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    Original article (Basic research)
    Metabotropic glutamate receptor 1/5 agonist improves doxorubicin-induced renal injury in mice
    TAO Hua, GU Le-yi, WANG Li-hua, et al
    2012, 32 (10):  1283. 
    doi: 10.3969/j.issn.1674-8115.2012.10.001

    Abstract ( 1073 )   PDF (747KB) ( 1336 )  

    Objective To investigate the effects of selective agonist for metabotropic glutamate receptors 1 and 5 (mGluR1/5), (S)-3,5-dihydroxyphenylglycine (DHPG), on the doxorubicin (ADR)-induced nephrosis in mice. Methods Eighteen 6-week-old male BALB/c mice were randomly divided into control group, ADR group (nephrosis model established by intravenous injection of ADR) and ADR+DHPG group (pretreatment with DHPG injection before model establishment), with 6 mice in each group. Twenty-four-hour urinary albumine levels were measured by enzyme-linked immunosorbent assay (ELISA), and the foot processes effacement and the width of foot processes were determined with electron microscopy. Laser confocal microscope with immunofluorescence staining was employed to detect the expression of nephrin and desmin, and the expression of WT-1 in glomerulus was determined by immunohistochemistry. Besides, the apoptosis of podocytes was detected by TUNEL staining. Results Twenty-four-hour urinary albumine levels were (1.67±0.22) mg, (22.55±2.34) mg and (8.23±2.74) mg in control group, ADR group, and ADR+DHPG group respectively, and there were significant differences among groups (P<0.01). Compared with ADR group, the width of foot processes in ADR+DHPG was shorter, the expression of desmin was lower, and the expression of nephrin was higher. The number of WT-1 positive cells was negatively related to the number of apoptotic cells in glomerulus (R2=0.8 482,P<0.05), and the number of apoptotic podocytes in ADR+DHPG group was significantly smaller than that in ADR group (P<0.01). Conclusion Selective mGluR 1/5 agonist DHPG may inhibit ADRinduced foot processes fusion of podocytes and decreased expression of nephrin, reduce cell apoptosis, and attenuate urinary albumine in ADR-induced nephrosis in mice.

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    Effects of ultrasound exposure and sodium butyrate on transfection of adeno-associated virus to rat retinal pigment epithelial cells
    LI Hong-li, DU Lian-fang, LI Feng-hua, et al
    2012, 32 (10):  1288. 
    doi: 10.3969/j.issn.1674-8115.2012.10.002

    Abstract ( 1489 )   PDF (492KB) ( 1056 )  

    Objective To investigate the role of ultrasound exposure and sodium butyrate in transfection of type 2 recombinant adeno-associated virus carrying enhanced green fluorescent protein (rAAV2-EGFP) to rat retinal pigment epithelial (RPE) cells. Methods Rat RPE cells were incubated in 24-well plates, and were transfected with rAAV2-EGFP (control group), rAAV2-EGFP+ultrasound exposure (ultrasound exposure group, ultrasound exposure for 60 s with ultrasound intensity of 0.5 and 1 W/cm2) and rAAV2-EGFP+different concentrations of sodium butyrate (sodium butyrate group) respectively. Forty-eight hours after transfection, the expression of EGFP in the transfected cells was observed by inverted microscopy, and the transfection efficiency (percentage of EGFP positive cells) was detected by flow cytometry. Twenty-four hours after transfection, the cell proliferation was determined by MTS method. Results Flow cytometry indicated that the percentages of EGFP positive cells in ultrasound exposure group and sodium butyrate group were significantly higher than that in control group (P<0.05), and the increase in transfection efficiency in sodium butyrate group was significantly higher than that in ultrasound exposure group (P<0.05). Cell proliferation detection revealed that the absorbance of the transfected cells in ultrasound exposure group was significantly higher than that in sodium butyrate group (P<0.05). Conclusion Both sodium butyrate and ultrasound exposure can increase the transfection efficiency of rAAV2-EGFP to rat RPE cells, and the effect of sodium butyrate is more significant, while ultrasound exposure has less inhibition effect on cell proliferation.

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    Effect of 5-hydroxytryptamine on activity of bladder afferent nerves in rats
    SUN Qiao, SUN Bi-ying, LUO Ping, et al
    2012, 32 (10):  1292. 
    doi: 10.3969/j.issn.1674-8115.2012.10.003

    Abstract ( 1072 )   PDF (1043KB) ( 1176 )  

    Objective To investigate the effect of 5-hydroxytryptamine (5-HT) on the spontaneous and mechanosensitive activity of bladder afferent nerves. Methods The effects of intravesical instillation of different concentrations of 5-HT on the spontaneous and distension-induced pelvic afferent nerve activity were observed in the isolated rat bladder/pelvic nerve preparations. Results At rest, with the bladder empty, there was little background activity (<10 imp/s) in the pelvic nerve branch innervating the bladder. During ramp distension, the afferent nerve activity increased progressively as the intravesical pressure rose. Intraluminal instillation of 0.1 mL 5-HT (1 to 30 μmol/L) caused an increase of the ongoing afferent discharge and potentiated the low threshold (0-15 mmHg) mechanosensory responses in a concentration-dependent manner. Conclusion 5-HT directly activates low threshold bladder afferent fibers in the pelvic nerve, and can potentiate their mechanosensitivity.

