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    Translational medicine
    2016, 36 (01):  1. 
    Abstract ( 340 )   PDF (684KB) ( 810 )  
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    YU Jian-xiu team got new progress in miRNA mechanism
    2016, 36 (01):  4. 
    Abstract ( 562 )   PDF (449KB) ( 822 )  
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    Innovation-driven a new developing chapter of SJTU School of Medicine
    2016, 36 (01):  6. 
    Abstract ( 305 )   PDF (760KB) ( 860 )  
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    Original article (Basic research)
    Study on the biological and genomic characteristics of Pseudomonas aeruginosa phage D204
    XU Bin, GAO Jing, GUO Xiao-kui, et al
    2016, 36 (01):  8. 
    doi: 10.3969/j.issn.16748115.2016.01.001

    Abstract ( 594 )   PDF (1338KB) ( 972 )  

    Objective To identify efficient and broad-spectrum phages aiming at multi-drug resistant Pseudomonas aeruginosa. Methods Clinical isolated P.aeruginosa strains were used as host bacteria. The P.aeruginosa phages were isolated and purified from sewage. The shape and size of phages were observed by transmission electron microscope (TEM) after phosphorus acid negative staining. Titer, host range, pH stability, and thermal stability were detected. One-step growth curve, adsorption curve, and infection curve were plotted. The DNA of phages was extracted for sequencing and analysis. Results One strain of P.aeruginosa phage was isolated and named D204. The activity of D204 was high at temperatures from 37 to 50 ℃ and pH values from 4 to 11. TEM observation showed that the phage consisted of a polyhedron head with the diameter of 50 nm and a 15 nm long tail. One step growth curve indicated that during the lysis of host bacteria, the latent period of phages was about 30 min, outbreak period was about 40 min, and the burst size was about 160 pfu/cell. The adsorption curve showed that the adsorption rate was more than 95% within 50 min. The infection curve indicated that the growth of host bacteria was inhibited when the multiplicities of infection were 0.1 and 1. The growth of host bacteria was totally inhibited after 180 min. The genome of phages was circular double-stranded DNA with total length of 50 609 bp and the content of GC was 44.8%. It was predicted that there were 75 open reading frames in the genome. Conclusion Isolated P.aeruginosa phages D204 have a strong lytic ability and wide ranges of thermal and pH stability and can serve as reserved phages of P.aeruginosa.

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    Prevention of apoptosis of podocytes by protein kinase A via cAMP response element binding protein signaling pathway
    XIANG Peng, XIE Ke-wei, JIANG Jin-xing, et al
    2016, 36 (01):  9. 
    doi: 10.3969/j.issn.1674-8115.2016.01.002

    Abstract ( 895 )   PDF (2879KB) ( 706 )  

    Objective To explore the effects of cAMP response element binding protein (CREB) signaling pathway on the protection of podocytes by the protein kinase A (PKA). Methods The 14-25 generations of mouse podocytes 5P12 differentiated under constant condition were selected and divided into the control group, adriamycin (ADR) treatment group (ADR group), and PKA specific agonist (pCPT-cAMP) pre-culture+ADR stimulation group (pCPT-cAMP+ADR group). Cell toxicity was detected by CCK-8 method. The expression of cleaved caspase-3 in podocytes was detected by Western blotting. The expression of CREB in podocytes was inhibited by siRNA and the localization and expression of phosphorylated CREB (p-CREB) were detected by immunofluorescence confocal microscopy and Western blotting. Results ADR induced up-regulation of the expression of cleaved caspase-3 in podocytes and pre-culture by pCPT-cAMP could significantly decrease the elevated expression of cleaved caspase-3 induced by ADR. ADR decreased the number of podocytes to (40.45±6.78)% of its original number and pre-culture by pCPT-cAMP increased the number of podocytes to (69.8±5.48)% of its original number. Results of Western blotting showed that pre-culture by pCPT-cAMP for 5 and 15 min could increase the expressions of p-CREB in total protein of podocytes by (105.64±38.21)% and (98.61±41.03)% and those in nuclei by (114.52±11.28)% and (118.84±14.44)%. Immunofluorescence confocal microscopy showed that pCPT-cAMP mainly increased the expression of p-CREB in nuclei. siRNA could decreased the protein expression of CREB in podocytes to (25.1±2.44)% of its original expression and pre-culture by pCPT-cAMP could not prevent the ADR-induced up-regulation of the expression of cleaved caspase-3. Conclusion Transcription factor CREB mediates the protective effect of PKA signaling pathway on podocytes.

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    Effects of AMD3100 on rats of spared nerve injury model
    HUANG Xue-hua, LIU Ning-jie, DAI Li-hua, et al
    2016, 36 (01):  13. 
    doi: 10.3969/j.issn.1674-8115.2016.01.003

    Abstract ( 628 )   PDF (1055KB) ( 762 )  

    Objective To observe the effects of intrathecal injection of CXCR4 specific antagonist AMD3100 on rats of spared nerve injury (SNI) model. Methods A total of 60 male SD rats were randomly divided into 3 groups, i.e. sham group (n=10), control group (n=25), and AMD3100 group (n=25). SNI was adopted to establish the neuropathic pain model. Rats of AMD3100 group underwent continuous intrathecal injection of AMD3100 (1μg per mouse, once a day for two weeks), while rats of sham group and control group underwent intrathecal injection of the same volume of normal saline. The paw withdrawal threshold (PWT) under mechanical stimulus of affected extremities of rats was measured by Von-Frey filaments. The expression of glial fibrillary acidic protein (GFAP) in the hippocampus was detected by Western  blotting and immunofluorescence 14, 21, 28, and 35 d after first administration. Results Compared with sham group, PWT of control group significantly decreased after SNI operation and the expression of GFAP in the hippocampus increased. The continuous intrathecal injection of AMD3100 significantly increased the PWT of rats and down-regulated the expression of GFAP in the hippocampus. Conclusion The intrathecal injection of AMD3100 can down-regulate the expression of GFAP in the hippocampus of rats of SNI model and effectively alleviate symptoms of neuropathic pain of rats.

