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    Original article (Basic research)
    Construction and identification of Notch1 gene induced T-cell leukemia with double florescence tracer in transgenic zebrafish
    QING Kai, CHEN Fang-yuan, SHEN Li-jing, et al
    2013, 33 (3):  257. 
    doi: 10.3969/j.issn.1674-8115.2013.03.001

    Abstract ( 1220 )   PDF (829KB) ( 1186 )  

    Objective To establish stable germline ICN1 (intracellular domain Notch1)transgenic and double tracer T acute lymphoid leckemia, T-ALL zebrafish models by overexpressing human ICN1 gene in fli-EGFP zebrafish through T lymphocytes specific Rag2 promoter. Methods ICN1 plasmid carrying red fluorescent protein “reporter gene” (Rag2-ICN1-EGFP) was constructed and microinjected into zebrafish single-cell embryos, then the F0 (founder) generation was identified by fluorescence screening for establishing the zebrafish stable transgenic germline. The expression of ICN1 gene and protein was determined by fluorescence microscope, RT-PCR and Western blotting, and the phenotype of T-ALL zebrafish models was identified by flow cytometry and peripheral blood smear. Results Twenty of the 867 (2.3%) mosaic F0 zebrafish embryos injected with the constructed vector were identified to be the germline transgenic zebrafish, including 9 males and 11 females. The F0 adult fish of sexual maturity was copulated as one-to-one form, then F1 generation was produced. By using general view fluorescence microscope, RT-PCR and Western blotting, the expression of ICN1 was validated at the general view, mRNA and protein levels. Flow cytometry and peripheral blood smears suggested a significant reduction in the proportion of red blood cells and an increase of lymphocyte ratio in transgenic zebrafish as compared to control group. Conclusion Notch1 gene induced T-ALL zebrafish models with double tracer system have been successfully constructed, which may provide a research platform for the in-depth discussion on the ICN1 in the promotion of regulatory mechanism of T-ALL and high throughput drug screening in vivo.

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    Expression of recombinant baculovirus vector-mediated sodium iodine symporter gene in islet cells
    LIU Shuai, PAN Yu, ZHANG Yi-fan
    2013, 33 (3):  263. 
    doi: 10.3969/j.issn.1674-8115.2013.03.002

    Abstract ( 999 )   PDF (658KB) ( 1037 )  

    Objective To investigate the feasibility of monitoring islet cells with baculovirus as vector and sodium iodine symporter (NIS) gene as report gene. Methods Green fluorescent protein (GFP) and NIS gene baculovirus (Bac-GFP and Bac-NIS) were produced according to Bac-to-Bac baculovirus expression system. The rat islet cells were isolated and infected by Bac-GFP at different multiplicities of infection (MOI), and the infection percentage and fluorescence intensity were observed with fluorescence microscope. The islet cells were infected by Bac-GFP at MOI of 40, and the florescence protein expression time and cell survive state were observed with fluorescence microscope. The islet cells were infected by Bac-NIS at different MOI, and the iodide uptake of infected cells was determined. The islet cells were infected by Bac-NIS at MOI of 40, and the iodide uptake and effect of natrium perchloricum (NaClO4) on iodide uptake of infected cells were  dynamically observed. Results Bac-GFP could effectively infect SD rat islet cells, with no cytotoxicity. Both infection percentage and fluorescence intensity of islet cells increased with MOI, the infection percentage could be as high as 95% at MOI of 40, and fluorescence microscopy revealed that the florescence protein expression time could last for about two weeks. Bac-NIS infected islet cells exhibited enhanced iodide uptake function and inhibition property of NaClO4. The radioactive iodine uptake of infected cells increased with MOI. At MOI of 40, the radioactive count of iodide uptake of Bac-NIS infected cells was as 12 times as that of control group. Conclusion Recombinant NIS gene baculovirus can highly express in islet cells and effectively mediate iodine uptake of infected islet cells, which may provide a potent method to monitor the islet cell transplantation.

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    Relationship between Activin A and endometriosis
    SU Xiao-ling, ZHAO Ai-min, SHI Jun, et al
    2013, 33 (3):  269. 
    doi: 10.3969/j.issn.1674-8115.2013.03.003

    Abstract ( 865 )   PDF (904KB) ( 1131 )  

