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28 April 2019, Volume 39 Issue 4 Previous Issue    Next Issue
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Outstanding international article
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Outstanding international article

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A molecular switch that controls activation of adult quiescent neural stem cells The research group of XU Nan-jie 2019, 39 (4):  339.  doi: 10.3969/j.issn.1674-8115.2019.04.001 Abstract ( 566 )   PDF (2993KB) ( 313 )   Related Articles | Metrics

Original article (Basic research)

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Study on the of Toll-like receptor 4 and its effect on prognosis in fat embolism mice model SHANG Jia-wei1, LIU Xi2, LI Ying-chuan3, WANG Ai-zhong1 2019, 39 (4):  342.  doi: 10.3969/j.issn.1674-8115.2019.04.002 Abstract ( 634 )   PDF (7458KB) ( 216 )   Objective · To investigate the effect of Toll-like receptor 4 (TLR4) in the pathological injury in fat embolism mice model. Methods · One hundred and twenty male C57BL/6 mice were randomly divided into 10 groups. One group was set as blank control group, and others were injected separately with 1, 2…9 μL/g of allogeneic perirenal fat via tail vein, respectively. The mortality of each group was counted, median lethal dose (LD50) of fat injection in mice was calculatedBliss method, and the fat embolism LD50 mice model was established. The TLR4 protein in the pulmonary tissue of surviving mice was detectedWestern blotting. Sixty male C57BL/6 mice were randomly divided into the control group (the same dose of saline was given via tail vein) and the experimental groups (group 2 h, group 8 h, group 24 h and group 48 h, the LD50 fat was given via tail vein). The TLR4 protein at different time after fat injection was detectedWestern blotting. The mortality of 20 TLR4 gene-knockout mice (TLR4-/mice) was recorded and compared with 60 wild-type mice after LD50 fat injection. Results · The LD50 of fat embolism mice model was (3.93±0.78) μL/g. After the injection of 1-7 μL/g fat, the s of TLR4 protein in the pulmonary tissue of all seven groups were significantly increased, compared with the control group (all P0.000). In the fat embolism LD50 mice model, compared with the control group, the s of TLR4 protein in group 2 h were significantly increased (P0.005). Then, level of TLR4 protein was gradually reduced after 2 h, and there was no significant difference between the control group and group 48 h. The mortality of TLR4-/-mice injected with LD50 fat was lower than that of wild-type mice (P0.043). Conclusion · TLR4 protein involves in the pathologic process of fat embolism syndrome. The knockout of TLR4 gene can reduce the mortality of fat embolism mice. TLR4 and its correlated non-infectious inflammatory response may be an important molecular mechanism of biochemical injury in fat embolism syndrome. Blocking the activation of TLR4-mediated signaling pathway can significantly improve the prognosis, which provides new basis for the prevention, evaluation and treatment of fat embolism syndrome. [Key words]Toll-like receptor 4 (TLR4); fat embolism syndrome (FES); pathological mechanism; median lethal dose (LD50); mortality Related Articles | Metrics

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Light-induced size-switchable nanosystem for doxorubicin delivery LAI Xing, FANG Chao 2019, 39 (4):  347.  doi: 10.3969/j.issn.1674-8115.2019.04.003 Abstract ( 597 )   PDF (8567KB) ( 271 )   Objective · To engineer a light-induced size-switchable (large to small) nanosystem for doxorubicin (DOX) delivery and characterize its light-induced size change and cytotoxicity. Methods · The poly(ethylene glycol)-polylactide nanoparticles loading DOX (PEG-PLA-DOX) were fabricated with the dropwise addition method. Then the nanoparticles were encapsulated into the inner cavity of liposome (LP), and a photosensitizer (verteporfin, VP) was loaded in the bilayers of the LP to engineer the near-infrared light-sensitive core-shell nanoparticles (PEG-PLA-DOX@LP). The morphology of the nanoparticles was observed under a transmission electron microscope. Dynamic light scattering was used to examine the particle size at each stage. The size-switchable property of the nanoparticles and its influence on viability of murine melanoma B16F10 cells under near-infrared light were evaluated. The stability of the nanoparticles was also investigated. Results · PEG-PLA-DOX@LP, the light-sensitive nanoparticles, were successfully developed. The nanoparticles had a particle size of (194.83±5.70) nm and Zeta potential of (-1.43±0.32) mV. The drug loading was 2.82% for DOX, and 1.16% for VP. The small-sized PEG-PLA-DOX [(37.42±8.67) nm]was quickly released the nanoparticles upon light for enhanced toxicity to B16F10 murine melanoma cells. Conclusion · The particle size of the novel DOX delivery nanosystem rapidly changes large size to small size upon the irradiation of near-infrared light, and thus the cytotoxic effect on tumor cells can be enhanced. [Key words]near-infrared light; doxorubicin; nanoparticle; size-switchable[National Natural Science Foundation of China, 81773274; Foundation of Shanghai Local High Level University (First-class Discipline–Pharmacy) ]。 Related Articles | Metrics

