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28 December 2017, Volume 37 Issue 12 Previous Issue    Next Issue

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Translational medicine 2017, 37 (12):  3.  Abstract ( 421 )   PDF (4104KB) ( 740 )   Related Articles | Metrics

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Relationship between neuropeptide Y gene polymorphism and schizophrenia ZHAO Jing, Lü Qin-yu, LU Ying, HU Guo-qin, BAO Chen-xi, ZHU Ming-huan, JIA Si, CHENG Xiao-yan, GENG Rui-jie, JIANG Ya-qin, YU Shun-ying, YI Zheng-hui 2017, 37 (12):  1581.  doi: 10.3969/j.issn.1674-8115.2017.12.001 Abstract ( 919 )   PDF (8735KB) ( 1027 )   [Abstract] Objective · To explore the association between neuropeptide Y (NPY) gene polymorphism and schizophrenia in Chinese Han population. Methods · Four single nucleotide polymorphism (SNP) loci (rs16148, rs1859290, rs16147, and rs16478 in NPY gene) were selected and genotyped by TaqMan genotyping assay in a case-control study with 678 schizophrenia cases (case group) and 685 healthy controls (control group). The allele, genotype and haplotype frequencies distribution of the SNPs between the groups were compared with SHEsis online software. Results · The distribution of genotype frequency of locus rs16478 showed a nominal statistically difference between the adult-onset schizophrenia (AOS group) and control group (χ2=6.66, P=0.036, P correction=0.144). Under recessive inherited model, the distribution of CC genotype frequency of locus rs1859290 showed statistically difference between the male schizophrenia cases and control group (P=0.012, OR=0.97, 95%CI 0.94-0.99, P correction=0.048). The distribution of haplotype CCTA (consisted of rs16148, rs1859290, rs16147, and rs16478) frequency showed statistically difference between the male AOS group and control group (8.1% vs 13.2%, OR=0.57, P=0.010, P correction=0.040). Conclusion · The polymorphisms in NPY gene may be associated with schizophrenia in Chinese Han population. Related Articles | Metrics

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Effect of blocking RAGE on macrophage infiltration of diabetic wound healing WANG Qi, CAO Xiao-zan, ZHU Guan-ya, SONG Fei，LU Shu-liang, NIU Yi-wen 2017, 37 (12):  1588.  doi: 10.3969/j.issn.1674-8115.2017.12.002 Abstract ( 818 )   PDF (7229KB) ( 855 )   [Abstract] Objective · To investigate the influence of blocking receptor for advanced glycation end products (RAGE) on macrophages infiltration in diabetic wound healing. Methods · Ninety-six male C57BL/6J mice (8-week-old) were divided into diabetic group (n=72) and normal group (n=24) randomly. Diabetic mice were induced by streptozocin multiple intraperitoneal injection. One full-thickness excisional wound (diameter of 9 mm) was created by a sterilized punch. Diabetic mice were divided into 3 groups in which different topical treatments were applied to the wounds. Anti-RAGE antibody were applied in group R, rabbit IgG applied in group I, normal saline applied in group C. Normal mice were applied with saline topically (group N). All treatments were repeated on day 3 and day 7 after wounded. The wound healing conditions were observed. The wound and surrounding tissues from animals in each group were excised on day 1, 3, and 7 after wounded. Immunohistochemistry was utilized to investigate the changes of macrophages infiltration in quantity. Macrophages were also analyzed with respect to morphology by transmission electron microscopy (TEM). Results · ① The wound closure ratio of group R was higher than those of group C and group I on day 14 after being wounded (P=0.000). ② On day 1, the numbers of macrophages in group R and group N were both bigger than those of group C and group I, but smaller on day 14 (P=0.000). ③ The morphological characters of macrophages also existed great differences under TEM. Conclusion · Number and morphology of macrophages are both abnormal in diabetic wound in a RAGE pathway depending manner. Based on macrophages, it suggests that impaired healing of diabetic wound is closely related to RAGE pathway. Related Articles | Metrics

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Effects of sodium houttuyfonate on spinal cord injured neurons in rats TANG Wei, XIA Yong-zhi, LIU Jing-xian, LIU Lu, YAN Yi 2017, 37 (12):  1594.  doi: 10.3969/j.issn.1674-8115.2017.12.003 Abstract ( 693 )   PDF (8172KB) ( 832 )   [Abstract] Objective · To investigate the effects of sodium houttuyfonate (SH) on neurons in early traumatic spinal cord injury (TSCI) rats and its mechanism. Methods · Forty adult female rats were randomly divided into sham group (n=8), control group (n=8) and experimental group (n=24). The sham group only received opened laminectomy without spinal cord clamping, the spinal cords in other two groups were clamped. The experimental group was divided into low [0.06 g/(kg·d)], moderate [0.12 g/(kg·d)] and high [0.24 g/(kg·d)] dose subgroups, in which SH was administrated intragastrically 1 h after operation and next two days. The other groups were given equivalent normal saline. The best therapeutic dose of SH was screened out by the results of the BBB scores and Nissl staining. To explore the neuroprotection mechanisms of SH, 72 rats were randomly divided into sham group (n=24), model group (n=24) and SH best dose group (n=24), the postoperative interventions were as same as above. Immunofluorescence and immunohistochemistry were respectively used to detect the number of motor neurons and cleaved-caspase3 positive staining neurons, the expression of Bax, Bcl-2, NeuN and cleaved-caspase3 was detected by Western blotting. Results · The BBB scores on day 5 and day 7 after operation in low dose group were higher than those of control group (all P<0.01), but lower than those of moderate and high dose groups (all P<0.01), and the scores in the moderate and high dose groups were not different significantly. On day 7 after operation, compared with moderate and high dose groups, the dissolution of Nissl bodies in low dose group and control group increased, the number of Nissl bodies reduced, and the colour shallowed. But Nissl staining in moderate and high dose groups were similar. The optimal dose of SH was 0.12 g/(kg·d), which was judged by the results of BBB scores and Nissl staining. On day 3 and day 7 after operation, compared with control group, the number of motor neurons and the expression of NeuN and Bcl-2 in SH best dose group were increased (all P<0.01), while the number of cleved-caspase3 positive staining neurons and the expression of Bax and cleaved-caspase3 were reduced (all P<0.01). Conclusion · SH has a certain neuroprotection on neurons in TSCI, its mechanism may be through upregulating the ratio of Bcl-2/Bax, thereby reducing the neuronal apoptosis. Related Articles | Metrics

