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    NING Guang team has made breakthrough in adrenal tumor research field
    2014, 34 (7):  956. 
    Abstract ( 555 )   PDF (488KB) ( 889 )  
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    Original article (Basic research)
    Experimental study on differentiating human induced pluripotent stem cells towards renal cells in vitro
    HUANG Jia-hui, NIU Xin, HU Bin, et al
    2014, 34 (7):  957. 
    doi: 10.3969/j.issn.1674-8115.2014.07.001

    Abstract ( 845 )   PDF (546KB) ( 1043 )  

    Objective To investigate the method of differentiating human induced pluripotent stem (iPS) cells towards renal cells in vitro and to provide the experimental basis for the application of stem cells in kidney regeneration. Methods The normal human iPS cells were treated by cytokines such as Activin-A, BMP7, hVEGF, b-FGF, lithium, and retinoic acid (RA) in renal epithelial cell growth medium (REGM) for inducing the differentiation towards renal cells. After 14, 21, and 28 d of differentiation, the expressions of proteins relevant to the renal development, i.e. Bry, Pax2, AQP1, and E-cad, were detected by the immunofluorescence staining and Real-Time PCR. The expressions of pluripotent genes of Nanog and OCT4 of each differentiation stage were measured by the RT-PCR. Results After being induced by the medium for 14, 21, and 28 d, the results of immunofluorescence staining showed that the differentiated cells expressed the proteins of Bry, Pax2, AQP1, and E-cad, while undifferentiated iPS cells did not express. The results of Real-Time PCR indicated that the expressions of Bry, Pax2, AQP1, and E-cad of differentiated cells were about 4, 30, 37, and 25 times higher than those of undifferentiated iPS cells (P<0.05). The expressions of pluripotent genes of Nanog and OCT4 of differentiation stages decreased gradually (P<0.05). Conclusion Human iPS cells can be efficiently induced and differentiate towards renal cells by cytokines in renal epithelial cell growth medium.

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    Study on mechanisms of zole-resistance of clinical Candida glabrata isolates
    DONG Dan-feng, JIANG Cen, ZHANG Li-hua, et al
    2014, 34 (7):  962. 
    doi: 10.3969/j.issn.1674-8115.2014.07.002

    Abstract ( 704 )   PDF (560KB) ( 1016 )  

    Objective To investigate the mechanism of azole resistance of clinical Candida glabrata isolates. Methods Thirty-eight clinical Candida glabrata isolates were collected from 28 patients of five hospitals between 2009 and 2010. The minimum acteriostatic concentrations of five commonly used antifungal agents (amphotericin B, 5-flucytosine, fluconazole, itraconazole, and voriconazole) were determined by the broth microdilution antifungal susceptibility test. The expressions of efflux-related genes (CDR1, CDR2, and SNQ2), ERG11, and transcription factor PDR1 were detected by the Real-Time PCR. The efflux ability of rhodamine 6G was analyzed by the flow cytometry. The function of the efflux pump of cell membrane was investigated. The whole sequence of ERG11 gene and the major functional domains of PDR1 were amplified by the PCR, sequenced, and compared to standard sequences. Results All 38 Candida glabrata isolates were sensitive to amphotericin B and 5-flucytosine and 17 of which were azole resistant. The expression of CDR1 and the efflux ability of rhodamine 6G of azole resistant isolates were significantly higher than those of sensitive isolates (P=0.001). The difference of the expression of ERG11 of sensitive isolates and azole resistant isolates was not statistically significant (P=0.283). No mutations of ERG11 were found in azole resistant isolates. The difference of the expression of PDR1 of 17 azole-resistant isolates and sensitive isolates was not statistically significant (P=0.086). But one sense mutation of PDR1 was found in each azole resistant isolate. Conclusion Mutations of transcription factor PDR1, up-regulation of efflux pump related gene CDR1, and the increase of the function of efflux pumps are the main mechanisms of clinical zole resistance of Candida glabrata.

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    Effects of immune inhibitory receptor LILRB2 on proliferation and apoptosis of leukemia cell lines
    YU Xiao-ting, XIE Li, ZHAN Meng-na, et al
    2014, 34 (7):  967. 
    doi: 10.3969/j.issn.1674-8115.2014.07.003

    Abstract ( 1030 )   PDF (847KB) ( 1131 )  

    Objective To explore the expression, function, and relevant mechanism of the immune inhibitory receptor of leukocyte immunoglobulin-like receptors subfamily B member 2 (LILRB2) in human leukemia cell lines and to provide new clues for the targeting treatment of leukemia. Methods The expressions of LILRB2 in leukemia cell lines, such as THP1, U937, and K562 were detected by the flow cytometry and Western blotting. The shRNA plasmids specific for the knockdown of LILRB2 (with GFP tag) was constructed and by which the virus was packaged. THP1 cells with high expression of LILRB2 were then infected by the virus. Cell lines with steady expression of GFP+ were obtained by the flow cell sorting. The knockdown efficiency of shRNA at both mRNA level and protein level was detected. The changes of cell proliferation and apoptosis at different time points were observed and the relevant molecular mechanisms, such as changes of downstream regulatory signals, were analyzed after the knockdown of LILRB2. Results All three cell lines expressed LILRB2 and the expression level of LILRB2 of THP1 cells was the highest. The Real-Time PCR and Western blotting findings showed that among four constructed shRNAs plasmids, shLILRB2-717 and shLILRB2-1312 significantly down-regulated the expression of LILRB2. The inhibition of LILRB2 expression in THP1 cells dramatically decreased the proliferation and significantly increased the apoptosis. The results of the flow cytometry indicated that the apoptotic rates of cells of the shLILRB2-717 group and shLILRB2-1312 group at the early stage were (7.90±1.61)% and (24.80±1.32)%, much higher than (3.96±0.48)% of the control group (Scramble group) (P<0.05). The apoptotic rates of cells of the two groups at the late stage were (13.80±0.98)% and (23.60±1.03)%, much higher than (10.80±0.48)% of the Scramble group (P<0.05). The knockdown of LILRB2 led to significant down-regulation of expressions of SHP1 and p-SHP1, which indicated that LILRB2 might regulate the proliferation and apoptosis of leukemia cell lines through SHP1. Conclusion Immune inhibitory receptor LILRB2 can be expressed in a variety of leukemia cell lines. The inhibition of LILRB2 expression can lead to significant down-regulation of SHP1 and p-SHP1 in THP1 cells and mass apoptosis, which suggests that SHP1 may positively regulate the development of leukemia.