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Generation and phenotypic analysis of Fbxo22knockout mice ZHANG Hui-lin, ZHU Xiao-na, YANG Shuo, LIU Meng-di, ZHU Di, YU Yun 2019, 39 (4):  353.  doi: 10.3969/j.issn.1674-8115.2019.04.004 Abstract ( 775 )   PDF (5915KB) ( 603 )   Objective · To establish the Fbxo22 knockout momodel and study the biological function of FBXO22. Methods · The Fbxo22 knockout mice were generatedCRISPR-Cas9 technology. The number, appearance, weight of different embryos and mice were measured. Meanwhile, the food intake and survival of Fbxo22-/-mice were analyzed. Results · Although the Fbxo22-/-embryos were present at approximately Mendelian ratios on embryonic day 17.5/18.5, most of them died within 48 hours of birth. Furthermore, those surviving Fbxo22-/- mice showed reduced body size and food intake and decreased life span. Conclusion · FBXO22 is an important, albeit not essential, protein for early postnatal survival and normal development. [Key words]FBXO22; CRISPR-Cas9 technology; early postnatal lethality Related Articles | Metrics

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Effect of inhibitor of differentiation 1 deficiency on ocular neovascularization YAO Yi-yun1*, NI Dong-qing2*，SU Ting1, SUI Ai-ling1, YAO Yi-xuan1, ZHU Yan-ji1, XIE Bing1 2019, 39 (4):  358.  doi: 10.3969/j.issn.1674-8115.2019.04.005 Abstract ( 718 )   PDF (8796KB) ( 363 )   Objective · To study the effect of inhibitor of differentiation 1 (ID1) on ocular neovascularization. Methods · The oxygen-induced retinal neovascularization (OIR), laser-induced choroidal neovascularization (CNV) and over- of vascular endothelial growth factor (VEGF) (Rho-VEGF) transgenic mice were established. The localization and mRNA level of ID1 in retina of OIR mice and Rho-VEGF transgenic mice were determinedimmunofluorescence staining and quantitative real-time PCR. Mice deficient in ID1 (ID1./.) were used to induce retinal neovascularization in accordance with the above three models, and to compare the changes of ID1 on the number of retinal, subretinal and choroidal neovascularization areas. Into explore the role ID1 in neovascularization, the numbers and areas of retinal, subretinal and choroidal neovascularization in the mice models with or without ID1 deficiency were compared. Its effect on the related factors, i.e. hypoxia-inducible factor-1α (HIF-1α), VEGF and vascular endothelial growth factor receptor 1/2 (VEGFR1/2) were also observed. Results · Mice deficient in ID1 showed a significant reduction in the area of neovascularization in these three models(P<0.05). Mice lacking ID1 showed reduced levels of HIF-1α, VEGF and VEGFR 1. Conclusion · ID1 promotes the of HIF-1α, VEGF and VEGFR1 in the retina and choroidal neovascularization during hypoxia and oxidative injury. [Key words]inhibitor of differentiation-1 (ID1); ocular neovascularization; hypoxia-inducible factor-1α (HIF-1α); vascular endothelial growth factor Related Articles | Metrics

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Synthesis, activity determination of tropane compounds as muscarinic M3 receptor antagonists and quantitative relationship between their molecular structure and activity JIN Yu-jie1, LIU Hui-zhong1, HU You-min2, ZHANG Jian-hua3, CAI Yu-xing1, LI Ning1, NIU Yin-yao3 2019, 39 (4):  366.  doi: 10.3969/j.issn.1674-8115.2019.04.006 Abstract ( 703 )   PDF (7458KB) ( 285 )   Objective · To provide theoretical guidance for the design of molecules with high activitybuilding the quantitative structure-activity relationship (QSAR) model for tropane compounds as muscarinic M3 receptor antagonists. Methods · Six compounds (J1-J6) were prepared with 3α-hydroxy-tropane (J0) as the starting materialmodifying the structure in C-3α position of the tropane skeleton. The antagonistic activity of new tropane compounds to muscarinic M3 receptors on tracheal rings of guinea pigs was evaluatedfunctional assays in vitro. The antagonistic parameters (pA2) of new tropane compounds prepared in this paper and former studies were applied to construct the QSAR model. The information about structural optimization was acquiredanalyzing the effect of steric field and electrostatic field of model on activity of tropane compounds. Results · The six new tropane compounds showed obvious antagonistic activity against M3 receptors. Among them, J4 had the greatest activity (pA27.992). The cross-validation correlation coefficient squared (q2) and the non-cross-validated correlation coefficient squared (r2) of the QSAR model were 0.585 and 0.993, respectively. Conclusion · The antagonistic activity to muscarinic M3 receptors can be obviously improved, when the conjugating extent of π-bonds is large and O or N atoms participate in conjugation on the rings in the R-substituting group at C-3α position of the compounds. [Key words]chronic obstructive pulmonary disease (COPD); tropane; M3 receptor antagonist; quantitative structure-activity relationship (QSAR) Related Articles | Metrics

