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    Original article (Basic research)
    Establishment of the mouse model of conditional knockout of Apr3 and preliminary study on the phenotypes
    TAN Dong-qiong, YE Jun, HAN Lian-shu, et al
    2015, 35 (8):  1091. 
    doi: 11.3969/j.issn.1674-8115.2015.08.001

    Abstract ( 816 )   PDF (3844KB) ( 880 )  

    Objective  To establish the mouse model of conditional knockout of apoptosis related protein 3 (Apr3) and preliminary explore the phenotypes. Methods  The knockout plan was designed and Apr3(-/+) chimeric mice were obtained and bred to get Apr3(-/-) mice. The Apr3(-/-) homozygous mice with complete knockout of Apr3 were obtained by inbreeding and wild type control mice. DNAs of genome of mouse tail tissues were extracted. Wild type and knockout gene fragments were amplified by PCR and the phenotypes of mice were determined at DNA level. RNAs and proteins of mouse livers were extracted and the expression of Apr3 gene was detected by RT-PCR and Western blotting. The genetic traits and trend of body weight change of Apr3 knockout mice and indexes that might affect the growth, development, and metabolism, such as blood glucose, blood lipid, and liver function, were observed. Major lysosomal accumulated organs were hematoxylin-eosin stained and observed. Results  The mouse model of Apr3 knockout was successfully established. Apr3(-/-) mice were survived and fertile, but the body weight of two-month-old Apr3(-/-) mice was smaller than that of wild type mice. Results of the liver function test showed that the aspartate aminotransferase (AST) level of two-month-old Apr3(-/-) mice was higher than that of wild type mice (P<0.05). Results of H-E staining indicated significant degeneration and edema of liver cells and periportal inflammatory cell infiltration. Conclusion  The mouse model of conditional knockout of Apr3 is established. The knockout of Apr3 causes low body weight, abnormal morphology of liver tissue, and elevated AST of two-month-old mice.

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    Study on drug concentration of rabbit VX2 tumor model intervened by combination of embedded ultrasound tumor hyperthermia instrument and pegylated liposomal doxorubicin
    ZHAO Yin-zhu, XIONG Ping, CHEN Ya-zhu
    2015, 35 (8):  1098. 
    doi: 11.3969/j.issn.1674-8115.2015.08.002

    Abstract ( 653 )   PDF (782KB) ( 786 )  

    Objective  To observe changes of the drug concentration of rabbit VX2 tumor model intervened by the combination of embedded ultrasound tumor hyperthermia instrument and pegylated liposomal doxorubicin (PLD). Methods  Twelve Zelanian female rabbits with VX2 tumors in superficial thigh muscle were randomly divided into the hyperthermia+PLD group (n=4), PLD group (n=4), and doxorubicin group (n=4) when the diameter of tumor was larger than 10 mm. For hyperthermia+PLD group, embedded ultrasound tumor hyperthermia instrument was used to perform ultrasound hyperthermia (42 ℃-43℃) for 30 min immediately after the injection of PLD drug. High-pressure liquid chromatography (HPLC) was adopted to determine the concentration of doxorubicin in tumor tissues. Results  The temperature of heated zone of the hyperthermia+PLD group was controlled accurately (42.5 ℃±0.2 ℃). The concentration of doxorubicin in tumor tissues of the hyperthermia+PLD group was 2.0 and 11.2 times higher than those of PLD group and doxorubicin group, respectively, and differences were statistically significant (P<0.05). The concentration of doxorubicin in tumor tissues of the PLD group was 5.5 times higher than that of the doxorubicin group and the difference was statistically significant (P<0.05). Conclusion  The combination of embedded ultrasound tumor hyperthermia instrument and PLD can effectively increase the drug concentration of the rabbit VX2 tumor model.

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    Activation of protective autophagy of PC12 cells induced by hypoxia
    WANG Wen-ying, CUI De-rong, JIANG Wei
    2015, 35 (8):  1102. 
    doi: 11.3969/j.issn.1674-8115.2015.08.003

    Abstract ( 577 )   PDF (1819KB) ( 810 )  

    Objective  To explore the effect of hypoxia on the autophagy of PC12 cells. Methods  The hypoxia incubator was used to establish the hypoxic environment with oxygen concentration of 1% for treating cells of the experimental group, while cells of the control group were placed in the incubator with normal oxygen concentration. Firstly, cells of the experimental group were treated in hypoxic environment for 6, 12, and 24 h respectively. Expressions of autophagy-related proteins LC3 and Beclin1 were detected by Western blotting and changes of mRNA of LC3 were detected by RT-PCR. Changes of autophagosomes were observed by the transmission electron microscope. Secondly, after being treated by autophagy inhibitor 3-MA, the viability of cells was detected by MTT, the activity of caspase-3 was detected by caspase-3 activity assay kit, and the expression of cleaved caspase-3 was detected by Western blotting. Results  ①With the increase of time of exposure to hypoxic environment, expressions of autophagy-related proteins LC3 and Beclin1 and mRNA level of LC3 of PC12 cells increased, reached peaks during 12-24 h, and decreased afterward. ②The autophagy inhibitor 3-MA further decreased the viability of cells treated by hypoxic environment and increased the activity of caspase-3 and expression of active caspase-3. Conclusion  Hypoxia activates the autophagy of PC12 cells and may play a protective role by inhibiting the apoptosis.

