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    Original article (Basic research)
    Identification and analysis of chimeric rates in Down syndrome chimeric micequantitative real time PCR
    MENG Xiao-wei1, YANG Guan-heng1, 2, WANG Yun-jie1, 2, MA Qing-wen1, 2
    2018, 38 (11):  1277. 
    doi: 10.3969/j.issn.1674-8115.2018.11.001

    Abstract ( 625 )   PDF (7355KB) ( 493 )  
    Objective · To establish a method for identifying the chimeric rates in Down syndrome chimeric mice, and study the chimeric rules in different organs. Methods · The proportion of trisomic cells (Tc1 cells) in different organs was calculateddetecting the relative quantity of human chromosome 21 (Hsa21) and mochromosome 15 (Mmu15) in samples. The relative quantity of Hsa21 and Mmu15 was evaluated with specific primers for genes SIM2 on Hsa21 and Derl1 on Mmu15, respectively,quantitative real time PCR (qPCR) technology. Results · Three mice were chimeras and the chimeric levels of Tc1 cells were different in various tissues. The chimeric rates in hearts of these 3 mice were 8.98%, 21.71% and 57.70%; in cerebellums, the chimeric rates were 5.62%, 20.17% and 40.43%; in brains, the rates were 8.48%, 15.35% and 20.45%; in livers, the rates were 2.66%, 6.50% and 16.84%; and in spleens, the rates were 1.73%, 3.80% and 11.80%. Conclusion · The chimeric rate of trisomic cells in Down syndrome chimeric mice can be detectedqPCR technologyusing primers for genes on specific chromosomes. The chimerism occurs in the hearts, cerebellums, brains, livers and spleens of the chimeric mice and the chimeric rate of Tc1 cells tends to be the highest in the hearts.
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    Characterization and genome sequencing of SH-Ab 15599, a novel bacteriophage targeting carbapenem-resistant Acinetobacter baumannii
    JI Jia-wei1, 2, WANG Rui1, LUO Ting-ting4, XU Meng-sha1, GUO Xiao-kui1, HU Fu-pin3, LI Min2, HE Ping1
    2018, 38 (11):  1283. 
    doi: 10.3969/j.issn.1674-8115.2018.11.002

    Abstract ( 573 )   PDF (6399KB) ( 456 )  
    Objective · To find lytic bacteriophages which have potential to combat carbapenem-resistant Acinetobacter baumannii (CRAB) infections and analyze the biological characterizations and genomic sequences of the phages. Methods · The phages were isolated sewage followedamplification and purification. They were characterizedthe transmission electron microscopy, the host specificity, the biological characterizations, the lysis assay in vitro and the genome sequence analysis. Results · A novel bacteriophage, SH-Ab 15599, was isolated sewage. The electron microscope revealed SH-Ab 15599 belongs to Myoviridae. Among the 51 clinical CRAB isolates tested, 15 (29.4%) were lysedthe phage. SH-Ab 15599 was relatively sat temperature range 4 ℃ to 50 ℃ or between pH 6 and 9. About 90% of the phage was approximately adsorbed to the host CRAB isolate in 5 min. The one-step growth curve showed that the latent period was about 10 min and the growth period was about 20 min. The burst size was estimated at 43 pfu per infected cell. The growth of the host CRAB isolate was inhibitedthe phage in vitro. The genome of SH-Ab 15599 was a linear, 143 204 bp double-stranded DNA with GC content of 38.45%. Conclusion · SH-Ab 15599 is a novel phage targeting CRAB and has potential as an alternative against CRAB infections in the future.
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    Effect of epigallocatechin-3-gallate on oxidative stress and inflammation in 3T3-L1 adipocytes
    Maidinayi · KUDELAITI1, TANG Wen-jing2, HE Wen-nan2, WANG Jia-lu2, SONG Huan-lei3, SHEN Xiu-hua2, 3
    2018, 38 (11):  1289. 
    doi: 10.3969/j.issn.1674-8115.2018.11.003

    Abstract ( 408 )   PDF (6565KB) ( 468 )  
    Objective · To explore the effect of epigallocatechin-3-gallate (EGCG) on oxidative stress and inflammation in 3T3-L1 adipocytes, and provide a theoretical basis for EGCG to prevent obesity and related chronic diseases. Methods · 3T3-L1 preadipocytes were differentiated to mature adipocytesin vitro cell culture. The cells were divided into blank control group, and 1, 10 and 50 μg/mL EGCG groups. After 24 hour treatment, intracellular oxidative stress indicators glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) levels in the cells were measured. The levels of inflammatory indexes interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and monocyte chemoattractant protein-1 (MCP-1) were testedELISA and realtime PCR, while the of nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) was testedrealtime PCR. Results · Compared with the control group, GSH and SOD levels in 3T3-L1 adipocytes increased in a dose-dependent manner after treatment of EGCG (both P<0.05), while MDA level in 3T3-L1 adipocytes decreased dose-dependently after treatment of EGCG (P<0.05). IL-6, MCP-1 and TNF-α levels in 3T3L1 adipocytes supernatant declined significantly in a dose-dependent manner after treatment of 1, 10 and 50 μg/mL EGCG (all P<0.05). The levels of IL-6, MCP-1 and TNF-α in 3T3-L1 adipocytes were decreased in a dose-dependent manner after 24 h treatment of different concentrations of EGCG. Nrf2 and HO-1 mRNA levels in 3T3-L1 adipocytes increased significantly in a dose-dependent manner after treatment of 10 and 50 μg/mL EGCG (both P<0.05). Conclusion · EGCG plays an antioxidation and anti-inflammatory effects in 3T3-L1 adipocytes, which may be related to up-regulation of Nrf2/HO-1.
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    Mechanism of HIF-1α-PDK1 signaling system involved in glucose metabolism and drug resistance in acute monocytic leukemia
    XU Xiao-wei, ZHAO Chu-xian, LI Su, WANG Chun, SONG Xian-min, BAI Hai-tao
    2018, 38 (11):  1294. 
    doi: 10.3969/j.issn.1674-8115.2018.11.004

