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    Original article (Basic research)
    Isotope labeling experiment of fatty acid oxidation in gastrocnemius of rats with nonalcoholic fatty liver
    CANG Zhen, ZHU Chao-xia, Jiazireya·Zaiyinati, et al
    2015, 35 (6):  789. 
    doi: 11.3969/j.issn.1674-8115.2015.06.001

    Abstract ( 489 )   PDF (335KB) ( 912 )  

    Objective To investigate the changes of fatty acid oxidation in gastrocnemius of rats with nonalcoholic fatty liver disease (NAFLD) by the isotope labeling. Methods A total of 18 male SD rats were randomly divided into the normal group (n=6) and high-fat feed group (n=12). The NAFLD model was successfully established by feeding rats of the high-fat feed group with lipid rich food (the ratio of fat energies is 42%) for 12 weeks. Then the high-fat feed group was randomly divided into the NAFLD group (n=6) and berberine intervention group (n=6, intragastric administration of berberine hydrochloride for 16 weeks). The changes of body weight and blood lipid level of each group were observed. After 16 weeks of intervention, rat gastrocnemius tissues were collected and cultured in 1 μCi 9,10-3H-palmitic acid solution. The oxidation rate of fatty acid was calculated according to the specific activity of 3H2O detected by liquid scintillation counter. Results After 16 weeks of intervention, body weights and blood lipid levels of the NAFLD group were significantly higher than those of the normal group and berberine intervention group (P<0.05). The oxidation rates of fatty acid of the normal group, NAFLD group, and berberine intervention group were (3.96±1.16)%, (2.13±1.00)%, and (3.20±1.47)%, respectively. Results of statistical analysis revealed that compared with the normal group, the oxidation rate of fatty acid of gastrocnemius of the NAFLD group decreased significantly (P<0.05). The oxidation rate of fatty acid of gastrocnemius of the berberine intervention group was higher than that of the NAFLD group and lower than that of the normal group, but the differences were not statistically significant (P>0.05). Conclusion The decrease of oxidation and usage of fatty acid in muscle tissues such as gastrocnemius is an important cause of lipid metabolism disorder of rats with nonalcoholic fatty liver disease. It is a target for the treatment of nonalcoholic fatty liver disease.

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    Preliminary study on transfection of human periodontal ligament cells and human bone marrow mesenchymal cells by human β-defensin 3
    ZHU Jian-hua, MIAO Bo, LIU Na, et al
    2015, 35 (6):  794. 
    doi: 11.3969/j.issn.1674-8115.2015.06.002

    Abstract ( 431 )   PDF (722KB) ( 936 )  

    Objective To investigate the transfection efficiency and bone formation of human periodontal ligament cells (hPDLCs) and human bone marrow mesenchymal cells (hBMCs) after being transfected by the lentivirus containing the gene of human β-defensin 3 (hBD3). Methods The lentivirus containing target gene and green fluorescent protein (GFP) gene was transfected to hPDLCs and hBMCs by the transfection agent polybrene. The expression of hBD3 was detected by the RT-PCR and Western blotting. The green fluorescence microscope was adopted to count cells and the transfection efficiency was calculated. The potential of bone formation was detected by the alkaline phosphatase staining and alizarin red staining. Results The transfection efficiencies of lentivirus containing hBD3 and GFP genes towards hBMCs and hPDLCs were 44.44% and 28.98%, respectively. The transfection efficiencies of lentivirus containing only GFP gene towards hBMCs and hPDLCs were 79.94% and 31.71%. Conclusion The transfection efficiencies of hPDLCs and hBMCs towards hBD3 gene are similar. And hPDLCs and hBMCs are ideal candidates for promoting the regeneration of periodontal tissue and transfected cells are still capable of forming bone.

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    Expression level of BAX gene of patients with acute promyelocytic leukemia and its significance
    LUO Lan, CHEN Yan-juan, WAN Yuan-fang
    2015, 35 (6):  799. 
    doi: 11.3969/j.issn.1674-8115.2015.06.003

    Abstract ( 583 )   PDF (634KB) ( 939 )  

    Objective To investigate the expression level of BAX gene of acute promyelocytic leukemia (APL) and its regulation mechanism. Methods The expression level of BAX gene of patients with APL was detected by the real-time PCR. The enrichment of PML/RARα fusion protein at the promoter region of BAX gene was detected by the chromatin immunoprecipitation (ChIP). The expression level of BAX gene and protein after the drug induced degradation of PML/RARα was detected by the real-time PCR and Western blotting. Results The expression level of BAX gene in APL samples was significantly low. PML/RARα fusion protein directly bound the promoter region of BAX gene. The expression level of BAX gene significantly increased after PML/RARα was induced to degrade. Conclusion PML/RARα inhibits the expression of BAX gene in APL by directly binding to the promoter region of BAX gene and inhibiting the activity of promoter.

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    Changes of activity of PI3K/Akt/mTOR signaling pathway in early stage of spinal cord injury of rats and its relationship with recovery of motor function of posterior limbs
    LIU Yang, MIAO Yu-chuan
    2015, 35 (6):  804. 
    doi: 11.3969/j.issn.1674-8115.2015.06.004

    Abstract ( 604 )   PDF (557KB) ( 967 )  

