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    Monographic report (Bipolar disorder)
    Application of Chinese version of Mood Disorder Questionnaire in patients with mood disorder
    CAO Lan, YUAN Cheng-mei, LI Ze-zhi, et al
    2011, 31 (11):  1509. 
    doi: 10.3969/j.issn.1674-8115.2011.11.001

    Abstract ( 1986 )   PDF (4412KB) ( 1469 )  

    Objective To evaluate the feasibility of Chinese version of Mood Disorder Questionnaire (MDQ-C) in screening patients with mood disorder, and analyse the clinical characteristics of patients with potential bipolar disorder in those with depression disorder. Methods Three hundred and eight patients with mood disorder were evaluated by MDQ-C, including 134 patients with bipolar disorder(bipolar disorder group) and 174 patients with depression disorder (depression disorder group). The clinical characteristics of patients with MDQ-C score≥5 and those with MDQ-C score<5 in depression disorder group were compared and analysed. Results MDQ score in depression disorder group (3.90±2.92) was significantly lower than that in bipolar disorder group (6.48±3.76)(t=6.574, P=0.000). The percent of patients with MDQ-C score≥5 in depression disorder group(34.5%, 60/174) was significantly lower than that in bipolar disorder group (64.9%, 87/134)(χ2=28.121, P=0.000). Logistic regression analysis revealed that the majority of patients with depression disorder and MDQ-C score≥5 were males (odds ratio=0.342, P=0.004) and younger ones age<25 years (odds ratio=0.952, P=0.001), and were characterized by appetite increase at first episode (odds ratio=5.007, P=0.029). Conclusion A substantial proportion of patients with depression disorder may have unrecognized bipolar disorder, and MDQ-C may serve as a screening tool to increase the recognition of bipolar disorder. Patients with depression disorder and characteristics of male gender, age<25 years and appetite increase at first episode may potentially be those with bipolar disorder.

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    Clinical features of bipolar depression versus unipolar depression
    LI Ze-zhi, YUAN Cheng-mei, WU Zhi-guo, et al
    2011, 31 (11):  1513. 
    doi: 10.3969/j.issn.1674-8115.2011.11.002

    Abstract ( 1787 )   PDF (4916KB) ( 1959 )  

    Objective To explore the differences in clinical features between bipolar depression and unipolar depression from the clinical phenomenology. Methods The clinical data of 200 patients with bipolar depression (bipolar depression group) and 563 patients with recurrent unipolar depression (recurrent unipolar depression group) were compared, and multiple stepwise Logistic regression was employed to identify the clinical features related to bipolar disorder. Results The age at onset in bipolar depression group was younger than that in recurrent unipolar depression group (P<0.001), the percent of patients with age at onset <25 years in bipolar depression group was significantly higher than that in recurrent unipolar depression group (P<0.01). Hypersexuality, which was one of the atypical depressive symptoms, were more common in bipolar depression group than in recurrent unipolar depression group (P<0.01). The percents of patients with psychiatric symptoms, psychomotor retardation, mood instability and duration of every depressive episode <3 months in bipolar depression group were much higher than those in recurrent unipolar depression group (P<0.05). The score of cognitive impairment factor, one of the factors of 17-item Hamilton Rating Scale for Depression (HAMD-17), was significantly higher in bipolar depression group than in recurrent unipolar depression group (P<0.05). Logistic regression analysis revealed that age at onset, age at onset <25 years, family history of bipolar disorder, hypersexuality, psychiatric symptoms, psychomotor retardation, mood instability, duration of every depressive episode <3 months and score of cognitive impairment factor were independent factors for bipolar disorder, and the odds ratios were 1.54, 1.50, 3.25, 1.99, 1.89, 1.48, 1.63, 1.63 and 1.42, respectively. Conclusion Bipolar depression and unipolar depression are different disorders, and distinct clinical features may be potential predictors of bipolar disorder.

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    Association of 5HTTLPR gene polymorphisms with bipolar disorder and affective temperaments
    YUAN Cheng-mei, YU Shun-ying, LI Ze-zhi, et al
    2011, 31 (11):  1518. 
    doi: 10.3969/j.issn.1674-8115.2011.11.003

    Abstract ( 1927 )   PDF (5405KB) ( 1214 )  

    Objective To explore the association of serotonin transporter gene-linked polymorphic region (5-HTTLPR) gene polymorphisms with bipolar disorder and affective temperaments. Methods Case-control design was adopted, and 305 patients with bipolar disorder and 272 normal controls were enrolled. Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A) was employed to assess the affective temperaments. Chi-square test, T test, nonparametric test and ANOVA were used to explore the association of 5-HTTLPR gene polymorphisms with bipolar disorder and affective temperaments. Results 5-HTTLPR L/S polymorphisms were associated with bipolar disorder in females (genotype, χ2=6.769, P=0.034;allele, χ2=6.028, P=0.014), S allele of 5-HTTLPR L/S polymorphisms was associated with anxious temperament of patients with bipolar disorder (t=8.248,P=0.005), and LA allele of 5-HTTLPR rs25531 A/G polymorphisms was associated with hyperthymic temperament of patients with bipolar disorder (Z=-2.205,P=0.027). Conclusion 5-HTTLPR gene polymorphisms are associated with the prevalence of bipolar disorder in females, which can also regulate the affective temperaments of patients with bipolar disorder in some degree.

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    Correlation of early trauma experience with depression and bipolar disorder
    HUANG Jia, YUAN Cheng-mei, LI Ze-zhi, et al
    2011, 31 (11):  1523. 
    doi: 10.3969/j.issn.1674-8115.2011.11.004

    Abstract ( 1356 )   PDF (4565KB) ( 1136 )  

    Objective To explore the correlation of early trauma experience with depression and bipolar disorder. Methods Three hundred and seventeen patients with depression and 124 patients with bipolar disorder were enrolled. The general data of patients were collected by self-made questionnaire, including gender, age, education experience, age at first episode, family history of mental diseases, disease duration, number of attack, working status and family status. Early trauma experience was assessed with early trauma experience inventory-short form, which involved four dimensions of common trauma, body trauma, emotional abuse and sexual abuse, and the scores of patients with depression and bipolar disorder were compared with nonparametric test. The correlation of different kinds of early trauma experience with depression and bipolar disorder was explored by Logistic regression analysis. Results The incidence of common trauma experience and total score of inventory in patients with bipolar disorder were significantly higher than those in patients with depression (P<0.05). In patients with depression, common trauma was related to family status (P<0.001), body trauma was significantly related to gender, family status and working status (P<0.05), and emotional abuse was related to family status and number of attack (P<0.05). In patients with bipolar disorder, common trauma was significantly related to family status and family history of metal diseases (P<0.05), emotional abuse was significantly related to family status (P<0.01), and sexual abuse was related to gender (P<0.01). Conclusion Early trauma experience is correlated with both depression and bipolar disorder, and different kinds of trauma may play different roles in the onset and development of these two diseases.

