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    Current situation analysis and development plan for clinical specialties of Shanghai Jiao Tong University School of Medicine based on bibliometric methods
    LI Dong-liang1, ZHANG Wei-wei1, YAN Jia-yu2, LI Chun-hong1, SHI Qiong-yun1, TAO Ye-xuan1
    2019, 39 (6):  557. 
    doi: 10.3969/j.issn.1674-8115.2019.06.001

    Abstract ( 438 )   PDF (8303KB) ( 247 )  
    Objective · To compare the current situation and propose the development plan for the clinical specialties of Shanghai Jiao Tong University School of Medicine. Methods · Based on Scopus database, English academic papers issued39 clinical specialties of Shanghai Jiao Tong University School of Medicine during 2011-2015 were analyzedbibliometric methods. Results · The overall performance of the clinical specialties was good. The total scholarly output was 8 957 and showed an increasing trend yearyear, the total citation was 99 342, the total average citation was 11.1, the total number of Top 1% of highly cited papers was 83, the total international cooperation papers accounted for 16.3%, and the total field-weighted citation impact of 22 clinical specialties was higher than the world average level. However, the development of each clinical specialty was not balanced. According to the number of the outstanding indexes, the 39 clinical specialties could be divided into five types, including leading type, advantage type, potential type, characteristic type, and disadvantaged type. Conclusion · According to the different types of clinical specialties, medical colleges should adhere to the development concept of classified management and take targeted measures to promote the overall level of clinical specialties.
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    Original article (Basic research)
    Analysis of niacin skin flush in clinical high risk population of psychosis
    WANG Yan, ZHENG Yan-qun, ZHANG Tian-hong, XU Li-hua,WANG Ji-jun
    2019, 39 (6):  564. 
    doi: 10.3969/j.issn.1674-8115.2019.06.002

    Abstract ( 613 )   PDF (9409KB) ( 245 )  
    Objective · To explore and analyze the characteristics of nicotinic acid skin sensitivity in clinical high risk (CHR) population of psychosis. Methods · One hundred and five patients with CHR of psychosis (CHR group) and fifty-one patients with first episode schizophrenia (FES) (FES group) in Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine Jun. 2016 to Jun. 2018, and fifty-four healthy controls (HC group) were included. The patients of CHR group met the criteria of prodromal syndromes, and the patients of FES group met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). The patients of HC group were matched with CHR group in age and gender . The niacin skin flush of the three groups were detected. The niacin skin flush scores of the three groups were comparedsingle factor repeated measurement variance analysis (MANOVA). The niacin flush negative rates of the three groups were comparedChi-square test. Results · Compared with HC group, the niacin skin flush of CHR group and FES group reduced at different concentrations and time points. MANOVA showed a significant main group effect of niacin skin flush (F1.746, P0.009). There were no significant group × concentration interaction (F1.628, P0.138) and group × time interaction (F0.851, P0.531). Compared with HC group, the niacin total flush scores of CHR group were lower (t-2.697, P0.008). The significant differences of the proportion of patients with negative niacin reaction among the three groups were found for the concentration of 0.1 mol/L at 5 min (χ216.709, P0.000) and 0.001 mol/L at 20 min (χ26.380, P0.041). Conclusion · The reduction of the niacin skin flush can occur not only in the patients with schizophrenia but also in the CHR of psychosis in the precursor phase. Niacin skin flush may be an early biological marker of schizophrenia.
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    Effects of lutein on transforming growth factor-β2 induced epithelial-mesenchymal transition in ARPE-19 cells
    Lü Ya-nan, GU Qing, LI Dong-li, GONG Yuan-yuan
    2019, 39 (6):  571. 
    doi: 10.3969/j.issn.1674-8115.2019.06.003

