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    Monographic report (Basic and clinical research on neonatology)
    Theophylline improves intra-amniotic LPS-induced alveolar arrest through inflammatory regulation in neonatal rats
    HE Hua, CHEN Fei, LI Hui-ping, et al
    2013, 33 (7):  897. 
    doi: 10.3969/j.issn.1674-8115.2013.07.001

    Abstract ( 830 )   PDF (610KB) ( 1052 )  

    Objective To investigate the role of theophylline on amelioration of chorioamnionitis-induced alveolar arrest, and explore the potential mechanism. Methods Chorioamnionitis was induced by intra-amniotic injection of lipopolysaccharides (LPS) in SD rats (E16.5), and the same amount of normal saline was intra-amniotically injected in control SD pregnant mice (E16.5). Pups of same litter with intra-amniotic injection of LPS were randomly divided into LPS+theo group and LPS+saline group. In LPS+theo group, pups were injected subcutaneously in the neck with theophylline once a day until the seventh day, and the same amount of normal saline instead in LPS+saline group. Pups with intra-amniotic injection of normal saline obtained identical postnatal treatment as LPS+saline group, which was defined as control group. Seven days after treatment, the lungs of neonatal rats were harvested, sections with HE staining and cytokine antibody arrays were prepared, the pathological changes of lung tissues were observed, and the expression of inflammatory cytokines was determined. Results Histopathological examination revealed that the alveolar counts and secondary septa counts in LPS+saline group were significantly smaller than those in control group (P<0.05), and the alveolar counts and secondary septa counts in LPS +theo group were significantly larger than those in LPS+saline group (P<0.05). The detection of antibody arrays indicated that the expression of inflammatory cytokines such as interferon γ (IFN-γ), interleukin (IL)-α, IL-6 and chemokine receptor type 4 (CXCR4) in lung tissues of neonatal rats in LPS+saline group was higher than that in control group, the expression of pro-inflammatory cytokines such as tumor necrosis factor-α (TNF-α), macrophage inflammatory protein (MIP)-1α and MIP-2 in LPS+theo group was significantly lower than that in LPS+saline group (decreased by 37.4 times, 12.5 times and 8.6 times respectively), and the expression of anti-inflammatory cytokines such as transforming growth factor (TGF)-β1, TGF-β2 and TGF-β3 in LPS+theo group was significantly higher than that in LPS+saline group (increased by 2.4 times, 56.9 times and 17.8 times respectively). Conclusion Theophylline can inhibit the expression of pro-inflammatory cytokines, increase the expression of anti-inflammatory cytokines, and relieve alveolar arrest through regulating the balance between pro- and anti-inflammatory cytokines. Theophylline may play a role in the amelioration of chorioamnionitis-induced bronchopulmonary dysplasia.

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    Effect of lactadherin on secretion of IL-12 and IL-10 by immature dendritic cells through ERK and p38 MAPK signaling pathway
    LI Can, SHEN Jue, SHI Jun, et al
    2013, 33 (7):  902. 
    doi: 10.3969/j.issn.1674-8115.2013.07.002

    Abstract ( 721 )   PDF (583KB) ( 1017 )  

    Objective To investigate the effect of lactadherin on secretion of interleukin (IL)-12 and IL-10 by immature dendritic cells (iDCs) through ERK and p38 MAPK signaling pathway. Methods Cord blood monocytes were isolated from human umbilical cord blood and cultured in vitro in the presence of recombinant human granulocyte-macrophage colony-stimulating factor (50 ng/mL) and recombinant human interleukin-4 (10 ng/mL) to obtain the iDCs. According to different interventions with lactadherin (10 μg/mL) and signaling pathway inhibitors, iDCs were divided into 8 groups: ①control group; ②lactadherin group; ③ERK signaling pathway inhibitor group; ④ERK signaling pathway inhibitor+lactadherin group; ⑤p38 MAPK signaling pathway inhibitor group; ⑥p38 MAPK signaling pathway inhibitor+lactadherin group; ⑦JNK signaling pathway inhibitor group; ⑧JNK signaling pathway inhibitor+lactadherin group. The phosphorylation of ERK, JNK and p38MAPK protein was detected by Western blotting, and the levels of IL-12 and IL-10 in the culture media were determined by ELISA. Results Compared with control group, the phosphorylation of ERK protein was increased (P<0.05), the phosphorylation of p38 MAPK protein was decreased (P<0.05), the levels of IL-12 and IL-10 were significantly decreased (P<0.05), and the ratio of IL-12/IL-10 was significantly increased in lactadherin group (P<0.05). There was almost no phosphorylation of ERK protein in ERK signaling pathway inhibitor group and ERK signaling pathway inhibitor+lactadherin group, the levels of IL-12 and IL-10 in ERK signaling pathway inhibitor+lactadherin group were significantly higher than those in lactadherin group (P<0.05), and the ratio of IL-12/IL-10 in ERK signaling pathway inhibitor+lactadherin group was significantly lower than that in lactadherin group (P<0.05). There was almost no phosphorylation of p38 MAPK protein in p38 MAPK signaling pathway inhibitor group and p38 MAPK signaling pathway inhibitor+lactadherin group, the levels of IL-12 and IL-10 in p38 MAPK signaling pathway inhibitor+lactadherin group were significantly lower than those in lactadherin group (P<0.05), and the ratio of IL-12/IL-10 in p38 MAPK signaling pathway inhibitor+lactadherin group was significantly higher than that in lactadherin group (P<0.05). Conclusion Lactadherin regulates the secretion of IL-12 and IL-10 by iDCs through activation of ERK signaling pathway and inactivation of p38 MAPK signaling pathway.

