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    Editorial
    Integration of innovation and inheritance promotes the development of GI discipline in Renji Hospital
    FANG Jing-yuan, MA Xiong, LU Hong
    2009, 29 (9):  1017. 
    Abstract ( 1378 )   PDF (5817KB) ( 2413 )  
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    Original article (Basic research)
    Association between RGS5 and ATP1B1 and essential hypertension
    XIAO Bing, ZHANG Yi, GAO Ping-jin, et al
    2009, 29 (9):  1022. 
    Abstract ( 1736 )   PDF (4342KB) ( 1420 )  

    Objective To explore the relationship between functional single nucleotide polymorphisms (SNPs) of regulator of G-protein signaling 5(RGS5) and ATP1B1 and essential hypertension, as well as the interaction among genetic variations in Chinese Han populations. Methods Tag-SNPs in promoter, exons and 3'UTR with minor allele frequency >5% in the Chinese Han population in Beijing were selected to capture the common variation in or around this gene with a minimum R2 of 0.80. Tag single SNPs of RGS5 and ATP1B1 were genotyped in 906 patients with essential hypertension (EH group) and 894 age- and gender-matched normotensive controls (control group). The allelic frequency and genotype distribution between EH group and control group were analysed. MDR software was employed to analyse the interaction between SNPs selected. Results Three SNPs were selected and genotyped. There was no significant difference in the allelic frequency and genotype distribution between EH group and normal control group(P>0.05). Haplotype-based analysis revealed no significant difference for the haplotype distribution between EH group and normal control group(P>0.05). There was no significant difference in the interaction model between two and three SNPs analysed by MDR(P>0.05). Conclusion There is no significant association between 3 SNPs selected and EH, and there may be no interactions among them.

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    Anti-atherogenic effects and mechanism of fasudil on ApoE-/- mice
    WU Duo-jiao, JI Yan, WU Yong-jie, et al
    2009, 29 (9):  1026. 
    Abstract ( 1971 )   PDF (5789KB) ( 1513 )  

    Objective To examine the effects of fasudil, a specific Rho kinase inhibitor, on atherosclerotic plaque progression in apolipoprotein E-deficient (ApoE-/-) mice, and explore the potential mechanisms. Methods After 12 weeks of fat-feeding, ApoE-/- mice were orally administrated with fasudil for 12 weeks. Mice were randomly allocated into three groups: control group (tap water), low-dose fasudil group (30 mg•kg-1•d-1) and high-dose fasudil group (100 mg•kg-1•d-1) (n=10 in each group). At the end of the study, body weight, blood pressure and blood lipid were measured, and atherosclerosis of brachiocephalic arteries were determined by histological examinations. Production of superoxide anion and reactive oxygen species (ROS) were measured in the thoracic aorta of mice using chemiluminescence and histofluorescence techniques. Results Fasudil treatment had no effect on body weight, blood pressure and blood lipid concentrations of ApoE-/- mice. The plaque area and intima-medial thickness of brachiocephalic artery were attenuated by 54% and 42%, respectively in high-dose fasudil group in comparison with control group (P<0.01 and P<0.05, respectively). Furthermore, fasudil treatment significantly reduced in situ ROS production of thoracic aorta (P<0.01). And the production of superoxide anion in the aortic wall was lower in high-dose fasudil group than in control group(P<0.05). Conclusion Blocking Rho kinase may inhibit the progression of atherosclerotic plaques of brachiocephalic arteries in ApoE-/- mice, and the effect may be independent of blood pressure and blood lipid changes, while probably be related with the anti-oxidative stress effect.

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    Construction of lentivirus vector containing human β-catenin-EGFP and its expression in human hair follicle stem cells
    YANG Peng-gao, HU Xiao-hui, GAO Feng-hou, et al
    2009, 29 (9):  1030. 
    Abstract ( 2336 )   PDF (7325KB) ( 1460 )  

    Objective To construct the lentivirus carrying human β-catenin-EGFP(enhanced green fluorescent protein)and observe its expression in human follicle stem cells. Methods The β-catenin gene sequence was amplified by RT-PCR from extraction of total RNA of human vascular endothelial cells. TA cloning technique was utilized to acquire gene subcloned pUCm-T-β-catenin. After transformation reaction, candidate clone was further analyzed by PCR and gene sequencing. Then the plasmid was transfected into FT293 cells. After identification by Western blotting, the plasmid was transfected into FT293 cells again for packaging. Infection titer was monitored by green EGFP expression. The expression of β-catenin-lentivirus in human follicle stem cells were observed under inverted fluorescence microscope. Results The β-catenin gene was cloned into the lentivirus successfully. The high expression of green fluorescence protein in FT293 cell line was found under fluorescent microscope. Viral titer checked by real-time PCR was about 2.0×108 TU/mL. When the multiplicity of infection (MOI) was 10, the infection efficiency of β-catenin-lentivirus in human follicle stem cells was nearly 80% after infection 48 h around. After 3 weeks of continuous observation, we found the infection efficiency still keeping in the range of 80%—90%. Conclusion The lentivirus expression vector for β-catenin was successfully constructed. It can steadily infect human follicle stem cells and the infection efficiency is considerable high.