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    Application of multi-channel in vivo recording techniques to amygdala-kindling epilepsy mice
    LI Jia-jia, LI Yong-hua, GONG Hai-qing, et al
    2015, 35 (8):  1108. 
    doi: 11.3969/j.issn.1674-8115.2015.08.004

    Abstract ( 582 )   PDF (2341KB) ( 962 )  

    Objective  To provide a new experimental method for studying the mechanisms of epileptic network by integrating the multi-channel in vivo recording techniques and the establishment of epilepsy model. Methods  Multi-channel in vivo recording techniques were adopted to simultaneously record neural activities of the basolateral amygdala, cornu ammonis 1 of hippocampus, primary somatosensory cortex, and mediodorsal thalamus of amygdala-kindling mice. Meanwhile, behaviors of mice were also observed and recorded. Results  The afterdischarge was recorded in four recording regions for epilepsy from grade 1 to 5 and the duration of afterdischarge increased with the grade of epilepsy. The incidence and development of epilepsy accompanied dynamic changes of frequency-specific electrical signals. Conclusion  This experimental method may be a valuable method for study the network mechanism of the ictogenesis and epileptogenesis.

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    Study on mechanism of alleviating myocardial injury of rabbit model of ventricular fibrillation-resuscitation by α-methylnorepinephrine
    JIANG Li-jing, YAN Mei-ling, LI Xiang, et al
    2015, 35 (8):  1115. 
    doi: 11.3969/j.issn.1674-8115.2015.08.005

    Abstract ( 530 )   PDF (1169KB) ( 771 )  

    Objective  To investigate the protective effect of α-methylnorepinephrine on cardiac function of rabbits at early stage after cardiopulmonary resuscitation (CPR). Methods  A total of 30 rabbits were randomly divided into the control group (group A, n=10), epinephrine group (groups B, n=10), and α-methylnorepinephrine group (group C, n=10). The rabbit model of CPR (group B and C) was established by in vitro induced ventricular fibrillation. Rabbits of group B were given epinephrine and group C were given α-methylnorepinephrine during the course of CPR, respectively. Changes of hemodynamic and serum indexes were dynamically monitored before ventricular fibrillation and at each time point after CPR. The ultrastructure of myocardial tissue was observed by transmission electron microscope after CPR. Results  After spontaneous circulation was restored, rabbits of both groups B and C appeared cardiac dysfunction and indexes of cardiac function significant decreased (P<0.05). The slope of contraction velocity (peak+dp/dt) of group C was significantly higher than that of group B (P<0.05), but the difference between groups C and A was not statistically significant (P>0.05). The slope of vasodilation velocity (peak-dp/dt) of group C was significantly lower than that of group A (P<0.05). The BNP and cTnⅠ levels of group C were significantly lower than those of group B (P<0.05). Observation by the transmission electron microscope showed that the myocardial structure of groups C and A was similar. Compared with group B, the myocardial injury of group C was mild. Conclusion  The α-methylnorepinephrine can improve hemodynamic and serum indexes, alleviate myocardial injury, and protect the cardiac function at early stage after CPR.

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    Experimental study on repairing lacerations on rabbit eyelids by photochemical tissue bonding
    SHEN Qiong, YAO Min, YANG Peng-gao
    2015, 35 (8):  1120. 
    doi: 11.3969/j.issn.1674-8115.2015.08.006

    Abstract ( 507 )   PDF (3231KB) ( 607 )  

    Objective  To investigate the application value of photochemical tissue bonding (PTB) technique on repairing lacerations on rabbit eyelids. Methods  Parallel, perpendicular, and oblique (45°) incisions were made on rabbit upper eyelid skin and closured by PTB (PTB group) or suturing (suturing group). The exposure doses of PTB group were 25, 50, 100 J/cm2 and radiancy was 0.25 W/cm2. Incisions that were not treated or underwent laser exposure (100 J/cm2) served as controls. Leak pressure and skin strength were measured and inflammatory infiltration of surrounding dermis on 1, 3, and 7 d after operation were observed. Results  The differences of leak pressure between PTB subgroups (25, 50, 100 J/cm2, 0.25 W/cm2) and suturing group, and among  PTB subgroups were not statistically significant (P>0.05). The skin strength of PTB group was remarkably higher than that of the control group within one week after operation and the differences of skin strength among groups one week after operation were not statistically significant (P>0.05). Compared with the suturing group, operation time of the PTB group was significantly shorter (P<0.05) and the inflammatory infiltration of surrounding dermis on 1 d after operation was milder (P<0.05). Conclusion  PTB can achieve the same anti-tension effect as suturing for repairing the laceration on eyelids with simpler operation and milder inflammatory infiltration.

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    Effects of sevoflurane anesthesia on spatial recognition and expressions of pCreb and Egr1 in hippocampus tissues of aged mice
    ZHOU Guo-xia, PENG Li-chao
    2015, 35 (8):  1125. 
    doi: 11.3969/j.issn.1674-8115.2015.08.007

    Abstract ( 617 )   PDF (1156KB) ( 745 )  

    Objective  To explore the effects of sevoflurane anesthesia on spatial recognition and expressions of pCreb and early growth response factor 1 (Egr1) in hippocampus tissues of aged mice. Methods  A total of 12 Eighteen-month-old mice were randomly divided into the anesthesia group (n=6) and control group (n=6). Mice of the anesthesia group and control group inhaled 3% sevoflurane and 100% oxygen for 4 h, respectively. Spatial learning and memory abilities were tested by the Morris water maze 48 h after anesthesia. The spatial probe test was conducted 24 h after memory acquisition test. Hippocampus tissues were harvested 15 min after the spatial probe test and expressions of Egr1, Creb, and pCreb in hippocampus tissues were detected by Western blotting and RT-qPCR. Results  The escape latency of anesthesia group was significantly longer than that of the control group on day 4, 5, and 6 (P<0.05). The time spent in the target quadrant of the control group was significantly longer than that of the anesthesia group and the percentage of distance of the control group was significantly higher than that of the anesthesia group during the spatial probe test (P<0.01). Compared with the control group, the expression of Egr1 in hippocampus tissues of the anesthesia group remarkably decreased (P<0.05) and the expression of pCreb decreased (P<0.05). The difference of the expression of Creb between two groups was not significant (P>0.05). Conclusion  Sevoflurane down-regulates expressions of pCreb and Egr1 in hippocampus tissues and affects the spatial recognition of aged mice.