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    Relationship between expression of specificity protein 1 of colorectal adenocarcinoma and  clinicopathological parameters
    SONG Li-wei, WANG Wen-yue, ZOU Xiu-qun, et al
    2014, 34 (7):  973. 
    doi: 10.3969/j.issn.1674-8115.2014.07.004

    Abstract ( 803 )   PDF (479KB) ( 1017 )  

    Objective To investigate the expression changes of specificity protein 1 (Sp1) in colorectal adenocarcinoma tissues and its relationship with the clinicopathological parameters of patients. Methods The levels and differences of Sp1 mRNA of colorectal adenocarcinoma tissues and normal tissues were analyzed by retrieving the mRNA array database of Oncomine. The expression of Sp1 protein of 65 colorectal adenocarcinoma tissues and adjacent normal tissues was detected by the immunohistochemistry (IHC) assay. The expression of Sp1 protein of colorectal cancer cell lines of 5 different malignant degrees was detected by the Western blotting. The relationship of the expression level of Sp1 and the clinicopathological parameters of patients with colorectal adenocarcinoma was analyzed. Results There was no significant difference of Sp1 mRNA level between colorectal adenocarcinoma tissues and normal tissues according to the mRNA array database of Oncomine. The results of immunohistochemistry and Western blotting showed that the expressions of Sp1 of colorectal adenocarcinoma tissues and cell lines were highly consistent, but were not different from those of adjacent normal tissues. There was no significant correlation between the expression level of Sp1 protein of colorectal adenocarcinoma tissues and lymph node metastasis, as well as distant metastasis. Conclusion The expression of Sp1 of colorectal adenocarcinoma tissues is not significantly different from that of normal tissues and is not significantly correlated to the cancer metastasis.

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    Effects of changes of interstitial cells of Cajal from mice with post-infection irritable bowel syndrome on intestinal motility and visceral sensitivity
    YANG Bo, LAN Cheng, ZHOU Xu-chun
    2014, 34 (7):  978. 
    doi: 10.3969/j.issn.1674-8115.2014.07.005

    Abstract ( 816 )   PDF (755KB) ( 1031 )  

    Objective To observe the effects of changes of interstitial cells of Cajal from mice with post-infection irritable bowel syndrome (PI-IBS) on the intestinal motility and visceral sensitivity. Methods Thirty four female C57BL/6 mice were randomly divided into the model group (n=17) and control group (n=17). Mice of the model group were intragastricly injected by normal saline of 0.2 mL with 400 larvae of trichina. Mice of the control group were intragastricly injected by normal saline of the same volume. Pathological examinations were conducted for tissues of terminal ileum and proximate colon 14, 28, and 56 d after infection. The abdominal withdrawal reflex (AWR) scores, intestine transportation time, fecal grain numbers for every 2 h, and Bristol scores were determined 56 d after infection. The expressions of c-kit protein and mRNA in interstitial cells of Cajal of different intestinal segments were detected by the immunohistochemical staining and RT-PCR. Results The intestinal inflammatory reaction of mice of the model group regressed completely 56 d after infection. Compared to the control group, the AWR scores of mice of the model group were significantly higher (P<0.01) and the intestine transportation time was significantly shorter (P<0.01). Grain numbers for every 2 h, wet weights, and Bristol scores of the model group were significantly higher than those of the control group (P<0.05). Results of the immunohistochemical staining and RTPCR showed that compared to the control group, the expressions of c-kit protein and mRNA in interstitial cells of Cajal of each intestinal segment of mice of the model group were significantly increased (P<0.05). Conclusion The changes of the interstitial cells of Cajal of mice with PI-IBS may be one of the mechanisms of intestinal motility disorders and visceral hypersensitivity.

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    Effects of TRAF3 on inhibiting cartilage breakdown induced by IL-17
    ZHANG Ning, LIU Hong-qiang, ZHAO Xiao-ying, et al
    2014, 34 (7):  984. 
    doi: 10.3969/j.issn.1674-8115.2014.07.006

    Abstract ( 795 )   PDF (669KB) ( 1159 )  
    Objective To investigate the effects of TNF receptor associated factor 3 (TRAF3) on signaling pathways and expressions of downstream products of MAPK and NF-κB in chondrocytes stimulated by the interleukin-17 (IL-17); to observe the cartilage destruction of TRAF3 transgenic mice stimulated by the IL-17; and to explore the protective effect of TRAF3 on the cartilage. Methods Changes of signaling pathways of NF-κB and MAPK in normal chondrocytes and TRAF3 transgenic hondrocytes stimulated by the IL-17 were detected by the Western blotting. The changes of mRNA of downstream inflammatory factor IL-6, metabolic factors MMP13, disintegrin and metalloproteinase with thrombospondin motif 4 (ADAMTS-4), and ADAMTS-5 in normal chondrocytes and TRAF3 transgenic chondrocytes stimulated by the IL-17 were detected by the Real-Time PCR. Differences of cartilage changes of wildtype mice and TRAF3 transgenic mice stimulated by the IL-17 were observed by the histochemistry. Results The over-expression of TRAF3 significantly inhibited the signaling pathways of MAPK and NF-κB in chondrocytes stimulated by the IL-17 and significantly down-regulated the expression of mRNA of downstream inflammatory factors IL-6, MMP13, ADAMTS-4, and ADAMTS. The cartilage breakdown of TRAF3 transgenic mice induced by the IL-17 was significantly less than that of wildtype mice. Conclusion TRAF3 is a negative regulatory inhibitor of the signaling
    pathways of IL-17 and may be a new target of inhibiting the cartilage breakdown.
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    Regulative effect of hydrogen on oxidative stress level of placental ischemia-reperfusion cell model of preeclampsia
    ZOU Ying-fen, CHENG Wei-wei
    2014, 34 (7):  990. 
    doi: 10.3969/j.issn.1674-8115.2014.07.007

