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    Translational medicine
    2017, 37 (05):  567. 
    Abstract ( 514 )   PDF (4035KB) ( 629 )  
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    Original article (Basic research)
    Metabolic profiling analysis associated with acquired erlotinib resistance of lung adenocarcinoma cells based on liquid chromatography–high resolution mass spectrometry
    MENG Shuang, WANG Yang*, LEI Hui-min, TANG Ya-bin, ZHU Liang
    2017, 37 (05):  571. 
    doi: 10.3969/j.issn.1674-8115.2017.05.001

    Abstract ( 748 )   PDF (9591KB) ( 856 )  

    Objective · To explore the change of metabolomic profiling after erlotinib (an epithelial growth factor receptor tyrosine kinase inhibitor) resistance of lung adenocarcinoma cells (PC9-ER), and find the differential metabolome associated with erlotinib resistance. Methods · Metabolic profiling of PC9-ER cells and homologous parent PC9 cells was acquired by the ultraperformance liquid chromatography tandem quadrupole time-of-flight mass spectrometry (UPLC-QTOF/MS). The data were analyzed by multi-dimensional statistical methods, such as partial least squares projection to latent structures-discriminant analysis (PLS-DA), to select and identify differential metabolites associated with erlotinib resistance. Results · A total of 14 differential metabolites were identified in PC9-ER cells. Seven up-regulated metabolites included N-acetylspermidine, phosphatidylethanolamine, AMP, pantothenic acid, proline, glutamate, and histidine, while seven down-regulated metabolites included citrulline, phosphorylcholine, glutathione, cysteinylglycine, glutathione oxidized, NAD, and S-adenosylmethionine, mainly participating in glutathione metabolism, glutamate metabolism, ammonia recycling, and protein biosynthesis. Conclusion · Metabolic profiling of erlotinib-resistant lung adenocarcinoma cells was changed. The information of differential metabolites associated with erlotinib resistance could provide clues for new resistance mechanisms and potential metabolism-related drug targets.

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    Establishment of a replicative senescence model of human gingival fibroblasts
    XIA Yi-ru, XIE Yu-feng, SHU Rong
    2017, 37 (05):  578. 
    doi: 10.3969/j.issn.1674-8115.2017.05.002

    Abstract ( 880 )   PDF (6706KB) ( 1321 )  

    Objective · To establish a replicative senescence model of human gingival fibroblasts (hGFs), investigate changes in aging related biological characteristics, and provide an efficient cell model for further study on the aging in periodontal diseases. Methods · hGFs were isolated from healthy gingival tissues and cultured with tissue block method in vitro. The tissue source was verified with immunofluorescence. hGFs were continuously cultured and cumulative population doublings (CPD) were calculated and used to draw the curves. Changes in the proliferative capacity of hGFs with CPDs of 10.82, 20.65, 29.52, 42.22, 60.79, and 70.03 were examined with CCK-8. Real-time PCR was used to evaluate changes in the mRNA expression of senescence-related genes p16INK4a and p21Cip1. Results · CPD curves showed that after continuous culture, the CPD value increased gradually and became stable after achieving 70.03. hGFs became flatter and more cell processes appeared with the increase of CPD value. The cell proliferative capacity declined and mRNA levels of p16INK4a and p21Cip1 significantly increased (P=0.000). Conclusion · A replicative senescence model of hGFs is established through continuous culture. CPD curves can reflect the aging of hGFs.

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    Identification and analysis of arsenic interactors by Escherichia coli proteome microarray
    LIU Yin, YANG Li-na, ZHANG Hai-nan, TAO Sheng-ce
    2017, 37 (05):  583. 
    doi: 10.3969/j.issn.1674-8115.2017.05.003

    Abstract ( 636 )   PDF (6907KB) ( 721 )  

    Objective · To globally study the influence of arsenite to the various biological pathways of Escherichia coli as a model organism. Methods · The protein-arsenite interactions was globally studied based on a proteome microarray constructed by 4 256 affinity-purified Escherichia coli proteins. The functions of interacting proteins and their network were then analyzed by bioinformatics. Results · 91 proteins that remarkably interact with arsenic were successfully identified. Bioinformatics analysis found that most of the proteins possess catalytic activity and are involved in various biosynthesis and cellular metabolism pathways. The interactions of arsenic with proteins encoded by malY, cfa and hypF genes were further validated by Western blotting, which proves the results of proteome microarray reliable. Conclusion · Arsenite interacts with a variety of enzymes of Escherichia coli and can greatly affect its biological metabolism.

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    Effect of adipose stem cells derived conditioned medium on fibrogenesis of dermal fibroblasts co-stimulated by transforming growth factor-β1
    SONG Fei, YUAN Bo
    2017, 37 (05):  588. 
    doi: 10.3969/j.issn.1674-8115.2017.05.004

    Abstract ( 703 )   PDF (7990KB) ( 641 )  

     Objective · To clarify effect of adipose stem cells derived conditioned medium (ASCs-CM) on fibrogenesis of dermal fibroblasts co-stimulated by transforming growth factor-β1 (TGF-β1), and explore the possible paracrine pathway of ASCs in regulating the dermal tissue rehabilitation. Methods · Co-stimulated by TGF-β1, dermal fibroblasts were treated with different concentrations of ASCs-CM. Various cellular events including cell proliferation, apoptosis, and mRNA and (or) protein levels of α-smooth muscle actin (α-SMA), type Ⅰ collagen (COL-1) , type Ⅲ collagen (COL-3), hepatocyte growth factor (HGF), basic fibroblast growth factor (FGF-2) were explored. Furthermore, the effect of HGF antibody on apoptosis of fibroblasts caused by ASCs-CM and TGF-β1 were also observed. Results · ASCs-CM inhibited fibroblasts proliferation caused by TGF-β1 and lead to cell apoptosis. α-SMA expression in fibroblasts was attenuated by 10% ASCs-CM +TGF-β1. It was demonstrated that 100% ASCs-CM with TGF-β1 had promoted collagens (especially COL-3) expression in fibroblasts, and increased HGF mRNA level as well. HGF antibody inhibited fibroblasts apoptosis produced by 100% ASCs-CM and TGF-β1. Conclusion · ASCs may have an effect on fibrogenesis of dermal fibroblasts co-stimulated by TGF-β1 through a paracrine way. High concentration of ASCs-CM not only increases collagen production and secretion, but also inhibits fibroblasts proliferation and accelerates apoptosis.