    Abstract ( 506 )   PDF (7324KB) ( 386 )  
    Objective &middot; To investigate the mechanism of HIF-1&alpha;-PDK1 signaling system mediated glucose metabolism and drug resistance in acute monocytic leukemia cells. Methods &middot; The of pyruvate dehydrogenase kinase 1 (PDK1) mRNA in U937, U937/DNR and acute monocytic leukemia cells was detectedquantitative polymerase chain reaction (qPCR). siRNA HIF-1&alpha; plasmid was constructed and transferred to U937 and U937/ DNR cells for 24 hgene silencing. Cell proliferation inhibition was examinedMTT assay. The level of PDK1 mRNA was detectedqPCR, and the of PDK1 and multi-drug resistance gene 1 (MDR1) proteins was detectedWestern blotting. Cell membrane potential was measuredflow cytometry using JC-1. Lactic acid level in the culture fluid was determinedblood gas analyzer. Dichloroacetate (DCA) and daunorubicin (DNR) were added to treat U937/DNR and acute monocytic leukemia cells for 24 h, MTT was used to calculate cell proliferation inhibition and Western blotting was used to estimate the of PDK1 and MDR1 proteins. Results &middot; PDK1 mRNA was highly expressed in U937, U937/DNR and acute monocytic leukemia cells. Silencing hypoxia-inducible factor-1&alpha; (HIF-1&alpha;) significantly inhibited the proliferation activity, PDK1 and MDR1 and lactic acid production in U937 and U937/DNR cells. DCA could reverse the resistance to DNR in U937/DNR and relapsed acute monocytic leukemia cells. Conclusion &middot; HIF-1&alpha;-PDK1 signaling system may regulate glucose metabolism and participate in the drug resistance of acute monocytic leukemia.
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    N-Ethylation facilitates simultaneous quantification of amino neurotransmitters using UHPLC-MS/MS
    XUE Hai-si, TANG Hui-ru
    2018, 38 (11):  1300. 
    doi: 10.3969/j.issn.1674-8115.2018.11.005

    Abstract ( 482 )   PDF (7700KB) ( 542 )  
    Objective &middot; To investigate the effect of content changes of neurotransmitters on multiple physiological and pathophysiological processes in mammals, and explore simultaneous sensitive quantification of these metabolites. Methods &middot; An efficient and sensitive method for simultaneous quantification of 20 amino neurotransmitters was achieved through pre-column N-ethylation of neurotransmitters with acetaldehyde and NaBH3CN followed with quantitative analysis using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). And NaBH3CN and NaBD3CN were used as a pair of sisotope labeling reagents together with natural isotopic standards to achieve accurate quantification. Results &middot; The analysis showed all 20 neurotransmitters had excellent linearity with R2 over 0.991 0 and sensitivity with the limits of detection (LOD) in the range of 0.5-10 fmol except for histidine with an LOD of 36.5 fmol. The result also showed good robustness with the interday and intraday RSD (relative standard deviation) below 15%. The method was further applied to human urine, serum and saliva samples for validation, in which 14, 10 and 8 neurotransmitters were detected, respectively. Conclusion &middot; The method is of high sensitivity and precision. Compared to previous ones, this method is of great applicability in different matrices, with mild reaction and straightforward procedures. Besides, the reaction reagents are easy to be removedsimple quenching thus avoiding interference in the subsequent analysis.
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    Knocking out Lpp gene of E.coli CLM37 strain and extracellular production of N-glycosylated recombinant proteins
    RUAN Yao, WANG Li-fan, GUO Long-hua, FU Xin, DING Ning, HU Xue-jun
    2018, 38 (11):  1306. 
    doi: 10.3969/j.issn.1674-8115.2018.11.006