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    Self-stigma in patients with mood disorders and its related factors
    WU Zhi-guo, YUAN Cheng-mei, WANG Zhen, et al
    2011, 31 (11):  1527. 
    doi: 10.3969/j.issn.1674-8115.2011.11.005

    Abstract ( 1214 )   PDF (5071KB) ( 1628 )  

    Objective To investigate the level of self-stigma in patients with mood disorders and its related factors. Methods Self-stigma in 446 patients with mood disorders was evaluated using Internalized Stigma of Mental Illness scale (ISMI), and levels of self-stigma were compared among patients with different sociodemographic or clinical features. Spearman correlation analysis was conducted between self-stigma and clinical variables in 384 patients with depressive episode. Results Self-stigma existed in 72.9% of patients, and moderate to severe self-stigma accounted for 24.2%. The percent of patients with stigma resistance was the highest (79.6%), and the percent of patients with discrimination experience was the lowest (41.0%). Male patients had higher scores of stereotype endorsement, discrimination experience and social withdrawal subscale than female patients (P<0.05). Employed patients had lower score of discrimination experience subscale than the unemployed (P<0.05). Patients with higher education had lower ISMI total score, as well as lower alienation, stereotype endorsement, discrimination experience and social withdrawal subscale scores than those with lower education (P<0.05). There was no significant difference in ISMI total score between patients with major depressive disorder and those with bipolar disorders (P>0.05). ISMI total score and alienation, stereotype endorsement, social withdrawal and stigma resistance subscale scores of unrecovered patients were significantly higher than those of the recovered (P<0.05). Age and depression severity (total score of 17-item Hamilton Rating Scale for Depression) were positively associated with ISMI total score (r=0.168, P<0.01; r=0.300, P<0.01), and education experience was negatively associated with ISMI total score (r=-0.178, P<0.01) in patients with depressive episode. Conclusion Self-stigma and high stigma resistance are common in patients with mood disorders. Self-stigma of patients with certain sociodemographic and clinical features should be attached great importance and assessed cautiously and comprehensively. Efforts on helping patients to enhance their ability to resist stigma should be strengthened.

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    Changes of plasma brain-derived neurotrophic factor in patients with bipolar disorder type Ⅰ
    WANG Zuo-wei, LI Ze-zhi, LIN Zhi-guang, et al
    2011, 31 (11):  1532. 
    doi: 10.3969/j.issn.1674-8115.2011.11.006

    Abstract ( 1510 )   PDF (3770KB) ( 931 )  

    Objective To explore the relationship between plasma brain-derived neurotrophic factor (BDNF) and manic episode of bipolar disorder type Ⅰ. Methods With comprehensive clinical review and structured clinical interview for DSM-Ⅳ axis Ⅰ disorders patient version (SCID-Ⅰ/P), 28 patients with manic episode of bipolar disorder type Ⅰ were enrolled (case group), and were treated with lithium and quetiapine. Another 30 gender- and age-matched healthy volunteers were served as controls. Plasma mass concentrations of BDNF in case group and control group were detected by ABC-ELISA before treatment and 2 weeks, 4 weeks and 8 weeks after treatment, and the relationship between plasma mass concentration of BDNF and Young mania rating scale (YMRS) was analysed in case group. Results The plasma mass concentrations of BDNF in case group were significantly higher than those in control group before treatment and 8 weeks after treatment (P<0.05), while there was no significant difference in the plasma mass concentrations of BDNF between two groups 2 weeks and 4 weeks after treatment (P>0.05). In case group, the plasma mass concentrations of BDNF before treatment and 2 weeks and 8 weeks after treatment were not related to the score of YMRS (P>0.05), while the plasma mass concentration of BDNF 4 weeks after treatment was significantly related to the score of YMRS (r=-0.450, P<0.05). Conclusion The episode state of mania in patients with bipolar disorder type Ⅰ is not linearly associated with the plasma level of BDNF, and further studies with large samples are necessary to elucidate the relationship between them.

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    Clinical efficacy and safety of lithium carbonate combined with aripiprazole in treatment of bipolar depression
    SU You-song, CHEN Jun, LI Ze-zhi, et al
    2011, 31 (11):  1536. 
    doi: 10.3969/j.issn.1674-8115.2011.11.007

    Abstract ( 1984 )   PDF (4463KB) ( 1356 )  

    Objective To investigate the clinical efficacy and safety of lithium carbonate combined with aripiprazole in treatment of bipolar depression. Methods Eighty-one patients with bipolar depression were randomly divided into lithium carbonate combined with aripiprazole group (n=42) or lithium carbonate group (n=39), and were treated with lithium carbonate combined with aripiprazole and lithium carbonate for 8 weeks respectively. At the baseline and the end of fthe irst, second, fourth and eighth week of treatment, Hamilton Depression Scale-17 (HAMD-17) and Young Mania Rating Scale (YMRS) were employed to evaluate the clinical efficacy, the effective rates were calculated, and Treatment Emergent Symptom Scale (TESS) was adopted to assess the side effects. Results There was no significant difference in HAMD-17 score between two group at the baseline (P>0.05), while HAMD-17 scores at the end of first, second and fourth week of treatment in lithium carbonate combined with aripiprazole group were significantly lower than those in lithium carbonate group (P<0.05 or P<0.01). Though HAMD-17 score at the end of the eighth week of treatment in lithium carbonate combined with aripiprazole group was lower than that in lithium carbonate group, there was no significant difference between two groups (P>0.05). All the scores of YMRS at the baseline and the end of the first, second, fourth and eighth week of treatment were lower than 7. There was no significant difference in the effective rate and prevalence of side effects between two groups (P>0.05). Conclusion Compared with lithium carbonate, lithium carbonate combined with aripiprazole may have earlier effects, similar clinical efficacy and no more side effects in treatment of bipolar depression.

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    Research progress of immunological mechanisms of bipolar disorder
    HONG Wu, FANG Yi-ru
    2011, 31 (11):  1540. 
    doi: 10.3969/j.issn.1674-8115.2011.11.008

    Abstract ( 1282 )   PDF (6132KB) ( 1350 )  

    The pathogenesis of bipolar disorder has not been clearified. Heredity, neurotransmitter, neurotrophy, oxidative stress, immunology and environment have been reported to be related to the pathogenesis of bipolar disorder. Nowadays, the relationship between bipolar disorder and immunity has become the focus of attention. This review summarizes the immunity-related gene polymorphisms and cytokines in the pathogenesis of bipolar disorder, discusses the causal relationship between bipolar disorder and dysimmunity, and explore the application of immunity-related methods in the diagnosis and treatment of bipolar disorder.

