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28 February 2015, Volume 35 Issue 2 Previous Issue    Next Issue
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Inside front cover
Monographic report (SJTU-YALE Collaborative Program: Pilot Researchs in China's Communities)
Original article (Basic research)
Original article (Clinical research)
Original article (Public health)
Review
Brief original article
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YANG Huang-tian team made new progress in study of cardiac ischemia/reperfusion injury 2015, 35 (2):  147.  Abstract ( 670 )   PDF (288KB) ( 1343 )   Related Articles | Metrics

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XIANG Kun-san won the first “Scientific Contribution Award” of Diabetes Mellitus Branch of Chinese Medical Association 2015, 35 (2):  148.  Abstract ( 702 )   PDF (462KB) ( 774 )   Related Articles | Metrics

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SJTU-YALE Collaborative Program: Pilot Researchs in China's Communities 2015, 35 (2):  149.  Abstract ( 700 )   PDF (2201KB) ( 825 )   Related Articles | Metrics

Monographic report (SJTU-YALE Collaborative Program: Pilot Researchs in China's Communities)

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Effects of framing on tobacco control intervention for families with pregnant women in Shanghai CHEN Hao, CHEN Xiao-wen, CAI Yu-yang 2015, 35 (2):  151.  doi: 11.3969/j.issn.1674-8115.2015.02.002 Abstract ( 950 )   PDF (299KB) ( 1166 )   Objective To select families with pregnant women for verifying the framing effect on tobacco control intervention and to explore specific tobacco control strategies. Methods Randomized controlled trials were conducted for pregnant women who had undergone prenatal health education. The experimental intervention was performed by reading the text and graphic materials of tobacco control. Results A total of 346 valid samples were obtained. The average age of investigated pregnant women was (29.68±3.58) years old. The smoking rates of pregnant women and their husbands were 0.87% and 26.88%, respectively. The monthly family income per capita (median) was 6 600 yuan. And 26.59% of pregnant women considered that they were in poor health condition. Compared with the control group, the effect of tobacco control intervention of the experiment group was significantly better. The effect of tobacco control intervention with the health information framing and family target-framing was the best. Conclusion The tobacco control intervention of families with pregnant women is influenced by the framing effect. For families with pregnant women more attentions are paid to the tobacco control intervention that can deliver health messages and target the family members. The framing effect can be used to perform customized tobacco control intervention in practice. Related Articles | Metrics

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Analysis of smoking status and influencing factors of families with pregnant women in Shanghai CHEN Hao, CHEN Xiao-wen, SHI Li-li, et al 2015, 35 (2):  156.  doi: 11.3969/j.issn.1674-8115.2015.02.001 Abstract ( 721 )   PDF (291KB) ( 1114 )   Objective To investigate the smoking and passive smoking status of pregnant women in Shanghai, to analyze the smoking status of their families (including pregnant women, spouses, and family members) from perspectives of health and finance, and to provide research evidences for further smoking quiting strategies. Methods Pregnant women who underwent antenatal examinations and health education at 3 maternity hospitals in Shanghai from June to October, 2014 were selected. Self-designed questionnaire was adopted to conduct the survey, which covered the demographic information, smoking and health status of pregnant women and their family members. Results Among 812 investigated pregnant women, 0.98% of them, 38.79% of their spouses, and 33.58% of their family members smoked. The health condition of pregnant women was the major factor that influenced the smoking status of pregnant women (P＜0.05), while the family income per capita was the major factor that influenced the smoking status of their spouses (P＜0.05). Conclusion The smoking status of families of pregnant women is influenced by the health condition of pregnant women and family income per capita. Customized intervention strategies should be taken for the tobacco control of families of pregnant women. Related Articles | Metrics

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Exploration of smoking addiction health education model for teenagers based on system dynamics SHI Li-li, CAI Yu-yang, Tabacaru Michaela, et al 2015, 35 (2):  161.  doi: 11.3969/j.issn.1674-8115.2015.02.003 Abstract ( 754 )   PDF (328KB) ( 1097 )   Objective To establish a smoking addiction health education model for teenagers based on interactive, dynamic, and visual computer technologies and to let teenagers understand the mechanism of smoking addiction and further realize the smoking hazards. Methods According to the physiological mechanisms of smoking addiction, system dynamics was adopted to establish a dynamic education model. The correctness, efficiency, and education significance of the model was verified by the model test and preliminary simulation. Results The model structure correctly demonstrated the mechanism of smoking addiction and the model ran normally in extreme conditions. Computer model simulations proved that the awareness of smoking control ability of teenagers was significantly different before and after the experiment. Conclusion This model can help teenagers to realize that they can not maintain smoking at a low level for a long period of time. So smokers can not avoid smoking addiction only by self-control. This model can play a role of warning and education for teenagers. Related Articles | Metrics

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Survey of quitting intention of elderly smokers with chronic diseases and analysis of tobacco control strategies BO Yan-qing, CHEN Xiao-wen, CAI Yu-yang, et al 2015, 35 (2):  166.  doi: 11.3969/j.issn.1674-8115.2015.02.004 Abstract ( 730 )   PDF (324KB) ( 1043 )   Objective To investigate the quitting history and quitting intention of elderly smokers with chronic diseases, to analyze relevant political influencing factors, and to explore new ideas for tobacco control strategies. Methods Elderly smokers with chronic diseases in Waigang community of Jiading District were selected and the self-designed questionnaire was used to conduct the survey. Data was input by the EpiData 3.1 and statistically analyzed by the SPSS 20.0. Results Among 430 respondents, 138 (32.1%) had tried quitting and 69 (50.0%) in 138 respondents only tried once, while 68 (49.3%) in 138 respondents tried twice or more. Nearly half of them failed to quit within 3 months, which is the critical period of cessation. At present, only 56 (13.0%) respondents had quitting intention and 16 respondents had specific quitting date. Among 234 respondents who did not receive free hypertension drugs, 70 of them were willing to quit smoking for free hypertension drugs. The percentage of respondents with quitting intention increased from 14.1% to 29.9% (P=0.000, OR=10.208, 95%CI=4.305-24.204). The percentage of respondents with quitting intention who had received health education within 1 month was 20.5%, which was higher than that (8.8%) of respondents who had not received health education (P=0.001, OR=2.677, 95%CI=1.512-4.741). Conclusion The awareness of tobacco hazards and the quitting intention of elderly smokers with chronic diseases in Waigang community are weak. Tobacco control education have an effect on the quitting intention. Special education that aims at diseases should be conducted and it is also a new idea for tobacco control that free drugs can be used to inspire smokers with chronic diseases to quit smoking. Related Articles | Metrics

