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    Original article (Basic research)
    Surgery procedures of piglet model of aortic coarctation
    MA Zhou-rui, YU Yun-peng, PU Tian, et al
    2013, 33 (11):  1431. 
    doi: 10.3969/j.issn.1674-8115.2013.11.001

    Abstract ( 664 )   PDF (836KB) ( 1084 )  

    Objective To compare long-term effects between banding method (Bme) and transverse aortic incision with longitudinal suture method (TLme) in establishment of experimental aortic coarctation models. Methods Forty piglets were randomly divided into Bme group and TLme group (20 in each) to establish aortic coarctation models. Angiographic and histological examinations were carried out 1, 3, and 6 months after model establishment. Another 10 piglets were served as shamoperation group (S group). Results The stenotic vessel models were established successfully. Compared to S group, the diameters of stenotic vessels were significantly smaller in Bme and TLme groups in 1 month (P<0.01), which existed pressure gradients. But the diameter of stenotic vessels in Bme group gradually increased in time of 3 and 6 months and pressure gradients disappeared, which had no significant differences with S group. However, in TLme group, both diameter of stenotic vessels and pressure gradients maintained the same (P<0.01). Conclusion TLme is an effective surgery procedure to establish experimental coarctation model with long-term stability, and the model may be ideal for the study of cardiovascular stents.

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    Rosuvastatin inhibits homocysteine-induced oxidative stress and apoptosis in endothelial progenitor cells involving Nox4
    BAO Xiao-mei, ZHENG Hong-chao, WU Chun-fang, et al
    2013, 33 (11):  1436. 
    doi: 10.3969/j.issn.1674-8115.2013.11.002

    Abstract ( 834 )   PDF (391KB) ( 845 )  

    Objective To study inhibition of rosuvastatin (Rosu) on homocysteine (Hcy)-induced reactive oxygen species (ROS) and apoptosis in endothelial progenitor cells (EPCs). Methods EPCs were isolated from peripheral blood and then incubated with Hcy, or pre-incubated with Rosu or with different stress signaling pathway inhibitors including mevalonate (100 μmol/L), acetyl-cysteine (NAC, 10 μmol/L), NADPH oxidase inhibitor (DPI, 10 μmol/L), and endothelial nitric oxide synthase inhibitor (LNMA, 1 mmol/L) before adding Hcy. Apoptosis rate was evaluated by fluorescence activated cell sorting (FACS) analysis. ROS levels were detected by 2’,7’-dichlorodihydrofluorescein diacetate (H2DCFH-DA). NADPH oxidases were evaluated with lucigenin-enhanced chemiluminescence. Expression of Nox4 mRNA was measured by RT-PCR. Results Rosu remarkably inhibited Hcy-induced ROS accumulation and apoptosis of EPCs, and antagonized Hcy-induced activation of NADPH oxidase and Nox4 mRNA expression. Nox4 siRNA transfected EPCs with a similar effect. Conclusion The protective effect of Rosu on EPCs possibly involves inhibition of Hcy-induced activation of Nox, ROS accumulation, and apoptosis of EPCs through Nox4 dependent mechanisms.

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    Effects of X-ray on cell proliferation and apoptosis of human pancreatic cancer cell lines SW1990 and Capan-2
    LIU Xiao-xing, HOU Yan-li, MA Xiu-mei, et al
    2013, 33 (11):  1440. 
    doi: 10.3969/j.issn.1674-8115.2013.11.003

    Abstract ( 799 )   PDF (439KB) ( 1166 )  

    Objective To explore the effects of X-ray irradiation on cell proliferation and apoptosis of human pancreatic cancer cell lines SW1990 and Capan-2. Methods SW1990 and Capan-2 cells were obtained at logarithmic growth phase and then irradiated by X-ray at different dosage (2, 4, 6, 8, and 10 Gy) for 24, 48, and 72 h. The inhibition rates were detected by CCK-8 assay. Apoptosis rates of SW1990 and Capan-2 cells were determined by flow cytometry with Annexin V/PI double staining. Apoptosis related proteins and mRNA expressions were detected by using Western blotting and RT-PCR. Results Compared to control group, the inhibition rates of SW1990 and Capan-2 cells were significantly higher in X-ray irradiated group (P<0.05), and the inhibition was in a dose-dependent manner. The apoptosis rates of SW1990 and Capan-2 were significantly increased with a dose-dependent manner under X-ray irradiation. Western blotting results indicated that expressions of Bax, a pro-apoptotic protein, increased with irradiation of X-ray. And RT-PCR results indicated that mRNA of Bcl-2, an anti-apoptotic protein, decreased while mRNA of Bax increased under X-ray irradiation. Conclusion X-ray irradiation has significant inhibitive effect on pancreatic cancer cell lines, SW1990 and Capan-2, in a dose- and time-dependent manner, which may be related with pancreatic cancer cells apoptosis.

