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Table of Content

    28 September 2015, Volume 35 Issue 9 Previous Issue    Next Issue
    Inside front cover
    Original article (Basic research)
    Original article (Clinical research)
    Original article (Public health)
    Review
    Brief original article
    Technique and method
    Case report
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    Inside front cover
    Original article (Basic research)
    Effect of transforming growth factor β1 on expressions of C/EBPα and relevant nuclear transcription factors of renal tubular epithelial cells
    DU Yun-lei, LIU Jian, YING Ji, et al
    2015, 35 (9):  1243. 
    doi: 10.3969/j.issn.1674-8115.2015.09.001
    Abstract ( 944 )   PDF (975KB) ( 1137 )  

    Objective  To observe the effect of transforming growth factor β1(TGF-β1) on expressions of CCAAT enhancer binding protein α (C/EBPα) and nuclear transcription factors of peroxisome proliferator-activated receptor γ (PPARγ) and explore the expression of C/EBPα in the process of TGF-β1 induced renal fibrosis and relevant mechanisms. Methods  Human renal tubular epithelial cells (HK-2) were cultured in vitro and stimulated by TGF-β1 of different concentrations (5 and 10 ng/mL) at different time points (0, 4, 12, and 24 h). Total RNA and protein (nucleoprotein and total protein) and supernatant were collected. Changes of expressions of C/EBPα, nuclear transcription factor PPARγ, and epithelial-mesenchymal transition (EMT) related proteins α-SMA and E-cadherin were detected by real-time PCR and Western blotting. The expression level of monocyte chemotactic protein 1(MCP-1) in supernatant was detected by ELISA. Results  The change of C/EBPα level was the same as that of PPARγ level after HK-2 cells were stimulated by TGF-β1 (5 ng/mL) for 24 h. The difference was not statistically significant (P>0.05) and the expression of E-cadherin decreased. The expression of C/EBPα in nucleoprotein decreased remarkably at 12 h and the expression of PPARγ increased at 4 h after HK-2 cells were stimulated by TGF-β1 (10 ng/mL) for 0, 4, 12, and 24 h. The mRNA expressions of E-cadherin, C/EBPα, and PPARγ decreased by 70%, 50%, and 90%, respectively after HK-2 cells were stimulated by TGF-β1 (10 ng/mL) for 12 h (P<0.05). The MCP-1 level increased by 6 and 10.67 times at 12 h and 24 h after HK-2 cells were stimulated by TGF-β1 (10 ng/mL). Conclusion  C/EBPα involves in the renal interstitial fibrosis induced by TGF-β1 and is relevant to inflammatory response and EMT process of the renal interstitial fibrosis.  C/EBPα also interacts with PPARγ and enhances or inhibits the renal interstitial fibrosis.

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    Correlation between HIF-1α and MMPs in synovial tissues of patients with rheumatoid arthritis
    ZHAI Tian-hang,ZHANG Jie, LI Hui-dan, et al
    2015, 35 (9):  1248. 
    doi: 10.3969/j.issn.1674-8115.2015.09.002
    Abstract ( 1008 )   PDF (900KB) ( 1189 )  

    Objective  To investigate the correlation between the expression of hypoxia-inducible factor-1α (HIF-1α) and the expression of matrix metalloproteinases (MMPs) in synovial tissues of patients with rheumatoid arthritis (RA). Methods  The  expressions of HIF-1α and MMPs in synovial tissues of patients with RA and osteoarthritis (OA) were detected by real-time PCR and the correlation analysis was conducted. Results  The mRNA expressions of HIF-1α, MMP-1, MMP-3, MMP-9, and MMP-13 in synovial tissues of patients with RA were significantly higher than those of patients with OA. Highly expressed HIF-1α in synovial tissues of patients with RA significantly and positively correlated with MMP-9. Conclusion  Highly expressed HIF-1α in synovial tissues of patients with RA may involve in the regulation of the expression of MMP-9 and the process of pathological change of RA.

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    Inhibiting effects of dihydroartemisinin and triptolide on glioma cells
    YE Fu-yue, ZHENG Chuan-yi, MA Chun-yang, et al
    2015, 35 (9):  1252. 
    doi: 10.3969/j.issn.1674-8115.2015.09.003
    Abstract ( 1066 )   PDF (3467KB) ( 1110 )  

    Objective  To investigate the effects of alone and combined administration of two natural drugs dihydroartemisinin (DHA) and triptolide (TP) on in vitro inhibition and in vivo treatment of glioma. Methods  CCK-8 method was adopted to detect the inhibitory effect of alone and combined administration of DHA and TP on the viability of glioma cells. Hochest 33258 staining was used to observe changes of cell nucleus after administration. Rhodamine123 and PI staining was adopted to detect the mitochondrial membrane potential and cell cycle. The transplanted tumor model of mice with glioma was established. The body weight and size of tumor were observed after administration and were statistically analyzed. Pathological sections of main organs were H-E stained and the in vivo toxicity of drugs was observed. Results  Alone and combined administration of DHA and TP of 12 μg/mL for treating glioma cells C6 and U87 for 48 h significantly inhibited the cell viability and inhibition rates were 85% and 80%, respectively. Alone and combined administration of DHA and TP could cause the karyopyknosis and significant decline of mitochondrial membrane potential. The decline of mitochondrial membrane potential caused by combined administration was more than that caused by alone administration (P<0.01). Combined administration of DHA and TP mainly arrested the cell cycle at Sub-G1 and G2/M phases. The results of in vivo tests suggested that combined administration could inhibit the growth of tumor more effectively than alone administration and controls (P<0.01). H-E stained pathological sections showed that combined administration had little in vivo toxicity. Conclusion  Combined administration of DHA and TP has significant synergetic inhibition effect on glioma cells and the in vivo therapeutic effect is also remarkable, which provides a new method for clinical treatment of glioma with natural drugs.

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    Effect of regulating expression of matrix metalloproteinase by topical application of insulin on angiogenesis of diabetic wounds
    CHANG Qing-xuan, YANG Pei-lang, LIU Yan, et al
    2015, 35 (9):  1258. 
    doi: 10.3969/j.issn.1674-8115.2015.09.004
    Abstract ( 864 )   PDF (3151KB) ( 781 )  

    Objective  To investigate the regulation of vascular endothelial growth factor (Vegf) and matrix metalloproteinase 2/9 (Mmp-2/9) by topical application of insulin and explore the effects of Vegf and Mmp-2/9 on promoting the angiogenesis of diabetic wounds and their correlation. Methods  The diabetes of 60 Wistar rats were induced by multiple intraperitoneal injections with a low dose of streptozocin (STZ) after high-fat diet feeding. After 5 weeks, four full-thickness skin wounds with the diameter of 0.9 cm were made on the back of rats. Two wounds were treated with 20 μL saline (saline group) and insulin of 0.1 U/20 μL saline (insulin group) in diagonal form each day until complete healing. The healing speed of wounds was observed and recorded and samples were harvested on 3, 7, 13, and 21 d. The structure of skin tissues of healed wounds and angiogenesis of wounds on 7 and 13 d were observed by H-E staining. The mRNA expressions of Vegf, Vegfr-2, and Mmp-2/9 were detected by real-time PCR. Results  Compared with the saline group, the healing speed of the insulin group was faster and the difference between two groups was statistically significant (P<0.05). The number of spikes in the epidermis of insulin group was larger than that of the saline group on 21 d after wounds were healed and dermal tissues were denser. The number of angiogenic blood vessel of the insulin group was larger than that of the saline group on 7 and 13 d. The mRNA expressions of Vegf, Vegfr-2, and Mmp-2/9 of the insulin group increased progressively on 3, 7, and 13 d, reached peak on 13 d, and then decreased. The mRNA expressions of Vegf and Vegfr-2 were still higher than those of the saline group on 21 d and the  mRNA expression of Mmp-2/9 decreased. The difference between two groups was statistically significant (P<0.05). Conclusion  Topical application of insulin promotes the up-regulation of mRNA expressions of Vegf and Vegfr-2, regulates the mRNA expression of Mmp-2/9, and promotes the angiogenesis of diabetic wounds.