    Objective To investigate the effects of Activin A on the invasiveness, migration, adhesion and proliferation of endometrial cells, and explore the mechanism. Methods The endometrium in secretion phase was collected, primary endometrial cells were isolated and cultured, and endometrial stromal cells and endometrial epithelial cells were incubated with 0 ng/mL (control), 8 ng/mL, 16 ng/mL, 32 ng/mL and 64 ng/mL Activin A for 12 h. The effects of different concentrations of Activin A on the migration and invasiveness of endometrial stromal cells and endometrial epithelial cells were determined by in vitro scratch test and Transwell invasion test, the effects of 16 ng/mL Activin A on the proliferation and adhesion of endometrial stromal cells and endometrial epithelial cells were measured by CCK8 method, and the effects of 16 ng/mL Activin A on the expression of vascular endothelial growth factor A (VEGF-A) mRNA and VEGF-C mRNA in endometrial stromal cells and endometrial epithelial cells were detected by Real-Time PCR. Results In vitro scratch test revealed that the differences in areas of scratch of endometrial cells within 14 h in different concentrations Activin A groups were not significantly different from that in control group (P>0.05). Transwell invasion test indicated that the numbers of penetrating cells among endometrial stromal cells in 8 ng/mL, 16 ng/mL and 32 ng/mL Activin A treatment groups were significantly larger than that in control group (P<0.05), the numbers of penetrating cells among endometrial epithelial cells in 16 ng/mL and 32 ng/mL Activin A treatment groups were significantly larger than that in control group (P<0.05), and the number of penetrating cells was the largest in 16 ng/mL Activin A treatment group. The proliferation and adhesion of endometrial cells treated with 16 ng/mL Activin A were not significantly different from those of controls (P>0.05). The expression of VEGF-A mRNA and VEGF-C mRNA in endometrial stromal cells and endometrial epithelial cells treated with 16 ng/mL Activin A was not significantly different from that in controls (P>0.05). Conclusion Activin A can significantly increase the invasiveness of endometrial cells, while has no significant effect on the migration, proliferation and adhesion of endometrial cells. The increase of invasiveness of endometrial cells regulated by Activin A is not related to the regulation of expression of VEGF-A and VEGF-C in endometrial cells.

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    Resistance mechanism of Enterobacter aerogenes to carbapenems
    LIU Ying, YU Jing, FEI Qi-li, et al
    2013, 33 (3):  275. 
    doi: 10.3969/j.issn.1674-8115.2013.03.004

    Abstract ( 1677 )   PDF (535KB) ( 1178 )  

    Objective To investigate the resistance mechanism of Enterobacter aerogenes to carbapenems. Methods Sixteen isolates of carbapenem-resistant Enterobacter aerogenes were collected, and modified Hodge test was used to screen the strains producing carbapenemase. PCR amplification and gene sequencing were employed to detect and verify the resistance-associated gene. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was adopted to analyze the outer membrane porin of the strains. Results Modified Hodge test revealed that all the 16 strains of Enterobacter aerogenes produced carbapenemase. PCR amplification and gene sequencing indicated that all the 16 strains of Enterobacter aerogenes possessed KPC-2 gene, but did not carry IMP-1, IMP-2, VIM-1, VIM-2, NDM-1, OXA-1 and OXA-9 carbapenemase gene. SDS-PAGE demonstrated that Omp36 porin was absent in 5 of the 16 strains of Enterobacter aerogenes. Conclusion The major resistance mechanism of 16 strains of Enterobacter aerogenes to carbapenem may be associated with the expression of KPC-2 cabarpenemase accompanied with the absence of Omp36 porin in some strains.

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    Early observation of bacterial cellulose membrane for repair of dural defects in rabbits
    XU Chen, CHEN Shi-wen, TIAN Heng-li, et al
    2013, 33 (3):  280. 
    doi: 10.3969/j.issn.1674-8115.2013.03.005

    Abstract ( 822 )   PDF (930KB) ( 1255 )  

    Objective To patch up the dural defects of rabbits with bacteria cellulose membrane, and observe the early pathological change and inflammatory response after implantation. Methods Twenty-four New Zealand rabbits were randomly divided into group A and group B, with 12 rabbits in each group. The bilateral dura matter of rabbits were removed, and defects of 2 cm×1 cm were prepared. In group A, the right dural defects were repaired with bacteria cellulose membrane, no repair was made on the left dural defects, and samples were taken 30 d, 90 d and 180 d after operation for pathological examinations. In group B, the right dural defects were repaired with bacteria cellulose membrane, the left dural defects were repaired with artificial dura matter, and the tissues on the repaired sites were collected on day 7, 14 and 21 after operation for determination of expression of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) mRNA by RT-PCR. Results All rabbits survived without the presence of wound infection. On the patched side of group A, bacteria cellulose membrane evenly covered the surface of brain without adhesion and visible inflammatory cells, fibrous connective tissues proliferated on the outer side of bacteria cellulose membrane, fibroblasts uniformly distributed in the inner side, and new blood vessels appeared. On the unpatched side of group A, the brain was directly connected with subcutaneous tissues. In group B, RT-PCR revealed that the expression of IL-1β and IL-6 mRNA in bacteria cellulose membrane was significantly lower than that in artificial dura matter at each time point, while the expression of TNF-α mRNA of both sides was similar. Conclusion Bacterial cellulose membrane may avoid the adhesion to the brain tissues and has slighter early inflammatory response in repair of dural defects. Bacterial cellulose membrane may be used as the ideal substitute material for dura matter.