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    Neuroprotective effects of Catalpol on BV2 cells injured by MPP+
    WANG Zi-mei, XU Gang, ZHANG Yong-fang, et al
    2012, 32 (10):  1296. 
    doi: 10.3969/j.issn.1674-8115.2012.10.004

    Abstract ( 1233 )   PDF (457KB) ( 1100 )  

    Objective To explore the role of cerebral dopamine neurotrophic factor (CDNF) in the protection effect of Catalpol on the injured dopaminergic glial cells. Methods ①Mouse glial BV2 cells were randomly divided into control group, Catalpol group, 1-methyl-4-phenylpyridinium (MPP+) model group and MPP+ model+Catalpol group. The expression of CDNF mRNA in BV2 cells 0, 6, 24 and 48 h after treatment was detected by RT-PCR. ② BV2 cells were treated with 0.1, 1 and 10 μmol/L Catalpol respectively, MPP+ was added 24 h later, and the expression of CDNF protein was determined by Western blotting 48 h later. Normal cells were served as control group, and those without pretreatment with Catalpol were established as MPP+ model group. ③Control group, MPP+ model group, Catalpol group, anti-CDNF antibody group and Catalpol+ anti-CDNF antibody group were established, all groups were treated with MPP+ except control group, and the effect of Catalpol on dopamine uptake after CDNF antibody blockade was examined by [3H]-dopamine radiometry. Results ①Compared with control group, the expression of CDNF mRNA in Catalpol group and MPP+ model group was not significantly changed 0 to 72 h after administration of MPP+. However, the expression of CDNF mRNA in MPP+ model+ Catalpol group was significantly higher than that in MPP+ model group 48 h after administration of MPP+ (P<0.01). ②The expression of CDNF protein in MPP+ model group was significantly lower than that in control group 48 h after administration of MPP+ (0.679±0.013 vs 1.009±0.015, P<0.001). The expression of CDNF protein in BV2 cells after pretreatment with 10 μmol/L Catalpol (0.812±0.011) was significantly higher than that in MPP+ model group (P<0.01), while the expression of CDNF protein in BV2 cells after pretreatment with 0.1 and 1 μmol/L Catalpol was not significantly changed compared with MPP+ model group. ③The dopamine uptake in MPP+ model group was significantly lower than that in control group (63.5±2.5 vs 99.9±0.8, P<0.01). The dopamine uptake in Catalpol group (87.2±2.4) was significantly higher than that in MPP+ model group (P<0.01). The dopamine uptake in Catalpol+anti-CDNF antibody group (73.6±2.7) was significantly lower than that in Catalpol group (P<0.01), while was higher than that in anti-CDNF antibody group (P<0.05). Conclusion The neuroprotection effect of Catalpol against MPP+ toxicity may be associated with the upregulation of expression of CDNF mRNA and protein in BV2 cells.

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    Molecular mechanisms of substance P-induced monocyte chemoattractant protein-1 secretion in fibroblasts under high glucose culture condition
    JIA Zhi-gang, FANG Yong, YAO Min, et al
    2012, 32 (10):  1302. 
    doi: 10.3969/j.issn.1674-8115.2012.10.005

    Abstract ( 1268 )   PDF (569KB) ( 981 )  

    Objective To investigate the molecular mechanisms of substance P (SP)-induced monocyte chemoattractant protein-1 (MCP-1) secretion in fibroblasts under high glucose culture condition. Methods Human skin fibroblasts were cultured in high glucose DMEM medium, and were incubated with 10 nmol/L SP for different time. The expression of inhibitor α of nuclear factor kappa B (NF-κB)(IκBα), phosphonated IκBα (p-IκBα) and phosphonated NF-κB subunit p65 (p-NF-κBp65) in cells was detected by Western blotting, and the expression and translocation of p-NF-κBp65 was observed by immunofluorescence method. Human skin fibroblasts cultured in high glucose DMEM medium were divided into control group, SP group and SP+NF-κB inhibitor (MG132) group (pretreatment with MG132 for 60 min), the expression of p-NF-κBp65 in cells was detected in each group, and the concentration of MCP-1 in the supernatant was determined by ELISA. Results The expression of IκBα significantly decreased, and that of p-IκBα significantly increased in fibroblasts with the time increase of treatment with SP (P<0.05). The expression of p-NF-κBp65 significantly increased after treatment with SP (P<0.05), which was in a time-dependent manner. The expression of p-NF-κBp65 in nuclei significantly increased after treatment with SP observed under laser confocal microscope with immunofluorescence staining. The expression of p-NF-κBp65 in cells and the concentration of MCP-1 in the supernatant in SP+MG132 group were significantly lower than those in control group (P<0.05). Conclusion The mechanisms of SP-induced MCP-1 secretion in fibroblasts may be related to the activation of NF-κB signalling pathway.

