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    Original article (Basic research)
    Relationship between pluripotency maintenance of residual embryonic stem cells and exogenous leukemia inhibitory factor
    PI Qing-meng, FU Wei, SHI Lun-gang, et al
    2009, 29 (8):  897. 
    Abstract ( 2155 )   PDF (8490KB) ( 1245 )  

    Objective To investigate the pluripotency of residual undifferentiated embryonic stem (ES) cells from differentiated embryoid bodies (EBs), and explore the relationship between pluripotency maintenance and exogenous leukemia inhibitory factor (LIF). Methods Mouse R1 ES cells were differentiated for 20 days to form EBs. EBs were then trypsinized and re-plated on tissue culture plate in DMEM without LIF. The expression of phenotypes (CD9, SSEA1 and Flk-1)of expanded cells was analysed by flow cytometry. The expression of Oct-4, Nanog, Rex1, FGF5, Nestin, Brachyury, Flk-1 and GATA6 was detected by RT-PCR before and after secondary EB differentiation. The residual cells after expansion were subcutaneously injected into nude mice, and the ability to form teratoma was examined. Single Oct-4/GFP transgenic mouse ES cells were differentiated in semi-solid media to determine the residual rates after 20 days. Results The residual cells grew out to form ES-like colonies in DMEM without LIF, and expressed undifferentiated ES markers such as CD9, SSEA1, Oct-4, Nanog and Rex1. Meanwhile, the residual cells could be redifferentiated to form EBs and express Nestin, Brachyury, Flk-1 and GATA6. Teratoma was formed 6 weeks after subcutaneous injection of residual cells into nude mice. Single cell differentiation of Oct-4-GFP cells showed that about 14% ES cells in primary culture possessed the potential to generate residual undifferentiated cells after long-term differentiation. Conclusion The pluripotency of residual cells from differentiated EBs can be maintained without exogenous LIF. Only a part of the primary cultured ES cells possess the potential to generate residual undifferentiated cells after long-term differentiation.

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    Expression and regulatory mechanism of hypoxia inducible factor-1alpha during fracture healing
    LUO Tao, QI Jin, ZHOU Qi, et al
    2009, 29 (8):  902. 
    Abstract ( 1603 )   PDF (9379KB) ( 1126 )  

    Objective To explore the expression and regulatory mechanism of hypoxia inducible factor-1α(HIF-1α)during fracture healing. Methods Mouse models of tibia fracture healing were established, and callus samples were collected 1, 3, 7, 14, 21 and 28 days after fracture. The development of callus and new bone formation were evaluated with roentgenology, Micro-CT and tetracycline double labeling method, and the expression of HIF-1α, vascular endothelial growth factor (VEGF), Runx2 and ALP in callus were detected with RT-PCR, Western blotting and immunohistochemistry. The relationship between HIF-1α and fracture healing was analysed. Results The expression of HIF-1α was detected in cells in the fracture sites as well as in evolved osteoblasts, chondrocytes and osteocytes in early callus under hypoxia. The highest expression rate of HIF-1α achieved on the 7th day after fracture, lasted for about 7 days, then decreased gradually, and returned to intact level on the 28th day after fracture. The expression tendency of VEGF resembled that of HIF-1α. Bone formation activity was more active in early callus, and the callus volume peaked on the 14th day after fracture and decreased gradually. The mineralization of callus mainly took place in the late healing period (14th to 28th day after fracture). Conclusion Cells involved in fracture healing are hypoxia-responsive cells, which express HIF-1α. HIF-1α can regulate cell state and function, and can promote angiogenesis so as to play a crucial role in fracture healing.

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    Effects of hypoxia on expression of Cyr61/CCN1 in murine osteoblasts
    CUI Lun, WANG Jun, QI Jin, et al
    2009, 29 (8):  909. 
    Abstract ( 1774 )   PDF (5571KB) ( 1350 )  

    Objective To investigate the effects of hypoxia on the expression of cysteine-rich protein 61(Cyr61/CCN1) in murine osteoblasts. Methods Murine osteoblasts were cultured under oxygen of lower concentration or treated with desferrioxamine, and Real-time PCR and Western blotting were employed to detect the expression of HIF-1α, Cyr61/CCN1 and vascular endothelial growth factor in osteoblasts at different time points. HIF-1α gene or VHL gene were knocked out in murine osteoblasts, and the expression of Cyr61/CCN1 in murine osteoblasts was detected. Results HIF-1α pathway was activated in murine osteoblasts under the condition of hypoxia, and the expression of Cyr61/CCN1 in osteoblasts was significantly increased (P<0.05 or P<0.01). The expression of Cyr61/CCN1 was significantly decreased in murine osteoblasts with HIF-1α gene knockout, and that was significantly increased in osteoblasts with VHL gene knockout (P<0.05 or P<0.01). Conclusion The expression of Cyr61/CCN1 in murine osteoblasts may be up-regulated by hypoxia through activation of HIF-1α pathway.

