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    28 November 2016, Volume 36 Issue 11 Previous Issue    Next Issue
    Inside front cover
    Original article (Basic research)
    Original article (Clinical research)
    Original article (Public health administration)
    Review
    Case report
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    Inside front cover
    Translational medicine
    2016, 36 (11):  1539. 
    Abstract ( 421 )   PDF (3633KB) ( 548 )  
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    Original article (Basic research)
    Construction of a rabbit model of early brain injury after subarachnoid hemorrhage with endovascular puncture
    Lü Tao, DAI Jiong, MIAO Yi-feng, JIN Yi-chao, JIN Ke, ZHANG Xiao-hua
    2016, 36 (11):  1543. 
    doi: 10.3969/j.issn.1674-8115.2016.11.001
    Abstract ( 981 )   PDF (7518KB) ( 741 )  
    Objective · To build a rabbit model of early brain injury (EBI) after subarachnoid hemorrhage (SAH) with endovascular puncture and to assess the validity and reliability of the model. Methods · A total of 59 New Zealand rabbits were used. Five of them were assigned to the sham operation group (undergoing super choice imaging for internal carotid artery without puncture) and other fifty-four underwent endovascular puncture under the guidance of digital subtraction angiography (DSA). The 30 survived rabbits were randomly assigned to the 6 h, 24 h, and 72 h groups (n=10) for subsequent study. The intracranial pressure (ICP) monitor was used to observe the intraoperative ICP of the animals. SAH scores and neurological scores were used to assess the amount of bleeding and neurological dysfunction. TUNEL and FJB staining were used at three postoperative time points to evaluate the degeneration/necrosis and apoptosis in cortical and hippocampal tissues. Results · The successful rate of the SAH rabbit model was 55.6% (30/54). The endovascular puncture resulted in different degrees of intracranial hemorrhage and neurological dysfunction (P=0.000), which caused degeneration/necrosis and apoptosis in cortical and hippocampal tissues. Conclusion · The rabbit model of SAH with endovascular puncture successfully simulates changes in haemodynamics and pathophysiology for EBI and is important for studying the mechanisms of EBI after SAH.
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    Potassium-deficient culture induces Mycobacterium tuberculosis into a dormant state
    YANG Ting, CAO Jun, XU Li, GUO Shu-liang
    2016, 36 (11):  1549. 
    doi: 10.3969/j.issn.1674-8115.2016.11.002
    Abstract ( 786 )   PDF (6262KB) ( 1165 )  
    Objective · To induce Mycobacterium tuberculosis into a dormant state by potassium-deficient culture. Methods · The potassium-deficient Sauton medium was used to culture Mycobacterium tuberculosis at logarithmic phase and to induce it into a dormant state. Colony count, resazurin colorimetric assay, and most probable number (MPN) method were used to measure the survival rate and the proportion of dormant Mycobacterium tuberculosis. Transmission electron microscope (TEM) was used to observe the thickening of cell wall. Auramine O-Nile red double fluorescent staining was employed to detect the lipid accumulation and loss of acid fastness. Drug sensitivity test was performed to detect the drug resistance to isoniazide and rifampicin. Results · Mycobacterium tuberculosis turned to spherical, cell wall thickening, experienced lipid accumulation, and loss of acid fastness, and became resistant to antituberculosis drugs after being cultured under potassium-deficient condition for 30 days. Conclusion · Potassium-deficient culture can induce Mycobacterium tuberculosis at logarithmic phase into a dormant state.
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    Study on dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars
    SONG Fei, LIU Ying-kai, WANG Xi-qiao
    2016, 36 (11):  1553. 
    doi: 10.3969/j.issn.1674-8115.2016.11.003
    Abstract ( 823 )   PDF (6077KB) ( 1035 )  
    Objective · To investigate dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars. Methods · Patients with early, hypertrophic, regressive, and mature scars were respectively assigned to four groups with 8 patients in one group. Partial pressure of oxygen was percutaneously measured before scar surgery with normal skin as the control. Scar tissues were fixed, sectioned, and H-E stained after surgery. CD34 and hypoxia inducible factor-1 (HIF-1) were measured with immunohistochemistry. Significance analysis was performed on results with two sample mean comparison test (t test). Results · Percutaneous measurement of partial pressure of oxygen found that compared with normal control [(75.3±10.1)mmHg], partial pressure of oxygen started to decrease in early scars [(51.2±8.3) mmHg，P=0.037], further decreased in hypertrophic scars [(30.2±6.1)mmHg，P=0.026], reached the lowest in regressive scars [(6.9±2.1)mmHg，P=0.011], and returned to normal in mature scars [(71.1±9.6) mmHg，P=0.080]. H-E staining revealed that there were a small amount of microvessels in normal skin. Microvessels gradually increased in early scars and reached the highest number in hypertrophic scars. Stenosis or occlusion occurred in most microvessels in regressive scars and microvessels returned to normal in mature scars. Results of CD34 examination further confirmed these changes in microvascular morphology and number. HIF-1 examination found that the HIF-1 expression was low in normal skin, significantly increased in early scars, further increased in hypertrophic scars, significantly decreased in regressive scars, and almost returned to normal in mature scars. Conclusion · There are dynamic changes in microvessels and partial pressure of oxygen during the occurrence and development of hypertrophic scars. These changes are associated with pathological changes in scars and may be mediated by HIF-1.
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    Study on the human scaffold protein FN3 for displaying NT-proBNP epitopes
    LI Meng-yang, YANG Chun-guang, SUN Shen-xia, XU Wei-ye, WANG Xuan-Yu, HU Xue-jun, DING Ning, QU Peng
    2016, 36 (11):  1558. 
    doi: 10.3969/j.issn.1674-8115.2016.11.004
    Abstract ( 1199 )   PDF (6965KB) ( 784 )  
    Objective · To display NT-proBNP epitopes using human scaffold protein FN3 and to efficiently express a stable recombinant protein with active NT-proBNP epitopes via E.coli expression system. Methods · The FG loop sequence of scaffold protein FN3 was replaced by NTproBNP epitope 12-21 and 13-20 sequences at amino acid residue, respectively, and was cloned into the E.coli expression vector pET28(a)+. The recombinant FN3 proteins displaying NT-proBNP epitopes were expressed in E.coli BL21(DE3) plySs and were purified. The antigen activity was detected and physiochemical properties were analyzed. Results · The expression vector for recombinant protein FN3 displaying NT-proBNP epitope 12-21 and 13-20 sequences at amino acid residue was successfully constructed. The E.coli strain with efficient expression of scaffold protein FN3 displaying NT-proBNP epitopes was obtained. Highly purified recombinant protein with antigen immune activity against NT-proBNP was obtained with nickel column purification and was verified with Western blotting and ELISA. Differential thermal scanning method showed that the recombinant protein maintained the stability of scaffold protein FN3. Plasma stability test indicated that the recombinant protein was a highly stable substitute for antigen protein with the same effect and could significantly extend the degradation cycle (serous half-life). Conclusion · NT-proBNP was displayed successfully via scaffold protein FN3. A substitute for antigen protein of NT-proBNP with the same antigenicity can be simply, rapidly, and efficiently prepared with E.coli expression system.
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    Mechanism of age-related hyperoxia-induced lung injury in SD rats
    NING Wei, LI Jing, QI Xiu-jie, XU Feng, FANG Fang
    2016, 36 (11):  1562. 
    doi: 10.3969/j.issn.1674-8115.2016.11.005
    Abstract ( 1086 )   PDF (8980KB) ( 812 )  
