Table of Content

25 November 2009, Volume 29 Issue 11 Previous Issue    Next Issue
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Editorial
Monographic report (Prosthodontics)
Original article (Basic research)
Original article (Clinical research)
Original article (Public health administration)
Review
Brief original article
Clinical experience
Case report


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Editorial

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Pathogenesis, diagnosis and treatment of recurrent spontaneous abortion with immune type LIN Qi-de, QIU Li-hua 2009, 29 (11):  1275.  Abstract ( 2245 )   PDF (4140KB) ( 2449 )   Recurrent spontaneous abortion (RSA), which affects 1% to 5% of women of reproductive age,  is difficult to treat in the clinical setting. In the investigations of immunopathogenesis, diagnosis and treatment of RSA since the late 1980s, it was found that RSA was associated with abnormal maternal local or systemic immune response, the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA）, while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed, and anticardiolipin (ACL)+β2-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation, low-dose, short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up, and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China. Related Articles | Metrics

Monographic report (Prosthodontics)

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Establishment of finite element models for dentition defect using modular and parametric models JIN Wen-zhong, HUANG Qing-feng, WEI-Bin, et al 2009, 29 (11):  1279.  Abstract ( 1903 )   PDF (3649KB) ( 1291 )   Objective To establish the three-dimensional finite element model libraries for mandibular bilateral distal-extension prosthesis. Methods Models for bilateral mandibular free-end edentulous (765-567) and parametric prosthetic models were combined to establish the three-dimensional finite element model libraries by means of HyperMesh 7.0, UG 5.0 and Abaqus 6.5 softwares. Results The established finite element model libraries worked well with Abaqus 6.5 software, with no information loss. The models had satisfactory geometric configuration. Conclusion The three-dimensional finite element model libraries for bilateral mandibular free-end edentulous and mandibular bilateral distal-extension prosthesis have been rapidly established. Related Articles | Metrics

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Stress analysis of distal-extension prosthetics with mesial and distal occlusal rest JIN Wen-zhong, HUANG Qing-feng, WEI Bin, et al 2009, 29 (11):  1282.  Abstract ( 2648 )   PDF (4122KB) ( 1501 )   Objective To investigate the stress distribution in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest under loading. Methods A modular denture model was used to build a model of mandibular dentition defect (765-567 loss) with HyperMesh 7.0 software. Prosthetics with mesial (M model) and distal occlusal rest (D model) were designed with UG 5.0 software, and the finite element models were completed with HyperMesh 7.0 software. The stress distribution was analyzed in the abutment and supporting tissues of distal-extension removable partial dentures with mesial and distal occlusal rest when bilateral vertical forces were applied. Results Compared with M model, D model provided much larger maximum stress in abutments and periodontal membrane. Stress of D model mainly concentrated on roots of  4-4 , while that of M model uniformly distributed on roots of  43-34. The maximum stress of M model was significantly larger than that of D model on the mucosa of edentulous region. The maximum stress on alveolar bone of two models-edentulous region was equal, while the stress of M model distributed more widely. Conclusion It is prior to select mesial occlusal rest in distal-extension removable partial dentures. Related Articles | Metrics

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Model establishment and stress analysis of telescopic crown-retained removable partial dentures WEI Bin, HUANG Qing-feng, JIN Wen-zhong, et al 2009, 29 (11):  1285.  Abstract ( 1877 )   PDF (3969KB) ( 1455 )   Objective To redevelop the finite element model libraries and to analyse the stress distribution of telescopic crown dentures. Methods The finite element model libraries were redeveloped based on the model libraries of normal dentition, fixed partial denture and removable partial denture. With the help of softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, the telescopic denture models on the bilateral free-ended case were imported and edited, then the finite element stress analysis was performed. Results The models were easily established. The maximum value of stress and its distribution on abutment root, periodontal membrane, alveolar mucosa, alveolar bone and dental prostheses were observed and studied by the finite element stress analysis. Conclusion The way to establish models of telescopic crown dentures by model libraries is feasible and reliable. Related Articles | Metrics

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Comparison of stress distribution on telescopic denture and clasp-retention denture for the bilateral free-ended case WEI Bin, CHEN Jie, HUANG Qing-feng, et al 2009, 29 (11):  1288.  Abstract ( 1975 )   PDF (4034KB) ( 1341 )   Objective To establish three dimensional finite element model libraries of telescopic dentures and removable partial dentures by means of model libraries, and compare the characteristics of stress distribution among three prostheses. Methods Normal model libraries were imported and edited, and models of bilateral free-ended cases were established. Based on the model libraries of fixed partial dentures and removable partial dentures, the finite element models of telescopic dentures and removable partial dentures with medial or distal occlusal rest were established using softwares such as DELL Precision Graphics Workstation, UG 5.0, HyperMesh 7.0 and Abaqus 6.5, then finite element stress analysis was performed. Results The stress distribution on abutment root, parodontium, alveolar mucosa and alveolar bone was uniform. The maximum value of stress on the abutment root (6.205 MPa) was much less than those of two removable partial dentures (18.41 MPa and 34.49 MPa). Conclusion For bilateral free-ended cases, the telescopic denture design is uniform in stress distribution with less stress on abutment root, which is healthy to the abutment root and surrounding tissues. Related Articles | Metrics