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    Inhibitory effects of different isoforms of DLC1 on proliferation and migration of colon cancer cells
    PENG Hai-xia, HOU Ming-yue CHU Yi-min, et al
    2016, 36 (01):  17. 
    doi: 10.3969/j.issn.1674-8115.2016.01.004

    Abstract ( 713 )   PDF (2618KB) ( 739 )  

    Objective To investigate the inhibitory effect of different isoforms of deleted in liver cancer-1 (DLC1) on the proliferation and migration of the colon cancer cell line. Methods The expressions of isoforms of DLC1 in 17 colon cancer tissue samples and 17 normal tissue samples were detected by qRT-PCR. Colon cancer cells SW1116 were infected by over-expressed lentiviruses of different isoforms. The effects of different isoforms on the proliferation and migration of the colon cancer cell line were observed by CCK8 kit and Transwell test. Results The expressions of different isoforms of DLC1 in colon cancer tissues were significantly lower than those of adjacent normal tissues. Over-expression of DLC1 could inhibit the proliferation and migration of the colon cancer cell line SW1116 and the inhibitory effect of isoform2 (DLC1-isoform2) was the strongest. Conclusion The expressions of different isoforms of DLC1 in colon cancer tissues are significantly lower than those of adjacent normal tissues. The inhibitory effect of DLC1-isoform2 of DLC1 on the proliferation and migration of colon cancer cells is the strongest.

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    Preparation and in vitro experimental study on poly lactic-co-glycolic acid dual-targeted nanoparticle polymer ultrasound contrast agent carrying both anti-HER2 and anti-VEGFR2 antibodies
    LI Xiao-yu, DU Jing, YANG Shi-ping, et al
    2016, 36 (01):  23. 
    doi: 10.3969/j.issn.1674-8115.2016.01.005

    Abstract ( 539 )   PDF (2557KB) ( 585 )  

    Objective To prepare the poly(lactic-co-glycolic acid)(PLGA) dual-targeted ultrasound contrast agent carrying anti-human epidermal growth factor receptor 2 (anti-HER2) and anti-vascular endothelial growth factor receptor 2 (anti-VEGFR2) antibodies and observe the targeting ability and the effect of ultrasound imaging in vitro. Methods The PLGA nanoparticles (NPs) were prepared by a modified double emulsious-solvent evaporation technique and the general characteristics of PLGA NPs were analyzed by the transmission electron microscope and laser particle size analyzer. The anti-HER2 and anti-VEGFR2 antibodies were conjugated to PLGA NPs by the carbodiimide method to prepare the dual-targeted polymer nanoparticle ultrasound contrast agent carrying both anti-HER2 and anti-VEGFR2 antibodies. The targeting ability in vitro was assessed by the laser scanning confocal microscope (LSCM) and the rate of combination with target cells was detected by flow cytometer. The effect of imaging in vitro was observed by the high frequency ultrasonography. Results The PLGA NPs were round with smooth surface, good dispersion, and hollow structure. The average particle size was (152.00±58.08) nm. The results of targeting tests in vitro showed that the PLGA dual-targeted NPs carrying anti-HER2 and anti-VEGFR2 antibodies were firmly attached to the surface of human breast cancer cells SKBR3 and endothelial cells of angiosarcoma SVEN1 ras (SVR). The results of ultrasonic imaging tests in vitro indicated that the PLGA dual-targeted nanoparticle ultrasound contrast agent presented uniform and fine dotted dense high echo with no attenuated echo in the rear area.  Conclusion The PLGA dual-targeted nanoparticle polymer ultrasound contrast agent carrying both anti-HER2 and anti-VEGFR2 antibodies is successfully prepared. This contrast agent can specifically bind to SKBR3 cells with high expression of HER2 and SVR cells with high expression of VEGFR2 in vitro. The effect of ultrasound imaging in vitro is satisfactory.

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    Inhibition of growth and invasion of human gastric cancer cells via down-regulation of DUSP4/ERK pathway by sanguinarine
    ZHANG Rui, ZHANG Jing, WANG Ge, et al
    2016, 36 (01):  28. 
    doi: 10.3969/j.issn.1674-8115.2016.01.006

    Abstract ( 799 )   PDF (1521KB) ( 770 )  

    Objective To investigate the effects of sanguinarine on the proliferation, apoptosis and invasion of human gastric cancer cell line SGC-7901 and relevant molecular mechanisms. Methods The in vitro cultured SGC-7901 cells were treated by different concentrations of sanguinarine (0, 5, 10, and 30 μmol/L) for 24, 48, 72, and 96 h. The proliferative activity of cells was detected by CCK-8. The cell apoptosis was detected by flow cytometry and the cell invasion was analyzed by Transwell experiment. The protein expression levels of dual specificity phosphatase 4 (DUSP4), phosphorylated extracellular regulated protein kinases (p-ERK), proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-2 (MMP-2), and B-cell lymphoma-2 (Bcl-2) were detected by Western blotting. Results Sanguinarine inhibited the proliferation and induced the apoptosis of gastric cancer cells. Invasion experiment showed that the number of invasive cells of the sanguinarine treatment group was significantly lower than that of control group. Results of Western blotting showed that sanguinarine down-regulated protein expressions of DUSP4, p-ERK, PCNA, MMP-2, and Bcl-2 of SGC-7901 cells. Conclusion Sanguinarine inhibited the proliferation and invasion and induced the apoptosis of gastric cancer cells by down-regulating DUSP4/ERK pathway.

