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    FANG Yi-ru team has made some progress in the study of bipolar disorder
    2014, 34 (10):  1416. 
    Abstract ( 936 )   PDF (434KB) ( 1232 )  
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    Original article (Basic research)
    Effects of tumor suppressor gene VHL on H2O2 induced oxidative stress  of tumor cells
    LI Cai-xia, MAO Yu-qin, GAO Yao-hui, et al
    2014, 34 (10):  1417. 
    doi: 10.3969/j.issn.1674-8115.2014.10.001

    Abstract ( 939 )   PDF (815KB) ( 1229 )  

    Objective To observe the effects of tumor suppressor gene VHL on the H2O2 induced oxidative stress of tumor cells and to primarily explore the molecular mechanism. Methods The expressions of vhl-1 gene of C.elegans and homologous gene VHL of cancer cells were silenced by RNAi. The death of C.elegans was morphologically analyzed after being treated by H2O2 of different concentrations. Cells were labeled by AnnexinⅤ and PI and the death of cells was analyzed by the flow cytometry. Then the phosphorylation level of pathway protein c-Jun N-terminal kinase (JNK) of oxidative stress was detected by the Western blotting and the molecular mechanism of effects of VHL on the oxidative stress of cells was analyzed. Results Compared to the control group, the sensitivity of C.elegans with silenced VHL gene towards H2O2 increased significantly and the mortality rate also increased significantly. These effects depended on the concentration gradient and treatment time of H2O2. The mortality rate of tumor cells with silenced VHL gene was not significantly different from that of wild type tumor cells. But the mortality rate of tumor cells with silenced VHL gene significantly increased and the phosphorylation level of JNK also increased after being treated by H2O2 of 250 μmol/L and 500 μmol/L. Conclusion Silencing the expression of VHL can increase the sensitivity of cells towards the oxidative stress induced by H2O2. The protective effect of VHL on the H2O2 induced oxidative stress is conserved in species.

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    Establishment of rabbit model of esophageal stenosis in lower thorax by two catheter method
    LIU Yang, LIU Hui-dong, MA Zhou-rui, et al
    2014, 34 (10):  1423. 
    doi: 10.3969/j.issn.1674-8115.2014.10.002

    Abstract ( 984 )   PDF (1140KB) ( 1221 )  

    Objective To explore the optimal concentration of NaOH solution that can cause the esophageal stenosis and establish the animal model of esophageal stenosis in lower thorax of rabbits. Methods Twenty adult rabbits were randomly divided into the experiment groups (group A, B, and C) and control group. Each group consisted of 5 rabbits. Under fluoroscopy monitoring, 1.5 mL of 1%, 4%, and 10% NaOH solution and normal saline were given to the experiment groups (group A, B, and C) and control group by catheters, respectively. The mental status and appetite of rabbits were observed. The body mass was weighted once a week and the esophagogram was conducted every 2 weeks. Rabbits were sacrificed after 4 weeks and the esophagus in lower thorax was excised for the pathological examination. Results No obvious esophageal stenosis was found in rabbits of group A. All rabbits of group C died within 72 h after experiment. Seconddegree burn injury and esophageal stenosis were observed in rabbits of group B. Morphological manifestations indicated that stricture index of the esophagus increased. Immunohistochemical observations showed mucous layer defects and accumulation of submucosal collagen. The differences of the hydroxyproline level, histopathologic score, and body mass of group B were significantly different to the control group and group A (P<0.01). Conclusion The rabbit model of benign esophageal stricture can be established successfully by burning the esophagus with 4% NaOH solution under the fluoroscopy monitoring.

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    Study on method of directional differentiation of human induced pluripotent stem cells towards mesenchymal stem cells
    HU Guo-wen, LI Qing, NIU Xin, et al
    2014, 34 (10):  1428. 
    doi: 10.3969/j.issn.1674-8115.2014.10.003

    Abstract ( 1444 )   PDF (811KB) ( 1581 )  

    Objective To develop an efficient and simple method to induce the differentiation of human induced pluripotent stem cells (hiPS) towards mesenchymal stem cells (MSCs). Methods MSCs induction medium was used to induce iPS towards MSCs. The cell morphology was observed under the inverted microscope during the course of induction. The expressions of surface markers of iPS and iPS-MSCs were detected by the flow cytometry. The expressions of stemness genes such as NANOG, OCT-4, and MSX-1 in cells during the course of differentiation were detected by the RT-PCR. The osteogenesis, adipogenesis, and chondrogenesis were used to identify their tri-lineages differentiation pluripotency. Results The iPS gradually grew outward after being induced and MSCs gradually became fusiform in Passage 4. The iPS-MSCs were positive to CD29, CD44, CD73, CD90, and CD105 and negative to CD34, CD45, and HLA-DR. The expressions of NANOG and OCT-4 gradually decreased during the course of differentiation and NANOG and OCT-4 were not expressed in iPS-MSCs. The expression of MSX-1 increased to a high level after being induced for 4 d and maintained afterwards. The iPS-MSCs had abilities of osteogenesis, adipogenesis, and chondrogenesis. Conclusion An efficient and simple method is developed for directly inducing iPS towards functional iPS-MSCs, which provides the technical basis for further research and application of iPS-MSCs.

