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    Original article (Basic research)
    Effect of renin inhibitor on atherosclerosis and plaque inflammation in rabbits
    XU Hui, ZHOU Xiao-ming, XU Fei-fei, et al
    2012, 32 (3):  237. 
    doi: 10.3969/j.issn.1674-8115.2012.03.001

    Abstract ( 1752 )   PDF (772KB) ( 1145 )  

    Objective To investigate the effects of renin inhibitor, Aliskiren on atherosclerosis (As) and As inflammation. Methods Rabbit As model was established by high fat diet, and 24 New Zealand rabbits were randomly divided into single high fat group (n=8), Aliskiren group (n=8) and normal control group(n=8). Rabbits in single high fat group were fed with high fat diet (1.5% cholesterol+5% lard oil), those in Aliskiren group were fed with high fat diet and Aliskiren (25 mg·kg-1·d-1), and those in normal control group were fed with regular diet. Rabbits were fed for 16 weeks, and were sacrificed. Thoracic aorta samples were obtained for histological examination, and immunohistochemistry was used to detect the expression of biomarkers of macrophages and smooth muscle cells (RAM11 and α-actin) and lectin like oxidized LDL receptor-1 (LOX-1) in plague, which were indicated as ratios of area of positive expression. Results Histological examination with oil red O staining revealed that the area of plaque in Aliskiren group was significantly lower than that in single high fat group [(34.38±2.07)% vs (47.12±4.16)%, P<0.01]. Immunohistochemical detection indicated that the ratios of cells with positive expression of RAM11 and LOX-1 protein in plaque in Aliskiren group were (21.13±2.10)% and (11.38±1.69)% respectively, which were significantly lower than those in single high fat group [(30.63±2.26)% and (16.75±1.67)% respectively] (P<0.01, P<0.05). Spindle smooth muscle cells with positive expression of α-actin were observed in plaque in single high fat group and Aliskiren group, which mainly located in intima and media. Conclusion Aliskiren inhibits the progression of As, and reduces inflammatory response in plaque.

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    Expression and activity of matrix metalloproteinases 2 in pancreatic islets of rats with type 2 diabetes mellitus
    WAN Xiao-yu, DONG Yan, LIN Ning, et al
    2012, 32 (3):  242. 
    doi: 10.3969/j.issn.1674-8115.2012.03.002

    Abstract ( 1698 )   PDF (475KB) ( 1218 )  

    Objective To investigate the expression and activity of matrix metalloproteinases 2 (MMP2) in pancreatic islets of rats with type 2 diabetes mellitus. Methods SD rats were randomly divided into control group and diabetes mellitus group. Type 2 diabetes mellitus model was established by high calorie diet and intraperitoneal injection of low dose of streptozotocin (STZ, 15 mg/kg). The tissues of pancreatic islets were harvested from both groups 2 weeks and 6 weeks after model establishment, RT-PCR and Western blotting were employed to detect the expression of MMP2 mRNA and protein respectively, and the activity of MMP2 was analysed by gelatin zymography. Results There was expression of MMP2 mRNA and protein in tissues of pancreatic islets in both groups, and the expression of MMP2 mRNA and protein in diabetes mellitus group was significantly higher than that in control group (P<0.05). Gelatin zymography indicated that the activity of MMP2 in diabetes mellitus group was significantly higher than that in control group (P<0.05). The expression of MMP2 mRNA and protein and the activity of MMP2 6 weeks after model establishment were higher than those 2 weeks after model establishment in diabetes mellitus group, while there was no significant difference between them (P>0.05). Conclusion The expression of MMP2 gene and activity of MMP2 increase in pancreatic islets of rats with diabetes mellitus, which may be related to B cell dysfunction in rats with type 2 diabetes mellitus.

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    Effects of overexpression of CRELD1 gene on heart valve-related matrix proteins
    CHEN Xuan, GUO Ying, YUAN Lang, et al
    2012, 32 (3):  247. 
    doi: 10.3969/j.issn.1674-8115.2012.03.003

    Abstract ( 1700 )   PDF (355KB) ( 1144 )  

    Objective To investigate the effects of overexpression of CRELD1 gene on heart valve-related matrix proteins. Methods CRELD1 gene was obtained by PCR. Target gene eukaryote expression vectors were constructed by pcDNA3.1 (-) vector plasmid, and were identified by restriction enzyme digestion and DNA sequence analysis. Recombinant plasmid was transfected into human embryonic lung fibroblasts (HFL-I)with lipofectamine 2000 (recombinant plasmid group), and HFL-I cells transfected with empty vectors and those without transfection were served as transfection control group and blank control group respectively. Real-Time PCR and Western blotting were employed to detect the relative expression of mRNA and protein of heart valve-related matrix proteins Tenascin-C and Aggrecan in each group. Results DNA sequence of recombinant plasmid agreed very well with that in GenBank according to DNA sequence analysis. The relative expression of Aggrecan mRNA and protein in recombinant plasmid group was significantly lower than that in transfection control group and blank control group (P<0.05), while there was no significant difference in the expression of Tenascin-C mRNA and protein among groups (P>0.05). Conclusion CRELD1 gene overexpression can decrease the heart valve-related matrix protein Aggrecan in human embryonic lung fibroblasts, which serves as a theoretical framework to demonstrate the roles of CRELD1 gene on atrioventricular septal defect.

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    Effect of endoplasmic reticulum stress on expression of ubiquitin-fold modifier 1 in macrophages
    LIU Hui-fang, ZHANG Hui-jie, LIU Xiao-yan, et al
    2012, 32 (3):  252. 
    doi: 10.3969/j.issn.1674-8115.2012.03.004

    Abstract ( 1812 )   PDF (610KB) ( 1291 )  

    Objective To investigate the effect of endoplasmic reticulum stress (ERS) on expression of ubiquitin-fold modifier 1 (Ufm1) in macrophages. Methods Peritoneal macrophages were obtained from mice with diabetes (db/db mice, diabetes group, n=6) and wild type (WT) C57 mice (control group, n=6), and the expression of ERS-related factors (GRP78 and XBP1) and Ufm1 mRNA was detected by Real-Time PCR. RAW264.7 cells were induced with 8 μg/mL tunicamycin (TM), 0.5 μmol thapsigargin (TG) and 0.8 μmol TG separately, the expression of GRP78, XBP1 and Ufm1 mRNA was determined by Real-Time PCR, and the expression of ERS-related factors (p-eIf2α, eIf2α and CHOP) and Ufm1 protein was detected by Western blotting. Results The expression of GRP78, XBP1 and Ufm1 mRNA in peritoneal macrophages of diabetes group was significantly higher than that of control group (P<0.001). After induction by TM or TG, the expression of Ufm1 mRNA and protein in RAW264.7 cells was significantly higher than that in negative controls (P<0.05). Conclusion The expression of both ERS-related factors and Ufm1 in peritoneal macrophages increases in mice with diabetes. ERS in macrophages induced in vitro may increase the expression of Ufm1, which indicates that Ufm1 may participate in diabetic atherosclerosis by influencing function of macrophages partially through ERS pathway.