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Increased of interleukin-27 and its inhibitory effect on apoptosis in cisplatin-induced acute kidney injury ZHOU Pei-hui, WANG Li 2019, 39 (4):  372.  doi: 10.3969/j.issn.1674-8115.2019.04.007 Abstract ( 656 )   PDF (6348KB) ( 501 )   Objective · To investigate the of interleukin-27 (IL-27) in cisplatin-induced acute kidney injury (AKI) and explore its inhibitory effect on apoptosis in AKI. Methods · C57BL/6 mice were randomly divided to control group and cisplatin group, in which mice were sacrificed at 24, 48 and 72 h after cisplatin administration. Blood urea nitrogen (BUN) and serum creatinine (Scr) levels were estimated. And the levels of mRNA for the IL-27 subunits, i.e. p28 and EBI3 in kidneys were determinedreal-time PCR. As for in vitro experiments, after cisplatin incubation for 0.5, 1, 6, 12 and 24 h, HK-2 cells, a line of proximal tubular epithelial cells, were collected to assess the of IL-27 receptors (GP130 and WSX-1) at mRNA level. After that, HK-2 cells were treated with phosphate buffer saline or recombinant human IL-27 protein after cisplatin treatment, cell viability was detectedCCK-8, nuclear morphology was observedHoechst staining, and apoptosis related proteins including Bax, Bcl-2, and cleaved poly ADP-ribose polymerase (PARP) were estimatedWestern blotting. Results · Compared with control group, BUN and Scr in cisplatin group significantly increased in a time-dependent manner after cisplatin injection. The mRNA levels of p28 and Ebi3 grew in injured kidneys, and their highest s were exhibited at 48 h after cisplatin injection. In HK-2 cells, GP130 and WSX-1 mRNA significantly increased at 1 h after cisplatin treatment but reduced to the basal level at 6, 12 and 24 h. IL-27 treatment significantly up-regulated cell viability and alleviated apoptosis and necrosis in cisplatin-treated HK-2 cells. In addition, IL-27 treatment inhibited the cleaved PARP and pro-apoptotic protein Bax, and upregulated antiapoptotic protein Bcl-2 in cisplatin-treated HK-2 cells. Conclusion · The of IL-27 increases in cisplatin-induced AKI, and it may protect against AKIreducing cell apoptosis. [Key words]acute kidney injury; cisplatin; interleukin-27; apoptosis Related Articles | Metrics

Original article (Clinical research)

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Short-term clinical efficacy observation of adjunctive Er,Cr:YSGG laser application following subgingival scaling in patients with severe periodontitis WANG Ya-ping, LIN Zhi-kai, SHU Rong 2019, 39 (4):  378.  doi: 10.3969/j.issn.1674-8115.2019.04.008 Abstract ( 919 )   PDF (7617KB) ( 351 )   Objective · To observe the short-term clinical efficacy of adjunctive Er,Cr:YSGG laser application following subgingival scaling in patients with severe periodontitis. Methods · In this parallel control design clinical trial, 46 patients with severe periodontitis were selected. Baseline examination was performed 2 weeks after supragingival scaling. Then the patients were randomly divided into the test group and the control group, with 23 cases in each group. After ultrasonic subgingival scaling, sites with probing depth (PD) ≥5 mm of patients in two groups received subgingival debridement with Er,Cr:YSGG laser and hand curettes, receptively. The changes in plaque index (PLI), PD, clinical attachment level (CAL), the percentage of bleeding on probing (BOP) positive sites, and the degree of subjective pain during treatment with visual analogue scale（VAS）were compared between two groups at baseline, 6 weeks after treatment, and 3 months after treatment. Results · For sites with PD ≥5 mm, PLI, PD, CAL, and the percentage of BOP positive sites significantly reduced for both groups at 6 weeks and 3 months after treatment compared with baseline (all P0.000). For sites with 5 mm ≤PD ≤6 mm, the CAL of the test group was significantly lower compared with the control group at 6 weeks after treatment (P0.036). For sites with PD≥7 mm, the PDs of the test group were significantly lower compared with the control group at 6 weeks and 3 months after treatment (P0.002, P0.039). The PD reduction between baseline and 6 weeks after treatment was greater in the test group compared with the control group (P0.015). The CAL of the test group was lower compared with the control group at 6 weeks after treatment (P0.011). The VAS of the test group was significantly lower than that of the control group (P0.005). Conclusion · Adjunctive Er,Cr:YSGG laser application following subgingival scaling can achieve similar short-term clinical efficacy compared with traditional hand curettes. Er,Cr:YSGG laser may be beneficial particularly on the reduction of PD and regain of CAL in deep pockets on a short-term basis, which can make the patients more comfortable. Subgingival scaling with adjunctive Er,Cr:YSGG laser application can be an effective way for the non-surgical periodontal therapy. [Key words]Er,Cr:YSGG laser; subgingival scaling; severe periodontitis Related Articles | Metrics