    Abstract ( 637 )   PDF (633KB) ( 1057 )  
    Objective To investigate the effects of hydrogen on cell protection of placental ischemia-reperfusion cell model of preeclampsia and its possible mechanism. Methods JAR cells cultured in vitro were divided into five groups, i.e. the blank control group, saturated hydrogen group under normal oxygen cultivation conditions (normal oxygen+H2 group), ischemia-reperfusion model group (model group), ischemia-reperfusion group with saturated hydrogen intervention (model+H2 group), and ischemia-reperfusion positive control group with vitamin C intervention (model+VC group). Cells of the model group, model+H2 group, and model+VC group were cultured with sugar and serum free medium in hypoxia (5%CO2 and 95%N2) environment for 2 h, and then they were cultured with high sugar and 10% serum medium in the environment of 95% air and 5% CO2. The ischemia-reperfusion cell model was established. The hydrogen intervention and vitamin C intervention were performed during the hypoxia period and reoxygenation period, respectively. After cells were cultured in the complete medium for 24 h, the cell survival rate was detected by the MTT method; the content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) were measured by the chemical olorimetry; and the expression of SOD mRNA was detected by the Real-Time PCR. After cells were cultured in the complete medium for 1 h, the intracellular ROS level was measured by the DCHF-DA fluorescence. Results Compared to the model group, the cell survival rate of the model+H2 group increased (P<0.05); the ROS generation (P<0.01) and MDA content (P<0.05) decreased significantly; and the SOD activity (P<0.01) and the expression level of SOD mRNA (P<0.05) increased. Conclusion Hydrogen has the protective effect on the placental ischemia-reperfusion cell model of preeclampsia. The mechanism may be the reduction of cell oxidative stress level by up-regulating the transcription of SOD-mRNA, increasing the activity of SOD, and decreasing the level of intracellular reactive oxygen.
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    Relationship between CD4+CD25+FoxP3 regulatory T cells and endometriosis associated infertility
    LIANG Yan, CHEN Shu-fang, ZHANG Jian
    2014, 34 (7):  997. 
    doi: 10.3969/j.issn.1674-8115.2014.07.008

    Abstract ( 600 )   PDF (263KB) ( 987 )  

    Objective To explore the relationship between the endometriosis (EM) associated infertility and changes of CD4+CD25+FoxP3 Tregs in the peripheral blood and eutopic endometrium during peri-implantation phase. Methods Twenty-seven women with EM associated infertility of different stages were selected. The CD4+CD25+FoxP3 Tregs counts in peripheral blood mononulear cells (PBMCs) and the ratio of CD4+T cells and PBMCs were detected by the flow cytometry. The expression of CD4+CD25+FoxP3 mRNA of eutopic endometrium was detected by the RT-PCR. The controls were twenty procreated women without EM (n=20). Results Compared to the controls, the CD4+CD25+FoxP3 Tregs counts in PBMCs and the ratio of CD4+ T cells and PBMCs of women with minor EM were significantly higher. The differences were statistically significant (P<0.05). The CD4+CD25+FoxP3 Tregs counts in PBMCs and the ratio of CD4+ T cells and PBMCs of women with severe EM were significantly higher than those of women with minor EM. The differences were statistically significant (P<0.05). The relative expression of FoxP3 mRNA of eutopic endometrium showed that the expression of women with minor EM was significantly higher than that of controls (P=0.000 1), and the expression of women with severe EM was significantly higher than that of controls and women with minor EM (P<0.000 1). Conclusion The CD4+CD25+FoxP3 Tregs in the peri-implantation phase are not directly relevant to the pathogenesis of abnormal endometrial receptivity of infertile women with EM. CD4+CD25+ FoxP3 Tregs may be relevant to the incidence and development of EM and may aggravate lesions caused by EM and lead to the infertility.

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    Experimental study on inhibition of planktonic and biofilm Escherichia coli by 460 nm visible light
    YANG Peng-gao, WANG Chuan, WANG Ning, et al
    2014, 34 (7):  1001. 
    doi: 10.3969/j.issn.1674-8115.2014.07.009

    Abstract ( 699 )   PDF (645KB) ( 998 )  

    Objective To investigate the effects of 460 nm visible light (blue light) on planktonic and biofilm Escherichia coli (E.coli). Methods E.coli samples were isolated from wards of the Department of Burn and identified by the microbial identification system. The planktonic E.coli were irradiated by 460 nm visible light of different energy and the anti-bacteria effects of 460 nm visible light were evaluated by the colony counting and LIVE/DEAD staining. The E.coli biofilm model was built and irradiated by 460nm visible light of 240 J/cm2 and 360 J/cm2 after being identified by FM 1.43 and crystal violet staining. The survival of E.coli in the biofilm was observed by the LIVE/DEAD staining and laser confocal microscope and compared to samples without being irradiated by the light. Results Compared to the control group, the number of colonies of E.coli samples decreased significantly after being irradiated by 460 nm visible light of 60 J/cm2 and above and showed dose effect relation. The death rate of E.coli in the biofilm was significantly higher than that of E.coli of the control group after being irradiated by 460 nm visible light of 240 J/cm2 and 360 J/cm2. Conclusion Visible light of 460 nm can effectively inhibit planktonic and biofilm E.coli.

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    Effects of ADAM33 on proliferation and apoptosis of human airway smooth muscle cells and effects of IL-4 on expression of ADAM33
    TAO Tao, ZHU Xiao-hua, ZHANG Xiao-bin, et al
    2014, 34 (7):  1006. 
    doi: 10.3969/j.issn.1674-8115.2014.07.010

    Abstract ( 597 )   PDF (558KB) ( 991 )  

    Objective To investigate the effects of a disintegrin and metalloprotease 33 (ADAM33) on the proliferation and apoptosis of human airway smooth muscle cells (HASMCs) and the effects of interleukin-4 (IL-4) on the expression of ADAM33. Methods The HASMCs were stimulated by IL-4 in concentrations of 1, 10, 50, and 100 ng/mL. The unstimulated HASMCs were used as controls. The expressions of ADAM33 mRNA and ADAM33 protein were detected by the Real-Time PCR and Western blotting. ADAM33-siRNA was designed, synthesized, and transiently transfected to HASMCs. siRNA with the highest inhibition rate was screened by the Real-Time PCR and Western blotting and transiently transfected to HASMCs. The proliferation and apoptosis of cells were detected by the MTS and flow cytometry, respectively. Results The expressions of ADAM33 mRNA and ADAM33 protein were concentration-dependent for different concentrations of IL-4. Compared to the control group, the relative expressions of mRNA and protein of groups with IL-4 of 50 ng/mL and 100 ng/mL increased by 5.94 and 7.6 times, and 3.72 and 4.57 times, respectively. The differences were statistically significant (P<0.05). But the relative expressions of mRNA and ADAM33 protein of groups with IL-4 of 1 ng/mL and 10 ng/mL were not significant increased. The differences were not statistically significant (P>0.05). For three siRNA, the inhibition rate of ADAM33-siRNA-575 was the highest. The inhibition rate was 81.08% at the mRNA level. The cell proliferation of the intervention group was significantly lower than that of the negative control group at 24, 48, and 72 h (P<0.05). The inhibition rates were 15.38%, 32.83%, and 22.78%, respectively. The apoptotic rate of the intervention group was (25.88±3.37)%, which was significantly higher than that of the negative control group [(8.95±0.51)%](P<0.05). Conclusion ADAM33 can promote the proliferation of airway smooth muscle cells and cytokine IL-4 can promote its expression. Both of them may play important roles in airway remodeling.

