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    Original article (Basic research)
    Structure optimum and biological activity studies of APC/Asef peptide inhibitors
    QIAN Jin-xing, ZHANG Jian
    2018, 38 (10):  1139. 
    doi: 10.3969/j.issn.1674-8115.2018.10.001

    Abstract ( 669 )   PDF (8083KB) ( 455 )  
    Objective · To design and synthesize APC/Asef peptide inhibitors, and investigate the relationship between the structures and affinity of peptides. Methods · Based on crystal structure of the APC-MAI-150 complex, on the one hand, 3-phenylpropane, Glu-Glu (GG) and β-Ala-Ala (β-AA) were used to replace carbobenzoxy (CBZ) at the N terminal of MAI-150 to bind -NH2; on the other hand, -CN, -NO2, -NH2, and -F were replaced the parahydroxyl on the sixth tyrosine (Tyr) side chain benzene at the N terminal of MAI-150. And seven peptides were synthesized. Fluorescence polarization was applied to test peptide affinity, and molecular design laboratory-3 (MDL-3), MDL-4 and MDL-5 were docked into APC protein based on the results of activity. The structure-activity relationship of the three peptides was studiedcombining the binding patterns of computer docked peptide and APC protein. Results · Among the seven peptides, the N terminal 3-phenylpropane linked -NH2 of peptide MDL-5 had the highest affinity, which IC50 was 2.35 μmol/L. Compared with MDL-5, the affinity of MDL-6 and MDL-7 were significantly reduced. The para-hydroxyl on the sixth Tyr side chain benzene at the N terminal replaced with -NH2 (MDL-3) and -F (MDL-4), which the affinity were higher than -CN (MDL-1) and -NO2 (MDL-2). However, the affinity of newly synthesized peptides was lower than MAI-150. Conclusion · Transforming peptide N terminal linked -NH2 and the para-hydroxyl group on the sixth Tyr side chain benzene doesnt help to improve the affinity of peptides.
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    Metabolomics study of the effect of arsenic trioxide on hepatocellular carcinoma cell line HepG2
    HUANG Jin-guo1*, ZHANG Hai-nan1*, CHEN Zi-qing1*, YANG Li-na2, GUO Shu-juan1, TAO Sheng-ce1
    2018, 38 (10):  1145. 
    doi: 10.3969/j.issn.1674-8115.2018.10.002

    Abstract ( 410 )   PDF (6885KB) ( 430 )  
    Objective · To reveal the mechanism of the effect of arsenic trioxide (ATO) on hepatocellular carcinoma (HCC) cells through metabolomics study. Methods · HCC cell line HepG2 was treated with ATO for 12 h, 24 h and 36 h respectively. The global metabolite profiles were monitoredmetabolomics analysis using GC/MS and LC/MS/MS. Results · A total of 307 certified metabolites were detected. Bioinformatics analysis showed that glycosylation and one-carbon metabolism were the main cellular functions that have been affected. Other affected cellular functions/pathways included mitochondrial function fatty acid β-oxidation, TCA cycle, pentose phosphate pathway (PPP) and glutathione metabolism. Conclusion · ATO treatment affects the main metabolomic pathway of HepG2, and inhibits cell growth and migration, then exacerbates oxidative stress to induce cancer cell apoptosis.
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    Effect of 3-methyladenine on autophagy, migration and invasion in epithelial ovarian cancer cells under hypoxia
    TANG Zhong-yuan1, 2, ZHANG Ning2, 3, DI Wen2, 3, LI Wei-ping2, 3
    2018, 38 (10):  1152. 
    doi: 10.3969/j.issn.1674-8115.2018.10.003

    Abstract ( 423 )   PDF (5439KB) ( 428 )  
    Objective · To investigate the effect of 3-methyladenine (3-MA) on autophagy, migration and invasion of epithelial ovarian cancer (EOC) cells under hypoxia. Methods · Different concentrations of 3-MA were used to treat EOC cells in hypoxic environment. The of autophagy-associated protein LC3 was detectedWestern blotting. The autophagosome formation was observedtransmission electron microscopy. The proliferation, adhesion, migration and invasion of EOC cells were determinedthiazole blue colorimetry, adhesion test, Transwell migration test and Matrigel invasion test, respectively. Results · 3-MA was able to inhibit the increase of LC3-Ⅱ and autophagosome formation inducedhypoxia. In hypoxic environment, the survival rate of EOC cells was significantly decreased5.00 mmol/L 3-MA for 24 h (P0.000). The adhesion ability of EOC cells was significantly decreased2.50 mmol/L 3-MA for 6 h (P0.007). 1.25 mmol/L and 2.50 mmol/L 3-MA could inhibit the migration and invasion of EOC cells in hypoxic environment (P<0.01). Conclusion · 3-MA can inhibit the autophagy, migration and invasion of EOC cells in hypoxic environment.
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    Resistant dextrin improves insulin resistance in db/db miceenhancing insulin signaling pathway
    HU Fan, NIU Yi-xin, TU Xiao-fang, SU Qing, ZHANG Hong-mei
    2018, 38 (10):  1157. 
    doi: 10.3969/j.issn.1674-8115.2018.10.004

