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    Original article (Basic research)
    Effects of trichosanthin on apoptosis and proliferation of colorectal cancer cell line CMT-93
    ZHOU Lin, LIU Fei, ZHOU Guang-yan, et al
    2014, 34 (3):  257. 
    doi: 10.3969/j.issn.1674-8115.2014.03.001

    Abstract ( 619 )   PDF (1017KB) ( 939 )  

    Objective To investigate effects of trichosanthin (TCS) on apoptosis and proliferation of colorectal cancer (CRC) cell line CMT-93. Methods CMT-93, a mouse colorectal cell line cultured in vitro, was treated by TCS of different mass concentrations. The control group was CMT-93 without being treated by TCS. The activity of cell proliferation was measured by the Real-Time Cellular Analysis (RTCA) system. The proliferation and apoptosis was detected by the flow cytometry. Real-Time PCR was used to evaluate gene expressions related to the apoptosis. Expressions of Akt and γ-H2AX and the phosphorylation level of Akt (pAkt 473 and pAkt 308)  were assayed by the Western blotting. Results Compared to the control group, TCS of 5.0 μg/mL significantly inhibited the cell viability of CMT-93 cells and induced apoptosis of CMT-93 cells. The mRNA levels of Bid, Bax, and Bad were up-regulated in TCS-treated group. The expressions of pAkt 473 and pAkt 308 decreased significantly after treated by TCS, while the expression of γ-H2AX increased. Conclusion The results suggest that TCS can induce the apoptosis and inhibit the proliferation of CMT-93 cells. The mechanism may be relevant to inhibiting the expressions of active proapoptotic related proteins of Akt and DNA damage of the TCS.

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    Study on expression of Islet1 in mouse testis development
    CHEN Qi-shen, WANG Lu, YU Zhuo, et al
    2014, 34 (3):  263. 
    doi: 10.3969/j.issn.1674-8115.2014.03.002

    Abstract ( 710 )   PDF (644KB) ( 967 )  

    Objective To investigate the expression of Islet1 in mouse testis and the process of embryonic organ development in which Islet1 may involved. Methods The RT-PCR was used to detect the time-course expression of Islet1 in mouse testis development and the PCR products were further sequenced and verified. The relative time-course expression quantities and sequences of Islet1 mRNA in mouse testis were measured by the Real-Time PCR. Immunofluorescence staining was then employed to identify Islet1-positive cell types in mouse testis at different time points and subcellular localizations of Islet1-granule were detected by the surface spreading experiment. Results The results of RT-PCR indicated that Islet1 mRNA has transcriptional activation during the entire course of testis development and relative expression quantities of Islet1 mRNA gradually increased with the development of testis tissues in Real-Time PCR results. Immunofluorescence staining showed that the expression of Islet1 was mainly in germ cells. Surface spreading experiments proved that Islet1 localized on the XY body in the nucleus of primary spermatocyte. Conclusion For the first time, we discovered the expression of conservative transcription factor Islet1 in primary spermatocytes of mouse testis and the Islet1 localized on the XY body in the nucleus of primary spermatocyte, which provides new genes for studying the regulation of spermatogonium maintenance and differentiation.

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    Effects of microRNA-128a on proliferation and migration of non-small cell lung cancer cells
    WANG Lin, LOU Jia-tao
    2014, 34 (3):  268. 
    doi: 10.3969/j.issn.1674-8115.2014.03.003

    Abstract ( 509 )   PDF (899KB) ( 1232 )  

    Objective To investigate the expression of microRNA-128a (miR-128a) in non-small cell lung cancer (NSCLC) tissues and its effects on proliferation and migration of NSCLC cells. Methods The miR-128a expression in NSCLC and normal lung tissues was determined by Real-Time PCR. The effects of miR-128a on proliferation and migration of NSCLC cells were tested by MTT assay, Transwell assay, and soft-agar assay with A549 cells transfected with miR-128a mimics and H1299 cells transfected with miR-128a inhibitor. Results The expression level of miR-128a was significantly down-regulated in NSCLC tissues than that in normal lung tissues. Overexpression of miR-128a could inhibit proliferation, migration, and colony formation of A549 cells. And down-regulation of miR-128a in H1299 cells could promote proliferation, migration, and colony formation. Conclusion The expression of miR-128a is down-regulated in NSCLC tissues, and miR-128a plays an important role in the initiation and development of NSCLC.

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    Effects of CTRP3 on TGF-β1 induced proliferation and α-SMA expression in adventitial fibroblasts
    LIN Shao-hui, SHENG Jing, MA Shao-jun, et al
    2014, 34 (3):  274. 
    doi: 10.3969/j.issn.1674-8115.2014.03.004

    Abstract ( 756 )   PDF (502KB) ( 1038 )  

    Objective To investigate the effects of C1q/TNF-related protein-3 (CTRP3) on transforming growth factor-β1 (TGF-β1) induced proliferation and expression of α-smooth muscle actin (α-SMA) among adventitial fibroblasts (AFs). Methods AFs were isolated from thoracic aortas of male Sprague Dawly (SD) rats. The cells in passage 3 to 5 were treated with various concentrations of CTRP3 (0.1, 1, 10, 50 μg/mL). The effects of CTRP3 on proliferation of AFs were examined by Cell Counting Kit (CCK-8). Immunoflueresence assay, Real-Time PCR, and Western blotting were adopted to detect the expression of α-SMA of AFs. Results CTRP3 attenuated the proliferative activities induced by TGF-β1 in a dose-dependent manner, and the most marked effect could be observed at the concentration of 10 μg/mL (P<0.01). Immunoflueresence assay, Real-Time PCR and Western blotting showed that CTRP3 could significantly inhibited TGF-β1 induced upregulation of α-SMA both at the mRNA and protein levels (P<0.01). Conclusion CTRP3 has significant inhibition effects on proliferation and α-SMA expression of adventitial fibroblasts induced by TGF-β1, which suggests the potential value of CTRP3 in the treatment of pathological vascular remodeling.