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    Effects of recombinant human amelogenin on expressions of inflammatory factors of human periodontal ligament fibroblasts under inflammatory microenvironment
    LIAO Wei-wen, SONG Zhong-chen, SHU Rong, et al
    2016, 36 (01):  33. 
    doi: 10.3969/j.issn.1674-8115.2016.01.007

    Abstract ( 670 )   PDF (1935KB) ( 1115 )  

    Objective To investigate the effects of recombinant human amelogenin (rhAm) on expressions of inflammatory factors of human periodontal ligament fibroblasts (hPDLCs) cultured in vitro under inflammatory microenvironment. Methods hPDLCs were cultured in vitro and identified by immunohistochemical staining method. The inflammatory microenvironment was simulated by lipopolysaccharide (LPS) with Porphyromonas gingivalis  of 10 μg/mL and hPDLCs were treated by rhAm of 20 μg/mL. Expressions of inflammatory factors interleukin-1β (IL-1β), IL-6, and IL-8 were detected by real-time PCR and ELISA. Results Results of immunohistochemical staining confirmed that cultured cells were hPDLCs. Expressions of IL-1β, IL-6, and IL-8 could be induced by LPS with P. gingivalis of 10 μg/mL at four time points (6, 12, 24, 72 h). Expressions of inflammatory factors decreased after being treated by rhAm of 20 μg/mL. Conclusion The rhAm can inhibit expressions of inflammatory factors of hPDLCs under inflammatory microenvironment.

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    Expression of APLP2 of patients with endometrial cancer and its value for predicting the prognosis
    YANG Si-qin, HE Xiao-ying, TIAN Fu-ju, et al
    2016, 36 (01):  38. 
    doi: 10.3969/j.issn.1674-8115.2016.01.008

    Abstract ( 747 )   PDF (1797KB) ( 750 )  

    Objective To investigate the expression of amyloid precursor-like protein 2 (APLP2) in tissues of endometrial cancer and analyze the correlation between the expression of APLP2 and relevant clinical indexes. Methods RNA-SEQ data of 335 cases of endometrial cancer in the Cancer Genome Atlas (TCGA) database was analyzed by data mining. The correlation between the expression of APLP2 and the survival of patients with endometrial cancer was analyzed by Kaplan-Meier method based on RNA-SEQ data and complete survival information of patients. The mRNA expression of APLP2 in 30 frozen tissues of normal endometrium and 30 frozen tissues of endometrial cancer was detected by real-time PCR. The protein expression of APLP2 in 32 tissues of normal endometrium and 88 tissues of endometrial cancer was detected by immunohistochemical method. Results Analysis of Kaplan-Meier survival curve showed that the overall survival of patients with low expression of APLP2 significantly decreased (HR=2.87, P=0.002). Results of real-time PCR indicated that mRNA expressions of APLP2 in tissues of endometrial cancer were significantly lower than those in tissues of normal endometrium (P=0.031). Results of immunohistochemical method showed that the positive expression rate of APLP2 in tissues of endometrial cancer was significantly lower than that of in tissues of normal endometrium (P=0.025) and the expression level of APLP2 was correlated with the expression level of estrogen receptor (P=0.010). Conclusion APLP2 plays the role of tumor-suppressor gene for patients with endometrial cancer. APLP2 genes may take effect via the estrogen receptor and may be a target for the treatment and predicting the prognosis of patients with endometrial cancer.

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    Establishment and identification of a mice model of transgenic IgA nephropathy
    GU Yu, LIU Shuang, ZHU Yi, et al
    2016, 36 (01):  43. 
    doi: 10.3969/j.issn.1674-8115.2016.01.009

    Abstract ( 867 )   PDF (2485KB) ( 817 )  

    Objective To mimic the effects of structural changes of the hinge area of human IgA1 molecules on the pathogenesis of IgA nephropathy via a novel mouse model of spontaneous IgA nephropathy established by the transgenic method. Methods Sequences of the hinge area of wild type (transgenic group A) and O-glycan sites-mutated (transgenic group B) human IgA1 were inserted into the fertilized eggs of C57BL/6J mice by the transgenic method to replace the original sequences. Mice propagated based on genetic rules and genotype-positive mice were identified by PCR. The urine samples of positive parental mice at the age of 24 weeks and positive F1 mice at the age of 8 weeks were collected to conduct the property observation, microscopic examination of urinary sediment, and detection of the ratio of urine protein to urine creatinine. Renal tissues were harvested and IgA immunofluorescence staining and H-E staining were performed to assess the IgA deposition and histological changes of renal tissues. The blood was drawn from the heart of mice and the serum was isolated. Then IgA and IgG levels were detected. Results A total of 3 and 8 positive parental mice were obtained in transgenic group A and B, from which 17 and 52 positive F1 mice were obtained. The results of immunofluorescence staining indicated that IgA deposited in the glomerular mesangial area of kidneys of positive parental mice and positive F1 mice. The results of H-E staining showed mesenteric cell proliferation, increase of mesangial matrix, and inflammatory cell infiltration in mesenchyma. No erythrocytes were found in fresh urinary sediment by microscopic examination. The ratio of urine protein to urine creatinine and serum IgA and IgG levels of transgenic mice were significantly higher than those of wild type mice with the same age. Conclusion A mice model of IgA nephropathy is established by inserting sequences of the hinge area of human IgA1. Structural changes of the hinge area of IgA1 play a crucial role in the pathogenesis of IgA nephropathy.