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    Comparison of pressure support ventilation and controlled mechanical ventilation in lung injury model
    WU Jing-bo, ZHOU Wen-xian, WU Li-zhen, et al
    2015, 35 (9):  1264. 
    doi: 10.3969/j.issn.1674-8115.2015.09.005
    Abstract ( 960 )   PDF (634KB) ( 791 )  

    Objective  To determine the long-term effect of pressure support ventilation (PSV) on experimental lung injury. Methods  The animal model of acute lung injury (ALI) was established by repetitive lung lavage for 20 healthy adult female rabbits. Rabbits were randomly divided into the PSV group (n=10) with the pressure level of tidal volume>4 mL/kg and respiratory rate of <40/min and controlled mechanical ventilation (CMV) group (n=10) with the pressure level of tidal volume of 4 mL/kg and respiratory rate of 20/min. The positive end-expiratory pressure of two groups was set at 10 cmH2O. Blood gas analysis and determination of ventilation-perfusion (VA/Q) distribution were performed at the onset of ALI and 2, 4, 8, and 12h after the onset of ALI. Results  The oxygenation of PSV group improved remarkably because the pulmonary shunt remarkably decreased and the area with normal VA/Q ratio increased. Compared with the PSV group, the pulmonary shunt of CMV group significantly decreased (P<0.05). Conclusion  PSV remarkably improves the gas exchange by reducing the inequality of VA/Q in the animal model of ALI. However, as far as the improvement of VA/Q distribution is concerned,  CMV is more effective than PSV.

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    Therapeutic effect of TNF-α monoclonal antibody on rats with allergic rhinitis and relevant mechanisms
    TANG Qiao-fei, ZHANG Shuang, CHENG Yang, et al
    2015, 35 (9):  1270. 
    doi: 10.3969/j.issn.1674-8115.2015.09.006
    Abstract ( 1057 )   PDF (1485KB) ( 982 )  

    Objective  To explore the therapeutic effect of the intervention of TNF-α monoclonal antibody on rats with allergic rhinitis (AR) and the underlying molecular mechanism. Methods  Eighteen BALB/c rats were randomly divided into the control group, AR model group, and TNF-α antibody intervention group. The ovalbumin (OVA) induced AR model was established and TNF-α monoclonal antibody was dropped nasally before nasal cavity was stimulated. Behavioral scores of mice were obtained and histopathologic changes of nasal mucosa were observed by H-E staining. The apoptosis of cells was detected by the TUNEL method. Expression levels of TNF-α, IL-1β, and IgE in nasal mucosa fluid were detected with ELISA. Changes of expressions of NF-κB p65, IκB, and apoptosis-related proteins were measured by Western blotting. Results  Symptoms of AR and inflammatory response of the TNF-α antibody intervention group alleviated. Compared with the AR model group, expression levels of TNF-α, IL-1β, and IgE in nasal mucosa fluid and NF-κB p65, cleaved caspase-3, and Bax in nasal mucosa tissues decreased significantly, but expression levels of IκB and Bcl-2 increased. Conclusion  The intervention of TNF-α monoclonal antibody has certain therapeutic effect on rats with allergic rhinitis by inhibiting the activation of NF-κB signaling pathway, regulating Th1/Th2 balance, decreasing expression levels of inflammatory factors, and inhibiting apoptosis of cells.

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    Effect of dexmedetomidine on expression of triggering receptor expressed on myeloid cells-1 in lung tissues of rats with sepsis
    LU Yang, XUE Fei, ZHAO Hong-sheng, et al
    2015, 35 (9):  1274. 
    doi: 10.3969/j.issn.1674-8115.2015.09.007
    Abstract ( 858 )   PDF (2764KB) ( 852 )  

    Objective  To observe the effect of dexmedetomidine on the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in lung tissues of rats with sepsis. Methods  Sixty male Sprague Dawley (SD) rats were randomly divided into the sham group (n=15), sepsis group (n=15), dexmedetomidine group (n=15), and yohimbine+ dexmedetomidine group (n=15). The sepsis model was established by cecal ligation and puncture (CLP). The survival rate of rats in 24 h was observed. Serum IL-6, TNF-α, and sTREM-1 levels were measured by enzyme-linked immunosorbent assay (ELISA). The pathological changes of lung tissues were observed and scored. The expression of TREM-1 in lung tissues was detected by real-time PCR and immunohistochemichal method. Results  Compared with the sepsis group, the mortality rate and serum IL-6, TNF-α, and sTREM-1 levels of dexmedetomidine group remarkably decreased (P<0.05). The inflammatory response of lung tissue significantly alleviated (P<0.05) and the expression of TREM-1 remarkably decreased (P<0.05). Conclusion  Dexmedetomidine can alleviate the inflammatory response of lung tissues of rats with sepsis by inhibiting the expression of TREM-1.

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    Effect of tensile force on expression of extracellular matrix metalloproteinase inducer in human periodontal ligament fibroblasts and study on relevant signal pathways
    BAO Jing, XIE Ming, JIAO Ting
    2015, 35 (9):  1280. 
    doi: 10.3969/j.issn.1674-8115.2015.09.008
    Abstract ( 856 )   PDF (1489KB) ( 876 )  

    Objective  To investigate changes of the expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in periodontal ligament fibroblasts (PDLFs) under cyclic tensile force and relevant effect on the expression of vascular endothelial growth factor (VEGF) and evaluate possible effect of EMMPRIN during the course of periodontium remodeling under mechanical stress. Methods  Immunofluorescent histochemical staining was performed to locate the expressions of EMMPRIN and VEGF in PDLFs. PDLFs were exposed to 6%, 12%, and 20% cyclic tensile force by the Flexcell System for 0.5, 2, 6, 12, 24, 36, 48, and 72 h. Changes of gene and protein expressions of EMMPRIN and VEGF in PDLFs were observed by real-time PCR and Western blotting. Changes of mRNA and protein expressions of VEGF in PDLFs were observed 6, 12, and 24 h after exogenous EMMPRIN protein was added into the PDLFs culture medium. Results  The protein expression of EMMPRIN was mainly detected in the cell membrane and cytoplasm of PDLFs, while the expression of VEGF was observed in nuclei as well as cell cytoplasm. The mRNA and protein expressions of both EMMPRIN and VEGF specifically up-regulated after PDLFs were exposed to 6%, 12%, and 20% mechanical tensile force. The exogenous EMMPRIN protein enhanced the mRNA expression of VEGF in PDLFs. Conclusion  The mechanical tensile force can specifically up-regulate the expressions of EMMPRIN and VEGF in PDLFs. EMMPRIN may regulate the expression of VEGF and involve in the course of periodontal remodeling under stress with VEGF.