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Stress analysis of precision attachment dentures for mandibular distal-extension edentulous cases HUANG Qing-feng, JIN Wen-zhong, ZHANG Fu-qiang, et al 2009, 29 (11):  1291.  Abstract ( 2164 )   PDF (4539KB) ( 1595 )   Objective To analyse the stress distribution of precision attachment dentures used in distal-extension edentulous cases. Methods The finite element models of conventional removable partial dentures and precision attachment dentures were established by modular denture model, and the models of precision attachment dentures were established with 4-4 as one abutment or 43-34as two abutments. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5. Results Under vertical loading or oblique loading, the stress of abutments and supporting tissues from attachment dentures with two abutments was significantly lower than that from attachment dentures with one abutment. The stress of conventional removable partial dentures significantly increased under oblique loading. Conclusion It is reasonable for the design of attachment dentures with two abutments for mandibular distal-extension edentulous cases. Related Articles | Metrics

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Stress analysis of distal-extension removable partial dentures supported by mini implants HUANG Qing-feng, JIN Wen-zhong, ZHANG Fu-qiang, et al 2009, 29 (11):  1295.  Abstract ( 2390 )   PDF (5374KB) ( 1629 )   Objective To analyse the stress distribution of distal-extension removable partial dentures supported by mini implants. Methods The finite element analysis models of conventional removable partial dentures (CRPD) and mini implants supported removable partial dentures (ISRPD) were established by modular denture model. The stress distribution of abutments and supporting tissues was compared by finite element analysis software Abaqus 6.5. Results Under vertical loading, the stress of abutment teeth, mucosa of edentulous region and alveolar bone of ISRPD model was lower than that of CRPD model. Under oblique loading, the stress of each part of CRPD model and alveolar bone of ISRPD model significantly increased, while that of abutment teeth and parodontium of ISPRD model decreased. Conclusion The distal-extension removable partial dentures supported by mini implants work well in protecting the abutments and supporting tissues. Related Articles | Metrics

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Survey on application and proportion of different types of dentures in Shanghai WEI Bin, ZHENG Yuan-li, LUO Yi-xi, et al 2009, 29 (11):  1299.  Abstract ( 1902 )   PDF (3007KB) ( 1292 )   Objective To collect the information about types and clinically-used materials for the dentures, and evaluate the current conditions and characteristics of prosthodontic treatment in Shanghai. Methods Three municipal public hospitals and two private commercial dental labs in Shanghai were served as sample units. The application information on fixed partial dentures, removable partial dentures and complete dentures from January 2005 to December 2007 was collected. The number of dentures in each sample unit, the total proportion of each type of dentures, and the proportion of each type of dentures in public hospitals or private labs were retrospectively analysed. Results From 2005 to 2007, the number of dentures increased by approximately 20% annually. The number of dentures made in private labs increased by 43.58% in 2005 to 2006 and 23.23% in 2006 to 2007. As to the types of dentures, fixed partial dentures constituted the largest proportion (74.49%-76.19% for public hospitals and more than 80% for private labs), while complete dentures accounted for the smallest proportion (5.07% to 6.24% for public hospitals and 1.02% to 1.38% for private labs). Conclusion With an ever-growing awareness of oral health, prosthodontics has been developing rapidly in Shanghai. The rapid increase trend of private dental clinics is noticeable. Fixed partial dentures constitute the largest proportion, while the proportion of complete denture gradually decreases year by year. Related Articles | Metrics

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Survey on application of different types of fixed partial dentures in Shanghai LUO Yi-xi, HU Bin, HU Yan-yan, et al 2009, 29 (11):  1302.  Abstract ( 1918 )   PDF (2866KB) ( 1560 )   Objective To collect the information about the types and clinically-used materials for fixed partial dentures, and evaluate the current conditions and characteristics of fixed partial dentures in Shanghai. Methods Three municipal public hospitals and two private commercial dental labs in Shanghai were served as sample units. The data of fixed partial dentures from January 2005 to December 2007 were retrospectively analysed. The number, type and material of dentures of each year were observed, and the proportion of different types and materials of dentures were analysed. Results From 2005 to 2007, the total number of fixed partial dentures gradually increased year by year, and porcelain fused metal crowns accounted for the largest proportion. The application of noble crown in public hospitals increased annually, and the increase rates were 13.85% in 2005 to 2006 and 30.86% in 2006 to 2007, respectively, while the application of casting basic metal full crown decreased annually. Computer-aided design and computer-aided manufacture (CAD/CAM) fixed partial dentures (CAD/CAM crown) and implant dentures occupied a tiny percentage of total fixed partial dentures in public hospitals and privated dental labs, while both had a remarkable increase trend in number between 2005 and 2007 (227.78% and 53.01%, respectively for 2005 to 2006, and 120.34% and 27.41%, respectively for 2006 to 2007). Conclusion Fixed partial dentures are the most common prostheses for tooth defect, and are characterized by the growing application of advanced techniques and high-quality materials. Related Articles | Metrics