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    Influence of graft site on long-term survival of transplanted pancreatic islet
    LIU Ding-zhi, LUO Shi-qiao, DU Cheng-you, et al
    2012, 32 (3):  257. 
    doi: 10.3969/j.issn.1674-8115.2012.03.005

    Abstract ( 1934 )   PDF (1172KB) ( 1473 )  

    Objective To investigate the influence of graft site on long-term survival of transplanted pancreatic islets in mice with diabetes. Methods Pancreatic islets of donor mice were obtained by infusion of collagenase P solution with pancreatic duct and Ficoll-400 density gradient centrifugation. Homeogenetic and allogenetic pancreatic islet transplantation into renal capsule, lesser omentum and armpit of recipient mice with diabetes was performed, and the values of blood glucose of recipient mice after transplantation were monitored. The transplanted pancreatic islet samples with rejection were selected according to the values of blood glucose, and the histological changes of transplanted pancreatic islets of different graft sites were observed. Results The pancreatic islets of mice were successfully isolated and purified, with the purification of (94±5)% or (90±5)% and survival of (92±3)%. The hyperglycemia state of recipient mice was reversed to normal range after pancreatic islet transplantation. As far as short-term survival of homeogenetic and allogenetic islet transplantation was concerned, there was no significant difference in the decreased value of blood glucose between renal capsule group and lesser omentum group (P>0.05), the value of blood glucose in renal capsule group was significantly lower than that in lesser omentum group after transplantation (P<0.05), and the decreased value of blood glucose and value of blood glucose in armpit group were significantly different from those in renal capsule group and lesser omentum group (P<0.05). As far as long-term survival of homeogenetic and allogenetic islet transplantation was concerned, there were significant differences in the decreased values of blood glucose between renal capsule group and lesser omentum group (P<0.05), with lower value of blood glucose and higher survival of transplanted pancreatic islet in renal capsule group, there was no case of long-term survival in armpit group, and there were significant differences in the decreased values of blood glucose in the same graft site between homeogenetic and allogenetic islet transplantation donors (P<0.05). Histological examination revealed that the pancreatic islets in renal capsule group and lesser omentum group were intact, with less inflammatory cell infiltration, while the pancreatic islet cells in armpit group were destroyed, with more inflammatory cell infiltration. Conclusion Pancreatic islet transplantation into renal capsule may produce fast and stable effect in decreasing blood glucose, and may achieve long-term survival, which can be used as an ideal site for pancreatic islet transplantation.

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    Topology shape and mechanism of variation of bone layer during growing process of femur
    Aikeranmu Mahemuti, Mamtimin Geni, Julaiti Maitirouzi, et al
    2012, 32 (3):  263. 
    doi: 10.3969/j.issn.1674-8115.2012.03.006

    Abstract ( 2057 )   PDF (614KB) ( 1129 )  

    Objective To observe the rule of formation, growth and figuration of femur in the process from embryonic development to maturation, and analyse the formation of bone growth center, volume of bone layer and variation of bone shape. Methods CT scan technology was employed to obtain the imaging information of femur development process of rabbits, and the CT imaging information was processed with Mimics Medical Image Processing software. Time-phase and stratified space analysis of rule of femur figuration and variation of volume of bone layer were performed with unit bone volume method. Results Femur has multiple bone growth centers. The femur bone first emerged as spongy bone during embryonic process, and gradually got harden and formed the compact bone and enamel bone along with the growth. Finally, the femur bone developed its optimal shape and bone mass distribution. Conclusion The femur is developed by combination of 4 independent bone growth centers. There is obvious change in volume of bone layer and position in the process of bone growth, while stabilized state is eventually arrived.

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    Expression of angiotensin converting enzyme 2 and angiotensin converting enzyme in thoracic aorta in hypertensive rats induced by N-Nitro-L-arginine methyl ester
    XU Meng-dan, DAI Qiu-yan, LIU Shao-wen
    2012, 32 (3):  269. 
    doi: 10.3969/j.issn.1674-8115.2012.03.007

    Abstract ( 1588 )   PDF (368KB) ( 1214 )  

    Objective To investigate the activity and mRNA expression of angiotensin converting enzyme (ACE) and ACE2 in thoracic aorta in hypertensive rats, and explore the role of ACE2 and ACE2/ACE in regulation of hypertension. Methods Forty age-matched SD rats with normal blood pressure were divided into model group and control group, with 20 rats in each group. Hypertension model was established in rats in model group by administration of Nω-nitro-L-arginine methyl ester (L-NAME) in drinking water (50 mg/100 mL, 50 mg/kg per day), and rats in model group were subdivided into 4 subgroups according to time of treatment (2, 4, 8 and 12 weeks), with 5 rats in each subgroup. Similar subgroups were established in control group, and same amount of clear water was taken in each group at corresponding time. The activity of ACE and ACE2 in thoracic aorta was determined by high performance liquid chromatography, and the expression of ACE and ACE2 mRNA in thoracic aorta was detected by RT-PCR. Results The blood pressure of rats in model group was significantly higher than that in control group 4, 8 and 12 weeks after treatment with L-NAME (P<0.05), while there was no significant change in blood pressure after intervention in each subgroup of control group (P>0.05). The activity and relative mRNA expression of ACE in thoracic aorta in model group were significantly higher than those in control group 4, 8 and 12 weeks after treatment with L-NAME (P<0.05), while the activity and relative mRNA expression of ACE2 in thoracic aorta in model group were significantly lower than those in control group 4, 8 and 12 weeks after treatment with L-NAME (P<0.05), and there was no significant difference in the activity and relative mRNA expression of ACE and ACE2 among subgroups of control group (P>0.05). Conclusion The activity and mRNA expression of ACE and ACE2 in thoracic aorta of rats are associated with the increase of blood pressure during the development of hypertension induced by NO synthesis inhibition.

