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    Translational medicine
    2017, 37 (03):  269. 
    Abstract ( 377 )   PDF (3741KB) ( 468 )  
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    Original article (Basic research)
    Characterization and genomic analysis of bacteriophage SH-Kp152234 infecting extensively drug-resistant Klebsiella pneumonia
    ZHI Ye, LUO Ting-ting, WANG Rui, FENG Xi-jia, LIU Ke, SHI Chen-kun, WANG Lu-lu, HU Fu-pin, HE Ping
    2017, 37 (03):  273. 
    doi: 10.3969/j.issn.1674-8115.2017.03.001

    Abstract ( 1092 )   PDF (5898KB) ( 1543 )  

    Objective · To identify broad-spectrum bacteriophages against extensively drug-resistant Klebsiella pneumonia and analyze their characteristics by biological and genomic methods. Methods · Multi-drug resistant Klebsiella pneumonia strains collected from a hospital were used as host bacteria to isolate and purify broad-spectrum phages in the wastewater at the same hospital area. The size and shape of phages were observed by transmission electron microscope. Titer, host range, pH stability and thermal stability were measured. Moreover, the DNA extracted from the phage SH-Kp152234 was sequenced and analyzed. Results · One strain of bacteriophage against Klebsiella pneumonia was isolated and named as SH-Kp152234. The electron microscope revealed it belongs to Podoviridae family. Moreover, genome of SH-Kp152234 showed to be a linear double-stranded DNA of 40 578 bp with the GC content of 52.85%. It was predicted to have 49 open reading frames with related known functions. Conclusion · SH-Kp152234, with a broad host range and a short latent period, which could exert its activity in a wide range of temperature and pH, is a promising candidate to be exploited in the treatment of multiple drug-resistant Klebsiella pneumonia.

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    IL-10 promotes ocular neovascularization by regulating macrophages
    SUI Ai-ling, SU Ting, GAO Yu-shuo, ZHU Yan-ji, XIE Bing
    2017, 37 (03):  278. 
    doi: 10.3969/j.issn.1674-8115.2017.03.002

    Abstract ( 1220 )   PDF (12653KB) ( 1045 )  
    Objective · To investigate the role of interleukin-10 (IL-10) in regulating ocular neovascularization (NV). Methods · Expression of IL-10 was investigated in mice with oxygen-induced retinopathy (OIR) and transgenic mice with VEGF expression in photoreceptors by immunofluorescence, RT-PCR, and Western blotting. Mice deficient in IL-10 were used to test the effect of IL-10 in retinal, sub-retinal, and choroidal NV. Results · In OIR mice and transgenic mice with VEGF expression in photoreceptors, the staining intensity and mRNA expression of IL-10 were increased. Mice deficient in IL-10 showed a significant reduction in ischemia-induced retinal NV, and choroidal NV at rupture sites in Bruch’s membrane. Mice lacking IL-10 showed reduced levels of hypoxia-inducible factor-1α (HIF-1α) and suppression of ischemia-induced expression of VEGF and VEGF receptor 1. Macrophage was regulated and reduced in ischemic retina of mice with IL-10 deficiency. Conclusion · IL-10 stimulates ocular NV through modulation of HIF-1α and its target genes VEGF and VEGF receptor 1. IL-10 promotes ocular NV via macrophage response to retina ischemia.
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    Novel EDA gene splicing mutation in a X-linked hypohidrotic ectodermal dysplasia family
    GU Ben-hong, ZHU Xiao-bin, ZHU Zi-jue, TIAN Ru-hui, LI Peng, ZHI Er-lei, YAO Chen-cheng, WANG Hong, CHEN Hui-xing, WAN Zhong, HUANG Yuhua, HE Zu-ping, LI Zheng
    2017, 37 (03):  288. 
    doi: 10.3969/j.issn.1674-8115.2017.03.003

    Abstract ( 1228 )   PDF (6665KB) ( 849 )  

     Objective · To detect the EDA mutation in an X-linked hypohidrotic ectodermal dysplasia (XHED) family. Methods · Genomic DNA of 13 members in this family was extracted and the sequence of 8 exons and exon–intron boundaries of EDA gene were amplified by PCR. The PCR products were sequenced directly to identify the mutation site. Results · A splicing site donor mutation, IVS (intronic variations of sequence) 6+2T>A (g.69250372, Xq22.3), was identified in the proband and his elder brother who had the same clinical signs.No similar clinical features or mutation at the same site were found in other 11 members. Conclusion · The splicing site aberration, IVS 6+2 T>A (g.69250372, Xq22.3), is a novel mutation which causes XHED in this pedigree. To date, this mutation has never been reported previously. Analysis of the mutation allows for genetic counseling and prenatal diagnosis, and contribute to control birth defects.

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    Effects of Gadd45α-knockdown on human extravillous trophoblast cell migration and invasion functions under hypoxia/re-oxygenation
    MU Hua-qiao, LUO Xin, QI Hong-bo, LIU Xi-ru
    2017, 37 (03):  293. 
    doi: 10.3969/j.issn.1674-8115.2017.03.004

    Abstract ( 889 )   PDF (6527KB) ( 840 )  
    Objective · To investigate the effects of growth arrest and DNA damage 45 alpha (Gadd45α) on the migration and invasion function of human extravillous trophoblast cells under hypoxia/re-oxygenation (H/R). Methods · Human extravillous trophoblast cells were infected by shRNA lentivirus targeting Gadd45α gene, to knock down Gadd45α gene expression. Then the oxidative stress model of preeclampsia was used in vitro to observe the changes of cell biological functions. The experiments were divided into 4 groups, nontreated group, hypoxia/re-oxygenation group, shRNA Gadd45α+H/R group and shRNA negative control+H/R group. Human villous explant experiments were used to determine the effects of silencing Gadd45α on human extravillous trophoblast cell under oxidative stress. Protein expression of Gadd45α was identified by Western blotting. Changes of cell migration and invasion were detected by transwell migration and Matrigel invasion assay. Gelatin zymography was used to detect the expression of matrix metalloproteinase (MMP) -2/9 in culture medium. Results · Hypoxia/re-oxygenation can increase the expression of Gadd45α in HTR8/SVneo cells and damage the trophoblast cell migration and invasion. Knocking down Gadd45α can increase the activities of MMP2/9, which can increase the cell migration and invasion. Conclusion · Knockdown of Gadd45α gene has promoted cell migration and invasion function of human extravillous trophobalst cells under oxidative stress.
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    Expression of RCAN1 and CnA in tissues of in-stent restenosis after intervention of lower extremity arteriosclerosis obliterans and its significance
    XIE Rui, FENG Yang-yang, WEN Yue-tao, REN Wei
    2017, 37 (03):  298. 
    doi: 10.3969/j.issn.1674-8115.2017.03.005

