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28 February 2020, Volume 40 Issue 2 Previous Issue    Next Issue
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Novel coronavirus article
Original article (Basic research)
Original article (Clinical research)
Original article (Public health)
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Novel coronavirus article

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Management on prevention of new coronavirus infection in periodontal treatment QIAN Jie-lei, SHU Rong 2020, 40 (2):  145.  doi: 10.3969/j.issn.1674-8115.2020.02.001 Abstract ( 1080 )   PDF (6287KB) ( 577 )   Currently, corona virus disease 2019 (COVID-19) causedsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious disease. The epidemic situation was so severe that the accumulative number of confirmed diagnoses in China reached more than seventy thousand24:00, Feb. 18, 2020. This paper, based on the etiological and epidemiological characteristics of the virus, introduces the infection prevention protocols for COVID-19 before, during and after the periodontal treatment for the reference of stomatologists. Proper prevention methods can reduce the risks of nosocomial infection, prevent further spreading, ensure the safety of the medical staff and patients, and then ensure both medical quality and safety. Related Articles | Metrics

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A source-seeking analysis and its implication on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) WANG Xiao-yu, CUI Li 2020, 40 (2):  149.  doi: 10.3969/j.issn.1674-8115.2020.02.002 Abstract ( 1195 )   PDF (11577KB) ( 457 )   The epidemic causedsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has seriously compromised the security of human life as well as resulted in huge economic damages. Currently, it has yet to be determined that who are the intermediate animals of SARS-CoV-2 transmission during the transition its origin to the human infection. Into prevent and control infectious diseases, the effective measures are identifying the animals serving as the source and intermediate hosts and interrupting the transmission pathways. They are thus highly significant in the prevention of epidemic recurrence and the protection of public health security in society. This article summarizes the latest developments in the research on transmission hosts of SARS-CoV-2, and makes the inference of potentially-multiple transmission hosts based on the facts current epidemic. Therefore, it is vital to strengthen the construction of the integrated prevention-and-control system (with human and veterinary medicines) using the innovative One Health approach during the current epidemic prevention and control stage, as well as emerging epidemic in the future. Related Articles | Metrics

Original article (Basic research)

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Effect of intranasal administration of glibenclamide on the treatment of traumatic brain injury in mice WANG Ju, CHEN Jin, XU Xin-Lu, YU Qi, SONG Ming-ke 2020, 40 (2):  157.  doi: 10.3969/j.issn.1674-8115.2020.02.003 Abstract ( 1076 )   PDF (8984KB) ( 583 )   Objective · To observe the effect of intranasal administration of glibenclamide on the treatment of traumatic brain injury (TBI), providing new ideas for the treatment of TBI. Methods · Eight-week-old C57BL/6J mice were randomly divided into glibenclamide treatment group (n21), control group (n19) and in vivo fluorescence imaging group (n1). Glibenclamide labeled with fluorescent probe was injected into the nose of mice in the in vivo fluorescence imaging group to observe the transportation of glibenclamide into the brain. The TBI model was established in the right hemisphere of mobrain of the glibenclamide treatment group and the control groupthe controlled cortical impact (CCI) method. The mice in the glibenclamide treatment group received intranasal delivery of the drug after TBI induction, while the mice in the control group received equal doses of the solvent without glibenclamide under the same conditions. Mice were decapitated after 24 h of successful modeling. The degree of brain edema in the two groups was measuredthe percentage change in water content of brain tissues. The volume of brain damage in the two groups was measured2, 3, 5-triphenyltetrazolium chloride (TTC) staining. The neurological function of the two groups was evaluatedrotarod test. Results · In vivo fluorescence imaging experiment showed that glibenclamide successfully reached the brain after intranasal administration. The degree of brain edema and the volume of brain damage in the control group were significantly larger than those in the glibenclamide treatment group (both PConclusion · Intranasal delivery of glibenclamide can significantly reduce TBI-caused brain edema and brain damage volume, suggesting that the drug has a certain neuroprotective effect on TBI. Related Articles | Metrics