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    Effects of 1α,25-dihydroxyvitamin D3 on differentiation, maturation and apoptosis of cord blood monocyte-derived dendritic cells
    LI Hai-yuan, TANG Zheng, SHI Ying-ying, et al
    2013, 33 (7):  907. 
    doi: 10.3969/j.issn.1674-8115.2013.07.003

    Abstract ( 753 )   PDF (847KB) ( 873 )  

    Objective To investigate the effects of 1α,25-dihydroxyvitamin D3 [1,25 (OH)2D3] on the differentiation, maturation and apoptosis of cord blood monocyte-derived dendritic cells (DCs). Methods Cord blood monocytes were isolated from human umbilical cord, and were cultured in vitro in the presence of recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF), recombinant human interleukin-4 (rhIL-4) and recombinant human tumor necrosis factor-α (rhTNF-α) to obtain the immature DCs (iDCs) and mature DCs (mDCs), with addition of 1,25 (OH)2D3 or not (treatment group or control group). The differentiation and maturation surface markers on DCs were determined by immunofluorescence staining and flow cytometry. The expression of vitamin D receptor (VDR) mRNA and 1-α-hydroxylase (CYP27B1) mRNA was detected by Real-Time PCR. The apoptosis of DCs was measured using Annexin V-FITC and PI staining by flow cytometry. Results ①Compared with control group, the expression of CD14 on iDCs was significantly higher (40.05% vs 5.14%, P<0.001), the expression of CD1a and CD11c on iDCs was significantly lower (12.73% vs 30.07%, P<0.01;91.27% vs 95.94%,P<0.05), and the expression of CD80, CD86 and HLA-DR on mDCs was significantly lower in treatment group (3.52% vs 17.75%,P<0.01;51.10% vs 69.76%,P<0.01;69.38% vs 92.35%,P<0.01). ②With the differentiatiation and maturation of DCs, the expression of CYP27B1 in iDCs or mDC was significantly higher than that in monocytes (P=0.005, P=0.002), and the expression of CYP27B1 in mDCs was significantly higher than that in iDCs (P=0.01). The expression of VDR in iDCs or mDCs was significantly lower than that in monocytes (P=0.01,P=0.003), while there was no significant difference in the expression of VDR between iDCs and mDCs (P=0.43). ③The expression of CYP27B1 in iDCs in treatment group was significantly higher than that in control group (P<0.01), and the expression of VDR in iDCs in treatment group was significantly lower than that in control group (P<0.01), while 1,25 (OH)2D3 did not have effect on the expression of CYP27B1 and VDR in mDCs (P>0.05). ④The early apoptosis rate of mDCs stimulated by rhTNF-α for 48 h in treatment group was significantly higher than that in control group (20.8% vs 9.23%, P<0.01), and the late apoptosis rate of mDCs stimulated by rhTNF-α for 72 h was significantly higher than that in control group (19.39% vs 7.27%,P<0.01). Conclusion 1,25 (OH)2D3 inhibits the differentiation and maturation of DCs derived from cord blood monocytes, and promotes the apoptosis of DCs derived from cord blood monocytes.

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    Cell apoptosis and expression of ATP7A in brain of Atp7btx-J mice
    HU Jing, JIAO Xian-ting, LIU Xiao-qing, et al
    2013, 33 (7):  916. 
    doi: 10.3969/j.issn.1674-8115.2013.07.004

    Abstract ( 819 )   PDF (586KB) ( 926 )  

    Objective To explore the mechanism of nervous system injury in Wilson's disease by analysis of cell apoptosis, determination of concentrations of Ca and Cu and detection of expression of ATP7A in different parts of brain tissues of Atp7btx-J mice. Methods The tissues of cerebral cortex, cerebellum, basal ganglia and hippocampus of Atp7btx-J mice aged 20 weeks were isolated, the cell apoptosis was analyzed after Hoechst staining, the concentrations of Ca and Cu were determined by inductively coupled plasma mass spectrometry, and the expression of ATP7A mRNA in different parts was detected by Real-Time PCR. Results Compared with wild type mice, the cell apoptosis in cerebellum and basal ganglia of homozygous mice was most significant (P<0.05). The concentrations of Ca and Cu in cerebellum, basal ganglia and hippocampus of homozygous mice were significantly higher than those of wild type mice (P<0.01). The expression of ATP7A mRNA in different parts of brains of homozygous mice was lower than that of wild type mice, and there were significant differences between the expression of ATP7A mRNA in basal ganglia and that in cerebellum (P<0.05). Conclusion Many factors contribute to the nervous system damage in Wilson's disease. The abnormal accumulation of Cu in specific parts of the brain is the initiating factor, Ca mediated apoptosis is one of the important factors, and the incompetency of ATP7A in Cu discharge may exacerbate the nervous system damage in Wilson's disease.

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    Risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants
    ZHU Tian-wen, ZHANG Yong-hong, CHEN Yan, et al
    2013, 33 (7):  920. 
    doi: 10.3969/j.issn.1674-8115.2013.07.005

    Abstract ( 618 )   PDF (390KB) ( 971 )  

    Objective To investigate the risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants. Methods Sixty-eight neonates with respiratory failure hospitalized in neonatal intensive care unit (NICU) were divided into late preterm infants group (n=34) and full-term infants group (n=34), the general clinical characteristics, perinatal parameters, treatment process of respiratory failure, main disease diagnosis and prognosis evaluation were compared between these two groups. Besides, the clinical parameters and respiratory parameters were compared between favorable prognosis group and unfavorable prognosis group. Results The average birth weight in late preterm infants group was significantly lower than that in full-term infants group (P<0.01), and the proportion of infants with low body weight in late preterm infants group was significantly higher than that in full-term infants group (P<0.05). However, there was no significant difference in the gender constituent ratio, age at NICU admission and proportion of infants small for gestational age between two groups (P>0.05). There was no significant difference in the healthy status and other perinatal parameters between late preterm infants group and full-term infants group (P>0.05). Apnea was only found in late preterm infants group, and NO inhalation treatment and high frequency ventilation were only adopted in full-term infants group, while there was no significant difference in the main disease diagnosis, respiratory treatment modality and prognosis between two groups (P>0.05). The proportion of infants small for gestational age in favorable prognosis group was significantly lower than that in unfavorable prognosis group (P<0.05), while the Caesarean section rate in favorable prognosis group was significantly higher than that in unfavorable prognosis group (P<0.05). Conclusion Relationship between gestational age and body weight of neonates with respiratory failure and way of delivery are influencing factors of prognosis.

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    Incidence and analysis of mother-related factors of late preterm infants
    YIN Zhang-hua, QIAN Ji-hong, ZHAO Dong-ying, et al
    2013, 33 (7):  926. 
    doi: 10.3969/j.issn.1674-8115.2013.07.006

    Abstract ( 734 )   PDF (357KB) ( 757 )  

    Objective To observe the trend of birth rate of late preterm infants, and explore the mother-related factors. Methods The annual birth rates of premature and late preterm infants born at Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between 2001 and 2011 were analyzed with the method of epidemiological survey. Meanwhile, the data of infants who were born at this hospital in 2011 were collected, and all the late preterm infants (n=183) and term infants (n=2 144) were observed. The data of birth and prognosis in two groups were analyzed, and their mother-related factors were recorded for univariate and multivariate analysis. Results The epidemiological data revealed that the overall birth rate of late preterm infants born at this hospital between 2001 and 2011 was 5.47%, accounting for 67.39% of all the preterm infants. The annual birth rates of premature and late preterm infants were increasing yearly. There were significant differences in the birth weight, delivery mode, length of hospital stay and proportion of infants who were transferred into neonatal ward due to complications between late preterm and term infants (P<0.05 or P<0.01). For the infants who were transferred into neonatal ward, the prognosis of term infants was significantly better than that of late preterm infants (P<0.01). Univariate and multivariate analysis indicated that mother-related factors, including gestational hypertension, anemia, heart dysfunction, premature rupture of membranes, placenta previa, multiple pregnancy as well as smoking were independent risk factors of late preterm birth. Conclusion The incidence of late preterm infants increases yearly, and obstetricians should pay attention to the targeted intervention for mother-related factors.