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    Study on constructing tissue engineered urethra by enriched rabbit hair follicle stem cells
    PENG Wen-biao, LIU Chun-xiao, XIE Qun, et al
    2013, 33 (3):  285. 
    doi: 10.3969/j.issn.1674-8115.2013.03.006

    Abstract ( 783 )   PDF (644KB) ( 1126 )  

    Objective To construct tissue engineered urethra with enriched rabbit hair follicle stem cells, and observe its effect in repair of urethral defect. Methods Rabbit hair follicle cells were isolated and cultured by mechanical separation and enzyme digestion, and were in vitro cultured and proliferated to 3×106. Integrin-α6+/cd71- cells of <10 μm in diameter were sorted by flow cytometry, and the expression of K19, p63 and β1 integrin was detected by immunofluorescence method. Hair follicle stem cells were seeded on bladder acellular matrix scaffold, tissue engineered urethra was constructed, and the cell distribution on scaffold was observed by scanning electron microscope. Rabbit urethral defect of 2.5 cm was repaired with tissue engineered urethra, and the effect of repair was observed by urethrography and histological examination. Results Immunofluorescence detection revealed that there was positive expression of K19, p63 and β1 integrin in hair follicle stem cells. Scanning electron microscope demonstrated that cells firmly attached to the scaffold and moderately stretched, and there was matrix secretion. Histological and immunohistochemical examinations indicated there was stratified epithelium-like structure, with positive staining of AE1/AE3 in hair follicle cells. Three months after repair of urethral defect by tissue engineered urethra, urethrography illustrated the urethra was smooth and unobstructed. Conclusion Tissue engineered urethra constructed by enriched rabbit hair follicle stem cells can be used for repair of rabbit urethral defect.

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    Original article (Clinical research)
    Differentiation and maturation of dendritic cells in patients with end-stage renal disease undergoing maintenance hemodialysis
    WU Jun-yi, ZHANG Wei
    2013, 33 (3):  290. 
    doi: 10.3969/j.issn.1674-8115.2013.03.007

    Abstract ( 729 )   PDF (519KB) ( 995 )  

    Objective To investigate the changes of capacity of differentiation and maturation of dendritic cells (DC) in peripheral blood in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis, and explore the possible mechanism of impaired immune responses of patients with ESRD. Methods The peripheral blood samples of patients with ESRD undergoing maintenance hemodialysis (ESRD group, n=20) were collected, and in vitro culture with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-4 (IL-4) and lipopolysaccharide (LPS) was conducted. The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC was detected by flow cytometry, and the level of interleukin-12 (IL-12) in the culture supernatant of DC was determined by enzyme-linked immunosorbent assay (ELISA). Besides, normal control group was established (n=20). Results The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC in ESRD group was significantly lower than that in normal control group (P<0.05, P<0.01). The level of IL-12 in the culture supernatant of DC in ESRD group was significantly higher than that in normal control group (P<0.01). Conclusion Peripheral blood monocyte-derived DC of patients with ESRD are immature, with the decrease in chemotactic function, migration ability and exogenous antigen-presenting capacity. The reduction of immune activation capacity of DC is likely to further participate in the immune dysfunction of T cells, and ultimately induces specific immune tolerance.

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    Preliminary study of relationship between aryl hydrocarbon receptor and unexplained spontaneous abortion
    FAN Hong-jie, LU Ji-hong, YANG Bin-lie, et al
    2013, 33 (3):  294. 
    doi: 10.3969/j.issn.1674-8115.2013.03.008

    Abstract ( 971 )   PDF (333KB) ( 938 )  

    Objective To investigate the expression of aryl hydrocarbon receptor (AhR) in decidua and villus, and explore its relationship with unexplained spontaneous abortion. Methods Real-time PCR and Western blotting were employed to detect the expression of AhR mRNA and protein in decidua and villus of 34 patients with unexplained spontaneous abortion (abortion group), and 38 women of normal early pregnancy were served as control group. Results The expression of AhR mRNA and protein in villus was significantly higher than that in decidua in two groups (P<0.01, P<0.05). The expression of AhR mRNA and protein in decidua in abortion group was significantly higher than that in control group (P<0.01, P<0.05). The expression of AhR mRNA and protein in villus in abortion group was significantly higher than that in control group (P<0.01, P<0.05). Conclusion The expression of AhR mRNA and protein in villus is significantly higher than that in decidua, and the upregulation of expression may be associated with the pathogenesis of unexplained spontaneous abortion.

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    Expression and clinical significance of ID1 in gastric cancer
    ZHU Bo, SONG Chao, WANG Ping
    2013, 33 (3):  298. 
    doi: 10.3969/j.issn.1674-8115.2013.03.009

    Abstract ( 991 )   PDF (502KB) ( 1001 )  

    Objective To investigate the relationship between expression of inhibitor of DNA binding/differentiation 1 (ID1) and clinicopathological parameters, and explore the role of ID1 in the development and prognosis prediction of gastric cancer. Methods The expression of ID1 protein in 91 samples of gastric cancer tissues, 30 samples of normal gastric tissues and 35 samples of atypical hyperplasia gastric tissues was examined by immunohistochemical EliVision method. The relationship between expression of ID1 protein and differentiation, invasion, TNM stage and lymph node metastasis of gastric cancer was analysed, the survival curves were drawn, and the correlation of clinicopathological parameters and expression of ID1 protein with prognosis of patients with gastric cancer was explored with Log-rank univariate analysis. Results Immunohistochemical staining revealed that the positive rate of expression of ID1 protein in gastric cancer tissues was 63.7% (58/91), which was significantly higher than those in normal gastric tissues (10.0%) and atypical hyperplasia gastric tissues (42.9%) (P<0.05). Statistical analysis indicated that the expression of ID1 protein was related to the differentiation, invasion, TNM stage and lymph node metastasis of gastric cancer (P<0.05). Log-rank univariate analysis demonstrated that the invasion and lymph node metastasis of gastric cancer were related to the prognosis of patients (P<0.05), while the prognosis of patients was not related to the age, sex, diameter of tumor, gross type, differentiation, Lauren classification and expression of ID1 protein (P>0.05). Conclusion The expression of ID1 in gastric cancer is abnormal, which may be associated with  the occurrence and development of gastric cancer. ID1 may be the new therapeutic targets for the treatment of gastric cancer, while it may not be the prognostic factors of patients with gastric cancer.