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Analysis of quitting intention and relevant influencing factors of elderly smokers in the Jiading district of Shanghai CHEN Xiao-wen, LOU Jie-qiong, SHI Li-li, et al 2015, 35 (2):  171.  doi: 11.3969/j.issn.1674-8115.2015.02.005 Abstract ( 729 )   PDF (423KB) ( 1104 )   Objective To investigate the quitting intention of elderly smokers and relevant influencing factors and to provide evidences for exploring key populations of tobacco control and developing personalized tobacco control strategies. Methods The elderly who underwent the community medical examination were selected and multi-stage sampling method was adopted to conduct the questionnaire survey. The quitting intention and relevant influencing factors were analyzed by methods such as descriptive analysis, χ2 test (univariate), and logistic regression analysis (multivariate). Results The quitting intention rate was 12.1%. The univariate analysis showed that the quitting intention was relevant to years of smoking, average daily amount of smoking, average monthly cost of smoking, time of the first cigarette smoking in the morning, previous experience of quitting, recognition of hazardous substances in tobacco, awareness of respiratory diseases caused by smoking, self-rating of health, propaganda and education of tobacco control, and free administration stimulation (P<0.05). The multivariate analysis showed that previous experience of quitting (OR=2.940, 95%CI: 1.098-7.867), awareness of respiratory diseases caused by smoking (OR=4.343, 95%CI: 1.503-12.551), and free medication stimulation (OR=17.658, 95%CI: 6.380-48.877) were influencing factors of the quitting intention. Conclusion Elderly smokers are a special group that the effects of their personal and environmental factors on the quitting intention should be fully considered. Health propaganda and education must be strengthened with effective intervention measures for quitting smoking. Related Articles | Metrics

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Analysis of correlation of nicotine dependence and cognition and behaviors of elderly male smokers  in the rural community CHEN Xiao-wen, CHEN Hao, SHI Li-li, et al 2015, 35 (2):  178.  doi: 11.3969/j.issn.1674-8115.2015.02.006 Abstract ( 627 )   PDF (352KB) ( 1138 )   Objective To investigate the nicotine dependence of elderly male smokers in rural areas and to analyze the effects of different degrees of nicotine dependence on smoking and quitting behaviors and cognition of the harmfulness of smoking. Methods A total of 769 old people in Jiading District of Shanghai who underwent the free medical examination were selected and multi-stage sampling method was adopted to conduct the questionnaire survey. Descriptive analysis was used to analyze the degree of nicotine dependence of elderly male smokers. The respondents were categorized according to scores of Fagerstrom test for nicotine dependence (FIND). The correlation of the degree of nicotine dependence, cognitvon and behaviors was analyzed. Demographic factors of the degree of nicotine dependence were also analyzed. Results According to the degree of nicotine dependence, 769 elderly male smokers were divided into the low nicotine dependence group (n=519, 67.5%) and high dependence group (n=250, 32.5%). The family income per capita below the median was a risk factor of high nicotine dependence (OR=1.984, P<0.001). Other social and demographic factors had no effect on nicotine dependence. Compared with the low dependence group, more respondents in high dependence group considered that smoking was ok or beneficial (r=－0.173); the age of starting smoking was earlier (r=0.086), average monthly tobacco cost was higher (r=－0.295); smoking history was longer (r=－0.088); less likely to have quitting experience (r=0.076); recent cessation period was shorter (r=0.140); there were more smokers in 5 most closest friends (r=－0.151); main entertainments were playing mahjong or cards (r=0.095); and more respondents in high dependence group drink too much (r=－0.171). The differences were statistically significant (P<0.05). Conclusion Social and demographic factors have little effect on the nicotine dependence. Nicotine dependence has certain influence on the cognition and important impact on smoking cessation behaviors and lifestyle. In order to change smoking behaviors of rural elderly male smokers and achieve smoking cessation, it is necessary to conduct proper clinical nicotine withdrawal treatment as well as health education and social support. Related Articles | Metrics

Original article (Basic research)

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Effects of dexmedetomidine on expressions of IL-1β and TNF-α in hippocampus tissues of aged mice after surgery QIAN Xiao-lan, WANG Qing-duan, ZHANG Wei, et al 2015, 35 (2):  184.  doi: 11.3969/j.issn.1674-8115.2015.02.007 Abstract ( 735 )   PDF (353KB) ( 1154 )   Objective To explore the effects of dexmedetomidine on expressions of IL-1 β and TNF-α in hippocampus tissues of aged mice after surgery and postoperative cognitive decline (POCD). Methods A total of 105 aged Kunming mice were randomly divided into 4 groups, i.e. control group (n=15) that received no anesthesia and surgery, anesthesia group (n=30) that received consecutive isoflurane inhalation for 60 min and intraperitoneal injection of ketamine of 100 mg/kg, splenectomized group (n=30) that underwent splenectomy after anesthesia, intervention group (n=30) that received intraperitoneal injection of dexmedetomidine of 15 and 25 μg/kg (15 mice for each dose) 30 min before anesthesia and surgery. Y-maze experiments were conducted 1 d and 3 d after surgery (Y-maze experiments were conducted 3 d after surgery for the intervention group). The trial numbers of each group were recorded. The mRNA and protein expressions of IL-1β and TNF-α in hippocampus tissues were detected by the qRT-PCR and Western blotting. Results The trial number of the anesthesia group was more than that of the control group 1 d after surgery (P<0.05) and was back to normal 3 d after surgery (P>0.05). The trial number of the splenectomized group was more than that of the control group 1 d and 3 d after surgery (P<0.01, P<0.05). The differences of the intervention group and control group 3 d after surgery were not statistically significant (P＞0.05). Compared with the control group, the mRNA and protein expressions of IL-1β and TNF-α of the splenectomized group significantly increased 1 d and 3 d after surgery (P<0.05 or P<0.01), and the differences of the mRNA and protein expressions of IL-1β and TNF-α of the anesthesia group (1 d and 3 d after surgery), intervention group (3 d after surgery), and control group were not statistically significant (P>0.05). Conclusion Pretreatment with dexmedetomidine can decrease the mRNA and protein expressions of IL-1β and TNF-α in hippocampus tissues of mice. The improvement of POCD of mice is relevant to the inhibition of inflammation responses of hippocampus. Related Articles | Metrics

