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    Original article (Basic research)
    Effects of IRF3 knockdown on the nuclear of Irak1bp1 protein in LPS-stimulated Raw 264.7cell
    TAN Zhi-li*, WANG Ying-ying*, ZHONG Huan, HE Yu, SHI Qing-qing, YANG Xue, XU Guo-rong, LIU Liang-ming
    2018, 38 (6):  589. 
    doi: 10.3969/j.issn.1674-8115.2018.06.001

    Abstract ( 1093 )   PDF (6898KB) ( 672 )  
    Objective · To amplify the interferon regulator factor 3 (IRF3) short hairpin RNA (shRNA) virus and investigate the effect of the virus on the nuclear of Irak1bp1 protein in lipopolysaccharide (LPS)-stimulated Raw 264.7 cells. Methods · Adenovirus was amplified in HEK293Tcells and the virus titer was detectedTCID 50 assay. The Raw 264.7 cells were randomly divided into four groups including adenovirus (-) LPS (-) group, adenovirus (-) LPS (+) group, adenovirus (+) LPS (-) group and adenovirus (+) LPS (+) group. The of intracellular IRF3 mRNA was detectedreal-time PCR, and the nuclear of IRF3 and Irak1bp1 protein were detectedWestern blotting. Results · The titer of adenovirus was 2.2×1011 PFU/mL and the best MOI was 300. The of IRF3 mRNA and nuclear IRF3 protein in LPS-stimulated Raw 264.7 cells were significantly higher than those of the control group. The cellular constitutive of IRF3 at mRNA level and the LPS-induced ofIRF3 were significantly inhibited after transfection of Raw 264.7 cells with adenovirus strains carrying IRF3 shRNA. However, the nuclear constitutive of IRF3 protein was not affectedIRF3 shRNA in the unstimulated state. The of nuclear Irak1bp1 protein was significantly higher than that of the control group. The nuclear constitutive and the LPS-induced of Irak1bp1 protein were not affectedIRF3 shRNA. Conclusion · Transfection of LPS-stimulated Raw 264.7 cells with adenovirus strains carrying IRF3 shRNA could effectively inhibit the ofIRF3, but not affect the nuclear of Irak1bp1 protein.
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    Effects of propofol sedation on BDNF-TrkB/p75 signal and cognitive function in rat hippocampus
    YU Wen-juan1*, ZHU Min2*, WO Yan3, YU Yi-min1, LI Yan1, FANG Hong-wei4, ZHU Hao4
    2018, 38 (6):  594. 
    doi: 10.3969/j.issn.1674-8115.2018.06.002

    Abstract ( 919 )   PDF (5598KB) ( 752 )  
    Objective · To detect the effects of propofol sedation on cognitive function in rats and its mechanism. Methods · Forty-eight SD rats were randomly divided into three groups, i.e. control group, 100 mg/kg group and 300 mg/kg group. Rats were administrated intraperitoneally with propofol (10 mg/mL, 100 mg/kg or 300 mg/kg). The mRNA levels of brain derived neurotropic factor (BDNF)-TrkB/p75 signal molecules in rat hippocampus were evaluatedreal time PCR 45 min after propofol treatment. Learning and memory ability was examinedinhibitory avoidance (IA) test after propofol treatment. Results · The mRNA levels of BDNF in the hippocampal tissue were (1.20±0.13) fold (P0.002) and (88±12) % (P0.044) of that in control group, respectively, in 100 mg/kg group and 300 mg/kg group after injection of propofol. The mRNA levels of TrkB were (1.01±0.11) fold (P0.982) and (86±11) % (P0.018) of that in control group, respectively, in 100 mg/kg group and 300 mg/kg group. The mRNA levels of p75 were (1.02±0.10) fold (P0.778) and (1.59±0.18) fold (P0.000) of that in control group, respectively, in 100 mg/kg group and 300 mg/kg group. There was no significant difference of the 24 h IA memory retention latency between 100 mg/kg group and control group. The 24 h IA memory retention latency in 300 mg/kg group was significantly decreased compared with control group (P0.028) and 100 mg/kg group (P0.020). Conclusion · Propofol dose-dependently regulates the of BDNF-TrkB/p75 signal molecules, and high dose propofol may reduce cognitive function via BDNF-TrkB/p75 signal.
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    Expression of TTF1 in hypothalamus of female rats and its relationship with GnRH and KiSS1
    ZHEN Ni, Lü Yong-fen, LI Pin
    2018, 38 (6):  598. 
    doi: 10.3969/j.issn.1674-8115.2018.06.003