    Objective To explore changes of the activity of PI3K/Akt/mTOR signaling pathway in early stage of spinal cord injury (SCI) of rats and the effects on the recovery of motor function of posterior limbs. Methods SD rats were randomly divided into the normal group, control group, and 4 experiment groups (1 d, 3 d, 5 d and 7 d after SCI groups). The Allen’s WD-SCI model was established for rats of the control group and experiment groups. Then 20 μL LY294002 (inhibitor of PI3K/Akt/mTOR signaling pathway) and 20 μL sterile purified water were intrathecally injected into the rats of control group and other groups. The combine behavioral score (CBS) method was adopted to evaluate the motor function of posterior limbs. The changes of the activity of PI3K/Akt/mTOR signaling pathway of spinal cord tissue of injured segments were detected by the RT-PCR and immunohistochemistry assay. Results For experiment groups, the motor function of both posterior limbs improved and the CBS scores declined with time after SCI. The relative mRNA expressions of PI3K, Akt, and mTOR in spinal cord tissue of injured segments upregulated and the number of cells with positive expression of PI3K, Akt, and mTOR proteins increased. Compared with rats of the 7 d after SCI group, the recovery of muscle strength and motor function of both posterior limbs of the control group were poor, and the relative mRNA expressions of PI3K, Akt, and mTOR and the number of cells with positive expression of PI3K, Akt, and mTOR proteins in spinal cord tissue of injured segments decreased. Conclusion PI3K/Akt/mTOR signaling-pathway is relevant to the reconstruction of nerve function in early-phase of SCI and can be used as a target of clinical treatment.

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    Effects of P2Y12 receptor antagonist on growth of transplanted tumor of nude mice
    SHI Yi-cheng, SONG Xiao-wei, ZHAO Xian-xian, et al
    2015, 35 (6):  809. 
    doi: 11.3969/j.issn.1674-8115.2015.06.005

    Abstract ( 577 )   PDF (403KB) ( 1026 )  

    Objective To investigate the effects of P2Y12 receptor antagonist on the growth of tumor. Methods Two kinds of nude mice transplanted tumor models HT29 and MDA231 were established. Mice were randomly divided into the control group, clopidogrel group, and ticagrelor group. For HT29 transplanted tumor model, the numbers of nude mice of control group, clopidogrel group, and ticagrelor group were 20, 20, and 19, respectively. For MDA231 transplanted tumor model, the numbers of nude mice of control group, clopidogrel group, and ticagrelor group were all 4. Mice of three groups were intragastric administration with phosphate buffer solution, clopidogrel suspension, and ticagrelor suspension, respectively and sacrificed after 10 d. The weight and body surface area of tumors were measured and the effects of P2Y12 receptor antagonist on the growth of tumor were observed. Results For HT29 transplanted tumor model, the weight and body surface area of tumors of the control group, clopidogrel group, and ticagrelor group were (1.20±0.12) g and (233.60±20.77)mm2, (0.99±0.08) g and (192.30±13.28)mm2, and (1.04±0.11) g and (211.10±19.21) mm2, respectively. The differences of the weight and body surface area of tumors of three groups were not statistically significant (P>0.05). For MDA231 transplanted tumor model, the weight and body surface area of tumors of the control group, clopidogrel group, and ticagrelor group were (0.65±0.17) g and (149.80±27.08) mm2, (1.04±0.24) g and (183.80±30.18) mm2, and (1.08±0.35) g and (201.30±45.62) mm2, respectively. The differences of the weight and body surface area of tumors of three groups were not statistically significant (P>0.05). Conclusion P2Y12 receptor antagonist has no remarkable effect on the growth of transplanted tumor of nude mice.

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    Effects of angiotensin Ⅱ on necroptosis of rat renal tubular epithelial cells
    WANG Yu-xuan, GAN Hua
    2015, 35 (6):  813. 
    doi: 11.3969/j.issn.1674-8115.2015.06.006

    Abstract ( 475 )   PDF (549KB) ( 1016 )  

    Objective To explore the effects of angiotension Ⅱ (Ang Ⅱ) on the necroptosis of rat renal tubular epithelial cells (NRK-52E). Methods The small interfering RNA (siRNA) targeted at the RIP3 mRNA was synthesized in vitro and was transfected by the transfection reagent siRNA-mate to NRK-52E. The protein expression of RIP3 was detected by the Western blotting. The cell viability was evaluated by the MTT assay. The cell apoptosis rate was determined by the flow cytometer. The intracellular reactive oxygen species (ROS) level was detected by the fluorescent microplate reader. The mRNA and protein expressions of RIP1 and RIP3 were detected by the qPCR and Western blotting. Results Compared with the control group, the protein expression of RIP3 significantly decreased after RIP3 siRNA was transfected by NRK-52E (P<0.01). Compared with the control group, the cell viability of the AngⅡ group decreased, while the apoptotic rate, ROS level, and expressions of RIP1 and RIP3 significantly increased (P<0.01). Compared with the AngⅡ group, Z-VAD increased the cell viability, decreased the apoptotic rate and ROS level (P<0.01), and up-regulated the expressions of RIP1 and RIP3 (P<0.01). Nec-1 and RIP3 siRNA decreased the necrosis rate (P<0.01), had no significant effect on the apoptotic rate (P>0.05), and decreased the ROS level and expressions of expressions of RIP1 and RIP3 (P<0.01). Conclusion AngⅡ can induce the necroptosis of rat renal tubular epithelial cells, which is relevant to the generation of RIP1, RIP3 and ROS.

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    Establishment of model of adaboost classifier and evaluation of harmful mutations in non-coding regions of liver cancer cells
    XU Li-ping, LI Jia, FANG Lin
    2015, 35 (6):  819. 
    doi: 11.3969/j.issn.1674-8115.2015.06.007

    Abstract ( 533 )   PDF (533KB) ( 970 )  

    Objective To establish a model of adaboost classifier, evaluate the possibility of disease related mutations in non-coding regions of liver cancer cells, and identify harmful mutations in non-coding regions. Methods A total of 13 108 disease related mutations in non-coding regions were selected from HGMD database and used as subjects and neutral SNPs were used as controls. Combined with regulatory factors of non-coding regions, such as conserved regions, evolutionary RNA conservative structures, high-expressed genes, DNAseⅠ hypersensitive sites, transcription factor binding sites, histone modification, and early replicated genes, the model of adaboost classifier was established. The value of these factors for predicting harmful mutations in non-coding regions was analyzed. The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUCROC) was calculated. The genome-wide association study (GWAS) and ClinVar disease-associated variants database were used to verify the model. Results Factors sorted by the importance for identifying disease related mutations were conserved regions, early replicated genes, untranslated Regions (UTR), promoters, high-expressed regions, H3K36me3, and conserved TFBSs. The ROC curve was established by using the prediction probability of adaboost classifier and the AUCROC was 0.90. The average scores of GWAS and ClinVar diseaseassociated variants were significantly higher than that of neutral SNPs (P<0.05). Conclusion The adaboost classifier is helpful for evaluating the possibility of harmful mutations in non-coding regions of liver cancer cells and is an accurate prediction tool.