    Objective · To observe the similarities and differences in neonatal rats and immature rats with hyperoxia-induced lung injury and to preliminary explore the role of Rho/Rock signaling pathway in age-related hyperoxia-induced lung injury. Methods · Sprague-Dawley neonatal rats and immature rats aged 3 weeks were randomly assigned to the neonatal air group, the neonatal hyperoxia group, the immature air group, and the immature hyperoxia group. The changes in survival rate and body mass were statistically observed form the construction of animal model till 14 d. Lung tissues of SD rats were harvested. Pathological examination and injury scoring were performed and hydroxyproline, SOD, MDA, ROCK1, p-MYPT1, and MYPT1 were examined. Results · ① The neonatal hyperoxia group had a significantly lower survival rate than the neonatal air group, the immature air group, and the immature hyperoxia group. There was no significant difference in survival rate between the immature air group and the immature hyperoxia group. The body weight increased slower in the neonatal and immature hyperoxia groups than in the neonatal and immature air groups. The body weight increased slower in the neonatal hyperoxia group than in the immature air group. ② The neonatal hyperoxia group and immature hyperoxia group developed lung injury and fibrosis. The neonatal hyperoxia group was more serious than the immature hyperoxia group. ③ The neonatal and immature hyperoxia groups had higher MDA level and lower SOD activity than the neonatal and immature air groups. The neonatal hyperoxia group had lower SOD activity than the immature hyperoxia group. The SOD activity was significantly decreased after hyperoxia treatment. ④ The neonatal and immature hyperoxia groups had higher ROCK1 and p-MYPT1 expressions than the neonatal and immature air groups. The neonatal hyperoxia group had higher p-MYPT1 expression than the immature hyperoxia group. Conclusion · Hyperoxia-induced lung injury is age-dependent. Neonatal rats have significantly weaker hyperoxia tolerance than immature rats and this is associated with the weak antioxidant capacity of their own. The degree of activation of Rho/Rock signaling pathway may play an important role in age-related hyperoxia-induced lung injury.
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    Establishment and evaluation of standardized steps for building a rat model of vein graft restenosis
    WANG Xiao-wen, HU Jia-biao, XE Xiang-jun, FENG Bo, HUANG Chun, LU Zhi-qian
    2016, 36 (11):  1568. 
    doi: 10.3969/j.issn.1674-8115.2016.11.006
    Abstract ( 964 )   PDF (9775KB) ( 1311 )  
    Objective · To explore the standardized steps for building an animal model of vein graft restenosis by suture anastomosis and to verify the effectiveness via evaluation experiments. Methods · Thirty-two female SD rats underwent interposition bypass grafting of the autologous external jugular vein to the carotid artery for building a model of vein graft restenosis. Modelling steps were optimized. The success rate and modelling effects were evaluated using electron microscopy, HE staining and optical microscope, and color Doppler ultrasonography. Results · All rats successfully underwent vein graft surgery and survived the surgery. Vein grafts were all well without thrombosis or necrosis during 45 days of follow up except for one graft that developed thrombosis. The
    success rate of modelling was 96.8%. Electron microscopy observation showed that anastomoses and sutures were almost completely covered with regenerated vascular endothelium 14 days after surgery with irregular bulges in vascular intima due to intimal hyperplasia. Color Doppler ultrasonography suggested that the peak systolic velocity at anastomoses was significantly increased compared with contralateral normal carotid artery 21 days, and especially 45 days after surgery due to venous stenosis. HE staining and optical microscope observation found typical restenosis pathological changes in vein grafts with significant increase in thickness and area of hyperplastic intima. Conclusion · The standardized steps for building an animal model of vein graft restenosis have a high success rate of modelling and favorable repeatability and have been verified via evaluation experiments.
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    Study on the effects of miR-155 on epithelial-mesenchymal transition in renal tubular epithelial cells and relevant mechanisms
    NING Ya-xian, WANG Jian-qin, WANG Xiao-yuan
    2016, 36 (11):  1575. 
    doi: 10.3969/j.issn.1674-8115.2016.11.007
    Abstract ( 984 )   PDF (7921KB) ( 757 )  
    Objective · To investigate serum miR-155 expression in patients with chronic kidney disease (CKD) and to explore whether miR-155 influences epithelial-mesenchymal transition (EMT) in renal tubular epithelial cells via down-regulating Krüppel-like factor 4 (KLF4). Methods · Serum samples from 126 CKD Ⅰ
    stage patients, 163 CKD Ⅲ stage patients, and 170 healthy individuals were collected. RT-PCR was used to test the serum miR-155 expression. In cell experiment, EMT in renal tubular epithelial cells was induced with 10 μg/L TGF-β. miR-155 mimic and miR-NC were transfected to renal tubular epithelial cells cultured in vitro. Changes in cell morphology were observed with optical microscope. Transwell assay was used to test the cell migration ability. Western blotting was used to examine the expressions of SMα-actin, Collagen Ⅰ, Collagen Ⅳ, E-cadherin, and KLF4. Bioinformatics predicted that the potential target gene for miR-155 was KLF4, which was confirmed with luciferase assay. Plasmids with over-expressed KLF4 were transfected to renal tubular epithelial cells and expressions of SMα-actin, collagen Ⅰ, collagen Ⅳ, E-cadherin, and KLF4 were detected. Results · CKD Ⅲ stage patients had lower serum miR-155 expression compared with healthy individuals and CKD Ⅰ stage patients. In cell experiment, the expression of SMα-actin, collagen Ⅰ, collagen Ⅳ and KLF4 renal tubular epithelial cells decreased and the expression of E-cadherin increased after being transfected with miR-155 mimic, as compared with the control group. Results of the luciferase assay showed that miR-155 significantly decreased the luciferase activity of KLF4-3'-UTR plasmid. Expressions of SMα-actin, collagen Ⅰ, and collagen Ⅳ in renal tubular epithelial cells were increased and the expression E-cadherin was decreased after being transfected with plasmids with over-expressed KLF4. Conclusion · CKD patients have low serum miR-155 expression. miR-155 can inhibit EMT in renal tubular epithelial cells by down-regulating KLF4.
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    Effects of mitochondrial dicarboxylate carrier SLC25A10 on the proliferation of glioma cells and relevant mechanisms
    Lü Yi-xuan, WANG Xiao-na*, WU Jin-liang, XU Yan, MI Jun
    2016, 36 (11):  1581. 
    doi: 10.3969/j.issn.1674-8115.2016.11.008
    Abstract ( 1024 )   PDF (9624KB) ( 956 )  
    Objective · To explore the role and underlying mechanisms of mitochondrial dicarboxylate carrier SLC25A10 in the occurrence and progression of glioma. Methods · The U251 glioma cell lines over-expressing or depleted of SLC25A10 were obtained via lentivirus infection. Western blotting and real-time PCR were used to measure the efficiency of knockdown and over expression of SLC25A10. The effects of SLC25A10 on proliferation and tumorigenicity of U251 cells were detected with cell counting, CCK-8 assay, clonogenic assay, and tumor formation in nude mice. The ATP level and the activity of AMPK and its downstream mTOR signaling pathway were detected with kits and Western blotting, respectively. Results · Knock down of SLC25A10 decreased the proliferation, clone number, tumorigenicity, and ATP level in U251 cells. However, over expression of SLC25A10 didn’t significantly affect the proliferation of U251 cells, but increased the ATP level and the radiation resistance. Study showed that knock down of SLC25A10 activated AMPK, which in turn inhibited mTOR signaling pathway, resulting in decreased cell proliferation and increased cell sensitivity to radiotherapy. Conclusion · Knock down of SLC25A10 inhibits the mTOR signaling pathway, slows down glioma proliferation, and increases cell sensitivity to radiotherapy. These findings provide a potential target for the treatment of glioma.
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    Effects of silencing GP73 with siRNA interference on the migration and invasion of human hepatoma HepG2 cells
    CHEN Mo, ZHAO Kun, LIU Peng-cheng, WANG Gen-nian, WEI Feng-xian, NI Rui, XU Xiao-dong, ZHANG You-cheng
    2016, 36 (11):  1588. 
    doi: 10.3969/j.issn.1674-8115.2016.11.009
    Abstract ( 1021 )   PDF (7621KB) ( 887 )  