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    Comparative study on genotyping of Candida albicans by repetitive sequence-based PCR and multilocus sequence typing
    WEI Bing, LIU Jin-yan, SHI Ce, et al
    2013, 33 (11):  1445. 
    doi: 10.3969/j.issn.1674-8115.2013.11.004

    Abstract ( 737 )   PDF (401KB) ( 995 )  

    Objective To compare repetitive sequence-based polymerase chain reaction (REP-PCR) and multilocus sequence typing (MLST) in genotyping of Candida albicans, and assess the two methods. Methods Forty Candida albicans strains were isolated from Candida vaginitis patients from local hospitals of shanghai. With the most suitable primers used to amplify, the amplicons were analyzed through electrophoresis to generate different REP-PCR types. Seven loci in housekeeping genes were amplified and sequenced. The sequences were compared with MLST database to obtain sequence type (ST). Results For REP-PCR, Ca22-Ca22 has the best genotyping effect. Seven REP-PCR types were found in 40 Candida albicans isolates. Twenty-nine MLST types were found and they were all new types. Conclusion MLST has much better discriminatory power than REP-PCR, but REP-PCR offers a simple and rapid method for molecular typing. Therefore, REP-PCR can be the first choice for a large number of isolates in laboratory and clinical practice. MLST is more objective and more suitable for the research of evolutionary and global epidemiology investigation.

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    Expressions of adiponectin receptors in lung tissue of type 1 and type 2 diabetic rats
    GUO Zhu-ying, WANG Shi-ting, XU Mang-hua, et al
    2013, 33 (11):  1449. 
    doi: 10.3969/j.issn.1674-8115.2013.11.005

    Abstract ( 579 )   PDF (899KB) ( 1013 )  

    Objective To investigate expressions of adiponectin receptors (AdipoR1, AdipoR2) in lung tissue in type 1 and type 2 diabetes mellitus rats induced by streptozotocin (STZ). Methods A total of 40 SD rats were randomly divided into 4 groups: control (Con) group, type 1 diabetes mellitus (1-DM) group, 72 h after STZ injection (72 h) group, and type 2 diabetes mellitus (2-DM) group. The rats in 1-DM group and 72 h group were injected STZ intraperitoneally with a dose of 60 mg/kg while the ones in Con group were only done with the same dose of citric acid buffer. The rats in 2-DM group were injected STZ intraperitoneally with a dose of 35 mg/kg. Serum insulin and adiponectin levels were evaluated by ELISA. The content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in lung tissue were measured. Expression of AdipoR1, AdipoR2 in lung tissue was determined by immunohistochemistry. The pathological changes of lung tissue were examined by HE staining under light microscope. Results The levels of serum adiponectin in 1-DM and 2-DM groups were lower than that in Con group (P<0.05). The level of serum adiponectin in 2-DM group was lower than that of 1-DM group (P<0.05). Compared with Con group, the expression of AdipoR1 and activity of SOD in lung tissue in 1-DM and 2-DM groups were lower while those in 72 h group were similar. In 1-DM and 2-DM groups, the rat lung tissue manifested injuries such as basement membrane thickening and blood vessel occlusion. Conclusion Adiponectin receptors expression in lung tissue is given priority to AdipoR1. High blood glucose may result in lung injury and decrease AdipoR1 expression and SOD activity.

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    Expression changes of regeneration gene protein-2 in rats after different degrees of spinal cord injury
    LIU Yang, MIAO Yu-chuan
    2013, 33 (11):  1454. 
    doi: 10.3969/j.issn.1674-8115.2013.11.006

    Abstract ( 582 )   PDF (499KB) ( 906 )  

    Objective To detect expression changes of regeneration gene protein (Reg)-2 in rats with different degrees of spinal cord injury (SCI). Methods Thirty SPF Wistar rats were randomly divided into 5 groups: normal control group, sham operation group, slight injury group (injury energy: 25 g·cm), moderate injury group (injury energy: 50 g·cm), and severe injury group (injury energy: 75 g·cm). The SCI model rats were established with own-made device by modified Allen's crush method. The combine behavioral score (CBS) of injury groups rats were assessed in 1, 3, 5, and 7 d after injury. The rats were sacrificed at 7 d after surgery, then the content of Reg-2 mRNA and expression of Reg-2 were detected with RT-PCR and immunohistochemistry assay, respectively. Results The results of CBS in injury groups, which were higher than that in normal control group, declined gradually with the lapse of injury time, and the differences in every injury group were statistically significant (P<0.05). The contents of Reg-2 mRNA and Reg-2 in injury groups, which were higher than that in normal control group (P<0.05), elevated with the severity of injury. The differences of Reg-2 mRNA and Reg-2 among every injury group were statistically significant (P<0.05). In slight injury group, the Reg-2 positive cells were mainly neurons, but in severe injury group they were mainly neurogliocytes. Conclusion Reg-2 could improve the function of neurons after SCI, which was dependent on the injury degree.

