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28 August 2017, Volume 37 Issue 8 Previous Issue    Next Issue

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Mechanism of hsa-miRNA124-3p regulating the proliferation and migration of human lung cancer cell line NCI-H460#br# WANG Ye, XIE Wang, ZHANG Jie, SHENG Jie-ying, GUO Zhong-liang 2017, 37 (8):  1051.  doi: 10.3969/j.issn.1674-8115.2017.08.001 Abstract ( 760 )   PDF (11680KB) ( 758 )   Objective · To study the regulation of hsa-miRNA124-3p on the proliferation and migration of human lung cancer NCI-H460 cells and its mechanism.  Methods · Four pairs of lung cancer and para-carcinoma tissues were harvested in clinical and measured for hsa-miRNA124-3p and Krüppellike factor 4 (KLF4) levels. The theoretical binding site of hsa-miRNA124-3p in 3’-UTR of KLF4 was predicted by bioinformatics, and validated by luciferase report assay. NCI-H460 cells were transfected with pshRNA-Sponge-miRNA124 or pshRNA-KLF4, and 48 hours later, the proliferation of NCI-H460 cells after genetic intervention was assayed by the MTT method, and cell migration ability was observed by streak method.  Results · For all four pairs of samples tested, hsa-miRNA124-3p was higher in the cancer tissues than in the adjacent tissue (P<0.01), and KLF4 protein was lower in the cancer tissues than in the adjacent tissue (P<0.01). The bioinformatic analysis showed there is a theoretical binding site (5’-UGCCUUAA-3’) of hsa-miRNA124-3p in 3’-UTR of KLF4. Luciferase activity assay showed that hsa-miRNA124-3p could bind to the 3’-UTR region of KLF4 gene and negatively regulate the expression of protein. The proliferation of NC-H460 cells was suppressed by transfection with pshRNA-Sponge-miRNA124 72 h after transfection (P<0.05 ). Compared with the control group, the proliferation activity of pshRNA-KLF4 transfection group was further enhanced (P<0.05) There was no significant difference in the proliferation of pshRNA-Sponge-miRNA124 and pshRNA-KLF4 cotransfection group and the control group (P>0.05). The data of cell migration assay showed that the changes of cell migration ability were the same as proliferation activity of the cells in groups 72 h after transfection.  Conclusion · Hsa-miRNA124-3p increases the proliferation and migration in NCI-H460 cells via suppressing the expression of KLF4, and reducing the content of miRNA124-3p in NC-H460 cells can inhibit cell proliferation and migration via upregulating KLF4 expression. Related Articles | Metrics

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Study of antagonistic activity against M3 receptor and inhibition activity to neutrophil elastase of tropane compounds#br# CAI Yu-xing, LIU Hui-zhong, HU You-min, ZHANG Jian-hua, JIN Yu-jie, LI Ning, NIU Yin-yao 2017, 37 (8):  1059.  doi: 10.3969/j.issn.1674-8115.2017.08.002 Abstract ( 770 )   PDF (5972KB) ( 1033 )    Objective · To design and synthesize five new tropane compounds， and test their antagonistic activity against M3 receptor and inhibition activity to neutrophil elastase (NE), of which the structure-activity relationship were preliminarily investigated.  Methods · The five compounds, A1-A3, B1 and C1, were prepared with 3α-hydroxy-tropane (A0) as the starting material by modifying the structure in C-3α position and N atom on the tropane skeleton. The antagonistic activity of the compounds to muscarinic M3 receptors on tracheal rings of guinea pigs was evaluated by functional assays in vitro. The hydrolysis of PGlu-Pro-Val-PNA as substrate was catalyzed by NE to get colorful nitroaniline (PNA). The NE inhibition activity of the tropane compounds was obtained by determining the absorbance [(D(405 nm)] of PNA.  Results · The five new tropane compounds generated strong antagonistic activity against M3 receptors. Among them, A2 had the greatest activity [antagonistic parameter pA2(M3)=9.004], and elicited obvious inhibitory effect to NE (inhibition ratio YA2=20.29%).  Conclusion · Introducing strong electron-attraction group, such as sulfuryl and hydrophobic group with large volume into C-3α position on the tropane skeleton can improve the M3 receptor antagonistic activity as well as the NE inhibition activity. Related Articles | Metrics

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Ameliorative effect of metformin on insulin resistance induced by olanzapine gavage in rats SHI Jia-li, ZHANG Lei, QIAO Ying, SHEN Yi-feng, LI Hua-fang 2017, 37 (8):  1064.  doi: 10.3969/j.issn.1674-8115.2017.08.003 Abstract ( 932 )   PDF (6693KB) ( 771 )   Objective · To investigate the effect of metformin on insulin resistance (IR)-related metabolic parameters in olanzapine-bearing rats.  Methods · Thirty female SD rats were randomly divided into metformin intervention group, olanzapine group and control group. During the first 6 weeks, 5 mg /(kg·d) olanzapine was given to the two test groups . The control group was given the same amount of saline. From the 7th week, the intervention group began to combine with metformin 500 mg / (kg·d), while the olanzapine group combined with the same amount of saline, continuing  for 4 weeks. At the end of 6th week and 10th week, intraperitoneal glucose tolerance and homeostasis model assessment IR index were assessed.  Results · The area under the glucose tolerance curve (P=0.040) and the IR index (P=0.000) were significantly higher for the intervention group and the olanzapine group than the control group at the end of 6th week. At the 10th weekend, the glucose tolerance (P=0.015) and IR index in the intervention group were significantly lower than those in the olanzapine group (P=0.001).  Conclusion · Metformin may rectify the impaired glucose tolerance and improve IR induced by olanzapine partly. Related Articles | Metrics