    Abstract ( 924 )   PDF (9086KB) ( 871 )  
    Objective · To investigate the expression of the regulator of calcineurin 1 (RCAN1) and calcineurin A (CnA) in tissues of in-stent restenosis after intervention of arteriosclerosis obliterans (ASO), and to explore the relationship between their expression levels and the occurance of in-stent restenosis. Methods · Superficial femoral arterial tissues were collected from 15 ASO patients undergoing lower extremity amputation for in-stent restenosis in Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University from September 2013 to June 2016. H-E staining and Masson staining were performed on the stenosis tissues, as well as on the proximal and distal tissues, and the morphological changes of these tissues were observed under optical microscope. Western blotting was used to detect the protein levels of RCAN1, CnA and proliferating cell nuclear antigen (PCNA). The distribution of RCAN1 and CnA proteins was observed by immunohistochemistry and immunofluorescence methods. In addition, co-immunoprecipitation was used to validate the protein-protein interaction between RCAN1 and CnA in vascular tissues. Results · The expression of RCAN1 in the distal tissues was significantly elevated compared with the proximal tissues and the stenosis tissues (P<0.05). The expression of RCAN1 in the proximal tissues was higher than that in the stenosis tissues (P <0.05). The expression of CnA and PCNA in the stenosis tissues was significantly elevated compared with the proximal tissues and the distal tissues (P<0.05). Immunohistochemistry and immunofluorescence analyses showed that RCAN1 and CN proteins were mainly expressed in the cytoplasm of vascular smooth muscle cells. Co-immunoprecipitation analysis showed there is protein-protein interaction between RCAN1 and CnA in arterial tissues. Conclusion · The low expression of RCAN1 and the high expression of CnA are probably related to the occurrence of in-stent restenosis.
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    Mechanisms of inhibiting the proliferation of triple negative breast cancer cell lines by silencing the CD147 gene
    WANG Cheng, ZHUANG Zhi-gang, SHAN Ming, XU Ming
    2017, 37 (03):  305. 
    doi: 10.3969/j.issn.1674-8115.2017.03.006

    Abstract ( 890 )   PDF (8963KB) ( 787 )  

    Objective · To explore the inhibitive effect of silencing the CD147 gene on the proliferation of triple negative breast cancer cells and relevant mechanisms. Methods · Normal human mammary epithelial cell line HMEC and three triple negative breast cancer cell lines MDA-MB-231, HCC70 and T4-2 were cultured in vitro. mRNA and protein expressions in cells were measured using realtime-PCR and Western blotting, respectively. A siRNA sequence targeting the coding region of human CD147 gene was designed and used to construct a recombinant lentivirus Lv-shRNA-CD147, which was used to infect the three breast cancer cell lines. The negative control group (Lv-NC infected group) and the noninfected cell control group (cell control group) were simultaneously used. The effects of silencing the CD147 gene were measured with real-time PCR and Western blotting. The proliferation and migration of cells were measured with MTT and Transwell assay, respectively. HCC70 cells were collected 72 h after viral infection and proteins related to proliferation, migration and apoptosis of cells (β-catenin, MMP2, MMP9, and Bax) were measured with Western blotting. Results · mRNA and protein expressions of CD147 were significantly higher in three breast cancer cell lines than in HMEC (P<0.01). The Lv-shRNA-CD147 infected group had lower mRNA and protein expressions of CD147, cell proliferation, and cell migration as compared with the Lv-NC infected group and the cell control group, the differences were statistically significant (P<0.01). The Lv-shRNA-CD147 infected group had lower expressions of β-catenin, MMP2, and MMP9, and higher Bax expression in HCC70 cells 72h after viral infection as compared with the Lv-NC infected group and the cell control group, the differences were statistically significant (P<0.01). Conclusion · Silencing the CD147 gene can inhibit the proliferation and migration of triple negative breast cancer cells.

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    Effect of fucoidan on autophagy, migration and invasion of U266 cells
    LUO Guo-ping, LIU Fen, GU Wen, CHEN Li-xue, Lü Jing-long, XIAO Qing
    2017, 37 (03):  312. 
    doi: 10.3969/j.issn.1674-8115.2017.03.007

    Abstract ( 1010 )   PDF (7672KB) ( 677 )  

    Objective · To investigate effect of fucoidan on autophagy, migration and invasion in human multiple myeloma U266 cells. Methods · The U266 cells treated with fucoidan were cultured in vitro. The formation of autophagosomes was observed by transmission electron microscopy (TEM).Transwell assay was used to evaluate the effect of fucoidan on migratory and invasive abilities of U266 cells. The protein levels of LC3-Ⅱ/LC3-Ⅰ, Beclin-1, P62, MMP9, CXCR4, p-AKT/T-AKT, p-mTOR/T-mTOR were detected by Western blotting. MMP9 concentration in the culture medium was examined by ELISA. Results · ①Autophagosomes increased in fucoidan-treated cells compared with control group under TEM. ② Migratory and invasive abilities were inhibited by fucoidan in a dose-dependent manner, which were suppressed by chloroquine. ③Western blotting demonstrated that expression of LC3-Ⅱ/LC3-Ⅰ, Beclin-1 and MMP9 increased in fucoidan-treated cells, while P62, CXCR4, p-AKT/T-AKT and p-mTOR/T-mTOR decreased compared with control group. ④The result of ELISA showed that MMP9 concentration in the culture medium of fucoidan-treated cells significantly decreased. Conclusion · Fucoidan induces autophagy and inhibits migration and invasion in U266 cells.