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    Comparison of two methods of extraction outer membrane vesicles from Psedomonas aeruginosa
    ZHANG Jia-xing, SHEN Li, HUA Zi-yu, et al
    2014, 34 (3):  279. 
    doi: 10.3969/j.issn.1674-8115.2014.03.005

    Abstract ( 1113 )   PDF (466KB) ( 1435 )  

    Objective To compare two methods for extracting the outer membrane vesicle (OMV) from Pseudomonas aeruginosa (PA) and analyze it's purity, yield, and the content of exotoxin A (ETA). Methods The OMV of PA was extracted by ultrafiltration concentration and Optiprep density gradient centrifugation. The purity, yield, and content of ETA were detected by negative-stain electron microscopy, BCA method, and Western blotting, respectively. Human lung epithelial cells of A549 were immunized with these two OMVs and the IL-8 was determined by ELISA. Results There were more impurities in OMV extracted by ultrafiltration concentration than OMV extracted by Optiprep density gradient centrifugation. The yield of these two OMVs were 21.3 μg/1010 bacteria and 48.7 μg/1010 bacteria respectively. OMV extracted by Optiprep density gradient centrifugation had more ETA and stronger ability to increase the IL-8 level of A549 cell. Conclusion The OMV of PA extracted by Optiprep density gradient centrifugation have higher purity, yield, and content of ETA, and can induce stronger inflammatory response of host cells.

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    Biodistribution characteristics and pharmacokinetics in normal mice and uptake of 99Tcm-REG
    XIE Wen-hui, ZHANG Bin, LIU Ci-yi, et al
    2014, 34 (3):  283. 
    doi: 10.3969/j.issn.1674-8115.2014.03.006

    Abstract ( 584 )   PDF (379KB) ( 882 )  

    Objective To investigate the uptake of 99Tcm labeled arginine-glutamic-glycine (REG) in human lung cancer cells and the biodistribution characteristics and pharmacokinetics of 99Tcm labeled REG in normal mice. Methods The REG was directly labeled by the 99Tcm and binding tests of 99Tcm and non-small cell lung cancer cells A549 and H1299 were performed. Normal mice were killed at different time points after receiving tail intravenous injections of 99Tcm-REG. Major organs or tissues were excised for determining the percentage of the injected dose per gram of tissue mass (%ID/g). The blood at different time points after mice had received tail intravenous injections of 99Tcm-REG was measured by the gamma counter and parameters of pharmacokinetics were calculated. The tumor %ID/g of H1299 tumor-bearing nude mice and tumor/muscle ratio were measured at different time points. Results The values of radiochemical purity of 99Tcm-REG were (92.90±2.86)%. The binding rates of 99Tcm-REG and A549 cells, and 99Tcm-REG and H1299 cells were (1.29±0.16)% and (2.32±0.31)%, respectively. The biodistribution indicated that 99Tcm-REG in mouse blood was removed rapidly. The radioactivity at 2h after injection was only 20.26% of the radioactivity at 5 min after injection. The radioactivity was mainly concentrated in liver and slowly decreased with time. The radioactivity of kidneys, hearts, and lungs were decreased gradually with time and the levels of radioactivity of other tissues were low. The %ID/g of tumor was 2.02±0.67 and the tumor/muscle ratio was 3.50±1.27 at 2h after injection. Conclusion 99Tcm-REG can be uptaken by human lung cancer cells and may become a potential lung cancer imaging agent.

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    Effect of Oct4 and Nanog gene silencing on drug resistance of pancreatic cancer stem cells
    LU Yang, LU Yu-hua, ZHU Hui, et al
    2014, 34 (3):  289. 
    doi: 10.3969/j.issn.1674-8115.2014.03.007

    Abstract ( 810 )   PDF (650KB) ( 1083 )  

    Objective To investigate the effects of Oct4 and Nanog gene silenced by shRNA on drug resistance of pancreatic cancer stem cells and explore new ways of improving chemotherapeutic effect on the pancreatic cancer. Methods The CD44+CD24+ESA+ pancreatic cancer stem cells (PCSCs) were isolated from PANC-1 cell line by flow cytometry and constructed cell strains in vitro. We constructed lentiviral virus-shRNA-Oct4/Nanog vector target Oct4 and Nanog and silenced them simultaneously, and then identified whether PCSCs inhabited expressions of the two genes (PCSCs-shOct4+shNanog) showed the changes of drug resistance to gemcitabine by cell counting Kit-8 (CCK-8) cell proliferation assay and the expression of ABCG2 were examined by Real-Time RT-PCR and Western blotting analysis. Results The high expressions of Oct4 and Nanog were in CD44+CD24+ESA+ PCSCs, which indicated enhanced resistance to gemcitabine in vitro. Double knockdown of Oct4 and Nanog significantly reduced stemness of PCSCs, expression of ABCG2, and chemoresistance to gemcitabine. The differences were statistically significant (P<0.05). Conclusion The results suggest that Oct4 and Nanog play critical roles in maintaining the stemness of PCSCs. Gene silencing of Oct4 and Nanog may inhabit the drug resistance of PCSCs.