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    Value of serum total bile acid and γ-glutamyl-transferase in etiological diagnosis of prolonged jaundice
    ZHAO Dong-ying, HE Zhen-juan, ZHU Jian-xing, et al
    2013, 33 (7):  931. 
    doi: 10.3969/j.issn.1674-8115.2013.07.007

    Abstract ( 921 )   PDF (596KB) ( 1074 )  

    Objective To determine the value of serum total bile acid and γ-glutamyl-transferase (γ-GT) in the determination of etiology and prediction of prognosis of prolonged jaundice. Methods Ninety-five infants with prolonged jaundice were divided into infantile hepatitis syndrome group (n=35), biliary atresia group (n=30) and elevated indirect bilirubin group (n=30) according to the bilirubin levels. Besides, 30 age-matched hospitalized infants without jaundice and liver function injury were served as controls. The liver function parameters were measured before and after treatment, the diagnosis value of serum total bile acid and γ-GT was determined with receiver operator characteristic (ROC) curve, and the correlation of liver function parameters after treatment was analysed. Results The serum γ-GT level in biliary atresia group was significantly higher than those in the other groups (P<0.01), and the serum total bile acid levels in infantile hepatitis syndrome group and biliary atresia group were significantly higher than those in elevated indirect bilirubin group and control group (P<0.05). ROC curve analysis indicated that serum total bile acid had lower diagnostic efficiency for infantile hepatitis syndrome and biliary atresia, and γ-GT had definite diagnostic value for biliary atresia. When serum total bile acid level was 88.35 μmol/L and γ-GT was 250.5 U/L, the sensitivity of diagnosis of biliary atresia was 97.9% in a parallel trial, and the specificity was 90.5% in a serial test. Correlation analysis revealed that the changes of serum bilirubin were related to direct bilirubin, alanine aminotransferase and bile acid in infantile hepatitis syndrome group. Conclusion In the prolonged jaundice with an elevated indirect bilirubin, total bile acid and γ-GT are not significantly elevated, and the prognosis is favorable. In the prolonged jaundice with an elevated direct bilirubin, when total bile acid and γ-GT are significantly elevated, the diagnosis may tend to be biliary atresia. In the prolonged jaundice with an elevated direct bilirubin,when total bile acid is significantly increased, while γ-GT is not, the diagnosis may tend to be infantile hepatitis syndrome.

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    Effect of intrapleural instillation of erythromycin for treatment of neonates with congenital chylothorax
    LI Hua-jun, ZHU Jian-xing, XIE Li-juan
    2013, 33 (7):  936. 
    doi: 10.3969/j.issn.1674-8115.2013.07.008

    Abstract ( 887 )   PDF (305KB) ( 955 )  

    Objective To investigate the outcome of intrapleural instillation of erythromycin for treatment of neonates with congenital chylothorax. Methods The clinical data of neonates with diagnosis of congenital chylothorax between January 2007 and December 2011 were retrospectively analysed, and those caused by operations were excluded. Conservative treatment has been carried out for all neonates, including drainage of pleural fluid, respiratory support, total parenteral nutrition and supplementation of lost electrolytes and protein. Intrapleural instillation of erythromycin was done in those with no response to treatment, whose amount of pleural effusion was > 10-15 mL/(kg·d) for two weeks. Follow up with telephone survey was conducted in June 2012, and pulmonary function tests were performed in part of the neonates. Results Sixteen neonates were diagnosed as congenital chylothorax, and intrapleural instillation of erythromycin was conducted in 7 (once in 2 neonates, twice in 3, 3 times in 1, and 4 times in 1). The pleural fluid significantly decreased till disappeared, and none of these cases required surgical intervention, with the effective rate of 100%. The duration required for chest drainage after intrapleural instillation of erythromycin was significantly shorter than that before intrapleural instillation of erythromycin (P<0.01).The follow-up findings indicated that there was no significant difference in the parameters of pulmonary function tests between neonates with intrapleural instillation of erythromycin and those without (P>0.05). Conclusion Intrapleural instillation of erythromycin is a safe and effective treatment for neonates with congenital chylothorax, which is a conservative method worthy of clinical application.

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    Situation of Acinetobacter baumannii infection in Department of Neonatology and evaluation of sulbactam treatment
    YAN Chong-bing, QIU Gang, GONG Xiao-hui, et al
    2013, 33 (7):  940. 
    doi: 10.3969/j.issn.1674-8115.2013.07.009

    Abstract ( 1079 )   PDF (312KB) ( 976 )  

    Objective To investigate the situation of Acinetobacter baumannii infection in Department of Neonatology, and observe the curative effect of sulbactam on multidrug-resistant Acinetobacter baumannii (MDRAB) infection. Methods The data of 192 cases of Acinetobacter baumannii infection in Department of Neonatology were retrospectively analysed, and the location of infection and drug resistance were investigated. Meanwhile, the efficacy and safety of ampicillin sulbactam plus cefoperazone sulbactam in treatment of infection were evaluated. Results A total of 9 722 cases were admitted to Department of Neonatology between 2010 and 2012, and Acinetobacter baumannii infection developed in 192 (1.97%), most of which were respiratory infection. Among the 192 cases, 171 (89.0%) were cured, 8 (4.2%) died, and the outcomes were not available in the other 13 (6.8%). Thirty-eight cases of MDRAB infection were treated with ampicillin sulbactam plus cefoperazone sulbactam, the favorable clinical response rate was 65.8% (25/38), and there were 9 cases (23.7%) with no response and 4 cases (10.5%) of death. The levels of blood urea nitrogen, creatinine, aspartate aminotransferase and alanine transaminase were monitored before and after treatment with ampicillin sulbactam plus cefoperazone sulbactam in 31 patients, and no therapy-caused hepatic and renal function damage was found. Conclusion The rate of Acinetobacter baumannii infection increases gradually in Department of Neonatology, with serious drug resistance. The efficacy and safety of ampicillin sulbactam plus cefoperazone sulbactam for treatment of Acinetobacter baumannii infection are acceptable, and further studies are needed.

