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    Original article (Basic research)
    Effects of regulation of N-cadherin expression by interaction of Ajuba and Twist on migration ability of colorectal cancer cells
    CHEN Ning, SONG Li-wei, YUAN Xiao-yuan, et al
    2015, 35 (4):  465. 
    doi: 11.3969/j.issn.1674-8115.2015.04.001

    Abstract ( 711 )   PDF (502KB) ( 967 )  

    Objective To explore the interaction between LIM protein Ajuba and transcription factor Twist in colorectal cancer cells and the effects of this interaction on the migration ability of colorectal cancer cells. Methods Co-immunoprecipitation test was used to verify whether the interaction exists between exogenous Ajuba and Twist. The transcription activity of Ajuba towards N-cadherin promoter of downstream target gene of Twist was detected by the luciferase activity assay. Ajuba knock-down stable cell lines SW1116-shAjuba were established. Changes of the cell migration ability were detected by the Transwell assay. Results The interaction between Ajuba and Twist existed and Ajuba could enhance the regulation of N-cadherin expression through Twist. The expression of Ajuba gene in SW1116-shAjuba cells decreased; protein expression down-regulated; and cell migration ability was inhibited. Conclusion Ajuba is a new coactivator of transcription factor Twist. Ajuba can promote the expression of N-cadherin and enhance the migration ability of colorectal cancer cells.

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    Preliminary study on correlation between eukaryotic initiation factor 5A and spontaneous abortion
    QIN Xiao-li, LIU Xiao-rui, TIAN Fu-ju, et al
    2015, 35 (4):  470. 
    doi: 11.3969/j.issn.1674-8115.2015.04.002

    Abstract ( 749 )   PDF (898KB) ( 1077 )  

    Objective To investigate the correlation between eukaryotic initiation factor 5A (eIF5A) and spontaneous abortion. Methods Expressions of eIF5A-1 and eIF5A-2 in mouse uterine tissue of spontaneous abortion model and normal pregnancy controls and in decidua tissue of patients undergoing spontaneous abortion and artificial abortion were detected by immunofluorescence staining, real-time PCR, and Western blotting analysis. Results Both eIF5A-1 and eIF5A-2 were detected in mouse uterine tissue and human decidua tissue, but the expression of eIF5A-1 was significantly higher than that of eIF5A-2. The mRNA and protein expressions of eIF5A-1 and eIF5A-2 of the spontaneous abortion group were lower than those of the control group. Conclusion The down-regulation of eIF5A expression may be relevant to the occurrence and development of spontaneous abortion.

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    Analysis of mutation in 3′UTR region of NOTCH2 gene of children with tetralogy of Fallot disease
    FENG Chao, TANG Ning, FANG Shao-hai, et al
    2015, 35 (4):  476. 
    doi: 11.3969/j.issn.1674-8115.2015.04.003

    Abstract ( 742 )   PDF (978KB) ( 1025 )  

    Objective To screen mutations in 3′UTR region of NOTCH2 gene of children with tetralogy of Fallot disease (TOF) and explore possible mechanisms that how mutations in this region affect the expression of NOTCH2 gene. Methods One hundred and fifty-two children confirmed with TOF were selected as subjects (TOF group), and another 107 healthy children were chosen as controls (CON group). PCR was employed to amplify 3′UTR region of NOTCH2 gene. Direct forward and reverse sequencing was performed on the PCR products. The sequence of 3′UTR region of NOTCH2 gene was compared with the known sequence (NG_008163.1) in GenBank by the BLAST program and possible mutations were screened. Online software PicTar and TargetScan were used to predict miRNA which could bind to 3′UTR region of NOTCH2 gene. The effects of mutations in 3′UTR region of NOTCH2 gene on the expression of miRNA-regulated NOTCH2 gene were analyzed. Results A new mutation and 5 reported SNPs in 3′UTR region of NOTCH2 gene, i.e. 2 672(157020T>G), rs368873082(156595C>T), rs835576(156691A>G), rs3795664(156937C>T), rs699779(156967T>C), and rs699780(156836T>C) were detected. The differences of the frequencies of alleles of 5 reported SNPs of the TOF group and CON group were not statistically significant (P>0.05). Results of prediction showed that there were 34 miRNAs that might bind to 3′UTR region of NOTCH2 gene and this mutation did not locate in binding regions of 34 miRNAs and 3′UTR region of NOTCH2 gene. Conclusion A new mutation 157020T>G exists in 3′UTR region of NOTCH2 gene. This mutation may affect the binding efficiency of miRNA and 3′UTR region of NOTCH2 gene by spatial configuration changes, and further affect the normal expression of NOTCH2 gene. Five SNPs in 3′UTR region of NOTCH2 gene are not significantly correlated with the susceptibility of TOF.

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    Effects of berberine on gut microbiota of rats with non-alcoholic fatty liver disease induced by high-fat diet
    ZHU Chao-xia, CANG Zhen, Jiazireya·Zaiyinati, et al
    2015, 35 (4):  483. 
    doi: 11.3969/j.issn.1674-8115.2015.04.004

    Abstract ( 701 )   PDF (728KB) ( 1058 )  
    Objective To observe the effects of berberine on gut microbiota of rats with non-alcoholic fatty liver disease (NAFLD) induced by high-fat diet. Methods A total of 18 male SD rats were randomly divided into the normal diet group (ND group, n=6), high-fat diet-induced NAFLD group (NAFLD group, n=6), and high-fat diet-induced NAFLD intervened by berberine group (berberine intervention group, n=6). Changes of gut microbiota were investigated by the 16SrRNA gene sequence analysis and morphological changes of liver and ileum tissue were observed. Results Gut microbiota were mainly Firmicutes and Bacteroidetes. Compared with the ND group, the ratio of Firmicutes of the NAFLD group was significantly higher (P<0.05), while ratios of Bacteroidetes and beneficial bacteria Lactobacillus were significantly lower (P<0.01). Compared with the NAFLD group, the ratio of Firmicutes of the berberine intervention group was significant lower (P<0.01), while ratios of Bacteroidetes and  beneficial bacteria Lactobacillus were significantly higher (P<0.01).  Results of the liver histological examination of liver showed that the arrangement of hepatic cells of the ND group was normal and fatty infiltration and inflammatory cell infiltration were not observed. Compared with the ND group, the arrangement of hepatic cells of the NAFLD group was disordered and much steatosis was observed. The steatosis was observed in liver tissues of the berberine intervention group, but less serious than the NAFLD group. Results of the histological examination of ileum showed that the ileum mucosal villus of the ND group arranged neatly and tight and the surface structure was integrated. The ileum mucosal villus of the NAFLD group was broke or lost and the gap of intervillous space widened. The ileum mucosal villus of the berberine intervention group arranged relatively neatly and less ileum mucosal villus was broke or lost than that of the NAFLD group. Conclusion Berberine can relieve the non-alcoholic fatty liver disease induced by high fat diet. The mechanism may be relevant to the changes of structure of gut microbiota and the decrease of intestinal mucosa damages caused by high-fat diet.
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    Role of CXCL12/CXCR4 in chronic inflammatory pain for activation of satellite glial cells
    YANG Yue-cheng, SONG Ming-min, DAI Li-hua, et al
    2015, 35 (4):  489. 
    doi: 11.3969/j.issn.1674-8115.2015.04.005