    Abstract ( 457 )   PDF (7880KB) ( 179 )  
    Objective · To establish the transforming growth factor-β2 (TGF-β2) induced epithelial-mesenchymal transition (EMT) model of retinal pigment epithelium cells, and investigate the effect and mechanism of lutein on EMT. Methods · ARPE-19 cells were cultured and divided into 4 groups including control group, TGF-β2 group, TGF-β2+lutein group and lutein group. The mRNA levels of α-smooth muscle actin (α-SMA), fibronectin (FN) and E-cadherin were analyzedreal-time PCR. The protein of α-SMA, FN and occludin were assayedWestern blotting. Immunofluorescence was used to detect the change of α-SMA. Meanwhile, Western blotting was performed to detect the levels of pSmad3 in the TGF/Smad signaling pathway. Results · TGF-β2 induced EMT was inhibitedlutein. Lutein decreased the mRNA and protein levels of the mesenchymal markers α-SMA and FN, and increased the of the epithelial markers E-cadherin and occludin (all P<0.05). Immunofluorescence showed that lutein can inhibit the conversion of epithelial cells into myofibroblasts. Lutein significantly downregulated the high of pSmad3 in TGF-β2 treated ARPE-19 cells (P0.001). Conclusion · Lutein inhibits TGF-β2 induced EMTdownregulating the of pSmad3 in TGF-β/ Smad signaling pathway, indicating it may attenuate subretinal fibrosis.
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    Regulation on brain-derived neurotrophic factor and relevant mechanism of anemarrhena saponin in H2O2-induced SH-SY5Y cells
    YANG Shuang-shuang1*, GAO Tian-xing2*, HE Xuan1, ZHANG Rui1, ZHANG Yong-fang1
    2019, 39 (6):  578. 
    doi: 10.3969/j.issn.1674-8115.2019.06.004

    Abstract ( 366 )   PDF (10104KB) ( 196 )  
    Objective &middot; To investigate the effect of anemarrhena saponin (ZMS) on mRNA level of brain-derived neurotrophic factor (BDNF) and relevant mechanism in oxidative stress damage of SH-SY5Y cells. Methods &middot; SH-SY5Y cells treated with H2O2 were chosen as cell models of oxidative stress. Cell viability was determined using cell counting kit-8 (CCK-8). The mRNA levels of BDNF and its important transcripts were detectedquantitative real-time PCR (qPCR). The histone deacetylases (HDACs) activity fluorescence quantification assay kit was used to measure the effect of ZMS on HDACs activity. Western blotting was used to detect the protein levels of acetylated histone H3, acetylated histone H4, specific acetylation site-related proteins, and HDAC1/2/3. Results &middot; qPCR showed that ZMS could increase the mRNA levels of BDNF and its transcript Ⅳ in the cell models. Western blotting showed that ZMS pretreatment could increase the protein levels of acetylated histone H3, acetylated histone H4 and acetylated histone H3K14, and there was no significant effect on protein levels of HDAC1/2/3. In addition, HDACs activity fluorescence quantification assay kit showed that ZMS could inhibit HDACs activity significantly. Conclusion &middot; ZMS can increase the mRNA levels of BDNF and its transcript Ⅳ in oxidative stress damage cell models, which may be related to the regulation of histone acetylation level.
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    Regulating effect of fatty acid binding protein 3 on survival and apoptosis of cardiomyocytes under hypoxia
    ZHUANG Ling-fang, CHEN Kang
    2019, 39 (6):  586. 
    doi: 10.3969/j.issn.1674-8115.2019.06.005