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    Effects of insulin on macrophage phenotype transformation under high glucose condition
    GAO Min, YANG Pei-lang, YU Tian-yi, LIU Yan, ZHANG Xiong
    2017, 37 (05):  595. 
    doi: 10.3969/j.issn.1674-8115.2017.05.005

    Abstract ( 1003 )   PDF (7299KB) ( 747 )  

    Objective · To investigate the effects of insulin on high glucose-cultured human mononuclear cell line THP-1 and macrophage phenotype transformation in diabetic wounds. Methods · THP-1 cells were cultured with normal (5.6 mmol/L) and high (25 mmol/L) glucose, respectively, stimulated with PMA for differentiation, and induced to M1 macrophages with LPS. After treated with insulin for 6 h, expression changes of M1 type macrophage markers inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), and interleukin-1β (IL-1β), as well as M2 type macrophage markers arginase1 (Arg1) and IL-10 were detected using real-time PCR and Western blotting. High fat diet feeding plus multiple intraperitoneal injections of low dose streptozotocin (STZ) were used to induce type II diabetes rat model. After blood glucose level has been stable for five weeks, two full-thickness skin wounds with the diameter of 1cm were made on the back of DM rats. Wounds were randomly assigned to being treated with insulin (0.2 U insulin /20 μL saline) or saline (20 μL saline) using the random number table. Characteristics of macrophage phenotypes were observed 3, 7, and 25 days after wounds were made. Normal rats (n=3) served as controls. Results · After being cultured with high glucose, the mRNA levels of M1 markers iNOS and TNF-α were up-regulated in LPS-induced THP-1 cells, while the mRNA levels of M2 markers Arg1 and IL-10 were down-regulated. After being treated with insulin for 6 h, mRNA levels of iNOS and TNF-α were down-regulated, protein levels of iNOS, IL-1β were down-regulated too, while mRNA and protein levels of Arg1 and IL-10 were up-regulated. In addition, the expression level of phosphorylated NF-κB-p65 was significantly increased after high glucose culture and was significantly decreased after insulin intervention. Compared to normal rat skin wounds, the expression of iNOS in macrophages was significantly increased in wounds of diabetic rats. The expression of iNOS in macrophages was high in saline treated wounds 3 and 7 days after the wounds were made and the expression of Arg1 was low 25 days after the wounds were made. In insulin treated wounds, the expression of iNOS started to decrease on day 7 after the wounds were made and the expression of Arg1 was significantly higher than that in saline treated wounds on day 25 after the wounds were made. Conclusion · Insulin can induce macrophage phenotype transformation from M1 to M2 under high glucose condition and the mechanism may be associated with the phosphorylation of NF-κB-p65.

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    Identification of biological characteristics of platelet-rich fibrin and its effects on proliferation and differentiation of adipose derived stem cells
    DING Li-dan, HU Yun, TANG Shi-jun, YANG Lan, CHEN Yang, ZHENG Lei-lei
    2017, 37 (05):  601. 
    doi: 10.3969/j.issn.1674-8115.2017.05.006

    Abstract ( 705 )   PDF (6818KB) ( 998 )  

    Objective · To explore the biological characteristics of platelet-rich fibrin (PRF) and its effects on proliferation and differentiation of adipose derived stem cells (ADSCs). Methods · The whole blood was collected from the forelimb vein of healthy beagles to prepare the PRF membrane, which were observed with optical microscope and scanning electron microscope. ADSCs were collected from the inguinal adipose tissue and were isolated and cultured.Identification of multi-directional differentiation potential was performed. ADSCs were assigned to the PRF group and the control group, the former was treated with PRF in vitro. Cell proliferation was measured with CCK-8. Osteogenesis induction was performed for two groups and the expression of genes associated with osteogenesis, including osteocalcin (OCN), osteopontin (OPN) and collagen I (Col-Ⅰ), was measured with RT-PCR before induction and 4 and 7 days after induction. The alkaline phosphatase (ALP) activity was measured 7 days after induction. Results · PRF is a milk white fibrin glue with elasticity and toughness. PRF can form loose and porous three dimensional network structure, which harbors lots of platelets and leucocytes. The cell proliferation activity was significantly higher in the PRF group than in the control group. After osteogenesis induction, the ALP activity and the mRNA levels of OCN, OPN, and Col-Ⅰ were significantly increased. Conclusion · PRF is a fibrin glue with three dimension network structure and contains lots of platelets, which can slowly release growth factors. PRF can promote the proliferation and osteogenic differentiation of ADSCs.

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    Effects of cisplatin-alginate conjugate liposomes in cervical cancer-bearing nude mice
    GAO Hua, WANG Yun-fei, WANG Wen-jing, ZHANG Mei-ying, LI Qing, DING Ying, DI Wen
    2017, 37 (05):  606. 
    doi: 10.3969/j.issn.1674-8115.2017.05.007

    Abstract ( 715 )   PDF (6556KB) ( 1177 )  

    Objective · To establish human cervical cancer xenografts in nude mice and investigate the antitumor therapeutic effects and safety of EGF modified cisplatin-alginate conjugate liposomes. Methods · Cervical cancer-bearing mouse model was established by subcutaneously injecting Hela cells in nude mice. General state and xenograft growth of the mice were observed. Tumor volumes, tumor weights, and the body weights of mice during the treatment were recorded and analyzed. The expression levels of EGFR in xenografts were detected by immunohistochemistry. Results · ① EGFR was highly expressed in the xenografts. ② CS-EGF-Lip inhibited the tumor growth effectively (P=0.000). ③ The inhibition rates of tumor volume and tumor weight of CS-EGF-Lip were 80.22% and 58.60% respectively, which were better than those of cisplatin (P=0.000). ④ CS-EGF-Lip had minimal influence on body weight in mice (P=0.000). Conclusion · CS-EGF-Lip has more effective antitumor effects than cisplatin in cervical cancer-bearing mice, which can inhibit tumor growth of solid tumors with enhanced efficacy and safety.