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    Effects of autophagy on adenanthin-induced death of human hepatocellular carcinoma Bel-7402 cells
    XU Yi-Wei, SUN Han-dong, HUANG Ying
    2015, 35 (8):  1130. 
    doi: 11.3969/j.issn.1674-8115.2015.08.008

    Abstract ( 576 )   PDF (2044KB) ( 861 )  

    Objective  To investigate the effects of autophagy on adenanthin-induced death of human hepatocellular carcinoma (HCC) Bel-7402 cells. Methods  Bel-7402 cells were treated by adenanthin of 9 μmol/L for 0, 0.5, 1, 2, 4, 6, 8, 12, and 24 h. Expressions of autophagy related proteins Beclin-1 and LC3 were detected by Western blotting. The distribution of expression of endogenous LC3 protein in Bel-7402 cells treated by adenanthin of 9 μmol/L for 0, 2, and 4 h was detected by immunofluorescence.The cell line that the expression of Beclin-1 gene was specifically intervened was constructed. The effects of low expression of Beclin-1 on changes of autophagy activity, cell growth, and cell death induced by adenanthin were analyzed and observed by western blotting and light microscopy, respectively.  CCK-8 was adopted to detect the effects of wild type and ATG5 knockout (ATG5-/-) mouse embryonic fibroblasts (MEFs) on the inhibition of cell growth induced by adenanthin of different concentrations. The difference of sensitivity to adenanthin between wild type and ATG5 knock out MEFs was analyzed by comparing the IC50. Results  Western blotting and immunofluorescence showed that adenanthin significantly increased the autophagy activity of Bel-7402 cells. Knockout of Beclin-1 did not remarkably affect adenanthin-induced autophagy activity and cell death. Compared with wild type MEFs, ATG5-/- MEFs were more resistant to the inhibition of cell growth induced by adenanthin. Conclusion Adenanthin can significantly increase the autophagy activity of Bel-7402 cells and promote adenanthin-induced cell death. But the increase of autophagy activity is independent of the expression of Beclin-1.

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    Original article (Clinical research)
    Group cognitive behavioral therapy for patients with mild depressive disorder and factors of therapeutic effect
    WANG Yu, YUAN Cheng-mei, SUN Xia, et al
    2015, 35 (8):  1136. 
    doi: 11.3969/j.issn.1674-8115.2015.08.009

    Abstract ( 637 )   PDF (854KB) ( 982 )  

    Objective  To evaluate the effect of independently compiled structured group cognitive behavioral therapy handbook for treating patients with mild depressive disorder and influencing factors. Methods  The before-and-after control design was adopted to compare depressive symptoms and life quality of patients before and after the structured group cognitive behavioral therapy and factors that might influence the therapeutic effect were analyzed. Results  A total of 23 patients were enrolled and the differences of depressive symptoms and life quality before and after therapy were statistically significant (P<0.01). Follow-up findings in 24th, 36th, and 48th week indicated that changes of depressive symptoms and life quality still existed. Life quality was an important variable for predicting the effect of group cognitive behavioral therapy (β=-0.436, Wals=4.246, P=0.039). Conclusion  The independently compiled structured group cognitive behavioral therapy handbook has positive and durable effect for treating patients with mild depressive disorder and has important value for clinical applications.

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    Relationship between rs2576178 mutation of renalase gene and incidence of hypertension of type 2 diabetic nephropathy patients
    ZHANG Rong, GE Xiao-xu, WANG Feng, et al
    2015, 35 (8):  1141. 
    doi: 11.3969/j.issn.1674-8115.2015.08.010

    Abstract ( 574 )   PDF (955KB) ( 831 )  

    Objective  To investigate the relationship between rs2576178 mutation of renalase gene (RNLS) and the incidence of hypertension of type 2 diabetic nephropathy patients with micro-albuminuria. Methods  A total of 225 type 2 diabetic nephropathy patients with micro-albuminuria (DN group, all Han nationality) and 251 healthy controls (control group) were enrolled. The DN group was further divided into the DN-HTN(+) group (combined with hypertension, n=169) and DN-HTN(-) group (not combined with hypertension, n=56). The genotype of locus rs2576178 of RNLS gene of subjects was detected by the Taqman PCR assay. The differences of genotypic and allelic frequencies and clinical variables between two groups were compared. Results  The genotype distribution of rs2576178 of DN group and control group was consistent with Hardy-Weinberg equilibrium. Compared with the control group, AA genotypic and A allelic frequencies of the DN group significantly decreased (P<0.05). AA genotype of rs2576178 significantly correlated with hypertension after sex, age, and BMI of all subjects were corrected by non-conditional Logistic regression analysis with OR of 0.48 (95%CI: 0.28-0.81). Compared with the DN-HTN (-) group, GG+GA genotypic and G allelic frequencies significantly increased in DN-HTN(+) group (P<0.05). AA genotype of rs2576178 significantly correlated with hypertension after sex, age, and BMI of the DN group were corrected with OR of 0.37 (95%CI: 0.17-0.79). Conclusion  AA genotype of rs2576178 of RNLS may decrease the incidence of hypertension of type 2 diabetic nephropathy patients with micro-albuminuria.