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Vitamin D level in patients with menstrually related migraine YUAN Xin1, JIANG Wei-qing1, REN Xiao1, LIU Chen2, WANG Yong-gang1 2019, 39 (4):  383.  doi: 10.3969/j.issn.1674-8115.2019.04.009 Abstract ( 609 )   PDF (5464KB) ( 351 )   Objective · To compare vitamin D levels in the patients with menstrually related migraine and those with non-menstrual migraine. Methods · A total of 100 patients with menstrually related migraine were enrolled as case group, and 100 patients with non-menstrual migraine were matched as control group in Renji Hospital, Shanghai Jiao Tong University School of Medicine, June 2017 to June 2018. The patients’ information was collected and serum vitamin D levels were measured. Univariate analysis was performed to analyze the differences between the groups, and Logistic regression model was performed to analyze the relationship between menstrually related migraine and vitamin D levels. Results · Vitamin D levels were lower in case group than those in control group [(13.48±5.02) ng/mL vs (14.93±4.94) ng/mL, P0.042]. There were no statistically significant differences in other indexes between the groups (P>0.05). Logistic regression analysis showed that the patients with vitamin D less than 10 ng/mL were more likely to have menstrually related migraine than those with vitamin D more than 20 ng/ml (OR3.656, 95% CI 1.382-9.672，P0.009). In addition, there were no statistically significant differences in clinical characteristics and vitamin D levels between the patients with migraine occurring in premenstrual period and menstrual period (P>0.05). Conclusion · Low vitamin D levels may be associated with menstrually related migraine, but not with its occurrence in premenstrual or menstrual period. [Key words]migraine; menstrually related; vitamin D Related Articles | Metrics

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Application of four-dimensional flow MRI in hemodynamic study of autogenous arteriovenous fistula in renal dialysis patients LI Su-qin1, ZHU Ming-li2, ZHANG Lan3, NI Qi-hong3, TANG Hui1, LU Qing1 2019, 39 (4):  387.  doi: 10.3969/j.issn.1674-8115.2019.04.010 Abstract ( 796 )   PDF (8162KB) ( 326 )   Objective · To investigate the feasibility of four-dimensional flow MRI (4D flow MRI) in evaluating the hemodynamics of forearm autologous arteriovenous fistula (AVF) in renal dialysis patients. Methods · Forty-five patients Renal Division of Renji Hospital, Shanghai Jiao Tong University School of Medicine were included. Patients with forearm AVF underwent ultrasonography and MRI. The consistency of 4D flow MRI hemodynamic parameters measuredtwo radiologists and hemodynamic parameters at the same plane of AVF4D flow MRI and ultrasonography were analyzedpaired t test. The morphological parameters of AVF were acquired black blood sequence, and they were used for Pearson correlation analysis with the hemodynamic parameters obtained 4D flow MRI. Results · Forty-two patients completed the forearm AVF ultrasonography and MRI successfully. Paired t test showed that the consistency of 4D flow MRI hemodynamic parameterstwo radiologists was good (all P0.000), and all hemodynamic parameters measured4D flow MRI and ultrasonography were in good agreement (r0.292-0.569, all P<0.05) except for the peak flow velocity at anastomosis (r-0.078, P>0.05). Pearson correlation analysis showed that the cephalic venous flow volume of AVF was correlated with the diameter ratio of the cephalic venous to radial artery and the anastomosis area ( r-0.671, r0.482, both P<0.05), and the wall shear stress (WSS) near the anastomosis was correlated with the anastomosis angle and wall thickness (r0.530, r0.462, both P<0.05). Conclusion · 4D flow MRI can be used to evaluate the hemodynamic parameters of forearm AVF in renal dialysis patients, which can provide a reference for further study of AVF dysfunction. [Key words]four-dimensional flow MRI (4D flow MRI); autologous arteriovenous fistula (AVF); hemodynamics Related Articles | Metrics

