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    Original article (Basic research)
    Liver metabonomics analysis of olanzapine-induced weight gaining in rats
    WANG Ye-wei, FANG Xin-yu, CHEN Yan, WANG Dan-dan, YU Ling-fang, ZHANG Chen
    2019, 39 (9):  933. 
    doi: 10.3969/j.issn.1674-8115.2019.09.001

    Abstract ( 439 )   PDF (8701KB) ( 223 )  
    Objective · To observe the changes in metabolites and metabolic pathways in SD rats after olanzapine treatment. Methods · Twenty female SD rats were randomly assigned to two groups, control group and olanzapine treatment group, respectively. During the treatment period, body weight and food intake of two groups were monitored. At the end of treatment, the liver tissues were collected and LC/MS technique was applied to detect metabolites in liver tissue. Subsequently, the raw data were converted for further analysis on the MetaboAnalysis platform. Results · Short-term olanzapine administration resulted in significant increases in body mass, food intake, and impaired glucose tolerance. Metabonomics results indicated rats olanzapine treatment group had a significantly higher level of primary bile acid and 9-OxoODE (9-oxo-octadecadienoic acid) in liver tissue than those control group. Conclusion · Primary bile acid biosynthesis process is significantly enhanced after short-time olanzapine treatment.
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    Impact of maternal gestation combined exposure to lead and mental stress on offsprings fear-conditioning memory
    HUANG Li-hua1, 2, XU Jian1, 2, ZHANG Yi-jing1, 2, LIU Jun-xia1
    2019, 39 (9):  940. 
    doi: 10.3969/j.issn.1674-8115.2019.09.002

    Abstract ( 362 )   PDF (10600KB) ( 195 )  
    Objective · To explore whether prenatal stress can enhance the accumulation of blood/bone lead in the offspring on the basis of prenatal lead exposure, and to compare the effects of prenatal single exposures to stress/lead and prenatal combined exposure to lead and stress on fear-conditioning memory in the offspring. Methods · Pregnant rats were randomly divided into control group, stress exposure group, lead exposure group and combined lead-stress exposure group. After delivery, each group contained twelve pups (male:female1:1). The extinction process of fear-conditioning memory was evaluatedthe fear-conditioning test in the offspring at 3 weeks old. The offspring were then sacrificed at 4 weeks old. Blood and tibia samples were collected, blood lead was measuredusing the atomic absorption spectrometer, and tibia lead was measuredusing the inductively coupled plasma–mass spectrometry. The levels of blood lead, bone lead and fear memory were comparedanalysis of variance, and the relationship between blood lead, bone lead and fear memory were analyzedLogistic regression model. Results · The levels of blood and bone lead in the lead exposure group (P blood lead0.013, P bone lead0.000) and combined exposure group (P blood lead0.000, P bone lead0.000) were significantly higher than those in the control group; the level of blood lead in the stress group was higher but not significantly different that in the control group (P blood lead0.056) and the level of bone lead in the stress group was significantly higher than that in the control group (P bone lead0.004); the levels of blood and bone lead in combined exposure group were higher than those in the lead exposure group, but the differences didn’t reach statistical significance (P blood lead0.682, P bone lead0.124). Compared with young rats in the lowest blood lead/bone lead groups, young rats in the groups of higher blood/bone lead levels had higher odds ratios of high fear reaction during the second (P0.008/ P0.016) and the third (P0.019/P0.005) time periods. The ratios of freezing time in the first [(83.73±25.47)%] and the second [(92.97±15.75)%] periods of the fear-conditioning test in the combined exposure group were significantly higher than those in the control group [the first period, (65.35±28.80)%, P10.048; the second period, (68.78±27.22)%, P20.021]. Conclusion · Compared with the single exposure to lead during pregnancy, maternal gestation combined exposure to lead and stress may induce more increases in the blood and bone lead levels in the offspring. Lead exposure during pregnancy may inhibit the process of the extinction of fear memory in the offspring, and this effect may be aggravatedprenatal concurrent exposure to stress.
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    Fabrication of an antibacterial hydrogel laden with adhesive liposomes for bone repairment
    XIANG Yi1, 2, LIU Li-li1, 2, CUI Wen-guo1, 2
    2019, 39 (9):  947. 
    doi: 10.3969/j.issn.1674-8115.2019.09.003

    Abstract ( 456 )   PDF (9989KB) ( 223 )  
    Objective · To construct an antibacterial hydrogel laden with adhesive liposomes (A-LIP-PEG) for bone repair. Methods · Adhesive liposomes (A-LIP) were fabricated based on the Schiff-based reaction between dopamine and the liposome. To prepare the liposome composite hydrogel, the A-LIPs were mixed with thiolated polyethylene glycol (4SH-PEG) which was then crosslinked with Ag+. Bone morphogenetic protein 2 (BMP-2) was loaded in the A-LIPs for its uniform dispersion and sustained release in the hydrogel network. The size distribution and zeta-potential of the A-LIPs were characterized with a particle size analyzer. The morphology of the A-LIPs was observed under transmission electron microscope. Flushing test was employed to examine the viscidity of the A-LIPs, and CCK-8 assay was conducted to demonstrate the biocompatibility of the A-LIP-PEG. Osteogenic activity of the A-LIP-PEG was evaluatedalkaline phosphatase assay and alizarin red S staining in bone marrow mesenchymal stem cells (BMSCs). Results · Strong adhesion toward soft tissue of the A-LIPs was indicatedin vitro study. A-LIP-PEG showed significant inhibition on Staphylococcus aureus. A-LIP-PEG showed superior promotion of osteogenic differentiation to hydrogel laden with liposomes (LIP-PEG), without disrupting cell proliferation. Conclusion · The A-LIP-PEG developed in this study shows nopotential to expand the application of hydrogels to drug delivery, antibacteria and bone repair.
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    Identification of differentially expressed lncRNA in human gastric cancer tissues based on high-throughput RNA sequencing
    YU Zhi-long, RONG Ze-yin, LUO Zai, ZHANG Jian-ming, HUANG Chen
    2019, 39 (9):  955. 
    doi: 10.3969/j.issn.1674-8115.2019.09.004