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    Mechanism of inhibiting proliferation of vascular endothelial cells by rapamycin combined with cyclosporin A
    SHANG Ming-hua, GUO Hai-ying, WANG Ling, et al
    2015, 35 (9):  1286. 
    doi: 10.3969/j.issn.1674-8115.2015.09.009
    Abstract ( 929 )   PDF (652KB) ( 867 )  

    Objective  To investigate the inhibitory effect of rapamycin (Rapa) on the proliferation of vascular endothelial cells induced by cyclosporin A (CsA) and possible mechanisms. Methods  Human umbilical vein endothelial cells (HUVECs) that proliferated under the induction of CsA were treated by different concentrations of Rapa. The synthesis of DNA and protein was detected by 3H-TdR incorporation and 3H-leucine incorporation. The secretion of Ang Ⅱ in cytoplasm and culture medium was measured by radioimmunoassay. Western blotting was adopted to assess expressions of ribosomal protein S6 kinase (p70S6K) and ERK2. Results  Compared with the CsA group, the synthesis of DNA and protein of vascular endothelial cells of the CsA+Rapa intervention group was significantly inhibited and AngⅡ levels in culture supernatant and protein extract significantly decreased and were dose-dependent with Rapa. Results of Western blotting showed that compared with the CsA group, the expressions of p70S6K of the CsA+Rapa (10 nmol/L) intervention group and CsA+Rapa (100 nmol/L) intervention group significantly decreased. The expression of ERK2 of the CsA+Rapa intervention group decreased in a dose-dependent manner, but the difference was not statistically significant (P>0.05).  Conclusion  Rapa may inhibit expression of p70S6K, block PI3K-p70S6K signaling pathway, and inhibit the vascular endothelial cells stimulated by CsA from secreting AngⅡ, so as to inhibit the proliferation of vascular endothelial cells by inhibiting the expression of signal protein p70S6K. The immunosuppression therapy of Rapa combined with CsA facilitates inhibiting the proliferation of vascular endothelial cells of grafts.

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    Original article (Clinical research)
    Analysis of pathologic features of recurrent gliomas and therapeutic effect of surgery
    HOU Yan-li, BAI Yong-rui, CHEN Hai-yan, et al
    2015, 35 (9):  1299. 
    doi: 10.3969/j.issn.1674-8115.2015.09.011
    Abstract ( 915 )   PDF (698KB) ( 924 )  

    Objective  To explore the pathological changes of recurrent gliomas and the clinical value of operation. Methods  A total of 13 patients with recurrent brain gliomas who underwent surgical treatment at the Department of Neurosurgery of Renji Hospital of Shanghai Jiao Tong University School of Medicine between January 2004 and January 2014 were retrospectively analyzed. The pathological changes of different grades of recurrent gliomas and the prognosis were compared. Results  Among all patients, 7 of them (53.8%) pathologically upgraded, 5 of them (38.5%) remained the same, and one patient (7.7%) pathologically degraded. The median survival time of patients was 28 months (2-63 months), 1 year survival rate was 52%, and 2 year survival rate was 42%. Univariate analysis showed that the pathological level of recurrent gliomas, time between two operations＞12 months, expressions of phosphatase and tensin homolog deleted on chromosome ten (PTEN) of patients with primary gliomas, and expressions of p53 and Ki-67 of patients with recurrent gliomas were closely correlated with the overall survival time of patients (P<0.05). Multivariate analysis suggested that the pathological level of recurrent gliomas was the independent prognostic factor for the survival of patients (P=0.031). Conclusion  Most patients with recurrent gliomas pathologically upgrade and operation is helpful for the survival of patients.

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    Study on polymorphism of HLA-DRB1 alleles of Han and Uygur patients with nasopharyngeal carcinoma in Xinjiang
    HUANG Li, TAN Yao, WANG Ruo-zheng
    2015, 35 (9):  1304. 
    doi: 10.3969/j.issn.1674-8115.2015.09.012
    Abstract ( 993 )   PDF (548KB) ( 859 )  

    Objective  To investigate the relationship between polymorphism of human leukocyte antigen (HLA) HLA-DRB1 alleles and the incidence of nasopharyngeal carcinoma (NPC) of Han and Uygur people in Xinjiang. Methods  Polymerase chain reaction-sequence specific primers (PCR-SSP) technique was adopted to detect the allele frequencies of HLA-DRB1 for 55 Han patients with NPC, 41 Uygur patients with NPC, 62 Han healthy controls, and 35 Uygur healthy controls. The difference of distribution of allele frequencies between patients and controls were compared. Results  ①The allele frequency of HLA-DRB1*08 of Han patients with NPC was higher than that of controls (P<0.05) and the allele frequencies of DRB1*11 and DRB1*15 were lower than those of controls (P<0.05). After P was corrected by Bonferroni correction, the difference of allele frequencies of HLA-DRB1 were not statistically significant (Pc>0.05). ②The difference of allele frequencies of HLA-DRB1 between Uygur patients with NPC and controls were not statistically significant (Pc>0.05). ③The allele frequencies of HLA-DRB1*08, DRB1*09, and DRB1*12 of Han patients with NPC were higher than those of Uygur patients with NPC (P<0.05) and the allele frequencies of DRB1*07 and DRB1*13 were lower than those of Uygur patients with NPC (P<0.05). After Bonferroni correction, the differences of allele frequencies of DRB1*07 (Pc=0.002), DRB1*08 (Pc=0.009), and DRB1*09 (Pc=0.039) were statistically significant. Conclusion  The allele frequencies of HLA-DRB1 of Han patients with NPC are different from those of Uygur patients with NPC in Xinjiang. Polymorphism of HLA-DRB1 alleles may not correlate with the incidence of NPC of Han and Uygur people.

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    Effect of viral clearance on function of grafts and long-term prognosis of renal transplant recipients with BK virus associated nephropathy
    HUANG Gang, WU Lin-wei, DENG Lang-hui, et al
    2015, 35 (9):  1309. 
    doi: 10.3969/j.issn.1674-8115.2015.09.013
    Abstract ( 1192 )   PDF (1136KB) ( 881 )  

