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    28 June 2017, Volume 37 Issue 6 Previous Issue    Next Issue

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    2017, 37 (6):  0. 
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    Accelerating the professional clinical research team building in the process of transforming towards research-oriented hospitals
    ZHU Li-jun, CHENG Sha-ni, WANG Hao, DU Ye-ye, PAN Wan-rong, XU Xiao-jing, LIU Hui-jun, ZHOU Shan-sheng, ZHU Hai-ying, MOU Shan, ZHU Jian-zheng
    2017, 37 (6):  715. 
    doi: 10.3969/j.issn.1674-8115.2017.06.001

    Abstract ( 827 )   PDF (6272KB) ( 1130 )  

     Building a professional clinical research team inside hospitals is in favor improving their research abilities, accelerating the clinical discipline construction, improving their comprehensive influence. Also it fits the objective of general hospital development under gate-keeping system. Now in domestic, the percentage of professional research staff in large hospitals accounts was much less than the international level. The main reasons included the misunderstanding of constructing the research-oriented hospitals, insufficient human resources enrollment, less attractive environment to the highlevel researchers and the absence of relevant degree training programs. To enhance the construction of research-oriented hospitals, it’s of key importance to build the professional research team in hospitals. Besides, the hospital has to update management conception, broaden the channels of talent cultivation, grasp the development of the subject accurately and interact with the basic medicine and public health subject, increase the financial investment and perfect the relevant management regulations.

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    Promotion of TRIM59 on neuroglioma genesis
    SONG Li-na, FENG Hai-zhong
    2017, 37 (6):  719. 
    doi: 10.3969/j.issn.1674-8115.2017.06.002

    Abstract ( 703 )   PDF (8069KB) ( 766 )  

     Objective · To demonstrate the effect of TRIM59 on gliomagenesis and the molecular mechanism.  Methods · TRIM59 protein expression in glioma specimens was analyzed by immunohistochemical staining, and in several glioma cell lines by Western blotting and quantative PCR. After TRIM59 was knocked down by shRNAs, cell proliferation, migration, colony formation, and orthotopic xenograft brain tumor development were detected. The signaling pathway of TRIM59 in gliomas was also explored by RNA-Seq and KEGG PATHWAY analyses.  Results · The levels of TRIM59 protein expression in clinical glioma specimens were positively correlated with glioma malignancy. TRIM59 was highly expressed in LN229 and U87 glioma cells compared with normal human astrocytes. Knockdown of TRIM59 in these two cell lines with lentivirus-mediated shRNAs inhibited their proliferation, migration, and colony formation. Compared with the control xenograft models, knockdown of TRIM59 significantly inhibited glioma tumor growth. RNASeq and KEGG PATHWAY analyses identified that TRIM59 knockdown down-regulated 306 genes, among which PI3K/AKT signal pathway-related genes were the most. Moreover, TRIM59 knockdown suppressed AKT phosphorylation, whereas overexpression of a constitutively actived AKT (Myr-AKT) rescued TRIM59 knockdown-inhibited cell proliferation.  Conclusion · TRIM59 is a new glioma oncogene, which may take effect through activating PI3K/ AKT signaling pathway.

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    Exosomal miRNA-7 from TWEAK-stimulated macrophages inhibiting the invasion and migration of ovarian cancer cells
    LI Dong, HU Yuan, WU An-yue, QIU Xing-di, QIU Li-hua
    2017, 37 (6):  726. 
    doi: 10.3969/j.issn.1674-8115.2017.06.003

    Abstract ( 905 )   PDF (8022KB) ( 912 )  

     Objective · To determine the expression of miRNA-7 in TWEAK-stimulated macrophages and their secreted exosomes; to investigate the role of exosomal miRNA-7 from TWEAK-stimulated macrophages in modulating the metastasis of epithelial ovarian cancer (EOC) cells.  Methods · Real-time PCR analysis was used to determine the miRNA-7 expression in TWEAK-stimulated macrophages, their exosomes and recipient HO8910-PM cells. The activity of EGFR signaling pathway in HO8910-PM cells was detected by Western blotting analysis. AntagomiR-7 was used to downregulate the miRNA-7 expressions in macrophage exosomes and then their effect on metastasis of HO8910-PM cells was examined by transwell assay.  Results · TWEAK increased the levels of miRNA-7 in macrophages and their secreted exosomes and also resulted in an elevated level of miRNA-7 in recipient HO8910PM cells, which eventually reduced the activity of EGFR/AKT/ERK1/2 pathway. Pre-transfection of antagomiR-7 remarkably decreased the levels of miRNA-7 in macrophages, their secreted exosomes and the recipient EOC cells, with the enhancement of HO8910-PM metastasis.  Conclusion · Exosomal miRNA-7 from TWEAK-stimulated macrophages plays a critical role in suppressing the metastasis of EOC cells by attenuation of EGFR signaling
     pathway.

