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    Association study of synaptotagmin 2 gene polymorphisms with schizophrenia in Chinese Han population
    Hong YANG, Xin-xin HUANG, Chao LIU, Qing-song LIANG, Hua YANG, Jian-biao ZHANG, Jian XU, Ying-yi WANG, Hai-su WU, Qin-yu LÜ, Zheng-hui YI
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (1): 16-22.   DOI: 10.3969/j.issn.1674-8115.2021.01.003
    Abstract246)   HTML2)    PDF(pc) (1352KB)(469)       Save
    Objective

    ·To investigate the relationship between synaptotagmin 2 (SYT2) gene and schizophrenia (SZ) in Chinese Han population.

    Methods

    ·TaqMan probe genotyping technique was used to detect 5 single nucleotide polymorphism (SNP) sites (rs6427957,rs907697,rs12564274,rs10800856 and rs61820945) of SYT2 gene in 478 SZ patients (SZ group) and 474 healthy controls (HC group). HaploView software, SHEsis and SNPstats online software were used to compare the alleles, genotypes, genotypes under different genetic models and haplotypes frequency distribution between the SZ group and HC group.

    Results

    ·The frequency distribution differences of rs10800856 allele and genotype were statistically significant between the SZ group and HC group, respectively (P=0.003, P=0.012). After Bonferroni correction, the allele frequency difference of rs10800856 site was still statistically significant (P=0.015), while the genotype frequency difference was not statistically significant. Under the dominant and additive genetic mode, the genotype frequency distributions of rs10800856 site were significantly different between the SZ group and HC group (P=0.004, P=0.005). After correction, the differences were still statistically significant (P=0.020, P=0.025). The frequency distribution of haplotype C-T-C, composed of rs12564274-rs10800856-rs61820945, between the SZ group and HC group was significantly different (P=0.009). After Bonferroni correction, the difference was still statistically significant (P=0.036).

    Conclusion

    ·In Chinese Han population, SYT2 may be the susceptibility gene of SZ, and rs10800856 site may be associated with the risk of SZ.

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    A novel antithrombotic antibody targeting the binding sites of the coagulation factor FⅨa-FⅧa complex
    Tian-yao SUN, Shi-feng JIANG, Qin XU, Jun-ling LIU, Su-ying DANG, Xue-mei FAN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1133-1141.   DOI: 10.3969/j.issn.1674-8115.2021.09.001
    Abstract133)      PDF(pc) (6502KB)(383)       Save
    Objective

    ·To prepare a monoclonal antibody targeting coagulation factor Ⅸa (FⅨa), a key factor in endogenous coagulation pathways, and study its antithrombotic roles and mechanisms.

    Methods

    ·Immunization of mice, hybridoma technology, cell expression and purification were used to prepare the anti-FⅨa monoclonal antibodies of high purity. The monoclonal antibodies with high affinity for FⅨa were screened by enzyme-linked immunosorbent assay. The activated partial thromboplastin time (APTT) and prothrombin time (PT) were used to evaluate the antithrombotic effects of the monoclonal antibody. And then chromogenic substrate method was used to detect the effect of monoclonal antibody on the enzyme activity of FⅨa. The method of computer simulation of protein-protein docking was adopted to predict the possible binding sites between FⅨa and the antibody, and the binding site, was verified by competitive experiments (indirectly through the chromatic substrate method).

    Results

    ·FⅨa-4, an anti-FⅨa monoclonal antibody with high affinity, was generated. Although FⅨa-4 did not affect PT and the enzyme activity of FⅨa, it significantly prolonged APTT to 88.8 s, which was 3.5 times of the control group (25.5 s), in a concentration-gradient dependence. The protein-protein docking prediction results revealed that FⅨa-4 did not directly bind to substrate catalytic sites of FⅨa, but occupied the binding region of FⅨa and FⅧa. Competitive experiments further verified the above results. FⅨa-4 inhibited FⅩa production in a dose-dependent manner, almost completely inhibiting FⅩa production at the concentrations of 400 pmol/L, and FⅧa could correct the inhibition effect of the antibody up to nearly 50%.

    Conclusion

    ·The monoclonal antibody against FⅨa-4 is obtained. FⅨa-4 competes with FⅧa to bind FⅨa, and inhibits the conversion of FⅩ to FⅩa which is catalyzed by FⅧa-FⅨa complex; it plays an antithrombotic role mainly by inhibiting endogenous coagulation pathway.