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    Original article (Clinical research)
    Effect of circulating miR-192 on early diagnosis of acute kidney injury after cardiac surgery
    XU Yuan, ZHANG Lu-lu, YAN Yu-cheng, et al
    2015, 35 (6):  824. 
    doi: 11.3969/j.issn.1674-8115.2015.06.008

    Abstract ( 576 )   PDF (340KB) ( 1067 )  

    Objective To investigate the value of circulating miR-192 in early diagnosis of acute kidney injury (AKI)  after cardiac surgery. Methods Blood samples were prospectively collected at different time points before and after cardiac surgery. After cardiac surgery, serum creatinine (Scr) and miR-192 levels of 35 patients with AKI and 35 patients without AKI whose clinical data were similar to patients with AKI were detected. Dynamic changes of miR-192 and Scr levels of two groups during the perioperative period were observed.  Receiver operating characteristic (ROC) curves and areas under curves (AUC) were used to evaluate the precision of diagnosing AKI by miR-192. AKI was defined as the increase of Scr level was above 0.3mg/dL or 1.5 times of baseline value within 48 h after surgery. Results The  mean age of 70 patients was (64.31±8.17) and the baseline Scr level was (74.97±16.25) μmol/L. The median time of diagnosing AKI by Scr of the AKI group was 24 h after admission in ICU. There was no significant difference in the level of plasma miR-192 between two groups before surgery. Compared with levels of plasma miR-192 of two groups before surgery, levels of plasma miR-192 after surgery immediately increased [1.12 (0.47, 2.42) vs 1.93 (0.93, 3.24) and 0.79 (0.41,1.16) vs 1.65 (0.97, 2.36) for patients with AKI and without AKI, P<0.05]. Levels of plasma miR-192 of the AKI group were higher, but the difference of two groups was not statistically significant. The level of plasma miR-192 of the AKI group 2 h after surgery continuously increased, while that of the non-AKI group began to decrease. The difference of two groups was statistically significant [1.80 (0.94, 5.10) vs 1.21 (0.88, 1.77), P<0.05]. AUC for diagnosing AKI by plasma miR-192 was 0.67 (95%CI 0.54-0.81, P=0.01). Conclusion The level of plasma miR-192 of patients with AKI significantly increases at early stage after cardiac surgery and the level of circulating miR-192 2 h after surgery can be used as a biomarker for early diagnosis of AKI after cardiac surgery.

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    Analyses of KRAS and BRAF gene mutations in distal colorectal adenoma and adenocarcinoma
    ZHENG Qing-qing, JIA Wei-ping, ZHANG Rong, et al
    2015, 35 (6):  829. 
    doi: 11.3969/j.issn.1674-8115.2015.06.009

    Abstract ( 471 )   PDF (498KB) ( 946 )  

    Objective To investigate the relationship between mutations of KRAS and BRAF genes and distal colorectal adenoma and adenocarcinoma. Methods Lesion tissues of patients with distal colorectal adenoma (n=32, adenoma group) and adenocarcinoma (n=20, adenocarcinoma group) were obtained by endoscopic biopsy forceps. The genomic DNAs of lesion tissues were extracted and sequences of KRAS and BRAF genes were detected. Results Among 32 patients with adenoma, 7 of them were detected with KRAS mutations and the mutation rate was 21.9%. Among 20 patients with adenocarcinoma, 7 of them were detected with KRAS mutations and the mutation rate was 35.0%. Mutation types of codons 12 and 13 of KRAS gene of two groups were mainly G12D and G13D mutations. The difference of positive mutation rates of KRAS gene between two groups was not statistically significant (P>0.05). BRAF V600E mutation was not found in two groups. Conclusion Among Chinese patients with distal colorectal adenoma and adenocarcinoma, the mutation rate of BRAF V600E is low and that of KRAS gene is high. The difference of mutation rate of KRAS gene between distal colorectal adenoma and adenocarcinoma is not remarkable.

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    Case analysis of applying Omaha system to community rehabilitation nursing for stroke patients
    GAO Qing-qing, HUANG Jin-yue, ZHU Jin-ping, et al
    2015, 35 (6):  834. 
    doi: 11.3969/j.issn.1674-8115.2015.06.010

    Abstract ( 761 )   PDF (376KB) ( 1108 )  

    Objective To introduce the effect and methods of community rehabilitation nursing for one stroke patient by community rehabilitation nursing according to the Omaha system. Methods Community rehabilitation nurses provided community rehabilitation nursing for a stroke patient and performed the nursing evaluation according to the Omaha system. Relevant nursing intervention included health education, guidance and consultation, treatment and procedure, and case management and monitoring. The effect of nursing was continuously evaluated. Results The patient could use a walker to walk and go up and down the stairs and had the basic self-care ability of daily life. The score of Activity of Daily Living (ADL) increased from 35 to 90. Conclusion The Omaha system can comprehensively evaluate the health status of patients, guide community rehabilitation nurses to perform relevant nursing intervention, and correctly evaluate the effect of nursing intervention.

