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    Original article (Basic research)
    Effect of (S)-3,5-dihydroxyphenylglycine on puromycin aminonucleoside-induced apoptosis of podocytes in vitro
    LI Xiao-ying, GU Le-yi, NI Zhao-hui, et al
    2013, 33 (4):  385. 
    doi: 10.3969/j.issn.1674-8115.2013.04.001

    Abstract ( 924 )   PDF (879KB) ( 1165 )  

    Objective To investigate the effect of (S)-3,5-dihydroxyphenylglycine (DHPG), a selective metabotropic glutamate receptors (mGluR) 1 and 5 agonist, on aminonucleoside puromycin (PAN)induced podocyte apoptosis in vitro, and explore the possible mechanism. Methods Conditional immortalized mouse podocytes 5P12 were cultured in vitro, and were grouped based on different interventions. CCK-8, Western blotting, EIA, JC-1 staining and flow cytometry, immunofluorescence staining, TUNEL staining and confocal laser scanning microscopy were employed to examine the cell viability, expression of mGluR1/5 and activated cleaved caspase-3, cyclic adenosine monophosphate (cAMP) level, mitochondrial membrane potential, cAMP responsive element binding protein (CREB) and apoptosis of podocytes. Results Podocytes treated with DHPG generated cAMP and activated expression of CREB. DHPG inhibited PANinduced podocyte loss, cleaved caspase-3 upregulation, decrease of mitochondrial membrane potential and advanced apoptosis, which could be suppressed by selective antagonist of mGluR1/5 (AIDA), adenylate cyclase inhibitor (SQ22536) and RNA interference-mediated knockdown of mGluR1 or mGluR5. Conclusion DHPG can protect against PAN-induced apoptosis of podocytes, which may be associated with mGluR/cAMP signalling pathway.

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    Effect of hypothermia on expression CIB1 in hippocampus after traumatic brain injury in rats
    YIN Yu-hua, LI Ming, JIA Feng, et al
    2013, 33 (4):  392. 
    doi: 10.3969/j.issn.1674-8115.2013.04.002

    Abstract ( 686 )   PDF (334KB) ( 1073 )  

    Objective To investigate the effect of hypothermia on the expression of calcium and integrin-binding protein 1 (CIB1) in CA1 region of hippocampus after traumatic brain injury (TBI) in rats. Methods Fifty-four SD rats were randomly assigned to hypothermia group (n=24), normothermia group (n=24) and sham injury group (n=6). TBI models were established in hypothermia group and normothermia group, and hypothermia intervention (32 ℃,4 h) was conducted in hypothermia group. Rats in hypothermia group and normothermia group were sacrificed 4 h, 6 h, 12 h and 24 h after TBI, and those in sham injury group were sacrificed 24 h after injury, with 6 rats at each time point. Tissues in CA1 region of the injury side were obtained, and RT-PCR and Western blotting were adopted to detect the expression of CIB1 mRNA and protein. Results The expression of CIB1 mRNA and protein in CA1 region of hippocampus of the injury side in hypothermia group and normothermia group was significantly higher than that in sham injury group at each time point after injury (P<0.05), and the expression reached the peak at the time points of 4 h and 6 h after TBI. The expression of CIB1 mRNA and protein in hypothermia group was significantly lower than that in normothermia group (P<0.05). Conclusion Hypothermia treatment can suppress the upregulation of expression of CIB1 mRNA and protein in hippocampus after TBI in rats.

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    Effect of dl-3-n-butylphthalide on autophagic cell death in Aβ-treated U87 cells
    WANG Hong-mei, ZHANG Ting, Li Qiang, et al
    2013, 33 (4):  396. 
    doi: 10.3969/j.issn.1674-8115.2013.04.003

    Abstract ( 1128 )   PDF (315KB) ( 1088 )  

    Objective To observe the effect of dl-3-n-butylphthalide on the autophagic cell death in β-amyloid (Aβ1-42)-treated U87 cells. Methods U87 cells were divided into Aβ group, Aβ+dl-3-n-butylphthalide group and control group (blank control). Cells in Aβ group were treated with Aβ1-42 (20 μmol/L) for 24 h, and cells in Aβ+ dl-3-n-butylphthalide group were pre-incubated with dl-3-n-butylphthalide (10 μmol/L) for 0.5 h prior to treatment with 20 μmol/L Aβ1-42 for 24 h. Cell viability was detected by MTT, Caspase-3 activity of was examined, intracellular reactive oxygen species (ROS) was determined by CM-H2 DCFDA, and the expression of LC3-Ⅰ and LC3-Ⅱ protein was detected by Western blotting. Results The viability of U87 cells in Aβ group was significantly lower than that in control group (P<0.01), and the viability of U87 cells in Aβ+ dl-3-n-butylphthalide group was significantly higher than that in Aβ group (P<0.05). There was no significant difference in the Caspase 3 activity among Aβ group, Aβ+ dl-3-n-butylphthalide group and control group (P>0.05). The ROS level in U87 cells in Aβ group was significantly higher than that in control group (P<0.01), and the ROS level in U87 cells in Aβ+ dl-3-n-butylphthalide group was significantly lower than that in Aβ group (P<0.01). The LC3-Ⅱ/LC3-Ⅰ ratio in U87 cells in Aβ group was significantly higher than that in control group (P<0.01), and the LC3-Ⅱ/LC3-Ⅰ ratio in U87 cells in Aβ+ dl-3-n-butylphthalide group was significantly lower than that in Aβ group (P<0.01). Conclusion dl-3-n-butylphthalide exhibits neuroprotective effect through inhibition of ROS-mediated autophagic cell death in Aβ-treated U87 cells.