    Objective · To explore the effects of silencing Golgi protein 73 (GP73) with RNA interference (RNAi) on the migration and invasion ability of human hepatoma HepG2 cells. Methods · GP73 small interfering RNA (siRNA) synthesized with cathodolyte liposome transfection method was used to transiently transfected into HepG2 cells. HepG2 cells were assigned to the blank control group, the negative control group, and the GP73 siRNA group. Cells were cultured for 48 hours. Real time quantitative PCR (qRT-PCR) and ELISA were used to detect the changes in mRNA and protein expressions of GP73 in HepG2 cells after transfection. Changes in migration and invasion of HepG2 cells were observed using Transwell migration assay, wound healing assay, and Transwell invasion assay. qRT-PCR and Western blotting were used to measure the expressions of matrix metalloproteinase 2 (MMP-2) and MMP-9. Results · GP73 siRNA significantly down-regulated the mRNA and protein expressions of GP73 in HepG2 cells. The migration and invasion of HepG2 cells and mRNA and protein expressions of MP-2 and MMP-9 were significantly decreased after transfection. Conclusion · siRNA interference-mediated GP73 silencing can inhibit the migration and invasion of human hepatoma HepG2 cells. The mechanism may be related to the down-regulation of MMP-2 and MMP-9.

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    Optimization of the method for sorting human lung cancer cell A549 with FACSAria Ⅱ
    TIAN Ye, ZHAO Ben-peng, FU Rong, YANG Jie, YIN Hui-jing
    2016, 36 (11):  1594. 
    doi: 10.3969/j.issn.1674-8115.2016.11.010
    Abstract ( 1116 )   PDF (6056KB) ( 893 )  
    Objective · To improve the purity and survival rate and to reduce the time for sorting SP subpopulation of human lung cancer cell A549 by optimizing flow- cytometry sorting method. Methods · Single cell suspension was prepared, incubated with different concentration of Verapamil, and stained with different concentrations of Hoechst33342. The ratio of SP cells was detected following PI marking. One time sorting method (purity mode) and two time sorting method (enrichment and purity mode) were used to sort SP and MP cells with the best staining concentration, 100 μm nozzle, and sorting velocity of 10 μL/min. The sorting purity and time were compared between two methods. SP cells and MP cells sorted with the two time sorting method underwent tumor forming experiment and confocal observation after Lyso-Tracker Red and Hoechst 33342 stainings. Results · The purity of SP cells sorted with two times sorting method was more than 99% and the sorting time was less than 5.2 h for sorting 1×108 cells. Under confocal microscopy, the size of SP cells was not different from that of MP cells and MP cells had more lysosomal granules than SP cells. Both cells were able to be stained with Hoechst 33342 and the cell survival rate was not affected. In mice tumor forming experiment, the size of tumor formed with SP cells was significantly larger than that formed with MP cells. Conclusion · The optimal staining concentration of Hoechst33342 for A549 lung cancer cells is 6 μg/mL. Using two time sorting method and FACSAria Ⅱ flow sorter to sort SP cells can not only significantly improve the purity of SP cells, but also greatly reduce the sorting time without affecting the survival rate of SP cells.
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    Original article (Clinical research)
    JAG1 gene screening and mutation function analysis for an Alagille syndrome patient
    ZHANG Er-ge, XU Yue-juan, CHEN Sun, XU Rang, SUN Kun
    2016, 36 (11):  1599. 
    doi: 10.3969/j.issn.1674-8115.2016.11.011
    Abstract ( 1488 )   PDF (8108KB) ( 1030 )  