    Abstract ( 637 )   PDF (7675KB) ( 379 )  
    Objective &middot; To construct the E.coli CLM37 strain with Lpp gene deletion and to study the production of N-glycosylated recombinant proteins in this E.coli strain. Methods &middot; Firstly, Red homologous recombination system was used to knock out the Lpp gene the genome of E.coli CLM37. And then, the growth curve was detected to study the effects of deleted Lpp gene on the growth states of E.coli strain. Finally, the vector pIG6-rFn3Gly which expresses receptor protein and the vector pACYCpgl, which carries N-glycosylation gene cluster that derives Campylobacter jejuni, were co-transformed into E.coli CLM37&Delta;Lpp to investigate the extracellular production of N-glycosylated recombinant proteins. Results &middot; The E. coli CLM37&Delta;Lpp with Lpp gene deletion was obtained, and the extracellular production of N-glycosylated rFn3-Gly was successfully achieved in this strain. Compared with E. coli CLM37, the total amount of rFn3-Gly produced via extracellular production of E. coli CLM37&Delta;Lpp increased about 4 times, and the glycosylation efficiency increased about 6 times. Conclusion &middot; N-glycosylated rFn3-Gly was successfully produced via extracellular production in E. coli CLM37&Delta;Lpp, and the production of interest glycoprotein and the glycosylation efficiency were improved.
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    Methylation of leptin promoter in ovarian granulosa cells of polycystic ovary syndrome-metabolic syndrome patients
    YUAN Hao1, NIU Zhi-hong2
    2018, 38 (11):  1312. 
    doi: 10.3969/j.issn.1674-8115.2018.11.007

    Abstract ( 374 )   PDF (8723KB) ( 349 )  
    Objective &middot; To investigate the characteristics of leptin secretion and DNA methylation of leptin gene of ovarian granulosa cells in patients with polycystic ovary syndrome (PCOS) associated with metabolic syndrome (MS). Methods &middot; Twenty patients underwent in vitro fertilization for fallopian tube factor at the Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine September to December 2016 were selected. They were divided into two groups, i.e. PCOS group (n10) and PCOS-MS group (n10). Chemiluminescence method was used to detect serum sex hormones and glucose metabolism indexes. Glycerol phosphate oxidase-peroxidase-4-aminoantipyrine and phenolic method was used to detect lipid metabolism indexes. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentration of leptin in serum and follicular fluid. Combined bisulfite restriction analysis was used to test methylation level of the leptin DNA promoter in ovarian granulosa cells. Wilcoxon rank and &chi;2 test were used for statistical analysis. Results &middot; There was no difference in age and basic hormone levels between two groups. Compared with the PCOS group, the insulin resistance index and triglyceride level in patients with PCOS-MS group were significantly higher (P0.045, P0.044), high density lipoprotein level was decreased significantly (P0.048), the level of leptin in serum and follicular fluid was increased significantly (P0.031, P0.042), the methylation sites of CpG island in leptin DNA promoter upstream 299-556 sequence of luteinized granulosa cells were reduced significantly (P0.026), and the good quality embryo rate was significantly lower (P0.043). Conclusion &middot; The leptin levels in the serum and follicular fluid of patients with PCOS-MS are elevated, accompanieda decrease in the methylation level of the leptin DNA promoter in luteinized granulosa cells and in the proportion of high-quality embryos, which may be one of the reasons leading to the decline of PCOS-MS female fertility.
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    Original article (Clinical research)
    Relationship between homocysteine in plasma and carotid atherosclerosis in the elderly patients
    GUO Dong-hao, LIU Hui, MIAO Ya, ZHONG Yuan
    2018, 38 (11):  1318. 
    doi: 10.3969/j.issn.1674-8115.2018.11.008

    Abstract ( 536 )   PDF (5341KB) ( 480 )  
    Objective · To study the relationship between homocysteine (HCY) in plasma and carotid atherosclerosis in the elderly patients and its clinical significance. Methods · The intima-media thickness (IMT) of the common carotid arteries and the sclerotic lesions at the carotid arteries bulbs were evaluatedcolor Doppler ultrasonography in 99 elderly in-patients (65 years old or above). Fasting venous blood was drew the patients for the determination of plasma HCY and other indexes. According to the plasma HCY concentration, the patients were divided into two groups, i.e., control group (HCY<15 μmol/L) and high HCY group (HCY ≥ 15 μmol/L). General clinical data, carotid plaque number, plaque thickness, plaque stability and carotid IMT were investigated in the two group of patients. Results · The numbers (P0.015), stability (P0.013) and thickness (P0.001) of carotid plaques between the two groups were significantly different. After balancing the effects of agethe partial correlation analysis, plasma HCY concentration was positively correlated with the number (partial correlation coefficient0.133, P0.049), instability (partial correlation coefficient0.046, P0.023) and thickness (partial correlation coefficient0.119, P0.024) of carotid plaques. Nevertheless, the difference in the IMT of carotid arteries between the two groups was not significant (P0.057). Conclusion · Plasma HCY concentration is correlated with the number, stability and thickness of carotid plaques.
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    Clinical characteristics and genetic analysis of nevoid basal cell carcinoma syndrome with epilepsy
    LIU Gai-ling1, 2, TAO Kun3, DU Ai-lian2, LIU Xiao-li4, LIANG Hui1
    2018, 38 (11):  1322. 
    doi: 10.3969/j.issn.1674-8115.2018.11.009