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    Function and mechanism of death domain-associated protein in zebrafish embryonic development
    ZHANG Tao, YUAN Hao, LIU Xi, et al
    2013, 33 (11):  1458. 
    doi: 10.3969/j.issn.1674-8115.2013.11.007

    Abstract ( 952 )   PDF (705KB) ( 1004 )  

    Objective To explore the spatio-temporal mRNA expression pattern of death domain-associated protein (Daxx) in the whole process of zebrafish embryonic development, and to study the physiological role and possible molecule mechanism of Daxx in the process. Methods Whole-mount mRNA in situ hybridization (WISH) was performed to ascertain the spatio-temporal expression pattern of Daxx in the process of zebrafish embryonic development. Daxx expression was knocked down by using morpholino mediated gene knockdown. TUNEL and pH3 staining assay were applied to check cell apoptosis and proliferation in Daxx deficient embryos. The molecule mechanism of Daxx was explored by using Real-Time PCR. Results Knock-down Daxx activated p53 dependent cell apoptosis pathway,thus caused increasing rate of apopotosis and malformation, whereas those could be rescued by p53 co-knockdown. Moreover, the acid-enriched domain of Daxx mediated the interaction between Daxx and p53 and regulated the expression of p53 target genes bax, mdm2, p21, and cyclin G1. Conclusion Daxx could bind to p53 via its specific motif and regulate the expression of key genes downstream of p53, which may be the key mechanism of Daxx during zebrafish embryonic development.

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    Study of biocompatibility of chondrocytes and composite hydrogel
    WANG De-fang, QIAO Guang-yan, LIU Li
    2013, 33 (11):  1465. 
    doi: 10.3969/j.issn.1674-8115.2013.11.008

    Abstract ( 630 )   PDF (851KB) ( 1201 )  

    Objective To evaluate biocompatibility of chondrocytes with composite hydrogel system of light-cured chitosan and sodium alginate, and to study its feasibility for cartilage tissue engineering. Methods Three-dimensional porous light-cured chitosan hydrogel was prepared as the carrier of chondrocytes in space. Chondrocytes were enclosed into light-cured chitosan hydrogel by means of sodium alginate hydrogel. The structure and morphology of light-cured chitosan scaffolds and cell distribution and morphology within scaffolds were observed by scanning electron microscopy (SEM). The method of CCK8 was used to draw the cell growth curve and cell activity was tested by DAPI staining. Results Pure light curing chitosan hydrogel material presented as a porous structure of uniform pores with the average pore size about 300 μm. Composite hydrogel could mimic natural cartilage extracellular matrix environment to maintain the chondrocytes as natural round state and could promote the proliferation of chondrocytes. Conclusion Composite hydrogel of light-cured chitosan and sodium alginate can provide a similar natural biological environment for chondrocytes, and promote their proliferation and growth, which may be a very promising cartilage tissue engineering scaffolds for in vivo experimental studies of cartilage defects.

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    Influence of hormone inhibition during minipuberty on sex development of male rats
    WANG Rui-fang, DONG Zhi-ya, WANG Wei, et al
    2013, 33 (11):  1470. 
    doi: 10.3969/j.issn.1674-8115.2013.11.009

    Abstract ( 684 )   PDF (635KB) ( 961 )  

    Objective To investigate the impacts of hormone inhibition during minipuberty on adolescent gonadal axis function of male rats. Methods ①The concentrations of serum testosterone (T), luteotropic hormone (LH), follicle-stimulating hormone (FSH) and testicular weight of normal male rats were measured at different time points after birth (0, 2, 4, 6, and 24 h) to confirm the existence of minipuberty. ②“No minipuberty” models were established by using ether inhalation to male neonatal rats in 5 min after birth. ③Bilateral testes and epididymis weight and testicular pathologic changes were compared between the model and control group at the age of 45 d and 75 d. Serum T levels were tested by ELISA. And expressions of testicular androgen receptor (AR) mRNA, insulin-like growth factor 3 (INSL3) mRNA, anti-mullerian homone (AMH) mRNA, and Ghrelin mRNA were determined by real-time PCR assay. Results ①In the neonatal male rats, serum T and LH levels reached a maximum at 2 h after birth. FSH level rose to peak in 30 min, and bilateral testicular weight also reached a short-term peak at 4 h. ②In model group, serum T, LH, and FSH levels showed remarkable descent, which was proved establishment of “no minipuberty” model. ③Impaired evidences were found in testicular pathologic images of model group at the age of 45 d. Ghrelin gene mRNA expression at 45d of age and AR gene mRNA expression at 75 d of age had no statistical difference between the two group, but there was an obvious decrease tendency in model group (P=0.055, P=0.050). AMH mRNA expression in model group was significantly lower than that in the control group at 75 d of age (P=0.024). Conclusion Minipuberty was confirmed to exist in male rats which lasted about 6 h. Inhibition of minipuberty by ether inhalation was proved to have long-term effect on gonadal function of male rats.