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    Research progress of bipolar disorder and signaling pathway of brain derived neurotrophic factor
    HU Ying-yan, FANG Yi-ru
    2011, 31 (11):  1546. 
    doi: 10.3969/j.issn.1674-8115.2011.11.009

    Abstract ( 1429 )   PDF (3937KB) ( 1194 )  

    Brain derived neurotrophic factor (BDNF) can prevent neurons from death, promote growth, development and differentiation of neurons, enhance restoration and regeneration of neurons, and reinforce signal transduction among synapses. It has been revealed that BDNF is related to the pathogenesis and treatment of bipolar disorder. The downstream signaling pathway of BDNF changes accordingly in bipolar disorder, and the mechanism of mood stabilizers in treatment of bipolar disorder may be related to the up-regulation of BDNF expression by mediating factors in the downstream signaling pathway of BDNF. In this paper, the relationship between the pathogenesis and treatment of bipolar disorder and signaling pathway of BDNF is reviewed.

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    Research progress of early diagnosis of bipolar disorder
    HUANG Jia, YUAN Cheng-mei, FANG Yi-ru
    2011, 31 (11):  1550. 
    doi: 10.3969/j.issn.1674-8115.2011.11.010

    Abstract ( 1284 )   PDF (4317KB) ( 1617 )  

    Bipolar disorder is a kind of serious mental disease. Bipolar disorder occurs as depression in most cases, which may result in the misdiagnosis as unipolar depression, delayed therapy and unfavorable prognosis. Therefore, the early diagnosis of bipolar disorder is very important. The pathogenesis of bipolar depression is extremely complicated, which concerns with numerous fields. However, few studies have focused on the specific molecular biomarkers in bipolar depression. This review is to introduce the research progress of early diagnosis of bipolar disorder on the fields of genetics, neuroendocrine and biochemistry, discussing the molecular biomarkers which may contribute to the early diagnosis of bipolar disorder.

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    Original article (Basic research)
    Numerical simulation of influence of wall elasticity of patient-specific carotid bifurcation on hemodynamics
    QIU Xiao-ning, FEI Zhi-min, ZHANG Jue, et al
    2011, 31 (11):  1554. 
    doi: 10.3969/j.issn.1674-8115.2011.11.011

    Abstract ( 1566 )   PDF (8599KB) ( 3861 )  

    Objective To investigate the relationship between bifurcation carotid atherosclerosis and hemodynamics by analysing the influence of carotid artery elastic wall deformation on hemodynamics. Methods A carotid bifurcation model was developed by Mimics software through three-dimensional reconstruction of CT medical images. Three-dimensional flows of rigid wall model and elastic wall model were numerically simulated through computational fluid dynamics. The differences between rigid and elastic models were analysed by comparing hemodynamic parameters such as wall displacement, Von Mises stress, time average wall shear stress (TAWSS) and oscillatory shear index (OSI). Results For elastic model, although the differences between distributions of carotid artery velocity and wall shear stress were not significant, the velocity and wall shear stress of carotid artery decreased significantly compared to rigid model. It was revealed that the maximum velocity and TAWSS in elastic model decreased 14% and 11.8% respectively. The flow in carotid artery became more complicated due to the disturbance of wall deformation. Conclusion Wall elasticity has important influence on the hemodynamics of carotid bifurcation, and the elastic wall is more suitable for simulating flows in carotid artery.

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    Acute hyperglycemia on vessel function of normal rats
    ZHENG Jun, WANG Yuan, LIANG Yun-xing, et al
    2011, 31 (11):  1560. 
    doi: 10.3969/j.issn.1674-8115.2011.11.012

    Abstract ( 1239 )   PDF (5788KB) ( 1087 )  

    Objective To investigate the influence and possible mechanism of acute hyperglycemia on vessel function of normal rats. Methods The isolated thoracic aorta of Wistar rats (n=5) were taken for determination of vascular function in vitro. Vascular rings were incubated with high glucose solution containing 25, 50 and 100 mmol/L glucose (high glucose group) or hyperosmotic solution containing 25, 50 and 100 mmol/L mannitol (hyperosmotic control group) for 10 min, and blank control group was also established. The contraction response to phenylephrine (PE) and relaxation response to acetylcholine (Ach) of vessels were examined with tension transducer, and the relative production of reactive oxygen species (ROS) and nitric oxide (NO) of vascular rings was determined with DCF method and DAF-FM fluorescent probe respectively. Results There was no significant difference in the contraction response to 1 μmol/L PE among blank control group, high glucose group and hyperosmotic control group (P>0.05). Compared with blank control group, the relaxation response to 1 μmol/L acetylcholine in high glucose group and hyperosmotic control group decreased with the increase of glucose concentrations and osmotic pressure (P<0.05), and the decrease of relaxation response in hyperosmotic control group was more significant than that in high glucose group (P<0.05). The relative production of NO in high glucose group and hyperosmotic control group and the relative production of ROS in high glucose group were significantly higher than those in blank control group (P<0.05 or P<0.01), while there was no significant difference in the relative production of ROS between hyperosmotic control group and blank control group (P>0.05). Conclusion Acute high glucose leads to concentration-dependent reduction in vasodilatation, which may be associated with the endothelial damage caused by increased ROS production. Excessive NO production induced by hyperosmosis may also serve as free radicles to damage blood vessels.

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    Effects of co-treatment with puerariae radix flavones and arsenic trioxide on proliferation and apoptosis of Kasumi-1 cells and HL-60 cells
    TANG Yu-hong, SHAO Hua-min, ZHU Hong-qing, et al
    2011, 31 (11):  1564. 
    doi: 10.3969/j.issn.1674-8115.2011.11.013

    Abstract ( 1455 )   PDF (4561KB) ( 1382 )  

    Objective To investigate the effects of co-treatment with puerariae radix flavones (PRF) and arsenic trioxide (ATO) on proliferation and apoptosis of Kasumi-1 cells and HL-60 cells of acute myeloid leukemia M2. Methods Kasumi-1 cells and HL-60 cells were treated with 100 μg/mL PRF and 1 μmol/L ATO for 48 h (RRF+ATO group). MTT assay was employed to measure the inhibition rate of cell proliferation, Annexin V-FITC/PI double staining was used to determine the early apoptosis rate by flow cytometry, the expression of Bcl-2 and Survivin mRNA was detected by Real-Time PCR, and the expression of Caspase-3, Caspase-8 and Caspase-9 protein was detected by Western blotting. Cells only treated with 100 μg/mL PRF were served as PRF group, and blank control group was also established. Results The inhibition rate of cell proliferation, early apoptosis rate and expression of Caspase-3 and Caspase-9 protein of Kasumi-1 cells in RRF+ATO group were significantly higher than those in PRF group (P<0.05), and there was an obvious trend of down-regulation of expression of Bcl-2 mRNA in Kasumi-1 cells. There was no significant difference in each parameter of HL-60 cells between RRF+ATO group and PRF group (P>0.05). Conclusion Co-treatment with PRF and ATO can effectively inhibit the proliferation and induce early apoptosis of Kasumi-1 cells, while that has no significant effect on HL-60 cells.