    Objective  To investigate the factors affecting BK virus (BKV) clearance and analyze the effect of the course of viral clearance on graft function and long-term prognosis of renal transplant recipients with BK virus associated nephropathy (BKVAN). Methods  Forty-nine cases of BKVAN confirmed by renal transplant biopsy, quantitative assay of urine cytology, and detection of DNA levels of BKV in urine and blood were selected. Patients underwent reduction of maintenance immunosuppression and the activity of BKV and renal function were monitored regularly. According to the clearance of BKV (including Decoy cell, viruria, and viremia), patients were divided into the clearance group and non-clearance group. Differences of serum creatinine between two groups and within group at diagnosis and 6 and 12 months after reduction of immunosuppression were compared. Differences of clinical indexes between two groups were also compared. The viral clearance time and 1-, 3-, and 5-year graft survival rates were calculated by Kaplan-Meier curves and the difference of graft survival rates between two groups were compared by Log-rank test. Results  The clearance rates of Decoy cell, viruria, and viremia of recipients with BKVAN after reduction of maintenance immunosuppression were 63.8%, 27.7%, and 80.5%, respectively. The median clearance time of Decoy cell, viruria, and viremia calculated by Kaplan-Meier curves was 11, 41, and 5 months, respectively. Regular monitoring of BKV after surgery affected the viral clearance (P<0.05). The serum creatinine levels of the clearance group 6 and 12 months after reduction of immunosuppression were lower than or almost the same as those at diagnosis, while the serum creatinine levels of the non-clearance group 6 and 12 months after reduction of immunosuppression were higher than those at diagnosis. The difference of serum creatinine levels of the clearance group between 6 and 12 months after reduction of immunosuppression and at diagnosis were smaller than those of the non-clearance group (P<0.05). No acute rejection was observed after reduction of immunosuppression. The 1-, 3-, and 5-year graft survival rates of patients with BKVAN were 100%, 83.4%, and 66.4%. The 1-, 3-, and 5-year graft survival rates of the clearance group were significantly higher than those of the non-clearance group (P<0.05). Conclusion  Regular monitoring of BKV after surgery and detection of BKVAN by early renal transplant biopsy is helpful for the clearance of BKV, which can affect the function and long-term survival rate of grafts.

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    Analysis of effects of prevention and control and clinical features of cross-infection of multi-drug resistant Acinetobacter baumannii in surgery intensive care unit
    HUANG Jie, GU Qiu-ying, LI Mei-ling, et al
    2015, 35 (9):  1315. 
    doi: 10.3969/j.issn.1674-8115.2015.09.014
    Abstract ( 753 )   PDF (683KB) ( 896 )  

    Objective  To evaluate the effect of de-escalation prevention and control strategy on controlling the cross-infection of multi-drug resistant Acinetobacter baumannii (MDRAB) in surgery intensive care unit (SICU) and analyze characteristics of strains and clinical features of colonization and infection. Methods  The active bacterial surveillance and the de-escalation prevention and control strategy were carried out for all patients admitted in SICU of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from August 2013 to July 2014. Effects of prevention and control, characteristics of strains, and clinical parameters were analyzed. Results  A total of 49 strains of MDRAB with high antibiotic resistance were isolated and 32 (65.3%) of them were strains of colonization and 17 (34.7%) of them were strains of infection. Both overall detection rate and SICU acquired rate of MDRAB significantly decreased (P<0.001). The administration rate of carbapenem before admission and incidence of high APACHEⅡ score, shock, acute respiratory dysfunction, acute kidney injury and mechanical ventilation of patients with MDRAB colonization/infection were significantly higher than those of patients without MDRAB colonization/infection (P<0.05).  However, the differences of clinical features between patients with MDRAB colonization and patients with MDRAB infection were not statistically significant (P>0.05). Conclusion  It is difficult to analyze and predict the MDRAB infection based on clinical high risk factors. However, the spread of drug resistant bacteria can be efficiently controlled and cross-infection rate of MDRAB in SICU can be decreased by classification of high risk factors and application of de-escalation prevention and control strategy.

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    Value of features of sentinel lymph node revealed by subcutaneous contrast-enhanced ultrasound for identifying malignant and benign axillary lymph nodes
    LI Yi, WANG Yan, CHANG Ting, et al
    2015, 35 (9):  1320. 
    doi: 10.3969/j.issn.1674-8115.2015.09.015
    Abstract ( 1146 )   PDF (1311KB) ( 855 )  

    Objective  To investigate whether subcutaneous contrast-enhanced ultrasound can identify the features of sentinel lymph node (SLN) and the value for identifying malignant and benign axillary lymph nodes. Methods  The rabbit model of breast cancer was established under sterile condition. Contrast enhanced agent was injected around the breast tumor subcutaneously after tumors were inoculated for six weeks. The features of lymph nodes were identified and marks were made on the skin. Activated nono-carbon particles were injected after 30 min. Results of contrast-enhanced ultrasound of SLNs were observed. Malignant and benign SLNs were identified and marks were made on the skin. Rabbits were sacrificed after observation and tumors were harvested. The axillary lymphadenectomy was conducted and pathological examination was performed for all lymph nodes. Results  A total of 16 tumors were found in 20 breasts of 10 rabbits and 11 of them metastasized and 5 of them did not metastasize. The subcutaneous contrast-enhanced ultrasound detected 16 of 17 SLNs (94.12%). The sensitivity, specificity, PPV, NPV, and accuracy of subcutaneous contrast-enhanced ultrasound for diagnosing malignant lymph nodes were 80.0%, 71.42%, 80.0%, 71.42%, and 76.47% respectively. The P value between contrast-enhanced ultrasound and differential test of pathological diagnosis (McNemar test) for diagnosing malignant SLNs was 0.688. Two methods were consistent with Kapp=0.514 and P=0.034. Conclusion  Subcutaneous contrast-enhanced ultrasound is valuable for diagnosing malignant SLNs of breast cancer and can reveal the metastasis of axillary lymph nodes.

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    Application of low-dose combined with iDose iterative reconstruction in CT scan of upper abdomen
    YUAN Xiao-na, GAO Zhi-ling, ZHU Kai, et al
    2015, 35 (9):  1325. 
    doi: 10.3969/j.issn.1674-8115.2015.09.016
    Abstract ( 1297 )   PDF (1280KB) ( 1059 )  

    Objective  To compare differences of reconstruction with filtered back projection (FBP), iDose1, iDose3, and iDose5 on the quality of CT images of upper abdomen between low-dose CT scan and routine-dose CT scan. Methods  According to the examination order, 60 patients underwent the contrast-enhanced routine-dose CT scan of upper abdomen and another 60 patients underwent the low-dose CT scan of upper abdomen. The automatic tube current technique was adopted and the mAs reference value of portal venous phase of the low-dose group was 20% lower than that of the routine-dose group. CT images of portal venous phase of two groups were reconstructed by filtered back projection, iDose1, iDose3, and iDose5. The noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of images were calculated. The subjective quality (noise, diagnostic acceptability, artifacts, and sharpness) of images was evaluated by 2 radiologists with work experience of more than 5 years. Patients of routine-dose group and low-dose group were divided into two subgroups according to the gender. Volume CT dose index (CTDIvol) and dose length product (DLP) were recorded and effective dose (ED) were calculated. Results  Low-dose CT scan combined with iDose reconstruction could satisfy the diagnostic demand. Compared with the routine-dose group, CTDIvol, DLP, and ED of male patients of the low-dose group decreased 26.39%, 26.71%, and 26.71%, respectively, while those of female patients of the low-dose group decreased 24.52%, 25.27%, and 25.27%, respectively. Conclusion  Low-dose CT scan combined with iDose iterative technique can effectively reduce the radiation dose while meeting the diagnostic quality of images.