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    The role of c-Myb in the pathogenesis of acute promyelocytic leukemia
    WANG Guo, DENG Wang-long, ZHANG Ji
    2013, 33 (11):  1475. 
    doi: 10.3969/j.issn.1674-8115.2013.11.010

    Abstract ( 944 )   PDF (557KB) ( 989 )  

    Objective To study the role of transcription factor c-Myb in the pathogenesis of acute promyelocytic leukemia (APL). Methods Through analyzing microarray data of acute myeloid leukemia (AML) patients, we compared the levels of c-Myb expressions in APL cells and normal promyelocytic cells. Through inducing the differentiation of NB4 with ATRA and the expression of PML-RARα in PR9 cells with ZnSO4, we investigated whether c-Myb was involved in the pathogenesis of APL. Using RNAi, we researched whether knocking down c-Myb could rescue APL. Results The levels of c-Myb expression in APL cells were higher than those in normal promyelocytic cells. The expression of c-Myb gradually declined along with the differentiation of NB4, and gradually rose along with the expression of PML-RARα in PR9. The knockdown of c-Myb could rescue the blocked differentiation of NB4, which increased the positive rate of CD11b of NB4 cells to about 20%. Conclusion The level of c-Myb expression in APL is higher than that in normal promyelocytic cells, which indicates that c-Myb has an important role in the pathogenesis of APL. The knockdown of c-Myb can partly reverse APL.

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    Analysis of cerebro-spinal fluid and clinical data from 31 children with Kawasaki disease
    GUO Qian-qian, WANG Li-ping, XU Rang, et al
    2013, 33 (11):  1480. 
    doi: 10.3969/j.issn.1674-8115.2013.11.011

    Abstract ( 758 )   PDF (373KB) ( 1055 )  

    Objective To explore relationship between changes of  cerebro-spinal fluid (CSF) and acute Kawasaki disease (KD), and to study abnormalities of electroencephalograms and lab results of KD patients with aseptic meningitis. Methods A total of 462 cases were collected while 35 patients among them once had lumbar puncture. Aseptic meningitis was diagnosed according to white blood cell count in CSF while coronary artery expansion was confirmed on the basis of the diameters. Electroencephalograms of the patients with aseptic meningitis were analyzed, and laboratory indexes were compared between aseptic meningitis group and white blood cell count normal group, and between coronary artery expansion group and coronary artery non-expansion group. Results Thirty-one children were finally involved in this study. Seven children (22.6%) had high white blood cell count including 4 children combined with abnormal electroencephalogram, while 8 (26.7%) children had coronary artery expansion. Compared to white blood cell count normal group, there was significantly higher white blood cell count in aseptic meningitis group (P=0.029), whereas no significant differences were found among other laboratory indexes (P>0.05). And similar findings were found between coronary artery expansion group and coronary artery non-expansion group (P>0.05). Conclusion The results suggested that KD patients with aseptic meningitis commonly had abnormal electroencephalogram, and high white blood cell count might be a hint for aseptic meningitis.

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    Original article (Clinical research)
    Forecast value of computed tomography coronary angiography for prognosis of patients with non-significant coronary stenosis
    GUAN Shao-feng, QU Xin-kai, HAN Wen-zheng, et al
    2013, 33 (11):  1484. 
    doi: 10.3969/j.issn.1674-8115.2013.11.012

    Abstract ( 633 )   PDF (534KB) ( 915 )  

    Objective To evaluate forecast value of coronary computed tomography angiography (CTCA) for prognosis of patients with non-significant coronary stenosis. Methods Patients with suspected coronary artery disease underwent CTCA were enrolled and followed up. Cardiovascular clinical endpoints were defined as major adverse cardiac event (MACE) including cardiac death, nonfetal myocardial infarction, and hospitalization due to chest pain. The relationships between MACE and baseline patient characteristics, stenosis severity, and lesion characteristics were evaluated respectively. Results A total of 847 patients (53.8% males) were enrolled, whose mean age was (61.7±12.7) years. CTCA results showed normal lumen in 61.3% patients, mild stenosis in 22.2%, and moderate stenosis in 16.5% patients. During follow-up of (20.3±2.2) months, MACE rate was 1.5%. Multivariate COX hazard regression analysis showed that the severity of lesion in coronary CTCA was the only factor causing MACE (HR=4.43, 95%CI: 1.78-11.05, P<0.01). Compared to patients without coronary lesions, more MACEs occurred in patients with coronary lesions (P<0.001). Conclusion MACE rate in patients with non-significant coronary stenosis detected by CTCA was correlated well to the severity of lesion, while MACE rate was very low in patients with normal and mild coronary lesion.