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    Vitamin E could reverse effects of bisphenol A on steroidogenesis in rat ovary granulosa cells
    CHEN Wei-wei, SUN Wei-jie, WANG Lei, JIAO Xian-ting, YU Xiao-dan
    2017, 37 (6):  732. 
    doi: 10.3969/j.issn.1674-8115.2017.06.004

    Abstract ( 705 )   PDF (8222KB) ( 731 )  

     Objective · To investigate whether vitamin E could reverse the disruptive effects of bisphenol A (BPA) on steroidogenesis and to explore the optimal vitamin E concentration.  Methods · Rat primary granulosa cells were extracted and exposed to BPA (0, 0.01, 0.1,1,10,100 μmol/L). After 48 h of incubation, culture medium was collected and estradiol (E2) and progesterone (P4) were measured using ELISA kits. Then, granulosa cells were incubated with 5 μmol/L(average concentration in follicular fluid) or 25 μmol/L (high concentration in follicular fluid) vitamin E (α-tocopherol) or vitamin E (5 μmol/ L or 25 μmol/L) plus BPA (10 μmol/L or 100 μmol/L) for 48 h, E2 and P4 were measured.  Results · BPA at 10 μmol/L and 100 μmol/L suppressed E2 and P4 production in a dose-dependent manner (P<0.05). Vitamin E at 25 μmol/L significantly increased E2 and P4 levels by (44.89±15.18) % and (43.33±8.82) % (P<0.05), respectively. Coincubation of the granulosa cells with BPA and vitamin E (5 μmol/L or 25 μmol/L) restored the productions of E2 and P4, which were not significantly different from the control group (P>0.05).  Conclusion · Vitamin E (5 μmol/L/ 25 μmol/L) could reverse BPA-induced reduction in steroid hormone production in rat ovary granulosa cells, and the antagonistic effect of 25 μmol/L vitamin E was more obvious than that of 5 μmol/L vitamin E.

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    Effect of gambogic acid on NK/T-cell lymphoma
    LI Gao-yang, JIANG Ji-feng, LIU Chuan-xu, TAO Rong
    2017, 37 (6):  738. 
    doi: 10.3969/j.issn.1674-8115.2017.06.005

    Abstract ( 797 )   PDF (7961KB) ( 724 )  

     Objective · To identify the effect and potential mechanism of gambogic acid (GA) on natural killer/T-cell lymphoma (NK/TCL) cell lines.  Methods · SNK-1, SNK-6 and SNT-8 were incubated with various concentrations of GA for 24 h, and cell viability was detected with CCK-8 assay. Cell apoptosis was examined by Annexin V-FITC/PI staining assay. Levels of proteins regulating cell apoptosis and phosphorylation levels of proteins in key signaling pathways were detected by Western blotting.  Results · GA showed a potent effect on reduction of cell viability of NK/TCL cell lines in CCK-8 assay. GA increased the percentages of Annexin V positive cells and induced activation of caspase-3 and caspase-9, cleavage of PARP as well as the reduction of Bcl-xl. GA also inhibited the phosphorylation levels of STAT3 in SNK-1 and SNT-8, and ERK1/2 in SNK-1 and SNK-6 significantly.  Conclusion · GA induces cell apoptosis in NK/TCL cell lines SNK-1, SNK-6 and SNT-8. Anti-apoptosis protein Bcl-xl and signaling pathway JAKs/ STATs and MEK/MAPK might be involved in this process.

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    Study on the predictive effect of baseline lipid profiles on recurrent cardiovascular events after antidiabetic drugs intervention
    ZHAO Dan-dan, GU Yan-yun, WANG Ji-qiu, HU Chun-xiu, HONG Jie, ZHANG Yi-fei, the SPREAD-DIMCAD study group
    2017, 37 (6):  744. 
    doi: 10.3969/j.issn.1674-8115.2017.06.006

    Abstract ( 529 )   PDF (11776KB) ( 794 )  

     Objective · To explore the relationship between baseline lipid profiles and long-term cardiovascular outcomes after intervention with hypoglycemic drugs metformin and glipizide and to detect lipid components that can predict the long-term cardiovascular effect of metformin and glipizide.  Methods · Liquid chromatography–quadrupole time of flight–mass spectrometry (LC-QTOF/MS) was used to measure 119 lipid components in baseline serum for 116 patients with type 2 diabetes (T2DM) and atherosclerotic heart disease (CHD) who were treated with glipizide (56 cases, the glipizide group) or metformin (60 cases, the metformin group). Cardiovascular complex end points (including cardiovascular death, all-cause death, nonfatal myocardial infarction, nonfatal stroke, and arterial revascularization) of all patients were followed up. The relationship between lipid components and cardiovascular  complex end points was analyzed with Logistic regression analysis. The category-free net reclassification index (cfNRI) and the integrated discrimination improvement (IDI) were used to evaluate whether lipid components are helpful for predicting the recurrent cardiovascular events.  Results · The differences in baseline drug distribution, clinical characteristics, and biochemical indexes between two groups were not statistically significant, except for diuretics use, serum PC (O-34:2) level, and SM (d18:0-24:0) level. Logistic regression analysis showed that baseline ChE (20:4) was a protective factor for recurrent cardiovascular events in the glipizide group (OR=0.87, P=0.039). ChE (20:4) significantly increased the cfNRI and IDI of cardiovascular  complex end points by 69% and 0.07, respectively (P=0.011, P=0.028). Baseline SM (d18:1-22:0) was a risk factor for recurrent cardiovascular events in the metformin group and all participants (OR=1.65, P=0.039; OR=1.64, P=0.014). SM (d18:1-22:0) significantly increased the cfNRI of cardiovascular  complex end points in the metformin group and all participants by 74% and 55%, respectively (P=0.012, P=0.005).  Conclusion · Of 119 lipid components measured with LC-QTOF/ MS, baseline ChE (20:4) is a protective factor and SM (d18:1-22:0) is a risk factor for cardiovascular  complex end points in with T2DM and CHD patients after long-term treatment with metformin and glipizide. Both lipid components are helpful for improving the prediction of recurrent cardiovascular events.