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    Design, preparation and synchronous transplantation experiments of laser micropore porcine acellular dermal matrix
    ZENG Tao-fang, LUO Xu, XIN Guo-hua, et al
    2012, 32 (10):  1307. 
    doi: 10.3969/j.issn.1674-8115.2012.10.006

    Abstract ( 1138 )   PDF (940KB) ( 1161 )  

    Objective To prepare laser micropore porcine acellular dermal matrix (LPADM), a new type of dermal substitute, and to verify the healing effect on full-thickness skin defect. Methods Splitthickness dermis of the healthy white pigs was harvested and treated by high-sodium-SDS method, and the porcine acellular dermal matrix (ADM) was obtained. Besides, LPADM was prepared using laser micropore technology on the dermis, followed by the procedure of high-sodium-SDS acellular treatment. The physical properties of LPADM were evaluated. Four full-thickness skin wounds (2.0 cm×2.0cm) were created on each dorsum of 30 SD rats. Group L (LPADM grafted with the split-thickness autograft), group A (nonporous ADM grafted with the split-thickness autograft), group F (full-thickness autograft) and group C (split-thickness autograft) were divided on the basis of different grafts used through one-step method. Six rats were randomly selected on day 3, 5, 7, 10 and 14 after surgery, the survival of skin graft was observed, and histological examination was conducted after sacrifice. Results The well-prepared micropore LPADM was characterized by its porcelain white color, softness and good elasticity. Histological examination revealed that LPADM was totally devoid of epidermis and cellular components. On day 3 after surgery, the cavity-like structure formed by surrounding endothelial cells was observed in group L. On day 3, 5, 7 and 10 after surgery, the grafts of group L and C survived well, and new vessels were generated in group L. However, epidermal necrosis with black and blistering tissues occurred in group A, while some grafts blistering with ruddy epidermal basement were observed in group F. On day 14 after surgery, abundant blood vessels formed in group L, and all the grafts survived in group L, C and F, with the wound healing rates of (99.10±0.66)%, (99.25±0.23)%, and (97.07±1.32)%, respectively, and there was no significant difference among groups (P>0.05). The wound healing rate of group A was (27.46±2.05)%, which was significantly lower than those of the other groups (P<0.01). Conclusion The new type of micropore porcine acellular dermis matrix can be used as an ideal dermal substitute due to high survival rate when grafted with the split-thickness autograft and the ability of initiating early revascularization.

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    Application of 18F-FLT and 18F-FDG in evaluation of tumor proliferation of nude mouse models of leukemia
    LU Li-yan, JIANG Lei, GAO Yun-chao, et al
    2012, 32 (10):  1312. 
    doi: 10.3969/j.issn.1674-8115.2012.10.007

    Abstract ( 1193 )   PDF (510KB) ( 1006 )  

    Objective To investigate the application of 18F-fluoro-3´-Deoxy-3´-L-fluorothymidine (18F-FLT) and 18F-fluorodeoxyglucose (18F-FDG) in evaluation of tumor proliferation of nude mouse models of chronic myelogenous leukemia(K562 cell lines). Methods 18F-FLT was synthesized and K562 cells were traditionally cultured. The in vitro experiment of 18F-FLT and 18F-FDG uptake assay was performed in K562 cells at 15 min, 30 min, 60 min and 120 min. After tumorbearing mouse models of leukemia were successfully established by injection of K562 cells, positron emission computed tomography (PET) was performed 30 min, 60 min and 120 min after injection of 18F-FLT and 18F-FDG. The region of interest was drawn over the tumor and background to calculate the ratio of tumor to non-tumor (T/NT). Results High-performance liquid chromatography indicated that the radiochemical purity of 18F-FLT was over 95% within 6 h. Pathological examination revealed that tumor-bearing nude mouse models of leukemia were successfully established by subcutaneous inoculation of K562 cells. A significantly higher uptake of 18F-FLT than that of 18F-FDG was observed in K562 cells in the tracer uptake experiment at various time points (P<0.05). And ratios of T/NT of 18F-FLT PET were significantly higher than those of 18F-FDG PET at different time points after injection (P<0.05). Conclusion Compared with 18F-FDG, 18F-FLT may have better performance in evaluation of tumor proliferation of nude mouse models of leukemia.

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    Influence of insulin resistance on ventricular remodeling and intervention effect of rosuvastatin
    XU Wei-yuan, ZHENG Liang-rong, GUO Hang-yuan, et al
    2012, 32 (10):  1316. 
    doi: 10.3969/j.issn.1674-8115.2012.10.008

    Abstract ( 1211 )   PDF (653KB) ( 1044 )  