    Abstract ( 946 )   PDF (10075KB) ( 705 )  
    Objective · To investigate the changes and distribution of thyroid transcription factor-1 (TTF1) around the puberty and to explore the position relationship among gonadotropin-releasing hormone (GnRH), KiSS1 and TTF1 in the hypothalamus of female SD rats. Methods · Female SD rats were divided into three groups: juvenile (JUV), early puberty (EP), and adult (AD). Tissue immunofluorescence staining was used to detect the of TTF1, KiSS1 and GnRH immunoreactive cells in the hypothalamus and the relative position among them. Real-time PCR was used to measure the of KiSS1, GnRH, TTF1 on mRNA levels in the hypothalamus, anteroventral periventricular nucleus (AVPV), and arcuate nucleus (ARC) respectively. Western blotting was performed to detect the changes in protein level of KiSS1 and TTF1. Results · TTF1 was densely expressed in hypothalamus nucleus AVPV, ARC and median eminence (ME) of female rats. GnRH,KiSS1 and TTF1 were adjacently expressed in ARC and ME. The mRNA level of TTF1 in the hypothalamus showed an upward trend after a slight decrease, while in AVPV and ARC tended to be consistent and showed an upward trend. The GnRH mRNA levels were significantly increased and reached the peak at AD. The mRNA levels of KiSS1 showed a sharp rise which was prior to the peak of GnRH mRNA at EP and then sustained the high level until AD. The protein level of TTF1 reached the peak at AD and the KiSS1 showed a sustained growth. Both of them showed an upward trend and basically consistent with the mRNA trend. Conclusion · Neuronal nuclei protein TTF1 mainly expressed in the nuclei AVPV, ARC, and ME of female rat hypothalamus. It was prominent in cells of ARC and ME which were localized GnRH, KiSS1, TTF1 positive neural cells. During the development of puberty onset, KiSS1 mRNA preceded GnRH mRNA to reach the peak at EP. The of TTF1 mRNA increased and reached a peak at AD, which was consistent with the overall increase of KiSS1 and GnRH . Protein of KiSS1 showed a corresponding upward trend together with their mRNA . TTF1 protein increased and peaked in AD.
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    Discovery of lead compounds to inhibit proliferation of cervical cancer cells based on privileged structure of 6,11-dihydro-5H-benzo[a]carbazole
    DONG Ya, YANG Ruo-lin, SHEN Zheng-wu, LIU Jian-hua
    2018, 38 (6):  605. 
    doi: 10.3969/j.issn.1674-8115.2018.06.004

    Abstract ( 774 )   PDF (6375KB) ( 906 )  
    Objective · To discover lead compounds with 6,11-dihydro-5H-benzo[a]carbazole as core scaffold that can inhibit the proliferation of cervical cancer cells. Methods · A series of 6,11-dihydro-5H-benzo[a]carbazole derivatives and analogs were synthesized using Fischer indole synthesis method, and their anticancer activity against HeLa cells was tested in vitroCCK8 test. Results · 2-Methoxy-6,11-dihydro-5H-benzo[a]carbazole and 8-chloro-2methoxy- 6,11-dihydro-5H-benzo[a]carbazole could significantly inhibit the proliferation of HeLa cells with the half maximal inhibitory concentration (IC50)values of 9.61 μmol/L and 16.52 μmol/L, respectively. Conclusion · Two objective lead compounds were found. Among 6,11-dihydro-5H-benzo[a]carbazole derivatives, compounds with methoxy group at the C-2 position of the core scaffold show better activity against proliferation of cervical cancer cells.
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    Effects of UBE3C on proliferation and invasion in ovarian cancer SKOV3 cells
    XU Hua-li, LIU Wen-xue, SHEN Fang-qian, XI Xiao-wei
    2018, 38 (6):  610. 
    doi: 10.3969/j.issn.1674-8115.2018.06.005

    Abstract ( 950 )   PDF (5992KB) ( 796 )  
    Objective · To explore the effects of ubiquitin protein ligase E3C (UBE3C) on proliferation and invasion in epithelial ovarian cancer SKOV3cells. Methods · Western blotting was used to detect the difference of UBE3C in epithelial ovarian cancer cell lines and normal ovarian cell lines. SKOV3 cells were transfected with si-UBE3C to knockdown UBE3C protein level, while ex-UBE3C plasmid was used to upregulate the of UBE3C. Cell proliferation was measuredCCK-8 assay and colony formation assay. Wound healing assay and Transwell assay were performed to investigate the effect of UBE3C on migration and invasion. Protein levels of β-catenin and c-Myc were also detected in different groups, which were closely related to proliferation and invasion. Results · UBE3C was highly expressed in epithelial ovarian cancer cell lines. UBE3C was successfully silenced with si-UBE3C transfection in SKOV3 cells. Inhibition of UBE3C significantly weakened the abilities of cell proliferation, migration and invasion. A reduction of β-catenin and c-Myc protein levels was also accompaniedUBE3C knockdown. Over of UBE3C with exUBE3Cplasmid promoted the abilities of proliferation, migration and invasion. Enhanced levels of β-catenin and c-Myc were also verified. Conclusion · UBE3C promotes proliferation and invasion of epithelial ovarian cancer SKOV3 cells. This might be to do with upregulation of β-catenin and c-Myc protein levels.
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    Effects of bone marrow mesenchymal cells immune thrombocytopenia patients on the biological behaviors of megakaryocytes
    WANG Jun-ying1, LI Xin1, YIN Ting-yu2, LIU Jia2, WANG Xiao-dong3, ZHONG Hua1
    2018, 38 (6):  616. 
    doi: 10.3969/j.issn.1674-8115.2018.06.006