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    Resistance reverse effects of honokiol on multidrug resistance of U937/ADR cell line
    XUE Fang, CHENG Zhi-yong, LIANG Wen-tong, et al
    2009, 29 (9):  1035. 
    Abstract ( 1565 )   PDF (5381KB) ( 1322 )  

    Objective To investigate reverse effects of honokiol (HNK) on human multidrug resistance of in vitro leukemia U937/ADR cell line. Methods According to high-dose (IC50) short-term adriamycin induction method, human acute myeloid leukemia (AML) multidrug resistant U937/ADR cell line was produced. The drug resistances to different chemotherapeutic drugs were measured. Low-dose (IC20) HNK and different chemotherapeutic drugs were used to U937/ADR for measuring the drug resistance reversal fold. Drug excretion was tested by rhodamine 123 (Rho123). NF-κB (p65) and MDR1(P-gp) were detected by real-time fluorescent relativequantification reverse transcriptional PCR (FQ-PCR) or Western blotting after U937/ADR treated with different concentrations of HNK. NF-κB activity was also detected by NF-κB activity detection kits. Results Multidrug resistance U937/ADR cell line was successfully established and the ADR resistant index was 11 fold than U937 cells. Low concentration of HNK combination with adriamycin could reverse drug resistance and reversal index of ADR was 2.2 fold after treated with 6.5 μg/mL HNK. It also could decrease the NF-κB (p65) and MDR1(P-gp) expressions dose-dependently. Conclusion HNK could inhibit NF-κB activity to inhibit P-gp expression and reverse the multidrug resistance of U937/ADR cells.

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    Effects of rapamycin on nephropathy of diabetic rats and expressions of vascular endothelial growth factor and its receptor
    XIAO Li-fang, GU Le-yi, LIANG Xin-yue, et al
    2009, 29 (9):  1040. 
    Abstract ( 1907 )   PDF (7655KB) ( 1143 )  

    Objective To elucidate the role of vascular endothelial growth factor (VEGF) in the pathogenesis of diabetic nephropathy by investigating the effect of rapamycin on the kidney in experimental diabetic rats. Methods Diabetic rat models were established by intraperitoneal injection of streptozotocin (65 mg/kg). Twelve weeks later, all the 27 rat models were divided into rapamycin treatment group (treated by rapamycin for 4 weeks, n=9), angiotensin Ⅱ receptor antagonist, L-158809, treatment group (positive control group, treated by L-158809 for 4 weeks, n=5), and diabetic nephropathy group (intragastric administration of same amount of saline for 4 weeks, n=9). Another 9 normal SD rats were as normal control group. Blood, urine, and renal tissue samples were collected for determining changes of glomerular structure and function. Expressions of VEGF and VEGF receptor 2 (VEGFR2) in renal tissues were investigated by Western blotting and immunohistochemistry. Results Compared with normal control group, the 24 h urinary albumin increased; creatinine clearance rate rose; glomerular volume increased; and glomerular basement membrane thickened in diabetic nephropathy (P<0.01). Compared with diabetic nephropathy group, the 24 h urinary albumin decreased, and glomerular volume and glomerular basement membrane were almost same in rapamycin treatment group and positive control group. The expressions of VEGF and VEGFR2 in diabetic nephropathy group were higher than those in normal control group (P<0.01). The expressions of VEGF and VEGFR2 in rapamycin treatment group and positive control group were lower than those in diabetic nephropathy group (P<0.01). Conclusion Rapamycin can slow the progression of diabetic nephropathy by ameliorating the albuminuria and renal hypertrophy, preventing thickness of glomerular basement membrane, and reducing the expressions of VEGF and VEGR2.

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    Expressions of TLR-2 and TRL-4 in gingival tissues of patients with periodontitis
    GUO Qiu-man, SHU Rong
    2009, 29 (9):  1045. 
    Abstract ( 1988 )   PDF (5008KB) ( 1334 )  

    Objective To detect the distributions and expressions of Toll-like receptor-2 (TLR-2) and TLR-4 in different kinds of periodontitis and different extent of the inflammation of gingival tissues and to discuss the roles of TLR-2 and TLR-4 in the progress of periodontal inflammation. Methods Gingival biopsies were divided into 5 groups: control group (n=10), chronic periodontitis group (n=10), chronic periodontitis clinically healthy group (n=10), aggressive periodontitis group (n=10), and aggressive periodontitis clinically healthy group (n=10). The distributions and expressions of TLR-2 and TLR-4 were detected by immunohistochemistry. Results TLR-2 and TLR-4 expressed in all layers of gingival connective tissues. TLR-4 was also observed in gingival epithelium. Compared to control group, expressions of TLR-2 and TLR-4 were significantly higher than those in the other 4 groups (P<0.05). Expressions of TLR-2 and TLR-4 in chronic periodontitis group were significantly higher than those in aggressive periodontitis group (P<0.05). Expression of TLR-4 in chronic periodontitis clinically healthy group was significantly higher than that in aggressive periodontitis clinically healthy group (P<0.05). But expression of TLR-2 in chronic periodontitis clinically healthy group was significantly lower than that in aggressive periodontitis clinically healthy group (P<0.05). Conclusion TLR-2 and TLR-4 might be involved in the progress of periodontal inflammation. But expressions of TLR-2 and TLR-4 in gingival tissues from different kinds periodontitis may be different.