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    Responsive ability of obese non-diabetic rats to acute inflammatory stimulus
    ZHANG Yao, HAN Ting-ting, SU Budegerile, et al
    2013, 33 (4):  400. 
    doi: 10.3969/j.issn.1674-8115.2013.04.004

    Abstract ( 1004 )   PDF (292KB) ( 1056 )  

    Objective To investigate the responsive ability to acute inflammatory stimulus of type 2 diabetic rats and obese non-diabetic rats induced by high-fat diet. Methods Type 2 diabetic GK rats (GK group) and Wistar rats (Wistar group) were fed with high-fat diet for 14 weeks, and the body weight of rats in two groups were observed. Then rats were allocated to GK high-fat feeding baseline group (GK+HFF group), Wistar+HFF group, GK highfat feeding+lipopolysaccharide (LPS) injection group (GK+HFF+LPS group) and Wistar+HFF+LPS group by random number table, with 6 rats in each group. Severe sepsis model was established by intraperitoneal injection of 5 mg/kg LPS in GK+HFF+LPS group and Wistar+HFF+LPS group. The blood glucose fluctuation was observed, and the expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6 and IL-10 mRNA in liver, lung, kidney and myocardial tissues was determined by Real-Time PCR. Results After feeding with highfat diet for 14 weeks, the body weight of rats in Wistar group was significantly higher than that in GK group (P<0.05), and the blood glucose concentration of rats in GK group was significantly higher than that in Wistar group (P<0.05). After LPS injection, the blood glucose concentration of rats in GK+HFF+LPS group significantly increased, while the blood glucose concentration of rats in Wistar+HFF+LPS group did not change significantly. Real-Time PCR revealed that the expression of TNF-α, IL-1β, IL-6 and IL-10 mRNA in Wistar+HFF+LPS group was significantly higher than that in Wistar+HFF group (P<0.05), and the expression of TNF-α, IL-1β, IL-6 and IL-10 mRNA in GK+HFF+LPS group was significantly higher than that in GK+HFF group (P<0.05). The increase of expression of TNF-α, IL-1β, IL-6 and IL-10 mRNA in Wistar+HFF+LPS group was not significantly different from that in GK+HFF+LPS group (P>0.05). Conclusion After feeding with high-fat diet, the tolerance to acute inflammation may increase in obese non-diabetic rats, which is more significant than that in type 2 diabetic rats.

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    Study on activity of GAL4/VP16 fusion artificial transcription factor
    ZHANG Ping, YING Lei, QIAN Guan-xiang, et al
    2013, 33 (4):  404. 
    doi: 10.3969/j.issn.1674-8115.2013.04.005

    Abstract ( 1663 )   PDF (427KB) ( 1174 )  

    Objective To construct GAL4/VP16-up-stream activating sequence (UAS) system, which is composed of expression vector containing GAL4/VP16 fusion transcriptional factor and expression vector containing UAS promoter driving reporter gene enhanced green fluorescent protein (EGFP), and evaluate the activity of GAL4/VP16 fusion transcriptional factor. Methods The expression vector pcDNA3-GAL4/VP16 containing GAL4/VP16 fusion transcriptional factor was constructed, and the expression vector pGL3-G5E1b-TATA-EGFP was also constructed, in which the reporter gene EGFP was driven by G5E1b-TATA promoter consisted of five tandem-repeat copies of UAS and E1b core promoter. Hep3B and HEK 293 cells were transiently transfected by these two vectors. After 48 h, the expression of EGFP was determined by RT-PCR and flow cytometry, and the effect of GAL4/VP16 fusion transcriptional factor on the G5E1b-TATA promoter activity was observed. Results The activity of G5E1b-TATA promoter was significantly up-regulated by GAL4/VP16 fusion transcriptional factor, and might even reach the level of cytomegalovirus (CMV) promoter. Conclusion In transcriptional level, the GAL4/VP16 fusion transcriptional factor can significantly up-regulate the activity of G5E1b-TATA promoter, and the G5E1b-TATA promoter can drive the efficient expression of downstream target genes in the presence of GAL4/VP16 protein. It is expected to make a valuable contribution in the study of gene function and gene therapy.

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    Effect of nitrated pollen on airway inflammation in asthmatic mice
    YANG Ling, HAN Li, WANG Gen-fa, et al
    2013, 33 (4):  409. 
    doi: 10.3969/j.issn.1674-8115.2013.04.006

    Abstract ( 955 )   PDF (637KB) ( 1219 )  

    Objective To observe the allergic airway inflammation and lung pathology in mice with asthma induced by nitrated pollen. Methods Sixty mice were randomly divided into 5 groups according to different sensitization and challenge. Group A to group D were asthma model groups, and group E was normal control group. The right lung tissues of mice were obtained, the pathological changes of lung tissues were observed with HE staining, and the tracheal wall thickness (total wall area/basement membrane perimeter, WAt/Pbm) and airway smooth muscle thickness (smooth muscle area/basement membrane perimeter, WAm/Pbm) were calculated. The cytological changes in bronchoalveolar lavage fluid (BALF) were observed, the level of nuclear factor kappa B (NF-κB) p65 activation and expression of 3-nitrotyrosine (3-NT) in lung tissues were determined by immunohistochemical method, and the apoptosis of eosinophils (EOS) in lung tissues was detected by TUNEL. Results The numbers of white cells, EOS and neutrophil (NEU) and percents of them in total cells in BALF, WAt/Pbm and WAm/Pbm, the level of NF-κB p65 activation and expression of 3-NT in each asthma model group were significantly higher than those in group E (P<0.01), while the apoptosis rate of eosinophils in lung tissues in each group was significantly lower than that in group E (P<0.01). Compared with the other model groups, the values of those indicators in group D in which mice were immunized and challenged with nitrated pollen changed more significantly (P<0.05 or P<0.01). Pearson correlation analysis revealed that the expression of 3-NT was significantly negatively correlated with apoptosis rate of EOS (r=-0.632, P<0.05), and was significantly positively correlated with the level of NF-κB p65 activation (r=0.667, P<0.05). Conclusion High level of oxidative stress which exists in asthmatic mice immunized and challenged with nitrated pollen may elevate the expression of 3-NT, activate NF-κB signaling pathway, delay apoptosis of EOS, and result in more severe airway inflammation and pathological changes.

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    Influence of inhibition of EGFR gene expression by RNA interference on epithelial-mesenchymal transition in endometrial carcinoma cells
    XU Wei, WANG Juan, XU Yan-li, et al
    2013, 33 (4):  415. 
    doi: 10.3969/j.issn.1674-8115.2013.04.007

    Abstract ( 1087 )   PDF (710KB) ( 1235 )  