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Effects of different permeating time of penetrating resin on permeating depth of early artificial enamel caries ZHU Xue-hua, MA Wen-zhu, LIN Ju-hong 2015, 35 (2):  189.  doi: 11.3969/j.issn.1674-8115.2015.02.008 Abstract ( 786 )   PDF (497KB) ( 1137 )   Objective To explore the effects of different permeating time of penetrating resin on the penetration depth (PD) of early artificial enamel caries. Methods Fifty healthy premolars without caries that were extracted for orthodontic reason were selected and the model of artificial enamel caries was established. Samples were randomly divided into 5 groups (n=10) and penetrated by the penetrating resin for 1, 2, 2.5, 3, and 4 min, respectively, then cured by light for 60 s. Specimens were prepared after the teeth were sliced and polished and observed under the inverted fluorescence microscope. The lesion depth (LD) and PD were measured and the penetration percentage (PP) was calculated. Results PD of penetrating resin at 1 min was significantly less than that at 3 min. And 90% of maximum LD could be achieved at 2.5 min and the maximum LD could be achieved at 3 min. More permeating time would not significantly affect the PD. The differences were not statistically significant (P>0.05). Conclusion The maximum LD of early enamel caries can be achieved at permeating time of 3 min. Related Articles | Metrics

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Changes of expressions of Puma and CytC in hippocampus tissues of rats with pilocarpine-induced status epilepticus WANG Xin-lin, GENG Zhi 2015, 35 (2):  193.  doi: 11.3969/j.issn.1674-8115.2015.02.009 Abstract ( 656 )   PDF (820KB) ( 1089 )   Objective To study the expressions of P53 up-regulated modulator of apoptosis (Puma) and cytochrome C (CytC) in hippocampus tissues of rats in pilocarpineinduced status epilepticus (SE) rat model. Methods Adult male Sprague Dawley (SD) rats were intraperitoneally injected with pilocarpine of 10% (300 mg/kg) and the seizure was ceased 60 min after SE was induced. Hippocampus tissues of the rats were removed after 24 h. Brain tissues were stained by H-E and the number of neurons in CA1 area of hippocampus was observed. Then brain tissues were stained by TUNEL and the injury of hippocampus neurons was observed. The Western blotting was adopted to detect the expression of Puma in hippocampus tissues and immunohistochemical method was used to detect the CytC level in hippocampus tissues. The correlation of expressions of Puma and CytC was analyzed by the Pearson correlation analysis. Results The number of stained neurons in the CA1 area of hippocampus greatly decreased 24 h after SE and the number of TUNEL positive neurons significantly increased. Expressions of Puma and many CytC positive neurons appeared. The expression of Puma was correlated with the expression of CytC (r=0.906, P=0.000). Conclusion Apoptosis is found in hippocampus neurons of rats 24 h after SE. Expressions of Puma and CytC increase in hippocampus neurons of rats with SE and the expression of Puma is positively correlated with the expression of CytC. Related Articles | Metrics

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Relationship between polymorphism of IL-4 gene and susceptibility and severity of respiratory syncytial virus bronchiolitis ZHANG Ming-zhi, ZHANG Xiao-bo, LU Ai-zhen, et al 2015, 35 (2):  199.  doi: 11.3969/j.issn.1674-8115.2015.02.010 Abstract ( 661 )   PDF (338KB) ( 1089 )   Objective To investigate the relationship between the polymorphism of loci 589C/T(rs2243250) and 33 C/T(rs2070874) of gene promoter region of interlukin-4 (IL-4) and susceptibility and severity of respiratory syncytial virus (RSV) bronchiolitis and to explore the effects of differences of genetic mechanisms on the incidence and prognosis of RSV infection. Methods Polymorphism of IL-4-589C/T and IL-4-33C/T of 218 patients with RSV bronchiolitis (RSV bronchiolitis group) and 303 healthy controls (control group) were detected by MGB-Taq Man probe method and the severity of RSV bronchiolitis was evaluated by the respiratory scoring system. Results The frequencies of CC, CT and TT genotypes of IL-4-589 of the RSV bronchiolitis group were 1.4%, 21.1%, and 77.5% and those of the control group were 1.7%, 34.0%, and 64.4%, respectively. The differences were statistically significant (P=0.005). The frequencies of all elomorphic genes C and T of IL-4-589 of the RSV bronchiolitis group were 11.9% and 88.1% and those of the control group were 18.6% and 81.4%, respectively. The differences were statistically significant (P=0.003). The frequencies of CC, CT and TT genotypes of IL-4-33 of the RSV bronchiolitis group were 1.4%, 20.6%, and 78.0% and those of the control group were 2.3%, 35.6%, and 62.0%, respectively. The differences of two groups were statistically significant (P=0.001). The frequencies of all elomorphic gene C and T of IL-4-33 of the RSV bronchiolitis group were 11.7% and 88.3% and those of the control group were 20.1% and 79.9%, respectively. The differences were statistically significant (P=0.000). Haplotype analysis found linkage disequilibrium at IL-4-589 and IL-4-33 (D′=0.75). The differences of the frequency of T-T haplotype of IL-4-589 and IL-4-33 of two groups were statistically significant (P=0.000). The clinical respiratory scores of patients with IL-4-589TT in the RSV bronchiolitis group were significantly higher than those of patients with IL-4-589CT (P=0.002). The clinical respiratory scores of patients with IL-4-33TT were significantly higher than those of patients with IL-4-33CT (P=0.001). Conclusion The polymorphism of IL-4-589C/T and IL-4-33C/T was relevant to the susceptibility and severity of RSV bronchiolitis. Related Articles | Metrics