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    Application of optical coherence tomography angiography to evaluation of clinical effect of anti- vascular endothelial growth factor agents on wet age-related macular degeneration
    ZHANG Qiong, LIN Zhong-jing, ZHANG Shi-sheng, HU Qi-wei, SHEN Xi, XU Jian-min
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)   
    Online available: 31 July 2020

    Progress and controversy in comprehensive treatment of hilar cholangiocarcinoma
    Wei CHEN, Yingbin LIU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 1-8.   DOI: 10.3969/j.issn.1674-8115.2022.01.001
    Abstract76)   HTML13)    PDF(pc) (1076KB)(329)       Save

    Hilar cholangiocarcinoma is a tumor with a poor prognosis, which is difficult to diagnosis in the early stage and has caused lots of controversies in clinical treatment. At present, surgical resection provides the main possibility for cure. Precise evaluation and adequate preparation before surgery and safe, effective, standardized resection are the key methods to successful treatment. Comprehensive treatment based on chemotherapy improves the survival of patients. In the future, guided by concepts of oncology, comprehensive treatment of multiple modes, containing surgery, chemotherapy, targeted therapy, immune therapy and biological therapy, is the development trend of hilar cholangiocarcinoma treatment.

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    Expression characteristics of silent information regulator transcript 1 in intestinal tissues of neonatal necrotizing enterocolitis
    Rui CHEN, Yun ZHAO, Xiao-xia ZHAO, Dong MA, Yi-jiang HAN, Deng-ming LAI, Wei-zhong GU, Jin-fa TOU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1154-1161.   DOI: 10.3969/j.issn.1674-8115.2021.09.004
    Abstract113)      PDF(pc) (4204KB)(325)       Save
    Objective

    ·To explore the expression characteristics of silent information regulator transcript 1 (SIRT1) in intestinal tissues of necrotizing enterocolitis (NEC), and preliminarily discuss the effect and possible mechanisms of SIRT1 in NEC.

    Methods

    ·From June 2018 to October 2020, 80 children with NEC who were treated by neonatal surgery in the Children's Hospital, Zhejiang University School of Medicine were divided into observation group and control group. The tissue samples of the observation group were inflammatory necrotic intestinal tubes, while those of the control group were incised intestinal tubes. The NEC children in the control group were with intestinal strictures after conservative treatment, and then were treated by surgery again. The clinical data of the two groups were collected 24 h before surgery, including procalcitonin (PCT), hypersensitive C reactive protein (hs-CRP), cytokines [interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ)] in the serum, gender, gestational age and so on. The expression characteristics of SIRT1, nuclear factor-κB (NF-κB), transforming growth factor β1 (TGF-β1) and Smad3 proteins of the tissues in the two groups were detected by immunohistochemistry. IEC-6 cells of small intestinal epithelium of SD female rats were cultured in vitro. After SIRT1 expression in IEC-6 cells was inhibited by small interfering RNA (siRNA) technology, the protein expression of NF-κB was detected by Western blotting and the effects of SIRT1 on IEC-6 cells were detected by Cell Counting Kit-8 (CCK8) and Transwell migration assay.

    Results

    ·There was no significant difference in gender, gestational age, birth weight and delivery mode between the two groups. Compared with the control group, the levels of hs-CRP, PCT, IL-6 and IL-10 in the serum in the observation group increased within 24 h before surgery (all P=0.000).Compared with the margin tissues of narrow intestines in the control group, the positive expression of SIRT1 in NEC necrotic intestinal tissues in the observation group showed low expression, and the positive expression of NF-κB was overexpressed (both P=0.000). There was no significant difference in the expression of Smad3 and TGF-β1 between the two groups. The expression of SIRT1 in NEC necrotic intestinal tissue was negatively correlated with the expression of NF-κB (r=-0.592, P=0.000). After inhibiting the mRNA and protein expression of SIRT1, the relative expression of NF-κB in IEC-6 cells was increased, and the proliferation and migration ability of the cells was significantly decreased.

    Conclusion

    ·The mechanism for the SIRT1 reducing progression of NEC may be that SIRT1 can inhibit the expression of NF-κB to reduce the expression of inflammatory factors in NEC, and another possible mechanism may be that SIRT1 can protect intestinal epithelial cells by promoting cell proliferation and migration.

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    Factors related to prognosis of portoenterostomy for type Ⅲ biliary atresia
    Geng-feng JI, Zhi-bo ZHANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1142-1146.   DOI: 10.3969/j.issn.1674-8115.2021.09.002
    Abstract113)      PDF(pc) (1150KB)(321)       Save
    Objective

    ·To explore the factors related to the jaundice clearance and native liver survival after portoenterostomy (Kasai's operation) in the children with type Ⅲ biliary atresia.

    Methods

    ·The clinical data of the patients diagnosed as having type Ⅲ biliary atresia, who underwent Kasai's operation in Shengjing Hospital of China Medical University from January 2012 to January 2018, were analyzed retrospectively. According to the prognosis, the children were divided into jaundice clearance group (JC group, which was divided further into early and late JC group) and jaundice non-clearing group (JOC group), or native liver survival group and non-native liver survival group (liver transplantation/death). T/U test, χ2 test, Kaplan-Meier survival analysis, and multivariate Cox regression analysis were employed to analyze the prognostic factors.