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    Original article (Basic research)
    Effects of different concentrations of ox-LDL on the proliferation of rat theca cells and the expression of steroidogenesis related genes LXR-α and StAR
    CHEN Ying, ZHANG Yi, LI Cong
    2017, 37 (03):  318. 
    doi: 10.3969/j.issn.1674-8115.2017.03.008

    Abstract ( 888 )   PDF (10686KB) ( 646 )  
    Objective · To investigate the effects of ox-LDL on the proliferation of rat theca cells and expression of LXR-α and StAR, two genes associated with androgen biosynthesis. Methods · The expression of LXR-α in the ovarian tissue of rats was determined by immunohistochemistry. Primary theca cells were isolated and collected from rat ovary and cultured in vitro. Furthermore, the theca cells were treated with 25, 50, 100, 150, 200, 300 and 400 mg/L ox-LDL,respectively. The variations in LXR-α mRNA were identified using real-time PCR. MTT assay was performed to detect cell viability. The expression of LXR-α and StAR was measured by Western blotting analysis. Results · The effect of ox-LDL on the proliferation of rat theca cells and the levels of LXR-α and StAR in theca cells was in a concentration-dependent manner. Following exposure to various concentration of ox-LDL for 24 h, the proliferation of theca cells was induced by low concentration of ox-LDL (25-150 mg/L), and 100 mg/L ox-LDL showed the most significant inducing effect. Moreover, the cell survival rate was diminished considerably following with ox-LDL concentration increasing, especially lowered by 400 mg/L ox-LDL. The mRNA level of LXR-α was increased with low concentration of ox-LDL (25-150 mg/L) and the impact of ox-LDL on the induced expression of LXR-α mRNA was considerably distinct at the concentration of 150 mg/L. On the other hand, the expression of LXR-α mRNA was reduced with high concentration of ox-LDL, and the impact of 400 mg/L
    ox-LDLwas substantially distinct. The protein expression levels of LXR-α and StAR were increased with 150 mg/L ox-LDL, but StAR protein level in 150 mg/L
    ox-LDL group revealed no significant difference when compared with control group. The expression of LXR-α and StAR protein was significantly inhibited with 400 mg/L ox-LDL in the rat theca cells. Conclusion · Low concentrations of ox-LDL can induce the proliferation of theca cells, and promote the expression of StAR and LXR-α. Whereas, high concentrations of ox-LDL can reduce the cell viability and inhibit the expression of StAR and LXR-α.
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    Differential expression of miR-143 in colon cancer tissue and its effect on apoptosis and migration of colon cancer cell
    ZHANG Xiao-yun, WANG Li-feng
    2017, 37 (03):  325. 
    doi: 10.3969/j.issn.1674-8115.2017.03.009

    Abstract ( 883 )   PDF (6627KB) ( 1085 )  
    Objective · To study the expression of microRNA-143 (miR-143) in human colon cancer and adjacent normal tissues, and to explore its effect on the function of colon cancer cells and downstream target genes. Methods · Lentiviral expression vector of miR-143 was designed and used to stably transfect colon cancer cell lines HCT116 and RKO. Real-time PCR was used to detect the expression of miR-143 in colon cancer, adjacent normal tissues, HCT116 cells and RKO cells infected with lentivirus. The apoptosis ratio of HCT116 cells and RKO cells was detected by Annexin V-APC single staining and flow cytometry. The migration ability of HCT116 cells and RKO cells was detected by Transwell method. The expression of FOSL2 protein was detected by Western blotting assay. Results · The expression of miR-143 in colon cancer tissue was significantly lower than that in adjacent mucosal tissue (0.339±0.454 vs 1.003±0.003) (U=16.000, Z=-4.231, P=0.000). By up-regulation of miR-143, apoptosis rates were significantly higher in HCT116 and RKO cells than those in the negative controls (P=0.000). The count of migrating HCT116 cells in up-regulated group was significantly lower than that in the negative control group (P=0.000). The count of migrating RKO cells in down-regulated group was significantly higher than that in the negative control (P=0.003). By down-regulation of miR-143, the expression of FOSL2 protein was increased. Conclusion · The expression of miR-143 was significantly decreased in colon cancer tissues. Up-regulation of miR-143 can promote the apoptosis rate in both cell lines, and inhibit the migration ability of HCT116 cells. Down-regulation of miR-143 could promote the migration ability of RKO cells. By inhibiting miR-143, the expression of FOSL2 protein in colonic cancer cells would be increased.
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    Original article (Basic research)
    Novel small-molecule CDK2-cyclinA2 inhibitors: design, synthesis, and biological evaluation
    WEI Ying-qing, ZHANG Lu, HU Yu-tong, ZHANG Jian, SHEN Ying
    2017, 37 (03):  330. 
    doi: 10.3969/j.issn.1674-8115.2017.03.010

    Abstract ( 964 )   PDF (7118KB) ( 709 )  

    Objective · To design and synthesize a series of benzenesulfonamide derivatives, test their inhibitory activity to CDK2-cyclinA2 kinase, and investigate the structure-activity relationship. Methods · Virtual screening was executed via computer-aided drug design according to the ATP binding site in CDK2-cyclinA2 protein crystal. A series of benzenesulfonamide derivatives were designed and synthesized on the basis of the interaction modes between the lead compound and the CDK2-cyclinA2. The biological evaluation of compounds was made through the CDK2-cyclinA2 in-vitro kinase activity detection system. Results · Twenty-nine new benzenesulfonamide compounds were prepared, and their inhibitory activity to CDK2-cyclinA2 was elicited. WZ-026 had the highest inhibitory parameter, which half maximal inhibitory concentration (IC50) was 3.81 μmol/L. Conclusion · By multipurpose utilization of virtual screening, chemical synthesis, and biological activity test, a benzenesulfonamide compound WZ-026 was found, which has great inhibitory activity towards CDK2-cyclinA2. Preliminary structure-activity relationship of compounds was obtained.