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Isolation and characterization of bacteriophage against extended-spectrum β-lactamase-producing Escherichia coli strains HUANG Lei-jie, LIU Xiao-liang, ZHU Rui, LIN Fang-qi, QIN Jin-hong, HE Ping, GUO Xiao-kui, ZHAO Wei 2017, 37 (8):  1069.  doi: 10.3969/j.issn.1674-8115.2017.08.004 Abstract ( 712 )   PDF (6480KB) ( 828 )   Objective · To isolate phages which can fight against extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli (E. coli), and provide basic research for establishment of E. coli phage library and treatment of bacterial infection.  Methods · Samples collected from sewage were co-cultured with 93 ESBLs-producing E. coli strains. A phage named JDEC001 was isolated by double agar overlay plaque assay. The biological characteristics, complete genome sequence and comparative genome analyses of JDEC001 were studied respectively.  Results · JDEC001 belongs to the lytic phage as a member of the Caudovirales order, Podoviridae family. It has high activity at pH from 5 to 11 and with temperature from 0 to 39 ℃ . Whole-genome sequencing of JDEC001 demonstrated double-stranded DNA genome of 38 745 bp with GC content of 49.93%, which encoded 46 open reading frames. The comparative genomics also showed that there was no virulent genes or antibiotic resistant genes in its genome.  Conclusion · The phage JDEC001 against ESBLs-producing E. coli was isolated and purified, with good stability in a broad range of pH and temperature. Related Articles | Metrics

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Effect of estrodial on C type natriuretic peptide and insulin like growth factor 1 expression in rat growth plate chondrocytes YU Bo, WANG Jun-qi, WANG Wei, SUN Man-qing, XIAO Yuan 2017, 37 (8):  1074.  doi: 10.3969/j.issn.1674-8115.2017.08.005 Abstract ( 731 )   PDF (6499KB) ( 881 )    Objective · To observe effect of 17β estrodial (17β E2) with different concentrations on C type natriuretic peptide (CNP), insulin like growth factor 1 (IGF1), and natriuretic peptide receptor B (NPR-B) expression and proliferation of growth plate chondrocytes of rats in vitro.  Methods · Eight Wistar rats were sacrificed and their epiphyseal cartilages of the upper tibias were separated to obtain chondrocytes on the 14th day after birth. Then chondrocytes were cultured with 17β E2 in different concentrations (10-4、10-6、10-8、10-10 and 10-12 mol/L) for 48 h, while control group was cultured without 17β E2. CCK8 method, ELISA and qRT-PCR were used to analyze the proliferation of chondrocytes, the levels of CNP and IGF1 in culture medium and mRNA levels of CNP, NPR-B and IGF1, respectively.  Results · 17β E2 in different concentrations affected the proliferation of growth plate chondrocytes significantly. When the concentration of 17β E2 was 10-8 mol/L, it had the strongest effect on the cell proliferation. When the concentration increased to 10-4 mol/L, the proliferation of chondrocytes was inhibited. With the increasement of 17β E2 concentration, the levels of CNP in the culture medium and the mRNA levels of CNP in the chondrocytes were significantly different. The highest levels of CNP protein and mRNA both appeared in 10-8 mol/L group, while the lowest levels both appeared in 10-4 mol/L group. IGF1 and its mRNA also reached the highest levels in 10-8 mol/L group, but the lowest concentration and mRNA level were in 10-10 mol/L group and 10-12 mol/L, respectively. Both CNP mRNA and protein levels were positive correlated with the proliferation of chondrocytes (P=0.000). Nevertheless, there was no significant correlation between the proliferation of chondrocytes and IGF1 mRNA or protein levels (P>0.05).  Conclusion · 17β E2 modulates proliferation of rat growth plate chondrocytes in a dose-effect manner. It enhances proliferation at relatively low concentrations (10-10-10-8 mol/L) and inhibits proliferation at high concentration. This effect is positively related to CNP expression in chondrocytes. Related Articles | Metrics

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Gender dependence of metabolomic phenotypes for human saliva using ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry LI Jing, LIU Si, LEI He-hua, WANG Yu-lan, TANG Hui-ru 2017, 37 (8):  1079.  doi: 10.3969/j.issn.1674-8115.2017.08.006 Abstract ( 665 )   PDF (7526KB) ( 774 )   Objective · To investigate the gender-related metabolomic differences in human saliva.  Methods · The saliva metabolomic profiles of 5 male and 5 female healthy volunteers with matched age, body mass index (BMI), living and tooth-brushing condition were acquired using ultra-high performance liquid chromatography with quadrupole time-of-flight mass spectrometry. Metabolites were identified using publicly accessible databases and further confirmed individually with standard compounds. Both multivariant and univariate statistics were conducted to find inter-gender differences.  Results · Forty-eight metabolites in human saliva were identified including 13 amino acids, 6 choline metabolites, 15 carnitines, 4 sphinganine metabolites, 7 lysophosphatidylcholine and 3 organic acids. Levels of phenylalanine, acetylcarnitine, propionylcarnitine, butyrylcarnitine, isobutyrylcarnitine, isovalerylcarnitine and sphinganine were higher in the saliva of females than that of males.  Conclusion · Rich metabolic information present in human saliva with significant gender diffference which ought to be taken into consideration in study on the metabonomics of saliva. Related Articles | Metrics