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    Regulation of interaction of osteoblasts and osteoclasts by hypoxia/hypoxia-inducible factor-1&alpha|pathway
    WANG Luo-wen, DENG Lian-fu, ZHU Ya-ping, et al
    2012, 32 (3):  274. 
    doi: 10.3969/j.issn.1674-8115.2012.03.008

    Abstract ( 1820 )   PDF (599KB) ( 1273 )  

    Objective To investigate the regulation of interaction of osteoblasts and osteoclasts by hypoxia/hypoxia-inducible factor-1α (HIF-1α) pathway. Methods Osteoblasts were obtained from newborn (2 to 3 d) conditional gene knockout mice, osteoclast precursor cells were harvested from C57BL/6 mice aged 4 to 8 weeks, and co-culture system of osteoblasts and osteoclast precursor cells was established (wild-type, HIF-1α-/-, Vhl-/-, HIF-1α-/-/Vhl-/- co-culture). RT-PCR was employed to detect the expression of receptor activator of nuclear factor-κB ligand (RANKL) mRNA and osteoprotegerin (OPG) mRNA in osteoblasts and that of marker enzyme gene TRAP mRNA in osteoclasts, and resorption pits produced by osteoclasts were observed with toluidine blue staining. Results RT-PCR revealed that compared with wild-type co-culture, the expression of RANKL mRNA increased and that of OPG mRNA decreased in osteoblasts of HIF-1α-/- co-culture (P<0.05 for both), the expression of TRAP mRNA increased in osteoclasts of HIF-1α-/- co-culture, the expression of RANKL mRNA decreased and that of OPG mRNA increased in osteoblasts of Vhl-/-co-culture and HIF-1α-/-/Vhl-/- co-culture (P<0.05 for all), and the expression of TRAP mRNA decreased in osteoclasts of Vhl-/-co-culture and HIF-1α-/-/Vhl-/- co-culture. With the time increase of co-culture, the expression of RANKL mRNA and OPG mRNA in osteoblasts gradually decreased, and that of TRAP mRNA in osteoclasts gradually increased. Observation under inverted microscope with toluidine blue staining indicated that resorption pits of osteoclasts began to appear on the ninth day of co-culture, the area and depth of resorption pits gradually increased with the time increase of co-culture, the area and depth of resorption pits increased after HIF-1α-/- co-culture, and those decreased after Vhl-/- co-culture and HIF-1α-/-/Vhl-/- co-culture. Conclusion Osteoblasts may inhibit the differentiation of osteoclasts after the activation of hypoxia/HIF-1α pathway, while osteoblasts may promote the differentiation of osteoclasts after interruption of hypoxia/HIF-1α pathway.

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    Contribution of BDNF/TrkB pathway to development of neuropathic pain by activation of astrocytes in rats
    WANG Jing, ZHANG Xin, JIANG Wei, et al
    2012, 32 (3):  279. 
    doi: 10.3969/j.issn.1674-8115.2012.03.009

    Abstract ( 2105 )   PDF (335KB) ( 1263 )  

    Objective To investigate the effects of exogenous brain-derived neurotrophic factor (BDNF) on mechanical pain threshold and astrocytes, and explore the potential mechanism of BDNF-induced pain. Methods Thirty rats with successful intrathecal catheterization were randomly divided into blank control group, placebo group, BDNF group, BDNF+astrocyte inhibitor group (BDNF+fluorocitrate group) and BDNF+tyrosine kinase receptor B(TrkB) inhibitor group (BDNF+K252a group), with 6 rats in each group. Intrathecal administration was performed once daily for 7 d. Fifty percent paw withdrawal threshold (50% PWT) was measured 1 h before each injection. Spinal enlargement parts were obtained 1 h after the last administration, and the expression of glial fibrillary acidic protein (GFAP) and phosphorylated TrkB protein was detected by Western blotting. Results Compared with blank control group, 50% PWT of hind limbs in BDNF group was significantly lower (P<0.05). Seven days after administration, the expression of GFAP and phosphorylated TrkB protein in spinal enlargement parts in BDNF group was significantly higher than that in blank control group (P<0.01). The expression of GFAP protein and 50% PWT in BDNF+ fluorocitrate group and BDNF+K252a group were not significantly different from those in blank control group (P>0.05). There was no significant difference in the expression of phosphorylated TrkB protein between BDNF+K252a group and blank control group (P>0.05). Conclusion BDNF may activate astrocytes via phosphorylated TrkB receptor, which in turn produce neuropathic pain.

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    Effects of lipopolysaccharide on activity of COX-2 gene promoter of human gastric cancer cells
    XU Ling, MA Yan-hui, YUAN Xiang-liang, et al
    2012, 32 (3):  283. 
    doi: 10.3969/j.issn.1674-8115.2012.03.010

    Abstract ( 1802 )   PDF (712KB) ( 1225 )  

    Objective To investigate the activity of cyclooxygenase-2 (COX-2) gene promoter of human gastric cancer cells under inflammatory state. Methods The expression of COX-2 in human gastric cancer tissues was detected with immunohistochemical staining. Recombinant pGL3-COX-2-promoter of human COX-2 gene promoter was constructed, and gastric cancer cell line SGC-7901 and BGC-823 were co-transfected with pGL3-COX-2-promoter and pRL-TK with lipofectin reagent-mediated transfection. Cells were collected after treatment with different mass concentrations of lipopolysaccharide (LPS) for different time, the activity of dual-luciferase reporter gene was determined with dualluciferase reporter system, and the expression of COX-2 protein was detected by Western blotting. Results Immunohistochemical staining indicated that COX-2 protein expressed both in cytoplasm of gastric cancer cells and cytoplasm of para-cancer mucosal epithelial cells. At the same time point, the activity of COX-2 gene promoter of SGC-7901 cells and BGC-823 cells increased with the mass concentrations of LPS (P<0.05). The activity of COX-2 gene promoter reached the peak after treatment with high concentration of LPS (10 μg/mL) for 6 h, and then gradually decreased (P<0.05). Western blotting revealed that the expression of COX-2 protein of SGC-7901 cells and BGC-823 cells increased with the time of treatment with 10 μg/mL LPS. Conclusion Inflammatory stimulation may activate COX-2 gene promoter of human gastric cancer cells.