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Knocking out ERG3 gene of Candida albicans and its effect on drug resistance WANG Yu-ting, LIU Jin-yan, SHI Ce, ZHAO Jun-tao, XIANG Ming-jie 2020, 40 (2):  163.  doi: 10.3969/j.issn.1674-8115.2020.02.004 Abstract ( 1093 )   PDF (9477KB) ( 552 )   Objective · To construct the ERG3 gene knockout strain of Candida albicans, and to analyze the effect of ERG3 knockout on the resistance of Candida albicans to azole drugs and the of its common resistance genes. Methods · Knockout components were constructed with genomic DNA of Candida albicans SN152 and plasmid DNA with screening markers as templatesfusion PCR and homologous recombination techniques. The knockout components were transfected into Candida albicans SN152lithium acetate transfection method to obtain ERG3+/- and ERG3-/- strains. The differences of drug resistance in SN152, ERG3+/- and ERG3-/- strains to azole drugs were determinedmicrobroth dilution method. Meanwhile, real-time quantitative PCR (qPCR) was used to detect the of drug resistance-related genes in the three strains. Results · Candida albicans ERG3 gene knockout strains were efficiently constructed. The resistance of ERG3-/- strains to azole drugs was significantly higher than that of ERG3+/- and SN152 strains. The of drug resistance-related genes (CDR1, CDR2, MDR1, ERG11) in ERG3-/- strains increased significantly (all PConclusion · Candida albicans SN152 ERG3-/- double allelic knockout strain is successfully constructed. The knockout of ERG3 gene improves the resistance of Candida albicans to azole drugs, and the down-regulation of ERG3 gene is accompaniedthe up-regulation of other resistance related genes. Related Articles | Metrics

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Evaluation of exosome-derived miRNA-323a-3p human plasma as a potential biomarker for tuberculosis LIN Li, LI Hai-bo, XIA Fan, ZHOU Ji-xue, GUO Xiao-kui, ZHANG Shu-lin 2020, 40 (2):  171.  doi: 10.3969/j.issn.1674-8115.2020.02.005 Abstract ( 810 )   PDF (12098KB) ( 518 )   Objective · To study the microRNA (miRNA) derived plasma exosomes, and to find the potential biomarker for the diagnosis of tuberculosis. Methods · Macrophages [Bacille Calmette-Guérin (BCG) group] human monocytic leukemia cells (THP-1) were infected with BCG, and uninfected macrophages were set as control group. Exosomes the cell culture supernatant of the two groups were obtainedultracentrifugation. The morphology and protein markers of exosomes were identifiedtransmission electron microscopy (TEM) and Western blotting. Total RNA of exosomes was analyzedtranscriptome sequencing. Three miRNAs with different were selected the sequencing results, and the plasma exosomes of 10 patients with tuberculosis (tuberculosis group) and 8 healthy volunteers (healthy control group) were clinically verified. The target genes of miRNAs with potential differential were predictedTargetScan, miRDB and PicTar databases. Results · The sequencing results of exosomes the cell culture supernatant showed that compared with the control group, the of miRNA-323a-3p, miRNA-29a-3p and miRNA-29b-3p in BCG group were significantly different. In clinical verification, only miRNA-323a-3p between the tuberculosis group and the healthy control group was statistically significant (P0.004). miRNA-323a-3p was significantly down-regulated in the plasma-derived exosomes of tuberculosis patients, which was consistent with the results of sequencing results. Conclusion · The of miRNA-323a-3p plasma exosomes in patients with tuberculosis is significantly down-regulated, and its target gene is closely related to autophagy, which is expected to provide new ideas for the mechanism of tuberculosis. Related Articles | Metrics

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Inhibition of resveratrol on colonic movement in mice and its mechanism YANG Meng, LU Hong-li, HUANG Xu, XU Wen-xie 2020, 40 (2):  180.  doi: 10.3969/j.issn.1674-8115.2020.02.006 Abstract ( 733 )   PDF (8668KB) ( 309 )   Objective · To investigate the effect of resveratrol (Res) on colonic movement in mice and its mechanism. Methods · The effects of Res (10, 20, 40, and 80 μmol/L) on spontaneous contraction of colonic smooth muscle in mice and colonic migrating motor complex (CMMC) were recordedusing a multi-channel physiological recorder. Colonic smooth muscle strips were pretreated with the following tool medicines: BayK8644 (an activator of L-type Ca2+ channel), TEA (tetraethylammonium, a non-selective K+ channel blocker), TTX (tetrodotoxin, a Na+ channel blocker), atropine (a cholinergic neuron inhibitor), L-NAME [Nω-nitro-L-arginine methyl ester, a nitric oxide (NO) synthase inhibitor], NPPB[5-nitro-2-(3-phenylpropylamino) benzoic acid, an ANO1 (anoctamin 1) channel inhibitor] and apamin [a small conductance Ca2+-activated K+ channel 3 (SK3) channel inhibitor].elution, the effects of Res on spontaneous contraction of colonic smooth muscle strips before and after pretreatment were recorded and compared. Finally, the effect of Res on L-type Ca2+ channel currents were recordedusing the whole-cell patch clamp technique in freshly dispersed colonic smooth muscle cells. Results · Res significantly inhibited colonic smooth muscle spontaneous contraction in a dose-dependent manner and markedly decreased CMMC in the proximal and the distal colon. BayK8644 significantly blocked the Res-induced inhibition. Besides, Res dramatically inhibited L-type Ca2+ channel currents in colonic smooth muscle cells. However, TEA did not block the inhibitory effect of Res. In addition, TTX, atropine, L-NAME, NPPB and apamin had no effect on the inhibitory effect of Res on spontaneous contraction of colonic smooth muscle. Conclusion · Res inhibits colonic movement via inhibiting L-type Ca2+ channel in mice, and its mechanism may be irrelevant to potassium channel, the enteric nervous system, NO and interstitial cell. Related Articles | Metrics