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    Molecular mechanism of oxLDL inducing lipid accumulation and inflammation in macrophages to promot atherosclerosis via TLR4 signaling pathway
    ZHA Qing, CAO Li-juan*,WANG Yan-ping, YANG Ke, LIU Yan
    2017, 37 (05):  611. 
    doi: 10.3969/j.issn.1674-8115.2017.05.008

    Abstract ( 876 )   PDF (6138KB) ( 1048 )  

    Objective · To investigate the possible role of TLR4 signaling pathway in the mediation of atherosclerosis. Methods · TLR4 were knocked down via transfection with TLR4-specific siRNA, and the lipid accumulation was further detected in control and TLR4-knockdown groups by oil red O staining. The expression of CD36 and Lectin-like oxLDL receptor 1 (LOX-1) in macrophages were detected by Western blotting to investigate the role of TLR4 in the expression of oxLDL-related receptors. Cytokines such as interleukin-6 (IL-6), IL-8, monocyte chemoattractant protein 1 (MCP-1), and matrix metalloproteinase-9 (MMP-9) were tested by ELISA to confirm the possible role of TLR4 in the secretion of inflammatory factors. Results · Macrophages
    (namely CD68+ cells) were found to accumulate within atherosclerosis plaques with TLR4 highly expressed on the surface of macrophages; the stimulation with oxLDL promoted the lipid accumulation (P<0.01), the secretion of inflammatory factors (P<0.01), and the expression of CD36 and LOX-1. The oxLDL-associated expression of CD36 was decreased but the expression of LOX-1 was not affected. The knockdown of TLR4 inhibits oxLDL-induced lipid accumulation (P<0.01)and inflammatory cytokines (IL-6, IL-8, MCP-1 and MMP-9) secretion (P<0.01). Conclusion · TLR4 signaling pathway possibly promotes the lipid accumulation and the secretion of inflammatory factors via up-regulating the expression of CD36 to affect the formation and development of atherosclerosis.

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    Original article (Clinical research)
    Study on factors affecting the gastric emptying in patients with type 2 diabetes mellitus
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    FENG Ri-lu, JIN Yun-qiu, XU Hua, SONG Shao-li, LIU Wei, MA Jing
    2017, 37 (05):  616. 
    doi: 10.3969/j.issn.1674-8115.2017.05.009

    Abstract ( 664 )   PDF (7217KB) ( 691 )  

    Objective · To investigate the possible factors affecting the gastric emptying rate in patients with type 2 diabetes mellitus. Methods · 94 type 2 diabetic patients treated at the Department of Endocrinology of Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September 2013 to March 2014 were enrolled. The half gastric emptying time (T1/2) and retention at 120 min (R120 min) were measured. Results · Female patients had longer T1/2 (P=0.000) and higher R120 min (P=0.000) than male patients. The differences in age, duration of diabetes, BMI, blood glucose level, chronic diabetic complications, and gastrointestinal symptoms between normal and delayed gastric emptying groups were not statistically significant. Acarbose had no effect on the gastric emptying rate in type 2 diabetic patients. Conclusion · The gastric emptying rate in type 2 diabetic patients is associated with the gender and has no significant correlation with blood glucose level, chronic diabetic complications, gastrointestinal symptoms, and acarbose.

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    Clinical effects of photo-activated disinfection as an adjunctive therapy for the treatment of chronic periodontitis
    HU Shu-cheng, SHU Rong, SONG Zhong-chen, SUN Meng-jun, WANG Yi-wei
    2017, 37 (05):  621. 
    doi: 10.3969/j.issn.1674-8115.2017.05.010

    Abstract ( 900 )   PDF (9366KB) ( 691 )  

    Objective · To investigate the clinical effects of photo-activated disinfection (PAD)-assisted non-surgical therapy on the treatment of chronic periodontitis. Methods · Eleven patients with chronic periodontitis (totally 118 selected sites) were randomly enrolled. A split-mouth self-control method was adopted. Selected sites with the probing depth (PD) of bilateral homonymous teeth ≥ 5 mm were randomly assigned to the group A (receiving scaling and root planning, SRP) and the group B (receiving SRP+ PAD). Periodontal clinical indexes, inflammation indexes, and periodontal pathogens at selected sites were examined at baseline and 6 and 12 weeks after treatment. Results · Both SRP alone and SRP+PAD improved the periodontal inflammation significantly. The positive rate of bleeding on probing (BOP) 12 weeks after treatment was remarkably lower in the group B than in the group A (37.3% vs 57.6%, P=0.042). Both SRP and SRP+PAD effectively decreased matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) levels in gingival crevicular fluid. The IL-1β levels 6 and 12 weeks after treatment were significantly lower in the group B than in the group A [(17.99±14.26) pg/mL vs (32.64±30.69) pg/mL, P=0.007; (11.37±10.25) pg/mL vs (23.85±15.55) pg/mL, P=0.000]. Both treatments decreased the ratio of P. gingivalis and F. nucleatum in total bacteria. Conclusion · PAD can serve as a potential adjunctive therapy to conventional SRP in the treatment of chronic periodontitis with better improvement of bleeding gums and control of periodontal inflammation.