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    Epidemiology and advances in management of antibiotic resistance in neonates
    TANG Jun, ZHANG Yong-jun
    2013, 33 (7):  944. 
    doi: 10.3969/j.issn.1674-8115.2013.07.010

    Abstract ( 775 )   PDF (410KB) ( 861 )  

    Nosocomial infection is common in the neonatal intensive care unit. The rapid development of perinatal medicine and medical technology in neonatal intensive care unit has improved the survival of premature infants. With the longer duration of hospitalization, premature infants are exposed to the threat of nosocomial infection. Empiric antimicrobial therapy has resulted in an increase in the proportion of antibiotic-resistant organisms. Multi-resistance is mainly found in Gram-positive bacteria, and Vancomycin is the main treatment. However, the number of Vancomycin-resistant bacteria is increasing, and the potential threat has been a concern. Gram-negative bacteria, including carbapenem-resistant strains, is much more ominous, and the treatment options are extremely limited. Non-first-line drugs such as Colistin and Tigecycline are more frequently used, while intensive management should be done in application of these drugs on neonates for severe infection.

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    Original article (Basic research)
    Effects of Eriocalyxin B on immunoglobulin class switch recombination
    REN Jian-ting, ZHANG Hong-xin, LU Shun-yuan, et al
    2013, 33 (7):  949. 
    doi: 10.3969/j.issn.1674-8115.2013.07.011

    Abstract ( 969 )   PDF (593KB) ( 942 )  

    Objective To investigate the effects of Eriocalyxin B (EriB) on immunoglobulin class switch recombination (CSR). Methods B lymphocytes (1B4.B6) were treated with lipopolysaccharide (LPS) and different doses (0 μmol/L, 0.75 μmol/L, 1.5 μmol/L and 2.0 μmol/L) of EriB, the proliferation of these cells was analyzed by MTT and flow cytometry, the generation of immunoglobulin, efficiency of CSR and expression of relevant genes which play important roles in CSR were examined by ELISA, RT-PCR and Western blotting respectively, and the regulation of NF-κB transcription via EriB was determined by luciferase assay. Results With the increase of EriB concentration, the proliferation and CSR of B cells were defective. EriB inhibited the activation of NF-κB1 through blocking IκBα phosphorylation and degradation. It also directly repressed the transcription level of NF-κB1. Conclusion EriB could inhibit CSR through repressing the activation of NF-κB signaling pathway.

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    Influence of testosterone deficiency on pathological changes of liver, skeletal muscle and pancreatic islet of male rats
    XU Xiao, XIA Fang-zhen, ZHAI Hua-ling, et al
    2013, 33 (7):  955. 
    doi: 10.3969/j.issn.1674-8115.2013.07.012

    Abstract ( 607 )   PDF (815KB) ( 1013 )  
    Objective To observe the influence of testosterone deficiency on pathological changes of liver, skeletal muscle and pancreatic islet of male rats. Methods Healthy male SD rats were randomly assigned into normal control group (n=5, sham castration was performed), castrated group (n=7, testosterone deficiency model was established with castration) and replacement group (n=5, castration was performed, and intraperitoneal injection of 12.5 mg/kg testosterone propionate was conducted for 10 weeks). Thirty weeks later, serum concentration of testosterone was measured by radioimmunoassay in each group. The tissues of liver, skeletal muscle and pancreatic islet were obtained, and were observed by light microscopy with HE staining. Results The serum concentration of testosterone in castrated group was significantly lower than those in normal control group and replacement group(P<0.01). Light microscopy revealed that there was accumulation of lipid droplets in the cytoplasm of liver in castrated group, and there were less lipid droplets in replacement group than in castrated group. The size of nuclei in castrated group was smaller than that in normal control group. In castrated group, most skeletal muscle tissues were not clear in cross-sectional diameter, the pattern of cross striation in muscles disappeared, swelled and arranged in disorder, and the round lipid droplets were seen focally. However, the structure of muscle tissues in replacement group was similar with that in normal control group. The histological structure of pancreatic islet β cells was normal in normal control group, and the histological structure in castrated group and replacement group was similar with that in normal control group. Conclusion Fat deposition may cause pathological damage to liver and muscle tissues of male rats with castration, and exogenous testosterone replacement therapy may improve the pathological changes to some degree.
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    Morphological and electrophysiologic changes during differentiation of marrow-derived cardiac stem cells induced with bone morphogenetic protein-2 towards cardiomyocytes
    WANG Xin-yan, SUN Ying-gang, YANG Zhi-fang
    2013, 33 (7):  960. 
    doi: 10.3969/j.issn.1674-8115.2013.07.013

    Abstract ( 565 )   PDF (622KB) ( 886 )  

    Objective To investigate the morphological changes, expression of cardiac specific protein and electrophysiologic changes of the marrow-derived cardiac stem cells (MCSCs) induced with bone morphogenetic protein-2 (BMP-2) during differentiation towards cardiomyocytes. Methods MCSCs were screened from the bone marrow of SD rats, cultured with 10 ng/mL BMP-2 for 24 h, and treated with DMEM containing 10% fetal bovine serum. The morphological changes of cells were observed with phase contrast microscope, and the expression of myocardium-specific protein cTnT of cells was detected with immunocytochemical staining. The ventricular cardiomyocytes of normal rats were served as controls. The action potential and L-type calcium ion current of cells were recorded with the whole cell patch clamp. Results After induction with BMP-2, the morphology and arrangement of MCSCs changed. Four weeks after induction, a few cells were conjunct to form the myotube-like structures, and cTnT exhibited dense and striation-like expression. Three weeks after induction, the action potential of the cells could be recorded, which was similar to that of the ventricular cardiomyocytes, while the plateau of the action potential of the cells was not obvious. Four weeks after induction, the plateau of the action potential was obvious, which was similar to that of the ventricular cardiomyocyte of adult rats. The L-type calcium ion current of the cells could be recorded three weeks after induction, while it was small. The L-type calcium ion current of the cells was increased four weeks after induction, the depolarizing potential was -40 mV, the peak activated potential was 0 mV, and the reversal potential was +60 mV, the characteristics of which were similar to those of ventricular cardiomyocytes of adult rats. Conclusion BMP-2 may induce MCSCs to differentiate into cardiomyocytes. The differentiated cells have the morphological and electrophysiological characteristics of the mature cardiomyocytes.