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Effect and mechanism of ethyl pyruvate on delayed cerebral vasospasm after subarachnoid hemorrhage #br# JIN Ke, JIN Yi-chao, Lü Tao, ZHANG Feng-chen, ZHANG Xiao-hua 2017, 37 (12):  1601.  doi: 10.3969/j.issn.1674-8115.2017.12.004 Abstract ( 782 )   PDF (8802KB) ( 726 )   [Abstract] Objective · To observe the degree of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) at different time poininvestigate the effects of ethyl pyruvate (EP) on CVS following SAH and its mechanism. Methods · Fifty healthy SD rats were randomly difive groups i.e. sham group, SAH-3 d group, SAH-5 d group, SAH-7 d group and SAH-9 d group (n=10 in each group). Sham group was built cisternal injection with 0.3 mL saline each time, and SAH group was built by double cisternal injection with 0.3 mL autologous blood each neurological function and degree of CVS were observed. Another forty-eight healthy SD rats were randomly divided into three groups i.e. sh(equal volume) group, SAH+saline (equal volume) group and SAH+EP [100 mg/(kg·d)] group (n=16 in each group). The neurological functionCVS and cell apoptosis of basilar artery were observed on day 7. The expressions of p-Akt, Bax, Bcl-2 and cleaved caspase-3 were also observed Results · CVS significantly increased on day 3, decreased on day 5, and then significantly increased to top level on day 7, and gradually decreased Compared with sham+saline group, the neurological scores were significantly decreased in SAH+saline group on day 7. Compared with sham+saCVS and cell apoptosis of basilar artery were significantly increased in SAH+saline group on day 7. Compared with sham+saline group, the eof Bax and cleaved caspase-3 were significantly up-regulated, while the expressions of p-Akt and Bcl-2 were significantly down-regulated in SAgroup on day 7. Compared with SAH+saline group, the neurological scores significantly increased in SAH+EP group on day 7. Compared with Sgroup, CVS and cell apoptosis of basilar artery significantly decreased in SAH+EP group on day 7. Compared with SAH+saline group, the exprBax and cleaved caspase-3 were significantly down-regulated, while the expressions of p-Akt and Bcl-2 were significantly up-regulated in SAH+EP day 7. Conclusion · The double hemorrhage model rat has most severely CVS on day 7. EP can attenuate vasospasm after SAH, and its mechanisassociated with inhibition of cell apoptosis. PI3K/Akt signaling pathway may be involved, which may provide a novel therapeutic target for CVS. Related Articles | Metrics

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Modulation of mesenchymal stem cells on autophagy in hippocampus of rats with hypoxic-ischemic #br# brain damage YANG Miao, HE Mu-lan, GU Yan, YANG Ting, LI Ting-yu, CHEN Jie 2017, 37 (12):  1608.  doi: 10.3969/j.issn.1674-8115.2017.12.005 Abstract ( 767 )   PDF (10623KB) ( 842 )   [Abstract] Objective · To investigate the effect of mesenchymal stem cells (MSCs) on autophagy in hippocampus of neonatal rats with hypoxic-ischemic brain damage (HIBD). Methods · Western blotting was used to detect the expression levels of autophagy associated proteins Beclin1, LC3 Ⅱ , and p62 in the hippocampus of HIBD rats following MSCs transplantation and oxygen glucose deprivation (OGD)-injured primary neurons following MSCs seperated coculture. The learning-memory function in the HIBD rats after MSCs transplantation was tested by Morris water maze test. Transmission electron microscopy was also used to observe the number of autophagic neurons in OGD damaged neurons after coculture with MSCs. Results · The levels of Beclin1 and LC3 Ⅱ protein expressions were significantly increased at 12-24 h in the rat hippocampus following HIBD injury. MSCs transplantation statistically downregulated the autophagy level in the hippocampus, and obviously improved the learning-memory function of HIBD rats. Meanwhile, the levels of Beclin1 and LC3 Ⅱ protein expressions in the primary neurons in vitro were also induced by OGD for 12 h. MSCs seperated coculture significantly downregulated the autophagy level of hippocampal neurons by OGD injury, decreased the number of autophagosome in the OGD-injured neurons. Conclusion · MSCs may inhibit the autophagy of hippocampal neurons by partly regulating the damaged microenvironment to improve the learning and memory function of HIBD rats. Related Articles | Metrics