    Abstract ( 350 )   PDF (9475KB) ( 219 )  
    Objective · To explore the potential mechanisms of gastric cancer (GC), long noncoding RNA (lncRNA) and mRNA profiling of 3 paired GC fresh tissues and their matched adjacent non-cancerous tissues was detected through microarray analysis. Methods · The functions of differentially expressed lncRNA and mRNA were recognizedgene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. The co- network was constructed to find the relevance with corresponding mRNAusing hypergeometric cumulative distribution function of MATLAB 2012b and Cytoscape software. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the of 5 differentially expressed key lncRNAs, which were selected in 30 paired GC fresh tissues. Results · Compared with normal tissues, 1 499 lncRNAs and 6 002 mRNAs were dysregulated in GC tissues. The qRT-PCR results showed that the 5 key lncRNAs were consistent with those the microarray data. Cis-regulatory gene analyses showed the chromosome location of these key lncRNAs, and revealed the associated co-expressed genes. The trans-analyses results demonstrated that enormous transcription factors regulated lncRNA and gene . Conclusion · These differentially expressed lncRNAs in GC may be promising biomarkers and provide valuable information for GC targeted treatment.
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    Structural changes of rectal smooth muscle after spinal cord injury in rats
    GAO Tao, ZHU Xiao-zhong, BAO Bing-bo, LI Xing-wei, LIN Jun-qing, HUANG Teng-li, CHAI Yi-min, ZHANG Chang-qing, ZHENG Xian-you
    2019, 39 (9):  963. 
    doi: 10.3969/j.issn.1674-8115.2019.09.005

    Abstract ( 335 )   PDF (8085KB) ( 172 )  
    Objective · To investigate the changes of rectal smooth muscle structure after spinal cord injury in rats. Methods · Twenty adult female Sprague-Dawley rats were randomly divided into two groups, i.e., spinal cord injury group and control group. In the spinal cord injury group, the spinal cord was completely disconnected between L5 and L6, and control group was not surgically treated. After 3 months, gastric instillation was used to measure the intestinal transit time with the administration of activated carbon suspension and the mass of fecal pellets within 24 h was recorded. Then the rectal tissue was taken at about 1 cm proximal to the anus. The changes of rat rectal smooth muscle were detectedhematoxylin-eosin (H-E) staining, Masson staining and immunohistochemistry staining. Results · Gastric instillation showed that compared with control group, the intestinal transit time of spinal cord injury group significantly prolonged, and the mass of fecal pellets within 24 h significantly reduced. H-E staining showed that the arrangement of rat rectal smooth muscle cells was disordered after spinal cord injury. Masson staining showed fibrotic changes in the rectal smooth muscle layer of rats after spinal cord injury. Immunohistochemistry staining showed that the of α smooth muscle actin (α-SMA) in rat rectal smooth muscle decreased after spinal cord injury. Conclusion · After spinal cord injury, rats present defecation dysfunction. The structure of rectal smooth muscle also changes significantly, mainly including smooth muscle atrophy, fibrosis and decreased α-SMA .
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    Research of live cell membranes modification based on cholesterol-DNA
    LIU Jiang-bo1, 2, WANG Li-hua1, ZUO Xiao-lei3
    2019, 39 (9):  969. 
    doi: 10.3969/j.issn.1674-8115.2019.09.006

    Abstract ( 577 )   PDF (7859KB) ( 267 )  
    Objective · To investigate the modification of live cell membranes with cholesterol linked deoxyribonucleic acid (cholesterol-DNA). Methods · The suspension L1210 cells and adherent PC-12 cells were included. L1210 cells and PC-12 cells were divided into the experimental group (incubated with cholesterol-DNA) and the control group (treated with phosphate buffer saline), respectively. The fluorescence intensity of the cells in the two groups was obtained and the experimental group cells were three-dimensional reconstructedconfocal microscopy. The morphology of the cells in the experimental group was observedscanning electron microscopy (SEM). The effect of cholesterol-DNA modification on cell membrane fluidity was detectedfluorescence recovery after photobleaching. Results · The results of suspension cells and adherent cells were consistent. Compared with the control group, the fluorescence intensity of cell surface in the experimental group was increased (both P0.000). Three-dimensional reconstruction of confocal microscopy showed that the fluorescence of the cells in the experimental group was distributed across the surface of the global cell. SEM showed that the morphology of the cells in the experimental group did not change with cholesterol-DNA modification. After fluorescence photobleaching, the relative fluorescence intensity of the L1210 cells in the experimental group was decreased to 0.090, and then recovered to 0.860 within 110 s. Conclusion · Cholesterol-DNA can modify the whole live cell membranes, and the modified cell membranes still have fluidity. This method can modify not only the suspension cells, but also the adherent cells.
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    Gut microbiota of polycystic ovary syndrome model rats induced with dehydroepiandrosterone
    CHU Wei-wei, XU Jie-ying, LI Shang, ZHAI Jun-yu, DU Yan-zhi
    2019, 39 (9):  975. 
    doi: 10.3969/j.issn.1674-8115.2019.09.007