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    Efficacy and prognostic analysis of ICE regimen for 84 patients with relapsed/refractory diffuse large B-cell lymphoma
    ZHAO Bing-bing, ZHANG Mu-chen, HAO Jie, LIU Zhen-yu, XIONG Hong, ZHAO Wei-li, WANG Li
    2017, 37 (6):  752. 
    doi: 10.3969/j.issn.1674-8115.2017.06.007

    Abstract ( 985 )   PDF (8042KB) ( 751 )  

     Objective · To evaluate the efficacy and prognostic factors of ifosfamide-cisplatin-etoposide (ICE) chemotherapy as salvage regimen for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).  Methods · A retrospective analysis was performed on 84 relapsed/refractory DLBCL patients who were treated with ICE salvage regimen at Ruijin Hospital (Shanghai Jiao Tong University School of Medicine, China) from July 2004 to June 2016. Overall survival (OS) was analyzed by Kaplan-Meier method and multivariate Cox proportional hazards models.  Results · Of the 84 patients who were treated with ICE regimen, 37 (44.0%) patients had responses, including 26 (31.0%) achieving complete remission. The median number of cycles per patient was 3 (range 1-6 cycles). The 1-year and 2-year OS rates were 49.5% and 30.0%, respectively. The median OS time was 12.2 months. On univariate analysis, patients with early progression/recurrence (P=0.041) and a high-intermediate/high risk according to the international prognostic index (IPI) (P=0.024) and NCCN-IPI (P=0.002) had poorer outcomes. While improved outcome was found in patients in complete remission after chemotherapy (P=0.000). The multivariate analysis revealed that the intermediate-high/high risk according to NCCN-IPI was an independent risk factor, and remission after chemotherapy was an independent prognostic factor for prolonging survival.  Conclusion · The ICE regimen can be used as an effective salvage therapy for patients with relapsed/refractory DLBCL.

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    Clinical analysis of mandibular reconstructions using synthetic bones based on three-dimensional printing technology in 149 cases
    ZIN Mar Aung*, HAN Wen-qing*, CHEN Xiao-jun, LIN Li, ZHANG Yan, XU Hai-song, CHAI Gang
    2017, 37 (6):  758. 
    doi: 10.3969/j.issn.1674-8115.2017.06.008

    Abstract ( 696 )   PDF (7954KB) ( 664 )  

    Objective · To assess the clinical value of the computer-assisted three-dimensional reconstruction technique design and evaluate the clinical experience of manufacture artificial bone precision to repair the mandibular defect.  Methods · From 2001 to 2016, 163 computer-assisted reconstruction surgeries had been performed in Craniofacial Department, Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine. During six months followup, the measurement data was conducted and compared with three-dimensional CT result. Random measurement of the three key anatomical points pre- and post-operative carried out with statistical error was used to evaluate the accuracy of computer-assisted three-dimensional reconstruction in mandibular defects repairation and to investigate the clinical application value of the operation time and postoperative complication rate.  Results · From July 2001 to July 2016, a total of 163 patients underwent computer-assisted three-dimensional reconstruction of artificial bone repair for mandibular defects; 149 patients met the statistical criteria in which preoperative design and postoperative actual effect’s average distance error (1.27±0.15) mm, operation time (2.5±1.2) h.  Conclusion · Threedimensional design of artificial bone to repair the mandibular defect is a valuable technology, by relying on quantitative design and preoperative simulation to simplify the difficulty and improve the accuracy of surgery. The patients showed high satisfaction rate with low surgical complications and long-term efficacy.

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    Modified levator lengthening for thyroid-associated ophthalmopathy related upper eyelid retraction
    SUN Jing*, ZHANG Yi-dan*, LIU Xing-tong, ZHONG Si-si, WANG Yang, ZHOU Hui-fang#, FAN Xian-qun#
    2017, 37 (6):  764. 
    doi: 10.3969/j.issn.1674-8115.2017.06.009

    Abstract ( 709 )   PDF (7361KB) ( 636 )  

    Objective · To improve the surgical procedure of correcting upper eyelid retraction.  Methods · Patients suffering upper eyelid retraction of 2-5 mm caused by thyroid-associated ophthalmopathy were treated with modified levator lengthening technique in Shanghai Ninth People’s Hospital (Shanghai Jiao Tong University School of Medicine, China) from July 2013 to December 2014.  Results · Of the 34 patients underwent the modified levator lengthening surgery for upper eyelid retraction correction, there were 7 males and 27 females. After 6 months, upper eyelid retraction got fully resolved in 25 cases and partly improved in 9 cases. The palpebral fissure height demonstrated an average decrease of 3.7 mm (P=0.000). Patient’s ocular discomfort such as photophobia and tearing were either cured or improved.  Conclusion · Modified levator lengthening surgery can effectively correct upper eyelid retraction, improve the patient's appearance and cure their ocular discomfort.