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    Analysis of expression profile of miRNAs in plasma of patients with systemic lupus erythematosus and diffuse pulmonary hemorrhage
    TU Yang, CHEN Guang-liang, YE Ping, et al
    2015, 35 (8):  1148. 
    doi: 11.3969/j.issn.1674-8115.2015.08.011

    Abstract ( 520 )   PDF (583KB) ( 743 )  

    Objective  To screen abnormally expressed microRNAs (miRNAs) in plasma of patients with systemic lupus erythematosus (SLE) and pulmonary diffuse alveolar hemorrhage (DAH). Methods miRNAs were isolated from plasma samples of five patients with SLE and DAH and five health controls for microarray analysis. The target genes of miRNAs were predicted by miRDB and the PANTHER protein classification system was used to find the gene ontology (GO) of target proteins. Results  Compared with controls, many abnormally expressed miRNAs were found in plasma of patients with SLE and DAH. Expression levels of 59 miRNAs up-regulated by 5 times and expression levels of 15 miRNAs were 30% lower than the normal expression level. Conclusion  Many miRNAs abnormally express in plasma of patients with SLE and DAH, which indicates that some miRNAs may be used to predict the development of disease and prognosis of patients with SLE and DAH.

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    Analysis of therapeutic effect of radiotherapy for 117 pancreatic cancer patients without distant metastasis
    HU Bin, XU Lei, BAI Yong-rui, et al
    2015, 35 (8):  1153. 
    Abstract ( 530 )   PDF (1738KB) ( 869 )  

    Objective  To explore and compare the safety and outcome between separate usage of three-dimensional conformal radiotherapy or γ ray stereotactic body radiotherapy or combined usage of three-dimensional conformal radiotherapy and γ ray stereotactic body radiotherapy for pancreatic cancer patients without distant metastasis. Methods  A total of 117 pancreatic cancer patients without distant metastasis were enrolled. Among them, 34 patients underwent three-dimensional conformal radiotherapy, 22 patients underwent γ ray stereotactic body radiotherapy, and 61 patients underwent γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy. The responses of patients towards radiotherapy and the outcome of radiotherapy were observed. Results  The clinical symptoms of patients were alleviated after radiotherapy and the pain relief rate was 82.1% (64/78). The median survival time (MST) of all patients was 10.1 months and the one-year survival rate was 39.9%. MSTs of patients who underwent three-dimensional conformal radiotherapy, γ ray stereotactic body radiotherapy, and γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy were 7.5, 10.3, and 12.4 months, respectively. The outcome of patients who underwent γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy was better than that of patients who underwent three-dimensional conformal radiotherapy, and the MSTs were 12.4 and 7.5 months and one-year survival rates were 49.9% and 22.7%, respectively (χ2=3.300, P=0.069). The prognosis of patients with high KPS scores before radiotherapy (≥90), tumors located in pancreatic tail, tumor staging were T1-T3, CA19-9 level was less than 150 U/mL before radiotherapy, and gross tumor volume (GTV) was smaller than 100 cm3 was better. These factors were all independent prognostic factors. Conclusion  Radiotherapy can significantly improve the life quality of pancreatic cancer patients without distant metastasis who are unable to undergo operations and extend their survival time. For these patients, the outcome of γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy is better than traditional treatment.

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    Correlation between thyroid function and gestational diabetes mellitus in second trimester of pregnancy
    WANG Li-hua, LIU Chun, LI Qi-fu, et al
    2015, 35 (8):  1160. 
    doi: 11.3969/j.issn.1674-8115.2015.08.013

    Abstract ( 637 )   PDF (921KB) ( 829 )  

    Objective  To investigate the correlation between blood glucose and thyroid-stimulating hormone (TSH) during gestation and evaluate the role of thyroid hormones and thyroid autoantibodies levels during gestation in screening gestational diabetes mellitus (GDM). Methods  A total of 265 women with 14-28 weeks of pregnancy who were examined at the First Affiliated Hospital of Chongqing Medical University were randomly selected. Levels of serum TSH, free triiodothyronine (FT3), free thyroxine (FT4), and thyroid peroxidase antibodies (TpoAb) were detected. The 75 g OGTT examination was performed in 28th week of pregnancy. The incidence of GDM was recorded. Spearman rank correlation analysis was adopted to analyze the correlation between the incidence of GDM and TpoAb level and between TSH and blood glucose level at each time point of OGTT. Results  ①The incidence of GDM in second trimester of pregnancy was 19.2%, the overall incidence of abnormal thyroid function was 3.8%, and the positive rate of TpoAb was 6.8%. ②The incidence of GDM in second trimester of pregnancy did not correlate with TSH. ③The incidence of GDM in second trimester of pregnancy did not correlate with whether TpoAb was positive (P=0.774). ④The differences of thyroid function and autoantibodies between women with GDM and without GDM were not significant. Conclusion  There is no obvious evidence that supports the correlation between thyroid disease and GDM. Two diseases should be screened separately to avoid misdiagnosis.

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    Quantitative study on abdominal organs of healthy adults by sound speed correction
    WU Qiong, LI Yi, NAN Shu-liang, et al
    2015, 35 (8):  1165. 
    doi: 11.3969/j.issn.1674-8115.2015.08.014

    Abstract ( 507 )   PDF (1445KB) ( 764 )  

    Objective  To estimate reference values of sound velocity (SV) of  abdominal organs of healthy adults by sound speed correction (SSC) technology and investigate relative influencing factors. Methods  A total of 81 healthy volunteers underwent SV measurements of liver, pancreas, spleen, bilateral renal parenchyma, and renal sinus by two operators. Zone speed indexes were acquired and SV values were calculated. Normal SV reference values of organs were estimated and the correlation of age, body mass index, and SV was analyzed. Results  The difference of SV values of organs measured by two operators was not statistically significant (P>0.05). The differences of SV values between left and right lobes of liver and between renal parenchyma and renal sinus were statistically significant (P<0.05). Results of correlation analysis showed that both age and body mass index were negatively correlated with SV values of organs. Conclusion  SSC technology is expected to provide valuable information for ultrasonic diagnosis of abdominal organ diseases by quantitative assessment.