    Abstract ( 858 )   PDF (10094KB) ( 531 )  
    Objective · To investigate changes of immune thrombocytopenia (ITP) patients-derived bone marrow mesenchymal cells (BMCs) in cells survival, cytokines as well as the effects of BMCs on the biological behaviors of megakaryocytes. Methods · BMCs were collected 7ITP patients and 5 normal controls (NC), and cultivatedthe whole marrow adherent method. Surface markers and basal apoptosis rate of BMCs were analyzedflow cytometry (FCM). Proliferation of BMCs was assessedCCK-8 method. Phorbol 12-myristate 13-acetate (PMA) was used to stimulate differentiation of HEL cells. The induced HEL cells (inHEL) were divided into 3 groups: inHEL cultured alone (group a), inHEL co-cultured with BMCs derived ITP patients (group b), inHEL co-cultured with BMCs derived NC (group c). After 72 h incubation, the of cell surface proteins (CD41a, CD42b) and cell apoptosis rate were analyzedFCM. The mRNA and proteins levels of cytokines IL6, IL11, TPO, SCF were detectedreal-time fluorescent quantitative PCR (RT-qPCR) and enzyme linked immunosorbent assay (ELISA), respectively. Results · Compared with NC, BMCs ITP patients grew progressively slowly (Day 4, P0.039; Day 6, 10, P0.009; Day 8, P0.007), cell basal apoptosis rates were increased [AV+PI-(early apoptosis rate), P0.036; AV+PI+ (late apoptosis rate), P0.003; AV+PI-/+ (total apoptosis rate), P0.004]. Compared with group a, the of CD41a in group c was much higher (P0.000). The of CD41a in group b was higher than that in group a (P0.015), but still much less than that in group c (P0.000). Compared with group a, the early and total apoptosis rate in group b, c and the late apoptosis rate in groupc were decreased obviously (all P0.000), whereas there was no obvious change of the late apoptosis rate in group b. However, compared with group c, the late and total apoptosis rate in group b were significantly increased (both P0.000). The levels of IL6, SCF mRNA and IL6 protein were significantly decreased in ITP BMCs (all P0.000), but there was no obvious difference in the levels of IL11 and TPO between ITP BMCs and NC BMCs. Conclusion · BMCs ITP patients show some defects in supporting megakaryocytic differentiation and survival under co-culture conditions, which mechanisms are related to the reduction of IL6 and SCF .
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    Original article (Clinical research)
    Application of intestinal CT texture analysis and nonlinear discriminant analysis in differential diagnosis of colorectal cancer and ulcerative colitis
    WANG Xiao1, 2, SUO Shi-teng1, ZHU Jiong1, FENG Qi1, HUA Xiao-lan1, WANG Wei-zhong2, GONG Jian-zhong2, LIU Jun1, LU Qing1
    2018, 38 (6):  624. 
    doi: 10.3969/j.issn.1674-8115.2018.06.007

    Abstract ( 970 )   PDF (8795KB) ( 673 )  
    Objective · To evaluate the value of texture analysis in the discrimination of colorectal cancer (CRC) and ulcerative colitis (UC).Methods · The CT images of 61 CRC patients, 62 UC patients and 42 control objects were retrospectively analyzed. All the patients were pathologically proved and performed triphasic contrast-enhanced CT scan: non-enhanced phase (NP), the arterial phase (AP) and the enteric phase (EP). The region of interest was drawn along the abnormal bowel wall’s edge in each scan phase and texture features were generatedMaZda software. Based on 3 texture feature selection methods, the optimal subsets were generated and analyzed6 texture feature classification methods. The results were shownmisclassification rate (MCR). To compare the performance of texture-based classification and human visual classification, two radiologists with more than 10 years of gastrointestinal disease diagnostic experience analyzed the data. Results · The texture analysis based average MCR of differentiation between CRC and UC was (28.42±6.89)%, (28.19±4.07)%, (19.10±3.58)% in NP, AP, EP respectively. Compared with other texture feature classification methods, nonlinear discriminant analysis (NDA) was more accurate. In EP, NDA achieved an excellent classification result (MCR12.61%). The average MCR between CRC and normally dilated bowel wall (NOR) was (13.33±7.21)%, (15.49±5.47)%, (6.74±3.02)%, while the average MCR between UC and NOR was (19.26±4.68)%, (20.04±6.63)%, (16.74±6.36)% in NP, AP and EP respectively. For visual classification between CRC and UC, the average MCR was (40.48±3.21)%, (35.71±1.60)%, (26.43±1.15)% in NP, AP, EP respectively. But the MCR of texture classification was lower than that of human vision classification, and computer texture classification had higher differential diagnosis rate. Conclusion · The CT-based texture analysis could be a feasible supplementary method to differentiate CRC UC. NDA is more accurate than other classification methods, especially in EP.
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    Analysis of liver function, serum lipid and blood routine in patients with differentiated thyroid cancer before radioactive iodine treatment
    XU Fei, TANG Ling-lin, YUAN Hong, SONG Shao-li, HUANG Gang
    2018, 38 (6):  632. 
    doi: 10.3969/j.issn.1674-8115.2018.06.008