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Combination of BI-RADS for ultrasound and shear wave elastography in differential diagnosis of benign and malignant breast lesions HE Feng-jie, ZHANG Hui-ping, GU Ji-ying, DU Lian-fang, WU Rong, BAI Min 2019, 39 (4):  393.  doi: 10.3969/j.issn.1674-8115.2019.04.011 Abstract ( 760 )   PDF (6471KB) ( 535 )   Objective · To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system (BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography (SWE) to identify benign and malignant breast lesions. Methods · A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignantBI-RADS classification criteria. Then all the masses were examined with shear wave elastography (SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions, the pathological results were used as the gold standard to construct the receiver operating characteristic (ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results · The area under curve (AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination (BI-RADS classification vs. combination: Z2.883, P0.002; SWE vs. combination: Z4.081, P0.000). Conclusion · The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions. [Key words]breast lesions; breast imaging reporting and data system (BI-RADS); shear wave elastography (SWE） Related Articles | Metrics

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Analysis of X-ray signs and postoperative pathological features of breast cancer SUN Xiao-yin, ZHUANG Zhi-gang, FU Yun, CHENG Xiao-lin 2019, 39 (4):  398.  doi: 10.3969/j.issn.1674-8115.2019.04.012 Abstract ( 806 )   PDF (7860KB) ( 246 )   Objective · To investigate the relationship between the mammographic signs and the pathological features in breast cancer. Methods · August 2015 to August 2018, 300 patients with primary breast cancer confirmedoperation and pathology in Shanghai First Maternity and Infant Hospital, Tongji University were selected. All patients had mammography before operation. The relation between characteristics of molybdenum target imaging and pathological types were retrospectively analyzed. The correlation between specific imaging signs such as lump, calcification, spiculation sign and important pathological features were further analyzed. Results · Among 300 cases of breast cancer, 251 cases (83.7%) had lumps, of which 183 cases had spiculation sign, and 190 cases had calcification. Besides, 235 cases (78.3%) had calcification; 77 cases (25.7%) had structural disorder with diffdensity; 98 cases (32.7%) had positive signs of vascular symptoms. Lump (95.1%), spiculation sign (82.3%) and calcification (83.7%) were mostly observed in invasive ductal carcinoma. Structural disorder (88.2%) was mostly observed in invasive lobular carcinoma. Calcification (96.1%) and lump (60.8%) were mostly observed in intraductal carcinoma. Calcification (100.0%) was mostly observed in lobular carcinoma in situ. Lump was mostly observed in simple carcinoma, medullary carcinoma and mucinous adenocarcinoma. The positive rates of estrogen receptor (ER) and progesterone receptor (PR) were higher in patients with tumor lump >5 cm than those with tumor lump ≤ 5 cm, but there were no significant differences (P0.165, P0.317). The positive rate of ER was 54.5% and the positive rate of PR was 60.8% in patients with calcification, which were lower than those without calcification (P0.027, P0.006). The positive rate of PR in patients with spiculation sign was 71.6%, which was higher than those without spiculation sign (P0.018). But there was no significant difference in the of ER in patients with or without spiculation sign (P0.321). Patients with lumps alone had a lower incidence of lymph node metastasis (29.5% vs 37.9%, P0.009), and lower histological grade (P0.043), in comparison with patients with lumps and calcification. But they had higher ER positive rate (70.5% vs 57.9%, P0.033) and PR positive rate (73.8% vs 65.3%, P0.014). Conclusion · Breast cancer patients with different pathological types show different signs of mammography which may have certain associations with the of immunohistochemical indicators such as ER and PR. Simple lump shadows in mammography may be a predictor in the good prognosis of breast cancer. [Key words]breast cancer; molybdenum target X-ray; pathological feature; immunohistochemical indicator Related Articles | Metrics