    Abstract ( 438 )   PDF (12836KB) ( 249 )  
    Objective · To explore the changes of gut microbiota in polycystic ovary syndrome (PCOS) model rats and to study the possible role of gut microbiota in the pathological progress of PCOS. Methods · Six-week-old female Sprague Dawley rats were randomly divided into control group and experimental group (n10 per group). Subcutaneous injection with dehydroepiandrosterone (DHEA) in 0.2 mL phosphate buffer saline (PBS) was adopted to establish PCOS model rats, while the control group rats were subcutaneously injected with the same amount of PBS. After treatment for 4 weeks, the estrous cycle, ovarian weight and morphology were detected. The change of relative abundance of gut microbiota was detected with high-throughput Illumina sequencing technique. Results · Ovarian weight in experimental group was lower than that in control group (P0.010). The estrous cycle was disrupted and ovarian morphology was greatly changed with enlarged follicles and polycystic ovaries, indicating successful PCOS rat model inducedDHEA. Relative abundance of gut microbiota was significantly altered in genus level, with enrichment of genus Alloprevotella (P0.040) and Parasutterella (P0.009) in experimental group. Several kinds of microbial taxa, such as Alphaproteobacteria, Betaproteobacteria, Deltaproteobacteria, Burkholderiale, Elusimicrobia, Elusimicrobiales, Elusimicrobiaceae, and microbial genera Elusimicrobium, Parasutterella and Allobaculum, were remarkably enriched in experimental group, while the abundance of Psychrobacter, Odoribacter and Moraxellaceae were reduced compared with control group revealedLEfSe analysis (LDA ≥ 2.0). Conclusion · The gut microbiota in PCOS model rats is greatly changed compared with that of control group. Many kinds of microbial taxa varies significantly in abundance, suggesting there might be close association between gut microbiota and occurrence and development of PCOS.
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    Effect of extracellular potassium on the activity of distal renal tubule in mice
    YANG Yang, ZHANG Ya, GUO Qin, ZHANG Chong
    2019, 39 (9):  984. 
    doi: 10.3969/j.issn.1674-8115.2019.09.008

    Abstract ( 402 )   PDF (9537KB) ( 185 )  
    Objective · To investigate the effect of extracellular potassium (K+) concentration on the activities of sodium chloride co-transporter (NCC) and large conductance Ca2+-activated K+ channel (BK) in distal renal tubule of mice. Methods · Six specific pathogen free (SPF) C57BL/6 mice aged 8 to 10 weeks were sacrificed, and the kidney slices were made with previously reported method. Then, these slices were incubated randomly in normal K+, high K+, BaCl2 and RbCl solutions, respectively. The abundance and phosphorylation level of NCC in kidney slices at different K+ concentrations and different time courses were detectedWestern blotting. The overall and membrane s of BK in kidney slices were also detected after incubation with different K+ solutions for 2 h. Results · Compared with normal K+ solution, NCC phosphorylation level was significantly decreased after incubation with high K+ solution for 5, 15, 30 min (all P<0.05), and NCC phosphorylation level was also decreased after intervention with K+ channel inhibitor Ba2+ or Rb+ (both P<0.05). After the treatment with high K+ solution for 2 h, neither the overall cell of BKα subunit and β4 subunit, nor membrane of BKα subunit was found significant changes compared with normal K+ incubation. Conclusion · High K+ can directly down-regulate NCC phosphorylation level, which may be preparation for kaliuresis of the downstream tubule of distal convoluted tubule.
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    Effect of the PI3K/AKT signaling pathway regulatedHMGCS1 on drug sensitivity of HL-60 cells
    JIA Yan1,2, WANG Hui-wen1, YI Jin-mou1, ZENG Hui2, LU Min3
    2019, 39 (9):  991. 
    doi: 10.3969/j.issn.1674-8115.2019.09.009

    Abstract ( 418 )   PDF (9750KB) ( 229 )  
    Objective &middot; To explore the mechanism of 3-hydroxymethyl-3-methylglutaryl-CoA synthase 1 (HMGCS1) on drug sensitivity of acute myelocytic leukemia (AML) HL-60 cells. Methods &middot; HL-60 cells were cultured. The negative control group and the HMGCS1 overexpressed group were constructedinfecting the negative control lentivirus and HMGCS1 lentivirus, and the untreated HL-60 cells were set as the blank control group. Real-time quantitative PCR (qPCR) was used to detect the of HMGCS1 mRNA in the 3 groups, and to verify whether the cell lines of the HMGCS1 overexpressed group were successfully constructed. The effect of HMGCS1 on the of AKT and phosphorylated AKT (p-AKT) in phosphatidylinositol 3 kinase (PI3K) / protein kinase B (PKB / AKT) signaling pathway was detectedWestern blotting. CCK8 method was used to detect the effects of HMGCS1 and PI3K/AKT signaling pathway inhibitor LY29400 on the activity of HL-60 cells. The effect of LY29400 on HMGCS1 was detectedqPCR and Western blotting. Results &middot; Compared with the negative control group, the HMGCS1 mRNA was increased significantly in the HMGCS1 overexpressed group (P0.000). Compared with the blank control group and the negative control group, the p-AKT protein level in the HMGCS1 over group was significantly increased, while the AKT of the 3 groups was not significantly different. CCK8 method showed that compared with the blank control group and the negative control group, HMGCS1 could reduce the effect of adriamycin on cell viability in the HMGCS1 overexpressed group (P0.003, P0.006), while LY294002 could inhibit the effect producedHMGCS1 (P0.000). The intervention of LY294002 could reduce the levels of HMGCS1 and p-AKT protein and HMGCS1 mRNA (both P0.000) in the negative control group and the blank control group. Conclusion &middot; HMGCS1 can reduce the sensitivity of HL-60 cells to chemotherapy drug adriamycin, while PI3K/AKT signaling pathway inhibitor LY294002 can restore its sensitivity.
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    Two-photon in vivo imaging of blood brain barrier injury in the ultra-early stage of cerebral ischemic stroke
    HUANG Ting-ting, LI Yan, ZHANG Yue-man, ZHOU Na-ying, FAN Ren-hui, LI Pei-ying
    2019, 39 (9):  998. 
    doi: 10.3969/j.issn.1674-8115.2019.09.010