    Objective · To perform JAG1 gene screening and mutation function analysis for an Alagille syndrome patient. Methods · Clinical data and auxiliary examination results of the patient and his parents were collected. Genomic DNA was extracted for JAG1 mutation screening. Vectors with wild-type and mutant JAG1 expressions were constructed and transfected into NIH-3T3 cells. mRNA and protein expression levels were analyzed with real-time RT-PCR and Western blotting. Endoglycosidase H digestion experiment was performed to analyze the glycosylational structure. The effect of JAG1 protein on activating the transcription factor RBP-Jκ in Notch signaling pathway was detected with RBP-Jκ luciferase reporter gene assay. Results · A novel missense mutation c.1655C>T (p.Pro552Leu) was detected in the patient and his father, but was not found in his mother or healthy controls. Wild-type and mutant JAG1 had no difference in mRNA or protein expression levels. Post-translational glycosylational structure of the mutant JAG1 was the same as wild-type JAG1. However, the effect of activating the transcription factor RBP-Jκ in Notch signaling pathway was reduced in mutant JAG1 than in wild-type JAG1. Conclusion · The JAG1 missense mutation carried by the patient results in impaired function of JAG1, which may be the cause of Alagille syndrome.

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    Clinical significance of colonization index for monitoring invasive candidiasis infection in EICU
    WANG Chen, LI Zhen, HE Yu-tong, YAO Tian-yue, CHEN Chen, WANG Si-jian, PENG Yi-bing
    2016, 36 (11):  1605. 
    doi: 10.3969/j.issn.1674-8115.2016.11.012
    Abstract ( 980 )   PDF (7325KB) ( 805 )  

    Objective · To analyze the clinical significance of colonization index (CI) for patients in emergency intensive care unit (EICU) to develop invasive candidiasis (IC) infection. Methods · Samples from patients admitted in EICU from February 2014 to January 2015 were collected, including sputum (or throat swabs), stool (or rectal swabs), midstream urine, skin swabs, and other samples. Samples were cultured with CHROMagar Candida chromagenic medium and Candida was isolated and primarily identified. Then detailed identification was performed by amplifying and sequencing the internal transcribed spacer (ITS) regions using the ITS1/ITS4 primers. Meanwhile, the clinical information of the patients was collected and the clinical significance of CI on monitoring the incidence of IC was analyzed. Results · A total of 111 patients were enrolled. Nine were infected with IC and 8 of them had Candida colonization before infection. The CI ≥0.5 group had significantly higher incidence of IC, mortality, and incidence of pyemia compared with the 0<CI<0.5 and CI=0 groups. Conclusion · The incidence of IC in patients in EICU is associated with the Candida colonization. CI can be used to reflect the Candida colonization in patients. Patients with CI ≥0.5 are more likely to have IC infection. Antifungal drugs and some invasive medical procedures such as central venous catheter (CVC) puncture, mechanical ventilation, renal replacement therapy, and surgeries are all risk factors for influencing Candida colonization and infection.

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    Observation on the efficacy of modified Qinzhu Liangxue decoction plus tazarotene gel for the treatment of blood-heat syndrome psoriasis vulgaris
    WANG Jie, XU Rong, LI Bin
    2016, 36 (11):  1610. 
    doi: 10.3969/j.issn.1674-8115.2016.11.013
    Abstract ( 848 )   PDF (11807KB) ( 857 )  

    Objective · To observe the clinical efficacy of modified Qinzhu Liangxue decoction plus tazarotene gel for the treatment of blood-heat syndrome psoriasis vulgaris. Methods · Ninety-six patients with blood-heat syndrome psoriasis vulgaris were enrolled and randomly assigned to the control group (n=47) and the treatment group (n=49). The control group received modified Qinzhu Liangxue decoction and the treatment group received modified Qinzhu Liangxue decoction plus tazarotene gel for skin lesions. Both groups were consecutively treated for two courses (one month per course). Changes in Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), and serum cytokines in two groups were observed before and after treatment. Results · PASI, DLQI, TNF-α, IL-8, and IL-22 in both groups were significantly reduced after treatment, especially in the treatment group. The total effective rate in the treatment group was 81.63%, which was significantly higher than that in the control group (70.21%). Conclusion · Modified Qinzhu Liangxue decoction plus tazarotene gel have significant efficacy for the treatment of blood-heat syndrome psoriasis vulgaris. The efficacy is associated with the negative regulation of TNF-α, IL-8 and IL-22.