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    Aldosterone-induced apoptosis of MIN6 cells and its mechanism
    PAN Yu, LIU Xiao-li, SHU Jin-lian, et al
    2012, 32 (3):  288. 
    doi: 10.3969/j.issn.1674-8115.2012.03.011

    Abstract ( 1740 )   PDF (381KB) ( 1020 )  

    Objective To investigate the effects of aldosterone on apoptosis of murine pancreatic islets B cell line MIN6, and explore its possible mechanism. Methods Murine pancreatic islets B cell line MIN6 cultured in vitro was divided into control group (treated with serum-free DMEM culture medium), aldosterone group (treated with 10, 100 or 1 000 nmol/L aldosterone) and aldosterone+aldosterone antagonist group (treated with 100 nmol/L aldosterone and 100 nmol/L aldactone). Cell viability was determined by MTT assay, glucose-stimulated insulin secretion (GSIS) was measured by radioimmunoassay, cell apoptosis was detected by flow cytometry in combination with FITC-Annexin V/PI fluorescein staining, Caspase-3 activity in supernatant of culture fluid was determined by ELISA, and the expression of apoptosisrelated proteins of cytochrome C(Cyt-C), Bcl-2, Bax and phosphorylated protein kinase C (p-Akt) was detected by Western blotting. Results The viability of MIN6 cells decreased with the increase of concentrations of aldosterone, with a concentration-dependent manner. Under physical glucose concentration (5.6 mmol/L) and high glucose concentration (28 mmol/L) environment, GSIS of aldosterone group was significantly lower than that of control group (P<0.01), and GSIS of aldosterone+aldosterone antagonist group was significantly higher than that of aldosterone group (P<0.01). The cell apoptosis ratio of aldosterone group was significantly higher than that of control group (P<0.01), and the cell apoptosis ratio of aldosterone+aldosterone antagonist group was significantly lower than that of aldosterone group (P<0.01). Compared with control group, the Caspase-3 activity and expression of Cyt-C were significantly higher, and Bcl-2/Bax and the expression of p-Akt were significantly lower (P<0.01 for all), while aldosterone antagonist significantly inhibited aldosterone-mediated Caspase-3 activity increase and abnormal expression of related proteins. Conclusion Aldosterone enhances apoptosis of MIN6 cells, which may be associated with Cyt-C, Bcl-2, Bax and Akt-mediated mitochondria signaling pathway.

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    Effects of artificial saliva with albumen on corrosion behavior of titanium
    CAO Yi-ting, YU Wei-qiang, WENG Wei-min
    2012, 32 (3):  293. 
    doi: 10.3969/j.issn.1674-8115.2012.03.012

    Abstract ( 1726 )   PDF (491KB) ( 972 )  

    Objective To investigate the corrosion behavior of titanium in artificial saliva with albumen. Methods Samples of titanium were prepared, and were treated with Fusayama artificial saliva (control group, n=3), Fusayama artificial saliva added with 0.01% bovine serum albumin (experiment group 1, n=3) and Fusayama artificial saliva added with 0.05% bovine serum albumin (experiment group 2, n=3) respectively. Tafel curve tests were performed with electrochemical methods, and the change of corrosion behavior of titanium in artificial saliva with albumen was analysed. Results Tafel curve tests indicated that the values of self-corrosion potential of titanium samples were (-349.1±19.6)mV,(-325.2±18.8) mV and (-218.2±12.5) mV respectively, and the values of self-corrosion current density of titanium samples were (3.57±0.52)×10-2 A/cm2, (3.52±0.29) ×10-2 A/cm2 and (3.64±0.70)×10-2 A/cm2 respectively in control group, experiment group 1 and experiment group 2. Statistical analysis revealed that there was no significant difference in the values of self-corrosion current density among three groups (P>005), and the value of self-corrosion potential in experiment group 2 was significantly higher than that in control group (P<0.05). Conclusion Artificial saliva with albumen may influence the corrosion behavior of titanium, which may be related to the change of self-corrosion potential of titanium.

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    Original article (Clinical research)
    Association of arteriosclerosis with plasma resistin and high sensitive C-reactive protein
    LI Fa-hong, WEI Fang-fei, ZOU Jun, et al
    2012, 32 (3):  296. 
    doi: 10.3969/j.issn.1674-8115.2012.03.013

    Abstract ( 1647 )   PDF (380KB) ( 1220 )  

    Objective To explore the association of arteriosclerosis with plasma resistin and high sensitive C-reactive protein (hs-CRP). Methods Three hundred and sixty-eight subjects undergoing ambulatory blood pressure monitoring at Shanghai Institute of Hypertension were enrolled, and all subjects had not taken antihypertensive drugs for at least 2 weeks. Brachial-ankle pulse wave velocity (baPWV) was measured, and plasma concentrations of resistin and hs-CRP were examined with enzyme linked immunosorbent assay. Correlation analysis and multiple linear regression analysis were used to analyse the association between plasma inflammation markers and arteriosclerosis. Results Hs-CRP (r≥0.13, P≤0.02), but not resistin (r≤0.04, P≥0.44), was significantly associated with baPWV in both simple and partial correlation analyses after adjustment for age, sex, body mass index and systolic blood pressure. Multiple stepwise regression analysis revealed that age and systolic blood pressure accounted for 42% of the variation of baPWV, while hs-CRP only explained 0.7% of the variation. Conclusion Plasma hs-CRP, but not resistin, is independently associated with arteriosclerosis. Aging and elevated systolic blood pressure are major determinants of arteriosclerosis, while inflammation has less impact on arteriosclerosis.

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    Relationship between single nucleotide polymorphisms in promoter region of cyclooxygenase-2 gene and aspirin resistance in the elderly
    WANG Yi-meng, NI Pei-hua,YANG Rong, et al
    2012, 32 (3):  301. 
    doi: 10.3969/j.issn.1674-8115.2012.03.014

    Abstract ( 1627 )   PDF (818KB) ( 1130 )  

    Objective To explore the relationship between 765G>C, 1195G>A and 1290A>G single nucleotide polymorphisms (SNP) in the promoter region of cyclooxygenase-2 (COX-2) gene and aspirin resistance in the elderly. Methods One hundred and sixty-two elder patients taking aspirin for antithrombotic therapy were selected, platelet aggregation tests were performed, groups were divided according to test findings, and risk factors of aspirin resistance were analysed. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed to analyse 765G>C, 1195G>A and 1290A>G SNP in the promoter region of COX-2 gene. Results Patients were divided into aspirin sensitive group (n=108) and non-aspirin sensitive group (n=54). Multiple stepwise Logistic regression analysis indicated that hypertension was an independent risk factor of aspirin resistance. There were significant differences in the genotype distribution and allele frequency of -765G>C SNP between two groups (P=0.027, P=0.030). Logistic regression analysis demonstrated that compared with -765GG genotype, OR of aspirin resistance for -765GC genotype was 3.872 (95% CI 1.081-13.870,P=0.038). There were significant differences in genotype distribution of -1195G>A SNP between two groups (P=0.018), and there was no significant difference in allele frequencies of A and G between them (P=0.156). There was no significant difference in genotype distribution of -1290A>G SNP between two groups (P=0.091), and there were significant differences in allele frequencies of A and G between them (P=0.025). The frequency of haplotype CGG of -765G>C, -1195G>A and -1290A>G in non-aspirin sensitive group was significantly higher than that in aspirin sensitive group (P<0.05). Conclusion Haplotype C-G-G of -765G>C, -1195G>A and -1290A>G may be related to aspirin resistance, and -765G>C gene polymorphisms may be genetic risk factor of aspirin resistance for elder patients.