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    Effects of thiamine and riboflavin on H2O2-induced DNA oxidative damage
    LIU Xiu-ling, WANG Li, JIANG Chun-hua, et al
    2009, 29 (9):  1049. 
    Abstract ( 1669 )   PDF (4686KB) ( 1446 )  

    Objective To explore the effects of thiamine and riboflavin on H2O2-induced DNA oxidative damage in human umbilical vein endothelial cell line ECV304. Methods ECV304 cells were incubated with 10, 100, 500, 1000 mg/L of thiamine or 20, 100, 300, 500 nmol/L of riboflavin for 24 h, and then oxidative damage of cells were induced by 25 mol/L H2O2 for 30 min. DNA damage was detected with single cell gel electrophoresis (SCGE) assay. ECV304 cells incubated without H2O2, thiamine and riboflavin were served as negative controls, and those incubated with H2O2 and without thiamine and riboflavin were served as positive controls. Results H2O2 induced DNA damage, and the indices of percent of DNA damage cells, percent of tail DNA, tail length and Olive tail moment were increased. The indices of cells pretreated with 10, 100, 500 mg/L of thiamine or 20, 100, 300 nmol/L riboflavin were significantly decreased (P<0.05 or P<0.01). There was no significant difference in the indices between cells treated with 1000 mg/L of thiamine or 500nmol/L of riboflavin and positive controls (P>0.05). Conclusion Proper supplementation of thiamine and riboflavin may decrease H2O2-induced DNA oxidative damage, while excess thiamine and riboflavin supplementation may be harmful to DNA and enhance the susceptibility to H2O2 potentially.

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    Detection of serum cytokines in patients with early diabetic retinopathy
    LU Chun, ZHU Hong, SHI Cai-hong
    2009, 29 (9):  1053. 
    Abstract ( 1826 )   PDF (4810KB) ( 1442 )  

    Objective To determine serum cytokine profiles and levels in patients with early diabetic retinopathy (DR) by using antibody array technology and analyze their clinical significances. Methods Among 32 patients with type 2 diabetes mellitus, 16 patients with mild to moderate non-proliferative DR were as DR group; and 16 patients without retinopathy, as diabetic control group. Eight healthy subjects were selected as normal control group. The profiles of 42 cytokines were detected by human cytokines antibody array (Raybiotech). Results Compared with diabetic control group, in DR group, levels of epithelial neutrophil-activating peptide-78 (ENA-78), growth related gene (GRO), regulated upon activation normal T cell expressed and secreted (RANTES), angiogenin, vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) increased significantly (P<0.05); but IL-1α decreased (P<0.05). In DR group, the serum ENA-78 excretions were 1.88 folds and 3.6 folds in comparison to diabetic control and normal control groups, respectively. Conclusion The findings of significant changes in serum cytokine profiles of patients with early DR provide evidence to support the role of inflammation in the pathogenesis of DR. These cytokines may also provide biological markers to clinical prediction of early DR.

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    Effects and mechanism of visfatin on MMP-9 in macrophages
    FAN Yu-qi, HE Ben, WANG Bin-yao
    2009, 29 (9):  1057. 
    Abstract ( 2139 )   PDF (7101KB) ( 1547 )  

    Objective To investigate the effects and mechanism of visfatin on matrix metalloproteinases-9 (MMP-9) expression and invasive activity in macrophages. Methods THP-1 monocytes were induced into macrophages. To investigate the effects of visfatin on MMP-9, cells were divided into 2 groups: ①macrophages+visfatin 12 h;②macrophages+visfatin 24 h. The concentrations of visfatin in each group were:0(control), 50, 100, 200, 400 ng/mL. MMP-9 mRNA and protein expression were analysed by RT-PCR and Western blotting, and MMP-9 invasive activity was assayed by gelatin zymography. To investigate the mechanism of visfatin on MMP-9, cells were divided into 5 groups: ①macrophages without stimulation (control); ②macrophages pretreated with MAPK p38, ERK1/2, JNK pathway inhibitor for 1 h, then stimulated with visfatin (200 ng/mL)for 24 h; ③macrophages pretreated with retinoid X receptors (RXR) nature ligand or peroxisome proliferators activated receptor γ (PPARγ) natural/synthetic ligand for 1 h,then stimulated with visfatin(200 ng/mL)for 24 h; ④macrophages stimulated with visfatin (200 ng/mL) for 24 h; ⑤macophages+visfatin (200 ng/mL)for different time(5, 10, 15, 30, 60 min). MMP-9 expression, PPARγ expression, and the effect of visfatin on MAPK phosphorylation were analysed by Western blotting. Results Visfatin not only significantly enhanced MMP-9 mRNA and protein expression in macrophages(P<0.05, P<0.01), but also up-regulated MMP-9 invasive activity(P<0.01). p38 MAPK inhibitor, ERK1/2 MAPK inhibitor and RXR ligand significantly blocked visfatin activity. Visfatin activated the phosphorylation of p38 MAPK and ERK1/2 MAPK, while had no effect on expression of PPARγ protein. Conclusion Visfatin enhances inflammatory factors expression and activity in macrophages which is related with ERK1/2 MAPK and p38 MAPK, and RXR may mediate visfatin activity.