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    Protective effects of continuous positive airway pressure against bronchopulmonary tissue of chronic obstructive pulmonary disease rat
    YIN Hui-ming, WU Chuan-xiang, ZHANG Zai-qi
    2014, 34 (3):  295. 
    doi: 10.3969/j.issn.1674-8115.2014.03.008

    Abstract ( 548 )   PDF (664KB) ( 1050 )  

    Objective To explore the protective effect of exogenous expansionary pressures generated by continuous positive airway pressure (CPAP) against lung tissues of rats with chronic obstructive pulmonary disease (COPD). Methods Forty Wistar rats were randomly divided into four groups (n=10): control group, sham group, COPD group, and COPD+CPAP group. COPD rat model was developed by inhaling cigarette smoke. The pathological changes of lung tissues of different groups were observed by HE staining. The p-EGFR, p-ERK, and TGF-β1 expressions were detected by immunohistochemistry. The EGFR and TGF-β1 mRNA expressions were measured by RT-PCR. The p-EGFR, ERK, p-ERK, and TGF-β1 protein levels were detected by Western blotting. Results Compared with normal control group, there were significantly bronchopulmonary pathological changes in COPD group, and EGFR, ERK, and TGF-β1 expression levels and the degree of phosphorylation were also significantly enhanced (P<0.01). After CPAP treatment, these indicators were significantly decreased (P<0.01). The differences between the sham group and the normal control group were not statistically significant (P>0.05). Conclusion The improvement of lung inflammation of COPD rats after CPAP treatment may be relevant to the EGFR and TGF-β signaling pathways regulation.

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    Research on indicating human embryo developmental potential by morphology of oocyte at metaphase Ⅱ (MⅡ)of the first polar body and pronucleus
    YE Ya-ping, YUAN Hua, ZHAI Dan-mei, et al
    2014, 34 (3):  302. 
    doi: 10.3969/j.issn.1674-8115.2014.03.009

    Abstract ( 789 )   PDF (417KB) ( 999 )  

    Objective To evaluate the development of human embryos by morphology discrepancies of oocyte at metaphase Ⅱ (MⅡ) of the first polar body and pronucleus. Methods The 269 infertile couples (269 transfer cycles) who treated with intracytoplasmic sperm injection (ICSI) from June 2009 to June 2012 in the First Affiliated Hospital of Guangxi Medical University were selected. Oocytes at MⅡ were classified by the morphology of first polar body and pronucleus zygotes were classified by the Scott scoring system. Fertilization rate, cleavage rate, and good quality embryo rate of each type of oocytes and zygotes were campared. Results According to different grades of first polar body and pronucleus zygote, embryos were divided into group A (69 cases), group B (102 cases), and group C (98 cases). The embryos of oocytes (1-2 grade) and pronucleus (Z1-Z2 grade) had higher fertilization rate, cleavage rate, good quality embryo rate, implantation rate, and pregnancy rate. Conclusion The higher the grade of oocyte at metaphase Ⅱ of first polar body and pronucleus, the better potential of human embryo development. So this can increase the implantation and pregnancy rate of intracytoplasmic sperm injection/embryo transplantation.

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    Effects of Bag1 expression inhihition on cell growth and chemotherapy sensitivity in gastric cancer
    MA Fei, ZHENG Lei-zhen, GU Jian-chun, et al
    2014, 34 (3):  308. 
    doi: 10.3969/j.issn.1674-8115.2014.03.010

    Abstract ( 612 )   PDF (379KB) ( 1015 )  

    Objective To investigate the effects of Bag1 expression level on the growth of gastric cancer cells and chemo-sensitivity to 5-fluorouracil (5-FU). Methods The expression levels of Bag1 in five different gastric cancer cell lines were determined by Real-Time PCR and Western blotting. Cells with highly expressed Bag1 were selected and the basic expression level of Bag1 was down-regulated by the lentiviral shRNA. The efficiency of Bag1 silencing was confirmed by Real-Time PCR and Western blotting. The effects of the Bag1 knockdown on cell proliferation and chemo-sensitivity to 5-FU were detected by CCK-8 method. Results The expression levels of mRNA and protein of Bag1 were significantly increased in SGC7901 and KATO-Ⅲ cells. Efficient knockdown of Bag1 resulted in suppressing the proliferation of SGC7901 and KATO-Ⅲ cells and significantly enhancing the chemo-sensitivity to 5-FU. Conclusion Knockdown of Bag1 can significantly suppress the proliferation of gastric tumor cells and enhance chemo-sensitivity to 5-FU. Bag1 could be a new therapeutic target for chemotherapy of GC.

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    Effects of different fluorine-containing oral artificial saliva solution on anti-corrosion behavior of selective laser melting cobalt-chromium alloy
    ZENG Li, ZHANG Yong, YANG Xu, et al
    2014, 34 (3):  314. 
    doi: 10.3969/j.issn.1674-8115.2014.03.011

    Abstract ( 564 )   PDF (551KB) ( 987 )  

    Objective To evaluate the effects of different fluoride-containing artificial saliva solution on the corrosion of the dental cobalt-chromium (Co-Cr) alloy fabricated by selective laser melting (SLM). Methods The study involved two groups, each group has 40 cylinder specimens and all specimens were fabricated by the same Co-Cr alloy. One group adopted SLM, while the other group used the cast method. Under conditions of two different pHs (2.5 and 5.0) and four different fluoridecontaining artificial saliva solution concentration (0, 0.05%, 0.1%, and 0.2%), polarization curve tests were performed to compare the anti-corrosion ability of two groups. Results For pH of 5.0 (fluoride-containing artificial saliva solution concentrations were 0 and 0.05%), differences of Rp values between two groups were not statistically significant (P>0.05). For pH of 5.0 (fluoride-containing artificial saliva solution concentration were 0.1% and 0.2%) and pH of 2.5 (fluoride-containing artificial saliva solution concentration were 0, 0.05%, 0.1%, and 0.2%), the Rp value of SLM specimens were significantly higher than those of the cast ones (P<0.05). Conclusion Fluorine can affect the anti-corrosion ability of Co-Cr alloy. SLM specimens exhibited a significantly better anti-corrosion ability than cast ones.