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    Effects of modeling IMRT on cell cycle and expression of Cyclin D1/Cyclin B1 in CNE-2 cell lines
    WANG Ruo-zheng, WANG Duo-ming, LI Pin-dong, et al
    2009, 29 (8):  914. 
    Abstract ( 1717 )   PDF (5323KB) ( 1358 )  

    Objective To detect the cell cycle and mRNA expression of Cyclin B1 and Cyclin D1 in human nasopharyngeal carcinoma cell line (CNE-2) with modeling intensity modulated radiation therapy (IMRT).  Methods CNE-2 cell lines were divided into acute irradiation therapy (ART) group and modeling IMRT group, and both groups were irradiated at 2, 4, 6 and 8Gy dose levels by 6 MV X-ray. The time of irradiation in ART group was 1 to 3 min, and that in IMRT group was 35 min. Besides, blank control group without irradiation was established. The distribution of cell cycle was analysed by flow cytometry, and RT-PCR was employed to detect the mRNA expression of Cyclin D1 and Cyclin B1.  Results Compared with ART group, the proportion of G2 phase of IMRT group was lower at each dose point, and gradually increased with the irradiation dose. There was no significant difference in the mRNA expression of Cyclin D1 at each dose point between these two groups (P>0.05). The mRNA expression of Cyclin B1 of IMRT group was significantly higher than that of ART group at each dose point(P<0.05), and the mRNA expression of both groups were down-regulated in a dose-dependent manner.  Conclusion Modeling IMRT leads to relatively higher expression of Cyclin B1 and decreased radiation-induced G2 arrest.

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    Effects of nitroglycerine of different concentrations on rat cardiac preservation for 8 h
    CHEN Qi, LI Zhou-bin, XIANG Jie, et al
    2009, 29 (8):  918. 
    Abstract ( 1997 )   PDF (5502KB) ( 1387 )  

    Objective To investigate the effects of Thomas solution in combination with nitroglycerine of different concentrations on rat cardiac preservation for 8 h. Methods Thirty Wistar rats were selected, and Langendorff heart perfusion models were established. Rats were randomly divided into Thomas solution group, Thomas solution+4×10-6 mol/L nitroglycerine group and Thomas solution+4×10-5 mol/L nitroglycerine group (n=10). After hypothermic preservation (4 ℃)for 8 h, the cardiac function of each group was determined. Tissues of left ventricular wall were obtained, and changes of myocardial ultrastructure were observed by electron microscopy. Results Compared with Thomas solution group, the cardiac function was significantly improved and the myocardial ultrastructure injury was less severe in Thomas solution+4×10-5 mol/L nitroglycerine group after hypothermic preservation (4 ℃)for 8 h, while there was no significant difference in myocardial ultrastructure injury and cardiac function between Thomas solution group and Thomas solution+4×10-6 mol/L nitroglycerine group. Conclusion Thomas solution in combination with 4×10-5 mol/L nitroglycerine can significantly improve the preservation effects for isolated hearts in rats.

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    Pancreatic beta cell apoptosis inhibited by visfatin via mitochondrial pathways
    CHENG Qun, PENG Yong-de, DONG Wei-ping, et al
    2009, 29 (8):  922. 
    Abstract ( 1823 )   PDF (4970KB) ( 1372 )  

    Objective To investigate the effects of visfatin on palmitate-induced islet β cell apoptosis.  Methods Mouse pancreatic cell line MIN6 was performed in vitro serial subcultivation, and subjected to experiment during exponential phase of growth. Cell viability of MIN6 was detected by MTT assay 24 to 72 h after induction by visfatin with different concentrations (0 to 10-7 mol/L). Cell apoptosis rate of MIN6 was examined by flow cytometry after induction by 0.5 mmol/L palmitate and/or 10-8 mol/L visfatin for 24 h, and expression of bcl-2, bax, cleaved caspase-3 and cytochrome C in endochylema was determined by Western blotting. Results Cell viability of MIN6 increased in a dose-dependent manner after treatment with visfatin for 24 to 48 h (P<0.05). It was revealed by flow cytometry that palmitate-induced apoptosis significantly reduced by 10-8 mol/L visfatin (P<0.05). It was demonstrated by Western blotting that 10-8 mol/L visfatin significantly inhibited the decreased expression of bcl2 and increased expression of cleaved caspase3 and cytochrome C induced by palmitate (P<0.05). Conclusion Visfatin may promote proliferation of pancreatic β cells, and inhibit palmitate-induced islet β cell apoptosis via mitochondrial pathways.