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    Effects of community mental health services on depression, anxiety, and happiness of the elderly
    ZHAN Gui-lai, LI Chen-hu, ZHAO Li-yu, et al
    2015, 35 (6):  839. 
    doi: 11.3969/j.issn.1674-8115.2015.06.011

    Abstract ( 664 )   PDF (283KB) ( 1128 )  

    Objective To explore the effects of community mental health services on the mental health of the elderly. Methods Four resident committees of Longhua Street community of Xuhui District in Shanghai were randomly selected and a total of 1 431 subjects were enrolled and finished the study according to the principle of voluntary and informed consent. Subjects were randomly divided into the observation group (n=692) and control group (n=739). The observation group received a series of community mental health services. Subjects were evaluated by the patient health questionnaire-9 (PHQ-9), generalized anxiety disorder screening scale-7 (GAD-7), and general well-being schedule (GWB) at baseline and by the end of 6 months and 12 months. Results ①Intra-group comparison of the GWB scores indicated that for the observation group, the differences of scores of worries about health, vigor, satisfaction of and interest in life, doldrums or pleasant mood, and relaxation and tension (anxiety) were statistically significant (P=0.00), except the control of the emotions and behavior (F=0.32, P=0.63). For the control group, the differences of scores of worries about health (F=4.33, P=0.02) and relaxation and tension (anxiety) (F=154.26, P=0.00) were statistically significant. ②Inter-group comparison of the GWB scores indicated that by the end of 6 months, scores of worries about health and doldrums or pleasant mood of the observation group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, scores of satisfaction of and interest in life, worries about health, doldrums or pleasant mood, and relaxation and tension (anxiety) of the observation group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③For the observation group, the total score of PHQ-9 (F=1 603.27) and total score of GAD-7 (F=653.68) at baseline and by the end of 6 and 12 months decreased, while the total score of GWB (F=2 158.86) increased. The differences before and after intervention were statistically significant (P<0.01). The differences of the control group were not statistically significant (F=0.42, P=0.57; F=1.29, P=0.28; F=3.69, P=0.06). ④The differences of scores of PHQ-9, GAD-7, and GWB at baseline between two groups were not statistically significant (P>0.05), while the differences of scores by the end of 6 and 12 months between two groups were statistically significant (P<0.01). Conclusion The implementation of community mental health services can improve the mental health status of the elderly and the effect of persistent implementation will be more remarkable.

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    Clinical analysis of ocular symptoms of patients with early and middle stage Parkinson's disease
    YING Li, WANG Wen-an, SHEN Sa
    2015, 35 (6):  843. 
    doi: 11.3969/j.issn.1674-8115.2015.06.012

    Abstract ( 589 )   PDF (277KB) ( 992 )  

    Objective To investigate the ocular symptoms of patients with early and middle stage Parkinson's disease (PD) and its clinical significance. Methods The videonystagmography (VNG) was used to perform ocular saccade function examination and observe eye blinks for 24 patients with idiopathic Parkinson's disease (PD group). The latency of saccades, accuracy of saccades, and blink rates before and after treatment were recorded. Another 24 healthy people with similar age and gender were selected as controls (control group). Results For the PD group and control group, the latency of saccades was (292.18±50.51) ms and (237.40±32.78) ms, the accuracy of saccades was 89.51±10.59 and 96.69±11.00, and the blink rates were 13.21±7.55 times and 20.04±6.56 times per minute. For patients of the PD group who underwent treatment (n=19), the accuracy of saccades was 90.36±11.09 and 92.98±10.18 and the blink rates were 12.58±7.91 times and 16.63±6.98 times per minute before and after taking medicines. Results of statistical analysis showed that compared with the control group, the latency of saccades of the PD group significantly prolonged (P<0.01) and the accuracy of saccades and blink rate significantly decreased (P<0.05, P<0.01). For the PD group, the accuracy of saccades and blink rate after taking medicines significantly improved (P<0.05, P<0.01) and compared with the control group, the differences were not statistically significant (P>0.05). Conclusion The ocular saccade and blink rate of patients with PD were markedly abnormal and can be used as reference indexes for the early diagnosis of PD. Anti-PD drug treatment can relieve ocular symptoms of patients with PD.

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    Effects of cycloplegia on children's ocular parameters measured by Lenstar LS900
    ZHANG Qiong, ZHANG Shi-sheng, WU Yan-lin, et al
    2015, 35 (6):  847. 
    doi: 11.3969/j.issn.1674-8115.2015.06.013

    Abstract ( 698 )   PDF (257KB) ( 922 )  

    Objective To evaluate the effects of cycloplegia on children’s biometric parameters measured by the optical biological measuring instrument Lenstar LS900. Methods A total of 30 children (58 eyes) were selected as subjects. Their age was between 5 and 13 and the mean age was 9.4. Sixteen of them were males (30 eyes) and 14 were females (28 eyes). The axial length (AL), central corneal depth (CCT), anterior chamber depth (ACD), corneal curvature (K1 and K2), white to white (WTW), lens thickness (LT), and pupil diameter (PD) before and after cycloplegia by compound tropicamide eye drops were measured by Lenstar LS900. Data were analyzed by t test and Pearson coefficient analysis. Results The AL, ACD, and CCT values before cycloplegia were (23.81±1.23) mm, (3.56±0.21) mm, and (539.62±24.88) μm and those after cycloplegia were (23.84±1.23) mm, (3.63±0.21) mm, and (550.55±24.77) μm. Results of statistical analysis showed that AL, ACD, CCT, and PD after cycloplegia were markedly larger than those before cycloplegia and differences were statistically significant (P<0.05). Changes of CCT before and after cycloplegia of males and females were (12.63±6.12) μm and (9.11±4.87) μm. Changes of CCT of males were markedly larger than those of females (t=2.42, P=0.02). Changes of K1, K2, LT, and WTW before and after cycloplegia were not significant. Conclusion Lenstar LS900 can be used to measure children's biometric parameters. Cycloplegia has certain effect on ACD, AL, and CCT. But more samples are needed for further evaluation.