    Abstract ( 603 )   PDF (471KB) ( 1037 )  
    Objective To observe the expressions of CXCL12, CXCR4, and glial fibrillary acidic protein (GFAP) in dorsal root ganglion (DRG) of rat inflammatory pain model,  the activation of satellite glial cell (SGC), and variations of pain behaviors after the inhibition of CXCR4. Methods A total of 18 rats were randomly divided into the blank control group, sham-inflammatory group, and inflammatory group(n=6). The model of inflammatory pain was established by subcutaneous injection of complete Freund’s adjuvant (CFA) at the right thenar. Paw withdraw thresholds (PWTs) were measured on day 3 and the DRGs were removed. The protein expressions of CXCL12, CXCR4, and GFAP were detected by the Western blotting. Another 22 rats were randomly divided into the sham-inflammatory group (n=6), control group (CFA+normal saline, n=8), and treatment group (CFA+inhibitor, n=8). PWTs were measured before treatment, 2 h before and after drug injection, and after being treated for 1, 2, and 3 d. Ipsilateral DRGs were removed on day 3 and the expression of GFAP was detected by the Western blotting and immunofluorescence. Results Inflammatory pain significantly up-regulated expressions of CXCL12, CXCR4, and GFAP in ipsilateral DRGs (P<0.05). PTWs decreased within 2 h (P<0.05) and the expression of GFAP significantly decreased after the inhibition of CXCR4 (P<0.05). Conclusion Inflammatory pain up-regulates the expressions of CXCL12, CXCR4, and GFAP. The inhibition of CXCR4 can relieve the inflammatory pain for a short time and suppress the activation of SGC in DRG.
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    Gene detection and genetic characteristic analysis of PER type extended-spectrum β-lactamases in Enterobacteriaceae
    XIE Lian-yan, WANG Xiao-li, ZHANG Fang-fang, et al
    2015, 35 (4):  494. 
    doi: 11.3969/j.issn.1674-8115.2015.04.006

    Abstract ( 467 )   PDF (862KB) ( 1043 )  
    Objective To investigate genotypes, epidemiological characteristics, and possible  transmit mechanisms of resistance of PER type extended-spectrum β-lactamase in clinical Enterobacteriaceae isolates. Methods A total of 254 clinical isolates of Enterobacteriaceae with resistance to ceftazidime, cefotaxim, and cefepime were collected from June, 2009 to January, 2014 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The blaPER was identified by the PCR and sequencing. Conjugation experiments were performed for blaPER-positive strains and epidemiological analysis was conducted by the pulsed field gel electrophoresis (PFGE). The upstream and downstream sequences of PER gene were amplified by the PCR. Results A total of 14 clinical Enterobacteriaceae isolates carried the blaPER, including PER-1 type and PER-4 type. Two P. mirabilis isolates were successfully transferred by IncA/C conjugative plasmid. Nine isolates of blaPER-positive P. mirabilis showed 7 different PFGE patterns. The most common genetic environment of Enterobacteriaceae was ISCR1-blaPER-gst-abct and the genetic environment of 2 blaPER-positive P. mirabilis were ISPa12-blaPER-gst-like-ISPa13. Conclusion The blaPER was detected among a variety of clinical Enterobacteriaceae isolates. The upstream genetic environment of blaPER is given priority to the genetic environment with ISCR1 element, which may play an important role in the transmission of Chinese blaPER gene.
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    Effects of marginal vitamin A deficiency in pregnancy on expressions of retinoic acid receptor alpha, Src, and NMDAR1 of newborn rats
    CHEN Li-jun, REN Lan, LIU Zu-yin, et al
    2015, 35 (4):  500. 
    doi: 11.3969/j.issn.1674-8115.2015.04.007

    Abstract ( 447 )   PDF (769KB) ( 919 )  
    Objective To explore the marginal vitamin A deficiency (MVAD) in pregnancy on the expressions of retinoic acid receptor alpha (RARα), sarcoma gene Src, and N-methyl-D-aspartate receptor subunit 1 (NMDAR1) in the hippocampus of newborn rats. Methods The pregnant rat models of vitamin A normal (VAN group) and marginal vitamin A deficiency (MVAD group) were established. The hippocampus tissue of newborn rats was isolated. The primary hippocampus neurons were cultured in vitro and detected by the immunofluorescence staining. The mRNA and protein expressions of RARα, Src, and NMDAR1 in hippocampus tissue and primary hippocampus neurons of newborn rats were detected by the real-time PCR and Western blotting. The calcium excitability of primary hippocampus neurons was detected by the calcium imaging instrument. Results The results of immunofluorescence staining showed that 95% of primary hippocampus neurons of newborn rats that were isolated and cultured in vitro expressed the neuron maker of neuron-specific enolase (NSE). The mRNA and protein expressions of RARα, Src, and NMDAR1 in hippocampus tissue and primary hippocampus neurons of newborn rats of the MVAD group were significantly lower than those of the VAN group (P<0.05). The calcium excitability of hippocampus neurons of newborn rats of the MVAD group was significantly lower than that of the VAN group (P<0.05). Conclusion MVAD in pregnancy can decrease expressions of RARα, Src, and NMDAR1 in the hippocampus. This may be relevant to the impaired learning and memory functions of newborn rats caused by MVAD in pregnancy.
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    Effects of air, water, and glaze liquid on color of all-ceramic veneer for different abutment colors
    DU Yi-min, CHEN Li-ping, WENG Wei-ming, et al
    2015, 35 (4):  506. 
    doi: 11.3969/j.issn.1674-8115.2015.04.008