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    Prognostic significance of preoperative peripheral blood neutrophil/lymphocyte ratio and platelet/ lymphocyte ratio in patients with ovarian cancer
    ZHANG Li-wei, PAN Hui-ying, YAO Xiao-tian, WANG Tian-qin, ZHOU Xiao-xin, WANG Yu
    2017, 37 (05):  627. 
    doi: 10.3969/j.issn.1674-8115.2017.05.011

    Abstract ( 693 )   PDF (5462KB) ( 981 )  

    Objective · To explored the correlation of preoperative peripheral blood neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) with clinical characteristics and prognosis of ovarian cancer. Methods · Patients’ clinicopathological data of 127 cases of benign tumors and 286 cases of malignant tumor were collected, and the correlation between the level NLR and PLR in patients with ovarian cancer clinical pathology indicators and overall survival was analyzed. Results · preoperative NLR and PLR levels in patients with ovarian cancer were higher than those in benign tumors(P=0.000). The optimal cut-off point of NLR and PLR were 3.0 and 151. There was statistical significant difference between the high level of NLR group (NLR≥ 3) and the low level of NLR group in pathological type, FIGO staging, lymph node metastasis, CA125 level and the amount of ascites (P<0.05). There was statistical significant difference between the high level of PLR group (PLR≥151) and the low level of PLR group in FIGO stage, transfer status, CA125 level and quantity of ascites (P<0.05). The median survival time for NLR/PLR in the high level group were 33 and 33.5 months lower than that of the corresponding group of 44.5 and 49.5 months (P=0.044, P=0.000). Multivariate Cox regression analysis showed that PLR ≥ 151 were independent risk factors affect OS in ovarian cancer patients (HR=1.936, 95% CI=1.013-3.698, P=0.045). Conclusion · The elevated blood preoperative PLR indicates poor prognosis of ovarian cancer patients. Preoperative PLR may serve as an important independent prognostic factor for ovarian cancer patients.

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    Expression of androgen receptor in breast cancer and its prognostic significance
    FEI Xiao-chun, XU Hai-yan*, YAN Ning-ning,XU Ying-chun, ZHANG Feng-chun
    2017, 37 (05):  632. 
    doi: 10.3969/j.issn.1674-8115.2017.05.012

    Abstract ( 1176 )   PDF (6457KB) ( 1046 )  

     Objective · To investigate the expression of androgen receptor (AR) in human breast cancer and its prognostic significance. Methods · A total of 183 female patients with breast cancer were selected. The expression of AR in breast cancer tissues was detected by immunohistochemical staining. The relationship of AR expression with the clinicopathological characteristics was analyzed. Survival analysis of AR gene expression by an online database (Kmplot) was also performed. Results · The positive rate of AR expression was 47.5% and was significantly higher in grade 1 and grade 2 group than that in grade 3 group (57.6% vs 25.0%, P<0.05). Breast cancer patients with estrogen receptor, progesterone receptor and P53 positive expression had significantly increased AR levels (P<0.05). AR expression were significantly higher in patients with luminal type as compared with those in patients with human epidermal growth factor receptor-2 (HER2) positive and patients with triple negative breast cancer (51.7% vs 31.6%,P<0.05). Kaplan-Meier curves identified that AR gene expression was positively correlated with relapse-free survival, overall survival and distant metastasis-free survival of breast cancer patients (P<0.05). Conclusion · The breast cancer patients with AR positive expression have a better prognosis, which suggests that inhibitors of AR pathway may be a treatment option for breast cancer.

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    Difference in myocardial strain between obstructive hypertrophy cardiomyopathy and nonobstructive hypertrophy cardiomyopathy
    WU Hao, WAN Qing, GAO Cheng-jie, TAO Yi-jing, XIA Zhi-li, WEI Meng, PAN Jing-wei
    2017, 37 (05):  637. 
    doi: 10.3969/j.issn.1674-8115.2017.05.013

    Abstract ( 874 )   PDF (6098KB) ( 824 )  

    Objective · To investigate the difference in myocardial strain of left ventricle between obstructive hypertrophy cardiomyopathy (HCM) and nonobstructive HCM. Methods · Cardiac magnetic resonance imaging (MRI) exam was performed on 48 sequential enrolled patients with HCM (18 with obstructive HCM, and 30 with nonobstructive HCM), whose left ventricular ejection fractions (LVEF) were over 50%. Twenty-five healthy volunteers were examined as normal controls. Global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), LVEF, left ventricular end diastolic volume (LVEDV), left ventricular mass (LVM), left ventricular end diastolic volume index (LVEDVI), and left ventricular mass index (LVMI) were collected and compared. Radial strain, circumferential strain and peak radial displacement were also measured in medial segment of left ventricle according to American Heart Association (AHA) 17-segment model. Results · ① LVEF of the patients with obstructive HCM was bigger than those of nonobstructive HCM patients and control group (P<0.05). LVM and LVMI of the HCM groups were bigger than those of control group (P<0.01). ② Left ventricle GLS, GRS, and GCS significantly decreased in the patients with nonobstructive HCM compared to those with obstructive HCM (P<0.05). The three parameters of two HCM groups were significantly lower than those of healthy volunteers (P<0.05). ③ Compared with obstructive HCM patients, he segmental parameters of left ventricule, the medial segment circumferential strain and radial strain of nonobstructive HCM patients significantly decreased (P<0.05), and the two parameters of both HCM groups were lower than those in healthy volunteers. Compared with obstructive HCM patients and healthy volunteers, peak radial displacement of left ventricule medial segment in nonobstructive HCM witnessed a significant decrease, while no significant difference was observed between obstructive HCM patients and healthy volunteers. Conclusion · In the LVEF preserved HCM patients, the myocardial strain of left ventricle in nonobstructive HCM patients decrease significantly than that in obstructive HCM patients, which may result in the different clinical outcomes in two types of HCM patients. It is suggested that the myocardial strain is more sensitive than ejection fraction in the evaluation of myocardial performance of HCM patients.