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Effect of miR-27a down-regulation on proliferation, migration and invasion in triple-negative breast cancer cells CHENG Long, XU Wu-qin, ZHANG Peng, HUANG Jian-jun, LI Xiao-ning 2020, 40 (2):  188.  doi: 10.3969/j.issn.1674-8115.2020.02.007 Abstract ( 738 )   PDF (7350KB) ( 393 )   Objective · To investigate the effect of miR-27a down-regulation on proliferation, migration and invasion in triple-negative breast cancer (TNBC) cell line MDA-MB-453. Methods · Sixty-eight pairs of breast cancer tissues and para-carcinoma tissues the TNBC cancer patients were harvested for the study. The differential of miR-27a in the collected tissues, MDA-MB-453 cell line and normal breast epithetial cell line MCF-10A were detectedquantitative real-time PCR (qPCR). The relationship between miR-27a and the clinical characteristics of TNBC patients was analyzed. miR-27a inhibitor was transfected into MDA-MB-453 cell line. CCK-8 assay and Transwell chamber test were used to detect the difference in proliferation, migration and invasion of MDA-MB-453 cells between miR-27a inhibitor group and negative control group (NC group). The levels of F-box and WD repeat domain-containing 7 (FBW7) and Egl nine homolog 2 (EGLN2) protein were examinedWestern blotting. Results · The of miR-27a in TNBC tissues was significantly higher than that in para-carcinoma tissues (PPPPPPPConclusion · The of miR-27a in TNBC tissues and TNBC cell line increases. Down-regulation of miR-27a can inhibit the proliferation, migration and invasion of MDA-MB-453 cells, which may be through increasing FBW7 and decreasing EGLN2 . Related Articles | Metrics

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Bioinformatics analysis of esophageal squamous cell carcinoma genomic chip and prediction of targeted drug LI Qian, GAO Jing-ze, LI Yun, SONG Kun, SHEN Qian-cheng 2020, 40 (2):  194.  doi: 10.3969/j.issn.1674-8115.2020.02.008 Abstract ( 1024 )   PDF (6948KB) ( 501 )   Objective · To explore the mechanism of esophageal squamous cell carcinoma (ESCC) and its potential targeted drugs, and to provide the theoretical basis for diagnosis and treatment of ESCC. Methods · Two GEO sets GSE38129 and GSE20347 were selected, and differentially expressed genes (DEGs) were screenedR language. GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis were conducted for DEGs. The most significant module genes and key genes were analyzedprotein-protein interaction (PPI) network for DEGs. Targeted drug prediction was made for phosphorylase B kinase (PBK). Results · A total of 670 DEGs were identified, consisting of 342 down-regulated genes and 328 up-regulated genes. The enriched functions and pathways of DEGs included extracellular structure organization, extracellular matrix organization, p53 signaling pathway, IL-17 signaling pathway and cell cycle. Twenty key genes were identifiedanalyzing DEGs’ PPI network. The key gene PBK was related to the cell cycle, and the of PBK was up-regulated in the two data sets. The potential drug Compound 1 of PBK was predictedallosteric site detection and compound library virtual screening. Conclusion · The key genes of ESCC can be effectively analyzedbioinformatics. The prediction results of targeted drugs of key gene PBK may provide reference for the targeted therapy of ESCC. Related Articles | Metrics

