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    Original article (Basic research)
    Effects of high glucose on apoptosis of human umbilical vein endothelial cells and expression of Caspase-3
    SUN Jie, SHEN Xi, XIE Bing, et al
    2014, 34 (12):  1709. 
    doi: 11.3969/j.issn.1674-8115.2014.12.001

    Abstract ( 622 )   PDF (466KB) ( 1068 )  

    Objective To investigate the effects of high glucose on the apoptosis of human umbilical vein endothelial cells (HUVECs) and its correlation with Caspase-3 expression. Methods HUVECs were cultured by glucose solution of different concentrations for 48 h. The apoptosis of cells was observed by the TUNEL staining. The survival, apoptosis, and necrosis of cells were detected by the flow cytometry (Annexin V-FITC and PI dual fluorescence). The expression of cleaved Caspase-3 of cells was observed by the Western Blot analysis. Results The apoptotic cells of the high glucose group (33 mmol/L) were significantly more than those of the normal glucose group (5.5 mmol/L) under the optic microscope. The TUNEL-positive nuclei of the high glucose group were more than those of the normal glucose group in 3 randomly selected fields. The results of flow cytometry showed that for the normal glucose group; the apoptosis rate was (4.10±2.16)%, the necrosis rate was (0.47±0.05)%; and the survival rate was (94.44±2.13)%. While for the high glucose group, the apoptosis rate was (16.13±1.51)%; the necrosis rate was (1.09±0.27)%; and the survival rate was (81.99±1.13)%. The difference of apoptosis rate of two groups was statistically significant (P<0.05). The results of Western blotting method showed that the Caspase-3/β-actin levels of the normal glucose group and high glucose group were 0.062±0.005 and 0.125±0.05, respectively. The difference was statistically significant (P<0.05).  The expression of cleaved Caspase-3 of the high glucose group increased. Conclusion The apoptosis of HUVECs under high glucose increases, which may be relevant to the increase of expression of cleaved Caspase-3.

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    Relationship between reference value of left ventricular posterior wall thickness and geographical factors based on neural network
    CEN Min-yi, GE Miao, WANG Cong-xia, et al
    2014, 34 (12):  1714. 
    doi: 11.3969/j.issn.1674-8115.2014.12.002

    Abstract ( 350 )   PDF (1119KB) ( 1060 )  

    Objective To analyze the relationship between the reference value of left ventricular posterior wall thickness (LVPW) of Chinese middle-aged and elderly people and geographical factors and to provide scientific evidences for establishing the uniform standard. Methods Reference values of LVPW of 3 543 Chinese healthy middle-aged and elderly people from 67 cities were collected. The correlation analysis method was adopted to investigate the relationship between the reference value and 18 geographical factors, including terrain, climate, soil, etc. Geographical factors that significantly correlated with the reference value were selected for conducting the multiple linear regression and BP neural network modeling. The spatial distribution map of the reference value of LVPW of Chinese middle-aged and elderly people was fitted by the inverse distance weight method. Results The reference value of LVPW of Chinese middle-aged and elderly people was significantly correlated with the longitude, altitude, percentage of sand in topsoil, percentage of silt in topsoil, total exchangeable capacity of topsoil, and alkalinity of topsoil. The simulation and prediction performance of BP neural network model was better than that of the multiple linear regression model. The spatial distribution map of the reference value of LVPW of Chinese middle-aged and elderly people showed a distribution feature of higher in the west and lower in the east. Conclusion If the geographical factors of a certain area are known, the reference value of LVPW of Chinese middle-aged and elderly people can be obtained by establishing the neural network model or plotting the spatial distribution map.

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    Screening pathogenic genes of hereditary gingival fibromatosis by exome sequencing
    GAO Wei-wei, YANG Jing, ZHU Yu-fei, et al
    2014, 34 (12):  1721. 
    doi: 11.3969/j.issn.1674-8115.2014.12.003

    Abstract ( 566 )   PDF (499KB) ( 1052 )  

    Objective To construct and analyze the mutant genetic profile of hereditary gingival fibromatosis (HGF) and to predict specific mutations and genes relevant to pathogenesis. Methods Samples from a family with obvious maternal inheritance were collected and whole exome sequencing was performed by Agilent SureSelect exome capture and Illumina Solxa sequencing platform. Single nucleotide polymorphisms (SNP) and genes relevant to the onset of HGF were screened by bioinformatic methods and experimental verification and verified against normal people. Results A total of 17 SNPs relevant to the onset of HGF were screened. Verification against about 200 normal people only found a small number of same mutations. Five novel mutations were screened from 5 maternal imprint genes by analyzing the results of expression profile chip. Conclusion The mutation profile of exome of HGF was successfully constructed. Some SNPs were found in normal people with low frequency. Novel mutations were found in 5 maternal imprint genes. Pioneering study has been conducted by introducing the whole exome sequencing technique and can provide reference for the further study.

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    Effects of bufalin albumin nanoparticles on telomerase activity of stem cells of colon cancer
    ZHU Li-min, SHEN Ke-ping, ZHANG Hui-qing, et al
    2014, 34 (12):  1727. 
    doi: 11.3969/j.issn.1674-8115.2014.12.004

    Abstract ( 413 )   PDF (430KB) ( 995 )  

    Objective To observe the effects of bufalin albumin nanoparticles on the proliferation and telomerase activity of stem cells of colon cancer SW480. Methods The cell subset CD133+/CD44+ of colon cancer SW480 (stem cells of colon cancer SW480) were separated by the flow cytometry and intervened by different concentrations of bufalin and bufalin albumin nanoparticles (1, 10, 50, and 100 nmol/L). The MTT method was used to observe the proliferation of colon cancer stem cells and the TRAPELISA was adopted to detect the variations of telomerase activity. Results Compared to the control group, low concentrations (1 and 10 nmol/L) of bufalin and bufalin albumin nanoparticles had no significant effect on the proliferation and telomerase activity of stem cells of colon cancer SW480 (P>0.05). Compared to the control group and high concentrations (50 and 100 nmol/L) of bufalin, high concentrations (50 and 100 nmol/L) of bufalin albumin nanoparticles significantly inhibited the proliferation and telomerase activity of stem cells of colon cancer SW480 (P<0.05). Conclusion Bufalin albumin nanoparticles of 50 and 100 nmol/L can significantly inhibit the proliferation and telomerase activity of stem cells of colon cancer and the effects are better than those of bufalin.