    Objective To construct targeting epidermal growth factor receptor (EGFR) short hairpin RNA (shRNA) plasmid vector and transfect it into human endometrial carcinoma Ishikawa cells, evaluate the influence of RNA interference (RNAi) to the EGFR gene expression and epithelial-mesenchymal transition (EMT) in endometrial carcinoma cell. Methods shRNA plasmid targeting EGFR (pRNATEGFR shRNA) was constructed in vitro, and was transfected into Ishikawa cells with lipofectamine technique. Negative control group (without transfection), pRNAT-EGFRneg group (blank plasmid vector), pRNAT-EGFR1 group, pRNAT-EGFR2 group and pRNAT-EGFR3 group were established. RT-PCR and Western blotting were employed to detect the expression of EGFR mRNA and protein, and the expression of EMT related markers such as E-cadherin, α-catenin, N-cadherin and Vimentin in Ishikawa cells was determined before and after transfection. Results The expression of EGFR mRNA and protein in Ishikawa cells in pRNAT-EGFR2 group and pRNAT-EGFR3 group was significantly lower than that in negative control group (P<0.05), while there was no significant difference in the expression of EGFR mRNA and protein in Ishikawa cells between pRNAT-EGFR1 group and negative control group (P>0.05). After RNA interference inhibited the expression of EGFR gene in Ishikawa cells, the expression of E-cadherin and α-catenin mRNA and protein in pRNAT-EGFR2 group and pRNAT-EGFR3 group was significantly higher than that in negative control group (P<0.05), while the expression of N-cadherin and Vimentin in pRNAT-EGFR2 group and pRNAT-EGFR3 group was significantly lower than that in negative control group (P<0.01). Conclusion The inhibition of EGFR gene expression could partially reversed the expression of EMT related genes in endometrial carcinoma cells.

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    Effects of blocking Notch3 pathway by siRNA under hypoxic condition on proliferation of human lung adenocarcinoma A549 cells
    HAN Rui-chao, FAN Zhi-wen, ZHOU Min
    2013, 33 (4):  421. 
    doi: 10.3969/j.issn.1674-8115.2013.04.008

    Abstract ( 958 )   PDF (335KB) ( 1007 )  

    Objective To observe the effects of blocking Notch3 by siRNA under hypoxic condition on the proliferation of human lung adenocarcinoma A549 cells. Methods Human lung adenocarcinoma A549 cells were cultured under hypoxic condition (1% O2). After transfection with Notch3 siRNA (Notch3 siRNA group), RT-PCR and Western blotting were used to detect the expression of Notch3 and its downstream gene HES1 mRNA and protein in A549 cells respectively, and the cell viability 24 h, 48 h and 72 h after transfection was determined by MTT assay. Besides, negative control group and blank control group were established. Results After transfection with Notch3 siRNA, the expression of Notch3 and HES1 mRNA and protein in A549 cells was significantly decreased (P<0.05). Transfection with Notch3 siRNA time-dependently inhibited the growth of A549 cells, and the cell viability 48 h and 72 h after transfection in Notch3 siRNA group was significantly different from those in negative control group and blank control group (P<0.05). Conclusion Transfection with Notch3 siRNA under hypoxic condition may effectively inhibit the expression of Notch3 and its downstream gene HES1 in human lung adenocarcinoma A549 cells, and may suppress the growth of A549 cells.

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    Construction of eukaryotic expression vector of heme oxygenase-1 and its expression in rat peritoneal mesothelial cells
    ZHU Chun, GUO Zhi-yong, LIU Yi-sheng, et al
    2013, 33 (4):  425. 
    doi: 10.3969/j.issn.1674-8115.2013.04.009

    Abstract ( 876 )   PDF (474KB) ( 1230 )  

    Objective To construct the eukaryotic expression vector of heme oxygenase-1 (HO-l) gene, and transfect the recombinant expression vector to rat peritoneal mesothelial cells (RPMCs) in vitro. Methods Total RNA was extracted from SD rat spleen, and the full length fragment of HO-1 CDS part was amplified by RT-PCR. The product of PCR was cloned to pMD-18T vector. The pMD-18T-HO-1 and pcDNA3-1 (-) vector were digested with restriction endonuclease BamHⅠ and KpnⅠ, then T4 DNA ligase was used to ligate HO-1 gene fragment and digested pcDNA3-1 (-) vector to construct the eukaryotic expression vector pcDNA3-1 (-)-HO-1. The recombinant plasmid pcDNA3-1 (-)-HO-1 was transfected into RPMCs. The expression of HO-1 in RPMCs was detected by RT-PCR and Western blotting respectively. Results The full length of rat HO-1 gene was cloned, and the eukaryotic expression vector pcDNA3-1 (-)-HO-1 was successfully constructed. Restriction endonucleases digestion confirmed the target DNA fragment was inserted into the expression vector, and was verified by DNA sequencing. RT-PCR and Western blotting revealed that HO-1 was highly expressed in RPMCs after transfection with pcDNA3-HO-1. Conclusion HO-1 eukaryotic expression vector has been successfully constructed, and HO-1 expresses effectively in RPMCs, which lays a foundation for the further study of the effect of HO-1 in RPMCs injury during peritoneal dialysis.

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    Effect of IL-1 released by necrotic cells on oxidative stress of vascular smooth muscle cells
    MENG Liang, LI Jia-zhen, SUN Xiao, et al
    2013, 33 (4):  430. 
    doi: 10.3969/j.issn.1674-8115.2013.04.010

    Abstract ( 961 )   PDF (347KB) ( 960 )  

    Objective To investigate the effect of necrotic cells on oxidative stress of normal vascular smooth muscle cells, and explore the main active factors. Methods Necrosis of vascular smooth muscle cells was induced by glucose-free hypoxic conditions, and the supernatants were collected. Normal vascular smooth muscle cells were divided into control group (without any treatment), necrotic cell supernatants group (NCS group, treated with culture supernatants of necrotic cells) and NCS+interleukin 1 receptor antagonist (IL-1RA) group (treated with NCS+IL-1RA). The production of reactive oxygen species (ROS) of cells and the content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in culture supernatants were determined, and the expression of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase(iNOS) and oxidase subunit p47phox mRNA and protein was detected by RT-PCR and Western blotting. Results The production of ROS and content of MDA in NCS group were significantly higher than those in control group (P<0.05), and the activity of SOD in NCS group was significantly lower than that in control group (P<0.05). The production of ROS and content of MDA in NCS+IL-1RA group was significantly lower than those in NCS group (P<0.05), and the activity of SOD in NCS+IL-1RA group was significantly higher than that in NCS group (P<0.05). RT-PCR and Western blotting revealed that the expression of iNOS, eNOS and p47phox mRNA and protein in cells in NCS group was significantly higher than that in control group (P<0.05), and the expression of iNOS, eNOS and p47phox mRNA and protein in cells in NCS+IL-1RA group was significantly lower than that in NCS group (P<0.05). Conclusion Necrotic cells can induce oxidative stress of normal vascular smooth muscle cells, and the inhibition of IL-1 signaling pathway can alleviate the oxidative stress.