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    Effects of citalopram on electrophysiological properties of cardiac myocytes
    WANG Kai-li, LI Ci-zhen, YANG Zhi-fang, et al
    2009, 29 (8):  926. 
    Abstract ( 1901 )   PDF (5488KB) ( 3504 )  

    Objective To investigate the influence of citalopram on the fast response action potential, slow response action potential, in vitro electrocardiogram (ECG) and in vivo ECG of cardiac myocytes, and explore its mechanism of  adverse cardiac effects. Methods Conventional microelectrode technique was employed to record the fast and slow response action potentials of the isolated papillary muscles of guinea pigs. In vivo and in vitro ECG were recorded from anesthetized animals and Langendorff-perfused hearts, respectively. Results Citalopram could prolong the RR interval and QRS duration of in vivo ECG. The premature ventricular contraction and atrial ventricular block were induced by 12.5×10-6 mol/L citalopram. The maximum ascending velocity of 0 phase (Vmax), action potential amplitude (APA) and action potential duration (APD50 and APD90) were dosedependently decreased by citalopram in the fast and slow response action potentials of guinea pigs, respectively. Conclusion Citalopram can inhibit sodium and calcium channels effectively, which may be the ionic mechanism that citalopram induces arrhythmia in the clinical practice.

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    Protective effects of MG-132 on p38 signaling pathway and cell apoptosis in lung injury induced by hyperoxia
    HUANG Yu-ge, FENG Zhi-chun, YU Yan-liang, et al
    2009, 29 (8):  931. 
    Abstract ( 2189 )   PDF (6992KB) ( 1594 )  

    Objective To investigate the protective effects of the ubiquitin proteasome inhibitor MG-132 on p38 signaling pathway and apoptosis in lung injury induced by hyperoxia. Methods Twenty-six SD rats were randomly divided into 4 groups: normal control group (n=5), MG-132 control group (n=5), hyperoxia group (n=8) and MG-132 hyperoxia group (n=8). Hyperoxia lung injury rat models were established, and proteasome inhibitor (0.5 mg/kg) was intraperitoneally injected in control group and MG-132 hyperoxia group once daily. The resected lungs were histopathologically examined, and cell apoptosis and expression of ubiquitin and p38 were detected by TUNEL and immunohistochemistry, respectively. Results After hyperoxia exposure, there were edema and inflammatory cell infiltration in the lung tissues of SD rats. The apoptosis index and expression of p38MAPK of hyperoxia group were higher than those of normal control group and MG-132 hyperoxia group (P<0.05 or <0.01). Conclusion High oxygen can induce cell apoptosis and may activate p38MAPK signaling pathway. The proteasome inhibitor MG-132 can reduce the lung injury induced by hyperoxia and inhibit P38MAPK signaling pathway.

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    Effects of signal transduction interruption of transforming growth factor-β1 by anti-Smad3 on proliferation of vascular smooth muscle cells
    CHENG Zhi-hui, CAI Wen-wei, LU Ping, et al
    2009, 29 (8):  935. 
    Abstract ( 2001 )   PDF (5166KB) ( 1367 )  

    Objective To observe the effects of anti-Smad3 adenovirus vector transfection on proliferation of proliferative vascular smooth muscle cells (VSMCs). Methods Rat models of acute balloon injury of common carotid artery  were established. The injured vascular tissues were obtained, proliferative VSMCs were cultivated by tissue explants adherent method, and anti-Smad3 adenovirus vector transfection was performed (experiment group). Virus without anti-Smad was served as negative control, and that without adenovirus vector was served as blank control. Total RNA of transfected cells was extracted, and the expression of Smad3 mRNA after transfection in each group was detected by RT-PCR. The changes in cell proliferation after transfection was determined by MTT. Results The expression of Smad3 mRNA in experiment group was significantly lower than that in negative control group and blank control group. Cell proliferation of experiment group was significantly decreased on day 2, 3 and 5 after transfection (P<0.05), while there was no significant difference in cell proliferation among each group on day 7 after transfection(P>0.05). Conclusion Anti-Smad3 adenovirus vector transfection may inhibit the proliferation of proliferative VSMCs, which lays a foundation for the signal transduction interruption of TGF-β1 by gene modification in the prevention of proliferative vascular diseases.