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    Study of tissue-engineered small vascular graft sheathed with nano poly (1,3-diamino-2-hydroxypropaneco-polyolsebacate) on adventitia and coated with heparin on intima
    LIU Jun, ZHANG Xiao-ying
    2017, 37 (03):  337. 
    doi: 10.3969/j.issn.1674-8115.2017.03.011

    Abstract ( 843 )   PDF (8845KB) ( 667 )  
    Objective · To develop a new hybrid tissue-engineered vascular graft (HTEV) with excellent mechanical properties and biological functions. Methods · Decellularized rat aortas (DRAs) were prepared. Then, electrospinning nano poly (1,3-diamino-2-hydroxypropane-co-polyolsebacate) (ES-APS) was used to sheathe DRAs in order to improve the mechanical properties. After that, the intima of HTEV scaffold was modified with heparin coating. HTEVs were implanted in rat models in vivo to evaluate their biological functions. Six weeks later, vascular ultrasound and micro-CT angiography were carried out. Results · The donor aortic vessels were successfully decellularized. The total DNA content of DRA group [(115.4±10.9) ng/mg] significantly decreased compared with natural aorta group [(398.6±14.6) ng/mg] (P=0.000). But collagenous fibers and elastic fibers of decellularized vessels were severely injured. Mechanical tests of scaffolds showed that ES-APS significantly enhanced the mechanical properties. The wall thickness [(187±11) μm], suture retention strength [(0.51±0.06) N] and burst pressure [(2 103±232) mmHg] of HTEV group all significantly increased compared with DRA group (P<0.01). Heparin coating modification of HTEV significantly reduced the number of adhesive platelets. Vascular ultrasound and micro-CT angiography showed all grafts were totally patent 6 weeks after implantation in rat models. ES-APS sheath successfully prevented the occurrence of vasodilation and aneurysm formation. Conclusion · DRA sheathed with ES-APS on adventitia and coated with heparin on intima is a new kind of HTEV, which possesses increased tensile strength and improved biocompatibility.
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    Original article (Clinical research)
    Effect of the quality of embryos on biochemical pregnancy or arrest of embryo development in the freezing and thawing cycles
    XIA Lan, WU Xian, XU Hui-hui, ZHAO Shen, XU Bu-fang, ZHANG Ai-jun
    2017, 37 (03):  344. 
    doi: 10.3969/j.issn.1674-8115.2017.03.012

    Abstract ( 932 )   PDF (6262KB) ( 1173 )  
    Objective · To investigate whether the quality of embryos will result in biochemical pregnancy or arrest of embryo development in the freezing and thawing cycles of in-vitro fertiliazation-embryo transfer (IVF-ET). Methods · The clinical data of patients who accepted IVF-ET in Center of Reproductive Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to June 2016 were retrospectively studied. The data includes 115 cycles of biochemical pregnancy, 64 cycles of arrest of early embryonic development and 871 cycles of ongoing pregnancy after frozen thawed embryo transfer. We compared the embryo score on the third day after embryo transfer (D3), the blastocyst development rate and the blastocyst grade in the three groups. Results · There were no significant differences in the period of infertility, the age of the patients and their spouses, the endometrial thickness, the estrogen and progestogen levels of the day of transplantation among the three groups (P > 0.05). The scores of most frozen thawed embryos on D3 were from 6 to 8, and the scores were not statistically significant among the three groups (P > 0.05). The proportion of transplanted blastocyst on D5 was higher than that on D6 in the three groups, but there was no significant difference among the three groups (P > 0.05). There was no significant difference in the proportion of inner cell mass of blastocysts which were scored as Grade A&B or Grade C among the three groups. Nevertheless, in the arrest of early embryonic development group, the proportion (52.2%) of the trophoblast of blastocysts which were cored as Grade C was significantly higher than the proportion (35%) in biochemical pregnancy group and the proportion (29.3%) in ongoing pregnancy group (P<0.05). Conclusion · The quality of embryos is not necessarily related to biochemical pregnancy, but the score of trophoblastic may be related to the arrest of early embryo growth.
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    Original article (Preventive medicine)
    Surgical treatment with RPR technique for complex hypertrophic obstructive cardiomyopathy
    LI Hai-qing, ZHOU Ren, YAO Hao-yi, YUAN Zhi-ze, WANG Zhe, CHEN An-qing, ZHAO Qiang
    2017, 37 (03):  348. 
    doi: 10.3969/j.issn.1674-8115.2017.03.013

    Abstract ( 1195 )   PDF (6014KB) ( 2452 )  
    Objective · To evaluate the surgical outcome of RPR composite technique for complex hypertrophic obstructive cardiomyopathy (HOCM). Methods · From June 2009 to December 2015, 9 complex HOCM patients received RPR procedure. There were 6 males and 3 females with age from 22 to 63 years old and the average age of (43±19) years old. Transthorax echocardiography (TTE) showed systolic anterior motion (SAM) and at least moderate mitral valve regurgitation (MR) in all patients before operations. Transesophageal echocardiography (TEE) was used to evaluate the results of procedures during operation. All the patients had been followed up since one week after operation and examined by TTE. Results · All the patients were discharged without complications. Intraoperative TEE indicated that left ventricular outflow tract pressure gradient (LVOTPG) significantly decreased from (92±14) mmHg before operation to (9±3) mmHg after operation (P<0.01). SAM in all the patients disappeared. One week after operation, TTE demonstrated remarkable reduction in the thickness of ventricular septum, LVOTPG and MR than those before operation (P<0.01). Mean follow-up was 26 months. All the patients became asymptomatic. LVOTPG remained low and MR remained mild. There were no deaths, reoperations, or any other adverse consequences. Conclusion · RPR technique is an effective surgical method to relieve LVOTO and MR of complex HOCM to lead a better life.
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    Original article (Clinical research)
    Relationship of adipose chemerin and its receptor chemerinR gene expression to obesity and type 2 diabetes mellitus
    WANG Ling-yan, YU Hao-yong, WEI Li
    2017, 37 (03):  352. 
    doi: 10.3969/j.issn.1674-8115.2017.03.014