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    Inhibitory effects of combination of gemcitabine with sorafenib on proliferation and invasion of gallbladder cancer cells
    QIN Yi-yu, ZHOU Xue-ping, LIN Pei-yi, et al
    2014, 34 (3):  318. 
    doi: 10.3969/j.issn.1674-8115.2014.03.012

    Abstract ( 692 )   PDF (278KB) ( 913 )  

    Objective To evaluate the effects of gemcitabine combined with sorafenib on the proliferation, apoptosis, migration, and invasion of gallbladder cancer cell line SGC996. Methods The cells were treated with gemcitabine and/or sorafenib. The concentrations of the group treated with gemcitabine were 0.1, 1.0, 2.0, 4.0, and 10.0 μg/mL. The concentrations of the group treated with sorafenib were 0.1, 1.0, 2.5, 5.0, 10.0, and 20.0 μmol/L. The concentrations of the group treated with gemcitabine and sorafenib were as follows: gemcitabine (2.0, 4.0, and 10.0 μg/mL) and sorafenib (2.5, 5.0, 10.0, and 20.0 μmol/L). The cells of control group were not treated with gemcitabine or sorafenib. The proliferation of SGC996 cells was examined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The migration and invasion of SGC996 cells were examined using Transwell assay. The apoptosis of SGC996 cells was examined by FITC-Annexin V/PI double staining. Results Sorafenib inhibited the proliferation of SGC996 cells, and this growth inhibition was dependent on time and dose (P<0.05). Sorafenib also inhibited migration and invasion of SGC996 cells (P<0.05), but it did not induce apoptosis (P>0.05). Gemcitabine induced apoptosis and inhibited invasion of SGC996 cells (P<0.05), but it did not inhibit proliferation and migration of SGC996 cells (P>0.05).The combination of gemcitabine and sorafenib induced apoptosis of SGC996 cells and significantly inhibited the proliferation, migration, and invasion of SGC996 cells (P<0.05). Conclusion The antitumor ability of combination of gemcitabine and sorafenib is much higher than that of either gemcitabine or sorafenib, which may be an effective chemical therapy for gallbladder cancer.

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    HOXB7 promotes colorectal cancer metastasis through targeting NKX3-1
    QI Lu, DING Yan-qing
    2014, 34 (3):  323. 
    doi: 10.3969/j.issn.1674-8115.2014.03.013

    Abstract ( 518 )   PDF (720KB) ( 918 )  

    Objective To investigate the molecular mechanism underlying the occurrence and metastasis of colorectal cancer by analyzing the HOXB7 gene over-expression profile. Methods The enriched transcription factor binding site (TFBS) was analyzed by comparing the different genes of HOXB7 over-expressed colon cancer cell strain and blank control group. Intersection genes of enriched TFBS and differential genes were obtained to get differential TFBS and co-expression genes of which were analyzed to clarify the co-expression features. The interactive regulatory network of correlated proteins was analyzed to determine the potential cell signal pathways in which these genes participated. Results It was assumed that the transcription factor NKX3-1 might regulate some up-regulated genes because its combining site was highly enriched in transcript region of HOXB7 over-expressed genes and it was an up-regulated differential gene. The NKX3-1 gene had the co-expression relationship with other 14 genes within TFBS and the molecular signal network controlled by which mainly participated in signal pathways of tumor related, Wnt, MAPK, intercellular connection, and extracellular matrix connection that were closely related to tumor occurrence and metastasis. Conclusion HOXB7 gene might accelerate the occurrence and metastasis of colon cancer by regulating the NKX3-1 gene.

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    Protective effects of luteolin on immune-mediated liver injury in mice
    ZHANG Qi
    2014, 34 (3):  329. 
    doi: 10.3969/j.issn.1674-8115.2014.03.014

    Abstract ( 590 )   PDF (397KB) ( 1029 )  

    Objective To investigate the protective effects of luteolin on immune-mediated liver injury in mice. Methods The mouse model of immune-mediated liver injury was established by ConA injection to C57BL/6 mouse. Serum ALT and AST levels in mice were determined by an automatic biochemistry analyzer. HE stain and TUNEL stain were used to determine the extent of liver injury. Serum TNF-α and IFN-γ concentrations were measured by ELISA. Results Luteolin treatment significantly decreased the ALT and AST levels in ConA-induced hepatitis (CIH) mice (P<0.001). Luteolin treated mice also displayed less inflammatory infiltration in the liver and hepatocyte apoptosis. Meanwhile, luteolin significantly inhibited the release of inflammatory cytokines such as TNF-α and IFN-γ in ConA injected mice (P<0.05, P<0.01). Conclusion Luteolin can protect mice from immune-mediated liver injury by inhibiting the release of ConA-induced inflammation mediator.