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    Risk factors of pulse pressure and association of pulse pressure with mortality in patients undergoing peritoneal dialysis
    GE Li-na, FANG Wei, ZHANG Lin, et al
    2012, 32 (3):  307. 
    doi: 10.3969/j.issn.1674-8115.2012.03.015

    Abstract ( 1742 )   PDF (346KB) ( 1178 )  

    Objective To investigate the risk factors of pulse pressure, and explore the association of pulse pressure with mortality in patients undergoing peritoneal dialysis. Methods Patients aged over 18 and had a history of peritoneal dialysis for more than 6 months were selected, and the related clinical data of patients were collected. Mean blood pressure in the first 6 months of peritoneal dialysis was obtained, and baseline pulse pressure was calculated. All patients were followed up till death, cessation of peritoneal dialysis, transfer to the other centers, lost in follow-up or to the end of the study (December 31, 2010). Multivariate linear regression was employed to determine the independent influencing factors of pulse pressure, and the association of pulse pressure with mortality was explored with multivariate Cox proportional hazards model. Results A total of 498 patients undergoing peritoneal dialysis were included. Multivariate linear regression revealed that age (β=2.34,P<0.001), serum albumin (β=-0.235,P=0.004) and diabetes (β=4.93,P<0.001) were independent influencing factors of pulse pressure. Univariate analysis demonstrated that pulse pressure was closely associated with all-cause death (HR=1.017, 95%CI 1.007-1.027, P<0.001) and cardiovascular death (HR=1.016, 95%CI 1.003-1.030, P=0.019). Multivariate Cox proportional hazards model indicated that advanced age (HR=1.065, 95%CI 1.047-1.082, P<0.001), low serum albumin (HR=0.945, 95%CI 0.909-0.983, P=0.005) and low hemoglobin (HR=0.981, 95%CI 0.971-0.991, P<0.001) were independent risk factors of all-cause death, and advanced age (HR=1.041, 95%CI 1.016-1.066, P=0.001) and low hemoglobin (HR=0.983, 95%CI 0.969-0.996, P=0.014) were independent risk factors of cardiovascular death. However, pulse pressure was not an independent risk factor of allcause death (HR=1.019, 95%CI 0.996-1.043, P=0.104) and cardiovascular death (HR=0.988, 95%CI 0.860-1.136, P=0.870) in the model after multivariate adjustment. Conclusion Age, serum albumin and diabetes are independent influencing factors of pulse pressure in patients undergoing peritoneal dialysis. The association of pulse pressure with mortality in patients undergoing peritoneal dialysis needs further study.

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    Relationship between pre-operative serum uric acid and acute kidney injury after cardiac surgery
    CHE Miao-lin, LIU Shang, LI Yi, et al
    2012, 32 (3):  312. 
    doi: 10.3969/j.issn.1674-8115.2012.03.016

    Abstract ( 1746 )   PDF (371KB) ( 1229 )  

    Objective To investigate the relationship between serum uric acid increase and acute kidney injury (AKI) after cardiac surgery. Methods The clinical data and follow-up data of patients undergoing cardiac surgery were collected, and patients were divided into elevated uric acid group and non-elevated uric acid group according to pre-operative serum uric acid. The prevalences of AKI, severity of AKI and outcomes in two groups were retrospectively analysed, and the relationship between the incidence of AKI and serum uric acid increase was evaluated by multivariate Logistic regression analysis. Results After cardiac surgery, 328 of 1 056 patients (31.1%) developed AKI. There were significant differences in the prevalences of AKI between elevated uric acid group and non-elevated uric acid group (49.3% vs 26.0%, P<0.001). The duration of ICU stay was longer, and the survival was lower in elevated uric acid group than in non-elevated uric acid group (P<0.001 and P=0.001). After adjustment for age, pre-operative renal function, left ventricular insufficiency, combined surgery, operation time and post-operative circulation volume insufficiency, multivariate Logistic regression analysis revealed that pre-operative serum uric acid increase was an independent risk factor of AKI after cardiac surgery (OR=1.97, 95%CI 1.22-3.18, P=0.006). Conclusion Pre-operative serum uric acid increase may be associated with incidence of AKI after cardiac surgery, and the former may be an independent risk factor of the later.

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    Photoelastic analysis of stress distribution in complete dentures with lingualized occlusion (mandibular implant-retained overdenture)
    PENG Yan, JIAO Ting, JIN Wen-zhong, et al
    2012, 32 (3):  317. 
    doi: 10.3969/j.issn.1674-8115.2012.03.017

    Abstract ( 1903 )   PDF (532KB) ( 1053 )  

    Objective To investigate the stress distribution of supporting tissues in mandible  implantretained overdentures with lingualized occlusion and anatomic occlusion under the loads of centric, lateral and protrusive occlusion. Methods Photoelastic models of epoxy were fabricated according to the Cawood Ⅴ edentulous model with two implants in the area between lateral incisor and canine with three dimension photoelastic experiment method. One kilogram force was vertically applied in the centric, lateral and protrusive occlusion. After stress frozen, the stress distribution of supporting tissues in mandible implant-retained overdentures with lingualized occlusion and anatomic occlusion was evaluated. Results When using implant-retained overdentures, the force between working and balancing side of lingualized occlusion was smaller than that of anatomic occlusion, and the implant stress of lingualized occlusion was less than that of anatomic occlusion in both lateral and protrusive load. Conclusion When using two-implant-retained overdentures, lingualized occlusion could protect the bone around the implant, and was more stable in lateral movement, which might be considered first for complete implant-retained overdenture.