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    Correlation of serum S100B protein with depressive episode of bipolar disorder and its prognosis
    ZHANG Zai-fu, YANG Fan, WANG Wei-ping, SHI Bo, ZHAO Jun-xiong, Lü Wang-qiang, YU Yue-guo, JIA Yu-ping, ZHANG Chen
    2017, 37 (6):  769. 
    doi: 10.3969/j.issn.1674-8115.2017.06.010

    Abstract ( 605 )   PDF (7256KB) ( 665 )  

    Objective · To explore the correlation of serum S100B protein with depressive episode of bipolar disorder (BD) and its prognosis.  Methods · Based on BD criteria of Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM- Ⅳ ), 80 patients with depressive episode of BD (case group) and 42 healthy controls (control group) were enrolled. Patients were randomly assigned into quetiapine group who were treated with lithium and quetiapine and modified electroconvulsive therapy (MECT) group who received lithium and MECT. The serum S100B level and Hamilton Rating Scale for Depression (HAMD) were assayed before and after 4-week treatment.  Results · The serum S100B levels before treatment in patients with depressive episode of BD were significantly higher than those in healthy controls (P=0.000). The levels of S100B in both drug and MECT groups decreased after 4-week treatment. The HAMD score after treatment significantly decreased than that before treatment (P=0.000). Pearson correlation analysis showed that the change of S100B level was positively correlated with the change of HAMD score before and after treatment in case group (r=0.33, P=0.013).  Conclusion · S100B may be associated with depressive episode of BD and its prognosis.

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    Analysis of clinical and genetic features of one Chinese family with paroxysmal exercise-induced dyskinesia
    TIAN Wo-tu, CAO Li
    2017, 37 (6):  774. 
    doi: 10.3969/j.issn.1674-8115.2017.06.011

    Abstract ( 626 )   PDF (8145KB) ( 728 )  

    Objective · To study the clinical and genetic features of familial paroxysmal exercise-induced dyskinesia (PED) in a Chinese mainland family, and review the advances of clinical and genetic studies on PED.  Methods · The clinical information of 7 family members in one Chinese pedigree, including 5 patients and 2 healthy people, was analyzed and the patients’ response to treatment and prediction were followed up. The SLC2A1 gene in all 7 members of this family was sequenced. The clinical and genetic characteristics of 5 patients were analyzed. Advances of recent clinical and genetic studies related with PED were further reviewed.  Results · Among the total 5 patients (male : female=1:4), four patients had pure form of PED, and one patient had PED plus epilepsy. Attacks of the proband and his daughter could not be well controlled by carbamazepine or sodium valproate. In addition, three patients showed a remission trend with age advancing. In this family, the SLC2A1 c.C284T (p.S95L) was identified in all 5 patients, but not in 2 healthy members. According to the American College of Medical Genetics and Genomics (ACMG) criteria and guideline, the variant SLC2A1 c.C284T (p.S95L) was classified as “pathogenic variant”.  Conclusion · PED is a rare paroxysmal movement disorder with highly phenotypic heterogeneity as well as a remission trend with age advancing. This paper reviews advances in clinical and genetic studies on PED recently, in order to contribute to the clinical diagnosis and appropriate treatment of PED.

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    Clinical characteristics of patients with macrophage activation syndrome secondary to adult-onset Still’s disease
    TU Yang*, WANG Ran*, GUO Ru-ru, WANG Su-li, FU Qiong, Lü Liang-jing
    2017, 37 (6):  780. 
    doi: 10.3969/j.issn.1674-8115.2017.06.012

    Abstract ( 691 )   PDF (8251KB) ( 778 )  

    Objective · To investigate the clinical features of macrophage activation syndrome (MAS) associated with adult-onset Still's disease (AOSD), and provide the basis for clinical diagnosis and treatment of the disease.  Methods · The clinical data of 42 patients with AOSD, including 14 patients with AOSD-induced MAS (the MAS group) and 28 AOSD patients paired by age and sex (the non-MAS group), diagnosed in Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from October 2013 to June 2016 were collected and then retrospectively analyzed.  Results · There was no significant difference in age, sex and duration of AOSD between two groups. The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group, as well as the rates of rash, splenomegaly and hemophagocytosis. The levels of ALT and serum ferritin in MAS group were higher than those in non-MAS group, while the level of FDP is lower. Glucocorticoids were used in all 42 patients, and the dosage of glucocorticoids was significantly higher in MAS group than non-MAS group. Only 1 patient with AOSD-induced MAS received MTX, the percentage of patients receiving MTX was significantly lower in MAS group than non-MAS group. Five patients with AOSD-induced MAS received IVIG, the percentage of patients receiving IVIG was significantly higher in MAS group than non-MAS group. Two patients with AOSD-induced MAS received VP-16.  Conclusion · The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group, as well as the rates of rash, splenomegaly and hemophagocytosis. The levels of ALT and serum ferritin in patients with AOSD-induced MAS were higher than patients without MAS, while the level of FDP was lower. Early diagnosis and active treatment is the key point to improve clinical outcome.