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    Effects of inhibiting secretion of mesenchymal stem cells originated interleukin-6 on oxygen glucose deprivation injured PC12 cells
    HE Mu-lan, LIU Jing-jing, GU Yan, et al
    2014, 34 (10):  1435. 
    doi: 10.3969/j.issn.1674-8115.2014.10.004

    Abstract ( 783 )   PDF (866KB) ( 1219 )  

    Objective To investigate the effects of mesenchymal stem cells (MSCs) originated interleukin-6 (IL-6) on the nerve cells injury. Methods The rat siIL-6 recombinant lentivirus plasmid was constructed and the siIL-6 recombinant lentivirus was infected by MSCs. The MSCs cell line with stable siIL-6 expression was selected by puromycine. The variations of IL-6 mRNA and protein expression levels were detected by the Real-Time PCR and Western blotting. The secretion level of IL-6 was detected from the cultured supernatant of siIL-6-MSCs by the ELISA. The siIL-6-MSCs cells and PC12 cells injured by oxygen glucose deprivation (OGD) were separated and co-cultured. Cell apoptosis was detected by the Annexin V-FITC/PI. Expressions of key protein STAT3 of IL-6 signaling pathway and apoptosis related factors Bax and Bcl-2 were detected by the Western blotting. Results The IL-6 siRNA sequence was correctly cloned to the lentivirus plasmid. Expression levels of IL-6 mRNA and protein and the secretion level of IL-6 significantly decreased after MSCs were infected by the siIL-6 lentivirus. After being separated and co-cultured with siIL-6-MSCs, the apoptosis of OGD injured PC12 cells increased; protein expression levels of STAT3 and Bcl-2 significantly decreased; and the protein expression of Bax significantly increased. Conclusion MSCs-originated IL-6 may regulate the anti-apoptotic function of OGD injured PC12 cells through the STAT3 signaling pathway.

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    Mechanism of relieving hyperoxia-induced lung fibrosis of neonatal rats by Rock inhibitor fasudil
    QI Xiu-jie, LI Jing, XU Feng, et al
    2014, 34 (10):  1442. 
    doi: 10.3969/j.issn.1674-8115.2014.10.005

    Abstract ( 1110 )   PDF (415KB) ( 1114 )  

    Objective To investigate the mechanism of relieving hyperoxia-induced lung fibrosis of neonatal rats by the Rho kinase (Rock) inhibitor fasudil (FAS). Methods According to the random number tables, 24 Sprague-Dawley neonatal rats were randomly divided into the air group (control group), FAS air group, hyperoxia group, and FAS hyperoxia group. Animal models of each group were established. Rats were sacrificed after models were established for 21d. The radial alveolar count (RAC) was conducted for lung tissue. Expressions of transforming growth factor-β1 (TGF-β1) protein and Rock1 and myosin phosphatase target subunit-1 phosphorylation (p-MYPT1) proteins in Rho/Rock signaling pathway were detected by the Western blotting. Results Compared to the air group, the RAC of the hyperoxia group decreased significantly (P<0.05). The RAC of the FAS hyperoxia group increased compared to the hyperoxia group, but the difference was not statistically significant (P>0.05). Compared to the air group, the expression of TGF-β1 protein in pulmonary tissues of the hyperoxia group up-regulated significantly (P<0.05), while the expression of TGF-β1 protein in pulmonary tissues of the FAS hyperoxia group down-regulated significantly compared to the hyperoxia group (P<0.05). Compared to the air group, the expression of Rock1 protein in pulmonary tissues of the hyperoxia group tended to up-regulate, but the difference was not statistically significant (P>0.05), while the expression of p-MYPT1 protein up-regulated significantly (P<0.05). Compared to the hyperoxia group, the expression of Rock1 protein in pulmonary tissues of the FAS hyperoxia group down-regulated, but the difference was not statistically significant (P>0.05), while the expression of p-MYPT1 protein down-regulated significantly (P<0.05). Conclusion FAS can relieve hyperoxia-induced lung fibrosis of neonatal rats to a certain extent by downregulating the expression of TGF-β1. The regulation mechanism may be relevant to inhibiting the activation of Rho/Rock signaling pathway.

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    Effects of UbcH10 gene silencing on drug sensitivity of drug resistant breast cancer cell MCF-7/TXT
    WANG Cheng, SHAN Ming, PAN Yun-hao, et al
    2014, 34 (10):  1448. 
    doi: 10.3969/j.issn.1674-8115.2014.10.006

    Abstract ( 1027 )   PDF (565KB) ( 1187 )  

    Objective To investigate the effects of UbcH10 gene silencing on the drug resistance of human breast cancer cell MCF-7/TXT. Methods The shRNA expression vectors were constructed using the siRNA sequences which were designed based on the coding sequence of UbcH10. MCF-7/TXT cells were then infected by lentivirus. After being infected for 72 h, the infection efficiency was observed through the fluorescent marker and infected cells were collected. The variations of UbcH10 mRNA and protein levels of infected cells were detected by the Real-Time PCR and Western blotting, respectively. The effects of gene silencing on the sensitivity of chemotherapeutic drugs for MCF-7/TXT cells were detected by the CCK-8. Results The gene silencing test of MCF-7/TXT cells was successfully. After being infected for 72 h, the infection efficiency was about 90% and UbcH10 mRNA and protein levels of infected cells significantly decreased. Compared to the control group, the differences were statistically significant (P<0.05). Silencing the UbcH10 gene significantly enhanced the drug sensitivity of taxotere towards MCF-7/TXT cells. IC50 values of taxotere of the gene silencing group at different time points were significantly lower than those of the control group. The differences were statistically significant (P<0.05). Conclusion Silencing the UbcH10 gene can significantly enhance the chemotherapy sensitivity of drug resistant breast cancer cell MCF-7/TXT towards taxotere.

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    Application of acellular artificial dermis carrying nanospheres containing platelet derived growth factor-BB for repairing skin defects of nude mice
    LIU Cheng, FU Jin-song, XIONG Qing-hua, et al
    2014, 34 (10):  1454. 
    doi: 10.3969/j.issn.1674-8115.2014.10.007

    Abstract ( 805 )   PDF (494KB) ( 1188 )  

    Objective To construct the decellular artificial dermis that carries nanospheres containing platelet derived growth factor-BB (PDGF-BB) and to explore the feasibility of repairing skin defects of nude mice by the constructed decellular artificial dermis (DAD). Methods Using tissue engineered technologies, nanospheres were made by enveloping PDGF-BB in the copolymer of polylactic acid-glycolic acid (PLGA). Nanospheres were then bonded to DAD. The decellular human dermis which carried nanospheres containing PDGF-BB was transplanted to nude mice (the experiment group, n=10). Nude mice of the control group (n=10) were transplanted by the decellular human dermis which carried nanospheres not containing PDGF-BB. The repair effect of decellular human dermis which carried nanospheres containing PDGF-BB was observed. Expressions of a-SMA and lumican in local tissue were detected by the Real-Time PCR and Western blotting. Results The decellular human dermis which carried nanospheres containing PDGF-BB repaired skin defects more quickly than the decellular human dermis which carried nanospheres not containing PDGF-BB. The difference was statistically significant (P<0.05). Relative expressions of a-SMA and lumican in local tissue increased significantly after transplantation of the decellular human dermis which carried nanospheres containing PDGF-BB. Conclusion The decellular human dermis which carried nanospheres containing PDGF-BB can significantly improve the treatment of skin defects and is possible to be used in clinical applications.

