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    Translational medicine
    2016, 36 (10):  1401. 
    Abstract ( 413 )   PDF (1871KB) ( 464 )  
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    Original article (Basic research)
    Generation and identification of renal tubular epithelial cell C/EBPα conditional knockout mice
    YING Ji, LIU Jian, ZHANG Li-wen, ZHONG Fang, ZHOU Fang-fang, WANG Wei-ming
    2016, 36 (10):  1403. 
    doi: 10.3969/j.issn.1674-8115.2016.10.001

    Abstract ( 938 )   PDF (1953KB) ( 979 )  

    Objective·To generate renal tubular epithelial cell C/EBPα conditional knockout  mice, perform phenotypic identification, and lay a foundation for further study on the role of C/EBPα in renal interstitial fibrosis.Methods·C/EBPαflox/flox and pepck-Cre+ transgenic mice were bred and hybridized.The first generation offspring were mated to reproduce the second generation. Mice with C/EBPαflox/flox.pepck-Cre+ genotype (C/EBPα-/- mice) were identified using PCR. The mRNA and protein expressions of C/EBPα in renal tissues were measured using RT-qPCR and immunohistochemistry staining. The morphologic changes in renal tissues of C/EBPα-/- mice and wide type (WT) mice aged 6-8 weeks were observed using H-E staining and Masson staining.Results·The genotype of the second generation offspring of two types of transgenic mice accorded with the Mendelian laws and C/EBPα-/- mice were generated. C/EBPα-/- mice had lower mRNA and protein expressions of C/EBPα in renal tissues and no significant renal morphologic changes compared with WT mice.Conclusion·Cre-loxp system can successfully knock out the C/EBPα gene in mouse renal tubular epithelial cells. C/EBPα-/- mice have no significant renal morphologic changes in baseline condition.

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    Synthesis of a novel type of terminal alkyne-functionalized magnetic beads and its application in enriching glycopeptides
    LU Fei-jie, XU Zhi-jue, ZOU Xia, GUO Xun-xiang, ZHANG Yan
    2016, 36 (10):  1408. 
    doi: 10.3969/j.issn.1674-8115.2016.10.002

    Abstract ( 856 )   PDF (3313KB) ( 706 )  

    Objective·To effectively and specifically enrich glycopeptides or glycoproteins by synthesizing a novel type of terminal alkyne-functionalized magnetic beads with a hydrophilic structure.Methods·An alkynyl carbons chain with multiple hydrophilic groups was linked to the surface of magnetic beads using chemical synthesis and the enrichment effect of synthesized magnetic beads were verified by GalNAz labeled fluorescent peptide.Results·The results of fluorescence value detection and mass spectrometry showed that synthesized magnetic beads could specifically enrich glycopeptides and were able to enrich glycopeptides from the mixture of bovine serum albumin peptides and azido glycopeptides in a mass ratio of 1 000∶1 with the same efficiency.Conclusion·Magnetic beads with a hydrophilic structure that can efficiently and specifically enrich glycopeptides were successfully synthesized and can provide a novel method for enriching various glycopeptides or glycoproteins and identifying the sites of glycosylation in complex samples.

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    Pro-1 regulates the lifespan of Caenorhabditis elegans through DAF-16
    MAO Yu-qin, HAN San-feng, WANG Li-shun
    2016, 36 (10):  1415. 
    doi: 10.3969/j.issn.1674-8115.2016.10.003

    Abstract ( 697 )   PDF (2046KB) ( 678 )  

    Objective·To observe the effects of pro-1 gene on the lifespan of Caenorhabditis elegans (C. elegans) and preliminary explore the molecular mechanisms. Methods·RNAi technique was used to intervene the expression of pro-1 gene in C. elegans. The lifespan of C. elegans with silent pro-1 was analyzed and changes in growth, development, motion, diet, and reproduction were detected. The molecular mechanisms of pro-1 to affect the lifespan were explored using RNAi technique, fluorescence localization technology, and RT-PCR. Results·The lifespan of silence group C. elegans was significantly increased by 14.58% after the expression of pro-1  intervented as compared with controls (P=0.002). DAF-16 translocated into nucleus in C. elegans  of TJ356 strain after intervening the expression of pro-1 and mRNA expressions of downstream target genes such as old-1, sod-3, hsp-16.1, mtl-1 and ctl-2 were up-regulated. Conclusion·pro-1 prolongs the lifespan of C. elegans via promoting the translocation of DAF-16 into nucleus and up-regulating the mRNA expressions of downstream target genes.

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    Molecular mechanism of abnormal neddylation of Cullin3 pathogenic mutant in familial hyperkalemic hypertension
    NIU Wei, ZHOU Bo, WU Ping, CHEN Shun-jie, JIANG Geng-ru, ZHANG Chong
    2016, 36 (10):  1420. 
    doi: 10.3969/j.issn.1674-8115.2016.10.004

    Abstract ( 685 )   PDF (1636KB) ( 632 )  

    Objective·To investigate whether abnormal neddylation of pathogenic mutant Cullin3 Δ9 (missing exon 9, i.e. CUL3 Δ9) is the result of reduced binding between CUL3 Δ9 and COP9 signalosome (CSN). Methods·HEK 293 cells were cultured in high glucose DMEM containing 10% fetal bovine serum and were co-transfected with FLAG-CUL3 or FLAG-CUL3 Δ9 plasmids and CSN5 siRNA using liposome transfection technique. Changes of the neddylation level of CUL3 or CUL3 Δ9 were observed using Western blotting. After transfection of FLAG-CUL3 or FLAG-CUL3 Δ9 plasmids, HEK 293 cells were preincubated with metalloprotease inhibitor 1,10-phenanthroline. Change of neddylation level of CUL3 or CUL3 Δ9 were observed using Western blotting. After transfection of FLAG-CUL3 or FLAG-CUL3 Δ9 plasmids, co-immunoprecipitation was performed with FLAG antibody and Dynabeads Protein G. The binding between CSN5 and CUL3 or CUL3 Δ9 was observed using Western blotting. Results·Neddylation level of CUL3 was increased after transfection of CSN5 siRNA, while the neddylation level of CUL3 Δ9 showed little change. After preincubation with 1,10-phenanthroline, the neddylation level of CUL3 was increased, while the neddylation level of CUL3 Δ9 showed little change. Co-immunoprecipitation results showed that CUL3 bound with CSN5 and the binding between CUL3 Δ9 and CSN5 was reduced. Conclusion·Abnormal neddylation of pathogenic mutant Cullin3 Δ9 is the result of reduced binding between CUL3 Δ9 and CSN5.