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    Prospective study of the treatment of adenomyosis by combining hysteroscopic transcervical resection of endometrium with levonorgestrel-releasing intrauterine system
    CHEN Fu-qiang, ZHANG Ai-feng, WANG Xiao-bo
    2017, 37 (05):  641. 
    doi: 10.3969/j.issn.1674-8115.2017.05.014

    Abstract ( 714 )   PDF (7155KB) ( 710 )  

    Objective · To explore the clinical application value of hysteroscopic transcervical resection of endometrium (TCRE) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis. Methods · A total of 112 cases of adenomyosis patients were divided randomly into the combination group and Mirena group. The combination group (56 cases) was treated by TCRE endometrium endometrial resection, assisted Mirena treatment after operation. Mirena group (56 cases) was treated by Mirena only. The follow-up lasted 36 months after treatment, including measures of the volumes of menstrual bleeding, hemoglobin levels, dysmenorrhea scores, uterine volume, serum CA125 levels and incidences of complications. Results · The median follow-up duration was 42 months, and the three-year follow-up rate was 73.21% for the combination group and 50% for the Mirena group. After surgery, the volumes of menstrual bleeding of patients in 3-36 months decreased significantly, with an increase in hemoglobin level and a decrease in serum CA215 level and dysmenorrhea scores. Compared with their situations before surgery, the difference was significant (P<0.05). A comparison of uterine volume before and after surgery showed that there is a significant decrease in the uterine volume in both groups in 6-12 months after surgery (P<0.05). Twenty-four months after surgery, it shows that the combination group has a much more significant decrease in uterine volume [(171.3±34.8) mm3] than Mirena group [(213.7±38.6) mm3] (P<0.05). The hysterectomy rate in Mirena group was significantly higher than that in the combination group (12.50% vs 5.36%); the ring expulsion rate was 16.07% in Mirena group and 5.36% in the combination group, and the break through bleeding happening rate was 8.93% in Mirena group and 3.57% in the combination group. After 36 months an irregular small amount of vaginal bleeding rate was 62.25% in Mirena group, while it was only 12.50% in the combination group. There was significant difference when comparing above indices between two groups (P<0.05). There was no obvious differences in most common side effects of both groups. Conclusion · Hysteroscopic TCRE combined with Mirena reduces significantly the irregular menstrual bleeding caused by merely applying Mirena. It has a prominent clinical efficacy and can be an effective approach in treatment of adenomyosis.

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    Performance verification and preliminary application of a specific antibody separation and detection device for syphilis
    LU Huang-ying, LIANG Guang-shu, GU Zhi-dong
    2017, 37 (05):  646. 
    doi: 10.3969/j.issn.1674-8115.2017.05.015

    Abstract ( 629 )   PDF (9488KB) ( 807 )  

    Objective · To design an immuno-affinity chromatography device for the separation and detection of syphilis specific antibody, then verify its performance of detection and clinical application. Methods · Affinity filler packed by Treponema pallidum (TP) antigen in affinity chromatography can specifically adsorb TP specific antibody (including IgG and IgM) in samples. After balance, elution and desalination, IgG or IgM gold labeled chromatography strip detects the possibly present syphilis specific IgG or IgM antibody. Twenty cases of syphilis antibody negative samples and 230 cases of syphilis antibody positive clinical specimens were detected by this chromatography device, and 40 cases were also detected by Western blotting. Results ·The standard operation procedure of the affinity chromatography device was optimized, which could effectively detect the specific IgG and IgM antibody of syphilis. The results of 20 syphilis antibody negative samples were all negative. In 230 syphilis antibody positive cases, the detection results were 2 cases with TP-IgG(-) and TP-IgM(-), 210 cases with TP-IgG(+) and TP-IgM(-),10 cases with TP-IgG(-) and TP-IgM(+), and 2 cases with TP-IgG(+) and TP-IgM(+). The detection results of 40 cases were compared with the results detected by Western blotting, among which 2 cases detected by affinity chromatography device were TP-IgG(-) and TP-IgM(-), while the results detected by Western blotting were TP-IgG(+) and TP-IgM(-). But the results of the two methods showed no statistically significant difference (P>0.05). Conclusion · The application of the device in separation and detection of IgG and IgM antibodies against TP pathogens is feasible, and it has important value for further application in clinical diagnosis.

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    Clinical efficacy of intravitreal injection of Conbercept in treatment of diabetic macular edema
    SUN Qing-lei, YAN Yan, ZHU Li-na, QIN Xiao-ling, TAN Ye, LIU Jie, TAN Hai-bo, NING Li, LIU Lin
    2017, 37 (05):  652. 
    doi: 10.3969/j.issn.1674-8115.2017.05.016

    Abstract ( 1016 )   PDF (5043KB) ( 975 )  

    Objective · To investigate the clinical effect of intravitreal injection of Conbercept in the treatment of diabetic macular edema (DME). Methods · Eleven patients (17 eyes) with DME (inflammatory type) received intravitreal injection of Conbercept monthly. After the first treatment, the patients were treated on demand. Follow-up after treatment for more than 6 months, the best corrected visual acuity (BCVA), central retinal thickness (CRT), diminished rate of DME and result of fundus fluorescein angiography(FFA) of DME eyes before and after treatment were compared. Results · During a follow-up of 7-29 months [(12±7) months], the injections were given 1-10 times [(4±3) times]. The results showed that the treatment effects on improving BCVA (logMAR) and diminishing of CRT were significant (t=7.306, P=0.001; t=5.272, P=0.000). The diminished rate of DME of our patients was 76.5%. Conclusion · Intravitreal injection of Conbercept in the treatment of DME is effective on reducing macular edema and improving visual acuity.