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    Effects of adenosine A2A receptor agonist CGS21680 on concanavalin-induced acute hepatic injury of mice
    DAI Hui-juan, ZHAI Xiu-yu, LI Da-wei, et al
    2014, 34 (10):  1459. 
    doi: 10.3969/j.issn.1674-8115.2014.10.008

    Abstract ( 1069 )   PDF (423KB) ( 1234 )  

    Objective To investigate the effects of adenosine A2A receptor agonist CGS21680 on the concanavalin (ConA)-induced acute liver injury of mice and possible mechanisms. Methods C57BL/6 male mice were randomly divided into the ConA group and CGS21680+ConA group. Mice of the ConA group were given ConA of 20 mg/kg by caudal vein injection. Mice of the CGS21680+ConA group were given adenosine A2A receptor agonist CGS21680 of 2.1 mg/kg by intraperitoneal injection and then were given ConA of 20 mg/kg by caudal vein injection after 10 min. Levels of serum ALT, AST, IFN-γ, IL-4, and TNF-α were detected. Pathologic changes of liver tissue were measured under the optical microscope and the level of hepatic injury was evaluated. Expressions of IFN-γ and IL-4 of CD4+T cells in mononuclear cells (MNCs) were detected by the flow cytometry. Results Compared to the ConA group, levels of serum ALT, AST, IFN-γ, IL-4, and TNF-α of the CGS21680+ConA group significantly decreased; inflammatory cell infiltration of liver tissues significantly decreased; hepatic injuries were mild; and expressions of IFN-γ and IL-4 of CD4+T cells in liver tissues decreased. Conclusion Pretreatment by the adenosine A2A receptor agonist CGS21680 can significantly relieve the ConA-induced acute hepatic injury of mice. This may be relevant to activating A2A receptor on the surface of CD4+ T cells by the CGS21680 and inhibiting the release of proinflammatory factors.

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    Dependency of intranuclear mobility of PLZF-RARα fusion proteins on ligand and its transcription activity revealed by FRAP
    HE Wei, HUANG Ying
    2014, 34 (10):  1463. 
    doi: 10.3969/j.issn.1674-8115.2014.10.009

    Abstract ( 1072 )   PDF (1329KB) ( 1359 )  

    Objective To detect the mobility of a series of green fluorescence protein (GFP) tagged wild-type and mutant promyelocytic leukemia zinc finger-retinoic acid receptor α (PLZF-RARα) expressing proteins by fluorescence recovery after photobleaching (FRAP). Methods The electrophoretic mobility shift assay (EMSA) was adopted to detect the ability of GFP tagged wild-type and mutant PLZF-RARα fusion protein binding with retinoic acid response elements (RARE). The intranuclear mobility of PLZF-RARα and its mutant expressing proteins was analyzed by FRAP and confocal fluorescence microscopy. GFP-RARα and GFP-PLZF-RARα expressing cells were treated by transcriptional inhibitor actinomycin D (Act D) and/or ATRA. Variations of the intranuclear mobility of PLZF-RARα and wild-type RARα under these treatments was observed by FRAP. Results POZ and zinc finger domains within PLZF moiety not only contributed to the reduction of intranuclear mobility of PLZF-RARα, but also caused the decrease of ligand-induced intranuclear mobility. Act D could effectively immobilize the intranuclear mobility of PLZFRARα and RARα protein molecules. Treatment with differentiation inducer all-trans retinoic acid (ATRA) could reverse Act D induced immobilization of the intranuclear mobility of RARα, but could not reverse the immobilization of intranuclear mobility of PLZF-RARα treated by Act D. Conclusion Decreased intranuclear mobility of PLZF-RARα fusion protein detected by FRAP may rely on the existence of ligand and its transcription activity.

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    Effects of vascular endothelial growth factor receptor inhibitor SU5614 on airway inflammation in mouse models of asthma
    JIANG Ai-ying, YU Ren-zhi, Lü Yu-feng, et al
    2014, 34 (10):  1471. 
    doi: 10.3969/j.issn.1674-8115.2014.10.010

    Abstract ( 910 )   PDF (573KB) ( 1121 )  

    Objective To observe the effects of vascular endothelial growth factor (VEGF) receptor inhibitor SU5614 on the expression of VEGF, airway inflammation, and airway responsiveness in mouse models of toluene diisocyanate (TDI) induced asthma. Methods Thirty BALB/C mice were randomly divided into 3 groups (n=10), i.e. the control group, model group, and SU5614 group. Asthmatic models were established by using TDI as the allergen. For the SU5614 group, SU5614 dissolved in dimethylsulfoxide (DMSO) was intraperitoneally injected 1 h before challenge with the dose of 2.5 mg/kg per day for 3 d. For the model group, no medicine was administered before challenge. While for the control group, no medicine was administered and no challenge was conducted. The expression of VEGF, variations of airway responsiveness, and variations of the total cell count and leukocyte differential count in bronchoalveolar lavage fluid of each group were observed. Results Results of the Western blotting and immunohistochemistry analysis showed that the VEGF expression of the model group increased significantly and the VEGF expression of the SU5614 group decreased significantly. The airway responsiveness of the model group was significantly higher than that of the control group and the airway responsiveness of the SU5614 group was significantly lower than that of the model group. The differences were statistically significant (P<0.05). The number of total cells, neutrophils, macrophage, tymphocytes, and eosinophils in bronchoalveolar lavage fluid of the model group were significantly higher than those of the control group and those of the SU5614 group were significantly lower than those of the model group. The differences were statistically significant (P<0.05). Conclusion SU5614 can inhibit the expression of VEGF in bronchoalveolar lavage fluid, decrease the airway hyperresponsiveness, and relieve the airway inflammation.