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Meta-analysis of topiramate to improve body weight increase causedatypical antipsychotic drugs WANG Dan-dan, WANG Ye-wei, FANG Xin-yu, CHEN Yan, YU Ling-fang, ZHANG Chen 2020, 40 (2):  200.  doi: 10.3969/j.issn.1674-8115.2020.02.009 Abstract ( 816 )   PDF (8139KB) ( 334 )   Objective · To systematically evaluate the effect of topiramate on reducing body weight increase causedatypical antipsychotic drugs. Methods · A literature search was performedusing PubMed database, Embase database, PsycINFO database, Cochrane Library, CNKI, WanFang data and SinoMed. Randomized placebo-controlled trials of topiramate targeting weight-gain causedatypical antipsychotic drugs inception to Mar. 2019. Two researchers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. The meta-analysis was performed using RevMan 5.3 software. Results · A total of 20 randomized controlled trials were included, consisting of 1 024 subjects. The results of meta-analysis showed that topiramate was significant effective in reducing atypical antipsychotic-related weight gain [weighted mean difference (WMD)-4.09, 95% CI -5.74 - -2.44, P0.000]. The body mass index (BMI) was also improved significantly (WMD-2.42, 95% CI -3.02 - -1.82, P0.000). Conclusion · Topiramate can effectively improve the body weight and BMI increase causedatypical antipsychotic drugs. Related Articles | Metrics

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Psychological mechanism of event-based prospective memory deficit in patients with first-episode schizophrenia LI Xuan, XIANG Qiong, ZHAN Yan, ZHU Dian-ming, ZHUO Kai-ming, WANG Ya, CHEN Hai-ying, LIU Deng-tang 2020, 40 (2):  208.  doi: 10.3969/j.issn.1674-8115.2020.02.010 Abstract ( 769 )   PDF (8581KB) ( 420 )   Objective · To analyze the difference of the event-based prospective memory (PM) between first-episode schizophrenia (FES) patients and normal patients, and to explore its possible psychological mechanism. Methods · Thirty-four FES patients without medication (FES group) and 31 healthy volunteers (healthy control group) were enrolled. Cue identification and intention retrieval components of event-based PM were examinedusing dual-task paradigm. Besides, verbal working memory was assessedLetter-Number Span, retrospective memory was assessedcomprehension memory test, and multitasking capability was assessedmodified six-element test (MEST). The mental symptoms and their severity were evaluatedPositive and Negative Symptom Scale (PANSS), Clinician-Rated Dimensions of Psychosis Symptom severity (CRDPS) and Clinical Global Impression (CGI). Results · The cue identification PM and intention retrieval PM in the FES group were significantly lower than those in the healthy control group (all PP0.000), while there was no significant difference in the multitasking capability between the two groups. After the working memory, retrospective memory and executive function being controlled, the difference in cue identification and intention retrieval of the two groups were still significant (both P0.000). Besides, there was no significant correlation between clue recognition ability and intention extraction ability of schizophrenia and clinical symptoms. Conclusion · Both cue identification deficit and intention retrieval deficit in event-based PM may be primary cognitive defects in patients with schizophrenia. Related Articles | Metrics

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Perceived stress as a mediator between personality traits and panic disorder symptoms YANG Chen, LIU Xi-tong, XU Ting-ting, WANG Pei, LIU Qiang, WANG Yong, ZHU Yi, CHEN Jue, WANG Lan-lan, QIU Jian-yin, WANG Zhen, SHAO Yang 2020, 40 (2):  214.  doi: 10.3969/j.issn.1674-8115.2020.02.011 Abstract ( 774 )   PDF (7344KB) ( 395 )   Objective · To explore the relationship among perceived stress, personality traits and panic disorder (PD) symptoms, and to test the mediating effect of perceived stress on PD symptoms in different personality traits. Methods · A total of 55 PD patients were selected according to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). The NEO Five-Factor Inventory (NEO-FFI) was used to measure the personality traits. The Panic Disorder Severity Scale (PDSS) was used to measure the PD symptoms severity. The Perceived Stress Scale (PSS) was used to measure the level of the perceived stress. Results · Both the neuroticism, agreeableness subscale scores of NEO-FFI and scores of PSS were significantly correlated with the total scores of PDSS, and the correlation coefficient were r0.379 (P0.004), r-0.420 (P0.001) and r0.330 (P0.014), respectively. The mediating effect analysis showed that perceived stress completely mediated the effect of agreeableness on PD symptoms, and the mediating effect was 32.43%. Conclusion · In personality traits, neuroticism may be positively correlated with PD symptoms, while agreeableness may be negatively correlated with PD symptoms. The perceived stress may play a completely mediating role between agreeableness and PD symptoms. Related Articles | Metrics