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    Study on the relevant factors affecting the hydration status in peritoneal dialysis patients
    LI Feng, FANG Wei, YAN Hao, LI Zhen-yuan, YUAN Jiang-zi, NI Zhao-hui
    2017, 37 (6):  786. 
    doi: 10.3969/j.issn.1674-8115.2017.06.013

    Abstract ( 644 )   PDF (7749KB) ( 662 )  

     Objective · To explore influencing factors associated with the hydration status in peritoneal dialysis (PD) patients.  Methods · Eligible PD patients treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine from September 2016 to January 2017 were enrolled. Demographic data of patients were collected and biochemical indexes were measured. Their peritoneal transport characteristics and dialysis adequacy were evaluated. Hydration status index overhydration (OH) value was measured with bioimpedance spectroscopy. Multivariate linear regression was used to analyze the independent factors associated with the OH.  Results · A total of 147 PD patients with a median age of 58.52 years and a median PD duration of 43.03 months were enrolled. Of them, 90 (61.2%) were male, 21(14.3%) were accompanied by diabetes mellitus, and 107 (72.8%) were overhydrated (OH>1.1L). Compared to those with normal hydration status (OH ≤ 1.1 L), the overhydrated patients had higher proportion of diabetes,
     BSA, Charlson comorbidity score, brain natriuretic peptide (BNP), 4 h D/Pcr, and 24 h dialysate protein, and lower tKt/V, serum albumin than the normal hydrated patients (all P<0.05). Multivariate linear regression showed that comorbid diabetes mellitus (P=0.000), higher 4h D/Pcr (P=0.000), and lower serum albumin level (P=0.001) were independent relevant factors for the increase of OH.  Conclusion · Overhydration is common in PD patients. Comorbid diabetes mellitus, higher 4 h D/Pcr, and lower serum albumin are independent relevant factors for the hydration status in
     PD patients.

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    Prospective value of early postoperative PI-APD in children with ureteropelvic junction obstruction
    JIANG Da-peng, CHEN Zhou-tong, GENG Hong-quan, XU Mao-sheng, WANG Li-guo, XU Guo-feng, LIN Hou-wei, FANG Xiao-liang, HE Lei
    2017, 37 (6):  792. 
    doi: 10.3969/j.issn.1674-8115.2017.06.014

    Abstract ( 732 )   PDF (6644KB) ( 950 )  

    Objective · To investigate the prospective value of early postoperative PI-APD in children with hydronephrosis.  Methods · Data of children with hydronephrosis who underwent pyeloplasty in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine between Jan 2012 to Nov 2015 was collected. PI-APD was divided into 3 categories ( ≤ 19%, 19%<PI-APD<40% and ≥ 40%). The relationship between PI-APD value and the degree of renal function (DRF) and dilation recovery after surgery was analyzed.  Results · There were 360 children with hydronephrosis. The median follow-up was 20 months. The PI-APD value (3 months after pyeloplasty) was positively correlated with the degree of DRF recovery (r=0.631, P=0.000). Five patients received redo-pyeloplasty. PI-APD of all these patients was <19%.  Conclusion · PI-APD is a new feasible ultrasound parameter in pyeloplasty followup. PI-APD ≥ 40% at the first post-operative visit predicts pyeloplasty success. PI-APD ≤ 19% indicates close follow-up after operation. PI-APD can also help select children at high risk for repeat intervention after pyeloplasty.

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    Safety of neoadjuvant chemo-hormonal therapy by the combination of docetaxel and maximal androgen blockage for locally advanced prostate cancer
    PAN Jia-hua, CHI Chen-fei, DONG Bai-jun, ZHU Yin-jie, SHAO Xiao-guang, WANG Yan-qing, XU Fan, SHA Jian-jun, HUANG Yi-ran, XUE Wei
    2017, 37 (6):  797. 
    doi: 10.3969/j.issn.1674-8115.2017.06.015?

    Abstract ( 580 )   PDF (8645KB) ( 713 )  

    Objective · To evaluate the safety of neoadjuvant therapy which was constituted by docetaxel based systemic chemotherapy and maximal androgen blockage for patients with locally advanced prostate cancer and to summarize the related adverse events and clinical managements.  Methods · From June 2015 to February 2017, the clinical data of 55 patients undergoing neoadjuvant chemotherapy combined with complete androgen deprivation were retrospectively reviewed. The patients were given docetaxel and prednisone as DP regimen every 3 weeks and LHRH analogues with bicalutamide as maximal androgen deprivation for a total of 4 cycles. All treatment-related adverse events were observed and then recorded.  Results · Two cases with liver function impairment after 2 cycles of treatment were withdrawn from the study. No severe allergic reactions occurred during neoadjuvant therapy. The most common adverse events were hematologic toxicity, while 23.6% of patients had grade III-IV neutropenia, and about 12.7% had anemia. Due to a relatively short course of treatment, the skin or mucous damage, peripheral neurotoxicity and fluid retention were rare. However, hot flash, male breast development as well as erectile dysfunction were very frequently observed due to maximal androgen deprivation. The majority of these adverse events were relieved by symptomatic and supportive treatment.  Conclusion · After strict selection, 4 cycles of neoadjuvant chemotherapy combined with total androgen blockade could be well tolerated by the patients with high-risk locally advanced prostate cancer. Even though the adverse events were controllable, they still need to be closely monitored during treatment in order to reduce the incidence. In addition, the very low testosterone level associated endocrinal metabolic disorders caused by complete androgen deprivation were also of great concern.