    Abstract ( 600 )   PDF (7302KB) ( 457 )  
    Objective · To investigate the effect of resistant dextrin on insulin resistance in db/db mice and preliminarily explore potential molecular mechanisms. Methods · Ten 8-week-old db/db mice were randomly assigned into two groups, i.e., control group and resistant dextrin group, which were administered with distilled water and resistant dextringavage for 9 weeks, respectively. Fasting blood glucose (FBG) and body weight were measured every week. Intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance test (ITT) were performed separately at the 8th and 9th week. Fasting serum insulin (FINS) was measured, homeostasis model assessment insulin resistance (HOMA-IR) index was calculated, and triacylglycerol (TAG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-Ch), high density lipoprotein-cholesterol (HDL-Ch) were detected after the mice were sacrificed. The relative of Ir, Irs-1, Pi3k, Akt, and Glut-2 in insulin signaling pathways in the liver was determinedreal-time quantitative PCR. The of IRS-1, p-AKT, GLUT-2 in the liver were determinedWestern blotting. Results · After 9 weeks of treatment with resistant dextrin, the body weight of the resistant dextrin group decreased, but the difference was not statistically significant (P0.384); FINS decreased, and HOMA-IR index significantly decreased (P0.032); insulin resistance was significantly improved (all P<0.05); the blood biochemical parameters, including TAG, TC, LDL-Ch, and HDL-Ch were lower, but only LDL-Ch was statistically different (P0.034); the of Ir, Irs-1, Akt, and Glut-2 mRNA in the liver significantly increased (all P<0.05); the of IRS-1 and GLUT-2 proteins also significantly increased (P0.026, P0.039). Conclusion · Resistant dextrin may improve insulin resistance in db/db miceenhancing insulin signaling pathway.
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    Effect of resveratrol on proliferation of CT26 colonic cancer cells
    HUANG Shi-qi, YANG Meng, TONG Ling, LU Hong-li, HUANG Xu, XU Wen-xie
    2018, 38 (10):  1162. 
    doi: 10.3969/j.issn.1674-8115.2018.10.005

    Abstract ( 518 )   PDF (6694KB) ( 543 )  
    Objective &middot; To investigate the effect of resveratrol (RSV) on proliferation of mocolonic cancer cells CT26 and its underlying molecular mechanisms. Methods &middot; CT26 cells were incubated with 20, 40, 60, 80 and 100 &mu;mol/L RSV respectively for 24 h. The effect of RSV on cell proliferation was tested with CCK8 kits. The effect of RSV on cell apoptosis was detectedliving cell dye Hoechst 33342. The plasma protein and nucleoprotein of the cells were extracted separatelyusing the nuclear protein and cell plasma protein extraction kits. And the s of apoptosis related proteins (Bax and Bcl-2), PTEN, NF-&kappa;B and Akt were detectedWestern blotting. Results &middot; RSV inhibited the proliferation of CT26 cells. The inhibitory effect was dose-dependent. Treatment with RSV promoted the apoptosis of CT26 cells. The of NF-&kappa;B protein in the cell nucleus was down-regulated compared to the control cells, and the of NF-&kappa;B in the cytoplasm was up-regulated in the CT26 cells after 24 h incubation with RSV. In the CT26 cells after 24 h incubation of RSV, the s of Bax and PTEN were up-regulated, the of Bcl-2 was down-regulated, and the phosphorylation of Akt protein was down-regulated. Conclusion &middot; RSV can inhibit the proliferation of colon cancer cells in mice, which may be associated with Bax, Bcl-2, NF-&kappa;B, p-Akt and PTEN.
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    Intradermal administration of formalin to the cheek induces itch as well as pain behaviors in rats
    QIAN Jia-hong, GAO Po, RONG Wei-fang
    2018, 38 (10):  1167. 
    doi: 10.3969/j.issn.1674-8115.2018.10.006

    Abstract ( 419 )   PDF (7214KB) ( 374 )  
    Objective &middot; Formalin is a classic and most widely used algogenic substance, but its itchy effect is not clear. The present study aims to explore the hypothesis that formalin may induce itch as well as pain. Methods &middot; Flinching, as well as licking and forelimb wiping of the site of injection were counted as pain responses, whereas biting and hind paw scratching of the cheek were counted as itchy responses. To discriminate formalin-induced sensations in rats, the irritant (saline as control) was injected, and then pain and itchy responses were recorded. Results &middot; Intraplantar injection of formalin elicited biphasic behavior responses characterized as flinching, as well as biting or licking of the hind paw without significant gender differences. Following intradermal administration of formalin to the cheek, rats exhibited episodic forelimb wiping of the cheek, representative of pain. No gender difference was noticed for this type of behavior. In addition, episodes of hind paw scratches of the cheek, representative of pruritoceptive responses, also occurred. Interestingly, hind paw scratches appeared to be more pronounced in male than in female rats. Conclusion &middot; Intradermal administration of formalin elicits pruritoceptive as well as nociceptive responses in rats.
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    Screening of putative transcriptional regulators in Salmonella enterica serovar Typhimurium
    LIU Shu-ting, YAO Yu-feng, NI Jin-jing
    2018, 38 (10):  1174. 
    doi: 10.3969/j.issn.1674-8115.2018.10.007

