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    Translational medicine
    2017, 37 (04):  424. 
    Abstract ( 312 )   PDF (3974KB) ( 601 )  
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    2016 Shanghai Science and Technology Awards
    2017, 37 (04):  426. 
    Abstract ( 387 )   PDF (3625KB) ( 867 )  
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    Original article (Basic research)
    Biological effects and mechanism of adenanthin on multiple myeloma cells
    XIAO Xin-hua, YU Miao, WU Yun-zhao, WU Ying-li, LIU Wei
    2017, 37 (04):  427. 
    doi: 10.3969/j.issn.1674-8115.2017.04.001

    Abstract ( 738 )   PDF (6533KB) ( 1026 )  
    Objective · To explore the biologic effect and mechanism of adenanthin (Aden) on multiple myeloma (MM) cells. Methods · MM cells, H929 and U266 were treated with various dose of Aden for different time, and the density and viability of MM cells were detected by trypan blue exclusion assay. After H929 and U266 cells were treated with various dose of Aden for 24 hours, cell growth inhibition was examined by CCK8 assay, and cell apoptosis was examined by AnnexinV-APC/PI staining assay. Apoptosis related proteins, NF-κB signaling pathway associated proteins and the NFκB regulated proteins were detected by Western blotting. The effect of Aden on the thermal stability of IKKβ protein was determined by CETSA assay. Results · Trypan blue exclusion results showed that Aden inhibited cell growth and reduced cell viability in concentration and time dependent manners. U266 was more sensitive than H929 when exposed to the same concentration of Aden. The CCK8 results showed that Aden inhibited the growth of H929 and U266 cells in a concentration dependent manner. Flow cytometry results suggested that Aden induced a low apoptosis rate of MM cells. Moreover, cleavage of caspase3 and PARP were detected in U266 cells but not in H929 cells. CETSA assay indicated that Aden decreased the thermal stability of IKKβ. Expression of p-p65 and p-IκBα proteins decreased in MM cells treated with Aden. Conclusion · Aden significantly inhibits MM cell proliferation by inhibiting NF-κB activation through interacting with IKKβ. Aden has little effect on apoptosis of MM cells.
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    Establishment of cell-based screening system for compound regulating the stability of retinoic acid receptors
    JING Bo, CHEN Peng-hui, GAO Xiang, XU Yuan-yuan, WU Yun-zhao, SUN Yun, WU Ying-li
    2017, 37 (04):  432. 
    doi: 10.3969/j.issn.1674-8115.2017.04.002

    Abstract ( 841 )   PDF (7155KB) ( 636 )  
     Objective · To establish a cell-based screening system for identification of compounds with activity in regulating retinoic acid receptor (RARα) stability. Methods · The modified pMSCV plasmid constructs, named as RARα-EGFP-IRES-DsRed, consists of enhanced green fluorescent protein (EGFP) fusing to RARα and red fluorescent protein (DsRed) as internal references incorporating the internal ribosome entry site (IRES) as interval sequence. The RARα-EGFP-IRES-DsRed plasmid was stably transfected into NB4 cells which were named as NB4-pMGIR-RARα. Fluorescence signals of EGFP and DsRed indirectly reflecting the expression of RARα, were detected by flow cytometry in cells that were treated with all-trans retinoic acid, sodium valproate, cytarabine, lenalidomide, etoposide, montelukast and gambogic acid, respectively. Effects of these compounds on the expression of RARα protein were further examined by Western blotting. Results · A double fluorescence reporter system for screening compounds that can increase the stability of RARα protein was successfully established, and sodium valproate was identified as a potent compound to promote the stability of RARα. Conclusion · The double fluorescence reporter system can be used to screen compounds regulating the stability of RARα protein, which can be further used to identify compounds regulating the stability of other proteins.
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    Effects of CTHRC1 on human ovarian cancer cell metastasis and its mechanism
    GUO Bi-ying, YAN Huan, ZHANG Shu
    2017, 37 (04):  438. 
    doi: 10.3969/j.issn.1674-8115.2017.04.003

    Abstract ( 690 )   PDF (6865KB) ( 660 )  
    Objective · To investigate the role of collagen triple helix repeat containing-1 (CTHRC1) in ovarian cancer cell metastasis and the related mechanism. Methods · The expression of CTHRC1 in ovarian cancer cells was detected by Western blotting. The cell line which had high expression of CTHRC1 was transfected with a CTHRC1 specific shRNA, and the lenti-CTHRC1 was used to overexpress CTHRC1 in the cell line whose expression of CTHRC1 was very low. Then the expression of Slug and MMP-2 was assessed. Transwell assay was used to determine the migration and invasion capability of ovarian cancer cells after transfection. Results · The expression of CTHRC1 in HO8910 cells was the lowest, while the CTHRC1 protein level was dramatically increased after transfection of lenti-CTHRC1. Meanwhile, there was a distinct rise of the migration and invasion ability, as well as the expression of Slug and MMP-2 (all P<0.05). Conversely, CaOV3 cells had a higher protein expression of CTHRC1. By using lenti-shCTHRC1, a remarkable knockdown of CTHRC1 was obtained. Likewise, the capability of migration and invasion was decreased, and the Slug and MMP-2 expression was reduced (all P<0.05). Conclusion · CTHRC1 might positively regulate Slug and MMP-2 to promote ovarian cancer cell metastasis.
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    Construction of shRNA lentivirus vector targeting rat Eap1 gene and Eap1 effects on Kiss1 gene at cellular level
    LI Chen-xi, LI Pin
    2017, 37 (04):  443. 
    doi: 10.3969/j.issn.1674-8115.2017.04.004

