the quality of graduate education services.

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    Status survey on medical students′ professional thinking and the analysis of influencing factors
    WANG Dao-zhen, ZOU Yang, LI Xing-wei, et al
    2014, 34 (2):  230. 
    doi: 10.3969/j.issn.1674-8115.2014.02.023

    Abstract ( 855 )   PDF (363KB) ( 983 )  

    Objective To comprehensively collect the developing trends of professional thinking from students with different programs and majors, to analyze major influent factors, to provide possible suggestions and countermeasures for education and management, and to guide students to form correct views of professional learning and career development based on the investigation and analysis of students′ professional thinking of Shanghai Jiao Tong University School of Medicine. Methods Questionnaires were prepared and the survey was performed for students of five-year program (n=300) and eight-year program (n=180). Results were statistically analyzed. Results There were 455 returned questionnaires (94.8%), among which 432 were valid questionnaires (94.9%, 285 from five-year program and 147 from eight-year program). Differences were not significant in terms of professional thinking and understanding, while differences were significant in terms of personal career development (P<0.05) and relevant planning (P<0.001). Conclusion The instability of medical students′ professional thinking reflects in many aspects, as well as the influence factors. It is necessary to enhance education management, mental health and career planning education, teachers′ capacities, and integrate the professional thinking education into every phase of pre-school education and school education.

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    Application of geographic information system in spatial distribution of HIV infected people in Henan province
    LIU Lu, CHEN Yu, WANG Shuai, et al
    2014, 34 (2):  235. 
    doi: 10.3969/j.issn.1674-8115.2014.02.024

    Abstract ( 996 )   PDF (624KB) ( 1216 )  

    Objective To analyze the spatial distributions and influence factors of HIV infected people of Henan province so as to provide scientific evidences for the prevention and treatment of HIV. Methods Based on the HIV data of 17 counties (cities) in Henan province from 2010 to 2011, the spatial database was set up by ArcGIS10.0 and the spatial analysis and spatial regressive analysis were performed by the GeoDa_0.9.5.I software. Results HIV infected people in Henan province in 2010 and 2011 showed spatial aggregation, Moran′s I values were 0.283 0 and 0.283 1 and were statistically significant (P<0.05). The result of spatial regressive analysis showed that the HIV infection rate in Henan province was related to per capita number of medical institutions (Z2010=-0.014 8, P2010=0.046 6; Z2011=-0.015 2, P2011=0.009 2). Conclusion The spatial distribution of HIV infections is non-random and exists significant clustering in Henan province from 2010 to 2011. The HIV infection rate is affected by the per capita number of medical institutions at the spatial level.

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    Review
    Advances of regulation of endoplasmic reticulum stress and HIF-1 to VEGF in diabetic retinopathy
    WANG Jing, ZHU Hong, SHI Cai-hong
    2014, 34 (2):  240. 
    doi: 10.3969/j.issn.1674-8115.2014.02.025

    Abstract ( 954 )   PDF (278KB) ( 1133 )  

    Diabetic retinopathy is one of the most severe microvascular complications of diabetes mellitus, which can lead to irreversible blindness. The main pathological changes of DR are breakdown of blood-retinal barrier and neovascularization. Vascular endothelial growth factor (VEGF) is considered to be the most important intraocular neovascularization factor. Recent researches show that endoplasmic reticulum stress (ERS) and hypoxia-inducible factor-1 (HIF-1) can regulate the expression of VEGF and advance the progress of diabetic retinopathy together. This paper reviews the latest advance of the regulation mechanism of ERS and HIF-1 to VEGF.

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    Signal pathway and mechanism of long non-coding RNA HOTAIR and its relationship with digestive system tumors
    QIAN Li, YANG Yi, LI Zhen-yang, et al
    2014, 34 (2):  244. 
    doi: 10.3969/j.issn.1674-8115.2014.02.026

    Abstract ( 1307 )   PDF (268KB) ( 1295 )  

    Long non-coding RNAs (LncRNA) widely involve in physical and pathological processes of human body. Among them, the HOX transcript antisense RNA (HOTAIR) is transcribed by HOXC gene but mainly regulates the HOXD gene. The HOTAIR can mediate the polycomb repressive complex 2 (PRC2) and histone demethylase complex [LSDl (lysine specific demethylase 1)/CoREST (Co-repressor of REl-silencing transcription factor)/REST] to their target genes, and leads to histone H3 tri-methylated at lysine27 (H3K27me3) and histone H3 dimethylated at Lysine4 (H3K4me2). This causes chromosome state reprogramming and chromosome closing, and consequently resulting in target gene silencing. HOTAIR is relevant to the oncogenesis, progression, recurrence and metastasis of various human cancers, such as hepatocellular carcinoma, pancreatic cancer, gastrointestinal stromal tumors, and colorectal cancer. It is a potential prediction index and new therapeutic target for related cancers. This paper discusses possible molecular mechanisms and signal pathways of HOTAIR and summarizes the latest research developments of the relationship between HOTAIR and forementioned cancers.

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    Advances of role of autophagy in cerebral ischemia-reperfusion injury
    WANG Wen-ying, CUI De-rong, JIANG wei
    2014, 34 (2):  248. 
    doi: 10.3969/j.issn.1674-8115.2014.02.027

    Abstract ( 989 )   PDF (404KB) ( 1090 )  

    Diseases related to cerebral ischemia are main causes of mortality and morbidity in China. Most of them are mainly caused by hypertension associated thrombosis and thrombus embolism. The principle of cerebral ischemia treatment is to promptly restore blood perfusion of the ischemic area. But in some cases, the restoration of blood flow after ischemia can not restore tissue functions, instead tissue damage and dysfunction are more serious, namely ischemia-reperfusion (I/R) injury. So to better understand the mechanism of promoting or preventing neuron death during ischemia-reperfusion injury is critical. The article mainly reports new studies on autophagy about its regulation and roles in cerebral I/R injury.

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    Brief original article
    Impact of patients′ demographic characteristics on operative difficulty of impacted mandibular third molar
    DONG Jian-hui, ZHU Ya-qin
    2014, 34 (2):  254. 
    doi: 10.3969/j.issn.1674-8115.2014.02.028

    Abstract ( 846 )   PDF (175KB) ( 943 )  

    Objective To analyze the effect of patients′ age, sex, height, and body mass index (BMI) on the impacted mandibular third molar surgery. Methods Patients who needed third molar extractions were selected. The correlation of patients′ age, sex, weight, height, BMI and operation time was determined by Spearman′s rank correlation coefficient analysis. Statistically significant variables were selected for linear regression analysis. Results A total of 370 patients were enrolled. Only patients′ age showed a statistically significant correlation with operation time (P<0.001). Linear regression analysis indicated that patients′ age contribute 30.8% risk of increased operation time (β= 0.308, P<0.001). Conclusion Patients′ age is an important factor for affecting the operative difficulty of the impacted mandibular third molar.

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