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    Systematic evaluation of therapeutic effect and safety of stem cell transplantation for dilated cardiomyopathy
    XING Dong-mei, ZHU Ming-jun, WU Tai-xiang, et al
    2012, 32 (3):  321. 
    doi: 10.3969/j.issn.1674-8115.2012.03.018

    Abstract ( 2067 )   PDF (816KB) ( 1202 )  

    Objective To systematically assess the efficacy and safety of stem cell transplantation in the treatment of idiopathic dilated cardiomyopathy. Methods China Biomedical Literature Database on disc, CNKI, VIP, Wanfang Data, Cochrane Controlled Trails Register, OVID Medline and EMBASE were searched. Two researchers independently extracted information, which was then cross-checked by each other. The primary parameters of therapeutic effects were mortality and heart failure questionnaire, the secondary parameters of therapeutic effects were left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVED) and 6-minute walking distance, and the parameter of safety was prevalence of adverse events. Meta-analysis was performed with RevMan 5.0.2 software. Results Seven randomized clinical trials (RCT) were enrolled, and 263 patients were included. Meta-analysis revealed that there was no significant difference in 3-year mortality between stem cell transplantation combined with standard therapy and single standard drug therapy, stem cell transplantation combined with standard therapy did not performed better than single standard drug therapy in improving LVEF 3 months after operation, and there was no stem cell transplantation-related adverse events. Conclusion The therapeutic effect of stem cell transplantation combined with standard therapy is no better than single standard drug therapy. However, due to the small scale and low quality of included RCT, more studies in large scale and high quality are needed to verify the results.

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    Electrophysiological research on mechanism of formation of abnormal muscle response
    SHANG Ming, ZHENG Xue-sheng, TANG Yin-da, et al
    2012, 32 (3):  326. 
    doi: 10.3969/j.issn.1674-8115.2012.03.019

    Abstract ( 1832 )   PDF (729KB) ( 1136 )  

    Objective To explore the mechanism of formation of abnormal muscle response (AMR) by electrophysiological methods. Methods The clinical data of 15 patients with idiopathic hemifacial spasm undergoing microvascular decompression were collected. Myoelectricity response (i.e.AMR) was recorded from the orbicularis oculi muscles when the mandibular branch of the facial nerve was electrically stimulated. Conduction potential and myoelectricity response were recorded respectively from the orbicularis oculi muscles and the mandibular branch of the facial nerve when the compression positions of facial nerve were electrically stimulated. The latencies and changes of responses after microvascular decompression were analysed. Results The mean latency of AMR recorded from orbicularis oculi muscles was (10.49±0.35) ms when the mandibular branch of the facial nerve was electrically stimulated. The mean latency of responses recorded from the mandibular branch was (3.99±0.18) ms, and the mean latency of responses recorded from the orbicularis oculi muscles was (4.62±0.32) ms when the compression positions were electrically stimulated. The mean latency of AMR was significantly longer than the sum of the mean latency of responses recorded from the marginal mandibular branch and that recorded from the orbicularis oculi muscles when the compression positions of facial nerve were electrically stimulated (P<0.05). AMR completely disappeared in 14 (93.3%) patients after decompression. Conclusion Offending vessels may participate in the abnormal electrical transmission circuit of hemifacial spasm, which is one of the necessary factors leading to hemifacial spasm.

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    Protective effect of isoflurane posttreatment on acute lung injury induced by sepsis in rats
    DONG Xiang, HU Rong, LV Xiang, et al
    2012, 32 (3):  330. 
    doi: 10.3969/j.issn.1674-8115.2012.03.020

    Abstract ( 1683 )   PDF (550KB) ( 1307 )  

    Objective To investigate the effect of isoflurane (ISO) posttreatment on the membrane permeability of alveolar capillaries and activity of nitric oxide (NO) and inducible nitric oxide synthase (iNOS) in acute lung injury (ALI) induced by sepsis in rats. Methods One hundred and twenty male SD rats were randomly divided into sham operation group (Sham group), ISO intervention after sham operation group (Sham-ISO group), ALI model induced by sepsis group (ALI group) and ISO intervention after ALI induced by sepsis group (ALI-ISO group), with 30 rats in each group. Rats in ALI group and ALI-ISO group were selected, and ALI model induced by sepsis was established by cecal ligation and puncture (CLP). Six hours after model establishment, rats in ALI-ISO group inhaled 1.0 MAC ISO for 2 h. Ten rats in each group were served for survival analysis. Ten rats in each group were randomly selected, Evans blue was intravenously injected 30min before sacrifice, lung tissues were obtained for examination of permeability of alveoli (Evans blue content determination). Blood samples were taken from the rest of 10 rats in each group before sacrifice, serum NO contents were measured, right lung tissues were obtained for histopathological examination and protein detection, wet/dry weight ratios and water content were measured, neutrophil counts in bronchoalveolar lavage fluid (BALF) were obtained, lung permeability indexes (LPI) were calculated, and the activity of iNOS in lung tissues was determined. Results The survival of rats in ALI-ISO group 24 h,48 h and 10 d after model establishment was higher than that in ALI group. The parameters of histopathologic accumulative score, lung wet/dry weight ratio, water content of lung, Evans blue content in lung tissues, LPI, serum NO content and activity of iNOS in lung tissues in ALI group and ALI-ISO group were significantly higher than those in Sham group and Sham-ISO group (P<0.05), while these parameters in ALI-ISO group were significantly lower than those in ALI group (P<0.05). The neutrophil counts in BALF in ALI group and ALI-ISO group were significantly higher than those in Sham group and Sham-ISO group (P<0.05), while there was no significant difference between ALI group and ALI-ISO group (P>0.05). Conclusion Posttreatment with 1.0 MAC ISO can reduce the membrane permeability of alveolar capillaries in ALI induced by sepsis, attenuate severity of ALI, and increase the survival.

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    Expression of sodium iodine symporter mRNA in benign or malignant thyroid diseases
    HE Rui-ping, WU Yi-jie
    2012, 32 (3):  336. 
    doi: 10.3969/j.issn.1674-8115.2012.03.021

    Abstract ( 1370 )   PDF (569KB) ( 1255 )  

    Objective To investigate the expression of sodium iodine symporter (NIS) in thyroid tissues in benign or malignant thyroid diseases. Methods Fresh thyroid specimens were obtained from thyroid ablation operation, and were divided into nodular goiter group, thyroid adenoma group, thyroid carcinoma group and control group according to pathological findings. The expression of NIS mRNA in thyroid tissues of each group was detected by Real-Time PCR. Results The relative expression of NIS mRNA in nodular goiter group, thyroid adenoma group and thyroid carcinoma group was significantly lower than that in control group (P<0.01). The relative expression of NIS mRNA in thyroid carcinoma group was significantly lower than that in nodular goiter group and thyroid adenoma group (P<0.01). There was no significant difference in the relative expression of NIS mRNA between nodular goiter group and thyroid adenoma group (P>0.05). Conclusion The expression of NIS mRNA decreases both in benign thyroid diseases and in malignant diseases, especially for the latter, which indicates that “iodine pump” defects exist in different thyroid diseases.