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    Comparison and analysis of clinical features of primary and recurrent malignant pheochromocytoma
    CAO Wan-li, HUANG Bao-xing, SUN Fu-kang, et al
    2015, 35 (8):  1169. 
    doi: 11.3969/j.issn.1674-8115.2015.08.015

    Abstract ( 827 )   PDF (1161KB) ( 871 )  

    Objective  To explore the differences of intraoperative conditions and prognosis between patients with primary malignant pheochromocytomas (pheos) and recurrent malignant pheos. Methods  A total of 284 cases of pheos were retrospectively analyzed and 32 cases that were pathologically diagnosed with biological malignance or metastasis were included in the study and divided into the primary malignant pheos group (n=17) and recurrent malignant pheos group (n=15). Baseline characteristics, intraoperative conditions, and prognosis of two groups were compared and analyzed. Results  Compared with patients pathologically diagnosed with metastasis, baseline characteristics of patients pathologically diagnosed with biological malignance were similar, while the prognosis was much better (P=0.015). The risk of surrounding organs excision and debulking surgery of patients with recurrent malignant pheos was significantly higher than that of patients with primary malignant pheos (P=0.023, P=0.016). Results of postoperative follow-ups showed that the prognosis of patients with recurrent malignant pheos was significantly worse than that of patients with primary malignant pheos (P=0.029, P=0.025) and the prognosis was not significantly correlated with biological malignance or metastasis. Conclusion  Surgical removal is still the main treatment for malignant pheos. Compared with patients with primary malignant pheos, the operation risk of patients with recurrent malignant pheos increases and the prognosis is worse.

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    Effects of Traditional Chinese Medicine compound on cytokines and antibodies of patients with Hashimoto's thyroiditis
    LI Yun-hao, YANG Hong-jie, HE Yan-ming, et al
    2015, 35 (8):  1174. 
    doi: 11.3969/j.issn.1674-8115.2015.08.016

    Abstract ( 720 )   PDF (807KB) ( 835 )  

    Objective  To explore the necessity of treating Hasimoto thyroiditis patients with normal thyroid function by observing the changes of antibodies and cytokines relevant to thyroiditis after taking compound granules of Traditional Chinese Medicine. Methods  A total of 166 Hasimoto thyroiditis patients with normal thyroid function were randomly divided into the Traditional Chinese Medicine group (TCM group, n=55), placebo group (n=54), and EUTHYROX group (n=57). Changes of TPOAb, TgAb, CD195%, and CD30% in peripheral blood of patients before and after treatment were compared. Results  CD30% and CD195% of the TCM group significantly decreased after treatment (P<0.01), while CD30% and CD195% of placebo group and EUTHYROX group mildly increased after treatment (P>0.05). TPOAb and TgAb levels of the TCM group significantly decreased after treatment and the differences of three groups were statistically significant (P<0.01). Spearman correlation analysis showed that TgAb negatively correlated with CD30% and CD195%, while TPOAb did not correlate with CD30% and CD195%. Conclusion  Traditional Chinese Medicine compound can decrease high levels of TPOAb and TgAb and inhibit positive expressions of CD30 and CD195, which indicates Traditional Chinese Medicine can regulate locally disordered immune status of thyroid.

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    Value of N-terminal-pro-brain natriuretic peptide for predicting risk during peri-operation for infants with simple congenital heart disease
    BAI Kai, CHEN Sun, MEI Ju, et al
    2015, 35 (8):  1179. 
    doi: 11.3969/j.issn.1674-8115.2015.08.017

    Abstract ( 567 )   PDF (1110KB) ( 742 )  

    Objective  To explore the value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) for predicting the risk during peri-operation for infants with simple congenital heart disease. Methods  A prospective study of 25 infants with congenital heart disease who underwent open-heart surgery of left-to-right shunt was conducted. Venous blood samples were collected before operation and 6, 12, 24, and 48 h after operation. Serum NT-proBNP levels were detected by electrochemical luminescence and clinical indexes were recorded. Results  Preoperative serum NT-proBNP levels were significantly higher than normal levels and positively correlated with Ross scores and negatively correlated with ejection fraction (EF). Serum NT-proBNP levels 6 and 12 h after operation were significantly higher than those before operation (P<0.05) and serum NT-proBNP levels 24 and 48 h after operation were higher than those before operation, but the differences were not statistically significant (P>0.05). NT-proBNP levels at different time points were not significantly correlated with the duration of mechanical ventilation, vasoactive-inotropic score, ICU stay time, and hospitalization time. Conclusion  As a novel biomarker, NT-proBNP can be used as an important complementary factor for evaluating preoperative cardiac function. But the value of using NT-proBNP as a factor for predicting the postoperative risk for infants with congenital heart disease who have undergone open-heart surgery of left-to-right needs further study.