Original article (Basic research)

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Role of hypoxia inducible factor-1alpha and VHL in murine endochondral ossification SHAO Jin, DENG Lian-fu, QI Jin, et al 2009, 29 (11):  1305.  Abstract ( 2127 )   PDF (9058KB) ( 1194 )   Objective To investigate the role of hypoxia inducible factor-1α (HIF-1α) and von Hippel-Lindau (VHL) in murine endochondral ossification. Methods The knockout of HIF-1α or VHL gene in murine osteoblasts was accomplished by conditional knockout technique at 4th, 8th and 12th week, and the differences between wild-type group and knock-out group in endochondral ossification were detected by HE staining, micro-CT scanning, trabecular bone area measurement, calcium content measurement, tetracycline fluorescence labeling, Real-time PCR and Western blotting. Results After knockout of HIF-1α gene in osteoblasts, the expression of vascular endothelial growth factor(VEGF) reduced, the rate of new bone formation stepped down, the content of calcium became less, and the trabecular bone volume decreased （P<0.05）. After knockout of VHL gene in osteoblasts, the expression of VEGF increased, the rate of new bone formation stepped up, the content of calcium became more, and the trabecular bone volume was promoted （P<0.001）. Conclusion During murine endochondral ossification, VHL/HIF-1α signal pathway promotes angiogenesis through the stimulation of VEGF expression，which subsequently accelerates osteogenesis. Related Articles | Metrics

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Inhibition effects of monoclonal antibody C225 on breast cancer stem cells SHI Ya-fei, HUANG Ming-zhu, ZHANG Feng-chun, et al 2009, 29 (11):  1311.  Abstract ( 2200 )   PDF (6018KB) ( 1634 )   Objective To explore the inhibition effects of epidermal growth factor receptor (EGFR) antagonist monoclonal antibody cetuximab (C225) on breast cancer stem cells in human breast cancer cell line MCF-7. Methods The effects of C225 on the proliferation of breast cancer cell line MCF-7 were detected by MTT assay. MCF-7 cells were cultured to generate primary mammospheres, and were divided into control group, C225 group, epidermal growth factor (EGF) group and EGF+C225 group according to whether or not the culture media contained exogenous EGF and C225. Thirteen days after culture, the volume and number of mammospheres of these four groups were observed, and mammosphere-forming efficiency (MFE) was calculated. The percentages of CD44+CD24- cells in mammospheres of these four groups and in routinely cultured MCF-7 cells were determined by flow cytometry. Results The inhibition rate on MCF-7 cells increased with the concentration of C225. Compared with control group, the volume of mammospheres in C225 group significantly decreased, and MFE and percentages of CD44+CD24- cells in mammospheres significantly decreased [(0.61±0.04)% vs (1.44±0.09)%, P<0.01; (3.50±0.29)% vs (9.07±0.52)%, P<0.01]. Compared with EGF group, the volume of mammospheres in EGF+C225 group significantly decreased, and MFE and percentages of CD44+CD24- cells in mammospheres significantly decreased [(0.68±0.04)% vs (1.61±0.05)%, P<0.01; (4.00±0.58)% vs (10.47±0.79)%, P<0.01]. The percentage of CD44+CD24- cells in routinely cultured MCF-7 cells was (2.03±0.15)%, and was significantly different from those in EGF group and control group (P<0.01). There was no significant difference in volume of mammospheres, MFE and percentage of CD44+CD24- cells in mammospheres between EGF group and control group (P>0.05). Conclusion C225 has significant inhibition effects on CD44+CD24- cells in MCF cells. Related Articles | Metrics

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Synergic effects of bexarotene and TRAIL on apoptosis of leukemic cell line KG1a ZHOU Li-yu, ZHANG Zheng, YING Shao-xu, et al 2009, 29 (11):  1316.  Abstract ( 1987 )   PDF (4495KB) ( 1434 )   Objective To explore the effects and mechanism of bexarotene in combination with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on apoptosis of leukemic cell line KG1a. Methods KG1a cells at logarithmic growth phase were obtained, and were divided into TRAIL group, bexarotene group, 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group. Cell apoptosis rate was detected in each group by flow cytometry. Flow cytometry was also employed to determine the apoptosis rates of KG1a cells after treatment with bexarotene and TRAIL in different sequences. The expression of Fas associated death domain-like IL-1 beta converting enzyme inhibitory protein (c-FLIP) was detected by Western blotting. Results There was no significant difference in cell apoptosis rates between TRAIL group and bexarotene group of each concentration (except for bexarotene 2.0 μmol/L) (P>0.05).The cell apoptosis rates of 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group were significantly higher than those in TRAIL group and bexarotene group of each corresponding concentration (P<0.01). Sequential analysis revealed that bexarotene could reverse the resistance of KG1a cells to TRAIL (P<0.001). Compared with single use of 2.0 μmol/L bexarotene or 300 ng/mL TRAIL, combination use could significantly down-regulated the expression of c-FLIP (P<0.05). Conclusion Bexarotene can significantly enhance the apoptosis of KG1a cells induced by TRAIL, which may be attributed to the down-regulation of c-FLIP expression. Related Articles | Metrics