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    Original article (Clinical research)
    Analysis of plasma brain-derived neurotrophic factor levels in patients with anxiety disorders
    WANG Yuan, XIAO Ze-ping, LIN Zhi-guang, et al
    2009, 29 (8):  939. 
    Abstract ( 2078 )   PDF (5590KB) ( 1426 )  

    Objective To explore the characteristics of plasma brain-derived neurotrophic factor (BDNF) levels in patients with anxiety disorders. Methods One hundred and four patients with generalized anxiety disorder (GAD), 114 patients with obsessive-compulsive disorder (OCD), 37 patients with social anxiety disorder (SAD) and 63 normal controls were enrolled, and patients in GAD, OCD and SAD groups were divided into two subgroups, respectively (subgroup A: those with no history of antipsychotic drug use or those with drug washout for more than 1 week; subgroup B: those with drug treatment at enrollment). Assessment was performed with Hamilton Anxiety Scale (HAMA)/Yale-Brown Obsessive-Compulsive Severity Scale (Y-BOCS)/Interaction Anxiousness Scale (IAS) and State-Trait Anxiety Inventory (STAI), and plasma BDNF levels were detected by ELISA. Eighteen patients with drug treatment were performed a second scale assessment and detection of plasma BDNF levels 10 weeks later. Results ①The plasma BDNF levels in each patient group were significantly lower than that in normal control group (P<0.001), while there was no significant difference among three patient groups(P>0.05). ②There was no significant difference in plasma BDNF levels between subgroup A and subgroup B of GAD, OCD and SAD groups (P>0.05). ③Age and sex did not significantly influence BDNF plasma levels in each group (P>0.05). Disease severity, state anxiety inventory (SAI) score and disease course were not relative factors with BDNF plasma levels in GAD, OCD and SAD groups (P>0.05). ④The BDNF plasma levels did not change significantly in the 18 patients with drug treatment for 10 weeks (P>0.05). Conclusion Plasma BDNF level may be a useful biomarker for the state of anxiety disorders.

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    Relationship between predictable ocular motor control and cognitive function in Parkinson´s disease
    YING Li, LIU Zhen-guo, WANG Wen-an
    2009, 29 (8):  944. 
    Abstract ( 1707 )   PDF (3989KB) ( 1088 )  

    Objective To explore the relationship between predictable ocular motor control and cognitive function in Parkinson's disease (PD). Methods Videonystagmography was used to examine 24 patients with idiopathic PD (PD group) and 24 healthy controls (control group) on predictable ocular motor control. The accuracies of saccade were compared between two groups. The correlation among accuracy for predictive saccade (latency<80 ms)and MoCA score, score in motor portion of UPDRS and Hoehn-Yahr stage was analyzed. Results The accuracy of predictive saccade decreased significantly compared with unpredictive saccade in two groups (P<0.01). The total accuracy of saccade in PD group decreased significantly compared with that in control group (P=0.018). The decrease amplitude of predictive saccade in PD group was higher than that in control group (P=0.000). The accuracy of predictive saccade had correlation with MoCA score (correlation coefficient was 0.485, P=0.016), while had no correlation with scores in motor portion of UPDRS and Hoehn-Yahr stage (correlation coefficients were 0.087 and 0.007, P=0.686 and P=0.974, respectively). Conclusion Patients with PD have difficulties in predictive ocular motor control. The accuracy of predictive saccade is an objective parameter reflecting cognitive function in PD.

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    Ultrasonography of enthesopathy in lower limbs
    WANG Yan, LI Feng-hua, ZHAO Lian, et al
    2009, 29 (8):  947. 
    Abstract ( 2022 )   PDF (4996KB) ( 1468 )  

    Objective To explore the ultrasonographic features of enthesopathy in lower limbs in spondyloarthropathy (SPA) and rheumatoid arthritis (RA). Methods The ultrasonographic features of enthesopathy in both lower limbs of  43 patients with SPA (SPA group) were retrospectively analysed, and were compared with those of 40 patients with RA (RA group)  and 30 healthy controls (HC group). The diagnosis of enthesopathy was made based on the abnormal findings such as increased tendon thickness, bursa fluid, intratendinous calcifications, bony spur and bony erosion, and vascularization. Results Abnormal ultrasonographic findings of tendon were observed in 93% of SPA group,85% of RA group and 23% of HC group, respectively. There was no significant difference in the detection rates of enthesopathy by ultrasonography between SPA group and RA group (P>0.05), while both were significantly higher than that of HC group (P<0.05). The number of tendons with bursitis in SPA group was smaller than that in RA group(8.6% vs 14.0%,P<0.05), and  bursitis in SPA group was less severe than that in RA group [(3.92±1.79 )mm vs(5.97±2.63)mm, P<0.05], while there was no significant difference in the number of tendons with the other abnormal ultrasonographic findings between SPA group and RA group(P>0.05). The major abnormalities in HC group were calcification and bony spur in distal part of achilles tendon insertion, and no bursa fluid or vascularization was found. Conclusion The ultrasonographic features of  enthesopathy is highly sensitive with lower specificity. The severity of bursitis may help to discriminate the disease cause.