    Abstract ( 599 )   PDF (516KB) ( 946 )  
    Objective To investigate the effects of different mediums (air, water, and glaze liquid) and different abutment colors on the final color of all-ceramic veneer. Methods Specimens of different abutment colors (ND1-ND7) and IPS e.max CAD LTA1 0.7 mm ceramics slices were superposed and the final color of veneers of restorations was measured by the color spectrometer. The color difference (ΔE) was calculated according to reference colors of 2 mm LTA1 and LTA2 ceramic blocks. Two-way ANOVA analysis was carried out based on ΔE values of ND1-ND6 and Tamhane T2 test was performed for multiple comparisons. Results Both mediums and abutment colors affected ΔE values and the interactive effect existed between two factors (P<0.05). The differences of ΔE values of air and water, and air and glaze liquid were statistically significant (P<0.05), while the differences of ΔE values of water and glaze liquid were not statistically significant (P>0.05). The effect of different mediums on the lightness of restorations was the most significant. Conclusion All of mediums air, water, and glaze liquid affect the color of allceramic veneer. The effect of mediums on the lightness is the most significant. The interactive effect exists between mediums and abutment colors. Water and glaze liquid can make the color of all-ceramic veneer closer to the target color. Maintenance of a certain degree of moisture benefits the color matching.
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    Expression of sodium channel Nav1.8 and behavioral changes of rats with bone cancer pain
    JI Xiao-yan, ZHAO Xuan, CHENG Zhi-jun, et al
    2015, 35 (4):  511. 
    doi: 11.3969/j.issn.1674-8115.2015.04.009

    Abstract ( 429 )   PDF (475KB) ( 935 )  
    Objective To observe the expression changes of sodium channel Nav1.8 in dorsal root ganglion (DRG) and thalamus of rats with tibial cancer pain caused by Walker256 mammary gland carcinoma cells and explore the correlation of Nav1.8 and cancer pain. Methods Wistar rats were randomly divided into the bone cancer pain group (n=15) and sham-operation group (n=15). The bone cancer pain model was established by injecting the Walker256 mammary gland carcinoma cells of 107/mL into the tibia medullary cavity of rats of the bone cancer pain group. The tibia medullary cavity of rats of the sham-operation group was injected with the same volume of normal saline. The mechanical withdraw threshold and paw withdrawal thermal latency were assessed 8, 11, 14, 17, and 21 d after surgery. Imaging examination was conducted 21 d after surgery and DRG and thalamus of rats were collected. Expression changes of Nav1.8 mRNA in DRG and thalamus were observed by the real-time PCR. The protein expression of Nav1.8 in DRG was detected by the immunofluorescence method. Results The mechanical hyperalgesia of the bone cancer pain group was significant at each time point after surgery. Compared with sham-operation group and before surgery, the differences of mechanical withdraw threshold were statistically significant (P<0.05). The paw withdrawal thermal latency of the bone cancer pain group did not change significantly after surgery. The differences of paw withdrawal thermal latency of the sham-operation group and bone cancer pain group after surgery and before surgery were not statistically significant (P>0.05). The mRNA expressions of Nav1.8 in operation homolateral DRG and operation contralateral thalamus were significantly increased (P<0.05). The differences of mRNA expressions of Nav1.8 in operation contralateral DRG and operation homolateral thalamus of the bone cancer pain group and sham-operation group were not statistically significant (P>0.05). Conclusion The up-regulation of Navl.8 expression is relevant to the incidence of bone cancer pain of rats.
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    Study on separation of enantiomers of tropane derivatives by Chiralpak AD and Chiralcel OD-H columns
    XIE Yi-fan, NIU Yin-yao, CHENG Bing, et al
    2015, 35 (4):  516. 
    doi: 11.3969/j.issn.1674-8115.2015.04.010

    Abstract ( 737 )   PDF (431KB) ( 1171 )  
    Objective To develop a high performance liquid chromatography (HPLC) chiral separation method for the enantiomers A and B of tropane derivatives by the normal phase chiral chromatographic column. Methods The chiral columns of Chiralpak AD and Chiralcel OD-H were employed under the normal phase condition. Effects of the composition of mobile phase, flow rate, and temperature on the chiral separation of enantiomers were observed. Thermodynamic parameters of the interaction of enantiomers and stationary phase such as the enthalpy difference and entropy difference were calculated. Results The optimal enantiomeric separation condition for compound A was obtained on the Chiralpak AD column. The optimal enantiomeric separation condition for compound B was obtained on the Chiralcel OD-H column. The lnα was linear with 1/T between 15 ℃ and 35 ℃. The chiral separation was controlled by enthalpy. Conclusion This HPLC chiral separation method can be used for the analysis and identification of optical purity of tropane derivatives A and B.
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    Effects of soybean isoflavones on apoptosis of rat hippocampal neurons after global cerebral ischemia/reperfusion
    ZHAO Shi-di, CHEN Yao, DONG Yin-feng, et al
    2015, 35 (4):  521. 
    doi: 11.3969/j.issn.1674-8115.2015.04.011