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    Analysis of serum reproductive hormones in patients with erectile dysfunction and symptomatic late-onset hypogonadism
    LIANG Guo-qing, LI Jian-hui,ZHENG Jun-biao, YU Xiao-hua, SHI Hui-juan, ZHU Qian-xi, WANG Jun, LI Yu-min, SUN Jian-ming, ZHANG Shu-cheng, LI Zheng
    2016, 36 (11):  1613. 
    doi: 10.3969/j.issn.1674-8115.2016.11.014
    Abstract ( 843 )   PDF (2661KB) ( 911 )  
    Objective · To explore the correlation between reproductive hormones and symptomatic late-onset hypogonadism combined with erectile dysfunction (SLOH/ED) via observing the changes in serum reproductive hormones in patients with SLOH/ED. Methods · Questionnaire survey was used and 3 000 males aged 40 to 80 years with regular sexual partners were selected with random cluster and age-stratified multi-phase disproportionate samplings. SLOH was evaluated with the aging male symptoms (AMS) scale. ED was evaluated with the simplified international index of erectile function (IIEF-5). Serum reproductive hormones such as total testosterone (TT), free testosterone (FT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) were examined. Bioavailable testosterone (Bio-T) was calculated. The correlation between reproductive hormones and SLOH/ED was analyzed using univariate and multivariate Logistic regression analyses. Results · The study population consisted of 2 588 eligible males with a mean age of (57.95±8.50) years. SLOH (AMS≥27) was observed in 930 (35.94%) males. Of them, 812 (31.38%) had ED. 739 (28.56%) had neither SLOH nor ED. Logistic regression analyses revealed that TT and FT levels were not significantly correlated with SLOH/ED, while the correlation of age, SHBG, and Bio-T with SLOH/ED was statistically significant (P<0.01). Conclusion · SHBG and Bio-T are significantly correlated with SLOH/ED and can correctly reflect reproductive hormone levels in patients with SLOH/ED.
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    Effects of low tidal volume mechanical ventilation and lung recruitment maneuver on early pulmonary infection after abdominal operations in elderly patients
    DING Wen, SHEN Liang, XIANG Ming-jie, YU Cong-yi, LU Zhi-jun
    2016, 36 (11):  1617. 
    doi: 10.3969/j.issn.1674-8115.2016.11.015
    Abstract ( 960 )   PDF (6946KB) ( 832 )  

    Objective · To investigate the effects of applying low tidal volume mechanical ventilation and lung recruitment maneuver during general anesthesia on early pulmonary infection after abdominal operations in elderly patients. Methods · Sixty elderly patients (ASAⅠ-Ⅱ) aged 60-75 years undergoing elective
    digestive tract operations ( ≥2 h) were randomly assigned to the standard ventilation group and the protective ventilation group with 30 cases in each group.
    The standard ventilation group received a tidal volume of 8 mL/kg ideal body weight and zero-positive end-expiratory pressure. The protective ventilation
    group received a tidal volume of 6 mL/kg ideal body weight, 5 cm H2O positive end-expiratory pressure (PEEP), and recruitment maneuvers pressure. Patients underwent conventional induction of anesthesia, endotracheal intubation, mechanical ventilation with an initial respiratory rate of 12 breaths/min and a stable tidal volume. The respiratory rate was adjusted according to EtCO2. Blood gas analysis parameters (PH, PO2, PCO2, HCO3-, oxygenation index), clinical pulmonary infection score (CPIS), procalcitonin (PCT), and C-reactive protein (CRP) were recorded before and 24 h after operation. Intraoperative adverse events were also documented. Results · CPIS and CRP 24 h after operation were significantly lower in the protective ventilation group than in the standard ventilation group. However, no significant differences in PCT, blood gas analysis parameters, and intraoperative adverse events were found. Conclusion · Low tidal volume mechanical ventilation and recruitment maneuver can reduce early postoperative CPIS and CRP, and the risk of early postoperative pulmonary infection in elderly patients.