    Abstract ( 1026 )   PDF (7067KB) ( 565 )  
    Objective · To investigate the effect of temporary hypothyroidism state to liver function, serum lipid and blood routine in patients with differentiated thyroid cancer (DTC) prepared for radioactive iodine treatment. Methods · A total of 182 patients with DTC undergoing radical operation of thyroid cancer and radioactive iodine treatment were collected. All these patients were divided into 3 groupsage: 26 in young group (<30 years), 112 in middle-aged group (30-54 years) and 44 in elderly group (≥55 years). Indicators of liver function, blood lipids and blood routine were compared before and after operation, among groups as well. Results · Patients under hypothyroidism state had significantly elevations in ALT, AST, LDH and serum bile acid, but a nodecrease of serum bilirubin (all P<0.05). Meanwhile they had remarkable elevations in triglyceride, cholesterol, LDL and HDL (all P<0.05). In the young group before thyroid hypothyroidism treatment, the elevation of ALT, AST, LDH and serum bile acid were more significant than those of the middle-aged and elderly patients (all P<0.05). Conclusion · The temporary hypothyroidism state of differentiated thyroid cancer patients could elevate liver enzymes as well as dyslipidemia.
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    Risk factors for gestational diabetes mellitus among multiparae
    WANG Yin-yu1, LIU Ye1, LIU Han1, DONG Ze-han1, HUANG He-feng1, 2
    2018, 38 (6):  637. 
    doi: 10.3969/j.issn.1674-8115.2018.06.009

    Abstract ( 994 )   PDF (8138KB) ( 625 )  
    Objective &middot; To investigate the risk factors for gestational diabetes mellitus (GDM) among multiparae. Methods &middot; Women who had two consecutive pregnancies records in the International Peace Maternity and Child Health Hospital January 2012 to January 2017 were included into this study. The case group (116 cases) and control group (464 cases) were matched at the ratio of 1:4 according to the pre-pregnancy age in index pregnancy. Clinical characteristics, biochemical parameters including oral glucose tolerance test (OGTT) and lipid profiles were took into considerationvirtue of their medical records. Multivariate Logistic regression analysis was used to compute the adjusted odds ratio (aOR) and 95%CI so as to identify the risk factors. Results &middot; Compared with the control group, the case group was associated with greater body mass index (BMI) change between pregnancies(aOR1.35, 95% CI1.07-1.69), greater postprandial 1 h glucose load (aOR1.99, 95% CI1.55-2.55) and 2 h glucose load (aOR2.02, 95% CI1.512.70)at OGTT in index pregnancy, and greater first-trimester fasting plasma glucose (aOR1.96, 95% CI1.16-3.32), total cholesterol (aOR1.37,95% CI1.06-1.77) and triacylglycerol (aOR1.53, 95% CI1.10-2.14) in subsequent pregnancy. Conclusion &middot; The elevated BMI change between pregnancies, the abnormal glucose and lipid profiles persisting index to subsequent pregnancy lead to the occurrence of GDM.
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    Ultrasonic evaluation of different congenital heart diseases with mitral regurgitation
    WANG Jing1, SUN Kun2, LI Fen1, WU Lan-ping1
    2018, 38 (6):  643. 
    doi: 10.3969/j.issn.1674-8115.2018.06.010

    Abstract ( 957 )   PDF (5430KB) ( 721 )  
    Objective &middot; To evaluate the characteristics of different congenital heart diseases (CHD) with mitral regurgitation (MR)two-dimensional echocardiography. Methods &middot; A total of 217 patients with simple CHD and MR and 85 normal children (control group) were enrolled for analysis. All the patients with MR were divided into 3 groups, i.e. ventricular septal defect (VSD) with MR, patent ductus arteriosus (PDA) with MR and coarctation (CoA) with MR. The size of defects, the peak pressure gradient of CoA and the malformation of mitral valve were described respectively in MR groupsechocardiography. In addition, the bore of left atrioventricular cavity, the left ventricular ejection fraction (LVEF) and the diameter of mitral valve annulus were compared with control group. Results &middot; Compared with control group, left atrium diameter, left ventricular diameter, mitral annular diameter (MAD), and MAD/tricuspid annulus diameter (MAD/TAD) increased in 3 MR groups, while only LVEF decreased significantly in CoA with MR group. The characteristics of CHD with MR were displayed as below. VSD was with less tissue formation and large defect diameter, the diameters of PDA were over 0.3 cm mostly and the peak pressure gradients of CoA were all above 48 mmHg (1 mmHg0.133 kPa). Furthermore, there were different mitral valve morphology in the 3 MR groups. Conclusion &middot; The mechanism of MR based on CHD may be related to increased atrioventricular cavity, MAD, MAD/TAD and abnormal morphology of mitral valve. These abnormal manifestations observedtwo-dimensional echocardiography are useful for surgery inthe patients with MR.
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    Effect of serum IgA1 on human mesangial cells and of TGF-&beta;1 in patients of IgA nephropathy with different renal function progress
    KONG Ling-yun, JIANG Geng-ru
    2018, 38 (6):  647. 
    doi: 10.3969/j.issn.1674-8115.2018.06.011