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    Comparison of impacts on efficiency and safety between two types of microwires during mechanical thrombectomy for stroke
    SHI Yan-hui, LIU Yi-sheng, ZHAO Rong, LI Ge-fei, WU Yi-lan, PAN Hui, TANG Xue-mei, SUN Ji, SHI Nan, LIU Jian-ren
    2017, 37 (6):  803. 
    doi: 10.3969/j.issn.1674-8115.2017.06.016

    Abstract ( 827 )   PDF (9351KB) ( 858 )  

     Objective · To compare the impacts on clinical efficiency and safety between 0.014 inch Synchro microwire and Transend microwire used during mechanical thrombectomy for acute ischemic stroke (AIS) caused by large artery occlusion.  Methods · Forty-six patients undergoing mechanical thrombectomy with stent retrievers between October 2012 and January 2016 were included, who were classified into Synchro group (21 cases) and Transend group (25 cases). The clinical outcome, procedure time, and safety were analyzed and compared between two groups.  Results · The recanalization rates were similar between two groups (P=0.600) , but time from puncture to vascular recanalization of Synchro group was much shorter than that of Transend goup (48.88 min vs 82.33 min, P=0.001). The rates of functional independence (modified Rankin scale score ≤ 2) were similar between two groups (P=1.000). There was no significant difference of the rates of post-procedure subarachnoid hemorrhage (PSAH) between two groups (P=1.000). However, there were two cases that had fatal subarachnoid hemorrhage with intracranial hematoma in Transend group, while there was only one case of mild subarachnoid hemorrhage who recovered well in Synchro group.  Conclusion · Compared with Transend microwire, Synchro microwire can significantly shorten the procedure time of mechanical thrombectomy, and the risk of fatal subarachnoid hemorrhage is rather small.

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    Association between neck circumference and cardiovascular risk factors in middle-aged and elderly nondiabetic people in Jiading District, Shanghai
    LIU Shan-shan, WANG Long, DING Lin, PENG Kui, XU Yu, XU Min, LU Jie-li, BI Yu-fang, WANG Wei-qing, NING Guang
    2017, 37 (6):  809. 
    doi: 10.3969/j.issn.1674-8115.2017.06.017

    Abstract ( 520 )   PDF (9147KB) ( 757 )  

     Objective · To investigate the association between neck circumference (NC) and cardiovascular risk factors among middle-aged and elderly people without diabetes in Jiading District in Shanghai.  Methods · A cross-sectional study was conducted among 4 657 nondiabetic inhabitants aged 40 and above in Jiading District, Shanghai from August 2014 to July 2015. Clinical information collection, anthropometric measurements, and biochemical analyses were performed. The objects were divided into 4 groups according to the quartiles of NC in order to analyze association between NC and cardiovascular risk factors.  Results · With increase of NC, the prevalences of abdominal obesity, insulin resistance, hypertension, and dyslipidemia all increased as well as waist circumference, body mass index (BMI), blood pressure, lipid profile, fast blood glucose, and HOMA-IR level (all Ptrend <0.01). Multiple Logistic regression analysis showed that individuals in Q2, Q3 and Q4 group had significantly higher risk of abdominal obesity, insulin resistance, hypertension, and dyslipidemia compared with those in Q1 group after age, sex, smoking, drinking, physical activity, BMI, waist circumference, systolic blood pressure, C-reactive protein, fast blood glucose, and lipid profile were corrected (all Ptrend <0.01).  Conclusion · NC is positively and independently correlated with cardiovascular risk factors in middle-aged and elderly nondiabetic people in Jiading District in Shanghai.

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    Urine sample collection methods for measuring urinary concentrations of phenolic endocrine disrupting chemicals and their comparison in pregnant women
    TANG Ning*, WANG Xia*, WANG Xu, ZHAO Sha-sha, YU Xiao-gang, OUYANG Feng-xiu
    2017, 37 (6):  816. 
    doi: 10.3969/j.issn.1674-8115.2017.06.018

    Abstract ( 680 )   PDF (7908KB) ( 705 )  

     Objective · To compare urine sample collection methods for measuring urinary concentrations of phenolic endocrine disrupting chemicals including bisphenol A (BPA), triclosan (TCS), and 4-n-nonylphenol (4-n-NP) in pregnant women.  Methods · Urine samples were collected from women at late pregnancy by two methods: urine catheter and collection bag (n=176), urine collecting containers made of polypropylene (PP) (n=642). Urinary concentrations of BPA, TCS and 4-n-NP were measured with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. Confirmation experiment used PP containers, urine catheter and collection bags, as well as low-density polyethylene (LDPE) tubes and glass containers as both negative controls to collect urine samples from each of the 5 women.  Results · Geometric mean (GM) of urinary BPA concentration collected by urine catheter and collection bags was 82.5 ng/mL (95% CI 71.4-95.4 ng/mL), which was 63 times higher than that from PP containers (GM 1.3 ng/mL; 95% CI 1.3-1.5 ng/mL). Concentrations of urinary 4-n-NP and creatinine were similar between two collection methods. Confirmation experiment showed that urinary BPA concentration collected by urine catheter and collection bags was much higher than those collected by other three methods.  Conclusion · In collection of urine samples for measuring phenolic chemicals, PP urine collection container as well as LDPE containers are adequate for use in epidemiologic studies, but urine catheter and collection bag is not.