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    Prevalence and spontaneous regression of cervical high risk human papillomavirusinfection of women in final or third trimester pregnancy stage
    WANG Dan-dan, YANG Hui-lin, YANG Ling-li
    2013, 33 (11):  1488. 
    doi: 10.3969/j.issn.1674-8115.2013.11.013

    Abstract ( 724 )   PDF (304KB) ( 904 )  

    Objective To investigate prevalence and spontaneous regression of cervical high risk human papillomavirus (HR-HPV) infection of women in final or third trimester pregnancy stage. Methods Form January 2010 to December 2011, a total of 3 382 women with 37 to 42 gestational weeks were enrolled in the study. The women were given ThinPrep cytology test (TCT) before pregnancy and HPV hybrid capture Ⅱ (HPV HC-Ⅱ) before delivery. The infection status of HPV was monitored during one-year-long follow-up after delivery, and those positive cases received cytological test, colposcope and pathological examinations. Results The HR-HPV infection rate was 18.4% (623/3 382). The infection rate was significantly higher in women with 3 or over times of pregnancy, whereas age and gravidity had no significant correlation with HR-HPV infection. In 530 positive cases, 140 were still positive in the end of follow-up, whose cytological test findings were 90 cases of normal/inflammation, 40 cases of atypical squamous cells, 6 cases of low grade squamous intraepithelial lesion, and 4 cases of high grade squamous intraepithelial lesion. And 50 cases were given colposcope examination, who were 22 cases of inflammation/HPV, 16 cases of cervical squamous intraepithelial lesion (CIN) Ⅰ, 4 cases of CIN Ⅱ, and 8 cases of CIN Ⅲ. Conclusion Women with 3 or over times of pregnancy had significantly high infection rate of HR-HPV. HR-HPV infection during pregnancy would spontaneously regress, which had no correlation with delivery mode. Patients with continued HR-HPV infection after delivery should undergo cytological test, colposcope and pathological examinations.

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    Early diagnostic and prognostic value of procalcitonin and interleukin 6 for catheter-related bloodstream infections in critically ill patients
    SUI Ming-liang, WU Chang-jiang, HUANG Chao-fa, et al
    2013, 33 (11):  1491. 
    doi: 10.3969/j.issn.1674-8115.2013.11.014

    Abstract ( 891 )   PDF (935KB) ( 1125 )  

    Objective To evaluate the early diagnostic and prognosis value of procalcitonin  (PCT), interleukin 6 (IL-6), and PCT kinetics for central venous catheter related bloodstream infections (CRBSI) in selected critically ill patients. Methods Thirty-six patients received central venous catheter, who were suspected of having CRBSI. All the patient blood samples were obtained for detection of PCT, IL-6 levels, and for blood culture on the first day, and catheter were also obtained for culture. PCT levels were measured on day 1, 2, 3, and 7 after infection. The patients were divided into CRBSI group and non-CRBSI group. The CRBSI group was divided into controlled infection group and non-controlled infection group, and PCT kinetics for prognostic value was observed. Results Fifteen patients were diagnosed as CRBIS (41.67%). Levels of PCT and IL-6 were significantly higher in patients with CRBIS than those without CRBIS on the first infection day (P<0.001 and P<0.005). The ROC curves indicated that the area under the curve (AUC) for PCT and IL-6 was 0.832 and 0.78, respectively. The cutoff points of PCT and IL-6 were set to be 4.3 μg/L and 464.5 ng/L for patients with proven CRBSI, respectively. The corresponding sensitivity, specificity, positive predictive value, and negative predictive value were 80.0% and 77.3%, 95.2% and 66.7%, 92.25% and 61.12%, and 86.95% and 77.76%, respectively. PCT serum levels tended to decrease in patients with controlled CRBSI, whereas in non-controlled patients was proven to remain stably in high level. Conclusion PCT and IL-6 might be valuable early diagnostic parameters for CRBIS with high specificity and negative predictive value, and PCT kinetics has certain predictive value for the prognosis of CRBSI.