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Effects of citalopram on learning, memory, and Aβ neuropathies of APP23 transgenic mice ZHOU Wei-tao, HUANG Dao-chao, ZHONG Hai-ying, et al 2015, 35 (2):  204.  doi: 11.3969/j.issn.1674-8115.2015.02.011 Abstract ( 834 )   PDF (496KB) ( 1062 )   Objective To investigate the effects of administration of low dose citalopram in early stage on the learning, memory, and pathological changes of amyloid β-protein (Aβ) of mice with Alzheimer disease (AD). Methods Thirty 5-month-old APP23 transgenic mice were randomly divided into the citalopram group (n=15) and control group (n=15). Mice of the citalopram group were intraperitoneally injected with 10 mg/kg citalopram for 3 months and mice of the control group were intraperitoneally injected with the same volume of normal saline for 3 months. Morris water maze test was adopted to determine the learning and memory functions 24 h after the final injection. Mice were sacrificed and brain tissues were obtained after the final Morris water maze test. Aβ40 and Aβ42 levels of brain tissues were detected by the ELISA. The amount of senile plaques was counted by the immunohistochemical staining. The expression levels of amyloid precursor protein (APP), β-site APP-cleaving enzyme (BACE1), and β-CTF C99/C89 of hippocampus tissues were determined by the Western blotting. Results Compared to the control group, the escape latency of the citalopram group was significantly shorter; total swimming distance decreased; the number of crossing the platform increased (P<0.05); Aβ40 and Aβ42 levels were significantly lower; and the number of senile plaques significantly decreased (P<0.05). But the expressions of APP, BACE1, and β-CTF did not change significantly (P>0.05). Conclusion Long-term administration of low dose citalopram in early stage can improve the learning and memory functions of mice with AD and decrease Aβ neuropathies. The mechanism may be relevant to the up-regulation of expression of α-secretase and enhancing the metabolism of APP in this splicing pathway by citalopram. Related Articles | Metrics

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Experimental study on inhibition of proliferation of keloid fibroblasts by decitabine ZOU Qi-pa, LING Jing, LIU Chao-dong 2015, 35 (2):  210.  doi: 11.3969/j.issn.1674-8115.2015.02.012 Abstract ( 609 )   PDF (1008KB) ( 1116 )   Objective To evaluate the effects of decitabine on the proliferation of keloid fibroblasts and the expression of proteins relevant to TGF-β/Smad signal pathways. Methods CCK8 assay was adopted to detect the effects of decitabine of different concentrations on the proliferation of keloid fibroblasts. The expressions of transforming growth factor-β1 (TGF-β1), phosphorylated p-Smad2/3 (p-Smad2/3), Smad4, collagen type I alpha 1 (COL1A1), and COL3A1 of keloid fibroblasts before and after being intervened by decitabine were detected by the Western blotting. Immunoprecipitation assay and Smad4 siRNA transfection were adopted to explore the role of p-Smad2/3-Smad4 complex during the formation of keloid. Real-time PCR was used to detect the expression of downstream transcriptional factors. Results The results of CCK8 assay showed that the growth inhibition rate of fibroblasts increased with the concentration of decitabine after being intervened for 48 h. IC50 concentration of decitabine of 4.38 μmol/L was selected as the intervention concentration of ear lobe keloid fibroblasts. After being intervened by decitabine, expressions of TGF-β1, p-Smad2/3, COL1A1, and COL3A1 of keloid fibroblasts and the formation of p-Smad2/3-Smad4 complex significantly decreased. The expression of COL1A1 of keloid fibroblasts decreased and mRNA expressions of transcriptional factors c-jun, runx2, and irf-7 were down-regulated after Smad4 was silenced. Conclusion Decitabine can inhibit the proliferation of keloid fibroblasts and the synthesis of collagens. The mechanism may be relevant to the inhibition of phosphorylation of Smad2/3 and the formation of p-Smad2/3-Smad4 protein complex. Related Articles | Metrics

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Correlation of expressions of EGFR, c-jun, and c-fos of cervical squamous cell carcinomas and clinical features and short-term efficacy ZHAO Jun-ling, MA Dong-hui, Gulina·Kuerban, et al 2015, 35 (2):  216.  doi: 11.3969/j.issn.1674-8115.2015.02.013 Abstract ( 636 )   PDF (897KB) ( 1236 )   Objective To investigate the correlation of expressions of epidermal growth factor receptor (EGFR) and proto-oncogenes c-jun and c-fos of cervical squamous cell carcinomas (CSCC) and clinical features and short-term efficacy. Methods The fluorescence in situ hybridization (FISH) and immunohistochemistry method were adopted to detect the number of EGFR gene copies and protein expression levels of EGFR, c-jun, and c-fos of CSCC tissues of 60 cases. Results The numbers of EGFR gene copies were 32.2% for diploid, 25.4% for triploid, 30.5% for polyploid, and 11.9% for gene amplification. The positive protein expression rates of EGFR, c-jun, and c-fos were 70.0%, 76.7%, and 68.3% and correlated with the lymph node metastasis and tumor differentiation (P<0.01). The protein expression of EGFR correlated with the clinical stages (P<0.01). Spearman rank correlation analysis showed that the protein expression level of EGFR positively correlated with the increase of gene copies (r=0.622, P=0.000); protein expressions of c-jun and c-fos positively correlated with the clinical stages (r=0.293, P=0.023; r=0.296, P=0.022); the protein expression level of EGFR positively correlated with protein expressions levels of c-jun and c-fos (r=0.422, P=0.001; r=0.509, P=0.000); and protein expressions of EGFR, c-jun, and c-fos did not significantly affect the objective efficiency (P>0.05). Conclusion Expressions of EGFR, c-jun, and c-fos may be reference indexes of the development and metastasis of CSCC and may not be independent factors that affect the short-term efficacy of CSCC. The c-jun and c-fos may play a positive regulatory role in EGFR-mediated signal transduction pathway. Related Articles | Metrics