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    Clinical outcomes of a modified laterally moved and coronally advanced flap combined with a connective tissue graft for the treatment of severe recession defects
    LIN Zhi-kai, SHU Rong, QIAN Jie-lei, XIE Yu-feng
    2017, 37 (05):  656. 
    doi: 10.3969/j.issn.1674-8115.2017.05.017

    Abstract ( 779 )   PDF (6701KB) ( 1032 )  

     Objective · To observe the clinical outcomes of a modified laterally moved and coronally advanced flap combined with a connective tissue graft (CTG) for
    the treatment of severe Miller class II or class Ⅲ isolated recession defects. Methods · Three patients with initial defect depths of more than 5 mm and malposition in some teeth were enrolled and underwent a modified laterally moved and coronally advanced flap combined with CTG. Recession depth (RD), keratinized tissue height (KTH) of both donor and adopted site, pocket depth (PD), and clinical attachment loss (CAL) at baseline and follow-up one-year after treatment were documented. Root coverage rate (RC) was calculated and visual analogue scale (VAS) was used to evaluate patient’s satisfaction degree. Results · The mean RDs at baseline and follow-up were (5.3±0.5) mm and (0.3±0.5) mm. The mean RC at follow-up was (93.3±9.4)%and two cases had complete root coverage. The KTHs at adopted and donor sites were (0.3±0.5) mm and (6.0±0.8) mm at baseline and (4.3±0.5) mm and (5.7±1.3) mm at follow-up, respectively. PD and CAL were decreased from (1.7±0.5) mm and (7.0±0.8) mm at baseline to (1.3±0.5) mm and (1.3±1.2) mm at follow-up, respectively. The VAS value was 9.0±0.8 and subjective evaluation of patients was improved significantly at one-year follow-up, including root sensitivity and aesthetics. Conclusion · The modified laterally moved and coronally advanced flap with CTG has ideal clinical outcomes and satisfaction degree for the treatment of patients with severe recession defects that lack keratinized tissue and combine with buccal malposition.

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    Clinical analysis of 56 cases with vaginal intraepithelial neoplasia after hysterectomy
    XU Ying, LI Zhu-nan, CHEN Yi, SHI Wei, WANG Li-ya, WU Dan
    2017, 37 (05):  661. 
    doi: 10.3969/j.issn.1674-8115.2017.05.018

    Abstract ( 688 )   PDF (6581KB) ( 942 )  

    Objective · To investigate the relationship between the results of thin prep cytologic test (TCT), high-risk human papillomavirus (Hr-HPV) detection and vaginal intraepithelial neoplasia (VAIN) after hysterectomy. Methods · A retrospective study was conducted of 56 patients with VAIN after hysterectomy. The analysis included TCT and Hr-HPV examination, clinical data and the relationship between Hr-HPV examinenation and histopathological examination of colposcopy. Results · Postoperative follow-up of TCT and Hr-HPV parallel pathological examination showed that 56 patients had vaginal stump lesions, including cervical factor hysterectomy accounted for 5.81% (45/775) and non cervical factor hysterectomy accounted for 0.19% (11/5 933). The difference was statistically significant (P=0.000). In 56 cases of patients with vaginal stump lesions, Hr-HPV infection were 40 cases (accounting for 71.43%), uninfected patients were 16 cases (accounting for 28.57%). The Hr-HPV infection rates of cervical hysterectomy and non cervical factor hysterectomy patients were 80.00% (36/45) and 36.36% (4/11) respectively, and the difference was statistically significant (χ2= 6.248, P= 0.012). TCT results showed that the incidence of squamous intraepithelial lesions were 42.22% (19/45) and 9.09% (1/11) respectively. Conclusion · The Hr-HPV infection rate and the morbidity of VAIN of the patients undergone hysterectomy due to the cervical lesion factors is higher than those who had none cervical lesion factors. In order to identify VAIN early, patients who have the history of hysterectomy should undergo careful evaluation of cervical and vaginal circumstance before surgery and the routine examinations of TCT and Hr-HPV in the follow-up.

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    Effect of stiffness parameter β combined with carotid intima-media thickness on predicting ischemic stroke
    CAI Ye-hua, WANG Yong, WANG Yi, CHEN Li
    2017, 37 (05):  666. 
    doi: 10.3969/j.issn.1674-8115.2017.05.019

    Abstract ( 707 )   PDF (5337KB) ( 898 )  

    Objective · To explore whether stiffness parameter β could help carotid intima-media thickness (IMT) to predict ischemic stroke. Methods · Ninety-nine patients with acute ischemic stroke and transient ischemic attacks were retrospectively evaluated by routine ultrasound and divided into increased IMT group and normal IMT group. The normal IMT group cases were further divided into 30~39 years, 40~49 years, 50~59 years and ≥60 years groups, and were compared with healthy crowd respectively. Results · ① The common carotid artery wall β of both increased IMT group and normal IMT group were significantly higher than healthy crowd (each P=0.000). ② Further analysis showed that β of ≥ 60 years group were significantly higher than healthy crowd (left side P=0.047, right side P=0.007); while the difference was not found across younger age groups (30~39 years, 40~49 years and 50~59 years). Conclusion · Stiffness parameter β may help carotid intima-media IMT to predict ischemic stroke in high risk subjects ≥ 60 years old without morphology changes.

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    Study of pituitary glands in normal adults by high-resolution MRI
    CHEN Jie, WANG Hao-ran, FANG Chao, LIU Min
    2017, 37 (05):  670. 
    doi: 10.3969/j.issn.1674-8115.2017.05.020

    Abstract ( 893 )   PDF (6170KB) ( 1019 )  

    Objective · To study changes of morphological characteristics of pituitary glands in normal adults by high-resolution magnetic resonance imaging (MRI). Methods · A total of 245 healthy adults were scanned by 3.0T MRI to measure widths,lengths,heights and volumes of pituitary glands and observe pituitary gland morphology. Results · The average height of pituitary was (5.47±1.33) mm in males and (6.06±1.32) mm in females; the average volume of pituitary was (614.07±125.52) mm3 in males and (660.00±117.35) mm3 in females. The difference between the genders was statistically significant (P<0.01). The pituitary height was positively related to the pituitary volume (r=0.829,P<0.01). Except the pituitary lengths, there was statistically significance in the pituitary widths, heights and volumes among different age groups (P<0.05), and all of them were negatively correlated with age (P<0.01). Conclusion · The pituitary heights and volumes peak in the 18-29 age group in adults and tend to decline with increased age. In female subjects, however, there is a tendency of pituitary heights and volumes to increase again in the 50-59 age group. The average height and volume of female pituitary glands are significantly greater than those of males.