    Results

    ·A total of 96 patients were enrolled in this study, including 48 males and 48 females. The average age of operation was (62.1±18.9) d, and the average follow-up time was (16.2±20.3) months. Direct bilirubin decreased to normal within 6 months postoperatively in 61 cases (63.5%). Compared with the JOC group, the indirect bilirubin (IBIL) level was higher and the albumin level was lower in the JC group before operation (both P<0.05). The result of Kaplan-Meier survival curve analysis showed that the native liver survival rates at 3, 6, 12 and 24 months after operation were 92.3%, 70.9%, 57.8% and 55.8%, respectively. The native liver survival rate of the JC group was higher than that of the JOC group (P=0.000). The rate was also higher in the early JC group when compared with the late JC group (P=0.001). Multivariate Cox regression analysis revealed that gender of male [P=0.049, RR=2.163 (95%CI 1.076?4.797)] and jaundice clearance [P=0.001, RR=11.488 (95%CI 2.726?48.415)] were the protective factors of 2-year native liver survival rate.

    Conclusion

    ·Preoperative IBIL and albumin levels may affect jaundice clearance in the children with type Ⅲ biliary atresia after portoenterostomy; gender of male and jaundice clearance are protective factors for 2-year native liver survival in these children.

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    Laparoscopic diagnosis and treatment of high jejunal atresia and stenosis in neonates
    Bao-hong ZHAO, Hong-xia REN, Xiao-xia WU, Yuan-yuan JIN, Wen-yue LIU, Liang ZHAO, Hui ZHANG, Xin GUO, Xue SUN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1162-1168.   DOI: 10.3969/j.issn.1674-8115.2021.09.005
    Abstract91)      PDF(pc) (2950KB)(320)       Save
    Objective

    ·To investigate the effect of laparoscope on the treatment of high jejunal atresia and stenosis in neonates.

    Methods

    ·From January 2009 to December 2019, 90 neonates with high jejunal atresia and stenosis were operated on Children′s Hospital of Shanxi province. According to whether laparoscopic surgery was used or not, they were divided into laparoscopic group (n=66) and laparotomy group (n=24). In the laparoscopic group, 27 cases of type Ⅰ atresia and stenosis less than 10 cm from Treitz ligament were anastomosed under laparoscopy, and 39 cases of jejunal atresia and stenosis 10?30 cm from the Treitz ligament, underwent extraperitoneal anastomosis by expanded trocar hole with the aid of single-site laparoscope. Traditional laparotomy exploratory incision was used in the laparotomy group. The operation time, the first postoperative oral feeding time, postoperative full oral feeding time [postoperative oral feeding volume reaching 150 mL/(kg·d)], the length of hospital stay, and mortality and incidence of complications were compared between the two groups.

    Results

    ·There was no significant difference between the laparoscopic group and laparotomy group in age, gender, weight, premature infant, low birth weight, other systems malformation and pathological type. There was no significant difference in operation time between the laparoscopic group and laparotomy group [(77.0±24.0) min vs (82.0±24.0) min]. The first postoperative oral feeding time, postoperative full oral feeding time [postoperative oral feeding volume reaching 150 mL/(kg·d)], and the length of hospital stay in the laparoscopic group were shorter than those in the laparotomy group [(13.3±7.2) d, (19.1±8.1) d, (22.1±8.5) d vs (17.2±7.8) d,(23.7±10.6) d, (27.0±11.8) d, all P <0.05]. There was no significant difference between the laparoscopic group and laparotomy group in mortality (1/66 vs 2/24) and incidence of complications (7/66 vs 6/24).

    Conclusion

    ·Laparoscopic surgery is a safe and effective method in the diagnosis and treatment of neonatal high jejunal atresia/stenosis.

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    Role of bile acid on maintaining metabolic homeostasis
    LI Sen1, JIA Zi-heng1, WEI Xue-rui1, MA Sai1, LU Tian-cheng1, LI Ting-ting2, GU Yan-yun2
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2020, 40 (08): 1126-1130.   DOI: 10.3969/j.issn.1674-8115.2020.08.021
    Abstract399)      PDF(pc) (8992KB)(305)       Save
    Bile acids are the main products of the cholesterol degradation in the liver. They promote the absorption and transportation of the intestinal lipids. Diverse bile acid receptors are widely distributed in human tissues and organs, including farnesoid X receptor (FXR) and Takeda G protein receptor (TGR5). The expression pattern of different bile acid receptors and their different affinities to various bile acids as their ligands determines their pleiotropic downstream effects, including regulating bile acid synthesis and transportation, immune and metabolism homeostasis. In addition, the bile acid pool includes components derived from both host and gut microbiota, which collaboratively contribute to the bile acid signaling activation in different compartments. Therefore, bile acid pool represents an information hub allowing the crosstalk between the host and gut microbiome and hereby modulating host metabolic homeostasis and gut microbiome symbiosis. This article reviews the recent advances in the field of bile acid regulation and the related mechanisms of bile acid signaling pathway to maintain metabolic homeostasis.
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    Application of modified Nutrition Risk in the Critically Ill score to critically ill elderly patients
    Xuemei LU, Lan CHEN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 16-20.   DOI: 10.3969/j.issn.1674-8115.2022.01.003
    Abstract65)   HTML8)    PDF(pc) (859KB)(293)       Save
    Objective

    ·To validate the role of the modified Nutrition Risk in the Critically Ill (mNUTRIC) score in the assessment of nutritional risk and clinical prognosis in critically ill elderly patients.