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Clinical research of improved epidural catheter used in labor analgesia XU Tao, ZHENG Jing, AN Xiao-hu 2020, 40 (2):  219.  doi: 10.3969/j.issn.1674-8115.2020.02.012 Abstract ( 833 )   PDF (7265KB) ( 388 )   Objective · To explore the clinical feasibility of a new kind of improved epidural catheter used in labor analgesia. Methods · A total of 144 patients who were spontaneous labor and required epidural labor analgesia Jan. to Aug. 2018 in the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine were selected, and randomly divided into three groups. The improved epidural catheters were used in epidural catheterization in group A, the Arrow FlexTip Plus epidural catheters were used in group B, and the conventional epidural catheters were used in group C (control group). The incidences of epidural venous injuries and intravascular insertion, paresthesia, subarachnoid insertion, unilateral block, difficult insertion, repeated re-insertion, loss of resistance feeling, difficult extubation and catheter damage in the three groups were recorded. Fisher exact test was used to compare the difference among the above indexes in the three groups, and then Dunnett t test was further used to compare the differential indicators between each two groups. Re-insertion with improved epidural catheter in group B and group C and its success rate were also recorded. Results · Compared with group C, the incidences of epidural venous injuries and intravascular insertion (P0.002), difficult insertion (P0.000) and repeated re-insertion (P0.006) in group A were decreased significantly. Compared with group B and group C, the incidence of loss of resistance feeling was also decreased significantly (P0.021，P0.000). Conclusion · Compared with the conventional epidural catheter, the improved epidural catheter can effectively reduce the incidence of epidural venous injuries and intravascular insertion, difficult insertion and loss of resistance feeling, and improve the success rate after repeated re-insertion, which has the potential value in clinical use. Related Articles | Metrics

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Clinical value of IVIM MRI and DCE MRI in assessment of lymphovascular space invasion status in early cervical cancer MI Hong-lan, CHENG Jie-jun, YIN Xia, ZHU Li, LIN Cong, LU Qing 2020, 40 (2):  224.  doi: 10.3969/j.issn.1674-8115.2020.02.013 Abstract ( 861 )   PDF (9273KB) ( 281 )   Objective · To investigate the clinical value of intravoxel incoherent motion (IVIM) MRI and dynamic contrast enhancement (DCE) MRI in assessment of lymphovascular space invasion (LVSI) in early cervical cancer patients preoperatively. Methods · Fifty-six patients with early cervical cancer were collected, all of whom underwent preoperative IVIM and DCE MRI. The tumor maximum diameter, the depth ratio of cervical infiltration and the IVIM (f, D and D*) and DCE (Ktrans, Kep and Ve) MRI quantitative parameters were measured, respectively. According to postoperative pathological results, patients were divided into LVSI positive group and LVSI negative group. Patients age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathological type and differentiation degree were also recorded. The difference of basic characteristics and MRI parameters of the two groups was compared. Logistic regression was used to analyze the risk factors of LVSI in early cervical cancer, and the receiver operator characteristic curve (ROC curve) was applied to assess the diagnostic efficacy of these risk factors of LVSI. Results · There were no significant differences in patients age, FIGO stage, pathological type, differentiation degree and tumor maximum diameter between LVSI positive group and LVSI negative group. The depth ratio of cervical infiltration in LVSI positive group was significantly higher than that in LVSI negative group (P0.000), while D* value and Ktrans value in LVSI positive group were significantly lower than those in LVSI negative group (P0.003, P0.004). D value, f value, Kep value and Ve value showed no significant difference between the two groups. Logistic regression analysis showed that the depth ratio of cervical infiltration and Ktrans value were independently correlated with LVSI. The area under the curve AUC and the accuracy of independent diagnosis of LVSI state were 0.760 and 75.1%, 0.723 and 71.4%, respectively. The AUC of combined diagnosis was 0.839 and the accuracy was 76.8%. After the inclusion of D* value, the AUC of the three diagnosis was 0.874, with the accuracy of 87.5%. Conclusion · The depth ratio of cervical infiltration and Ktrans value are helpful for preoperative evaluation of LVSI status in early cervical cancer, and they can improve the diagnostic efficacy when combined with D* value. Related Articles | Metrics