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    Study value of 3.0T diffusion tensor tractography in diagnosis of cerebral blast injury
    WU Peng, Lü Guo-shi, HAN Feng, et al
    2013, 33 (4):  434. 
    doi: 10.3969/j.issn.1674-8115.2013.04.011

    Abstract ( 945 )   PDF (572KB) ( 962 )  

    Objective To investigate the efficacy of diffusion tensor tractography (DTT) in study of changes of cerebral white matter fiber after cerebral blast injury. Methods Cerebral blast was conducted in 30 rabbits, and routine MRI and diffusion tensor imaging (DTI) were performed after injury. DTI was adjusted with Tensor software of Functool2, and cerebral white matter fiber of region of interest (ROI) was reconstructed on the basis of fractional anisotropy images. The cerebral histopathological changes were observed, and contrast analysis was carried out with findings from DTT. Results After blast, 17 rabbits died, and the other 13 survived, among which 2 survived for more than 72 h. There were 4 types of cerebral white matter abnormality, which were color abnormality of ornamental code (n=2), deficiency/breakage+displacement (n=8), rarity+deficiency/breakage (n=6) and color abnormality of ornamental code+deficiency/breakage+displacement (n=14). Pathological examination indicated there was capillary break, capillary endothelial injury and hemorrhage, nerve cell and colloid cell degeneration and necrosis, nerve myelin sheath loss and formation of axon bulb. Conclusion DTT may clearly and directly illustrate the injury of cerebral white matter fiber, especially for the small abnormal cerebral white matter fiber, and more complicated change of cerebral white matter fiber may lead to shorter duration of survival.

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    Transfection efficiency and cytotoxicity of lentivirus-GFP on rabbit adipose-derived stem cells
    LI Hong-song, XU Chen, ZOU Jun
    2013, 33 (4):  439. 
    doi: 10.3969/j.issn.1674-8115.2013.04.012

    Abstract ( 1193 )   PDF (645KB) ( 1158 )  

    Objective To evaluate the transfection efficiency and cytotoxicity of lentivirus containing green fluorescence protein (GFP)(lentivirus-GFP) on rabbit adipose-derived stem cells (rADSCs), and establish a method of cell tracer marker in the study of reconstruction of tissue engineered corneal epithelium. Methods rADSCs were transfected with lentivirus-GFP at different multiplicity of infection (MOI). Cell transfection was observed under fluorescent microscope, and influence of lentivirus transfection on proliferation of rADSCs was detected by MTT. Results rADSCs were successfully transfected at MOI of 50, 100 and 500, and the transfection efficiency could reach more than 50% 120 h later. Lentivirus-GFP had no significant effect on proliferation of rADSCs at MOI of 50 and 100, while the proliferation of rADSCs was significantly inhibited at MOI of 500. Conclusion rADSCs are successfully transfected with lentivirus-GFP, which can be used in the study of reconstruction of tissue engineered corneal epithelium.

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    Original article (Clinical research)
    Cross-sectional study of prevalence of anxiety and depression in patients with osteonecrosis of femoral head
    CHEN Sheng-bao, YIN Ji-min, HU Hai, et al
    2013, 33 (4):  445. 
    doi: 10.3969/j.issn.1674-8115.2013.04.013

    Abstract ( 1071 )   PDF (352KB) ( 1150 )  

    Objective To investigate the prevalence of anxiety and depression in patients with untreated osteonecrosis of the femoral head (ONFH), and explore the potential risk factors. Methods A total of 235 patients with untreated ONFH were consecutively enrolled from January 2010 to December 2010. Seventeen items including demographic characteristics, living habit, history of ONFH and history of other diseases were investigated with self-designed questionnaire. Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS) were employed to assess the prevalence of anxiety and depression. The risk factors of prevalence of anxiety and depression in patients with ONFH were explored with univariate and multivariate analysis. Results Two hundred and sixteen effective questionnaires were recovered, with the effective rate of 91.91%. The prevalence of anxiety was 20.4%, that of depression was 21.8%, and that of anxiety complicated with depression was 15.7%. Univariate analysis revealed that inducement of necrosis, stage of necrotic severity, unilateral or bilateral necrosis, VAS score and Harris score were risk factors of anxiety (P<0.05), and working state, inducement of necrosis, stage of necrotic severity, gender, history of concomitant diseases, unilateral or bilateral necrosis and Harris score were risk factors of depression (P<0.05). Multivariate analysis indicated that risk factors of prevalence of anxiety included unilateral or bilateral necrosis of the femoral head (OR=3.159, 95%CI: 1.492-6.682) and stage of necrotic severity (OR=2.443, 95%CI: 1.417-4.211), and risk factors of prevalence of depression included gender (OR=2.941, 95%CI: 1.476-5.863), history of concomitant diseases (OR=4.091, 95%CI: 1.906-8.779) and stage of necrotic severity (OR=4.529, 95%CI: 2.425-8.458). Conclusion Patients with untreated ONFH are associated with higher prevalence of anxiety and depression, and targeted intervention should be performed.

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    Clinical manifestation and chromosomes karyotype analysis of children with disorders of sex development
    HUANG Ying-ying, LI Pin
    2013, 33 (4):  450. 
    doi: 10.3969/j.issn.1674-8115.2013.04.014

    Abstract ( 1029 )   PDF (306KB) ( 1189 )  

    Objective To investigate the classification and clinical manifestation of disorders of sex development (DSD), and explore the correlation of gonads phenotype and clinical manifestation with nuclear type of chromosome in DSD. Methods The clinical symptoms, signs,  nuclear type of chromosome, B ultrasound of abdomen and sex hormone were examined in 55 cases of DSD, and the pathological findings of gonads were analysed. Results The social genders of 26 cases were female, and the other 29 were male. Twenty (36.3%) cases were 46,XX DSD, including 7 cases of true hermaphrodism and 13 cases of congenital adrenal cortical hyperplasia. Twenty-nine (52.7%) cases were 46,XY DSD, including 8 cases of androgen insensitivity syndrome. Six (10.9%) cases were sex chromosome DSD, including 3 cases of Turner syndrome and 1 case of Klinefelter syndrome. Conclusion The majority of 46,XX DSD cases are congenital adrenal hyperplasia, most 46, XY DSD cases are androgen insensitivity syndrome and hypofunction of testis, and some cases of DSD with unknown etiology may have relationship with insufficient testosterone secretion in embryonic stage.