    Abstract ( 462 )   PDF (7119KB) ( 199 )  
    Objective &middot; To investigate the effects and potential mechanisms of fatty acid binding protein 3 (FABP3) on cell survival under hypoxia. Methods &middot; Neonatal rat ventricular myocytes were stimulated with recombinant human FABP3 proteins, and then the differences of cell viability and cell death between groups were verifiedtrypan blue assay and MTT assay. Besides, the of PARP and caspase 3 protein, the level of reactive oxygen species (ROS), and mitochondrial membrane potentials under hypoxia were compared between groups for more confirmation. Results &middot; FABP3 increased cardiomyocytes&rsquo; death and decreased cell viability under hypoxia (P0.021). It was discovered that FABP3 upregulated the levels of cleaved PARP and cleaved caspase 3 (P0.006, P0.002), increased the level of intracellular ROS (P0.038), and declined the mitochondrial membrane potentials as well (P0.002). Conclusion &middot; FABP3 contributes to cell survival and apoptosisregulating intracellular ROS and mitochondrial membrane potentials under hypoxia.
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    Original article (Clinical research)
    Abnormality of &theta; oscillation in auditory event-related potential P300 in patients with clinical high risk of psychosis or first-episode schizophrenia
    GUO Qian1*, WANG Jun-jie2*, LIU Xu3, ZHENG Li-na4, LI Guan-jun1, LI Jin2, WANG Ji-jun5
    2019, 39 (6):  593. 
    doi: 10.3969/j.issn.1674-8115.2019.06.006

    Abstract ( 496 )   PDF (7510KB) ( 217 )  
    Objective · To explore the relationship between θ oscillation of auditory event-related potential P300 and clinical symptoms in the patients with clinical high risk (CHR) of psychosis or first episode schizophrenia (FES). Methods · A total of 18 patients with CHR of psychosis (CHR group), 18 patients with FES (FES group) and 19 healthy controls (control group) were recruited to complete the standard auditory Oddball paradigm as well as electroencephalogram (EEG) recording with 64-channel EEG cap. Fz, Cz and Pz electrodes were selected to compare the amplitudes and peak latent periods among the three groups, and time-frequency analysis of the θ oscillation in P300 was performed. Results · There was significant difference in the amplitudes of P300 among the three groups (P0.004). The amplitudes of P300 in FES group (P0.001) and CHR group (P0.026) were both significantly lower than that of control group. There was no difference between CHR group and FES group in P300 amplitude (P>0.05). θ Oscillation induced power was significantly different among the three groups (P0.022). The induced power value of FES group was significantly lower than that of control group (P0.008); and it was marginally lower in CHR group as compared to that of control group (P0.054). There was no difference between CHR group and FES group (P>0.05). There was trending difference in θ oscillation evoked power among the three groups (P0.054). The correlation analysis showed that the total and subscale scores of Positive and Negative Syndrome Scale in FES group were significantly correlated with the amplitudes of P300 at Cz and Pz electrodes (P<0.05). Conclusion · There are significant abnormalities in the amplitude of auditory P300 and θ oscillation of P300 in both CHR and FES patients; however, the change in CHR patients is less severe than that of FES patients. The impaired θ oscillation of P300 in CHR patients is limited to induced power, but evoked power is not impaired.
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    Automated analysis of microaneurysm lesions in standard seven-field color fundus photography
    YU Qi1, 2, LIU Meng-xue3, YANG Jie3, LIU Kun1, 2, XU Xun1, 2
    2019, 39 (6):  598. 
    doi: 10.3969/j.issn.1674-8115.2019.06.007

    Abstract ( 481 )   PDF (8760KB) ( 168 )  
    Objective &middot; To evaluate the accuracy and efficiency of the automated supervised machine-learning algorithm for microaneurysm lesion detection in seven-field color fundus photography. Methods &middot; A total of 616 seven-field color fundus photographs were obtained 44 patients with diabetic retinopathy (DR) Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine 2014 to 2016. Using the microaneurysm detection algorithm developed in this study, the automated identification and labeling of microaneurysm lesions in the standard seven-field color photography of DR were performed. The results were compared with manual labelingophthalmologists to evaluate the sensitivity and efficiency of the automated algorithm. Results &middot; In the standard seven-field fundus color photographic image library, the automated algorithm achieved sensitivity of 94.15% in total and 93.09% in the optic disc field (F1), 94.84% in the macula field (F2), 95.16% in the temporal to macula field (F3), 94.99% in the superior temporal field (F4), 93.77% in the inferior temporal field (F5), 92.40% in the superior nasal field (F6) and 93.75% in the inferior nasal field (F7), and specificity of 98.05% in total and 98.02% in F1, 98.06% in F2, 97.97% in F3, 97.91% in F4, 98.07% in F5, 98.03% in F6 and 98.23% in F7. The cost of time per image was (9.2&plusmn; 0.6) s, 93.2% less time than manual labeling. Conclusion &middot; The automated microaneurysm detection algorithm can accurately and efficiently identify microaneurysm lesions in color fundus photography.
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    Macular blood flow changes assessedoptical coherence tomography angiography after pars plana vitrectomy with gas or silicone oil tamponade for the patients with rhegmatogenous retinal detachment
    CHEN Yu-hong1*, XIANG Xiao-qiong1*, ZHU Hong1, 2, SUN Tao1, LI Xian-Chen3, WANG Hong1
    2019, 39 (6):  605. 
    doi: 10.3969/j.issn.1674-8115.2019.06.008

