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28 March 2019, Volume 39 Issue 3 Previous Issue    Next Issue
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Outstanding international article
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Original article (Clinical research)
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Outstanding international article

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EGFR and ERBB germline mutations expected to become new therapeutic targets for lung cancer patients The research group of LU Shun 2019, 39 (3):  221.  doi: 10.3969/j.issn.1674-8115.2019.03.001 Abstract ( 835 )   PDF (3626KB) ( 383 )   Related Articles | Metrics

Original article (Basic research)

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Inhibition of the activity of methyltransferase Legionella pneumophilaby histone H3K14M mutation LI Tian-tian, SUI Yi, LIU Fang, TANG Yu-jie 2019, 39 (3):  224.  doi: 10.3969/j.issn.1674-8115.2019.03.002 Abstract ( 590 )   PDF (10015KB) ( 397 )   Objective · To investigate the effect of histone H3K14M mutation on the activity of methyltransferase RomA, a secreted effector of Legionella pneumophila in eukaryotic cells and the underlying mechanisms. Methods · Wide-type histone H3 (H3WT) and mutant histone H3 (the lysine residue 14 was replacedmethionine, isoleucine or arginine residue, and named as H3K14M, H3K14I, and H3K14R, respectively) recombinant plasmids were constructed. Packaged lentiviruses with these plasmids were used to infect eukaryotic cells 293T and THP-1 with or without over- of RomA. The H3K14 methylation and acetylation were analyzedWestern blotting. The interaction of RomA with H3WT and H3K14 mutants was detectedco-immunoprecipitation. Results · A secreted effector of Legionella pneumophila named RomA targeted the host cell nucleus to upregulate the H3K14 methylation level and downregulate the H3K14 acetylation level for inhibiting the gene in host cells and promoting Legionella pneumophila’s efficient intracellular replication. But histone H3K14M mutation could promote the interaction between H3K14M and RomA and thus inhibited the methyltransferase activity of RomA. Conclusion · Histone H3K14M mutation significantly inhibits the activity of Legionella pneumophila methyltransferase RomA. Related Articles | Metrics

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Effect of α1-adrenergic signaling pathway on doxorubicin-induced apoptosis in cardiomyocytes YE Yu-jiao, LI Zhuo-yan, WANG Qing-jie, LI Wen-juan, CHEN Sun 2019, 39 (3):  233.  doi: 10.3969/j.issn.1674-8115.2019.03.003 Abstract ( 553 )   PDF (6453KB) ( 285 )   Objective · To investigate the effects of α1-adrenergic receptor agonist phenylephrine (Phe) and antagonist prazosin (Pra) on cardiomyocyte apoptosis induceddoxorubicin (DOX). Methods · H9C2 cardiomyocytes were divided into 4 groups. Except for the control group incubated with medium alone, all other groups were treated with 1.8 μmol/L DOX. For agonist group and antagonist group, 0.1 mmol/L Phe and 10 μmol/L Pra were added respectively in DOX-treated cells. After culture for 24 h, flow cytometry and TUNEL assay were performed to detect the apoptosis rate. Western blotting was used to detect the of cleaved caspase 3. Real-time PCR was used to detect the of anti- and pro-apoptotic Bcl-2 family genes. CCK-8 assay was used to detect the cell viability. Results · The DOX-induced apoptosis was inhibitedPhe with decreased apoptosis rate of H9C2 and decreased of cleaved caspase 3, but promotedPra. Increased of Bcl-2 and Bcl-w and decreased of Bax and Bad at mRNA levels were found in agonist group in comparison with the cells treated with DOX alone; while decreased of Bcl-2 and Bcl-w and increased of Bax and Bad were found in antagonist group. The cell viability after 24 h of treatment with agonist was higher than cells treated with DOX alone, but no signifiant difference was found in cell viability between antagonist group and DOX group. Conclusion · α1-Adrenergic signaling pathway may be involved in endogenous myocardial protection in the process of cardiomyocyte apoptosis inducedDOX. Related Articles | Metrics