    Abstract ( 492 )   PDF (6756KB) ( 372 )  
    Objective &middot; To investigate the clinical and genetic characteristics of nevoid basal cell carcinoma syndrome (NBCCS) combined with epilepsy. Methods &middot; The clinical data of a proband with the symptom of epileptic seizures in Department of Neurology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine was retrospectively analyzed. Facial nevoid was resected and hematoxylin-eosin (H-E) staining was examined. Wholeexome sequencing was performed on the blood DNA of the proband and his family members. Sanger sequencing was used for co-segregation analysis. Results &middot; The proband was highly suspected of having NBCCS according to the clinical diagnostic criteria of NBCCS. H-E staining showed typical pathological features of basal cell carcinoma. Heterozygous deletion at c.3364_3365del base in the exon 20 of patched 1 (PTCH1) gene was found in this family. Conclusion &middot; The heterozygous deletion in the exon 20 of PTCH1 gene (c.3364_3365del) may be a potential hot spot mutation for NBCCS, especially in patients combined with neurological manifestations, such as epilepsy.
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    Application and clinical value of multi-voxel magnetic resonance spectroscopy in the diagnosis of tongue carcinoma
    WANG Bo-cheng1, 2, ZHU Dan2, LI Xiao-guang3, WU Li-zhong2, ZHAO Jiang-ming2, MEI Jun1
    2018, 38 (11):  1327. 
    doi: 10.3969/j.issn.1674-8115.2018.11.010

    Abstract ( 369 )   PDF (7922KB) ( 307 )  
    Objective · To determine clinical value of multi-voxel magnetic resonance spectroscopy (MVMRS) in the diagnosis of tongue carcinoma. Methods · A total of 56 cases that were pathologically diagnosed as having unilateral squamous cell carcinoma (SCC) or adenoid cystadenocarcinoma (ACC), January to December 2017, were selected in this retrospective study. The characteristics of metabolic profiles in MVMRS were analyzed. The signals of choline (Cho), creatine (Cr), choline creatine ratio (Cho/Cr), and lactate/lipids (LL) and the apparent diffusion coefficient (ADC) were comparatively analyzed among the tumor parenchymal area, the paratumor area, and the contralateral control area in SCC/ACC group. The above indexes in the relative areas between SCC and ACC were also compared. Moreover, the relationship between the LL or Cho signal intensity with ADC in all the areas of two groups was investigated. Results · Higher Cho and LL signals were observed in the tumor parenchymal areas than those in the paratumor areas and the contralateral control areas in both SCC and ACC groups (P0.000), while ADC values in the tumor parenchymal areas were obviously lower (P0.000). Cho and LL signal intensities and ADC values in the paratumor areas were between the tumor parenchymal areas and contralateral control areas in both groups (P0.000). However, no significant difference among the areas in Cr or Cho/Cr signal was found (P>0.01). There was no significant difference between SCC and ACC groups in the relative areas, either (P>0.01). The signal intensity of LL in the tumor parenchymal area in SCC group was negatively linearly correlated with the ADC value (P0.000). Conclusion · MVMRS can detect the content of metabolites in tongue carcinoma, and LL and Cho signal intensities with ADC value can reflect the degree of tumor invasion in the paratumor areas.
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    Efficacy of Xu-Huang mixtures for the treatment of diabetic lower extremity atherosclerotic occlusive disease
    WANG Jie1, YANG Ke2, CHEN Jing-xian1, Lü Ling-ling1, BIAN Xiao-lan3, ZHENG Lan1
    2018, 38 (11):  1333. 
    doi: 10.3969/j.issn.1674-8115.2018.11.011

    Abstract ( 429 )   PDF (5650KB) ( 408 )  
    Objective · To observe the clinical efficacy of Xu-Huang mixtures for the treatment of diabetic lower extremity atherosclerotic occlusive disease (LEAOD). Methods · 68 patients with diabetic LEAOD were divided into control group (n33) and experimental group (n35)random number method. The control group received the oral administration of atorvastatin calcium tablets and beraprost sodium tablets, the experimental group received the same oral administration of the control group plus Xu-Huang mixtures. Two groups were treated for 12 weeks. The intima-media thickness (IMT) of lower extremity artery (including anterior tibial artery, posterior tibial artery and dorsalis pedis artery), blood viscosity, fibrinogen, plasma D-dimer, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-Ch), high density lipoprotein-cholesterol (HDL-Ch) in both groups were recorded at the beginning and end of the treatment. The blood and urine routine examinations and the hepatic and renal function tests were performed every 2 weeks. After treatment, the curative effect of each group was evaluated through measuring the intermittent limp distance. Results · After treatment, the improvement of anterior tibial artery IMT, posterior tibial artery IMT, dorsalis pedis artery IMT, blood viscosity, fibrinogen, plasma D-dimer, TC, LDL-Ch and HDL-Ch in the experimental group were significant superior to that in the control group (all P<0.05). There were no significant abnormalities in the blood and urine routine examinations and the hepatic and renal function tests between two groups. The total effective rate in the experimental group was 91.43%, which was significantly higher than that in the control group (75.76%) (P0.014). Conclusion · Xu-Huang mixtures has significant efficacy for the treatment of diabetic LEAOD.
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    Comparison of quantitative analysis between QGS and ECTb software programs used in gated myocardial perfusion imaging
    SONG Jie-ping, SHOU Yi, JIANG Jian-jun, YOU Zhi-wen, MENG Qing-yuan, ZHAO Jun
    2018, 38 (11):  1337. 
    doi: 10.3969/j.issn.1674-8115.2018.11.012