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    Expressions of insulin-like growth factor binding protein 7 in human gastric cancer cell lines and methylation regulation
    ZHAO Dan-yu, LI Xia, ZHONG Jie, et al
    2009, 29 (9):  1062. 
    Abstract ( 2027 )   PDF (4772KB) ( 1541 )  

    Objective To investigate the insulin-like growth factor binding protein 7 (IGFBP7) gene expressions in gastric cancer cell lines and methylation regulation. Methods Four gastric cancer cell lines, high-differentiated MKN28, middle-differentiated SGC-7901 and AGS, poorly differentiated MKN-45, and normal gastric epithelial cell line (GES-1) were cultured. The IGFBP7 mRNA expressions in different cell lines were detected by RT-PCR. The DNA methylation status was assayed by methylation-specific PCR (MSP). Gastric cancer cell line was treated with DNA methyltransferase inhibitor, 5'-aza-2'-deoxycytidine (5-aza-dc). And the IGFBP7  mRNA expression was detected using real-time PCR. Results Compared with the GES-1, the expression of the IGFBP7  mRNA decreased or disappeared in gastric cell lines. Through the MSP, the aberrant methylation of IGFBP7 mRNA in exon 1 was found. After the 5-aza-dc treatment, the IGFBP7 expression was up-regulated dose-dependently. Conclusion Hypermethylation is responsible for the tumor-specific loss of IGFBP7 gene expression. Treatment with a demethylating agent, 5-aza-dc, can lead to the reexpression of IGFBP7 mRNA in the gastric cancer cell lines. It suggests an important role of hypermethylation in the loss of IGFBP7 mRNA expression.

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    Original article (Clinical research)
    Prevalence of hypertension and associated risk factors in Songnan community
    ZHU Ji-wei, HUANG Yun, LIU Li-ping, et al
    2009, 29 (9):  1066. 
    Abstract ( 1721 )   PDF (4761KB) ( 1527 )  

    Objective To investigate the prevalence and associated risk factors of hypertension in Songnan community so as to provide evidence for the early prevention of hypertension. Methods Cluster sampling was employed, and questionnaire survey was performed in 10 185 residents aged above 40 years in Songnan community of Baoshan District. The questionnaires involved with hypertension and associated risk factors. Results The prevalence of hypertension was 49.9% in Songnan community of Baoshan District, and that of men was significantly higher than that of women (53.7% vs 47.3%)(P<0.0001). The rates of hypertension awareness and control of this community were 70.2% and 23.7%, respectively. The prevalences of hypertension of men and women increased with age(P<0.0001). Compared with those with normal body mass index (BMI), the prevalences of hypertension in patients with overweight and obesity were significantly increased (53.7% vs 36.3%, P<0.0001; 70.7% vs 36.3%, P<0.0001). The prevalences of hypertension in patients with impaired fasting glucose and diabetes mellitus were significantly higher than those with normal glucose tolerance(64.5% vs 43.7%, P<0.0001; 71.2% vs 43.7%, P<0.0001). Stepwise Logistic regression revealed that age, male, drinking, overweight/obesity, glycometabolism abnormality and high triglyceride level were independent risk factors of hypertension (P<0.05). Conclusion It is of utmost importance to take measures to prevent and treat hypertension in communities, especially in the elderly and those with overweight and obesity.

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    Impact of gastroesophageal reflux disease to chronic obstructive pulmonary disease exacerbation
    HU Jiaan, CAO Zhenying, XU Zhihong, et al
    2009, 29 (9):  1070. 
    Abstract ( 2118 )   PDF (3938KB) ( 1263 )  

    Objective To explore relationship between gastroesophageal reflux disease (GERD) and chronic obstructive pulmonary disease (COPD) and to evaluate impact of GERD on COPD exacerbation. Methods A total of 80 COPD patients (COPD group) in the Outpatient Department and 61 non-COPD male smokers (control group) were recruited in this study. All people completed diagnostic questionnaires for GERD and chronic mucus hypersecretion (CMH) and lung function test. The rates of hospital related acute exacerbations of COPD (rehospitalization and visits in Department of Emergency) in the following one-year-long follow-up were obtained. Results GERD incidences were 18.5% and 14.8% in COPD and control groups, respectively. GERD incidence in COPD patients with severe dyspnea was higher than that in patients with slight dyspnea (28.9% vs 17.1%, P>0.05). GERD was observed in 23.8% of patients with CMH, while 8.2% in patients without CMH (P<0.05). COPD patients with GERD and without GERD had similar rates of exacerbation during the one-year follow-up period. The incidences of hospital-related acute exacerbation and re-hospitalization were similar in the two groups. Conclusion GERD is not associated with COPD, exacerbation, and hospital-related exacerbations of COPD. CMH is significantly correlated with GERD, which reveals the potential role of CMH and the consideration of GERD in treating COPD patients with CMH.