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    Effects of losartan potassium on myocardial mitochondrial proteins in spontaneously hypertensive rats with left ventricular hypertrophy
    MENG Chao, JIN Xian, WANG Xiao-ling, XIA Li, CAI Jun, FANG Ning-yuan
    2016, 36 (10):  1425. 
    doi: 10.3969/j.issn.1674-8115.2016.10.005

    Abstract ( 560 )   PDF (3296KB) ( 614 )  

    Objective·To explore changes in myocardial mitochondrial proteinogram in spontaneously hypertensive rats (SHR) with left ventricular hypertrophy (LVH) and to investigate the effects of losartan potassium anti-hypertensive treatment on the proteinogram. Methods·20-week-old SHRs (SHR group) were randomly assigned to the 8-week losartan potassium anti-hypertensive treatment group (therapy group, 28-week-old) and the untreatment group (control group, 28-week-old). Wistar-Kyoto (WKY) rats aged 20 weeks were used as the controls of the SHR group (WKY group). Left ventricular mitochondrial proteinogram was measured using two-dimensional fluorescence difference gel electrophoresis (2D-DIGE) combined with MALDI-TOF/TOF tandem mass spectrometry. Blood pressure and myocardial diameter of rats were also measured. Results·Thirteen mitochondrial protein spots showed alterations by more than 1.3 folds in the SHR group compared with the WKY group. Some spots were identified as the same protein by digestion and mass spectrometry analysis. Five identified proteins were all related to the energy metabolism of mitochondria. No additional different spots were identified after 8 weeks of anti-hypertensive treatment. The therapy group had significantly lower systolic blood pressure and diastolic blood pressure than the control group (P=0.000, P=0.002) and remarkably shorter myocardial diameter in enlarged left ventricles (P=0.000). Conclusion·SHRs with LVH have mitochondrial energy metabolism dysfunction. Losartan potassium can significantly decrease the blood pressure and partially reverse LVH, but has no significant effect on mitochondrial energy metabolism proteins, suggesting changes in mitochondrial proteins are possibly not caused by the load after hypertension.

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    Effects of glucose reperfusion after low-glucose on the activity of autophagy in rat H9c2 cells
    BI Ya-guang, WANG Guang-yu, LIU Xiang-dong, WEI Meng, ZHANG Qing-yong
    2016, 36 (10):  1432. 
    doi: 10.3969/j.issn.1674-8115.2016.10.006

    Abstract ( 580 )   PDF (1888KB) ( 935 )  

    Objective·To investigate the effects of glucose reperfusion after low-glucose on the activity of autophagy in rat cardiomyocyte H9c2. Methods·H9c2 cells were assigned to low glucose group (LG), glucose reperfusion group (RG), autophagy inhibition group (RG+CQ), and control group (Con). LG group was treated with low glucose medium for 2 h. RG group was treated with high glucose medium for 2 h after being treated with low glucose medium for 2 h. For RG+CQ group, CQ was added 1 h before low glucose and high glucose treatment. Con group was treated with high glucose medium. MTT assay was used to detect the proliferation of H9c2 cells, lactate dehydrogenase assay was used to detect the cytotoxicity, and Western blotting was used to measure the expressions of p-mTOR, mTOR, p-AMPK, AMPK LC3, and beclin-1. Results·RG group had reduced cell proliferation capacity and increased LDH activity as compared with LG group (P<0.05). RG+CQ group had lower cell proliferation capacity and higher LDH activity as compared with RG group (P<0.05). Results of Western blotting showed that RG group had higher expressions of p-AMPK, LC3II/I, and beclin-1 and lower expression of p-mTOR as compared with LG group (P<0.05), and RG+CQ group had higher expression of LC3II/I and beclin-1 as compared with RG group (P<0.05). Conclusion·Glucose reperfusion after low-glucose increases autophagy activity in H9c2 cells. This may be related to the activation of AMPK/mTOR pathway and increased autophagy activity can protect cardiomyocytes.

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    Study on the existence of epithelial stem cells, melanocyte stem cells, and autofluorescence in the bulge region of hair follicles
    WU Gui-ju, HOU Qiang, GU Jun, LIU Ji-yong
    2016, 36 (10):  1436. 
    doi: 10.3969/j.issn.1674-8115.2016.10.007

    Abstract ( 687 )   PDF (1933KB) ( 587 )  

    Objective·To investigate whether there are epithelial stem cells, melanocyte stem cells, and autofluorescence in the bulge region of hair follicles. Methods·Samples were collected from the posterior occipital and temporal whole layer scalp of healthy volunteers with complete separation of hair follicles. Autofluorescence in hair follicles was observed using fluorescence microscope. Expressions of hair follicle keratins K15 and K19 were measured using indirect immunofluorescence and immunohistochemistry. RT-PCR was used to measure the mRNA expression levels of epithelial stem cell and melanocyte stem cell markers Dct, K15, and K19 and mature cell markers Tyrase, Tyrp1,MITF-M, and MC1R in hair bulbs and bulge region. Results·Autofluorescence was observed in the bulge region of hair follicles. Immunofluorescence and immunohistochemistry showed K15 and K19 were expressed in bulge region. RT-PCR showed that the mRNA expressions of Dct and K15 in bulge region were significantly higher than those in hair bulbs. The mRNA expression of K19 in bulge region was not significantly different from that in hair bulbs, while the mRNA expressions of Tyrase, Tyrp1, MITF-M, and MC1R in bulge region were significantly lower than those in hair bulbs. Conclusion·Autofluorescence can be observed and epithelial stem cells and melanocyte stem cells exist in the bulge region of hair follicles.