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    Protective effects of AT2R+ and AT2R- human bone marrow mononuclear cells on cardiomyocytes after incidence of myocardial infarction
    DU Ming-jun, LIAN Feng, XUE Song
    2016, 36 (01):  49. 
    doi: 10.3969/j.issn.1674-8115.2016.01.010

    Abstract ( 724 )   PDF (1521KB) ( 849 )  

    Objective To observe the expression of AT2R of human bone marrow mononuclear cells (BMMNCs) after the incidence of myocardial infarction (MI) and compare the ability of AT2R+ BMMNCs and AT2R- BMMNCs to protect impaired cardiomyocytes in vitro. Methods The bone marrow were drawn during operation and AT2R+ BMMNCs were isolated by flow cytometer. The migration ability of AT2R+ BMMNCs and AT2R-BMMNCs were compared by Transwell migration detection system with the pore size of 8 μm. The cardiomyocytes of neonatal SD mice were isolated and co-cultured with AT2R+ BMMNCs and AT2R- BMMNCs. The effects of AT2R+ BMMNCs and AT2R- BMMNCs on the transdifferentiation of cardiomyocytes (expressions of transcription factors Nkx2.5 and Gata4 relevant to the cardiac development) were detected by RT-PCR. AT2R+ BMMNCs and AT2R- BMMNCs were co-cultured with cardiomyocytes H9C2 under the conditions of hypoxia and non-serum and the cell apoptosis was detected by flow cytometry. Results Isolation results of flow cytometer showed that the expression of AT2R in bone marrow samples of patients with myocardial infarction was 5.85% higher than that of patients without myocardial infarction (P=0.039 8). In vitro experiment found that the migration ability and the ability of transdifferentiating towards cardiomyocytes of AT2R+ BMMNCs were better than those of AT2R- BMMNCs. Compared with AT2R- BMMNCs, the antiapoptosis effect of AT2R+ BMMNCs on cardiomyocytes H9C2 was stronger under the conditions of hypoxia and non-serum. Conclusion The expression of AT2R in bone marrow of patients with myocardial infarction significantly up-regulates. AT2R+ BMMNCs may protect the cardiomyocytes after the incidence of myocardial infarction.

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    Protective effect of resveratrol on lipopolysaccharide-induced damage of H9c2 cells and relevant mechanisms
    YE Ting-ting, LI Li, WANG Guang-yu, et al
    2016, 36 (01):  54. 
    doi: 10.3969/j.issn.1674-8115.2016.01.011

    Abstract ( 648 )   PDF (1664KB) ( 983 )  

    Objective To investigate the protective effect of resveratrol (RSV) on lipopolysaccharide (LPS)-induced damage of H9c2 cells and relevant mechanisms. Methods Mouse myocardial cells H9c2 were treated by LPS of 10 μg/mL for 0, 5, 10, 20, 30, and 60 min. The inductive effect of LPS on the expressions of nuclear factor κB inhibitory protein (IκBα), p-p65, p65, and β-actin at different time points was evaluated. H9c2 cells were stimulated by LPS after being pre-treated by different concentrations of RSV and the effects of RSV on the LPS-induced damage of H9c2 cells were observed. The proliferation of H9c2 cells was detected by MTT. The intracellular oxygen species reactive (ROS) level was detected by fluorescence method. The expressions of IκBα, p-p65, p65, and β-actin were detected by Western blotting. Results LPS inhibited the proliferation of H9c2 cells and the intracellular ROS level significantly elevated. LPS significantly decreased the expression level of IκBα and significantly increased the phosphorylation of p65. Pretreatment by RSV remarkably reduced the LPS-induced damage of H9c2 cells and significantly decreased the intracellular ROS level. RSV up-regulated the expression of IκBα and down-regulated the expression of p-p65. Conclusion RSV may inhibit the LPS-induced damage of H9c2 cells via down-regulating the expression of p-p65 and up-regulating the expression of IκBα.

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    Original article (Clinical research)
    Prevalence of low bone mineral density in patients undergoing maintenance hemodialysis and relevant factors
    CHANG An-jin, QIAN Ying, CHEN Xiao-nong, et al
    2016, 36 (01):  59. 
    doi: 10.3969/j.issn.1674-8115.2016.01.012

    Abstract ( 633 )   PDF (647KB) ( 654 )  

    Objective To explore the prevalence of low bone mineral density (BMD) in patients undergoing maintenance hemodialysis (MHD) and relevant influencing factors. Methods A total of 144 patients undergoing MHD in the Hemodialysis Center of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in April, 2014 were enrolled. The BMD values of lumbar spine and hip were measured by the dual energy X-ray absorptiometry (DEXA). Levels of serum alkaline phosphatase (AKP), calcium (Ca), phosphate (P), intact parathyroid hormone (iPTH), and 25 hydroxy vitamin D [25 (OH) D3] were detected. Correlations among BMD, clinical characteristics [such as gender, age, body mass index (BMI), and dialysis age], and examination indexes were analyzed. Results Among 144 enrolled patients undergoing MHD, 85 patients were male and 59 patients were female. The prevalence of osteoporosis and osteopenia were 19.44% and 30.56%, respectively. The prevalence of osteoporosis of females (28.8%) was higher than that of males (12.9%) and the difference was statistically significant (P=0.029). Results of correlation analysis showed that BMD positively correlated with BMI and negatively correlated with dialysis age and serum AKP and iPTH levels. Conclusion Based on standardized treatment of osteoporosis, the incidence of low BMD of patients undergoing MHD is still as high as 50%. Gender, dialysis age, BMI, and serum AKP and iPTH levels closely correlate with BMD.

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    Analysis of the correlation between the polymorphism of locus rs498422 in HLA-DRA gene of Chinese Han population and the hereditary susceptibility #br# of non-obstructive azoospermia
    SONG Ping-ping, ZOU Sha-sha, YANG Juan-juan, et al
    2016, 36 (01):  65. 
    doi: 10.3969/j.issn.1674-8115.2016.01.013

    Abstract ( 660 )   PDF (980KB) ( 738 )  

    Objective To explore the correlation between the polymorphism of locus rs7194 in HLA-DRA gene of Chinese Han population and the hereditary susceptibility of non-obstructive azoospermia (NOA).  Methods The method of direct sequencing of PCR products was used for genotyping of 275 patients with NOA (case group) and 221 healthy controls (control group). The genotypes and distribution frequencies of alleles of two groups were compared. Logistic regression analysis was adopted to explore the susceptible genotypes of NOA. The meta-analysis was used to further verify the correlation between the polymorphism of locus rs7194 and NOA.  Results The differences of frequencies of genotypes and alleles of locus rs7194 between two groups were statistically significant (P=0.003 and P=0.001, respectively). Results of the logistic regression analysis showed that genotypes A/G and G/G correlated with the elevated incidence of NOA (OR=1.837, P=0.002; OR=1.942, P=0.048). Results of the meta analysis also indicated that the polymorphism of locus rs7194 in HLA-DRA gene correlated with NOA. Conclusion The polymorphism of locus rs7194 in HLA-DRA gene correlates with the hereditary susceptibility of NOA of Chinese Han population. The incidence of NOA of people carrying G allele with genotype A/G or G/G elevates. Genotypes A/G and G/G may be risk factors of the incidence of NOA.