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    Changes in zona fasciculata and reticularis of adrenal cortex in castrated male rats and effect of low androgen on signal pathway of COX-2
    SHI Chao, LI Yan-xiang, ZHAI Hua-ling, et al
    2011, 31 (11):  1568. 
    doi: 10.3969/j.issn.1674-8115.2011.11.014

    Abstract ( 1529 )   PDF (9056KB) ( 980 )  

    Objective To investigate the changes in structure and function of zona fasciculata and reticularis of adrenal cortex in castrated male rats, and explore the effect of low androgen on  the signal pathway of cyclooxgenase-2 (COX-2). Methods Thirty male SD rats aged 10 weeks were randomly divided into control group (n=8), castration group (n=11) and replacement group (n=11). Rats in control group received sham castration, those in castration group underwent castration, and those in replacement group were managed with testosterone undecanoate (50 mg/kg per month) after castration. Ten weeks later, serum samples were collected for determination of serum concentrations of testosterone (T), corticosterone (F), adrenocorticotrophic hormone (ACTH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by radioimmunoassay, adrenal cortex tissues were obtained for observation of morphological changes in zona fasciculata and reticularis of adrenal cortex with HE staining by light microscopy and ultrastructural changes by transmission electron microscopy, and the expression of COX-2 mRNA in tissues of adrenal cortex and thoracoabdominal aorta was detected by RT-PCR. Results Serum T concentration in castration group was significantly lower than those in control group and replacement group (P<0.01), and serum concentrations of F, ACTH, LH and FSH in castration group were significantly higher than those in control group and replacement group (P<0.05). Cells in zona fasciculate and reticularis of adrenal cortex in castration group were larger, with bigger nuclei, more mitochondrion, better-developed smooth endoplasmic reticula and less lipid droplets. However, the morphology and ultrastructure of cells in zona fasciculata and reticularis of adrenal cortex in replacement group were similar to those in control group. The expression of COX-2 mRNA in adrenal cortex tissues in castration group was significantly lower than that in control group and replacement group (P<0.05), while the expression of COX-2 mRNA in aorta tissues in castration group was significantly higher than that in control group and replacement group (P<0.05). Conclusion There are hyperplasia and hyperfunction of zona fasciculate and reticularis of adrenal cortex and lower expression of COX-2 mRNA in adrenal cortex tissues in castrated male rats, and the increased expression of COX-2 mRNA in aorta tissues may be related to the vascular disease induced by low androgen.

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    Effects of estradiol on behavior and expression of serotonin transporter in hippocampus and amygdala of rats in forced swimming test
    YANG Fu-zhong, WU Yan, SHAN Hong-ying, et al
    2011, 31 (11):  1574. 
    doi: 10.3969/j.issn.1674-8115.2011.11.015

    Abstract ( 1686 )   PDF (5390KB) ( 1268 )  

    Objective To investigate the effects of estradiol on behavior and expression of serotonin transporter (SERT) protein in hippocampus and amygdala in bilaterally ovariectomized rats in forced swimming test. Methods Twenty-eight adult female SD rats were randomly divided into control group, stress group, estradiol group and fluoxetine group (n=7). Three weeks after bilateral ovariectomy, drugs were administered to rats for 14 d. On the fourteenth day of administration, rats in stress group, estradiol group and fluoxetine group were subjected to 15 min forced swimming test, and the behavior of rats was evaluated. The expression of SERT in hippocampus and amygdala of rats in each group was determined by immunofluorescence histochemical method. Results In forced swimming test, the counts of swimming behavior in estradiol group and fluoxetine group were significantly more than that in stress group, while the counts of immobility behavior in estradiol group and fluoxeitne group were significantly less than that in stress group (P<0.001 for all). Immunofluorescence histochemistry indicated that the integral absorbance of SERT in hippocampus and amygdala in stress group was significantly higher than that in control group (P<0.001), while the integral absorbance of SERT in hippocampus and amygdala in estradiol group and fluoxeitne group was significantly lower than that in stress group (P<0.05, P<0.001). Conclusion Estradiol may increase the counts of swimming behavior and decrease the counts of immobility behavior of bilaterally ovariectomized rats in forced swimming test. Pretreatment with estradiol may inhibit stress-induced content increase of SERT protein in hippocampus and amygdala, which resembles the effects of antidepressant fluoxetine.

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    Effects of BDNF on activation of spinal dorsal horn astrocytes in rats with spinal nerve ligation
    WANG Jing, ZHANG Xin, DU Dong-ping, et al
    2011, 31 (11):  1578. 
    doi: 10.3969/j.issn.1674-8115.2011.11.016

    Abstract ( 1646 )   PDF (5866KB) ( 1992 )  

    Objective To observe the changes of expression of brain-derived neurotrophic factor (BNDF) and glial fibrillary acidic protein (GFAP) in rats with spinal nerve ligation (SNL), and investigate the effects of TrkB/Fc, BDNF inhibitor on expression of GFAP and pain. Methods Eighteen SD rats were randomly divided into blank control group, sham operation group and SNL group (n=6). Values of 50% paw withdrawal threshold (50% PWT) were measured before surgery and on six consecutive days after surgery. Spinal dorsal horn of the spinal enlargement was obtained after last measurement for determination of expression of GFAP and BDNF by Western blotting. Another 18 SD rats were randomly allocated into control group, SNL+placebo group and SNL+TrkB/Fc group (n=6). Rats in control group only underwent intrathecal catheterization, while rats in SNL+placebo group and SNL+TrkB/Fc group received intrathecal injection of either PBS or TrkB/Fc 10 μL once before the operation of SNL catheterization and 6 times after the operation. Values of 50% PWT were measured 1 h before drug administration. Spinal dorsal horn of the spinal enlargement was obtained 1 h after last injection for determination of the expression of GFAP by Western blotting. Results On the first to the sixth days after operation, values of 50% PWT on the ipsilateral hindpaw in SNL group were significantly lower than the baseline value before operation (P<0.01). On the sixth day after operation, the expression of BDNF and GFAP in the ipsilateral dorsal horn in SNL group was significantly higher than that in blank control group (P<0.01). However, the value of 50% PWT in the ipsilateral hindpaw in SNL+TrkB/Fc group was not significantly different from the baseline value (P>0.05), and the expression of GFAP in SNL+TrkB/Fc group was also not significantly different from that in control group (P>0.05). Conclusion BDNF-induced astrocyte activation contributes to the development of neuropathic pain produced by SNL.