    Abstract ( 548 )   PDF (1092KB) ( 1017 )  
    Objective To investigate the effects of soybean isoflavones (SI) on the apoptosis of rat hippocampal neurons after global cerebral ischemia/reperfusion and relevant mechanisms. Methods A total of 60 adult healthy SD rats were randomly divided into the sham group, ischemia/reperfusion group (I/R group), SI low dose group(SI-L group, 60 mg/kg), SI medium dose group (SI-M group, 120 mg/kg), and SI high dose group (SI-H group, 240 mg/kg)(n=12 in each). The global ischemia/reperfusion model was established by 3-vessel occlusion. Rats were sacrificed after being reperfused for 1 h after 1 h of ischemia and the hippocampal tissue was collected. The morphological changes of hippocampal neurons were observed under the light microscope. Changes of the ultra-structure of hippocampal neurons were observed by the transmission electron microscope. Annexin V-FITC/PI double staining was adopted to detect the apoptosis rate of hippocampal neurons. The chemical colorimetry was employed to detect the activity of superoxide dismutase (SOD) and inducible nitric oxide synthase (iNOS) and contents of methane dicarboxylic aldehyde (MDA) and nitric oxide(NO). The expression of NF-κB/p65 mRNA of hippocampal tissue was detected by the semi-
    quantitative RT-PCR. The protein expressions of TNF-α and NF-κB/p65 of hippocampal tissue were detected by the immunohistochemical method. Results Shrivel of hippocampal neurons, marginalization of nucleus chromatin, incompletion of nuclear membrane, disintegration of partial mitochondria membrane, disappearance of partial mitochondrial cristae, and apoptosis of partial neurons were observed in I/R group. Compared with the I/R group, the damage of ultrastructure of hippocampal neurons of SI-L, SI-M, and SI-H groups was relieved significantly and the rate of cell apoptosis decreased (P<0.01). The activity of SOD and iNOS and contents of MDA and NO of the I/R group were obviously higher than those of the Sham group (P<0.01). Compared with the I/R group, the activity
    of SOD and iNOS and contents of MDA and NO of SI-L, SI-M, and SI-H groups decreased (P<0.05). The mRNA expression of NF-κB/p65 and protein expressions of TNF-α and NF-κB/p65 of the I/R group were significantly higher than those of the Sham group (P<0.01). Compared with the I/R group, the mRNA expression of NFκB/p65 and protein expressions of TNF-α and NF-κB/p65 of SI-L, SI-M, and SI-H groups decreased significantly (P<0.01). Conclusion SI can decrease the apoptosis of rat hippocampal neurons after global cerebral ischemia/reperfusion, which may be relevant to inhibiting the oxidative stress, decreasing the expression of TNF-α, and inhibiting the activity of NF-kB/p65.
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    Effects of transforming growth factor β1 on inducing epithelial-mesenchymal transition of human cervical cancer cells
    SHI Yu-rong, CHEN Su-lian, YANG Ying, et al
    2015, 35 (4):  530. 
    doi: 11.3969/j.issn.1674-8115.2015.04.012

    Abstract ( 567 )   PDF (512KB) ( 837 )  
    Objective To investigate the effects of transforming growth factor β1 (TGF-β1) on inducing the epithelial-mesenchymal transition (EMT) of HeLa cells of human cervical cancer. Methods HeLa cells were treated by TGF-β1 of 10 ng/mL for 72 h and the morphological characteristics of HeLa cell lines were observed under the electron microscope. The expressions of epithelial markers and mesenchymal markers relevant to EMT were detected by the real-time PCR and Western blotting. The invasion and migration of HeLa cells were detected by the wound healing assay and Transwell chambers. Results TGF-β1 could induce morphological alteration of HeLa cells from epithelial morphology to mesenchymal morphology, down-regulate the expressions of epithelial marker of E-cadherin and β-catenin, up-regulate the expressions of mesenchymal makers of Vimentin and N-cadherin, and significantly increase the invasion and migration of HeLa cells. Conclusion TGF-β1 can induce the incidence of EMT of HeLa cells and enhance the invasion and migration of HeLa cells.
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    Original article (Clinical research)
    Epidemiological study on hospitalized burns children admitted by Department of Burns and Plastic Surgery of Ruijin Hospital during 2003-2012
    YUAN Bo, MIAO Ming-yuan, YANG Hui-zhong, et al
    2015, 35 (4):  535. 
    doi: 11.3969/j.issn.1674-8115.2015.04.013

    Abstract ( 677 )   PDF (339KB) ( 1038 )  
    Objective To review the clinical data of burned children admitted in the Department of Burns and Plastic Surgery of Ruijin Hospital between 2003-2012, understand epidemiological rules, and identify efficient ways to reduce the incidence of paediatric burns. Methods Medical histories of 0-14 years old burned children who admitted in Ruijin Hospital from 2003 to 2012 were summarized. Research indexes included the basic information of patients, burn etiology, burn extent, anatomical locations, burn areas, operation, and hospitalization days, etc. Results A total of 1 844 patients were enrolled and 1 112 (60.3%) patients were from migrant families. The number of patients admitted during 2008-2012 doubled as compared to the number of patients admitted during 2003-2007. Most patients were 0-3 years old and accounted for 73.8% of all patients. Scalding was the main cause of paediatric burns of each age group. The incidence of burns was high in spring (29.6%) and summer (26.7%). The upper extremities of 1 015 patients were burned and 575 patients underwent skin graft operations. The average hospital stay was 11 d. Seven amputations were performed for patients with electrical burns. Seven patients died. Six of them died from scalding and one died from flame burn injury. Conclusion Most burned children are from migrant families. The number of burned children increases with the growth of resident population in Shanghai. Safety education for migrant families, especially those with 0-3 years old children, may be an effective way to reduce the incidence of paediatric burns.
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    Application of three scoring systems in evaluation of prognosis of patients undergoing continuous renal replacement therapy after cardiac surgery
    ZHANG Hai, PAN Yan, YANG Min, et al
    2015, 35 (4):  540. 
    doi: 11.3969/j.issn.1674-8115.2015.04.014