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    Effects of inhibiting JAK2/STAT3 signaling pathway on expressions of HIF-1α, VEGF, and miRNA-145 of A549 lung cells
    YI Qing-qiang, ZHAO Mei, WANG Jiong-yi, et al
    2014, 34 (7):  1011. 
    doi: 10.3969/j.issn.1674-8115.2014.07.011

    Abstract ( 896 )   PDF (430KB) ( 1056 )  

    Objective To explore the effects of the inhibition of Janus kinase 2/signal transducers and activator of transcription 3 (JAK2/STAT3) on the expression of hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), and microRNA-145 (miRNA-145) in A549 lung cancer cell line. Methods The  expressions of HIF-1α, VEGF, and miRNA-145 protein and mRNA in A549 cells were detected by the Western blotting and RT-PCR after being treated by Jak2/STAT3 specific inhibitor AG490 of different concentrations (the AG490 group) or transfected by siRNA targeting to STAT (the siRNA-STAT group). Cells of the blank control group were not treated by AG490 or transfected. Cells of the negative control group were siRNA cells of sequences irrelevant to the transfection. Results Compared to the blank control group, the expression of miRNA-145 of A549 cells of the AG490 group up-regulated significantly (P<0.05) and the expressions of HIF-1α and VEGF protein and mRNA gradually decreased with the increase of the concentration of AG490. Compared to the blank control group and negative control group, the expressions of STAT3, phosphorylated STAT3, HIF-1α, and VEGF mRNA of A549 cells of the siRNA-STAT group down-regulated significantly, while the expression of miRNA145 increased significantly (P<0.05). Conclusion The inhibition of JAK2/STAT3 signaling pathway of A549 human lung adenocarcinoma cell can up-regulate the expression of miRNA-145 and down-regulate the expressions of HIF-1α and VEGF.

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    Effects of quinacrine combined with thioridazine on inducing apoptosis of chronic myelogenous leukemia cells
    TU Yao-yao, XU Han-zhang, LEI Hu, et al
    2014, 34 (7):  1016. 
    doi: 10.3969/j.issn.1674-8115.2014.07.012

    Abstract ( 691 )   PDF (538KB) ( 1097 )  

    Objective To study the effects of Quinacrine (QC) and Thioridazine (THZ) on chronic myelogenous leukemia (CML) cells (K562 cells). Methods K562 cells were treated by different concentrations of QC (0, 1, 2, 3, and 4 μmol/L) and THZ (0, 2, 4, 8, and 16 μmol/L) for 0, 24, and 48 h. The effects of each drug on the viability of cells were examined by the trypan blue exclusion assay. Then K562 cells were treated by different concentrations of QC (2, 3, and 4 μmol/L) and THZ (2, 4, and 8 μmol/L) for 24 h alone or in combination. The viability of cells was examined by the trypan blue exclusion assay. The combinational index was calculated by the CompuSyn software. Next K562 cells were treated by QC of 3 μmol/L and THZ of 4 μmol/L for 24 h alone or in combination, with or without being treated by pancaspase inhibitor Z-VAD-FMK of 20 μmol/L. Variations of the mitochondrial transmembrane potential were detected by the Rh123/PI staining and flow cytometry. Apoptosis related proteins were detected by the Western blotting. Results Results of the trypan blue exclusion assay indicated that being treated by QC or THZ of low concentrations alone had no significant influence on the viability of K562 cells, while being treated by QC combined with THZ had a good synergistical effect on inducing death of K562 cells. Results of the Western blotting showed that the cleavage of PARP-1 and the reduction of expressions of apoptosis-related proteins Mcl-1 and Bcl-2 were induced after being treated by two drugs in combination and could not be reversed by Z-VAD-FMK. Results of the flow cytometry showed that compared to being treated by one drug, the mitochondrial transmembrane potential of K562 cells treated by QC of 3 μmol/L and THZ of 4 μmol/L in combination for 24 h was significantly decreased and could not be reversed by Z-VAD-FMK. Conclusion QC plus THZ can synergistically induce caspase-independent apoptosis of K562 cells. The decrease of mitochondrial transmembrane potential may involve in this process.

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    Effects of heat shock protein A12B on damage of mouse pulmonary microvascular endothelia cells induced by lipopo-lysaccharide
    YU Gui-fang, ZHANG Xu, ZHU Ke-ming
    2014, 34 (7):  1022. 
    doi: 10.3969/j.issn.1674-8115.2014.07.013

    Abstract ( 694 )   PDF (561KB) ( 899 )  
    Objective To explore the effects of down-regulation of the expression of heat shock protein A12B (HSPA12B) of mouse pulmonary microvascular endothelia cells (mPMVECs) on the inflammatory reaction, migration, and ultrastructural changes induced by lipopolysaccharide (LPS). Methods The mPMVECs subcultured in vitro were divided into the LPS group (LPS of 1 μg/mL was added), LPS+siRNA group (siRNA oligonucleotides of relevant gene segments of HSPA12B were transiently transfected into mPMVECs and then LPS of 1 μg/mL was added), and LPS+NC group (siRNA oligonucleotides of negative controls were transiently transfected into mPMVECs and then LPS of 1 μg/mL was added). The migration of cells of the LPS+siRNA group and LPS+NC group was observed by the Transwell assay and wounding assay. The ultrastructural changes of mPMVECs were observed by the transmission electron microscopy. The expressions of TNF-α, IL-6, IL-10, and IL-1β mRNA of cells of each group were detected by the Real-Time PCR. Results Compared to the LPS+NC group, the mitochondrion damage of mPMVECs of the LPS+siRNA group was severer; the edema of endoplasmic reticulum was more significant; the expressions of TNF-α, IL-6, and IL-10 mRNA significantly up-regulated (P<0.05); the expression of IL-1β down-regulated, but the difference was not statistically significant (P>0.05); and the ability of cell migration was significantly decreased (P<0.05). Conclusion The inflammatory reaction of LPS-induced mPMVECs was enhanced and the cell migration was inhibited after HSPA12B was down-regulated. HSPA12B may be involved in the process of protecting mPMVECs from being invaded by LPS.
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    Original article (Clinical research)
    Relationship between variation of rs3760106 of PRKCB1 gene and incidence of end-stage renal disease of Shanghai Han people with type 2 diabetes mellitus
    ZHAO Ming-ming, ZHANG Rong, LI Can, et al
    2014, 34 (7):  1027. 
    doi: 10.3969/j.issn.1674-8115.2014.07.014