    Abstract ( 986 )   PDF (8178KB) ( 693 )  
    Objective &middot; To extract serum IgA1 patients with IgA nephropathy (IgAN) (end stage renal disease vs long-term srenal function) to explore the effect on proliferation rate of human mesangial cells (HMCs) and the level of transforming growth factor-&beta;1 (TGF-&beta;1). Methods &middot; Nine patients with primary IgAN were divided into rapidly progressive group (n6) and long-term sgroup (n3). Jacalin affinity chromatography and sephacryl S-200HRmolecular sieves were used to distract serum IgA1. HMCs were cultured and co-cultivated with different IgA1 concentration (10, 50, 250 and 1 000 &mu;g/mL)at point of 12 h and 24 h respectively. The proliferation rate was measuredcell counting kit-8 (CCK8). The of TGF-&beta;1 mRNA was measured via quantitative real-time PCR (qRT-PCR). Enzyme-linked immunosorbent assay (ELISA) was used to detect TGF-&beta;1 protein. Results &middot; Serum IgA1 IgAN patients with different renal functions (end stage renal disease vs long-term srenal function) activated proliferation of HMC significantly, presenting with time-dependence and concentration-dependence. The highest value showed at 250 &mu;g/mL and 1 000 &mu;g/mL respectively. Serum IgA1 in two groups of patients statistically increased the of TGF-&beta;1 mRNA and protein. In group with end stage renal disease, the summit stood at 10 &mu;g/mL and started to decreasedegrees afterwards; while in group with long-term srenal function, the level of TGF-&beta;1 increased in a parallel manner with the serum IgA1. Conclusion &middot; Serum IgA1 IgAN patients with different renal functions (end stage renal disease vs long-term srenal function) can both promote the proliferation of HMC. There is no dramatical difference observed with in10-50 &mu;g/mL, but the IgA1 group with end stage renal disease reveals a stronger effect on TGF-&beta;1, in accordance with the pathological type of the patients (IgA sclerosis), suggesting the prognostic value of serum IgA.
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    Application of electrical impedance tomography for postoperative lung recruitment in patients undergoing off pump coronary artery bypass grafting surgery
    WANG Ying-hua1*, PAN Yan2*, YANG Min1
    2018, 38 (6):  653. 
    doi: 10.3969/j.issn.1674-8115.2018.06.012

    Abstract ( 963 )   PDF (6219KB) ( 892 )  
    Objective &middot; To find out the optimal positive end expiratory pressure (PEEP)electrical impedance tomography (EIT) for better lung recruitment and ventilation distribution in patients undergoing off pump coronary artery bypass grafting surgery (OPCAB). Methods &middot; 105 patients under went OPCAB Jan. 2017 to Dec. 2017 were analysed. Patients were randomly divided into two groups, i.e. experiment group (54 cases) and control group (51 cases). Four regions of interest (ROI) were recordedEIT. PEEP were 3 cmH2O in control group while PEEP were increased stepwiseby 2 cmH2O 0 cmH2O to 14 cmH2O in experiment group. The optimal PEEP for lung recruitment was applied in experiment group. Postoperative oxygenation index (PaO2/FiO2) and pulmonary complication were compared between two groups. Results &middot; The overall mortality was 2 (1.90%). The incidence of postoperative pulmonary complication, pulmonary infection, atelectasis, pleural effusion were 18.10%, 2.86%, 18.10%, 18.10%, respectively. The optimal PEEP zone was 6-9 cmH2O. PaO2/FiO2 was significantly increased with the optimal PEEP in experiment group (P0.00). There were significant differences in postoperative pulmonary complication between two groups (P0.02). Conclusion &middot; EIT can directly monitor ventilation distribution and titrate suiPEEP for better lung recruitment in patients undergoing OPCAB. It can significantly reduce postoperative pulmonary complication, improve oxygenation, and decrease ICU stay and ventilation duration.
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    Correlation between red blood cell distribution width and right heart failure in patients with chronic obstructive pulmonary disease
    WANG Hai-li1, 2, ZHOU Jian-ping1, 3, MENG Jun4, LI Qing-yun1, 3
    2018, 38 (6):  658. 
    doi: 10.3969/j.issn.1674-8115.2018.06.013