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Extraction and identification of exosomes in follicular fluid from patients with polycystic ovary syndrome and isolation and detection of miRNAs in exosomes#br# YANG Qian, LIU Lan-xin, HUANG He-feng 2017, 37 (8):  1085.  doi: 10.3969/j.issn.1674-8115.2017.08.007 Abstract ( 1205 )   PDF (7239KB) ( 883 )   Objective · To extract and identify exosomes in follicular fluid from patients with polycystic ovary syndrome in order to determine the existence of exosomes in follicular fluid, to isolate and extract miRNAs in exosomes, and to detect relative expression of miRNAs.  Methods · Exosomes in follicular fluid were collected with membrane affinity chromatography and their size and morphology were observed with the transmission electron microscope. Exosome protein markers CD63 and CD81 were detected with flow cytometry. miRNAs in purified exosomes were extracted and expressions of miR-125b, miR-19b, and miR-222 were measured with TaqMan real-time PCR.  Results · Exosomes in follicular fluid were circular or elliptic under the transmission electron microscope with diameters of around 30-100 nm. They had complete membrane structure and contained low density matter. Flow cytometry showed that CD63 and CD81 were positively expressed in exosomes. Real-time PCR detected expressions of miR-125b, miR-19b, and miR222.  Conclusion · Exosomes can be collected in follicular fluid from patients with polycystic ovary syndrome. Transmission electron microscopy and flow cytometry can be used to identify exosomes in follicular fluid. miR-125b, miR-19b, and miR-222 can be detected in exosomes. Related Articles | Metrics

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Risk factors analysis of initial high peritoneal solute transport status in peritoneal dialysis patients LIN Tao, YU Ge-ping, XIE Jing-yuan, HUANG Xiao-min, XU Tian, WANG Li, LI Xiao, ZHANG Chun-yan, XU Yao-wen, REN Hong, CHEN Nan 2017, 37 (8):  1090.  doi: 10.3969/j.issn.1674-8115.2017.08.008 Abstract ( 1000 )   PDF (6757KB) ( 699 )   Objective · To investigate the clinical characteristics of initial peritoneal dialysis (PD) patients with different peritoneal transport status, and analyze risk factors of high peritoneal transport status in PD patients.  Methods · A total of 455 consecutive PD patients newly starting PD between January 2007 to October 2015 were retrospectively analyzed. According to the results of the first sPET, patients were divided into H/HA (4h D/Pcr≥0.65) and L/ LA (4h D/Pcr<0.65) groups. Clinical and biochemical characteristics between the two groups were compared. Multivariate logistic regression model was established to investigate risk factors of higher peritoneal transport status of incident PD patients.  Results · The study included 372 incident PD patients. The L/LA group and H/HA group had 264 cases (71.2%) and 108 cases (28.8%) respectively. The H/HA group had higher proportion of male patients (63.0% vs 50.8%, P=0.03), lower residual renal function [RRF, (4.26±2.77) mL/min vs (5.79±4.53) mL/min, P<0.01], lower serum albumin level [(29.34±6.89) g/L vs (32.08±5.86) g/L, P=0.00], and more frequent diabetic nephropathy (19.4% vs 9.5%, P=0.00), compared with L/LA group. Univariate and multivariate logistic regression analysis showed that higher peritoneal transport status was associated with lower serum albumin level (OR=0.96, 95% CI 0.28-0.99; P=0.02), male (OR=1.92, 95% CI 1.19-3.12; P=0.00), presence of diabetic nephropathy (OR=2.52, 95% CI 1.26-5.05; P=0.00) and lower residual renal function (OR=0.90, 95% CI 0.83-0.96; P=0.00). The level of hsCRP in patients with hypoalbuminemia was higher than that in patients with normal albumin level (1.69 mg/L vs 0.69 mg/L, P=0.00).  Conclusion · Low and low average peritoneal transport status accounted for the majority of the patients in this study. Low serum albumin levels, male, diabetic nephropathy, RRF were risk factors of initial high peritoneal solute transport status. Chronic inflammatory status might partially explain for the correlation between hypoalbuminemia and high peritoneal solute transport status in PD patients. Related Articles | Metrics