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    Effects of Stilnox on QUISI parameters in patients with insomnia
    YAO Pei-fen, CHEN Xing-shi, ZHU Yi-sheng, et al
    2009, 29 (9):  1074. 
    Abstract ( 1611 )   PDF (3569KB) ( 1249 )  

    Objective To investigate the effects of Stilnox on brain electrical activity in patients with insomnia using QUISI sleep instrument. Methods QUISI sleep instrument was employed  for 32 patients with insomnia for 3 consecutive nights, among whom 10 mg Stilnox was administrated before sleep on the third night, and the changes of AUISI parameters were observed after Stilnox administration. Another 28 normal controls were selected, and received one night of acclimatization and the other night of baseline QUISI monitoring. Results There were significant differences in QUISI parameters between patients with insomnia and normal controls before Stilnox administration (P<0.05 or P<0.01). Compared with those before Stilnox administration, patients with insomnia had improved sleep efficiency [(87.7±7.3%)% vs (91.4±3.8)%], reduced awake time [(40.5±15.5) min vs (22.1±6.1) min], reduced S1 [(29.9±18.3)% vs (16.1±6.5)%], increased S2 [(43.9±17.3)% vs (59.1±4.7)%] and shortened sleep latency [(35.7±17.0)min vs (21.1±11.0)min] after Stilnox administration(P<0.05 or P<0.01). Conclusion Stilnox not only can improve the subjective evaluation on sleep, but also have effects on brain electrical activity in night in patients with insomnia.

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    Correlation of serum thromboxane A2 and cerebral infarction
    ZHU Yu-ping, FU Yi, LIU Gui-dong, et al
    2009, 29 (9):  1077. 
    Abstract ( 1635 )   PDF (4379KB) ( 1379 )  

    Objective To investigate the relationship between serum thromboxane A2 (TXA2) and cerebral infarction. Methods Serum TXA2 contents of 72 patients with cerebral infarction and 39 normal controls were measured. The severity of symptoms and signs in 72 patients were evaluated by NIH Stroke Scale (NHISS). Results Serum TXA2 contents were significantly higher in cerebral infarction than those in controls (P=0.00). Serum TXA2 was an independent risk factor for cerebral infarction (P=0.000). Linear regression analysis showed that there was a positive correlation between serum TXA2 and NHISS in cerebral infarction (r=0.753, P=0.000). Multiple linear regression analysis indicated that serum glucose had significant effect on serum TXA2 (P=0.002). Conclusion Serum TXA2 is an independent risk factor for cerebral infarction, and there is a positive correlation between serum TXA2 and severity of cerebral infarction. Increased serum TXA2 in cerebral infarction may be associated with increased serum glucose.

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    Efficacy and mechanism of rhG-CSF in treatment of different leukopenia
    MA Yu-jie, LIANG Hui
    2009, 29 (9):  1081. 
    Abstract ( 1629 )   PDF (4632KB) ( 1337 )  

    Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor (rhG-CSF) in treatment of different leukopenia. Methods A total of 50 patients were divided into 4 groups: aplastic anemia (AA) group (n=10), myelodysplastic syndromes (MDS) group (n=10), drug-induced leukopenia group (n=20) (subdivided into hyperplasia group and hypoplasia group by the degree of cellularity) and iron deficiency anemia group (control group, n=10). The concentrations of G-CSF of peripheral blood were measured by ELISA method. The ratio of CD34+ cells and G-CSFR expression in blood marrow mononuclear cells (BMMNC) were measured by flow cytometry. Granulocyte colony-forming units (CFU-G) of MNC were cultured. Clinical efficacy of rhG-CSF to all patients were determined. Results The concentrations of G-CSF were higher in AA and druginduced leukopenia groups than those of MDS and control groups (P<0.05). Expressions of G-CSFR in AA group were lower than those in other groups (P<0.05). There were no significant differences between MDS group and drug-induced leukopenia and control groups (P>0.05). Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups (P<0.05). There was no significant difference between hyperplasia group and control group (P>0.05). The ratio of CD34+ cells was lower in AA group than that of other groups (P<0.05), without significant differences between the others groups (P>0.05). Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups (P<0.05). There were no significant differences between AA group and MDS group, and between drug-induced leukopenia group and control group (P>0.05). The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group, and superior in MDS group than in AA group (P<0.05). Conclusion The efficacy of rhG-CSF is related to expression ratio of G-CSFR, ratio of CD34+ cells, and response of stem/progenitor cells to G-CSF and endogenous concentration of G-CSF.

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    Comparisons of imageology in postoperative cervical lymph node metastasis of thyroid carcinoma
    WANG Qiang, YU Yong-li, GAO Xiu-li, et al
    2009, 29 (9):  1085. 
    Abstract ( 1722 )   PDF (4554KB) ( 1537 )  