    Abstract ( 389 )   PDF (9444KB) ( 169 )  
    Objective &middot; To investigate the effect of different vitreous fillers on the macular blood flow of patients with rhegmatogenous retinal detachment (RRD), and the correlation between the macular blood flow and the best corrected visual acuity (BCVA). Methods &middot; In this retrospective study, 74 eyes in 74 patients with RRD for first time underwent pars plana vitrectomy in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine Dec. 2017 to Jun. 2018 were included. According to different vitreous fillers, the patients were divided into two group, i.e. pars plana vitrectomy with gas tamponade group (gas group) and pars plana vitrectomy with silicone oil tamponade group (silicone oil group). The blood flow in 3 mm&times;3 mm macular area was detectedoptical coherence tomography angiography (OCTA). The blood flow densities of superficial capillary plexus (SCP) and deep capillary plexus (DCP) at foveal and parafoveal area, and the areas and perimeters of foveal avascular zone (FAZ) were calculated. The correlations between the macular blood flow parameters and BCVA were analyzedpartial correlation. Results &middot; Compared with the silicone oil group, the blood flow densities of SCP and DCP in the whole 3 mm&times;3 mm regions in the gas group were higher at 6 months after surgery (both P0.000). The partial correlation showed that the improvement of visual acuity was negatively correlated with the change of FAZ area (r-0.216, P0.015). Conclusion &middot; Gas is an advantageous tamponade for the patients with RRD in improvement of blood flow density in the macular area. Meanwhile, assessing the macular blood flow density of the patients with retinal detachmentusing OCTA after vitrectomy is significant to monitor the changes of structure and function of retina.
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    Automatic layer segmentation of optical coherence tomography images in retinal vascular diseases
    XU Yu-peng1*, DU Yu-chen1, 2*, CHEN Feng-e1
    2019, 39 (6):  613. 
    doi: 10.3969/j.issn.1674-8115.2019.06.009

    Abstract ( 468 )   PDF (10392KB) ( 150 )  
    Objective &middot; To explore the layer segmentation method of optical coherence tomography (OCT) images of retinal vascular diseases using an unsupervised learning method, and compare it with the built-in layering method of OCT machine. Methods &middot; Standardized image acquisition was performed on OCT images 50 patients with myopic choroidal neovascularization (mCNV) and 20 patients with diabetic macular edema (DME). Standards were establishedmanual marking of hierarchical informationprofessional physicians. A retinal multi-layer segmentation method based on the minimization of interlayer energy was proposed, and the results were compared with those obtainedthe built-in layering method of OCT machine. The layering accuracy was verifiedthe unmarked boundary position error. Results &middot; This segmentation method divided the retina of each patient into five layers: internal limiting membrane, lower layer of nerve fiber layer, upper layer of outer nuclear layer, upper layer of ellipsoid zone and Bruchs membrane. The average segmentation error in the overall data set was (4.831&plusmn;7.015) &mu;m. The error of mCNV group and DME group were (4.839&plusmn;16.819) &mu;m and (5.048&plusmn;9.986) &mu;m, respectively, both of which were lower than the automatic measurement results of OCT machine [(13.638&plusmn;58.024) &mu;m and (14.796&plusmn;45.342) &mu;m, respectively]. The accuracy of this method at each layer was higher than that of the automatic measurement. Conclusion &middot; This multi-layer segmentation method can be used for segmentation of different types of retinal vascular diseases, and the results are significantly better than those obtainedthe built-in method in OCT machine. It can be extended for layer segmentation of other retinal vascular diseases.
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    Efficacy and cost-effectiveness of internet-based cognitive behavioral therapy for obsessive-compulsive disorder
    ZHOU Yu-xin1, GAO Rui1, WANG Zhen2, WANG Chun3, FAN Qing4
    2019, 39 (6):  622. 
    doi: 10.3969/j.issn.1674-8115.2019.06.010