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    Original article (Clinical research)
    Clinical features of breast cancer patients with hypertension and influencing factors of chemotherapy
    LIU Jun-jun, CHEN Xiao-song, MAO Yan, et al
    2014, 34 (10):  1476. 
    doi: 10.3969/j.issn.1674-8115.2014.10.011

    Abstract ( 1188 )   PDF (310KB) ( 1282 )  

    Objective To investigate the clinical pathological features of breast cancer patients with hypertension and influencing factors of the treatment and chemotherapy. Methods The clinical data and treatments of 186 breast cancer patients with hypertension (the observation group) and 671 breast cancer patients without complications (the control group) were retrospectively analyzed. Results Compared to the control group, the average age of the observation group was older; the rate of postmenopausal patients was higher; and the rate of undergoing chemotherapy was lower. The differences were statistically significant (P<0.001). The differences of tumor size, pathological grade, lymph node status, hormone receptor, and expressions of HER2 and ki67 were not statistically significant (P>0.05). Results of the Logistic regression analysis showed that the age, combined with hypertension, lymph node status, hormone receptor, and expressions of HER2 and ki67 were influencing factors of chemotherapy (P<0.05). Conclusion The differences of clinical pathological features of breast cancer patients with hypertension and breast cancer patients without complications are not significant. The rate of undergoing chemotherapy of breast cancer patients with hypertension is lower than that of breast cancer patients without complications. Combined with hypertension is an important influencing factor for the chemotherapy of breast cancer patients.

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    Analysis of clinical characteristics of Clostridium difficile infection for hospitalized patients with diarrhea
    GAO Yan-ting, ZHANG Li-hua, WANG Su, et al
    2014, 34 (10):  1481. 
    doi: 10.3969/j.issn.1674-8115.2014.10.012

    Abstract ( 1086 )   PDF (343KB) ( 1188 )  

    Objective To analyze the clinical characteristics of Clostridium difficile (C.difficile) infection for hospitalized patients with diarrhea in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Methods A total of 706 unformed stool samples of hospitalized patients with diarrhea from November 2013 to February 2014 were collected. The anaerobic culture, latex agglutination test, and glutamate dehydrogenase gene (gluD) amplification were performed for identification of C.difficile strains. The DNA of strains was detected by the polymerase chain reaction (PCR) for the toxin A gene (tcdA) and toxin B gene (tcdB), and toxin types of the strains were analyzed. Clinical symptoms and medications of patients were analyzed based on their medical history. Results Among 706 samples, 34 C.difficile strains (4.82%) from 30 hospitalized patients were isolated. The C.difficile infection of 23 patients was nosocomial infection (76.67%) and they all had used one or more antibiotics, including cephalosporins, carbopenems, quinolones, etc. The toxin detection by the PCR showed that among 34 C.difficile strains, the toxin type of 21 strains were A+B+ type (61.76%); 12 strains were A-B+ type (35.30%); and only 1 strain was A-B- type (2.94%). Conclusion The C.difficile infection of most patients with diarrhea in Ruijin Hospital is nosocomial infection. The toxin type of strains is mainly A+B+ type. The use of antibiotics is an important factor of C.difficile infection.

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    Evaluation of antibacterial effect of lidocaine/prilocaine on Staphylococcus aureus
    GU Fei-fei, JIANG Jie, XIANG Jin, et al
    2014, 34 (10):  1485. 
    doi: 10.3969/j.issn.1674-8115.2014.10.013

    Abstract ( 1061 )   PDF (301KB) ( 1153 )  

    Objective To evaluate the antibacterial effect of lidocaine/prilocaine on Staphylococcus aureus (S.aureus). Methods One hundred and twenty-six S. aureus isolates were collected from patients with skin and soft tissue infection (SSTI). The drug resistance of S.aureus towards 18 antibiotics, including penicillin, cefoxitin, and gentamicin, were measured by the disk diffusion method. Methicillin-resistant S.aureus (MRSA) was screened based on the result of antimicrobial susceptibility test of cefoxitin and mecA gene. The minimum inhibitory concentration (MIC) of vancomycin was detected by E-test. The agar dilution method was adopted to detect the MIC of lidocaine/prilocaine. Results Twenty-three of 126 S. aureus isolates were MRSA. The resistance rates of penicillin and erythromycin were higher and were 86.5% and 46.8%, respectively. No isolates were resistant to teicoplanin, vancomycin, linezolid, and quinupristin/dalfopristin. The MIC range of S.aureus lidocaine/prilocaine towards was (1/1~2/2) mg/mL and MIC50 and MIC90 were both (2/2) mg/mL. Conclusion Lidocaine/prilocaine shows significant antibacterial effect on S.aureus isolated from patients with skin and soft tissue infections. They can stop pain and itch for patients with skin diseases and effectively prevent and inhibit S. aureus infections.

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    Study on variation of cardiac troponin T level for patients undergoing radiotherapy after mastectomy
    CHEN Gang, JIN Ye-ning, LI An-lin, et al
    2014, 34 (10):  1489. 
    doi: 10.3969/j.issn.1674-8115.2014.10.014

    Abstract ( 971 )   PDF (291KB) ( 1110 )  

    Objective To explore variations of the serum cardiac troponin T (cTNT) level for patients who underwent radiotherapy after mastectomy and to investigate the relationship between cTNT and myocardial damage. Methods Patients undergoing radiotherapy after mastectomy were selected and divided into the L group (50 patients underwent left mastectomy) and R group (50 patients underwent right mastectomy). The control group included 50 patients underwent radiotherapy at locations other than the thorax. The cTnT level of all patients was detected by the colloidal gold method before, in the middle of, and at the end of radiotherapy, 3 months, 6 months, and 12 months after radiotherapy, respectively. cTnT>0.03 ng/mL was the criterion for the diagnosis of myocardial damage. Results Positive rates of the serum cTNT level of the group L and group R after radiotherapy were significantly different to that of the control group (P<0.05), while the difference of the L group and R group was not statistically significant (P>0.05). Compared to the serum cTNT level of the L group and R group detected before radiotherapy, the serum cTNT level detected at the end of radiotherapy increased significantly and reached the peak value. The differences were statistically significant (P<0.01). The serum cTNT level was back to normal 6 months after radiotherapy. Conclusion Postmastectomy radiotherapy (PMRT) may lead to the significant rise of serum cTNT level and increase the incidence of myocardial damage. Variations of the cTNT level can predict radioactive myocardial damage at early stage and is helpful for the early prevention and treatment of complications and sequelae relevant to the radiotherapy.