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Effects of chaperone-mediated autophagy on the level of α-synuclein oligomers in Parkinsons disease cell model YANG Xiao1, DU Yun-lan1, BAI Xue-feng2, ZHU De-sheng1, WANG Fei1, HAN Lu1, GUAN Yang-tai1 2019, 39 (3):  239.  doi: 10.3969/j.issn.1674-8115.2019.03.004 Abstract ( 509 )   PDF (6722KB) ( 377 )   Objective · To investigate the effects of chaperone-mediated autophagy (CMA) on α-synuclein oligomers level in the Parkinsons disease (PD) cell model with impaired ubiquitin proteasome system (UPS). Methods · The PD cell model was establishedadding the proteasome inhibitor lactacystin in the SK-N-SH cell line stably transfected with wild type α-synuclein. The levels of α-synuclein oligomers, lysosome-associated membrane protein type 2A (LAMP2A) and 70 kDa heat shock homologous protein (HSC70) were detected using Western blotting. CMA function was inhibited with LAMP2A siRNA, and its effects on α-synuclein oligomers and cell viability were detected. Furthermore, the interaction of LAMP2A with α-synuclein oligomers was detectedimmunoprecipitation. Results · In the PD cell model, the levels of α-synuclein oligomers, and CMA related proteins, i.e. LAMP2A and HSC70, were increased. Inhibiting the of LAMP2A further increased α-synuclein oligomers level, while it decreased cell viability. Furthermore, LAMP2A could interact with α-synuclein oligomers. Conclusion · In the PD cell model, CMA is one of the pathways regulating α-synuclein oligomers level. Inhibiting CMA function can further increase the α-synuclein oligomers level and deteriorate cell survival. Related Articles | Metrics

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Effect of recombinant human amelogenin-loaded PCLA-PEG-PCLA hydrogels on biological properties of human periodontal ligament fibroblasts NING Hang, XIA Yi-ru, DONG Jia-chen, SHU Rong 2019, 39 (3):  244.  doi: 10.3969/j.issn.1674-8115.2019.03.005 Abstract ( 655 )   PDF (10208KB) ( 453 )   Objective · To determine the effect of recombinant human amelogenin (rhAm)-loaded PCLA-PEG-PCLA hydrogels on cell proliferation, immigration, attachment and osteogenic differentiation of human periodontal ligament fibroblasts (HPDLFs). Methods · HPDLFs were obtainedtissue block method in vitro extracted premolars and the 3rd-5th passages of HPDLFs were treated with DMEM medium (control group), 20 μg/mL rhAm (rhAm group) or rhAm-loaded PCLA-PEG-PCLA hydrogels (rhAm-loaded hydrogel group). Proliferation activity was measuredCCK-8, while cell migration was assayed bothwound-healing experiment in vitro and Transwell experiment. Cell attachment was measuredhemocytometer and observedscanning electron microscope. Osteogenic differentiation was measuredreal-time PCR, with ALP, Runx2, CEMP1 and CAP as the target genes. Results · RhAm-loaded PCLA-PEG-PCLA hydrogels had no significant effect on cell growth curve of HPDLFs, but promoted cell proliferation after 3 days (P<0.05). RhAm accelerated cell migration mostly both in wound-healing experiment and Transwell experiment, with rhAm-loaded hydrogels in the second place. RhAm-loaded hydrogels promoted cell attachment, and in the 4th hour the promotion was of statistic significance (P<0.05). Meanwhile cells of rhAm group and rhAm-loaded hydrogel group had a better stretch condition than control group under the scanning electron microscope. After culture with rhAm-loaded hydrogels, ALP, Runx2, CEMP1, and CAP mRNA were upregulated in different time points. Conclusion · Recombinant human amelogenin-loaded PCLA-PEG-PCLA hydrogels can significantly improve proliferation, attachment and osteogenic differentiation of HPDLFs, but has no effect on cell migration on a statistical scale. Related Articles | Metrics

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Effect of insulin-like growth factor 1 on phagocytosis and production of interleukin-10 in murine alveolar epithelial cells WU Feng-jiao, MU Mi-mi, HE Jing, MA Hua, GUO Shu-jun, SONG Chuan-wang 2019, 39 (3):  253.  doi: 10.3969/j.issn.1674-8115.2019.03.006 Abstract ( 682 )   PDF (5819KB) ( 350 )   Objective · To investigate the effect of insulin-like growth factor 1 (IGF-1) on phagocytosis and production of interleukin-10 (IL-10) in the murine alveolar epithelial cell line MLE-12. Methods · After treatment with IGF-1 for 48 h, MLE-12 cells were incubated with fluorescent microspheres for 2 h in the presence or absence of wortmannin (phosphatidylinositol-3-kinase inhibitor). Flow cytometry was then used to assess cell phagocytosis of fluorescent microspheres. Enzyme linked immunosorbent assay (ELISA) was used to detect the content of IL-10 in MLE-12 cells culture supernatant stimulatedIGF-1 for 24 h. After pretreatment with IGF-1 for 2 h, MLE-12 cells were stimulatedlipopolysaccharides (LPS) for 24 h, and the of phosphorylated signal transduction and activator of transcription 3 (p-STAT3) in cytoplasm was detectedWestern blotting. Results · With the increase of IGF-1 stimulation concentration, the ability of MLE-12 cells to phagocytose fluorescent microspheres increased, and the ability to phagocytose fluorescent microspheres reached the peak in the presence of IGF-1 at 50 ng/mL. However, the ability of IGF-1 to phagocytose fluorescent microspheres was completely blockedwortmannin in MLE-12 cells. IGF-1 promoted IL-10 secretion and inhibited LPS-induced enhancement of STAT3 activation in MLE-12 cells. Conclusion · IGF-1 promotes phagocytosis of MLE-12 cells via the PI3K/protein kinase B (Akt) pathway and exhibits anti-inflammatory properties. Related Articles | Metrics