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Microarray analysis of DHPG-induced rat hippocampal slice epileptic seizure model LU Qin-chi, JING Li, CHEN Sheng-di 2009, 29 (11):  1320.  Abstract ( 2625 )   PDF (5141KB) ( 1536 )   Objective To investigate the gene expression pattern of metabotropic glutamate receptor-Ⅰ(mGluR-Ⅰ), D-p-hydroxyphenylglycine (DHPG)-induced rat hippocampal slice epileptic seizure model. Methods In vitro rat hippocampal sclice was continously perfused with artificial cerebrospinal fluid containing 50 μmol DHPG, and epileptic seizure model was established (DHPG group, n=3). cDNA microarray chip was applied to explore the gene expression pattern in DHPG group, the differentially expressed genes were screened in comparison with control group (n=3), and functional classification analysis was conducted. Results There were 206 up-regulated genes and 489 down-regulated genes, among which 67 up-regulated genes and 86 down-regulated genes differentially expressed by 1.5 fold, 6 up-regulated genes differentially expressed by more than 2.0 folds, and 25 down-regulated genes differentially expressed by less than 0.5 fold. Functional classification analysis revealed that differentially expressed gene function involved in protein binding (19 genes), molecular function, calciumion binding and nucleotide binding. Conclusion Epileptic seizure and roles of mGluR-Ⅰagonist may be related to various genes, which is a complicated process. This experiment provides evidences for further researches. Related Articles | Metrics

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ZMS regulation of M2 muscarinic receptor stability mediated by de novo synthesis of protein ZHANG Yong-fang, XIA Zong-qin, HU Ya-er 2009, 29 (11):  1324.  Abstract ( 2187 )   PDF (4468KB) ( 1491 )   Objective To explore the mechanism of ZMS regulation of M2 muscarinic receptor mRNA expression. Methods In vitro cultured CHOm2 cells were divided into ZMS 1 group (treatment with 1×10-5 mol/L ZMS for 24 h), ZMS 2 group (treatment with 1×10-5 mol/L ZMS for 24 h and 1 μg/mL cycloheximide for 12 h) and ZMS 3 group (treatment with 1 μg/mL cycloheximide for 4 h and 1×10-5 mol/L ZMS for 24 h), and their corresponding control groups were also established (substitution of ZMS by DMSO). Actinomycin D was added to cultured CHOm2 cells of each group to inhibit the synthesis of mRNA. CHOm2 cell samples were taken at different time points, the relative expression of M2 receptor mRNA was detected by Real-time PCR, and half life of M2 receptor mRNA was calculated. Results Compared with corresponding control groups, the half life of M2 receptor mRNA of CHOm2 cells in ZMS 1 group and ZMS 2 group was significantly prolonged [(4.75h±0.54) h vs (2.13±0.23) h, P<0.05; (5.43±1.13) h vs (2.46±0.09) h, P<0.05].There was no significant difference in half life of M2 receptor mRNA of CHOm2 cells between ZMS 3 group and its corresponding control [(3.06±0.23) h vs (3.00±0.20) h, P>0.05]. Conclusion De novo protein synthesis is required for the enhancement of M2 receptor mRNA stability regulated by ZMS. Related Articles | Metrics

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Effects of A3 adenosine receptor antagonist on lung injury after cardiopulmonary bypass in rabbits BAO Chun-rong, MEI Ju, DING Fang-bao, et al 2009, 29 (11):  1328.  Abstract ( 1684 )   PDF (4673KB) ( 1618 )   Objective To investigate the effects of A3 adenosine receptor (A3AR) agonist on lung injury after cardiopulmonary bypass (CPB) in rabbits. Methods Twenty-four rabbits were randomly divided into 3 groups, with 8 in each group. Rabbits in control group only received CPB, those in agonist group were given selective A3AR agonist IB-MECA intravenously 15 min before aorta clamp, and those in agonist+antagonist group were managed with selective A3AR receptor antagonist MRS-1191 intravenously before IB-MECA infusion. After CPB, serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8), concentrations of malondialdehyde (MDA) and myeloperoxidase (MPO) in lung tissues, lung wet/dry weight ratio (W/D), lung function related indexes of PaO2/FiO2, airway pressure (AWP) and pulmonary vascular resistance (PVR), and histological changes of lung tissues were observed.ResultsConcentrations of serum TNF-α and IL-8 were significantly lower in agonist group than in control group and agonist+antagonist group (P<0.05). Compared with control group and agonist+antagonist group, W/D was much smaller, and concentrations of MDA and MPO were significantly lower in agonist group after CPB （P<0.05). PaO2/FiO2 was significantly higher, while AWP and PVR were significantly lower in agonist group than in control group and agonist+antagonist group (P<0.05). It was revealed by histological examinations that the pathological changes were less severe in agonist group than in control group and agonist+antagonist group. Conclusion A3AR agonist IB-MECA can reduce lung injury after CPB. Related Articles | Metrics