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    Analysis of clinical characteristics and prevention of traumatic spinal fracture of elderly patients
    CHEN Guo-qiang, FANG Xiu-tong, YU Meng
    2014, 34 (10):  1493. 
    doi: 10.3969/j.issn.1674-8115.2014.10.015

    Abstract ( 813 )   PDF (268KB) ( 1290 )  

    Objective To investigate the clinical characteristics of traumatic spinal fractures of the elderly and to provide evidences for improving preventive measures and treatment for elderly patients with spinal fractures. Methods One hundred and sixty eight elderly patients with traumatic spinal fractures were selected. Their clinical data, such as distributions of age and sex, causes of fractures, fractured levels, and osteoporosis levels, etc. were retrospectively analyzed. Results Most patients were 62 to 69 years old, accounting for 64.3% (108/168) of all patients. Falling was the main cause of traumatic spinal fracture, accounting for 51.8% (87/168), and female patients were more than male patients (P<0.05). The rate of falling from high places and hitting by heavy objects of male patients was higher than that of female patients (P<0.05). Among 285 vertebral body fractures, thoracic and lumbar vertebral body fractures accounted for 81.1% (231/285), in which thoracolumbar segment fractures accounted for 54.7% (156/285). The rate of cervical spinal fractures of male patients was significantly higher than that of female patients (P<0.05). The rate of thoracic and thoracolumbar spinal fractures of female patients was significantly higher than that of male patients (P<0.05). The grade of trabecular bone of male and female patients decreased progressively with the age (P<0.05). Among patients with the same age, the grade of trabecular bone of female patients was significantly lower than that of male patients (P<0.05). Conclusion Causes of traumatic spinal fractures and the segments of spinal fractures between elderly male patients and elderly female patients are significantly different. All patients have different degrees of osteoporosis. Prevention of traumatic spinal fractures should be carried out according to the gender difference and their own characteristics.

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    Cross-sectional survey of attitudes of patients towards biosample donation
    DING Wen-bin, MA Yi, WANG Ye, et al
    2014, 34 (10):  1497. 
    doi: 10.3969/j.issn.1674-8115.2014.10.016

    Abstract ( 968 )   PDF (384KB) ( 1156 )  

    Objective To investigate the attitudes of patients towards the donation and usage of clinical biosamples and their affecting factors. Methods Questionnaires of donation of clinical biosamples were prepared and 639 patients in Renji Hospital of Shanghai Jiao Tong University School of Medicine were randomly selected. The attitudes and motivation of patients towards donating clinical biosamples, usage of biosamples, expectations for feedback of research results, and trust in medical institutions were investigated and statistically analyzed. Results The response rate was 81.7%. And 66.7% of respondents would donate biosamples and 40.8% of them would donate anonymously; 17.2% of respondents desired that they could withdraw their donations anytime afterwards; and 42.3% of respondents trusted or strongly trusted medical institutions. The donation rate of young respondents with high education levels was high (P<0.05). The donation rate of patients with hepatitis B was significantly lower than that of other patients (26.7% vs 70.4%, P<0.05). Conclusion The willingness of Chinese patients to donate biosamples is lower than that of patients of other countries. The trust level of patients towards medical institutions and their education levels may be the main factors affecting the donation. The survey is helpful for understanding the real attitudes of patients towards biosample donation, improving their awareness of usage of and clinical research on biosamples, enhancing their willingness of biosample donation, and promoting the development of ethical laws for biobanks of China.

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    Significance of CD64 index for early diagnosis of neonatal sepsis
    RUAN Li-li, DU Jun-jun, LIN Yan, et al
    2014, 34 (10):  1503. 
    doi: 10.3969/j.issn.1674-8115.2014.10.017

    Abstract ( 1113 )   PDF (270KB) ( 1053 )  

    Objective To evaluate the significance of the CD64 index for the early diagnosis of neonatal sepsis. Methods The prospective case-control study was adopted to conduct the analysis. A total of 41 neonatal patients were divided into the documented sepsis group (n=14), clinical sepsis group (n=15), and control group (n=12). Venous blood specimens of all patients were collected with in 24 h after admission. The CD64 index was measured by the flow cytometry. Results Results of the flow cytometry showed that the CD64 indexes of the documented sepsis group, clinical sepsis group, and control group were 12.93±4.08, 9.51±2.21, and 2.98±0.72, respectively. Compared to the control group, the CD64 indexes of the documented sepsis group and clinical sepsis group were significantly higher (t=8.97, P=0.00; t=6.27, P=0.00). The CD64 index of the documented sepsis group was significantly higher than that of the clinical sepsis group (t=2.39,P=0.023). Conclusion Detection of CD64 contributes to the early diagnosis of neonatal sepsis, identifies the degree of infection, and provides an important evidence for appropriate clinical treatment.