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    Impact of family management on psychological and behavioral problems in children with chronic diseases
    ZHANG Ying, WEI Min, ZHANG Ya-qing, et al
    2013, 33 (3):  303. 
    doi: 10.3969/j.issn.1674-8115.2013.03.010

    Abstract ( 965 )   PDF (472KB) ( 1162 )  

    Objective To investigate the impact of family management on the psychological and behavioral problems of children with chronic diseases, and provide evidences for individualized family intervention. Methods A total of 618 caregivers of children with chronic diseases from 7 hospitals in Shanghai and Beijing were included, and Family Management Measure (FaMM) and Achenbach Child Behavior Checklist (CBCL) were employed for survey. The influencing factors of family management and psychological and behavioral problems of children were identified by univariate analysis and Pearson correlation analysis, and the variables with significant differences were selected to enter the multiple hierarchical regression model. Results Child´s daily life, condition management ability, family income (≥3 000 per month), living with grandparents and unemployed mother were significant predictors of childs internalizing behaviors. Child´s daily life, view of condition impact, parental mutuality, duration of condition (<1 year), male child and father with less education were significantly associated with child´s externalizing behaviors. Conclusion Family management is an important determinant of psychological and behavioral problems in children with chronic diseases. Improvement of key aspects of family management may directly affect the mental health of children.

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    Diagnostic value of tomographic ultrasound imaging for ectopic pregnancy
    LI Meng-sen, ZHENG Li, WU Yan
    2013, 33 (3):  310. 
    doi: 10.3969/j.issn.1674-8115.2013.03.011

    Abstract ( 835 )   PDF (836KB) ( 1001 )  

    Objective To investigate the diagnostic value of tomographic ultrasound imaging (TUI) for ectopic pregnancy. Methods Two-dimensional (2D) ultrasound, color Doppler flow image (CDFI) and TUI were performed in 40 patients suspected of ectopic pregnancy, and diagnosis was made according to ultrasonic imaging. All patients were followed up, and the pathological findings were obtained from those undergoing operation. The diagnostic results of three ultrasonic techniques were compared with those of follow-up and pathological findings. Results There was no significant difference in the accuracy of diagnosis of ectopic pregnancy between 2D ultrasound (75%) and CDFI (80%)(P>0.05), and the accuracy of diagnosis of TUI (95%) was significantly different from those of 2D ultrasound and CDFI (P<0.05). Conclusion TUI can provide multiple plane and multiple section ultrasound imaging information and more evidences for diagnosis of ectopic pregnancy. TUI, combined with 2D ultrasound, CDFI and clinical manifestations, is an effective method for early diagnosis of ectopic pregnancy.

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    Superselective arterial thrombolysis combined with mechanical thrombectomy for treatment of acute cerebral infarction
    SONG Jun, SHI Wan-chao, SU Zhi-guo, et al
    2013, 33 (3):  314. 
    doi: 10.3969/j.issn.1674-8115.2013.03.012

    Abstract ( 881 )   PDF (578KB) ( 1070 )  

    Objective To investigate the efficacy and safety of superselective arterial thrombolysis combined with mechanical thrombectomy for the treatment of acute cerebral infarction. Methods Thirty patients with acute cerebral infarction were treated with superselective arterial thrombolysis combined with mechanical thrombectomy. The vascular recanalization was illustrated by digital subtraction angiography (DSA). The neurological deficits were assessed by NIHSS before thrombolysis and 7 d, 1 month and 3 months after thrombolysis. The state of consciousness was evaluated by GCS before thrombolysis, immediately after thrombolysis and 1 d and 3 d after thrombolysis. The state of life was examined by Barthel Index (BI) 1 month and 3 months after thrombolysis. The symptomatic intracranial hemorrhage after thrombolysis was investigated by brain CT scan. Results After treatment, 26 patients had vascular recanalization, and the rate of vascular recanalization was 86.7%. The scores of NIHSS 7 d, 1 month and 3 months after thrombolysis were significantly lower than that before thrombolysis (P<0.05). The GCS scores immediately after thrombolysis and 1 d and 3 d after thrombolysis were significantly higher than that before thrombolysis (P<0.05). The good rates of BI were 76.7% and 80.0% respectively 1 month and 3 months after thrombolysis. The imaging examination revealed that the prevalence of symptomatic intracranial hemorrhage rate was 6.7%. Conclusion Superselective arterial thrombolysis combined with mechanical thrombectomy in treatment of acute cerebral infarction can improve the rate of recanalization and prognosis of patients, which is a relatively safe and effective method.