    Abstract ( 634 )   PDF (597KB) ( 1191 )  
    Objective To evaluate the prediction of prognosis of patients undergoing the continuous renal replacement therapy (CRRT) after cardiac surgery by the multiple organ dysfunction score (MODS), simplified acute physiology score Ⅱ (SAPSⅡ), and vasoactive-inotropic score (VIS). Methods Data of patients undergoing CRRT after the cardiac surgery from November, 2010 to June, 2014 in the Surgical Intensive Care Unit of Shanghai Chest Hospital were collected. Patients were divided into the survival group and death group according to the result of treatment. The severity of disease of all patients was evaluated one day after surgery and one day before CRRT. The prediction of prognosis of patients by 3 scoring systems was evaluated by the area under the receiver operator characteristic curve (AUCROC). Results A total of 32 adult patients with acute kidney injury (AKI) who underwent CRRT after the cardiac surgery were enrolled. Among them, 9 patients survived and 23 patients died. The mortality rate was 71.9%. The scores of MODS, SAPSⅡ, and VIS of the death group one day after surgery and one day before CRRT were significantly higher than those of the survival group. The differences were statistically significant (P<0.05 or P<0.01). AUCROC of VIS one day after surgery and MODS, SAPSⅡ, and VIS one day before CRRT were 0.821, 0.816, 0.800, and 0.768 respectively. The differences of any two of them were not statistically significant (P>0.05). The survival rate of the group with high VIS 90 d after surgery was significantly lower than that of the group with low VIS. The incidences of low cardiac output syndrome (LCOS) and exploratory thoracotomy of the group with high VIS were higher than those of the group with low VIS. Conclusion VIS one day after surgery and MODS, SAPSⅡ, and VIS one day before CRRT can ideally predict the prognosis of patients undergoing CRRT after cardiac surgery. VIS one day after surgery is the best early index. High VIS is correlated with the poor prognosis.
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    Smoothly clipped absolute deviation penalty technology based retrospective analysis of factors of preoperative lymph node metastasis in  patients with colorectal cancer
    XING Wei, SUN Chi, ZOU Qiong-qiong, et al
    2015, 35 (4):  545. 
    doi: 11.3969/j.issn.1674-8115.2015.04.015

    Abstract ( 610 )   PDF (264KB) ( 921 )  

    Objective To reveal the influencing factors of preoperative lymph node metastasis of colorectal cancer by the smoothly clipped absolute deviation (SCAD) penalty technology. Methods Clinical data of 252 patients with colorectal cancer were analyzed retrospectively. By using SCAD technology, the main influencing factors of the lymph node metastasis were sifted and the model parameters were also calculated. Results The statistical results showed that the effects of abnormality in abdominal pain, bloody stools, carcinoembryonic antigen, and serum total bile acid on the lymph node metastasis of colorectal cancer were statistically significant. The probability of lymph node metastasis of patients with colorectal cancer was calculated based on the model. Conclusion The results of SCAD can be clinically applied to preoperative estimation of the possibility of lymph node metastasis for patients with colorectal cancer and guidance of the preoperative intervention therapy.

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    Clinicopathological observation of breast micropapillary pure mucinous carcinoma combined with invasive micropapillary carcinoma
    XU Ming, YE Man-na, WANG Cheng, et al
    2015, 35 (4):  549. 
    doi: 11.3969/j.issn.1674-8115.2015.04.016

    Abstract ( 717 )   PDF (808KB) ( 1074 )  

    Objective To explore the clinicopathological features of micropapillary pure mucinous carcinoma (MPPMC) and MPPMC combined with invasive micropapillary carcinoma (IMPC). Methods Clinical pathological data of 8 cases of MPPMC and 5 cases of MPPMC combined with IMPC were collected and the histological morphology, immune phenotypes, and clinical features were analyzed. Results Transitional regions were observed in 5 cases of MPPMC combined with IMPC. The mucus around the micropapillary gradually disappeared and formed IMPC. The expression of Ki-67 in cancer tissues significantly increased after the transformation of MPPMC to IMPC. The rate of lymph node metastasis of the MPPMC group was only 12.5%, while that of the MPPMC combined with IMPC group was 80%. The main type of cancer in lymph node metastases was IMPC. Conclusion Breast MPPMC and IMPC may be in the same tumor lineages. The biological behavior of MPPMC combined with IMPC is more serious. The treatment of MPPMC combined with IMPC should reference that of IMPC.

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    Prevention of atrial fibrillation after lobectomy by infusion of magnesium sulfate: a prospective cohort study
    QU Can, WANG Xiao-wen, HUANG Chun, et al
    2015, 35 (4):  554. 
    doi: 11.3969/j.issn.1674-8115.2015.04.017

    Abstract ( 461 )   PDF (317KB) ( 1033 )  

    Objective To evaluate the effectiveness of protective intravenous infusion of magnesium sulfate in perioperation on postoperative atrial fibrillation (POAF) after the lobectomy. Methods The method of matching the preoperative age and risk factors of POAF was adopted and 103 patients who underwent a scheduled lobectomy were divided into the magnesium sulfate group (n=49) and control group (n=54) according to whether magnesium sulfate was infused. Patients of the magnesium sulfate group were infused with 25% magnesium sulfate of 2.5 g/d for 3 d before and after surgery. The primary end point to be observed was the incidence of POAF and the secondary end point to be observed was the incidence of side effects and other complications. Results The differences of clinical data of two groups were not statistically significant. The incidence of POAF of the magnesium sulfate group was lower than that of the control group (6.1% vs 22.2%, P=0.026). The incidences of supraventricular tachycardia and ventricular premature beat of the magnesium sulfate group were also lower than those of the control group, but the differences were not statistically significant. The differences of other complications of two groups were not statistically significant. Conclusion Intravenous infusion of magnesium sulfate in perioperation can reduce the incidence of POAF. More randomized controlled studies are needed for further verification and clinical application.

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    Effects of enoxaparin and unfractionated heparin on extrinsic coagulation system and activity of platelets in patients with unstable angina pectoris and non-ST-elevation acute myocardial infarction
    LIU Hua, GUAN Shao-feng, NI You-fang, et al
    2015, 35 (4):  559. 
    doi: 11.3969/j.issn.1674-8115.2015.04.018

    Abstract ( 558 )   PDF (339KB) ( 1017 )  

    Objective To compare the differences of effects of enoxaparin and unfractionated heparin on the extrinsic coagulation system and activity of platelet in patients with unstable angina pectoris and non-ST-elevation acute myocardial infarction and the predictive value of two types of heparins for the occurrence of clinical events. Methods Selected cases were divided into the enoxaparin group and unfractionated heparin group. Levels of anti-Ⅹa factor, von Willebrand factor (vWF), free tissue factor pathway inhibitor (free-TFPI) were detected at different time points before and after administration. The correlation of detected indexes and clinical events of patients was analyzed. Results The anti-Ⅹa level of the enoxaparin group reached the efficient level 3 h after administration; remained within the efficient range at 3 h time point 48 h after administration; and was significantly higher than that of the unfractionated heparin group (P<0.05). The vWF level of the enoxaparin group was significantly lower than that of the unfractionated heparin group (P<0.05). The ⊿vWF of patients with clinical events was significantly higher than that of patients without clinical events (P<0.01). The ⊿vWF was relevant to clinical events occurring within 30 d (OR=1.373, P<0.05). Conclusion Compared with unfractionated heparin, enoxaparin can block the extrinsic coagulation pathway and prevent the platelet adhesion and aggregation more efficiently. The increase of vWF in early stage may be used to predict clinical events occurring within 30 d for patients with unstable angina pectoris and non-ST-elevation acute myocardial infarction.