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    Original article (Clinical research)
    Characterization of |rpsL and rrs genes of aminoglycoside-resistant clinical isolates of Mycobacterium tuberculosis in Wuhan
    WEN Zi-lu, SHEN Jian-guo, ZHANG Chao-bao, et al
    2011, 31 (11):  1583. 
    doi: 10.3969/j.issn.1674-8115.2011.11.017

    Abstract ( 1293 )   PDF (5662KB) ( 1373 )  

    Objective To characterize the rpsL and rrs genes of aminoglycoside-resistant clinical isolates of Mycobacterium tuberculosis in Wuhan. Methods Sixty-nine clinical isolates of Mycobacterium tuberculosis were collected from Wuhan Medical Treatment Center, including 35 streptomycin (SM)resistance isolates (4 were also resistant to kanamycin) and 34  isolates susceptible to SM (20 were pan-susceptible). Mutation characteristics of rpsL and rrs genes were analyzed with PCR direct sequencing. Results Of the 35 SM-resistant clinical isolates, 26 (74.3%) carried mutations in rpsL gene, with rpsL Lys43Arg and Lys88Arg being the most common rpsL mutations, and one new mutation in codon 88 of rpsL (Lys88Glu) was detected. Four types of mutations in rrs gene in 13 resistant isolates (37.1%) including A1401G (17.1%, 6/35), A514C (14.2%, 5/35), G1487A (2.9%, 1/35) and C517T (2.9%, 1/35) were revealed, and one pan-susceptible  isolate presenting C1029T mutation in rrs gene was detected. The mutations in rrs gene were only found in 3 kanamycin-resistant isolates, and G1487A mutation was detected in rrs gene, which was first reported. Conclusion Aminoglycoside-resistance of Mycobacterium tuberculosis is related to rpsL and rrs gene mutations, and the characteristics of these genes are diverse due to geographical differences.

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    Meta-analysis of XRCC1 Codon 399 polymorphism and susceptibility to hepatocellular carcinoma
    CHEN Bing-pu, LONG Xi-Dai, FU Guo-hui
    2011, 31 (11):  1588. 
    doi: 10.3969/j.issn.1674-8115.2011.11.018

    Abstract ( 1495 )   PDF (5065KB) ( 1163 )  

    Objective To explore the relationship between X-ray repair cross-complementary group 1(XRCC1) codon 399 polymorphism and genetic susceptibility to hepatocellular carcinoma (HCC). Methods Literatures of case-control studies about XRCC1 codon 399 polymorphism and genetic susceptibility to HCC were retrieved, related information was extracted, and meta-analysis was performed on research findings. Odds ratios (ORs) and 95% confidence interval (95% CI) were calculated using fixed- or random-effects model via heterogeneity test, and the publication bias and sensitivity were evaluated. Results Seven domestic and overseas literatures were enrolled, including 1 342 cases of HCC and 2 207 controls. The combined data analysis indicated that XRCC1 codon 399 Gln/Gln increased risk for HCC (OR=1.41, 95% CI=1.07-1.84), while XRCC1 codon 399 Lys/Gln was not related to risk for HCC. Subgroup analysis revealed that both Lys/Gln and Gln/Gln were related to HCC in areas with high incidence of HCC (OR=1.46, 95% CI 1.07-2.00; OR=1.45, 95% CI 1.09-1.93). Conclusion XRCC1 codon 399 polymorphism is associated with the susceptibility to HCC.

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    Development and validation of prognostic models for patients with traumatic brain injury
    YUAN Fang, DING Jun, GUO Yan, et al
    2011, 31 (11):  1592. 
    doi: 10.3969/j.issn.1674-8115.2011.11.019

    Abstract ( 1958 )   PDF (7997KB) ( 981 )  

    Objective To develop and validate prognostic models for mortality within 30 d after traumatic brain injury and for 6-month unfavorable prognosis after traumatic brain injury. Methods The clinical data of 1 016 patients with moderate to severe traumatic brain injury were collected to develop prognostic models. The relationship between admission-related risk factors and prognosis was systematically analysed, different prognostic models were established with Logistic regression analysis, and the performance of these models was assessed with goodness-of-fit test and C statistic (area under the receiver operating characteristic curve). These models were internally and externally validated, the ultimate prognostic model was determined to serve as the tool of prognostic evaluation for patients with traumatic brain injury. Results Logistic regression analysis revealed that old age, loss of pupillary light reflex, decreased motor Glasgow Coma Score, abnormal CT features and abnormal routine laboratory findings were independent risk factors for unfavorable prognosis in patients with traumatic brain injury. The prognostic model based on the risk factors of admission had favorable performance (P>0.05 for goodness-of-fit test, 0.709-0.882 for C statistic). No overoptimism was revealed by internal validation, and the external validity was proved to be better by external validation (P>0.05 for goodness-of-fit test, 0.844-0.922 for C statistic). Conclusion The established model, which is convenient to manage, can timely and accurately predict the prognosis of patients with traumatic brain injury, and can help in decision-making in clinics.

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    Surgical management and outcomes of involved aortic root in type A aortic dissection
    LI Qing-guo, WANG Qiang, PAN Jun, et al
    2011, 31 (11):  1599. 
    doi: 10.3969/j.issn.1674-8115.2011.11.020

    Abstract ( 1000 )   PDF (3977KB) ( 1100 )  

    Objective To summarize the clinical experience in surgical management of aortic root in type A aortic dissection. Methods The clinical data of 113 patients with type A aortic dissection were collected, among whom aortic root was involved in 97, and aortic root was uninvolved in 16. Bentall procedure (n=46), reconstruction of Valsalva's sinus (n=48) and Divid procedure (n=3) were employed in the management of involved aortic root. The surgical outcomes and follow-up findings were retrospectively analysed. Results Fourteen patients died early after operation, and the other 99 patients were discharged. Eighty-six patients were followed up for 6 to 108 months. During the follow-up, one of the 26 patients undergoing Bentall procedure died, one of the 45 patients with reconstruction of Valsalva's sinus had gradually enlarged Valsalva's sinus and mild to moderate aortic insufficiency, and one of the 3 patients receiving Divid procedure experienced mild to moderate aortic insufficiency. Conclusion Surgical management of aortic root in type A aortic dissection should be performed according to the condition of aortic root. Reconstruction of Valsalva's sinus is a valvesparing technique with favorable early and intermediate outcomes.