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    Changes of plasma somatostatin, glucagon-like peptide-1 and glucagon in patients with type 2 diabetes in early stage
    ZHU Hui, MA Li-min, XIA Fang-zhen, et al
    2012, 32 (3):  340. 
    doi: 10.3969/j.issn.1674-8115.2012.03.022

    Abstract ( 1611 )   PDF (290KB) ( 1439 )  

    Objective To investigate the changes of plasma somatostatin, glucagon-like peptide-1 (GLP-1) and glucagon in patients with type 2 diabetes in early stage. Methods Forty-nine patients with diabetes in early stage (diabetes group) and 21 normal controls (control group) were selected. Oral glucose tolerance tests (OGTT) were performed, the fasting plasma somatostatin, GLP-1 and glucagon and those 2 h after glucose load were measured, the increase ratios were calculated, and the correlation was analysed. Results The fasting plasma somatostatin, GLP-1 and glucagon and plasma somatostatin and GLP-1 2 h after glucose load in diabetes group were significantly lower than those in control group (P<0.05), and plasma somatostatin, GLP-1 and glucagon 2 h after glucose load were higher than fasting ones in both groups. The increase ratios of plasma somatostatin and glucagon in diabetes group were significantly higher than those in control group (P<0.05), and there was no significant difference in the increase ratio of plasma GLP-1 between two groups (P>0.05). The increase ratio of plasma somatostatin was significantly positively related to that of plasma GLP-1 in diabetes group (r=0.367, P=0.015). Conclusion The reduction of inhibition of somatostatin on GLP-1 may be the compensatory response in patients with type 2 diabetes in early stage. In the early stage of type 2 diabetes, improper increase of glucagon secretion has already existed, and plasma glucose and insulin may play a more important role than GLP-1.

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    Value of new Japanese severity score in assessment of severity and risk of severe acute pancreatitis
    LIU Xiao-ying, CHEN Er-zhen
    2012, 32 (3):  344. 
    doi: 10.3969/j.issn.1674-8115.2012.03.023

    Abstract ( 2132 )   PDF (758KB) ( 1473 )  

    Objective To investigate the value of new Japanese severity score in the assessment of severity and risk of severe acute pancreatitis (SAP). Methods The clinical data of patients with SAP were retrospectively analysed. New JSS was employed to predict the outcomes, prevalence of multiple organ dysfunction syndrome (MODS) and prevalence of transfer operation, and the results were compared with findings from acute physiology and chronic health evaluationⅡ (APACHEⅡ) score, Ranson score and Balthazar computed tomography severity index (CTSI) score. Results The areas under the receiver operating characteristic curve (AUCROC) were 0.88, 0.91 and 0.74 respectively (P<0.01), the values of sensitivity were 100%, 95.50% and 97.10% respectively, and the values of specificity were 69.60%, 75.80% and 46.90% respectively for new JSS in assessment of outcomes, prevalence of MODS and prevalence of transfer operation in patients with SAP. New JSS worked better than the other scoring systems in prediction of outcomes and prevalence of MODS in patients with SAP. In addition, new JSS could be used to assess the times of transfer operation, and the scores increased with the times of operation (P<0.05). Conclusion New JSS performs better in assessment of outcomes, prevalence of MODS and times of operation in patients with SAP. However, the outcomes and severity of SAP can not be evaluated with just one scoring system.

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    Evaluation of domestic plasma (1-3)-β-D-glucan detection reagent in diagnosis of invasive fungal disease
    CHEN Feng, TAO Xiao-qin, DIAO Wen-jing, et al
    2012, 32 (3):  348. 
    doi: 10.3969/j.issn.1674-8115.2012.03.024

    Abstract ( 1800 )   PDF (313KB) ( 1303 )  

    Objective To investigate the value of domestic plasma (1-3)-β-D-glucan detection reagent in the diagnosis of invasive fungal disease (IFD). Methods Patients suspected of IFD were screened from Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from April 2009 to June 2011. Based on the diagnostic standard of IFD from the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG), 63 true positive cases (57 confirmed as IFD and 6 preliminarily diagnosed as IFD) were selected as IFD group, and the other 100 nonIFD true negative cases were served as control group. Plasma mass concentrations of (1-3)-β-D-glucan were measured with domestic plasma (1-3)-β-D-glucan detection reagent, and comparison was made between groups. Receiver operating characteristic (ROC) curve was drafted, and the cutoff value of plasma (1-3)-β-D-glucan in diagnosis of IFD was analysed. Results Plasma levels of (1-3)-β-D-glucan in both groups exhibited non-normal distribution(positive skewness), with coefficient of kurtosis>0 and coefficient of skewness>0. The plasma mass concentrations of (1-3)-β-D-glucan of control group and IFD group were (33.62±5.0) pg/mL and (373.82±125.5) pg/mL respectively, and there were significant differences between them (P<0.001). Analysis of ROC curve revealed that the cutoff value of plasma (1-3)-β-D-glucan in diagnosis of IFD was 20.85, maximum area under the curve was 0.857 (P<0.05), 95% CI was 0.792 to 0.923, and values of sensitivity and specificity were 77.8% and 86.0% respectively. Conclusion Domestic plasma (1-3)-β-D-glucan detection reagent can be used in the diagnosis of IFD.

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    Original article (Public health administration)
    Personality characteristics of suicide ideation of freshmen in medical schools
    LI Na, ZHANG Hao, WANG Fang, et al
    2012, 32 (3):  352. 
    doi: 10.3969/j.issn.1674-8115.2012.03.025

    Abstract ( 1306 )   PDF (296KB) ( 1229 )  

    Objective To investigate the prevalence of suicide ideation and relationship between suicide ideation and personality characteristics among freshmen of  medical schools. Methods Questionnaire survey was conducted in 675 freshmen selected with random cluster sampling from 8 majors of grade 2007 of Shanghai Jiaotong University School of Medicine. The general conditions (gender, age, major and registered permanent residence) were investigated, Cattells 16 Personality Factor (16PF) Questionnaire was completed, and main personality characteristics for suicide ideation were screened with univariate analysis and multivariate Logistic regression model. Results Nine freshmen (1.33%) had suicide ideation, and the other 666 did not have suicide ideation. There was no significant difference in gender, major and registered permanent residence between freshmen with suicide ideation and those without (P>0.05). The scores of 5 factors of intelligence, emotional stability, rule-consciousness, mental health and professional success in freshmen with suicide ideation were significantly lower than those in freshmen without suicide ideation (P<0.05 or P<0.01), while the scores of 4 factors of vigilance, apprehensiveness, tension and environmental adaptation in freshmen with suicide ideation were significantly higher than those in freshmen without suicide ideation (P<0.01). Multivariate Logistic regression analysis revealed that personality characteristics of intelligence and emotional stability were negatively related to suicide ideation (β=-0.46,P=0.04;β=-0.23,P=0.02), and personality characteristic of vigilance was positively related to suicide ideation (β=0.30,P=0.02). Conclusion The personality characteristic of vigilance may be a risk factor, and personality characteristics of intelligence and emotional stability may be protective factors of suicide ideation of freshmen in medical schools.