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    Variations of retinol-binding protein 4 level of patients with non-obese gestational diabetes mellitus and the influence factors
    ZHU Jie-ping, JI Yu-qin, TAO Min-fang, et al
    2014, 34 (10):  1506. 
    doi: 10.3969/j.issn.1674-8115.2014.10.018

    Abstract ( 805 )   PDF (335KB) ( 990 )  

    Objective To observe variations of the serum retinol-binding protein 4 (RBP4) level of patients with gestational diabetes mellitus (GDM) whose body mass index (BMI) were normal before pregnancy and to analyze the influence factors. Methods A total of 177 patients with GDM who underwent normal antenatal examinations were selected. Their body mass indexes before pregnancy were 16-25 kg/m2. And 354 health pregnant women who underwent antenatal examinations at the same hospital and same period were selected as controls and their age and BMI matched with GDM patients. The 75 g oral glucose tolerance test (OGTT) was conducted in 24-28 gestational weeks. Observed indexes included the body mass increase during 24-28 gestational weeks, RBP4, blood sugar and serum insulin levels form OGTT (0, 30, 60, 120, and 180 min), glycosylated hemoglobin (HbA1C), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), homeostasis model assessment of insulin resistance (HOMA-IR) index, and homeostasis model assessment of β-cell function (HOMA-%B). Results The mean body mass increase of patients with GDM was significantly higher than that of controls and the difference was statistically significant (P<0.05). The plasma glucose and serum insulin levels at each time point of OGTT, HOMA-IR index, HbA1C, and TG level of patients with GDM were significantly higher than those of controls (P<0.001). The differences of TC, HDL, LDL, and HOMA-%B of patients with GDM and controls were not statistically significant (P>0.05). Pearsons correlation analysis showed that the serum RBP4 level of patients with GDM was significantly and positively correlated with the body mass increase during midtrimester, TC, HDL, LDL, fasting plasma glucose (FPG), and HbA1C (P<0.05), and significantly and negatively correlated with HOMA-%B (P<0.05). Results of multiple stepwise regression analysis showed that parameters that were included in the regression equation were FPG, body mass increase during pregnancy, and TC (r2=0.180, P<0.01). Conclusion The serum RBP4 level of GDM women with normal pre-pregnancy body mass increases significantly during mid-trimester. Body mass increase during pregnancy, FPG level, and TC level were positively correlated with the serum RBP4 level.

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    Application of real-time tissue elastography in differential diagnosis of axillary lymph nodes of patients with breast cancer
    YU Li, HU Bing, LIN Yan-ping, et al
    2014, 34 (10):  1511. 
    doi: 10.3969/j.issn.1674-8115.2014.10.019

    Abstract ( 816 )   PDF (830KB) ( 1135 )  

    Objective To evaluate the value of real-time tissue elastography (RTE) for the differential diagnosis of axillary lymph nodes of patients with breast cancer. Methods Sixty-nine axillary lymph nodes of patients with breast cancer underwent grey-scale ultrasound and RTE. The grey-scale sonograms and elastograms were scored from 1 to 5. The region of interest of elastogram scoring is the hypoechoic region in the lymph nodes. The combined score was the sum of both grey-scale and elastogram scores. The strain ratio (SR) index was also measured. Results of RTE were compared to the pathological results of the lymph node core biopsy. Results According to the ROC curve, the diagnostic cutoff value of grey-scale ultrasound and RTE scores was 3; combined evaluation was 6; and SR was 2.28. Sensitivity, specificity, and diagnostic accuracy of grey-scale sonography were 89.74%, 76.67%, and 84.06% and those of RTE were 84.61%, 90.00% and 87.96%. Sensitivity, specificity, and diagnostic accuracy of combined evaluation were 92.31%, 93.33% and 92.75%, and those of SR were 94.87%, 83.33% and 89.86%. Conclusion RTE is a complementary method of the grey-scale ultrasound for the differential diagnosis of axillary lymph nodes of patients with breast cancer.

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    Analysis of results of preoperative staging for 133 patients with gastric cancer by the endoscopic ultrasonography
    ZHENG Xiong, LI Jian, SUN Ying, et al
    2014, 34 (10):  1516. 
    doi: 10.3969/j.issn.1674-8115.2014.10.020

    Abstract ( 872 )   PDF (252KB) ( 1294 )  

    Objective To analyze the correctness of endoscopic ultrasonography (EUS) for the preoperative TN staging of gastric cancer and to explore the application value of EUS for the preoperative staging of gastric cancer. Methods Clinical data of 133 patients with gastric cancer who underwent preoperative EUS examinations and clinical staging were collected. The results of preoperative TN staging were compared to the results of postoperative histopathological staging. Results The overall accuracy rate of preoperatively clinical staging of T subsets for gastric cancer by EUS was 81.20%. The accuracy rates of T1 and T4 stages were higher and were 91.67% and 85.0%, respectively. The accuracy rates of T2 and T3 stages were lower and were 74.29% and 70.0%, respectively. Overestimation and underestimation were found during T-staging. Among all patients, 8 patients were overestimated and 17 patients were underestimated. The results of preoperative staging by EUS were highly consistent with the results of postoperative histopathological staging. The overall accuracy rate of N subsets by EUS was 78.95%. The accuracy rate for identifying positive lymph nodes was relatively low (66.10%). Conclusion Endoscopic ultrasonography can correctly identify the TN staging of gastric cancer and provide evidences for properly treatment options.

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    Analysis of influencing factors of pathological changes of pedal arch for critical limb ischemia patients with ischemic ulcers
    XIE Hui, YE Meng, CHEN Jia-quan, et al
    2014, 34 (10):  1519. 
    doi: 10.3969/j.issn.1674-8115.2014.10.021

    Abstract ( 998 )   PDF (738KB) ( 1495 )  