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    Original article (Clinical research)
    Clinical and pathological analysis of 977 children with renal biopsy
    LI Yu-feng, WEI Min-jiang, WU Wei-lan, et al
    2014, 34 (3):  333. 
    doi: 10.3969/j.issn.1674-8115.2014.03.015

    Abstract ( 744 )   PDF (308KB) ( 902 )  

    Objective To retrospectively analyze the pathological categories and clinical characteristics of childhood renal diseases. Methods The pathological diagnoses and clinical data of 977 children with percutaneous renal biopsy were collected and the differences between primary glomerular disease and secondary glomerular disease were analyzed. Results Among 977 patients, 971 renal biopsies were successfully performed. There were 755 (77.8%) cases of primary glomerular disease, 183 (18.8%) cases of secondary glomerular disease, and only 18 (1.9%) cases of heritage glomerular disease. For the primary glomerular disease, the top 3 clinical diagnoses were isolated hematuria, nephritic syndrome, and persistent glomerulonephritis, respectively. The top 3 pathological categories were minor lesion type, focal segmental glomerulosclerosis (FSGS), and focal glomerulonephritis (FGN). For the secondary glomerular disease, purpura nephritis, hepatitis B virus associated nephritis, and lupus nephritis (LN) were the top 3 clinical diagnoses. The top 3 pathological categories were mesangial proliferative glomerulonephritis, minor lesion type, and membranous nephropathy. Among 18 cases of heritage glomerular disease, 7 were thin basement membrane nephropathy (TBMN). For children diagnosed with isolated hematuria, the percentage of minor lesion type decreased with age (P<0.05), while the percentages of FGN and IgAN increased with age (P<0.05). Conclusion The primary glomerulary disease is the main type of children glomerulary diseases. The higher incidence of minor lesions is possibly due to the higher incidence of isolated hematuria. For the secondary glomerulary disease, purpura nephritis is the most common clinical diagnosis and MPG, minor lesion type, and membranous nephropathy are common pathological categories. While TBMN is the most common pathological category of the heritage glomerular disease. The renal biopsy is suggested for children with isolated hematuria whose ages are more than 6 years old.

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    Relationship between expression of estrogen receptor α isoforms in endometrial cancer and its prognosis
    OUYANG Yi-qin, YANG Min, LI Li, et al
    2014, 34 (3):  338. 
    doi: 10.3969/j.issn.1674-8115.2014.03.016

    Abstract ( 715 )   PDF (633KB) ( 914 )  

    Objective To explore the impacts of different estrogen receptor α (ERα) isoforms on biological effects of endometrial cancer (EC) and the prognosis of EC patients. Methods A retrospective study was carried out for 116 endometrial cancer patients and an analysis of relationship between the ERα isoform expression pattern of EC tissue and the clinicopathological data and prognosis was performed. Patients' RNAs were extracted from paraffin sections and Real-Time PCR was used to analyze the gene's expression level. Results ERα expression level was related to the tumor differentiation grade (rs=-0.214, Spearman's test), lymphonode metastases (rs=-0.186, Spearman's test), and FIGO stage (rs=-0.221, Spearman's test). ERα exon 7 skipping isoform (Δ7) was the most commonly detected isoform.  Δ7 was related to the tumor differentiation and FIGO stage and its high expression level was found relating to the preferred surviva (diseasespecific survival P=0.026, disease-progression free survival P=0.038). Conclusion ERαΔ7 is an independent prognosis factor of endometrial cancer and its expression level affects the prognosis of endometrial cancer patients.

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    Effects of inhaled nitric oxide in refractory hypoxemic patients after open heart surgery
    YU Min, MAO Jian-qiang, FAN Yong-liang, et al
    2014, 34 (3):  343. 
    doi: 10.3969/j.issn.1674-8115.2014.03.017

    Abstract ( 662 )   PDF (338KB) ( 916 )  

    Objective To evaluate the clinical effects of inhaled nitric oxide (NO) on patients with refractory hypoxemia after open heart surgery. Methods The patients in ICU with stable circulation but their PaO2/FiO2 (arterial oxygen tension/fraction of inspired oxygen) <100 mmHg (1 mmHg=0.133 kPa) over 4 h after cardiac surgery were given NO treatment. The concentration of inhaled NO was 5-10 ppm. Values of oxygenation and circulation index before, 1 h after, and 24 h after NO treatment were compared for 17 patients. Results Among 17 patients, 6 died and 11 were cured. After NO was inhaled for 1 h,PaO2/FiO2 improved significantly [(105.1±22.1) mmHg vs (77.9±15.6) mmHg](P<0.01), and further improved after 24 h [(141.1±50.6) mmHg vs (105.1±22.1) mmHg](P<0.05), during which heart rate, mean arterial pressure, and dopamine dose remained unchanged except that after 24 h the heart rate decreased [(85.1±14.5)/min vs (96.2±22.4)/min](P<0.05). There were no side effects relevant to inhaling NO. Conclusion For patients with refractory hypoxemia after cardiac surgery, inhaling NO can improve PaO2/FiO2 without causing side effects on hemodynamics.

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    Influential factors, change trends, and reference values of serum glycated albumin in pregnancy
    WANG Feng-huan, LI Hua-ping
    2014, 34 (3):  347. 
    doi: 10.3969/j.issn.1674-8115.2014.03.018

    Abstract ( 943 )   PDF (314KB) ( 964 )  