    Abstract ( 638 )   PDF (428KB) ( 937 )  
    Objective To explore the relationship between the rs3760106 (C/T) variation of protein kinase C-β gene (PRKCB1) and type 2 diabetic end-stage renal disease (ESRD). Methods Shanghai Han patients with type 2 diabetes were selected and divided into the end-stage renal disease of diabetic nephropathy group (DN-ESRD group)(n=174) and non-diabetic nephropathy group (the DN-0 group)(n=228). The genotypes of rs3760106 were detected by the Taqman PCR assay. Frequencies of genotypes and alleles of rs3760106, as well as clinical characteristics of two groups were compared and analyzed. Results The differences of frequencies of genotypes and alleles of rs3760106 of the DN-0 group and DN-ESRD group were statistically significant (P<0.05). The risk of incidence of DN-ESRD for people with CT+TT genotype significantly increased with OR of 2.14 (95%CI, 1.18-3.87). After sex, onset age of diabetes, and BMI correction, the risk of incidence of DN-ESRD for people with CT+TT genotype still existed. For the DN-0 group or DN-ESRD group, the fasting plasma glucose (FPG) level of people with CT+TT genotype was significantly higher than that of people with CC genotype (P<0.05) or had an increasing tendency (P>0.05). Conclusion The risk of incidence of ESRD for Shanghai Han patients with type 2 diabetes mellitus who carry T allele of rs3760106 of PRKCB1 gene is high.
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    Analysis of free fat mass measurement and related influencing factors in hospitalized patients with malignant tumor
    XU Ren-ying, TANG Mo-lian, WAN Yan-ping, et al
    2014, 34 (7):  1034. 
    doi: 10.3969/j.issn.1674-8115.2014.07.015

    Abstract ( 566 )   PDF (306KB) ( 826 )  
    Objective To measure the free fat mass (FFM) of hospitalized patients with malignant tumors and to analyze its influence factors. Methods The study selected 107 hospitalized patients from the Department of Medical Oncology. Among them, 31 were uppergastrointestinal tumors; 41 lower gastrointestinal tumors, 14 lung cancers; and 21 other types of tumors. General information (gender, age, diagnosis, disease duration, clinical stage, number of chemotherapy, history of cancer surgeries, history of chronic diseases, etc.) and relevant nutritional indexes (albumin, pre-albumin, and body mass index) of patients were collected. The FFM and basal metabolic rate (BMR) were evaluated by the bioelectrical impedance (BIA) method. The dietary energy and protein intake were evaluated based on the 24-hour dietary recalls. Results Among 107 patients, total incidence of malnutrition was 36.4%. The incidence of malnutrition of patients with upper gastrointestinal tumors and longer duration of disease (>1 year) was high, while the incidence of malnutrition of patients with adequate protein intake (≥75% of the recommended intake per day) was low. Energy and protein intake was positively correlated with FFM. FFM and corrected BMR of male patients decreased significantly with the increase of the number of chemotherapy (P<0.05). Only the corrected BMR of female patients with non-gastraintestinal tumors was significantly higher than that of patients with gastraintestinal tumors (P<0.05). The differences of other indexes were not statistically significant (P>0.05). Conclusion The incidence of malnutrition of patients with tumors was high. Adequate protein intake can improve the nutritional status. FFM and corrected BMR of male patients with malignant tumors decrease with the increase of the number of chemotherapy.
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    Analysis of therapeutic effect of empirically calculated dose of radioiodine therapy on hyperthyroidism of Graves disease
    FU Hong-liang, DU Xue-liang, LI Jia-ning, et al
    2014, 34 (7):  1039. 
    doi: 10.3969/j.issn.1674-8115.2014.07.016

    Abstract ( 759 )   PDF (261KB) ( 943 )  
    Objective To analyze the effects of empirically calculated dose of radioiodine (131I) therapy on hyperthyroidism of Graves disease. Methods A total of 299 patients with Graves disease underwent the 131I therapy. The dose of 131I therapy was determined based on the empirically calculated dose. The therapeutic effect was
    evaluated by the thyroid function test after 3 and 6 months of the treatment. Stepwise multiple regression analysis was performed to identify factors that influenced the effect of the 131I therapy. Results Among 299 cases of Graves disease, the 131I therapy was effective for 187 (62.5%) cases after being treated for 3 months and the incidence of hypothyroidism caused by the treatment was 84 (28.1%) cases. The 131I therapy was effective for 248 (83.0%) cases after being treated for 6 months and the incidence of hypothyroidism caused by the treatment was 107 (35.8%) cases. The multiple regression analysis showed that the weight of thyroid, the maximum radioiodine uptake of thyroid, and the free triiodothyronine (FT3) level were major factors that influenced the effect of the 131I therapy (P<0.05). Conclusion The empirically calculated dose of 131I therapy for the treatment of Graves disease should take into account the effects of weight of thyroid, the maximum radioiodine uptake of thyroid, and the FT3 level on the therapy. The empirically calculated dose of 131I therapy is suitable for recurrent patients or patients with poor therapeutic effect for anti-thyroid drug or severe side effects.
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    Analysis of related risk factors of incision complications after closed calcaneal fracture surgery via extensive L-shaped incision
    WU Kai, LIN Jian, HUANG Jian-hua, et al
    2014, 34 (7):  1043. 
    doi: 10.3969/j.issn.1674-8115.2014.07.017

    Abstract ( 616 )   PDF (399KB) ( 941 )  