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Effects of insulin-like peptide 6 on renal fibrosis and calcification in unilateral ureteral obstruction mice#br# GAO Lei, WU Shi-yong, JIANG Dan, WANG Ying, LI Yong-yong, WANG De-wei, CHANG Guang-lei, ZHANG Peng, QIN Zheng, ZHANG Dong-ying 2017, 37 (12):  1616.  doi: 10.3969/j.issn.1674-8115.2017.12.006 Abstract ( 756 )   PDF (8416KB) ( 996 )   Objective · To investigate the effects of insulin-like peptide 6 (Insl6) on renal fibrosis and calcification in unilateral ureteral obstruction (UUO) mice.  Methods · Twenty-four SPF male mice with genotypic background of C57BL/6 were divided into Sham (n=8), UUO+saline (n=8) and UUO+Insl6 (n=8) groups randomly. Mice were sacrificed 10 days after operation and renal tissues of surgical side were obtained. Sirus red staining, Masson staining and alizarin red S staining were used to verify the level of collagen and calcium deposition. TGF-β1 expression was determined by Western blotting. Realtime-PCR was used for determining TGF-β1, BMP2, Col1a1, and Col2a1 mRNA expression.  Results · Compared with sham group, fibrotic area especially collagen Ⅰ, calcium deposition, TGF-β1 protein, and TGF-β1, BMP2, Col1a1, and Col2a1 mRNA expression in UUO+saline group significantly  increased (all P<0.05). As compared with UUO+saline group, fibrotic area especially collagen Ⅰ, calcium deposition, TGF-β1 protein, and TGF-β1,  BMP2, Col1a1, and Col2a1 mRNA expression in UUO+Insl6 group significantly decreased (all P<0.05).  Conclusion · Insl6 inhibits UUO-induced renal fibrosis and calcification, which may be related to regulation of TGF-β1, collagen Ⅰ , BMP2 and collagen Ⅱ expression levels. Related Articles | Metrics

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Preliminary study of flavonoids affecting cAMP level in cannabinoid receptor overexpressed cells#br# LI Ting, LIU Jian-hua 2017, 37 (12):  1623.  doi: 10.3969/j.issn.1674-8115.2017.12.007 Abstract ( 727 )   PDF (8372KB) ( 857 )   Objective · To evaluate the effects of flavonoids on cyclic adenosine monophosphate (cAMP) level in cannabinoid receptor (CBR) overexpressed cells.  Methods · Eukaryotic expression vectors GV144-CB1R and GV144-CB2R were constructed, and transfected into HEK-293 cells to establish CBR overexpressed cell lines. Several flavonoid compounds were studied by measuring the change of cAMP level in CBR-overpressed HEK293 cell lines.  Results · The CBR overexpressed cell lines were constructed successfully. cAMP level in CBR-overexpressed HEK-293 cells decreased after incubation with flavonoid compounds. And these effects were selective for CB2R overexpressed cells.  Conclusion · All flavonoids studied exhibited decreasing effect on cAMP level in CBR-overexpressed cells at μmol/L level. Related Articles | Metrics

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Ultrasonic radiation reduces cerebral micro-emboli during cardiac surgery in pigs#br# AN Kang, MEI Ju, YAO Li-ping, ZHANG Zhen, BAI Jing-feng, TANG Min 2017, 37 (12):  1630.  doi: 10.3969/j.issn.1674-8115.2017.12.008? Abstract ( 592 )   PDF (5803KB) ( 872 )   Objective · To evaluate if ultrasound acoustic force can reduce cerebrovascular micro-emboli after cardiac surgery.  Methods · Seven pigs were used during the experiment, three for air emboli injection, three for solid emboli injection, and one for safety study. After anesthesia, right carotid artery, left atrial appendage, ascending aorta, and proximal innominate artery were exposed surgically. An intravenous catheter was inserted into left atrial appendage for injecting air or solid micro-emboli. The ultrasound transducer was placed at the bifurcation of the aorta and the innominate artery, with the sonic beacon toward the descending aorta. Micro-emboli through the right carotid artery were monitored by ultrasound transducer. Micro-emboli mixture (10 mL, air emboli or solid emboli) was injected with or without ultrasonic activation, each repeating three times. Micro-emboli through right carotid artery were measured under each condition. Ultrasonic time-intensity curves were performed and analyzed. For safety test, ultrasound with the same energy on a pig for 5 minutes was applied. The tissue samples were obtained for pathological evaluation from sonicated and non-sonicated areas of the aorta, trachea and the esophagus.  Results · Ultrasonic time-intensity curve showed that the mean ultrasonic intensity of the right common carotid artery significantly decreased after ultrasonic activation. The intensity of air emboli reduced from 128.8±32.7 to 56.4±21.1 (P=0.000), while the intensity of solid emboli reduced from 109.8±19.9 to 75.4±21.9 (P=0.000). H-E staining of the surrounding tissues showed no differences between sonicated and nonsonicated areas of the aorta, trachea and the esophagus.  Conclusion · Ultrasonic acoustic force can decrease the number of micro-emboli that enter the brain. Thus, it may lower the risk of postoperative neurological complications after cardiac surgery. Related Articles | Metrics