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Effects of perfluorochemical on in vitro long-term hypothermic heart preservation in rats XIANG Jie, LI Zhou-Bin, ZANG Wang-fu 2009, 29 (11):  1331.  Abstract ( 2278 )   PDF (7011KB) ( 1668 )   Objective To investigate the effects of perfluorochemical (PFC) on in vitro long-term hypothermic heart preservation in rats. Methods Thirty Wistar rats were randomly divided into control group (Celsior solution), Celsior+O2 group (Celsior solution plus oxygen) and PFC/Celsior+O2 group (two-layer method plus oxygen), with 10 rats in each group. Langendorff model of isolated rat heart was prepared. The isolated heart was preserved at 4℃ for 8 h, and hemodynamic parameters, coronary effluent flow, and leakage of creatine kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) were detected after reperfusion. Besides, the myocardial ultrastructure was also observed. Results Compared with control group and Celsior+O2 group, the left ventricular developed pressure and ±dp/dt in PFC/Celsior+O2 group significantly increased (P<0.01), while LDH, CK and AST leakage significantly decreased (P<0.01). However, there was no significant difference in the above paramters between Celsior+O2 group and control group (P>0.05). Compared with control group and Celsior+O2 group, the impairment of myocardial ultrastructure in PFC/Celsior+O2 group after hypothermic preservation was alleviated. Conclusion PFC as a supplementation to oxygen in heart preservation solution could enhance myocardial protection during in vitro long-term hypothermic heart preservation in rats via the improvement of energy metabolism. Related Articles | Metrics

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Effects of ginsenoside Rg3 on growth and apoptosis of gastric cancer cell lines in vitro WANG Ji, SHI Gui-ying, YUAN Yao-zong, et al 2009, 29 (11):  1336.  Abstract ( 2327 )   PDF (6061KB) ( 1395 )   Objective To investigate the effects of ginsenoside Rg3 on growth and apoptosis of gastric cancer cell line MKN-45 and SGC-7901 in vitro. Methods MKN-45 and SGC-7901 cells at logarithmic growth phase were obtained, and were cultured with ginsenoside Rg3 of different concentrations （20, 30, 40, 50 μg/mL）for 24, 48 h or 24, 48 and 72 h. Cells cultured without ginsenoside Rg3 were served as controls. The inhibition rates of ginsenoside Rg3 on MKN-45 and SGC-7901 cells were detected by MTT assay, apoptosis rate of SGC-7901 cells was determined by Annexin V/PI double staining flow cytometry, cell cycles of SGC-7901 cells were analysed by flow cytometry, and morphological changes of SGC-7901 cells in 50 μg/mL ginsenoside Rg3 treatment group were observed by transmission electron microscopy. Results The inhibition rates on MKN-45 and SGC-7901 cells in each ginsenoside Rg3 treatment group were significantly higher than those in control group (P<0.05), and the inhibition rates increased with the concentrations of ginsenoside Rg3 and time of culture (P<0.05). Compared with control group, the apoptosis rates of SGC-7901 cells and percentages of cells in G0/G1 cell cycle in each ginsenoside Rg3 treatment group were significantly increased in a concentration and time dependent manner. Typical morphology of SGC-7901 cell apoptosis was observed by transmission electron microscopy in 50 μg/mL ginsenoside Rg3 treatment group. Conclusion Ginsenoside Rg3 has significant inhibition effect on gastric cancer cell lines in vitro with a concentration and time dependent manner, the mechanism of which may involve the induction of gastric cell line apoptosis. Related Articles | Metrics

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Application of continuous cardiac index monitoring in acute heart failure model ZHOU Jian, WU Xiao-yun, HAN Chen-jun, et al 2009, 29 (11):  1341.  Abstract ( 1997 )   PDF (4351KB) ( 1609 )   Objective To establish the swine acute heart failure model for surgical experiment, and evaluate the heart function by continuous cardiac index (CCI). Methods Swine heart failure model was attempted to establish by coronary ligation in six swines. CCI was obtained by Swan-Ganz catheters and Vigilance monitor, and hemodynamic, biochemical and ultrasonocardiographic results were utilized to evaluate the changes of heart function. Results Five swines accomplished the experiment. Compared with basic status, there were significant differences in mean arterial pressure (MAP), pulmonary artery systolic pressure (PASP), mixed venous oxygen saturation (SVO2) and CCI for swines with heart failure (P<0.05), there was no significant change in biochemical parameters, while left ventricle ejection fraction (LVEF) significantly decreased (P<0.05). Conclusion CCI is feasible in monitoring and evaluating heart function of animal model. The swine acute heart failure model established by coronary ligations can meet the needs of surgical experiment in principle. Related Articles | Metrics

Original article (Clinical research)