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    Application of low permeability GORE EXCLUDER aortic covered stent graft to endovascular treatment of complex abdominal aortic aneurysm
    DING Jin-hui, LIU Guang, LI Wei-min, et al
    2015, 35 (4):  563. 
    doi: 11.3969/j.issn.1674-8115.2015.04.019

    Abstract ( 684 )   PDF (367KB) ( 948 )  

    Objective To evaluate the safety and effectiveness of the low permeability GORE EXCLUDER aortic covered stent graft for endovascular treatment of complex abdominal aortic aneurysm (AAA). Methods The data of 21 cases of complicated AAA that underwent the endovascular treatment with low permeability GORE EXCLUDER aortic covered stent graft from April, 2011 to April, 2014 were selected and retrospectively analyzed. Results Among 21 patients, 19 of them were males and 2 of them were females. Their ages were between 55 and 87 and the median age was 72.34. Complex AAA included one or more of the following circumstances: combined iliac artery aneurysm (10 cases), giant aneurysm (4 cases), short neck (3 cases), neck severe twisted (3 cases), approach seriously distorted (4 cases), femoral artery slim (1 case), and mural thrombus and severe calcification (6 cases). Operations of all cases were successful without laparotomy and intraoperative deaths and 2 cases died from complications during postoperative hospital stay. Operation time was (135.43±12.45) min and the intra-operative blood loss was (180.24±21.66) mL. No blood transfusion was conducted. There were 5 cases of intra-operative endoleak typeⅠ, 3 cases of endoleak type Ⅱ, and 2 cases of endoleak type Ⅲ. The intra-operative treatment of all cases was satisfactory. A total of 19 patients were followed up for 3-36 months and 18 of them survived and one patient died from the diabetic complication. All postoperatively followed up patients had undergone the computed tomography angiography (CTA) and no significant complications relevant to stents were found. Conclusion The low permeability GORE EXCLUDER aortic covered stent graft is suitable for the treatment of most patients with complex AAA and the safety and effectiveness are satisfactory due to low surgical risk and less intraoperative and postoperative complications.

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    Analysis of risk factors of postoperative early death for patients with total anomalous pulmonary venous connection
    CAO Rui-xue, GUO Ying, CHEN Sun, et al
    2015, 35 (4):  568. 
    doi: 11.3969/j.issn.1674-8115.2015.04.020

    Abstract ( 495 )   PDF (333KB) ( 906 )  

    Objective To analyze the risk factors of postoperative early death for patients with total anomalous pulmonary venous connection (TAPVC). Methods The clinical data of 52 TAPVC patients without other complex anomalies such as heterotaxy syndrome or single ventricle were collected. The risk factors of postoperative early deaths (patients died within 30 days after surgery) were analyzed. Results Five patients died within 30 d after surgery (9.62%). Among them, 4 patients were less than 4 kg and 1 patient was 4 kg. Their ages were all less than 3 months and 2 were newborns. Two patients were superacardiac type; 1 was cardiac type; and 2 were infracardiac type. Results of T-test and Chi-squared test showed that differences of body weight (P=0.005), body length (P=0.021), anatomical classification (P=0.007), and LA diameter (P=0.016) of the survival group and the death group were statistically significant. The result of binary logistic regression analysis showed that the variable of underweight (≤4 kg) was included in the regression equation (OR=22.857, P=0.009). Conclusion Underweight (≤4 kg) is an independent risk factor of postoperative early death of patients with TAPVC.

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    Original article (Public health)
    Estimation of potential waste of resources caused by unnecessary hospitalization
    TAO Jing-jing, LUO Cheng-zu, MA Jin
    2015, 35 (4):  573. 
    doi: 11.3969/j.issn.1674-8115.2015.04.021

    Abstract ( 570 )   PDF (335KB) ( 906 )  

    Objective To evaluate the waste of resources caused by unnecessary hospitalization from the perspectives of direct economic burdens and bed utilization efficiency according to the data of Department of Gynecology of a tertiary grade A hospital in Shanghai. Methods A total of 500 patients admitted in the first half year of 2012 were randomly selected from inpatients of Department of Gynecology of a tertiary grade A hospital in Shanghai. The retrospective review was adopted and the appropriateness of admissions and hospitalization of selected patients was evaluated by a clinical nurse according to the appropriate evaluation protocol (AEP). The direct economic burden caused by the unnecessary hospitalization was calculated according to the total cost and average daily cost paid by patients. The improvement of bed utilization efficiency after eliminating the unnecessary hospitalization was reflected by the average hospitalization days and bed turnovers. Results The rate of unnecessary admission was 12.40% and the rate of unnecessary hospitalization was 22.93%. After the unnecessary admission and unnecessary hospitalization were eliminated, the direct economic burden could be saved by 18%. Average hospitalization days decreased from 6.04 to 4.81, and bed turnovers decreased from 8.06 to 7.06. Conclusion The elimination of unnecessary admission and unnecessary hospitalization by scientific and appropriate measures during the course of providing the hospitalization service can relieve the direct economic burden of patients and efficiently decrease average hospitalization days without affecting the quality of medical services.

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    New grey relational analysis of hospitalization expense of patients with 5 major diseases in a city of Jiangsu Province
    LI Xiao-xiao, ZHANG Xiao, LIU Rong, et al
    2015, 35 (4):  577. 
    doi: 11.3969/j.issn.1674-8115.2015.04.022

    Abstract ( 539 )   PDF (255KB) ( 937 )  

    Objective To analyze the influencing factors and structure of hospitalization expense of patients with 5 major diseases and explore feasible measures of controlling the hospitalization expense. Methods The new grey relational analysis was adopted and 5 components of hospitalization expense of 2 184 patients with 5 major diseases in 2013 were quantitatively analyzed by SPSS 19.0 and Excel 2010. The relationship of each factor and hospitalization expense was calculated and the major influencing factor of the expense was identified. Results The results of relationship calculation of new grey relational analysis showed that the drug cost was the most important influencing factor of hospitalization expense of patients with 5 major diseases and the treatment cost was the second important influencing factor. The influence of other costs such as examination costs and costs for traditional Chinese medicine was relatively less. Conclusion The results of new grey relational analysis is close to the reality and the calculation is simple. It is suitable for analyzing the influencing factors of hospitalization expense of patients with major diseases.