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    Inhibitory effect of FLT3 inhibitor AC220 on ocular neovascularization and its mechanisms
    GAO Yu-shuo, XIE Bing
    2016, 36 (10):  1440. 
    doi: 10.3969/j.issn.1674-8115.2016.10.008

    Abstract ( 685 )   PDF (3630KB) ( 586 )  

    Objective·To investigate association between FMS-like tyrosine kinase 3 (FLT3) and ocular neovascularization (NV) and explore the mechanisms of action of a novel FLT3 inhibitor AC220 in inhibiting ocular NV. Methods·A mouse model of oxygen induced retinopathy (OIR) and a mouse model of choroidal neovascularization (CNV) were constructed. FLT3 expressions in two models were detected by immumofluorescence method and ELISA. AC220 was intravitreally administrated and the effects of AC220 on ocular NV and the number of dendritic cell (DC) were investigated by immumofluorescence method. Results·The level of retinal FLT3 was significantly higher in the OIR and CNV groups than in the control group. Intravitreal administration of AC220 significantly reduced the ocular NV area in OIR and CNV groups and decreased the number of DC in retina. Conclusion·FLT3 is closely associated with ocular NV. AC220 can inhibit the development of NV, adjust the number of DC, and is a potential adjuvant medicine for anti-NV treatment.

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    Original article (Clinical research)
    Study on the efficacy of bortezomib on CD56 negative multiple myeloma patients
    FAN Qing-ye, WANG Yan, MI Jian-qing
    2016, 36 (10):  1445. 
    doi: 10.3969/j.issn.1674-8115.2016.10.009

    Abstract ( 823 )   PDF (1262KB) ( 555 )  

    Objective·To investigate the effects of bortezomib on efficacy and prognosis in CD56 negative multiple myeloma (MM) patients. Methods·One hundred and sixty newly diagnosed MM patients were enrolled in this study. The immunophenotypes of myeloid cells were examined by flow cytometry before treatment. The patients were assigned to two groups based on treatment regimen. One hundred and ten cases received bortezomib based treatment (bortezomib group) and 50 cases received non-bortezomib regimens (non-bortezomib group). The efficacy in the two groups was observed. Kaplan-Meier method was used to evaluate the progression-free survival (PFS) and overall survival (OS) and determine the association between relevant factors and the prognosis. Results·There was no statistical difference between CD56 positive and negative patients in terms of PFS (P=0.159), but the difference in OS was statistically significant (P=0.013). CD56 negative patients had poor prognosis. No difference was observed in PFS between bortezomib and non-bortezomib groups (P=0.26), but bortezomib group had significantly higher OS than non-bortezomib group (P=0.02). No statistical difference was found in PFS between CD56 positive and negative patients in non-bortezomib group (P=0.16), while the difference in OS was statistically significant (P=0.04). The differences in PFS and OS between CD56 positive and negative patients in bortezomib group were not statistically significant (P=0.50 for PFS; P=0.15 for OS). Conclusion·CD56 can be a prognosis factor for MM. CD56 negative MM patients may have poor prognosis. Bortezomib may improve the prognosis of CD56 negative MM patients.

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    Association of serum and follicular fluid bisphenol A levels with pregnancy outcomes in patients undergoing in vitro fertilization-embryo transfer
    LIU Bin, YAO Ning, GAO Yu-ping
    2016, 36 (10):  1451. 
    doi: 10.3969/j.issn.1674-8115.2016.10.010

    Abstract ( 563 )   PDF (615KB) ( 602 )  

    Objective·To investigate the bisphenol A (BPA) level in serum and follicular fluid from patients undergoing in vitro fertilization-embryo transfer (IVF-ET) and its association with pregnancy outcomes. Methods·Serum and follicular fluid from 138 patients undergoing IVF-ET in Renji Hospital affiliated to the Shanghai Jiao Tong University School of Medicine between January 2014 and December 2015 were collected on ovum harvest day. BPA levels in serum and follicular fluid were measured using enzyme linked immunosorbent assay method. The association between serum and follicular fluid BPA levels, and BPA levels and pregnancy outcomes were analyzed. Results·Of 138 patients, BPA was detected in serum and follicular fluid from 60 patients with average serum and follicular fluid BPA levels of 14.8 ng/ml and 5.2 ng/mL. The difference was statistically significant (P=0.000). BPA levels in serum and follicular fluid were positively correlated (r=0.51, P=0.000). Of 138 patients, 59 underwent clinical transplantation and 31 (52.5%) of them were pregnant. Among these 31 patients, BPA was detected in 7 patients and was not detected in 24 cases. Patients without detection of BPA had a significantly higher pregnancy rate (77.4%) than patients with detection of BPA (22.6%). Pregnant patients had a lower follicular fluid BPA level (4.6 ng/mL) than patients failed to pregnancy (10.7 ng/mL) and the difference was statistically significant (P=0.015). Pregnant patients had a lower serum BPA level (5.9 ng/mL) than patients failed to pregnancy (16.7 ng/mL) and the difference was statistically significant (P=0.005). There was no significant difference in infertility age between patients with and without detection of BPA in serum or follicular fluid. The average age of patients with detection of BPA was older than that of patients without detection of BPA, but the difference was not statistically significant. Conclusion·BPA can be detected in serum and follicular fluid of some patients undergoing IVF-ET. The detection rate increases with the age. The serum BPA level can predict the follicular fluid BPA level. High serum BPA level may affect embryo implantation.