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    Effects of molecular chaperone 4-phenylbutyric acid on cell damage of steatotic HepG2 cells
    FAN Zhu-ping, AI Luo-yan, CHEN Li-ping, et al
    2014, 34 (12):  1731. 
    doi: 11.3969/j.issn.1674-8115.2014.12.005

    Abstract ( 500 )   PDF (465KB) ( 1044 )  

    Objective To observe the occurrence of endoplasmic reticulum stress in steatotic HepG2 cells and to explore the effects of chemical molecular chaperone 4-phenylbutyric acid (4-PBA) on the endoplasmic reticulum stress, oxidative stress, and apoptosis of steatotic HepG2 cells. Methods HepG2 cells were intervened by fatty acid mixtures of 0.5 mmol/L and 1.0 mmol/L. The mRNA expressions of endoplasmic reticulum stress related protein CHOP and glucose regulated protein 78 (GRP78) were detected by the Real-time PCR at different time points. Then steatotic HepG2 cells were intervened by 4-PBA of 2 mmol/L. At different time points, the mRNA expressions of CHOP and GRP78 and levels of malonaldehyde (MDA), which was the oxidative stress index, superoxide dismutase (SOD), and reduced glutathione (GSH) were detected and variations of the viability of apoptosis related protein Caspase-3 were observed. Results Compared to the control group, the mRNA expressions of CHOP and GRP78 in HepG2 cells of fatty acid intervened group increased significantly (P<0.05). The intervention of 4-PBA decreased the mRNA expressions of CHOP and GRP78 in steatotic HepG2 cells (P<0.05) and MDA level; significantly increased SOD and GSH levels (P<0.05); and decreased the viability of Caspase-3 (P<0.05). Conclusion Significant endoplasmic reticulum stress occurs in steatotic HepG2 cells. Molecular chaperone 4-PBA may alleviate oxidative stress and endoplasmic reticulum stress, decrease the viability of Caspase-3 of steatotic HepG2 cells, and alleviate the cell damage.

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    Effects of curcumin on vascular remodeling of rats with spontaneous hypertension
    XIE Jun, HU Jun, MAO Jia-liang
    2014, 34 (12):  1737. 
    doi: 11.3969/j.issn.1674-8115.2014.12.006

    Abstract ( 617 )   PDF (794KB) ( 1143 )  

    Objective To explore the therapeutic effect of curcumin on vascular remodeling of rats with spontaneous hypertension. Methods A total of 42 male SHR rats at 12 weeks of age were selected and randomly divided into six groups (n=7). Rats of five curcumin groups were given different doses (25, 50, 100, 200, and 400 mg/kg) of curcumin dissolved in l mL distilled water daily. Rats of one placebo group were given 1 mL distilled water daily. Another 7 WKy rats with same sex and age were used as the controls. Blood pressure of rats was measured before experiment and 6 and 12 weeks after experiment. Slices of the carotid artery of rats were stained by HE after 12 weeks. Media thickness (MT), lumen diameter (LD), and medial cross-sectional area (MSCA) of the carotid artery were measured. The expression of matrix metalloproteinase-9 (MMP-9) in the carotid artery was detected by immunohistochemical methods. Results The differences of systolic blood pressure (SBP) and diastolic blood pressure (DBP) of curcumin groups and placebo group before experiment and 6 and 12 weeks after experiment were not statistically significant (P>0.05). SBP and DBP of curcumin groups and placebo group were higher than those of the WKy control group (P<0.01). Compared to the placebo group, the MT of curcumin groups with doses of 400 and 200 mg/kg was thinner (P<0.01) and the LD/MT was higher (P<0.01); the LD/MT of curcumin groups with doses of 100 and 50 mg/kg was higher (P<0.05); the LD of curcumin group with doses of 200 mg/kg was larger (P<0.05) and MSCA was smaller (P<0.05); and the expression of MMP-9 of curcumin group with doses of 400 mg/kg was higher (P<0.05). Conclusion To some extent, curcumin can alleviate the carotid vascular remodeling of rats with spontaneous hypertension. The up-regulation of MMP-9 expression in carotid artery intima maybe one of the mechanisms.

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    Original article (Clinical research)
    Correlation between microRNA-24 expression and prognosis of aflatoxin B1-related hepatocellular carcinoma prognosis
    LONG Man-mei, HUANG Xiao-ying, YAO Jin-guang, et al
    2014, 34 (12):  1743. 
    doi: 11.3969/j.issn.1674-8115.2014.12.007

    Abstract ( 355 )   PDF (693KB) ( 982 )  

    Objective To explore the effects of microRNA-24 (miR-24) expression on the prognosis of aflatoxin B1 (AFB1)-related hepatocellular carcinoma (HCC). Methods A total of 207 patients with Ⅰ-Ⅱ TNM-stage HCC from high AFB1 exposure areas were selected and the corresponding surgical resection samples were collected. Expression levels of MiR-24 in the tumor tissue samples were detected by the TaqMAN-PCR technique. Cox’s regression model and logistic regression model were adopted to analyze the relationship between the miR-24 expression and the prognosis and clinicopathological features of HCC. Results Elevated expression level of miR-24 affected overall survival and tumor recurrence-free survival (P<0.01). The overall death risk and tumor recurrence risk were increased by 2.58 times and 3.75 times. This risk effect was more noticeable under high AFB1 exposure condition and the corresponding risk values were 8.13 (95%CI: 4.46-14.84) and 11.75 (95%CI: 5.15-26.79), respectively. The expression level of miR-24 was closely correlated with primary tumor size, tumor differentiation, and micro-vessel density (P<0.05), and could regulate the level of AFB1-DNA adducts. Conclusion The miR-24 expression affects the prognosis of AFB1-related HCC and regulates the clinicopathological features of HCC.