    Abstract ( 826 )   PDF (8264KB) ( 673 )  
    Objective · To explore the relationship of adipose chemerin and its receptor chemerinR gene expression to obesity and type 2 diabetes mellitus. Methods · Twenty-four patients undergoing elective abdominal surgery were enrolled, and were divided into normal glucose regulation-normal weight group (NGR-NW), normal glucose regulation-overweight/obesity group (NGR-OW/OB), and type 2 diabetic overweight/obesity group (T2DMOW/OB) according to the body mass index (BMI). The levels of chemerin and chemerinR mRNA were detected by reverse transcription PCR (RT-PCR). Results · Compare to the NGR-NW group, the chemerin mRNA levels of abdominal subcutaneous and omental fat were significantly increased in the NGR-OW/OB and T2DM-OW/OB group (P<0.05). Correlation analysis showed that the chemerin mRNA levels of abdominal omental fat were positively correlated with BMI, fasting insulin (FINS), triglyceride and serum chemerin (r=0.577, r=0.561, r=0.472, r=0.623, P<0.05 for all). The chemerin mRNA levels of abdominal subcutaneous fat showed significant positive correlation with BMI, FINS and serum chemerin (r=0.692, r=0.513, r=0.497, P<0.05 for all). Conclusion · The chemerin mRNA levels of abdominal subcutaneous and omental fat were positively correlated with BMI, FINS and serum chemerin, suggesting that the chemerin gene may play a crucial role in the pathophysiological mechanism of obesity and type 2 diabetes.
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    Analyses of vitamin D2/D3 levels in moderately and severely depressive patients
    HU Yao, MAO Xu-dong, LIU Xiao-hua, CHEN Hai-ying, QU Yi, FANG Yi-ru, SHI Shen-xun, WU Yan
    2017, 37 (03):  359. 
    doi: 10.3969/j.issn.1674-8115.2017.03.015

    Abstract ( 1378 )   PDF (6231KB) ( 852 )  
    Objective · To detect the vitamin D2 and D3 levels in the patients with moderate and severe depression. Methods · Eighty-five patients who met the criteria for major depressive disorder were recruited (53 patients with moderate depression, 32 patients with severe depression). Fifty age-matched healthy volunteers were recruited as controls. Serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels were detected by using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The risk factors which might influence the severity of depression were screened by Logistic regression analysis. Results · The serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in the case group was lower than those in the control group (P=0.012, P=0.000, P=0.000). The patients with moderate depression presented significantly lower serum 25 (OH) D3 and total 25 (OH) D2/D3 levels than the controls did (P=0.000), although no significant difference in serum 25 (OH) D2 levels was found between these two groups. As well, the serum 25 (OH) D2, 25 (OH) D3 and total 25 (OH) D2/D3 levels in patients with severe depression were significantly lower than those in patients with moderate depression and controls (P<0.05). The body mass index of severe depression group was much higher than that of moderate depression group and control group (P=0.002). Both overweight/obesity and the concentration of vitamin D may be the major influencing factors of depression severity (P=0.034, P=0.011). Conclusion · Vitamin D2 and D3 deficiency in depressive patients, particularly in those patients with severe depression, was shown in the present study. In addition, overweight/obesity as well as the concentration of vitamin D may exert the significant influence on the severity of depression. Vitamin D supplementation and weight control may be needed to be considered in making therapeutic strategies of major depressive disorder.
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    Morphological changes of mitral valve geometry caused by repair procedure
    CHEN Jia-fei, ZHANG Wei, SHI Wei, MA Wen-rui, YE Wei, WU Wei-hua
    2017, 37 (03):  363. 
    doi: 10.3969/j.issn.1674-8115.2017.03.016

    Abstract ( 783 )   PDF (7046KB) ( 629 )  
    Objective · To assess the morphological changes of mitral valve geometry after mitral valve repair by using real-time 3D transesophageal echocardiography. Methods · The clinical data including 3D echocardiography of 36 patients undergoing mitral valve repair for mitral valve prolapse and 56 patients without mitral valve diseases were collected. Parameters of mitral annular and leaflet geometry were acquired and analyzed. Results · The ellipse index of the two-dimensional view (E2D), and non-planar leaflet angle (θNPA) were decreased, while other parameters were increased significantly in patients with mitral valve prolapse compared with controls before mitral valve repair. After repair, patients displayed larger θNPA, and still smaller E2D. Some parameters also get smaller, such as the anterior to posterior diameter of the mitral annulus, the anterolateral to posteromedial coaptation diameter, the minimum circumference of the three-dimensional view of the annulus, the minimum area of the two-dimensional view of the annulus, the exposed area of the anterior leaflet, inter-commissural diameter. Other parameters were not changed significantly. All parameters showed no significant difference between respect group and resect group in posterior valve prolapse before and after mitral valve repair. Conclusion · The repair procedure can restore the function of the mitral valve effectively. In view of the morphology, the geometry of the mitral valve annulus is still different from the normal apparently after the mitral valve repair, but the normal morphology of the leaflets can be regained. It seems to have similar curative effect morphologically for patients with posterior leaflet prolapse to have respect or resect strategy.
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    Analysis of 3-year survival of implants in patients with chronic periodontitis
    QIAN Jie-lei, SHU Rong, SONG Zhong-chen, XIE Yu-feng, WANG Yi-wei
    2017, 37 (03):  368. 
    doi: 10.3969/j.issn.1674-8115.2017.03.017

    Abstract ( 1098 )   PDF (6834KB) ( 985 )  

    Objective · To observe short and medium term survival of implants in patients with chronic periodontitis after implantation. Methods · 54 patients with chronic periodontitis (133 implants) were enrolled from August 2011 to August 2013. The survival of implants was observed and the periimplant diseases were compared and analyzed between patients with different degrees of chronic periodontitis. Results · The 3-year survival rate of implants was 97.74%. The differences between patients with different degrees of chronic periodontitis were not statistically significant (P=0.452). Periodontal pocket depth (PPD) and modified plaque index (mPLI) were significantly higher in patients with severe chronic periodontitis than in patients with mild and moderate chronic periodontitis. For patients not receiving supportive periodontal therapy (SPT), the peri-implantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.009). For smokers, the periimplantitis rate in patients with severe chronic periodontitis was significantly higher than that in patients with mild and moderate chronic periodontitis (P=0.016). Conclusion · For patients with chronic periodontitis, the theraputic effect of implant treatment is good. Plaque control, SPT, and smoking cessation can reduce the incidence of peri-implantitis.