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    Selection of constant irrigation drainage plan for the treatment of children with septic gonarthritis
    MIAO Ming-yuan, CAI Hai-qing, WANG Zhi-gang
    2016, 36 (10):  1454. 
    doi: 10.3969/j.issn.1674-8115.2016.10.011

    Abstract ( 714 )   PDF (1867KB) ( 718 )  

    Objective·To observe the therapeutic effect of constant irrigation drainage on the treatment of septic gonarthritis in children at different stages of disease and to explore the choice of treatment plan. Methods·Twenty-one cases of septic gonarthritis were retrospective analyzed. All patients underwent emergency operations and conventional imaging and laboratory tests. The average CRP and ESR were 51 mg/L and 75 mm/h. Emergency operations were determined according to the onset time and imaging results, including arthroscopic irrigation, arthroscopic synovial membrane cleaning, and direct incision and drainage. All patients accepted constant irrigation drainage. Results·The average drainage duration and hospital stay were 10.9 d and 21.2 d for patients with the course of disease <1 week and 19.3 d and 29.9 d for patients with the course of disease > 1 week. The average CRP and ESR at discharge were 3 mg/L and 18 mm/h for patients with the course of disease <1 week and 2 mg/L and 16 mm/h for patients with the course of disease > 1 week. The average follow-up period was 26 months and there were no incidences of recurrence. Their Lysholm scores were all above 90 points. Conclusion·Reasonable selection of constant irrigation drainage for the treatment of septic gonarthritis in children at different stages of disease facilitates early control of infection, protects articular cartilage, recovers joint function, and prevents persistent or repeated infection.

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    A control study on neurocognitive function in first episode schizophrenia, ultra-high-risk, and high-risk populations
    WANG Wen-zheng, SHI Ying-ying*, YU Xin, PU Cheng-cheng
    2016, 36 (10):  1458. 
    doi: 10.3969/j.issn.1674-8115.2016.10.012

    Abstract ( 660 )   PDF (976KB) ( 846 )  

    Objective·To compare the neurocognitive function between first episode schizophrenia, ultra-high-risk population, and high-risk population. Methods·Twenty-two ultra-high-risk patients met the Criteria of Psychosis-risk Syndromes (ultra-high-risk group), 57 first episode schizophrenia patients who were at acute phase and met  “Diagnostic and Statistical Manual of Mental Disorders” (4th edition)(first episode group), and 34 first-degree relatives of patients with schizophrenia (high-risk group) were selected. Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Groove Pegboard Test, Trail Making Test A, Color Trail Making Test Ⅱ, Wisconsin Card Sorting Test, Category Fluency Test, Stroop Color Word Test, Symbol Coding Test, Paced Auditory Seria Addition Test were used to evaluate the neurocognitive function in three groups. Results·In all neurocognitive tests, the damage of subdominant hands in fine motor of Groove Pegboard Test (39.47±12.30) in the high-risk group was the most obvious. The damage of Brief Visuospatial Memory Test-Revised (38.75±8.21) and dominant hands in fine motor of Groove Pegboard Test (36.45±8.52) in the ultra-high-risk group was the most significant, while the damage of dominant hands (32.04±10.55) and subdominant hands (28.82±10.78) in fine motor of Groove Pegboard Test, and Color Trail Making Test Ⅱ (32.06±14.99) in the first episode group was the most obvious. In three groups, scores of all cognitive tests in the ultra-high-risk group were between those in the high-risk group and the first episode group except the Category Fluency Test, Stroop Color Word Test, and Wisconsin Card Sorting Test. Conclusion·First episode schizophrenia, high-risk, and ultra-high-risk populations have different neurocognitive impairments. Different areas of nerve cognitive function may develop differently in the process of schizophrenia development. Ultra-high-risk patients have extensive and significant impairments in nerve cognitive area with the degree between unaffected first-degree relatives and first-episode schizophrenia.

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    Clinical study on 121 cases of abdominal wall endometriosis
    ZHANG Ping, SUN Ya-bing, CHEN Zheng-yun, XU Hong, ZHANG Xin-mei, HUANG Xiu-feng
    2016, 36 (10):  1463. 
    doi: 10.3969/j.issn.1674-8115.2016.10.013

    Abstract ( 771 )   PDF (717KB) ( 620 )  

    Objective·To analyze clinical characteristics and diagnostic and therapeutic procedure of patients with abdominal wall endometriosis (AWE) and explore effective treatment and prevention methods. Methods·Clinical data of 121 AWE cases were retrospectively analyzed. Results·Of 121 AWE cases, 120 cases (99.2%) were secondary to cesarean section with a median latency of 24 months. Of 94 cases (77.7%) with the description of cesarean section incision type, 65 cases (69.1%) had the transverse incision (Pfannenstiel incision) and the other 29 cases (30.9%) had the vertical midline incision. All patients underwent the excision of endometriosis lesions and a total of 146 lesions were excised. Of 146 lesions, the upper bound of 97 lesions (66.4%) was in the subcutaneous fat layer, the upper bound of 26 lesions (17.8%) was in the anterior rectus sheath, and the upper bound of other 23 cases (15.8%) was in the muscular layer. Conclusion·Decreasing the cesarean section rate, optimizing the cesarean section procedure, and protecting the incision are key factors for the prevention of AWE.