    Objective To explore the risk factors relevant to incision complications after closed calcaneal fracture surgery via a lateral L-shaped incision and to evaluate the effectiveness of clinical intervention methods. Methods The medical records of 209 patients (239 calcaneal fractures) were retrospectively analyzed. The univariate analysis of seven factors (the timing of surgery, operative duration, bone grafting, skin distraction method, postoperative drainage, smoking, and antibiotic) that might cause complications of calcaneal incision was conducted. The multiple Logistic regression analysis was conducted for factors with statistical significance. Results Among 239 cases of calcaneal fracture, 21 (8.8%) involved surgical incision complications, including 8 (3.3%) of wound dehiscence, 7 (2.9%) of flap margin necrosis, 5 (2.1%) of hematoma, and 1 (0.4%) of osteomyelitis. The results of univariate analysis showed that six factors were relevant to surgical incision complications, i.e. the timing of surgery, operative duration, postoperative drainage, skin distraction method, bone grafting, and smoking. The results of multiple Logistic regression analysis showed that surgeries performed within seven days after fracture, operative time >1.5 h, no drainage after surgery, static skin distraction, and smoking were risk factors of calcaneal incision complications. The duration of antibiotic administration and bone grafting had no significant effect on incision complications. Conclusion It is helpful for avoiding complications after calcaneal surgeries by postponing the surgery at least 7 d after fracture, shortening the surgery time, performing postoperative drainage, retracting skin flaps gently and shortly, and prohibiting smoking.

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    Clinical study on connective tissue disease with pulmonary diseases
    CHEN Li-ping, CHEN Ying, YU Bi-qing, et al
    2014, 34 (7):  1049. 
    doi: 10.3969/j.issn.1674-8115.2014.07.018

    Abstract ( 627 )   PDF (307KB) ( 944 )  

    Objective To improve the awareness and diagnosis of connective tissue disease (CTD) with pulmonary diseases. Methods The clinical manifestations of the respiratory system, pulmonary function, and characteristics of lung imaging of 678 patients with CTD were retrospectively analyzed. The pathological types of pulmonary lesions of patients with interstitial lung disease associated with connective tissue disease (CTDILD) were determined. Results Among 678 patients with CTD, 117 patients (17.3%) were with pulmonary diseases. Pulmonary diseases mainly occurred in the course of (32.1±19.2) months. The first symptom of 17 cases (2.5%) was pulmonary manifestations. Pulmonary diseases associated with CTD included interstitial lung disease (94 cases, 13.9%), pulmonary hypertension (11 cases, 1.6%), pleural effusion (46 cases, 6.9%), pleural thickening (6 cases, 0.9%), and infection (6 cases, 0.9%). The primarily respiratory symptoms of CTD-ILD were dry cough (63.8%), dyspnea (43.6%), chest pain (13.8%), and hemoptysis (2.1%). The clinical manifestations of 62.8% of patients were chronic; 36.2% were asymptomatic; and only one (with dermatomyositis/polymyositis) was acute. According to the high-resolution computed tomography (HRCT), pathological types of CTD-ILD were non-specific interstitial pneumonia (70.2%), desquamative interstitial pneumonia (17.0%), and usual interstitial pneumonia (9.6%). Conclusion CTD is often associated with pulmonary diseases and the most common one is CTD-ILD. The clinical manifestations of the respiratory system of most CTD patients with pulmonary diseases are not typical. HRCT is helpful for the diagnosis of CTD-ILD and determination of its pathological types.

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    Clinical analysis of vacuum-aspiration induced abortion of early-early pregnancy
    LU Li-li, LIU Jian-hua
    2014, 34 (7):  1054. 
    doi: 10.3969/j.issn.1674-8115.2014.07.019

    Abstract ( 660 )   PDF (274KB) ( 886 )  

    Objective To observe the clinical effects of vacuum-aspiration induced abortion of early-early pregnancy. Methods Clinical data of 5 742 women (the early-early pregnancy group) who underwent vacuum-aspiration induced abortion of early-early pregnancy (amenorrhea ≤ 42 d and the mean diameter of the gestation sac diameters ≤ 10 mm) and 2 935 women (the routine group) who underwent vacuum-aspiration induced abortion (amenorrhea for 43-50 d and the mean diameter of the gestation sac diameters > 10 mm) were collected. The early-early pregnancy group was further divided into two subgroups, i.e. amenorrhea≤36 d group (n=902) and amenorrhea=37-42 d group (n=4 840). The amount of bleeding during induced abortion, amount of aspirated abortus, aspirating time, incidence of complications (induced abortion syndrome and perforation of uterus), and outcomes of induced abortion were analyzed and compared. Results The amount of bleeding and aspirated abortus (P<0.000 1) and the operating time (P<0.01) of the early-early pregnancy group were significantly less than those of the routine group. The incidence of induced abortion syndrome (P<0.05) and perforation of uterus (P<0.001) of the early-early pregnancy group was significantly lower than that of the routine group. The differences of outcomes of induced abortion of two groups were not statistically significant (P>0.05). The amount of bleeding and aspirated abortus (P<0.000 1) and the operating time (P<0.01) of the amenorrhea≤36 d group were less than those of the amenorrhea=37-42 d group. Conclusion Compared to the routine vacuum-aspiration, the advantages of vacuum aspiration of early-early pregnancy are less bleeding, less amount of aspirated abortus, and shorter operating time. For woman with amenorrhea≤36 d, the advantages of vacuum-aspiration induced abortion are more significant.

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    Clinical investigation of postprandial hypotension of senile inpatients
    TONG Di-yi, FANG Ning-yuan
    2014, 34 (7):  1058. 
    doi: 10.3969/j.issn.1674-8115.2014.07.020

    Abstract ( 625 )   PDF (312KB) ( 883 )  
    Objective To explore the prevalence and clinical characteristics of postprandial hypotension(PPH) of senile inpatients. Methods Seventy-one senile patients who were in stable condition and treated in the Department of Geriatrics from June, 2013 to November, 2013 were selected. Their blood pressure and heart rates were measured by the 24 h ambulatory blood pressure monitoring before and after three meals. Results The prevalence of PPH of senile in patients was 87.32%, which was irrelevant to age and sex. The prevalences of PPH after breakfast, lunch, and supper were similar. The prevalence of patients with more than three basic diseases or taking more than three drugs was significantly higher (P<0.05). The blood pressure dropped in varying degrees after three meals. The blood pressure dropped fast and most after breakfast. The lowest blood pressure occurred 60 min after breakfast and 120 min after lunch and supper. The heart rates dropped after three meals. The differences of variations of the heart rates before and after three meals were not statistically significant (P>0.05). Conclusion The prevalence of PPH of senile inpatients is high and the blood pressure drops significantly after meals. Attention should be paid in order to avoid adverse events induced by the hypotension.
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    Original article (Preventive medicine)
    Effects of BDE-209 exposure on sperm quality of prepubertal male rats
    WANG Ying, SHA Tian-yu, ZHOU Jing-zhe, et al
    2014, 34 (7):  1063. 
    doi: 10.3969/j.issn.1674-8115.2014.07.021