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    Correlation between γ-glutamyltransferase and hyperuricemia of male populations with metabolic syndrome
    GU Jing-li, CAO Qin, HUANG Rong, et al
    2015, 35 (8):  1185. 
    doi: 11.3969/j.issn.1674-8115.2015.08.018

    Abstract ( 712 )   PDF (596KB) ( 848 )  

    Objective  To investigate the effects of different levels of serum γ-glutamyltransferase (GGT) of male patients with metabolic syndrome (MS) on hyperuricemia (HUA). Methods  A total of 11 427 male adults who underwent the physical examination from January to December, 2012 at the physical examination center of a third level grade A hospital were selected as subjects and divided into the MS group (n=2 908) and normal control group (n=8 519). Their BMI, SBP, DBP, SUA, ALT, GGT, FPG, T-Ch, TAG, HDL-Ch, and LDL-Ch were measured. According to the GGT level, subjects were divided into 4 groups based on the quartile method. The effects of high quartile groups and low quartile groups on HUA were compared and multivariate non conditional Logistic regression analysis was adopted. Results  Compared with the normal control group, mean levels of BMI, SBP, DBP, SUA, ALT, GGT, FPG, TAG, T-Ch, and LDL-Ch of the MS group were significantly higher (P<0.001), HDL-Ch was significantly lower (P<0.001), and the incidence of fatty liver was significantly higher (P<0.001). The differences of above indexes of high quartile groups and low quartile groups were statistically significant (P<0.05). For the MS group, compared with low quartile groups, the OR value of the risk of HUA of high quartile groups was 3.09 after the indexes were corrected (P<0.01). For the normal control group, compared with low quartile groups, the OR value of the risk of HUA of high quartile groups was 2.17 (P<0.01). Conclusion  For male population with MS, the increase of GGT level indicates significant increase of the risk of HUA. Even for male population with normal components of MS, the risk of HUA also increases with the GGT level. So for clinical treatment and protection, more attention should be paid to the health management of GGT, including its level and dynamic change. Timely intervention should be performed and the incidence and development of relevant diseases should be concerned.

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    Effects of red cell distribution width on prognosis of inpatients with idiopathic interstitial pneumonias
    ZOU Xiao, NI Ying-meng, CHEN Wei
    2015, 35 (8):  1190. 
    doi: 11.3969/j.issn.1674-8115.2015.08.019

    Abstract ( 486 )   PDF (534KB) ( 748 )  

    Objective  To explore the correlation between red cell distribution width (RDW) and prognosis of idiopathic interstitial pneumonias (IIPs). Methods  A total of 61 patients with confirmed diagnosis of IIPs were divided into the survival group and death group by using death/survival as end point of observation. Their clinical data were recorded. The risk factors of IIPs were analyzed and the correlation between RDW and prognosis of IIPs was explored. Results  Among 61 patients, 33 were males and 28 were females, the ratio of male and female was 1.2∶1, and the average age was 64.60±16.33. Compared with the survival group (n=26), the average age of death group (n=35) was higher (P=0.004) and respiratory failure was severer (P=0.002). The baseline value of RDW of all patients was (15.12±1.71)% and last value of RDW was (16.30±2.54)%. The baseline value and last value of RDW of the death group were (15.95 ± 1.50)% and (17.84±2.26)% and significantly higher than those of the survival group (P=0.000).  Logistic multivariate analysis showed that RDW was an independent factor for predicting the prognosis of IIPs based on gender and age being controlled. The threshold value for predicting the prognosis of IIPs by RDW was 15.70% and the area under receiver operating characteristic (ROC) curve was 0.94 (95%CI: 1.61-1.95) with the sensitivity of 88.60% and specificity of 96.20%. The mortality of patients with RDW≥ 15.70% was significantly higher than that of patients with RDW<15.70% (P=0.000). Conclusion  RDW independently correlates with severity of IIPs and is an independent factor for predicting the prognosis of IIPs.

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    Therapeutic effect and safety of bevacizumab combined with cisplatin on malignant pleural effusion of patients with non-small cell lung cancer
    CHEN Lei, XIA Shu-yue
    2015, 35 (8):  1194. 
    doi: 11.3969/j.issn.1674-8115.2015.08.020

    Abstract ( 685 )   PDF (1089KB) ( 924 )  

    Objective  To explore the therapeutic effect and safety of intrathoracic injection of bevacizumab combined with cisplatin on malignant pleural effusion (MPE) of patients with non-small cell lung cancer (NSCLC). Methods  A total of 54 NSCLC patients with MPE were randomly divided into the cisplatin group (control group, n=26) and bevacizumab combined with cisplatin group (combined treatment group, n=28) according to different treatment plans. Patients of the control group received intrathoracic injection of cisplatin of 75 mg/m2 twice and each cycle was 21 d. Patients of the combined treatment group received intrathoracic injection of bevacizumab of 5 mg/kg twice and each cycle was 21 d, and the administration of cisplatin was the same as the control group. Patients of two groups all underwent systemic chemotherapy. The volume of pleural effusion and the level of vascular endothelial growth factor (VEGF) in pleural effusion were measured before each cycle. The therapeutic effect was evaluated according to control rates of pleural effusion and disease. The incidence of adverse reactions during the treatment was observed. Results  The control rates of pleural effusion of the combined treatment group and control group were 85.7% and 69.2% and the control rates of disease were 96.4% and 80.8% after treatment. The differences were statistically significant (P<0.05). The control rate of pleural effusion of the combined treatment group was significantly higher than that of the control group at each stage of treatment (P<0.05). The VEGF levels in pleural effusion of the combined treatment group and control group after treatment were lower than those before treatment and the reduction of pleural effusion of the combined treatment group was more remarkable (P<0.05). Compared with the control group, new or aggravating adverse reactions were not found in the combined treatment group. Conclusion  Intrathoracic injection of bevacizumab and cisplatin is an efficient and safe treatment method for NSCLC patients with malignant pleural effusion.