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Value of indexes of uterine artery blood flow for prediction of preeclampsia GU Wei, ZHOU Lei-ping, LIN Jing, et al 2015, 35 (2):  223.  doi: 11.3969/j.issn.1674-8115.2015.02.014 Abstract ( 832 )   PDF (415KB) ( 1387 )   Objective To explore the value of indexes of uterine artery blood flow for the prediction of preeclampsia. Methods A total of 1 630 pregnant women who were registered in our hospital from April, 2012 to June, 2013 were selected. The systolic to diastolic velocity ratio (S/D), pulsation index (PI), resistance index (RI), and early diastolic notch of blood flow spectrum of both sides of uterine artery were measured in 11-14 and 22-24 weeks of pregnancy by the color Doppler ultrasonic diagnostic apparatus and were followed up till puerperium. Pregnant women were divided into the preeclampsia group and control group according to the pregnancy outcome. S/D, PI, and RI were used as test variables for the ROC curve and the predicted results were compared by the statistical test. The maximal Youden index was used as the predicted cut-off value for each index, which was then used as the scoring criterion to establish comprehensive scores. This method was adopted for preeclampsia prediction to determine the prediction scores and to evaluate the prediction effect. Results Among 1 630 pregnant women, 52 of them developed preeclampsia and 96 of them suffered from gestational hypertension, while 1 482 of them remained normal. The predicted cut-off values of S/D, PI and RI in the second trimester were 2.355 0, 0.877 5, and 0.580 0, respectively. Methods that adopted these three indexes for the prediction of preeclampsia showed statistical significance (P<0.01). It was statistically significant to use the comprehensive score of 3 as the cut-off value for predicting the preeclampsia (P=0.012) and the prediction specificity was 97.33%. Results of the prediction method negatively correlated with the birth weight and gestational weeks (P<0.01). Conclusion Indexes of uterine artery blood flow have a good clinical application value for the prediction of preeclampsia. Related Articles | Metrics

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In vitro bacteriostasis effect of cephalosporin/sulbactam compound preparations on Gram negative bacilli causing bloodstream infections XU Zheng-peng, SHI Yan, DOU Yi, et al 2015, 35 (2):  229.  doi: 11.3969/j.issn.1674-8115.2015.02.015 Abstract ( 651 )   PDF (262KB) ( 1202 )   Objective To evaluate the in vitro bacteriostasis effect of cephalosporin/sulbactam compound preparations on Gram negative bacilli that cause bloodstream infections. Methods Thirty isolates of each of following bacteria that can cause bloodstream infections were collected, i.e. ESBLs producing Escherichia coli，nonESBLs producing Escherichia coli, ESBLs producing Klebsiella pneumoniae, non-ESBLs producing Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The minimum inhibitory concentrations (MIC) of CTX/SBT, ceftriaxone/sulbactam (CRO/SBT), cefoperazone/sulbactam (CPZ/SBT), CTX, CRO, and CPZ were determined by the agar dilution method and 50% minimun inhibitory concentrations (MIC50) were calculated. Results The antibacterial activity of three third-generation cephalosporin/sulbactam compound preparations was better than that of single prescription preparations. MIC50 decreased 4-8 times. The antibacterial activity of CTX/SBT was better than that of CRO/SBT and CPZ/SBT. MIC50 of CTX/SBT against ESBLs producing Escherichia coli and Klebsiella pneumoniae decreased to 32-64 μg/mL, which was 8 times lower than that of CTX preparation. Conclusion For Gram negative bacilli that can cause bloodstream infections, the antibacterial activity of three third-generation cephalosporin/sulbactam compound preparations is better than that of single prescription preparations. The antibacterial activity of CTX/SBT is the best, especially for ESBLs producing isolates. Related Articles | Metrics

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Analysis of single nucleotide polymorphisms of CD40 gene of Han people with Kawasaki disease in Shanghai PU Tian, XIE Jing, YANG Jian-ping, et al 2015, 35 (2):  233.  doi: 11.3969/j.issn.1674-8115.2015.02.016 Abstract ( 596 )   PDF (373KB) ( 1120 )   Objective To investigate the relationship of the incidence of Kawasaki disease and c.4833 C>T and c.5077 T>C polymorphisms of CD40 gene and to explore the possible molecular biological pathogenesis of Kawasaki disease. Methods Eighty-one children who were diagnosed with Kawasaki disease were selected as study subjects (case group) and 96 healthy children were chosen as controls (control group). PCR was adopted to amplify promoters and all exons of CD40 gene. Paired-end sequencing was performed for all amplified fragments. Sequenced CD40 gene was compared with the known sequence in GenBank (NG 007279-1) by the BLAST program and possible single nucleotide polymorphisms (SNP) were screened. Results Two reported SNP in the sequence of promoters of CD40 gene, i.e. rs752118 and rs1883832, were detected in both case group and control group. The differences of frequencies of alleles of two SNPs between two groups were not statistically significant (P=0.362, P=0.769). Conclusion Two SNPs in the sequence of promoters of CD40 gene have no significant effect on the incidence and prognosis of Kawasaki disease and can be regarded as normal SNPs of Chinese Han people. Related Articles | Metrics