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Application of indocyanine green in sentinel lymph node biopsy of breast cancer and analysis of dose-response#br# YE Xin, CUI Rong-rong, ZHOU Xiao-yun, WANG Zheng-yuan 2017, 37 (12):  1634.  doi: 10.3969/j.issn.1674-8115.2017.12.009? Abstract ( 822 )   PDF (8074KB) ( 886 )   Objective · To study the imaging of subcutaneous lymph-vessels and lymph-nodes in sentinel lymph node biopsy (SLNB) with different concentrations of indocyanine green (ICG), and to find the best concentration to improve the success rate of SLNB.   Methods · A total of 339 primary breast cancer patients with clinical negative axillary lymph node were enrolled in the study. Double tracer method [ICG and methylene blue (10 mg/ mL)] was used for sentinel lymph node biopsy. 1.25 mg/mL ICG was diluted to difference concentration. The injection volume was 1 mL for ICG and 1 mL for methylene blue. The imaging of subcutaneous lymph-vessels and lymph-nodes and the success rate of SLNB were recorded after injection of different concentrations of ICG.  Results · The concentration of ICG had significant effect on lymph-vessels and lymph-nodes imaging rate and SLNB success rate (P=0.001). In the group that breast tumors not located in the external upper quadrant (needle biopsy or excisional biopsy) and tumor located in the external upper quadrant without excisional biopsy (needle biopsy), concentration of ICG reached 80% subcutaneous lymph-vessels imaging rate is 0.723 mg/mL (95% CI 0.595-0.915 mg/mL). In this group, in this concentration range, the imaging rate of subcutaneous lymph node was 28%-53%, and the success rate of SLNB was 88%-92%. In the group that breast tumors located in the external upper quadrant and had been resected, the imaging rate of subcutaneous lymph-vessels and lymph-nodes was 50%-69% and 20%-42%, respectively, and the success rate of SLNB was 76%-81%. The difference of subcutaneous lymph-vessels imaging rate between two groups was statistically significant (P=0.014), but the difference of lymph-nodes imaging rate and SLNB success rate had no significance (P=0.628, P=0.232).  Conclusion · Using double tracer (ICG and methylene blue) in SLNB is simple and feasible. The best concentration of ICG is 0.723 mg/mL, which can improve the imaging rate of lymph nodes and lymph nodes. Related Articles | Metrics

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Relationship between quantitative indices of carotid plaque from contrast-enhanced ultrasound and leukocytes in patients with acute large artery atherosclerotic stroke#br# LI Zhao-jun, LI Wan-bin, BAI Yun, YANG Qing, DU Lian-fang, LUO Xiang-hong 2017, 37 (12):  1640.  doi: 10.3969/j.issn.1674-8115.2017.12.010? Abstract ( 498 )   PDF (6386KB) ( 898 )   Objective · To investigate the relationship between quantitative indices of carotid plaques from contrast-enhanced ultrasound and leukocytes, and explore the value in the patients with acute large artery atherosclerotic stroke (LAAS).  Methods · A total of 62 patients with LAAS and 48 matched control subjects hospitalized in Shanghai General Hospital, Shanghai Jiao Tong University from June 2016 to June 2017 were enrolled. Obvious carotid plaques were examined by contrast-enhanced ultrasound. The parameters of time-intensity curve i.e. peak (PTIC) and mean (MTIC), and the parameters of fitting curve i.e. peak (PFC), sharpness (SFC), and under the curve area (AUCFC) were obtained. These parameters were compared between the groups using two samples t tests. The correlations between the parameters and leukocyte counts were analyzed by Pearson correlation analysis.  Results · ① In LAAS group, the total leukocyte and neutrophil counts were higher than those of the control group, while the lymphocyte count was lower than that of the control group (P<0.05). ② The PTIC, MTIC, PFC, SFC and AUCFC were significantly larger in LAAS group than those in the control group, respectively (P<0.05). ③ PTIC, MTIC and PFC were negatively correlated with lymphocytes, respectively (r=-0.291, -0.263 and -0.270, P<0.05). SFC and AUCFC were positively correlated with neutrophils, respectively (r=0.261 and 0.298, P<0.05).  Conclusion · Quantitative indices of carotid plaques from contrast-enhanced ultrasound are associated with circulating leukocytes, and the association helps assess the vulnerability of the plaques. Related Articles | Metrics

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Mechanism research about the role of microbleeds for early cognitive impairment in small vascular disease#br# MI Jian-hua, LU Dong, ZHAO Wei, ZHI Nan, CAO Wen-wei, YU Ling, GENG Jie-li, XU Qun 2017, 37 (12):  1644.  doi: 10.3969/j.issn.1674-8115.2017.12.011 Abstract ( 735 )   PDF (8551KB) ( 749 )    Objective · To make clear the role of cerebral microbleeds (CMBs) for early cognitive impairment in small vessel disease (SVD).  Methods · Fifty-seven consecutive SVD patients without dementia were strictly recruited. All participants were examined with a comprehensive battery of neuropsychological tests, SWI and DTI. According to the amount of CMBs, the patients were divided into CMBs group and non-CMBs group, or divided into multiple CMBs group (CMBs ≥ 3) and non-multiple CMBs group (CMBs<3). The mean diffusivity (MD) and fractional anisotropy (FA) in periventricular, central semiovale and subcortical white matter was analyzed with a region-of-interest method.  Results · The score of multiple CMBs group in attention and memory function was significantly lower than that of the non-multiple CMBs group. Correlation analysis showed that the count of CMBs in the whole brain was significantly correlated with periventricular white matter MD, subcortical white matter MD, periventricular white matter FA and subcortical white matter FA. The count of CMBs in the whole brain adjusted by age, gender, education was significantly correlated with attention/ executive function. After adjustment of subcortical/ periventricular white matter FA and MD and locations of CMBs they still had significant correlation.  Conclusion · CMBs can reflect the degree of destruction of white matter integrity, and have independent effects on injury of brain parenchyma, resulting in early cognitive impairment. The research also suggests the role of CMBs in cognitive impairment may exist threshold value effect. Related Articles | Metrics