    Abstract ( 600 )   PDF (6384KB) ( 954 )  
    Objective · To construct effective shRNA-lentiviral vector targeting rat Eap1 gene and explore the effect of Eap1 on Kiss1 at cellular level. Methods · Four shRNA sequences targeting rat Eap1 mRNA and one negative control sequence were designed and synthesized, and then recombined with lentiviral vectors. After DNA sequencing identification, the shRNA recombinant vectors were co-transfected into 293T cells with pGag/Pol, pRev, pVSV-G to packaging lentiviral particles and the virus titers were determined. NRK-52E cells were transfected with all the four lentiviral-Eap1-shRNAs and the negative control lentivirus, and cells were harvested after 72 h. Real-time PCR and Western blotting was performed to detect the change of the mRNA and protein level
    of Eap1 gene. The most effective LV-Eap1-shRNA was used to infect NRK-52E cells [non-lentivirus and Eap1-shRNA(-) lentivirus as control groups], and
    then the level of Kiss1 mRNA expression was detected after infection for 72 h. Results · Seventy-two hours after transfection, the Eap1 mRNA and protein
    expression between blank group and LV-shRNA(-) group showed no significant difference; while Eap1 expression in all LV-Eapl-shRNA groups reduced
    significantly in comparing to the control groups. In addition, the lentiviral-Eap1-shRNA4 was the most effective in RNA interference. After blocking Eap1
    expression in NRK-52E cells, the Kiss1 mRNA level was significantly increased comparing to the control groups. Conclusion · The effective Eap1-shRNA
    lentiviral vector is established successfully. The Kiss1 gene expression decreases after blocking Eap1 in NRK-52E cell line.
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    Effect of Let-7a on osteoporosis by regulating proliferation of bone marrow mesenchymal stem cells
    YAN Luan, YANG De-qin
    2017, 37 (04):  448. 
    doi: 10.3969/j.issn.1674-8115.2017.04.005

    Abstract ( 638 )   PDF (6511KB) ( 889 )  
    Objective · To explore the effect of Let-7a regulating bone mesenchymal stem cells (BMSC) proliferation on osteoporosis. Methods · Eightweek-old healthy female mice were obtained to establish ovariectomy (OVX) and sham animal models. Micro-CT was applied to detect the parameters of bone density, bone volume fraction and trabecular number of both groups two months after surgery. MTT was used to detect the proliferation ability of BMSC in OVX and sham groups. Real-time PCR was used to detect the expression of Let-7a. After up-regulating or down-regulating the expression of Let-7a, MTT was also used to detect the proliferation ability of BMSC. Results · The results of Micro-CT showed that compared with sham group, bone density, bone volume fraction and trabecular number of OVX group were significant declined. Increased adipogenic ability and impaired osteogenic ability was found in BMSC in OVX group, in comparison with sham group. The proliferation ability of BMSC in OVX group was declined compared with sham group. The expression of Let-7a in OVX group was significantly increased compared with Sham group. The proliferation ability of BMSC was decreased when the expression of Let-7a was up-regulated, while increased when its expression was down-regulated. Conclusion · High expression of Let-7a inhibit the proliferation of BMSC, which may result in the pathogenesis of postmenopausal osteoporosis.
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    Synthesis and identification of sinomenine derivate 4EDB and its therapeutic effects on mice with experimental autoimmune myocarditis
    SU Xiao-lian, Lü Hong-xiang, JIANG Yuan-yuan, ZHOU Shan-shan, TANG Qing, SU Zhao-liang, SHAO Xiao-yi
    2017, 37 (04):  453. 
    doi: 10.3969/j.issn.1674-8115.2017.04.006

    Abstract ( 570 )   PDF (5819KB) ( 1073 )  
    Objective · To synthesize 4EDB, the derivative of sinomenine, and to observe its therapeutic effects on mice with experimental autoimmune myocarditis (EAM). Methods · The BALB/c mice were randomly divided into three groups: control group, EAM group and EAM+4EDB group with 6 mice in each group, and then treated with 4EDB [5 mg/(kg·d)] by intragastric administration from the 14th day of immunization until sacrificed on the 21th day. Hematoxylin-eosin (H-E) staining was used to identify the areas of inflammation, and the hematoxylin-picrosirius red staining was used to detect the degree of myocardial fibrosis. The expression levels of related inflammatory factors including IL-1, IL-6, IL-17A and TGF-β in myocardial tissues were detected by real-time PCR. Results · Compared with EAM group, the pathological score of myocardial inflammation decreased in EAM+4EDB group (P=0.020), with myocardial fibrosis alleviated, and the expression levels of inflammatory cytokines including IL-1, IL-6, IL-17A and TGF-β in myocardium reduced (P<0.05). Conclusion · The new derivative of sinomenine, 4EDB, can alleviate the myocarditis in EAM mice, and the inhibition of inflammatory factors may play an important role.
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    Analysis of IL-8 secretion in THP-1 cells stimulated by lipopolysaccharide and capsular polyssacharide extracted from Porphyromonas gingivalis
     
    WANG Yi-wei, LIU Da-li, SHU Rong
    2017, 37 (04):  458. 
    doi: 10.3969/j.issn.1674-8115.2017.04.007

    Abstract ( 676 )   PDF (5615KB) ( 847 )  

    Objective · To isolate lipopolysaccharide (LPS) and capsular polysaccharide (CPS) from Porphyromonas gingivalis (Pg) and analyze their ability to induce THP-1 cells to secrete interleukin 8 (IL-8) in vitro. Methods · LPS and CPS were isolated from the polysaccharides by gel filtration chromatography, which had already been extracted from Pg ATCC33277 and SJD4. The isolated LPS and CPS from different strains were used to stimulate THP-1 cells in different doses and for different periods. The level of IL-8 in the cell culture suspension was measured by ELISA. Results · LPS and CPS were successfully separated from the polysaccharides in Pg ATCC33277 and SJD4. The relative molecular masses of LPS and CPS were 20 000–50 000 and 150 000–500 000, respectively. LPS and CPS could induce THP-1 cells to produce IL-8 in vitro in a time- and dose-dependent manner. The effect of LPS from ATCC33277 on secretion of IL-8 was greater than that of CPS with the dose of 0.1 μg/mL (P<0.05). However, the difference could only be found at 24 h in SJD4, and the effect of CPS was greater (P<0.05). Conclusion · As a component of polysaccharides extracted from Pg, CPS can induce THP-1 cells to secrete IL-8 in vitro in a time- and dose-dependent manner.