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Effect of transforming growth factor &beta; signaling on the stem cell-mediated liver regeneration in mice after partial hepatectomy CHEN Zi-xin1, JIN Xin1, WAN Li1, LI De-wei2 2019, 39 (3):  258.  doi: 10.3969/j.issn.1674-8115.2019.03.007 Abstract ( 497 )   PDF (7449KB) ( 358 )   Objective · To explore the effect of inhibiting transforming growth factor β (TGF-β) signaling pathway on the stem cell-mediated liver regeneration in mice after partial hepatectomy (PH). Methods · Eighteen C57BL/6 male mice were selected to establish the model of hepatectomy. mRNA and protein levels of the signal molecules in TGF-β pathway, as well as stem cell markers α-fetoprotein (AFP) and leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) in the liver tissues were detected before (PH0) and on the 1st (PH1), 3rd (PH3) and 7th (PH7) day after operation. Then, additional 32 mice were assigned into inhibitor group [PH+SB-431542, 10 mg/(kg·d)] and control group (PH+normal saline). The mice were sacrificed on the 1st (PH1) and 3rd (PH3) day after operation and liver remnants were obtained. Realtime-PCR, Western blotting, and immunofluorescence staining were used to detect the expressing variation of TGF-β signaling pathway, AFP and LGR5. Results · The mRNA and protein of TGF-β1, phosphorylated SMAD2 (p-SMAD2) protein, Afp mRNA, the number of AFP immune-positive cells and Lgr5 mRNA were upregulated significantly after PH, peaked at PH3 (P<0.05) and recovered to pre-operative level at PH7. Compared with control group, the above indices were all obviously inhibited in inhibitor group at PH3 (P<0.05). Conclusion · TGF-β signaling pathway may regulate the stem cell-mediated liver regeneration in mice after PH. Related Articles | Metrics

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Effect of ultrasound combined with SonoVue microbubbles on vascular permeability in hind limbs of rats LU Can1, JI Xiang2, GENG Guan-nan3, ZHANG Su2, ZHANG Lan1, YE Meng1 2019, 39 (3):  264.  doi: 10.3969/j.issn.1674-8115.2019.03.008 Abstract ( 590 )   PDF (9012KB) ( 258 )   Objective · To investigate the effect of 500 kHz pulsed ultrasound combined with SonoVue microbubbles on the vascular permeability of hind limbs in rats and the permeability dynamics for the duration. Methods · Eighty male Sprague Dawley rats were randomly divided into eight groups (n10), including control group, only microbubble group (MB group), and microbubble combined with ultrasound groups (MB+US group). And MB+US groups classified into time subgroups according to the interval the endpoint of ultrasound exposure to the injection of Evans blue (EB), included 2.5 min group, 5 min group, 10 min group, 20 min group, 30 min group and 60 min group. The change of vascular permeability was quantitively analyzeddetecting the content of EB after ultrasound irradiation. Meanwhile, four rats in each group were randomly selected. Two of them were performed hematoxylin-eosin (H-E) staining; and the rest of them underlied transmission electron microscope analysis. Results · The results of EB content detected muscle samples demonstrated that the exposure of ultrasound in conjunction with microbubbles could alter the vascular permeability of hind limbs of rats. The optimal time window for extravasation was within 30 min after ultrasound exposure. And the permeability could return to the normal status 60 min after ultrasound irradiation. There was no apparent damage on arteries and muscles in the slices with H-E staining. the observation of transmission electron microscope, the tight junctions between endothelial cells on the arterial wall were significantly widened in MB+US groups. Conclusion · The application of ultrasound with the frequency of 500 kHz combined with SonoVue microbubbles can reversibly change the vascular permeability of hind limbs in rats without obvious damage to the tissues. Related Articles | Metrics