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    Protein expression of LRIG3 in tissues of cervical squamous cell carcinoma and its relation with cell proliferation
    GUO Li-chen, ZHANG Rui, YE Qin-fen, et al
    2015, 35 (9):  1331. 
    doi: 10.3969/j.issn.1674-8115.2015.09.017
    Abstract ( 787 )   PDF (489KB) ( 830 )  

    Objective  To explore the protein expression of LRIG3 in tissues of cervical squamous cell carcinoma and the correlation between the protein expression of LRIG3 and cell proliferation. Methods  The paraffin embedded specimens of 45 cases of cervical squamous cell carcinoma, 20 cases of cervical intraepithelial neoplasia (CIN), and 30 cases of normal cervical tissues from 2009 to 2011 were collected from the Pathology Department of the First Affiliated Hospital of Zhengzhou University. Immunohistochemical SP method was adopted to detect the protein expressions of LRIG3 and Ki-67 in cervical tissues and statistical analysis was performed. Results  The positive expression rates of LRIG3 in tissues of cervical squamous cell carcinoma and CIN and normal cervical tissues were 35.56%, 70.00%, and 100.00%, respectively and the differences were statistically significant (P<0.05). The positive expression rates of Ki-67 in tissues of cervical squamous cell carcinoma and CIN and normal cervical tissues were 86.67%, 30.00%, and 3.33%, respectively and the differences were statistically significant (P<0.01). The expression of LRIG3 significantly correlated with the expression of Ki-67 (P<0.01). Conclusion  The low protein expression of LRIG3 in tissues of cervical squamous cell carcinoma is relevant to the proliferation of tumor cells, which suggests the down-regulation of LRIG3 may be relevant to cervical squamous cell carcinoma.

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    Characteristics of acute kidney injury of senile patients and evaluation of blood purification treatment
    SITU Bi-ying, YAN Jia-lin, SUN Jian-she, et al
    2015, 35 (9):  1335. 
    doi: 10.3969/j.issn.1674-8115.2015.09.018
    Abstract ( 854 )   PDF (1049KB) ( 905 )  

    Objective  To investigate the characteristics and treatment of acute kidney injury (AKI) of senile patients. Methods  A total of 150 cases of AKI treated from January 2009 to December 2014 were retrospectively analyzed. All cases accorded with the diagnosis criteria of AKI of KDIGO. Accompanied diseases, severity of diseases, and 60-day fatality rate of patients older than 80 years and younger than 60 years were compared. Biochemical indexes and blood pressure of patients before and after blood purification were monitored and risk factors of mortality of two groups were analyzed. Results  Among 150 patients, 91 of them were older than 80 years (senile group) with average age of (88.6±5.0) years and 59 of them were younger than 60 years (adult group) with average age of (44.3±12.6) years. Accompanied diseases of the senile group were primary hypertension, coronary heart disease, and diabetes mellitus, while those of the adult group were acute or chronic nephritis, malignant tumor, systemic autoimmunity disease, and obstructive nephropathy. And 27.1% of patients of the adult group did not have any accompanied diseases. Diseases of the senile group were severer than those of the adult group. APACHE Ⅲ scores, rate of medical ventilation, and the incidence of sepsis, hypotension, and MODS of the senile group were significantly higher than those of the adult group (P<0.001). In the senile group, 94.5% of patients underwent bedside slow low-efficiency daily dialfiltration (SLEDD-f) therapy, while 93.2% of patients of the adult group accepted intermediate hemodialysis (IHD). The differences of systolic and diastolic pressures between two groups before treatment were statistically significant, but after blood purification, the differences between two groups were not statistically significant. The serum creatinine and HCO3- levels within the group before and after treatment were significantly different. The 60-day fatality rate of the senile group was 65.9%, which was significantly higher than that of the adult group (30.5%, P＜0.01). The risk factors of mortality of two groups were APPECH Ⅲ scores, MODS, and age. Conclusion  Diseases of senile patients with AKI were severer than those of the adult patients and the fatality rate of senile patients was higher due to decreased renal function and more accompanied diseases. Comprehensive treatment is more suitable for senile patients with complications and unstable hemodynamic indexes.

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    Analysis of effect of antithyroid drugs on efficacy of 131I for treating Graves' disease
    GU Ai-chun, ZHOU Wen-ting, MA Yu-bo
    2015, 35 (9):  1340. 
    doi: 10.3969/j.issn.1674-8115.2015.09.019
    Abstract ( 875 )   PDF (646KB) ( 854 )  

    Objective  To analyze the effect of antithyroid drugs (ATD) on the efficacy of 131I for treating Graves' disease (GD). Methods  Data of 460 cases of GD treated by 131I was retrospectively analyzed. Patients were cured and followed up for more than one year. Among them, 130 were males (28.3%) and 330 were females (71.7%). Their age was 11-84 years and average age was (41.8±13.4) years. Patients were divided into two groups, i.e. non ATD group (control group) and ATD group (analysis group), according to whether administration of ATD before treatment. The analysis group was divided into the drug withdrawal above 2 weeks subgroup and drug withdrawal under 2 weeks subgroup according to the drug withdrawal time before treatment. The differences of therapeutic effect of groups after first treatment were compared and the proper withdrawal time of ATD before treatment was analyzed. Results  ①The differences of age, 24 h 131I uptake rate, and 131I dose and thyroid mass ratio between the control group and analysis group were not statistically significant (t=-1.77-1.76, P>0.05). ②The first time cure rates of the control group and two analysis subgroups were 94.9% (74/78), 65.0% (89/137), and 83.3% (204/245) respectively, with χ2=5.71-22.64 and P<0.05 or 0.01. The later hypothyroidism rates of three groups were 66.7% (52/78), 38.0% (52/137), and 54.7% (134/245) respectively, with χ2=3.98-15.28 and P<0.05 or 0.01. ③The withdrawal time of ATD was positively correlated with the cure rate (r=0.96, P<0.01). The cure rate of analysis group was close to that of the control group for withdrawal time of ATD was more than 8 weeks. Conclusion  Administration of ATD and inadequate withdrawal time of ATD before 131I treatment of patients with GD can affect the therapeutic effect of 131I and decrease the first time cure rate. The effect of administration of ATD will be eliminated for withdrawal time of ATD is more than 8 weeks.

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    Therapeutic effect of high-flux hemodialysis combined with hemoperfusion on patients with end stage renal disease
    DOU Lin-bin, ZHANG Wei-ming, WANG Yong-mei, et al
    2015, 35 (9):  1344. 
    Abstract ( 750 )   PDF (732KB) ( 882 )  

    Objective  To investigate the effects of combination of high-flux hemodialysis (HFD) with hemoperfusion (HP) on the removal of middle and large molecule solutes such as serum fibroblast growth factor 23 (FGF23) and interleukin 6 (IL-6) and the improvement of life quality of patients undergoing maintenance hemodialysis (MHD). Methods  A total of 35 MHD patients were enrolled and underwent two HFD and one HFD+HP per week for 12 months. Indexes such as serum albumin, hemoglobin, phosphorus, calcium, and intact parathyroid hormone (iPTH) were measured every 3 months. Serum FGF23 and IL-6 were detected by ELISA in 0, 6, and 12 months. SF-36 scale was used to evaluate the life quality of patients at the beginning and end of study. Results  A total of 33 patients were followed up for 12 months. The mean age was (59.06±0.64) years and mean dialysis vintage was (178.94±51.50) months. Hemoglobin, pre-albumin, albumin, calcium, phosphorus, and iPTH of patients during follow-up were not significantly different from those before treatment. FGF23 decreased remarkably after being treated for 6 months (P=0.046) and decreased continuously after being treated for 12 months (P=0.006). IL-6 decreased remarkably after being treated for 6 months (P=0.015) and decreased continuously after being treated for 12 months (P=0.015). Scores of all items of MHD patients improved significantly after being followed up for 12 months (P<0.05). Conclusion  HFD+HP can efficiently remove middle and large molecule toxins and is an effect treatment for improving the life quality of MHD patients.