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    Effect of activating PKA signaling on dedifferentiation of podocytes in adriamycin-induced nephropathy mice
    JIANG Jin-xing, XIANG Peng, CHEN Xiao-huan, AYIJIAKEN Kasimumali, XIE Ke-wei, NI Zhao-hui, GU Le-yi
    2017, 37 (04):  462. 
    doi: 10.3969/j.issn.1674-8115.2017.04.008

    Abstract ( 638 )   PDF (6862KB) ( 690 )  
    Objective · To explore effects of pCPT-cAMP on proteinuria and dedifferentiation of podocytes in adriamycin (ADR)-induced nephropathy mice. Methods · Male BALB/c mice were divided into three groups. The control group did not make any intervention, and the other mice were administrated with ADR in a dose of 10 mg/kg by intravenous injection (ADR group). Some ADR-injected mice were treated with pCPT-cAMP [50 mg/(kg·d)] by intraperitoneal injection everyday (A+P group). Albumin urine was detected by Coomassie blue stain. Urine creatinine concentration was estimated by ELISA. The expression of WT-1 was detected by immunohistochemical staining. Immunofluorescence staining and Western blotting were used to evulate the dedifferentiation of podocytes. Results · Compared with the control group, the ratio of urinary albumin/creatinine in ADR nephropathy mice was significantly increased. WT-1 immunohistochemical staining showed that the number of podocytes was significantly decreased, while immunofluorescence double staining of podocyte-specific protein synaptopodin and podocalyxin remarkably reduced, and the expression of desmin was increased. pCPT-cAMP intervention decreased the ratio of albumin/creatinine in ADR mice, elevated the quantity of WT-1 positive cells and the expression of synaptopodin and podocalyxin, while desmin expression decreased. Conclusion · pCPT-cAMP activates the PKA signaling and protects ADR nephropathy mice by preventing the loss of podocytes and ameliorating the urine albumin/creatinine ratio, which may be mediated by pCPT-cAMPprevented dedifferentiation of podocytes.
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    Effects of the estrogen deficiency on Notch signaling pathway in osteoarthritis
    FU Chao, LI Yong, LI Li-feng, XIAO Ting-ting, MA Xiang-yu, ZHANG Bi
    2017, 37 (04):  467. 
    doi: 10.3969/j.issn.1674-8115.2017.04.009

    Abstract ( 554 )   PDF (8385KB) ( 839 )  
    Objective · To investigate the effects of estrogen deficiency on Notch signaling pathway in osteoarthritis via an estrogen deficiency-osteoarthritis model. Methods · Twenty female SD rats were randomly assigned to the experimental group (undergoing bilateral ovariectomy) and the control group (sham operation). Each group was further divided into the osteoarthritis subgroup (injection of collagenase into the articular cavity) and the non-osteoarthritis subgroup (injection of normal saline into the articular cavity). Knee specimens were collected after 6 weeks and the morphological changes of the articular cartilage were observed. Expressions of interleukin-1β (IL-1β), matrix metalloproteinases-1 (MMP-1), type Ⅱ collagen (Col Ⅱ), and Notch2 were measured with immunohistochemistry. Results · The degeneration of articular cartilage was more severe in the experimental-osteoarthritis subgroup than in the control-osteoarthritis subgroup. The expressions of IL-1β and MMP-1 in the experimental-osteoarthritis subgroup were higher and the expressions of Col Ⅱ and Notch2 were lower. The differences in measurement results of related indexes between the experimental-non-osteoarthritis subgroup and the control-non-osteoarthritis subgroup were not significant. Conclusion · The estrogen deficiency can down-regulate the expression of Notch signaling in cartilage tissues of rats with osteoarthritis.
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    Effects of IGF-1 on PRNP expression and APP metabolism of PC12 cells
    JIANG Guo-hong, WANG Chang-ming, ZHANG Li
    2017, 37 (04):  473. 
    doi: 10.3969/j.issn.1674-8115.2017.04.010

    Abstract ( 605 )   PDF (6150KB) ( 1042 )  
    Objective · To investigate the effects of insulin-like growth factor 1 on prion encoding gene (PRNP) expression and amyloid precursor protein (APP) metabolism of PC12 cells. Methods · After PC12 cells were treated with 20, 40, 80 ng/mL IGF-1 for 24 h, real-time PCR was used to detect the mRNA expression levels of PRNP, and Western blotting was used to detect the protein levels of AKT, phosphorylation of AKT (pAKT), ERK and phosphorylation of AKT (pERK). The level of β-amyloid 42 (Aβ42) in supernatant fluid was detected by ELISA. Results · Compared with the blank control group, the expression of PRNP mRNA in Alzheimer’s disease (AD) model group was increased significantly (P<0.01). The expression of PRNP mRNA was significantly increased after cells were treated with 40 and 80 ng/mL IGF-1 for 24 h (P<0.01). There was no significant difference in APP protein expression among AD model group and three IGF-1 treatment groups (P>0.05). Compared with the blank control group, the level of Aβ42 in supernatant fluid of model group was decreased significantly with the increasing of IGF-1 concentration. The expression level of Aβ42 was decreased significantly in 40 and 80 ng/ml IGF-1 treatment group (P<0.05). The expression of AKT/pAKT, ERK/pERK in AD model group was significantly increased along with the increasing of IGF-1 concentration (P<0.05). Conclusion · IGF-1 could regulate the expression of PRNP gene and effect the metabolism of APP, which may be associated with PI3K/AKT, MAPK/ERK1/2 signaling pathway.
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    Effects of interleukin-1β on intra-amniotic lipopolysaccharide-induced alveolar arrest in neonatal rats
    YANG Yi-hui, LIU Cheng-bo, CHEN Ze, LI Wen, ZHANG Yong-jun
    2017, 37 (04):  478. 
    doi: 10.3969/j.issn.1674-8115.2017.04.011