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    Original article (Public health)
    Effect of ego depletion and emotion regulation on students' health consumption choice
    KANG Li, CHEN Jie
    2017, 37 (05):  676. 
    doi: 10.3969/j.issn.1674-8115.2017.05.021

    Abstract ( 668 )   PDF (4944KB) ( 1040 )  

    Objective · To test the effect of ego depletion and emotion regulation on students' health consumption choice, according to online social network. Methods · The undergraduate students in a university in East China were taken as the research object. Public health psychology experiments were designed, using Stroop priming the extent of ego depletion, and SSEIT measuring the extent of emotional regulation. Results · When participants experienced high level ego depletion, for those who possessed weak emotional regulation capability, they were more inclined to select less healthy food(77% vs 18%, χ2=15.40, P=0.000). For those who possessed strong emotional regulation capability, there was no significant difference on food choice between those who experienced high level ego depletion and those who experienced low level ego depletion (40% vs 27%, χ2=0.91, P=0.340). For participants who experienced high level ego depletion, compared to those who overcame ego depletion and those who experienced low level ego depletion, were more inclined to select less healthy product (69% vs 23%, χ2=11.10, P=0.001), while there was no significant difference between those who experienced low level ego depletion and those who overcame ego depletion (32% vs 23%, χ2=0.51, P=0.470). Conclusion · When students experienced different level ego depletion, they chose different healthy consumption choice because of the different capability of emotional regulation. For students who possessed weak emotional regulation capability, they should be encouraged to choice healthy consumption, and interesting show should be organized to bring them positive emotion. They should also be encouraged to do long-term physical training to overcome the sensitivity to fatigue. Finally, They should be informed to realize the healthy consumption by active communication and interaction such as like, share and comment in social media.

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    Investigating predictors of the 641 elders’ willingness to enroll in nursing homes in Shanghai
    LUO Meng-yun, LIANG Hui-gang, DONG Yuan-yuan, MO Dan-dan, DONG Wei, ZHANG Yi3, WANG Yue, CAI Yong, ZHANG Zhi-ruo
    2017, 37 (05):  679. 
    doi: 10.3969/j.issn.1674-8115.2017.05.022

    Abstract ( 680 )   PDF (7075KB) ( 717 )  

    Objective · To survey the willingness to enroll in nursing homes among the elders in Shanghai and explore its predictors. Methods · A field survey was performed to collect data from 641 elders aged 60 years old and above in six community health centers in Shanghai. Sociodemographic variables, willingness to use nursing home, perceived barriers and perceived benefits were measured. Results · The questionnaire is with good structural validity and good intrinsic reliability. KMO index, P value of Bartlett’s test of sphericity, and the range of Cronbach’s α coefficients were 0.862, 0.000, and 0.739-0.824, respectively. Among the respondents, 46% were willing to enroll in a nursing home in this survey. Age had significant influence on their willingness (P=0.045). After adjusting for age, the multivariate Logistic regression analysis showed that shame (OR=0.76, 95% CI=0.620.94), adaptability (OR=0.61, 95% CI=0.50-0.74) and perceived benefits (OR=1.63, 95% CI=1.32-2.03) were related to willingness (P<0.05). Conclusion · Elders in Shanghai have a relatively high level of willingness to enroll in nursing homes, especially the elders aged from 60 to 69. Shame and adaptability of elders, and the services provided by nursing homes were the predictors of the elders’ willingness.

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    Brief original article
    Association between level of vitamin D in serum and peripheral neuropathy in elderly patients with type 2 diabetes
    XU Ji-chao, HU Hao-lu, DING Wei
    2017, 37 (05):  684. 
    doi: 10.3969/j.issn.1674-8115.2017.05.023

    Abstract ( 617 )   PDF (6738KB) ( 970 )  
    Objective · To investigate association between serum 25-hydroxyvitamin D3 [25(OH)D3] level and diabetic peripheral neuropathy (DPN) in elderly patients with type 2 diabetes mellitus and explore its value in clinical practice for early screening and prevention of DPN. Methods · A total of 188 elderly patients with type 2 diabetes mellitus were enrolled in this cross-sectional study, including 100 cases with DPN and 88 cases without. Clinical data was collected and serum levels of 25(OH)D3, glycosylated hemoglobin (HbA1c), blood lipids and hepatic and renal functions were determined in all patients. Spearman correlation analysis was used to evaluate relationship between each index and 25(OH)D3, and Logistic regression was used for statistical analysis of risk factors for DPN. Results · The median of serum 25(OH)D3 level was significantly lower in the patients with DPN (34.95 nmol/ L) than that of the patients without DPN (52.6 nmol/L)(P<0.01). Spearman correlation analysis showed that there existed a negative correlation between the level of 25(OH)D3 and age, HbA1c and fasting blood glucose (r=-0.37, -0.53, and -0.29, respectively, P<0.01). The multiple Logistical regression analysis revealed that the 25(OH)D3 level was an independent risk factor for DPN. The odds ratio of serum 25(OH)D3 was 15.5 (OR=15.50, 95% CI= 2.00~119.62) for the lowest quartile versus the highest quartile. Conclusion · The decreased level of 25(OH)D3 may increase risks for the occurrence of DPN in the elders with type 2 diabetes mellitus and monitoring the level of 25(OH)D3 contributes to early detection of DPN.
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    Review
    Research advance on BAP1 and its function in tumor suppression
    LI Ze, REN Zun, TU Hong-hu, JIAN Zheng, YU Jian-xiu, DENG Rong
    2017, 37 (05):  689. 
    doi: 10.3969/j.issn.1674-8115.2017.05.024