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Relationship between proportions of peripheral natural kill cells and dendritic cells and liver injury in patients with chronic hepatitis B virus infection#br# LIU Bin, ZHANG Li, REN Hong, HU Peng 2017, 37 (8):  1094.  doi: 10.3969/j.issn.1674-8115.2017.08.009 Abstract ( 644 )   PDF (6524KB) ( 977 )   Objective · To investigate the correlation between proportion of natural killer (NK) cells and dendritic cells (DCs) and liver injury in patients with chronic hepatitis B virus (HBV) infection.  Methods · Peripheral blood samples were collected from 65 patients with chronic HBV infection and 10 healthy volunteers (HCs group). Flow cytometry was used to detect the proportion of peripheral NK cells and DCs. The patient were divided into asymptomatic HBV carrier (AsCs) group, chronic hepatitis B in low or moderate grade (CHB-LM) group, and chronic severe hepatitis B (CSHB)group. The relationship of the proportion of NK cells, the proportion of DCs, and the ratio of NK/DC with the degree of  liver injury was analyzed.  Results · The proportion of peripheral NK cells was significantly lower in  CHB-LM group (9.29%±1.20%) and CSHB group (3.60%±0.79%) than that in HCs group (14.77%±2.90%) and AsCs group (14.05%±2.32%) (P=0.000). And the proportion of peripheral DCs was significantly higher in CHB-LM group (4.10%±1.18%) than that in HCs (1.67%±0.31%), AsCs (2.05%±0.46%) and CSHB groups (2.08%±0.41%) (P=0.000). The ratio of NK/DC was decreased in CSHB and CHB-LM groups compared to that in HCs and AsCs groups (P=0.000). The correlation analysis indicated the proportion of NK cells was negatively correlated with the levels of ALT, AST, TB and DB (r=-0.50, r=-0.49, r=-0.53, r=-0.51, P=0.000 for all) in patients with chronic HBV infection.  Conclusion · The proportion of peripheral NK cells and the ratio of NK/DC in patients with chronic hepatitis B were decreased. The decrease of the frequency of NK cells and the ratio of NK/DC were associated with liver injury in patients with chronic HBV infection. Related Articles | Metrics

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A phase IV study of homoharringtonine, cytarabine, aclacinomycin and G-CSF (HCAG) regimen compared with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia patients LIU Zhao*, ZHANG Yun-xiang*, WANG Li-ning*, XIA Zheng, MAO Yuan-fei, ZHAO Hui-jin, YOU Jian-hua, YU Yang, ZHAO Yu-bing, REN Yu-hong, LI Ya, WANG Yan, CHEN Qiu-sheng, LI Jun-min#, CHEN Yu# 2017, 37 (8):  1100.  doi: 10.3969/j.issn.1674-8115.2017.08.010 Abstract ( 671 )   PDF (7157KB) ( 653 )    Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients.  Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS).  Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification.  Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen. Related Articles | Metrics

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Effects of custom made fiber posts on the fracture resistance of young permanent teeth treated with calcium hydroxide#br# FU Meng-chen, YANG Xi, WANG Hui-hui, LI Cheng-hao, ZHAO Yu-mei 2017, 37 (8):  1106.  doi: 10.3969/j.issn.1674-8115.2017.08.011 Abstract ( 735 )   PDF (7284KB) ( 538 )   Objective · To observe the effects of custom made fiber posts on the fracture resistance of young permanent teeth treated with calcium hydroxide for different time.  Methods · Forty-five extracted human young permanent teeth (premolar) were selected and randomly assigned to 9 groups. One group was the control group and the rest 8 groups were treated with conventional root canal preparation. Of these 8 groups, 4 groups (FⅠ, FⅢ, FⅥ, FⅨ) were restored by custom made fiber posts after being treated with calcium hydroxide for 1, 3, 6, and 9 months respectively, and other 4 groups (CⅠ, CⅢ, CⅥ, CⅨ) were not restored by custom made fiber posts. All samples underwent fracture strength tests and their fracture modes were analyzed for the possibility of second repair.  Results · The fracture load was decreased with the treatment time after being treated with calcium hydroxide for 1 month (P<0.01). The fracture loads in groups restored by custom made fiber posts were increased after being treated with calcium hydroxide for 6 and 9 months (P<0.05, P<0.01). After being treated with calcium hydroxide for 1 month, groups restored by custom made fiber posts were likely to have fracture modes that facilitate the second repair as compared with groups not restored by custom made fiber posts (P<0.05).  Conclusion · The restoration by custom made fiber posts can increase the fracture resistance of young permanent teeth treated with calcium hydroxide for medium and long term ( ≥ 1 month). Related Articles | Metrics

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Application of CBCT in the detection of gingival biotype of Han nationality youths in Shanghai#br# GONG Yin, XIE Yu-feng, SHU Rong 2017, 37 (8):  1111.  doi: 10.3969/j.issn.1674-8115.2017.08.012? Abstract ( 758 )   PDF (7407KB) ( 582 )   Objective · To detect gingival thickness of the anterior teeth region of Han nationality youths in Shanghai by cone-beam computerized tomography (CBCT), and evaluate its clinical application feasibility and the gingival biotype.  Methods · Firstly, gingival thickness in the same site (5 participators, 30 sites) was detected by bone sounding and CBCT respectively, and the data were compared. A total of 30 participators with healthy gingival were recruited to the study and examined by the CBCT, the gingival thickness of selected sites (330 sites) was assessed and compared. All the subjects were examined by the experienced doctors and classified into three groups, “thick-type” “middle-type” and “thin-type”. Gingival thickness range and the proportion of every type were obtained. All data analyses were performed using SPSS 13.0.  Results · There was no statistical difference in the thickness of gingival measured by bone sounding and CBCT (P>0.05). The main gingival biotypes of Han nationality youths in Shanghai were “thin-type” and “middle-type”. The average gingival thickness of upper central incisors [(1.32±0.15） mm] was larger than those of upper lateral incisors [(1.07±0.16) mm, P=0.000] and upper canines [(1.08±0.18) mm, P=0.000].  Conclusion · CBCT is feasible for detecting gingival thickness. Gingival thickness of the upper central incisors is significantly larger than those of upper lateral incisors and upper canines. The main gingival biotype of Han nationality youths in Shanghai is “middle-type”, the proportion of “thick-type” is least. Related Articles | Metrics