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Correlation of etomidate and bispectral index in anesthesia induction of children with congenital heart disease shunting from left to right#br# WANG Chun, ZHU Chang-e, ZHANG Sai-ji, HAN Wen-dong, WEI Rong 2017, 37 (12):  1650.  doi: 10.3969/j.issn.1674-8115.2017.12.012 Abstract ( 720 )   PDF (4145KB) ( 849 )   Objective · To explore the correlation of etomidate dose and bispectral index (BIS) in children with congenital heart disease shunting from left to right during anesthesia induction.  Methods · After general anesthesia induction to 24 children with congenital heart disease shunting from left to right, sevoflurane inhaling was stopped in order to make the BIS value gradually return to 80. Intravenous injection of etomidate was sustained by 0.3 mg/(kg·min) until the BIS value reached 40. The heart rate (HR), arterial blood pressure (ABP) and central venous pressure (CVP) of the patients were recorded when BIS value was 80, 70, 60, 50， and 40, respectively.The correlation of etomidate dose and BIS value in the children during anesthesia induction was analyzed.  Results · There were no significant hemodynamic changes when the BIS value  were from 80 to 40. The amount of etomidate was highly negatively correlated with the BIS value (r=-0.769, P<0.01), the average dose of etomidate in children under 2 years of age was significantly higher than that in children over 2 years old (P=0.034).  Conclusion · The etomidate dose is highly negatively correlated with the BIS value. Etomidate has less influence on hemodynamic parameters of children with congenital heart disease shunting from left to right. The BIS value may have relationship with patients’ age. Related Articles | Metrics

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Characteristic analysis of fundus fluorescein angiography and optical coherence tomography findings in uveitis#br# CHEN Na, YAN Yan, LI Zhen, LU Shi-heng 2017, 37 (12):  1653.  doi: 10.3969/j.issn.1674-8115.2017.12.013 Abstract ( 812 )   PDF (5656KB) ( 995 )   Objective · To investigate the characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) findings of patients with uveitis.  Methods · The clinical data of 84 patients (135 eyes) diagnosed as uveitis in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Apr 2015 to Aug 2017 were studied retrospectively. FFA and OCT examinations were performed.  Results · Of 84 patients, the average age was (44±10) years old. There were more males than females. Fifty-one patients (102 eyes) were affected bilaterally, and 33 patients (33 eyes) were affected unilaterally. Optic fluorescence leakage was found in 73% of patients, and retinal vascular wall staining was found in 50% of patients by FFA. Cystoid macular edema was found in 23% of patients, and neuroepithelial detachment was found in 21% of patients by OCT. The proportion of common positive manifestation by OCT (10%–40%) was lower than that by FFA (23%–100%) (χ2=33.8, P=0.000).  Conclusion · The uveitis usually occurs in young and middle-aged male patients. The most common features of the uveitis patients are optic fluorescence leakage and retinal vascular wall staining by FFA, and cystoid macular edema and neuroepithelial detachment by OCT. Related Articles | Metrics

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Clinical results of multi-artery-graft and single-artery-graft off-pump coronary artery bypass grafting: a propensity score matching follow-up study#br# ZHU Peng-xiong, CHEN An-qing, LIU Jun, WANG Zhe, YE Xiao-feng, ZHOU Mi, ZHAO Qiang 2017, 37 (12):  1658.  doi: 10.3969/j.issn.1674-8115.2017.12.014 Abstract ( 736 )   PDF (7800KB) ( 836 )   Objective · To explore the difference between multi-artery-graft off-pump coronary artery bypass grafting (OPCABG) and single-artery-graft OPCABG on left main coronary artery or multivessel disease with propensity score matching.  Methods · A total of 1 578 patients with left main coronary artery or multivessel disease underwent isolated OPCABG were selected in Ruijin Hospital from January 2012 to September 2016. The propensity score methodology was used to obtain risk-adjusted outcome. Kaplan-Meier analysis was applied for estimation of freedom from major adverse cardiac and cerebrovascular events (MACCE) and readmission for heart disease. Independent predictor of MACCE were assessed by Cox regression analysis.  Results · The average follow-up time was 28 months (7-55 months). There was no statistical difference in short-term clinical endpoints in hospital. In the follow-up results, multi-artery-graft OPCABG patients had statistical improvement in readmission for heart disease (2.7% vs 12.7%, P=0.023), CCS class (1.2±0.4 vs 1.4±0.6, P=0.020) and patency rate of grafts in 1 year after operation (95.8% vs 85.9%, P=0.025), compared with single-artery-graft OPCABG. There was no statistical difference in other endpoints. There was statistical improvement for multi-artery-graft OPCABG patients in freedom from readmission for heart disease (P=0.028). Female was an independent predictor of MACCE (95% CI 0.117-0.906, P=0.032).  Conclusion · Multiartery-graft OPCABG appears to be safe and with good patency of grafts and clinical outcomes in treating left main coronary artery or multivessel disease. The follow up of female patients should be paid more attention. Related Articles | Metrics