    Methods

    ·A prospective observational study was carried out. The mNUTRIC score was employed to assess the nutritional risk of elderly patients who were admitted into the intensive care unit (ICU) of Shanghai General Hospital, Shanghai Jiao Tong University between October 2020 and February 2021. Patients were divided into high nutritional risk group and low nutritional risk group based on the mNUTRIC score results. The observational end-points were transferred, discharged or death. Different nutrition risk patients' nutritional support were analyzed, including nutritional support methods, the time period before nutritional support, and energy supply conditions. The length of ICU stay, days with mechanical ventilation, and 28-day mortality of different nutrition risk patients were compared.

    Results

    ·Among critically ill elderly patients, 51.8% were at high nutritional risk. The energy compliance rate of the low nutritional risk group was 73.3%, and that of the high nutritional risk group was 58.8%. It took 5.00 (1.00, 8.00) d for the low nutritional risk group and 9.00 (3.00, 12.50) d for the high nutritional risk group to reach the energy standard. There was no statistical difference in the nutritional support methods, the time period before nutritional support, and energy supply conditions between the two groups. The mechanical ventilation time of the high nutritional risk group was 5.00 (1.50, 12.50) d, longer than that of the low nutritional risk group (P=0.018). The 28-day mortality rate of the high nutritional risk group was 47.7%, higher than that of the low nutritional risk group (P=0.001). There was no statistical difference in ICU stay between the two groups.

    Conclusion

    ·mNUTRIC score can be used to evaluate nutritional risk and predict the clinical prognosis of critically ill elderly patients. It is suggested that stratified clinical nutrition management should be carried out for the critically ill elderly patients with different nutritional risks. Critically ill elderly patients can benefit from personalized nutritional support programs, and the clinical prognosis of patients may be improved.

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    Influences of oral administration of probiotics on postoperative infection and liver function recovery in patients with partial hepatectomy
    Yi WU, Fang FANG, Hao HUANG, Ying CHEN
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 9-15.   DOI: 10.3969/j.issn.1674-8115.2022.01.002
    Abstract68)   HTML11)    PDF(pc) (942KB)(293)       Save
    Objective

    ·To investigate the influences of oral administration of probiotics on postoperative infection and liver function recovery in patients with partial hepatectomy.

    Methods

    ·A total of 165 patients undergoing partial hepatectomy in Shanghai General Hospital, Shanghai Jiao Tong University, were involved in this prospective randomized control study. In accordance with the random number table, patients were divided into mechanical bowel preparation group (MBP group, n=55), non-bowel preparation group (NBP group, n=55) and probiotics bowel preparation group (PBP group, n=55). Patients' general information, postoperative fever, the first time of flatus and defecation, and infectious indexes and liver function indexes on the 1st,3rd and 5th day after operation were collected and compared among the groups.

    Results

    ·There was no significant difference in the basic data among the 3 groups (all P>0.05). On the 5th day after operation, the white blood count of the PBP group was significantly lower than that of the MBP group (P=0.012) and NBP group (P=0.029). The level of glutamic-pyruvic transaminase of the PBP group was significantly lower than that of the MBP group and NBP group on the 3rd day (P=0.040, P=0.036) and the 5th day (P=0.002, P=0.019) after operation.

    Conclusion

    ·Oral probiotics intestinal preparation is helpful to reduce infection after partial hepatectomy and accelerate the recovery of liver function.

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    Study on the correlation between the expression of miR-146a-5p and the severity of intestinal injury in neonatal necrotizing enterocolitis
    Jiang-long CHEN, Tong CHEN, Zhi-bao LÜ, Xue-li WANG, Qing-feng SHENG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (9): 1147-1153.   DOI: 10.3969/j.issn.1674-8115.2021.09.003
    Abstract121)      PDF(pc) (5829KB)(291)       Save
    Objective

    ·To detect the expression level of miR-146a-5p in the intestinal tract of neonatal necrotizing enterocolitis (NEC), and analyze its correlation with the severity of intestinal injury in children with NEC.