    Objective To explore the relevant influence factors and change trends and to set up normal reference value limits of glycated albumin (GA) of the gestation period through the study of serum GA of normal pregnant women. Methods A total of 1 046 normal pregnant women who presented to obstetric clinics of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University between December, 2010 and February, 2013 were studied with prospective study. The method of percentiles was used to establish the reference range of GA. And t test and multiple linear regression analysis method were used to study the influential factors and change trend. Results ①For 1 046 normal pregnant women, simple correlation analysis showed that GA values of the gestation period of 12-16, 24-28, and 36-38 weeks were negatively correlated with pre-pregnancy BMI and weight gain during the gestation period (P<0.05), and there were no significant correlations between GA and age, birth weight, and gravidity and parity (P>0.05). Multiples stepwise regression analysis showed that pre-pregnancy BMI and weight gain during the gestation period were main influence factors of GA. ②Based on the pre-pregnancy BMI level, pregnant women were divided into three groups, i.e. low BMI group, normal BMI group, and overweight obesity group. The differences of GA level among groups were statistically significant (P<0.05) during 12-16, 24-28, and 36-38 weeks of gestation period. The differences of GA values of gestation periods were statistically significant (P<0.05). ③The values of GA between 2.5% and 97.5% of 1 046 normal pregnant women were selected as normal GA reference values of gestation period by the percentile method and the range of GA values was 9.20%-14.60%. The ranges of GA reference values of gestation periods of 12-16, 24-28, and 36-38 weeks were 10.20%-15.18%, 9.70%-13.98%, and 8.70%-13.20%, respectively. The GA values of different gestation periods were different for normal pregnant women with different pre-pregnancy BMI. Conclusion With the progress of the pregnancy, GA level gradually reduces. The normal reference range of the GA of gestation period can be suggested as 9.20%-14.60%. But influence factors such as the pre-pregnancy BMI, gestation period, and weight gain during gestation period should be considered for clinical applications.

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    Clinical observation of rabeprazole combined with flupentixol and melitracen treatment to non-erosive gastroesophageal reflux disease
    SUN Qun, YAO Hui-xiang
    2014, 34 (3):  352. 
    doi: 10.3969/j.issn.1674-8115.2014.03.019

    Abstract ( 804 )   PDF (368KB) ( 913 )  

    Objective To investigate the efficacy of rabeprazole combined with flupentixol and melitracen (Deanxit) in the treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety. Methods The diagnosis of NERD was based on the results of clinical symptoms and endoscopy. GERDQ was used to evaluate clinical symptoms. The hospital anxiety and depressive scale (HADS) was used to evaluate depression and anxiety status. Ninety patients were randomly divided into rabeprazole group (n=30), Deanxit group (n=30), and rabeprazole combined with Deanxit group (n=30). Each group was treated for six weeks. The efficacy was evaluated by the symptom scores. Results There were some effects of rabeprazole or Deanxit alone on the improvement of symptoms of NERD. Although the effect of rabeprazole was better than Deanxit, the differences for the relieving heartburn and substemal pain between two groups at time point of 1, 2, 4, and 6 week after treatment were not statistically significant (P>0.05). For relieving the acid regurgitation, rabeprazole was better than Deanxit. For relieving the symptoms of NERD, the treatment of combining rabeprazole and Deanxit (obvious effective rate of 83.33%) was better and faster than either rabeprazole (33.33%) or Deanxit (16.67%)(P<0.01). The total efficacy rate of rabeprazole and Deanxit group (100%) was higher than that of rabeprazole group (76.67%) or Deanxit group (63.33%)(P<0.01). Conclusion The efficacy of the treatment of combining rabeprazole and Deanxit for NERD with depression and anxiety is better. The results suggest that depression and anxiety have certain effects on the treatment of NERD.

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    Comparative analysis of clinical efficacy of treatment to Budd-Chiari syndrome with inferior vena cava thrombosis
    HU Li-ping, WANG Hui, YU Chao-wen, et al
    2014, 34 (3):  357. 
    doi: 10.3969/j.issn.1674-8115.2014.03.020

    Abstract ( 581 )   PDF (261KB) ( 989 )  

    Objective To comparatively analyze the clinical efficacies of treatment to Budd-Chiari syndrome with inferior vena cava thrombosis. Methods Retrospective analysis of clinical data of 68 cases of membranous or short-segment occlusion Budd-Chiari syndrome with inferior vena cava thrombosis was performed. Depending on the treatment methods of inferior vena cava thrombosis, patients were randomly divided into three groups, i.e. predilation technique group (group A with 21 cases), catheter directed thrombolysis group (group B with 20 cases), and conservative treatment group (group C with 27cases). Digital subtraction angiography (DSA) observations of the inferior vena cava thrombolysis were conducted every 48 h. After thrombi were completely dissolved, conventional large balloons of 20-30 mm were used to inflate the lumen stenoses or occlusion segments. Results Two days after treatment, the thrombolytic rate of group A (76.2%) was significantly higher than that of group B (45.0%) and group C (18.5%)(P<0.05), and the thrombolytic rate of group B was significantly higher than that of group C (P<0.05). Four days after treatments, the difference of the thrombolytic rates of group A (85.7%) and group B (75.0%) was not statistically significant (P>0.05), and the thrombolytic rates of group A and group B were significantly higher than that of group C (37.0%)(P<0.05). Six days after treatments, the difference of the thrombolytic rates of group A (90.5%) and group B (90.0%) was not statistically significant (P>0.05), and the thrombolytic rates of group A and group B were significantly higher than that of group C (51.9%)(P<0.05). After six days, all patients with anticoagulant and thrombolytic therapy had no sign of symptomatic pulmonary embolism, bleeding, and other serious complications. Conclusion The clinical efficacies of predilation technique and catheter directed thrombolysis are all good for the treatment of Budd-Chiari syndrome with inferior vena cava thrombosis and the former is safer and quicker.