    Abstract ( 483 )   PDF (8307KB) ( 376 )  
    Objective &middot; To uncover new transcriptional regulatorsscreening putative transcriptional regulators in Salmonella enterica serovar Typhimurium (S. Typhimurium) through genome informatics and molecular biology analyses. Methods &middot; S. Typhimurium genome informatics was analyzed and 30 putative transcriptional regulators were screened out. All candidate genes were deleted&lambda;-Red system. The log-phase acid tolerance response (ATR) ability was compared between knock-out (KO) strains and wild type (WT) strain. Cell model was used to detect the invasion ability and intracellular ability of KO strains that showed differences in acid stress compared to WT strain. The transcription level of phoP was detectedrealtime-PCR in the mutants involved in both ATR and cell infection. Results &middot; All 30 deletion mutants were successfully constructed. &Delta;STM14_0739, &Delta;STM14_2717 and &Delta;STM14_1646 showed increased log-phase ATR ability, while ATR abilities of &Delta;STM14_4338, &Delta;STM14_1965 and &Delta;STM14_1878 decreased, compared with WT. &Delta;STM14_0739 and &Delta;STM14_2717 mutants showed weaker invasion ability in HeLa cells than WT, and &Delta;STM14_1878 and &Delta;STM14_2717 mutants showed stronger replication ability in RAW264.7 cells than WT. Realtime-PCR suggested STM14_2717 deletion had no effect on phoP transcription. Conclusion &middot; This work discovers unknown transcriptional regulators, and provides clues for future research in S. Typhimurium pathogenesis.
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    Down-regulation of aurora kinase A activity inhibits pro-angiogenesis, migration and invasion of Hep2 cells
    ZHANG Yu-han, CHEN Xue-hua, ZHANG Hao
    2018, 38 (10):  1181. 
    doi: 10.3969/j.issn.1674-8115.2018.10.008

    Abstract ( 495 )   PDF (6294KB) ( 502 )  
    Objective &middot; To investigate the effect of aurora kinase A (AURKA) activity on pro-angiogenesis, migration and invasion of Hep2 cells. Methods &middot; Down-regulation of AURKA phospholation in Hep2 cells with 100 nmol/L VX680. Western blotting was used to detect the of p-AURKA, vascular endothelial growth factor A (VEGFA) and its receptor VEGFR2 in blank control Hep2 cells and Hep2 cells treated with VX680 for 24 h and 48 h. Angiogenesis experiment was applied to observe the effect of Hep2 cells treated with VX680 on angiogenesis. CCK8 cell proliferation assay, Transwell migration and invasion experiment were used to observe the ability of cell proliferation, migration and invasion of Hep2 cells. Results &middot; Compared with control cells, the of p-AURKA in Hep2 cells treated with VX680 for 48 h was decreased (P0.000). After down-regulation of p-AURKA, the s of VEGFA and VEGFR2 were decreased (P0.000). Meanwhile, angiogenesis was inhibited (P0.000), and migration and invasion of Hep2 cells were reduced (P0.000). Conclusion &middot; AURKA regulates pro-angiogenesis, migration and invasion of Hep2 cells, which is a new strategy for the treatment of laryngeal cancertargeting AURKA.
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    Original article (Clinical research)
    A long-term follow-up study after the open-label proof-of-concept trial of metformin in systemic lupus erythematosus
    LIU Zhe1, WANG Hai-ting1, WANG Hui-jing1, TENG Xiang-yu2, YE Shuang1
    2018, 38 (10):  1186. 
    doi: 10.3969/j.issn.1674-8115.2018.10.009

    Abstract ( 718 )   PDF (7117KB) ( 352 )  
    Objective &middot; To evaluate the efficacy and safety of a long-term adding metformin to a basic treatment strategy in systemic lupus erythematosus (SLE), and analyze whether the beneficial effects of metformin add-on treatment during the open-label proof-of-concept trial persisted during a posttrial follow-up (the metabolic memory effect), as there is a paucity of systematically collected data concerning long-term metformin in SLE. Methods &middot;Subjects who had participated in the open-label proof-of-concept trial and gave informed consent to this study were enrolled, and the disease flares and long-term adverse effects between metformin group and control group were compared. In addition, whether the benefit regarding decreased disease flare persisted after metformin withdrawal during the post-trial follow-up was investigated. Results &middot; Twenty-nine subjects in the former metformin add-on strategy group and 28 subjects in the former control group were enrolled. No adverse reactions of metformin occurred during the study. The risk of disease flare in the control group was higher than that in the continuous metformin group, but the difference was not statistically significant (P0.326). After metformin withdrawal, the risk of disease flare in the metformin group gradually increased to the control group (P0.998). There was no significant difference between the two continuous metformin groups whose metformin using duration are 2.56 years and 5.00 years respectively (P0.802). Conclusion &middot; A long-term metformin add-on treatment is security, and can keep SLE patients in a lower risk of disease flare. The metabolic regulation of metformin in SLE immune disorder may present a time-dependent metabolic memory effect.
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    Case analysis based on 2017 version of Expert Consensus on the Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis
    XU Yang1, 2, LIU Kai-xiong1, 2, QU Jie-ming1, 2
    2018, 38 (10):  1191. 
    doi: 10.3969/j.issn.1674-8115.2018.10.010