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Expression profile analysis of long noncoding RNAs and mRNAs in the human colon cancer cells regulatedVTCN1 CHU Yi-min1, ZHOU Feng-li1, XU Ying1, KUAI Rong1, LI Ji1, HOU Zhao-yuan2, YANG Da-ming1, PENG Hai-xia1 2019, 39 (3):  270.  doi: 10.3969/j.issn.1674-8115.2019.03.009 Abstract ( 597 )   PDF (8452KB) ( 259 )   Objective · To investigate the effect of V-set domain containing T cell activation inhibitor 1 (VTCN1) on long noncoding RNAs (lncRNAs) and mRNAs in colon cancer cells. Methods · VTCN1 was overexpressedlentivirus plasmid in colon cancer cell line SW1116. RNA was extracted and sequenced. The differentially expressed lncRNAs and mRNAs were compared with the negative control group. The accuracy of RNA sequencing was verifiedreal-time quantitative PCR (qRT-PCR) using three differentially expressed lncRNAs and two mRNAs. BLAST2GO and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze and predict the functions of these differentially expressed lncRNAs and mRNAs. The online platform GEPIA18 (Gene Expression Profiling Interactive Analysis) was used to analyze the correlation between differentially expressed lncRNAs and survival of patients with colorectal cancer. Results · A total of 167 differential genes, i.e., 39 lncRNAs and 128 mRNAs, were identifiedRNA sequencing in VTCN1 overexpressed SW1116 cells. The results of qRT-PCR were consistent with those of RNA sequencing. Bioinformatics analysis showed that these different genes regulatedVTCN1 may be involved in endoplasmic reticulum protein processing and RNA monitoring signaling pathways. In addition, three lncRNAs (DNA JC9-AS1, HCG27, and RP11-339B21.13), which were significantly up-regulated in colorectal cancer cells overexpressing VTCN1, were also independent predictors of overall survival of colorectal cancer patients. Conclusion · In colon cancer cells, VTCN1 regulates several downstream lncRNAs and mRNAs, which may be involved in endoplasmic reticulum protein processing and mRNA monitoring signaling pathways. Related Articles | Metrics

Original article (Clinical research)

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Risk factors analysis for acute lower deep venous thrombosis in multiple injury patients FU Yi-mu1, JING Yao2, LI Dong-dong1, FENG Qi-ming1, TIAN Heng-li2 2019, 39 (3):  278.  doi: 10.3969/j.issn.1674-8115.2019.03.010 Abstract ( 606 )   PDF (5368KB) ( 441 )   Objective · To explore the incidence and analyze the risk factors of acute lower deep venous thrombosis (ALDVT) in multiple injury patients. Methods · A total of 175 multiple injury patients in trauma emergency center of The Sixth People′s Hospital, Shanghai Jiao Tong University, Jan. to Jun. in 2017 were chosen, and their clinical data were collected. The ALDVT group and the non-ALDVT group were differentiated according to the results of ultrasound, and the incidence of ALDVT was calculated. Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlations between the occurrance of ALDVT and the factors, including demographic characteristics, vital signs and hematological parameters. Results · Fifty-six patients (32%) developed ALDVT in 175 multiple injury patients. Univariate analysis showed that there were statistically significant differences in the numbers of multiple injury patients with upper limb fracture, lower limb fracture, spinal injury, pelvic fracture, chest and abdomen injury, higher injury severity score (ISS) (≥ 25 scores), or higher glucose ( ≥ 10 mmol/L) between two groups (all P<0.05). In the coagulation parameters, compared with the non-ALDVT group, the levels of D-dimer and fibrinogen degradation products in the ALDVT group were significantly elevated (both P0.001). Multivariate Logistic regression analysis showed that the level of glucose ( ≥ 10 mmol/L) (P0.009), ISS ( ≥ 25 scores) (P0.024), multiple injury with spinal injury (P0.048), and multiple injury with pelvic fracture (P0.029) were the independent risk factors of the ALDVT patients. Conclusion · There is a high occurrence of ALDVT in multiple injury patients. The level of glucose, ISS, multiple injury with spinal injury, and multiple injury with pelvic fracture have important predictive significance for the diagnosis of ALDVT. Related Articles | Metrics