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    Relationship between serum homocystein and leukoaraiosis
    CHEN Ya-fang, HUANG Yin-hui, CAI Ruo-wei, et al
    2015, 35 (8):  1199. 
    doi: 11.3969/j.issn.1674-8115.2015.08.021

    Abstract ( 467 )   PDF (528KB) ( 751 )  

    Objective  To explore the relationship between serum homocysteine (Hcy) and leukoaraiosis (LA). Methods  Patients with LA who were admitted and treated from May 2013 to May 2014 were selected as subjects and divided into LA group (n=164) and non-LA group (n=104) according to the incidence of LA. Clinical data of two groups (gender, age, hypertension, diabetes, smoking, alcohol consumption, blood lipid, plasma fibrinogen, fasting blood glucose, D-dimer, uric acid, albumin, and Hcy) were collected. Univariate analysis and multivariate logistic regression analysis were used to analyze risk factors relevant to LA. Results  Hcy levels of LA group [(15.57±6.22) μmol/L] were higher than those of non-LA group [(12.74±4.93) μmol/L] and the difference between two groups was statistically significant (P<0.001). The multivariate Logistic regression analysis showed that Hcy (P=0.041; OR: 1.118; 95%CI: 1.004-1.245) was independently correlated with the incidence of LA. Conclusion  Hcy is an independent risk factor of leukoaraiosis.

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    Original article (Public health)
    Effects of training of therapeutic communication skills on the outcome of internship assessed by a new evaluation model
    ZHU Jian-zheng, XUE Yun-yun, WANG Ren, et al
    2015, 35 (8):  1203. 
    doi: 11.3969/j.issn.1674-8115.2015.08.022

    Abstract ( 522 )   PDF (650KB) ( 760 )  

    Objective  To investigate the effect of training the therapeutic communication skills of interns on the outcome of internship. Methods  Interns of the child healthcare department who participated in training the feeling integration of children were selected as subjects and training for therapeutic communication skills was conducted. The dual-track parallel evaluation was performed according to indexes, i.e. measurements of the psychological scale of interns and curative effect and compliance of children before and after internship. Results  The differences of anxiety level, communication ability, and psychological adaptability between the communication skills training group and regular training group were not significant before internship. Compared with the regular training group, communication ability and psychological adaptability of the communication skills training group significantly improved after internship and the differences were statistically significant (P=0.00 and 0.01, <0.05). Communication ability and psychological adaptability of the two groups were both increased significantly after internship (P=0.002 and 0.014,<0.05). The curative effect and compliance of children trained by two groups were different. The tactile defense, proprioception, and compliance of children trained by the communication skills training group were better and the differences were statistically significant (P=0.02, 0.002, and 0.04, <0.05). Conclusion  The systematical and purposeful training of clinical communication ability and skills before internship can improve the outcome of internship. The dual-track parallel evaluation model is able to evaluate the communication ability more systematically and comprehensively and facilitates the establishment of relevant evaluation systems.

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    Analysis of the equity of public health resources allocation in Chongqing from the perspective of migration
    CHEN Fei, ZHANG Pei-lin, ZHENG Wan-hui, et al
    2015, 35 (8):  1207. 
    doi: 11.3969/j.issn.1674-8115.2015.08.023

    Abstract ( 495 )   PDF (832KB) ( 808 )  

    Objective  To empirically analyze the equity of the allocation of the public health resources in Chongqing from 2009 to 2012 according to the scale and direction of rural-urban migration. Methods  The Gini coefficient and scale variance were used to evaluate and analyze the equity of the allocation of the public health resources in Chongqing area since healthcare reform from the perspectives of registered population and permanent population. Results   The mean Gini coefficients of public health technical personnel for registered population and permanent population were 0.212 2 and 0.177 1 and the difference was statistically significant (P<0.05). The mean Gini coefficients of public health expenditure for registered population and permanent population were 0.480 0 and 0.413 3 and the difference was statistically significant (P<0.05). The mean Gini coefficients of public health work area for registered population and permanent population were 0.357 5 and 0.251 1 and the difference was statistically significant (P<0.05). The contributions of county scale variance of public health technical personnel, public health expenditure, and public health work area of registered population were 63.35%, 57.37%, and 79.39%. The contributions of county scale variance of public health technical personnel, public health expenditure, and public health work area of permanent population were 85.48%, 47.18%, and 78.11%. Conclusion  The equity of public health resources allocation of urban and rural areas is different. The difference among counties is the main cause of the difference of public health resource allocation in Chongqing. Location of public health resources based on scale and direction of rural-urban migration can promote the equity of regional public health resources allocation.

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    Effects of e-learning based international cooperative training on developing core competence of psychiatric nurses
    SHI Zhong-ying, ZHANG Shu-ying, GAO Qi, et al
    2015, 35 (8):  1213. 
    doi: 11.3969/j.issn.1674-8115.2015.08.024

    Abstract ( 445 )   PDF (562KB) ( 798 )  

    Objective  To explore the effects of e-learning based international cooperative training on developing the core competence of psychiatric nurses. Methods  Nurses of the experimental group (n=67) and control group (n=56) attended the training courses for consolidating and developing core competence of psychiatric nurses from June to October, 2013. The Nursing Department of Mental Health Center of Shanghai Jiao Tong University School of Medicine cooperated with Department of Nursing Science of University of Turku, Finland to provide the e-learning courses. Nurses of the experimental group attended five-month training courses in addition to regular hospital nursing training. Competency Inventory for Registered Nurse (CIRN) was adopted to evaluate the core competence of nurses before and after training. Results  The differences of the overall score of CIRN and values of factors (except professional development) of the experimental group before and after training were statistically significant (P<0.01). The differences of the overall score of CIRN and values of factors (except clinical nursing and professional development) between the experimental group and control group after training were statistically significant (P<0.05). Conclusion  The e-learning based international cooperative training has good effects on developing the core competence of psychiatric nurses and facilitates international cooperation and communication of psychiatric nursing continuing education.

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    Review
    New progresses of group psychotherapy for treatment of depression
    WANG Yu, YUAN Cheng-mei
    2015, 35 (8):  1217. 
    doi: 11.3969/j.issn.1674-8115.2015.08.025

    Abstract ( 626 )   PDF (497KB) ( 1028 )  

    Patients with depression seriously affect the society and their families. As a relatively short-term and efficient method, group psychotherapy develops rapidly. This paper introduces the therapeutic effect and factors of traditional group psychotherapy (group cognitive behavioral therapy and short-term dynamic group psychotherapy) and several new group psychotherapies (mindfulness-based cognitive therapy, dialectical behavior therapy, and interpersonal therapy) for the treatment of depression.