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    Value of 3.0T magnetic resonance imaging in diagnosis of severe traumatic brain injury and outcome prediction
    YUAN Lu-tao, WEI Xiao-er, XU Chen, et al
    2013, 33 (4):  454. 
    doi: 10.3969/j.issn.1674-8115.2013.04.015

    Abstract ( 995 )   PDF (532KB) ( 1022 )  

    Objective To investigate the value of 3.0T magnetic resonance imaging (MRI) in diagnosis of severe traumatic brain injury and outcome prediction. Methods Thirty-eight patients with severe traumatic brain injury were evaluated with MRI 4 to 6 weeks after injury, the lesion volumes in T1 and T2 weighted imaging and fluid attenuated inversion recovery (FLAIR) images were quantified and compared with simultaneous CT findings. The diffuse axonal injury (DAI) scores were recorded, and correlation analysis was performed with Glasgow coma scale (GCS) on admission and Glasgow outcome scale (GOS) 6 months after injury. Results MRI demonstrated more lesions than CT, especially for the corpus callosum and brain stem lesions. There were significant differences in DAI scores and lesion volumes in T1 and T2 weighted imaging and FLAIR images between different outcome groups (P<0.05). DAI score had strongest correlation with GOS 6 months after injury (r=-0.854, P<0.05), and the lesion volume detected by MRI was also negatively correlated with the outcome (P<0.05). Conclusion 3.0T MRI is superior to CT in detection of intraparenchymal injury, especially for deep lesions. A quantitative study of the lesion volume and location demonstrated by MRI may play a role in outcome prediction.

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    Correlation of thrombelastogram with platelet aggregation rate and D-dimer in patients with acute cerebral infarction
    ZHOU Xi-lin, LIANG Hui, HUANG Jie-jie
    2013, 33 (4):  459. 
    doi: 10.3969/j.issn.1674-8115.2013.04.016

    Abstract ( 1179 )   PDF (359KB) ( 1225 )  

    Objective To investigate the correlation of parameters of thrombelastogram (TEG) with platelet aggregation rate (PAgT) and D-dimer in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were selected, and were divided into mild acute cerebral infarction group (n=41), moderate acute cerebral infarction group (n=35) and severe acute cerebral infarction group (n=26) according to the scores of severity of neurological deficit. Besides, 50 healthy subjects were served as control group. All subjects were examined with the parameters of TEG (including R value, K value, α angle, MA value and CI value), PAgT and D-dimer. Results R-value and K value were significantly smaller, α angle, MA value and CI value were significantly larger and the D-dimer and PAgT levels were significantly higher in patients with acute cerebral infarction than in control group (P<0.01). The parameters of TEG and levels of PAgT and D-dimer in severe acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group and moderate acute cerebral infarction group (P<0.05). The parameters of TEG and PAgT level in moderate acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group (P<0.05), while there was no significant difference in D-dimer level between these two groups (P>0.05). Pearson correlation analysis revealed that the D-dimer and PAgT levels were positively related to α angle, MA value and CI level (P<0.01), and were negatively related to R-value and K value (P<0.01). Conclusion The parameters of TEG are significantly related to the D-dimer and PAgT levels in patients with acute cerebral infarction. TEG plays a role in the diagnosis of acute cerebral infarction, evaluation of severity of acute cerebral infarction and monitoring of hypercoagulable state.

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    Comparison analysis of 24 h ambulatory blood pressure monitoring between primary and secondary glomerular disease
    ZHANG Wei, YUAN Jin-zhong, YUAN Hong, et al
    2013, 33 (4):  463. 
    doi: 10.3969/j.issn.1674-8115.2013.04.017

    Abstract ( 795 )   PDF (335KB) ( 1112 )  

    Objective To investigate the characteristics of 24 h ambulatory blood pressure monitoring of primary and secondary glomerular disease so as to guide the individual antihypertensive treatment in clinics. Methods Sixty-four patients with primary glomerular disease were selected, more of them not undergone renal replacement treatment. Besides, 57 patients with secondary glomerular disease matched with age, gender and estimated glomerular filtration rate (eGFR) were randomly selected. Twenty-four hour ambulatory blood pressure monitoring was carried out in both groups. Results ①The 24 h mean systolic blood pressure, night mean systolic blood pressure and night systolic load in secondary glomerular disease group were significantly higher than those in primary glomerular disease group (P<0.05). ②There was no significant difference in blood pressure variability and morning surge between two groups (P>0.05). ③In primary glomerular disease group, dipper blood pressure accounted for 39.0%, non-dipper blood pressure 43.8% and anti-dipper blood pressure 17.2%. In secondary glomerular disease group, dipper blood pressure accounted for 10.5%, non-dipper blood pressure 47.4% and anti-dipper blood pressure 42.1%. There were significant differences in the percentage of abnormal blood pressure between primary glomerular disease group and secondary glomerular disease group (61.0% vs 89.5%, P<0.05). Conclusion The control of night systolic blood pressure in patients with secondary glomerular disease is poorer than that in patients with primary glomerular disease, and abnormal blood pressure in secondary glomerular disease is much more resistant. It is advised to individualize the antihypertensive treatment of night systolic blood pressure in patients with secondary glomerular disease.

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    Caspofungin for treatment of invasive fungal infections after allogeneic hematopoietic stem cell transplantation
    BAI Hai-tao, WANG Chun, WANG Li-ping, et al
    2013, 33 (4):  468. 
    doi: 10.3969/j.issn.1674-8115.2013.04.018

    Abstract ( 941 )   PDF (302KB) ( 934 )  

    Objective To investigate the efficacy and safety of Caspofungin for the treatment of invasive fungal infections after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Thirtynine cases of invasive fungal infections after allo-HSCT were selected, stratified diagnosis was made according to the standard of European Organization for Research on Treatment of Cancer (EORTC), and treatment with intravenous Caspofungin was performed. The initial dosage and maintenance dosage were 70 mg/d and 50 mg/d respectively, with time of infusion more than 1 h and course of treatment ranging from 14 d to 42 d. Imaging and microbiological examinations were carried out weekly before treatment and in the course of treatment. Side effects were assessed after treatment. Results The overall favorable response to Caspofungin was 76.9% (30/39). The response rates of confirmed cases, clinically diagnosed cases and suspected cases were 100% (3/3), 73.7% (14/19) and 76.5% (13/17) respectively. There was no significant difference in the response rates between clinically diagnosed cases and suspected cases (P>0.05). Three cases had mild liver function abnormalities, and hypokalemia occurred in 4 cases. Conclusion Caspofungin is an effective agent with minimal adverse effects for treatment of invasive fungal infections after allo-HSCT.