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Analysis of therapeutic effect of microsurgical varicocelectomy on treatment of subclinical varicocele WANG Hui, ZHANG Lei, HE Xue-you, et al 2015, 35 (2):  238.  doi: 11.3969/j.issn.1674-8115.2015.02.017 Abstract ( 889 )   PDF (290KB) ( 1184 )   Objective To observe the therapeutic effect of microsurgical varicocelectomy for the treatment of subclinical varicocele. Methods According to results of physical examinations and color Doppler flow imaging (CDFI), 40 patients were divided into the subclinical varicocele (SVc) group (n=20) and clinical varicocele (CVc) group (n=20). All patients underwent microsurgical varicocelectomy. Semen parameters of two groups before the surgery and semen parameters of patients of the same group before and 3 months after the surgery were compared. The main semen parameters were sperm concentration, sperm motility, and sperm viability. The recurrence and complications of patients 3 months after the surgery were collected. Results The differences of preoperative age and semen parameters of two groups were not statistically significant (P>0.05), but the mean inner diameter of spermatic vein of the SVc group was smaller than that of the CVc group [(2.62±0.39) mm and (4.09±0.86) mm, respectively, P<0.05]. Semen parameters of the SVc group 3 months after the surgery were not significantly better than those before the surgery (P>0.05), while semen parameters of the CVc group 3 months after the surgery were significantly better than those before the surgery (P<0.05). The recurrence and complications of testicular atrophy, testis pain, and hydrocele were not found in all 40 patients 3 months after the surgery. Conclusion Microsurgical varicocelectomy can not improve the seminal quality of patients with subclinical varicocele, but can relieve the preoperative scrotum complaints. Related Articles | Metrics

Original article (Public health)

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Effects of occupational aluminum exposure on psychology, neural behaviors, cognitive function, and autonomic nervous function of workers ZHOU Ze-wen, PANG Ya-qin, QI Guang-zi, et al 2015, 35 (2):  242.  doi: 11.3969/j.issn.1674-8115.2015.02.018 Abstract ( 807 )   PDF (414KB) ( 1145 )   Objective To investigate the effects of occupational aluminum exposure on psychology, neural behaviors, cognitive function, and autonomic nervous function of workers. Methods A total of 110 male aluminum-exposed workers of a large aluminum plant in Guangxi were selected as subjects of the exposure group and 110 workers from the service company affiliated to aluminum plant whose ages and education levels matched those of subjects were selected as controls of the control group. WHO neuro-behavior core recommendation test was adopted to evaluate the psychological feelings and neural behaviors of all workers. The cognitive function was evaluated by the mini-mental state examination (MMSE) and the changes of autonomic nervous function were examined. Aluminium levels of working environment and serum and urine samples of workers were monitored. Results The average air aluminum levels of the batch preparation workshop, electrolysis workshop, and casting workshop were (6.45±1.23), (7.02±1.45), and (6.95±1.86) mg/m3, which were significantly higher than that of the control group (F=7.463, P<0.001). Serum and urinary aluminum levels of the exposure group were significantly higher than those of the control group (P<0.05). The results of questionnaire survey of psychological feelings showed that scores of “confused-puzzled” and “nervous-anxious” of the exposure group were significantly higher than those of the control group (P<0.05) and the differences of other indexes were not statistically significant (P>0.05). Neurobehavioral function detection showed that simple reaction time, digital decoding hit points and management, and the correct number of the exposure group were significantly lower than those of the control group (P<0.05) and the differences of other indexes were not statistically significant (P>0.05). The total score of MMSE and scores of place orientation, immediate memory and language, calculation and attention, short-term memory, and verbal expression and Rmax∶Rmin of the exposure group were all significantly lower than those of the control group (P<0.05). Scores of place orientation, immediate memory and language, calculation and attention, short-term memory, verbal expression, and language understanding of workers who had exposed to aluminum for more than 10 years were significantly lower than those of workers who had exposed to aluminum for less than 5 years (P<0.05). Conclusion Occupational aluminum exposure can cause obvious changes of psychological state, nerve movement speed, accuracy, coordination ability, and parasympathetic nerve regulation function of workers. Related Articles | Metrics

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Analysis of main restricting factors and countermeasures for smoothly developing multihospital system in Shanghai YU Ting, WU Cong-rui, LI Han-wei, et al 2015, 35 (2):  248.  doi: 11.3969/j.issn.1674-8115.2015.02.019 Abstract ( 916 )   PDF (353KB) ( 1230 )   Objective To explore main factors that restrict the development of multihospital system in Shanghai and to provide ideas and improvement plans for broader promotion. Methods In-depth interview, analytic hierarchy process (AHP) method, and Delphi method were adopted to establish the hierarchical structure model of restricting factors of the multihospital system in Shanghai, which consisted of the target layer, criterion layer, and solution layer. The data was analyzed by the Matlab 7.8. Results There were 4 main factors that restricted the multihospital system in Shanghai in the criterion layer, i.e. policy, interest, management, and patient demand. Their weights of contribution to the target layer (smooth development of the multihospital system in Shanghai) were 38.69%, 36.13%, 19.36%, and 5.81%, which meant that more attention should be paid to first 3 factors during the practice of promoting the multihospital system. Meanwhile, although the factor of interest was the second important factor in the criterion layer, 7 of the top 8 elements of the solution layer that contributed most to the target layer were relevant to it. So the factor of interest should be treated as an important factor. The weight of the factor of patient demand was low, which might be relevant to the domination of medical services by suppliers and the unsmoothness of expression channel for interest appeals. Conclusion The factor of interest has become the core element for smoothly developing the multihospital system in Shanghai and is relevant to other three factors. Therefore, it is advised to regard the factor of interest as core driving force, re-establish the operating mechanism of multihospital system at macro and micro levels, consciously pay more attention to the demands of patients, and effectively resolve the problem of inadequate and expensive medical services. Related Articles | Metrics