    Objective To investigate the influence of insulin resistance on the ventricular remodeling, and to observe the intervention effect of rosuvastatin and explore its possible mechanism. Methods Forty male LDLR-/- mice aged 6 weeks were randomized into control group (NC group, fed with normal diet), high fat and high fructose diet group (HFF group, fed with normal diet+21.1% fat+20% fructose), rosuvastatin intervention group(HFFR group, intervention with rosuvastatin on the basis of that in HFF group) and rosuvastatin and mevalonic acid intervention group (HFFRMA group, fed with mevalonic acid on the basis of that in HFFR group), with 10 mice in each group. Mice were sacrificed 12 weeks after treatment, the fasting blood sugar (FBS) was determined by oxygen electrode method, fasting plasma insulin (FINS) was detected by ELISA, homeostasis model insulin resistance index (HOMA-IR) and left ventricular weight index (LVWI) were calculated, collagen volume fraction (CVF) of myocardial tissues was calculated with Picric-Sirius Red staining, and the expression of PPARα and MMP-9 protein in myocardial tissues was detected by Western blotting. Results FBS, FINS, HOMA-IR, LVWI, CVF and the expression of PPARα and MMP-9 protein in HFF group, HFFR group and HFFRMA group were significantly higher than those in NC group(P<0.05). After treatment with rosuvastatin, FBS, FINS and HOMA-IR in HFFR group and HFFRMA group were significantly improved, and LVWI, CVF and the expression of PPARα and MMP-9 protein in HFFR group and HFFRMA group were significantly lower than those in HFF group (P<0.05). However, there was no significant difference in these parameters between HFFR group and HFFRMA group (P>0.05). Conclusion Insulin resistance can be induced in LDLR-/- mice 12 weeks after high fat and high fructose diet. Insulin resistance may contribute to myocardial fibrosis and ventricular remodeling. Rosuvastatin can inhibit ventricular remodeling and improve insulin resistance, and the mechanism may be associated with the down-regulation of expression of MMP-9 and PPARα protein, which is independent of lipid-lowering effect.

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    Original article (Clinical research)
    Quantitative magnetic resonance imaging analysis of parts of hippocampal volume in normal adults
    GAO Mei-chun, LU Qin-chi
    2012, 32 (10):  1321. 
    doi: 10.3969/j.issn.1674-8115.2012.10.009

    Abstract ( 1659 )   PDF (495KB) ( 1155 )  

    Objective To investigate the quantitative magnetic resonance imaging (MRI) analysis of parts of hippocampal volume (HV), and to determine the normal range of HV. Methods Twenty-five subjects (13 males and 12 females) underwent a 3.0T MRI with oblique coronal thin sections (1.5 mm) oriented perpendicular to the hippocampal long axis. The hippocampus was divided into three parts of head, body and tail, and the HV including the hippocampal head volume (HHV), hippocampal body volume (HBV), hippocampal tail volume (HTV) and whole hippocampal volume (HCV) were measured on T1weighted imaging. Results The right-side HHV, HBV, HTV and HCV were (1 712.81±242.26) mm3, (1 126.59±133.10) mm3, (231.22±76.28) mm3 and (3 078.62±254.82) mm3 respectively, and the left-side ones were (1 640.86±208.70) mm3, (1 098.20±145.00) mm3, (229.52±78.39) mm3 and (2 979.69±227.25) mm3 respectively. There was no significant difference between left-side HTV and right-side HTV(P>0.05), and the right-side HHV, HBV and HCV were significantly larger than the left ones (P<0.05 for all). There was no significant difference in left-side and right-side HV between males and females (P>0.05 for both). Conclusion MRI can quantitatively analyse HV, and determine the normal range of HV in normal adults.

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    Cross-sectional study on birth defects among children aged 0 to 5 years in southeastern and northeastern Chongqing
    HUANG Qiao, ZHONG Zhao-hui, LI Jie, et al
    2012, 32 (10):  1326. 
    doi: 10.3969/j.issn.1674-8115.2012.10.010

    Abstract ( 1203 )   PDF (290KB) ( 1011 )  

    Objective To investigate the prevalence of birth defects among children aged 0 to 5 years in southeastern and northeastern Chongqing, to illustrate the main types and conditions of defects, and to provide scientific evidence for the prevention of birth defects. Methods Subjects were selected through multi-stage proportional cluster random sampling. The criteria for diagnosis and re-checking were standardized, and the data of medical history and physical examinations were obtained by investigators with strict training. Results The prevalence rates of birth defects in southeastern and northeastern Chongqing were 39.84‰ (41/1029) and 49.48‰ (114/2190) respectively, with no significant difference between them (χ2=1.49,P=0.22). Hernia, polydactylism and cryptorchidism took the first three places of birth defects in southeastern Chongqing, while hernia, cryptorchidism and congenital heart disease in northeastern Chongqing. The prevalence rates of birth defects among boys and girls in southeastern Chongqing were 59.65‰ and 15.25‰ respectively, and those in northeastern Chongqing were 71.37‰ and 21.67‰ respectively, with the prevalence rates of boys significantly higher than those of girls in both areas (P<0.05). There was no significant difference in the prevalence rates of birth defects among different age groups in southeastern Chongqing (χ2=1.22,P=0.87). The prevalence rate of birth defects of 1-year age group was the highest in northeastern Chongqing, with that of 4-5-year age group ranking second, and there were significant differences between these two age groups (χ2=9.91,P<0.05). The prevalence rate of birth defects in the rural area (56.72‰) was higher than that of the urban area (32.02‰) in northeastern Chongqing (χ2=7.80,P<0.05), and was higher than that of the rural area in southeastern Chongqing (37.36‰)(χ2=4.50,P<0.05). Conclusion The prevalence of birth defects among children aged 0 to 5 years has been vividly illustrated by the cross-sectional investigation, which helps to identify the birth defects with high prevalence rate and severe damage and find the risk factors for the disease control and prevention.