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Effect of simo decoction combined with mannitol on intestinal preparation before magnetically guided capsule endoscopy examination#br# QIN Huang-wen, WANG Lan, ZOU Jing, ZHU Jin-shui 2017, 37 (8):  1116.  doi: 10.3969/j.issn.1674-8115.2017.08.013? Abstract ( 715 )   PDF (6532KB) ( 874 )   Objective · To investigate the effects of simo decoction combined with mannitol on the intestinal preparation of magnetically guided capsule endoscopy (MGCE).  Methods · A total of 120 patients were enrolled in this randomized controlled trial and randomly divided into two groups according to the random number table. The observation group (n=60) was pretreated with simo decoction 20 mL each time, 3 times a day combined with mannitol 500 mL for oral administration before MGCE examination, while control group (n=60) only was done with mannitol 500 mL for oral administration. Then the intestinal cleanliness and occurrence of adverse reaction were observed.  Results · The intestine bubbles in observation group were less than that of control group based on evaluation criteria (Z=-1.976, P=0.048), and the intestine juices in observation group were also less than control group (Z=-2.489,  P=0.013)  suggesting that the intestinal cleanliness in observation group was superior to control group. Simultaneously, the score of nausea and vomiting in observation group was lower than control group according to the evaluation criteria (Z=-2.215, P=0.027), and abdominal pain, distension and anal stenosis in observation group were less than control group (Z=-2.158, P=0.031), meanwhile, the overall incidences of adverse reaction were 8.33% and 36.67%, respectively (χ2=13.811, P=0.000) , all of which implied that the occurrence of adverse reaction was lower in observation group compared to control group.  Conclusion · Simo decoction combined with mannitol could enhance intestinal cleanliness and reduce the occurrence of adverse reaction so as to improve the effect of intestinal preparation. Related Articles | Metrics

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Correlation analysis of coronary artery calcification score and prognosis of peritoneal dialysis patients#br# YAN Huan-qing, XIE Qiong-hong, SHANG Da, ZHU Tong-ying 2017, 37 (8):  1120.  doi: 10.3969/j.issn.1674-8115.2017.08.014? Abstract ( 521 )   PDF (8767KB) ( 657 )   Objective · To estimate correlation between coronary artery calcification score (CaCS) and prognosis of peritoneal dialysis (PD) patients.  Methods · The clinically stable patients who had undergone PD for at least 2 months were recruited for this prospective and observational cohort study. Coronary artery calcification was assessed by multislice spiral computed tomography and was recorded according to the Agatston score. The patients were assigned to 3 groups, i.e. no calcification group (CaCS=0), low calcification group (0<CaCS<400) and high calcification group (CaCS ≥ 400), to compare their basic data and endpoint events (including all-cause mortality, cardiovascular events and cardiovascular mortality). And then the correlation between CaCS and endpoint events was analyzed.  Results · A total of 254 PD patients (including 132 males) with a mean age of (62.9±15.0) years were recruited for this study. There were 93, 105, and 56 cases in no calcification group, low calcification group and high calcification group, respectively. Compared with no calcification group, patients with higher CaCS were older, had lower diastolic blood pressure, residual renal function, and serum albumin, and had higher glycosylated hemoglobin and serum insulin. Multivariate Cox regression revealed that CaCS was an independent risk factor for all the three endpoint events in PD patients.  Conclusion · CaCS was an independent predictor of all-cause mortality, cardiovascular events and cardiovascular mortality in PD patients. Related Articles | Metrics

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Association between adverse obstetric outcomes and abnormal maternal serum markers in the second trimester screening#br# ZHAO Ting-ting, ZHANG Hai-ou, ZHAO Xin-rong, CHENG Wei-wei, TAO Jiong 2017, 37 (8):  1127.  doi: 10.3969/j.issn.1674-8115.2017.08.015 Abstract ( 673 )   PDF (7572KB) ( 690 )    Objective · To evaluate the association between the abnormal maternal serum markers of alpha fetoprotein (AFP), human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) in the second trimester screening and the adverse obstetric outcomes other than trisomy 21 (T21), trisomy 18 (T18) and open neural tube defects (ONTD), and to provide local data for supporting evidence based clinical managements.  Methods · A retrospective cohort study was performed in the women who received second trimester maternal serum screening in the International Peace Maternal and Child Health Hospital between 2012 and 2014, with naturally conceived singleton pregnancies. Obstetric outcomes were followed up by searching electronic medical records within the hospital. Abnormal level of marker was defined as a MOM value ≥ 99th (P99) or  ≤?1st percentile (P1) of the overall screened population. Incidence of an adverse obstetric outcome was compared between the groups with abnormal markers and the control with all markers in normal.  Results · ① A total of 25 616 pregnancies were included in this study, in which 4 526 were identified as having various adverse obstetric outcomes. Among them 4 143 pregnancies were with isolated and 383 pregnancies were with co-occurring two or more adverse outcomes. ② When compared to pregnancies with normal levels of all three serum markers, pregnancies with decreased AFP or decreased hCG did not show associations with any adverse obstetric outcomes. However, pregnancies with increased AFP, increased hCG or decreased uE3 were at increased risk for a variety of abnormal pregnancy outcome. In 18 pregnancies with an outcome of fetal chromosomal abnormalities other than T21 and T18, 9 presented with either increased AFP, increased hCG or decreased uE3, with relative risk ratios of 13.33、35.00 and 59.00, respectively. ③ The performance of those markers tended to be improved in a subset of adverse obstetric outcomes, including low birth weight <P3, fetal loss prior to 28 weeks, and preeclampsia onset before 34 weeks. Compared to the conditions with a broad definition, relative risk ratios increased 1.5-15 folders in these narrowly defined more severe forms.  Conclusion · Pregnancies with abnormal serum markers should receive close attention. For women in particular with increased AFP, increased hCG or decreased uE3, invasive prenatal diagnosis for a comprehensive examination of fetal chromosomal abnormalities is strongly suggested. Even in the absence of positive diagnostic result, managements of increased frequency of antenatal visits and ultrasound surveillance should still be offered, in order to achieve an earlier or improved detection of adverse obstetric outcomes, especially of those with severe clinical manifestations such as early fetal loss, small for gestational age infant, and early onset preeclampsia. Related Articles | Metrics