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    Correlation between expression of miR-93 and surgical excitability of insulin resistance of patients with thyroid adenoma
    LU Guan-ming, PAN Yun-long, LI Zhen-dong, et al
    2014, 34 (12):  1749. 
    doi: 11.3969/j.issn.1674-8115.2014.12.008

    Abstract ( 384 )   PDF (276KB) ( 978 )  

    Objective To investigate the correlation between the expression level of miR-93 and surgical excitability of insulin resistance (EIR) of patients with thyroid adenoma (TA). Methods The total cholesterol (TC), triglyceride (TG), fasting blood glucose (FBG), and fasting serum insulin (FINS) of 32 cases of TA combined with EIR (experiment group), 32 cases of pure TA (control group), and 30 cases of healthy people (health group) were detected by the oxidase method and the expression level of miR-93 was detected by the qRT-PCR. The results of three groups were compared. Results TC, TG, FBG, FINS, and miR-93 level of the experiment group were (6.4±0.6) mmol/L, (2.4±1.0) mmol/L, (6.3±0.5) mmol/L, (36.2±12.6) MIU/L, and 1.83±0.61; those of the control group were (6.3±0.6) mmol/L, (1.9±1.0) mmol/L, (6.0±0.5) mmol/L, (20.5±10.3) MIU/L, and 2.95±0.49; those of the health group were (5.1±0.7) mmol/L, (1.4±0.7) mmol/L, (5.1±0.6) mmol/L, (17.7±9.1) MIU/L, and 3.44±0.42, respectively. Expression levels of miR-93 of the experiment group and control group were 1.82±0.62 and 2.93±0.49 before treatment. Levels of TG, FBG, and FINS of the experiment group were higher than those of the control group (P<0.01) and health group (P<0.01). The miR-93 level of the experiment group was lower than that of the control group (P<0.01) and health group (P<0.01). The differences of the expression level of miR-93 of the experiment group and control group before and after treatment were not statistically significant (P>0.05). The expression level of miR-93 was negatively correlated with TC, TG, FBG, and FINS. Conclusion The expression of miR-93 of TA patients and TA patients with EIR is low. The expression level of miR-93 is negatively correlated with TC, TG, FBG, and FINS. The miR-93 involve in the occurrence and development of surgical EIR of patients with TA as a protective factor, rather than a pathogenic factor.

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    Observation of cardiac and cerebral vascular endpoint events of families with familial hypertriglyceridemia
    LIU Wei-juan, HE Jin-chun, HE Jin-xiang, et al
    2014, 34 (12):  1753. 
    doi: 11.3969/j.issn.1674-8115.2014.12.009

    Abstract ( 386 )   PDF (262KB) ( 1043 )  

    Objective To investigate the effects of hypertriglyceridemia on cardiac and cerebral vascular endpoint events. Methods The data of familial hypertriglyceridemia in 10 years were collected and the occurrence of cardiac and cerebral vascular endpoint events of 2 family members was observed. Results In Family 1, Ⅲ 1 died of hemorrhagic stroke in the first year of study and Ⅲ 3 died of hemorrhagic stroke in the third year of study. Cardiac and cerebral vascular endpoint events did not occur among the rest family members. In Family 2, no cardiac and cerebral vascular endpoint events occurred. Conclusion For familial hypertriglyceridemia, pure hypertriglyceridemia does not cause cardiac and cerebral vascular endpoint events. The occurrence of cerebrovascular endpoint events increases with the presence of hypertension.

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    Analytical study on risk factors relevant to fall events of in inpatients
    XIAO Shuang, ZHAO Qing-hua
    2014, 34 (12):  1757. 
    doi: 11.3969/j.issn.1674-8115.2014.12.010

    Abstract ( 758 )   PDF (261KB) ( 998 )  

    Objective To analyze the data and risk factors of fall events of inpatients. Methods The retrospective case-control design was adopted to analyze fall events of inpatients reported in 2013 by the First Affiliated Hospital of Chongqing Medical University. Inpatients with age above 18 were selected and divided into the case group (43 patients with fall events) and control group (86 patients without fall events). The ratio of patients of two groups was 1∶2. For the control group, variables were controlled by two items, i.e. hospital stay and ward. Results The univariate analysis found that relevant influencing factors of fall events of inpatients were mobility (P=0.004 0), Morse score (P=0.047 2), and with or without companions (P<0.000 1). The multivariate logistic regression analysis found that Morse scores between 45 and 100 points (OR=0.476, 95%CI: 0.228-0.991) and without companions (OR=7.165, 95%CI: 2.666-19.260) were risk factors of fall events of inpatients. Conclusion Single factor analysis and multiple-factor analysis found that various factors influenced fall events of inpatients. Limited mobility, Morse scores between 45 and 100 points, and without companions are high risk factors. Clinical nursing should take measures to prevent and reduce fall events of patients.

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    Added value of 18F-FDG PET/CT for preoperative evaluation of distant metastasis of pancreatic cancer by abdominal contrast-enhanced CT
    XU Feng, XI Yun, ZHANG Min, et al
    2014, 34 (12):  1762. 
    doi: 11.3969/j.issn.1674-8115.2014.12.011

    Abstract ( 450 )   PDF (726KB) ( 1049 )  

    Objective To explore the added value of 18F-FDG PET/CT for preoperative evaluation of the distant metastasis of pancreatic cancer by the abdominal contrast-enhanced CT (CE-CT). Methods Data of abdominal CE-CT and 18F-FDG PET/CT of 51 patients with pancreatic cancer were retrospectively analyzed. The distant metastasis of pancreatic cancer was diagnosed by the CE-CT and CE-CT combined with 18F-FDG PET/CT. Results of pathological diagnosis or follow-up were adopted as the golden standard and the added value of 18F-FDG PET/CT was analyzed. Results The sensitivity, specificity, and accuracy of CE-CT combined with 18F-FDG PET/CT for diagnosing the distant metastasis of pancreatic cancer were 94.2% (33/35), 100% (16/16), and 96.1% (49/51). Compared to 71.4% (25/35), 100% (16/16), and 76.5% (41/51) of CE-CT, the differences of sensitivity and accuracy were statistically significant (χ2=6.43, P=0.011; χ2=6.04, P=0.014). A total of 26 patients were diagnosed of no distant metastasis by CE-CT, but 6 of them were diagnosed of liver metastasis (close to the liver capsule with diameter between 6.7-9.8 mm) and 2 of them were diagnosed of lung metastasis by CE-CT combined with 18F-FDG PET/CT. Another 25 patients were diagnosed of distant metastasis by CE-CT and confirmed by CE-CT combined with 18F-FDG PET/CT. Conclusion 18F-FDG PET/CT provides added value for patients who are diagnosed of pancreatic cancer with no distant metastasis by CE-CT, especially for patients with small liver lesion (diameter<1 cm) close to the liver capsular.