    Objective To analyze the factors that influence pathological changes of pedal arch for patients with critical limb ischemia (CLI) who suffer from ischemic ulcers. Methods The clinical data of 152 CLI patients with ischemic ulcers were retrospectively analyzed. The age, sex, smoking history, hypertension history, course of diabetes, body mass, and blood biochemical indexes were recorded. According to angiography results of the pedal arch, patients were divided into two groups, i.e. the good pedal arch group (n=37) and poor pedal arch group (n=115). The factors that influenced pathological changes of pedal arch were analyzed by single variate and multi-variate Logistic regression models. Results The fasting blood glucose (FBG) and mean platelet volume (MPV) of the poor pedal arch group were significantly higher than those of the good pedal arch group (P<0.05, P<0.01). The number of patients of the poor pedal arch group who suffered from diabetes for more than 10 years was far more than that of the good pedal arch group (P<0.001). The Logistic regression analysis showed that FBG, MPV, and diabetes history ≥10 years were independent risk factors of poor pedal arch (P<0.05). The receiver operating characteristic (ROC) curve indicated that the best cut-off value and the area under the ROC curve of FBG for predicting poor pedal arch were 6.60 mmol/L and 0.805 (P<0.05). The best cut-off value and the area under the ROC curve of MPV were 11.70 fl and 0.907 (P<0.05). Patients were divided into two groups based on cut-off points of FBG and MPV and diabetes duration ≥10 years. The results of Logistic regression analysis showed that the risk of incidence of poor pedal arch for patients with FBG≥6.60 mmol/L, MPV≥11.70 fl, and diabetes duration≥10 years was 8.684 times higher than that of patients with FBG<6.60 mmol/L (95%CI=3.496-21.571, P<0.05), 12.737 times higher than that of patients with MPV<11.70 fl (95%CI=5.358-30.232, P<0.05), and 7.75 times higher than that of patients with diabetes duration<10 years (95%CI=2.996-20.048, P<0.05). Conclusion Increased FBG and MPV, and diabetes duration ≥10 years are independent risk factors of predicting poor pedal arch for CLI patients with ischemic ulcers.

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    Study on expressions of IL-17 in gingival tissue of patients with different types of periodontitis
    GUO Qiu-man, SHU Rong
    2014, 34 (10):  1525. 
    doi: 10.3969/j.issn.1674-8115.2014.10.022

    Abstract ( 1009 )   PDF (486KB) ( 1169 )  

    Objective To detect the distribution and expression of IL-17 in the gingival tissue of patients with different types of periodontitis and to preliminary explore the possible effects of IL-17 on the occurrence and development of periodontitis. Methods Gingival biopsies were divided into the control group (n=10), chronic periodontitis group (n=10), and aggressive periodontitis group(n=10). The distribution and expression of IL-17 in the gingival tissue of each group were detected by the immunohistochemistry. Results IL-17 expressed in the gingival epithelium and connective tissue full layer. The expressions of IL-17 in the gingival tissue of the chronic periodontitis group and aggressive periodontitis group were significantly higher than that of the control group (P<0.01). The expressions of IL-17 in the gingival epithelium and connective tissue of the aggressive periodontitis group were significantly higher than those of the chronic periodontitis group (P<0.01). Conclusion IL-17 involves in the occurrence and development of periodontal inflammation. The expressions of IL-17 in the gingival tissue of patients with different types of periodontitis are different.

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    Surgical strategies and prognosis of malignant non-functioning pancreatic neuroendocrine tumors
    CHEN Xu-xiao, CHEN Yong-jun, PENG Cheng-hong, et al
    2014, 34 (10):  1529. 
    doi: 10.3969/j.issn.1674-8115.2014.10.023

    Abstract ( 1218 )   PDF (350KB) ( 1326 )  

    Objective To investigate the clinical features, pathological characteristics, surgical strategies, and prognostic factors of malignant non-functioning pancreatic neuroendocrine tumors (PNETs). Methods The clinical records of 37 patients with malignant non-functioning PNETs who underwent curative surgery were retrospectively analyzed. The data included sex, age, symptoms, pathological characteristics, surgical strategies, and prognosis. Based on the extent of resection, patients were divided into two groups, i.e. the non-extended resection group (n=25) and extended resection group (n=12). T test was adopted to compare continuous variables. Fisher's exact test was used to compare categorical variables. Kaplan-Meier method was used for survival analysis and univariate analysis. Log-rank test was adopted to evaluate the differences of survival rates of two groups. Multivariate analysis was performed by the Cox regression model. Results Among 37 patients, 20 of them were males (54%) and 17 of them were females (46%). Their age ranged from 28 to 72 years old and the median age was 48 years old. Twenty-one tumors (57%) were located in the head of the pancreas and 16 tumors (43%) were located in body or tail of the pancreas. According to the 2000 WHO classification, there were 30 cases of well-differentiated neuroendocrine carcinomas (81%), 3 cases of poorly differentiated neuroendocrine carcinomas (8%), and 4 cases of mixed exocrine-neuroendocrine carcinomas (11%). The differences of the rate of postoperative complications and hospital stay of two groups were not statistically significant (P>0.05). The cumulative survival and disease-free survival of the extended resection group were not significantly lower than those of the non-extended resection group (P>0.05). The multivariate analysis showed that liver metastases and Ki67 were independent factors that influenced the prognosis of this disease. Conclusion For malignant advanced non-functioning PNETs with peripancreatic invasion or liver metastases, active extended surgery is a reasonable and feasible choice. Liver metastases and Ki67 are independent risk factors that influence the prognosis.

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    Reducing dosage of corticosteroid by mycophenolate acid therapeutic drug monitoring for renal allograft recipients
    YANG Yang, ZHOU Pei-Jun, XU Da, et al
    2014, 34 (10):  1534. 
    doi: 10.3969/j.issn.1674-8115.2014.10.024

    Abstract ( 1348 )   PDF (338KB) ( 1293 )  