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    Surgical technique in clipping of ventral aneurysms in internal carotid artery
    FEI Zhi-min, ZHANG Jue, SHU Guo-wei, et al
    2012, 32 (10):  1330. 
    doi: 10.3969/j.issn.1674-8115.2012.10.011

    Abstract ( 1164 )   PDF (932KB) ( 1016 )  

    Objective To investigate the technique in clipping of ventral aneurysms in internal carotid artery. Methods Ten cases of ventral aneurysms in internal carotid artery confirmed by 3D-CT angiography (3D-CTA) and digital subtraction angiography (DSA) were analysed. Preoperative virtual reality model of 3D-CTA, based on the body position during surgery, simulated the position of aneurysm and direction of doom and determine the existence of branching artery originating from the aneurysm or nearby parent artery. Somatosensory evoked potential monitoring, microvascular Doppler sonography, and neuroendoscopy were used before and after clipping to confirm the obliteration of aneurysms and patency of parent vessels and branching artery.If the branching artery was originating from the aneurysm, lateral side of internal carotid artery with nonring clip was recommended. Otherwise, it was often preferable to clip the aneurysm with ring or so-called fenestrated clip, whose clip-blades were placed parallel to internal carotid artery axis. If necessary, the combination use of several clips was recommended to reconstruct the parent artery. Results The scores of Glasgow Outcome Scale one month after operation were 5 points in 8 patients, 4 points in 1 patient and 3 points 1 patient. There was no case of death. Three months after operation,DSA and/or 3D-CTA revealed that there was no aneurysmal residue and no stenosis of parent and adjacent vessels. One patient suffered from permanent visual loss. Conclusion Detailed preoperative planning and proper intraoperative assisted methods and neuroendoscopy are important for clipping of ventral aneurysms in internal carotid artery.

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    Study on visual P300 evoked by facial expression stimulus in patients with depression
    ZHU Yi, CHEN Xing-shi, QIU Jian-yin
    2012, 32 (10):  1334. 
    doi: 10.3969/j.issn.1674-8115.2012.10.012

    Abstract ( 1134 )   PDF (270KB) ( 1161 )  

    Objective To investigate the changes of visual P300 evoked by facial expression stimulus in patients with depression. Methods Thirty patients with depression (depression group) and 30 normal controls (control group) were enrolled, and were evaluated by self-designed demographic questionnaire and Hamilton depression scale (HAMD). Besides, the examinations of visual P300 evoked by five facial expression stimulus, including depression, happiness, surprise, anger and disgust were conducted, and were compared between two groups. The correlation analysis of HAMD score with visual P300 was performed in depression group. Results The target P3 latency evoked by depression facial expression was (447.23±26.90) ms, that evoked by happiness facial expression was (444.40±28.52) ms, and both were significantly longer than those of control group (P<0.05). The HAMD score was not correlated with visual P300 evoked by facial expression stimulus in depression group (P>0.05). Conclusion There are abnormal changes of visual P300 evoked by facial expression stimulus in patients with depression.

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    Isolation and identification of CO2-dependent Staphylococcus aureus small colony variant with methicillin resistance
    YU Jing, LIU Ying, CHEN Feng
    2012, 32 (10):  1338. 
    doi: 10.3969/j.issn.1674-8115.2012.10.013

    Abstract ( 1567 )   PDF (852KB) ( 1141 )  

    Objective To identify a clinical isolate of Staphylococcus aureus small colony variant and investigate its antibiotic resistance and auxotroph type, so as to provide a basis for the prevention and control of small colony variant infection. Methods One possible Staphylococcus aureus small colony variant strain was isolated from pus of brain tumor resection site of a patient. The bacterial colony morphology, biochemical characteristics and susceptibility test of this small colony variant strain were identified. Staphylococcus aureus specific gene nuc and methicillin resistance-associated gene mecA were detected and sequenced. Complementation test was used to identify the type of auxotroph. Results The strain was identified as Staphylococcus aureus by Vitek-2 Compact system, which contained Staphylococcus aureus specific gene nuc and methicillin resistance-associated gene mecA. Its major phenotypes included small colony, slow growth, indistinct zone of hemolysis (24 h), decreased coagulase and positive catalase reaction. This clinical isolate of Gram positive cocci in grape like clusters was resistant to β-lactam antibiotics, and complementation test showed that the growth of this clone was CO2dependent. Conclusion One CO2-dependent methicillin resistant Staphylococcus aureus small colony variant strain was isolated and identified, which laid the groundwork for the control and prevention of Staphylococcus aureus small colony variant strain-associated disease and research of its pathogenic mechanism.