    Abstract ( 496 )   PDF (10037KB) ( 240 )  
    Objective &middot; To compare the therapeutic effect, cost, cost-effectiveness and utility between internet-based cognitive behavioral therapy (ICBT) and cognitive behavioral group therapy (CBGT) in the patients with obsessive-compulsive disorder (OCD). Methods &middot; Twenty-eight patients who met the OCD diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) were assigned to ICBT group (n16) and CBGT group (n12) according to the patients willingness. Both groups were treated for 6 weeks. The study compared differences in the severity of OCD and symptoms of anxiety and depressive at baseline, during treatment and after treatment, as well as differences in cost, cost-effectiveness and utility between two groups. Results &middot; There was no significant difference in the scores of Yale-Brown Obsessive Compulsive Scale (YBOCS), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Visual Analog Scale (VAS) [a component of EuroQol Five Dimensions Questionnaire, (EQ-5D)]between the two groups at baseline (P0.291, P0.114, P0.478, P0.799). After treatment, the YBOCS scores decreased compared to pre-treatment in two groups. There was no statistical difference in subtraction rate of YBOCS between the two groups (P0.291). The SDS scores of ICBT group also decreased after treatment compared to pre-treatment (P0.003). The average cost per patient in ICBT group was 2 710.50 yuan less than that in CBGT group. When one YBOCS score per patient reduced, ICBT group spent 281.33 yuan less than CBGT group. The VAS scores were significantly improved after 6-week treatment and ICBT group has a more significant improvement. Conclusion &middot; ICBT and CBGT have comparable and significant efficacy. And ICBT is a lower cost and more cost-effectiveness and utility treatment than CBGT.
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    Analysis of risk factors of decreased heart rate variability in patients with type 2 diabetes mellitus
    GAO Wei1, WANG Xue-jiao2, ZHEN Qin2, DING Xiao-ying2, XU Huan-bai2, WANG Yu-fan2, PENG Yong-de2
    2019, 39 (6):  629. 
    doi: 10.3969/j.issn.1674-8115.2019.06.011

    Abstract ( 486 )   PDF (9978KB) ( 193 )  
    Objective · To analyze the related risk factors of decreased heart rate variability (HRV) in type 2 diabetes mellitus (T2DM) patients. Methods · A total of 210 cases with T2DM in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine Jan. 2013 to Dec. 2014 were divided into two groupsthe levels of urinary albumin creatinine ratio (UACR) and serum triacylglycerol (TAG), and with/without hypertension, respectively.comparing the differences of clinical characteristics, HRV parameters and other general clinical data between the two groups, the correlations between HRV indexes and their risk factors were explored. Results · The average heart rate of the whole day was higher, and SDNN [normal RR intervals of sinus beats (NN intervals) standard deviation]was lower in the high UACR group than those in the normal UACR group (both P<0.05). The average heart rate of the whole day was higher, while SDNN and pNN50 (percentage of total heart beats with adjacent NN intervals greater than 50 ms) were lower in the hypertriglyceridemia group than those in the normal TAG group (all P<0.05). Minimum frequency domain power hour was lower in the hypertension group than that in the normotension group (P<0.05). Regression analysis showed that the linear correlativity between TAG and SDNN was very prominent (P<0.05), as well as between the diastolic blood pressure (DBP) and the average heart rate of the whole day, SDNN, frequency domain power 24 hours and minimum frequency domain power hour (all P<0.05). Similarly, the age was linearly correlated significantly with the average heart rate of the whole day, SDNN, SDANN (the standard deviation of the mean NN intervals every 5 min), frequency domain power 24 hours, minimum frequency domain power hour and maximum frequency domain power hour (all P<0.05). Conclusion · Age, TAG level and hypertension are the risk factors of decreased HRV in T2DM patients. Thus, early detection of the decrease of HRV in these patients can prevent the cardiovascular events of T2DM.
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    Application and exploration of mixed reality technology in accurate operation of percutaneous vertebroplasty of spine
    MA Xiao-jun1, LIN Yan-ping2, HUANG Ya-lei3, SUN Wei1, SHEN Jia-kang1, SUN Meng-xiong1, ZUO Dong-qing1, FU Ze-ze1, WANG Lei1, FU Qiang1, CAI Zheng-dong1
    2019, 39 (6):  636. 
    doi: 10.3969/j.issn.1674-8115.2019.06.012