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    Epidemiological study on risk factors of knee osteoarthritis in Shanggang Community in Pudong New District
    XIANG Zhen-yong, MAO Jian-chun, QU Huan-ru, et al
    2013, 33 (3):  318. 
    doi: 10.3969/j.issn.1674-8115.2013.03.013

    Abstract ( 1184 )   PDF (353KB) ( 1071 )  

    Objective To investigate the prevalence of knee osteoarthritis in the elderly in Pudong New District in Shanghai, and explore the related risk factors. Methods With cluster stratified multistage random sampling method, 1 499 registered residents aged no less than 40 years in Shanggang Community in Pudong New District in Shanghai were selected for questionnaire survey. The contents of survey included name, sex, educational level, vocation, height, body weight, waist circumference, joint symptoms, past disease history, environment, recipes and living habit, and the risk factors for knee osteoarthritis were investigated with univariate and multivariate analysis. Results The prevalence of knee osteoarthritis was 33.3% (41.6% for females, 24.0% for males), which was increased with age. Stepwise Logistic regression analysis of factors possibly related to knee osteoarthritis revealed that old age, female, overweight/obesity, a lot of housework, family history of osteoarthritis, knee trauma, cold environment, prolonged standing and walking were the risk factors for knee osteoarthritis, while education, physical exercise, labor intensity, recipes, moist environment, drinking, smoking, wearing high heels, floors and stair climbing, squat toilet and prolonged squatting were not significantly associated with the prevalence of knee osteoarthritis. Conclusion There is a high prevalence of knee osteoarthritis in the elderly in Pudong New District in Shanghai, females have a higher prevalence of knee osteoarthritis than males, and the prevalence of knee osteoarthritis increases with age. Old age, female, overweight/obesity, a lot of housework, family history of osteoarthritis, knee trauma, cold environment, prolonged standing and walking are the risk factors for knee osteoarthritis.

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    Significance of serum anti-cyclic citrullinated peptide antibodies in diagnosis of juvenile idiopathic arthritis
    GUO Gui-mei, HE Wei-xun, ZHU Guang-hua, et al
    2013, 33 (3):  323. 
    doi: 10.3969/j.issn.1674-8115.2013.03.014

    Abstract ( 951 )   PDF (284KB) ( 1118 )  

    Objective To investigate the clinical significance of serum anti-cyclic citrullinated peptide (anti-CCP) antibodies in diagnosis of juvenile idiopathic arthritis (JIA). Methods Serum anti-CCP antibodies of 68 children suspected of JIA with fever and arthritis of unknown causes were determined by ELISA, and comprehensive analysis was carried out with clinical data and related laboratory findings. Results Among the 68 children suspected of JIA, there were 10 cases of polyarticular JIA, 13 cases of systemic onset JIA, 8 cases of oligoarticular JIA and 13 cases of enthesitis related JIA. There were 11 cases of other rheumatoid diseases, 8 cases of neoplastic diseases of blood and 5 cases of infectious diseases. The serum anti-CCP level in children suspected of polyarticular JIA was significantly higher than those in children suspected of systemic onset JIA, oligoarticular JIA and enthesitis related JIA (P<0.05). With serum anti-CCP≥15.8 RU/mL as the positive threshold value, the area under receiver operating characteristic curve was 0.80, and the sensitivity and specificity in diagnosis of polyarticular JIA were 80% and 67.6% respectively. The serum anti-CCP level was positively related to serum C-reaction protein level in children suspected of polyarticular JIA (r=0.764, P=0.017). Conclusion Serum anti-CCP can be used for the diagnosis of polyarticular JIA, and 15.8 RU/mL may be a suitable cut-off level.

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    Comparison of three techniques of anterior mitral valve repair in treatment of mitral insufficiency
    ZHANG Wei, FANG Liang, YE Wei
    2013, 33 (3):  327. 
    doi: 10.3969/j.issn.1674-8115.2013.03.015

    Abstract ( 974 )   PDF (290KB) ( 1016 )  

    Objective To compare the effects of chordal transfer, edge-to-edge suture and artificial chordae techniques in treatment of mitral insufficiency induced by anterior mitral valve diseases. Methods According to different surgical methods, 171 patients with anterior mitral valve diseases were divided into chordal transfer group (group Ⅰ), edge-to-edge suture group (group Ⅱ) and artificial chordate group (group Ⅲ), with 57 patients in each group. The mitral valve close was examined by transesophageal echocardiography (TEE), the effective mitral valve areas and parameters related to left ventricular function were measured by transthoracic echo, and the short and middle term data of mitral valve close were followed up. Results The percentages of patients with satisfied mitral valve revealed by postoperative TEE in group Ⅰ, group Ⅱ and group Ⅲ were 82.46% (47/57), 85.96% (49/57) and 84.21% (48/57), respectively. The postoperative effective mitral valve areas of all three groups were significantly smaller than those before operation (P<0.05). The postoperative left ventricular end diastolic diameters in all three groups were significantly shorter than those before operation (P<0.05). After follow up for 1 to 11 years (3.28 years in average), the percentages of satisfied mitral valve close in group Ⅰ, group Ⅱ and group Ⅲ were 82.46% (47/57), 85.96% (49/57) and 82.46% (47/57), respectively. Conclusion Chordal transfer, edge-to-edge suture and artificial chordae techniques are effective in treatment of anterior mitral valve diseases, and the choice of surgical procedure should be based on the age and disease condition.