    Abstract ( 677 )   PDF (8735KB) ( 304 )  
    Objective &middot; To evaluate the effect of two-photon in vivo imaging on detecting the blood brain barrier (BBB) injury in the ultra-early stage of cerebral ischemic stroke. Methods &middot; Twelve clean grade C57BL/6 healthy male mice aged 8-12 weeks were randomly divided into Sham group and middle cerebral artery occlusion (MCAO) group, which were sham operated or middle cerebral artery occluded, respectively. After 60 min of ischemia, MCAO mice were treated with reperfusion for 30-60 min after the suture being removed. The vessels and the neutrophils of mice in the two groups were labeled intravenously with Alexa-Fluora-488 conjugated dextran and rhodamine 6G, respectively. The integrity of BBB was detectedintravenous injection of tetramethylrhodamine-5-maleimide (TMR). Before and after the stroke, the real-time changes of the fluorescence intensity of the inside and outside cerebral vessels of mice in the MCAO group were observedtwo-photon fluorescence microscopy. Results &middot; The fluorescence intensity of TMR in the external cerebrovascular of mice in the MACO group was significantly increased within 30-60 min after stroke (P0.000), suggesting there existed tracer leakage. Compared with the Sham group, the movement of neutrophils in the blood vessels of mice in the MACO group was significantly slowed down (P0.000). Conclusion &middot; Two-photon in vivo imaging can be used to detect the BBB injury in the ultra-early stage of cerebral ischemic stroke, which provides a certain reference value for clinical application.
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    Effect of relA knockout on heterologous resistance of colistin to Acinetobacter baumannii
    YU Chun-bo1, LU Ming2, SHAO Lei3, PU Tian4, CHEN Dai-jie4, ZHOU Wei1, 5
    2019, 39 (9):  1004. 
    doi: 10.3969/j.issn.1674-8115.2019.09.011

    Abstract ( 409 )   PDF (7836KB) ( 266 )  
    Objective &middot; To observe the effect of the (p)ppGpp synthase gene (relA) on the heteroresistance of colistin against Acinetobacter baumannii. Methods &middot; The relA gene in Acinetobacter baumannii ATCC19606 was knocked outRed homologous recombination technique. The biofilm formation of Acinetobacter baumannii was observedcrystal violet staining. The change of heterogeneous colonies of Acinetobacter baumannii under the action of colistin was detectedpopulation analysis profiles (PAP) and the heterogeneity was calculated. The killing curve was used to detect the formation of persistent bacteria in Acinetobacter baumannii under the action of colistin. Results &middot; The relA gene in Acinetobacter baumannii was successfully knocked out, and the relA knockout strain ATCC19606-&Delta;relA was obtained. After relA gene knockout, the biofilm formation of Acinetobacter baumannii decreased significantly. After relA gene knockout, Acinetobacter baumannii significantly reduced the heterogeneous colonies and persistent bacteria formation under the action of colistin. Conclusion &middot; The bacterial stringent reaction (p) ppGpp synthase relA may be an important factor affecting the heteroresistance of Acinetobacter baumannii to colistin.
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    Cisplatin promotes heart failure in bladder cancer miceimpairing granulocytic myeloid-derived suppressor cells
    WU Ke1*, YAO Zhi-xian1*, ZHENG Zhong1*, CHENG Lei-lei2, LIU Zhi-hong1
    2019, 39 (9):  1011. 
    doi: 10.3969/j.issn.1674-8115.2019.09.012

    Abstract ( 360 )   PDF (7979KB) ( 195 )  
    Objective &middot; To investigate the effect of cisplatin on heart failure in bladder cancer miceimpairing granulocytic myeloid-derived suppressor cells (G-MDSCs). Methods &middot; Fifty 8-week-old specific pathogen free (SPF) C3H/He healthy female mice were used to establish the bladder cancer model after subcutaneous injection of MBT-2 mice bladder cancer cells. The mice were divided into group A&ndash;E, 10 mice in each group, and the group A was set as the blank control group. The group B&ndash;E mice were continuously intraperitoneally injected with 5 mg/ (kg.d) isoproterenol for 14 d to successfully establish the heart failure model. The group B was set as the control group. The mice were intraperitoneally injected with 7.5 mg/kg cisplatin every 48 h for chemotherapy, and killed at 14 d in the group C. G-MDSCs were identified, isolated and purifiedflow cytometry. 1&times;107 purified G-MDSCs were intravenously injected into the group D mice via the tail vein every 7 d. The group E mice was treatedcombining the procedure of the group C and the group D. The myocardial tissue of the mice was stainedhematoxylin-eosin staining. And the heart failure degree of the mice was analyzedthe heart weight/body weight ratio and the observation under the inverted phase contrast microscope. Results &middot; Flow cytometry results showed that compared with the group B, the level of G-MDSCs in the circulation system of the group C mice was significantly decreased (P0.000). Hematoxylin-eosin staining and Image J software analysis showed that compared with the group B, the heart weight/body weight ratio and the area of myocardial cells of the group C mice were significantly increased (P0.001, P0.002). However, after G-MDSCs injection, the above two indexes in the group D mice were decreased compared with those in the group B (P0.000, P0.011). After cisplatin/G-MDSCs combined treatment, the above two indexes in the group E were also decreased compared with those in the group C (P0.000, P0.001). Conclusion &middot; G-MDSCs have cardioprotective effects, while cisplatin can facilitate heart failureimpairing G-MDSCs.
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    Original article (Clinical research)
    One year follow-up study of sleep duration and cognitive function changes in the elderly with normal cognitive function
    HONG Bo*, HE Hai-ning*, LIU Yuan-yuan, SU Ning, YAN Feng, SHI Yan-chen, WANG Jing-hua, WANG Tao, XIAO Shi-fu
    2019, 39 (9):  1017. 
    doi: 10.3969/j.issn.1674-8115.2019.09.013