    Abstract ( 696 )   PDF (8158KB) ( 339 )  
    Objective &middot; To analyze the cases of ABPA based on 2017 version of Expert Consensus on the Diagnosis and Treatment of Allergic Bronchopulmonary Aspergillosis (ABPA) (Expert Consensus in short) developedAsthma Group of Chinese Medical Association Respiratory Diseases Society. Methods &middot; According to the Expert Consensus, the clinical data of 12 patients with ABPA admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine January 2013 to December 2017 were retrospectively analyzed. Results &middot; Among the 12 patients with ABPA, 6 were males and 6 were females. The clinical manifestations were cough, having phlegm, short of breath, etc. The total immunoglobulin E (tIgE) in sera of 10 cases increased, and the peripheral blood eosinophils of 9 cases increased. Seven cases underwent the skin test, 3 of whom were positive in aspergillus. Serum aspergillus-specific IgE (sIgE) of all the 5 cases tested was elevated. The most patients showed bronchiectasis in chest CT, and some also with mucus plug. Fifty percent of the cases fully met the diagnostic criteria of Expert Consensus. All the patients were treated with corticosteroid, and 9 of them were also treated with antifungal drugs. Conclusion &middot; The clinical manifestations of ABPA are atypical. For the patients with lung diseases such as asthma and bronchiectasis, serum tIgE, aspergillus sIgE and eosinophil levels need to be monitored. Aspergillus skin test and imaging examination are helpful to the diagnosis of ABPA. The main treatment is the combination of corticosteroid and antifungal drugs.
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    Early effects of umbilical cord milking on hemoglobin, bilirubin and cardiac function in premature infants
    ZHANG Li1, 2, HUANG Qi-wei1, GONG Xiao-hui1, LI Pin1
    2018, 38 (10):  1197. 
    doi: 10.3969/j.issn.1674-8115.2018.10.011

    Abstract ( 415 )   PDF (6875KB) ( 354 )  
    Objective · To investigate the impact of umbilical cord milking on hemoglobin, bilirubin and cardiac function in premature newborns, and the significance of prevention of anemia. Methods · A randomized controlled trial was performed in Maternal and Child Health Hospital of Shanghai Jiading July to November 2017 on neonates born<37 weeks. Preterm newborns were randomly assigned to umbilical cord compression group (experiment group, n41) and control group (cord clamping within 15 s without compression, n37). Clinical measures of the outcomes were measuredtranscutaneous oxygen saturation (TcSO2), hemoglobin at different periods, left heart function within 72 h, cranial ultrasound, transcutaneous bilirubin, the total time of phototherapy. Results · Hemoglobin values were significantly higher in the experiment group than those in the control group in vein at the first time (P0.008). Hemoglobin values were significantly higher in the experiment group than those in the control group 3-5 d, 8-11 d, and 14-18 d after birth (P<0.05). Four months after birth, hemoglobin in the experiment group was higher than that in the control group, but there was no significant difference (P0.075). There was no significant difference in the total time of phototherapy between the two groups (P0.849). There were no significant differences between the two groups on left ventricular ejection fraction and left ventricular short axis shortening score 72 h after birth (P>0.05). Conclusion · Umbilical cord milking can increase the hemoglobin level to premature infants and reduce the incidence of anemia at discharge, and it does not increase the risk of cardiac insufficiency and hyperbilirubinemia. This practice has been shown to be simple and safe.
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    Research on level of serum lipid metabolism related hormones in patients of obstructive sleep apnoea hypoxia syndrome combine with non-alcoholic fatty liver disease
    YING Chen1, LIU Cai-hong2, HU Jia-an2, JIANG Shi-hu3, XU Zhi-hong2, SUN Jing2
    2018, 38 (10):  1203. 
    doi: 10.3969/j.issn.1674-8115.2018.10.012

    Abstract ( 435 )   PDF (7024KB) ( 376 )  
    Objective · To assess the level of serum lipid metabolism related hormones in the patients of obstructive sleep apnoea hypoxia syndrome (OSAHS) combine with non-alcoholic fatty liver disease (NAFLD), and explore the potential role in the pathogenesis. Methods · Patients that main complaint for snoring were selected. According to polysomnography and NAFLD screening, the patients were divided as follows: OSAHS+NAFLD group, OSAHS group, NAFLD group, and control group, and the levels of serum lipid metabolism related hormones were measured. The patients with OSAHS were divided into three groups, i.e., mild, moderate and severe groups according to the degree of apnea hypopnea index (AHI) and minimal oxyhemoglobin saturation (MinSaO2) respectively. The statistical analysis about the morbidity of NAFLD in the patients with different OSAHS severity were analyzed. Multiple regression analysis was used to determine the independent predictors of NAFLD. Results · Significant differences were found in AHI, MinSaO2, the duration of hemoglobin desaturation (TSaO2<90%), body mass index, adiponectin, leptin, high sensitive C reactive protein and lipopolysaccharide (P<0.05 for all) among the groups of OSAHS, NAFLD and OSAHS+NAFLD. The morbidity of NAFLD exited statistical difference in the patients with different OSAHS severity (17.0%, 51.6% and 97.2%, P0.006), and the same trend was seen in the patients with different MinSaO2 severity (18.2%, 57.1% and 91.9%, P0.011). Multiple regression analysis showed that body mass index, AHI and adiponectin were independent predictors of the morbidity of NAFLD (P0.006,P0.020 and P0.008). Conclusion · The morbidity of NAFLD increases with the worsening of OSAHS. There is positive correlation between the severity and the level of serum adiponectin and leptin in the patients with OSAHS and NAFLD.
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    Evaluation of visual function and adverse effects of different correction methods in the infants with monocular aphakia after congenital cataract surgery
    CHEN Jun-jue1, SUN Ping2, WEI Yan1, KANG Xiao-li1
    2018, 38 (10):  1208. 
    doi: 10.3969/j.issn.1674-8115.2018.10.013