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    Clinicopathological significance of expressions of p27kip1 and Ki-67 in primary central nervous system germ cell tumors
    GAO Yu-ping, JIANG Ji-yao, LIU Qiang
    2014, 34 (12):  1767. 
    doi: 11.3969/j.issn.1674-8115.2014.12.012

    Abstract ( 477 )   PDF (536KB) ( 1027 )  

    Objective To investigate the clinicopathological significance of expressions of tumor suppressor gene p27kip1 and expression of cyclin Ki-67 in primary central nervous system germ cell tumors (CNSGCTs). Methods The expressions of p27kip1 and Ki-67 in tissues of 28 cases of primary CNSGCTs were detected by immunohistochemical method and Ki-67 labeling index (Ki-67 LI) was calculated. Results Among 28 cases of primary CNSGCTs, the p27kip1 expression of 17 cases (60.7%) was high, including 5 cases of mature teratomas, 10 cases of germinomas, 1 case of embryonal carcinoma, and 1 case of mixed GCT; and the p27kip1 expression of 11 cases (39.3%) was low, including 8 cases of germinomas, 1 case of immature teratoma, 1 case of choriocarcinoma, and 1 case of mixed GCT. The Ki-67 LI of 13 cases (46.4%) was higher than 50%; Ki-67 LI of 9 cases (32.1%) was 25%-50%; and Ki-67 LI of 6 cases (21.4%) was lower than 25%. The expression of p27kip1 and Ki-67 LI correlated with the histological types of CNSGCTs. The expression of p27kip1 did not correlate with sex, age, size of tumor, location, recurrence, prognosis, or Ki-67 LI (P>0.05). Conclusion The expression of p27kip1 is low in malignant primary CNSGCTs, which suggests that p27kip1 may involve in the formation and development of germ cell tumor by down-regulating the control point for transiting from G1 to S phase.

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    Study on early diagnosis of acute decompensated heart failure combined with acute renal injury
    YUAN Fang, LIU Hua, WANG Wen-xia, et al
    2014, 34 (12):  1771. 
    doi: 11.3969/j.issn.1674-8115.2014.12.013

    Abstract ( 513 )   PDF (326KB) ( 1050 )  

    Objective To evaluate the value of new biological indicators of acute kidney injury (AKI) for early diagnosis of acute decompensated heart failure (ADHF) combined with AKI, i.e. cardiorenal syndrome type 1 (CRS1). Methods A total of 200 patients with ADHF were enrolled. Levels of baseline serum creatinine (SCr), serum combination [neutrophil gelatinase associated lipocalin (NAGL) and Cystatin C (CysC)], and urine combination [NAGL and kidney injury molecule-1(KIM-1)] were detected. Levels of serum combination and urine combination were redetected after 6 h and 18 h and the level of SCr was redetected after 48 h. According to the criteria, CRS1 patients were selected. The correlations of serum and urine NAGL, serum CysC, urine KIM-1, and Scr were analyzed. According to receiver operating characteristic (ROC) curve, the cut-off value, sensitivity, specificity, and the area under the ROC curve (AUC) of NAGL, Cys C and KIM-1 at 6 h and 18 h for diagnosing AKI were obtained. The AUC of serum combination (NAGL,Cys C) and urine combination (NAGL,KIM-1) at 6 h and 18 h for diagnosing AKI was calculated. Results According to the diagnostic criteria of CRS1, 48 of 200 ADHF patients were diagnosed with AKI and the incidence was 24%. Serum NAGL at 6 h and serum Cys C at 18 h positively correlated with Scr (r=0.857, P<0.05; r=0.869, P<0.05). Urine NAGL and KIM-1 at 6 h positively correlated with Scr (r=0.756, P<0.05; r=0.742, P<0.05). The AUCs of serum combination at 6 h and 18 h were 0.87 and 0.89, while the AUCs of urine combination at 6 h and 18 h were 0.92 and 0.93. Conclusion Serum and urine NAGL, serum Cys C, and urine KIM-1 can be used as early diagnostic indicators for CRS1 patients. Combined detection of urine NAGL and KIM-1 may improve the sensitivity and specificity of early diagnosis of CRS1.

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    Decrease of serum asymmetric dimethylarginine level in patients with ischemic stroke under statin treatment
    LIU Tuan-jie, WANG Bo, FANG Qi-lin
    2014, 34 (12):  1775. 
    doi: 11.3969/j.issn.1674-8115.2014.12.014

    Abstract ( 498 )   PDF (325KB) ( 1154 )  

    Objective To design a prospective and controlled study to explore the relationship between the statin treatment and serum asymmetric dimethylarginine (ADMA) level of patients with ischemic stroke. Methods A total of 120 consecutive outpatients with non-cardiogenic ischemic stroke were selected. Study for 117 patients was completed. These patients were divided into the statin treatment group (n=57, treated with atorvastatin of 20 mg/d) and non-statin treatment group (n=60). Results Before treatment, the difference of serum ADMA level of two groups was not statistically significant (P=0.352). After treatment, the serum ADMA level of the statin treatment group was significantly lower than that of the non-statin treatment group (P=0.013). Multiple linear regression analysis showed that the age (β=0.26, P<0.05) and statin treatment (β=-0.20, P<0.05) were independent influencing factors of serum ADMA level, but serum cholesterol level (β=0.00, P=1.00) and low density lipoprotein level (β=0.00, P=0.98) were not independent influencing factors of serum ADMA level. Conclusion The statin treatment is significantly correlated with the decrease of serum ADMA level of patients with ischemic stroke and may prevent atherosclerotic diseases for patients with ischemic stroke by decreasing the serum ADMA level.