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    Chimeric antigen receptor T-cell immunotherapy and its applications in hematological malignancies immunotherapy
    XIA Li, WANG Yue-ying
    2017, 37 (6):  822. 
    doi: 10.3969/j.issn.1674-8115.2017.06.019

    Abstract ( 741 )   PDF (12008KB) ( 980 )  

     Chimeric antigen receptor T-cell (CAR-T) immunotherapy is a new type of immunotherapy, which has been developed rapidly in recent years. By using gene recombination and transfection techniques, CAR-modified effector T cells that specially recognize tumor-associated antigen was produced, which show better properties of targeting, killing activity and durability than conventional T cells. With the development of translational medicine research, CAR-T technology has experienced four generations of optimization and innovation, and presented a promising clinical efficacy in the treatment of various cancers, especially hematological malignancies. However, there are also potential risks with clinical use of this new technology, such as the off-target effect and cytokine storm. In this review, the progress, side effects, coping strategy, and development prospects of CAR-T in hematological malignancies immunotherapy were discussed.

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    Inflammatory response in cardiac remodeling after myocardial infarction
    FAN Qin, TAO Rong
    2017, 37 (6):  830. 
    doi: 10.3969/j.issn.1674-8115.2017.06.020

    Abstract ( 1068 )   PDF (9758KB) ( 870 )  

    The remodeling and reparative process post myocardial infarction (MI) can be divided into three phases: the inflammatory phase, the proliferative phase and the stable phase. The inflammatory immune response plays an important part in the process of cardiac remodeling. First of all, the initiation of inflammatory response relies on the activation of innate immunity with a group of pro-inflammatory cytokines, chemokines and adhesion molecules. These molecules lead to the infiltration of the infarct area with neutrophils and mononuclear cells, further clearing the wound from dead cardiomyocytes and matrix debris. After resolution of inflammatory response, reparative cells and cytokines infiltrate into the heart and promote the differentiation and growth of myofibroblasts and endothelial cells, contributing to wound contraction as well as producing fiber tissue to form a scar. Moreover, overactive immune responses could accentuate infarct injury and dilative remodeling while deficiency of inflammation leads to insufficient repair, which highlights the dual function of the immune response in myocardial injury and repair post MI. Also the intense immune response along with fibrosis in non-infarct area is also closely associated with adverse remodeling. Thus, targeting specific factors in the inflammatory reaction may hold promise in patients with MI.

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    Clinical research progress in immunotherapy against atherosclerosis
    YOU Sha-sha, CAO Hui-min, XUE Xiao-mei, HE Bin
    2017, 37 (6):  836. 
    doi: 10.3969/j.issn.1674-8115.2017.06.021

    Abstract ( 602 )   PDF (9347KB) ( 888 )  

     Atherosclerosis is a chronic inflammatory disease, with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens. Subsequent investigations have revealed that an immunomodulatory strategy via active immunization against atherosclerotic plaque antigen(s) could potentially alleviate atherosclerosis. Substantial data from clinical investigations support the key role of immune system in atherosclerosis. So, it may be promising to develop immunotherapy against atherosclerosis. The paper reviews current status of immunization studies and possible associated immunemediated inflammatory mechanisms in atherosclerosis.

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    Research progress of effect and mechanism of protein arginine methyltransferase in tumors
    WEN Jun, MIN Xue-jie, ZHAO Li, ZHAO Xiao-ping
    2017, 37 (6):  842. 
    doi: 10.3969/j.issn.1674-8115.2017.06.022

    Abstract ( 1210 )   PDF (7473KB) ( 1913 )  

     Protein arginine methyltransferase (PRMT) can methylate a variety of proteins, including histones and non-histones, affecting a variety of cellular processes such as transcription, RNA splicing, DNA repair, and cell cycle control. The activity of PRMT is affected by a variety of regulatory mechanisms, and its abnormal expression plays an important role in the development of the diseases, especially in tumors such as breast cancer and leukemia. PRMT has a unique value in the diagnosis or treatment of tumors. With the further exploration of PRMT methylation mechanism, PRMT selective inhibitors have made some progress. PRMT-specific inhibitors are expected to be targeted drugs for the treatment of tumors.

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    Different patterns of titanium surface nanocrystallization and drug load aimed at establishing orthopedic implants with antimicrobial property
    LI Hui, NIE Bin-en, YUE Bing
    2017, 37 (6):  847. 
    doi: 10.3969/j.issn.1674-8115.2017.06.023

    Abstract ( 617 )   PDF (10622KB) ( 733 )  

    Titanium and titanium alloys, which are bio-inert materials and have excellent mechanical properties, have broad applications in clinic.On the one hand, TiO2 nanotube can effectively enhance the osteogenic differentiation of bone marrow mesenchymal stem cells and have antimicrobial abilities in some extent; On the other hand, TiO2 nanotube, an outstanding drug-carrier, could effectively prevent and treat bone implant-related infection by loading antimicrobial agents. By means of modifying the nanotube coating, improving the efficiency of drug loading and ameliorating release profile, the ideal antimicrobial property could be achieved. Strategies for drug release can be divided into two approaches, namely mechanical release and intellectual release. Mechanical release could fortify the antibacterial ability of coating, but the unicity and uncontrollability of agents diluting need to be resolved. By contrast, intellectual agents release has the advantages of multiple drug species, controllable release volume and programmed trigger condition. This article reviews the current and potential methods of antibacterial substances loading and release from TiO2 nanotube, and expects to provide the orientation for future direction of controllable and intellectual nanotube drug release.

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    Research progresses in the effects of folate metabolism on ovarian function
    PAN Hui-ying, LAI Dong-mei
    2017, 37 (6):  853. 
    doi: 10.3969/j.issn.1674-8115.2017.06.024?