    Abstract ( 410 )   PDF (6342KB) ( 479 )  
    Objective · To analyze the changes in visual function and adverse effects of wearing rigid gas permeable contact lens (RGPCL) and primary intraocular lens (IOL) implantation in the infants with monocular aphakia after congenital cataract surgery. Methods · The pre- and postoperative visual acuity, strabismus, nystagmus, adherence to patching and adverse events of the patients with unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation were analyzed retrospectively. RGPCLs were used to correct aphakia who did not receive IOLs. Results · All of 60 patients were included in this study. Twenty patients with unilateral aphakia used RGPCLs (group 1). Forty patients were implanted with IOLs primarily (group 2). In group 1, there was obvious improvement in visual acuity and strabismus (P<0.05). There was no statistic difference in visual acuity and strabismus between group 1 and group 2 finally. Nystagmus remission rate in group 1 was higher than that in group 2. The patients with adherence to patching had better visual acuity after operation than those without (P<0.05). All of the patients in group 1 had no ocular disease that affect visual acuity. More adverse events happened in group 2. Conclusion · Wearing RGPCL is a safe and effective optical correction method for the patients with monocular aphakia after congenital cataract surgery, especially for the patients below 2 years old who are not suifor IOL implantation. RGPCL has similar visual correction effect on the patients with primary IOL implantation, but it is accompaniedless adverse events.
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    Expression of lactamase &beta; in gastric cancer and its clinical significance
    ZHAO Xue1, 2*, WU Lin1*, GU Qin3
    2018, 38 (10):  1212. 
    doi: 10.3969/j.issn.1674-8115.2018.10.014

    Abstract ( 552 )   PDF (7652KB) ( 409 )  
    Objective &middot; To investigate the level of lactamase &beta; (LACTB) in gastric cancer and its influence on the prognosis of gastric cancer patients. Methods &middot; The varied of LACTB in 90 pairs of gastric cancer tissue and peritumor tissue was analyzedimmunohistochemistry. The prognostic role of LACTB mRNA in gastric cancer was analyzedthe Kaplan-Meier Plotter database. The factors affecting the overall survival of gastric cancer patients were analyzed with Cox survival model. The prognostic nomogram model was established to predict overall survival of gastric cancer patients. The proteins which interacted with LACTB were analyzedthe STRING database, and they were taggedthe noassociated functional cluster of GO (gene ontology) and KEGG (Kyoto encyclopedia of genes and genomes) pathway. Results &middot; The of LACTB in gastric cancer tissue was obviously lower than that in peritumor tissue (P0.000). The low of LACTB mRNA may suggest that the prognosis of gastric cancer patient is poor, and the C-index of nomogram for predicting prognosis of gastric cancer patients was 0.641. A set of LACTB and 38 proteins which interacted with LACTB participated in five kinds of signaling pathway. Results for the classification of GO (gene ontology) annotation demonstrated that the proteins were involved in one kind of cellular component, nine kinds of molecular function and two kinds of biological process. Conclusion &middot; The low of LACTB may be a poor-prognostic factor in gastric cancer.
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    Diagnostic value of D-dimer combined with echocardiography and vascular ultrasonography of lower extremity in pulmonary thromboembolism
    GENG Yan-lai1, 2, NI Lei1, 3, SHI Guo-chao1, 3
    2018, 38 (10):  1219. 
    doi: 10.3969/j.issn.1674-8115.2018.10.015