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Study on differences of socioeconomic factors influencing adoption of cesarean section in Chongqing TAO Yi, ZHONG Xiao-ni 2015, 35 (2):  253.  doi: 11.3969/j.issn.1674-8115.2015.02.020 Abstract ( 674 )   PDF (298KB) ( 1280 )   Objective To analyze socioeconomic factors that influence the adoption of cesarean section in Chongqing. Methods Data of the fifth national health service survey that conducted in 2013 were collected and household wealth was calculated by the principal component analysis. The concentration index and decomposition of concentration index were adopted to evaluate the inequality of socioeconomic factors that influence the adoption of cesarean section and contributions of influencing factors to the inequality. Results Among 1 140 puerperae, 569 of them (49.91%) chose the cesarean section. The rate of cesarean section was influenced by socioeconomic factors, which were rural registered permanent residence (the rate of cesarean section was 45.06% and the contribution rate was -58.53%), education level was or below the high school (the rate of cesarean section was 44.12% and the contribution rate was 38.76%), participation of medical insurance for urban workers (the rate of cesarean section was 58.93% and the contribution rate was 26.49%), primiparity (the rate of cesarean section was 55.13% and the contribution rate was 23.38%), and age between 25 and 29 (the rate of cesarean section was 52.75% and the contribution rate was 18.89%). Conclusion Socioeconomic factors have some effect on puerperae for choosing the delivery method. In order to decrease the rate of cesarean section, relevant institutions should enhance the propaganda and education of pregnancy and delivery for target populations; assist them to choose the best delivery method; promote appropriate new obstetric technologies; improve the medical environment and quality; strength self-discipline; and make relevant medical and health policies. Related Articles | Metrics

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Analysis of effects of performance appraisal of clinical departments based on key performance indicators WANG Han-song, ZHANG Yun-ting, JIANG Zhong-yi, et al 2015, 35 (2):  258.  doi: 11.3969/j.issn.1674-8115.2015.02.021 Abstract ( 812 )   PDF (287KB) ( 1323 )   Objective To analyze the results and effects of performance appraisal of clinical departments based on the key performance indicators (KPI) and to explore the considerations and existing problems for the performance appraisal of clinical departments. Methods Performance evaluation indicators and grading results of a clinical department from 2011 to 2013 were systematically collected. KPI of the medical quality, medical operation, efficiency and benefit, science and technology, discipline construction, talent cultivation, spiritual civilization, and management. were selected and systematically analyzed and compared. Results The hundred mark system was adopted for the performance appraisal system of hospital. From 2011 to 2013, the score of performance appraisal increased from 93.9 to 95.6. Indicators such as medical operation, medical quality, and science and technology increased, but the indicator of efficiency and benefit needed to be improved. Conclusion The performance appraisal of hospital should pay more attention to quality improvement, connotation construction, scientificity and rationality of indicators, and rationality and differences of appraisal criteria and ensure the scientific nature and effectiveness of the performance appraisal system. Related Articles | Metrics

Review

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Research progresses of transcription factor CCAAT enhancer binding protein α YING Ji, WANG Wei-ming 2015, 35 (2):  262.  doi: 11.3969/j.issn.1674-8115.2015.02.022 Abstract ( 1837 )   PDF (427KB) ( 1423 )   CCAAT enhancer binding protein α (C/EBPα) is a member of CCAAT enhancer binding protein (C/EBP) family, which belongs to the basic region/zipper (bZIP) protein family. C/EBP family plays important roles in cell proliferation and differentiation, cell cycle regulation, immune responses, inflammatory reaction, energy metabolism, tumorigenesis, and tumor apoptosis. This paper reviews research progresses of the structure, expression regulation, and biology functions of C/EBPα. Related Articles | Metrics

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Advances of emotional intelligence in nursing organizations YAN Ya-min, GONG Mei 2015, 35 (2):  268.  doi: 11.3969/j.issn.1674-8115.2015.02.023 Abstract ( 683 )   PDF (297KB) ( 1359 )   Nowadays, multidiscipline studies on emotional intelligence (EI) increase gradually. Therapeutic relationships that are closely relevant to EI in nursing organizations can establish a harmonic care environment and promote the rehabilitation of patients. But the effects of EI on nursing education still need to be supported by theoretic studies. Monitoring tools for EI improve gradually, while the training of EI is still a research difficulty and lacks measuring and evaluating methods. This paper reviews current researches of EI in nursing organizations. Related Articles | Metrics

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Advances of relationship between SFRP3 and tumors LIN Ya-ying, ZHANG Ping 2015, 35 (2):  272.  doi: 11.3969/j.issn.1674-8115.2015.02.024 Abstract ( 749 )   PDF (343KB) ( 1139 )   The Wnt signaling pathway plays an important role in biological behaviors, such as embryonic development, tissue homeostasis, and tumor progression. The expression of Wnt signal was affected by many factors. The secreted frizzled-related protein (SFRPs) family is an important inhibitor of Wnt which extracellularly binds to Wnt or frizzled (Fz) receptor of Wnt to inhibit the transmission of Wnt signal. Secreted frizzled-related protein-3 (SFRP3) is the first discovered member of SFRPs. The silence of SFRP3 caused by the methylation of its promoter is closely relevant to the incidence and development of malignant tumors, so SFRP3 is often regarded as a tumor suppressor gene. The gene polymorphism of SFRP3 is also a high risk factor of some malignant tumors. This paper reviews research progresses of the relationship between SFRP3 and tumors. Related Articles | Metrics

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Signal transducers and activators of transcription 3: a small molecule nonpeptide inhibitor SUN Jin-ling, DENG Jun-jie, CHEN Ying-yi 2015, 35 (2):  276.  doi: 11.3969/j.issn.1674-8115.2015.02.025 Abstract ( 777 )   PDF (660KB) ( 1156 )   Signal transducers and activators of transcription (STAT) are proteins that play important roles in both signal transduction and transcription. The STAT family has seven members, i.e. STAT1, STAT2, STAT3, STAT4, STAT5a, STAT5b, and STAT6. Among them, STAT3 plays important roles in various pathophysiological processes such as incidence, development and metastasis of cancers, inflammation responses, and ischemia/reperfusion injury. In particular, constant abnormal activation of STAT3 is closely relevant to tumor growth and metastasis. So the inhibition of over activation of STAT3 is an important method for cancer treatment. At present, STAT3targeted inhibitors can generally be classified into two categories, i.e. peptide and peptidomimetics, and small molecular nonpeptide inhibitors. Most STAT3 inhibitors for cancer prevention are small molecular nonpeptide inhibitors. This paper reviews reported research progresses of STAT3 small molecule nonpeptide inhibitors. Related Articles | Metrics