    Objective To explore the clinical manifestations of ultrasonography(US), 99mTc-methoxyisobutylisonitrile (99mTc-MIBI), and 131I whole body scan (131I-WBS) of patients with differentiated thyroid carcinoma(DTC)and cervical lymph node metastasis. Methods A total of 117 cases received examinations of US and 99mTc-MIBI before uses of 131I and received 131I-WBS after 6 d of 131I treatment. Combined with serum thyroglobulin(Tg), 131I-SPECT/CT, lymph node biopsy and clinical follow-up of patients, cervical lymph node metastases were identified. Results In 117 patients, the sensitivity of US, 99mTc-MIBI and 131I-WBS were 76.5%, 67.1% and 83.5%(P<0.05); the specificity of US, 99mTc-MIBI, and 131I-WBS were 75.0%, 78.1% and 84.4%; and the accuracy of US, 99mTc-MIBI and 131I-WBS were 76.1%, 70.1% and 83.8% (P<0.05), respectively. The total sensitivity, total specificity, and total accuracy of combination of the three examinations were 98.8%, 75.0% and 92.3%, respectively. Detection rates by US, 99mTc-MIBI, and 131I-WBS of 134 cervical lymph node metastasis were 75.4%, 66.4% and 80.6% (P<0.05). Combined US with 99mTc-MIBI, detection rate for 26 false-negative 131I-WBS imaging was 96.2%. Conclusion The combination of US, 99mTc-MIBI, and 131I-WBS could improve the sensitivity, specificity, and accuracy of post-operative cervical lymph node metastases of DTC. The combined results of US and 99mTc-MIBI could detect false-negative 131I-WBS imaging.

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    Collateral vessel, ventricular segmental wall motion and ejection fraction in patients with chronic total coronary occlusion
    YANG Shuan-suo, TANG Lei, CHEN Hui, et al
    2009, 29 (9):  1088. 
    Abstract ( 1553 )   PDF (4267KB) ( 1208 )  

    Objective To analyse the differences of collateral vessel, ventricular segmental wall motion and ejection fraction between patients with chronic total coronary occlusion (CTO) and myocardial infarction and CTO with nonmyocardial infarction. Methods Two hundred and fifty-six patients diagnosed as CTO (occlusion duration ≥ 3 months) were retrospectively analysed of medical history, myocardial enzyme pedigree, electrocardiogram, coronary artery CT and coronary arteriography, and were divided into myocardial infarction group(n=138) and non-myocardial infarction group(n=118). The differences in general conditions, location distribution and extent of CTO, lesion distribution and degree of non-occlusion coronary artery, collateral vessel Rentrop grade, segmental ventricular wall motion and ejection fraction on echocardiography were compared between these two groups. Results There was no significant difference in general conditions, location distribution and extent of CTO, lesion distribution and degree of non-occlusion coronary artery and collateral vessel Rentrop grade between these two groups(P>0.05). Compared with non-myocardial infarction group, the prevalence of normal segmental ventricular wall motion and ejection fraction in myocardial infarction group was significantly lower, while those of akinesia and paradoxical motion were significantly higher (P<0.05). Conclusion There is no significant difference in collateral vessel grade of Rentrop classification between myocardial infarction and non-myocardial infarction in myocardium supplied by occluded artery with CTO duration beyond 3 months. Although collateral vessel can prevent myocardium from myocardial infarction, its protective effects on segmental wall motion and ejection fraction are limited.

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    Cardiorespiratory function and surgical outcomes of children with severe pectus excavatum deformity
    XIAO Hai-bo, MEI Ju, ZHANG Fu-xian, et al
    2009, 29 (9):  1092. 
    Abstract ( 1834 )   PDF (4858KB) ( 1311 )  

    Objective To explore the cardiorespiratory function and surgical outcomes of children with severe pectus excavatum deformity. Methods Eighteen children with severe pectus excavatum deformity (case group) and 18 matched normal children (normal control group) were examined. Doppler echocardiographic examinations and pulmonary function tests were performed. Results Compared with normal control group, the left ventricular ejection fraction (EF), stroke volume (SV), residual volume (RV), residual volume/total lung capacity(RV/TLC), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)in case group were significantly decreased (P<0.05 or P<0.01). The postoperative EF, SV, FVC and FEV1 were significantly higher than the preoperative ones in case group(P<0.05 or P<0.01). Conclusion There is impairment of cardiorespiratory function in children with severe pectus excavatum deformity, which is characterized by decrease of ventricular systolic function and restrictive ventilatory disorder, and surgical treatment may improve the cardiorespiratory function.

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    Contents of serum free fatty acid in old patients with metabolic syndrome and influencing factors
    XIA Yan-ping, CHEN Gang, YU Mao-hua
    2009, 29 (9):  1095. 
    Abstract ( 1636 )   PDF (3496KB) ( 1139 )  

    Objective To investigate contents of serum free fatty acid (FFA) in old patients with metabolic syndrome (MS) and to analyze its correlation with the components of MS. Methods Among 1 372 over 60-year-old people undergoing physical examination, 169 patients with MS and 89 healthy subjects were selected as MS group and control group. The blood pressure, height, weight, waist circumference, and hip circumference were measured. Levels of fasting blood glucose, insulin, blood lipid, and serum FFA were measured. Waist-hip ratio (WHR), body mass index (BMI), and insulin resistance index (HOMA-IR) were calculated. Results The levels of waist circumference, WHR, BMI, fasting blood glucose and insulin, HOMA-IR, blood lipid, and serum FFA in MS group were significantly higher than those in control group. The levels of HDL-C were lower in MS group (P<0.05). Serum FFA level was positively correlated with WHR, BMI, fasting blood glucose, HOMA-IR, triglyceride, and total cholesterol (P<0.001). BMI and triglyceride influenced the level of serum FFA independently. The levels of serum FFA were significantly higher when MS accompanied with glucose disorder, hyperlipemia, and insulin resistance (P<0.05). Conclusion The levels of serum FFA are associated with many components of MS, and high levels of serum FFA is one of biochemical indexes of MS.