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    Effect of sevoflurane on neuromuscular blockade of cisatracurium in elderly
    HU Xiao, WEN Da-xiang, HANG Yan-nan
    2013, 33 (3):  331. 
    doi: 10.3969/j.issn.1674-8115.2013.03.016

    Abstract ( 1244 )   PDF (349KB) ( 1126 )  

    Objective To investigate the effect of sevoflurane on neuromuscular blockade of cisatracurium in general anesthesia in the elderly. Methods Forty patients with ASA Ⅰ-Ⅱ undergoing elective surgery were randomly divided into elderly group (aged no less than 65) and adult group (aged between 18 and 65), and each group was randomly divided into sevoflurane group and propofol group, with 10 patients in each group. Anaesthesia was induced with midazolam, propofol, fentanyl and lidocaine aerosol. After induction, sevoflurane groups were maintained with 1.73% sevoflurane, and propofol groups were with 4-6 mg/kg propofol per hour. Thirty minutes later, 50 μg/kg cisatracurium was administered (20 μg/kg for the first injection, 10 μg/kg for the next three injections). Four myopalmus (amplitudes T1, T2, T3 and T4) was induced by train-of-four (TOF) stimulation, and neuromuscular monitoring was conducted. The time of onset after drug administration and maximum block effect were recorded, cumulative dose-effect curves for cisatracurium were determined, and 50% and 95% effective doses (ED50 and ED95) were obtained. After the last drug administration, the duration of recovery to 25% T1, 75% T1 and 90% T1 (T125%, T175% and T190%), duration of recovery to 70% TOF (TOF70%) and recovery index (RI) were recorded. Results ED50 of cisatracurium in elderly sevoflurane group, elderly propofol group, adult sevoflurane group and adult propofol group were 28.51 μg/kg, 33.47 μg/kg, 26.16 μg/kg and 31.77 μg/kg respectively, and ED95 of cisatracurium in these groups were 50.93 μg/kg, 59.86 μg/kg, 48.69 μg/kg and 55.43 μg/kg respectively. ED50 and ED95 of cisatracurium in sevoflurane groups were significantly lower than those in corresponding propofol groups (P<0.05). However, ED50 and ED95 in elderly groups were not significantly different from those in adult groups under the same condition of anesthesia (P>0.05). There was no significant difference in the time of onset of cisatracurium among groups (P>0.05). RI in sevoflurane groups were longer than those in corresponding propofol groups, and RI in elderly groups were longer than those in adult groups under the same condition of anesthesia (P<0.05). T125%, T175%, T190% and TOF 70% in elderly sevoflurane group were significantly longer than those in the other groups (P<0.05), and T125%, T175%, T190% and TOF 70% in adult sevoflurane group were significantly longer than those in adult propofol group (P<0.05). Conclusion Compared with total intravenous anesthesia, ED50 and ED95 of cisatracurium is significantly reduced and duration of recovery from the block is significantly prolonged after anesthesia with sevoflurane inhalation. Under the same condition of anesthesia, elderly patients may experience much longer duration of recovery from the block than adult patients.

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    Original article (Preventive medicine)
    Evaluation of reproductive health intervention based on IMB model among female migrants in Shanghai
    WANG Jin, YAN Sheng, WANG Ying, et al
    2013, 33 (3):  335. 
    doi: 10.3969/j.issn.1674-8115.2013.03.017

    Abstract ( 1106 )   PDF (345KB) ( 843 )  

    Objective To evaluate the effect of reproductive health intervention based on the Information-Motivation-Behavioral Skills model (IMB) among female migrants in Shanghai. Methods A total of 200 female migrants from Pudong New Area were randomly recruited and divided into intervention group and control group, with 100 female migrants in each group, and questionnaire survey was conducted in two groups before intervention and 2 weeks after intervention. Reproductive health intervention based on IMB model was carried out in intervention group, which included reproductive health and acquired immune deficiency syndrome (AIDS) related information, motivation and behavior skills. Results Ninety-six female migrants in intervention group and 92 female migrants in control group completed the questionnaire survey. After intervention, the score of reproductive health information increased from 9.12±1.91 to 12.22±1.51 in intervention group (P<0.05), the scores of knowledge of AIDS non-transmission, sexual transmitted infection and disease prevention by using condom significantly improved, more female migrants held the attitude against premarital sex and extramarital affair, and more agreed with condom use and discussion about condom use with sexual partner (P<0.05). The condom use rate increased from 35.0% to 53.1% in the recent sexual intercourse, and the consistent condom use rate in two weeks also improved from 8.0% to 27.1% in intervention group (P<0.05). Conclusion The reproductive health intervention based on IMB model is effective, which may improve the reproductive health information, reduce high risk behavior motivation and improve the preventive behavior techniques among female migrants in Shanghai.