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    Clinical features and 2-year outcomes of patients with impaired glucose regulation
    WANG Shen-qi, CHEN Hui-fen, HOU Xu-hong, et al
    2011, 31 (11):  1603. 
    doi: 10.3969/j.issn.1674-8115.2011.11.021

    Abstract ( 1661 )   PDF (5300KB) ( 1094 )  

    Objective To evaluate the insulin secretion and sensitivity in patients with different subtypes of impaired glucose regulation (IGR), and investigate the 2-year outcomes of glucose tolerance. Methods Ninety-two patients with IGR were followed up for 2 years. At baseline and during follow-up, 75 g oral glucose tolerance tests (OGTT) were performed. β cell function index of homeostasis model assessment (HOMA-β) and β cell secretion function (BCF) index (first-phase BCF, BCF-Ⅰ; second-phase BCF, BCF-Ⅱ) of homeostasis model assessment were employed to evaluate insulin secretion, insulin resistance index of homeostasis model assessment (HOMA-IR) was adopted to determine hepatic insulin sensitivity, and  insulin sensitivity index(ISI) was used to assess peripheral insulin sensitivity. Results According to baseline OGTT findings, 92 patients with IGR were divided into isolatedimpaired fasting glucose group (I-IFG group, n=16), isolated-impaired glucose tolerance group (I-IGT group, n=66) and complex glucose intolerance group (CGI group, n=10). There was no significant difference in age, gender, overweight/obesity, blood pressure and lipids among groups (P>0.05). At baseline, HOMA-IR declined in the order of CGI group, I-IFG group and I-IGT group, ISI increased in the order of CGI group, I-IGT group and I-IFG group, and BCF-Ⅰincreased in the order of I-IFG group, CGI group and I-IGT group, with significant differences among groups (P<0.05 for all). During the follow-up for 2 years, 20 patients with IGF developed into diabetes mellitus, with the cumulative incidence of 21.7%. Conclusion IGT is the main form of IGR. Impairment of first-phase secretion of β cell is most significant in I-IFG population. CGI population has the most serious hepatic and peripheral insulin resistance. I-IFG population has more serious hepatic insulin resistance than I-IGT population, and that is opposite for peripheral insulin resistance.

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    Analysis of therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm
    SHANG Ming, TANG Yin-da, ZHENG Xue-sheng, et al
    2011, 31 (11):  1608. 
    doi: 10.3969/j.issn.1674-8115.2011.11.022

    Abstract ( 1208 )   PDF (5204KB) ( 1221 )  

    Objective To investigate the therapeutic effect of microvascular decompression surgery on idiopathic hemifacial spasm with compression on different zones of facial nerve. Methods The clinical data of 548 patients with idiopathic hemifacial spasm treated by microvascular decompression surgery were retrospectively analysed. Patients were divided into 5 groups according to compression on different zones of facial nerve by offending vessels. Root exit point was compressed in 31 patients (group A), transitional zone of brainstem was compressed in 59 patients (group B), attached segment of brainstem was compressed in 47 patients (group C), distal cisternal portion was compressed in 28 patients (group D), and two or more zones were compressed in 383 patients (group E). The therapeutic effect was observed, and complete remission and partial remission were regarded as effectiveness. Results Patients were followed up for 0.5 to 2 years. The effective rates were 96.8%, 96.6%, 97.8%, 96.4% and 94.5% in group A, group B, group C, group D and group E respectively. No death occurred in operation, and there were no severe complications such as complete facial paralysis, intracranial hematoma and hearing loss after operation. Conclusion Microvascular decompression surgery is the first choice for treatment of patients with hemifacial spasm. Proper detection of offending vessels and complete decompression may be the key factors to increase the cure rate.

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    Creation and application of test methods for error-monitoring function
    CHEN Xing-shi, TANG Yun-xiang, XU Yi-feng, et al
    2011, 31 (11):  1612. 
    doi: 10.3969/j.issn.1674-8115.2011.11.023

    Abstract ( 1259 )   PDF (4647KB) ( 999 )  

    Objective To investigate the features of error-monitoring function in healthy adults with event-related potentials (ERP). Methods Sixty-two righthanded healthy adults (33 males and 29 females) aged between 19 and 50 years were enrolled, with the mean age of (29.6±6.6) years and mean education experience of (16.7±2.0) years. Error-related negativity (ERN) in frontal zone (Fz), central zone (Cz), left central zone (C3), right central zone (C4) and parietal zone (Pz) was detected with ERP instrument (Brain Products, Germany), and the latencies and wave amplitudes of ERN were statistically analysed. Results A negative wave was detected in each scalp electrode about 50 ms after the stimuli presented, and the ERN waveform was stable. Statistical analysis revealed that there was no significant difference in the latencies and wave amplitudes of ERN between C3 and C4 (P>0.05). In Fz, Cz and Pz, there was no significant difference in the latencies and wave amplitudes of ERN between males and females (P>0.05). The wave amplitudes of ERN in Fz and Cz were significantly positively related to the age of subjects (r=0.282, P=0.027; r=0.250, P=0.049). Conclusion ERN is stable and reliable in healthy adults. As a clinically valuable ERP component, ERN can be used in clinical practice of department of Neurology and Psychiatry.

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    Expression of hypoxia-inducible factor prolyl 4-hydroxylase in placentas of normal pregnant women and patients with pre-eclampsia
    LIU Wei, LIN Qi-de, WANG Shu-jun
    2011, 31 (11):  1616. 
    doi: 10.3969/j.issn.1674-8115.2011.11.024

    Abstract ( 1075 )   PDF (6644KB) ( 1213 )  

    Objective To investigate the expression of hypoxia-inducible factor prolyl 4-hydroxylase (HPH) in placentas of normal pregnant women and patients with pre-eclampsia, and explore the relationship between oxygen sensitivity of trophoblast and hypoxia in preeclamptic placenta. Methods Sixty-six pregnant women undergoing cesarean section or family planning surgery were divided into early pregnancy group (n=13), mid-pregnancy group (n=9), late pregnancy group (n=13, controls for pre-eclampsia group and gestational hypertension group), pre-eclampsia group (n=20) and gestational hypertension group (n=11). The expression of HPH-1, HPH-2 and HPH-3 mRNA in placentas and villous tissues was determined by in situ hybridization and Real-Time PCR. Results HPH-1, HPH-2 and HPH-3 mRNA was mainly expressed in cytoplasm of trophoblast, and HPH-1 mRNA was significantly expressed in cytoplasm of extravillous trophoblast. With the progress of pregnancy, the expression of HPH-1 mRNA significantly increased (r=0.616, P<0.001). The expression of HPH-1 mRNA in pre-eclampsia group was significantly lower than that in late pregnancy group (P<0.05). The expression of HPH-1 mRNA in gestational hypertension group was also lower than that in late pregnancy group, while there was no significant difference between them (P>0.05). The weight of placentas in pre-eclampsia group was significantly related to the expression of HPH-1 mRNA (r=0.457, P<0.05). Conclusion Low oxygen sensitivity of trophoblast (low expression of HPH-1 mRNA) may be an important cause for placenta hypoxia (overactivation of hypoxia reaction pathway) in patients with pre-eclampsia.