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Study on relationship between serum 25-hydroxyvitamin D level and leukoaraiosis CUI Yu, RAN Juan-juan, WANG Yi, GU Ping 2020, 40 (2):  231.  doi: 10.3969/j.issn.1674-8115.2020.02.014 Abstract ( 770 )   PDF (4915KB) ( 829 )   Objective · To investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D] level and leukoaraiosis (LA). Methods · A total of 170 patients with LA who underwent treatment in the Department of Neurology in Wuxi Fifth Peoples Hospital Oct. 2017 to Oct. 2018 were enrolled. Their general clinical data were collected and the serum 25(OH)D levels were measured. Head cerebral magnetic resonance imaging was performed to assess the severity of LA. The patients were divided into four groups according to Fazekas scale and the serum 25(OH)D levels of patients in different groups were compared. Correlation analysis and multivariate Logistic regression analysis were used to study the relationship between serum 25(OH)D level and the severity of LA. Results · With the increase of the severity of LA, the serum 25(OH)D levels showed a downward trend, and the difference was statistically significant (P0.000). Correlation analysis showed that serum 25(OH)D levels were negatively correlated with the severity of LA (r-0.534, P0.000). Multivariate Logistic regression analysis showed that the risk factors for LA were increased age (OR1.108, 95% CI 1.054–1.165, P0.000), hypertension (OR2.894, 95% CI 1.060–7.904, P0.038) and decreased 25(OH)D level (OR0.949, 95% CI 0.925–0.974, P0.000). Conclusion · Serum 25(OH)D level is associated with the severity of LA, and is a risk factor for LA. Related Articles | Metrics

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Virulence genes of Klebsiella pneumoniae isolated blood cultures and clinical characteristics of the patients GUAN Hong-yan, LIU Jing-xian, LIU Ying 2020, 40 (2):  235.  doi: 10.3969/j.issn.1674-8115.2020.02.015 Abstract ( 1000 )   PDF (8964KB) ( 344 )   Objective · To detect the virulence genes of Klebsiella pneumoniae isolated blood cultures, and analyze the clinical characteristics of the patients infected with hypervirulent Klebsiella pneumoniae (hvKP) or classic Klebsiella pneumoniae (cKP). Methods · A total of 80 Klebsiella pneumoniae strains isolated blood cultures in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine Oct. 2016 to Mar. 2018 were collected. String test was performed to determine hypermucoviscous Klebsiella pneumoniae (HMKP). The capsular serotypes were confirmedwzi sequencing. The 22 virulence genes, such as rmpA, magA, and aerobactin, were identifiedPCR. Multilocus sequence typing (MLST) was used to determine sequence type of these isolates. The clinical records were collected to analyze the characteristics of Klebsiella pneumoniae-infected patients. Results · The results of string test showed that 9 out of 80 Klebsiella pneumoniae strains were HMKP. The results of virulence gene detection showed that 10 strains were hvKP. Significant difference was found between hvKP and cKP in the detection rates of magA, allS, iucA, iroN, kfu, wcaG, rmpA2, iutA, pLVPK, silS and terW genes (PConclusion · cKP is the dominant type of the Klebsiella pneumoniae strains isolated blood cultures in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. Most cKPs are K14.K64/ST11 and the infections are mainly hospital-acquired. The proportion of hvKP infected patients with liver abscess is high. Related Articles | Metrics

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Diagnosis and surgical treatment of adult Merkel diverticulum with complications ZENG Ling-peng, ZHANG Qing, GUAN Yan-xing, LIU Shao-zheng, CHEN Qing-jie, ZHANG Qing 2020, 40 (2):  242.  doi: 10.3969/j.issn.1674-8115.2020.02.016 Abstract ( 1265 )   PDF (6980KB) ( 402 )   Objective · To analyze the clinical features, diagnosis and treatment of adult Merkel diverticulum (MD) with complications. Methods · The basic clinical data, 99mTcO4- ectopic gastric mucosal radionuclide imaging, abdominal CT and treatment methods of 39 patients with MD complications in the First Affiliated Hospital of Nanchang University 2009 to 2019 were analyzed retrospectively. The differences of age, gender and clinical characteristics among the patients with different complications were analyzed. Results · The incidence rate of male MD and female MD was 3.88:1; the symptoms were painless bloody stool, abdominal pain, nausea and vomiting, etc. The main complications were hemorrhage, diverticulitis and intestinal obstruction, accounting for 53.8%, 25.6% and 20.5%, respectively. The gender and age among the patients with complications of hemorrhage, diverticulitis and intestinal obstruction were not statistically different, while the distance between diverticulum and ileocecal was statistically significant among the three groups (P0.010). The distance between diverticulum and ileocecal in the hemorrhage group was farther than that in the intestinal obstruction group (P0.040). Nineteen patients underwent radionuclide imaging examination, the positive detection rate was 63.2% (12/19), and 12 cases were bleeding patients. Thirty-nine cases were examinedabdominal CT, and the overall detection rate was 15.4% (6/39). All the 10 patients were diverticulitis, in with the detection rate of CT examination was 60.0% (6/10). All patients underwent surgical resection. Conclusion · The incidence of MD complications in adults is low, mainly in males. The most common complication is hemorrhage, and the distance between diverticulum and ileocecal of hemorrhage patients is farther than that of intestinal obstructive patients. 99mTcO4- radionuclide imaging is important for the diagnosis of MD complicated with blood in the stool, and the abdominal CT has a high diagnostic value for diverticulitis. If necessary, combined examination can improve the detection rate. MD complications in adults can be treatedsurgery. Related Articles | Metrics