    Abstract ( 529 )   PDF (5143KB) ( 343 )  
    Objective · To analyze and evaluate the diagnostic value of plasma D-dimer combined with echocardiography and lower extremity vascular ultrasound for pulmonary thromboembolism (PTE). Methods · The clinical data of 140 clinically suspected PTE patients admitted to Department of Respiratory and Critical Care Medicine, Ruijin Hospital between January 2012 and December 2016 were retrospectively analyzed. Based on the results of computed tomographic pulmonary angiography (CTPA), all included patients were divided into CTPA negative group (non-PTE group) and CTPA positive group (PTE group). The univariate and multivariate analyses were used to compare and evaluate the diagnostic and predictive efficacy of plasma D-dimer combined with echocardiography and lower extremity vascular ultrasound for PTE. Results · There was no significant difference in gender, age, smoking, underlying diseases (malignancy, hypertension, coronary heart disease, dyslipidemia, and chronic obstructive pulmonary disease) and surgical history within 30 days between the two groups (All P>0.05). Univariate analysis revealed significant differences in D-dimer (P0.003), pulmonary artery pressure (P0.000), and partial pressure of carbon dioxide (P0.000) between the groups. Multivariate analysis suggested that deep venous thrombosis of the lower extremities, pulmonary hypertension, and elevated D-dimer levels were significantly associated with the incidence of PTE. Further ROC curve analysis suggested that the area under the curve (AUC) of deep venous thrombosis, pulmonary hypertension and D-dimer increase was 0.624, 0.673 and 0.624, respectively. The AUC of combined three factors was 0.837. The sensitivity, specificity, positive predictive value and negative predictive value of the combined diagnosis reached 86.8%, 88.4%, 87.5%, and 84.6%, respectively. Conclusion · D-dimer combined with echocardiography and vascular ultrasound of lower extremity might have diagnostic and predictive value for PTE.
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    Analysis of two Chinese Han families with Duchenne/Becker muscular dystrophy
    HONG Sha1, ZHAO Dong-ying1, XIE Li-juan1, CHANG Guo-ying2, LIU Xiao-qing3, ZHU Tian-wen1
    2018, 38 (10):  1223. 
    doi: 10.3969/j.issn.1674-8115.2018.10.016

    Abstract ( 526 )   PDF (7991KB) ( 322 )  
    Objective &middot; To deepen the understanding of Duchenne/Becker muscular dystrophyinvestigating dystrophin (DMD) gene variants in 2 Chinese Han families with this disease. Methods &middot; Retrospective analysis of the clinical characteristics of the probands in two families with Duchnne/ Becker muscular dystrophy and the results of multiplex ligation-dependent probe amplification (MLPA) for the probands and their relatives was performed. Results &middot; Three probands were identifiedsignificantly-elevated creatine kinase levels. Two probands in family one are fraternal twin brothers with the same deletions of exons 8-9, while their mother has no abnormality at this site. The proband in family two is the little brother in a pair of fraternal twins with duplication of exons 48-51, and his mother has heterozygous duplication of exons 48-51. Conclusion &middot; ① The presence of the same DMD gene mutation in the fraternal twins suggests that the mother may be a gonad chimera with this mutation if her gene detection of peripheral blood is normal. The mother must undergo prenatal gene diagnosis to reduce the risk of Duchenne/Becker muscular dystrophy in her offsprings. ② The exons 48-51 duplication of DMD gene is pathogenic mutation.
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    Association between folate metabolism in males and outcome of assistant reproductive technology
    WU Zheng-mu1, CHEN Song-chang2, XU Chen-ming2, JIN Li1
    2018, 38 (10):  1229. 
    doi: 10.3969/j.issn.1674-8115.2018.10.017

    Abstract ( 616 )   PDF (5205KB) ( 356 )  
    Objective · To investigate the association between polymorphisms in methylenetetrahydrofolate reductase (MTHFR), serum homocysteine (HCY) concentration and outcome of assistant reproductive technology (ART). Methods · A retrospective study was conducted in 285 infertile couples who underwent ART. Sperm quality, serum HCY concentration and MTHFR genotype of the males in these couples were collected. According to the results of MTHFR C677T and serum HCY of males, they were divided into four groups, i.e, TT+high HCY, TT+normal HCY, NOT TT+high HCY, and NOT TT+normal HCY (as control). Results · There was no significant difference in the frequency distribution of oligoasthenozoospermia of four groups (P>0.05). The fertilization rates were significantly lower in patients with high plasma HCY levels (P<0.05). The rates of effective embryo in NOT TT+high HCY group were significantly lower (P<0.05). Accumulated pregnancy rates and early abortion rates were not significantly different among four groups (P>0.05). Conclusion · High serum HCY of males may affect outcome of ART. The detection of MTHFR gene polymorphisms helps to remind supplement folic acid in time.
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    Nutritional status and risk factors for malnutrition in children with single ventricle physiology after total cavopulmonary connection
    SUN Chong-rui, ZHANG Ming-jie, XU Zhuo-ming
    2018, 38 (10):  1233. 
    doi: 10.3969/j.issn.1674-8115.2018.10.018