    Abstract ( 396 )   PDF (10159KB) ( 187 )  
    Objective &middot; To analyze the effect of sleep duration on cognitive function of the elderly with normal cognitive function. Methods &middot; A total of 572 elderly people with normal cognitive function (NC group), 224 patients with amnestic mild cognitive impairment (aMCI) and 48 patients with Alzheimers disease (AD) were selected as the subjects. A unified questionnaire was used to collect their general data including demographic information, daily life information and so on. At the baseline stage, the correlation between sleep duration and cognitive function of NC group, aMCI group and AD group were compared, respectively. The elderly in NC group were followed up for one year to confirm the change of their cognitive function and analyze the correlation between sleep duration and cognitive function. Results &middot; In NC group, the sleep duration in adolescence was positively correlated with Mini-Mental State Examination (MMSE) score (r0.114, P0.006) and Montreal Cognitive Assessment (MoCA) score (r0.116, P0.006), while the sleep duration in old age was positively correlated with MMSE score (r0.124, P0.004). For 572 elderly people with normal cognition, 282 cases of one year follow-up data were available. Twenty-nine patients diagnosed as aMCI and 6 patients diagnosed as AD were classified into progressive (NC-P) group, while 224 normal elderly subjects and 5 successful elderly subjects were classified into s(NC-S) group. The average age (P0.000), female percentage (P0.003) and heart disease rate (P0.001) in NC-P group were higher than those in NC-S group, while the number of years of education (P0.000), sleep duration in old age (P0.001) and the smoking history rate (P0.040) in NC-P group were lower than those in NC-S group, and the differences were statistically significant. Logistic multivariate regression analysis showed that decreased sleep duration (P0.001) and heart disease (P0.003) were the main risk factors for cognitive impairment in normal elderly people within one year. Conclusion &middot; There is a positive correlation between cognitive function level and sleep duration in the elderly with normal cognition. Reduced sleep duration in the elderly is a risk factor for aMCI.
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    Peritonitis is an independent risk factor for all-camortality and cardiovascular mortality in patients with peritoneal dialysis
    WANG Li1, 2, ZHANG Qian-ying1, LIN Tao1, XU Tian1, HUANG Xiao-min1, ZHANG Chun-yan1, XU Yao-wen1, WU Pei1, CHEN Nan1, REN Hong1, XIE Jing-yuan1
    2019, 39 (9):  1024. 
    doi: 10.3969/j.issn.1674-8115.2019.09.014

    Abstract ( 377 )   PDF (11292KB) ( 220 )  
    Objective &middot; To investigate the effect of peritonitis on all-camortality and cardiovascular mortality of peritoneal dialysis (PD) patients. Methods &middot; January 2003 to September 2017, 614 patients treated with PD in the Department of Nephrology of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively included. The patients were divided into the peritonitis group and the peritonitis-free group according to whether peritonitis occurred after PD treatment. According to the first standard peritoneal equilibrium test results, the patients were divided into low transport group (L group), low average transport group (LA group), high average transport group (HA group) and high transport group (H group). The study endpoints were defined as all-camortality or cardiovascular mortality. The demographic data, clinical data at baseline (within one month of starting PD treatment) and PD outcomes were compared between the peritonitis group and the peritonitis-free group. The proportional hazards model (Cox model) was established to analyze the effect of peritonitis on all-cadeath or cardiovascular death. Results &middot; In the peritonitis group (213 cases), 125 patients (58.7%) were positive for pathogenic bacteria, in whom 69 patients (32.4%) were Gram-positive bacteria, 46 patients (21.6%) were Gram-negative bacteria, and 6 patients (2.8%) were fungi. Compared with the peritonitis-free group, the patients in the peritonitis group had longer dialysis duration (P0.000), older age (P0.001), higher proportion of lower education level (P0.000), higher proportion of patients with cerebrovascular disease and diabetes mellitus (P0.004, P0.036), and lower serum albumin level (P0.016). Multivariate Cox regression analysis showed that peritonitis was an independent risk factor for all-camortality and cardiovascular mortality (P0.015, P0.046) after age, diabetes mellitus, serum albumin and other factors being adjusted. Subgroup analysis showed that compared with the patients with high educational level, the risk of all-camortality [HR: 1.99 (1.14-3.46) vs 1.39 (0.74-2.62)] and cardiovascular mortality [HR: 1.95 (0.89-4.25) vs 1.14 (0.50-2.61)] were more intensively increased in patients with low educational level after peritonitis. Compared with the H group+HA group, the risk of all-camortality [HR: 2.31 (1.30-4.11) vs 1.22 (0.70-2.12)] and cardiovascular mortality [HR: 3.24 (1.41-7.42) vs 0.95 (0.45-2.02)] were more intensively increased in the L group+LA group after peritonitis. Conclusion &middot; Peritonitis is an independent risk factor for all-camortality and cardiovascular mortality of PD patients. The risk of all-camortality and cardiovascular mortality after peritonitis increases more significantly in those with lower educational level or in L group+LA group than those with higher educational level or in H group+HA group.
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    Clinicopathology and prognosis analysis of adrenal lymphoma
    JIANG Tao1, 2, SHI Qing1, XU Peng-peng1, CHENG Shu1, WANG Li1, ZHAO Wei-li1
    2019, 39 (9):  1032. 
    doi: 10.3969/j.issn.1674-8115.2019.09.015