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    Effects of preoperative skin traction on pain relief and fracture reduction of patients with hip fracture
    SHAO Li-fang, XIA Xiao-bin, BAO Rong-hua
    2015, 35 (6):  851. 
    doi: 11.3969/j.issn.1674-8115.2015.06.014

    Abstract ( 775 )   PDF (270KB) ( 1040 )  

    Objective To evaluate whether preoperative skin traction can reduce the pain of patients with hip fracture and promote fracture reduction. Methods Patients who underwent hip fracture operations in the Fuyang Orthopaedics Hospital of Traditional Chinese Medicine from June 2010 to June 2013 were selected and randomly divided into the skin traction group and non-skin traction group by the computer. The primary index was visual analogue scale (0-10) for evaluating the degree of pain. The secondary index was fracture reduction, which was evaluated according to the differences of femur length and neck shaft angle on X-rays (anteroposterior view) at the time of admission, 1 d before operation, and after operation. Results Data of 106 cases were finally analyzed and 56 of them were from the skin traction group and 50 of them were from the non-skin traction group. The differences of basic line indexes between two groups were not statistically significant (P>0.05). The mean pain scores of skin traction group at the time of admission and before and after operation were 4.4±0.8, 2.9±0.5, and 1.4±0.4, respectively, while those of the non-traction group were 4.5±0.7, 2.8±0.6, and 1.6±0.5, respectively (P>0.05). The differences between two groups were not statistically significant (P>0.05). The differences of the dose of painkillers and the fracture reduction of two groups were not statistically significant (P>0.05). The incidence of erythema or blisters, numbness, and deep vein thrombosis of the skin traction group was significantly higher than that of the non-skin traction group (P<0.05). Conclusion Preoperative skin traction has no significant effect on preoperative pain relief and postoperative fracture reduction. But some complications such as erythema or blisters, numbness, and deep vein thrombosis may occur.

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    Relationship between serum low-density lipoprotein cholesterol level and prognosis of patients undergoing percutaneous coronary intervention
    BI Chun-hui, WEI Meng, SHEN Hong, et al
    2015, 35 (6):  855. 
    doi: 11.3969/j.issn.1674-8115.2015.06.015

    Abstract ( 567 )   PDF (336KB) ( 1023 )  

    Objective To explore the relationship between serum low-density lipoprotein cholesterol (LDL-C) and prognosis of patients with coronary atherosclerotic heart disease (CHD) who undergo the percutaneous coronary intervention (PCI). Methods Clinical data and LDL-C levels of 492 patients with CHD 1 d and 1, 6, 12, and 24 months after PCI were collected. Patients were divided into groups according to LDL-C levels (<1.81, 1.81-2.58, 2.59-3.36, and ≥3.37mmol/L or <70, 70~99, 100~129, and ≥130 mg/dL) at each time point. The relationship between end-point events (include cardiac death, recurrence of myocardial infarction, revascularization of target blood vessel, recurrence of angina, recently developed heart failure or existing heart failure becoming severe, and stroke, etc) during follow-up period and LDL-C levels were analyzed. Results The mean levels of LDL-C of patients 1 d and 1, 6, 12, and 24 months after PCI were (3.07±1.05), (2.03±0.75), (2.06±0.71), (2.13±0.82), and (2.17±0.89)mmol/L, respectively. The differences of incidence of end-point events of patients with different LDL-C levels 12 and 24 months after PCI were statistically significant (P<0.01). Results of logistic regression analysis showed that age, diabetes, stroke, LDL-C levels 12 and 24 months after PCI were independent predicting factors of the incidence of end-point events. Compared with patients whose LDL-C levels were below 1.81 mmol/L, the risk of developing end-point events of patients whose LDL-C levels were between 2.59-3.36 and above 3.37 mmol/L 12 and 24 months after PCI was higher. Conclusion The risk of developing cardio-cerebrovascular events of old patients or patients with diabetes or stroke after PCI is high. Compared with patients whose LDL-C levels are below 1.81 mmol/L, the risk of developing cardio-cerebrovascular events of patients whose LDL-C levels are above 2.59 mmol/L 12 and 24 months after PCI is higher.

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    Evaluation of diagnostic performance of serum pepsinogen Ⅰ, pepsinogen Ⅱ, and their ratio
    ZHANG Jie, LIU Yi-jing, WANG Zhen-hua
    2015, 35 (6):  860. 
    doi: 11.3969/j.issn.1674-8115.2015.06.016

    Abstract ( 2385 )   PDF (499KB) ( 1203 )  

    Objective To evaluate the diagnostic performance of adopting serum pepsinogenⅠ(PGⅠ),pepsinogenⅡ (PG Ⅱ), and the ratio of PGⅠ and PGⅡ (PGR) as indexes for screening the chronic atrophic gastritis and precursor lesions of gastric cancer. Methods A total of 474 patients who were diagnosed with diseases other than gastric cancer by the gastroscope were selected and divided into the minor non-atrophic gastritis group (control group, n=164), chronic atrophic gastritis group (n=162), and chronic atrophic gastritis with intestinal metaplasia group (n=148). Serum PG Ⅰ and PG Ⅱ levels were quantitatively measured by the latexenhanced immunoturbidimetric method and the PGR was calculated. The diagnostic performance of PGⅠ, PGⅡ, and PGR was evaluated by the receiver operator characteristic (ROC) curve. Results Compared with the control group, PGⅠ level, PGⅡ level, and PGR of the chronic atrophic gastritis group and chronic atrophic gastritis with intestinal metaplasia group decreased significantly (P<0.01). Values of the area under the ROC (AUCROC) of PGⅠ, PG Ⅱ, and PGR for diagnose of chronic atrophic gastritis were 0.679, 0.593, and 0.622; the best cutoff values were 71.8, 9.1, and 8.12; the values of sensitivity were 66.1%, 54.3%, and 77.2%; and the values of specificity were 61.0%, 61.6% and, 43.9%. Values of AUCROC of PGⅠ, PGⅡ, and PGR for diagnosis of atrophic gastritis with intestinal metaplasia were 0.787, 0.583, and 0.836; the best cut-off values were 59.4, 9.8, and 6.76; the values of sensitivity were 64.9%, 58.8%, and 81.8%; and the values of specificity were 78.1%, 55.5% and 77.4%. The values of parallel combined sensitivity and specificity of PGⅠ and PGR were 93.6% and 60.4%, while the values of series combined sensitivity and specificity of PGⅠ and PGR were 53% and 95%. Conclusion Combined use of PGⅠ level and PGR as indexes for monitoring the status of gastric mucosa can improve the diagnostic performance. It is an indication of atrophic gastritis with intestinal metaplasia if PGⅠ level and PGR are both smaller than the best cut-off values.