    Abstract ( 385 )   PDF (10670KB) ( 326 )  
    Objective &middot; To analyse nutritional status of children underwent total cavopulmonary connection (TCPC) also called Fontan procedure, furthermore to investigate risk factors related to malnutrition including underweight, stunting, and thinness. Methods &middot; Clinical data of 314 children underwent Fontan procedure in Shanghai Children&prime;s Medical Center Jan. 2012 to Dec. 2015 were reviewed. WHO Z score was used to evaluate nutritional status of the children underwent Fontan procedure at the time of long-term follow-up. According to the nutritional status, children were divided into underweight and no-underweight groups, stunting and no-stunting groups, thinness and no-thinness groups. Univariate and multivariate Logistic regression analysis were used to detect risk factors for malnutrition in the children after Fontan procedure. Results &middot; In the follow-up survey after Fontan procedure, the proportion of underweight, stunted and thin children were 11.9%, 17.8%, and 16.9%, respectively. Multivariate Logistic regression analysis showed that preoperative malnutrition, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time of diuretics were the risk factors for underweight in the children after Fontan procedure (P0.008, P0.000, P0.025, P0.001); preoperative malnutrition, elevated mean pulmonary artery pressure, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time of diuretics were the risk factors for stunting in the children after Fontan procedure (P0.001, P0.046, P0.000, P0.019, P0.004); preoperative malnutrition, elevated mean pulmonary artery pressure, worse cardiac function, moderate or severe atrioventricular valve regurgitation and long time of diuretics were the risk factors for thinness in the children after Fontan procedure (P0.019, P0.018, P0.015, P0.026, P0.000). Conclusion &middot; Malnutrition is still remained during follow-up period in the children with single ventricle physiology after Fontan procedure. Preoperative malnutrition, worse cardiac function, elevated pulmonary artery pressure, long time of diuretics and moderate or severe atrioventricular valve regurgitation may be associated with malnutrition after Fontan procedure.
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    Review
    Review of high-risk sexual behaviors in men who have sex with men: influencing factors and theoretical models
    SHI Shu-yuan1, WANG Ze-zhou1, SHEN Qiu-ming1, CAI Yong1, YUAN Dong2, WANG Ying1
    2018, 38 (10):  1242. 
    doi: 10.3969/j.issn.1674-8115.2018.10.019

    Abstract ( 509 )   PDF (7593KB) ( 405 )  
    The disproportionately high prevalence of HIV among men who have sex with men (MSM) is associated with the prevalence of unprotected anal intercourse (UAI), which has been the predominant high-risk behavior of HIV acquisition and transmission. MSM have become a target population for HIV prevention. The aspects affecting the high-risk sexual behaviors of MSM mainly include personal factors, environmental factors, and social psychological factors. Currently widely applied models of acquired immunodeficiency syndrome (AIDS) behavioral intervention include KABP (knowledge, attitude, belief, and practice) model, health belief model, theory of reasoned action, social network theory, and so on. These theories provide a reference for studying various influential factors and elaborating the occurrence of high-risk sexual behaviors of MSM. Exploring and building the comprehensive model and integrating the influencing factors of high-risk sexual behaviors of MSM can help us to predict their ultimate actions in the future. Similarly, it will also provide ideas for the further preventions and interventions in MSM.
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    Roles of SIRT2 in the tumorigenesis and development of hepatocellular carcinoma
    HAN Ke-qi*, RUAN Xin*, HE Ming
    2018, 38 (10):  1247. 
    doi: 10.3969/j.issn.1674-8115.2018.10.020

    Abstract ( 639 )   PDF (7207KB) ( 358 )  
    Silence information regulators (sirtuins) are highly conserved nicotinamide adenine dinucleotide (NAD+) dependent histone deacetylases, which play important roles in the process of aging, metabolism, apoptosis, gene transcription, and inflammation. There are seven kinds of sirtuins in mammals, SIRT1-SIRT7. These proteins have different subcellular localization and play diverse roles in metabolism. SIRT2, one of the members of sirtuins family, is mainly located in the cytoplasm and participates in the cell cycle control, oxidative stress and glycolipid metabolism. In addition, the level of SIRT2 has been widely associated with the development of cancers, including hepatocellular carcinoma. SIRT2 possesses a dual role in tumorigenesis, with both tumor-promoting and tumor-suppressing function. However, the mechanisms in which SIRT2 plays the roles in cancer are still controversial. In this review, the conflicting roles of SIRT2 in the tumorigenesis and development of hepatocellular carcinoma were mainly discussed.
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    Research progress on myasthenia gravis related autoantibody and detection approaches
    HUANG Xin-xin1, ZHU De-sheng2, XU Jian-rong3, GUAN Yang-tai1, 2
    2018, 38 (10):  1252. 
    doi: 10.3969/j.issn.1674-8115.2018.10.021

    Abstract ( 633 )   PDF (11068KB) ( 414 )  
    Myasthenia gravis (MG) is an autoimmue disease mediated mainlyhumoral immunity, which is characterisedskeletal muscle weakness and fatigue. Its pathogensis is closely related to the autoantibodies against the postsynaptic membrane components at neuromuscular junction (NMJ), including acetylcholine receptor (AChR) antibody, muscle-specific receptor tyrosine kinase (MuSK) antibody, and low-density lipoprotein receptor-related protein 4 (LRP4) antibody. In recent years, autoantibodies against antigens such as agrin, collagen Q, and cortactin have been identified. Based on serum antibody patterns, MG can be divided into different subgroups: AChR-MG, MuSK-MG, LRP4-MG and seronegative MG. The detection of autoantibody is vital in clinical for subgroup diagnosis, treatment and prognosis. With the development of medical techniques, the antibody detection approaches were improved, providing new opportunities for precise diagnosis and treatment of different subgroups. Thus, this paper reviewed the latest progress of MG autoantibody classification and the antibody detection approaches.
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    Application of programmed cell death protein 1/programmed death-ligand 1 blockade in advanced gastric cancer treatment
    LI Xia-yi, ZHENG Lei-zhen
    2018, 38 (10):  1259. 
    doi: 10.3969/j.issn.1674-8115.2018.10.022