    Abstract ( 754 )   PDF (6010KB) ( 733 )  
    Objective · To investigate the relationship between the red blood cell distribution width (RDW) and the severity of right heart failure inpatients with chronic obstructive pulmonary disease (COPD). Methods · A total of 265 patients with simple COPD and 268 COPD patients with right heart failure admitted to Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine October 2011 to September 2016 were enrolled. According to the New York Heart Association (NYHA) criteria, all COPD patients with right heart failure were divided into Group A (Class Ⅰ), Group B (Class Ⅱ), Group C (Class Ⅲ) and Group D (Class Ⅳ). The RDW, mean corpuscular volume (MCV), pro-brain natriuretic peptide, and erythrocyte sedimentation rate were measured within 24 h after admission for all patients. The RDW trends and related influencing factors in different groups were analyzed and compared. Results · There was no significant difference in the gender, age, forced expiratory volume in one second (FEV1), and COPD exacerbation times between the COPD group and the COPD with right heart failure group (all P>0.05). However, there was a significant difference in red blood cell (RBC), hemoglobin, MCV, RDW, pro-brain natriuretic peptide, and arterial partial pressure of oxygen (PaO2) (all P<0.05). In COPD with right heart failure group, there was no significant difference in age, RBC, hemoglobin, MCV, andPaO2 among the four groups (all P>0.05). With the increase of the patients′ NYHA functional class, both pro-brain natriuretic peptide and RDW showed a similarly significant increase (both P0.000). Through further multiple comparisons of RDW among four groups, there was a significant difference between any two groups (all P<0.05). Conclusion · RDW in patients with COPD with right heart failure is significantly elevated, and is closely related to right heart failure.
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    Clinical efficacy and prognostic factors of locally recurrent nasopharyngeal carcinoma with intensity-modulated radiotherapy
    ZHANG Hui-hui, ZHANG Xian-wen, JIANG Hao
    2018, 38 (6):  662. 
    doi: 10.3969/j.issn.1674-8115.2018.06.014

    Abstract ( 1135 )   PDF (10365KB) ( 618 )  
    Objective &middot; To retrospectively analyze the treatment outcome, radiation toxicity and the prognostic factors in patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Methods &middot; January 2012 to August 2016, a total of44 patients who were diagnosed with locally recurrent NPC and received reirradiation with IMRT were included in the study. Among all the patients, there were 33 male patients and 11 female patients, the median age of whom was 51.5 years (range 25&ndash;76 years). According to the 2012 American Joint Committee on Cancer Stage Classification Cancer Staging Manual, the distribution of disease restaging was 25.0% for stage rT1, 22.7% for stage rT2,22.7% for stage rT3 and 29.6% for stage rT4. The median recurrence interval was 28 months (range 5&ndash;168 months). The median prescribed dose to the target volume was 66 Gy (range 54&ndash;70 Gy). The toxicities were evaluatedRadiation Therapy Oncology Group (RTOG). The survival rate was determined using the Kaplan-Meier method. Prognostic factors were analyzedLog-rank tests and Cox proportional hazard model. Results &middot; Three months after reirradiation therapy, the complete remission rate, the partial remission rate, the stabilization rate and the progressive rate were 18.2%(8/44), 47.7% (21/44), 27.3% (12/44) and 6.8% (3/44), respectively. The 3-year overall survival (OS), 3-year progression free survival (PFS), 3-year local recurrence-free survival and distant metastasis rates were 56.8%, 43.2%, 58.9% and 11.4%, respectively. In a univariate analysis, age, recurrent T stage, recurrence interval, adverse reactions and response to re-IMRT were significant prognostic factors for OS and recurrent T stage was also an independent prognostic factor for PFS. In a multivariate analysis, recurrent T stage remained significant for OS and PFS. During follow-up, 21 patients died. Five patients died of nasopharynx hemorhea. Grade 3&ndash;4 toxicities were reported in 12 patients. Conclusion &middot; Re-irradiation with IMRT is available to improve OS and thus is a reasonable choice for patients with locally recurrent NPC. However, the incidence of severe adverse events is still high. Younger ages lower recurrent T stage and longer recurrent interval are independent prognostic factors for OS of recurrent NPC.
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    Original article (Public health administration)
    A comparative study on childrens basic medical insurance system and policies in four municipalities in China
    DONG Yuan-yuan1*, ZHANG Lin2*, YANG Ying-lei1, 3, DONG Wei1, MO Dan-dan1, FANG Yue1, QIAN Kun1, LUO Meng-yun1, LI Na1, ZHANG Zhi-ruo1
    2018, 38 (6):  670. 
    doi: 10.3969/j.issn.1674-8115.2018.06.015