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    Comparison of clinical outcomes between revision and primary endoscopic sinus surgery for chronic rhinosinusitis
    WANG An-qi, WANG Shi-li, CAI Chang-ping
    2014, 34 (3):  361. 
    doi: 10.3969/j.issn.1674-8115.2014.03.021

    Abstract ( 611 )   PDF (282KB) ( 983 )  

    Objective To investigate whether previous sinus surgeries will have adverse affects on the revision endoscopic sinus surgery (RESS), and whether the surgical outcomes of RESS is similar to that of the primary endoscopic sinus surgery (PESS) by comparing the postoperative results of PESS and RESS for chronic rhinosinusitis patients. Methods The quality of life status of patients underwent PESS (59 patients) and RESS (45 patients) was surveyed by visual analog scale (VAS), Sino-nasal outcome test-20 (SNOT-20), medical outcome study short form 36-items health survey(SF-36), and Lund and Kennedy endoscopic scores. The results were analyzed. Results The postoperative mean VAS, SNOT-20, and SF-36 scores were significantly higher than preoperative mean scores in both RESS and PESS groups (P<0.05).The effective rate, preoperative and postoperative quality of life scores, and postoperative Lund and Kennedy endoscopic scores were not statistically different between two groups (P>0.05). Conclusion The subjective and objective outcomes of RESS and PESS are not statistically different. Strict indications, perfect surgical technique, sufficient and reasonable perioperative care are essential to avoiding the adverse effects of prior sinus surgeries. RESS can have the similar outcomes as PESS.

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    Volumetric modulated arc therapy for recurrent nasopharyngeal carcinoma: a dosimetric comparison with intensity-modulated radiation therapy
    WU Fu-rong, TAN Bing, QIU Da, et al
    2014, 34 (3):  365. 
    doi: 10.3969/j.issn.1674-8115.2014.03.022

    Abstract ( 735 )   PDF (625KB) ( 1049 )  

    Objective To explore the dosimetric characteristics of volumetric modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) during the treatment of recurrent nasopharyngeal carcinoma (rNPC). Methods Thirty patients with rNPC were selected. The target areas received two dose levels using simultaneous integrated boosts (SIB) technique, i.e. PGTV 2.26Gy/F and PCTV 2Gy/F in 30 fractions. VMAT and IMRT treatment plans were designed with the same dosimetric constraints for each patient. Dosimetric comparisons between VMAT and IMRT plans were analyzed to evaluate ①target coverage, and homogeneity and conformity of PTV, ②sparing of OARs, and ③monitor units (MUs). Results The average dose of planning clinical target, dose received by 2% (D2), and 98% (D98) of the planning clinical target volume of VMAT were higher than those of IMRT (P<0.05). The target conformity index (CI) of VMAT was higher than that of IMRT (P<0.05) and the heterogeneity index (HI) of VMAT was lower than that of IMRT (P<0.05). The right temporal lobe D1 of VMAT was lower than that of IMRT (P<0.05), while brainstem Dmax and D1 of VMAT were higher than those of IMRT (P<0.05). The right temporal lobe D1 of VMAT was lower than that of IMRT (P<0.05), while brainstem Dmax and D1 of VMAT were higher than those of IMRT (P<0.05). The left temporomandibular joint Dmax and left temporal lobe Dmax of VMAT were higher than those of IMRT (P<0.05). The differences of spinal cord Dmax, optic nerve Dmax, crystal Dmax, and parotid gland D50 between VMAT and IMRT were not statistically significant (P>0.05). Compared to IMRT, the total MU of VMAT reduced by an average of 33.2% (P<0.05). Conclusion The results indicate that VMAT provides a better average dose of planning clinical target, conformity, and homogeneity, and fewer MUs than IMRT for recurrent nasopharyngeal carcinoma patients. But for normal tissue sparing, VMAT is similar to IMRT.

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    Comparison of two cryopreservation carriers in vitrification cryopreservation of human embryo
    ZHANG Jian-rui, HAO Da-yong, ZHANG Lu-wen, et al
    2014, 34 (3):  370. 
    doi: 10.3969/j.issn.1674-8115.2014.03.023

    Abstract ( 735 )   PDF (257KB) ( 823 )  

    Objective To explore the effects of different cryopreservation carriers on vitrification cryopreservation of human embryos. Methods Human embryos of D3 were vitrification cryopreserved using different cryopreservation carriers (265 half-closing cryopreservation carriers and 136 closing cryopreservation carriers). Pregnant outcomes were compared between the two groups. Results The survival rate, the clinical pregnancy rate, and the implantation rate of 258 (7 cancelled) halfclosing cryopreservation carriers were 96.88%, 48.44%, and 32.20%, respectively. Whereas those rates of 132 (4 cancelled) closing cryopreservation carriers were 95.31%, 47.72%, and 32.28%. The differences of mean age, years, types and causes of infertility, ratio of in vitro fetilization or intracytoplasmic sperm injection (IVF/ICSI), embryo recovery rate and transfer number, rate of pregnancy, and implant rate between two groups were not statistically significant (P>0.05). Conclusion The closing cryopreservation carrier was as effective as the half-closing cryopreservation carrier and can protect embryos from crossing contamination of pathogens. It is an ideal method to preserve human embryos.

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    Original article (Public health administration)
    Establishment of competency model after resident doctor standardization training
    CHEN Yan, ZHANG Yan-ping, MA Jin
    2014, 34 (3):  374. 
    doi: 10.3969/j.issn.1674-8115.2014.03.024

    Abstract ( 636 )   PDF (297KB) ( 881 )  

    Objective To establish the competency model for resident doctors who have received the standardized training. Methods Fifty feature terms had been preliminary determined by the literature analysis to compile the dictionary of competency of resident doctors and design the questionnaire. Two hundred resident doctors, clinical teachers, and management personnel from 12 resident doctor standardized training bases in Shanghai were surveyed. Acquired data were processed and analyzed by statistical methods, including descriptive statistical analysis and factor analysis. Results One hundred and eighty three valid questionnaires were returned and the return rate was 91.5%. Forty nine characters of competence averaged at least 4 points and reached the level of “more important” by the principal component analysis. The factor analysis identified nine essential factors that formed the competency model for resident doctors who have received the standardized training, including comprehensive quality, medical knowledge and clinical working ability, scientific research, and teaching ability. Conclusion The competency model for resident doctors who have received the standardized training is consistent with the goals of the standardized training of resident doctors. It has certain reference values for determining reasonable training methods and increasing training effects.