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    Levofloxacin based triple therapy for eradication of Helicobacter pylori: a meta-analysis
    ZHU Shi-yan, XU Lei-ming
    2014, 34 (12):  1780. 
    doi: 11.3969/j.issn.1674-8115.2014.12.015

    Abstract ( 577 )   PDF (674KB) ( 1050 )  

    Objective To systematically evaluate the efficacy and safety of eradicating Helicobacter pylori (H. pylori) by levofloxacin based triple therapy compared to standard triple therapy. Methods Correlated randomized controlled clinical trials (RCTs) evaluating the efficacy and safety of eradicating H. pylori by levofloxacin based triple therapy from papers published before 2014 were retrieved from Medline, Embase, Pubmed, Cochrane library, Sinomed retrieval platform, Wanfang Database, and CNKI. The quality of trials was assessed by the improved Jadad standard. Stata 12.0 software was used to analyze data. The combination model of effect size was selected according to the results of heterogeneity tests and the meta analysis was conducted. The Harbord and Trim and Filled method were utilized to evaluate the publication bias. Results Forty RCTs with 7 388 cases infected by H. pylori were selected for meta analysis according to the enrollment criteria. The results of analysis showed that compared to standard triple therapy, the eradication rate of H. pylori of levofloxacin based triple therapy was higher and the relative risk (RR) was 1.10 (95%CI=1.07-1.13); the healing rate of peptic ulcer was higher and RR was 1.06 (95%CI=1.02-1.09); and the side effect rate was lower and RR was 0.81 (95%CI=0.69-0.94). Conclusion Levofloxacin based triple therapy is effective for eradicating H. pylori and treating digestive ulcers with low side effect rate. It is an alternative choice of first-line treatments for eradicating H. pylori.

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    Detection of serum levels of mineral substances for Shanghai elite athletes and study on their correlations
    HUANG Xiao-xu, WANG Chen, ZHANG Ya-li, et al
    2014, 34 (12):  1786. 
    doi: 11.3969/j.issn.1674-8115.2014.12.016

    Abstract ( 391 )   PDF (324KB) ( 1119 )  

    Objective To detect serum levels of copper, zinc, calcium, and iron for Shanghai elite athletes and to provide evidences for establishing serum element reference values for athletes. Methods A total of 45 athletes were selected. The nutrients were investigated by the dietary survey and the serum levels of copper, zinc, calcium, and iron were detected by the atomic absorption sepectrophotometry. Results The difference of serum copper of male and female athletes was statistically significant. The differences of serum iron of athletes of different sports were statistically significant. The differences of zinc, calcium, iron, protein, vitamin C, carbohydrate, and dietary fiber intakes of athletes of different sports were statistically significant. The serum copper was positively correlated to energy, carbohydrate, and vitamin C. The serum iron was positively correlated to serum calcium, dietary calcium, and carbohydrate. Conclusion The reference ranges of serum elements of Shanghai elite athletes and normal people are not exactly the same. In order to ensure the health of athletes, reference ranges of serum copper, zinc, calcium, and iron for athletes of different sports and from different areas should be established.

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    Variations of islet β cell function during short-term intensive insulin pump treatment for patients with type 2 diabetes mellitus
    WANG Wei-dong, TENG Jun-ru, XING Lin, et al
    2014, 34 (12):  1791. 
    doi: 11.3969/j.issn.1674-8115.2014.12.017

    Abstract ( 430 )   PDF (355KB) ( 931 )  

    Objective To observe variations of functions of islet β cells during the short-term insulin pump intensive treatment for patients with type 2 diabetes mellitus. Methods A total of 120 cases of type 2 diabetes mellitus were randomly divided into the observation group and control group with 60 cases in each group. Patients of the control group administrated oral antidiabetic drugs to control the blood glucose, while patients of the observation group were treated by the intensive insulin pump. After 4 weeks of therapy, the blood glucose, blood lipid, and relevant indicators of insulin function of two groups before and after the treatment were compared. Results After treatment, fasting blood glucose (FPG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and insulin resistance index (HOMA-IR) of two groups were significantly lower than those before the treatment (P<0.05), while fasting C peptide (FCP), 2 h postprandial C peptide (CP2h), high density lipoprotein cholesterol (HDL-C), and insulin secretion index (HOMA-β) were significantly higher than those before the treatment (P<0.05). After treatment, the FPG, 2hPG, HbA1c, TC, TG, and LDL-C of the observation group were all significantly lower than those of the control group (P<0.05), while the FCP, CP2h, and HDL-C were significantly higher than those of the control group (P<0.05). The HOMA-IR of the observation group was significantly lower than that of the control group (P<0.05), while the HOMA-β was significantly higher than that of the control group (P<0.05). Conclusion The short-term intensive insulin pump treatment can quickly stabilize the blood glucose level of patients with type 2 diabetes mellitus, contribute to recovering functions of islet β cells, and alleviate the insulin resistance and lipid metabolism disorder.

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    Comparative study on assessing sedation level of mechanically ventilated patients by bispectral index and sedation scoring systems
    Song Lei, YE Lei, ZHANG Yu, et al
    2014, 34 (12):  1796. 
    doi: 11.3969/j.issn.1674-8115.2014.12.018

    Abstract ( 494 )   PDF (261KB) ( 1006 )  

    Objective To explore the feasibility and efficiency of bispectral index (BIS) monitor for assessing the sedation level of mechanically ventilated patients in the Pediatric Intensive Care Unit (PICU). Methods A total of 19 patients who underwent mechanical ventilation were selected. Patients were intravenously injected with midazolam 5-15 min after mechanical ventilation until the BIS score reached 60-80. Then after 30, 60, and 120 min, the concentration of oxygen inhalation (FiO2), transcutaneous oxygen saturation (SpO2), and values and scores of BIS, sedation-agitation scale (SAS), and Ramsay sedation scale (RSS) were recorded. The correlation of three sedation scales was analyzed. Results All patients were sedated. After being sedated, FiO2 of patients significantly decreased and SpO2 significantly increased (P<0.05). BIS value was significantly correlated with subjective scores. BIS value was significantly and negatively correlated with RSS scores (r=-0.650,P<0.05) and significantly and positively correlated with SAS scores (r=0.626,P<0.05). Conclusion BIS monitor is a simple and efficient method to assess the sedation level of mechanically ventilated patients and an ideal objective index for assessing the sedation level of mechanically ventilated patients in ICU.