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Safety of laparoscopic surgery in diagnosis and treatment of gynecologic diseases in elderly women#br# WANG Yue-ping, LONG Wen-qing 2017, 37 (12):  1664.  doi: 10.3969/j.issn.1674-8115.2017.12.015 Abstract ( 885 )   PDF (8090KB) ( 735 )    Objective · To investigate safety of laparoscopic surgery in diagnosis and treatment of gynecologic diseases in elderly women over 70 years old.  Methods · A total of 420 cases of elderly patients over 70 years old from January 2009 to December 2016 were retrospectively analyzed in Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. According to ages, the patients were divided into elderly group (70-80 years old, including 70 years old) and advanced age group (80 years old and above); according to surgical methods, the patients were divided into laparoscopy group and laparotomy group. The ages, American Society of Anesthesiology (ASA) classifications, body mass indexes (BMI), preoperative complications, surgical methods, intraoperative circumstances, postoperative pathology results and postoperative complications were analyzed.  Results · There were no significant differences in age, ASA classification and BMI between laparoscopy group and laparotomy group in the same age group (P<0.05). Most patients had various chronic diseases before operations. Taking total hysterectomy as an example, laparoscopy groups in the two age groups were superior to laparotomy groups in the comparison of surgical time, bleeding volume, anal evacuation time and length of hospital stay (P<0.05). In the two age groups, laparoscopic malignant tumor radical surgery took less time, less bleeding and shorter anal evacuation time than laparotomy (P<0.05). Elderly laparoscopy group had less poor wound healing cases than elderly laparotomy group (P<0.05), while there was no statistical difference in other postoperative complications (P>0.05). All the patients completed the surgeries without perioperative deaths.  Conclusion · Laparoscopy is safe in the diagnosis and treatment of gynecological benign and malignant diseases in elderly women with shorter operation time, less bleeding and faster postoperative recovery compared with laparotomy. Related Articles | Metrics

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Clinical and pathological characteristics of endometrial carcinoma in premenopausal and  postmenopausal patients#br# LIU Hua, JIAN Fang-fang, SONG Wei, SHEN Li-fei 2017, 37 (12):  1670.  doi: 10.3969/j.issn.1674-8115.2017.12.016 Abstract ( 857 )   PDF (5437KB) ( 1162 )   Objective · To analyze the clinical and pathological characteristics of endometrial carcinoma patients before and after menopause.  Methods · Fifty-two premenopausal cases and 150 postmenopausal cases with endometrial carcinoma from December 2013 to March 2017 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.   Results · The ratio of patients with hypertension in premenopausal group was 28.8%, which was significantly lower than that in postmenopausal group (P<0.01). In premenopausal group, the proportion of G3 in histological grading was 8.3%, and the ratio of deep myometrial invasion was 13.5%, all of which were significantly lower than those of postmenopausal group (P<0.05). The ratio of ovarian involvement was as high as 17.6%, which was significantly higher than that of postmenopausal group (P<0.05). There were no significant differences between the two groups in other clinical-pathological parameters such as obesity, diabetes, CA125, CA199, surgical-pathological staging, pathological type, vascular involvement, and lymph node metastasis.  Conclusion · Premenopausal endometrial carcinoma is less malignant, while the probability of ovarian involvement is higher. Related Articles | Metrics

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Analysis between somatosensory-evoked potential monitoring and postoperative effect in anterior cervical discectomy and fusion HUANG Xiao-hong, YAN Bin, LIU Jia, WANG Xiao-ning 2017, 37 (12):  1674.  doi: 10.3969/j.issn.1674-8115.2017.12.017 Abstract ( 829 )   PDF (5164KB) ( 906 )   Objective · To analyze the relationship between somatosensory-evoked potential (SEP) monitoring and function recovery in anterior cervical discectomy and fusion, and predict the postoperative therapy effect.  Methods · The clinical data of 99 cervical spondylotic myelopathy patients (from Nov 2014 to Apr 2016) were retrospectively collected. SEP monitoring was used during operation. According to variations of SEP, patients were divided into obvious group (SEP improved more than 50%) and normal group (SEP improved less than or equal to 50%). The therapy effect was evaluated with Japanese Orthopedic Association Scoring System (JOA) score.  Results · For all patients, mean SEP was improved by (181.624±371.311)%. For two groups, there was no difference in basic information and JOA score before operation. There was significant difference between two groups in JOA score and improved rate one week after operation (both P=0.000), but no difference between two groups in JOA score or improved rate six months after operation (both P>0.05).  Conclusion · SEP improvement is consistent with JOA score. Obvious improvement in SEP indicates a good recovery in shortterm, but not suitable for evaluating long-term effect. Related Articles | Metrics

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Relationship between serum level of caveolin-1 and early neurological deterioration in patients with acute cerebral infarction#br# ZHONG Yi-liang, ZHANG Rong-rong, HUANG Si-yuan, QIN Xin-yue 2017, 37 (12):  1678.  doi: 10.3969/j.issn.1674-8115.2017.12.018 Abstract ( 866 )   PDF (5418KB) ( 939 )   Objective · To investigate the relationship between serum level of caveolin-1 (Cav-1) and early neurological deterioration (END) in patients with acute cerebral infarction.  Methods · A total of 126 consecutive patients with acute cerebral infarction were recruited from July 2016 to January 2017 in Department of Neurology, the First Affiliated Hospital of Chongqing Medical University. The serum Cav-1 levels of all patients were detected by enzyme-linked immunosorbent assay (ELISA) test. The neurological deficits were assessed by the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS) at the same time. Compared with the admission baseline NIHSS score, if second motor NIHSS score increased ≥ 1 point or the total NIHSS score increased ≥ 2 points within 3 days after hospitalization, they were classified as END group, otherwise they were classified as non-END group. Multivariable Logistic regression analysis was used to examine the independent predictors of END in the patients. Receiver operating characteristic (ROC) curves were obtained to explore Cav-1 levels in predicting END.  Results · Serum Cav-1 levels in END group were significantly higher than those in non-END group [(29.88±19.57) ng/mL vs (16.08±13.37) ng/mL, P=0.000]. Based on the ROC curves, the best cut-off point of serum Cav-1 for predicting END was 16.55 ng/mL. The sensitivity and specificity were 73.33% and 74.07%, respectively. Multivariable Logistic regression analysis showed that Cav-1 ≥ 16.55 ng/mL remained an independent predictor of END (OR=4.936, 95%CI 1.608-15.155, P=0.005).  Conclusion · Serum Cav-1 is an independent predictor of END in patients with acute cerebral infarction. Related Articles | Metrics