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    Application value of virtual touch tissue imaging for differential diagnosis of thyroid solid nodules
    HAN Rui-jun, LI Feng-hua, WANG Yan, et al
    2015, 35 (6):  864. 
    doi: 11.3969/j.issn.1674-8115.2015.06.017

    Abstract ( 480 )   PDF (778KB) ( 985 )  

    Objective To explore the value of elastogram grading and area ratio of virtual touch tissue imaging (VTI) of acoustic radiation force impulse imaging for the differential diagnose of benign and malignant thyroid solid nodules. Methods A total of 194 thyroid solid nodules of 152 patients were underwent conventional ultrasound, ultrasound elasticity imaging (EI), and VTI examinations. Receiver-operating characteristic (ROC) curves were plotted. The value and diagnostic performance of VTI elastogram grading, area ratio, and ultrasound EI elastogram scoring for the differential diagnosis of benign and malignant nodules were studied. Results The VTI elastogram grades of malignant thyroid nodules (thyroid carcinoma) were significantly higher than those of benign nodules (P<0.001) and VTI area ratios of malignant nodules were significantly bigger than those of benign nodules (P<0.001). Results of ROC curve analysis showed that the optimal threshold value of VTI elastogram grading was grade IV and the optimal threshold value of area ratio was 1.05. The area under ROC curve of VTI elastogram grading was significantly larger than those of EI elastogram scoring and VTI area ratio (P<0.05). Conclusion VTI elastogram grading and area ratio can provide useful information for the differential diagnosis of malignant and benign thyroid solid nodules. The diagnostic performance of VTI elastogram grading is better than that of EI elastogram scoring and VTI area ratio.

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    Correlation between smoking and incidence of Alzheimer's disease ——a systematic analysis of case-control studies and prevalence studies
    HUANG Xia, SONG Yan-yan
    2015, 35 (6):  870. 
    doi: 11.3969/j.issn.1674-8115.2015.06.018

    Abstract ( 767 )   PDF (620KB) ( 986 )  

    Objective To systematically analyze the correlation between smoking and Alzheimer's disease (AD) based on different study designs of case-control study and prevalence study and evaluate the design methods. Methods English literature was retrieved from Cochrane Library and Medline and Chinese literature was retrieved from CBMDISC. Cases that met the NINCDS-ADRDA diagnose criteria were collected. Case control study, prevalence study, and meta-analysis were conducted. Results A total of 25 individual studies were selected, including 2 matched case-control studies, 21 parallel case-control studies, and 2 cross-sectional studies. Among all studies, 5 case-control studies only reported crude odds ratios, 16 case-control studies reported crude and adjusted odds ratios, and 25 studies yielded a pooled odds ratio of 0.877 (95%CI: 0.794, 0.969). After eliminating studies with crude odds ratios, 20 studies, which included 2 matched case-control studies, 16 parallel case control studies, and 2 cross-sectional studies, still yielded a pooled odds ratio of 0.886 (95%CI: 0.798, 0.985). After eliminating 2 cross-sectional studies, 18 case-control studies yielded a pooled odds ratio of 0.910 (95%CI: 0.816, 1.016) and was not statistically significant, while 2 cross-sectional studies yielded a pooled odds ratio of 0.641 (95%CI: 0.436, 0.941), which was statistically significant. Sixteen parallel case-control studies and 2 matched case-control studies yielded a pooled odds ratio of 0.911 (95%CI: 0.814, 1.019) and 0.896 (95%CI: 0.547, 1.466), respectively. Sixteen case-control studies yielded a pooled odds ratio of 0.739 (95%CI: 0.584, 0.934) for crude odds ratio and 0.911 (95%CI: 0.814, 1.019) for adjusted odds ratio, respectively, and the difference was statistically significant. A meta regression showed that the differences of pooled odds ratio of parallel case-control studies, matched case-control studies, and prevalence design studies were statistically significant. Begg's funnel plot and Egger's test showed that there was no evidence of publication bias. Conclusion Matched case-control studies and parallel case-control studies show that smoking is not an influencing factor of the incidence of AD. Crude odds ratio and crosssectional study design decrease the odds ratio of correlation between smoking and AD, but can not be regarded as an evidence of causal relationship.

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    Original article (Public health)
    Evaluation of hospitalization expense of patients with acute myocardial infarction before and after implementation of single disease quality control
    LIU Wen-wei, YANG Jing, YUAN Su-wei, et al
    2015, 35 (6):  876. 
    doi: 11.3969/j.issn.1674-8115.2015.06.019

    Abstract ( 628 )   PDF (337KB) ( 784 )  

    Objective To analyze and evaluate the hospitalization expense of patients with acute myocardial infarction before and after the implementation of single disease quality control in a tertiary grade A hospital in Shanghai and propose suggestions. Methods Medical records of discharged patients who had diagnosed with acute myocardial infarction between 2007 and 2013 were retrospectively analyzed. The socio-economic characteristics, disease diagnosis and treatment, and expense information on the first page of medical records were collected. Expenses before and after the implementation of single disease quality control were analyzed. The stepwise regression analysis was adopted to analyze the influencing factors of total hospitalization expense. Results After the implementation of single disease quality control (since 2010), the total hospitalization expense, medicine expenses, and surgery expenses decreased, while the examination and treatment expenses increased. The hospitalization time, operation, blood transfusion, gender, admitted after the implementation of single disease quality control, and transfer were major factors that significantly influenced the total hospitalization expense. Conclusion After the implementation of single disease quality control, the total expense of inpatient with acute myocardial infarction decreases and the structure of expenses tend to be rationalized. The hospitalization time and illness are major factors that significantly influence the total hospitalization expense. In the long run, we should further reduce the hospitalization time and improve the quality of medical services in order to decrease the total hospitalization expense of patients with acute myocardial infarction.