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    Analysis of multiple elements in urine of patients with Wilson´s disease during penicillamine therapy
    JIAO Xian-ting, LIU Xiao-qing, HUANG Li-su, et al
    2009, 29 (8):  951. 
    Abstract ( 1873 )   PDF (3871KB) ( 1231 )  

    Objective To analyse the concentrations of 21 elements in 24 h urine of patients with Wilson's disease (WD) during penicillamine therapy. Methods Forty patients with WD undergoing penicillamine therapy and hypocopper diets were collected (WD group), and another 12 healthy people were served as control group. The concentrations of 21 elements of Cr, Fe, Co, Se, Mn, Cu, Zn, As, Be, Al, V, Ni, Cd, Sb, Ba, Pb, Ti, Th, U, Ca and Mg in 24 h urine were determined by inductively coupled plasma mass spectrometry. Results For 7 essential trace elements (Cr, Fe, Co, Se, Mn, Cu and Zn), the concentrations of Mn, Cu and Zn in 24 h urine of WD group were significantly higher than those in control group (P<0.05, P<0.01 and P<0.01). For 12 unessential trace elements (As, Be, Al, V, Ni, Cd, Sb, Ba, Pb, Ti, Th and U), the concentration of As in 24 h urine of WD group was significantly higher than that in control group (P<0.05). For 2 macroelements (Ca and Mg), the concentration of Ca in 24 h urine of WD group was significantly higher than that in control group (P<0.001). Conclusion For patients with WD undergoing penicillamine therapy and hypo-copper diets, the concentration of Cu in 24 h urine increases, and those of Mn, Zn, As and Ca also change.

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    Correlation of maternal plasma placental leucine aminopepticlase and interleukin-6 with spontaneous preterm labor
    XIONG Ying, YANG Zu-jing
    2009, 29 (8):  955. 
    Abstract ( 1979 )   PDF (4617KB) ( 1338 )  

    Objective To analyse the changes of maternal plasma placental leucine aminopepticlase (P-LAP) and interleukin-6 (IL-6) levels during third trimester in spontaneous preterm labor. Methods Maternal plasma P-LAP and IL-6 levels were detected by enzyme-linked immunosorbent assay in preterm labor group(n=52), threatened preterm labor group (n=33) and control (normal labor)group (n=137). In preterm labor group, the P-LAP and IL-6 levels of the pregnant women with subclinical chorioamnionitis (SC) (n=41)were compared with those without SC (n=11). ROC curve was employed to analyse the maternal plasma P-LAP and IL-6 levels of spontaneous preterm labor to predict the inevitable preterm labor, and the correlation of P-LAP and IL-6 was explored with Pearson analysis. Results The plasma P-LAP and IL-6 levels in preterm labor group were lower than those in threatened preterm labor group and control group(P<0.01), while there was no significant difference between control group and threatened preterm labor group(P>0.05). There was no significant difference in plasma P-LAP and IL-6 levels between the pregnant women with SC and those without SC (P>0.05). It was revealed by ROC curve analysis that P-LAP≤38.12 U/L and IL-6≥3.40 pg/mL could be adopted as criteria to predict the inevitable preterm labor, and the Youden's index of the combination use of the parameters of P-LAP and IL-6 was significantly higher than that of the single use of each parameter(P<0.05). Maternal plasma P-LAP level was correlated to IL-6 level(r=-0.311,P<0.01). Conclusion Preterm labor can be more accurately predicted by combination detection of plasma P-LAP and IL-6. The oversecretion of IL-6 may lead to the decrease of P-LAP, which may be the key factor for spontaneous preterm labor.

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    Expression of aldosterone synthesis related enzyme and associated regulatory factor genes in aldosterone producing adenoma
    TIAN Xiu-li, YANG Yang, WU Jing-cheng, et al
    2009, 29 (8):  959. 
    Abstract ( 1909 )   PDF (5369KB) ( 1409 )  

    Objective To investigate the discrepancy of aldosterone synthesis process and potential regulation abnormality between aldosterone-producing adenoma (APA) and normal adrenal (NA) with microarray. Methods cRNA probes labelled with biotin were prepared from mRNA of APAs (APA group, n=10) or NAs (control group, n=7).The probes were hybridized with oligonucleotide microarray of target gene expression profile. Expression levels were read from the fluorescent intensity scanned. The difference of gene expression profile was analyzed by computer software. Differentially expressed genes were verified by real-time RT-PCR. Results Compared with control group, 97 genes were up-regulated and 168 genes were down-regulated in APA group. In the genes related to steroid hormone synthesis, only CYP11B2 was significantly up-regulated. In the physiologic regulators of aldosterone synthesis, CYB5A, CYP17A1, DUSP1 and HMGCR were down-regulated, while RENBP and NR1H2 were up-regulated. As a key enzyme in the biosynthesis of cortisol, the expression of CYP17A1 gene was inhibited. Conclusion Among the aldosterone synthesis related enzyme and corresponding regulatory genes in APA, CYP11B2 may be a key synthetase, and the suppressed physiologic regulators of aldosterone synthesis may indicate the existence of neoplastic modulation.