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    Screening of pathogenic genes and clinical analysis in patients with primary hypokalemic periodic paralysis
    LIU Xiao-li, HUANG Xiao-jun, SHEN Jun-yi, et al
    2016, 36 (01):  70. 
    doi: 10.3969/j.issn.1674-8115.2016.01.014

    Abstract ( 906 )   PDF (1758KB) ( 776 )  

    Objective To screen the mutation sites of pathogenic genes of patients with primary hypokalemic periodic paralysis (HypoPP) and summary the clinical characteristics. Methods Medical histories of 35 patients with primary HypoPP were collected and relevant examinations were conducted. SCN4A, CACNA1S, KCNJ2, KCNJ5, and KCNE3 genes were detected by PCR and DNA sequencing. Two hundred healthy volunteers of the Han nationality were selected as controls. Results All patients had episodic myasthenia gravis. Serum potassium levels of 29 patients were low and serum potassium levels of 6 patients were normal during onset. Muscle weakness of all patients was alleviated after potassium supplement therapy. Two patients with familial HypoPP had mutations at c.2024G>A and c.2015G>A of SCN4A gene and both mutations had been reported. A patient with Andersen-Tawil syndrome had a novel mutation at c.919A>G of KCNJ2 gene, while this patients parents and 200 healthy controls did not have this mutation. Other 29 sporadic cases and 3 familial cases did not have mutations of SCN4A, CACNA1S, KCNJ2, KCNJ5, and KCNE3 genes. Conclusion HypoPP shows clinical and genetic heterogeneity. For patients with familial HypoPP, hot spot mutations of SCN4A gene should be screened first. For patients with periodic paralysis, dysplasia, and arrhythmia, KCNJ2 and KCNJ5 genes should be screened first.

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    Application value of 18F-FDG PET/CT imaging for patients with differentiated thyroid carcinoma and negative results of 131I-whole body scan
    YE Zhi-yi, MA Chao, FU Hong-liang, et al
    2016, 36 (01):  76. 
    doi: 10.3969/j.issn.1674-8115.2016.01.015

    Abstract ( 541 )   PDF (1013KB) ( 804 )  

    Objective To investigate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging for detecting recurrent or metastatic foci of patients with differentiated thyroid carcinoma (DTC) and negative results of 131I-whole body scan. Methods A total of 178 patients with DTC who underwent thyroidectomy and 131I ablation of residual thyroid tissues and/or metastatic foci (results of cervical ultrasound or chest CT were persistent positive but results of 131I-whole body scan were negative during follow-up) were examined by 18F-FDG PET/CT imaging. Patients with suspicious foci and positive results of 18F-FDG PET/CT imaging underwent ultrasound-guiding aspiration biopsy or surgical resection. Values for predicting recurrent or metastatic foci by 18F-FDG PET/CT imaging at different levels of serum thyroglobulin (Tg) were analyzed using the results of pathological examinations as the golden criteria. Results A total of 77 patients with positive results of 18F-FDG PET/CT imaging were enrolled. Among them, 65 patients were pathologically confirmed as DTC metastases and 12 patients with false positive results of 18F-FDG PET/CT imaging were pathologically confirmed as inflammatory cell infiltration. Among 77 patients with positive results of 18F-FDG PET/CT imaging, 50 patients were serum Tg positive and 45 of them were pathologically confirmed as DTC metastases. For serum Tg positive patients, the rate for predicting the positive results by 18F-FDG PET/CT imaging was 90.00% (45/50). Among 27 serum Tg negative patients, 20 of them were pathologically confirmed as DTC recurrence or metastases. For serum Tg negative patients, the rate for predicting the positive results by 18F-FDG PET/CT imaging was 74.07% (20/27). Conclusion 18F-FDG PET/CT imaging is an effective examination method for patients with DTC who have suspicious recurrent or metastatic foci and negative results of 131I-whole body scan during follow-up.

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    Changes in the anterior segment of eyes of children with different genetic background under different accommodations
    DAI Yi-kang, FU Wei-cai, LU Wei-yu, et al
    2016, 36 (01):  80. 
    doi: 10.3969/j.issn.1674-8115.2016.01.016

    Abstract ( 520 )   PDF (560KB) ( 707 )  

    Objective To investigate and analyze the changes in the anterior segment of eyes of children with different genetic background and same refraction under different accommodations. Methods A total of 60 emmetropic children (60 eyes, +0.50~-0.50 DS) were enrolled and divided into A group (n=30) and B group (n=30). Parents of children of A group were emmetropic and parents of children of B group were highly myopic (≥6.0 DS). All children underwent subjective refraction after mydriasis. The anterior chamber depth, crystalline lens thickness, and dark pupil diameter were measured under relaxation and different accommodations. The difference between two groups was compared. Results The differences of age, accommodation amplitude, and naked vision between two groups were not statistically significant (P>0.05). The differences of measurements under relaxation and accommodation of 3D between two groups were not statistically significant (P>0.05). The decrease of anterior chamber depth and the increase of crystalline lens thickness of A group under accommodation of 6D were larger than those of B group (P<0.05), while the difference of the decrease of dark pupil diameter between two groups was not statistically significant (P>0.05). Conclusion Changes of anterior chamber depth and crystalline lens thickness in the anterior segment of eyes of children with highly myopic parents under accommodation of 6D are smaller than those of children with emmetropic parents. Whether this difference leads to the difference of refraction in the future still needs further study.