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Investigation and analysis of the working status and development situation of psychotherapy in psychiatric hospitals#br# ZHAO Wen-qing, LI Xiao-ping, WANG Lan-lan, ZHANG Hai-yin, SONG Li-sheng, QIU Jian-yin 2017, 37 (12):  1682.  doi: 10.3969/j.issn.1674-8115.2017.12.019 Abstract ( 813 )   PDF (7506KB) ( 847 )   Objective · To understand the current situation of psychotherapy applied and relevant personnel’s working in psychiatric hospitals, and provide advice to facilitate and promote the integrated service team building of domestic mental health institutions and the industry development of psychological treatment.  Methods · Ninety-six psychiatric hospitals in China were selected and self-compiled questionnaire was used during the investigation. The actual feedback was collected from 52 hospitals in 25 provinces.  Results · ① According to the classification criteria of ICD-10 mental disorder, patients mainly suffered from schizophrenia, schizotypal disorder and delusional disorder, followed by affective disorder, in the psychiatric hospitals. ② There were 50 (96.2%) hospitals with psychological outpatient clinics, and 37 (71.2%) hospitals were equipped with mental wards. ③ The main types of patients who came to the psychology department in the psychiatric hospitals were emotional disorders, neurosis, stress-related and physical form disorders. ④ The composition of psychotherapists was 6 physicians, 2 clinical psychologists, and 1 nurse. ⑤ The top five psychotherapy techniques used by the psychiatric hospitals were cognitive therapy, supportive psychotherapy, behavioral therapy, group therapy, and family therapy. ⑥ 44.2% of the practitioners working in this filed thought that the income had been too low if they only engaged in psychological treatment.  Conclusion · In the staffing of mental health agency, compared to previous studies, the number of the psychology specialists increases, but it still makes up a small percentage, which does not match the needs of outpatient and ward patients. Psychological practitioners who rely on psychological treatment alone are in a lower income, and the gap between the expected income and actual income is too large. Government, health administration departments and hospitals should provide more support to psychological services and promote the development of institutions and personnel. Related Articles | Metrics

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Comparison of caries and sealants between Shanghai native and migrant 12-year-old students from 2013 to 2015#br# WANG Yan, DA Dong-xin, ZENG Xiao-li, XU Wei, WANG Xun, ZHANG Hao, JIANG Yi-wei, LI Cun-rong, ZHANG Ying 2017, 37 (12):  1687.  doi: 10.3969/j.issn.1674-8115.2017.12.020 Abstract ( 736 )   PDF (4853KB) ( 977 )   Objective · To compare the caries prevalence, unmet restoration needs and sealant prevalence between Shanghai 12-year-old native and migrant students from 2013 to 2015.  Methods · From 2013 to 2015, a random cluster sample of 12-year-old native and migrant students was selected from each district in Shanghai. World Health Organization (WHO) indices were used to assess decayed-missing-filled teeth of permanent dentition (DMFT). The prevalence of caries and sealants, caries filling rate, unmet dental restoration needs and the value of DMFT were analyzed using the Mann-Whitney U test and chi-squared test.  Results · A total of 2 500 students were examined from 2013 to 2015, among which 36.8% were migrants. There was no significant difference in caries prevalence and DMFT value between native and migrant students from 2013 to 2015. Sealant prevalence of migrants was significantly lower than that of natives in 2013 (0.8% vs 6.6%) and 2015 (3.0% vs 9.9%). Unmet restoration needs of migrants were significantly higher than those of natives in 2015 (60.5% vs 46.4%).  Conclusion · There was no significant difference in caries prevalence between 12-year-old native and migrant students in Shanghai from 2013 to 2015. But there were lower sealants and higher unmet restoration needs in 12-year-old migrant students than their native counterparts, even though free public dental health services were available to both groups. Related Articles | Metrics

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Impact of one-child on body mass index and percentage of body fat in primary school students: a longitudinal study#br# XU Ren-ying, ZHOU Yi-quan, LI Yun, ZHANG Xiao-min, CHEN Zhi-qi, LU Li-ping, WAN Yan-ping 2017, 37 (12):  1691.  doi: 10.3969/j.issn.1674-8115.2017.12.021 Abstract ( 759 )   PDF (5800KB) ( 908 )    Objective · To evaluate the impact of one-child on body mass index (BMI), and percentage of body fat in primary school students.  Methods · All the sample was recruited from 5 elementary schools in Gaohang Town, Shanghai, China. The baseline data of height, body weight, and percentage of body fat was obtained in 2013, and re-measured in 2014 and 2015, respectively. Birth weight, breast feeding, diet and time for physical activities of each children and the highest education level, height, and body weight of their parents were also collected by a self-completed questionnaire. Logistic regression and Mix model was used to analyze the relationship between one-child and BMI, BMI-Z score, and percentage of body fat.  Results · A total number of 2 515 (1 323 boys and 1 192 girls) primary school students completed the study and entered the analysis. The percent of one child in this study population was 72.0% (1 812/2 515). BMI-Z score, time for physical activities, parental education level, and maternal BMI were higher, while the rate of breast feeding was lower in one-child group compared to non-one-child group. The results of Logistic regression showed boys (compared to girls), macrosomia ( ≥ 4 000g vs normal birth weight), overweight father and mother (compared to normal BMI) were risk factors for overweight. The factor of one-child didn’t increase the risk of overweight (OR=1.119, 95% CI 0.911-1.374). After potential con-founders adjusted, the annual increase of BMI (β=0.028, 95% CI -0.045-0.100), BMI-Z score (β=0.002, 95%CI -0.034-0.037) and percentage of body fat (β=0.013, 95% CI  -0.181-0.207) showed no obvious difference between the two groups.  Conclusion · One-child factor showed no obvious relationship with BMI, BMI-Z score and percentage of body fat in primary school students. Related Articles | Metrics