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    Value of ultrasonic measurement of distance from skin to epiglottis for predicting the difficult airway
    NI Hong-wei, HE Guang-bao, SHI Dong-ping, HANG Yan-nan
    2017, 37 (03):  373. 
    doi: 10.3969/j.issn.1674-8115.2017.03.018

    Abstract ( 1039 )   PDF (5216KB) ( 935 )  
    Objective · To evaluate the value of ultrasonic measurement of distance from skin to epiglottis (DSE) for predicting the difficult airway. Methods · 71 patients (20-80 year-old, ASAⅠ-Ⅲ) undergoing endotracheal intubation and general anesthesia for an elective surgical procedure were enrolled. Conventional airway evaluation was performed. The distance from skin at thyroid cartilage upper edge to epiglottis was measured using ultrasound before anesthesia and compared between patients with difficult airway and normal airway. The effects of different methods for evaluating difficult airway were analyzed .Results · The ultrasonic measurements of DSE on parasagittal view in patients with difficult airway and normal airway were (23.31±0.43) mm and (19.21±0.27) mm, respectively. The difference was statistically significant (P=0.003). The area under the ROC curve of ultrasonic measurement was 0.799 (95% CI:0.639-0.958) with the best cutoff point of 23.6 mm. The specificity of ultrasonic measurement was significantly increased as compared with Mallampati classification (96.43% vs 71.40%, P=0.004). The difference in sensitivity was not statistically significant (60.00% vs 73.33%, P=0.170). Conclusion · Ultrasonic measurement of DSE on parasagittal view can be used to predict the difficult airway.
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    Changes of the peripheral blood cells in children with high-risk neuroblastoma after chemotherapy and factors related to severe infection
    TAN Zhen, ZHANG Qin, SHENG Qi, HE Ke-jun, ZHANG Zhen-xing, YUAN Xiao-jun
    2017, 37 (03):  377. 
    doi: 10.3969/j.issn.1674-8115.2017.03.019

    Abstract ( 858 )   PDF (5766KB) ( 866 )  

    Objective · To investigate the changes of neutrophils and lymphocytes during chemotherapy courses in children with high-risk neuroblastoma, as well as severe infection rate and its relationship with combination chemotherapy regimens in order to provide guidance to prevent infection in these children. Methods · A total of 45 cases of children with high-risk neuroblastoma, who were hospitalized in Xinhua Hospital from July 2012 to September 2015 were recruited. Reactions after chemotherapy and the results of routine blood tests on every 5 days during the whole chemotherapy circles were recorded. Follow-up visits were carried out to learn the infection occurrence. Results · The counts of neutrophils and lymphocytes dropped to the minimum at the 10th day or so during chemotherapy, then rised near the 15th day. Infections were negatively correlated with the numbers of neutrophils (r =-0.245) and lymphocytes (r =-0.227) at the 10th day. Persistent lymphopenia occured after the forth course of chemotherapy. Rate of grade Ⅳ bone marrow suppression after chemotherapy was 90%, and severe infection rate was 15.5%. There were significant differences in the rates of grade Ⅲ bone marrow suppression (P=0.008), grade Ⅳ bone marrow suppression (P=0.001) and severe infection (P=0.010) among the 3 combination chemotherapy regimens used in high-risk neuroblastoma children. Conclusion · Children with high-risk neuroblastoma had obviously high rates of bone marrow suppression and severe infection after chemotherapy, especially after cyclophosphamide+doxorubicin+vincristine regimens. More attention should be paid to this group of children and preventive measures were worthy of taking into account.

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    Investigation of depression and anxiety among patients with recurrent spontaneous abortion and analysis of the influence factors
     
    HE Li-ying, WANG Tong-fei, LIU Zhi-lan, XU Hai-jing, CHEN Chao, KANG Xiao-min, ZHAO Ai-min
    2017, 37 (03):  381. 
    doi: 10.3969/j.issn.1674-8115.2017.03.020

    Abstract ( 1060 )   PDF (7226KB) ( 765 )  
    Objective · To investigate the status of depression and anxiety in patients with recurrent spontaneous abortion (RSA) and the possible influence factors and to provide theoretical support for further psychological intervention. Methods · RSA patients and women with no history of RSA were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). All data were analyzed by SPSS. Results · Of all 1 064 cases included in this study, 725 were RSA cases, 217 cases with one spontaneous abortion and 122 in control group with no history of spontaneous abortion. Our results showed that both RSA patients and patients with one spontaneous abortion have significantly higher SDS and SAS scores than control group. Furthermore, non-pregnant RSA patients with lower education level, lower household income and 3-5 years of marriage have significantly higher levels of depression and anxiety. Patients with multiple miscarriages (≥4), history of induced abortion and no live birth, score significantly higher in SDS. Conclusion · Whether pregnant or not, RSA patients are much easier to become depressive and anxious, which may be associated with education level, household income, length of marriage, numbers of pregnancy losses and previous live birth. Women with one spontaneous abortion also show a significant higher tendency of depression and anxiety. These patients should be given proper psychological intervention if necessary.
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    Antimicrobial resistances and clinical distributions of Acinetobacter junii and Acinetobacter lwoffii
    TANG Rong, CHEN Wen-jing, YI Jun-wen, YU Qi, HONG Qing, SHU Wen, LIU Qing-zhong, LI Li, CUI Ze-lin
    2017, 37 (03):  386. 
    doi: 10.3969/j.issn.1674-8115.2017.03.021