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    Analysis of risk factors of tricuspid valve replacement for patients with secondary tricuspid regurgitation after cardiac surgery
    ZHAO Jin-long, ZHANG Wei, SHI Wei, et al
    2015, 35 (9):  1350. 
    doi: 10.3969/j.issn.1674-8115.2015.09.021
    Abstract ( 812 )   PDF (531KB) ( 861 )  

    Objective  To retrospectively analyze death risk factors of tricuspid valve replacement for patients with tricuspid regurgitation after cardiac surgery and evaluate the risk prediction of New EuroSCORE Ⅱ after tricuspid valve replacement. Methods  The clinical data of 77 patients who underwent the tricuspid valve replacement after cardiac surgery were retrospectively analyzed and univariate analysis and multivariate analysis were conducted. Results  The univariate analysis showed that NYHA class Ⅳ, right heart failure, elevated pulmonary artery pressure, total bilirubin, creatinine, urea, uric acid, sinus rhythm, cardiopulmonary bypass time, protection fluid, blocking time, and smaller prosthesis during the operation were statistically significant for early postoperative death (P<0.05). Elevated creatinine before operation and absence of atrial fibrillation were independent risk factors of early death of patients undergoing the tricuspid valve replacement after cardiac surgery (P<0.05). The difference of EuroSCORE between the death group and survival group was statistically significant. Conclusion  Attention should be paid to patients with abnormal renal function who will undergo the tricuspid valve replacement after cardiac surgery due to tricuspid regurgitation. New EuroSCORE Ⅱ is a reliable scoring system for predicting the risk of operation.

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    Expression of CD44 of patients with pancreatic cancer and its clinical significance
    LI Xiao-ping, ZHANG Xiao-wei, GUO Wei-jian, et al
    2015, 35 (9):  1354. 
    doi: 10.3969/j.issn.1674-8115.2015.09.022
    Abstract ( 1082 )   PDF (1655KB) ( 964 )  

    Objective  To investigate possible effects of CD44 on the incidence and development of human pancreatic caner and the correlations among CD44 and clinical pathological parameters, survival period, and prognosis of patients with pancreatic cancer. Methods  A total of 67 pancreatic cancer samples were collected in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2010 to Dec. 2012. The gender, age, histological typing, location of tumor, and lymph node metastasis of patients were recorded and the expression of CD44 was detected by the immunohistochemical method. Results  The positive rate of CD44 expression of 67 samples was 73.1% (49/67). Univariate analysis showed that the positive expression of CD44 was correlated with T staging, TNM staging, lymph node metastasis, the differentiation degree, and location of tumor (P<0.05). The differences of the positive rate of CD44 expression of patients with different age, gender, vascular invasion, and nerve invasion were not statistically significant (P>0.05). The Cox proportional hazards model analysis showed that differentiation, CD44 expression, and nerve invasion were independent prognostic factors. Conclusion  The expression level of CD44 of patients with pancreatic cancer was high and correlated with the malignant degree of pancreatic cancer. CD44 expression, differentiation, and nerve invasion are independent prognostic factors of pancreatic cancer.

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    Expression of CA125 in epithelial ovarian cancer and analysis of its correlation with prognosis
    ZHENG Xuan, LU Hai-qian, LIN Qin
    2015, 35 (9):  1360. 
    doi: 10.3969/j.issn.1674-8115.2015.09.023
    Abstract ( 956 )   PDF (497KB) ( 793 )  

    Objective  To explore the expression of CA125 of epithelial ovarian cancer (EOC) and its correlation with the prognosis. Methods  The clinical data of 247 cases that diagnosed with EOC were retrospectively analyzed. All patients were followed up for at least 5 years or till they were dead. CA125 levels were detected by chemiluminescence immunoassay and divided into four intervals, i.e. q1, q2, q3, and q4. The differences of expressions of CA125 of patients with different clinical features and the survival of patients with CA125 levels within four intervals were compared. The prognosis factors were analyzed by Logistic regression analysis. Results  The differences of expressions of CA125 of patients with different age, pathological type, FIGO staging, histological differentiation, and postoperative residual lesion size were statistically significant (P<0.05). The median survival time of the four intervals (q1,q2,q3, and q4) were 58, 40, 19, and 11 months and 5-year survival rates were 48.4%(30/62), 32.3%(20/62), 21.0%(13/62), and 11.5%(7/61). The differences were statistically significant (P<0.05). Logistic regression analysis showed that compared with q1, OR (95%CI) of prognosis of death of q2, q3, and q4 were 1.624 (1.445-1.825), 2.447 (1.785-3.355) and 4.121 (2.624-6.472), respectively. Conclusion  The expression of CA125 is correlated with different clinical pathological characteristics of patients with epithelial ovarian cancer. Preoperative CA125 level may be an independent predictor of prognosis of epithelial ovarian cancer.

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    Effect of biofilm formation of Acinetobacter baumannii strains isolated from burn patients on expressions of efflux pump regulatory genes adeS and adeR and corresponding functional gene cluster adeAB
    XIANG Jun, GUO Hai-na, HUAN Jing-ning
    2015, 35 (9):  1364. 
    doi: 10.3969/j.issn.1674-8115.2015.09.024
    Abstract ( 796 )   PDF (812KB) ( 895 )  

    Objective  To explore changes of expressions of efflux pump upstream regulatory genes adeS and adeR and corresponding functional gene cluster adeAB of  Acinetobacter baumannii (AB) isolates under free and biofilm formation conditions and investigate the effect of biofilm formation on the active efflux function and drug resistance. Methods  Nine drug-resistant and nine drug-sensitive AB strains isolated from wound excretion, blood, and venous catheter of burn patients hospitalized in Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from March to September 2013 were collected. The strains were cultured for 24 h by tube method under shaking condition and the relative mRNA expressions of efflux pump gene adeA and adeB and regulatory genes adeS and adeR were detected by quantitative real-time PCR. Results  Expressions of adeA, adeB, adeS, and adeR of drug-resistant and drug-sensitive strains under free condition (free bacteria) were higher than those under biofilm formation condition (biofiim bacteria) (P<0.05). Expressions of adeA and adeB of drug-resistant strains under free and biofilm formation conditions were higher than those of sensitive strains (P<0.05). Conclusion  The active efflux function is a major mechanism of drug resistance of AB under free condition. After biofilm was formed, AB can down-regulate the expression of adeS by sensing the changes of biofilm condition, inactivating the adeR, and decreasing the expression of functional gene adeAB, which makes the biofilm being the leading cause for drug resistance.