    Abstract ( 414 )   PDF (8138KB) ( 134 )  
    Objective &middot; To explore the application and clinical significance of mixed reality technology in percutaneous vertebroplasty of spine. Methods &middot; A 79-year-old female patient with multiple osteoporotic compression fractures was selected in Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine. Lumbar 64-row CT scan was performed to obtain digital imaging and communications in medicine (DICOM) data. Three-dimensional reconstruction software was imported to construct the model of spinal compression fracture. Visual edge detection, segmentation, extraction and calculation of spinal skeleton were performed to generate a three-dimensional network. Collateral model,mixed reality smartglasses,three-dimensional image of the compression spine image was compared to the real world. Mixed reality technology could assist the surgeon to complete the preoperative simulation, communicate effectively with the patient, and guide percutaneous vertebroplasty of lumber. Results &middot; With mixed reality, the puncture was accurate. The distribution of bone cement was good. The pain of patients was relieved obviously after operation.mixed reality, the operation time was shortened and the side-effects were reduced. Based on reconstruction of mixed reality technology original CT imaging data, the compression fracture and anatomical structure were visualized clearly during operation. The operation path was clear and the compression fracture forming site was accurately located. Conclusion &middot;Mixed reality technology is helpful for accurate puncture in percutaneous vertebroplasty of spine, and has potential for development in minimally invasive treatment of spine.
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    Analysis of pregnancy outcomes and influencing factors of single embryo transfer and double embryo transfer byin vitrofertilization and embryo transfer
    ZHANG Su-qun, NI Chen, SHENG Mei-ping, WANG Yun
    2019, 39 (6):  642. 
    doi: 10.3969/j.issn.1674-8115.2019.06.013

    Abstract ( 436 )   PDF (7716KB) ( 210 )  
    Objective &middot; To compare the pregnancy outcomes between the patients undergoing single embryo transfer and double embryo transferin vitro fertilization and embryo transfer, and analyze the influencing factors. Methods &middot; Jan. 2011 to Jun. 2016, women who underwent single embryo transfer or double embryo transfer with in vitro fertilization and embryo transfer and successfully conceived in Shanghai Ninth People&prime;s Hospital, Shanghai Jiao Tong University School of Medicine were followed up to the pregnancy outcomes. According to the number of embryo transfer, the patients were divided into single embryo transfer group and double embryo transfer group. Univariate analysis (t test, Chi-square test) and multivariate Logistic regression analysis were used to compare the pregnancy outcomes between two groups, and analyze the influencing factors of adverse outcomes. Results &middot; A total of 19 030 patients (98.69%) were followed up to the pregnancy outcomes. Stratified analysis showed that there were significant differences in the composition of pregnancy outcomes (P0.000) and the number of live births (P0.000) between two groups. For the neonatal birth quality, the infants bornthe patients with single embryo transfer had higher birth weights than those bornthe patients with double embryo transfer (P0.000), and the proportions of newborns with low birth weights and full-term newborns with low birth weights were higher among the patients with double embryo transfer compared to those with single embryo transfer (P0.000). In addition, there was no statistically significant difference in he incidence of birth defects between the infants bornthe patients with single embryo transfer and double embryo transfer. Multivariate Logistic regression analysis showed that the risk of abortion or labor induction among the patients with double embryo transfer was higher than those with single embryo transfer with age, infertility causes and embryo type adjusted (OR0.88, P0.025). Conclusion &middot; The risk of adverse pregnancy outcomes is higher among the patients with double embryo transfer than those with single embryo transfer.
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    Survey on cognition, attitude, willingness and demand for non-invasive prenatal testing among pregnant women
    Maerziya YUSUFUJIANG1*, LUO Fei1*, LIU Yu2,3, DONG Yuan-yuan1, XU Gang1, ZHOU Xin-yi1, JIN Ping1, LI Na1
    2019, 39 (6):  648. 
    doi: 10.3969/j.issn.1674-8115.2019.06.014