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    Study on accuracy of computer assisted total knee arthroplasty for restoration of lower-extremity mechanical axis
    XU Jun, JIANG Xue-feng, SUN Hui-qing, et al
    2014, 34 (12):  1800. 
    doi: 11.3969/j.issn.1674-8115.2014.12.019

    Abstract ( 382 )   PDF (460KB) ( 984 )  

    Objective To compare the accuracy of computer assisted total knee arthroplasty (TKA) and conventional positioning TKA for restoration of lower-extremity mechanical axis. Methods A prospective study for 40 patients who underwent TKA from January 2012 to June 2013 was conducted. Patients were randomly divided into the conventional surgery (CS) group (n=20) and the navigation surgery (NS) group (n=20). For the CS group, there were 7 male patients and 13 female patients with average age of (62.4±6.9) years and the conventional positioning TKA was adopted. For the NS group, there were 9 male patients and 11 female patients with average age of (63.6±8.7) years and the computer assisted TKA was adopted. Patients of both groups used the same brand of joint prostheses and all surgeries were performed by the same surgeon. The operation time, 24-hour drainage volume, the HSS scores 1 month and 6 months after the surgery, knee flexion, and lowerextremity mechanical axis angle of two groups were compared. Results The average operation time of the NS group was longer than that of the CS group (t=3.273, P=0.019), but 24-hour drainage volume of NS group was less than that of the CS group (t=2.156, P=0.031). The HSS scores and the average knee flexion of the NS group 1 month after the surgery were higher than those of the CS group and the differences were statistically significant (P<0.05). The differences of the HSS scores of the two groups 6 months after the surgery were not statistically significant (P>0.05). The average knee flexion of the NS group was larger than that of the CS group (t=1.232, P=0.047). The postoperative lower-extremity mechanical axis angle of the NS group (0.87°±0.92°) was closer to 0° than that of the CS group (1.93°±1.37°) and the difference was statistically significant (t=2.756, P=0.025). The difference of the angle between joint prosthesis and lower-extremity mechanical axis of two groups was not statistically significant (P>0.05). Conclusion The computer assisted TKA is more accurate than the conventional positioning TKA for the restoration of lower-extremity mechanical axis.

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    Original article (Preventive medicine)
    Survey of current status of growth and development and health care of children under 3 years old in minority areas of western Sichuang and analysis of influencing factors
    CHEN Yin-zhi, TANG Xiao-jun, XU Hong, et al
    2014, 34 (12):  1805. 
    doi: 11.3969/j.issn.1674-8115.2014.12.020

    Abstract ( 490 )   PDF (369KB) ( 908 )  

    Objective To investigate current status and influencing factors of growth and development of children under 3 years old in minority areas of western Sichuang and to provide evidences for developing efficient healthcare measures. Methods Probability proportional to size (PPS) sampling method was adopted to randomly sample children under 3 years old and their guardians from 60 villages in two towns. Guardians were investigated by the questionnaire and the height and weight of children were examined. The logistic regression analysis was conducted to examine influencing factors of growth and development of children. Results A total of 482 children under 3 years old and their guardians were investigated. The rates of prenatal examination, institutional delivery, low-birth-weight infant, fetal macrosomia, stunting, low body mass, wasting, and malnutrition of these children were 65.7%, 33.6%, 5.8%, 8.3%, 15.5%, 15.1%, 10.0%, and 26.0%, respectively. The age, educational level, and income of guardians, delivery place, and early start of breast-feeding were major factors that influenced the indexes of growth and development. Conclusion The guardians of children in minority areas of western Sichuang lack enough knowledge of health care of children. Growth indexes of children are lower than the average indexes of the country and fail to meet requirements of the Outline of the Program for Chinese Children's Development (2011-2020). Therefore, appropriate and effective measures for promoting the health education are required to improve the knowledge of health care during the pregnant and perinatal period and scientific feeding of children.

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    Correlation analysis of health literacy, food safety knowledge, and food safety behaviors of catering service employees in Qibao area of Shanghai
    JIN Wei, YU Jin-ming, GU Shen-bin
    2014, 34 (12):  1811. 
    doi: 11.3969/j.issn.1674-8115.2014.12.021

    Abstract ( 353 )   PDF (374KB) ( 974 )  

    Objective To investigate the health literacy level, awareness of food safety knowledge, and food safety behaviors of catering service employees in Qibao area, to explore the correlation between food safety knowledge and behaviors and health literacy, and to provide the scientific basis for formulating intervention strategies for catering service employees. Methods The questionnaire survey of health literacy was conducted among 477 catering service employees by stratified cluster sampling in Qibao area of Shanghai. Independent samples T Test, distance (similarity) analysis, and Spearman correlation analysis were adopted to reveal the correlation among the health literacy, food safety knowledge, and food safety behaviors. Results In Qibao area, the percentage of catering service employees with health literacy was 22.9%. Three parts of health literacy were the health knowledge and concepts (25.4%), health lifestyle and behaviors (30.8%), and basic health skills (70.6%), respectively. Five types of health problems were the scientific health concepts (78.4%), infectious diseases prevention (41.9%), chronic disease prevention (30.2%), safety and emergency treatment (65.6%), and basic medical treatment (22.2%), respectively. The average score of food safety knowledge was 10.93±2.217. The percentage of catering service employees who were in accordance with rules and regulations was 67.3%-97.3%. The overall health literacy, three aspects of health literacy, and five types of health problems were closely correlated with food safety knowledge and were not significantly correlated with daily food safety behaviors. Conclusion Comprehensive intervention strategies that focuses on improving the health literacy of catering service employees and propagandizing rules and regulations should be adopted to improve working behaviors, protect public health, and perform further verifications.