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    Study on the correlation between dietary patterns and periodontal diseases
    ZHAO An-da, HUANG Yi-jing, ZHANG Hai-feng, et al
    2016, 36 (01):  83. 
    doi: 10.3969/j.issn.1674-8115.2016.01.017

    Abstract ( 827 )   PDF (881KB) ( 727 )  

    Objective To investigate the correlation between dietary patterns and the susceptibility of periodontal diseases. Methods A total of 50 patients newly diagnosed with moderate to severe periodontal diseases and 50 healthy controls were enrolled for the dietary frequency survey. Dietary patterns were established by the factor analysis module of SPSS 19.0 and the correlation between dietary patterns and periodontal diseases was analyzed by multivariate logistic regression model. Results Five dietary patterns were obtained by the factor analysis, i.e. coarse grain pattern, meat pattern, fruit and milk pattern, vegetable and nut pattern, and beverage pattern. After confounding factors were corrected, the coarse grain pattern (OR=0.296, 95%CI 0.102-0.860) and vegetable and nut pattern (OR=0.135, 95%CI 0.049-0.372) negatively correlated with the susceptibility of periodontal diseases, which was statistically significant. Conclusion Dietary patterns that are rich in coarse grains, vegetables, and nuts may be helpful for the prevention of periodontal diseases.

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    Assistant therapeutic effect of external cephalic version under intrathecal anesthesia for breech position pregnant women
    LI Hai-bing, FANG Xin, ZHAO Qin-song, et al
    2016, 36 (01):  89. 
    doi: 10.3969/j.issn.1674-8115.2016.01.018

    Abstract ( 599 )   PDF (577KB) ( 782 )  

    Objective To investigate the success rate of external cephalic version under intrathecal analgesia for breech position singleton pregnant women and analyze the complications of external cephalic version. Methods A total of 60 pregnant women who have undergone regular prenatal examinations and delivered normally were randomly divided into epidural anesthesia group (EA group, n=30) and combined spinal-epidural anesthesia group (CSEA group, n=30). Another 30 pregnant women who have delivered without analgesia were selected as controls. The pain scores of pregnant women of three groups when conducting the external cephalic version were compared by visual analogue scales. The proportion of head position, rate of cesarean section, and rate of adverse reactions of three groups were compared. Results After intrathecal analgesia was performed, the pain scores of EA group and CSEA group were 1.87±2.94 and 1.73±2.71, respectively, which were significantly lower than that of control group (6.84±3.08)(P=0.031 and P=0.027). The success rate of external cephalic version of EA group was 78.3%, which was higher than that of CSEA group (51.7%) and control group (48.3%)(P=0.023 and P=0.041). The difference between CSEA group and control group was not statistically significant. Compared with CSEA group and control group, both the rate of cesarean section and the rate of cesarean section with breech position as the first indication of EA group were lower and the differences were statistically significant (P=0.037 and P=0.029). The incidences of hypotension, nausea and vomiting, and decreased fetal heart rate of CSEA group were remarkably higher than those of control group and the differences were statistically significant (P=0.021, P=0.042, P=0.033). The placental abruption did not occur during the external cephalic version among pregnant women of three groups. The differences of incidences of preterm birth and umbilical cord around neck of three groups after external cephalic version were not statistically significant. Conclusion For breech position singleton pregnant women, the external cephalic version after epidural analgesia can effectively correct the fetal position and decrease the rate of cesarean section. But whether combined spinal-epidural analgesia can improve the success rate of instantaneous external cephalic version remains unclear.

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    Study on resistance mechanism of Klebsiella pneumoniae towards carbapenem
    LIU Jing-xian, YU Jing, LI Yuan-rui, et al
    2016, 36 (01):  93. 
    doi: 10.3969/j.issn.1674-8115.2016.01.019

    Abstract ( 1370 )   PDF (1170KB) ( 806 )  

    Objective To investigate the resistance mechanism of Klebsiella pneumoniae towards carbapenem. Methods Carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from clinical samples between January, 2010 and December, 2013 were collected and identified by the automated microbial analysis system Vitek-2 Compact. Combined with disk diffusion method (K-B method), drug sensitivity test was conducted. The identification results were verified by MicroflexTM MALDI-TOF MS. Modified Hodge test was performed to screen the phenotype of carbapenemase. Carbapenemase genes such as blaKPC, blaGES, blaIMP, blaVIM, blaNDM-1, and blaOXA-48 and AmpC β-lactamases genes were detected by PCR and DNA sequencing was performed for positive amplified products. SDS-PAGE was adopted to detect the expressions of outer membrane proteins Ompk35 and Ompk36 and the plasmid conjugation experiment was conducted for strains carrying cabapenemase genes. Results For 75 CRKP strains, 71 of them were positive towards modified Hodge test. Among 71 strains, 69 of them carried blaKPC-2 gene with abnormal expression (68 strains) or no expression (1 strain) of Ompk36, 1 strain carried blaIMP-4 gene with abnormal expressions of Ompk35 and Ompk36, and 1 strain carried blaNDM-1 and blaCIT-1 genes with abnormal expressions of Ompk35 and Ompk36. For 4 strains that were negative towards modified Hodge test, 3 of them carried DHA-1 gene with abnormal expression (2 strains) or no expression (1 strain) of Ompk36, and 1 strain did not carry any drug resistant genes with no expression of Ompk36. The plasmid conjugation experiment of only 4 carbapenemase-producing strains was successfully. Conclusion The major resistance mechanism of Klebsiella pneumoniae isolated from clinical samples towards carbapenem is the production of KPC-2 carbapenemase and abnormal expressions of outer membrane proteins. Measures for preventing and controlling the nosocomial infection should be enhanced to avoid the dissemination of these strains.