    Abstract ( 559 )   PDF (7374KB) ( 567 )  
    Objective · To investigate the effects of interleukin-1β (IL-1β) on neonatal rat alveolar arrest induced by intra-amniotic injection of lipopolysaccharide (LPS). Methods · A neonatal SD rat model of bronchopulmonary dysplasia (BPD) was constructed by intra-amniotic injection of LPS in pregnant rats. The pregnant rats (E19) were randomly assigned to Saline group, LPS group and LPS+anti-IL-1β group. The lungs of the neonatal rats were randomly collected 1, 3 and 7 days after birth. Pathological changes in the lungs were observed by hematoxylin-eosin (H-E) staining, and expression of IL-1β mRNA and protein was detected by real-time PCR and ELISA, respectively. Rat bone marrow derived primary macrophage was cultured in vitro, and given LPS intervention, then genes related with IL-1β were detected through whole transcriptome sequencing. Results · Compared with the Saline group, the alveolar counts and secondary septa counts significantly decreased, and mean liner intercept significantly increased in LPS group. Moreover, the expression of IL-1β mRNA and protein in lungs significantly increased in LPS group. The LPS-induced pathological changes of lung tissues in neonatal rats were improved by anti-IL-1β. LPS could up-regulate the expression of genes including Gbp5, Ccl3, Nod2, Ccr5, Mefv, Casp4 and Ifnar1, but down-regulate Lgals9 and Gstp1. Among these genes Gbp5, Ccl3, Nod2, Ccr5, Casp4, Ifnar1 and Lgals9 could positively regulate IL-1β production. Conclusion · LPS can induce alveolar arrest through up-regulating the expression of IL-1β in macrophages in neonatal rat BPD model. Whole transcriptome sequencing reveals that LPS can regulate the expression of IL-1β in macrophages through several paths.
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    Stress analysis of the supporting tissues for mandibular Kennedy Class Ⅰ defect repaired with removable partial dentures supported by implants
    ZHANG Shuo, FAN Rui*,ZHENG Yuan-li
    2017, 37 (04):  483. 
    doi: 10.3969/j.issn.1674-8115.2017.04.012

    Abstract ( 582 )   PDF (9814KB) ( 635 )  
    Objective · To compare the stress distribution at abutments, edentulous ridge, and peri-implant tissue under the vertical load between the RPI-type removable partial denture supported by implants with different diameter and the conventional RPI-type removable partial denture using a three-dimensional photoelastic method. Methods · The mandibular Kennedy I type denture defect models were fabricated according to the standard mandibular model. Four Straumann system soft tissue level implants with different diameters (two 4.1 mm implants and two 3.3 mm implants) were implanted into the bilateral first molar areas. Planting nails and epoxy resin teeth were inversely put into the mandibular silicone rubber molds to fabricate the epoxy resin photoelastic models and the regular neck (RN) healing abutments were screwed into the implants. A simulated alveolar mucosa with thickness of 2mm and a conventional RPI-type removable partial denture were placed on the epoxy resin models with or without implants. Then a force of 1 kg was vertically applied by a bite force loading device which fixed the model and denture in the centric occlusion. After the stress was frozen, model slices at different areas were cut and the stress fringes were observed. The stress was calculated according to the fringe value of per unit thickness. Results · For the conventional RPI-type removable partial denture, the maximum stress of distal abutment was mainly concentrated on the apical regions and the maximum stress of edentulous ridge was concentrated on the first molar area, particular on the lingual side of alveolar bone. For the implant-supported RPI-type removable partial denture, the maximum stress of distal abutment was lower than that of the conventional RPI-type removable partial denture, and the maximum stress of edentulous ridge (without the implants) was similar to that of abutment and supporting tissues and was lower than that of the conventional RPI-type removable partial denture. The stress around the implant was the largest and the peri-apical stress of implant was greater than the neck stress of implant. Meanwhile, the maximum stress around the implant was increased with the decrease of implant diameter. Conclusion · Compared to the conventional RPI-type removable partial denture, removable partial dentures supported by implants are more stable with a more balanced stress distribution in supporting tissues, thus benefit the health of abutments and supporting tissues.
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    Original article (Clinical research)
    Comparative study of clinical features between different subtype bipolar patients with first mania episode
    ZHOU Ru-bai, HONG Wu, ZHAO Guo-qing, HUANG Jia, SU You-song, WANG Yong, HU Ying-yan, CAO Lan, YUAN Cheng-mei, PENG Dai-hui, WU Zhi-guo, WANG Zuo-wei, XING Meng-juan, CHEN Jun, FANG Yi-ru
    2017, 37 (04):  490. 
    doi: 10.3969/j.issn.1674-8115.2017.04.013

    Abstract ( 639 )   PDF (7599KB) ( 609 )  
     Objective · To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods · This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (group Ⅰ), mania without psychotic symptoms (group Ⅱ), mania with psychotic symptoms (group Ⅲ ) and mixed state (group Ⅳ ). Results · There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ , Ⅲ , Ⅳ were further compared with group Ⅱ , which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ , but anxiety related symptoms was significantly higher in group Ⅰ , Ⅲ , Ⅳ . Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion · The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.
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    Comparison of 99mTc-MIBI SPECT/CT and ultrasonography in diagnosis of hyperparathyroidism
    XU Lian, SUN Xiao-guang, LIU Jian-jun, ZHOU Ming-ge, JIANG Zhou
    2017, 37 (04):  496. 
    doi: 10.3969/j.issn.1674-8115.2017.04.014