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Gender difference of obesity in bipolar disorder#br# XU Jing-jing, FANG Yi-ru 2017, 37 (12):  1695.  doi: 10.3969/j.issn.1674-8115.2017.12.022 Abstract ( 850 )   PDF (7249KB) ( 724 )   Bipolar disorder (BD) is a kind of psychiatric disorder with wildly alternating emotion and complicated symptoms. Subjects with BD had a significantly higher prevalence of metabolic syndrome when compared to subjects with major depressive disorder and non-psychiatric controls, with risk related to a higher depression score and abdominal obesity. Gender difference in the patients with BD and obesity may be related to childhood adversity, migraine, hormonal alterations, psychotropic medications, diet and lifestyle factors. This article reviewed clinical features and the potential mechanism of gender difference in bipolar disorder with comorbidity of obesity. Related Articles | Metrics

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Introduction and applications of bacteriophage polysaccaride depolymerases LI Xiao-qian1, WANG Rui1, GU Chuan-jia1, XU Meng-sha1, 2, HE Ping1, HU Fu-pin3 2017, 37 (12):  1699.  doi: 10.3969/j.issn.1674-8115.2017.12.023 Abstract ( 1374 )   PDF (5862KB) ( 1266 )   [Abstract] With the rising detection rate of strains with extensive drug resistance clinically, there is an increasingly urgent need of novel anti-microbial agents. More and more researchers put emphasis on bacteriophage therapy and have made great progress in this field. A large number of studies showed that some bacteriophages could produce enzymes which killed the host bacteria by degrading polysaccharides in their extracellular polymeric substances (EPS). This review introduces the classification of phage polysaccharide depolymerases and their action mode, the methods to determine whether the phage produces depolymerases, and their applications in anti-bacterial treatment, biofilm degradation and bacterial capsule typing. Related Articles | Metrics

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Research progress of monitoring and evaluation of immune state and renal function in renal transplant #br# recipients Olivier VYUNGURA, WANG Xiang-hui 2017, 37 (12):  1702.  doi: 10.3969/j.issn.1674-8115.2017.12.024 Abstract ( 754 )   PDF (7685KB) ( 778 )   [Abstract] Renal transplantation is still the most effective treatment for end stage renal disease up to date. Immunosuppression therapy can complicate the rejection and severe complications if it is used insufficient or excessive, which may lead to poor survival of patients and grafts . Currently and in the future, discovery of more sensitive biomarkers and better detection methods of allograft rejection and renal function is a major subject of clinical investigation and transplant medicine. This paper reviews the latest research progress in assessment of immune state and renal function after kidney transplantation Related Articles | Metrics

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Recent advances in surgery treatment of retinoblastoma complicated cataract LIANG Ting-yi, JI Xun-da, ZHAO Pei-quan 2017, 37 (12):  1707.  doi: 10.3969/j.issn.1674-8115.2017.12.025 Abstract ( 976 )   PDF (5096KB) ( 1121 )   [Abstract] Retinoblastoma (RB) is one of the most common primary intraocular malignant tumors of children. With improvement of the medical care, the goal of RB treatment is saving the eyeball and even the vision. In the process of globe-salvaging treatment, complicated cataract has been a serious problem which affects the treatment and follow-up. It is important to operate a cataract surgery timely and safely. In this paper related research advances were summarized. Related Articles | Metrics

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Lupus nephritis accompanied with Castleman’s disease: a case report and literature review ZHAO Chu-xian, GAO Feng, RONG Shu, SHANG Ming-hua 2017, 37 (12):  1710.  doi: 10.3969/j.issn.1674-8115.2017.12.026 Abstract ( 893 )   PDF (7338KB) ( 803 )   [Abstract] A 24-year-old male suffered from acute nephritic syndrome, liver dysfunction, and mesenteric mass. Laboratory examination showed a variety of autoantibodies (ANA, SM, and A-β2-GP1) were positive. The biopsies of the kidney and the mesenteric mass were performed. The diagnosis was type Ⅴ + Ⅲ lupus nephritis accompanied with Castleman’s disease. Then the patient was given induction therapy of glucocorticoids and cyclophosphamide for the first 3 months, followed by rituximab as maintenance therapy. The patient was followed up after 0, 3, and 9 months. After 3-month treatment, lupus nephritis was partially remitted, and systemic lupus erythematosus disease activity index (SLEDAI) decreased to 4 scores in an inactivity phase from 20 scores in a serious activity phase at baseline. Nine months later, lupus nephritis was completely remitted and 50% mesenteric mass was regressed through CT scanning. Lupus nephritis can accompany with multicentric Castleman’s disease. Due to lack of clinical specificity and effective therapy, patients may have a high misdiagnosis rate and poor prognosis. The most reliable way to establish a definitive diagnosis relays on histopathologic confirmation. The management of induction therapy of glucocorticoids and cyclophosphamide, followed maintenance therapy of rituximab may become a beneficial treatment. Related Articles | Metrics