    Abstract ( 2001 )   PDF (8174KB) ( 923 )  

    BAP1 is a member of the ubiquitin C-terminal hydrolases (UCH) subfamily of deubiquitylases with basic function of removing monoubiquitin or ubiquitin chains from the specific substrate proteins. As well, it is a key factor in regulating gene expression, cell cycle, cell differentiation, cell apoptosis and DNA damage response, dependent or independent of its deubiquitination function. Evidences have revealed that mutation or down-regulation of BAP1 can prominently increase the occurrence of cancers, including uveal melanoma, mesothelioma, renal cell carcinoma, breast cancer and lung cancer. Currently, the tumor spectrum and the pathogenic mechanism on BAP1 have not been illustrated clearly, and need to be further researched, which might bring a new opportunity in treatment of cancers.

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    Interaction and mechanism of various regulatory factors in osteogenic differentiation of mesenchymal stem cells
    CHEN Xiao-ting, GAO Yan-hong
    2017, 37 (05):  694. 
    doi: 10.3969/j.issn.1674-8115.2017.05.025

    Abstract ( 676 )   PDF (7875KB) ( 654 )  

    Osteogenic differentiation of mesenchymal stem cells (MSCs) is an important link of bone metabolism and bone repair, the mechanism of which is usually complicated. Recent studies have found that BMP, FGF, Wnt, Hedgehog, NELL1, IGF, Notch and other signaling molecules are involved in the regulation of osteogenic differentiation of MSCs. These signaling molecules themselves have been shown to have a strong ability to promote osteogenic differentiation. They can activate the corresponding receptors by specific ligands, thus initiating the specific signal transduction pathways in the cell, and finally promote the transcription and translation of the genes related to bone formation. Furthermore, all the signaling pathways form a complex network which regulates and influences the osteogenic differentiation of MSCs. Further researches on the mechanism of the interaction of these signaling pathways is of great significance in promoting the development of bone tissue engineering and the treatment of bone metabolic diseases.

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    Research status on haptic simulation in the virtual bone drilling surgery
    HUANG Yong-hui, PAN Xian-wei*, LIN Yan-ping, CHEN Hua-jiang, ZHANG Yin, YUAN Wen
    2017, 37 (05):  699. 
    doi: 10.3969/j.issn.1674-8115.2017.05.026

    Abstract ( 699 )   PDF (8865KB) ( 760 )  

    Virtual reality technology and force feedback technology are novel human-machine interaction technologies. The virtual surgery simulation training system combined with these two technologies provides a new method for orthopedic surgery training, which can improve the training efficiency, thereby reducing the training costs and shortening the growth cycle of young orthopedic surgeons. In recent years, the virtual drilling bone surgery simulation technology have been researched broadly and obtained a preliminary application. In this paper, the existing research status of virtual bone drilling operation depended on visuo-haptic techniques were studied, classified and summarized, the main content focused on three key techniques: bone modeling, drilling bone force prediction model and tactile simulation, and then analyzed the advantages and disadvantages of existing methods. Finally, some perspectives for related technology development trend of the virtual simulation bone drilling surgery in future was pointed out.

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    Research progresses of apelin in nervous system
    WEI Zhen-yu, WU Dan-hong
    2017, 37 (05):  704. 
    doi: 10.3969/j.issn.1674-8115.2017.05.027

    Abstract ( 521 )   PDF (6523KB) ( 918 )  

    Apelin is the endogenous ligand of a G protein-coupled receptor called APJ, its propeptide is an X-linked and coded peptide with 77 amino acids. Apelin/apelin receptor system is widely distributed in the body and is involved in various physiological and pathological regulations. It has been demonstrated that apelin is associated with the occurrence and development of many diseases, including angiocardiopathy, pulmonary arterial hypertension, nephropathy, cancer, endocrine disease, and so on. Currently, studies on apelin in nervous system have been developed gradually. This article focuses on apelin and summarizes the distribution and pathophysiological roles of apelin in nervous system, as well as in the occurrence and development of diseases associated with nervous system.

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    Research progress of magnetic resonance technology in investigating the role of cerebellar in the pathophysiology of obsessive-compulsive disorder
    XU Ting-ting, WANG Zhen
    2017, 37 (05):  708. 
    doi: 10.3969/j.issn.1674-8115.2017.05.028

    Abstract ( 720 )   PDF (6530KB) ( 1139 )  

    Obsessive-compulsive disorder (OCD) is a chronic disabling mental illness with the core symptoms of obsession and compulsion, while its pathological mechanism has not yet been fully understood. In recent years, magnetic resonance (MR) technology has been used in the study of mental illness, because of its nonradiative and non-invasive advantage, etc. Many MR studies have found that OCD patients have cerebellar changes in structure and function, and these changes have contact with the incidence of OCD. This paper reviews the cerebellar’s role in the onset of OCD applying MR technology.

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    Research advances on upper airway morphology measurement in patients with cleft lip and palate
    TONG Qian, CHEN Zhen-qi
    2017, 37 (05):  712. 
    doi: 10.3969/j.issn.1674-8115.2017.05.029

    Abstract ( 612 )   PDF (4887KB) ( 966 )  

     Cleft lip and palate (CLP) is one of common congenital malformations. The evaluation of upper airway morphology using two-dimensional (2D) and three-dimensional (3D) imaging data for CLP patients has important clinical significance. Studies have adopted various measurement methods, in which different anatomical landmarks and reference planes are used in 2D cephalometric measurement. Shooting positioning for cone beam computed tomography (CBCT), measurement software, reference plane, landmark selection, and measurement method in 3D studies are also different. Currently, comparison is unable to be performed across different studies due to various measurement methods and measurement standards. This article reviews studies on upper airway morphology measurement in CLP patients.

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