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    Value of ascending venography in diagnosis of nonthrombotic iliac vein compression syndrome
    YE Kai-chuang, LU Xin-wu, LI Wei-min, et al
    2009, 29 (9):  1098. 
    Abstract ( 2072 )   PDF (4740KB) ( 1477 )  

    Objective To determine the value of ascending venography in diagnosis of nonthrombotic iliac venous compression syndrome (NIVCS). Methods From January 2004 to December 2006, the clinical data of patients with NIVCS (group A + group B) and those with primary chronic venous insufficiency (CVI) in the left lower extremity (group C) diagnosed with ascending venography were retrospectively analysed. The diagnosis of NIVCS was confirmed by venous CT angiography (CTA). Patients in group A were treated with angioplasty and stent placement combined with endovascular laser ablation (EVLA), and those in group B and group C were treated with EVLA only. Patients were followed up and therapeutic effects were compared. Results Ninety-one patients with NIVCS (n=39 in group A and n=52 in group B) and 554 patients with primary CVI in the left lower extremity (group C) were diagnosed by ascending venography. Patients in group A and group C experienced a significant symptom relief, while those in group B did not. Conclusion The specificity of ascending venography is high in diagnosis of NIVCS, and ascending venography also plays a role in guiding the treatment. It is advised that patients diagnosed by ascending venography need treatment for the venous outflow occlusion and EVLA for the venous reflux.

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    Research on parameters of ultrasonic integrated backscatter of cardiac blood in children with dilated cardiomyopathy
    NIU Lin, LU Ying-jing, XU Da-di, et al
    2009, 29 (9):  1101. 
    Abstract ( 1740 )   PDF (3134KB) ( 1236 )  

    Objective To describe the characteristics of ultrasonic integrated backscatter (IBS) of cardiac blood in children with dilated cardiomyopathy (DCM). Methods Philips Sonos 7500 equipped with an acoustic densitometry software system was used. The subjects included 20 children with DCM and 20 normal children. The IBS parameters of the cardiac blood were collected. Results Compared to normal children, the cyclic variation of integrated backscatter (CVIB) of blood in the left atria (LA), left ventricle (LV), and right ventricle (RV) were decreased significantly (P<0.01) in children. There was significant difference between the blood AII and CVIB in different segments of the LV. Conclusion There is significant difference in IBS parameters of blood between children with DCM and normal children. Blood in LV is not a suitable calibration reference in integrated backscatter analysis for patients with DCM.

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    Influence of injection rate of isobaric ropivacaine on spinal anesthesia
    WANG Ting-ting, HUANG Shao-qiang, ZHOU Xiao-min
    2009, 29 (9):  1104. 
    Abstract ( 1558 )   PDF (3398KB) ( 1106 )  

    Objective To investigate the influence of injection rate of isobaric ropivacaine on sensory block, motor block and adverse effects in patients undergoing gynecologic surgery. Methods Forty-six patients undergoing selective gynecologic surgery were randomly divided into group A and group B, with 23 patients in each group. 2.0 mL of 1% ropivacaine (20 mg) was administered for spinal anesthesia. The injection rate of ropivacaine was 0.27 mL/s in group A and 0.04 mL/s in group B. The effects of sensory block and motor block were observed, adverse effects such as hypotension, nausea and vomiting were recorded, and data were compared between groups. Results Thirty minutes after ropivacaine injection, there was no significant difference in time to reach T6 in sensory block, level of maximum sensory block, time to reach maximum sensory block level, time to reach maximum motor block and prevalence of adverse effects between group A and group B (P>0.05). Conclusion There may be no significant difference in sensory block, motor block and prevalence of adverse effects between injection rates of 0.27 mL/s and 0.04 mL/s in spinal anesthesia with 20 mg isobaric ropivacaine.

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    Original article (Preventive medicine)
    Body mass index and influencing factors in students of a medical college in Shanghai
    SHEN Xiu-hua, CAI Wei, TAO Ye-xuan, et al
    2009, 29 (9):  1107. 
    Abstract ( 1989 )   PDF (4556KB) ( 1370 )  

    Objective To investigate the distribution of body mass index (BMI) of university students, and explore the influence of knowledge, attitude and practice of nutrition on BMI. Methods In 2008, a total of 2 251 students from Shanghai Jiaotong University School of Medicine were enrolled, and height, weight and BMI were obtained. Four hundred and thirteen students were selected by stratified cluster sampling and subjected to questionnaire about knowledge, attitude and practice of nutrition. Results Effective data of height and weight were available from 2 095 of all the 2 251 students, with the mean BMI of (21.2±6.8) kg/m2. Overweight and obesity were found in 11.2% and 2.6% of students, respectively. Compared with BMI at admission to college, that of each grade was significantly increased(P<0.05 or P<0.01). There was correlation among knowledge, attitude and practice of nutrition on questionnaire (P<0.05 or P<0.01), while none of them was directly related to BMI. Female students achieved higher scores than male students in attitude and practice of nutrition (P<0.01). There was no significant difference between self-reported height, weight and BMI and those measured by researchers. Conclusion Overweight and obesity have pervaded university students, and nutrition education designed separately for male and female students is an effective intervention method for obesity control. Self-report is feasible in obesity survey among university students.