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    Significance of fasting plasma glucose screening at gestational 6-24 weeks for gestational diabetes mellitus
    CHE Rong-hua, HUANG Ya-juan
    2013, 33 (4):  471. 
    doi: 10.3969/j.issn.1674-8115.2013.04.019

    Abstract ( 1092 )   PDF (349KB) ( 1101 )  

    Objective To investigate the value of fasting plasma glucose screening at gestational 6-24 weeks for gestational diabetes mellitus (GDM), and explore the influence of (FPG) on pregnancy outcomes. Methods The clinical data of 2 200 pregnant women undergoing antenatal examination and delivery were retrospectively analyzed. These women were divided into GDM group and normal group.The pregnancy outcomes and FPG levels at different gestational stages were compared between groups,the area under receiver operating characteristic (ROC) curve was used to determine the value of FPG in diagnosis of GDM, and multivariate Logistic regression analysis was employed to explore the risk factors of GDM. Results The neonatal birth weight and rates of cesarean section, macrosomia, diet and exercise therapy and insulin therapy in GDM group were significantly higher than those in normal group (P<0.05).There were also significant differences in total perinatal complications between two groups (P<0.05). The FPG levels in women at less than 24 gestational weeks and at no less than 24 gestational weeks in GDM group were significantly higher than that in normal group (P<0.001).There was no significant difference between FPG level of women at less than 24 gestational weeks and that at no less than 24 gestational weeks in GDM group (P>0.05), while there were significant differences between FPG level of women at less than 24 gestational weeks and that at no less than 24 gestational weeks in normal group (P<0.05). The area under ROC curve for FPG to predict GDM was 0.706 (95%CI 0.673-0.739), the optimal cutoff value was 4.6 mmol/L, and the sensitivity and specificity were 68.4% and 60.0% respectively. The positive rate of OGTT increased with FPG. Multivariate Logistic regression analysis revealed that FPG was positively related to GDM (OR 5.886, P=0.000, 95%CI 4.193-8.262). Conclusion The unfavorable pregnancy outcomes are closely related to plasma glucose level, and FPG screening for GDM has a higher predictive value. FPG screening in early pregnancy may help to treat GDM in the early stage, and decrease maternal and neonatal complications.

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    Clinical analysis of tamsulosin combined with pethidine in treatment of ureteral calculi during pregnancy
    XU Zhao-ping, SHEN Zhou-jun
    2013, 33 (4):  476. 
    doi: 10.3969/j.issn.1674-8115.2013.04.020

    Abstract ( 877 )   PDF (281KB) ( 931 )  

    Objective To investigate the efficacy and safety of tamsulosin combined with pethidine in the treatment of ureteral calculi during pregnancy. Methods Sixty-four pregnant women with ureteral calculi (renal colic for the first time) were divided into tamsulosin combined with pethidine group (n=26) and pethidine group (n=38). The degree of pain was evaluated by visual analogue scale (VAS) 48 h before and after treatment in two groups. B ultrasound was performed in 1 month after the end of pregnancy, YAG laser lithotripsy was carried out for those with residual stone, and stone clearance rate and operation rate were compared between two groups. Results In tamsulosin combined with pethidine group, 25 patients experienced pain relief, and the other 1 patient needed another dose of pethidine hydrochloride. In pethidine group, 24 patients achieved pain relief after treatment (double J stent was inserted in 1 patient), and the other 14 patients needed another dose of pethidine hydrochloride (double J stent was inserted in 4 patients). VAS decreased by 6.7±0.3 and 5.0±0.6 in tamsulosin combined with pethidine group and pethidine group respectively, and there were significant differences between them (P<0.05). At the end of pregnancy, the stone clearance rate in tamsulosin combined with pethidine group was significantly higher than that in pethidine group (96.2% vs 63.2%, P<0.01), and the stone clearance rates in middle or lower segment of ureter in tamsulosin combined with pethidine group were significantly higher than those in pethidine group (100% vs 50%, P<0.05; 100% vs 72.2%, P<0.05). The operation rate in tamsulosin combined with pethidine group was significantly lower than that in pethidine group (3.8% vs 31.6%, P<0.01). Conclusion For patients with renal colic due to ureteral calculi during pregnancy, tamsulosin combined with pethidine may provide favorable pain relief ratio and stone clearance rate, especially in middle or lower ureteral segment.

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    Therapeutic effects of whole brain radiotherapy with targeted therapy and concomitant chemo-radiotherapy in treatment of non-small-cell lung cancer with brain metastasis
    ZHOU Di, XU Xin, XIE Hua-ying, et al
    2013, 33 (4):  480. 
    doi: 10.3969/j.issn.1674-8115.2013.04.021

    Abstract ( 971 )   PDF (548KB) ( 1457 )  

    Objective To compare the short-term therapeutic effects, long-term survival and adverse effects between whole brain radiotherapy with targeted therapy and concomitant chemo-radiotherapy in treatment of non-small-cell lung cancer (NSCLC) with brain metastasis. Methods The clinical data of 58 patients with NSCLC with brain metastasis were retrospectively analysed. Thirty-six patients received whole brain radiotherapy with targeted therapy (oral administration of gefitinib 250 mg or erlotinib 150 mg per day), and the other 22 patients received whole brain radiotherapy with concomitant chemotherapy (platinum-based regimen). Survival analysis was conducted in two groups with Kaplan Meier method and Logrank test, and the differences in therapeutic effects were explored between two groups. Results The disease control rate in whole brain radiotherapy with targeted therapy group was significantly higher than that in concomitant chemo-radiotherapy group (66.7% vs 36.4%, P<0.05). The 1-year survival rate in whole brain radiotherapy with targeted therapy group was 68%, and the median duration of survival was 23.2 months. The 1-year survival rate in concomitant chemo-radiotherapy group was 41%, and the median duration of survival was 7.1 months. The median duration of survival in whole brain radiotherapy with targeted therapy group was significantly longer than that in concomitant chemo-radiotherapy group (P<0.05). Conclusion Whole brain radiotherapy with targeted therapy is superior to concomitant chemoradiotherapy in disease control rate and duration of survival for treatment of NSCLC with brain metastasis.