    Abstract ( 592 )   PDF (9590KB) ( 373 )  
    In the tumor microenvironment, the interaction of programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1) can promote the immune escape of tumor cells. The application of PD-1/PD-L1 blockade can restore host immune function to efficiently identify and kill tumor cells. In recent years, PD-1/PD-L1 blockade has shown remarkable clinical effects in a variety of tumors and U.S. Food and Drug Administration has approved nivolumab and pembrolizumab for the treatment of unresectable/metastatic melanoma, non-small cell lung cancer and etc. Hence, a growing number of clinical trials on PD-1/PD-L1 blockade for advanced gastric cancer have been carried out, and the overall survival and objective response rate of most trials are promising. This paper reviewed PD-1/PD-L1 signaling pathway, the relationship between the of PD-L1 and the classification and prognosis of gastric cancer, and the clinical results of PD-1/PD-L1 blockade in advanced gastric cancer.
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    Research progress of sentinel lymph node mapping in endometrial cancer surgery
    GUAN Yi-bei, TENG Yin-cheng
    2018, 38 (10):  1265. 
    doi: 10.3969/j.issn.1674-8115.2018.10.023

    Abstract ( 607 )   PDF (6298KB) ( 434 )  
    In recent years, research about sentinel lymph node mapping in endometrial cancer surgery has developed quickly. Several clinical studies indicate that sentinel lymph node mapping in early endometrial cancer can improve detecrate and decrease the false-negative rate. However, the technology is still controversial. Therefore, further study is needed to assess the role of sentinel lymph node mapping in endometrial cancer. This review mainly focused on the current clinical practice of sentinel node mapping technique in endometrial cancer, and the existing problems and controversies.
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    Techniques and methods
    Effect of vardenafil pretreatment on the activity of post-thaw sperm
    LU Ke-min1, 2, ZOU Sha-sha2, CHEN Xiang-feng2, LIU Qiang1
    2018, 38 (10):  1269. 
    doi: 10.3969/j.issn.1674-8115.2018.10.024

    Abstract ( 484 )   PDF (4371KB) ( 467 )  
    Objective &middot; To explore the effect of vardenafil pretreatment on the post-thaw sperm activity. Methods &middot; Semen samples were randomly collected 30 donors in Shanghai Human Sperm Bank. Then, each semen sample was aliquoted into six parts. One was immediately assayed for sperm activity without any treatment as the original control. The other five parts were incubated with vardenafil at 0, 0.4, 4.0, 40.0, and 400.0 &mu;g/mL respectively for five minutes. The protective agent was added according to the semen: protective agent ration (2:1), and the fumigation method was used for cryopreservation. After thawing, each specimen was examined for various parameters, including progressive motility, total motility and normal sperm morphology. Results &middot; After thawing, the progressive sperm rates were (41.47&plusmn;9.80)%, (42.57&plusmn;9.60)%, (47.77&plusmn;8.55)%, (37.27&plusmn;8.47)%, and (26.37&plusmn;6.99)% in the groups treated with 0, 0.4, 4.0, 40.0, and 400.0 &mu;g/mL of vardenafil, respectively. Compared to the control group (0 &mu;g/mL of vardenafil), 4.0 &mu;g/mL of vardenafil could significantly improve the post-thaw sperm motility (P0.034). Conclusion &middot; Vardenafil pretreatment can improve the activity of the post-thaw sperm; however, it may be toxic to sperm at the high concentration.
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    Case report
    Clinicopathological analysis of five cases of intrathyroid thymic carcinoma
    ZHAO Ling, GAO Run-lin, LIU Qiang, SHEN Yan-ying
    2018, 38 (10):  1272. 
    doi: 10.3969/j.issn.1674-8115.2018.10.025

    Abstract ( 798 )   PDF (6945KB) ( 412 )  
    Objective &middot; To investigate the clinicopathological features of intrathyroid thymic carcinoma. Methods &middot; Clinical data of 5 patients with intrathyroid thymic carcinoma were retrospectively reviewed. Histological examination and immunohistochemical staining were performed on the surgically resected tumors. The infection of EB virus (EBV) was detectedin situ hybridization of EBV-encoded RNAs (EBER). BRAF V600E mutation was examinedamplification refractory mutation system. Results &middot; There were 3 males and 2 females with age between 51 and 69 years (average of 60.8 years). All 5 cases were intrathyroid tumors. The tumors were 2.0-3.5 cm in diameter. All 5 cases showed positive staining for CK, CK19, P40, CD5, CD117, Bcl-2, and Ki-67 at protein level, and negative staining for other related differential diagnosis markers including 34&beta;E12, TPO, TG, TTF1, SYN, EBV, and BRAF. In situ hybridization of EBER showed negative results and no BRAF V600E mutation was found. Conclusion &middot; Intrathyroid thymic carcinoma is a low-grade malignant tumor. Expressions of CD5 and CD117 in tumor cells play a very important role in the differential diagnosis.
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