    Abstract ( 536 )   PDF (5663KB) ( 858 )  
    Objective · To explore the diagnostic value of 99mTc-sestamibi (99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) and ultrasonography in hyperparathyroidism. Methods · Fifty patients with hyperparathyroidism were included. 99mTc-MIBI SPECT/CT was performed before operations in all patients, while ultrasonography was performed in 33 patients. The diagnostic efficiency was calculated for both imaging methods in comparison to pathological data. Results · Serum parathyroid hormone (PTH) levels were 352.0 (141.5–846.0) pg/mL and 1 792.0 (1 018.5–2 358.5) pg/mL, respectively, in primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT), while maximum diameters of lesion were 14.5 (9.0–20.9) mm and 10.0 (8.0–12.6) mm, respectively (both P<0.01). The accuracy of SPECT/CT were 97.7% and 62.5%, respectively (P<0.01), in PHPT and SHPT. In 33 patients, the sensitivity and accuracy of SPECT/CT were 66.3% and 74.2%, respectively, whereas the sensitivity and accuracy of ultrasonography were 45.7% and 61.4%, respectively (both P<0.05). Conclusion · Serum PTH levels were higher, while maximum diameters of lesion were longer in PHPT than that in SHPT, and the diagnostic efficiency was also higher in PHPT than that in SHPT. In the other hand, the sensitivity and accuracy of SPECT/CT were higher than that of ultrasonography.
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    Value of ultrasonography in predicting the birth weight discordance of twin pregnancy
    SUN Jin-ling, NIU Jian-mei, GAO Jia-qi, Lü Shu-ping, WANG Yan-lin
    2017, 37 (04):  500. 
    doi: 10.3969/j.issn.1674-8115.2017.04.015

    Abstract ( 633 )   PDF (6811KB) ( 877 )  

     Objective · To identify the relationship between the estimated fetal weight (EFW) discordance and birth weight (BW) discordance, and evaluate the accuracy of ultrasonography in predicting birth weight discordance (ΔBW) of twin pregnancy. Methods · The ultrasound was used to detect the growth of twins at different gestational weeks and the data were analyzed to compare the difference between EFW discordance (ΔEFW) and ΔBW. Results · About 15.9 percent of twins (totally 277 cases) had severe ΔBW (ΔBW ≥20%) in our study, and the percentages of dichorionic-diamniotic twin (DCDA) and monochorionic-diamniotic twin (MCDA) were 68.2% and 31.8%, respectively (P>0.01). Compared with ΔEFW in other gestational weeks, ΔEFW last time before parturition was most consistent of ΔBW. Furthermore, the negative predictive value of MCDA was highest (94%) at 22–24 gestational weeks. Conclusion · Twin ΔBW was relatively better predicted by ΔEFW last time before parturition. Twin pregnancy without severe ΔEFW (ΔEFW<20%), especially MCDA with ΔEFW<20% at 22–24 weeks, had low probability of selective intrauterine growth restriction in the future.

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    Observation of preoperative cerebral tissue oxygenation in children with congenital heart disease
    JIANG Jing, BIAN Yong, HOU Hui-yan, JI Ying-ying, WANG Lu, HUANG Yue
    2017, 37 (04):  506. 
    doi: 10.3969/j.issn.1674-8115.2017.04.016

    Abstract ( 601 )   PDF (5459KB) ( 800 )  
    Objective · To explore the effect of intracardiac shunts direction on preoperative cerebral tissue oxygenation in children with congenital heart disease. Methods · Sixty children aged from 4 to 24 months diagnosed with ventricular septal defect (VSD group), tetralogy of Fallot (TOF group) and indirect inguinal hernia (control group) undergoing elective surgeries were recruited, with 20 cases in each group. The NIRS cerebral oximeter was used to monitor TOI of patients. Two sensors were placed on the subject’s forehead bilaterally for continuous monitoring of cerebral oximetry. Pulse oxygen saturation (SpO2), noninvasive blood pressure, heart rate were also measured and recorded. TOI and fractional tissue oxygen extraction (FTOE) were compared among the three groups and multiple linear regression analysis was used to evaluate the relationship between TOI and these parameters. Results · There was no significant difference in TOI between VSD group and control group (P>0.05). Both sides of TOI in TOF group were significantly lower than those in other two groups (P=0.000) and FTOE in TOF group were significantly higher than those in VSD group (P=0.005). Multiple linear regression analysis showed that only SpO2 was related to TOI in children with congenital heart disease (r=0.560, P=0.000). Conclusion · Different intracardiac shunts direction can affect cerebral tissue oxygenation through affecting systemic oxygen supply. Children with right-to-left shunt physiology have lower TOI and higher FTOE due to low systemic oxygenation.
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    Effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgery-transforaminal lumbar interbody fusion
    CAI Xiao-yang, Lü Hai-sheng, XIE You-zhuan
    2017, 37 (04):  510. 
    doi: 10.3969/j.issn.1674-8115.2017.04.017

    Abstract ( 801 )   PDF (6666KB) ( 978 )  
    Objective · To investigate the effect of early neurodynamic mobilization on the recurrence of sciatica after the minimally invasive surgerytransforaminal lumbar interbody fusion (MIS-TLIF). Methods · Fifty-four patients who underwent MIS-TLIF were divided into treatment group (n=28) and control group (n=26). The control group received conventional rehabilitation treatment, while the treatment group received neurodynamic mobilization every day after the first post-operative day. The score of visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were evaluated before and after the treatment. Results · There was no significant difference in the score of VAS or JOA between two groups before the treatment or three months after surgery (P>0.05). The score of VAS was significantly lower (P<0.05), and the JOA score was significantly higher (P<0.05) in the treatment group than in the control group four days after surgery. Conclusion · The early neurodynamic mobilization is effective to decrease the recurrence rate of sciatica in patients underwent MIS-TLIF.
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    Investigation of catheter-related thrombosis around the port in patients with breast cancer after chemotherapy
    CHEN Li, LUO Feng, XING Lei, LI Hong-yuan, LIU Hong
    2017, 37 (04):  514. 
    doi: 10.3969/j.issn.1674-8115.2017.04.018