    Abstract ( 526 )   PDF (7667KB) ( 148 )  
    Objective &middot; To investigate the clinical manifestations, pathological features and prognostic factors of patients with adrenal lymphoma. Methods &middot; A retrospective analysis was made with the clinical and pathological data of 77 patients with adrenal non-Hodgkins lymphoma confirmedpathology or confirmedimaging evidence in the Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine January 2002 to June 2018. The clinical characteristics of primary adrenal lymphoma (PAL) and secondary adrenal lymphoma (SAL) were compared. Kaplan-Meier curve was used for survival analysis, and Cox regression model was used to analyze the prognostic factors. Results &middot; Of the 77 patients, 28 were PAL and 49 were SAL. The predominant pathological type was difflarge B-cell lymphoma, accounting for 77.9%. There were 21 patients accompaniedbone and gastrointestinal involvement, respectively. The proportions of bilateral involvement (67.9%) and large mass (67.9%) were higher in the PAL patients, while the proportions of Ⅲ / Ⅳ stage (95.9%) and pancreas (24.5%) and bone (38.8%) involvement were higher in the SAL patients. The patients with T/ NK cell-derived lymphoma or with incomplete remission after treatment had significantly shorter survival time than those with B cell-derived lymphoma or with complete remission after treatment (P0.005, P0.000). Conclusion &middot; The clinical manifestations of adrenal lymphoma lack specificity. The main pathological type is difflarge B-cell lymphoma. Bilateral involvement and large mass are more common in PAL, while advanced disease and pancreas and bone involvement are more common in SAL. T/NK cell-derived lymphoma and incomplete remission after treatment are major adverse prognostic factors.
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    A preliminary study on the association between psychological problems and chest pain in patients undergoing coronary angiography
    CHEN Bing-xu1, LIO Ka U1, HU Jia-yu1, SU Xuan1, JIANG Meng2, MAO Jia-liang2, BU Jun2
    2019, 39 (9):  1038. 
    doi: 10.3969/j.issn.1674-8115.2019.09.016

    Abstract ( 445 )   PDF (10370KB) ( 176 )  
    Objective · To explore the role of psychological problems of somatization, anxiety, and depression in patients presenting chest pain who underwent coronary angiography (CAG). Methods · Altogether, 908 patients with chest pain referred to the cardiology inpatient department were enrolled in the present study. The enrolled patients underwent CAG and coronary angiographic results were classified into negative (<30% diameter stenosis in all vessels), mild to moderate coronary stenosis ( ≥ 30% and <75% diameter stenosis in all vessels) and severe coronary stenosis group ( ≥ 75% diameter stenosis in at least a single vessel). Patients also completed a battery of self-reported inventories before the CAG: the Self-Rating Somatic Symptom Scale (SSS), the Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Results · Compared with severe coronary stenosis group, male patients in the mild to moderate coronary stenosis group (n189) seemed to have higher rate of somatization (20.6% vs 18.5%, P0.014), higher rate of depression (20.6% vs 10.6%, P0.008), and higher rate of anxiety (13.4% vs 6.6%, P0.028). Compared with severe coronary stenosis group, female patients in the mild to moderate coronary stenosis group seemed to have higher rate of somatization (57.6% vs 39.4%, P0.008). Conclusion · The positive rate of somatization symptoms in patients with mild to moderate coronary stenosis was higher than that in patients with severe coronary stenosis. These findings suggest that psychological problems may contribute in part to the development of chest pain and other physical symptoms. It is also needed to evaluate the clinical and economic benefits of early psychological interventions, especially in mild to moderate coronary stenosis patients who are presenting chest pain.
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    A visualization study of deep convolutional neural network to classify the pathological type of sub-soild pulmonary adenocarcinoma of &le; 3 cm based on CT images
    JIANG Bei-bei, ZHANG Ya-ping, ZHANG Lin, LIU Gui-xue, XIE Xue-qian
    2019, 39 (9):  1045. 
    doi: 10.3969/j.issn.1674-8115.2019.09.017

    Abstract ( 427 )   PDF (9081KB) ( 225 )  
    Objective &middot; To investigate the feasibility of deep convolutional neural network (CNN) to classify the pathological type of sub-soild pulmonary adenocarcinoma of &le; 3 cm based on CT images, and to visualize the medical imaging features derived the activation area of CNN. Methods &middot; A total of 200 sub-solid lung nodules, which were confirmed as adenocarcinomaimmunohistochemical staining, were classified as preinvasive lesions (including atypical adenomatous hyperplasia and adenocarcinoma in situ), microinvasive adenocarcinoma and invasive adenocarcinoma, in which 160 (80%) were used to train the inception v3 CNN architecture, and the other 40 (20%) were used to test the model and visualize the activation area. The characteristics of the activated area were defined as 14 CT signs. Results &middot; The CNN yielded an accuracy of 87.5% to classify three categories of lung nodules. The visualization study found that the CNN activation area mainly focused on the non-solid component (43.0%) and smooth margin (20.2%) of the preinvasive lesions, on the spiculated margin (18.3%) of the microinvasive adenocarcinoma, and on the solid component (18.9%) and the spiculated margin (14.1%) of the invasive adenocarcinoma. Conclusion &middot; CNN can classify the pathological type of lung adenocarcinoma based on CT images. The visualization of activation area of CNN indicates the medical imaging characteristics of diagnosis.
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    Clinical application of Chinese customized TC4/UHMWPE connected total temporomandibular joint prostheses
    CHEN Xu-zhuo1*, MAO Yi1*, ZHENG Ji-si1, JIANG Wen-bo2, ZHANG Shan-yong1, CHEN Ke3, YANG Chi1
    2019, 39 (9):  1052. 
    doi: 10.3969/j.issn.1674-8115.2019.09.018

    Abstract ( 410 )   PDF (11472KB) ( 201 )  
    Objective &middot; To introduce a standardized workflow for clinical application of Chinese customized TC4/UHMWPE connected total temporomandibular joint (TMJ) prostheses, and to evaluate its accuracy and clinical effectiveness. Methods &middot; Eight patients with the end stage TMJ diseases were included in this study. The computed tomography (CT) data for patients were obtained and transformed into the Mimics 18.0 software preoperatively for the designing of the prostheses and digital templates. Three-dimensional (3D) printing, friction spot welding (FSW) and computer-aided manufacture (CAM) were used to fabricate different components of the prostheses. The effectiveness of intraoperative application and the accuracy of merging results were evaluated postoperatively. Results &middot; With the guidance of digital templates and virtual surgical planning (VSP), all the prostheses were placed smoothly and fixed stably during surgical procedures. The merging results showed that the prostheses position matched with the preoperative design well, with an mean deviation of 0.417 mm (range: 0.279 to 0.561 mm) for the whole prosthesis system. All the patients exhibited good facial symmetry and satisfactory improvement in pain, function and mouth opening postoperatively. Conclusion &middot; The standardized workflow ensures the accuracy and efficiency in clinical application of Chinese customized total TMJ prostheses.
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    A &ldquo;Reverse&rdquo; approach for the reconstruction of mandibular defect using fibular flap
    SHEN Shun-yao1, 2, LIU Zhi-xu1, 2, JIANG Teng-fei1, YU Jing-shuang1, 2, YUAN Hao1, 2, ZHANG Lei1, 2, SHI Jun1, 2, WANG Xu-dong1, 2
    2019, 39 (9):  1060. 
    doi: 10.3969/j.issn.1674-8115.2019.09.019