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Aprepitant therapy for prevention of moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer#br# XI Wen-qi, LU Li, JIANG Jin-ling, MA Tao, ZHANG Jun 2017, 37 (8):  1132.  doi: 10.3969/j.issn.1674-8115.2017.08.016 Abstract ( 786 )   PDF (8280KB) ( 789 )   Objective · To investigate antiemetic effect of aprepitant for moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer.  Methods · From 2014 July to 2015 August, 130 cases of gastrointestinal cancer patients were collected in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, who received moderate emetogenic risk of chemotherapy for at least four courses. One hundred and nine patients were treated with aprepitant, palonosetron and dexamethasone on day 1, and aprepitant and dexamethasone on day 2 and 3. Twenty-one patients only received aprepitant and dexamethasone on day 1 and dexamethasone on day 2 and 3 in the first course of chemotherapy. During subsequent courses of chemotherapy they received aprepitant and treated in the same way as 109 patients. MASCC antiemetic tool (MAT) was used to evaluate the intensity of nausea. The primary endpoint was complete response (CR, no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after chemotherapy) at the second course. The secondary endpoint was complete protection (CP, CR plus no significant nausea) during the overall, acute (0-24 h), and delayed (24-120 h) phases at the second course.  Results · The CR rates were 90.0%, 94.6% and 90.8% of patients in the overall, acute and delayed phases, respectively. The corresponding CP rates were 83.8%, 87.8% and 84.6 %, respectively. The CR rate increased from 42.9% to 57.1% during acute phase and increased from 9.5% to 90.5% during delayed phase for 21 patients after treatment with aprepitant. The main adverse reactions include constipation, anorexia and hiccups.  Conclusion · Aprepitant combined with palonosetron and dexamethasone can effectively prevent moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Aprepitant therapy can effectively maintain antiemetic effect in patients with many chemotherapy courses. Related Articles | Metrics

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Analysis of short to medium-term efficiency of 1 470 nm laser with foam sclerotherapy to treat varicose veins of lower extremity DING Yu, WANG Xin, WANG Bing, ZHAO Hai-guang 2017, 37 (8):  1138.  doi: 10.3969/j.issn.1674-8115.2017.08.017 Abstract ( 804 )   PDF (7334KB) ( 561 )   Objective · To compare the short and medium-term efficiency and safety of 1 470 nm laser with foam sclerotherapy with ligation of great saphenous vein and 808 nm laser with foam sclerotherapy to treat varicose veins of lower extremity.  Methods · Seventy-seven hospitalized patients patients and twenty-one day-surgery patients were retrospectively analyzed.  Results · There was no obvious difference in the closure of great saphenous vein for short to medium-term efficiency between the day-surgery group and hospitalized group. The postoperative complications and recurrence rate of day-surgery group was not higher than that of the hospitalized group, but the degree of perioperative comfort, economic cost and the time returning to normal life of day-surgery group were superior to that of the hospitalized group.  Conclusion · 1 470 nm laser with foam sclerotherapy with ligation of great saphenous vein and 808 nm laser with foam sclerotherapy to treat varicose veins of lower extremity had similar clinical effect, but the degree of safety and comfort was higher and trauma was less. The day surgery with 1 470 nm laser to treat varicose vein of lower extremity could also simplify the procedure of hospitalization and reduce the cost of health care, which could be a new option for patients. Related Articles | Metrics