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    Analysis of related factors of postoperative cognitive dysfunction for patients undergoing off-pump coronary artery bypass graft surgery
    ZHAO Yan-hong, WEN Da-xiang
    2016, 36 (01):  100. 
    doi: 10.3969/j.issn.1674-8115.2016.01.020

    Abstract ( 542 )   PDF (660KB) ( 686 )  

    Objective To explore the incidence and related factors of postoperative cognitive dysfunction (POCD) of patients undergoing off-pump coronary artery bypass graft surgery (OPCABG). Methods Seventy two patients undergoing OPCABG in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled. The POCD of patients was assessed by mini-mental state examination. Previous medical histories and perioperative information of patients were collected and related factors were analyzed.  Results The incidence of early POCD of patients undergoing OPCABG was 27.8%. Related influencing factors include history of diabetes (P=0.031), perioperative hyperglycemia (P=0.034), and history of cerebral infarction (P=0.044), which were all statistically significant. Conclusion The incidence of early POCD of patients undergoing OPCABG is high. Related influencing factors may include history of diabetes, perioperative hyperglycemia, and history of cerebral infarction, etc. Active preoperative intervention, maintenance of a proper blood glucose level, and good postoperative treatment are clinically significant for the prevention of POCD.

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    Original article (Public health)
    Analysis of quality of utilizing basic medical services by floating population in Shanghai
    GUO Li-jun, BAO Yong, LIU Xia, et al
    2016, 36 (01):  105. 
    doi: 10.3969/j.issn.1674-8115.2016.01.021

    Abstract ( 500 )   PDF (765KB) ( 771 )  

    Objective To analyze the quality of utilizing basic medical services by the floating population in Shanghai.  Methods The 2014 monitoring data of the floating population in Shanghai was adopted to analyze the quality of utilizing basic medical services by the floating population. The enumeration data was described by proportions and the quantitative data was described by means. The differences among groups were compared by the chi-square test. Results About 14.4% of floating population should be hospitalized, but did not. Main reasons were needless (41.5%) and economic hardship (30.2%). Annual hospitalization rate of the floating population was 3.9% and main reasons were childbirth (66.1%) and diseases (22.0%). A total of 142 (45.2%) hospitalized patients did not apply for reimbursement of hospitalization. Main reasons were no medical insurances (44.4%), inconvenient to go back hometown (16.2%), and forbiddance by policies (14.8%). About 61.1% of floating population was hospitalized in county or district hospitals. The average medical expense of floating population for hospitalization was 10 392.0 Yuan and 5 764.1 Yuan (55.5%) were paid by themselves, while 4 627.9 Yuan (44.5%) were reimbursed. Conclusion The utilization of health services by the floating population is insufficient and the quality of utilization is unsatisfactory. Relevant public health departments should comprehensively develop the medical security system, reduce the differences of medical security of different populations and regions, endeavor to ensure easy reimbursement and settlement for floating population by systems, establish the constraint mechanism of honesty and credit, and fundamentally solve the problem of low insurance coverage.

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    Review
    Research progresses of correlation between cigarette smoking andincidence of diabetes mellitus
    QIU Jie-yu-zhen, HOU Xu-hong, JIA Wei-ping
    2016, 36 (01):  110. 
    doi: 10.3969/j.issn.1674-8115.2016.01.022

    Abstract ( 642 )   PDF (526KB) ( 912 )  

    The incidence of diabetes is increasing rapidly in recent years. The global incidence of diabetes was 8.3% in 2013 and the number of Chinese patients with diabetes is the largest in the world, about 140 millions. At the same time, there are about 1 billion smokers worldwide and more than half of Chinese males are smokers. Although most population-based studies show that smoking increases the risk of diabetes, some studies indicate that smoking is irrelevant to the incidence of diabetes or decreases the risk of diabetes. The mechanism may be that smoking can reduce the body mass, so as to decrease the risk of diabetes. The effects of smoking on sugar elevating hormones and insulin resistance are not clear yet. This paper discusses the effects of smoking on the incidence of diabetes from the perspectives of population-based studies and pathophysiological mechanisms.

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    Signal transduction mechanisms of necroptosis and relevant advances in neurosurgical diseases research
    LIU Tao, BAO Ying-hui, WANG Yong, et al
    2016, 36 (01):  115. 
    doi: 10.3969/j.issn.1674-8115.2016.01.023

    Abstract ( 626 )   PDF (550KB) ( 965 )  

    Necroptosis is a new mode of cell death that starts with the form of apoptosis, performs as the necrosis-like phenotype, and is known as programmed necrosis or tumor necrosis factor-induced (TNF-induced) necrosis. The programmed necrosis plays an important role in the injury and death of neuronal cell due to some neurosurgical diseases, including craniocerebral trauma, brain tumor, and cerebrovascular diseases. The gradual understanding of signal transduction mechanisms of necroptosis and the discovery of potent specific inhibitors (such as necrostatin-1) provide new ideas for the clinical treatment of neurosurgical diseases. This paper reviews the advances in discovery and mechanisms of necroptosis.

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    Advances of quantitative detection of islet β-cells by molecular imaging
    JU Hui-jun, PAN Yu, ZHANG Yi-fan
    2016, 36 (01):  119. 
    doi: 10.3969/j.issn.1674-8115.2016.01.024

    Abstract ( 628 )   PDF (791KB) ( 757 )  

    Type 1 and type 2 diabetes are caused by the destruction of pancreatic islet β cells or the reduction of their function and mass (β-cell mass, BCM). Therefore, early detection of BCM is vital for the diagnosis and treatment of diabetes. The molecular imaging methods are an important way to detect BCM, mainly including optical imaging, magnetic resonance imaging (MRI), radionuclide imaging, etc. In recent years, specific imaging of islet β cells by utilizing the radionuclide-labelled glucagon-like peptide-1 (GLP-1) and its analogues has achieved remarkable achievements. This paper reviews novel molecular imaging methods for the detection of islet BCM.