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    Significance of serum estradiol monitoring in hormone replacement-frozen embryo transfer cycles
    NIU Zhi-hong, FENG Yun, SUN Yi-juan, et al
    2009, 29 (8):  963. 
    Abstract ( 2750 )   PDF (4519KB) ( 1738 )  

    Objective To investigate the influence of serum estradiol level on timing of embryo transfer and pregnancy outcome in hormone replacement-frozen embryo transfer cycles. Methods According to the oestradiol level on progesterone initiation day, 279 hormone replacement-frozen embryo transfer cycles were grouped into three groups (group 1, percentile 0-25th; group 2, percentile 26th-75th; group 3, percentile 76th-100th). The clinical characteristics and pregnancy outcomes in ovarian stimulation cycles and frozen embryo transfer cycles were compared among groups, and the serum estradiol and endometrium thickness on day 2 and day 12 of menstrual cycle and progesterone initiation day were compared among groups. Results There was no significant difference in clinical characteristics and pregnancy outcomes in ovarian stimulation cycles and frozen embryo transfer cycles among three groups (P>0.05). There was no significant difference in endometrium thickness on day 2 and day 12 of menstrual cycle and progesterone initiation day among three groups (P>0.05). Conclusion The serum estradiol level on progesterone initiation day may not influence endometrium thickness and pregnancy outcomes in hormone replacement-frozen embryo transfer cycles without pituitary downregulation.

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    Relationship between Noble grade and distribution of myocardial bridge and atherosclerosis
    YANG Shuan-suo, TANG Lei, CHEN Hui, et al
    2009, 29 (8):  967. 
    Abstract ( 2470 )   PDF (5235KB) ( 1994 )  

    Objective To study the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis. Methods The clinical data of 192 patients with myocardial bridge diagnosed by coronary artery angiography were retrospectively analysed. The clinical symptoms, electrocardiographic and echocardiographic findings were analysed to explore the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis, and the outcomes of medical treatment were also investigated. Results The positive rate of myocardial bridge detected by coronary artery angiography was 10.2%, which was usually observed in the middle part of left anterior descending coronary artery. All the patients with grade 3 of Noble grade experienced chest pain or palpitation, 43.8% had ischemic ST-T changes on electrocardiogram, and 37.5% had abnormal segmental ventricular wall on echocardiography. However, patients with Noble grade 1 and 2 did not have ischemic ST-T changes on electrocardiogram or abnormal segmental ventricular wall on echocardiography. The prevalence of atherosclerosis in proximal coronary artery of myocardial bridge was significantly higher than those of mural coronary artery and distal coronary artery (P<0.05). Furthermore, the prevalence of atherosclerosis in proximal coronary artery had the tendency to increase with the grade of myocardial bridge (P<0.0001). For patients with myocardial bridge, those with presence of symptoms were more frequently treated with β-receptor blocker, calcium antagonist and β-receptor blocker+calcium antagonist than those with absence of symptoms (80.0% vs 11.4%, 91.1% vs 15.9% and 62.2% vs 4.5%, respectively) (P<0.01). Conclusion The symptoms of chest pain or palpitation usually occurred in patients with grade 3 of myocardial bridge, while the proximal coronary artery of myocardial bridge is prone to atherosclerosis, and β-receptor blocker and calcium antagonist are predominant drugs in the treatment.

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    Outcomes of intranasal endoscopic holmium laser-assisted dacryocystorhinostomy in treatment of chronic dacryocystitis
    SUN Ping, ZHANG Lin, CAI Jun, et al
    2009, 29 (8):  971. 
    Abstract ( 1568 )   PDF (4969KB) ( 1227 )  

    Objective To observe the outcomes of intranasal endoscopic holmium laser-assisted  dacryocystorhinostomy in the treatment of chronic dacryocystitis. Methods Forty-seven patients (47 eyes) with chronic dacryocystitis underwent intranasal endoscopic holmium laser-assisted dacryocystorhinostomy. The postoperative follow-up included lacrimal irrigation and intranasal endoscopic examination. Results The patients were followed up for 3 to 6 months. The cure rate was 87.2%, the improvement rate was 6.4%, and the total effective rate (cure rate+improvement rate) was 93.6%. Conclusion Intranasal endoscopic holmium laser-assisted dacryocystorhinostomy causes no scar in the face, less nasal tissue damage, shorter operation time and less hemorrhage, and does not affect the lacrimal irrigation system, which allows correction of intranasal causes of failure in traditional dacryocystorhinostomy.