    Methods

    ·The clinical data of children with NEC and intestinal atresia (IA) admitted to the Department of General Surgery of Shanghai Children's Hospital, Shanghai Jiao Tong University from January 2014 to December 2018 were collected, respectively. According to the location of intestinal tissue samples, children with NEC were divided into NEC-inflamed group and NEC-unaffected group. The intestinal tissue samples of children with IA were used as control group (i.e. IA group). Newborn C57BL/6J mice aged 5-7 days were randomly divided into NEC model group and control group. The former group was treated by modeling, while the latter was not. After the mice were killed, the terminal ileum tissue samples were taken. Hematoxylin-eosin staining was performed on the tissue samples of newborn mice and children in each group, and histopathological grade of mice was performed. The expression level of miR-146a-5p in the intestine of the newborn mice and the children in each group were detected by in situ hybridization, and the differences of expression between the two groups were compared, respectively. The correlation between the expression level of miR-146a-5p and histopathological grade in intestinal tract of children with NEC was analyzed. The distribution of children with miR-146a-5p high expression (positive cells≥100) and low expression (positive cells <100) in different clinical data was compared.

    Results

    ·① Compared with the control group, the pathological grade and the expression level of miR-146a-5p (P=0.000) in the terminal ileum of NEC model mice were higher. ② Compared with IA group and NEC-unaffected group, the expression level of miR-146a-5p was higher in NEC-inflamed group (both P=0.000). And the expression level of miR-146a-5p was positively correlated with the pathological grade of intestinal tissues in children with NEC (P=0.015, r=0.578). ③ Compared with miR-146a-5p low expression, the number of children with intestinal resection length ≥5 cm in miR-146a-5p high expression was more (P=0.005).

    Conclusion

    ·The high expression of miR-146a-5p is related to the severity of intestinal injury in NEC, suggesting that miR-146a-5p is involved in the occurrence and development of NEC.

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    Relationship between preoperative glycosylated hemoglobin and postoperative delirium in patients following off-pump coronary artery bypass grafting
    Ye HE, Fang FANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 21-27.   DOI: 10.3969/j.issn.1674-8115.2022.01.004
    Abstract60)   HTML8)    PDF(pc) (1071KB)(288)       Save
    Objective

    ·To investigate the relationship between postoperative delirium and preoperative HbA1c in patients with off-pump coronary artery bypass grafting (OPCAB), so as to provide reference for further intervention.

    Methods

    ·A prospective study was used to collect 364 surgical patients admitted to the Department of Cardiac Surgery in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The data were collected through the general information questionnaire and the simple mental status assessment scale, and the Confusion Assessment Method of Intensive Care Unit, and Chinese Version of 3-minute Diagnostic Confusion Assessment Method were used to assess postoperative delirium. Univariate analysis was used to screen out the risk factors for delirium with P<0.05, and then a multi-factor Logistic regression analysis was used. The generalized additive model was used to observe the dynamic changes of HbA1c and the incidence of postoperative delirium, and the receiver operating characteristic (ROC) curve was drawn to clarify the boundary value.

    Results

    ·The influencing factors of postoperative delirium in OPCAB patients were age, alcohol use, peripheral vascular disease, NYHA function classification, LVEF, albumin, HbA1c, intraoperative blood transfusion, acid-base imbalance, and electrolyte imbalance. The generalized additive model and multivariate Logistic regression analysis showed that the higher the preoperative HbA1c, the higher the incidence of postoperative delirium in OPCAB patients.Through ROC curve analysis, it was determined that when the HbA1c>6.45%, the risk of delirium after OPCAB increased accordingly.

    Conclusion

    ·For patients undergoing OPCAB surgery, HbA1c is an independent risk factor for postoperative delirium. With the increase of HbA1c, the incidence of delirium gradually increases, suggesting that the preoperative HbA1c of OPCAB patients should be maintained at a normal level.

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    Development of knowledge-attitude-practice questionnaire for mechanical prophylaxis of deep venous thrombosis and its reliability and validity testing
    Chunhong HAN, Jie WANG, Yang HONG, Yahui TONG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (1): 28-35.   DOI: 10.3969/j.issn.1674-8115.2022.01.005
    Abstract59)   HTML6)    PDF(pc) (950KB)(278)       Save
    Objective

    ·To develop a knowledge-attitude-practice questionnaire for mechanical prophylaxis of deep venous thrombosis for orthopedic nurses in China, and analyze its reliability and validity.

    Methods

    ·On the basis of literature review, combined with the characteristics of orthopedic diseases and orthopedic nurses, a preliminary questionnaire for mechanical prophylaxis of deep venous thrombosis was prepared. In January 2020, two rounds of expert letter consultation were conducted to demonstrate and modify the items in the first draft and form the test version of the questionnaire for mechanical prophylaxis of deep vein thrombosis.In March 2020, tests were conducted among 620 orthopedic nurses from 36 medical units in 13 cities in Jiangsu Province. Item analysis was carried out with critical ratio method and homogeneity test. Reliability analysis was carried out from internal consistency reliability, split-half reliability and retest reliability. Validity was analyzed from content validity and structure validity.