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Progresses of diagnosis and treatment of children with refractory mycoplasma pneumoniae MEI Yu-xia, DING Li-ren, ZHUANG Cheng, et al 2015, 35 (2):  286.  doi: 11.3969/j.issn.1674-8115.2015.02.026 Abstract ( 1005 )   PDF (381KB) ( 1268 )   Mycoplasma pneumoniae (MP) is a common pathogen that can cause communityacquired pneumonia of children. The infection of MP is usually a benign and self-limited process and can be effectively treated with macrolides. But in recent years, it was discovered that clinical symptoms and imaging findings of some cases did not improve after being regularly treated with macrolide antibiotics for more than 1 week. Their conditions were worse or protracted. Even some serious sequelae developed and resulted in refractory mycoplcasma pneumoniae pneumonia (RMPP). Cases of RMPP increase year by year and there are many difficulties for early diagnosis and treatment. This paper reviews progresses of the diagnosis and treatment of RMPP. Related Articles | Metrics

Brief original article

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Effects of As2O3 on proliferation and apoptosis of SK-NEP-1 cells of human Wilms tumor LU Li-hui, XUE Tian-yang, XU Wei, et al 2015, 35 (2):  291.  doi: 11.3969/j.issn.1674-8115.2015.02.027 Abstract ( 626 )   PDF (285KB) ( 1121 )   Objective To investigate the effects of As2O3 on the proliferation and apoptosis of SK-NEP-1 cells of human Wilms tumor in vitro. Methods The SK-NEP-1 cells of human Wilms tumor was treated with As2O3 of 0, 1.25, 2.5, 5, and 10 μmol/L (group A, B, C, D, and E) for 24 h. The proliferation inhibition rates of different concentrations of As2O3 towards SK-NEP-1 cells were detected by the MTT assay, the apoptosis rates were detected by the flow cytometry; variations of the Bcl-2 level of SK-NEP-1 cells were detected by the ELISA; and the Caspase 3 activity was detected by the Caspase 3 Kit. Results The proliferation inhibition rates of A, B, C, D, and E groups were (3.25±1.05)％, (11.19±2.27)％, (20.72±2.21)％, (27.24±0.57)％, and (32.25±2.15)％, respectively. The apoptosis rates of 5 groups were (5.12±0.29)％, (13.42±1.03)％, (23.70±0.97)％, (32.44±0.82)％, and (40.22±1.31)％, respectively. The differences of 5 groups were statistically significant (P<0.05). The expression level of Bcl-2 of B, C, D, and E groups was lower than that of the A group (P<0.05) and the Caspase 3 activity was higher than that of the A group (P<0.05). Conclusion As2O3 can significantly inhibit the proliferation of SK-NEP-1 cells and induce the apoptosis. The mechanism may be relevant to down-regulating the expression of Bcl-2 and increasing the Caspase 3 activity. Related Articles | Metrics

Case report

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Sporadic Chinese Han case of Leopard syndrome caused by heterozygous missense mutation of Tyr279Cys of PTPN11 gene CAO Qin, CAO Xiao-xiao, WANG Yan 2015, 35 (2):  295.  doi: 11.3969/j.issn.1674-8115.2015.02.028 Abstract ( 871 )   PDF (682KB) ( 1132 )   Objective To investigate the clinical features and genetic diagnosis of Leopard syndrome. Methods The clinical data, physical examination, assistant examination, and genetic screening of 1 case of Leopard syndrome were analyzed and relevant literature was reviewed. Results An 18-year-old Chinese Han male was admitted due to precordial discomfort after hard work. Physical examination showed that the development was normal and diverse lentigines were found over the face, body, limbs, palms, and soles. Ocular distance was at the upper limit of the normal range. Systolic murmur of grade 3/6 was heard in precordial area. Hearing and gonad examination showed no abnormality. ECG and Holter revealed complete right bundle branch block. Cardiac echocardiography, catheterization, and magnetic resonance confirmed left hypertrophic cardiomyopathy with the stenosis of right ventricular outflow tract. Hereditary screening showed that a heterozygous missense mutation of Tyr279Cys in exon 7 of the protein-tyrosine phosphatase non-receptor type 11 (PTPN11) gene was found, but no mutation was found in his parents. Conclusion Results of the study show that this sporadic Chinese Han case of Leopard syndrome is caused by the heterozygous missense mutation of Tyr279Cys of PTPN11 gene. Related Articles | Metrics

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Report of two families of monogenic familial hypercholesterolemia like phenotype HE Jin-chun, ZHOU Shan-shan, LI Yan-ping, et al 2015, 35 (2):  298.  doi: 11.3969/j.issn.1674-8115.2015.02.029 Abstract ( 599 )   PDF (367KB) ( 1346 )   Objective To report 2 families of monogenic familial hypercholesterolemia and their pedigree analysis and to improve the understanding of familial hypercholesterolemia. Methods The pedigree, biochemical results, and clinical data of 2 families of monogenic familial hypercholesterolemia were analyzed. Results There were 17 patients among 22 surviving members of two families. The onset of homozygous patients was earlier. Typical xanthoma was found among them. Their serum total cholesterol and low density lipoprotein cholesterol significantly increased. Triglycerides were normal. Electrocardiogram changes caused by the myocardial ischemia was discovered in the early stage. Conclusion The onset of this disease is early and can cause serious damages. Patients should undergo the early lipid-lowering therapy. Related Articles | Metrics