    Abstract ( 318 )   PDF (7700KB) ( 191 )  
    Objective &middot; To design osteotomy templates for the construction of mandibular defectusing fibular flap in a reverse engineering technique approach. Methods &middot; Five patients with mandibular defect were enrolled and their treatments were designed in a three-dimensional (3D) virtual planning software package. The 3D printing model with shaped reconstruction plate and titanium-screws were under CT scanning and the image was reconstructed and registered back to the original mandible and fibula in a surface-best-fit method. Then the osteotomy template with screw holes of shaped reconstruction plate was designed and fabricated. The reconstruction of mandible with multiple fibular segments was guidedthe osteotomy template. Results &middot; All the five patients were discharged successfully with satisfied outcome. The deviation between virtual plan and actual results were calculated: max deviation (3.53&plusmn;2.33) mm and the angle deviation 3.31.&plusmn;1.48.. Conclusion &middot; The accuracy of the osteotomy template is satisfied and can be applied to the clinical use.
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    Correlation between plasma brain natriuretic peptide and functional outcome after intravenous thrombolysis in patients with acute ischemic stroke
    ZHUANG Mei-ting, HE Xin-wei, ZHAO Rong, YIN Jia-wen, HU Yue, LIU Jian-ren
    2019, 39 (9):  1065. 
    doi: 10.3969/j.issn.1674-8115.2019.09.020

    Abstract ( 323 )   PDF (7888KB) ( 212 )  
    Objective · To study the correlation between brain natriuretic peptide (BNP) in plasma and functional outcome in patients with acute ischemic stroke after intravenous thrombolysis and its clinical significance. Methods · An analysis was performed on 141 cases of acute ischemic stroke patients with intravenous thrombolysis. According to the modified Rankin Scale (mRS) 3 months after thrombolysis, the patients were divided into the good outcome group (mRS ≤ 1) and the poor outcome group (mRS>1). BNP level indicators after thrombolysis were compared between the two groups. The receiver operator characteristic (ROC) curve was used to analyze the ability of BNP level to predict the functional outcome 3 months after thrombolysis, and the influence of some other relevant factors was adjustedLogistic regression analysis. Results · Compared with the good outcome group, the level of BNP in the poor outcome group was significantly increased (P0.003). According to ROC curve analysis, the elevated BNP level (BNP>202.6 pg/mL) had a certain predictive ability for poor functional outcome 3 months after intravenous thrombolysis in patients with acute ischemic stroke. Elevated BNP level was an independent predictor of functional outcome 3 months after intravenous thrombolysis in patients with acute ischemic stroke (OR2.406, 95% CI 1.0695.417, P0.034). Conclusion · Elevated plasma BNP level after thrombolysis is significantly associated with poor functional outcome in patients with acute ischemic stroke after intravenous thrombolysis, suggesting a predictive role of BNP for poor outcome 3 months after intravenous thrombolysis.
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    Receptor status testing and its influence on following treatment selection in breast cancer patients with loco-regional recurrence
    LU Yu-jie, JIN Ze-yu, LI Ya-fen, SHEN Kun-wei, CHEN Wei-guo, CHEN Xiao-song
    2019, 39 (9):  1071. 
    doi: 10.3969/j.issn.1674-8115.2019.09.021

    Abstract ( 388 )   PDF (9037KB) ( 180 )  
    Objective &middot; To analyze the concordance rates of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), and Ki67 statuses between the primary and loco-regional recurrence (LRR) lesions and its influence on the following treatment in breast cancer patients. Methods &middot; The breast cancer patients undergoing surgery in Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine January 2009 to September 2018, who were reported recurrence only in loco-regional site were retrospectively analyzed. ER, PR, HER-2, and Ki67 statuses were detected in primary and LRR lesions. Concordance rates and their influence on following treatment were further analyzed. Results &middot; A total of 7 823 breast cancer patients received surgery, among whom 106 cases experienced LRR without distant metastasis. There were 56 patients having full information about ER, PR, HER-2, and Ki67 statuses of LRR lesions, with the positive rates of 48.2%, 25.0%, 35.2%, and 81.5%, respectively. Concordance rates of ER, PR, HER-2, and Ki67 between primary and LRR lesions were 76.8%, 76.8%, 89.1% and 77.8%, with &kappa; values at 0.538, 0.469, 0.729, and 0.402, respectively. Hormone receptor (ER or PR) (14 cases) and/or HER-2 (6 cases) statuses were altered in 18 patients. The hormone receptor status changed positive to negative in 9 cases, of which 4 cases did not receive following endocrine therapy. The HER-2 status changed negative to positive in 4 patients, and 1 of them received following anti-HER-2 targeted therapy. Conclusion &middot; The concordance rates between primary and LRR breast cancer lesions of ER, PR, and Ki67 are moderate, and the concordance rate of HER-2 is high. Changes in receptor status in LRR lesions may affect the choice of following treatment options.
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    Efficiency comparison of fasting plasma glucose combined with 1,5-anhydroglucitol and combined with glycated albumin in diabetes mellitus screening
    SU Hang, MA Xiao-jing, YING Ling-wen, HE Xing-xing, ZHU Wei, TANG Jun-ling, WANG Yu-fei, BAO Yu-qian, ZHOU Jian
    2019, 39 (9):  1077. 
    doi: 10.3969/j.issn.1674-8115.2019.09.022