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    Temporal-spatial distribution study on tuberculosis epidemiology in Chongqing between 1998 and 2009
    ZHOU Ze-wen, HU Dai-yu, LI Qin, et al
    2013, 33 (3):  340. 
    doi: 10.3969/j.issn.1674-8115.2013.03.018

    Abstract ( 914 )   PDF (360KB) ( 1048 )  

    Objective To describe and analyze the tendency and spatial clustering of tuberculosis in Chongqing between 1998 and 2009, and provide scientific basis for regional public health decisionmaking. Methods The data on prevalences of tuberculosis and population in 40 districts and counties of Chongqing between 1998 and 2009 were collected, and linear regression and clustering analysis were used to describe the spatial and temporal patterns of tuberculosis. Results ① Time trend: The prevalences of tuberculosis in Chongqing exhibited a range of fluctuation, rising from 1998 to 2005, then steadying from 2005. ② Spatial clustering: All the districts and counties were divided into four categories according to the prevalences, and the areas with highest prevalences were Pengshui, Fengdu, Zhongxian, Fuling, Wushan, Wulong, Yuzhong and Wanzhou. One-way ANOVA demonstrated a good clustering effect (F=33.68, P<0.000 1). Conclusion Tuberculosis is still very grim in Chongqing, and the geographic location and economic levels have great impact on the prevalences. The government should increase the financial investment and improve the health resource allocation proportion at high-risk areas.

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    Analysis of attitudes and influencing factors of obtaining information about HIV/AIDS via internet among female sex workers and men who have sex with men
    FU Guang-jian, TIAN Kao-cong, ZHONG Xiao-ni, et al
    2013, 33 (3):  345. 
    doi: 10.3969/j.issn.1674-8115.2013.03.019

    Abstract ( 934 )   PDF (521KB) ( 912 )  

    Objective To investigate the attitudes and influencing factors of obtaining information about human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) via internet among female sex workers(FSWs) and men who have sex with men (MSM). Methods FSWs and MSM selected from Xinjiang, Sichuan, Guangxi and Chongqing were surveyed with questionnaires, which included demographics, behavior characteristics, ways to obtain information about HIV/AIDS and the desirable ways to obtain it. Results Internet was the first choice for more than 80% of MSM to obtain information about HIV/AIDS. For FSWs, 27.54% obtained information about HIV/AIDS via internet, and 31.66% were willing to obtain information via internet. Logistic regression analysis revealed that ethnics, marital status, age, education background, workplace and frequency of sex service per week were influencing factors of acceptability to obtain information about HIV/AIDS via internet among FSWs, and ethnics, age, education background and seeking sex partner through internet were influencing factors of acceptability among MSM. Conclusion Obtaining information about HIV/AIDS via internet is acceptable for MSM, and it is feasible and useful to conduct health education via internet for MSM. While viable methods should be adopted to conduct health education for FSWs in order to achieve better effects.

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    Review
    Research progress of relationship between mutations of insulin gene and diabetes mellitus
    LI Can, LIU Li-mei
    2013, 33 (3):  354. 
    doi: 10.3969/j.issn.1674-8115.2013.03.020

    Abstract ( 988 )   PDF (422KB) ( 1094 )  

    Insulin is the unique hypoglycemic hormone which is secreted by islet β-cells. Insulin gene mutations could result in insulinopathies, permanent neonatal diabetes mellitus (PNDM), maturity onset diabetes of the young (MODY) and auto-antibodies-negative type 1 diabetes mellitus. The research progress of relationship between mutations of insulin gene and diabetes mellitus is reviewed in this article.

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    Research progress of relationship between obesity and adipocytokine secretion disorder induced by short sleep duration
    CHEN Ting, ZHANG Ze-yu, CHEN Zhe, et al
    2013, 33 (3):  359. 
    doi: 10.3969/j.issn.1674-8115.2013.03.021

    Abstract ( 925 )   PDF (310KB) ( 1006 )  

    Both short sleep duration and obesity are global concerns threatening human health. Recent research data have indicated that sleep duration is an important influential factor for obesity. Short sleep duration disturbs the secretory volume and rhythm of adipocytokines such as leptin, adiponectin and visfatin, and interrupts the dynamic balance between them, after which obesity and insulin resistance may be triggered. This paper is to systematically review the existing domestic and international literatures on the related mechanisms between short sleep duration and obesity, and discuss the effect of several important adipocytokines on sleep and obesity.

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    Clinical application of remote ischemic conditioning
    FENG Xiao-xiao, ZHOU Li-jia, WU Jian-yong
    2013, 33 (3):  363. 
    doi: 10.3969/j.issn.1674-8115.2013.03.022

    Abstract ( 901 )   PDF (348KB) ( 1010 )  

    Ischemic reperfusion injury (IRI) is a common clinical pathophysiology, and the severity of IRI correlates with the therapeutic effects of the diseases. Remote ischemic conditioning (RIC) is induced by several periods of ischemia on tissues (upper or lower limb) to produce systemic protection against IRI in distant organs. More studies confirm that RIC can reduce IRI in cardiac surgery, vascular surgery and elective percutaneous coronary intervention. RIC is non-invasive, safe, convenient and economical, which provides a new idea and method to treat IRI and has a promising prospect in clinical application.