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    Outcomes of different treatment methods for cesarean scar pregnancy
    ZHU Jun-yan, DI Wen
    2011, 31 (11):  1621. 
    doi: 10.3969/j.issn.1674-8115.2011.11.025

    Abstract ( 1413 )   PDF (3705KB) ( 1220 )  

    Objective To analye the outcomes of the treatment methods for cesarean scar pregnancy. Methods Forty-five women with cesarean scar pregnancy were divided into three groups according to different treatment methods. Methotrexate (MTX) was systemically applied in MTX group (n=6), dilation and curettage were performed in dilation and curettage group (n=17), and women in uterine artery embolisation (UAE) group (n=22) underwent uterine artery embolisation in combination of local injection of MTX and dilation and curettage. The outcomes were compared among groups. Results There were significant differences in success rates among MTX group (50%, 3/6), dilation and curettage group (64.71%, 11/17) and UAE group (100%, 22/22)(P<0.05). The volume of blood loss during operation in UAE group was significantly smaller than that in dilation and curettage group (P<0.05). There was no significant difference in age, number of cesarean section, gestational age, size of sac and initial level of human chorionic gonadotropin (β-HCG) among three groups (P>0.05). There were significant differences in duration of hospital stay, time for β-HCG recovery and time for mass disappearance among three groups (P<0.05). The duration of hospital stay and time for mass disappearance in UAE group were shorter than those in MTX group and dilation and curettage group (P<0.05). The time for β-HCG recovery in dilation and curettage group was shorter than that in MTX group and UAE group (P<0.05). In UAE group, 22.73% cases (5/22) had body temperature higher than 38 ℃, and 9.09% cases (2/22) experienced pelvic pain. Conclusion UAE is an effective and safe treatment method for cesarean scar pregnancy.

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    Application of cisatracurium in rapid tracheal intubation in children
    WEI Rong, DU Jing-hui, FU Yue-zhen, et al
    2011, 31 (11):  1625. 
    doi: 10.3969/j.issn.1674-8115.2011.11.026

    Abstract ( 1470 )   PDF (3498KB) ( 1180 )  

    Objective To observe the effect of cisatracurium on rapid tracheal intubation and intubation conditions in children under anesthesia with fentanyl and propofol. Methods Sixty children scheduled for adenotonsillectomy were randomly divided into group Ⅰ(0.1 mg/kg cisatracurium), group Ⅱ(0.15 mg/kg cisatracurium) and group Ⅲ (0.6 mg/kg rocuronium) according to muscle relaxant types and doses, with 20 children in each group. Anesthesia was induced with propofol, fentanyl and corresponding doses of muscle relaxant. Tracheal intubation was attempted 1 min after administration of muscle relaxant. Neuromuscular block was assessed by monitoring the electromyographic response of the adductor pollicis response to train-of-four (TOF) stimulations. The first twitch response (T1) and onset time (time from administration of muscle relaxant to maximal depression of T1) were recorded. Intubation conditions were evaluated. Results The scores of intubation conditions in group Ⅱ and group Ⅲ were significantly better than that in group Ⅰ 1 min after administration of muscle relaxant (P<0.05), while there was no significant difference between group Ⅱ and group Ⅲ (P>0.05). The maximal neuromuscular block effects of T1 were not achieved in three groups at the time of intubation. Maximum suppression of T1 in group Ⅱ and group Ⅲ was significantly shorter than that in group Ⅰ(P<0.05), time of action of muscle relaxant in group Ⅱ and group Ⅲ was significantly faster than that in group Ⅰ(P<0.05), while no significant difference was found between group Ⅱ and group Ⅲ (P>0.05). Conclusion Favorable rapid tracheal intubation conditions can be obtained 1 min after administration of 0.15 mg/kg cisatracurium under anesthesia with fentanyl and propofol in children.

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    Therapeutic effects of low carbohydrate and high fat enteral nutrition combined with parenteral nutrition in treatment of patients with chronic obstructive pulmonary disease undergoing mechanical ventilation
    WANG Hong-xing, HUA Wen-jin, XIA Yan, et al
    2011, 31 (11):  1628. 
    doi: 10.3969/j.issn.1674-8115.2011.11.027

    Abstract ( 1691 )   PDF (4208KB) ( 1239 )  

    Objective To evaluate the therapeutic effects of low carbohydrate and high fat enteral nutrition (EN) combined with parenteral nutrition (PN) in treatment of patients with chronic obstructive pulmonary disease (COPD) undergoing mechanical ventilation. Methods One hundred and thirteen patients with COPD undergoing mechanical ventilation were randomly divided into treatment group A (n=37), treatment group B (n=37) and control group (n=39), and were managed with low carbohydrate and high fat EN combined with conventional PN treatment, low carbohydrate and high fat EN combined with low carbohydrate and high fat PN treatment, and conventional EN combined with conventional PN treatment, respectively. Parameters of blood gas analysis, respiratory function and blood lipid were measured 1 d before nutrition treatment and 10 d after nutrition treatment, and time of weaning, days of PN and EN, hospitalization days, total cost of hospitalization and cost of nutrition treatment were recorded in each group. Results Ten days after nutrition treatment, the parameters of blood gas analysis and respiratory function in treatment group A and treatment group B were significantly improved compared with control group (P<0.05), and those in treatment group B were significantly improved compared with treatment group A (P<0.05). Ten days after nutrition treatment, the parameters of blood lipid in treatment group A and treatment group B were significantly higher than those in control group (P<0.05), and the parameters of blood lipid in treatment group B were significantly higher than those in treatment group A (P<0.05). The time of weaning, days of PN and EN, hospitalization days, total cost of hospitalization and cost of nutrition treatment in treatment group A and treatment group B were significantly lower than those in control group (P<0.05), and the parameters in treatment group B were significantly lower than those in group A (P<0.05). Conclusion Low carbohydrate and high fat EN combined with conventional PN treatment and low carbohydrate and high fat EN combined with low carbohydrate and high fat PN treatment may yield better therapeutic effects in patients with COPD undergoing mechanical ventilation, and the latter treatment may outperform the former one.

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    Original article (Public health administration)
    Correlation between occupational stress and job satisfaction in vocational college teachers
    BAO Ling, ZHANG Ya-qing, ZHU Qing-qing, et al
    2011, 31 (11):  1632. 
    doi: 10.3969/j.issn.1674-8115.2011.11.028

    Abstract ( 1275 )   PDF (6159KB) ( 1255 )  

    Objective To investigate the current status of occupational stress and job satisfaction of vocational college teachers in Shanghai, and analyse the correlation between them. Methods A total of 413 teachers from 7 vocational colleges in different areas of Shanghai were selected for questionnaire survey, and the questionnaires were composed of demographic characteristics, occupational stress questionnaire and job satisfaction scale. Results The occupational stress and job satisfaction of vocational college teachers were at medium and slightly higher levels respectively. The relationship between occupational stress and job satisfaction turned out an inverse-U shape. The job satisfaction was the highest when the occupational stress was at the mild level. However, the job satisfaction significantly declined when there was no or huge occupational stress. The influencing factors of occupational stress included part-time status, double competency teaching status, practicing in enterprise in regular timing, obtaining occupational qualification certificates and conducting research. The level of job satisfaction declined when occupational stress gradually increased over a certain degree on practicing in enterprise in regular timing, obtaining occupational qualification certificates and conducting research while teaching (P<0.05 or P<0.01). Conclusion Proper occupational stress may have positive effects on job satisfaction of vocational college teachers, and thus may enhance the working performance and teaching quality of them.