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    Empathy survey of clinical interns and residents: an empirical study based on Jefferson scale of physician empathy
    WANG Dao-zhen, LI Xing-wei, ZOU Yang, et al
    2015, 35 (6):  881. 
    doi: 11.3969/j.issn.1674-8115.2015.06.020

    Abstract ( 690 )   PDF (371KB) ( 1013 )  

    Objective To verify the validity of the Chinese version of Jefferson scale of physician empathy (JSPE), survey the empathy of clinical interns and residents by the JSPE, and provide evidences for establishing education and measuring methods of empathy. Methods The JSPE was translated into Chinese and the empathy of 1 043 clinical interns and residents of Shanghai Jiao Tong University School of Medicine were surveyed by the Chinese version of JSPE, so as to comprehend the general level of empathy and the differences of empathy of people with different gender, grade, and education. Results Mean scores of residents and females were higher than those of interns and males. The differences were statistically significant (P<0.05). The results of survey did not show the trend of decrease of empathy with age. Compared with results of other countries, the mean scores of empathy of surveyed clinical interns and residents were an intermediate level. Conclusion The reliability of Chinese version of JSPE is good. There are some limitations for conducting the survey only by JSPE. The education of empathy should be combined with multiple research methods in order to discover the correlation between the measure of empathy and other factors.

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    Relationship of psychological capital, job satisfaction, and retention willingness of nurses
    QIAN Ying, WANG Xiao-lei, FANG Xiao-mei, et al
    2015, 35 (6):  887. 
    doi: 11.3969/j.issn.1674-8115.2015.06.021

    Abstract ( 427 )   PDF (354KB) ( 1011 )  

    Objective To explore the relationship of psychological capital, job satisfaction, and retention willingness of nurses. Methods Convenience sampling method was adopted to investigate 912 nurses from 5 tertiary grade A hospitals in Hangzhou. Results The mean scores of nurses' psychological capital, job satisfaction, and retention willingness were 4.01±0.62, 2.84±0.52, and 3.11±0.60, respectively. Psychological capital and job satisfaction were positively correlated with retention willingness (P<0.01). Psychological capital played a partial mediation role in the relationship between job satisfaction and retention willingness. Conclusion Psychological capital and job satisfaction have a positive influence on nurses' retention willingness.

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    Satisfaction of patients with herpes zoster towards clinical pathway
    NI Yang, WANG Su-ping, GONG Rui-jie, et al
    2015, 35 (6):  892. 
    doi: 11.3969/j.issn.1674-8115.2015.06.022

    Abstract ( 442 )   PDF (468KB) ( 987 )  

    Objective To investigate the satisfaction of patients with herpes zoster towards medical services after the implementation of clinical pathway (CP). Methods Patients with herpes zoster who were hospitalized in Shanghai Dermatology Hospital and treated according to the clinical pathway from July 2010 to December 2012 were selected. Questionnaire survey and case interview method were conducted to analyze the satisfaction of patients towards medical services. Results Satisfaction scores of doctors’ technical level, respect, and getting help rose from 3.32, 3.34, 3.38 to 3.96, 3.97, 3.97 (the full mark was 4), respectively. More than 70% of interviewed patients satisfied with the administration, nursing, and medical services. Conclusion By regulating medical practices, CP reduces the burden of patients, alleviates medical contradictions to some extent, and improves the satisfaction of patients.

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    Review
    Research advances of mechanism of treating Alzheimer's disease by hydrogen sulfide
    ZHAO Feng-li, YAN Yong
    2015, 35 (6):  896. 
    doi: 11.3969/j.issn.1674-8115.2015.06.023

    Abstract ( 522 )   PDF (360KB) ( 1053 )  

    Hydrogen sulfide (H2S) is an endogenously generated gaseous mediator and can regulate a series of physiological and pathological processes of mammals. In recent years, the physiological and pathological effects of H2S on the central nervous system attract more and more attention. H2S can promote the longterm potentiation of hippocampus and regulate the intracellular calcium concentration and pH level of brain cells as a neuromodulator. H2S can also protect the nervous system from oxidative stress, apoptosis, or degeneration. Dysregulation of H2S is implicated in the pathological processes of Alzheimer's disease (AD). This paper reviews the potential mechanism of protective role of H2S in AD.

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    Research progresses of structure and functional magnetic resonance imaging of hippocampus
    QIU Mei-hui, WU Yan, PENG Dai-hui
    2015, 35 (6):  901. 
    doi: 11.3969/j.issn.1674-8115.2015.06.024

    Abstract ( 842 )   PDF (419KB) ( 1108 )  

    With the rapid development of neuroimaging in recent years, increasing evidences indicate that there are alterations of brain structure and function in patients with major depressive disorder. As an important region in limbic system, hippocampus is relevant to abnormal emotional regulation and cognitive impairment. This paper reviews the research advances of structure and functional magnetic resonance imaging of hippocampus of patients with major depressive disorder and discusses the biological mechanisms of hippocampus of patients with major depressive disorder.