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    Evaluation of diagnostic performance of glomerular filtration rate estimating equation
    YU Chong-zhao, CAO Yun, CHEN Feng, et al
    2013, 33 (11):  1496. 
    doi: 10.3969/j.issn.1674-8115.2013.11.015

    Abstract ( 1066 )   PDF (562KB) ( 806 )  

    Objective To evaluate the diagnostic performance of  estimated glomerular filtration rate (eGFR) based on serum creatinine (SCr) and serum cystatin C (CysC). Methods The concentrations of SCr and CysC were determined in 105 patients, whose GFRs were estimated by measuring 99mTc-DTPA clearance as the reference. Values of eGFR were calculated with eGFR algorithms recommended by Kidney Disease Improving Global Outcomes (KDIGO) guidance (2013 version). Diagnostic sensitivity, specificity, and likelihood ratios were calculated, and eGFR accuracies were assessed with receiver operator characteristic curve (ROC) analysis. Results When the cut-off values of the eGFR-SCr/CysC equation were 90, 60, and 45 mL/min/1.73 m2, the positive likelihood ratios (+LR) were 9.3, 30.1, and 13 and the odds ratio (OR) were 21.1, 68.4 and 39.4, respectively, which reached satisfactory diagnostic performance. As eGFR-SCr/CysC cut-off point at 60 mL/min/1.73 m2 with +LR at 30.1 and OR at 68.4, eGFR-SCr/CysC equation had the best diagnostic performance. The negative likelihood ratios (-LR) interval was 0.33-0.49, which had no value for diagnosis of chronic kidney disease (CKD). The diagnostic performance of eGFR-CysC equation was slightly better than eGFR-SCr equation. When the cut-off point was 60 mL/min/1.73 m2, both the +LR and OR of eGFR-CysC and eGFR-SCr/CysC equations were the highest (20.8, 94.5, respectively), which were also helpful to confirm diagnosis of CKD. The combined-LRs (0.12-0.22) of eGFR were lower than separate-LRs (0.33-0.49) of eGFR, so the combined-LRs increased the ability of excluding diagnosis of CKD. Conclusion For evaluating the renal damage clinically, the eGFR-SCr/CysC equation is more accurate than the equation of SCr or CysC alone.

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    Effects of sitagliptin combined with metformin for type 2 diabetes mellitus: a meta-analysis
    CHU Jing-jing, XU Zhe-rong, DING Cheng, et al
    2013, 33 (11):  1501. 
    doi: 10.3969/j.issn.1674-8115.2013.11.016

    Abstract ( 1041 )   PDF (1096KB) ( 1036 )  

    Objective To assess the effects and safety of sitagliptin (SITA) combined with metformin (MET) in treating type 2 diabetes mellitus (T2DM). Methods The Cochrane Library, PubMed, EMbase, CNKI Database, WangFang Database, and VIP Database were searched to collect the randomized controlled trials (RCTs) on SITA combined with MET versus MET in treating T2DM. Meta-analysis was performed using RevMan 5.2 software in accordance with the Cochrane Collaboration. Results A total of 12 RCTs involving 3 200 patients were included. The results of metaanalysis showed that, compared to MET alone, SITA combined with MET effectively improved glycosylated hemoglobin levels [WMD=-0.69%,95%CI (-0.85, -0.53), P<0.000 01] and fasting plasma glucose levels [WMD=-0.91%,95%CI (-1.14,-0.69),P<0.000 01], and increased insulin sensitivity and β-cell function [WMD=-0.54,95%CI (-0.99,-0.10),P=0.02]. But there were no significant differences between the two groups in body mass index and the percentage of patients with adverse events (P>0.05). Conclusion Compared to using MET alone, SITA combined with MET can improve glycemic control, and there is no statistical difference of adverse events.

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    Retinal nerve fiber layer thickness evaluation in ocular hypertensive eyes and primary open-angle glaucoma patients using optical coherence tomography
    SUN Jing-fen, YU Fang-zhi, ZHOU zheng-shen
    2013, 33 (11):  1509. 
    doi: 10.3969/j.issn.1674-8115.2013.11.017

    Abstract ( 1095 )   PDF (488KB) ( 1178 )  

    Objective To measure and compare retinal nerve fiber layer (RNFL) thickness by optical coherence tomography (OCT) in normal eyes, ocular hypertensive eyes, and primary open-angle glaucoma patients. Methods The RNFL thickness was measured in 3 groups: normal group (76 cases, 152 eyes), ocular hypertensive group (70 cases, 109 eyes), and primary open-angle glaucoma group (67 cases, 112 eyes). RNFL measurements were taken with OCT CIRRUS Zeiss. Results The average values of RNFL thickness were (107.61±8.03) μm, (105.26±9.22) μm, and (91.00±10.55) μm in normal eyes, ocular hypertensive eyes, and glaucomatous eyes, respectively. Compared normal eyes, RNFL average thickness, superior thickness, and inferior thickness showed significant differences in glaucomatous eyes (P<0.01). The RNFL average thickness was significantly different between ocular hypertensive eyes and glaucomatous eyes (P<0.01), whereas there was no significant difference between normal and ocular hypertensive eyes (P>0.05). Conclusion The RNFL thickness measurement is a kind of very useful and objective method to differentiate ocular hypertensive and primary open-angle glaucoma.