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    Status quo and analysis of intangible environment in Shanghai area universities from the perspective of students
    ZHANG Ya-qing, WANG Hao-cen, QIAN Yan, et al
    2014, 34 (3):  379. 
    doi: 10.3969/j.issn.1674-8115.2014.03.025

    Abstract ( 575 )   PDF (417KB) ( 917 )  

    Objective To understand the current intangible environment of Shanghai higher education institutions from students’ perspective and to analyze its influential factors. Methods The 1 600 undergraduate students from five higher education institutions, including two “985” universities and three ordinary universities, were surveyed by questionnaires. The questionnaires covered their perceptions towards the intangible environment of universities, which consisted of five aspects: education concept, academic atmosphere, learning atmosphere, campus life, and social practice. Then 1 246 valid questionnaires were returned. Results The results demonstrated that the average score of the intangible environment of Shanghai higher education institutions was above the average level (3.43±0.71). Among all aspects, the social practice gained the highest score (3.72±0.82), while the education concept got the lowest score (3.21±0.84). The evaluation scores of the intangible environment varied among students with different personal characteristics. The average score of academic atmosphere rated by junior students was higher than that rated by sophomores (P<0.01). Compared to male students, the female students rated higher scores on social practice and academic atmosphere of their universities (P<0.05). The total average score and all aspects’ scores of the university environment that rated by student cadres were significant higher than those rated by the rest students (P<0.05). Moreover, the intangible environment scores of “985” higher education institutions were significant higher than other institutions' scores. Conclusion The students gave positive feedbacks for the intangible environment of Shanghai universities. But higher education institutions should further improve their environments.

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    Review
    Research progress of related genes of endometrial cancer
    LIU Jie, TAO Min-fang
    2014, 34 (3):  385. 
    doi: 10.3969/j.issn.1674-8115.2014.03.026

    Abstract ( 770 )   PDF (312KB) ( 954 )  

    Endometrial cancer is a common gynecological malignant tumor which is induced both by genes and environment. The gene effects are prominent. Protooncogenes, tumor suppressor genes, estrogen metabolism genes, and estrogen and progesterone receptor gene mutations and polymorphisms could increase the risk of endometrial cancer. Exploration of gene factors of endometrial cancer helps predicting the onset of the endometrial cancer and may provide appropriate health guidance for women. Currently several genes have been found to be associated with endometrial cancer. The research progress of relevant genes of endometrial cancer is reviewed in this paper.

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    Effects of mesenchymal stem cells on tumor and prospects of oncotherapy
    GAO Wei-yue, QIN Zi-shun, YIN Li-hua, et al
    2014, 34 (3):  389. 
    doi: 10.3969/j.issn.1674-8115.2014.03.027

    Abstract ( 662 )   PDF (277KB) ( 992 )  

    Mesenchymal stem cells (MSCs) play an important role in tumorigenesis, but there are some disputes about their effects on the tumor growth. Different studies found that MSCs could promote or suppress the tumor growth. MSCs had the potential to be used for oncotherapy because of its tropism of tumor and low immunogenicity.

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    Effects of stem cells on kidney repair after acute kidney injury
    ZHOU Li-jia, WU Jian-yong
    2014, 34 (3):  393. 
    doi: 10.3969/j.issn.1674-8115.2014.03.028

    Abstract ( 860 )   PDF (335KB) ( 876 )  

    Acute kidney injury (AKI) is a clinical syndrome of rapidly declining renal function induced by a number of different causes with high rates of morbidity and mortality. Main pathological changes of AKI are necrosis and shedding of renal tubular epithelial cells, lumen blockage, and basement membrane exposure. Kidney repair relies on the migration of surviving epithelial cells to cover the exposed area of the basement membrane and cell differentiation and proliferation to restore renal function. Stem cells are characterized by their ability to self-renew and to differentiate into a variety of cell types and play an important role in kidney repair. Animal models of kidney injury demonstrated that the replacement of necrotic cells mainly relies on surviving mature cells to differentiate and re-enter into cell cycle, or depends on bone marrow stem cells or kidney specific stem/progenitor cells. This review summarizes the promoting effects of bone marrow stem cells and adult renal stem/progenitor cells on kidney repair of the acute kidney injury.

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    Advances of role of hypoxia inducible factor in acute kidney injury
    WEN Dan, ZHANG Wen
    2014, 34 (3):  398. 
    doi: 10.3969/j.issn.1674-8115.2014.03.029

    Abstract ( 574 )   PDF (544KB) ( 1041 )  

    Acute kidney injury (AKI) is a set of clinical syndromes characterized by acute renal function impairment. Shock, surgery, and sepsis are major pathogeneses of AKI. Hypoxia inducible factor(HIF) is a kind of transcription factor which acts as a main switch in the regulation of multiple hypoxia adaptive responses of the body. The stucture and function of HIF, and the epidemiology and pathophysiology of AKI are reviewed in this paper, and the research progress of the main role that HIF plays in AKI is analyzed.

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    Case report
    Leiomyomatosis peritonealis disseminata associated with benign metastasizing leiomyoma: a case report
    YI Qing-qiang, WANG Mei-ling, YUAN Hai-hua, et al
    2014, 34 (3):  404. 
    doi: 10.3969/j.issn.1674-8115.2014.03.030

    Abstract ( 572 )   PDF (415KB) ( 969 )  

    To report the clinical and pathological data of a case of leiomyomatosis peritonealis disseminata and benign metastasizing leiomyoma in order to further understand the pathological and clinical features of this rare disease.

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