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Mutations of WNK gene in patients with hypokalemic salt-losing tubulopathies ZHANG Chong, QIN Ling, SHAO Le-ping, et al 2009, 29 (11):  1344.  Abstract ( 1889 )   PDF (8919KB) ( 1280 )   Objective To explore the molecular mechanisms involved in hypokalemic salt-losing tubulopathies (SLTs) through genetic screening of WNK gene in patients with SLTs. Methods Forty-four kindreds of SLTs were diagnosed Batter's syndrome or Gitelman's syndrome after CLCNKB and SLC12A3 sequencing and analysis, 8 of whose phenotype can not be simply attributed to CLCNKB or SLC12A3 mutations. Primers for PCRamplified exons of WNK4 and WNK1 gene in genomic DNA were designed, and direct sequencing was performed to analyse the PCR products. Results Two missense mutations of WNK1, Ile1172→Met (I1172M) and Ser2047→Asn (S2047N), were identified. Both of these 2 mutations segregated with the disease in SLTs kindred. Conclusion Two heterozygote missense mutations of WNK1 gene (I1172M and S2047N) were found in 8 SLTs kindreds, indicating that WNK1 might be another gene responsible for hypokalemic salt-losing tubulopathies. Related Articles | Metrics

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Study on neural generators of N400 in first episode schizophrenia CHEN Xing-shi, TANG Yun-xiang, XIAO Ze-ping, et al 2009, 29 (11):  1351.  Abstract ( 1864 )   PDF (5599KB) ( 1619 )   Objective To explore the features and neural generators of the events related potentials (ERP) component N400, elicited by congruent and incongruent ending sentences, in first episode schizophrenia patients. Methods N400 was elicited by 76 congruent (31) or incongruent (45) ending Chinese sentences paradigm, and recorded by WJ-1 ERP instruments in 56 first episode schizophrenia. The neural generators of N400 different wave in 105-615 ms time windows were analyzed by Brain Electrical Activity Mapping software. Results ① The N400 latencies were significantly longer and amplitudes significantly higher in incongruent conditions than in congruent conditions in first episode schizophrenia (P<0.05 or P<0.01). ② N400 elicited by Chinese sentences distributed on frontal, parietal, occipital and temporal regions, and had a clear waveform. ③ The main brain areas activated by N400 were frontal areas in 345-405 ms time windows, and central areas in 420-570 ms time windows. Conclusion N400 elicited by Chinese sentences are multi-generated in first episode schizophrenia, especially in frontal area. Related Articles | Metrics

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Outcomes and survival analysis of patients with AML and high risk MDS treated by CAG regimen NI Bei-wen, CHEN Fang-yuan, HAN Jie-ying, et al 2009, 29 (11):  1355.  Abstract ( 2213 )   PDF (4579KB) ( 1412 )   Objective To evaluate the clinical efficacy and adverse effects of CAG regimen in treatment of primary, refractory and relapsed acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS), and analyse the factors influencing long-term survival. Methods Sixty-one patients with AML (primary, n=27; refractory, n=18; relapsed, n=16) and 9 patients with MDS were treated with CAG regimen. Examinations on liver and renal function, electrocardiogram and bone marrow cytology were performed before and after treatment, and adverse effects of CAG were observed. Short-term efficacy was evaluated based on clinical manifestation, peripheral blood and bone marrow cytologic examinations. Patients were followed up, overall survival (OS) and disease free survival (DFS) were analysed, and long-term efficacy of CAG regimen was evaluated. The factors influencing long-term survival were analysed by Log-rank test of survival curve. Results After a course of treatment by CAG regimen, the total effective rate was 71%, and 34 patients (49%) experienced complete remission. The median time of follow-up was 45 months, the median OS was 28 months, and the median DFS was 23 months. Age, level of lactate dehydrogenase (LDH), remission condition after a course of treatment by CAG regimen and adoption of HD-Ara-C regimen as consolidation treatment were influencing factors for OS and DFS. The dominant clinical adverse effects were bone marrow depression, with 13 d as the median duration of agranulocytosis (neutrophil <0.5×109/L) and 9 d as the median duration of thrombocytopenia (platelet<20×109/L). Conclusion CAG regimen may lead to favourable therapeutic effects in treatment of primary, refractory and relapsed AML and high risk MDS, and may yield less adverse effects and better long-term therapeutic effects. Age, level of LDH, remission condition after a course of treatment and adoption of HD-Ara-C regimen as consolidation treatment are dominant influencing factors for survival. Related Articles | Metrics