    Abstract ( 694 )   PDF (7236KB) ( 351 )  
    Objective &middot; To study the differences and correlations of quantitative analysis between Cedars-Sinai quantitative gated SPECT (QGS) and Emory cardiac toolbox (ECTb) used in single photon emission computed tomography (SPECT) gated myocardial perfusion imaging (G-MPI). Methods &middot; A total of 28 patients were examined with 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) SPECT G-MPI. The left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV), phase histogram bandwidth (PHB) and phase standard deviation (PSD) were calculated with QGS and ECTb. The correlations and differences of the results these two programs were analyzed. Results &middot; These two software programs showed high correlation for LVEF, EDV and ESV (LVEF: r0.917, P0.000. EDV: r0.976, P0.000. ESV: r0.981, P0.000). The analysis showed no significant correlation for PHB and PSD (PHB: r0.319, P0.055. PSD: r0.172, P0.310). In the analysis of cardiac function, the ESV measuredQGS was higher than that measuredECTb, and the EDV and LVEF were lower than those measuredECTb. In the phase analysis, the PSD and PHB measuredQGS were lower than those measuredECTb. These differences between the results measuredthe two software programs were not consistency. There were significant differences in LVEF, ESV and PSD in the comparison of QGS and ECTb [LVEF: (47.8&plusmn;16.9)% vs (57.4&plusmn;17.2)%, P0.000. ESV: (67.5&plusmn;51.0) mL vs (58.3&plusmn;50.0) mL, P0.000. PSD: 20.5o&plusmn;10.3o vs 30.6o&plusmn;18.9o, P 0.004]. The EDV and PHB showed no significant difference between the QGS and ECTb [EDV: (116.8&plusmn;52.8) mL vs (120.8&plusmn;55.7) mL, P0.050. PHB: 72.2o&plusmn;37.0o vs 86.1o&plusmn;55.7o, P0.139]. Conclusion &middot; These two software programs have good consistency in quantitative analysis of cardiac function. But the result shows no significant consistent in the evaluation of left ventricular mechanical dyssynchrony. There are differences between the data measuredQGS and ECTb. Using the results measuredthe two software programs for direct comparison may be not suiin clinical applications. The differences between these two software programs indicate that it may be necessary to establish a normal databases in clinical work based on the local conditions.
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    A double-blinded randomized control trial for conscious sedation in post thoracic surgery patients undergoing flexible bronchoscopy suction sputum
    ZHU Min-fang1, YU Kai-yan1, PAN Yan2, YANG Min1
    2018, 38 (11):  1343. 
    doi: 10.3969/j.issn.1674-8115.2018.11.013

    Abstract ( 530 )   PDF (8260KB) ( 323 )  
    Objective · To compare the efficacy and safety of propofol and dexmedetomidine in conscious sedation in post thoracic surgery patients undergoing flexible bronchoscopy suction sputum. Methods · A total of 90 post thoracic surgery patients who would receive suctioning sputumfiberoptic bronchoscope were randomly divided into three groups, i.e. control group, propofol group, and dexmedetomidine group. The control group received intravenous injection of saline. A bolus dose of 1% propofol (0.4 mg/kg) followeda 1-2 mg/(kg · h) continuous injection was applied in the propofol group. In the dexmedetomidine group, a bolus dose of dexmedetomidine (1 μg/kg) intravenously injected, followeda 0.6 μg/(kg · h) continuous injection. The vital signs and Ramsay score were recorded before taking drugs, before sucking sputum, sucking sputum, sucking sputum immediately, 0.5 h after sucking sputum, and 1 h after sucking sputum. Difficulty in entering glottis, adverse events, and visual pain score were also recorded and compared. Results · Compared with the dexmedetomidine group, the heart rate and mean arterial pressure in the propofol group and the control group were higher before and after flexible bronchoscopy suction sputum (all P<0.05). Compared with the control group, the mean arterial pressure in the propofol group was lower before sucking sputum and sucking sputum immediately (both P<0.05). Compared with the control group, Ramsay sore in propofol group was higher before sucking sputum and sucking sputum (P0.026, P0.026), and Ramsay score in the dexmedetomidine group was higher before sucking sputum, 0.5 h after sucking sputum and 1 h after sucking sputum (P0.015, P0.000, P0.000). The incidence of adverse events was lower in the dexmedetomidine group than that in the control group (P0.004). The visual pain score was lowest in the propofol group and highest in the control group. Conclusion · Both dexmedetomidine and propofol can be used in conscious sedation during flexible bronchoscopy suction sputum after thoracic surgery. The of propofol can make patients much more comfortable. Compared with propofol, patients with dexmedetomidine have a lower incidence of adverse events, and their heart rate and blood pressure are more sduring sputum suction. Therefore, dexmedetomidine may be more suifor patients combined with cardiovascular disease.
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    Percutaneous oxygen saturation measurement combined with echocardiography remote consultation in screening of neonatal critical congenital heart disease
    SHEN Yi1, ZHAO Li-qing2, LIU Xiao-qing1, YU Yan1, LIU Lan1, WU Yu-rong2
    2018, 38 (11):  1349. 
    doi: 10.3969/j.issn.1674-8115.2018.11.014