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Effect of cerebellar vermal repetitive transcranial magnetic stimulation with theta burst stimulation paradigm on cognitive functions of patients with schizophrenia ZHU Li-na1, ZHANG Qiong2, CAI Jun1, ZHANG Wei-bo1, ZHU Hong-xia1 2019, 39 (3):  282.  doi: 10.3969/j.issn.1674-8115.2019.03.011 Abstract ( 633 )   PDF (7077KB) ( 311 )   Objective · To explore the effect of cerebellar vermal repetitive transcranial magnetic stimulation (rTMS) with theta burst stimulation (TBS) paradigm on cognitive functions of patients with schizophrenia. Methods · Thirty-one schizophrenia patients were randomly assigned into study group (n14) and control group (n17). Patients in the study group received a combination of rTMS and drug therapy, and patients in the control group received a combination of sham rTMS and drug therapy. The intervention lasted for 2 weeks, a total of 10 times. To evaluate the effect of rTMS on cognitive functions, MATRICS consensus cognitive battery (MCCB) was used to assess at baseline, after the intervention, 12 weeks and 24 weeks after the end of the intervention. Results · At baseline, there were no significant differences between two groups in the scores of each factor and the overall composite scores (P>0.05). After the intervention, repeated measures analysis of variance showed that the main effect of time was statistically significant in the scores of social cognitive (F3.901, P<0.05). However, the main effect of group and the interaction between time and group showed no significance in the scores of the factor (P>0.05). Moreover, in the scores of speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving and the overall composite scores, the main effect of group/time and the interaction between time and group were not significant (P>0.05). Conclusion · Application of TBS rTMS to cerebellar vermal is not superior compared with sham rTMS in improving the above seven cognitive domains. Related Articles | Metrics

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Prevalence and related factors of abnormal four-limb blood pressure difference in elderly people in Shanghai SHENG Chang-sheng, HUANG Qi-fang, HUANG Jian-feng, LI Yan, WANG Ji-guang 2019, 39 (3):  287.  doi: 10.3969/j.issn.1674-8115.2019.03.012 Abstract ( 522 )   PDF (6283KB) ( 370 )   Objective · To investigate the prevalence and related factors of abnormal four-limb blood pressure difference in elderly people in Shanghai. Methods · 2016 to 2018, the elderly aged 60 years and over in Zhaoxiang Town, Qingpu District, Shanghai were selectedcluster sampling. General data was collected. Height, body mass, and blood pressure were measured. Fasting venous blood was taken for routine blood test, blood glucose, blood lipids, serum creatinine and other biochemical indicators. Four limb blood pressures were measured simultaneouslyVascular Profiler-1000 device, which ankle-brachial index, inter-arm systolic pressure difference and inter-ankle systolic pressure difference were calculated. Multivariate Logistic regression was used to analyze the related factors of abnormal four-limb blood pressure difference. Results · A total of 4 090 subjects were enrolled with an average age of (68.5±7.6) years, of which 44.6% were males. The people with hypertension and diabetes mellitus accounted for 60.1% and 8.6%, respectively. The prevalence of ankle-brachial index ≤0.90, inter-arm systolic pressure difference ≥15 mmHg (1 mmHg0.133 kPa) and inter-ankle systolic pressure difference ≥15 mmHg were 2.7%, 1.9%, and 8.4%, respectively. After incorporating age, sex, body mass index (BMI), smoking, drinking, hypertension, diabetes mellitus, total cholesterol and triacylglycerol, the results of multiple Logistic regression analysis showed that age and hypertension were the related factors of the three indicators for abnormal four-limb blood pressure difference. The related factors of ankle-brachial index≤ 0.90 also included diabetes mellitus, total cholesterol and smoking; the related factors of inter-arm systolic pressure difference ≥15 mmHg also included BMI; the related factors of inter-ankle systolic pressure difference ≥15 mmHg also included BMI and diabetes mellitus. Conclusion · Abnormal four-limb blood pressure difference is prevalent among the elderly in Shanghai, of which old age, hypertension, diabetes, dyslipidemia, obesity and smoking are risk factors. Related Articles | Metrics