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    Protein kinase MPK-1 inhibits fat accumulation via regulating FAT-7 by DAF-16
    HAN San-feng, HUANG Li-ying, WANG Li-shun
    2013, 33 (7):  965. 
    doi: 10.3969/j.issn.1674-8115.2013.07.014

    Abstract ( 899 )   PDF (608KB) ( 1068 )  

    Objective To investigate the effect of protein kinase MPK-1 on lipid metabolism, and explore the underlying mechanism. Methods C.elegans was served as model organism, and the expression of mpk-1, sbp-1 and daf-2 genes was interfered with RNA interference (RNAi). The fat contents in C.elegans were observed by Oil-red O staining and Sudan black staining, and were quantified after washing off the dye. Then, the mechanism of effect of MPK-1 on fat accumulation was determined by the combination of RNAi knockdown technique and the green fluorescence change in a specified location. Results The fat content significantly increased after interference of mpk-1 gene expression. Fluorescence microscopy revealed that fluorescence enhancement was detected after interference of mpk-1 gene expression in C.elegans with expression of lipogenic enzymes fat-7∷gfp, and intranuclear transference of DAF-16 was promoted after interference of mpk-1 gene expression in C.elegans with expression of DAF-16 fluorescin regulating fat-7. Conclusion Protein kinase MPK-1 may inhibit FAT-7 activity through DAF-16, and reduce the fat accumulation.

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    Original article (Clinical research)
    Diagnostic value of ELISPOT by recombinant Rv0315 protein of Mycobacterium tuberculosis in detection of active pulmonary tuberculosis
    ZHOU Ye-cheng, CHEN Cui-cui, YE Juan, et al
    2013, 33 (7):  970. 
    doi: 10.3969/j.issn.1674-8115.2013.07.015

    Abstract ( 643 )   PDF (597KB) ( 978 )  

    Objective To investigate the application of enzyme-linked immunospot assay (ELISPOT) by recombinant Rv0315 protein of Mycobacterium tuberculosis in the auxiliary diagnosis of active pulmonary tuberculosis. Methods A total of 25 patients with initial pulmonary tuberculosis (tuberculosis group) and 28 healthy people (control group) were enrolled. The peripheral blood mononuclear cells of all participants were co-cultured with Rv0315, earlier secreted antigen target 6 (EAST6) and culture filtrate protein 10 (CFP10) antigens, and spot forming cells (SFCs) were enumerated by ELISPOT. Results The values of sensitivity of Rv0315, EAST6 and CFP10 antigens by ELISPOT were 84.0% (21/25), 80.0% (20/25) and 92.0% (23/25) respectively, and those of specificity were 89.2% (25/28), 89.2% (25/28) and 92.8% (26/28) respectively. Rv0315 was more sensitive than EAST6, but was less sensitive in comparison with CFP10 in diagnosis of Mycobacterium tuberculosis infection. Conclusion ELISPOT with recombinant Rv0315 protein as antigen has the potential value in the auxiliary diagnosis of active pulmonary tuberculosis.

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    Observation of heart rate variability in patients with acute myocardial infarction and detection of its sensitive index
    ZHANG Ying, YANG Zhi-fang, WANG Wei, et al
    2013, 33 (7):  975. 
    doi: 10.3969/j.issn.1674-8115.2013.07.016

    Abstract ( 753 )   PDF (469KB) ( 897 )  

    Objective To observe the heart rate variability (HRV) at admission and before treatment in patients with myocardial infarction. Methods Electrocardiograms were recorded from healthy people, patients with coronary heart disease, patients with acute myocardial infarction and acute experimental ischemia animals, and shorttime HRV analysis was performed. Results Except for the heart rate, the other indexes of HRV in patients with acute myocardial infarction were significantly higher than those in healthy people, and SDNN (standard deviation of normal to normal RR intervals, representative of sympathetic tone), SD of delta NN (standard deviation of successive differences between adjacent normal cycles), NN50 (the percent of time that the difference between adjacent normal RR intervals was greater than 50 ms) and minor axis of poincare plot (SD1) which stood for parasympathetic tone, increased by 1.8, 2.7, 7.5 and 3.1 times respectively compared with healthy people. Those changes were also observed in the animal model with acute myocardial ischemia evoked by hypophysin. In comparison with healthy people, the HRV indexes of patients with coronary heart disease decreased substantially, although SDNN and SD of delta NN did not change significantly (P>0.05), SD1 decreased significantly (P<0.01). Conclusion HRV indexes in patients with acute myocardial infarction would elevate significantly. Compared with healthy people, on the other hand, the patients with chronic coronary heart disease exhibit decreased HRV indexes. In all probability, SD1 is more useful in evaluation of the changes in autonomic nervous activities than the other HRV indexes.

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    Features of extracellular matrix of pelvic floor muscles in pregnant women with stress urinary incontinence
    FENG Jie, WU Qing-kai, WU Deng-long, et al
    2013, 33 (7):  981. 
    doi: 10.3969/j.issn.1674-8115.2013.07.017

    Abstract ( 630 )   PDF (880KB) ( 814 )  

    Objective To explore the features of extracellular matrix of pelvic floor muscles in pregnant women with stress urinary incontinence (SUI). Methods Seventy-one primiparas with regular prenatal examination undergoing vaginal delivery were selected, and were divided into SUI group (n=33) and non-SUI group (n=38). Deep pelvic floor tissues were obtained after delivery, HE staining was conducted, electronic microscopy was performed for ultrastructure observation, and quantitative analysis of collagen and elastic fibers was carried out with Masson's trichrome staining and Verhoeff-van Gieson staining. Besides, another 3 women without pregnancy were served as non-pregnant controls. Results There were vacuolar degeneration, filament alteration and edema in smooth muscle cells of deep pelvic floor tissues in all pregnant women. There were plentiful of collagen and elastic fibers around striated muscles in non-SUI group. The main component of deep pelvic floor tissues in SUI group was smooth muscle, and there were sparse collagen and elastic fibers around smooth muscles. The relative contents of collagen fibers and elastic fibers of pelvic floor muscle tissues in SUI group were significantly lower than those in non-SUI group (P<0.05). Conclusion The extracellular matrix structure of pelvic floor muscle tissues in pregnant women with SUI is loose, with less collagen fibers and elastic fibres, which may be associated with the occurence of SUI.