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    Clinical analysis of lower respiratory tract fungal infection in patients with mechanical ventilation in emergency intensive care unit
    WANG Shu-yun, GE Qin-min
    2009, 29 (8):  975. 
    Abstract ( 1778 )   PDF (3247KB) ( 1368 )  

    Objective To investigate the clinical characteristics, pathogen distribution and outcome of lower respiratory tract fungal infection in patients with mechanical ventilation in emergency intensive care unit (EICU). Methods The clinical data of  patients with lower respiratory tract fungal infection treated with mechanical ventilation in EICU were retrospectively analysed. Results Eighty (64.5%) of the 124 patients with mechanical ventilation experienced lower respiratory tract infection, among whom 21(26.2%) were complicated with fungal infection. The predominant pathogen was Candida (Candida albicans, n=11; Candida tropicalis, n=5; Candida smooth, n=3; Candida parapsilosis, n=2). Compared with patients with non-fungal infection (n=59), those with fungal infection(n=21) had higher APACHE II score, longer mechanical ventilation time and longer ICU stay duration(P<0.05). No death occurred in patients with Candida albicans infection, while 7 patients with non-Candida albicans infection died. Conclusion The prevalence of lower respiratory tract fungal infection is high in patients with mechanical ventilation hospitalized in EICU, and the major pathogens are Candida, with Candida albicans as the dominant one. The mortality of patients with non-Candida albicans infection is high, and is drugresistant to fluconazol, which indicates early and effective interventions should be taken.

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    Effects of gender on post-stroke aphasia
    CHEN Ying, LI Yan-sheng
    2009, 29 (8):  978. 
    Abstract ( 1551 )   PDF (4127KB) ( 1396 )  

    Objective To analyse the effects of gender on the prevalence, disease type, severity and recovery rate of post-stroke aphasia (PSA). Methods One hundred and ten patients with acute PSA were enrolled, the Western Aphasia Battery was employed for the evaluation and classification of aphasia, and the Boston Diagnostic Aphasia Test was adopted for the severity grading of aphasia. Forty-four patients without specific speech therapy were evaluated again 12 weeks later. Results There were more male patients with PSA than female ones in the middleaged group(51 to 70 years old), while there were more female patients in the elderly group(>70 years old)(P<0.05). There was no significant difference in the types of aphasia between males and females, and the global aphasia and motor aphasia were the most common types of acute PSA for both sex.  Although there was no significant difference in the gender distribution between right hemisphere lesion-induced and left hemisphere lesion-induced PSA (P=0.062), there was a tendency that female patients were more likely to suffer from PSA when lesions located in the right hemisphere. It was revealed by correlation analysis that the improved scores on aphasia quotient (AQ) 12 weeks later were only related to sex(r=0.303, P<0.05). Conclusion The differences in brain structure and behavior between males and females may cause differences in the prevalence and recovery rate of PSA.

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    Original article (Preventive medicine)
    Optimal variables and corresponding cut-off points for identification of cardiovascular risk factors clustering among elderly males
    FAN Yu-hui, CAI Wei, TAO Ye-xuan, et al
    2009, 29 (8):  982. 
    Abstract ( 1964 )   PDF (4515KB) ( 1118 )  

    Objective To explore the optimal cut-off points of body mass index (BMI), percentage of body fat (PBF) and body fat mass index (BFMI) for identification of cardiovascular risk factors clustering among elderly males. Methods The data of physical examinations from 1 052 Shanghai elderly males in 2007 were collected. The relationship between cardiovascular risk factors clustering and different strata of BMI, PBF and BFMI was analyzed. Receiver Operator Characteristic (ROC) curve analysis was employed to determine the optimal cut-points for identification of cardiovascular risk factors clustering, and area under curve (AUC) was worked out. The population attributable risk proportion (PARP) of risk factors clustering was calculated. Results Odds ratios of risk factors clustering tended to increase with BMI, PBF and BFMI. BMI≥24 kg/m2, PBF≥21% and BFMI≥5 kg/m2 were the cut-off points that had approximate sensitivity and specificity, and/or had the shortest distance in ROC curve. AUC of all the three indexes was larger than 0.5. Analysis of PARP indicated that BMI under 24 kg/m2,  PBF under 21% and BFMI under 5 kg/m2 could prevent 27.1%, 37.44% and 36.63% risk factors clustering, respectively. Conclusion BMI≥24 kg/m2, PBF≥21% and BFMI≥5 kg/m2 can well reflect the cardiovascular risk factors clustering among elderly males.