    Abstract ( 1569 )   PDF (5742KB) ( 968 )  
    Objective · To investigate the incidence, risk factors and treatment of the catheter-related thrombosis (CRT) in breast cancer patients after implantation of totally implantable venous access port (TIVAP) in chemotherapy. Methods · A total of 190 cases after implantation of TIVAP were investigated. Color Doppler ultrasound was used to monitor the neck blood vessels to find whether there was CRT before chemotherapy and before taking out the port. The incidence of CRT, occurrence time, risk factors and treatment efficacy were observed. Results · There were 112 (58.9%) cases with CRT and 108 (56.8%) patients with asymptomatic thrombosis, and only 4 cases had symptomatic thrombosis, the incidence of which was 2.1%. Most thrombosis developed on the 21th day after catheterization, and the patients over the age of 60, with clinical stage III – IV and chemotherapy regimens TEC (docetaxel combined pirubicin and cyclophosphamide) were the risk factors for thrombosis. All the patients with asymptomatic thrombosis accepted anticoagulant treatment with low molecular heparin, earthworms enzyme or aspirin, respectively, but there was no significant difference in efficacy in the three groups (P=0.743). Conclusion · Port catheter related symptomatic thrombosis incidence is low but the incidence of symptomatic thrombosis is high in the breast cancer patients after chemotherapy. Age, tumor stage and TEC chemotherapy regimens are the risk factors for catheter-related thrombosis.
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    Effect of aspirin on uterine hemodynamics in patients with early recurrent spontaneous abortion
    WANG Tong-fei, HE Li-ying, KANG Xiao-min, LIU Zhi-lan, XU Hai-jing, LIU Fang-sun, ZHAO Ai-min
    2017, 37 (04):  518. 
    doi: 10.3969/j.issn.1674-8115.2017.04.019

    Abstract ( 729 )   PDF (7164KB) ( 752 )  
    Objective · To study the hemodynamic parameters of uterine at midluteal phase in patients with early recurrent spontaneous abortion (ERSA) and the effect of aspirin on them. Methods · Transvaginal color Doppler ultrasonography was used to measure the parameters of uterine blood flow and the endometrial thickness at midluteal phase of 271 women with ERSA (ERSA group) and 66 women without a history of recurrent spontaneous abortion (control group). Then ERSA group were administered with aspirin 50 mg/d orally for 2 months and other individualized treatment, and the effect of aspirin on parameters of uterine blood flow and the early pregnancy outcome of them were observed. Results · At midluteal phase, the endometrium was significantly thinner in ERSA group than that in control group. Pulsatility index (PI) of endometrial blood flow and mean PI (mPI), mean resistance index (mRI), and mean systolic/diastolic ratio value (mS/D) of uterine arteries were statistically significantly higher in ERSA group in comparison to control group (P<0.05). Following aspirin treatment, resistance to uterine blood flow reduced significantly in ERSA group (P=0.000), and the endometrial thickness increased in the patients with endometrial thickness less than 7 mm (P=0.000). Only 163 ERSA patients were re-examined by transvaginal color Doppler ultrasonography after aspirin treatment, among whom 136 women was pregnant after individualized treatment. Among these pregnant patients, 97 cases were pregnant for more than or equal to 12 weeks, while 10 cases aborted during the first 12 weeks, and the early pregnancy outcomes of the other 29 cases were still unclear. Conclusion · In comparison with normal fertile women, ERSA patients have significantly higher resistance to uterine blood flow and thinner endometrium. Aspirin can improve uterine blood perfusion, which improves early pregnancy outcome.
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    Original article (Preventive medicine)
    Changes of exhaled nitric oxide level in patients with chronic obstructive pulmonary disease and its clinical significance
    WANG Hai-feng, YANG Wen-lin, WANG Li-hua
    2017, 37 (04):  523. 
    doi: 10.3969/j.issn.1674-8115.2017.04.020

    Abstract ( 666 )   PDF (5104KB) ( 988 )  
    Objective · To observe changes of exhaled nitric oxide (FeNO) level in patients with chronic obstructive pulmonary disease (COPD) before and after inhaled corticosteroid (ICS) therapy and to explore the correlation of FeNO level with inflammation and pulmonary function indexes. Methods · Seventy COPD patients at stable stage who underwent ICS therapy (the COPD group) were enrolled. Levels of peripheral blood eosinophil (Eos) and neutrophil (N), FeNO, PEF, FEV1 and FEV1/pred before and after treatment were measured. Fifty healthy volunteers who received physical examination at the same time served as controls (the control group). The relationship between these indexes and clinical efficacy and the correlation between FeNO level and inflammation or pulmonary function indexes were analyzed. Results · The COPD group had significantly higher FeNO, Eos, and N levels before treatment, significantly lower PEF, FEV1 and FEV1/pred after treatment (P<0.05), and remarkably better indexes after treatment (P<0.05) compared with the control group. Indexes of the effective group and the improved group were significantly better than that of the ineffective group after treatment. Results of correlation analysis showed that before treatment, the FeNO level was positively correlated with peripheral blood Eos and N levels (P<0.05) and negatively correlated with PEF, FEV1 and FEV1/pred (P<0.05). After treatment, the FeNO level was positively correlated with peripheral blood Eos and N levels (P<0.05) and the correlation of the FeNO level with PEF, FEV1 and FEV1/pred was not statistically significant (P>0.05). Conclusion · The FeNO level increased significantly in patients with COPD at stable stage and is a sensitive index of airway inflammation. Combined with lung function test, it’s useful for evaluating the efficacy of ICS and guiding treatment.
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    Original article (Clinical research)
    Analysis of distribution and drug resistance of pathogenic bacteria in burn wards
    XU Zheng-peng, WANG Su, HAN Li-zhong, WANG Wen-kui
    2017, 37 (04):  527. 
    doi: 10.3969/j.issn.1674-8115.2017.04.021