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    Analysis of one Chinese pedigree with hereditary protein C deficiency
    ZHU Rui, ZHANG Lan, GU Yi, et al
    2013, 33 (7):  986. 
    doi: 10.3969/j.issn.1674-8115.2013.07.018

    Abstract ( 743 )   PDF (412KB) ( 1341 )  

    Objective To identify the phenotype and gene mutation in one Chinese pedigree with hereditary protein C deficiency, and explore the action mechanism of mutant site. Methods The plasma levels of protein C activity and protein C antigen of the propositus and family members were detected using chromogenic assay and ELISA respectively. All of the nine exons and intron-exon boundaries of PROC gene were amplified by PCR and analyzed by direct sequencing for the propositus. To the family members, only the exons with mutations were amplified and analyzed. The molecular mechanism of mutant site was explored through conformational analysis of protein before and after mutation. Results The plasma levels of protein C activity and protein C antigen of the propositus were 38% and 33.6% respectively. Gene sequencing revealed that there existed a heterozygous missense mutation [c.541T>G (p. Phe181Val)] and a nonsense mutation [c.595C>T (p.Arg199*)] on exon 7 of PROC gene of the propositus. The former caused the transformation from Phe to Val on site 181, and the latter led to the mutation from Arg to stop codon on site 199. The plasma levels of protein C activity of the father and son were 49% and 42.2% respectively, and those of protein C antigen were 90% and 97.4% respectively, and both had the same heterozygous nonsense mutation c.595C>T. The plasma level of protein C activity of the mother was 84.4%, that of protein C antigen was 100%, and there was missense mutation on site c.541T>G in exon 7. The levels of protein S: A and AT: A were in the normal range in all the members. Conclusion Inherited protein C deficiency is indicated by phenotype diagnosis and gene analysis for the propositus. Two mutations of the propositus are inherited from father and mother respectively, which may be the cause for protein C deficiency, and c.595C>T mutation may be the main cause of decrease in protein C activity.

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    Serum transforming growth factor-β levels in patients with diabetic retinopathy
    LUO Da-wei, ZHENG Zhi, LIU Kun, et al
    2013, 33 (7):  990. 
    doi: 10.3969/j.issn.1674-8115.2013.07.019

    Abstract ( 659 )   PDF (228KB) ( 795 )  

    Objective To investigate the serum transforming growth factor-β (TGF-β) levels in patients with diabetic retinopathy  (DR). Methods Seventy-two patients with diabetes were selected, including 15 patients with proliferative diabetic retinopathy (PDR group), 32 patients with non-proliferative diabetic retinopathy (NPDR group) and 25 patients with non-diabetic retinopathy group (NDR group). Besides, 45 healthy people were served as normal control group. The serum TGF-β levels were detected by ELISA. Results Serum TGF-β levels in groups with diabetes were significantly higher than that in normal control group (P<0.01). Serum TGF-β level in PDR group was significantly higher than those in NPDR group and NDR group (P<0.05). Conclusion Serum TGF-β level is associated with the severity of diabetic retinopathy.

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    Contrast study of artifacts of MRI caused by Au alloy and Ni-Cr alloy crowns in oral cavity
    XIN Xian-zhen, DONG Jian-hui
    2013, 33 (7):  993. 
    doi: 10.3969/j.issn.1674-8115.2013.07.020

    Abstract ( 672 )   PDF (596KB) ( 911 )  

    Objective To compare the magnetic resonance imaging (MRI) artifacts caused by porcelain-fused-to-metal crowns made of Ni-Cr alloy and Au alloy in oral cavity. Methods Six samples were divided into Ni-Cr porcelain-fused-to-metal crowns group and 86.2% Au alloy porcelain-fused-to-metal crowns group (n=3), and were placed into the oral cavity of subjects (with no prosthetics or absence of teeth) for MRI examinations. The images were observed, the types, degree and sizes of artifacts were determined, and the pixel values of area of artifacts were calculated. SAS 8.2 software was employed for statistical analysis. Results The artifacts of Ni-Cr crowns involved images of 4 to 6 layers, those of Au alloy crowns involved images of 3 layers. Statistical analysis indicated that compared with 86.2% Au alloy porcelain-fused-to-metal crowns group, the area of artifacts of sagittal images on MIR from 6-crown was significantly larger (P<0.05), and the number of layers on involved images was much bigger in Ni-Cr porcelain-fused-to-metal crowns group (P<0.05). Conclusion Both Ni-Cr porcelain-fused-to-metal crowns and Au porcelain-fused-to-metal crowns would produce artifacts in oral cavity, and the artifacts caused by Au alloy crowns are smaller in area and number of layers involved.

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    Application of dual energy heart imaging in patients with moderate to severe renal insufficiency
    CAO Li-xiu, PAN Zi-lai, ZHANG Huan, et al
    2013, 33 (7):  996. 
    doi: 10.3969/j.issn.1674-8115.2013.07.021

    Abstract ( 924 )   PDF (961KB) ( 1069 )  

    Objective To investigate the application of dual energy heart imaging in evaluation of coronary artery, first-past myocardial perfusion and left ventricular cardiac function in patients with moderate to severe renal insufficiency. Methods The results of dual energy CT-helical (DECT-helical) in 20 patients confirmed as moderate to severe renal insufficiency were retrospectively analysed, the coronary artery stenosis, myocardial perfusion imaging and cardiac function were evaluated, and the correlation among the three items was explored. Besides, the consistency of heart function analysed by dual-source CT (DSCT) and echocardiogram was determined. Results A total of 248 coronary segments in 20 patients with moderate to severe renal insufficiency were analysed, among whom 14 had different degrees of pathological changes, involving 60 coronary segments, and most patients had multi-vessel lesion with mild stenosis of the lumen. A total of 340 segments of myocardial perfusion were analysed, and 15 patients had perfusion defects, involving 72 myocardial segments. There were significant differences in the iodine values among defective perfusion region, sparse perfusion region and normal myocardium (P<0.01). Twelve patients had abnormal left ventricular cardiac function, among whom 9 had whole cardiac anomalies and 11 had regional wall movement abnormalities, which involved 61 myocardial segments. The consistency of end-diastolic volume, end-systolic volume, stroke volume and ejection fraction between DSCT and echocardiogram was favorable. Conclusion DECT-helical can evaluate the morphology of coronary artery, first-past myocardial perfusion and left ventricular cardiac function in patients with moderate to severe renal insufficiency with appropriate heart rate, and can comprehensively make diagnosis of cardiovascular disease.