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Diagnostic value of multidetector CT in acute and chronic mesenteric venous thrombosis YANG Yue1, 2, YAO Chun-hui1, TANG Xue-lian1 ZHANG Qin1, LI Bo1, TAN Juan1,MA Hai-hong1, MAI MAI TI MING · Ma-he-mu-ti1,DI LI XIA TI · Yi-ming1, TU ER XUN A YI · A-bu-li-mi-ti1, CHENG Fan-zhi1, LI Wen-bin1, 2 2019, 39 (4):  403.  doi: 10.3969/j.issn.1674-8115.2019.04.013 Abstract ( 575 )   PDF (5109KB) ( 353 )   Objective · To analyze the multidetector CT (MDCT) manifestations of mesenteric venous thrombosis (MVT) and further explore the diagnostic value of MDCT in acute and chronic MVT. Methods · MDCT findings of 47 MVT patients clinically confirmed in Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University and Second Peoples Hospital in Kashgar January 2012 to October 2018 were retrospectively analyzed. The mean CT value of thrombus on CT axial images of acute and chronic MVT was measured and calculated. According to CT values and CT manifestations, differences between the two groups were statistically analyzed. Results · Among 47 patients with MVT, there were 46 (97.87%) with filling defect of mesenteric vein and its branches, 34 (72.34%) with dilatation of blood vessels at the thrombosis site, 30 (63.82%) with intestinal wall thickening, 9 (19.15%) with enhanced delamination of intestinal wall, 11 (23.40%) with intestinal dilatation, 21 (44.68%) with ascites, and 25 (53.19%) with mesenteric edema. The mean CT value of MVT thrombus in acute group [(42.88±17.77) HU]was higher than that in chronic group [(31.80±6.18) HU](P<0.05). The proportion of MVT with vasodilation and target sign in acute group was higher than that in chronic group (P<0.05). There was no difference in the ratio of other signs between the two groups. Conclusion · The MDCT findings of MVT patients are characteristic. CT value of thrombus, vasodilation and target sign are valuable in evaluating acute and chronic MVT. [Key words]mesenteric venous; thrombosis; CT value Related Articles | Metrics

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Analysis of factors influencing postoperative gastrointestinal function recovery in patients undergoing hyperthermic intraperitoneal chemotherapy YANG Hua1, CHEN Qing1, DENG Li1, CAO Ye1, LI Wen-xiang1, XU Jing1, 2, WANG Jiong-yuan1, 2, TONG Han-xing1, 2, ZHOU Yu-hong3, ZHANG Yong1, 2, LU Wei-qi1, 2 2019, 39 (4):  407.  doi: 10.3969/j.issn.1674-8115.2019.04.014 Abstract ( 742 )   PDF (7521KB) ( 327 )   Objective · To investigate the effect of hyperthermic intraperitoneal chemotherapy on postoperative gastrointestinal function recovery in patients with gastrointestinal cancer. Methods · Sixty-two cases of gastrointestinal cancer patients were enrolled who accepted cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, July 2014 to June 2017. The gastrointestinal function of patients were evaluated according to the I-FEED scoring system. The patients were divided into normal recovery group (I-FEED score<6, n38) and delayed recovery group (I-FEED score ≥6, n24). Univariate and multivariate Logistic analyses were performed on characteristic factors that may affect the recovery of postoperative gastrointestinal function including gender, age, presence of diabetes, preoperative albumin, and so on. Results · There were significantly differences in the preoperative serum albumin level (P0.040), intraoperative bleeding (P0.044), the time of extraction of the peritoneal cavity drainage tube (P0.026), the time of urethral tube extraction (P0.021) and the time of hospitalization (P0.017) in the two groups of patients with normal or delayed gastrointestinal function recovery. Multivariate Logistic regression results suggested that preoperative serum albumin level may be beneficial for the recovery of postoperative gastrointestinal function (OR0.84, 95% CI 0.17-4.27, P0.041). Conclusion · The preoperative serum albumin level can be used as an independent predictor of postoperative gastrointestinal functional recovery in patients with gastrointestinal cancer after cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. [Key words]gastrointestinal tumor; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; gastrointestinal function recovery Related Articles | Metrics