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    Analysis of nursing service needs of old people in Shanghai nursing institutions for the aged and policy recommendations
    SHEN Wan-wan, BAO Yong
    2015, 35 (4):  581. 
    doi: 11.3969/j.issn.1674-8115.2015.04.023

    Abstract ( 628 )   PDF (248KB) ( 1010 )  

    Objective To understand the needs of nursing service for the elderly in Shanghai nursing institutions and propose corresponding policy recommendations. Methods A total of 331 old people in 19 nursing institutions were investigated by the letter survey and visits. Results Among them, 298 old people suffered from chronic diseases and 206 old people said that medical treatment was inconvenient. For life care, the improvement of diet and nutrition and assistance of taking bath were urgent demands of old people. For medical care, being accompanied to undergo medical treatments was the most urgent demand. The family health service and periodic health examination conducted by the medical staff of designated medical institutions was the second most urgent demand. For psychological care, being accompanied to read, walk, and chat and psychological consultation were urgent demands. Conclusion Different levels of needs for life care, medical care, and psychological care of old people in nursing institutions should be satisfied according to the special psychology, physiological characteristics, and common diseases, so as to provide financial support, medical care, and recreation for old people.

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    Review
    Advances of carboxyl ester lipase, diabetes, and pancreatic exocrine diseases
    ZHANG Rong, LIU Li-mei
    2015, 35 (4):  585. 
    doi: 11.3969/j.issn.1674-8115.2015.04.024

    Abstract ( 596 )   PDF (312KB) ( 1083 )  

    The protein encoded by carboxyl ester lipase (CEL) gene is a kind of cholesterol ester hydrolase secreted by pancreatic acinar cells and is the only protein that is not synthesized and secreted by islet beta cells in 7 molecules relevant to the maturity-onset diabetes of the young (MODY). Mutations of the variable-number tandem repeat (VNTR) of CEL can cause the syndrome of MODY and pancreatic exocrine dysfunction, insulin-dependent diabetes mellitus (type 1 diabetes) or noninsulin-dependent diabetes mellitus (type 2 diabetes), and pancreatic exocrine diseases such as alcoholic pancreatitis. This paper reviews latest research progresses of gene mutations of CEL, diabetes, and pancreatic exocrine diseases.

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    Effects and mechanisms of sclerostin in bone metabolism
    ZHANG Shuang, GAO Yan-hong
    2015, 35 (4):  589. 
    doi: 11.3969/j.issn.1674-8115.2015.04.025

    Abstract ( 737 )   PDF (359KB) ( 1117 )  

    Sclerostin is a glycoprotein encoding by SOST gene and can bind to Lrp4/5/6 receptor to block the Wnt signaling pathway, so as to regulate the bone metabolism. Mutations of the SOST gene are relevant to osterporosis and autosomal dominant diseases such as sclerosteosis, Van Buchem disease, and craniodiaphyseal dysplasia. Recent studies have confirmed that sclerostin can not only block the differentiation of osteoblast to inhibit bone formation by various ways, but also have a catabolic action through promotion of osteoclast formation and activation of osteocytes in a RANKL-dependent manner. The sclerostin monoclonal antibody may bring a new way for the treatment of osteoporosis. Currently, the clinical test is underway. The safety and validity of sclerostin monoclonal antibody need to be further researched.

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    Roles of Sirtuins in occurrence and development of chronic kidney disease
    ZHANG Lin, HE Ming
    2015, 35 (4):  594. 
    doi: 11.3969/j.issn.1674-8115.2015.04.026

    Abstract ( 569 )   PDF (535KB) ( 1117 )  

    The incidence of chronic kidney disease has been increasing worldwide over recent years. Aging is a risk factor of the occurrence and development of chronic kidney disease. Sirtuin (silent mating type information regulation 2 homolog) is a conserved family of proteins with NAD+-dependent deacetylase. Sirtuins play vital roles in caloric restriction, longevity, and various metabolic diseases. The activation of nuclear SIRT1 and SIRT6 may induce gene silencing through deacetylation, then lead to reduction of apoptosis, inhibition of inflammation and fibrosis induced by chronic kidney disease. Meanwhile, SIRT1 may regulate stress responses, glucose and lipid metabolism, induction of autophagy, blood pressure, and sodium handling. SIRT3 locates in the mitochondria and regulates the activity of mitochondrial enzymes to involve in the pathogenesis of chronic kidney disease. This paper reviews the latest research progresses of the roles of Sirtuins in the occurrence and development of chronic kidney disease.

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    Domestic and overseas research developments of obesity in children and adolescents
    ZOU Zhen, ZHANG Jing, ZHENG Zhi-jie
    2015, 35 (4):  601. 
    doi: 11.3969/j.issn.1674-8115.2015.04.027

    Abstract ( 990 )   PDF (275KB) ( 1515 )  
    In recent years, the prevalence of obesity in children and adolescents is rising all over the world. Obesity in children and adolescents has become a worldwide public health problem which needs to be resolved immediately. This paper reviews the current situation and research developments of obesity in children and adolescents; reveals current research problems in China; and recommends conducting evidence-based health management researches based on community practices and multidisciplinary participation.
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    Application of image processing and analysis techniques in molecular imaging
    CHEN Ying, XU Li-jun, GONG Zhu-lin, et al
    2015, 35 (4):  605. 
    doi: 11.3969/j.issn.1674-8115.2015.04.028