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    Analysis of cognition of clinicians on clinical trails and their educational demand
    LU Jing, FANG Hong-juan, CHEN Li-zhang
    2011, 31 (11):  1638. 
    doi: 10.3969/j.issn.1674-8115.2011.11.029

    Abstract ( 1427 )   PDF (5285KB) ( 1084 )  

    Objective To investigate the cognition of clinicians on clinical trials and their educational demand, and provide reasonable proposals for clinical trial education. Methods A total of 160 clinicians with experience in clinical trials were randomly selected from 5 upper first-class hospitals in Beijing, Jinan, Hangzhou and Chongqing for questionnaire survey. One hundred and forty-one questionnaires were recovered, with the recovery rate of 88.1%. The questionnaire included the basic information of clinicians, cognition of clinicians on clinical trials (basic knowledge, recent advances or relevant knowledge about clinical trials), current situation on clinical trial taining and influencing factors. Results The scores of trial procedure, ethics and monitor knowledge and total score of basic knowledge in clinicians with training were significantly higher than those in clinicians without training (P<0.05), while there was no significant difference in scores of quality control and data management of basic knowledge between clinicians with and without training (P>0.05). The scores of clinical trial design, new technology and idea in clinical trials, and scientific report of findings were lower in clinicians. The influencing factors for mastery of basic knowledge of clinical trials were training participation, educational degree and technical titles, and the influencing factors for training participation were training opportunity, training content and job involvement. Conclusion Clinicians have a poor cognition on clinical trials, and most clinicians have not received systemic training on clinical trials. The current training is not standardized or systemic, but it can improve the cognition of clinicians to some degree. The establishment of occupation qualification system, professional clinician team and qualified teachers for clinical trials is the effective way to improve the clinical trial levels.

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    Review
    Research progress of DNA methylation in schizophrenia
    ZHANG Chen, YI Zheng-hui, FANG Yi-ru
    2011, 31 (11):  1643. 
    doi: 10.3969/j.issn.1674-8115.2011.11.030

    Abstract ( 1493 )   PDF (4437KB) ( 1542 )  

    Environmental factors play an important role in the etiology of schizophrenia. Recent studies have found that environmental factors may regulate gene expression though DNA methylation, and enhance risk of schizophrenia. The role of DNA methylation in contribution of environmental factors to etiology of schizophrenia is reviewed in this paper.

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    Application and advances of detection technology for tumor markers
    ZHAO Shi-yan, NIE Xiu-li, LIU Xing-dang, et al
    2011, 31 (11):  1647. 
    doi: 10.3969/j.issn.1674-8115.2011.11.031

    Abstract ( 1337 )   PDF (5317KB) ( 1306 )  

    Malignant tumors have been threatening the human health critically, and the detection of tumor markers plays an important role in the early diagnosis and following treatment of malignant tumors. With the advances in cellular and molecular biology, the tumor markers and their application have become the hot spot of tumor diagnosis and research in clinics. The rational use of detection technology for tumor markers has direct effect on diagnosis and treatment of tumors. The application and advances of detection technology for tumor markers are reviewed in this paper.

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    Relationship between nonalcoholic fatty liver disease and obesity
    YANG Zhi, NING Guang
    2011, 31 (11):  1652. 
    doi: 10.3969/j.issn.1674-8115.2011.11.032

    Abstract ( 1254 )   PDF (5287KB) ( 1216 )  

    Nonalcoholic fatty liver disease (NAFLD) is one of the chronic liver diseases, which has a rising prevalence in recent years. Patients with NAFLD are usually asymptomatic, but it is associated with a series of metabolic diseases and may even progress to fatal end-stage liver disease. Epidemiological evidence demonstrates that NAFLD is closely related to obesity and is more common among obese individuals than those with normal body weight. Besides, many studies explore the related molecular mechanism between NAFLD and obesity, which may involve insulin resistance, increased release of free fatty acid, changes in concentrations of proinflammatory cytokines and adipocytokines. The epidemiologic characteristics and molecular mechanism about NAFLD and obesity are reviewed in this paper.

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    Brief original article
    Clinical research on Th1 and Th2 cytokines in children with acute leukemia
    WANG Li, LIU Jia-ying, XIA Min, et al
    2011, 31 (11):  1657. 
    doi: 10.3969/j.issn.1674-8115.2011.11.033

    Abstract ( 1254 )   PDF (4008KB) ( 968 )  

    Objective To investigate the expression of Th1 and Th2 cytokines in peripheral blood of children with acute leukemia, and explore its roles in the onset and chemotherapy of leukemia. Methods Seventy-eight children with acute leukemia were enrolled, including 53 cases of acute lymphoblastic leukemia (ALL) and 25 cases of acute nonlymphocytic leukemia (ANLL). Twenty-one cases were newly diagnosed (newly diagnosed group). All cases were divided into complete remission group 1 (n=42, duration of complete remission<12 months) and complete remission group 2 (n=36, duration of complete remission ≥12 months) after chemotherapy. Another 30 healthy children were served as normal controls. The percentages of Th1 (IL-2 and IFNγ) and Th2 (IL-4) cytokines in peripheral blood were detected by flow cytometry. Results The levels of IL-2, IFNγ and IL-4 in newly diagnosed group were significantly different from those in normal control group and complete remission groups before treatment (P<0.05). The levels of IL-2, IFNγ and IL-4 in newly diagnosed group significantly improved after treatment, which were not significantly different from those in normal control group (P>0.05). The levels of IL-2 and IFNγ in complete remission group 1 were significantly higher than those in complete remission group 2 (P<0.05), while there was no significant difference in levels of IL-4 between these two groups (P>0.05), and the levels of IL-2, IFNγ and IL-4 in these two groups were not significantly different from those in normal control group (P>0.05). There was no significant difference in the levels of IL-2, IFNγ and IL-4 between patients with ALL and ANLL (P>0.05). Conclusion Th1 and Th2 cytokines may play a role in the process of acute leukemia, and they may produce a similar effect in ALL and ANLL. Along with the prolongation of duration of complete remission, the immunologic function gradually recovers, but it is disturbed again latter, which may be related to immunosuppression secondary to chemotherapy.

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