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    Meta-analysis of the effects of different orthognathic surgeries on the upper airway of patients with skeletal class Ⅲ malocclusion
    HE Jin-long, WANG Yun-ji, HU Hong-tao, LIAO Qian, ZHANG Wei-yi, FAN Xiao-ping
    2016, 36 (10):  1467. 
    doi: 10.3969/j.issn.1674-8115.2016.10.014

    Abstract ( 860 )   PDF (4079KB) ( 663 )  

    Objective·To systematically compare the effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class III malocclusion. Methods·Randomized controlled trials and clinical case-control trials about the comparison of effects of maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery and simple mandibular setback surgery on the upper airway of patients with skeletal class Ⅲ malocclusion were retrieved from Cochrane Library, EMBASE, PubMed, CNKI and Wanfang databases up to February 29, 2016. Included studies were evaluated and analyzed using Rev Man 5.3 software. Results·A total of 6 clinical case-control trial articles and 205 cases were included. The results of meta-analysis showed that the difference in cross-sectional area (CSA) changes on the posterior nasal spine plane and epiglottis plane between two procedures was statistically significant (P<0.05), but the difference in CSA changes on the velar plane was not statistically significant. The difference in nasopharynx volume and upper airway volume changes was statistically significant (P<0.05), but the difference in oropharynx volume and hypopharynx volume changes was not statistically significant. Conclusion·Compared with simple mandibular setback surgery, maxillary LefortⅠosteotomy advancement surgery combined with mandibular setback surgery has slighter effects on CSAs on nasopharynx plane and hypopharynx plane and volumes of nasopharynx volume and upper airway. The combined surgery is more suitable for the treatment of patients with skeletal class Ⅲ malocclusion, especially for those with potential breathing problems.

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    Study on the association between ankle-brachial index and gastrocnemius muscle spasm in patients with type 2 diabetes mellitus
    TU Mei, WEI Wen, QIU Yong-ming, HUANG Rong, CHEN Tong
    2016, 36 (10):  1473. 
    doi: 10.3969/j.issn.1674-8115.2016.10.015

    Abstract ( 684 )   PDF (847KB) ( 547 )  

    Objective·To investigate the association between ankle-brachial index (ABI) and gastrocnemius muscle spasm in patients with type 2 diabetes mellitus (T2DM). Methods·Three hundred patients with T2DM were assigned to the positive group (n=70) and the negative group (n=230) according to the presence of gastrocnemius muscle spasm. Indexes such as blood glucose, blood lipids, blood electrolytes, and ABI were measured and color doppler ultrasound for lower extremity blood vessels was performed. One-way analysis of variance and Chi-square test were conducted. The risk factors for gastrocnemius muscle spasm in patients with T2DM were analyzed using multivariate non-conditional Logistic regression. Results·①Fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein cholesterin, smoking rate, and incidences of lower extremity arteriosclerosis and lower extremity arterial plaque in patients with T2DM were significantly higher in the positive group than in the negative group (P<0.05). ABI was significantly lower in the positive group than in the negative group. ②The incidence of gastrocnemius muscle spasm was significantly higher in T2DM patients with ABI<0.9 than in those with normal ABI or ABI>1.3. ③Low ABI, hyperglycemia, high cholesterol, high low-density lipoprotein cholesterol, smoking, lower extremity arteriosclerosis, and lower extremity arterial plaques were risk factors for gastrocnemius muscle spasm in patients with T2DM. Non painful diabetic neuropathy did not cause an increase in the incidence of gastrocnemius muscle spasm in diabetic patients. Conclusion·Gastrocnemius muscle spasm in patients with T2DM is associated with lower extremity arterial disease, smoking, hyperglycemia, and hyperlipidemia. Once patients with T2DM develop gastrocnemius muscle spasm, ABI examination should be performed to detect lower extremity arterial disease.

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    Comparison of the marginal accuracy between selective laser melting Co-Cr basal crowns and casting Co-Cr basal crowns
    XU Wei-xing, YUAN Jian-ming, TANG Ying, TIAN Xiao-mei, ZHANG Bi-chu
    2016, 36 (10):  1478. 
    doi: 10.3969/j.issn.1674-8115.2016.10.016

    Abstract ( 697 )   PDF (1834KB) ( 530 )  

    Objective·To explore the difference in marginal accuracy between cobalt-chromium basal crowns produced by selective laser melting (SLM) and casting in clinical application. Methods·Twenty plaster casts for 20 clinical teeth that were prepared according to the standard of full crown were produced. Twenty SLM cobalt-chromium basal crowns and 20 casting cobalt-chromium basal crowns were produced and placed on plaster casts. A stereomicroscope was used to observe the marginal gap pattern between basal crowns produced with silicon rubber replication technology and plaster casts, and measure the marginal gap widths. Finally, average values of two groups were calculated and compared. Results·The average marginal gap widths of SLM cobalt-chromium basal crowns and casting cobalt-chromium basal crowns were (60.39±10.63) μm and (91.41±37.68) μm, respectively. The former was significant smaller than the latter (P=0.000). Conclusion·SLM cobalt-chromium basal crowns have a much high marginal accuracy and a better clinical restoration effect than casting cobalt-chromium basal crowns.