    Results

    ·The first draft of the questionnaire contained 37 items; after the first round of expert consultation, 4 items were revised and 7 items were added; after the second round of expert consultation, a test version of the questionnaire containing 44 items was formed. A total of 620 questionnaires were distributed. The effective recovery rate of the questionnaire was 96.77%. The critical ratio method showed that the item decision values t, which reflected the t-test results of independent samples of high and low groups, ranged from 5.89 to 20.31, and the difference was statistically significant (all P<0.05). The homogeneity test showed that Pearson correlation coefficient r, which reflected the correlation between the score of each item and the total score of the scale, ranged from 0.49 to 0.79, and the difference was statistically significant (all P<0.05). Therefore, 44 items were retained after item analysis. The Cronbach's α coefficient reflecting the internal consistency of the total questionnaire was 0.893, the Spearman-Brown coefficient reflecting the half-fold reliability was 0.794, and the intraclass correlation coefficient reflecting the retest reliability was 0.909. The scale-level content validity index reflecting content validity was 0.926 and the item-level content validity index was 0.833?1. Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's sphericity test chi-square value which reflected the structure validity were 0.883 and 12 560.176 (df=666, P<0.05) respectively. These values indicated that the questionnaire was suitable for exploratory factor analysis. In addition, 7 items were deleted according to the absolute value of factor load. Finally, 37 items remained. Seven common factors with eigenvalue greater than 1 were extracted. The 7 common factors were named the act of mechanical prophylaxis, risk perception of mechanical prophylaxis, indications of mechanical prophylaxis, contraindications of mechanical prophylaxis, conceptual cognition of mechanical prophylaxis, mechanical preventive response and health education cognition of mechanical prophylaxis, respectively. The cumulative variance contribution rate was 61.992%.

    Conclusion

    ·The questionnaire in this study shows good reliability and validity. It can be used as an investigation tool to study the current attitude, knowledge and behavior of mechanical prophylaxis of orthopedic nurses.

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    Advances in estimating fetal weight by maternal and fetal ultrasound variables
    Yi-fei WANG, Yan-ting WU, He-feng HUANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (3): 366-370.   DOI: 10.3969/j.issn.1674-8115.2021.03.014
    Abstract492)   HTML8)    PDF(pc) (1084KB)(252)       Save

    The estimated fetal weight (EFW), using the parameters of pregnant woman and fetuse before birth, plays an important role in helping evaluating fetal development and pregnancy outcome. Various methods have been used to calculate EFW. Predictive accuracy of estimating EFW by using pregnant women's parameters depends on doctors' experience and standardization of measurement. Some appraisal procedures, such as Hadlock formula, which mainly focus on prenatal fetal ultrasound parameters, have been widely used in clinics but still have large errors. Measurements of fetal volume by 3-dimentional ultrasound and magnetic resonance imaging methods show significant improvements, yet they cannot be widely used because of time and economic issues. The prediction coincidence rate of a model with big data based on analysis of neural network, is better than that of traditional ultrasonic detection. It could be a better method of EFW in the future. In summary, accurate evaluation of EFW and its application to obstetric clinic are still major challenges in the future.