    Abstract ( 2843 )   PDF (5836KB) ( 975 )  
    Objective · To analyze the clinical distribution and drug resistance of Acinetobacter junii (A. junii) and Acinetobacter lwoffii (A. lwoffii) from a grade 3A hospital in Shanghai, China, and provide the foundation for prevention and control of infections caused by them. Methods · A. junii and A. lwoffii were collected from the hospital between Aug, 2011 and Aug, 2016. VITEK2 Compact of bioMérieux (French) was used for bacterial identification and antibiotic susceptibility tests, clinical information of each strain was also analyzed. Results · 28 strains of A. junii and 58 strains of A. lwoffii were enrolled. A. junii was mainly from the departments of urology, thoracic surgery and geriatrics, and the samples were mainly sputum and urine. The resistant rates of A. junii to gentamicin, ampicillin sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, levofloxacin, ciprofloxacin and cotrimoxazole were 35.71%, 3.57%, 10.71%, 3.57%, 3.57%, 3.57%, 3.57%, 3.57%, 0, 3.57% and 35.71%, respectively. A. lwoffii was mainly isolated from the departments of urology, geriatrics, respiratory and renal medicine, and the samples mainly included urine, blood and sputum. The rates of antibiotics (mentioned above) resistance were 29.31%, 13.79%, 13.79%, 6.90%, 20.69%, 18.97%, 12.07%, 15.52%, 18.97%, 31.03% and 31.03%, respectively. The levels of antibiotic resistance of these two strains were constant during the five years. Conclusion · A. junii and A. lwoffii antibiotic resistant rates were much lower than those of reported A. baumannii, the over-all antibiotic resistances of A. junii were lower than those of A. lwoffii. This study provided fundamental data for prevention or control of these two strains by empirical use of antibiotics.
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    Gene diagnostic method for primary immunodeficiency disease based on targeted panel sequencing
    YANG Li-jun, Li Niu, LIU Yi, WANG Jian
    2017, 37 (03):  390. 
    doi: 10.3969/j.issn.1674-8115.2017.03.022

    Abstract ( 973 )   PDF (6081KB) ( 1200 )  
    Objective · To design and build a high-throughput sequencing approach based on targeted panel sequencing (TPS) using for the primary immunodeficiency disease (PID) diagnosis. Methods · By reviewing the literature and querying the relevant databases to determine the known disease-causing genes of PID, capture probes using for the TPS were designed and customized for all exons and flanking sequences of these genes. A child suspected with PID was diagnosed by the customized TPS. Results · The PID sequencing panel contains a total of 100 known pathogenic genes. The sequencing data of the patient has 16 414 298 reads. The average coverage depth is 157 X, 98.35% of the target region sequencing depth is greater than 20 X, and 99.97% of the target region sequencing depth is greater than 1 X. Finally, a heterozygous nonsense mutation was found in the exon 2 of the CXCR4 gene (c.1000C>T, p.Arg334*) in the child. The results of Sanger sequencing confirmed the variation in the child and showed that his parents were wild-type at the corresponding sites, indicating the mutation is de novo. Conclusion · This study established a high-throughput sequencing diagnostic approach for PID, with which a case of WHIM syndrome was successfully diagnosed.
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    Original article (Public health)
    Association between age of first spermatorrhea and physical activity or sleeping time in boys
    PENG Lin-li, WANG Hong, HE Fang, CHENG Xu-ting, WANG ling-yi, JIANG Jia-jia
    2017, 37 (03):  394. 
    doi: 10.3969/j.issn.1674-8115.2017.03.023

    Abstract ( 1056 )   PDF (5619KB) ( 1185 )  
    Objective · To understand boys’ pubertal timing in school in two urban districts of Chongqing and explore the relationship between pubertal timing and physical activity or sleeping time. Methods · Using a stratified random cluster sampling, 3 403 boy students (10-18 year-old) were selected and completed the physical examination and questionnaire survey. 1 282 participants experiencing first spermatorrhea were chosen as research objects. According to age of first spermatorrhea, the objects were divided into on-time group (964 cases) and later group (318 cases). Results · The composition of weekly high (χ2=11.488, P=0.009), medium (χ2=7.829, P=0.050) physical activity and daily sleeping time (χ2=17.803, P=0.000) in two groups were significantly different. Controlling covariates (age, height and weight), compared with boys in on-time group, later group boys were less likely to engage in 5-7 days (OR=0.596, 95% CI: 0.367-0.967) and 3-4 days (OR=0.590, 95% CI: 0.370-0.941) high physical activity every week, and 9-11h (OR=0.207, 95% CI: 0.088-0.489) sleep every day. Conclusion · The age of first spermatorrhea in boys might be associated with the intensity of weekly physical activity and daily sleeping time.
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    Family medical intervention model of senile dementia with behavioral and psychological symptoms
    YANG Dao-liang, LI Xia, SU Ning, JI Wei-dong, CHEN Xuan-xuan
    2017, 37 (03):  398. 
    doi: 10.3969/j.issn.1674-8115.2017.03.024

    Abstract ( 1012 )   PDF (7273KB) ( 593 )  

    Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the
    intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and
    psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD),
    Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life
    Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the total scores of BEHAVE-AD and the factor scores of affective disorder, anxiety and terror (P<0.001). The interactive effect of time×group was significant in the total scores of BEHAVE-AD and the factor scores of delusion and affective disorder (P<0.05). ② Intergroup comparison of the BEHAVE-AD scores indicated that by the end of 6 months, factor scores of hallucination, circadian rhythm disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). By the end of 12 months, total scores of BEHAVE-AD, and factor scores of delusion, conduct disorder, affective disorder, anxiety and terror of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.01). ③ There was no significant difference in the scores of MMSE, ADL, QOL-AD and GQOLI-74 between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.

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    Review
    Liver fibrosis and stem cell therapy
    XU Dong-sheng, WAN Ai-ni, CHEN Yun, HE Yang, YANG Jian-feng, JIN Jian
    2017, 37 (03):  403. 
    doi: 10.3969/j.issn.1674-8115.2017.03.025

    Abstract ( 1101 )   PDF (7177KB) ( 838 )  

    Liver fibrosis is a common chronic liver disease, which is a stress response process of liver cells affected by one or more pathogenies for long term or repeatedly. During the fibrosis process, massive accumulated extracellular matrix can form scar tissue, which results in liver dysfunction or failure and seriously endangers the health of people. According to many independent reports, stem cell therapy can facilitate the alleviation of liver fibrosis. During the stem cell therapy, stem cells migrate to the injury site of liver and alleviate the liver fibrosis by improving the microenvironment of the scar area via paracrine way. This article reviews the formation, treatment, and stem cell therapy of liver fibrosis.