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    Association between breast atypical ductal hyperplasia and breast cancer
    XU Yan-chun, YAO Xiao-hong, XU Ke-chun, GUAN Wen-bin, WANG Li-feng, ZHU Ming-jie
    2016, 36 (10):  1482. 
    doi: 10.3969/j.issn.1674-8115.2016.10.017

    Abstract ( 1036 )   PDF (1478KB) ( 672 )  

    Objective·To explore the association between breast atypical ductal hyperplasia (ADH) and breast cancer. Methods·A total of 442 benign and malignant breast samples were collected, including 253 invasive carcinoma samples, 79 noninvasive carcinoma (ductal carcinoma in situ, 25 low grade carcinoma and 54 high grade carcinoma) samples, and 110 benign samples. Histological characteristics and immunohistochemical changes of ADH were observed. The detection rates of ADH in different types of samples were statistically analyzed. Results·The diameters of ADH were all less than 2 mm. Lumens cells were negative for CK5/6 and myoepithelial cells were positive for p63. The detection rate of ADH in noninvasive carcinoma samples was significantly higher than those in benign samples and invasive carcinoma samples (both P=0.000). The detection rate of ADH in low grade noninvasive carcinoma was significantly higher than those in invasive carcinoma samples and high grade noninvasive carcinoma (both P=0.000). Conclusion·Breast ADH is closely associated with ductal carcinoma in situ. Timely detection and removal of ADH are important for preventing breast cancer.

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    Three dimensional analysis of root canal morphology of mandibular first premolar with single canal for individuals at different ages
    HE Xu, LIANG Jing-ping
    2016, 36 (10):  1486. 
    doi: 10.3969/j.issn.1674-8115.2016.10.018

    Abstract ( 655 )   PDF (1399KB) ( 626 )  

    Objective·To observe the three dimensional morphology of root canal of mandibular first premolars with single canal for individuals at different ages. Methods·Ten mandibular first premolars with single canal that needed to be extracted due to orthodontic reason from individuals aged 15-25 years (the young group) and ten mandibular first premolars with single canal that needed to be extracted due to periodontal diseases from individuals aged 55-75 years (the elderly group) were selected. Data were gathered by Micro-CT scanning and CTAn software was used to analyze root volume, canal volume, canal area, and structure model index (SMI). Results·Average canal volume and area were (12.308±4.550) mm3 and (48.869±8.064) mm2 in the young group and (3.798±0.944) mm3 and (25.187±5.072) mm2 in the elderly group. The differences were both statistically significant (P<0.05). The differences in average volume fractions of middle and apical third of root canals were statistically significant (P<0.05). The elderly group has a significantly higher SMI than the young group (P<0.05). Conclusion·For the treatment of patients at different ages, we need to thoroughly understand anatomic characteristics of root canals, pay more attention to root canal preparation, so as to improve the success rate of root canal treatment.

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    Comparison of central corneal thickness measured using Lenstar LS900 and Tomey EM-3000 after vitrectomy
    XU Jian-min, ZHANG Shi-sheng*, WU Yan-lin, ZHANG Qiong
    2016, 36 (10):  1490. 
    doi: 10.3969/j.issn.1674-8115.2016.10.019

    Abstract ( 615 )   PDF (1036KB) ( 542 )  

    Objective·To compare the accuracy and consistency between Lenstar LS900 and Tomey EM-3000 for measuring central corneal thickness after vitrectomy. Methods·Fifty-four patients (55 aphakic eyes) who had undergone post-vitrectomy for at least three months were assigned to three groups based on the axial length, i.e. group A (axial length≥26 mm), group B (axial length between 24 mm and 26 mm), and group C (axial length<24 mm ). The patients were also assigned to the silicone oil-filled eye group (26 eyes) and the non-silicone oil-filled eye group (29 eyes), and then each group was assigned to three groups according to the axial length. The central corneal thickness was measured using Lenstar LS900 and Tomey EM-3000 analyzer and the data were statistically analyzed. Results·The mean central corneal thickness values measured by Lenstar LS900 and Tomey EM-3000 were (550.44±32.03) μm and (547.58±34.29) μm, respectively and the difference was statistically significant (P<0.01). But the differences in mean central corneal thickness values between the two methods in group A, group B, or group C were not statistically significant (P>0.05). The differences in mean central corneal thickness values between the two methods in the silicone oil-filled eye group or the non-silicone oil-filled eye group were not statistically significant (P>0.05). Only the differences in mean central corneal thickness values between the two methods in group A of the non-silicone oil-filled eye group were statistically significant (P<0.05). Mean central corneal thickness values measured by the two methods were linearly correlated (r=0.957, P<0.01). The width of the 95% limit of agreement ranged from -16.77 μm to 22.47 μm, containing 92.7% (51/55) measurements. Conclusion·The central corneal thickness measured by Lenstar LS900 is slightly larger than that measured by Tomey EM-3000. The two methods are positively correlated and consistent, and both of them can be used to measure the central corneal thickness after vitrectomy.

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    Correlation between the polymorphism of CD147 gene and instability of carotid plaque
    SHEN Chen-chen, MA Fei-yue*, Feng Yu-lan, Sun Jia-lan, FU Yi
    2016, 36 (10):  1494. 
    doi: 10.3969/j.issn.1674-8115.2016.10.020

    Abstract ( 593 )   PDF (1023KB) ( 648 )  

    Objective·To investigate the correlation between the polymorphism of locus rs8637 in CD147 gene and instability of carotid plaque. Methods·Four hundred and forty-two inpatients with cerebral infraction were assigned to the vulnerable plaque group (n=320) and the stable plaque group (n=122) according to the results of carotid B-mode ultrasonography. The polymorphism of locus rs8637 in CD147 gene was analyzed by polymerase chain reaction-the ligase detection reaction (PCR-LDR). Results·The frequencies of AG+GG genotype and G allele at locus rs8637 in the vulnerable plaque group were 94.38% and 73.42%. The differences between two groups were statistically significant (P<0.05). The differences in age, blood glucose, blood pressure, TC, TAG, LDL-C, and HDL-C between the two groups were not statistically significant. Conclusion·The polymorphism of locus rs8637 in CD147 gene may be associated with carotid vulnerable plaque and the G allele may be a genetic susceptible gene for carotid vulnerable plaque.