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    Electrocardiographic characteristics and catheter ablation of ventricular ectopic beats originating from junction of left and right coronary sinuses of Valsalva in aorta
    ZANG Min-hua, ZHOU Lei, MA Jian-wei, et al
    2013, 33 (7):  1002. 
    doi: 10.3969/j.issn.1674-8115.2013.07.022

    Abstract ( 782 )   PDF (540KB) ( 994 )  

    Objective To explore the electrocardiographic characteristics and catheter ablation of ventricular ectopic beats originating from the junction of left and right coronary sinuses of Valsalva in the aorta. Methods Electrocardiographic examination and ablation were performed under the guidance of three dimensional mapping systems in two patients with ectopic beats originating from left ventricular outflow tract. Results Ectopic beats were mapped to originate from the junction of left and right coronary sinuses of Valsalva in both patients. The electrocardiograms showed early precordial transition of QRS complex prior to lead V3 in two patients, the notching QS morphology in lead V1, the qrS pattern in leads V1-V3 in one patient and non-specific morphology in the other patient. Subsequent ablation by positioning the irrigated catheter at the junction of two sinuses of Valsalva or at the left side of the junction (in left coronary sinus of Valsalva) successfully abolished ectopic beats in two patients. Conclusion There may be or may not be characteristic electrocardiographic findings for ventricular ectopic beats originating from the junction of left and right coronary sinuses of Valsalva in the aorta, and catheter ablation could abolish them successfully by proper catheter placement.

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    Interobserver variability in thyroid imaging reporting and data system description of sonographic features of thyroid nodules
    JIA Xiao-hong, ZHOU Jun-yu, XU Shang-yan, et al
    2013, 33 (7):  1006. 
    doi: 10.3969/j.issn.1674-8115.2013.07.023

    Abstract ( 940 )   PDF (295KB) ( 952 )  
    Objective To evaluate the interobserver variability in the thyroid imaging reporting and data system (TI-RADS) description of sonographic features of thyroid nodules with different sizes. Methods The retrospective study was conducted on 225 thyroid nodules. All the cases were divided into ≤1.0 cm group and >1.0 cm group according to the diameters. Interobserver variability was determined using Cohen's Kappa statistics. Results About the sonographic features of thyroid nodules, the shape, internal content and calcifications exhibited substantial agreement in both groups. There was moderate agreement with regard to echogenicity, posterior
    attenuation and vascular pattern in two groups. The kappa values of internal content, echogenicity, calcifications and posterior attenuation were higher in
    ≤1.0 cm group, while those of shape and vascular pattern were higher in >1.0 cm group. Of the elastography, there was also moderate agreement, and in
    particularly the kappa values were equal. There was moderate agreement on boundary and echotexture in ≤1.0 cm group, while there was substantial agreement
    in >1.0 cm group. There was fair agreement on margin in ≤1.0 cm group, and there was substantial agreement in >1.0 cm group. Conclusion There are higher
    interobserver agreement on the TI-RADS description of sonographic features of thyroid nodules, and there are differences in some description between
    different sizes of thyroid nodules.
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    Correlative study of bispectral index and Glasgow coma scale in adults with acute brain injury
    SHU Guo-wei, ZHANG Jue, FEI Zhi-min, et al
    2013, 33 (7):  1010. 
    doi: 10.3969/j.issn.1674-8115.2013.07.024

    Abstract ( 811 )   PDF (301KB) ( 903 )  
    Objective To investigate the correlation between Glasgow coma scale (GCS) and bispectral index (BIS) in adults with acute brain injury, and explore the feasibility of BIS value in assessment of brain injury. Methods The prospective and double-blinded design was adopted, and the GCS and BIS values of 89 adults were collected. The mean BIS values of patients with different severity of brain injury were calculated. Linear regression between BIS value and GCS value was constructed, and receiver operating characteristic (ROC) curves at GCS <9 or <13 were plotted respectively. Results There were significant differences in BIS values among patients with mild, moderate and severe brain injury (81.29±7.29, 69.32±8.50 and 45.79±12.39 respectively, P<0.01). There was a significantly
    positive correlation between GCS value and BIS value (R2=0.825, P<0.01). The regression equation was BIS=4.23×GCS+22.22. The ROC curve at GCS<9
    demonstrated that the area under the curve (AUC) was 0.963, and the cut-off point (BIS value) corresponding with the maximum sensitivity (0.932) and
    specificity (0.933) was 63.8.The ROC curve at GCS score<13 demonstrated that AUC was 0.933, and the cut-off point (BIS value) corresponding with the
    maximum sensitivity (0.905) and specificity (0.851) was 71.6. Conclusion BIS value significantly correlates with GCS value in adults with acute brain
    injury. As a continuous, real-time and objective parameter, BIS can be used as a new tool to assess and monitor the severity of brain injury.
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    Short-term clinical effect of single-visit root canal therapy for infected root canals
    LIU Shuang, LENG Zhi-yong
    2013, 33 (7):  1014. 
    doi: 10.3969/j.issn.1674-8115.2013.07.025

    Abstract ( 800 )   PDF (322KB) ( 878 )  
    Objective To compare the short-term effects of single-visit and multi-visit root canal therapy for infected root canals. Methods One hundred and thirty patients (143 teeth) with acute and chronic periapical inflammation or pulp necrosis were randomly divided into single-visit root canal therapy group (n=95, root canal preparation and filling in one visit) and multi-visit root canal therapy group (n=48, conventional root canal therapy with 1 to 2 subsequent visits). Twenty-four hours after root canal filling (single-visit root canal therapy group) or intracanal medication in first visit (multi-visit root canal therapy group), the pain degree was self-assessed by patients with visual analogue scale (VAS). In single-visit root canal therapy group, subsequent visit was done 1 week after root canal filling, and the pain degree was clinically evaluated. In multi-visit root canal therapy group, the pain degree was clinically evaluated during subsequent visits 1 week after intracanal medication and 1 week after root canal filling respectively. Six months and 1 year after root canal filling, the therapeutic effect was determined with X-ray examination and clinical assessment. Results There was no significant difference in the degree of pain self-assessed by patients (P>0.05), and the incidences of acute reaction were 10.53% and 12.5% in single-visit root canal therapy group and multi-visit root canal therapy group respectively (P>0.05). There was no significant difference in the degree of pain in clinical evaluation (P>0.05). Six months and 1 year after root canal filling, the cure rates were 83.3% and 88.5% in single-visit root canal therapy group, and those were 88.9% and 90.5% in multi-visit root canal therapy group, with no significant difference between two groups (P>0.05). Conclusion For infected root canals, single-visit root canal therapy may yield similar short-term postoperative pain and therapeutic effect with multi-visit root canal therapy.
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    Original article (Public health administration)
    Application of comprehensive evaluation methods in medical quality evaluation of clinical departments
    CHEN Wei, WANG Zhong
    2013, 33 (7):  1018. 
    doi: 10.3969/j.issn.1674-8115.2013.07.026