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Effect of prophylactic phenylephrine in parturients prone to develop spinal hypotension#br# YANG Shi-ke, CHEN Jie, LIU Min, WANG Tao, SUN Wen-qun, LI Li, MAO De-zhi 2017, 37 (8):  1143.  doi: 10.3969/j.issn.1674-8115.2017.08.018 Abstract ( 975 )   PDF (6138KB) ( 1105 )   Objective · To evaluate the efficacy and safety of prophylactic phenylephrine in parturients prone to develop spinal hypotension.  Methods · Fifty parturients undergoing elective cesarean delivery whose preoperative positional mean arterial pressure (MAP) change from supine to right lateral position were bigger than 8 mmHg (1 mmHg=0.133 kPa) were randomly allocated into 2 groups, i.e. high-risk prevented group (group A) and high-risk control group (group B). Another 25 parturients whose positional MAP change were smaller than 8 mmHg were allocated into low-risk prevented group (group C). After spinal anesthesia, phenylephrine (50 µg bolus and 50 µg/min infusion) was given immediately to group A and C, and the pump speed was adjusted to 25 µg/min 10 min later till fetuses were removed. Normal saline with the  same volume and pump speed was given to group B. The incidences of hypotension, reactive hypertension, and bradycardia, the occurrence of nausea and vomiting, and Apgar scores at 1 min and 5 min of three groups were compared.  Results · The incidence of hypotension in group A was 28%, 76% in group B, and 16% in group C. Group A and C were significantly lower than group B (P<0.01). The reactive hypertension rate was 4% in group A and 28% in group C. There was a difference between these two group (P=0.015). There were no significant differences among 3 groups in Apgar scores at 1 min and 5 min (P>0.05).  Conclusion · Prophylactic phenylephrine in the paturients prone to develop spinal hypotension reduces the incidence of spinal hypotension without obvious adverse effects on the paturients and neonates. Related Articles | Metrics

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Survey on the current situation of professional knowledge and protection consciousness in CSSD practitioners in Shanghai#br# CAO Lei, YE Hua, HU Xin-hua, CHEN Qiang, CAI Yu-yang, CAI Yin-hua 2017, 37 (8):  1147.  doi: 10.3969/j.issn.1674-8115.2017.08.019 Abstract ( 862 )   PDF (5153KB) ( 1018 )   Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD.  Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing’an, Jinshan, Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status.  Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.  Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management. Related Articles | Metrics

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Study on the phospholipid composition of human milk at different lactation stages GAO Run-ying, WU Ke, ZHU Jie, CAI Mei-qin 2017, 37 (8):  1151.  doi: 10.3969/j.issn.1674-8115.2017.08.020 Abstract ( 926 )   PDF (7830KB) ( 728 )   Objective · To obtain the latest data on phospholipid composition of human milk in Shanghai and compare the differences in phospholipid composition at different lactation stages.  Methods · Healthy postpartum women who delivered full-term infants in the Obstetrical Department of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between April and July, 2016 were enrolled. The colostrum, transitional milk, and mature milk were collected at Day 3, 10, and 45 after delivering babies, respectively. Human milk fat was extracted with Folch’s method and phospholipids were separated with solid phase extraction (SPE). The phosphatidylethanolamine, phosphatidylcholine, and sphingomyelin were quantitatively analyzed with HPLC/VWD. The differences in phospholipid composition at different lactation stages were compared with univariate analysis of variance and GamesHomell test.  Results · One hundred women who provided at least one breast milk sample were enrolled. A total of 70 colostrum samples, 96 transitional milk samples, and 82 mature milk samples were collected. The total phospholipid content of mature milk [(281.93±118.54) μg/g] was significantly lower than that of colostrum [(381.99±205.90) μg/g]. At all lactation stages, the relative content of phosphatidylcholine was the highest (53.74%-59.36%), followed by sphingomyelin (28.12%-32.74%). The relative content of phosphatidylethanolamine was constant (P=0.617), the relative content of phosphatidylcholine gradually decreased (P=0.000), and that of sphingomyelin gradually increased (P=0.000) during the lactation.  Conclusion · Sphingomyelin and phosphatidylcholine are major components of human milk phospholipids. The amount of phospholipids varies during the lactation. The total amount of phospholipids is lower in mature milk than in colostrum and transitional milk. The relative content of phosphatidylethanolamine is consistent at all lactation stages, the relative content of phosphatidylcholine gradually decreases, and that of sphingomyelin gradually increases. Related Articles | Metrics

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Advances in neuroimaging studies on executive impairment of patients with euthymic bipolar disorder#br# YANG Tao, ZHAO Guo-qing, FANG Yi-ru, CHEN Jun 2017, 37 (8):  1156.  doi: 10.3969/j.issn.1674-8115.2017.08.021 Abstract ( 823 )   PDF (8425KB) ( 988 )   Bipolar disorder (BD) is a chronic mental illness with high recurrence rate and disability. As one of the core symptoms, cognitive impairment may occurs at every stage of the disease. Evidence from the neuroimaging studies revealed that the abnormal brain volumes, the blood flow and oxygen saturation of key brain areas are related to executive impairment in patients with bipolar disorder. This article reviews current structural and functional neuroimaging studies about the executive impairment of patients with euthymic bipolar disorder and research progresses. Related Articles | Metrics

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Progress of antimicrobial peptides in the treatment of sepsis#br# XU Yao, MA Shuai, DING Feng 2017, 37 (8):  1161.  doi: 10.3969/j.issn.1674-8115.2017.08.022 Abstract ( 869 )   PDF (6413KB) ( 1019 )   Sepsis is a severe systemic inflammatory response syndrome, and is common in the patients with infection, extensive burn injury and major surgery. As it may cause multiple organ dysfunction and septic shock, it is always accompanied with high mortality and poor prognosis. Currently there’s no effective medication available for treatment of sepsis. During the process of killing bacteria, the classical antibiotics lead to release of a large quantity of proinflammatory cytokines, such as lipopolysaccharide, which exacerbates the malfunction of immune system. Furthermore, the growing number of multiresistant bacteria present a new challenge to the management of sepsis. Antimicrobial peptides (AMPs) are small, cationic, and amphipathic peptides with broad-spectrum microbicidal activity against bacteria, fungi and viruses. In addition, they also can neutralize endotoxin and suppress inflammatory cascade through multiple immunomodulation, which potentially serves as a promising alternative approach for sepsis treatment. This review briefly summarizes the progress of AMPs in the treatment of sepsis as well as the relevant mechanisms. Related Articles | Metrics