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    Value of 99mTc-MIBI single photon emission computed tomography/computerized tomography in the diagnosis of primary hyperparathyroidism
    XIE Qian, ZHU Rui-sen, QIU Zhong-ling, HU De-sheng, LUO Quan-yong
    2016, 36 (10):  1498. 
    doi: 10.3969/j.issn.1674-8115.2016.10.021

    Abstract ( 724 )   PDF (1787KB) ( 629 )  

    Objective·To evaluate diagnostic value and advantages of 99mTc-MIBI single photon emission computed tomography integrated with X-ray computerized tomography (SPECT/CT) in diagnosing patients with primary hyperparathyroidism (PHPT). Methods·Clinical data, postoperative pathological diagnosis, and clinical follow-up results of 249 patients with PHPT who underwent 99mTc MIBI SPECT/CT for diagnosis were systematically reviewed and compared with neck ultrasound, blood index tests (according to the diagnostic criteria of WHOs that must meet both high PTH and hypercalcemia), and double phase planar imaging (intravenous injection of 99mTc MIBI 740 MBq and undergoing 30 min and 120 min of cervical and thoracic early and delayed double phase static plane acquisition) results. Results·For 249 patients, diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 99mTc-MIBI SPECT/CT for the diagnosis of PHPT were 89.9%, 88.1%, 90.4%, 85.0%, and 88.0%. Those of neck ultrasound were 82.7%, 57.8%, 74.3%, 69.3%, and 72.6%.Those of blood indexes were 91.4%, 82.6%, 87.1%, 80.4%, and 87.6%. Those of planar imaging were 77.9%, 89.0%, 90.1%, 75.8%, and 82.7%. Conclusion·99mTc-MIBI SPECT/CT has greater clinical diagnostic value of PHPT than neck ultrasound and 99mTc-MIBI double phase planar imaging and can accurately locate lesions, so as to facilitate the parathyroidectomy.

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    Original article (Public health)
    Empirical study on methods for handling medical disputes in public hospitals
    YUAN Jia-jun, QIU Xiao-chun, TONG Tian-lang, CHEN Jing-hua, LI Xiang-nan, SHENG Wei-hui
    2016, 36 (10):  1503. 
    doi: 10.3969/j.issn.1674-8115.2016.10.022

    Abstract ( 636 )   PDF (1378KB) ( 846 )  

    Objective·To explore effective models for handling medical disputes in public hospitals and to establish a harmonious relationship between the hospital and patients. Methods·Data on medical disputes in one Shanghai public hospital between 2012 and 2015 were collected and statistically analyzed. Changes in resolution rate, duration, and handling methods of medical disputes before and after the standardization of medical dispute handling were compared. Results·After the standardization of medical dispute handling, the solution rate of medical disputes was increased by 16.08%, from 59.26% (2102) to 75.34% (2015) and the duration of medical disputes was decreased by 14.85 d, from 203.96 d (2102) to 189.11 d (2015). The main method for handling medical disputes was changed from the consultation between the hospital and patients in 2012 (accounted for 65.40%) to the consultation by the peoples mediation committee of medical disputes in 2015 (accounted for 71.81%). Conclusion·A patient centered, clinical department involved, multi-department cooperated, and professional legal evaluation supported method for handling medical disputes facilitates the high efficient handling of medical disputes in public hospitals and establishment of a harmonious relationship between the hospital and patients.

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    Review
    Advances in structural neuroimaging studies on major depressive disorders
    ZHOU Ru-bai, ZHAO Guo-qing, LIN Ye-zhe, FANG Yi-ru
    2016, 36 (10):  1508. 
    doi: 10.3969/j.issn.1674-8115.2016.10.023

    Abstract ( 972 )   PDF (1277KB) ( 663 )  

    Structural neuroimaging is an important field in mental disorder researches and magnetic resonance imaging (MRI) is widely used for studying major depressive disorders (MDD). However, no consensus has been reached in structural neuroimaging researches on depression and measured variables have many limitations, so it is not suitable for clinical practices. This study analyses brain structural changes during onset and development of MDD using MRI via new variables such as brain volume, cortical thickness, surface area, and hypergyrification. This article focuses on etiology, diagnosis, treatment, as well as prognosis of MDD, and reviews structural neuroimaging researches according to brain regions, so as to introduce clinical advances in this field.

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    Research progresses of MafA gene mutations/variations and diabetes mellitus
    GE Xiao-xu, LIU Li-mei
    2016, 36 (10):  1513. 
    doi: 10.3969/j.issn.1674-8115.2016.10.024

    Abstract ( 649 )   PDF (695KB) ( 603 )  

    V-maf musculoaponeurotic fibrosarcoma oncogene homolog A (MafA) is an important transcription factor of mature pancreatic islet β-cells, which is essential for insulin gene transcription, insulin secretion, and proliferation and differentiation of β-cell mass. MafA, together with PDX-1 and NeuroD1/BETA2, can synergistically induce insulin gene expression in islet β-cells and non-islet β-cells, which is expected to be a potential therapeutic target for the treatment of diabetes. Studies have shown that genetic deficiency of MafA gene in diabetic mouse models and diabetic patients can cause impaired glucose tolerance and the occurrence of diabetes. Mutations/variations of human MafA gene may be associated with the pathogenesis of special types of diabetes such as neonatal diabetes mellitus (NDM) and maturity-onset diabetes of the young (MODY), and the increased susceptibility to type 1 or type 2 diabetes mellitus.