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    Clinicopathological features and prognosis of 12 cases of gastric Schwannomas
    HE Chao, SHEN Yan-ying, NI Xing-zhi, et al
    2012, 32 (10):  1343. 
    doi: 10.3969/j.issn.1674-8115.2012.10.014

    Abstract ( 1424 )   PDF (856KB) ( 1326 )  

    Objective To investigate the clinicopathologic features, diagnosis and differential diagnosis of gastric schwannoma (GS), and to summarize the treatment experience and prognosis. Methods The clinical data of 12 cases of GS were analysed. The pathological features, immunohistochemical characteristics,surgical management and follow-up data were evaluated. Results The tumors located in the gastric antrum in 3 cases, in the gastric body in 8 cases and in the gastric fundus in 1 case. The tumors grew to the cavity in 7 cases, and grew outside to the cavity in 5 cases. Serum CEA increased in 1 patient with GS and gastric cancer before operation, and serum CEA and CA199 increased in another patient with GS. All tumors cells were spindle under microscope. Immunohistochemical detection revealed that GS tumor cells were positive for S-100 protein and Vimentin protein in all cases, and were weakly positive for CD34 in 2 cases. Molecular biological detection in 4 patients indicated that exon 9,11,13 and 17 of C-kit gene and exon 12 and 18 of PDGFRA gene were wild type, with no gene mutations. No tumor recurrence or metastasis occurred in the 9 cases with follow-up except that one patient with GS and gastric cancer died of recurrence of gastric cancer. Conclusion The diagnosis of GS depends on pathological and immunohistochemical examinations. S-100 is an important marker for the diagnosis of GS. Preoperative gastroscopic and imaging CT examinations can provide clues to the diagnosis. Surgical en bloc resection is necessary for the treatment of GS, and minimally invasive surgery can be used as the first choice of operation for GS.

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    Relationship between anxiety and serum β-endorphin in patients with vitiligo
    ZANG Yun-shu, JI Xiao-li
    2012, 32 (10):  1347. 
    doi: 10.3969/j.issn.1674-8115.2012.10.015

    Abstract ( 1158 )   PDF (304KB) ( 992 )  

    Objective To investigate the relationship between anxiety and serum β-endorphin in patients with vitiligo. Methods Eighty patients with developing vitiligo (case group) and 40 healthy controls (control group) were selected. ZUNG self-rating anxiety scale (SAS) was employed to determine the anxiety status, and enzyme linked immunosorbent assay (ELISA) was adopted to measure the serum β-endorphin levels. Results The SAS scores in case group (50.85±12.23)was significantly higher than that in control group (37.86±11.23)(t=5.63,P<0.01). The prevalence of anxiety in case group (47.5%, 38/80) was significantly higher than that in control group (5.0%,2/40)(χ2=21.67,P<0.01). In case group, the SAS score and prevalence of anxiety of females were significantly higher than those of males; the SAS score and prevalence of anxiety of the unmarried were significantly higher than those of the married; the SAS score and prevalence of anxiety in patients with vitiligo in exposed skin were significantly higher than those in non-exposed skin; and the SAS score and prevalence of anxiety in patients aged between 16 and 24 were significantly higher than those aged more than 25 (P<0.05 or P<0.01). There was no significant difference in SAS score and prevalence of anxiety between patients with disease duration ≤6 months and those with disease duration >6 months and between patients with higher education and those without higher education (P>0.05). The mass concentration of serum β-endorphin in case group was (219.11±30.18)ng/L, which was significantly higher than that in control group [(162.16±19.65)ng/L] (t=9.12,P<0.01). In case group, the mass concentration of serum β-endorphin in patients with anxiety was (241.71±31.76)ng/L, which was significantly higher than that in patients without anxiety [(197.91±23.29)ng/L](t=8.66,P<0.01). Conclusion Patients with vitiligo may be affected by anxiety, and the serum β-endorphin levels may be associated with vitiligo and anxiety.

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    Effects of motor imaginary therapy on lower limb motor function in hemiplegic patients after stroke
    GUO Yun, ZHANG Hui-ying, ZHANG Ya-qing, et al
    2012, 32 (10):  1351. 
    doi: 10.3969/j.issn.1674-8115.2012.10.016

    Abstract ( 1552 )   PDF (366KB) ( 1066 )  

    Objective To investigate the effect of motor imaginary therapy on lower limb motor function in hemiplegic patients after stroke. Methods Thirty-two hemiplegic patients after stroke were randomly divided into experiment group (n=16) and control group (n=16). Conventional rehabilitation was conducted in both group, and motor imaginary therapy was performed in experiment group after conventional rehabilitation (once a day, 15 min for each time). The treatment was made up of three stages: first stage, from the first week to the third week; second stage, from the fourth week to the fifth week (systemic conventional rehabilitation and motor imagery therapy were not performed during this period); and the third stage, from the sixth week to the eighth week. The therapeutic outcomes were evaluated with Fugl-Meyer motor assessment (FMA) and functional independent measurement (FIM). Results There was no significant difference in FMA and FIM scores between two groups before treatment (P>0.05). Compared with those before treatment, the FMA and FIM scores significantly increased after each stage of treatment in both groups (P<0.01), while there was no significant difference between FMA and FIM scores before the second stage of treatment and those after the second stage of treatment. The FMA and FIM scores in experiment group were significantly higher than those in control group in each stage of treatment (P<0.01). Conclusion Motor imaginary therapy combined with conventional rehabilitation can improve the lower limb motor function and activities of daily living in hemiplegic patients after stroke.