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    Analysis of the correlation between lymph node ratio and the prognosis in patients with locally advanced rectal cancer
    ZHOU Di, RONG Ling, BAI Yong-rui, YE Ming
    2016, 36 (11):  1622. 
    doi: 10.3969/j.issn.1674-8115.2016.11.016
    Abstract ( 888 )   PDF (7173KB) ( 736 )  
    Objective · To investigate the effects of the lymph node ratio (LNR) on overall survival and disease free survival after surgeries in patients with locally advanced rectal cancer. Methods · We retrospectively analyzed clinical data of 299 patients who underwent curative resection for locally advanced rectal cancer (T3/4 or N+) between July 2005 and March 2010. The best cutoff value for predicting the survival outcome was obtained with ROC curve analysis method. Kaplan-Meier method was used to perform survival analysis and Cox regression models were used to conduct multivariate analysis. Results · The 5-year overall survival rate and 5-year disease free survival rate were 30% and 25% in 299 cases of locally advanced rectal cancer. Lymph node ratio of 0.21 (21%) could favorably predict the survival and prognosis. The median overall and disease-free survival rates were significantly higher in the low LNR group (LNR ≤0.21) than in the high LNR group (LNR＞0.21) (59.6 vs 39.5months, P=0.000; 30.0 vs 19.5 months, P =0.004). Univariate and multivariate analyses showed that besides pathological type, pathological differentiation, lymphovascular invasion, number of lymph nodes examined, pN stage, and TNM stage, LNR was an important factor for predicting the prognosis. Conclusion · LNR is an important factor for predicting the overall survival and disease free survival after surgeries in patients with locally advanced rectal cancer.
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    Clinical study on pocket-related complications in patients undergoing pacemaker implantation after valvular surgery
    LI Yan-Jie, ZHANG Wei-Wei, YANG Xiao-Xiao, HUANG Jing-Juan, YE Mao-Qing, QU Xin-Kai, YANG Yi-Qing, LI Ruo-Gu
    2016, 36 (11):  1628. 
    doi: 10.3969/j.issn.1674-8115.2016.11.017
    Abstract ( 909 )   PDF (5925KB) ( 1190 )  
    Objective · To investigate risk factors for pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery, as well as prevention and treatment strategies. Methods · The clinical data of 115 patients undergoing permanent pacemaker implantation after valvular surgery were collected. Postoperative pocket-related complications and the effects of long term administration of warfarin on them were retrospectively analyzed. Results · A total of 12 patients (10.43%) had pocket-related complications, including 8 cases (6.96%) of capsular hematoma and 4 cases (3.48%) of capsular infection or rupture. The average age of 12 patients at their first implantation was 66.5±7.1 years, among whom five are male (41.7%). For the warfarin group, 6 patients (9.23%) had capsular hematoma and 4 patients had capsular infection or rupture (6.15%). Conclusion · The incidence of pocket-related complications in patients undergoing permanent pacemaker implantation after valvular surgery is high. Long term administration of warfarin is a risk factor. Enhancing the awareness of pocket-related complications and prompt treatment can decrease the incidence of complications.
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    Analysis of ultrasound-guided Mammotome procedure for resecting breast lumps in 1 034 cases
    XU Ting, WANG Jie, SHAO Yu-guo, JI Min, YANG Li, HE Qi
    2016, 36 (11):  1632. 
    doi: 10.3969/j.issn.1674-8115.2016.11.018
    Abstract ( 827 )   PDF (5883KB) ( 1120 )  
     Objective · To observe the effects of ultrasound-guided Mammotome procedure on the treatment of breast lumps. Methods · 1 034 patients (1 347 mammary focuses) underwent ultrasound-guided Mammotome procedure in the Department of Breast Disease at the International Peace Maternity & Child Health Hospital affiliated to Shanghai Jiao Tong University School of Medicine in 2013. The effects of ultrasound-guided Mammotome procedure on the diagnosis and treatment of mammary lumps were evaluated via pathological examinations and follow-up visits. Results · All focuses were successfully resected. The diameters of lumps ranged between 0.8 and 2.4 cm with the mean time of 10 min (2-20 min) and the average resected tissue strip number of 15 for resecting a single lump and the skin wound length of 0.3-0.5 cm. There were no serious complications. Postoperative pathological examinations suggested 15 (1.11%) cases of breast cancer. Conclusion · Ultrasound-guided Mammotome procedure can completely resect benign breast tumors and facilitates the early diagnosis of malignant breast tumors with accurate biopsy findings, small wound, short operation duration, and less postoperative complications.
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    Analysis of the association of hepatitis B virus positive with gestational diabetes mellitus
    CHE Rong-hua, LIU Min, YANG Jie-lian, QU Jun-jie, YING Hao
    2016, 36 (11):  1636. 
    doi: 10.3969/j.issn.1674-8115.2016.11.019
    Abstract ( 1047 )   PDF (5858KB) ( 968 )  
    Objective · To investigate the relationship of hepatitis B virus (HBV) infection in different liver function status with gestational diabetes mellitus (GDM). Methods · Clinical data of 748 pregnant women with GDM were retrospectively analyzed. They were assigned to three groups according to HBV infection status and their liver function at second trimester, the A group (with abnormal liver function and chronic hepatitis B, n=124), the B group (with normal liver function and chronic HBV carriers or inactive HBsAg carriers, n=264), and the C group (without HBV infection, n=360). The glucose metabolism, pregnancy outcomes, and neonates were compared among three groups. Results · The A group had significantly higher blood glucose and HbA1c levels at all time points in OGTT than the B and C groups. The A group had markedly higher rates of HDCP, ICP, and cesarean delivery than the B and C groups. The A group had significantly lower body weight, Apgar score, and the rate of macrosomia than the B and C groups. Conclusion · Abnormal liver function in pregnant women with chronic hepatitis B at the second trimester can result in apparent abnormal glucose metabolism, increase the risk of pregnancy, childbirth, and neonatal complications, and deteriorate GDM. Enhancing the management of HBV-positive GDM pregnant women, regularly monitoring liver function and blood glucose, and maintaining normal liver function and blood glucose are helpful for reducing adverse pregnancy outcomes.
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    Observation of the efficacy of tocilizumab in combination with methotrexate for the treatment of refractory rheumatoid arthritis
    SUN Fang-fang, YE Shuang
    2016, 36 (11):  1640. 
    doi: 10.3969/j.issn.1674-8115.2016.11.020
    Abstract ( 1749 )   PDF (5169KB) ( 1114 )  
    Objective · To investigate the efficacy and safety of tocilizumab in combination with methotrexate (MTX) for the treatment of refractory rheumatoid arthritis (RA) with moderate to severe activity. Methods · Ten patients with refractory active RA underwent tocilizumab injection in combination with oral MTX. Changes in indexes such as tender joint count (TJC), swollen joint count (SJC), blood sedimentation (ESR), C reactive protein (CRP), disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) were observed before (baseline), 12 weeks, and 24 weeks after treatment and adverse reactions were documented. Results · After treatment for 12 and 24 weeks indexes including joint symptoms, signs, ESR, DAS 28, CDAI, and SDAI significantly improved than baseline(P<0.05). No adverse reactions such as leukopenia, cardiac insufficiency, and severe infection were observed.
    Conclusion · Tocilizumab can rapidly and significantly improve clinical symptoms, signs, active indexes, and arthritis scores for patients with refractory active
    RA.
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    Analysis of the correlation between febrile seizure and hot-spot polymorphism variation in SCN1A gene in children from Chongming County, Shanghai
    YE Gui-yun, CHEN Liu, DAI Hong, LIU Xiao-qing
    2016, 36 (11):  1643. 
    doi: 10.3969/j.issn.1674-8115.2016.11.021
    Abstract ( 845 )   PDF (6276KB) ( 1005 )  
    Objective · To explore the correlation of febrile seizure (FS) with voltage-gated sodium channel alpha 1 subtype (SCN1A) gene exons 25, 26 and 3’UTR region in children from Shanghai chongming County. Methods · The genomic DNA in peripheral venous blood was extracted from 96 children with FS
    (including 32 cases of genetic epilepsy with febrile seizures plus [GEFS+]) and 53 healthy controls. PCR amplification and sequencing analysis were performed for SCN1A gene exons 25, 26 and 3’UTR region. Results · No mutation in SCN1A gene exons E25, E26 was found in both groups. For 3’UTR region, c.310311 delgt GT variation was found in 1 case of GEFS+, c.589 T> G variation in 2 cases of FS, and c.593 T>G variation in 6 cases, while no mutation was found in the control group. Reported frequencies of single nucleotide polymorphism (SNP) c.1025T>C were 18.2% (the case group) and 24.5% (the control group). The difference between two groups was not statistically significant. Prediction results showed that 114 microRNAs could bind with the 3’UTR region of SCN1A gene. C.310-311 delGT was not located in the sequence where miRNAs bound with 3’UTR region of SCN1A gene, while c. 589 T>G and c.593 T > G variations were located in this sequence. Conclusion · No mutation was found in SCN1Agene exons E25, E26. The c. 310-311delGT, c.589 T > G, and c. 593 T > G variations were found in 3’UTR region. There is no obvious correlation between SNPc.1025T>C and FS.
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    Original article (Public health administration)
    Correlation of innovation behaviors with innovation climate and psychological capital in nurses
    HU Zi-yi, ZHANG Ya-qing, QIAN Yan
    2016, 36 (11):  1648. 
    doi: 10.3969/j.issn.1674-8115.2016.11.022
    Abstract ( 812 )   PDF (7108KB) ( 666 )  