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Curative efficacy and influencing factors of 131I treatment for pulmonary metastases differentiated thyroid carcinoma XU Zhong-yun, WU Shu-qi, WANG Shao-yan, WANG Dan-yang, FU Hong-liang 2019, 39 (4):  412.  doi: 10.3969/j.issn.1674-8115.2019.04.015 Abstract ( 774 )   PDF (6321KB) ( 385 )   Objective · To investigate the curative efficacy and influential factors of 131I treatment for pulmonary metastases differentiated thyroid carcinoma (DTC). Methods · A total of 95 DTC patients (33 males and 62 females) with pulmonary metastasis who underwent 131I treatment in Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, April 2012 to May 2016 were retrospectively analyzed. The efficacy of 131I treatment was assessed using determination of serum thyroglobulin level and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT). The possible factors affecting efficacy included gender, age, pathological classification, wheteer pulmonary metastasis diagnosed before treatment, the iodine and 18F-FDG uptake of pulmonary lesions, the size and number of lung lesions, extrapulmonary distant metastasis. Univariate analysis was performed using Rank test and χ2 test, the critical value was obtained through receiver operating characteristic (ROC) curve and Logistic regression was also performed. Results · The rates of efficacy and inefficacy of 131I treatment were 53.68% and 46.32%, respectively. Univariate analyses showed that maximum standardized uptake value (SUVmax) evaluated18F-FDG PET/CT (P0.004), the size of lung metastases (P0.000), age<45 years (P0.004), 131I uptake (P0.022), whether pulmonary metastasis diagnosed before treatment (P0.000), extrapulmonary distant metastasis (P0.014) were the factors influencing outcome of 131I treatment. The critical value of 18F-FDG uptake for patients obtainedROC curve was 1.45 (sensitivity of 56.8% and specificity of 76.5%) and the critical value of lung lesion diameter was 9.63 mm (sensitivity of 43.2% and specificity of 88.2%). Multivariate Logistic regression analysis showed that the influential factors included the age of patients, the size and 18F-FDG SUVmax of lung metastases and whether pulmonary metastasis diagnosed before treatment. Conclusion · 131I treatment is an effective method for pulmonary metastases DTC. The patients aged less than 45 years, with the lung lesion size less than 9.63 cm, low 18F-FDG SUVmax and diagnosed before treatment may have good response to 131I treatment. [Key words]thyroid neoplasm; neoplasm metastasis; lung; radiotherapy; iodine radioisotope Related Articles | Metrics

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Analysis of contrast-enhanced ultrasound performance of adrenal cortical adenoma and cortical hyperplasia nodules LI Chun-xiao, LI Fan, BAI Min, LI Xin, SHAO Si-hui 2019, 39 (4):  416.  doi: 10.3969/j.issn.1674-8115.2019.04.016 Abstract ( 915 )   PDF (6527KB) ( 322 )   Objective · To explore the features of contrast-enhanced ultrasound (CEUS) image of adrenal cortical adenoma and cortical hyperplasia nodules (size greater than 10 mm) and its diagnostic value. Methods · Fifty cases of adrenal cortical adenoma and 22 cases of cortical hyperplasia nodules which were confirmedpathology were retrospectively analyzed. The conventional ultrasound and CEUS features were recorded, including the size,border,arrival time, peak time, wash-out time, enhancement degree [hypo, hyper (iso-)],enhancement pattern (peripheral to central,overall,and nonspecific), etc. Results · There was no significant differences between two groups among conventional ultrasonic features. Multi-parameters of CEUS images analysis results showed that the wash-out time of cortical adenomas were significantly longer than the cortical hyperplasia nodules (P0.002), the under area of the receiver operating characteristic (ROC) curve was 0.694, had the 75.7% sensitivity and 53.3% specificity with the cutoff of 42 s. Conclusion · There is no significant difference between the adrenal cortical adenoma and cortex hyperplasia nodules in CEUS pattern, but it still can provide certain information for differentiation. [Key words]contrast-enhanced ultrasound; adrenal tumor; adrenal cortical adenoma Related Articles | Metrics

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Exposure status of multiple environmental pollutants during pregnancy: based on biomonitoring data Laizhou Wan Birth Cohort in Shandong QIN Kai-li1*, LIU An-ming2*, YUAN Chong-gang3, SHI Rong1, YAO Qian1, CAI Chen4, ZHOU Yi-jun1, TIAN Ying1, 5, ZHANG Yan1, GAO Yu1 2019, 39 (4):  421.  doi: 10.3969/j.issn.1674-8115.2019.04.017 Abstract ( 628 )   PDF (9978KB) ( 372 )   Objective · To evaluate the levels of environmental pollutants including lead, mercury, organophosphorus pesticides (OPs), perfluoroalkyl and polyfluoroalkyl substances (PFASs) and triclosan (TCS) and further analyze the correlation between these pollutants in pregnant women. Methods · Pregnant women were recruited the Laizhou Wan Birth Cohort (LWBC) in Shandong September 2010 to December 2013. A total of 149 pregnant women were finally enrolled who completed questionnaires and provided sufficient biological samples for pollutants measurement including blood lead, blood mercury, urinary metabolites of OPs[dimethylphosphate (DMP), dimethylthiophosphate (DMTP), diethylphosphate (DEP), diethylthiophosphate (DETP), etc.], serum perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS), as well as urinary TCS. Spearman correlation analysis and cosine cluster analysis were used to explore the correlation between pollutants. Results · The detection rates of lead, DMP, PFOA and PFOS were all 100.0%. And the detection rates of mercury, DMTP, DEP, DETP and TCS were 89.3%, 81.2%, 97.3%, 96.6% and 59.1%, respectively. The median and range of concentrations for lead, mercury, PFOA, PFOS and TCS were 28.40 (11.30–65.70) μg/L, 0.85 ( Related Articles | Metrics