    Abstract ( 479 )   PDF (7168KB) ( 355 )  
    Objective &middot; To investigate the value of percutaneous oxygen saturation measurement combined with echocardiography remote consultation in the screening and referral of neonatal critical congenital heart disease (CCHD) in remote areas. Methods &middot; The live newborns who were born between 2014 and 2016 in Chongming District of Shanghai were taken as the objects of study, the percutaneous oxygen saturation was measured at 24-48 h after birth. The data were classified according to congenital heart disease segmental diagnosis standard in the mean time, and the echocardiography was preliminary diagnosed after the remote consultation through WeChat platform. Results &middot; A total of 4 450 live newborns were screened, 11 cases were positive, 6 cases were preliminary diagnosed as CCHDthe echocardiography remote consultation, and 1 case of negative screening was later diagnosed as pulmonary atresia with ventricular septal defectechocardiography. The sensitivity of percutaneous oxygen saturation screening for CCHD was 85.71%, the specificity was 99.89%, the false positive rate was 0.11%, the false negative rate was 14.29%, and the area under the ROC curve was 0.928. Conclusion &middot; CCHD can be screened out effectivelypercutaneous oxygen saturation combined with the WeChat platform, and it can be preliminary diagnosedthe echocardiography remote consultation, which can provide timely referral and avoid unnecessary referral. This screening model is simple and practical. It has practical value in remote areasare lack of professional medical technicians for the diagnosis and treatment of congenital heart disease.
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    Clinical characteristics of X-linked infantile nystagmus in a Chinese family
    CHEN Jun-jue, TIAN Lin-lu, WEI Yan, KANG Xiao-li
    2018, 38 (11):  1355. 
    doi: 10.3969/j.issn.1674-8115.2018.11.015

    Abstract ( 411 )   PDF (6361KB) ( 480 )  
    Objective &middot; To identify the clinical features of a Chinese Han family with X-linked infantile nystagmus. Methods &middot; A Chinese family with X-linked infantile nystagmus was recruited Department of Ophthalmology in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Peripheral blood the members of the family was collected and molecular genetic analysis was done. The 5 patients in the family received comprehensive ocular examinations including measurement of visual acuity, degree of anomalous head posture, stereoscopic vision, binocular function, electroretinogram, visual evoked potential, optical coherence tomography, eye movement recording and cycloplegic refraction. Results &middot; A frame-shift mutation (c.823-829delACCCTAC, p.Thr275fs) in the 9th exon of FERM domain containing protein 7 (FRMD7) in the family was found. The similar clinical features of the family included moderate impairment of visual acuity, mild astigmatism, reduced stereoscopic vision, no fusion function, and bidirectional jerk wave form. Their electroretinograms were normal, but there was a peak latency and decreased amplitudes in visual evoked potential. And the structures of maculae had no obvious abnormality. The performance of the anomalous head posture was varied. Conclusion &middot; Thr275fs in FRMD7 protein is identified as the main factor in the Chinese family with X-linked infantile nystagmus. The clinical features of the family show a certain degree of consistency.
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    Reliability and validity of the Chinese version of the endometriosis health profile-5 (EHP-5)
    YANG Zhi-You, LI Yu, WANG Chao, MA Jun, WU Bin, WANG Yu
    2018, 38 (11):  1360. 
    doi: 10.3969/j.issn.1674-8115.2018.11.016

    Abstract ( 690 )   PDF (7524KB) ( 614 )  
    Objective · To evaluate the reliability and validity of the Chinese version of the endometriosis health profile-5 (EHP-5) and to evaluate whether patients with different syndromes can be well discriminated with EHP-5. Methods · A total of 102 patients with pathologically proven endometriosis completed the questionnaire. The reliability and internal consistency of the Chinese version of EHP-5 were assessedCronbachs α coefficient. Creteria validity of the Chinese version of EHP-5 was investigatedcomparing it with the EuroQol five-dimension questionnaire (EQ-5D). The patients were further subdivided into two subgroups according to the symptom of dysmenorrhea, dysmenorrhea, menstrual disorder or infertility. The scores in the five items of core questionnaire were compared between asymptomatic and symptomatic patients using Mann-Whitney U test. Results · The Cronbachs α coefficient was 0.877 for five items the core questionnaire, and 0.843 for six items the modular questionnaire. The internal consistency also showed satisfactory result (Cronbachs α >0.7). The correlations of related subscale scores between EHP-5 and EQ-5D were significant in some dimensions. There was significant differences in scores between asymptomatic and symptomatic subgroups dividedthe symptom of dysmenorrhea or dyspareunia. But no significant difference was founds in scores between asymptomatic and symptomatic subgroups dividedthe symptom of menstrual disorders or infertility. Conclusion · The Chinese version of EHP-5 is an acceptable, reliable and valid measure of quality of life in endometriosis patients with the symptom of dysmenorrhea or dysmenorrhea. However, EHP-5 could not well discriminate endometriosis patients with the symptom of menstrual disorder or infertility. More specific items are necessary so as to make EHP-5 an intervention tool for the prognosis and follow-up of patients with different symptoms.
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    Value of combined detection of cervical cytology and high-risk human papillomavirus in the diagnosis of cervical adenocarcinoma
    PAN Lei, LI Juan, LIU Yuan, ZHANG Hui-juan
    2018, 38 (11):  1366. 
    doi: 10.3969/j.issn.1674-8115.2018.11.017