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Study on social participation and influencing factors in young and middle-aged patients after coronary artery bypass grafting WU Sheng-jia, LI Xian-hua, KANG Lei, XIN Xiao, NI Xue-ping, SONG Ting 2020, 40 (2):  247.  doi: 10.3969/j.issn.1674-8115.2020.02.017 Abstract ( 773 )   PDF (10163KB) ( 268 )   Objective · To investigate the social participation level of young and middle-aged patients with coronary artery bypass grafting (CABG) 3 months after discharge and analyze the influencing factors. Methods · Oct. 2018 to Jul. 2019, 259 patients aged 18-65 after CABG were selected in Ruijin Hospital, Shanghai Jiao Tong University School of Medicineconvenient sampling. Impact on Participation and Autonomy Questionnaire (IPA) was used to investigate the social participation level of the patients 3 months after discharge. General Situation Questionnaire, All Aspects of Health Literacy Scale, Social Support Rate Scale, Coronary Artery Disease Self-management Scale and Medical CopingModes Questionnaire were used to measure the patients social demographic information, disease-related information, health literacy level, social support, self-management level and disease coping style. Results · The score of social participation of young and middle-aged patients with CABG 3 months after discharge was 46.58±8.83. The results of stepwise regression showed that pain (β6.191), life self-care ability (β-0.270), medical resource accessibility (β-3.228), support utilization (β-1.992), social support (β-0.439), and critical health literacy (β-1.325) were the influencing factors of social participation. Conclusion · Within 3 months after the discharge of young and middle-aged CABG patients, the social participation level of the patients should be promotedimproving the pain situation of the patients, improving the support role of the caregivers, making of the medical resources in the community, and providing a reliable way to obtain health information. Related Articles | Metrics

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Effect of cytoskeleton-associated protein 4 on tumor diagnosis and prognosis LIU Jin-yan, ZHAO Jun-tao, WANG Heng-ru, HUANG Jia-yi, WANG Yu-ting, XIANG Ming-jie 2020, 40 (2):  255.  doi: 10.3969/j.issn.1674-8115.2020.02.018 Abstract ( 1121 )   PDF (6591KB) ( 755 )   Cytoskeleton-associated protein 4 (CKAP4), also known as p63, is a non-glycosylated type Ⅱ membrane protein. Expression of CKAP4 in tissues, cells and serum can be used as a diagnostic marker for a variety of tumors, and has a certain correlation with the prognosis of these tumors. This article reviews the subtype and function of CKAP4, as well as its research and application as a diagnostic and prognostic indicator of tumor. Related Articles | Metrics

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Application of artificial intelligence in assisted diagnosis and treatment of cardiovascular disease LU Yan-qiao, SHEN Lan, HE Ben 2020, 40 (2):  259.  doi: 10.3969/j.issn.1674-8115.2020.02.019 Abstract ( 1059 )   PDF (6215KB) ( 1061 )   With the continuous development of science and technology, artificial intelligence (AI) with self-directed learning, induction and deduction, low error rate and other advantages has become the most popular emerging technology. In the traditional medical field, especially in cardiovascular diseases with high incidence, AI can not only provide auxiliary diagnosis and treatment for patients, but also enable doctors to optimize traditional risk assessment models which can predict the evolution of the disease better. Thereby, AI can provide more convenience and new perspectives for clinical work. This paper reviews the research progress of AI in the cardiovascular field in recent years. Related Articles | Metrics