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    Original article (Public health administration)
    New grey correlation analysis of hospitalization expenses of 600 patients with non-small cell lung cancer
    DU Wei, ZHANG Xiao, GAO Cui, et al
    2012, 32 (10):  1356. 
    doi: 10.3969/j.issn.1674-8115.2012.10.017

    Abstract ( 1182 )   PDF (264KB) ( 1091 )  

    Objective To analyse the structure of medical cost and its development in inpatients with non-small cell lung cancer, and to explore appropriate methods to analyse the impact of different expenses on the hospitalization expenses. Methods New grey correlation analysis was employed to quantitatively analyse 6 kinds of hospitalization expenses of 600 patients with non-small cell lung cancer in 2 municipal hospitals in Nanjing between 2005 and 2009. Results New grey correlation analysis revealed that the relational degree of 6 kinds of hospitalization expenses sort order from the highest to the lowest were medicine, treatment, operation, examination, laboratory test and bed occupation. Medicine charges and treatment costs were the main factors affecting hospitalization expenses of patients with non-small cell lung cancer, while bed charges had the lowest association with hospitalization expenses. Conclusion New grey correlation analysis can provide reliable results with simple calculation steps, which is suitable for the dynamic analysis of relational degree of different hospitalization expenses.

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    Empirical analysis of reimbursement level of children´s medical insurance in Shanghai
    REN Yi-jiong, JIANG Hou-jia, ZHANG Yun-ting, et al
    2012, 32 (10):  1360. 
    doi: 10.3969/j.issn.1674-8115.2012.10.018

    Abstract ( 1450 )   PDF (325KB) ( 1135 )  

    Objective To investigate the economic disease burden and true level of reimbursement of children with serious illness in Shanghai, and to provide reference for the perfection of Shanghai children’s medical insurance system. Methods The data of medical expense of 1 917 children with 6 types of serious diseases from 2008 to 2010 in three pediatric hospitals were collected, and the mean medical expense was analysed with non-parametric test. Results The true level of reimbursement of children with serious illness was relatively lower, with the average level of 69.88%, which was lower than the required value of 90%. Significant differences in reimbursement levels existed among different types of diseases, with the highest of 80.85% and the lowest of 47.18%. The reimbursement level of 6 types of serious diseases of Mutual Fund of Children Hospitalization was significantly lower than that of Basic Medical Insurance for Urban Residents (P=0.000). Conclusion There is room for improvement of Shanghai children's medical insurance system. The integration of existing Shanghai children's medical insurance is advised, and the financing and reimbursement level should be elevated, so as to enhance the level of childrens health insurance.

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    Key problems in sustainable development of training of general practitioners in Shanghai
    YANG Jing, BAO Yong
    2012, 32 (10):  1364. 
    doi: 10.3969/j.issn.1674-8115.2012.10.019

    Abstract ( 1210 )   PDF (350KB) ( 1261 )  

    Objective To identify the key problems in the training of general practitioners in Shanghai, and to offer practical advice on the establishment of a standardized training system and the making of relevant policies. Methods Questionnaire survey was conducted in 1 300 general practitioners from 3 districts of Shanghai and 400 medical students from 2 universities in Shanghai on the conditions of training of general practitioners, which concerns with the demographic information, career goal, understanding of family doctor system and satisfaction level in practice. Results An analysis of the basic information revealed a shortage of of academic degree and professional title in general practitioners of Shanghai, as measured by international standards and China's national requirements. The evaluation from medical students on the profession of general practition was relatively lower, with the majority (78.6%) aiming to become specialists. Only 4.6% of medical students would take general practition as preferred career. There was a low satisfaction level in both social environment and personal development among general practitioners in practice, and 15.2% of them were dissatisfied with comprehensive situation. Conclusion There are some critical problems in the training of general practitioners in Shanghai. More image building effort, more standardized training system and more systemized curricula may help to ensure a sustainable development of training of general practitioners.

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    Analysis of waiting time in medical visits of Shanghai residents
    LIANG Ying, BAO Yong
    2012, 32 (10):  1368. 
    doi: 10.3969/j.issn.1674-8115.2012.10.020

    Abstract ( 1180 )   PDF (326KB) ( 1278 )  

    Objective To investigate the waiting time in medical visits of Shanghai residents, and to put forward specific policy recommendations. Methods Three thousand and six hundred residents in 6 districts in the center, combination of town and country and suburbs of Shanghai were selected by stratified random sampling method, and self-designed questionnaire survey was conducted to investigate the waiting time in medical visits of the outpatients and inpatients. Results The number of valid questionnaires was 3 287, with the effective rate of 91.3%. The average waiting time in registration for outpatients was about 13 min, and that of inpatients was 16 min. The average waiting time for doctors was about 30 min. There were differences in the waiting time in registration among patients with different forms of medical visits (inpatients or outpatients), various occupations and different types of medical insurance. There were differences in the waiting time for doctors among patients with various levels of education, different residences and different types of medical insurance. Conclusion In order to shorten the invalid waiting time and triage the population, diversified forms in registration should be taken, registered reservation platform should be established, and sub-time medical visits should be encouraged.