    Objective To reduce the dosage of corticosteroids and to evaluate its efficiency and safety based on mycophenolate acid (MPA) therapeutic drug monitoring (TDM) and rational use of mycophenolate mofetil (MMF) for renal allograft recipients during the maintenance period of immunosuppressive therapy. Methods Eighty kidney transplant recipients who underwent CsA+MMF+Pred triple immunosuppressive therapy were selected and randomly divided into the MPA TDM group and control group. For patients of the MPA TDM group, the area under the plasma MPA concentration-time curve (MPA-AUC) was calculated by the simplified formula of limited sampling method. The dosage of MMF was adjusted according to the MPA-AUC, so the range of MPA-AUC0-12 h  reached 30-60 mg·h-1·L-1 and the dosage of corticosteroid was reduced by at least 50%. For patients in the control group, relatively fixed dosage of MMF was used and the dosage of corticosteroids was not reduced. The incidence of graft rejection and various adverse reactions and the level of fasting blood glucose of two groups were compared. Results For patients of the MPA TDM group and control group, the differences of functions of the allograft, incidence of graft rejection and various adverse reactions, and the dosage of CsA and MMF were not statistically significant (P>0.05). Dosages of prednisone of the MPA TDM group and control group were (2.77±0.79) mg/d and (6.00±1.77)mg/d, respectively, and the difference was statistically significant (P<0.05). Fasting plasma glucose levels of the MPA TDM group and control group were (5.36±0.50) mmol/L and (5.78±1.19) mmol/L, and the difference was statistically significant (P<0.05). Conclusion For renal transplant recipients, the dosage of corticosteroids can be safely and effectively reduced based on the MPA TDM and rational use of MMF during the maintenance period of immunosuppressive therapy.

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    Review
    MicroRNA: a novel regulatory molecule of acute lung injury
    CAO Yong-mei, LI Ying-chuan
    2014, 34 (10):  1539. 
    doi: 10.3969/j.issn.1674-8115.2014.10.025

    Abstract ( 1258 )   PDF (290KB) ( 1186 )  

    Acute lung injury (ALI) is a common and complex disease characterized by severe pulmonary inflammation. As a new type of gene regulator, microRNA (miRNA) plays vital roles in a wide range of human disorders and diseases, including ALI. During the process of lung injury and repair, certain kinds of miRNA express abnormally and can modulate inflammation pathways as well as immune response by affecting expressions of target genes. Therefore, miRNA can serve as biological markers for ALI. This paper reviews the effects of miRNA on ALI.

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    Research progresses of effects of placental growth factor on myocardial regeneration treatment after acute myocardial infarction
    ZHANG Wen-tian, LIAN Feng, XUE Song
    2014, 34 (10):  1543. 
    doi: 10.3969/j.issn.1674-8115.2014.10.026

    Abstract ( 1133 )   PDF (378KB) ( 1140 )  

    Hypoxic condition of myocardial cells will stimulate myocardial cells and interstitial cells to release growth factors to induce angiogenesis and cardiac remodeling after acute myocardial infarction (AMI). Placental growth factor (PlGF) is a stress product after the injury of myocardial tissue. It can not only promote angiogenesis and regulate the inflammatory response, but also closely related to ventricular remodeling and paracrine mechanism of stem cells. This paper reviews the effects of PlGF on the myocardial regeneration treatment after AMI.

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    Research progresses of correlation between depression and temporomandibular disorder
    YU Fei, CHEN Si-han, YU Qian, et al
    2014, 34 (10):  1548. 
    doi: 10.3969/j.issn.1674-8115.2014.10.027

    Abstract ( 1842 )   PDF (390KB) ( 1185 )  

    Depression is a common mental disease and temporomandibular disorder (TMD) is a common temporomandibular disease. The correlation of two diseases still needs further study. Hypothalamic-pituitary-adrenal (HPA) axis, serotoninergic system, tumor necrosis factor-α (TNF-α), and catechol-O-methyltransferase (COMT) gene are possible internal correlation factors of depression and TMD. The treatment of depression can relieve the symptoms of TMD to some extent. Clinicians should be aware of the coexistence of depression and TMD and conduct proper treatments. Further study should focus on the internal correlation of depression and TMD. This paper reviews research progresses of the correlation among symptoms, mechanism, and treatment of depression and TMD.

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    Advances of application of blue light in medicine
    WANG Ning, YAO Min, FANG Yong
    2014, 34 (10):  1554. 
    doi: 10.3969/j.issn.1674-8115.2014.10.028

    Abstract ( 1311 )   PDF (271KB) ( 1324 )  

    The blue light can successfully inactivate various Gram-positive bacteria (S. aureus, Staphylococcus epidermidis, Enterococcus faecalis, and Clostridium perfringens) and Gram-negative bacteria (A. baumannii, P. aeruginosa, Escherichia coli, Proteus vulgaris, and Klebsiella pneumonia) and is widely used for the clinical treatment of neonatal jaundice and acne. Recently researchers found that the blue light is also effective for the treatment of atopic dermatitis and psoriasis vulgaris. This paper reviews the literature published in recent years from home and abroad, introduces research progresses of the blue light in basic medicine and clinical medicine, and provides references for clinicians and scientific researchers.

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    Technique and method
    Preparation of curcumin-loaded methoxypolyethylene glycols-polylactide nanoparticle and its in vitro and in vivo evaluations
    GU Ming-jie, GONG Fei-rong, CHEN Shu-jun
    2014, 34 (10):  1557. 
    doi: 10.3969/j.issn.1674-8115.2014.10.029

    Abstract ( 940 )   PDF (1020KB) ( 1077 )  

    Objective To improve the water solubility, circulation time in vivo and anti-tumor effect of the curcumin. Methods Degradable methoxypolyethylene glycolspolylactide (mPEG-PLA) with various molecular weights was synthesized as the carrier and stabilizer for preparing the curcumin nanoparticles. The polymer was characterized and the encapsulation efficiency, drug loading, distribution of size, micromorphology, in vitro release behaviors, pharmacokinetics, and anti-tumor effect of the curcumin nanoparticle were studied. Results The encapsulation efficiency was 95%; the drug loading was 17%; the mean particle size was 98 nm; and the distribution was even. Spherical particles were observed under transmission electron microscope. The in vitro release effect was satisfactory, but the differences of release behaviors of nanoparticles with carriers of different molecular weights were not statistically significant (P>0.05). Compared to the pure curcumin, the area under the curve (AUC) of the curcumin nanoparticle increased significantly and the maximum inhibiting rate towards the tumor was 68.7%. The differences of body weights of mice of the control group and test group were not statistically significant (P>0.05). Conclusion The release effect of curcumin nanoparticles is satisfactory both in vitro and in vivo and the inhibiting rate towards the tumor is high. No advert reactions are found.

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