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    Review
    Research progress of structure and function of mitochondrial permeability transition pore
    FENG Yang, LIU Jian-jun, HUANG Gang
    2012, 32 (3):  356. 
    doi: 10.3969/j.issn.1674-8115.2012.03.026

    Abstract ( 2144 )   PDF (378KB) ( 1531 )  

    The change of mitochondrial permeability plays an important role in the apoptosis and necrosis of cells, and mitochondria permeability transition pore may influence the change of mitochondrial permeability. However, the molecular structure and function of mitochondria permeability transition pore are not clearly revealed. The research progress of molecules involved in structure composition and function regulation of mitochondria permeability transition pore, including adenine nucleotide translocase (ANT), voltage-dependent anion-selective channel (VDAC), cyclophilin D (Cyp D), phosphatic carrier (PiC) and Bcl-2 proteins is reviewed in this paper.

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    Advances in treatment of IgA nephropathy
    JIA Xiao-yuan, WANG Wei-ming
    2012, 32 (3):  361. 
    doi: 10.3969/j.issn.1674-8115.2012.03.027

    Abstract ( 1760 )   PDF (357KB) ( 1362 )  

    IgA nephropathy (IgAN) is the most common glomerulus disease in the world, and IgAN accounts for 45.2% to 58.2% of primary glomerulonephritis in China. The pathogenesis of IgAN remains unknown, and angiotensin converting enzyme inhibitor (ACEI)/angiotensin Ⅱ receptor blocker (ARB), corticosteroid and immunosuppressive agents are widely used in clinics. However, there has been no unified standard in IgAN therapy.In 2010 Renal Week of American Society of Nephrology (ASN), Kidney Disease Improving Global Outcomes (KDIGO) put forward suggestions on the treatment of IgAN based on evidence-based medicine. In this paper, these suggestions are reviewed.

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    Research progress of adrenocorticotropic hormone-independent macronodular adrenal hyperplasia
    ZHU Li-ying, NING Guang
    2012, 32 (3):  366. 
    doi: 10.3969/j.issn.1674-8115.2012.03.028

    Abstract ( 1962 )   PDF (364KB) ( 1412 )  

    Adrenocorticotropic hormoneindependent macronodular adrenal hyperplasia (AIMAH) is a rare adrenal pathological lesion. AIMAH presents clinically as overt or subclinical Cushing's syndrome with typical radiological findings, occasionally with other diseases. What is rarer is the familial type. The mechanism of AIMAH may be the aberrant expression of several hormones and cytokines receptors in adrenal, which leads to the oversecretion of glucocorticoid, and the molecular mechanism involves genic mutation or deficiency of the receptors. Although presently adrenalectomy is the main treatment, with further research on pathophysiology,more and more effective medication will be used. The research progress of clinical features, mechanism, and treatment of AIMAH is reviewed in this paper.

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    Research progress of cardiovascular imaging of Kawasaki disease with coronary artery lesion
    YU Yi, SUN Kun
    2012, 32 (3):  371. 
    doi: 10.3969/j.issn.1674-8115.2012.03.029

    Abstract ( 1704 )   PDF (406KB) ( 1204 )  

    Kawasaki disease (KD) is an acute vasculitis syndrome, which mainly affects medium and small arteries, with a particular predilection for coronary arteries. Patients with KD having serious coronary artery lesion may result in myocardial infarction and sudden death. There is no specific method in diagnosis of KD with coronary artery lesion. Cardiovascular imaging techniques such as echocardiography, myocardial contrast echocardiography, myocardial perfusion scan, stress echocardiography, magnetic resonance imaging, CT, coronary angiography and intravascular ultrasound imaging can evaluate coronary abnormalities. The research progress of cardiovascular imaging in diagnosis of KD with coronary artery lesion is reviewed in this paper.

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    Brief original article
    Efficacy of Supreme laryngeal mask airway on ventilation in patients undergoing gynaecological surgery
    SHI Mei-xin, YOU Xin-min
    2012, 32 (3):  375. 
    doi: 10.3969/j.issn.1674-8115.2012.03.030

    Abstract ( 1658 )   PDF (268KB) ( 1165 )  

    Objective To evaluate the efficacy of Supreme laryngeal mask airway (SLAM)on ventilation in patients undergoing gynaecological surgery under general anesthesia. Methods Eighty patients undergoing gynaecological surgery under general anesthesia were divided into SLAM group (group S) and tracheal intubation group (group T), with 40 patients in each group. SLAM was inserted after anesthesia induction in group S, and tracheal catheter was intubated under direct laryngoscope after anesthesia induction in group T. The general conditions of patients and the time and conditions of SLAM placement or tracheal catheter intubation were recorded. The heart rates (HR), mean arterial blood pressure (MAP), pulse oxygen saturation(SpO2), end tidal carbon dioxide pressure (PETCO2) and peak airway pressure (Ppeak) were monitored during operation. The airway seal effects at neutral position, flexed position, over-extension position and side position of SLAM were observed. Fiberoptic bronchoscope was inserted into the airway tube of SLMA to verify its position. The times of successful gastric tube placement and incidences of hypoxemia, nausea and vomiting, choking, hoarseness, sore throat and regurgitation of gastric contents after SLAM or tracheal catheter withdrawal were observed. The time of anesthesia, extubation and emergence was recorded. Results The time of intubation, extubation and emergence in group S was shorter than that in group T, and the incidences of hypoxemia, choking and sore throat in group S were lower than those in group T. No regurgitation of gastric contents took place in two groups. HR and MAP 1 min and 5 min after tracheal catheter intubation in group T were significantly higher than those in group S (P<0.05). SpO2, PETCO2 and Ppeak of different time points in two groups were in the normal range, and there was no significant difference between two groups (P>0.05). The airway seal pressure was (25±4) cmH2O in group S, and different head and neck position did not change the airway sealing effect in group S. The success rate of gastric tube insertion was 100%. Fiberoptic bronchoscopy showed that SLAM was in good position. Conclusion SLAM can provide reliable airway seal effect and adequate ventilation with less complications, which can be effectively applied in gynaecological surgery under general anesthesia with safety.

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