    Abstract ( 572 )   PDF (6428KB) ( 706 )  
    Objective · To analyze changes in the type distribution and drug resistance of pathogenic bacteria isolated from burn wards and to provide evidence for rational use of antibiotics, reduction of drug-resistant isolates, and hospital infection control. Methods · Isolates from burn patients were collected from January 2011 to December 2014. Statistical analysis of infection sources, type distribution, and changes in resistance rates of main pathogens during the four year period was performed. Results · A total of 2 399 isolates were collected, including 1 286 (53.61%) gram-negative bacilli (G-b), 1 088 (45.35%) gram-positive cocci (G+c), and 25 (1.04%) fungi. The most common G-b pathogens were Pseudomonas aeruginosa (447, 34.76%) and Acinetobacter baumannii (369, 28.69%). The most common G+c pathogen and fungus were Staphylococcus aureus (489, 44.94%) and Candida albicans (8, 33.33%), respectively. In the last two years, the detection rates of S.aureus and A.baumannii were significantly lower and the detection rate of P.aeruginosa was significantly higher than those in the first two years (P<0.05). P.aeruginosa and A.baumannii showed high resistance (>80%) to the third and fourth generation cephalosporins, carbapenems, aminoglycosides and quinolones, but the changes were not statistically significant (P>0.05). S.aureus was only highly resistant to penicillin (97.58%) and was 100% susceptible to vancomycin. Its resistance rates toward cefazolin, ampicillin/sulbactam, gentamicin, levofloxacin, and rifampin decreased significantly (P<0.05). The detection rate of methicillin-resistant S. aureus (MRSA) dropped from 72.28% to 63.00%. Conclusion · Many types of drug resistant bacteria were detected in burn wards. The drug resistance problem was serious. Improving management and rational use of antibiotics can reduce the occurrence of drug-resistant bacteria and increase the efficacy of clinical anti-infective treatment and nosocomial infection control.
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    Study on haptoglobin polymorphism and plasma concentration in patients with polycystic ovarian syndrome
    WANG Liu, QIU Yan
    2017, 37 (04):  532. 
    doi: 10.3969/j.issn.1674-8115.2017.04.022

    Abstract ( 614 )   PDF (8150KB) ( 528 )  

    Objective · To investigate the correlation between the serum haptoglobin (Hp) level and the metabolic parameters in patients with polycystic ovarian syndrome (PCOS), and explore the distribution of Hp genotype and allele frequency in PCOS patients and their correlations with PCOS. Methods · A total of 106 patients with PCOS and 86 cases of patients with non-hyperandrogenic and regular menstruation (control group) were enrolled. Serum Hp level was measured by enzyme-linked immunosorbent assay (ELISA); Hp genotype and allele frequency were determined by polymerase chain reaction (PCR), respectively. Results · The serum Hp level in PCOS group was significant higher than that in the control group (P=0.000). Correlation analysis reveals that serum Hp level was positively related to body mass index (BMI) (P=0.000) and homeostatic model assessment insulin resistance (HOMA-IR) (P=0.000). Compared with control group, proportion of Hp2-2 genotype (Hp2/Hp2) increased significantly in PCOS group (P=0.006), and the frequency of Hp2 allele was also higher (P=0.002). Conclusion · Serum Hp level was positively related to BMI and HOMA-IR, which maybe associated with the occurrence and development of obesity and insulin resistance. Patients with Hp2-2 genotype might have genetic predisposition to PCOS, and high frequency Hp2 allele was found in them.

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    Clinical analysis of 77 cases with ovarian hyperstimulation syndrome
    QIAN Min, LIU Jian-hua
    2017, 37 (04):  538. 
    doi: 10.3969/j.issn.1674-8115.2017.04.023

    Abstract ( 484 )   PDF (5951KB) ( 912 )  
    Objective · To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods · Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results · Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion · The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required.
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    Investigation on the reference range for 25-hydroxyvitamin D in second trimester pregnant women in Shanghai
    LI Dong-ping, LI Ze-zhi, XIAO Shi-jin
    2017, 37 (04):  542. 
    doi: 10.3969/j.issn.1674-8115.2017.04.024

    Abstract ( 1036 )   PDF (4524KB) ( 957 )  
    Objective · To investigate the reference range for serum 25-hydroxyvitamin D in pregnant women in Shanghai. Methods · A total of 4 969 healthy pregnant women in second trimester were enrolled, in whom there were 554 women aged over or equal to 35 years old and 4 415 women aged under 35 years old. Meanwhile, 1 048 non-pregnant women in child-bearing period were enrolled. The new born children had no complications of vitamin D deficiency such as rickets. The levels of 25-hydroxyvitamin D of all participants were detected by ELISA. The reference interval was defined as the central 95% range between the 2.5th and the 97.5th percentiles. Results · The 95% reference range for 25-hydroxyvitamin D levels showed a positive skewness distribution in second trimester pregnant women. The median of 25-hydroxyvitamin D levels was 36.8 nmol/L. The maximum was 108.6 nmol/ L whereas the minimum was 11.8 nmol/L. The 95% reference range for 25-hydroxyvitamin D levels was from 15.9 nmol/L to 70.3 nmol/L. The median 25-hydroxyvitamin D was 36.6 nmol/L in women less than 35 years old, and 35.5 nmol/L in women aged over or equal to 35 years old. A significant difference was found between women aged under 35 years old and women aged over or equal to 35 years old (Z=-2.75, P<0.05). The median, maximum and minimum of 25-hydroxyvitamin D in non-pregnant women was 38.5 nmol/L, 110.5 nmol/L, 12.1 nmol/L, respectively, which were all higher than those in pregnant women (P<0.05). Conclusion · There was a lack of vitamin D in pregnant women in Shanghai, especially in pregnant women aged over or equal to 35 years old, despite the multivitamin supplements. However, no complications of vitamin D deficiency such as rickets were found in new born children. To determine the reference range of vitamin D in Shanghai is helpful for pregnancy women in taking vitamin supplement, especially important in preventing maternal and fetal complications caused by vitamin D deficiency.
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    Original article (Public health)
    Epidemiological study on periodontal health status of medical students
    LI Chao-lun, LIU Da-li, XIE Yu-feng, SONG Zhong-chen, GE Lin-hua, SHU Rong
    2017, 37 (04):  545. 
    doi: 10.3969/j.issn.1674-8115.2017.04.025