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    Airway bacterial colonization and asthma
    DONG Yang-yang, YANG Ling
    2015, 35 (8):  1221. 
    doi: 11.3969/j.issn.1674-8115.2015.08.026

    Abstract ( 635 )   PDF (617KB) ( 897 )  

    Bronchial asthma is one of common diseases of respiratory system, but its causes and pathogenesis can not be explained clearly. Among various pathogenic factors and predisposing factors, including respiratory viruses, bacteria, mycoplasmas, fungi, etc, respiratory infection plays an important role in the incidence of asthma. This paper reviews the correlation among airway bacterial colonization, pathogenesis of asthma, and refractory asthma.

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    Research advances of the involvement of cannabinoid receptor 1 in the nerve growth
    ZHAO Qian-qian, HAN Hong-xiu
    2015, 35 (8):  1225. 
    Abstract ( 561 )   PDF (472KB) ( 914 )  

    Disorder of cannabinoid systems leads to diseases of nervous system, metabolism, immune system, cardiovascular system,and digestive system and cancer. Thus, the cannabinoid receptor is considered as a potential therapeutic target for various diseases. Recent studies found the involvement of cannabinoid receptor 1 in the growth and development of central nervous system. This paper reviews the molecular mechanism of cannabinoid receptor 1 for regulating the growth of nerve.

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    Research progresses of biomarkers for early diagnosis of contrast-induced acute kidney injury by cystatin C
    ZHANG Wei-feng, SHEN Ling-hong, HE Ben
    2015, 35 (8):  1229. 
    doi: 11.3969/j.issn.1674-8115.2015.08.028

    Abstract ( 611 )   PDF (514KB) ( 824 )  

    With the development of intervention therapy, CT, and three dimension reconstruction technology and the application of intravascular contrast media, the incidence of contrast-induced acute kidney injury (CI-AKI) increased rapidly. Early diagnosis of CI-AKI contributes to timely treatment and significantly improves the prognosis. However, it is lagging and unreliable to use serum creatine (SCr) as a biomarker for the diagnosis of acute kidney injury (AKI). With the development of research, much attention has been paid to the biomarker of cystatin C (CysC), which seems to provide the possibility for the early diagnosis of CI-AKI and predicting the incidence of major adverse cardiac events (MACE). This paper reviews recent researches relevant to using CysC as the biomarker for early diagnosis of CI-AKI and prediction of MACE and discusses the possibility and prospect of application of CysC.

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    Technique and method
    Comparison of effects of different decalcification agents on calcific aortic valves
    LI Can-bo, LI Hai-qing, YE Xiao-feng, et al
    2015, 35 (8):  1234. 
    Abstract ( 638 )   PDF (1232KB) ( 741 )  

    Objective  To compare the effects of three decalcification agents on calcific aortic valves. Methods  Samples of calcific aortic valves of six patients were harvested. Each valve was equally divided into three parts and decalcified by nitric acid of 5% (nitric acid group), formic acid of 10% (formic acid group), and EDTA of 10% (EDTA group), respectively. Pathological sections of three groups were observed and compared after H-E staining and immunohistochemical staining. Results  Although the decalcification time of EDTA group is the longest, but the morphological structure of valve tissues was complete and clear and the effects of decalcification and immunohistochemical staining were the best among three groups. The decalcification time of nitric acid group was the shortest, while the effect of decalcification was satisfactory. The decalcification time of formic acid group was short, but the effect of decalcification was the worst among three groups. Conclusion  EDTA is the best decalcification agent for pathological study on calcific aortic valves. When considering the time factor, nitric acid is a good alternative. Formic acid is not recommended due to the poor decalcified effect on calcific aortic valves.

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    Clinical experience
    Investigation of knowledge of nutrition, attitudes, and behaviors of medical students with non-nutrition majors in Shanghai
    LU Ting, CHEN Fei, ZHANG Qiao-sen, et al
    2015, 35 (8):  1238. 
    doi: 11.3969/j.issn.1674-8115.2015.08.030

    Abstract ( 635 )   PDF (861KB) ( 780 )  

    Objective  To investigate the knowledge of nutrition, attitudes, and behaviors of medical students with non-nutrition majors at universities in Shanghai, analyze factors that affect dietary behaviors of students, and provide evidences for developing nutrition and health education for medical students. Methods  According to relevant literature, a total of 398 medical students with non-nutrition majors at four universities in Shanghai were randomly selected. Questionnaire was designed to conduct the sampling survey of the knowledge of nutrition, attitudes, and behaviors and scores of the knowledge of nutrition, attitudes, and behaviors were analyzed. Results  A total of 377 valid questionnaires were returned form 398 medical students with non-nutrition majors. Most of them lacked nutrition knowledge and the scores were 16.05±3.02. Their attitudes were active and the scores were 21.74±4.14, while dietary behaviors were unsatisfactory and the scores were 19.95±5.08. Scores of attitudes and behaviors of female students were higher than those of male students (P<0.001 and P<0.05). Students with normal BMI accounted for 74.54%. The knowledge of nutrition was positively correlated with attitudes, and behaviors (r=0.157, P=0.002; r=0.250, P=0.000). Conclusion  Medical students with non-nutrition majors in Shanghai commonly lack knowledge of nutrition and their behaviors are unsatisfactory. It is necessary to provide nutrition intervention courses, improve the understanding of nutrition, strengthen education and guidance of behaviors, and enhance the consciousness of nutritional therapy of medical students for future medical practices.

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