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    Original article (Public health administration)
    Current situation survey and analysis of a district general hospital in Shanghai
    XIANG Jun, HUANG Qi-min, ZHANG Jin-fu
    2009, 29 (8):  986. 
    Abstract ( 1716 )   PDF (4388KB) ( 1111 )  

    Objective To analyse the changes of a district general hospital before and after management by Shanghai Renji Medical Group through current situation survey, and explore the conditions for the development of district general hospitals. Methods The Zhujiajiao People's Hospital of Qingpu District in Shanghai was selected, and patients(n=50)and hospital staff (n=100) were conducted current situation survey with questionnaires which included the knowledge and evaluation of the hospital's current situation as well as the changes before and after management by Shanghai Renji Medical Group. Results Half year after management by Shanghai Renji Medical Group, great progress in medical work was achieved, with a favourable development trend. The rate of satisfaction on medical service evaluated by inpatients reached 89.60%, and 81.91% hospital staff had confidence in the sustainable development of the hospital. Conclusion Management by Shanghai Renji Medical Group has brought prospects for the Zhujiajiao People's Hospital. Under current environment, only certain conditions are met can a district general hospital achieve sustainable development.

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    Review
    Research progress of spheroid colonies culture of liver cells
    KUANG Jie, HAN Bao-san
    2009, 29 (8):  990. 
    Abstract ( 1292 )   PDF (4382KB) ( 1118 )  

    Bioartificial liver plays an important role in the treatment of liver failure. Spheroid colonies culture is one of the main methods in culturing liver cells to maintain high density and biofunction for a long time. This paper reviews the influential factors and methods for spheroid colonies culture of liver cells.

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    Research progress of relationship between mitochondrial DNA and bipolar disorder
    ZHANG Chen
    2009, 29 (8):  994. 
    Abstract ( 1402 )   PDF (3548KB) ( 1199 )  

    Mitochondria are essential elements that generate energy in cells. Mutations of human mitochondrial DNA may lead to aberrant oxidative phosphorylation and energy supplement in cells, indicating a possible relationship with bipolar disorder. The research progress on relationship between mitochondrial DNA and bipolar disorder is reviewed in this paper.

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    Research progress of hepatic oval cells and differentiation into pancreatic cells
    ZHAO Li-Juan
    2009, 29 (8):  997. 
    Abstract ( 1688 )   PDF (4303KB) ( 1316 )  

    Islet cell transplantation is a possible method to cure diabetes mellitus. However, the limited islet resources can not meet the clinical requirement. Hepatic oval cells can be induced in vitro to differentiate into pancreatic cells, and can sever as a potential alternative resource. This article reviews the research progress of hepatic oval cells and differentiation into pancreatic cells.

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    Study on mechanism of sleep disorders associated with Parkinson´s disease
    WU Jia-ying
    2009, 29 (8):  1001. 
    Abstract ( 1795 )   PDF (4324KB) ( 1225 )  

    Sleep disorders are commonly occurred among patients with Parkinson's disease, such as difficulties in the initiation of sleep, fragmented sleep, sleep behavior disorder and excessive daytime sleepiness. The mechanism of sleep disorders associated with Parkinsons disease is not clear, which may be associated with the injury of brain stem, nuclei of median raphe, nuclei fasciculi solitarii, thalamencephalon and the changes of neurotransmitters as dopamine, hypocretin (orexin) and melatonin. This article gives an overview of the mechanism of sleep disorders associated with Parkinson's disease.

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    Brief original article
    Relationship between bone mass density and contents of muscles and fats in perimenopausal women
    ZHU Jie-ping, TAO Min-fang, HU Wei-wei, et al
    2009, 29 (8):  1005. 
    Abstract ( 1628 )   PDF (2288KB) ( 1214 )  
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    Analysis of 346 cases of pediatric respiratory diseases diagnosed by bronchofibroscopy
    ZHANG Lei, YIN Yong, QIAN Juan, et al
    2009, 29 (8):  1007. 
    Abstract ( 1791 )   PDF (2402KB) ( 1015 )  
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    Application of Actovegin in treatment of radiation-induced oral mucositis
    CHEN Hai-yan, MA Xiu-mei, LI Li, et al
    2009, 29 (8):  1009. 
    Abstract ( 1619 )   PDF (3260KB) ( 1245 )  
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    Result analysis of diabetic retinopathy screening
    WU Ying, FAN Yi-ting
    2009, 29 (8):  1012. 
    Abstract ( 1748 )   PDF (3084KB) ( 2600 )  
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    Case report
    One case report of successful treatment of Fusarium solani keratitis by topical amphotericin B liposome
    FENG Xiao-bo, YAO Zhi-rong, LING Bo, et al
    2009, 29 (8):  1015. 
    Abstract ( 1314 )   PDF (3238KB) ( 1032 )  
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    One case report of cavernoma of foramen of Monro complicated with hydrocephalus
    XU Chun-hua, GAO Xiang, CHEN Ming-yu
    2009, 29 (8):  1016. 
    Abstract ( 1608 )   PDF (3170KB) ( 908 )  
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