    Abstract ( 799 )   PDF (425KB) ( 962 )  
    Molecular imaging is a new interdisciplinary technology, which characterizes and measures biological processes of live animals, animal model systems, and human bodies at cell and molecule levels by external imaging detection devices. Image processing and analysis technique is a general term for image processing and analysis algorithm techniques, which adopts methods of pattern recognition, artificial intelligence, and computer graphics field to extract features of digital medical images, quantitatively describe image features and molecular imaging, describe digital features of molecular imaging by mathematical models, reveal the processes and rules of life phenomena, and predict trends of development. This paper reviews 2 602 papers published between 2010 and 2013 by major journals and academic institutions of the molecular imaging field and summarizes the development and application of image processing and analysis techniques in the study of molecular imaging.
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    Brief original article
    Effects of ultrasound irradiation on prostaglandins E2 in inflammatory tissue of rabbit paw
    REN Li-li, QIAO Hai, SHE Chao-kun, et al
    2015, 35 (4):  611. 
    doi: 11.3969/j.issn.1674-8115.2015.04.029

    Abstract ( 583 )   PDF (214KB) ( 990 )  
    Objective To investigate the effects of low-intensity ultrasound irradiation on prostaglandins E2 in inflammatory tissues. Methods Twenty-four New Zealand rabbits were randomly divided into the ultrasound irradiation paw group, ultrasound irradiation biceps femoris group, pseudo irradiation group, and normal control group. Except the normal control group, paws of rabbits of other groups were injected with carrageenan solution to establish the inflammatory pain model. Paws of rabbits of the ultrasound irradiation paw group and ipsilateral biceps femoris of rabbits of the ultrasound irradiation biceps femoris group were irradiated with 0.2 MHz ultrasound for 20 min. Rabbits of the pseudo irradiation group were ultrasound were irradiated without power for 20 min. The blood samples were collected from ear artery immediately and 1 h after irradiation. The level of β-endorphin was detected by the ELISA. After the second blood sampling, 10 mg of paw tissue of both hind legs were collected and the level of prostaglandin E2 was detected by the ELISA. Results The level of prostaglandin E2 of the ultrasound irradiation paw group was significantly higher than those of the ultrasound irradiation biceps femoris group, pseudo irradiation group, and the normal control group. The differences of serum levels of β-endorphin of the ultrasound irradiation paw group and ultrasound irradiation biceps femoris group at two time points were not statistically
    significant. Conclusion Low-intensity ultrasound irradiation of biceps femoris can improve the serum level of β-endorphin and will not promote the release of prostaglandin E2 in inflammation tissues. It is an ideal method for relieving the inflammatory pain by ultrasound irradiation.
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    Effects of chronic sleep deprivation on expression of adipocytokine of young rats
    CHEN Zhe, YANG Qian, CHEN Ting, et al
    2015, 35 (4):  614. 
    doi: 11.3969/j.issn.1674-8115.2015.04.030

    Abstract ( 593 )   PDF (254KB) ( 1018 )  
    Objective To investigate the effects of chronic sleep deprivation on the expression of circulating adipocytokine of young rats. Methods A total of 27 three-week-old Sprague-Dawley (SD) rats were randomly divided into the sleep deprivation group, recovery group, and control group. A motor-driven walking wheel method was adopted to establish the sleep deprivation model. The expressions of serum cytokines, including leptin, adiponectin, RBP-4, and Vaspin, were detected by the ELISA. The LEE's index was used to evaluate the adiposity status of rats. Results The LEE's index of the sleep deprivation group was significantly higher than that of the control group (P<0.05). Compared with the control group, RBP-4 levels of the sleep deprivation group and recovery group significantly decreased (P<0.1). Expressions of leptin, adiponectin, and Vaspin of 3 groups were not significantly different. Conclusion Chronic sleep deprivation results in the increase of adiposity status and decrease of RBP-4 expression in serum, which do not improve significantly with the recovery of sleep.
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    Neonatal screening for glucose-6-phosphate dehydrogenase deficiency in Shanghai and determination of cut off value
    GUO Jing, XU Hong-ping, YAO Jing, et al
    2015, 35 (4):  618. 
    doi: 11.3969/j.issn.1674-8115.2015.04.031

    Abstract ( 882 )   PDF (433KB) ( 914 )  
    Objective To screen the newborns with glucose-6-phosphate dehydrogenase (G6PD) deficiency in Shanghai, determine the cut off value for the screening laboratory, reduce the false positive rate, and improve the quality of population. Methods G6PD levels of filter paper blood samples were detected by the quantitative fluorometric method. Definite diagnoses were made for suspected cases by the G6PD/6PGD quantitative ratio method. Results A total of 217 447 newborns (116
    549 boys and 100 898 girls) were screened and 270 of them were definitely diagnosed with G6PD deficiency (250 boys and 20 girls). The incidences of G6PD deficiency of all newborns, boys, and girls were 0.18%, 0.31%, and 0.03%, respectively. The cut off values of G6PD of all newborns, boys, and girls were 2.165 U/g, 1.97 U/g, and 2.165 U/g, respectively. Conclusion Early diagnosis and prevention of G6PD deficiency can be achieved by the neonatal screening, which should be popularized in Shanghai. Screening laboratories should determine the cut off values for newborns, boys, and girls that can reduce the false positive rate for screening G6PD deficiency and improve the screening efficiency.
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    Case report
    Diagnosis of geminated maxillary second premolar by CBCT: a case report
    DONG Jian-hui, ZHU Ya-qin
    2015, 35 (4):  622. 
    doi: 11.3969/j.issn.1674-8115.2015.04.032

    Abstract ( 656 )   PDF (357KB) ( 922 )  
    Objective To investigate the application value of cone beam computed tomography (CBCT) for the diagnosis of twin teeth. Methods CBCT was adopted as an auxiliary method for diagnosing 1 rare case of twin maxillary second premolar. Data of the clinical examination, X-ray, and CBCT examination were retrospectively analyzed and discussed according to literature reviews. Results Clinical examination revealed that the patient had a complete dentition and the right maxillary second premolar was two completely separated crowns sharing one fused root. X-ray findings showed that right maxillary second premolar was incompletely split and no periapical lesion was found. The exact anatomic structure of the tooth was not shown clearly. CBCT images showed that two crowns joined to form 1 single root at the enamel cementum junction of the teeth and 2 completely separated dental pulp chambers fused to form 1 root at the enamel cementum junction. Conclusion Germination is a rare developmental dental anomaly. It is difficult to diagnose and treat due to complicated structures. The high-end diagnostic imaging modalities of CBCT can assist clinicians to make the correct diagnosis and determine the treatment plan, so as to prevent or reduce potential complications.
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