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Efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension HU Ya-rong, CHEN Shao-xing, ZHANG Jin, et al 2009, 29 (11):  1359.  Abstract ( 2064 )   PDF (4057KB) ( 1675 )   Objective To evaluate the efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension in comparison with losartan. Methods Two hundred and thirty-seven patients with mild to moderate essential hypertension were enrolled in a randomized, double-blind, multi-center, paralleded and active-controlled trial, and were divided into olmesartan group (olmesartan 20 mg+losartan 50 mg placebo) and losartan group (losartan 50 mg+olmesartan 20 mg placebo) for a 8-week therapy. Four weeks after treatment, dosages of drugs were doubled in patients with seated diastolic blood pressure ≥90 mmHg (1 mmHg=0.133 kPa). All patients were followed up every two weeks, and the efficacy and adverse effects were observed. Another 32 patients with mild to moderate essential hypertension were enrolled and given olmesartan only, and ambulatory blood pressure monitoring was performed before and 8 weeks after treatment. Results Compared with those before treatment, both systolic blood pressure and diastolic blood pressure significantly decreased in olmesartan group and losartan group 8 weeks after treatment [(15.2±13.3）mmHg and (19.5±11.8) mmHg, respectively for systolic blood pressure (P<0.001); (15.9±7.48) mmHg and (16.2±5.95) mmHg, respectively for diastolic blood pressure (P<0.01)], while there was no significant difference between these two groups (P>0.05). There was no significant difference in total effective rate and incidence of adverse effect between these two groups (86.9% vs 93.7% and 7.63% vs 5.88%, P>0.05). Ambulatory blood pressure monitoring demonstrated that trough to peak ratios of systolic blood pressure and diastolic blood pressure were 86% and 71%, respectively. Conclusion Domestic olmesaratan provides an effective, safe and long action in the treatment of mild to moderate essential hypertension. Related Articles | Metrics

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Expression of transforming growth factor-beta and metalloproteinases in joint capsule of frozen shoulder LI Hong-yun, CHEN Shi-yi, ZHAI Wei-tao, et al 2009, 29 (11):  1363.  Abstract ( 1646 )   PDF (3993KB) ( 1432 )   Objective To explore the role of transforming growth factor (TFG)-β and matrix metalloproteinases（MMPs）in the development of frozen shoulder. Methods Twenty-four patients who underwent shoulder arthroscopy were included, and were divided into frozen shoulder group (n=12) and control group (n=12; n=2 for shoulder instability, n=5 for rotator cuff tear and n=5 for subacromial impingement). Joint capsule tissues at the rotator cuff interval were obtained, and the expression of TGF-β, MMP-1, MMP-2, MMP-3, MMP-9 and MMP-12 mRNA and protein was detected by Real-time PCR and Western blotting, respectively. Results The expression of TGF-β mRNA in frozen shoulder group and control group was 3.36×104±2.18×103 and 1.85×104±3.31×103, respectively, the expression of TGF-β protein was 1.55±0.33 and 1.13±0.21, respectively, and there were significant differences between these two groups （P<0.05）. The expression of MMP1, MMP2, MMP3, MMP9 and MMP12 mRNA and protein in frozen shoulder group was significantly higher than that in control group（P<0.05）. Conclusion The higher expression of TGF-β and MMPs in joint capsule of frozen shoulder may be associated with the development of frozen shoulder. Related Articles | Metrics

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Levels of soluble endoglin in peripheral blood and intervillous space blood of patients with preeclampsia SHEN Li, CHEN Jing, TENG Yin-cheng 2009, 29 (11):  1367.  Abstract ( 1677 )   PDF (4298KB) ( 1450 )   Objective To study the levels of soluble endoglin (sEng) in peripheral blood and intervillous space blood of patients with preeclampsia, and analyse the correlation between levels of sEng and clinical performance. Methods Levels of sEng in peripheral blood and intervillous space blood of 22 patients with preeclampsia (preeclampsia group, 12 cases of severe preeclampsia and 10 cases of mild preeclampsia) were detected by ELISA, and the correlation between levels of sEng and blood pressure, 24 h urine protein and fetal birth weight was analysed. Twenty-two normal pregnant women were served as control group. Results The sEng levels in peripheral blood and intervillous space blood of preeclampsia group were significantly higher than those of control group [(31.89±8.80) ng/mL vs (5.24±1.60) ng/mL, P<0.01; (37.74±7.12) ng/mL vs (6.63±1.76) ng/mL, P<0.01]. In preeclampsia group, the sEng levels in peripheral blood and intervillous space blood of severe preeclampsia were significantly higher than those of mild preeclampsia (P<0.01). In preeclampsia group, the sEng level in peripheral blood was significantly correlated with that in intervillous space blood of preeclampsia group (r=0.876, P<0.01), neither was significantly correlated with blood pressure (P>0.05), both were significantly correlated with 24 h urine protein (r=0.729, P<0.01; r=0.743, P<0.01), and both were significantly correlated with fetal birth weight (r=-0.736, P<0.01; r=-0.707, P<0.01). Conclusion Levels of sEng in peripheral blood and intervillous space blood of patients with preeclampsia are significantly higher than those of normal pregnant women, and the levels of sEng are significantly correlated with the clinical performance of preeclampsia. Related Articles | Metrics