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Action of ketamine and endocannabinoid system in rapid anti-depression therapy YAO Ya-min, FANG Yi-ru 2019, 39 (4):  428.  doi: 10.3969/j.issn.1674-8115.2019.04.018 Abstract ( 772 )   PDF (7335KB) ( 340 )   Major depression disorder (MDD) is a common but serious affective disorder in modern society. Suicide idea and suicide behaviour inducedMDD during its later stage put a heavy burden on society and family. Anti-depression drugs lack efficiency in treating a portion of MDD patients. This is referred to as treatment resistant depression (TRD). A study reported the rapid onset and long lasting anti-depression effect of ketamine, which also come into effect in TRD patients. Δ9-Tetrahydrocannabinol is the active substance of marijuana, which also exerts rapid anti-depression effect via targeting at brain cannabinoid receptors. The two central nerve system stimulants belonging to the tightly controlled psychoactive substances have obvious adverse effects. This article summarizes the action of ketamine and endocannabinoid system in rapid anti-depression therapy in recent researches. [Key words]ketamine; endocannabinoid system; major depression disorder; Δ9-tetrahydrocannabinol (Δ9-THC); brain derived neurontrophic factor (BDNF); mammalian target of rapamycin (mTOR) pathway; N-methyl-D-aspartate (NMDA) receptor Related Articles | Metrics

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Advances on risk factor for eating disorders GAO Yi-ming, CHEN Jue 2019, 39 (4):  432.  doi: 10.3969/j.issn.1674-8115.2019.04.019 Abstract ( 800 )   PDF (6675KB) ( 700 )   Eating disorder is a kind of complex multifactorial disease. Although the etiology of the disease is still not fully expounded, it is certain that its etiology is closely related to biological, psychological and sociocultural factors. It is helpful to make early predictions and interventions for patients with eating disorderslearning through the studies of risk factors for eating disorder, which is also meaningful to provide more guidance and evidence for clinical work. Guidedrecent studies, this review summarizes recent findings and clarifies the latest identified risk factors for eating disorders in the main areas of biology, psychology, and sociocultural environment. [Key words]eating disorders; risk factors; biology; psychology; sociocultural environment Related Articles | Metrics

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Imaging evaluation of post-myocardial infarction injury MIAO Yu-tong1, SHEN Lan1, 2, HE Ben1 2019, 39 (4):  436.  doi: 10.3969/j.issn.1674-8115.2019.04.020 Abstract ( 834 )   PDF (7328KB) ( 310 )   Imaging techniques play a vital role in evaluating myocardial damage in patients with myocardial infarction. Accurate evaluations of post-infarction function and scar can help identify high-risk patients and provide prognosis information, which contributes much to clinical practice. The assessment of myocardial damage mainly includes overall evaluations of ventricular function and remodeling and targeted characterization of myocardial infarction including infarct size, myocardial viability and microvascular obstruction. Echocardiography, cardiac magnetic resonance, CT and nuclear examinations are most common imaging techniques currently. This review is to evidence on applications of these modalities in evaluation of post-infarction myocardial damage and offer some helps to health workers. [Key words]myocardial infarction; myocardial damage; image techniques Related Articles | Metrics

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PET/CT for guidance of lymphadenectomy of high-risk prostate cancer in patients with chronic lymphocytic leukemia: 1 case report ZHU Yin-jie, WANG Yan-qing, PAN Jia-hua, DONG Bai-jun, XUE Wei 2019, 39 (4):  440.  doi: 10.3969/j.issn.1674-8115.2019.04.021 Abstract ( 908 )   PDF (4189KB) ( 414 )   A 70-year-old male with chronic lymphocytic leukemia (CLL) 9 years ago initially presenting elevation of prostate specific antigen (PSA) was diagnosed with high-risk prostate cancer in March, 2018. He received 18F-FDG positron emission tomography/computed tomography (PET/CT), which showed mild FDG-avidity in swollen lymph nodes across the entire body, considering CLL. Then he underwent neoadjuvant androgen deprivation therapy for 1 month and then robot-assisted radical prostatectomy and biopsy of the right iliac vascular obturator lymph nodes. The prostate pathology was prostate cancer, and the pathology of lymph nodes was CLL. His serum PSA levels 1 month and 3 months after operation both reached the level of cure. For the patients with concomitant high-risk prostate cancer and CLL, PET/CT may be valuable in distinguishing whether the swollen lymph nodes were infiltratedprostate cancer and guiding the lymphadenectomy. [Key words]prostate neoplasm; chronic lymphocytic leukemia; positron emission tomography/computed tomography; lymphadenectomy Related Articles | Metrics