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    Research progress in animal models of cholangiocarcinoma
    SHA Meng, XIA Qiang
    2017, 37 (03):  407. 
    doi: 10.3969/j.issn.1674-8115.2017.03.026

    Abstract ( 1444 )   PDF (6029KB) ( 1060 )  
    Cholangiocarcinoma (CCA) is a malignant neoplasm derived from cholangiocytes. The incidence of CCA is only lower than that of hepatocellular carcinoma and ranked the second in liver malignant cancers. The prognosis of CCA patients is poor and most patients will die within a few months after diagnosis. CCA is related to various risk factors, including primary sclerosing cholangitis, cirrhosis, certain chemical agents and liver fluke. Establishment of proper animal models of CCA can not only be helpful for understanding the mechanisms of incidence and development, but also lay a solid foundation for developing novel treatment strategies. Common animal models of CCA include carcinogen-induced models, implantation models, operation models, and genetically engineered models.
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    Recent research advances in the relationship between caffeine intake and atrial fibrillation
    ZHOU Dan-dan, HONG Jiang
    2017, 37 (03):  411. 
    doi: 10.3969/j.issn.1674-8115.2017.03.027

    Abstract ( 945 )   PDF (5434KB) ( 1196 )  
    Atrial fibrillation is one of common arrhythmias and can significantly increase risks of stroke and heart failure with high rates of mortality and disability. The incidence of atrial fibrillation increases year by year due to aging population, high incidences of coronary heart disease and hypertension, and lifestyle changes. As one of widely consumed drinks in the world, coffee affects the daily life of modern people. The intake of caffeine, which is the main ingredient of coffee, can influence the incidence of atrial fibrillation, but the relationship between them is still controversial. Most studies deem that the intake of caffeine is negatively correlated with the incidence of atrial fibrillation. This paper reviews current studies in China and abroad on the relationship between the intake of caffeine and the incidence of atrial fibrillation.
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    Research advances of gastrointestinal hormones and polycystic ovary syndrome
    QIAN Cheng, YANG Wei, MA Jing
    2017, 37 (03):  414. 
    doi: 10.3969/j.issn.1674-8115.2017.03.028

    Abstract ( 797 )   PDF (11038KB) ( 737 )  

    Polycystic ovary syndrome (PCOS) is a common syndrome in adolescent women and women of reproductive age. Main manifestations are oligomenorrhea, anovulation, polycystic ovarian, and hyperandrogenism with metabolic abnormalities such as dyslipidemia, insulin resistance, and glucose intolerance. PCOS can lead to type 2 diabetes mellitus, cardiovascular diseases, and endometrial cancer, which seriously threat the health of women. The pathogenesis of PCOS is not clear. Over 60% of women with PCOS are obese or overweight. Appetite and energy intake regulation plays an important role in body weight management. Nutrients are mainly digested and absorbed in gastrointestinal track, which is also one of the largest endocrine organs in human body. Special endocrine epithelial cells in stomach, proximal small intestine, and distal small intestine can secrete ghrelin, CCK, GLP-1, and PYY, which involve in the regulation of appetite and are also known as appetite regulating hormones. This review focuses on changes in the secretion of gastrointestinal hormones and related weight loss treatment in patients with PCOS.

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    Brief original article
    Strategic analysis of microsurgical treatment to obstructive azoospermia
    LI Peng, TAN Guang-xing*, HUANG Yu-hua, CHEN Hui-xing, XIA Shu-jie, LI Zheng
    2017, 37 (03):  420. 
    doi: 10.3969/j.issn.1674-8115.2017.03.029

    Abstract ( 865 )   PDF (4485KB) ( 820 )  
    Objective · To investigate the strategy of microsurgical treatment to obstructive azoospermia (OA). Methods · There were totally 182 OA patients received surgical treatments. Various patients were preformed various microsurgical treatment. Results · Among the 182 patients, 86 patients had epididymal obstruction. Other etiologies included vasal obstruction in 30 cases, congenital bilateral absence of vas deferens in 48 cases, ejaculatory duct obstruction in 17 cases, obstruction of rete testis in 1 case. 114 patients were performed microsurgery, 92 cases were followed up. The mean follow-up period was 9 months (3-16 months). The patent rate was 71.7% (66/92), the natural pregnant rate was 32.6% (29/89). Conclusion · For the obstructive azoospermia, the etiology and the obstructive site is multiform, microsurgery is the first choice, various patients can be preformed various treatment. The microsurgery techniques in OA treatments have an obvious advantage, especially for the chance for achieving natural pregnancy.
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    Changes in peripheral blood CD14dimCD16+ monocyte count and serum C- reactive protein level in elderly patients with chronic heart failure
    ZHOU Xi-lin, LIANG Hui
    2017, 37 (03):  423. 
    doi: 10.3969/j.issn.1674-8115.2017.03.030

    Abstract ( 830 )   PDF (4954KB) ( 966 )  
    Objective · To observe the changes in peripheral blood CD14dimCD16+ monocyte count and serum C-reactive protein (CRP) level in elderly patients with chronic heart failure (CHF) and analyze the relationship between these changes and the cardiac function of patients. Methods · 42 elderly patients with CHF (the CHF group, consisting of 18 cases of NYHA cardiac function grade Ⅱ, 18 cases of NYHA cardiac function grade Ⅲ, and 6 cases of NYHA cardiac function grade Ⅳ) and 25 healthy elderly people (the control group) were enrolled. Peripheral blood CD14dimCD16+ monocyte count, serum CRP level, left ventricular ejection fraction (LVEF), and left ventricular end-diastolic diameter (LVEDD) were measured and statistical analysis was performed. Results · CD14dimCD16+ monocyte count and serum CRP level were significantly higher in the CHF group than in the control group (P<0.05). In the CHF group, the CD14dimCD16+ monocyte count, serum CRP level, and LVEDD of NYHA grade Ⅳ patients were significantly higher than those of NYHA grade Ⅱ patients, while their LVEF was remarkably lower than that of NYHA grade Ⅱ patients. The differences were statistically significant (P<0.05). Correlation analysis results showed that peripheral blood CD14dimCD16+ monocyte count and serum CRP level were positively correlated with LVEDD (r =0.37, r =0.45, P<0.05) and negatively correlated with LVEF (r=-0.56, r =-0.33, P<0.05) in the CHF group. Conclusion · The deterioration of elderly patients with CHF is associated with inflammation and the monocyte dysfunction may exist in the heart failure process. Peripheral blood CD14dimCD16+ monocyte count and serum CRP level are expected to be novel biomarkers that can reflect the severity of heart failure.
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