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    Analysis of factors of radiation pneumonitis in patients with lung cancer treated with intensity-modulated radiation therapy
    MA Xiu-mei, CHEN Hai-yan, BAI Yong-rui, et al
    2013, 33 (4):  485. 
    doi: 10.3969/j.issn.1674-8115.2013.04.022

    Abstract ( 1022 )   PDF (377KB) ( 1048 )  

    Objective To evaluate the correlation of clinical factors and radiation therapy factors with incidence of radiation pneumonitis in patients with lung cancer treated with intensity-modulated radiation therapy (IMRT). Methods The medical records of 63 patients with lung cancer treated with IMRT were retrospectively analysed. The dose volume histogram of treatment program and clinical influencing factors were compared between patients with radiation pneumonitis and those without radiation pneumonitis. The clinical parameters were observed, which included pathology, tumor location, concurrent chemotherapy, dose and pattern of radiation, and the dosimetric factors included V5, V10, V15, V20, V25, V30, V35, V40 and mean lung dose. The effect of above factors on the incidence of radiation pneumonitis was analysed. Results Among the 63 patients, 19 experienced radiation pneumonitis. Univariate analysis revealed that total dose and small cell lung cancer as pathological type were significantly associated with the incidence of radiation pneumonitis. Multivariate analysis indicated that only V5 was the risk factor of radiation pneumonitis. Conclusion Pathological type and V5 value should be considered in the IMRT for lung cancer, and low dose may also cause injury to sensitive lung tissues.

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    Original article (Preventive medicine)
    Analysis of spatial distribution and influencing factors of tuberculosis in Chongqing from 2008 to 2011
    WU Tian-yong, ZENG Qing, LIU Shi-wei, et al
    2013, 33 (4):  489. 
    doi: 10.3969/j.issn.1674-8115.2013.04.023

    Abstract ( 855 )   PDF (535KB) ( 987 )  

    Objective To analyze the spatial distribution and influencing factors of tuberculosis in Chongqing using spatial autocorrelation analysis and spatial autoregressive model. Methods The data on tuberculosis of 40 districts (counties) in Chongqing from December 2008 December to 2011 were collected, and spatial autocorrelation analysis and spatial regressive analysis were performed using GeoDa_0.9.5.i software. Results The global Moran´sⅠ values of tuberculosis in Chongqing from 2008 to 2011 were 0.310, 0.399, 0.327, and 0.306, respectively, which indicated that there was a spatial positive correlation among each year in the incidences of tuberculosis in Chongqing. Spatial regressive analysis revealed that the incidence of tuberculosis in Chongqing was associated with the unemployment rate of urban area (Z=2.150, P=0.032). Conclusion The spatial clusterings of tuberculosis are found in Chongqing from 2008 to 2011, and the incidence of tuberculosis in Chongqing is associated with the unemployment rate of urban area at the spatial level.

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    Original article (Public health administration)
    Exploration and practice of regional mutual recognition of laboratory examination results
    XIONG Huai-min, JIANG Ting-wang, ZHOU Jin-bao, et al
    2013, 33 (4):  493. 
    doi: 10.3969/j.issn.1674-8115.2013.04.024

    Abstract ( 927 )   PDF (336KB) ( 991 )  

    Objective To explore the methods and significance of regional mutual recognition of laboratory examination results. Methods Institution for laboratory medicine was established to provide services for all hospitals in Changshu health system. Unified management mode, examination assays and quality control materials, method comparison assays, information sharing platform and sample transfer standard were applied to ensure mutual recognition of laboratory examination results in Changshu. Results Laboratory resources of manpower, property and facilities were employed effectively, laboratory sample transfer system and information platform were standardized, laboratory quality control and examination efficiency were significantly improved, and turnaround time of samples was effectively reduced. Conclusion Mutual recognition of laboratory examination results can be effectively achieved by establishing government controlled regional institution for laboratory medicine, which can reduce the financial burden of patients and improve the diagnosis and treatment levels of hospitals ranging from third-grade hospitals to community health centers.

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    Establishment of shared platform of continuing medical education in multihospital system
    XIE Bing, LIN Jing, JIANG Ying, et al
    2013, 33 (4):  497. 
    doi: 10.3969/j.issn.1674-8115.2013.04.025

    Abstract ( 1041 )   PDF (360KB) ( 924 )  

    Objective To establish a shared platform of continuing medical education in regional multihospital system to facilitate the integration of medical education resources. Methods On the basis of practical experience of shared platform of continuing medical education of Ruijin-Luwan Healthcare Alliance, literature review and Modified Delphi Survey, the framework of a sharing platform of continuing medical education in multihospital system was constructed, which included 7 primary indicators (teaching aim, objective, duration, faculty, content, management and evaluation) and 31 secondary indicators. Thirty experts in the fields of medical education, medical affairs administration, clinical practice and policy research on medical reform were screened, two rounds of expert consultation were performed for the above indicators, and the ultimate framework of sharing platform of continuing medical education in multihospital system was established. Results The responding rate was 100% in the two rounds of expert consultation. The experts´ confidence was defined as 0.931 9 based on the self-evaluation. Eighty percent of the coordination coefficients were less than 0.5 in the first round of expert consultation (0.167-0.216), and none of the coordination coefficient was larger than 0.5 in the second round (0.153-0.192). The framework of the sharing platform of continuing medical education was finalized with 9 primary indicators (teaching aim, objective, duration, faculty, content, management, evaluation, module details and promotion) and 35 secondary indicators. Conclusion The established shared platform of continuing medical education consolidates the medical education resources in regional multihospital system, from which community physicians can obtain medical theories, clinical insights and research skills for a sustainable career path.

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    Review
    Research progress of regulatory mechanism of Hedgehog signal in cilia
    WANG Ya-nan, ZOU Sha-sha, LI Zheng, et al
    2013, 33 (4):  502. 
    doi: 10.3969/j.issn.1674-8115.2013.04.026

    Abstract ( 1190 )   PDF (334KB) ( 1306 )  

    Cilia serve as an important regulator of various signaling pathways, as well as the Hedgehog (Hh) signaling pathway. Recent studies have revealed that there is a close relationship between Hh signaling pathway and intraflagellar transport of cilia, and further evidences from genetics and cytobiology have also proved the relationship between primary cilia and Hh signaling pathway. All of the core components of Hh signaling pathway are found on the primary cilia, and intraflagellar transport proteins are required for the transmission of information between the signaling molecules that mediate the activity of Hh signaling pathway. Flagella of sperm share the same structure with cilia, and ciliopathies can also lead to the defects of spermatic flagella. Ciliopathies and other diseases caused by the defects of structure and function of cilia could affect Hh signaling. Regulatory molecules such as Foxj1 contribute to the construction of cilia, which brings new ideas in the field of infertility and contraception. The research progress of regulatory mechanism of Hedgehog signal in cilia is introduced in this paper.