    Abstract ( 505 )   PDF (9416KB) ( 775 )  

    As one of important B vitamins, folate is an essential nutrient for the body and involves in various biochemical and metabolic reactions. Studies have shown that as an important methyl donor in the carbon metabolism cycle, folate has an important impact on pregnancy, pregnancy complications, and birth defects. Further studies have shown that in the folate metabolic pathway, the gene polymorphism and folic acid metabolism of a key enzyme, 5,10- methylenetetetrahydrofolate reductase (MTHFR), play an important role in ovarian function. Gene polymorphism and the high homocysteine levels caused by it can lead to the damage of reproductive function and endocrine function, including follicular development, embryonic development, and hormone secretion. Gene polymorphism is also associated with the occurrence and development of ovarian disease and its response to treatment. With the deep understanding of folate metabolism, MTHFR gene polymorphism may become a new genetic marker for predicting the risk of disease and a new target for related gene therapies

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    Research progress on the relationship between sudden sensorineural hearing loss and serum lipids
    ZHENG Zhong, SUN Yuan-yuan, XIA Liang, GUO Yang, FENG Yan-mei
    2017, 37 (6):  859. 
    doi: 10.3969/j.issn.1674-8115.2017.06.025

    Abstract ( 548 )   PDF (9550KB) ( 951 )  

    Sudden sensorineural hearing loss (SSHL), which is a common and frequently encountered disease, is considered to be a medical emergency in otolaryngology. The prevalence of SSHL is increasing in China. The pathogenesis of SSHL is not clear yet. Microcirculatory disorder of inner ear is considered as one of the most important causes of SSHL. In recent years, several reports have found the levels of serum lipids were changed in patients affected by SSHL. The relationship between SSHL and serum lipids was reviewed to provide new ideas for the diagnosis and treatment of SSHL.

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    Progress on roles and mechanisms of CCAAT/enhancer binding protein β in endometrium decidualization
    DI Fang-fang, LIU Jian-sheng, LI Shang, DU Yan-zhi
    2017, 37 (6):  865. 
    doi: 10.3969/j.issn.1674-8115.2017.06.026

    Abstract ( 664 )   PDF (8651KB) ( 715 )  

     CCAAT/enhancer binding protein β (C/EBPβ) is a critical member of C/EBP family. C/EBPβ, based on the leucine zipper located in C terminal of the protein, can regulate transcriptional activities of downstream target genes involved in diverse cellular processes, such as proliferation and differentiation. Recently published studies have identified that C/EBPβ is essential in the decidualization of endometrial stromal cells. This review summarizes the roles and mechanisms of C/EBPβ during the courses of decidualization, which is aimed at providing novel insights for dysfunctional decidualization.

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    Effects of lifestyle intervention on glucose control in people with type 2 diabetes
    LI Lin, XU Yu
    2017, 37 (6):  870. 
    doi: 10.3969/j.issn.1674-8115.2017.06.027

    Abstract ( 574 )   PDF (10373KB) ( 819 )  

    Lifestyle intervention is basic and background treatment for people with type 2 diabetes. Effective lifestyle intervention contributes to better glucose control and delay of diabetic complications. Dietary and exercise interventions as well as lifestyle advice are major components of lifestyle intervention. Dietary intervention focuses on restriction of total caloric intake and balanced nutritional composition, while exercise intervention focuses on exercise mode, frequency, intensity, timing, and duration. This review  introduced several lifestyle intervention measures including exercise and dietary interventions as well as lifestyle advice, and discussed their effects on glucose control in people with type 2 diabetes.

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    Advances in the application of intraoperative computed tomography to surgeries
    WANG Shu-ze, WANG Xu-dong
    2017, 37 (6):  876. 
    doi: 10.3969/j.issn.1674-8115.2017.06.028

    Abstract ( 666 )   PDF (7362KB) ( 635 )  

     With the proposal of the concept of precision surgery, doctors pay more attention to the precious balance of removing target lesions, protecting organs, and controlling damage. The application of intraoperative computed tomography (ICT) facilitates the realization of precision surgery. This paper summarizes the origination and development of ICT, as well as its wide applications in neurosurgery, otolaryngology, and maxillofacial surgery. Although ICT has many disadvantages to be improved, such as high radiation dose and high cost, it is still a good choice for improving the precision of treatment.

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    A sporadic case of tuberous sclerosis complex caused by a newly found heterozygous missense mutation of c.T1967C in TSC1 gene
    YAO Meng-sha, LIU Jun
    2017, 37 (6):  881. 
    doi: 10.3969/j.issn.1674-8115.2017.06.029

    Abstract ( 506 )   PDF (4977KB) ( 897 )  

     This paper reported a sporadic case of a 29-year-old Han female diagnosed with tuberous sclerosis complex (TSC) by next generation sequencing (NGS), one of genetic analysis techniques. She was admitted because of recurrent intractable seizure for 26 years, dizziness and headache for 3 months. Physical examination revealed angiofibromas over her face, shagreen patches in her lower back area, and hypomelanotic macules around her limbs and body. Cranial MRI manifested lesions on lateral ventricles, cerebellar vermis and left temporal lobe with abnormal signal changes on both sides of extensive cerebral cortex. A pathogenic and heterozygous missense mutation, c.T1967C, in exon 16 of her TSC1 gene was found via genetic tests, which has not yet been reported before.

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