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    Value of automated breast volume scanner for evaluating prognosis of breast cancer
    JIN Ye, LI Feng-hua, WANG Lin, et al
    2015, 35 (9):  1369. 
    doi: 10.3969/j.issn.1674-8115.2015.09.025
    Abstract ( 885 )   PDF (1737KB) ( 909 )  

    Objective  To investigate the value of automated breast volume scanner (ABVS) for evaluating the prognosis of breast cancer. Methods  ABVS images of 81 cases of breast cancer were analyzed. Morphological manifestations such as the lesion margin, growth orientation, posterior echo, calcification status, and retraction phenomenon were observed and the correlation with prognostic factors of breast cancer such as pathological grade, lymph node, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (c-erbB-2) was analyzed. Results  Among 81 cases, 42 (51.85%) had spiculate margin, and only 5 of them (11.90%) were found on the coronal plan. For patients with spiculate margin, the ER/PR positive rate was high (P<0.001) and c-erbB-2 positive rate was low (P<0.001). Among 81 cases, 25 (30.86%) had posterior enhancement and most of them were breast cancer patients with negative ER/PR and positive c-erbB-2 (P<0.001). Among 81 cases, 43 (53.09%) had microcalcification and was relevant to positive expression of c-erbB-2 (P=0.018). Among 81 cases, 37 (45.68%) had retraction phenomenon and most of them were breast cancer patients with low grades (grade Ⅰ/Ⅱ)(P=0.023), positive ER/PR, and negative c-erbB-2 (P<0.001). Conclusion  ABVS can reflect prognostic factors of breast cancer based on morphological features, especially retraction phenomenon, and can efficiently evaluate the prognosis of breast cancer.

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    Original article (Public health)
    Compilation of work value questionnaire for medical staff and evaluation of its reliability and validity
    GU Wei-min, JIANG Li-juan, GAO Yang, et al
    2015, 35 (9):  1374. 
    doi: 10.3969/j.issn.1674-8115.2015.09.026
    Abstract ( 1134 )   PDF (745KB) ( 1022 )  

    Objective  To compile the work value questionnaire for medical staff and provide a quantitative tool for studying the status and influencing factors of the work value of medical staff. Methods  According to work values questionnaire (WVQ), Minnesota satisfaction questionnaire (MSQ), and work values inventory (WVI), the work value questionnaire for medical staff was compiled. A total of 100 medical staff was enrolled by stratified random sampling. The t-test was adopted to perform the project analysis for questionnaires. The reliability and validity of the work value questionnaire for medical staff were evaluated by reliability test and factor analysis. Results  A total of 34 items were kept by screening. The Cronbach's alpha coefficient was 0.948; Kaiser-Meyer-Olkin (KMO) was 0.857; and P of Bartlett's test of sphericity was 0.000. Therefore, the results were highly effective and suitable for factor analysis. Conclusion  The work value questionnaire for medical staff has high reliability and validity after being adjusted and can be used to evaluate the work value of medical staff.

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    Review
    Angiotensin-(1-7)/Mas: novel therapeutic targets for treatment of pulmonary diseases
    LIU Yu-jing, LI Ying-chuan
    2015, 35 (9):  1379. 
    doi: 10.3969/j.issn.1674-8115.2015.09.027
    Abstract ( 1173 )   PDF (560KB) ( 967 )  

    Lung is a major site for the expression of angiotensin-converting enzyme (ACE) and generation of angiotensin Ⅱ (AngⅡ). Studies have showed that the renin-angiotensin system (RAS) involves in the pathogenesis of acute respiratory distress syndrome, pulmonary fibrosis, pulmonary hypertension, asthma, and lung cancer. There are two axes in the RAS, i.e. the ACE/AngⅡ/angiotensin Ⅱ type 1 receptor (AT1R) axis and the ACE2/angiotensin-(1-7) [Ang-(1-7)]/Mas axis. AngⅡ involves in the incidence and development of many pulmonary diseases through its specific receptor AT1R, while Ang-(1-7) counteracts the effect of AngⅡ via specific receptor Mas. This paper reviews the protective effect and possible molecular mechanisms of Ang-(1-7)/Mas during the course of several common pulmonary diseases.

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    Research advances of structural proteins of sperm flagella
    SONG Ping-ping, ZOU Sha-sha, LI Zheng, et al
    2015, 35 (9):  1384. 
    doi: 10.3969/j.issn.1674-8115.2015.09.028
    Abstract ( 995 )   PDF (626KB) ( 1103 )  

    The flagellum is the motility organ of mature sperms and its microtubule based axoneme structure is highly conservative during evolution. The defect or missing of sperm flagella protein, which is relevant to the structure and function of sperms, can lead to motility dysfunction of sperms and cause male infertility. This paper reviews the latest research advances of molecules relevant to the formation and motility of sperm tails. Problems of structure and function of these molecules are closely related to many clinical diseases.

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    Advances of calcium/calmodulin-dependent protein kinase Ⅱin major depressive disorder
    HUANG Yue-qi, PENG Dai-hui
    2015, 35 (9):  1389. 
    doi: 10.3969/j.issn.1674-8115.2015.09.029
    Abstract ( 1179 )   PDF (615KB) ( 1039 )  

    Calcium/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) plays a crucial role in regulation of synaptic plasticity, glutamate receptors, and phosphorylation of cyclic adenosine phosphate response element binding protein (CREB), which are relevant to the major depressive disorder. This paper reviews possible mechanisms of CaMKⅡ in the process of major depressive disorder.

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    Signal regulation between osteocalcin and glucose metabolism
    ZHAO Xue-lin, TANG Qing-ya
    2015, 35 (9):  1394. 
    doi: 10.3969/j.issn.1674-8115.2015.09.030
    Abstract ( 951 )   PDF (604KB) ( 857 )  

    The effect of osteocalcin (OC) on glucose and energy metabolism is an important part of endocrine function of the skeleton, which provides a new direction for the prevention and treatment of diabetes and obesity. OC has two forms, i.e. completely carboxylated and undercarboxylated OC (ucOC). The latter is an active form for facilitating the endocrine regulation by regulating the physiological action via affecting the expression and decarboxylation of OC. Many molecular or cellular level researches and animal experiments have revealed that OC may promote the proliferation of pancreatic β cell, secretion of insulin, and insulin sensitivity, and insulin may also affect the expression and decarboxylation of OC by various signal transductions. This paper reviews the signal regulation between OC and glucose metabolism.

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    Research progresses of sweet and bitter taste receptors on surface of enteroendocrine cells
    LI Xiang, ZHU Kai-wen, GAO Yue, et al
    2015, 35 (9):  1398. 
    doi: 10.3969/j.issn.1674-8115.2015.09.031
    Abstract ( 1124 )   PDF (591KB) ( 1125 )  

    Cells representing taste receptors and taste related factors in the mucosa of animal gastrointestinal tract regulate the secretion of intestinal hormones such as glucagon-like peptide (GLP) and 5-hydroxytrypamin (5-HT). This paper introduces enteroendocrine cells that partly locate in the mucosa of gastrointestinal tract and acting mechanisms of their taste receptors, signal transduction of taste, and mechanisms of the secretion of relevant intestinal hormones, which are not only helpful for understanding the regulatory mechanism of digestion and absorption functions of gastrointestinal tract, but also provide new ideas for the remission of diabetes mellitus, irritable bowel syndrome, and adverse reactions of chemotherapy drugs.