    Abstract ( 389 )   PDF (7923KB) ( 202 )  
    Objective &middot; To understand the cognition, attitude, willingness and demand for non-invasive prenatal testing (NIPT) of pregnant women. Methods &middot; A total of 852 pregnant women were enrolled, including 318 pregnant women with low risk of Down syndrome screened in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, and 534 pregnant women with high risk of Down syndrome screened in several hospitals in Shanghai who further went to Xinhua Hospital, Shanghai Jiao Tong University School of Medicine for NIPT to confirm the diagnosis of Down syndrome screening. The information about the cognition, attitude, willingness and demand for NIPT was collecteda standard questionnaire. Results &middot; A total of 760 questionnaires were collected, of which 728 ones were valid, with an effective questionnaire rate of 85.45%. The proportion of pregnant women with ideal cognition level was 51.24%. However, 83.10% of pregnant women held a positive attitude towards the promotion of NIPT. There were 79.54% of pregnant women considering it necessary to provide genetic counseling before NIPT. Conclusion &middot; It is of great significance to strengthen the prenatal propaganda and education and pre-test genetic counseling so as to improve the cognitive level of pregnant women and make rational of NIPT.
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    Review
    Modulating neural circuits in substance addiction with repetitive transcranial magnetic stimulation
    XU Xiao-min, CHEN Tian-zhen, JIANG Hai-feng
    2019, 39 (6):  655. 
    doi: 10.3969/j.issn.1674-8115.2019.06.015

    Abstract ( 466 )   PDF (10362KB) ( 178 )  
    Substance addiction is a chronic and recurrent disorder and may be related to complex neural circuits. However, there is no optimally effective treatment for substance addiction currently. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, safe and easy-to-operate neuroelectrophysiological technique, which is becoming an emerging therapeutic option for many mental disorders. The effect of rTMS on substance addiction is closely related to the stimulation of neural circuits. However, the mechanism is still unknown. The review summarizes recent research progress on the application of rTMS and its application combined with other therapies in substance addiction, as well as the regulation of rTMS on substance addiction-related neural circuits.
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    Research advances of physical-neuromodulation intervention of suicidal ideation
    ZHANG Ling1, ZHANG Tian-hong2, WEI Yan-yan2, HUI Li1, WANG Ji-jun2
    2019, 39 (6):  661. 
    doi: 10.3969/j.issn.1674-8115.2019.06.016