    Objective · To survey the innovation behaviors in clinical nurses in Chengdu, Sichuan and to explore the correlation of innovation climate and psychological capital with innovation behaviors. Methods · The convenience sampling method was used to select 400 nurses in Chengdu, Sichuan. Questionnaire survey was performed using the Innovation Climate Scale, Psychological Capital Questionnaire, and Nurse Innovative Behavior Scale. Results · ① The average scores of innovation behavior, innovation climate, and psychological capital were 3.14±0.82, 3.55±0.70, and 4.17±0.76, which were at the middle level. ②
    Innovation climate and psychological capital were negatively correlated to innovation behavior with correlation coefficients of 0.665 and 0.486, respectively (P＜0.01). ③ Stepwise multiple regression analysis showed that resource supply, management practice, position, salary, and education level accounted for 49.7% of the variance of innovation behavior. Conclusion · Improving the education level, focusing on career development, promoting remuneration, creating a climate facilitating innovation, and improving psychological capital are effective ways to improve the level of innovation behavior, increase the quality of care, and promote the development of nursing.

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    Preliminary study on fatigue status in female students at a Shanghai medical school and its influencing factors
    TAN Tian-yu, SHI Li-li, CAO Zhen, CAI Yu-yang, SHANG Li
    2016, 36 (11):  1653. 
    doi: 10.3969/j.issn.1674-8115.2016.11.023
    Abstract ( 789 )   PDF (6327KB) ( 1030 )  

    Objective · To evaluate the fatigue status in female students at a Shanghai medical school and to analyze the influencing factors. Methods · Questionnaire
    survey and professional instrument examinations were performed for 150 female students randomly selected from a Shanghai medical school. Data were input using EpiData 3.0 and were analyzed using SPSS 22.0, including methods such as descriptive analysis, χ2 test (univariate), Logistic regression analysis (multivariate), and paired t-test. Results · The fatigue rate was 56.0% for subjective self-assessment in questionnaire survey. Results of instrument examinations showed that 47.3% of students were under different degrees of tension and 56.0% of students were under different degrees of fatigue, which were consistent with self-assessment in questionnaire survey. Daytime drowsiness, dysmenorrhea, stress, depression, and salt-rich foods had significant influence on fatigue (P<0.05). The multivariate analysis showed that depression (OR=0.293, 95% CI 0.118-0.729), stress (OR=0.321, 95% CI 0.111-0.929), dysmenorrhea (OR=0.107, 95% CI 0.013-0.871) were influencing factors for fatigue. Conclusion · Female students at this medical school are commonly in fatigue condition. It is suggested that they should pay attention to the influence of factors such as depression, stress, and dysmenorrhea, etc. and relieve fatigue via yoga and proper exercises.

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    Review
    Research advances in transcription factor AP-2 in embryonic and cardiovascular development
     
    WANG Jing, LI Fen
    2016, 36 (11):  1658. 
    doi: 10.3969/j.issn.1674-8115.2016.11.024
    Abstract ( 912 )   PDF (4978KB) ( 801 )  

    Transcription factor AP-2 plays an important role in embryonic and cardiovascular development and often influences the development of embryo. AP-2α and AP-2β are associated with the development of cardiovascular system. AP-2α mainly affects ventricular outflow tract and arteries, while AP-2β has been identified to be involved in the opening and closing of ductus arterious. This paper systematically reviews latest research advances in the structure and expression of AP-2 gene family, as well as its functions and mechanisms in embryonic and cardiovascular development, especially in patent ductus arterious.