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Clinical symptoms and mechanism of psychological and behavioral impairment pre-dementia LIU Xiang, FANG Yuan, LI Xia 2020, 40 (2):  263.  doi: 10.3969/j.issn.1674-8115.2020.02.020 Abstract ( 982 )   PDF (6381KB) ( 482 )   Mild behavioral impairment (MBI) is a kind of pre-dementia syndrome, which presents abnormalities in perception, thinking, emotion, behavior, personality and other aspects. At the same time, the occurrence of MBI increases the risk of dementia. Behavioral and psychological symptoms of dementia (BPSD) refers to the mental and behavioral problems of patients during the course of dementia. Meanwhile, suffering this disease will increase the care burden of caregivers and the death rate of patients. MBI and BPSD constitute the neuropsychiatric symptoms (NPS) associated with dementia. As a new term and new concept, MBI can offer a new perspective to the clinical treatment and research of mild cognitive impairment (MCI) and dementia, which has aroused wide attention. This paper reviews the literature related to MBI and NPS, comprehensively analyzes the clinical manifestations of MBI and its relationship with the neurobiology of cognitive impairment, and proposes that MBI should be translated as pre-dementia psychosocial behavior impairment. Related Articles | Metrics

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Evolution of clinical treatment in inflammatory bowel diseasesfecal microbiota transplantation ZHOU Cheng, SUN Peng-fei, YIN Ji-yao, WANG Yang-yang, XIAO Hai-juan 2020, 40 (2):  267.  doi: 10.3969/j.issn.1674-8115.2020.02.021 Abstract ( 1038 )   PDF (6743KB) ( 528 )   The etiology of inflammatory bowel disease (IBD) is complex, and the mechanism has not yet been fully clarified. It is currently believed that the progression of the disease is related to the alterations of intestinal flora. Conventional medical anti-inflammatory treatment has large side effects. In recent years, with the continuous study of intestinal flora, a new kind of therapy has been applied to the disease. Many randomized controlled trials (RCT) of fecal microbiota transplantation (FMT) have achieved good therapeutic effects on IBD, and this regimen has received extensive attention. This paper reviews the progression of FMT and its mechanisms of intestinal function regulation in the past five years. Meanwhile, the challenges and future directions in the research of FMT are also summarized. Related Articles | Metrics

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Development of objective assessment of nociception during general anesthesia CHEN Li-ming, YU Bu-wei 2020, 40 (2):  271.  doi: 10.3969/j.issn.1674-8115.2020.02.022 Abstract ( 943 )   PDF (8696KB) ( 427 )   Pain diagnosis and management benefit the development of objective assessment of nociception during general anesthesia. In the past decades, research addressing this issue has focused on monitoring changes in the autonomic nervous system and monitoring electroencephalograph. The indicators for monitoring changes in the autonomic nervous system include analgesia nociception index, skin conductance, surgical pleth index and pupil diameter. This article introduces the most important developments and usages of current monitoring methods for noxious stimulation, which have their own advantages and disadvantages. There are currently no validated objective assessment of nociception that can be recommended for clinical use. Related Articles | Metrics

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Application of small diameter basilic vein transposition arteriovenous fistula to hemodialysis YE Zu-yang, LENG Bin, OU Jun, BI Hui-xin, PAN Xia, ZOU Di-sha 2020, 40 (2):  276.  doi: 10.3969/j.issn.1674-8115.2020.02.023 Abstract ( 789 )   PDF (4515KB) ( 441 )   Objective · To investigate the patency rate of small diameter basilic vein transposition arteriovenous fistula and its clinical application to hemodialysis. Methods · Eighteen patients with basilic vein transposition arteriovenous fistula Mar. 2015 to Mar. 2018 were analyzed retrospectively in the Department of Nephrology, Affiliated Hospital of Guilin Medical University. The diameters of the patients’ basilic veins were allResults · The success rate of operations was 100% in the 18 patients. The fistulas all could be used 6-10 weeks after operations. The hemodialysis blood flow reached 200-280 mL/min, and the puncture length reached 15-20 cm. The patency rates of 3 months, 6 months and 1 year after operations were 100%, 83.3% and 61.1%, respectively. No complications occurred after operations. Conclusion · The basilic vein of forearm with diameter<2 mm can be performed with transposition arteriovenous fistula, and the long-term patency rate is relative high with few complications. It can be used as an alternative surgical scheme when the cephalic vein is exhausted. Related Articles | Metrics