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    Analysis of causes of occupational exposure of 250 medical staff
    ZHANG Yi, HUANG Xia
    2014, 34 (12):  1816. 
    doi: 11.3969/j.issn.1674-8115.2014.12.022

    Abstract ( 534 )   PDF (192KB) ( 954 )  

    Objective To analyze main causes of occupational exposure of medical staff and to propose preventive measures for decreasing the occurrence of occupational exposure. Methods The data of 250 reported cases of occupational exposure in Ruijin Hospital from January 2012 to December 2013 were collected and main causes of occupational exposure were analyzed. Preventive treatments were conducted according to their actual situations and tracking survey and follow-up analysis were performed. Results The results of analysis of 250 reported cases of occupational exposure showed that top two exposure rates were observed among nurses (58.80%) and doctors (32.00%). Needle stick injuries (NSIs) were the most common cause (94.00%), which occurred frequently during needlewithdrawing and suturing. Unknown causes, negative causes or causes confirmed to be negative afterwards, and hepatitis B virus accounted for 34.00%, 32.40% and 23.20% respectively. Most cases underwent local treatments and disinfection properly and were reported immediately. Relevant preventive measures were taken and no blood borne infections were found by detections conducted afterwards. Conclusion Analysis of causes of occupational exposure of medical staff facilitates identifying the key target group of occupational safety education, taking relevant preventive measures, and decreasing the risk of occupational exposure.

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    Original article (Public health administration)
    Survey of satisfaction degree of elderly people towards community nursing service
    LIU Xiao-hua, HE Chao-zhu, YU Chao, et al
    2014, 34 (12):  1819. 
    doi: 11.3969/j.issn.1674-8115.2014.12.023

    Abstract ( 634 )   PDF (291KB) ( 1004 )  

    Objective To investigate the satisfaction degree of the elderly towards the community nursing service in Nanchang and to provide evidences for the reasonable planning of the health administrative department. Methods The stratified simple random sampling method was adopted and the questionnaire of satisfaction degree of the elderly towards the community nursing service was used to investigate 800 old people who were recorded in the community health service center. Results A total of 758 valid questionnaires were returned and the valid rate was 94.8%. Items with high satisfaction rates were regular health examination (89.9%), dynamic management of record information (89.1%), and guidance of diagnosis and subsequent visit (89.0%). Items with low satisfaction rates were guidance of rational use of healthy products (54.6%), guidance of immunization (56.3%), and home sickbed services (61.4%). The stepwise logistic regression analysis revealed that positive influencing factors of the satisfaction degree of the community nursing service were living in Honggutan new district, married, graduation from middle school, average salary of 2 001-3 000 Yuan, walking time less than 15 min from home to the community health service center, and absence of depression; while negative influencing factors were unmarried/widowed, average salary less than 1 000 Yuan, totally at own expense, household registration, chronic disease, vision loss, and persistent depression. Conclusion The overall satisfaction rate of the elderly towards the community nursing service is high, but satisfaction rates of some services are low. Various measures should be taken to improve the satisfaction rate of the elderly towards the community nursing service based on relevant negative influencing factors.

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    Study on positive experience of student nurses during clinical internship of psychiatric nursing and its influencing factors
    LI Cong-hong, ZHANG Mei-qin, XU Yun
    2014, 34 (12):  1824. 
    doi: 11.3969/j.issn.1674-8115.2014.12.024

    Abstract ( 437 )   PDF (532KB) ( 832 )  

    Objective To introduce the positive experience of student nurses during clinical internship of psychiatric nursing and to analyze the influencing factors. Methods An anonymous questionnaire survey was conducted for 128 student nurses who completed the clinical internship of psychiatric nursing. The questionnaire consisted of 8 domains with 32 items. Results The differences of scores of training group (P<0.05) and interest in psychiatric nursing (P<0.01) of undergraduate student nurses and college student nurses were statistically significant. Eight domains of positive experience were significantly correlated with each other. The results of multiple regression analysis showed that interaction with patients and nursing practice were major factors that influenced the overall evaluation and interest in psychiatric nursing. Interest in psychiatric nursing was also influenced by clinical instructing and teaching and educational level. Conclusion The positive experience of student nurses during clinical internship is affected by various factors. Psychiatric nursing education should focus on communication skills and understanding patients. Teachers should involve in practice guidance and play an active role in exerting positive affects on student nurses.

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    Review
    Advances of relationships among gut microbiota, obesity, and metabolic diseases relevant to obesity
    ZHU Chao-xia, LU Ying-li
    2014, 34 (12):  1829. 
    doi: 11.3969/j.issn.1674-8115.2014.12.025

    Abstract ( 701 )   PDF (354KB) ( 1440 )  

    The incidence of obesity is on the rise globally. Obesity has become a global disease that threatens human health and reduces the quality of human life. As a complicated disease affected by the interaction of genetic factors, environmental factors, and lifestyle, obesity can cause diseases such as hyperlipidemia, hypertension, cardiovascular diseases, metabolic syndrome, and non-alcoholic fatty liver disease. Metabolic activities of gut microbiota affect nutrition, metabolism, and immune functions of the host. Therefore, gut microbiota is an important environmental factor affecting obesity and metabolic disorders relevant to obesity. This paper reviews the relationships among gut microbiota, obesity, and metabolic disorders relevant to obesity and their affecting mechanisms.

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    Effects of long non-coding RNA on cardiac development
    LI Ting-ting, XU Rang
    2014, 34 (12):  1834. 
    doi: 11.3969/j.issn.1674-8115.2014.12.026

    Abstract ( 460 )   PDF (332KB) ( 1113 )  

    Mammalian cardiogenesis involves the differentiation of pluripotent cells in the embryo towards mesoderm and cardiac cell types, including cardiomyocytes, endothelial cells, and smooth muscle cells. The cardiogenesis requires fine regulation network. Long non-coding RNA (lncRNA) is found to be one of the most important RNAs in mouse and human transcriptomes. With the development of new transcriptome sequencing techniques, researches of lncRNA have drawn more and more attention. This paper reviews crucial effects of lncRNA on the gene regulation of cardiac differentiation and development of mammals.