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    Research advances in delirium after cardiac surgery
    CHE Zhi-mei, YU Min
    2016, 36 (11):  1661. 
    doi: 10.3969/j.issn.1674-8115.2016.11.025
    Abstract ( 1233 )   PDF (4726KB) ( 1138 )  

    Delirium is the most frequent neurologic complication after cardiac surgery. Delirium after cardiac surgery increases other complications and mortality, length of ICU and hospital stay, and long-term cognitive function, which is a hot research spot in the perioperative brain injury. This review focuses on the latest advances in risk factors, diagnosis, prevention, and treatment of delirium after cardiac surgery.

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    Research advances on manual thrombectomy for the treatment of acute ST segment elevation myocardial infarction
    ZHANG Ming-liang, ZHANG Jun-feng
    2016, 36 (11):  1664. 
    doi: 10.3969/j.issn.1674-8115.2016.11.026
    Abstract ( 851 )   PDF (6238KB) ( 925 )  
    In recent years, clinical studies on manual thrombectomy unceasingly have been carried out, especially on the treatment of acute ST segment elevation myocardial infarction (STEMI). However, study results are not consistent, which leads to doubts on extensive application of manual thrombectomy in the clinical practice. This article summarizes several representative clinical studies on the efficacy of treating STEMI with manual thrombectomy.
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    Research advances on the molecular mechanism of influencing the progression of gastric cancer by miR-146a
    WU Qiang-qiang, ZU Li-dong
    2016, 36 (11):  1668. 
    doi: 10.3969/j.issn.1674-8115.2016.11.027
    Abstract ( 789 )   PDF (6356KB) ( 1184 )  
    Gastric cancer is a major malignant tumor worldwide. Currently, lots of researches confirm that as a cancer suppressor gene, miR-146a can promote the degradation of mRNA and inhabit the synthesis of proteins, so as to maintain normal physiological metabolism function in cells. But the expression of miR-146a decreases in the progression of gastric cancer, resulting in losing normal control for many signaling pathways in cells and promoting the proliferation and metastasis of cancer cells. The molecular mechanism of influencing the progression of gastric cancer by miR-146a is still unclear. This paper reviews research advances on this topic and relevant clinical applications.
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    Research progresses of APPL1 and its role in cardiovascular diseases
    CHEN Cui, SHEN E
    2016, 36 (11):  1672. 
    doi: 10.3969/j.issn.1674-8115.2016.11.028
    Abstract ( 1229 )   PDF (6260KB) ( 989 )  
    APPL1 is a connexin that directly connects with adiponectin receptor, containing three main functional domains, i.e. phosphotyrosine binding domain (PTB) close to carboxyl terminus, Bin1/amphiphysin/rvs167 (BAR) close to amino terminus, and pleckstrin homology domain (PH) between PTB and BAR. APPL1 expresses in different tissues and organs, regulating insulin-signaling pathway and adiponectin-signaling pathway. APPL1 plays critical roles in processes such as cell apoptosis, cell survival, and chromatin remodeling by directly interacting with membrane receptors and signaling proteins, as well as fighting against myocardial apoptosis, atrial hypertrophy and fibrosis, and heart failure via relevant pathways. APPL1 can protect vessels through involving in regulating the production of endothelial cell NO and coordinating the balance between NO and vasoconstrictor effectors. APPL1 signal transduction pathway also plays an important role in mediation of the heart metabolism via adiponectin.
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    Suicidal behaviors in men who have sex with men: prevalence, influencing factors, and theoretical models
    LI Rui, CAI Yong
    2016, 36 (11):  1676. 
    doi: 10.3969/j.issn.1674-8115.2016.11.029
    Abstract ( 1122 )   PDF (10396KB) ( 724 )  
    Suicidal behaviors mainly include suicidal ideation, suicidal attempt, and suicide completion. Epidemiological studies suggest that men who have sex with men (MSM) are at a high risk of suicide. Factors influencing the suicidal behaviors of MSM include demographic, psychosocial, and behavioral factors. Minority stress theory provides references for studying the interaction between influencing factors and elucidating the development of suicidal behaviors in MSM. Currently mature psychological models of suicide include Cry of Pain and Schematic Appraisal Model of Suicide, The Comprehensive Cognitive Model, Two-Stage model of Outward and Inward Directed Model, Interpersonal Theory of Suicide, Integrated Motivational-Volitional Model of Suicidal Behavior, and so on. However, none of them has been applied to MSM. Influencing factors, minority stress theory, and theoretical models of suicide can be combined to further study the suicidal mechanisms in MSM.
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    Case report
    Peritoneal dialysis with encapsulating peritoneal sclerosis: a case report
    ZHANG He, LI Zhen-yuan, YAN Hao, ZHANG Min-fang, WANG Qin, WANG Ling, NI Zhao-hui, QIAN Jia-qi, FANG Wei
    2016, 36 (11):  1682. 
    doi: 10.3969/j.issn.1674-8115.2016.11.030
    Abstract ( 1088 )   PDF (4981KB) ( 1007 )  
    Objective · To improve awareness, prevention, and treatment of peritoneal dialysis-related encapsulating peritoneal sclerosis. Methods · A case developing encapsulating peritoneal sclerosis after discontinuing peritoneal dialysis and receiving medication treatment was analyzed. Results · A patient developed intestinal obstruction after discontinuing peritoneal dialysis due to peritoneal ultrafiltration failure. Combined with imaging examination, the diagnosis was encapsulating peritoneal sclerosis. Clinical symptoms were significantly improved after receiving medication treatment and total parenteral nutrition. Conclusion · Encapsulating peritoneal sclerosis is a serious complication in peritoneal dialysis patients. As the early diagnosis is difficult and the prognosis is poor, it significantly affects the quality of life. Both medication treatment and surgery have advantages and disadvantages. Early diagnosis and prompt treatment are necessary.
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