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    Original article (Public health administration)
    Analysis of related factors for medical discipline construction and development
    XI Xiao-ying, YAN Jia-yu, WANG Xiao-jin, et al
    2009, 29 (9):  1111. 
    Abstract ( 1852 )   PDF (5169KB) ( 1457 )  

    Objective To screen and analyse the dominated related factors for medical discipline construction and development, and provide evidences for the reinforcement of discipline connotation construction. Methods The candidate medical disciplines of State Key Disciplines Evaluation of 2007 were served as study subjects. Disciplines from the results of State Key Discipline Evaluation were divided into "new discipline" group (n=51), "breeding discipline" group (n=33) and "failed discipline" group (n=81). The differences between results of State Key Discipline Evaluation and corresponding data of past years (2001 to 2006) in academic team, scientific research, graduate education and lab construction were analysed by nonparametric Kruskal-Wallis test. Results There were significant differences in academic leader, state key project, prize level, graduates quality and scientific research base among the results of State Key Discipline Evaluation(P≤0.05), and the dominated factors for the unsuccessful result were lack of high-level academic leader, state key discipline, prize, gruaduates and scientific research base. Conclusion The adoption of appropriate measures for the construction of academic team, the reinforcement of scientific research and the establishment of academic achievement evaluation may help to upgrade the academic level.

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    Review
    Effects of chemokines and their receptors in pregnancy immune tolerance
    XIAO Shi-jin
    2009, 29 (9):  1116. 
    Abstract ( 1706 )   PDF (4354KB) ( 2717 )  

    Pregnancy immune tolerance is a special type of peripheral immunological tolerance formed by maternal immune system during pregnancy, which urges maternal immune system not to reject fetus as half-allogeneic graft. Chemokines and their receptors play important roles in induced immune tolerance as participating in activation and migration of immunocytes. This article reviews the effects of chemokines and their receptors in pregnancy immune tolerance.

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    Current status of tissue engineering in urology
    ZHAN Qi-jia
    2009, 29 (9):  1120. 
    Abstract ( 1566 )   PDF (3523KB) ( 1277 )  

    Tissue engineering provides urologists a new way to fix or reconstruct the impaired organs. Reconstitution of corporal bodies of penis with engineered tissue substitutes has been applied in animal models. In hypospadias reconstruction, the use of engineered tissue substitutes has been applied clinically. The clinical application of bladder tissue substitutes has been ongoing phase II clinical trial. Great progress has been made in renal replacement therapy with clinical application of human progenitor cells in hemofiltration units, and the engineered intracorporeal renal replacement unit will come true by additional studies. The current status of tissue engineering in clinical practice of urology is reviewed in this paper.

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    Assessment of left atrial function in patients with heart failure and normal ejection fraction
    FAN Hui-hua
    2009, 29 (9):  1123. 
    Abstract ( 1855 )   PDF (4493KB) ( 1300 )  

    Heart failure has been divided into heart failure with reduced ejection fraction (systolic heart failure) and heart failure with normal ejection fraction (HF-NEF) or heart failure with preserved systolic function (HF-PSF). Systolic heart failure has been more thoroughly studied than HF-NEF. However, the prevalence and mortality (especially in the elderly) of HF-NEF are much higher than expected. Therefore, the pathogenesis, diagnosis and prognosis of HF-NEF and the left atrial function in HF-NEF correlated with diastolic dysfunction have become the research focus.

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    Brief original article
    Analysis of influencing factors for hospital infection
    YANG Guo-ping, CHEN Min-sheng, YANG Bao-zhong
    2009, 29 (9):  1127. 
    Abstract ( 1527 )   PDF (2450KB) ( 978 )  
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    Clinicopathologic features of extraskeletal myxoid chondrosarcoma
    FENG Zhen-zhong, CHEN Jia-wei, ZHAO Yan, et al
    2009, 29 (9):  1129. 
    Abstract ( 1513 )   PDF (4176KB) ( 1134 )  
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    Clinical experience
    Surgical treatment of neurogenic tumor of brachial plexus
    FAN Yi-ling, WANG Yong, ZHOU Zheng-wen, et al
    2009, 29 (9):  1131. 
    Abstract ( 1418 )   PDF (2069KB) ( 1005 )  
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    Treatment of extensively deep burn with Meek skin grafting
    PAN Cai-qing, CHEN Qian-qian, LIN Wei, et al
    2009, 29 (9):  1133. 
    Abstract ( 1745 )   PDF (2046KB) ( 981 )  
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    Case report
    Four cases report of cardiac surgery in the parturient
    ZHU Jie, WU Zhen-ming, DI Wen, et al
    2009, 29 (9):  1135. 
    Abstract ( 1274 )   PDF (2350KB) ( 1032 )  
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    Embolization of dural arteriovenous fistulas in cavernous sinus area with coils and Onyx via superior ophthalmic vein approach
    YU Chao, PAN Yao-hua, WAN Jie-qing, et al
    2009, 29 (9):  1137. 
    Abstract ( 1012 )   PDF (3209KB) ( 1042 )  
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