    Abstract ( 415 )   PDF (8123KB) ( 164 )  
    Objective · To analyze and compare the clinical value of serum 1,5-anhydroglucitol (1,5-AG) with glycated albumin (GA) combined with fasting plasma glucose (FPG), respectively, in screening diabetes mellitus in Chinese population at the risk of diabetes mellitus. Methods · A total of 701 subjects with high risk of diabetes were enrolled in this study, including 324 males and 377 females. All subjects underwent 75 g oral glucose tolerance test (OGTT). Diabetes was diagnosed according to the cut-off points of 2010 American Diabetes Association standards. The sensitivity, specificity and area under ROC curve (AUC) of GA combined with FPG and 1,5-AG combined with FPG in screening diabetes mellitus were analyzed. Results · Among 701 subjects, 350 (49.93%) cases were diagnosed as having diabetes mellitus. The sensitivity, specificity, and AUC of 1,5-AG combined with FPG were 84.29%, 91.45% and 0.939, respectively. The sensitivity of GA combined with FPG was 77.71%, and the specificity and AUC were 90.88% and 0.932, respectively. There was no significant difference in AUC between the two screening methods (P>0.05), but the sensitivity of 1,5-AG combined with FPG was higher than that of GA combined with FPG (P0.001). The proportion of the subjects in need of further OGTT judged1,5-AG combined with FPG was 27.82%, which was 11.27% lower than that judgedFPG alone, and 2.57% lower than that judgedGA combined with FPG. Conclusion · In Chinese population with high risk of diabetes mellitus, serum 1,5-AG or GA combined with FPG can improve the efficiency of diabetes screening. Compared with GA combined with FPG, 1,5-AG combined with FPG may have more clinical value.
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    Role of gastrointestinal microbiota in tumorigenesis
    LU Hai-yang, ZHAO Wei-li
    2019, 39 (9):  1083. 
    doi: 10.3969/j.issn.1674-8115.2019.09.023

    Abstract ( 487 )   PDF (9159KB) ( 214 )  
    Gastrointestinal microbiota has an important impact on physiological functions of human body. In recent years, the importance of gastrointestinal microbiota in tumorigenesis has emerged. Aberrant location and proportion of microbiota can canot only carcinogenesis of local epithelia, but also tumorigenesis in submucous tissues or even distant organs. Certain microbes can produce genotoxin or generate reactive oxygen species to caDNA damage and affect DNA damage repair, which leads to genetic instability and induces cell transformation. Moreover, gastrointestinal microbiota is able to affect the function of host immune system and form an immunosuppressive microenvironment, while some other pathogenic bacteria can cachronic inflammation and may be involved in tumor immune escape. Based on the above, gastrointestinal microbiota is oncogenic and closely linked to tumorigenesis.
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    Progress of transcranial direct current stimulation for treatment of obsessive-compulsive disorder
    CHENG Jia-yue, WANG Zhen
    2019, 39 (9):  1089. 
    doi: 10.3969/j.issn.1674-8115.2019.09.024

    Abstract ( 462 )   PDF (10510KB) ( 208 )  
    Obsessive-compulsive disorder is a disabling disease with symptoms of repeated and persistent unwanted intrusive thoughts and compulsive behaviors. The current first-line treatment methods mainly include psychopharmacology, psychotherapy, and the combination of both, but nearly 40% patients still show no response to conventional treatment. Among the recently developed treatments, non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), are expected to alleviate the symptoms of various psychiatric disorders and improve cognitive function. tDCS has been applied to the treatment of depression, schizophrenia, generalized anxiety disorder and other mental diseases, and has achieved definite clinical effect. However, there are few studies about tDCS applying to the obsessive-compulsive disorder, especially in the number of randomized controlled trials. Most of the studies are open trials and case reports, and the results are inconsistent.reviewing the effect of tDCS in treating obsessive-compulsive disorder patients in existing reports, the possibility of applying tDCS widely to treating obsessive-compulsive disorder in the future is analyzed.
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    Advances of pathogenesis and clinical research in anti-N-methyl-D-aspartate receptor encephalitis
    NI You, CHEN Sheng
    2019, 39 (9):  1095. 
    doi: 10.3969/j.issn.1674-8115.2019.09.025

    Abstract ( 430 )   PDF (7086KB) ( 215 )  
    Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is one kind of autoimmune encephalitis that is mediatedNMDAR antibodies. Most of the patients are young women and some of them may suffer tumors. Diagnosis is mainly based on identification of NMDAR antibodies in cerebrospinal fluid and serum. Most patients can recover after removal of the tumor or through immunotherapy. This article reviews some viewpoints of pathogenesis, genetic features, clinical characteristics, treatment and prognosis of the disease.
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    Research progress in correlation between early life exposure to environmental endocrine disruptor chemicals and allergic diseases in children
    TANG Ning, OUYANG Feng-xiu
    2019, 39 (9):  1100. 
    doi: 10.3969/j.issn.1674-8115.2019.09.026

    Abstract ( 451 )   PDF (11635KB) ( 198 )  
    Endocrine disruptor chemicals (EDCs) are similar to steroid hormones in molecular structure, and may have steroid-like disrupting effects on the immune system and influence the risk of allergic diseases. For example, bisphenol A (BPA) and triclosan (TCS) are commonly EDCs existing in the environment, and both BPA and TCS are widely added to daily necessities and catering products. Animal experiments found that prenatal BPA exposure may be associated with higher risk of respiratory allergic diseases in offspring. It was also founda few epidemiological studies that TCS exposure was associated with higher risks of eczema, and allergic disorders in respiratory system and digestive tracts in children. EDCs may increase cytokines and immunoglobulins levelsinterrupting the function of helper T cells (Th1/Th2) so as to affect the immune system, which might be associated with allergic reactions. This review mainly focused on the correlation between EDCs (BPA and TCS) and childhood allergic diseases and the underlying mechanisms.
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