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    Advances of serine starvation and p53 regulating oxidative stress of tumor cells
    ZHANG Shuo, XU Bing-cong, CHEN Li-chang, et al
    2014, 34 (12):  1839. 
    doi: 11.3969/j.issn.1674-8115.2014.12.027

    Abstract ( 641 )   PDF (425KB) ( 1145 )  

    Fast proliferation of tumor cells is characterized by energy metabolism abnormality that the major energy supply is glycolysis. The biosynthesis of tumor cells depends on serine. Serine starvation causes oxidative stress of tumor cells and activates p53 gene, which support the survival of tumor cells. The relationship between serine starvation and p53 gene provides new ideas for the metabolic targeted treatment of tumors. This paper reviews research progresses of regulating oxidative stress of tumor cells by serine starvation and p53.

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    Triggers and research method of stroke onset
    WENG Lü-kan, LIANG Tong-tong, ZHENG Zhi-jie
    2014, 34 (12):  1845. 
    doi: 11.3969/j.issn.1674-8115.2014.12.028

    Abstract ( 543 )   PDF (393KB) ( 941 )  

    Based on basic pathological changes, the acute onset of stroke is often triggered by various inducing factors of daily life. The onset of stroke is usually unexpected, but relevant mechanisms are not clear. Currently, most studies in China focus on the relationship between events and the stroke by the case control method. However, systematic qualitative and quantitative studies on inducing events and thorough investigation and analysis of relevant factors are lack. This paper reviews common inducing factors and possible mechanisms of acute onset of stroke according to studies from home and abroad, provides theoretical evidences for identifying inducing factors of acute onset of stroke by introducing the case-crossover study, and provides methods for quantitative analysis of acute onset of stroke.

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    Technique and method
    Closing coronary artery fistula by Amplatzer Duct Occluder Ⅱ
    WANG Jian, CHEN Sun, SUN Kun, et al
    2014, 34 (12):  1851. 
    doi: 11.3969/j.issn.1674-8115.2014.12.029

    Abstract ( 568 )   PDF (294KB) ( 998 )  

    Objective To introduce the experience of using Amplatzer Duct Occluder Ⅱ (ADO Ⅱ) for closing coronary artery fistula and to analyze its efficacy and safety. Methods Clinical data of patients whose coronary artery fistulas were closed by ADO Ⅱ between September 2011 and October 2013 were collected. The retrospective analysis was conducted according to operation and short-term follow-up outcomes. Results The average age of 5 patients was 3.8 years. Among 4 cases of right coronary-right ventricular fistulas, 3 cases used 4 mm×6 mm ADO Ⅱ and 5F delivery sheath, while the other case used 4 mm×4 mm ADO Ⅱ and 4F delivery sheath. One case of left coronary-right ventricular fistula used 4 mm×6 mm ADO Ⅱ and 5F delivery sheath. Intraoperative angiography and postoperative echocardiography showed no residual shunt and the results of electrocardiogram were normal the next day after operations. The average follow-up time was 16 months and no complications were found. Conclusion The delivery sheath of ADO Ⅱ is small and soft, which facilitates for approaching the fistula and efficiently closing the coronary artery fistula.

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    Clinical experience
    Significance of surgery in treatment of spontaneous rupture of esophagus
    HAN Ding-pei, HANG Jun-biao, CAO Zi-ang, et al
    2014, 34 (12):  1854. 
    doi: 11.3969/j.issn.1674-8115.2014.12.030

    Abstract ( 504 )   PDF (296KB) ( 971 )  

    Objective To explore and summarize the experience of surgical treatment of spontaneous rupture of esophagus. Methods The data of 21 cases of spontaneous rupture of esophagus from January 1993 to December 2012 were retrospectively analyzed, including etiologies, symptoms, time interval between onset and treatment, treatment methods, prognosis, hospital stays, etc. Results There were 17 male patients and 4 female patients. Their age was between 32 and 82 years old (average 43 years old). There were 9 (42.8%), 6 (28.6%), and 6 (28.6%) cases whose time intervals between onset and treat were <24 h, <48 h, and >72 h, respectively. All patients underwent surgical treatment. The primary healing rates were 88.9% (<24 h), 66.7% (<48 h), and 0 (>72 h). All patients were discharged with recovery. The average hospital stays were 18.1 d (<24 h), 27.8 d (<48 h), and 51.2 d (>72 h). Conclusion Surgery was the best way to treat spontaneous rupture of esophagus. The less the time interval between onset and treatment would be with the better the prognosis. The time interval is no longer a judgment standard of surgery. The surgery is indicated if a clear diagnosis can be made.

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    Case report
    Serous microcystic adenoma of pancreas: a report of two cases
    ZHANG Su-xia, WU Yun-jin, LIANG Jun, et al
    2014, 34 (12):  1858. 
    doi: 11.3969/j.issn.1674-8115.2014.12.031

    Abstract ( 512 )   PDF (1055KB) ( 1011 )  

    Objective To investigate the clinicopathological features, diagnosis, and differential diagnosis of serous microcystic adenoma (SMA) of pancreas. Methods The clinicopathological and immunohistochemical features of 2 cases of SMA of pancreas were analysed and relevant literatures were reviewed. Results Both 2 patients were female. The clinical symptoms were abdominal distension and pain. Neoplasms were well demarcated frequently with multicystic appearance on section. Microscopically, the tumors were composed of numerous microcysts lined by a single layer of cuboidal cells. The stroma of tumor was found to contain thick or thin fibrous tissue. Both cases were accompanied with polycyst of both kidneys, and one case was also accompanied with hemangioblastoma of liver and gastric adenocarcinoma. CK7, CK19, CK8/18, EMA, Muc1, and NSE were positive and CEA, CgA, and Syn were negative. No recurrence was found during the follow-up of 12-23 months. Hemangioblastoma of retina or central nervous system was not occurred in patients and their relatives. Conclusion SMA is a rare benign tumor of pancreas. A definite diagnosis can be made according to the radiological, morphological, and immunohistochemical features. SMA may not be a single disease and is often accompanied with multiple organ lesions. This suggests that the clinician should pay attention to examining other organs of SMA patients.

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