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    Research progresses of imaging diagnosis of colorectal cancer
    XU Si-jia, ZHANG Xie-yi, HUANG Gang, et al
    2016, 36 (01):  124. 
    doi: 10.3969/j.issn.1674-8115.2016.01.025

    Abstract ( 638 )   PDF (516KB) ( 777 )  

    Imaging diagnostic techniques are crucial for screening and diagnosing the colorectal cancer. In recent years, the emergence of virtual CT colonoscopy, phased array coils, fluorodeoxyglucose-positron emission tomography (18F-FDG-PET), and novel contrast enhancement agents, etc has brought the revolution to the diagnosis of colorectal cancer. This paper compares the pros and cons of various imaging techniques and reviews recent research progresses of imaging diagnosis of colorectal cancer.

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    Advances of relevant factors to incidence of chronic obstructive pulmonary disease
    ZHAO Zhen-jun, DENG Jiong
    2016, 36 (01):  128. 
    doi: 10.3969/j.issn.1674-8115.2016.01.026

    Abstract ( 738 )   PDF (637KB) ( 814 )  

    The chronic obstructive pulmonary disease (COPD) is a chronic pulmonary disease featured by airflow obstruction. The fatality rate of COPD has risen to the fourth among all diseases in the world. The main characteristics are persistent obstruction, chronic inflammation, and remodeling of small airways, which slow down the airflow and weaken the elastic retraction of alveoli. In China, the incidence and fatality rate of COPD rise year by year due to cigarette smoking and air pollution. This paper reviews factors and possible mechanisms of the incidence and development of COPD from perspectives of environmental factors and cellular, sub-cellular, and molecular levels.

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    Research progress of HGF/c-Met-related targeted therapy of gastric cancer
    ZHU Xue-ru, ZHENG Lei-zhen
    2016, 36 (01):  133. 
    doi: 10.3969/j.issn.1674-8115.2016.01.027

    Abstract ( 737 )   PDF (578KB) ( 913 )  

    Gastric cancer is one of the most common malignancies and most patients have been at the advanced stage when they were diagnosed. In recent years, although diagnosis and treatment techniques of gastric cancer develop rapidly, problems such as local infiltration and metastasis still affect the prognosis of gastric cancer. The 5-year survival rate of patients with advanced gastric cancer remains very low. With the development of molecular biology, many novel targeted agents have been research hotspots and some of them are at the phase of clinical research. Hepatocyte growth factor/cellular-mesenchymal to epithelial transition factor (HGF/c-Met) signaling pathway is closely correlated with the occurrence, development, metastasis, and prognosis of gastric cancer and is a potential target for the targeted therapy of gastric cancer. This paper reviews research progresses of structures and functions of HGF/c-Met signaling pathway, effects of HGF/c-Met signaling pathway on the occurrence and development of gastric cancer, and HGF/c-Met signaling pathway-related targeted agents of gastric cancer.

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    Brief original article
    Experience of diagnosis and treatment of five patients with idiopathic pneumonia after allogeneic hematopoietic stem cell transplantation
    LI Su, YANG Jun, JIANG Jie-ling, et al
    2016, 36 (01):  138. 
    doi: 10.3969/j.issn.1674-8115.2016.01.028

    Abstract ( 676 )   PDF (1216KB) ( 707 )  

    Objective To investigate the clinical characteristics and treatment outcomes of patients with idiopathic pneumonia syndrome (IPS) after allogenetic hematopoietic stem cell transplantation (HSCT). Methods Clinical characteristics, manifestations of lung function and imaging, and treatment processes of 5 patients with IPS from 70 patients undergoing HSCT in the Department of Hematology of the General Hospital Affiliated to Shanghai Jiao Tong University from January 2013 to December 2014 were retrospectively analyzed. Results All patients with IPS had the clinical manifestations of cough, expectoration, and different degrees of acute and chronic graft versus host disease (GVHD). Some of them had the clinical manifestations of fever, chest tightness, and hypoxemia. Lung CT showed multiple patchy shadows scattered in the lung field featured by accompanying ground glass shadows. The manifestation of pulmonary function of three patients was obstruction based mixed ventilation dysfunction, while the manifestation of other two patients was diffuse ventilation dysfunction. Symptoms of all patients were remarkably alleviated after glucocorticoid therapy. Imaging results showed most lesions were significantly absorbed. Conclusion IPS has special manifestations of imaging and pulmonary function after allogeneic HSCT and the clinical manifestations of GVHD commonly accompanies. Early comprehensive treatment including administration of glucocorticoid can obtain a satisfactory therapeutic effect.

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    Technique and method
    Correlation between structure of free fatty acid and its retention time and establishment of prediction model
    WANG Shou-li, WEI Run-min, HUANG Feng-jie, et al
    2016, 36 (01):  143. 
    doi: 10.3969/j.issn.1674-8115.2016.01.029

    Abstract ( 624 )   PDF (2437KB) ( 766 )  

    Objective To analyze the correlation between the structure of free fatty acid (FFA) and its retention time (RT) and establish and verify a RT prediction model. Methods The RT and structural information of 72 standard samples of FFAs were detected by UPLC-QTOF/MS platform. The correlation between RT and the length, number of double bonds, and locations of double bonds of the carbon chain of FFAs was investigated. The multiple generalized regression models were established and the optimal model was selected by cross-validation and Akaike information criterion. Results The structural information was nonlinear with RT. The optimal prediction model was established and the performance was evaluated. Conclusion The multi-element orthogonal polynomical regression model can well predict the RT of 72 standard samples of FFAs and can be used to predict the RT of other target substances. It is helpful for identifying FFAs without standard samples.

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