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Diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease LI Hui, WU Ming-hui, NING Pei-gang, et al 2009, 29 (11):  1371.  Abstract ( 2146 )   PDF (3333KB) ( 1426 )   Objective  To explore the diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease (CAD). Methods Eighty-six patients suspected of CAD were divided into low risk group, intermediate risk group and high risk group according to estimated pretest probabilities of CAD. All patients underwent coronary angiography, 64-slice spiral CT and exercise treadmill test. With coronary artery stenosis rate >50% as positive findings, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 64-slice spiral CT and 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were calculated. Results With coronary angiography as the "golden criteria", the sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT in diagnosis of CAD were 95.2%, 88.6%, 88.9%, 95.1% and 91.9%, respectively. The sensitivity of low risk group, intermediate risk group and high risk group was 100%, 100% and 92.6%, specificity was 94.4%, 94.1% and 66.7%, PPV was 80.0%, 91.7% and 89.3%, NPV was 100%, 100% and 75.0%, and accuracy was 95.5%, 96.4% and 86.1%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were 97.6%, 97.7%, 97.6%, 97.7% and 97.7%, respectively. Conclusion 64-slice spiral CT combined with exercise treadmill test works well in screening CAD, especially for those with a low or intermediate estimated pretest probability. Related Articles | Metrics

Original article (Public health administration)

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Determinants of average length of stay of upper first-class general hospitals LIU Xia, HE Meng-qiao, LIU Jun, et al 2009, 29 (11):  1374.  Abstract ( 2208 )   PDF (3031KB) ( 1384 )   Objective To identify the determinants of average length of stay of 16 upper first-class general hospitals from 2000 to 2007. Methods Relative data of 16 upper first-class general hospitals from 2000 to 2007 were collected, and descriptive analysis and multiple linear regression analysis were employed to explore the determinants of average length of stay. Results Operation ratio and days before operation of inpatients, ratio of salary to medical income, ratio of doctors to nurses, successful rescue rate in emergency, number of operation tables and staff had impact on average length of stay. Conclusion Resource allocation should be optimized, health care quality be enhanced, reasonable salary scheme be designed, and rational medical insurance policies be implemented in hospitals to shorten average length of stay. Related Articles | Metrics

Review

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Influence of oxidative stress on p53 post-translational modifications SUN Zu-jun 2009, 29 (11):  1377.  Abstract ( 1835 )   PDF (6783KB) ( 1531 )   Protein post-translational modifications are important ways to regulate protein function and cell behavior, and oxidative stress directly influences protein post-translational modifications. p53 protein has various post-translational modifications, which can be quickly regulated under stress conditions to activate a series of downstream target genes and facilitate the p53 function diversity.The effects of oxidative stress on p53 post-translational modifications of phosphorylation, ubiquitination, sumoylation, acetylation and methylation are introduced in this paper. Related Articles | Metrics

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Research on autosomal dominant polycystic kidney disease YU Guo-peng 2009, 29 (11):  1383.  Abstract ( 1747 )   PDF (5289KB) ( 1452 )   Polycystic kidney disease is a common human congenital hereditary disease, which can be divided into autosomal dominant polycystic kidney disease and autosomal recessive polycystic kidney disease by genetic methods. In addition to the kidney changes, polycystic kidney disease may also involve multiple body organs and seriously endanger human health. In recent years, studies on etiology and pathogenesis (especially molecular biology), diagnosis and treatment of polycystic kidney disease have progressed by leaps and bounds. This paper briefly summaries the research status and development of the most common autosomal dominant polycystic kidney disease. Related Articles | Metrics

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Roles of interleukins in carcinogenesis and development of gastric cancer ZHANG Ben-yan 2009, 29 (11):  1387.  Abstract ( 1733 )   PDF (4006KB) ( 1631 )   Helicobacter pylori (H.pylori) infection has been an established risk factor for gastric cancer identified by World Health Organization. H.pylori triggers chronic inflammation of gastric mucosa and induces host cells to release various cytokines, some of which might lead normal epithelial cells to transfer to gastric cancer. Expression of interleukins in gastric mucosa experiences significant changes after H.pylori infection. Interleukins play different roles in carcinogenesis and development of gastric cancer. This article briefly reviews the research advances of roles of interleukins in carcinogenesis and development of gastric cancer. Related Articles | Metrics

Brief original article

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Diagnositic value of ultrasonography in soft tissue masses and comparison with magnetic resonance imaging YANG Xian-feng, WU min, ZHU Bin, et al 2009, 29 (11):  1391.  Abstract ( 1654 )   PDF (6092KB) ( 1839 )   Related Articles | Metrics

Clinical experience

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Classification and surgical treatment of intrathoracic esophageal perforation WEI Hua-bing, CAO Zi-ang, GU Xu-dong, et al 2009, 29 (11):  1395.  Abstract ( 1708 )   PDF (3144KB) ( 1533 )   Related Articles | Metrics

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Clinical experiences of 131I treatment for Graves disease of 391 patients GUAN Liang, LI Pei-yong, CHEN Gang, et al 2009, 29 (11):  1398.  Abstract ( 1641 )   PDF (3275KB) ( 1253 )   Related Articles | Metrics

Case report

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Two cases report of management of low cesarean section scar pregnancy CAI Mei-ling, ZHU Ya-ping, XU Wei, et al 2009, 29 (11):  1400.  Abstract ( 1688 )   PDF (3000KB) ( 1315 )   Related Articles | Metrics