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    Original article (Preventive medicine)
    Assessment of nutrition and health status of residents in poor areas of Chongqing
    LI Tao-ting, TANG Ren, LIAO He-ping, et al
    2013, 33 (11):  1513. 
    doi: 10.3969/j.issn.1674-8115.2013.11.018

    Abstract ( 680 )   PDF (371KB) ( 894 )  

    Objective To assess the nutrition and health status of residents in poor areas of Chongqing, China. Methods Probability proportional sampling (PPS) method was used. Each sampling household was asked with questionnaires and given medical examinations and laboratory tests. Results In poor areas of Chongqing, the adult residents malnutrition, overweight, and obesity rates were 5.37%, 22.07% and 6.59%, respectively. Malnutrition, overweight, and obesity rates in children and adolescents were came to a high level for 11.06%, 8.94%, and 7.66%, respectively. Nutrition-related diseases prevalence stood a high level with anemia prevalence of 6.90%, hypertension prevalence of 20.67%, diabetes and impaired fasting glucose prevalence of 8.92% and 4.11%, respectively, which were all higher than the prevalences of the Chinese population in 2002. Conclusion The nutrition and health status in poor areas of Chongqing are urgent. The problem of overweight and obesity in children and adolescents and the elderly nutrition-related health problems and chronic diseases will be an important public health problem in the future.

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    Original article (Public health administration)
    Preliminary study of humanistic medicine courses system for resident doctors
    YUAN Qing, JIANG Yi-han
    2013, 33 (11):  1519. 
    doi: 10.3969/j.issn.1674-8115.2013.11.019

    Abstract ( 804 )   PDF (309KB) ( 829 )  

    Objective To establish humanistic medicine courses system in training semester for resident doctors. Methods Thirty experts acquainting resident doctors’ training, clinical education, and administration were selected, and then they were interviewed in 2 rounds survey by Dephi method. Based on survey results, the humanistic medicine courses system was established. Results All the experts had sense of coherence in selecting humanistic medicine courses, and 4 categories including 12 courses were confirmed. The 4 categories consisted of skills in communication, career navigation, customer service, and humanistic and social courses. The 12 courses included compulsory and optional courses, and skills in communication with patients, team-work training, and emergency handling ranked in the top three positions. Conclusion The humanistic medicine courses should be set for resident doctors in training semester. In resident doctors’ training bases, we should enhance training to teachers who taught humanistic medicine course and heighten attention of resident doctors to humanistic medicine.

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    Specialty formation and practice of American nurse anesthetists
    HU Jia-le, RUAN Hong
    2013, 33 (11):  1524. 
    doi: 10.3969/j.issn.1674-8115.2013.11.020

    Abstract ( 991 )   PDF (398KB) ( 1101 )  

    Objective To explore mangement, practice, and education status of Certified Registered Nurse Anesthetists (CRNAs) in America through interviewing with American nurse anesthetists, and to support development of CRNAs in China. Methods Descriptive qualitative research design with purposive sampling was used. Data were collected by semi-structured interviews and analyzed by Colaizzi's content analysis. Results Twenty-four American CRNAs were interviewed. After analzing the interview contents, the researchers fully understood the management model of CRNAs in America, which the anesthesia physicians surpervised team-work model with focus on practicing anesthesia nursing. The training model was LACE (licensure, accreditation, creditation, and education) model, which was organized by professional organizations to address the practice competency and legal issues. Conclusion The health system and laws are totally different between America and China. To identify the role of CRNAs in China should be based on the current laws and status of China, and the status of CRNAs in America is helpful for China. The team-work spirit of anesthesia nurses and physicians could improve the anesthesia risk. Identifying the role and standardizing the education for the nurse anesthetists could be beneficial for quality and safety of anesthesia service.

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    Review
    Advanced research of liver X receptor in lipid metabolism
    GAO Gui-rong, DONG Ying
    2013, 33 (11):  1529. 
    doi: 10.3969/j.issn.1674-8115.2013.11.021

    Abstract ( 934 )   PDF (329KB) ( 1008 )  

    Liver X receptors (LXRs) are ligand-activated nuclear transcription factor, which play a crucial role in lipid metabolism. Recently, LXRs attracts a widely attention to us for its effects on keeping cholesterol homeostasis and anti-atherosclerosis. It might be worthy of development as a new drug target for clinic treatment. This review systematically illustrated the structure, function, and the molecular mechanism of LXRs in lipid metabolic regulation, in order to provide the principles and directions for further study.