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    Regulatory effect of serotonin 1A receptor on depression and anxiety behaviors and relevant mechanisms
    SU Hui, SHI Shen-xun
    2015, 35 (9):  1403. 
    doi: 10.3969/j.issn.1674-8115.2015.09.032
    Abstract ( 1351 )   PDF (518KB) ( 1273 )  

    Abnormal level of serotonin (5-HT) causes adaptive changes of neurotransmitter-receptor signaling pathways, which involve brain dysfunction and neuropsychiatric disorders and closely relate to the pathogenesis of anxiety and depression disorders. Serotonin 1A (5-HT1A) receptor is the most widely distributed subtype of serotonin receptor in the brain and has become an important target for drug treatment of anxiety and depression disorders. This paper reviews the regulatory effect of 5-HT1A receptor on depression and anxiety and relevant mechanisms from perspectives of electrophysiology, transgenic zoology, signaling pathways, and pharmacology, which are helpful for thoroughly understanding functions of 5-HT1A receptor.

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    Advances of treatment of metabolic abnormalities for patients with polycystic ovary syndrome
    XU Wen-di, TAO Tao, LIU Wei
    2015, 35 (9):  1407. 
    doi: 10.3969/j.issn.1674-8115.2015.09.033
    Abstract ( 1010 )   PDF (713KB) ( 920 )  

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women at childbearing age. The main manifestations include hirsutism and  acne due to hyperandrogenism, menstrual disorders, as well as infertility caused by anovulation or oligo-ovulation. Furthermore, the risks of suffering from adverse cardiovascular events and metabolic disorders increase significantly for patients with PCOS. Clinically, the internal medicine treatments of PCOS include diet and lifestyle interventions, anti-androgens, and improving metabolic syndrome. Nowadays, the metabolic treatment that integrates multiple therapies such as improving the insulin resistance, regulating lipids, and reducing the inflammatory has gradually become a trend. Metformin, berberine, glucagon-like peptide -1 (GLP-1) receptor agonist, and other drugs that can adjust the metabolic syndrome have been widely used for the treatment of PCOS and obtained multiple curative effects. This paper reviews advances of the treatment of metabolic abnormalities for patients with PCOS.

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    Comparison of curriculum of pediatrics education for medical students between Canada and China
    GAO Yi-jin, LU Mei-hua, YIN Lei, et al
    2015, 35 (9):  1414. 
    doi: 10.3969/j.issn.1674-8115.2015.09.034
    Abstract ( 926 )   PDF (755KB) ( 899 )  

    Our traditional undergraduate curricula in pediatrics are not adequate for the demands of a competent pediatrician. To discuss that reforming in content areas in pediatrics is of great importance in meeting the current needs of populations nationally. Content areas in pediatrics between China and Canada were compared in this study. Content area should be the starting point of pediatric medical education reform, as its importance in pediatrician training.

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    Brief original article
    Analysis of influencing factors on duration of parenteral nutrition in hospitalized patients
    XU Ren-ying, WAN Yan-ping, GAO Jian, et al
    2015, 35 (9):  1418. 
    doi: 10.3969/j.issn.1674-8115.2015.09.035
    Abstract ( 900 )   PDF (579KB) ( 848 )  

    Objective  To analyze influencing factors on duration of parenteral nutrition (PN) in hospitalized patients. Methods  The clinical data of hospitalized patients who received PN for more than 3 d were collected. General information (age, gender, height, body weight, diagnosis, surgery, mechanical ventilation, and chronic metabolic diseases), blood biochemical indexes (blood routine, fast blood sugar, liver function, kidney function, calcium, phosphorus, magnesium before PN), and PN related indexes (duration, blood sugar when infusion of PN, daily calorie and protein supplementation) were recorded and the calorie goal was calculated by Schofield equation. Results  The clinical data of 643 hospitalized patients who received PN were collected. Among them, 423 were males and 220 were females. The median duration of PN was 8 d (3-370 d) and 72.8% of patients underwent total fasting. The results of multivariate variance analysis showed that history of cardiovascular diseases, mechanical ventilation, blood gamma glutamyl transpeptidase level, and average daily calorie supplement (<75% energy goal) were influencing factors of PN duration. Conclusion  Cardiovascular diseases, mechanical ventilation, high gamma glutamyl transpeptidase level, and low average daily calorie supplement can lengthen the PN duration.

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    Technique and method
    Feasibility on treating indigestible cell lines by trypsin-EDTA solution for detection of cell apoptosis
    FU Rong, ZHAO Ben-peng, YANG Jie, et al
    2015, 35 (9):  1422. 
    doi: 10.3969/j.issn.1674-8115.2015.09.036
    Abstract ( 4520 )   PDF (2299KB) ( 1150 )  

    Objective  To explore the effect of the presence of EDTA in trypsin solution on detecting the apoptosis rate by flow cytometry method (FCM). Methods  Seven indigestible cell lines were divided into the control group and experimental group (treated by H2O2 to promote apoptosis). Cells were treated by different methods (digested by 0.25% trypsin without EDTA, 0.25% trypsin with EDTA, and 0.25% trypsin with EDTA and washed by 1×PBS after being centrifugated and supernatant was removed). Cells were labeled by Annexin V-FITC fluorescent antibodies and the apoptosis rate was detected by flow cytometry (FCM). The difference of apoptosis rate under the same digestion condition between two groups was calculated. Results  Results of statistical analysis showed that differences of the apoptosis rate of seven cell lines under three digestion conditions were not statistically significant (P>0.05). Conclusion  The presence of EDTA in trypsin solution has no significant effect on detecting the cell apoptosis by FCM. Given the anti-agglutinating characteristic of EDTA, it can be added into the trypsin solution for preparation of apoptosis samples for some indigestible cell lines.

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    Case report
    Restoration of clearance between maxillary central incisors by everStick ® fibre reinforced composite: a case report
    WANG De-fang, JIA Shuang, YE Rong-rong, et al
    2015, 35 (9):  1426. 
    doi: 10.3969/j.issn.1674-8115.2015.09.037
    Abstract ( 947 )   PDF (1232KB) ( 953 )  

    Objective  To restore the clearance between maxillary central incisors by everStick ® fibre reinforced composite. Methods  A 56-year-old female patient with a clearance of 2.5 mm between maxillary central incisors refused to restore by porcelain crowns or undergo orthodontic treatment. The clearance between maxillary central incisors was restored by everStick ® fibre reinforced composite (PERIO type), flow resin, and 3M light-cured composite resin. Results  The restoration showed no signs of loosening, debonding, or cracking during 6-30 months follow-up. No secondary caries were found between the restoration and adjacent surfaces of teeth. The color of restoration is stable and beautiful and no obvious margin dying was found. Conclusion  The restoration of clearance between maxillary central incisors by PERIO type everStick ® fibre reinforced composite is successful. The abrasion resistance and mechanical strength of the restoration are satisfactory with no damage to tooth tissues of abutments and the color was stable and beautiful. This restoring method is suitable for patients with large clearance between maxillary central incisors who do not wish to undergo the fixed prothesis.

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