    Abstract ( 670 )   PDF (526KB) ( 1044 )  
    Objective To investigate the effects of BDE-209 exposure on the sperm quality of prepubertal male rats. Methods Twenty four 3-week old SD rats were randomly divided into the control group and three BDE-209 groups. BDE-209 groups were given BDE-209 of 2, 10, and 50 mg/kg by the intragastric injection for one month after 28 d of birth. The control group was given pure corn oil by the intragastric injection for one month. Rats were sacrificed on Day 63. The morphological changes of sperms were observed. The deformity rate of sperms was calculated and kinesis parameters were measured. Results Typical morphological changes such as banana-shaped, no hook, and fat head were observed in BDE-209 groups. The deformity rates of BDE-209 groups were (10.50±3.987)‰, (11.50±6.775)‰, and (10.83±4.401)‰, respectively. The deformity rate of control group was (4.00±3.688). The deformity rates of BDE-209 groups were significantly higher than that of the control group (P<0.05). The differences of kinesis parameters of BDE-209 groups and the control group were not statistically significant (P>0.05). Conclusion Exposure to BDE-209 has certain influence on the sperm quality of male SD rats.
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    Original article (Public health administration)
    Study on treatment satisfaction of patients with hepatitis B and responsiveness of health systems of Jiangsu Province
    SONG Long, ZHANG Hua, ZHU Li-guo, et al
    2014, 34 (7):  1067. 
    doi: 10.3969/j.issn.1674-8115.2014.07.022

    Abstract ( 559 )   PDF (344KB) ( 843 )  

    Objective To analyze the influencing factors of treatment satisfaction of patients with hepatitis B and the responsiveness of health systems. Methods A total of 512 patients (349 outpatients and 163 inpatients) with hepatitis B from August to December, 2012 in Zhangjiagang city, Danyang city, and Taixing city were selected. Health system responsiveness scale designed by the World Health Organization and self-designed satisfaction questionnaire were used. Patients were surveyed for the treatment satisfaction (queuing satisfaction, medical environment satisfaction, facilities satisfaction, medical service satisfaction, medical expense satisfaction, technical level satisfaction, and infectious disease service satisfaction) and responsiveness of health systems (dignity, confidentiality, communication, selectiveness, autonomy, timeliness, and infrastructure). The influencing factors were analyzed by the multiple linear stepwise regression analysis. Results For the responsiveness of health systems, the confidentiality was recognized, but the score of timeliness was low. For the treatment satisfaction, there was no significant influence of demographic characteristics and the medical expense was the most important factor that influenced the overall satisfaction. Outpatients paid more attention to the diagnosis technologies, while inpatients paid more attention to the medical environment. Conclusion The confidentiality of patients with hepatitis B is effectively ensured. But waiting time should be reduced; medical expenses should be reasonably controlled; and medical environment should be improved for increasing the satisfaction of patients.

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    Study on correlation of moral distress and professional burnout of nurses in intensive care unit
    ZHANG Zhi-wei, WANG Xia, WANG Jian-ning, et al
    2014, 34 (7):  1073. 
    doi: 10.3969/j.issn.1674-8115.2014.07.023

    Abstract ( 640 )   PDF (340KB) ( 868 )  

    Objective To investigate the current status and correlation of moral distress and professional burnout of nurses in the intensive care unit (ICU). Methods A total of 105 nurses in ICUs of four third-grade class-A hospitals in Nanchang city were investigated by the self-designed demographic questionnaire and Chinese version of moral distress scale and nursing burnout scale from June to July, 2013. Results The mean scores of nurses' moral distress and professional burnout were 43.03±10.72 and 60.59±17.86 and the correlation coefficient of which was 0.224 (P<0.05). The moral distress was positively correlated to the emotional exhaustion, depersonalization, and professional burnout and negatively correlated to the personal accomplishment. Conclusion The moral distress can lead to emotional exhaustion, depersonalization, and professional burnout and decrease the personal accomplishment. Care administrators should take various appropriate approaches to help nurses overcome the moral distress and burnout and ensure the quality of clinical caring.

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    Review
    Biological characteristics of disrupted-in-schizophrenia 1 and relevant signaling pathways
    MAO Jin-li, LI Wen-ling, Lou Yan
    2014, 34 (7):  1078. 
    doi: 10.3969/j.issn.1674-8115.2014.07.024

    Abstract ( 653 )   PDF (367KB) ( 810 )  

    Disrupted-in-schizophrenia 1 (DISC1) is a key candidate gene involved in the pathogenesis of schizophrenia and a general risk factor for schizophrenia, schizoaffective disorder, bipolar disorder, major depression, autism, and Asperger. Many genetic studies have indicated that DISC1 is relevant to not only the schizophrenia, but also various brain dysfunctions associated with aberrant neurodevelopment and intracellular signaling pathways. Studies on DISC1 in the central nerve system mainly focus on the neurogenesis and neuronal synapse development, such as neuronal maturation, proliferation, migration, positioning, differentiation, dendritic growth, and synaptic plasticity. The DISC1 gene codes the DISC1 protein, which is a multifunctional scaffold protein and plays an important role in neurogenesis and neural development of the adult brain, especially in the dentate gyrus (DG) of the hippocampus. DISC1 is expected to be a therapeutic target of mental illness and epilepsy. This paper reviews the biological characteristics of DISC1 and relevant signaling pathways.

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    Research progresses of signaling pathways and genetics relevant to craniosynostosis
    XU Zhen-yu, BAO Nan
    2014, 34 (7):  1083. 
    doi: 10.3969/j.issn.1674-8115.2014.07.025

    Abstract ( 641 )   PDF (274KB) ( 1056 )  

    Craniosynostosis, also known as craniostenosis, is a common cranial facies frontalis malformation. It can seriously affect the appearance, partly hinder the mental development, and cause severe neurological and psychological disorders. To study the genetic rule of this disease is important for its diagnosis and prevention. This paper reviews the researches and progresses of mechanisms of cranial suture fusion from perspectives of the theories of skull and cranial suture development, molecular signaling pathways and genetics.