    Abstract ( 1182 )   PDF (9639KB) ( 759 )  
    Objective &middot; To analyze the basic medical insurance policies for children in Shanghai in 2011 and 2017, and compare with those of the other three municipalities to understand the basic medical security status of children in four municipalities in China and analyze the existing problems. Methods &middot; The current effective childrens basic medical insurance policies and child critical illness insurance policies and related insurance systems in four municipalities were collected systematically. The types of basic medical insurance for children in various municipalities and their funding standards, their own expenses and the proportion of government subsidies, the proportion of outpatient emergency payoff lines and reimbursement at all levels of medical institutions, and the coverage and coverage of major illness insurance reimbursement were collected and compared mainly. Results &middot; The basic medical insurance for children in Shanghai is a &ldquo;double insurance&rdquo; system, which contained childrens hospitalization fund and basic medical insurance for urban and rural residents. The basic medical insurance for children in other municipalities mainly consisted of basic medical insurance for urban (rural)residents. Compared with 2011, the level of financing and the reimbursement of the basic medical insurance for urban and rural residents and of the childrens hospitalization fund in Shanghai in 2017 was increased. In 2017, the level of financing of basic medical insurance for urban and rural residents in Shanghai was 1 100 yuan, which was slightly lower than that of Beijing medical insurance for urban residents and new rural cooperative medical insurance and was higher than that of basic medical insurance for urban and rural residents in Tianjin and Chongqing, and the individual payment level of Shanghai was the lowest. The hospitalization payoff lines in Shanghai were lower than those of other municipalities. Shanghais outpatient and inpatient reimbursement levels were higher those of than other municipalities. There wasnt a capping line in Shanghai. There were capping lines in other municipalities. There was a great difference in the insurance policy of the major diseases in four municipalities. Conclusion &middot; According to their own actual conditions, models for childrens medical care systems that suited each municipalities&rsquo; social and economic development have been established. Shanghai childrens basic medical insurance basically meets the needs of childrens growth but needs improvement in terms of the type and level of medical security for major illnesses.
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    Review
    Progress in researches on latent class analysis based subtyping of depression
    WANG Cheng-lei1, WU Zhi-guo1, FANG Yi-ru1, 2, 3
    2018, 38 (6):  676. 
    doi: 10.3969/j.issn.1674-8115.2018.06.016

    Abstract ( 1293 )   PDF (6954KB) ( 676 )  
    Depression is a highly heterogeneous syndrome. Homogeneous subtypes according to symptomatology of illness may contribute to development of individualized treatment, assessment on outcomes and prognosis. Latent class analysis is a flexible statistical approach to determine classes with similar symptom profiles in a heterogeneous group, which has been widely used in data-driven subtyping of depression to increase accuracy of subtyping. This article reviewed existing symptom-based subtypes of depression and findings of researches on latent class analysis based illness subtyping.
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    Application of functional near-infrared spectroscopy in schizophrenia
    WEI Yan-yan1, ZHANG Tian-hong1, TANG Yun-xiang2, TANG Xiao-chen1, XU Li-hua1, WANG Ji-jun1
    2018, 38 (6):  680. 
    doi: 10.3969/j.issn.1674-8115.2018.06.017

    Abstract ( 1163 )   PDF (9109KB) ( 722 )  
    Functional near-infrared spectroscopy (fNIRS) is a relatively new technique that can measure the hemoglobin changes in brain tissue. Depending on the absorption for different wavelength, relative changes in the concentration of hemoglobin in brain can be measured, obtaining the hemodynamic characteristics of brain to understand the brain functional state in real-time. Compared with other neuroimaging techniques, it has some advantages and has been used in psychiatry rapidly. Schizophrenia is one of the most common mental disorders, researches on its pathogenesis have focused on collection of structural and functional alteration in brain. Existing techniques can provide only indirect evidence, while fNIRS can perform brain function monitoring in real-time. A number of studies have suggested that fNIRS signal could be used as a biomarker for schizophrenia identification and adjuvant diagnosis. This paper reviewed the research progress in the application of fNIRS in schizophrenia.
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    Roles of neurosteroids in the treatment of depressive episodes
    CUI Lü-chun1, HONG Wu1, FANG Yi-ru1, 2, 3
    2018, 38 (6):  685. 
    doi: 10.3969/j.issn.1674-8115.2018.06.018

    Abstract ( 1023 )   PDF (7827KB) ( 751 )  
    Neurosteroids are the key molecules in the central nervous system that modulate neural functions. They can influence human mood and behavior in various physiological and pathophysiological situations. Neurosteroids have been implicated in the pathogenesis of depressive episodes, providing innovative therapies for psychiatric disorders such as depressive disorder and bipolar disorder. This paper reviewed the research progress on therole of neurosteroids in the treatment of depressive episodes.
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    Research progress of autophagy in non-alcoholic fatty liver disease
    JIAN Chao-hui, BAO Yu-qian
    2018, 38 (6):  690. 
    doi: 10.3969/j.issn.1674-8115.2018.06.019