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    Correlation between childhood trauma and schizophrenia symptoms
    REN Yan-yan, LÜ Qin-yu, YANG Wei-li, WANG Zhen
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2020, 40 (12): 1641-1645.   DOI: 10.3969/j.issn.1674-8115.2020.12.013
    Abstract220)      PDF(pc) (6330KB)(246)       Save
    Objective · To explore the relationship between different dimensions of childhood trauma and positive and negative symptoms of schizophrenia. Methods · A total of 124 patients with schizophrenia were recruited at Shanghai Mental Health Center. Childhood trauma was evaluated by the Early Trauma Inventory Short Form (ETI-SF), and psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). Pearson correlation analysis and Gaussian graphical model (GGM) were used to examine the relationship between 4 dimensions of ETI-SF and the scores of 3 subscales or total 30 items of PANSS. Results · There was a significant correlation between subscales of positive symptoms and physical abuse (r=0.29, P=0.000) or emotional abuse (r=0.21, P=0.024) after controlling age, sex and other confounding factors. All dimensions of ETI-SF were related to different items of positive symptom scale. GGM results also verified that physical and emotional abuse were strongly correlated with the positive symptoms in schizophrenia. In addition, the degree centrality value of active social avoidance was the biggest through the whole network. Conclusion · Childhood trauma is related to positive symptoms of schizophrenia. Physical abuse and emotional abuse are significantly related to the positive symptoms. Active social avoidance plays an important role in the whole network.
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    Injectable hydrogel loaded with bone morphogenetic protein-2 microspheres for bacteriostasis and osteogenesis
    LIU Li-li1, CUI Wen-guo1, 2
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2020, 40 (09): 1184-1192.   DOI: 10.3969/j.issn.1674-8115.2020.09.004
    Abstract321)      PDF(pc) (11465KB)(243)       Save
    Objective · To construct a novel antibacterial and injectable hydrogel (BMP/Gel/SH-Ag) loaded with bone morphogenetic protein-2 (BMP-2) microspheres, and investigate its biocompatibility, antibacterial properties and bone-promoting properties. Methods · The photocrosslinked gelatin microspheres loaded with BMP-2 were prepared by microfluidics. The microspheres were mixed with 4-arm thiol-terminated poly (ethylene glycol) (4SH-PEG) and crosslinked with Ag+ to prepare injectable sulfhydrylated PEG hydrogels (BMP/Gel/SH-Ag). The micromorphology of microspheres and hydrogels was observed by light microscope and scanning electron microscope. The drug release profile was investigated at 37 ℃ in a shaker (100 r/min). The injectability of BMP/Gel/SH-Ag was evaluated by injecting hydrogel using a syringe with a tip diameter of 0.5 mm. The antibacterial activity of BMP/Gel/SH-Ag against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) was evaluated by agar diffusion test. The biocompatibility of BMP/Gel/SH-Ag was verified by CCK-8, and the bone-promoting activity was evaluated by alkaline phosphatase (ALP) assay and calcium nodule staining in bone marrow mesenchymal stem cells (BMSCs). Results · Gelatin microspheres had smooth appearance and uniform particle size distribution (~ 350 μm). BMP/Gel/SH-Ag had porous microstructure and can be injected with a syringe needle with a diameter of up to 0.5 mm in diameter to produce hydrogel filament. The cumulative release of BMP-2 from BMP/Gel/SH-Ag was (81.8±3.6)% after being incubated for 8 d. BMP/Gel/SH-Ag had obvious inhibitory effect on S. aureus and E. coli. CCK-8 results showed that BMP/Gel/SH-Ag had good biocompatibility. BMP/Gel/SH-Ag can increase the expression of ALP and the content of calcium nodules in rat BMSCs. Conclusion · The BMP/Gel/SH-Ag has good performance in promoting osteogenesis and anti-infection.
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    Analysis of prevalence, mortality and disability-adjusted life year rate of diabetes in Chongqing City
    Xian-bin DING, De-qiang MAO, Yan JIAO, Li-ling CHEN, Jie XU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (1): 78-81.   DOI: 10.3969/j.issn.1674-8115.2021.01.014
    Abstract253)   HTML4)    PDF(pc) (1106KB)(242)       Save
    Objective

    ·To analyze the prevalence, mortality and disability-adjusted life year (DALY) of diabetes in Chongqing City, and provide the evidence for the prevention and treatment of diabetes.

    Methods

    ·The data of diabetes death cases of Chongqing recorded in National Death Registration System in 2018 and the data of diabetes prevalence of Chongqing in 2018 obtained according to Chronic Diseases and Nutrition Monitoring Scheme of Chinese Residents (Trial) were collected and sorted out. SPSS 25.0 software was used to calculate the mortality, standardized mortality, prevalence, standardized prevalence, years of life lost (YLL) rate, years live with disability (YLD) rate and DALY rate of diabetes in Chongqing.

    Results

    ·In 2018, the diabetes mortality and standardized mortality were 16.20/100 000 and 8.82/100 000 in Chongqing, respectively. The mortality of diabetes in women was higher than that in men (χ2=3.99, P=0.045). In 2018, the prevalence and standardized prevalence of diabetes among residents with the age of 15 and above were 17.90% and 9.25%, respectively in Chongqing. The prevalence of diabetes in men was higher than that in women (χ2=18.12, P=0.000). The rates of YLL, YLD and DALY of diabetes in Chongqing were 2.99‰, 7.44‰ and 10.43‰, respectively. The proportions of YLL rate and YLD rate in DALY rate were 28.67% and 71.33%, respectively.

    Conclusion

    ·The disease burden of diabetes in Chongqing is serious, and the mortality and prevalence of diabetes are high. The YLD rate accounts for more than 70% of DALY rate.

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    Inhibitory effect of sanguinarine on proliferaton and invasion of gastric cancer cells by upregulating m 6A methyltransferase 14
    Ming CHEN, Jing ZHANG
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2022, 42 (2): 135-141.   DOI: 10.3969/j.issn.1674-8115.2022.02.001
    Abstract113)   HTML365)    PDF(pc) (2415KB)(238)       Save
    Objective

    ·To investigate the effect of sanguinarine (SAG) on the proliferation and invasion of gastric cancer cells MGC-803 and AGS, and the relationship between the mechanism and N6-methyladenosine (m6A) methyltransferase 14 (METTL14).

    Methods

    ·After the gastric cancer cell lines (MGC-803 and AGS) were exposed to different concentrations of SAG (0, 10, 20 μmol/L) for 48 h, quantitative PCR and Western blotting analysis were used to detect the effect of SAG on the expression of METTL14. Then, MGC-803 and AGS cells transfected with lentiviruses-mediated small interfering RNA of METTL14 (si-METTL14) or control (si-NC) were treated with 10 μmol/L SAG or PBS for 48 h, and thus the two cell lines were divided into si-METTL14+SAG group, si-NC+SAG group and si-NC+PBS group, respectively. Quantitative PCR and Western blotting were used to verify the expression levels of METTL14 after it was transfected with si-METTL14 in gastric cancer cells. The proliferation level, number of clones formed and invasion potential of the 3 groups in both MGC-803 cells and AGS cells were observed by MTT proliferation assay, cell clone formation test and Transwell invasion assay, respectively. Independent samples t test was used for comparison between two groups of data, and one-way ANOVA was used for comparison between more than two groups of data.