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Analysis of distribution and drug resistance of pathogens in burned patients XU Zheng-peng1, WANG Su2, MI Chen-rong3, HAN Li-zhong2, WANG Wen-kui1 2019, 39 (3):  292.  doi: 10.3969/j.issn.1674-8115.2019.03.013 Abstract ( 584 )   PDF (7414KB) ( 310 )   Objective · To provide guidance for the rational usage of antibiotics, reduction of drug-resistant strains and hospital infection controlinvestigating the distribution and drug resistance of pathogens isolated burned patients. Methods · Isolates burned patients of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between Jan. 2016 and Dec. 2017 were collected. The VITEK 2 Compact automatic microbial analysis system and K-B disc diffusion method were used for antimicrobial susceptibility test. Statistical analysis was performed to investigate the type of specimens and strains and the resistance rates of major pathogens. Chi-square test was used to compare the changes of the detection rates and drug resistance rates of major pathogens between 2016-2017 and 2013-2014. Results · A total of 1 053 isolates were isolated, and most of them (73.88%) were wounds. Among them, 609 (57.83%) isolates were gram-negative bacilli (G-B), 422 (40.08%) were gram-positive cocci (G+C) and 9 (0.85%) were fungi. The most common pathogen of G-B was Klebsiella pneumoniae (218, 20.70%) in 2016-2017, the proportion of which was significantly higher than that in 2013-2014 (114, 10.72%) (P0.000). The most common pathogen of G+C was Staphylococcus aureus (210, 19.94%), the proportion of which was significantly higher than that in 2013-2014 (200, 18.81%) (P0.009). K. pneumoniae showed low resistance only to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, fosfomycin and tigecycline (<60%), but high resistance to ampicillin and cefazolin (>90%). The resistance rates of K. pneumoniae to ceftazidime, cefepime, imipenem, meropenem and amikacin in 2016-2017 were significantly higher than those in 2013-2014 (P<0.05). S. aureus was only resistant highly to penicillin (94.63%) and 100% susceptible to vancomycin and linezolid. The proportion of methicillin-resistant S. aureus (MRSA) was 59.05% in 2016-2017, which had no statistical difference compared with that in 2013-2014 (P0.412). Conclusion · The most two prevalent isolates burned patients were K. pneumoniae and S. aureus with multi-drug resistance. Improved management and rational of antibiotics can reduce the incidence of antibiotic resistant pathogens, and it’s still important to keep routine surveillance on pathogens isolated burned patients for control and prevention of nosocomial infections. Related Articles | Metrics

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Clinicopathological observation of 113 cases of rectal neuroendocrine neoplasms ZHENG Chu-yi1, SHI Yong-heng1, LIU Qiang1, CHEN Xiao-yu2 2019, 39 (3):  297.  doi: 10.3969/j.issn.1674-8115.2019.03.014 Abstract ( 743 )   PDF (9362KB) ( 314 )   Objective · To investigate the clinicopathological features, diagnosis and prognosis of rectal neuroendocrine neoplasms (R-NENs). Methods · The clinical data of 113 cases of R-NENs, January 2008 to June 2017, were collected in Renji Hospital, Shanghai Jiao Tong University School of Medicine, and the clinicopathological features and prognostic factors were retrospectively analyzed. The of synapsin (Syn), neural cell adhesion molecule (CD56), and chromogranin A (CgA) were observedimmunohistochemistry in the R-NENs specimens. The specimens were also observed after hematoxylin-eosin staining. Results · In 113 cases of R-NENs, there were 59 males and 54 females, and their ages ranged 25 to 83 with an average age of (52.3±13.3) years old. All the patients had no obvious clinical manifestations. The main symptoms included changes in bowel habits (21.3%), abdominal pain (8.9%) and anal symptoms (6.2 %), and 63.7% of cases were found in routine medical examinations. The R-NENs were diagnosed as G1 (79.6%), G2 (11.5%), and G3 (8.8%). Immunohistochemistry results demonstrated that 94.7% of tumors were positive for Syn, 80.9% for CD56, and 48.6% for CgA. Till November 2017, the median survival time was 33.10 months (0.40–114.67 months), with 1-year, 3-year, and 5-year survival rates of 93.8%, 90.0%, and 85.9%, respectively. The pathological grade, depth of tumor invasion, lymph node metastasis or distant metastasis, tumor size, and age were all associated with prognosis of patients with R-NENs. Conclusion · Most of R-NENs are low-grade malignant tumors with good overall prognosis and have a lack of specificity in clinical manifestations. Related Articles | Metrics