    Abstract ( 386 )   PDF (5571KB) ( 437 )  
    Objective &middot; To investigate the diagnostic value of combined detection of cervical cytology and high-risk human papillomavirus (HPV) in cervical adenocarcinoma. Methods &middot; The clinical data of patients diagnosed as cervical adenocarcinoma in the International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine January 2006 to December 2017 were retrospectively collected and analyzed. A comparison among cytology detection, high-risk HPV test, and combined detection of both methods was performed. Results &middot; A total of 2 291 cases of cervical cancer were collected, of which 480 cases were cervical adenocarcinoma patients. Finally, 409 cases of cervical adenocarcinoma were analyzed. The average age of all included patients was (46.8&plusmn;11.4) years old. The proportion of the patients aged 35-55 was 59.2%. All the patients were divided into three groups, i.e., group A (cytology detection, n208), group B (high-risk HPV test, n103), and group C (cytology and high-risk HPV combined test, n98). There were 142 (68.3%), 85 (82.5%), and 93 (94.9%) positive cases in group A, B, and C, respectively. There was a statistically significant difference among the three groups (P0.000). In the patients with cervical in situ adenocarcinoma, the positive detection rates in group A, B and C were 70.6%, 100.0% and 100.0%, respectively (P0.000). And in the patients with cervical invasive adenocarcinoma, the positive detection rates in group A, B, and C were 67.9%, 75.8% and 91.8%, respectively (P0.000). Conclusion &middot; Cervical cytology combined with high-risk HPV detection can significantly increase the positive detection rate of cervical adenocarcinoma.
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    Discussion on using ambulatory blood pressure monitoring in the diagnostic criteria of white coat and masked hypertension
    HU Zhe1, CHEN Xin1, CHANG Gui-li1, LI Ming-chun1, CHEN Jing1, CHU Shao-li1, WANG Ji-guang1, 2
    2018, 38 (11):  1370. 
    doi: 10.3969/j.issn.1674-8115.2018.11.018

    Abstract ( 447 )   PDF (6706KB) ( 328 )  
    Objective · To investigate different methods on the diagnosis of white coat and masked phenomena in ambulatory blood pressure monitoring (ABPM). Methods · Information of clinical characteristics and laboratory data were collected, and measurements of office blood pressure (OBP) and ambulatory blood pressure (ABP) in 274 subjects were performed, including 46 persons with high normal OBP (SBP/DBP 130-139/85-89 mmHg) (1 mmHg0.133 kPa), 187 untreated patients with grade 1 and grade 2 hypertension (SBP/DBP 140-179/90-109 mmHg), and 41 treated hypertensive patients. Differences of 95th and 5th percentile between OBP and daytime ABP, were respectively taken as the cutoff for the definition of white coat phenomenon and masked phenomenon. Results · If white coat and masked phenomenon were diagnosed according to the current hypertension guidelines, the prevalence of white coat phenomenon did not differ between untreated and treated hypertensive patients (11.2% vs 7.3%, P0.460). In the untreated group, the prevalence of white coat phenomenon was higher in grade 2 than in grade 1 hypertension (20.0% vs 8.5%, P0.033), whereas the prevalence of white coat hypertension did not differ (2.2% vs 7.0%, P0.230). The prevalence of masked hypertension was 73.9% in high normal blood pressure group. The prevalence of masked uncontrolled hypertension was 4.9%. If the difference of 95th percentile ( ≥20.50/20.50 mmHg) and 5th percentile (≤-18.67/-6.00 mmHg) between OBP and daytime ABP were, respectively, used as the cutoff for the definition of white coat and masked phenomenon, the prevalence of white coat phenomenon did not differ between treated and untreated groups (12.2% vs 9.1%,P0.543). In the untreated group, the prevalence of white coat phenomenon was higher in grade 2 than in grade 1 hypertension (24.4% vs 4.2%, P0.000). The prevalence of masked phenomenon did not differ between persons with high normal OBP (15.2%) and untreated (5.9%) as well as treated hypertensive patients (12.2%) (P>0.05). Conclusion · The percentile methods may be useful for the diagnosis of white coat and masked phenomena.
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    Comparison of alveolar bone changes in maxillary anterior area secondary to different kinds of retraction method of anterior teeth: a cone-beam computed tomography study
    ZHOU Di, WU Yan, WANG Yun-ji, FAN Xiao-ping
    2018, 38 (11):  1375. 
    doi: 10.3969/j.issn.1674-8115.2018.11.019