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Role of myosin regulatory light chain phosphorylation in the pathogenesis of chronic heart failure#br# HU Shan, WU Gang 2017, 37 (8):  1165.  doi: 10.3969/j.issn.1674-8115.2017.08.023 Abstract ( 840 )   PDF (6734KB) ( 1139 )    In the embryonic period, myosin regulatory light chain (MYL2) plays a pivotal role in the development and function of the heart. A large number of studies have previously confirmed that the mutation of MYL2 gene, also known as MLC2, confers intimate associations with hypertrophic cardiomyopathy. MYL2 gene mutation impacts the structure and function of myosin, thereby leading to the occurrence and progression of hypertrophic and dilated cardiomyopathy as well as the following chronic heart failure. Importantly, MYL2 phosphorylation renders crucial effects in the processes of cardiac contraction, ventricular torsion and cardiac function. Related Articles | Metrics

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Activation mechanism and therapeutic use of microglia in subarachnoid hemorrhage#br# HAN Shuo, Lü Tao, ZHANG Xiao-hua 2017, 37 (8):  1169.  doi: 10.3969/j.issn.1674-8115.2017.08.024 Abstract ( 1058 )   PDF (7854KB) ( 595 )   Microglia are activated and involve in the pathological and physiological processes of early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage, thus impact the outcome of patients. Numerous studies have shown that microglia have different typings, signaling pathways, and functions. Interference with microglial activation or reduction of cytotoxic metabolites is important for improving the prognosis of SAH patients. Related Articles | Metrics

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Application of metabonomics in the diagnosis and treatment of acute kidney injury#br# PING Feng, GUO Yong, LIU Yu-jing, CAO Yong-mei, LI Ying-chuan 2017, 37 (8):  1174.  doi: 10.3969/j.issn.1674-8115.2017.08.025 Abstract ( 881 )   PDF (8738KB) ( 936 )   Acute kidney injury (AKI) is the complex clinical syndrome attributed to multiple causes and risk factors, which is characterized by an abrupt loss of renal function. Metabonomics, recently advances in the field of omics, is the nontargeted measurement of all of the low-molecularweight compounds that appear in a particular cell, tissue, organ or biofluid in a living organism. Compared to genomics, transcriptomics and proteomics, metabonomics has its unique advantages, including fewer metabolites than genes, transcripts and proteins, the most accurate predictors of the signature of the actual processes, easy access to biofluids. Thus, metabonomics makes it possible to find new biomarkers for AKI on early diagnosis, identifying new metabolic pathways, finding new targets for drug therapy and individual medical treatment. Related Articles | Metrics

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Research progress of α1-antitrypsin deficiency of mutant Z#br# ZHOU Zhuo-chao, CHEN Ying, ZHU Shu-yi, SHEN Wen-qi, ZHOU Ai-wu 2017, 37 (8):  1179.  doi: 10.3969/j.issn.1674-8115.2017.08.026 Abstract ( 884 )   PDF (8406KB) ( 793 )   α 1-Antitrypsin (α1-AT) belongs to serine protease inhibitor (Serpin) superfamily and is the main protease inhibitor in human circulation. It can inhibit many proteases to protect tissues from digradation. The mutant Z (Glu342Lys) of α1-AT predisposes to the early onset of emphysema due to decreased functional α1-AT in the lung and to neonatal hepatitis due to accumulation of α1-AT polymers in the endoplasmic reticulum of hepatocytes, which disrupts the balance between protease and protease inhibitors. This paper reviews recent research progress on the pathogenic mechanism and the prognosis of α1-antitrypsin deficiency. Related Articles | Metrics

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A case report of Guillain-Barré syndrome associated with subarachnoid hemorrhagic aneurysm embolization WANG Chang-ming, ZHANG Jin-ju, LIU Hai-jun, WEI Zhi-jie, ZHANG Li 2017, 37 (8):  1184.  doi: 10.3969/j.issn.1674-8115.2017.08.027 Abstract ( 757 )   PDF (4358KB) ( 908 )    A case of a 47-year-old female patient who had a severe headache for 2 days was reported. Spontaneous subarachnoid hemorrhage (SAH, huntHess classification Ⅱ level)-anterior communicating aneurysm rupture was diagnosed by brain CT and digital subtraction angiography (DSA) examination. Intravascular interventional aneurysm embolization was performed, and the patient appeared progressive limb weakness 5 days after operation. Physical examination revealed grade Ⅱ upper limb muscle strength and grade Ⅰ lower limb muscle strength. The muscle tone of the extremities was decreased, and the tendon reflex disappeared. The pinprick pain was decreased below the double wrist joints and the ankle joints. After neuroelectrophysiology test and cerebrospinal fluid assay, the patient was diagnosed as Guillain-Barré syndrome associated with subarachnoid hemorrhagic aneurysm embolization. Related Articles | Metrics