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Comparison of the reliability and validity of depression scales for systemic lupus erythematosus and analysis of depression-related risk factors LI Jiao-yu*, QIAN Li-ping*, WU Jin-jin, LI Ting, YE Shuang 2019, 39 (3):  304.  doi: 10.3969/j.issn.1674-8115.2019.03.015 Abstract ( 713 )   PDF (7206KB) ( 295 )   Objective · To estimate the reliability and validity of Beck Depression Inventory (BDI), Self-rating Depression Scale (SDS) and Center for Epidemiologic Studies Depression Scale (CES-D) that used for systemic lupus erythematosus (SLE) to choose a more suidepression scale, and analyze the risk factors for depression in SLE. Methods · A total of 259 questionnaires were completedSLE patients with their informed consent in the early stage. Internal consistency, test-retest reliability, construct validity, consistency and correlation of depression outcomes were analyzed. The most suiscale was used in 70 SLE patients. The results of depression screening and clinical information were collected to analyze the risk factors for SLE with depression. Results · A total of 240 valid questionnaires were collected. The Cronbachs α coefficients of BDI, SDS, and CES-D were 0.899, 0.884, and 0.711, respectively. The total scores of the three scales were correlated with every item (P<0.05). The test-retest coefficients of BDI, SDS, and CES-D were 0.912, 0.635, and 0.728, respectively (P<0.01). The result of validity analysis showed that the KMO (Kaiser-Meyer-Olkin) values of BDI, SDS, and CES-D were 0.888, 0.895, and 0.918, respectively. The total variation of main factor interpretation of BDI, SDS, and CES-D was 63.13%, 57.09%, and 57.89%, respectively. The results of BDI showed 117 patients (48.25%) with depression, while SDS showed 154 patients (64.16%) with depression and CES-D showed 140 patients (58.33%) with depression. The correlation coefficients of the three scales were 0.939-0.971 (P<0.01). κ Values of all three scales were greater than 0.4 (P<0.01). Younger than 30, unemployment and renal involvement were independent risk factors for SLE with depression. Conclusion · With better internal consistency, test-retest coefficients, good brief framework and well-understood items, BDI seems to be a more suiscale for SLE. Unemployed, renal involved and young SLE patients are more likely to suffer depression. Related Articles | Metrics

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Value of stress hyperglycemia ratio in predicting the prognosis of patients with acute myocardial infarction XIA Zhi-li1, GAO Cheng-jie2, GAO Ya-jie1, TAO Yi-jing1, WAN Qing1, WU Hao1, WEI Jun-bo1, ZHOU Yi1, PAN Jing-wei1 2019, 39 (3):  309.  doi: 10.3969/j.issn.1674-8115.2019.03.016 Abstract ( 600 )   PDF (9195KB) ( 281 )   Objective · To explore the value of stress hyperglycemia ratio (SHR) in predicting the prognosis of patients with acute myocardial infarction(AMI). Methods · A total of 434 patients diagnosed as having AMI were enrolled October 2014 to October 2015. Immediate blood glucose, glycosylated hemoglobin (HbA1c) and SHR of each subjects were collected and calculated. Patients with and without diabetes were divided into several groups according to the occurrence of in-hospital and 2-year major adverse cardiovascular and cerebrovascular events (MACCEs). Indicators above were evaluated to predict the prognosis of patients with AMI. Results · Immediate blood glucose (P0.003) and SHR (P0.005) were significantly higher in MACCEs group than those in 2-year MACCEs-free group. Among AMI patients with diabetes mellitus, SHR in hospital MACCEs group was significantly higher than that in MACCEs-free group (P0.001). Among AMI patients without diabetes, values of immediate blood glucose (P0.001) and SHR (P0.001) were higher in 2-year MACCEs group than those in MACCEs-free group. All-camortality was the highest (P0.047, P0.007) in the highest SHR group (three-digit relationship), no matter with or without diabetes mellitus. AMI patients with and without diabetes were further divided into two groups according to the median of SHR. High SHR could better predict in hospital MACCEs rate in AMI patients with diabetes as well as 2-year MACCEs rate without diabetes (P0.023, P0.000). Conclusion · Abnormal stress hyperglycemia is a risk factor of long-term poor prognosis in AMI patients. The value of SHR is more valuable in predicting the poor prognosis of AMI than immediate blood glucose, no matter the patients with or without diabetes. Related Articles | Metrics

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Prediction of prognostic nutritional index for the primary resistance to abiraterone and the prognosis in metastatic castration-resistant prostate cancer patients FANG Xiao1, 2, GUO Jian-gong1, HUANG Jin-ming1, FAN Lian-cheng2 2019, 39 (3):  316.  doi: 10.3969/j.issn.1674-8115.2019.03.017 Abstract ( 619 )   PDF (8425KB) ( 344 )   Objective · To determine whether pre-treatment prognostic nutritional index (PNI) level and its variation can predict the primary resistance to abiraterone (AA) and the prognosis in metastatic castration-resistant prostate cancer (mCRPC) patients treated with AA. Methods · A total of 112 mCRPC patients treated with AA were included in Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. PNI levels were measured before and one month after AA treatment. PNI was calculated preoperative laboratory parameters using the formula [10×serum albumin level (g/dL) + 0.005×lymphocyte (per μL) in the peripheral blood]. Univariate and multivariate Logistic regression analyses were used to identify predictive factors of initial efficacy to AA treatment. Univariable and multivariable Cox regression analyses were performed to determine the prognostic factors that were associated with prostate-specific antigen (PSA) progression-free survival (PSA-PFS), radiographic PFS (rPFS) and overall survival (OS). Results · Eighty-one of all 112 (72.3%) patients showed initial response to AA treatment, and 15 patients experienced PSA flare during AA treatment. In multivariate Logistic regression analysis, the high baseline PNI level, the decrease of PSA level during the first month of AA treatment and the elevation of PNI level during the first month of AA treatment were significantly correlated with the initial response to AA treatment. In multivariate Cox regression analyses, the low baseline PNI level remained significant predictor of OS, rPFS and PSA-PFS. Conclusion · Independent of PSA level variation, the elevation of PNI level during the first month of AA treatment and high baseline PNI level are significantly correlated with the initial response to AA treatment. In addition, low baseline PNI level is a negative independent prognosticator of survival outcomes in mCRPC patients treated with AA. Related Articles | Metrics