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    Study of medical undergraduates´|talent based on scores of National Matriculation Test and medical courses
    LU Wei, YANG Yun, ZHANG Jian-ge, et al
    2012, 32 (10):  1373. 
    doi: 10.3969/j.issn.1674-8115.2012.10.021

    Abstract ( 1091 )   PDF (336KB) ( 1099 )  

    Objective To investigate the relationship between clinical medicine undergraduates’ talent and scores of National Matriculation Test (NMT) based on the analysis of scores of NMT and medical courses in medical undergraduates. Methods Three hundred and fourteen clinical medicine undergraduates of Shanghai Second Medical University enrolled in Shanghai in 2003 were selected, and the scores of NMT and medical courses, including preparatory medical courses, basic medical courses and clinical courses were analysed by regression statistics method. Results There was no significant correlation between total NMT score and medical courses, while the scores of English and Chinese in NMT had a significant correlation with the scores of medical courses. Conclusion The total NMT score may have no significant impact on the scores of medical courses, while the scores of English and Chinese in NMT may influence the scores of medical courses to some extent.

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    Review
    Research progress of fibroblast growth factor 19 with glucose, lipid and protein metabolism
    NI Jie, BAO Yu-qian
    2012, 32 (10):  1378. 
    doi: 10.3969/j.issn.1674-8115.2012.10.022

    Abstract ( 1446 )   PDF (293KB) ( 1454 )  

    Fibroblast growth factor 19 (FGF19) is one of the members of the fibroblast growth factor family, and has been shown to regulate the bile acid balance. Recent studies have revealed that FGF19 plays an important role in glucose, lipid and protein metabolism, which could induce glycogen and protein synthesis, suppress gluconeogenesis and triglyceride and cholesterol synthesis in liver. These new findings of FGF19 may pave a new way for the treatment of metabolic diseases such as diabetes mellitus.

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    Comparison analysis of researches on mental health of university students in China and abroad
    LU Wei, ZHAO Min
    2012, 32 (10):  1382. 
    doi: 10.3969/j.issn.1674-8115.2012.10.023

    Abstract ( 2984 )   PDF (404KB) ( 1938 )  

    The research on mental health of university students has been developing rapidly in China in recent years, but it still significantly lags behind that of the developed countries. Through analysis of related domestic and overseas literatures, the status of mental health and research method of mental health of university students in China are summarized, and are compared with those of the other countries in this paper. It is suggested that the team building, methodology, horizon and range of research on mental health of university students should be strengthened in China.

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    Research progress of relationship between cardiac neural remodeling and arrhythmia
    YU Tao, LI Jing-bo
    2012, 32 (10):  1387. 
    doi: 10.3969/j.issn.1674-8115.2012.10.024

    Abstract ( 1050 )   PDF (331KB) ( 1249 )  

    The heart is innervated by both sympathetic nerve and vagus nerve. Heart injury can cause denervation, nerve sprouting and excessive regeneration, which are known as cardiac neural remodeling. Cardiac neural remodeling plays an important role in the development of arrhythmia. It has been recently found that many heart diseases are associated with cardiac neural remodeling, which may be one of the arrhythmia mechanisms. The relationship between cardiac neural remodeling and arrhythmia is reviewed in this paper, hoping to bring inspirations for the treatment of related diseases.

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    Predictors of ovarian function for perimenopausal women
    JIN Feng, TAO Min-fang
    2012, 32 (10):  1391. 
    doi: 10.3969/j.issn.1674-8115.2012.10.025

    Abstract ( 1269 )   PDF (464KB) ( 1329 )  

    Ovarian function, also known as ovarian reserves, plays an important role in keeping normal physiological function for women. At present, there have been many methods for detecting ovarian function, and the combined multiple predictors used for prediction of ovarian reserves demonstrate clinic significance. Nowadays the related researches on the methods used for detecting ovarian function are mainly associated with assisted reproductive technology, while fewer researches are conducted on the ovarian function of specific age group, especially on that of perimenopausal women. Exploring the ovarian reserves of perimenopausal women may have important clinical significance in relieving symptoms of climacteric melancholia and preventing related diseases such as osteoporosis.

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    Brief original article
    Fibrous root canal dowel internal fixation combined with composite resin adhesion in treatment of crown-root fracture of anterior teeth in children
    WANG Sun, CAO Hui-zhen
    2012, 32 (10):  1397. 
    doi: 10.3969/j.issn.1674-8115.2012.10.026

    Abstract ( 1187 )   PDF (865KB) ( 1136 )  

    Objective To investigate the clinical effect of fibrous root canal dowel internal fixation combined with composite resin adhesion in treatment of crown-root fracture of anterior teeth in children. Methods Eleven children (11 teeth) aged 11 to 14 with crown-root fracture caused by trauma of upper mandible medial incisor were selected. All were horizontal fracture or oblique fracture, and there was no longitudinal fracture and alveolar bone fracture. Patients received one-visit endodontics treatment after external fixation of the injured teeth, and were follow up for one week. The crown-root broken ends were restored with fibrous root canal dowel internal fixation combined with composite resin adhesion. Results Nine teeth were successfully restored, and were cosmetically and functionally resumed in short term. One patient failed due to lower palatal fracture line, with more wound hemorrhage and exudation. And the other patient failed due to consumption of hard food, which led to the loose broken ends. Conclusion Fibrous root canal dowel internal fixation combined with composite resin adhesion may be an ideal temporary restoration method in treatment of crown-root fracture of anterior teeth in children, which can resume cosmetics and function in short term and decrease loss in dental and periodontal tissues to the full extent.

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