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    Application progresses in measuring cell adhesion by micropipette aspiration assay
    QIAN Tian-wei, WANG Ying
    2016, 36 (10):  1517. 
    doi: 10.3969/j.issn.1674-8115.2016.10.025

    Abstract ( 872 )   PDF (1360KB) ( 599 )  

    The adhesion between cells or subcellular structures participates in important pathophysiological processes such as cell migration, proliferation, differentiation, immune activation and tumor metastasis. Cross-discipline research methods can integrate cell biology, immunology, and biomechanics, and quantitatively measure the cell adhesion force. With the establishment of corresponding dynamic mathematical models, biophysical properties of cell adhesion can be further elucidated. Thus novel theoretic evidence and intervention strategies can be provided for in-depth understanding of interaction models of lymphocytes during immune response, targeting of drugs towards carrier cells, compatibility between biomaterials and tissue cells, as well as biomechanical mechanism of tumor metastasis. This article introduces the principles of micropipette aspiration assay for measuring cell adhesion and reviews its latest applications.

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    Research progresses of freehand 3D ultrasound calibration based on optical tracking system
    GUO Xiao-jie, LIN Yan-ping, ZENG Xiang-sen, WANG Hui-xiang, WANG Fang
    2016, 36 (10):  1522. 
    doi: 10.3969/j.issn.1674-8115.2016.10.026

    Abstract ( 643 )   PDF (2297KB) ( 939 )  

    This paper summarizes and reviews the freehand 3D ultrasound probe calibration techniques based on the optical tracking system. It firstly introduces the current researches on existing calibration methods and divides them into point phantom, line phantom, plane phantom, and method without phantom based on their principles. Then two approaches are introduced for determining the calibration matrix, including the iterative and the closed-form methods. Next two types of indexes for evaluating the precision and accuracy of a calibration transformation are introduced. At last the characteristics of various calibration methods are analyzed from perspectives of precision, accuracy, time, reliability, scope of application, and ease of use. The existing problems and trends of the freehand 3D ultrasound probe calibration are also discussed.

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    Research progresses of the mechanisms of thiopurine resistance in acute lymphoblastic leukemia
    FANG Hou-shun, LI Hui, YANG Fan, AI Xiao-jie, ZHOU Bin-bing
    2016, 36 (10):  1529. 
    doi: 10.3969/j.issn.1674-8115.2016.10.027

    Abstract ( 650 )   PDF (1165KB) ( 762 )  

    Thiopurine is one type of common chemotherapy drugs for the treatment of acute lymphoblastic leukemia (ALL) during remission. It must be metabolized and transformed to thioguanine nucleotides in vivo, which have the biological activity for killing tumor cells. Once key enzymes in thiopurine metabolic pathway develop single nucleotide polymorphisms or functional mutations, tumor cells will become resistant to thiopurine treatment and relapse will occur quickly. This article summarizes research progresses of metabolic enzyme mutations, which contribute to the thiopurine resistance in ALL, in order to provide novel ideas and strategies for overcoming the thiopurine resistance.

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    Research progresses of the correlation between Rho/Rock signaling pathway and pulmonary fibrosis
    QI Xiu-jie, LI Jing, TAN Li-ping, XU Feng, FANG Fang
    2016, 36 (10):  1533. 
    doi: 10.3969/j.issn.1674-8115.2016.10.028

    Abstract ( 1037 )   PDF (704KB) ( 839 )  

    Rho/Rock signaling pathway is a key signaling pathway regulating cell proliferation and tissue differentiation, as well as a signal transduction pathway moderating stem cell self-renewal process. Under the stimulation of a various inflammatory cytokines, Rho/Rock pathway is involved in biological behaviors such as cell contraction, chemotaxis, adhesion, and invasion via kinase cascade. Rho/Rock signaling transduction pathway is closely related to pulmonary fibrosis. Therefore, deep understanding of the effects and mechanisms of Rho/Rock pathway in pulmonary fibrosis may reveal novel breaking points for prevention and treatment of pulmonary fibrosis.

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    Brief original article
    Expression of PPARγ in follicular thyroid carcinoma and its clinicopathological significance
    JIAO Qiong, HUANG Wen-tao, LIU Liang, GU Ming-min, ZHANG Hui-zhen
    2016, 36 (10):  1537. 
    doi: 10.3969/j.issn.1674-8115.2016.10.029

    Abstract ( 535 )   PDF (958KB) ( 494 )  

    Objective·To explore the expression of peroxisome proliferator activated receptor γ(PPARγ) in follicular-patterned thyroid tumors. Methods·Follicular-patterned thyroid tumor samples from 194 cases that were diagnosed in recent two years were collected, including 60 cases of follicular carcinoma, 80 cases of benign adenoma, and 54 cases of atypical adenoma. The expression of PPARγ was measured by immunohistochemical staining (EnVision method). Results·The expression level of PPARγ gradually increased from benign adenoma to atypical adenoma and follicular carcinoma. The differences in strong positive PPARγ expression between follicular carcinoma and benign adenoma, and atypical adenoma and benign adenoma were statistically significant, while the difference between follicular carcinoma and atypical adenoma was not statistically significant. Conclusion·PPARγ is a specific immune marker for follicular carcinoma and important in the diagnosis of follicular carcinoma.

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    Case report
    Report on two college students with mental disorder resulted from cannabis abuse
    ZHANG Qiao-yang, ZHONG Na, ZHANG Lei, ZHAO Min, DU Jiang
    2016, 36 (10):  1540. 
    doi: 10.3969/j.issn.1674-8115.2016.09.030

    Abstract ( 770 )   PDF (682KB) ( 587 )  

    Objective·To explore the clinical characteristics and therapy of cannabis abuse among adolescents and college students. Methods·Clinical data of two college students with cannabis abuse were reported and medical treatment of cannabis abuse was summarized. Results·Cannabis abuse can result in severe psychiatric symptoms, including hallucination and delusion. Some patients may have emotional problem. Antipsychotic treatment can effectively alleviate symptoms. Conclusion·Cannabis abuse is harmful to young people. Relevant institutions should pay attention to cannabis abuse and implement related measures to prevent cannabis abuse among adolescents and college students.

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