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Research progress of gut microbiota in substance dependence DENG Di, ZHAO Min 2019, 39 (3):  322.  doi: 10.3969/j.issn.1674-8115.2019.03.018 Abstract ( 496 )   PDF (8603KB) ( 274 )   Substance dependence is a pervasive worldwide problem, of which the mechanism remains unclear, and there is no effective intervention. In recent years, it has been showed that the gut microbiota is closely related to substance dependence. As discussed in this review, gut microbiota is significantly affectedthe substances of abuse, and may serve as an important regulator in the development of substance dependence. This article reviews the research progress of gut microbiota in the most widely used substances, into provide ideas for future studies on underlying mechanisms and further interventions in substance dependence. Related Articles | Metrics

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Suicidal status and its risk factors of people living with HIV/AIDs PENG Zi-he1, CAI Yong1, WEI Wei2 2019, 39 (3):  327.  doi: 10.3969/j.issn.1674-8115.2019.03.019 Abstract ( 917 )   PDF (6393KB) ( 445 )   Although antiretroviral therapy appears to prolong the lifespan of people living with HIV/AIDS (PLWH), but the suicidal risk of these people is still significantly higher than the general population. Some PLWH had suicidal ideation, attempted suicide, and suicidal plan. The reasons for the high risk among these people mainly include as follows. ① The demographic factors include gender, sexual orientation, age, religion, race, etc. ② The social psychological factors are stressors (stressful or traumatic life events, social or interpersonal problems and mental illness), stigma, hiding HIV history, etc. Social or interpersonal problems include discrimination, social isolation, lack of social support, etc. Mental diseases include depression, anxiety disorders, substance disorders, etc. Into reduce the suicidal risk of PLWH, the government and related organizations can research and improve these social psychological factors. Related Articles | Metrics

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Recent advances in the role of SIRT3 in leukemia drug resistance LIU Xin-ying, LU Wen-qing, SHEN Xin-xin, MA Rui -xiang, LIU Peng-yi, MA Jiao 2019, 39 (3):  331.  doi: 10.3969/j.issn.1674-8115.2019.03.020 Abstract ( 625 )   PDF (8036KB) ( 274 )   Leukemia is a clonal malignant disease originating abnormal hematopoietic stem cells or progenitor cells. The key issue of leukemia treatment is its drug-resistance. SIRT3 is the main mitochondrial NAD+ dependent deacetylase. It regulates enzymes and transcription factors of many metabolism pathways. SIRT3 acts both as oncogenic gene and tumor-suppressing gene in the oncogenesis of different cancers. Studies have shown that reactive oxygen species (ROS) level is closely related to drug resistance of cancer cells. ROS level is elevated in leukemia cells, thus affecting its drug resistance. SIRT3 can downregulate ROS level in many ways and enhance cell survival in the case of oxidative stress. Decreased deacetylase activity of SIRT3 makes leukemic cells more vulnerable to oxidative stress so that they are more sensitive to current chemotherapies. Through discovering the function of SIRT3 in leukemia cells, a chance of finding a new target for leukemia treatment can be found. This article reviews recent advances on the role of SIRT3 in leukemia drug resistance. Related Articles | Metrics

Case report

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A case report: κ light chain multiple myeloma with posterior reversible encephalopathy syndrome HUANG Cong-hua, GAO Ting, LU Xiao-ye, ZHU Chang-qing 2019, 39 (3):  336.  doi: 10.3969/j.issn.1674-8115.2019.03.021 Abstract ( 534 )   PDF (4115KB) ( 484 )   Multiple myeloma (MM) is a common malignant tumor of blood system, often manifested as bone destruction, hypercalcemia, and hyperviscosity syndrome. Electrolyte disturbance and hypertension causedMM can induce posterior reversible encephalopathy syndrome (PRES). This case report reviews that a patient with osteodynia had several mental abnormalities, and was diagnosed as having κ light chain MM with PRES after thorough examination. Related Articles | Metrics