    Abstract ( 449 )   PDF (8647KB) ( 169 )  
    Suicide ideation is a serious problem in mental illness. The medication treatment is slow to take effect, of which intervention effect on suicidal ideation is limited. Physical therapy is widely used as an adjuvant therapy, which mainly regulates the central nervous system through physical action (such as electric, magnetic, etc). The common methods of physical therapy include electroconvulsive therapy, transcranial magnetic stimulation, magnetic seizure therapy, vagus nerve stimulation and other neuromodulation techniques. This paper mainly reviews the application and efficacy of physicalneuromodulation intervention on suicidal ideation in patients with mental illness.
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    Atmospheric fine particulate matter causing Alzheimers disease through olfactory bulb pathway: a review of recent studies
    WANG Hao1*, JIANG Shan1*, GONG Yang-ming2, LIU Yan3, HUA Li1, DENG Xiao-bei1
    2019, 39 (6):  666. 
    doi: 10.3969/j.issn.1674-8115.2019.06.017

    Abstract ( 416 )   PDF (8151KB) ( 152 )  
    With the improvement of quality of life, the life expectancy of residents is generally prolonged, and people suffering Alzheimer&prime;s disease (AD) is increasing. Epidemiological and animal experiments have found that atmospheric particulate matter is associated with AD. This article briefly reviews the mechanisms of AD-related oxidative stress damage and neuroinflammation causedatmospheric fine particulate matter entering the brain via olfactory bulb pathway.
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    Role of farnesol X receptor in glycolipid metabolism regulation
    ZHAO Ming-liang1, 2, ZHAO Ai-hua1, ZHENG Xiao-jiao1, JIA Wei1
    2019, 39 (6):  671. 
    doi: 10.3969/j.issn.1674-8115.2019.06.018

    Abstract ( 490 )   PDF (11737KB) ( 186 )  
    Farnesol X receptor (FXR), also known as bile acid nuclear receptor, is a ligand-dependent nuclear transcription factor distributed in multiple tissues and organs such as liver and intestinal tract. And bile acid is its endogenous natural ligand. Recent studies have shown that intestinal FXR plays an indispensable role in glycolipid metabolism regulation, and intestinal specific FXR agonists or antagonists can participate in glucose and lipid metabolism regulation in vivo. In this paper, the role of intestinal FXR in glycolipid metabolism reported in recent years is systematically reviewed.
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    Alterations in bile acid levels in metabolic diseases and related treatment strategies
    KUANG Jun-liang, ZHENG Xiao-jiao, ZHAO Ai-hua, JIA Wei
    2019, 39 (6):  678. 
    doi: 10.3969/j.issn.1674-8115.2019.06.019

    Abstract ( 524 )   PDF (9738KB) ( 234 )  
    Bile acid as a signaling molecule can specifically bind to bile acid receptors (such as farnesoid X receptor and G-protein-coupled bile acid receptor) to mediate a series of biological regulation reactions. In recent years, it has been found that bile acids are widely involved in glucose metabolism, lipid metabolism and energy metabolism. The development of metabolic diseases is usually accompaniedthe changes of bile acid profiles and receptors, and thus bile acids may be applied as potential biomarkers for clinical diagnosis, prediction, and evaluation of therapeutic effects. This article reviews the relationship between bile acids and metabolic diseases, and the treatment of metabolic diseases based on the regulation of bile acid metabolism.
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    Research progress of secreted protein acidic and rich in cysteine in glaucoma filtering bleb scarring
    LUO Li-ying, WU Jia-hui, XIANG Xiao-qiong, TANG Min, FU Yang
    2019, 39 (6):  684. 
    doi: 10.3969/j.issn.1674-8115.2019.06.020

    Abstract ( 590 )   PDF (6890KB) ( 219 )  
    Filtering bleb scarring is the main caof glaucoma filtration surgery failure. Subconjunctival injection of antimetabolites, such as mitomycin and 5-fluorouracil, is widely used clinically to reduce the incidence of scarring, which improves the success rate of the surgery. However, accompanied side effects such as cytotoxicity should not be ignored. Secreted protein acidic and rich in cysteine (SPARC) as a matricellular protein is widely distributed in the eyes, which plays an important role in the process of wound repairing and tissue remodeling. The of SPARC is significantly elevated in the momodel of subconjunctival scarring. Researches suggest that SPARC participates in and regulate the formation of bleb scarring through multiple pathways, therefore it may become a specific new target in the anti-scarring therapy.
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