    Results

    ·Compared with the control group (0 μmol/L), 10 μmol/L SAG and 20 μmol/L SAG up-regulated METTL14 mRNA and protein expression levels (P<0.05), showing a certain concentration dependence. Quantitative PCR and Western blotting results confirmed that the expression levels of METTL14 in gastric cancer cells were significantly reduced after transfection of si-METTL14 in both MGC-803 cells and AGS cells. MTT cell proliferation assay showed that the cell proliferation rate of the si-NC+SAG group was significantly lower than that of the si-NC+PBS group in each cell line (P=0.000). The cell clone formation test showed that the number of cell clones of the si-NC+SAG group was significantly smaller than that of the si-NC+PBS group in each cell line (P<0.01). The Transwell invasion assay showed that the cells crossing Matrigel gel in the si-NC+SAG group was significantly less than that in the si-NC+PBS group in each cell line (P<0.01). si-METTL14 could partially reverse the inhibitory effects of SAG on gastric cancer cells.

    Conclusion

    ·SAG can inhibit the proliferation activity, clonal formation and invasion potential of gastric cancer cells, which may be realized by upregulating METTL14 expression level.

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    Spatio-temporal analysis of incidence rate of syphilis in China
    Ting-ting TIAN, Ya-xuan HOU, Yu-qing LI, Hong-jiao QI, Mo CHEN, Mei-xia LÜ
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (5): 648-652.   DOI: 10.3969/j.issn.1674-8115.2021.05.015
    Abstract248)   HTML14)    PDF(pc) (1308KB)(232)       Save
    Objective

    ·To get the spatio-temporal distribution of the syphilis epidemic in 31 provinces, municipalities directly under the Central Government and autonomous regions of the mainland of China in 2017.

    Methods

    ·The data of syphilis incidence in 31 provinces, municipalities and autonomous regions of the mainland of China in 2017 were obtained from the China Public Health Science Data Center, and the time distrbution characteristics of the incidence rates were described. The global Moran′s I index and Anselin local Moran′s I index were used to analyze the spatial cluster characteristics of the syphilis cases, and then space-time scan analysis based on Poisson distribution was used to explore the spatio-temporal distribution characteristics.

    Results

    ·In 2017, the number of syphilis cases in the 31 provinces, municipalities, and autonomous regions of the mainland of China was 475 860, and the incidence rate was 34.49/100 000. Latent syphilis accounted for most of the cases, reaching 76.78% (365 353/475 860). August had the highest incidence rate. For the spatial distribution, Xinjiang Uygur Autonomous Region was the provincial-level unit with the highest incidence rate of syphilis, reaching 91.80/100 000. The incidence rates of latent, secondary, tertiary, and congenital syphilis appeared with positive spatial autocorrelation (all P<0.05). The high-high clusters of secondary and tertiary syphilis appeared in Shanghai, Jiangsu, and Zhejiang (all P<0.05), respectively, while the high-high clusters of congenital syphilis appeared in Xinjiang and Tibet (P=0.000). The results of space-time scan analysis showed that the main cluster appeared from April to September in Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui, and Guangdong (P=0.000). Compared with the outside area, the relative risk of syphilis in this cluster was 1.59 times.

    Conclusion

    ·The incidence rate of syphilis in China is relatively high. There are differences in the types and periods of syphilis prevention and control among provinces, municipalities and autonomous regions. From April to September, Fujian, Jiangxi, Zhejiang, Shanghai, Jiangsu, Hunan, Anhui and Guangdong are the key areas for syphilis prevention and control in the mainland of China.

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    Research status and prospect of transcranial focused ultrasound stimulation in treatment of psychiatric disorders
    Zhao-lin ZHAI, Deng-tang LIU
    JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE)    2021, 41 (1): 95-98.   DOI: 10.3969/j.issn.1674-8115.2021.01.017
    Abstract324)   HTML12)    PDF(pc) (1001KB)(226)       Save

    As a non-invasive neuromodulation technique, transcranial focused ultrasound stimulation has the advantages of safety, high focused accuracy, deep penetration depth and easy compatibility with the synchronous recording of neuroimaging. Transcranial focused ultrasound stimulation has been used in the treatment of essential tremor, Parkinson's disease, brain tumors, etc. However, the progress in the area of psychiatry is still limited. The current research status of transcranial focused ultrasound stimulation in the treatment of psychiatric disorders is reviewed in this article, including the analysis of difficulties in its application and the prospect for the future direction.

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