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    Progress toward cell wall glycoconjugates of Mycobacterium tuberculosis
    ZOU Yun, LIN Wen-feng, ZHANG Shu-lin
    2013, 33 (11):  1533. 
    doi: 10.3969/j.issn.1674-8115.2013.11.022

    Abstract ( 1122 )   PDF (782KB) ( 1126 )  

    Tuberculosis (TB), a chronic infectious disease mainly associated with respiratory tract, caused by Mycobacterium tuberculosis, is still the highest mortality infectious diseases of simplex cause today. Therefore a further understanding of physiological metabolism and pathogenesis of TB is critical to the control and prevention of TB spread. The special glycoconjugates in Mycobacterium tuberculosis's cell wall play an important role in the maintenance of cell wall integrity and its pathological process, thus becoming a focus of relevant researches. To provide a basis for basic research and clinical application of TB, the recent advance in major cell wall glycoconjugates of Mycobacterium tuberculosis is summarized in this paper.

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    Retrospect and prospect of bacteriophage therapy
    ZHONG Hui-juan, ZHANG Cheng-yuan, LIN Zhong-jing, et al
    2013, 33 (11):  1540. 
    doi: 10.3969/j.issn.1674-8115.2013.11.023

    Abstract ( 757 )   PDF (366KB) ( 1057 )  

    There has been nearly one hundred years of using bacteriophages to treat infectious disease. However, with the discovery of antibiotics and their production in industry and wide usage, bacteriophages were ignored as an approach of controlling infectious diseases in the western world, even though there were  lots of work continuously being done in the former Soviet Union countries. But their achievements were basically unknown by the people because the modern world was led by the western world. With the widespread of antibiotic resistant bacteria worldwide, the phage therapy was refocused on to deal with this challenge. In this paper, we reviewed the discovery to bacteriophage, the classification of bacteriophage preparation, the application of bacteriophage in the treatment of infectious diseases as well as their usage in the environmental, food, and agriculture disinfection recent years.

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    Research advances in Apolipoprotein A-Ⅰ and polycystic ovary syndrome
    TONG La-juan, QIU Yan
    2013, 33 (11):  1545. 
    doi: 10.3969/j.issn.1674-8115.2013.11.024

    Abstract ( 690 )   PDF (310KB) ( 960 )  

    Apolipoprotein A-Ⅰ(ApoA-Ⅰ)is an important factor participating in the process of reverse cholesterol transport (RCT). In patients with polycystic ovary syndrome (PCOS), level of ApoA-Ⅰ was significantly low. The decreased expression of ApoA-Ⅰ could cause disorder of RCT, which may be connected with abnormal lipid metabolism and insulin resistance (IR) of PCOS patients.

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    Clinical experience
    Analysis of Horner's syndrome following lumbar epidural blocking for caesarean section
    XU Zhen-dong, LIU Zhi-qiang
    2013, 33 (11):  1549. 
    doi: 10.3969/j.issn.1674-8115.2013.11.025

    Abstract ( 663 )   PDF (276KB) ( 1030 )  

    Objective To explore the mechanism, adverse effects, and management of Horner's syndrome (HS) following lumbar epidural blocking. Methods The clinical data of 3 parturients under caesarean section with HS after lumbar epidural blocking were analyzed. Results HS symptoms, such as lateral ptosis and miosis, were noted in 3 parturients 40 min after lumbar epidural blocking. The hemodynamic parameters of all 3 parturients were stable, and mild dyspnea occurred in one. The Apgar scores of neonates were normal. The symptoms spontaneously regressed 2 h later without any intervention. Conclusion The plausible mechanism for the development of HS associated with epidural blocking is the cephalad spread of local anesthesia, which may result from the decreased capacity of epidural space and increased intra-abdominal pressure of pregnant women. Sympathetic fiber hypersensitivity may also contribute to HS. HS as a complication of lumbar epidural blocking is usually benign and spontaneously reversible. These patients with HS should be monitored closely for autonomic complications.

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    Case report
    One case report of transaortic transcatheter aortic valve implantation
    ZHAO Qiang, ZHANG Rui-yan, WANG Zhe, et al
    2013, 33 (11):  1553. 
    doi: 10.3969/j.issn.1674-8115.2013.11.026

    Abstract ( 608 )   PDF (154KB) ( 810 )  

    Transcatheter aortic valve implantation (TAVI) is a new technique for patient with aortic stenosis who is not suitable for operation for having high surgical risk. The conventional route of TAVI is transfemoral and transapical. We reported one case of successful transaortic TAVI for a 92-year-old patient with failure of transfemoral approach.

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