    Abstract ( 739 )   PDF (377KB) ( 1060 )  
    Objective To evaluate the medical quality of clinical departments in tertiary comprehensive hospital with a variety of comprehensive evaluation methods, verify the
    feasibility of these methods, and provide reference for hospital management and policy making. Methods The comprehensive evaluation index system including 13
    key indicators from three dimensions of efficiency, quality and efficiency was constructed with literature analysis and expert consultation. The method of
    analytic hierarchy process was adopted to determine the weight of indicators. Weighted composite index method, weighted rank sum ratio method and weighted
    TOPSIS method were employed to build the comprehensive evaluation model for the assessment of medical quality of clinical departments in the First Affiliated
    Hospital of Medical College of Shihezi University in the year of 2011, and the standardization method was used to combine the evaluation results of three
    evaluation methods. Results There was a high consistency and correlation among three evaluation methods. There was a higher correlation between weighted
    composite index method and weighted rank sum ratio method and between weighted composite index method and weighted TOPSIS method (r=0.958 and 0.920, P<0.01 for both), and there was a second higher correlation between weighted rank sum ratio method and weighted TOPSIS method (r=0.866, P<0.01). The
    consistency efficient (w) of three evaluation methods and combination evaluation method was 0.954 (P<0.01). The correlation coefficients between
    combination evaluation method and weighted composite index, weighted rank sum ratio method and weighted TOPSIS method were 0.984, 0.956 and 0.951
    respectively (P<0.01 for all). Conclusion In the practice of medical quality comprehensive evaluation, several comprehensive evaluation methods can be used in
    combination, and the result may be more stable and reasonable.
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    Changing trend of government assigned overseas study in a tertiary hospital in Shanghai in the past ten years
    CHEN Qi, MENG Zhi-min, CHEN Wei, et al
    2013, 33 (7):  1024. 
    doi: 10.3969/j.issn.1674-8115.2013.07.027

    Abstract ( 741 )   PDF (695KB) ( 944 )  
    Objective To investigate the changing trend of government assigned overseas study in a tertiary hospital in Shanghai in the past ten years. Methods Through the hospital information system, the basic information of government assigned overseas study of Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine between 2001 and 2010 was collected, and the data of 388 cases of government assigned overseas study were obtained. The cases were divided into 2001-2005 group (n=224) and 2006-2010 group (n=164) based on the time abroad, and the overseas duration, objective, funding, professional title, administrative duty, education background and destinations were compared between groups. Results The number of government assigned overseas study increased year by year between 2001 and 2007, and decreased significantly after 2008. Among the 388 cases, the overseas duration was longer than 3 months in 73.20%, the objective was training in 92.52%, 43.81% held a medium professional title, 80.93% had no administrative duty, 39.95% had a master degree, the destination was North America in 39.43%, and 53.20% were funded by the other parties. Compared with 2001-2005 group, the percent of cases with administrative duty was significantly lower, that with doctor degree was significantly higher, that with bachelor degree was significantly lower, that with Asia as destination was significantly lower and that with North America as destination was significantly higher in 2006-2010 group (P<0.05 or P<0.01). There was no significant difference in overseas duration, objective and professional title distribution between two groups (P>0.05). Funding by nation and the other parties decreased year by year, while the number of funding by Shanghai Jiaotong University School of Medicine was the biggest, though the sum was limited. Conclusion The hospital should enhance the support on the midterm and longterm programs of overseas training, scientific cooperation and doctoral education in famous universities. The hospital should also expand the funding resources of overseas study. The policy and financial support is important for the development of government assigned overseas study.
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    Review
    Neural mechanism and hypothesis of cognitive aging
    LI Ting, LI Chun-bo
    2013, 33 (7):  1030. 
    doi: 10.3969/j.issn.1674-8115.2013.07.028

    Abstract ( 1045 )   PDF (368KB) ( 1126 )  
    During the course of cognitive aging, the structure and function of brain change at different levels. Brain imaging techniques have become important means for the neural mechanism research of cognitive aging since 1970s. Functional imaging studies have consistently found two “overactivation” models in regional brain area in the elderly:hemispheric asymmetry reduction in older adults (HAROLD) and posterior-anterior shift in aging (PASA). The theories and hypothesis relating to the two models, including compensation theory and dedifferentiation theory are reviewed, and the neural mechanism of cognitive aging is explained from different aspects in this paper.
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    Research progress of CCL7
    HU Qing-xiang, QI Wen-xiao, ZHANG Xue-fei, et al
    2013, 33 (7):  1035. 
    doi: 10.3969/j.issn.1674-8115.2013.07.029

    Abstract ( 2121 )   PDF (322KB) ( 1357 )  
    Chemokine (C-C motif) ligand 7 (CCL7) is widely expressed in fibroblasts, monocytes and tumor cells, and exerts a spectrum of functions as monocyte recruitment, elicitation of calcium influx and facilitation of tumor metastasis via its interaction with specific receptors of CCR1, CCR2 and CCR3. This review will represent the up-to-date findings of CCL7 on its genetic and molecular structure, physiologic function, and its correlation with diseases.
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    Application of thrombomodulin in treatment of sepsis
    LU Hua-xiang, JIA Yi-tao, YAO Min, et al
    2013, 33 (7):  1039. 
    doi: 10.3969/j.issn.1674-8115.2013.07.030

    Abstract ( 717 )   PDF (325KB) ( 964 )  
    Sepsis is a clinical syndrome which results from severe infection and systemic inflammatory response. Deregulated interplay between inflammation and coagulation plays a pivotal role in the pathogenesis of sepsis. Thrombomodulin is an endogenous anticoagulant protein that possesses both anti-inflammatory and anticoagulant properties in directly and indirectly ways, which provides a new choice for the treatment of sepsis. The structure, function and application of thrombomodulin in the treatment of sepsis are introduced in this paper.
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    Case report
    One case report of successful treatment of serious phenol burn with renal injury
    YANG Hui-zhong, HUANG Xiao-qin, LI Xue-chuan, et al
    2013, 33 (7):  1043. 
    doi: 10.3969/j.issn.1674-8115.2013.07.031

    Abstract ( 1121 )   PDF (159KB) ( 664 )  
    The clinical data of one case of serious phenol burn complicated with renal injury were collected, and the treatment course was retrospectively analyzed, so as to further confirm the clinical characteristics of phenol burn as well as the primary treatment and pivotal means for rescuing this kind of phenol burn patients especially with renal injury.
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