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    Advances of differentiation of neural stem cells regulated by long non-coding RNAs
    HU Guo-wen, ZHOU Xiang, WANG Yang, et al
    2014, 34 (7):  1087. 
    doi: 10.3969/j.issn.1674-8115.2014.07.026

    Abstract ( 766 )   PDF (348KB) ( 1035 )  

    Long non-coding RNAs (lncRNA) is the largest class of ncRNAs with a transcript length from 200 to several thousand nucleotides and have no known proteincoding potential. LncRNAs can regulate the gene expression at epigenetic, transcriptional, and post-transcriptional levels through a wide range of mechanisms. More and more studies suggest that lncRNAs play a critical role in the development of central nervous system. Some types of lncRNAs can regulate the differentiation of neural stem cells (NSCs) towards neuronal lineages, while other types of lncRNAs can regulate the differentiation of NSCs towards neuroglia lineages. This paper reviews the latest progresses of studies on the differentiation of NSCs regulated by lncRNAs and provides new ideas for exploring the development of the nerve system.

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    Advances of relationship between macrophages and glioma
    XIE Bao-shu, JIANG Ji-yao, YIN Yu-hua
    2014, 34 (7):  1092. 
    doi: 10.3969/j.issn.1674-8115.2014.07.027

    Abstract ( 1365 )   PDF (280KB) ( 1052 )  

    As front line immune cells, macrophages (predominant microgial cells in the brain) have great plasticity. Macrophages relevant to tumor (microgial cells/macrophages) have double effects on the occurrence and development of glioma, i.e. promoting the development and invasion of the tumor in glioma microenvironment under the regulation of cytokines secreted by glioma or killing tumor cells under the influence of human. Microgial cells/macrophages can cross the blood-brain barrier; change the glioma microenvironment; and inhibit the development and invasion of glioma. It is a new way for the treatment of malignant glioma.

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    Brief original article
    Clinical analysis of interventional therapy for seven cases of severe pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation
    WANG Cheng, PAN Xin, FANG Wei-yi
    2014, 34 (7):  1096. 
    doi: 10.3969/j.issn.1674-8115.2014.07.028

    Abstract ( 759 )   PDF (709KB) ( 1019 )  

    Objective To investigate the feasibility, efficiency, and safety of interventional therapy for severe pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation. Methods The clinical data of seven cases of severe pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation were retrospectively analyzed. During the course of interventional therapy, the small pulmonary arteriography and pulmonary phlebography were conducted first to detect the circumfluence path of four pulmonary veins and to determine the number, location, and extent of pulmonary vein stenosis, and then the balloon and stent technique were used to treat the stenosis. Results The interventional therapy of seven cases was successful and symptoms of all patients were improved after operation. The degree of pulmonary vein stenosis reduced; the pressure of pulmonary artery lowed; and the activity tolerance and heart function improved. Conclusion The interventional therapy is a safe and effective method for the treatment of severe pulmonary vein stenosis after radiofrequency ablation of atrial fibrillation.

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    Technique and method
    Improved method for  building model mouse of abdominal heterotopic cardiac transplantation
    BAO Chun-rong, MEI Ju, DING Fang-bao, et al
    2014, 34 (7):  1100. 
    doi: 10.3969/j.issn.1674-8115.2014.07.029

    Abstract ( 839 )   PDF (470KB) ( 983 )  

    Objective To improve the method of mouse abdominal heterotopic cardiac transplantation and to increase the success rate. Methods Fifty pairs of C57BL/6→C57BL/6 mouse and 50 pairs of BABL/c→C57BL/6 mouse were selected. Cardiac transplantations were performed for syngenic mice and allogeneic mice. The dissection of the aorta artery and pulmonary artery of donors was minimized to decrease the damage and bleeding. The inferior vena cava (IVC) and abdominal aorta of recipients were clamped by proper clamps. It was unnecessary to dissect the IVC and abdominal aorta and ligate their lumber vessels. The length of venotomy and aortotomy of recipients was the same as the opening of the pulmonary artery and ascending aorta of donors or a little bit shorter. Continuous stitches were performed for a single exposure position and the suture needle was unnecessary to go through the opposite side. Heart grafts were harvested and stained with H-E 30 d after the operation. The structural changes of cardiac tissues were observed by the optical microscope. Results The success rate was 95%. The operation time of the donor and recipient was (6.5±1.3) min and (23.7±4.5) min, respectively, of which the anastomosis time of the artery and vein was (7.6±1.3) min and (8.3±1.7) min. The average survival time of heart grafts of allogeneic transplantations was (8.1±0.75) d. All heart grafts of syngenic transplantations survived 30 d after the operation.The structure of heart grafts of syngenic transplantations was normal and the structure of heart grafts of allogeneic transplantations was destroyed with lytic necrosis and lymph cell infiltration. Conclusion The improvement of the method of mouse abdominal heterotopic cardiac transplantation can increase the success rate. It is easy to learn and grasp and is worth promotion and adoption.

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    Case report
    Electrocardiographic manifestations of arrhythmic right ventricular dysplasia: one case report
    MENG Chen, LU You, TANG Rong-rong, et al
    2014, 34 (7):  1104. 
    doi: 10.3969/j.issn.1674-8115.2014.07.030

    Abstract ( 768 )   PDF (389KB) ( 893 )  

    Objective To explore the changes of electrocardiogram (ECG) of the arrhythmic right ventricular dysplasia (ARVD). Methods The effects of the development of ARVD on ECG were analyzed by comparing ECGs of 2002 and 2011 with color ultrasonography of a patient with ARVD. Results With the increase of internal diameter of right ventricle and pulmonary arterial pressure, the QRS interval prolonged gradually; the end of QRS became slurring and notching; V1 lead showed ε wave; the degree of T wave inversion became serious from V1 to V4 leads; and the T waves of Ⅱ, Ⅲ and aVF leads also inversed. The patient showed multifocal ventricular tachycardia. Conclusion The QRS interval may not prolong at the early stage of ARVD, but with the development of the disease, it will prolong gradually and T waves of Ⅱ, Ⅲ and aVF leads may inverse. The multifocal ventricular tachycardia may accompany ARVD.

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