    Abstract ( 1130 )   PDF (7945KB) ( 728 )  
    Non-alcoholic fatty liver disease is a type of metabolic liver injury which is closely related to insulin resistance. Now it has become the leading caof chronic liver diseases worldwide, which is closely related to the high incidence of type 2 diabetes and arteriosclerotic cardiovascular disease. It can progress into cirrhosis and hepatocellular carcinoma. The pathogenesis of non-alcoholic fatty liver disease is complicated and not yet fully elucidated. In recent years, studies have found that autophagy plays an important role in the development of non-alcoholic fatty liver disease, mainly through regulation of insulin resistance, endoplasmic reticulum stress, mitochondrial dysregulation, lipid-toxicity causedlipid deposition and inflammation.
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    Application of drug-coated balloons in treatment of coronary small vessel diseases
    YANG Gan, PU Jun, HE Ben
    2018, 38 (6):  695. 
    doi: 10.3969/j.issn.1674-8115.2018.06.020

    Abstract ( 1276 )   PDF (5639KB) ( 961 )  
    Drug-coated balloons (DCB) have emerged as a new application in percutaneous coronary intervention. It is developed to circumvent some of the limitations faceddrug-eluting stents (DES). DES has some limitations, as follows: it could not be implanted in some lesions; bleeding risks are associated with prolonged dual antiplatelet therapy; risks of late and very late stent thrombosis increase. Many clinical trials had confirmed the efficacy and safety of DCB, particularly, the application of DCB in coronary small vessel diseases. This review discussed the basic concept, development, evolution of DCB and some clinical studies associated with the application of DCB in coronary small vessel diseases.
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    Roles of long non-coding RNA in intraocular malignant tumor and its mechanisms
    FU Xiao1, HUANG Rui1, FAN Xian-qun2, ZHANG He2
    2018, 38 (6):  699. 
    doi: 10.3969/j.issn.1674-8115.2018.06.021

    Abstract ( 888 )   PDF (7054KB) ( 638 )  
    Retinoblastoma (RB) is the most common intraocular malignant tumor in early childhood, which has an adverse effect not only on the eyesight, but also on patients&rsquo; life. Uveal melanoma (UM) is an another common intraocular malignant tumor in adults, nearly half of the patients will have metastasis of tumor with a low survival rate. The long non-coding RNAs (lncRNAs) are non-coding RNA with a length greater than 200 nt. More and more studies have confirmed that lncRNAs are involved in the proliferation, migration and invasion of tumorsregulating the gene at various levels, which makes lncRNAs become the novel target in the therapy of intraocular malignant tumors. This article reviewed studies of the roles and mechanisms of lncRNAs in RB and UM.
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    Relationship between the APOE genotypes and the common major psychosis
    YU Xiao-yan1, 2, LI-Xia1
    2018, 38 (6):  704. 
    doi: 10.3969/j.issn.1674-8115.2018.06.022

    Abstract ( 1205 )   PDF (6257KB) ( 880 )  
    Apolipoprotein E (APOE) is a lipid transfer protein, which plays an important role in maintaining the stabilization of nerve and recovering. Alzheimers disease (AD) is a neurodegenerative disorder. Most studies showed that APOE genotypes were closely related with AD. In clinical practice, AD is mainly manifested as progressive cognitive decline, and often accompaniedmental behavioral symptoms. These symptoms also exist in common severe mental illness. It is worth thinking about the correlation between APOE genotypes and these diseases. This article reviewed the relationship between the APOE genotypes and the common major psychosis.
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    Regulatory factors and modulation mechanisms of functions of ovarian germline stem cell niche
    LIU Yang-chun, YE Hai-feng, LI Xiao-yan, HU Chuan, HUANG Jian, ZHENG Yue-hui
    2018, 38 (6):  708. 
    doi: 10.3969/j.issn.1674-8115.2018.06.023

    Abstract ( 1149 )   PDF (5931KB) ( 874 )  
    With increasing age in women, the ovarian function declines, which leads to decreased follicle generation, declined female fertility and age-related diseases ultimately. Female germline stem cells are epithelial cells existing on the ovarian surface, which can divide into new stem cells symmetrically and differentiate into germ cells and granulosa cells asymmetrically. The discovery of female germline stem cells brings much hope for the post-natal renewal of oocytes and solving female infertility problems. Ovarian germline stem cell niche in which female germline stem cells live is the surrounding microenvironment which plays an essential role in maintaining the function of female germline stem cells. Many factors including nutrition supply, protein, cytokines and signaling pathways can control the biological characters of female germline stem cells, and also influence their prolife ration and differentiation. This paper reviewed the knowledge about the influencing factors and regulatory mechanisms of the function of ovarian germline stem cell niche.
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    Recent research progress in the field of translational medicine
    WU Hui1, FAN Rong1, DING Wen-jing1, ZHANG Xin-man2, QIU Xiao-chun1
    2018, 38 (6):  712. 
    doi: 10.3969/j.issn.1674-8115.2018.06.024

    Abstract ( 1219 )   PDF (11846KB) ( 836 )  
    Translational medicine is a new research system for rapid translation basic research achievement to clinical treatment. This article summarized the research progress in the field of translational medicine in the recent months, and carried out an inventory of the frontier important journals (such as Nature, Science, J Clin Invest, Nat Genet, Cell, Eur Heart J) into provide references for scientists and doctors, and promote the translation basic medicine to clinical diagnosis and treatment.
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