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    Effect of JAK/STAT pathway in atherosclerosis
    HUANG Wei-bin, Lü Lei, ZHANG Lan
    2013, 33 (4):  506. 
    doi: 10.3969/j.issn.1674-8115.2013.04.027

    Abstract ( 1031 )   PDF (318KB) ( 1131 )  

    Atherosclerosis is a chronic inflammatory disease including complex interactions between vascular cells and inflammatory cells. Janus kinase/signal transducer and activator of transcription(JAK/STAT) pathway acts as a common intracellular transduction pathway of various of cytokines and growth factors, which involves in many biological activities such as immunological response and growth, migration and apoptosis of vascular cells. The effects of JAK/STAT pathway on the development and progression of atherosclerosis are reviewed in this paper.

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    MicroRNA—new approach to diagnosis, treatment and prognosis prediction of breast cancer
    DU Wei, HUO Zi-rong, LIANG Cheng-cai, et al
    2013, 33 (4):  510. 
    doi: 10.3969/j.issn.1674-8115.2013.04.028

    Abstract ( 1176 )   PDF (494KB) ( 934 )  

    MicroRNA (miRNA) is a small and non-coding RNA that regulates gene expression at the post-transcriptional level, affecting on almost all the cellular processes. Recent studies have revealed the important role of miRNA in the tumorigenesis and development of breast cancer, indicating a new hope for its diagnosis, treatment and prognosis prediction. The latest progress in miRNA studies on breast cancer is introduced in this paper, and the potential application of miRNA is analysed.

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    Research progress of breast atypical ductal hyperplasia
    XU Yan-chun, YAO Xiao-hong, ZHU Ming-jie
    2013, 33 (4):  516. 
    doi: 10.3969/j.issn.1674-8115.2013.04.029

    Abstract ( 964 )   PDF (313KB) ( 1063 )  

    Breast atypical ductal hyperplasia (ADH) has the risk of progression into breast cancer, and there are characteristic molecular biological and genetic changes in ADH, which is to some extent similar to ductal carcinoma in situ (DCIS). The increase of cell proliferation index, hormone receptor expression and cell growth regulating factors may promote the formation of ADH. Chromosome abnormality and epigenetic changes may lead to the formation of ADH, among which 16p, 17q chromosome abnormality and promoter methylation of cancer related gene may be the early events of ADH. Studies have confirmed that ADH is the precursor of low grade ductal carcinoma in situ (LG-DCIS) which shares the similar molecular biological characteristics and genetic performance with ADH, and can progress to low grade invasive ductal carcinoma (LG-IDC) through LG-DCIS stage. Studies have also pointed out that ADH is not the precursor of high grade ductal carcinoma in situ (HG-DCIS), and high grade invasive ductal carcinoma (HG-IDC) has different pathogenesis. With the abnormal expression of cell adhesion molecule, extracellular matrix produces a large number of matrix protease which results in reduced cell-to-cell adhesion and degradation of basement membrane, and ultimately promotes the development of ADH to IDC.

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    Brief original article
    Effect of calcipotriol betamethasone ointment on treatment of non-generalized vitiligo
    ZHOU Jun, LI Jian, FU Wen-wen
    2013, 33 (4):  520. 
    doi: 10.3969/j.issn.1674-8115.2013.04.030

    Abstract ( 1042 )   PDF (492KB) ( 996 )  

    Objective To evaluate the therapeutic effect and safety of calcipotriol betamethasone ointment on the treatment of non-generalized vitiligo. Methods Calcipotriol betamethasone ointment was topically applied to the vitiliginous patches once daily in 51 patients with non-generalized vitiligo for 3 months, and the therapeutic effect and adverse effect were observed in each month. Results Of these 51 patients, 8 had complete repigmentation, 21 achieved excellent response, 10 experienced improvement, and the other 12 achieved almost no response. The excellent response rate was 56.86% (29/51, area of repigmentation≥50%), and the effective rate was 76.47% (39/51, area of repigmentation≥10%). Conclusion Calcipotriol betamethasone ointment is effective and safe in the treatment of vitiligo, with less adverse effect.

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    Clinical evaluation of vertebrobasilar ischemia by transcranial doppler ultrasonography and plasma adrenomedullin
    ZHU Xiu-li, ZHU Yu-si, SHU Xiao-dan
    2013, 33 (4):  523. 
    doi: 10.3969/j.issn.1674-8115.2013.04.031

    Abstract ( 1008 )   PDF (206KB) ( 1011 )  

    Objective To investigate the role of transcranial doppler ultrasonography (TCD) and plasma adrenomedullin (ADM) in evaluation of vertebrobasilar ischemia (VBI). Methods The data of TCD of 50 patients with VBI (VBI group) were analysed. The systolic velocity (Vs), diastolic velocity (Vd), mean velocity (Vm), pulsatility index (PI) and plasma ADM of vertebral artery (VA) and basilar artery (BA) of VBI group were recorded, and were compared with those of 50 healthy normal people (control group). Results The parameters of Vm, Vs and Vd of VA and BA in VBI group were significantly lower than those in control group (P<0.05), and PI in VBI group was significantly higher than that in control group (P<0.05). The plasma ADM in VBI group was significantly higher than that in control group (P<0.05). Conclusion TCD combined with plasma ADM can serve in the evaluation of disease condition and treatment in patients with VBI.

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    Case report
    One case report of tuberculosis with liver and spleen cold abscesses as initial symptom
    ZHANG Qiu-rui, CHEN Hong, ZHOU Min, et al
    2013, 33 (4):  526. 
    doi: 10.3969/j.issn.1674-8115.2013.04.032

    Abstract ( 921 )   PDF (483KB) ( 917 )  

    Systemic disseminated tuberculosis with liver and spleen abscesses as initial symptom is rare. The course of diagnosis and treatment of one case of tuberculosis with liver and spleen abscesses as initial symptom is reported in this paper. Based on the symptoms, signs and findings of pathological and CT examinations after splenectomy, tuberculosis was highly suspected, and diagnostic anti-tuberculosis treatment combined with anti-infection treatment was carried out. The temperature of the patient decreased to the normal range 2 weeks later, which indicated a effective therapy. Then, mycobacterium tuberculosis infection was proven by bacterial culture of puncture fluid and secretions, PCR amplification and nucleotide sequencing. Therefore, in case of highly suspected mycobacterium tuberculosis infection, diagnostic anti-tuberculosis treatment (combined therapy) can be tried out, and imaging examinations may play a role in the auxiliary diagnosis of tuberculosis.

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