    Abstract ( 554 )   PDF (7218KB) ( 759 )  
    Objective · To investigate and analyze periodontal health knowledge and behaviors in medical students and the relationship of these knowledge and behaviors with periodontal health status, and to determine the periodontal health level of this population. Methods · A total of 602 medical students were included in this cross-sectional epidemiological study. The questionnaire covered sociodemographic information, periodontal health-related behaviors and knowledge, experience about themselves, and periodontal health of parents, etc. Meanwhile, periodontal health indices of index teeth were examined, including probing depth (PD), clinical attachment loss (CAL), and bleeding on probing (BOP), etc. Results · Of 570 subjects aged 16-26 who completed the survey, 79.82% never used dental floss, and 78.25% never underwent periodontal debridement. 50.25% of the index teeth had BOP, and only 0.70% of the subjects had no BOP. 81.05% of the subjects had some degree of periodontal attachment loss. Male students were more susceptible to periodontitis (P=0.027) and gingivitis (P=0.012) than female students. Conclusion · No new risk factors affecting the periodontal health are identified. Regular periodontal cleaning and protection are important for young people to prevent periodontitis.
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    Review
    Tet: novel anti-tumor drug target based on DNA demethylation
    GONG Wei, MENG-ZHOU Wen-li*, TIAN Na, LIN Guan-qiao, FU Tian-ran, ZHANG Liang
    2017, 37 (04):  551. 
    doi: 10.3969/j.issn.1674-8115.2017.04.026

    Abstract ( 955 )   PDF (8476KB) ( 1002 )  
    Tet (ten-eleven translocation) proteins belong to α-ketoglutaric acid (α-KG or 2-OG) and Fe2+ dependent dioxygenases. Tets are found to be involved in the unique mammalian DNA active demethylation process by specifically oxidizing the methyl group of 5-methylcytosine (5mC) in mammalian genome, and play critical roles in gene regulation in early embryonic development and stem cell differentiation via regulating the dynamic balance distribution of 5mC. Abnormal expression and function of Tets are closely associated with various hematological malignances, including myelodysplastic syndrome, chronic myelomonocytic leukemia, and acute lymphoblastic leukemia, as well as solid tumors. Hence, Tets and Tets-mediated DNA demethylation are novel anti-tumor drug targets. Investigation of biological function and catalytic mechanism of Tets is helpful for further understanding mechanisms of tumor incidence and development relevant to DNA demethylation pathway and can provide reference for developing new anti-tumor targeted drugs.
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    Function of mammalian alternative promoter and its relationship with disease
    NIE Yong-qiang, MA Qing-wen
    2017, 37 (04):  556. 
    doi: 10.3969/j.issn.1674-8115.2017.04.027

    Abstract ( 1148 )   PDF (8016KB) ( 1079 )  
    An alternative promoter is a variable region corresponding to initiating transcription of a gene. The use of alternative promoters has led to the diversification of cell types and tissue types and the regulation of complex developmental genes. Aberrant use of alternative promoters plays an important role in the incidence and development of various diseases. As a common mechanism, alternative promoters are versatile and flexible during gene expression regulation. This paper reviewed functional effects of using mammalian alternative promoters, as well as the relationship between alternative promoters and the incidence of diseases based on the latest published studies.
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    Research advances in the mechanism of osteoarthritis caused by the mechanical instability
    JI An-qi, DENG Guo-ying, WANG Qiu-gen, WANG Qian
    2017, 37 (04):  561. 
    doi: 10.3969/j.issn.1674-8115.2017.04.028

    Abstract ( 614 )   PDF (8563KB) ( 623 )  
    Osteoarthritis is a common articular cartilage degenerative disease and the main cause is mechanical instability. The mechanical instability can reduce the number of chondrocytes and destroy extracellular matrix through direct injury, inducing cell apoptosis, and stimulating the production of inflammatory factors, leading to decrease of matrix type II collagen and proteoglycan and degeneration of cartilage. Long-term cartilage degeneration can result in osteoarthritis. Therefore, understanding how mechanical instability leads to the incidence of osteoarthritis can better improve the course of osteoarthritis from the perspective of mechanics.
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    Research progresses of applying MALDI-TOF mass spectrometry in the detection of β-lactamase
    YU Jia-jia, YU Jing, LIU Ying
    2017, 37 (04):  566. 
    doi: 10.3969/j.issn.1674-8115.2017.04.029

    Abstract ( 580 )   PDF (9282KB) ( 731 )  
    Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) is an emerging tool for detecting microorganisms. It can be used not only for rapid identification of microorganisms, but also for the research of resistance mechanisms. Producing β-lactamase is the main mechanism for resistance of β-lactam antibiotics in Gram-negative bacilli. Currently using MALDI-TOF MS for rapid detection of bacterial β-lactamase has been widely reported, including detection of β-lactam hydrolysis activity of β-lactamase, direct detection of β-lactamase molecule, peptide and relevant proteins, and detection of the single nucleotide polymorphisms (SNPs) of β-lactamase gene. This paper reviews current application of MALDI-TOF MS to the detection of β-lactamase based on the latest research findings.
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