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    Prospects of bacteriophage endolysins as antibacterial agents
    WANG Zheng, SHEN Wen-bin, ZHANG Hao-tian, et al
    2013, 33 (3):  368. 
    doi: 10.3969/j.issn.1674-8115.2013.03.023

    Abstract ( 1290 )   PDF (773KB) ( 1498 )  

    At present, there is an urgent need for better novel antibacterial agents due to the dramatic rise in antibiotic resistance among bacteria. Bacteriophage endolysins, encoded by dsDNA phages, synthesized by host bacteria, will result in bacteria death by inducing the lysis of bacteria cell wall specifically and effectively. Studies in vitro and in vivo have demonstrated that endolysins are possessed of strong bactericidal effect without any direct adverse effects, and have broad prospects of application in prophylaxis and treatment of bacterial infections. The prospects of bacteriophage endolysins as antibacterial agents are introduced in this article.

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    Brief original article
    Analysis of 23 cases of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation
    ZHANG Chao-kai, WU Li, DING Jing, et al
    2013, 33 (3):  374. 
    doi: 10.3969/j.issn.1674-8115.2013.03.024

    Abstract ( 848 )   PDF (334KB) ( 990 )  

    Objective To investigate the outcomes of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation. Methods Twenty-three patients with avulsion fractures of posterior cruciate ligament of knee joint were treated with tension band wire fixation, and the outcomes were evaluated by Lysholm knee joint scoring. Results All the patients were followed up for 6 months to 2 years. Favorable function recovery was achieved in 22 (95.7%) patients. The other senior patient suffered from osteoarthritis and narrow joint space before operation, and there still existed chronic pain and flexion-extension dysfunction after operation. Conclusion Treatment of avulsion fractures of posterior cruciate ligament of knee joint by tension band wire fixation is simple, economical and effective.

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    Pathogen detection and analysis of one case of food poisoning caused by Vibrio parahemolyticus
    XU Qiu-fang, TONG Rui, FEI Qiong, et al
    2013, 33 (3):  377. 
    doi: 10.3969/j.issn.1674-8115.2013.03.025

    Abstract ( 796 )   PDF (494KB) ( 993 )  

    Objective To investigate a food poisoning event in a wedding dinner, and use pulsed field gel electrophoresis (PFGE) technology with isolated strains for homology analysis. Methods The epidemiological characteristics of the case of food poisoning were investigated. The anal swabs of patients and cooks, the residual food samples and link samples were collected, and were identified and serotyped by the traditional bacterial detection. The isolated strains were analysed by PFGE molecular technology, and cluster analysis of PFGE classification photographs was performed by BioNumerics software. Results There were 28 confirmed cases reported, and 12 strains of Vibrio parahemolyticus were detected from 10 anal swabs and 2 residual food samples. The serotype of these strains was O4:K8, and 3 band types were identified by PFGE molecular technology and cluster analysis. These 3 band types were extremely similar, only with differences in 2 to 4 electrophoretic bands. Conclusion This case of food poisoning is caused by Vibrio parahemolyticus.

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    Value of color Doppler ultrasound in diagnosis and treatment of cesarean section scar pregnancy
    TU Ju-hong
    2013, 33 (3):  380. 
    doi: 10.3969/j.issn.1674-8115.2013.03.026

    Abstract ( 874 )   PDF (493KB) ( 890 )  

    Objective To investigate the value of color Doppler ultrasound in the diagnosis and treatment of cesarean section scar pregnancy. Methods The imaging feature and clinical history of 40 patients with cesarean section scar pregnancy were retrospectively analyzed, and the ultrasound characteristics of cesarean section scar pregnancy were investigated. Results Gestational sac type and mixed mass type were divided based on the sonograms. Non-hemorrhage type, little hemorrhage type, massive hemorrhage type and post-abortion type were classified according to the symptoms. Different types had different ultrasonographic features, and were treated by different clinical treatment schemes. Conclusion Color Doppler ultrasound can accurately diagnose cesarean section scar pregnancy and may have significant value in guiding the treatment.

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    Case report
    One case report of painless aortic dissection with consciousness disorders as initial symptom
    YIN Gui-zhi, SHI Lu-dong, LU Yi, et al
    2013, 33 (3):  383. 
    doi: 10.3969/j.issn.1674-8115.2013.03.027

    Abstract ( 812 )   PDF (171KB) ( 772 )  

    One old male patient was admitted to the hospital due to “consciousness disorders for 20 h”, with no presentation of chest distress, chest pain and abdominal pain. Emergency MRI demonstrated subacute focal infarction of left temporal-parietal gyri, physical examinations revealed the asymmetric blood pressure of  bilateral upper extremities, and aortic dissection was indicated by chest enhanced CT. Therefore, careful analysis of clinical manifestations and early diagnosis are important for treatment of aortic dissection among those with cerebral infarction as main presentation.

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