    Abstract ( 470 )   PDF (8453KB) ( 371 )  
    Objective · Using cone-beam computed tomography (CBCT) to compare alveolar bone changes in maxillary anterior area secondary to maxillary incisor retraction adjunct with tip (R&Tp) and retraction adjunct with torque (R&Tq) movements. Methods · Forty teenagers with Angles class Ⅱ division 1 malocclusion who had completed orthodontic treatment met the inclusion criteria and were selected, and all of their 160 maxillary incisors were classified into two categories, namely R&Tp group and R&Tq group, according to their actual retraction pattern. Pre- and post-treatment CBCT images and 3D measurement software were used to measure and analyze tooth retraction and alveolar bone height and thickness changes within each group and to compare treatment changes of teeth and alveolar bone between two groups. Results · Anterior teeth in each group were intensively retracted and uprighted, with a longer retraction distance of incisal edge and a greater retraction angle of teeth in R&Tp group than in R&Tq group (both P0.000). Alveolar bone thickness was significantly decreased at L3 and P1 in R&Tp group (both P<0.05), while it was significantly decreased at P1 and P2 in R&Tq group (both P<0.05). Total alveolar bone thickness decreased at T1 in R&Tp group (P0.000) and at all levels in R&Tq group (all P0.000). Finally, alveolar ridge height in two groups dropped both in the buccal (both P0.000) and palatal (both P0.000) sides, with a more prominent extent in the palatal side, and ridge height dropped most in palatal side of the teeth in R&Tq group. Conclusion · The buccal root apex area and the palatal alveolar ridge area of alveolar bone in the R&Tp group and the cervical and middle area of incisor root in palatal side of alveolar bone in the R&Tq group are high-risk areas for alveolar bone resorption when anterior teeth in teenagers with Angles class Ⅱ division 1 malocclusion are intended to have en masse retraction.
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    Research advances in acetylation modification of &alpha;-synuclein in Parkinsons disease
    YANG Xiao, DU Yun-lan, GUAN Yang-tai
    2018, 38 (11):  1381. 
    doi: 10.3969/j.issn.1674-8115.2018.11.020

    Abstract ( 467 )   PDF (7732KB) ( 340 )  
    Parkinsons disease (PD) is an incurable neurodegenerative disease, which seriously affects the life quality of patients. Researches in recent years found that excessive production or abnormal structure of &alpha;-synuclein and forming toxic aggregates are the key factors in the pathogenesis of PD. In a variety of mechanisms, abnormal modification of &alpha;-synuclein is closely related to its aggregation state, such as phosphorylation, ubiquitination and nitration modification, but the exact effects are still uncertain. Recent studies have shown that acetylation modification of &alpha;-synuclein plays an important role in the abnormal aggregation of &alpha;-synuclein. This article reviewed the progress of acetylation modification of &alpha;-synuclein.
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    Antibacterial mechanism and application of gold nanoparticles
    CHU Guang-yu, CHEN Yun-feng
    2018, 38 (11):  1386. 
    doi: 10.3969/j.issn.1674-8115.2018.11.021

    Abstract ( 819 )   PDF (8588KB) ( 771 )  
    Multi-drug resistance is a major clinical challenge today. The good antibacterial effect of gold nanoparticles (AuNPs) based on their unique physical and chemical properties make such systems ideal for application as antibacterial drug carriers or self-modified therapeutic agents both in vitro and in vivo. AuNPs also have good clinical application prospects for their broad antibacterial spectrum, various antibacterial mechanisms and good biocompatibility. However, their structural stability in vivo, antibacterial mechanism, long-term safety and cytotoxicity of the surface modification have yet to be further explored and improved through subsequent studies.
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    Research progress of roles of mammalian target of rapamycin signaling in bone homeostasis and associated diseases
    YANG Qian-hao, ZHU Dao-yu, CHEN Yi-xuan, GAO You-shui, ZHANG Chang-qing
    2018, 38 (11):  1391. 
    doi: 10.3969/j.issn.1674-8115.2018.11.022

    Abstract ( 548 )   PDF (7942KB) ( 365 )  
    Mammalian target of rapamycin (mTOR) is a serine/threonine protein kinase that integrates stimulation intracellular and extracellular environment to control many fundamental processes through two distinct protein complexes, i.e., mTOR complex 1 (mTORC1) and mTORC2. Recent studies have found that mTOR pathways play important roles in skeletal development and homeostasis. In addition, mTORC1 mediates the bone anabolic effect through insulin-like growth factor 1 (IGF-1), Wnt, and bone morphogenetic protein (Bmp). Dysregulation of mTORC1 contributes to osteoarthritis and osteoporosis. This article reviewed the current understanding of mTOR signaling in skeletal development, bone homeostasis, and maintenance of articular cartilage, which provided a reference for the mechanism and treatment of skeletal diseases.
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    Application of CRISPR-Cas9 technology in non-cancerous hematological disorders
    WENG Zhen1, NIU Xiao-yin2, ZHOU Jun-song1
    2018, 38 (11):  1396. 
    doi: 10.3969/j.issn.1674-8115.2018.11.023

    Abstract ( 476 )   PDF (8890KB) ( 412 )  
    The recent discovery of the clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR associated protein 9 (Cas9) system for precise genome editing has revolutionized methodologies in hematology studies. CRISPR-Cas9 technology can remove and correct genes or mutations, and introduce site-specific therapeutic genes in human cells. Therefore, it has become the ideal targets for inherited haematological disorders and could be the choice to alleviate disease-related symptomscorrecting disease-causing mutations in the near future. Prior to the of CRISPR-Cas9-mediated gene correction in humans, appropriate delivery systems with high efficiency and specificity must be identified, and ethical guidelines for applying the technology with controllable safety must be established. In this review, the latest applications of CRISPR-Cas9 technology in haematological disorders, current challenges and future directions were discussed.
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