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    Research progresses of luteinizing hormone receptor mRNA binding protein
    FAN Meng-xia, QIAO Jie
    2015, 35 (6):  906. 
    doi: 11.3969/j.issn.1674-8115.2015.06.025

    Abstract ( 567 )   PDF (357KB) ( 965 )  

    Luteinizing hormone receptor (LHR) plays a crucial role in the processes of reproduction and development. LHR can be down-regulated in response to preovulatory luteinizing hormone (LH) surge or by the administration of a pharmacological dose of human chorionic gonadotropin (hCG). LHR mRNA binding protein (LRBP) has been identified in ovarian cytoplasm of rats with down-regulated receptor. Researches show that the binding of LH/hCG and their receptors can stimulate the cAMP/PKA/ERK signaling pathway and expression of miR-122, which result in the increase of LRBP expression. The binding of LRBP with LHR mRNA can induce the suppression of translation and transfer to the p-bodies, which is closely relevant to the desensitivity of LHR during preovulatory phase. This paper reviews the research progresses of LRBP.

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    Advances of functions of antioxidation and relieving physical fatigue of Lycium barbarum polysaccharide
    ZHANG Ya-li, HUANG Xiao-xu, CAI Mei-qin
    2015, 35 (6):  911. 
    doi: 11.3969/j.issn.1674-8115.2015.06.026

    Abstract ( 474 )   PDF (348KB) ( 1098 )  

    Lycium barbarum polysaccharide (LBP) is the main functional component of Lycium barbarum and possesses various biological activities, including antioxidation, anti-aging, relieving physical fatigue, regulating blood sugar and blood fat metabolism, protecting retinopathy against pathologic changes, and protecting productive system. This paper focuses on recent researches relevant to functions of antioxidation and relieving physical fatigue of LBP and provides scientific evidences for the application of LBP to development of health care products, disease prevention, and recovery.

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    Correlation between reproductive toxicity of cadmium and structure and function of blood-testis barrier
    NING Wei, LIAO Xiao-gang, LIU Ya-ping
    2015, 35 (6):  915. 
    doi: 11.3969/j.issn.1674-8115.2015.06.027

    Abstract ( 492 )   PDF (344KB) ( 1009 )  

    Cadmium (Cd) is a major heavy metal pollutant. It can enter and accumulate in human body by eating and breathing, which cause damages to various organs finally. The toxicity of Cd towards testis is extremely complicated and may result in male infertility. So many studies focus on identifying action targets of drugs by thoroughly investigating the mechanism of toxicity of Cd. This paper reviews the effects of Cd on connexins relevant to blood-testis barrier and signaling pathways that may involved.

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    Brief original article
    Surgical strategies for treatment of tetralogy of Fallot with left pulmonary artery hypoplasia
    GAO Bo-tao, ZHENG Jing-hao, ZHU Zhong-qun, et al
    2015, 35 (6):  920. 
    doi: 11.3969/j.issn.1674-8115.2015.06.028

    Abstract ( 457 )   PDF (270KB) ( 941 )  

    Objective To investigate the surgical strategies for the treatment of tetralogy of Fallot (TOF) with left pulmonary artery hypoplasia. Methods A total of 17 TOF pediatric patients with left pulmonary artery hypoplasia were retrospectively analyzed. Among them, there were 12 males and 5 females with ages of 2 months-3 years and body weights of 4-13 kg. Curative repair or palliative repair was conducted according to the development of pulmonary artery. Regular postoperative examinations were performed, including X-ray, electrocardiogram, color Doppler echocardiography, and CT, to observe possible residual shunts, residual obstruction, and cardiac dysfunction. Results Among 17 TOF pediatric patients with the left pulmonary artery hypoplasia, 8 of them underwent patch cavoplasty of left pulmonary artery and curative repair and 7 patients survived. The 6 survived patients were followed up for 5-29 (14±10) months and among them, openings of left pulmonary artery of 2 patients were small and no complications were found among other 5 patients. One patient could not be treated due to pulmonary vein hypoplasia and died of severe low cardiac output syndrome. Among another 9 patients, 2 of them underwent single ventricular repair because of coronary artery abnormality and tricuspid valve hypoplasia, respectively, and 7 of them underwent palliative repair. Among 7 patients undergoing palliative repair, 5 of them underwent patch cavoplasty of left pulmonary artery; 6 of them survived, 5 of them were followed up for 6-18 (17±13) months and among them, there were 4 patients with left pulmonary hypoplasia and 1 patient died of cardiac dysfunction and multiple organ function failure. Conclusion TOF with left pulmonary artery hypoplasia should undergo the curative repair as far as possible based on patch cavoplasty of left pulmonary artery.If it is possible to develop the residual stenosis of left pulmonary artery after repair, the surgeon can punch a hole in the ventricular septal defect patch.

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    Observation of effect of sling-exercise-therapy combined with joint mobilization technique on treatment of cervical spondylosis
    CHEN Yan-yun
    2015, 35 (6):  924. 
    doi: 11.3969/j.issn.1674-8115.2015.06.029

    Abstract ( 504 )   PDF (202KB) ( 1009 )  

    Objective To observe the effect of sling-exercise-therapy (SET) combined with joint mobilization technique on the treatment of cervical spondylosis. Methods A total of 40 patients with cervical spondylosis were selected and randomly divided into the observation group and control group, with 20 patients in each group. The observation group was treated by SET combined with joint mobilization technique and the control group was treated by SET for 3 weeks. Results The marked effect rate (marked effect and healing) and score of visual analogue scale (VAS) of the observation group were better than those of the control group (P<0.05). Conclusion The overall effect of SET combined with joint mobilization technique on the treatment of cervical spondylosis is better than that of joint mobilization technique. SET can strengthen the therapeutic effect of manual therapy, improve the deep cervical stability, and increase the strength and endurance of neck muscle, therefore it is of great significance to maintain the long-term therapeutic effect for the treatment of cervical spondylosis.

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