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28 March 2020, Volume 40 Issue 3 Previous Issue    Next Issue
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Novel coronavirus article
Innovative research team achievement
Original article (Basic research)
Original article (Clinical research)
Original article (Public health)
Review
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Novel coronavirus article

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Mitigate the effects of home confinement on children during the COVID-19 outbreak WANG Guang-hai, ZHANG Yun-ting, ZHAO Jin, ZHANG Jun, JIANG Fan 2020, 40 (3):  279.  doi: 10.3969/j.issn.1674-8115.2020.03.001 Abstract ( 1051 )   PDF (3992KB) ( 487 )   More than 220 million Chinese children and adolescents are confined to their homes becaof the corona virus disease 2019 (COVID-19) outbreak. Thanks to the strong administrative system in China, the emergency home schooling plan has been rigorously implemented. Although these measures and efforts are highly commendable and necessary, there are reasons to be concerned becaprolonged school closure and home confinement during a disease outbreak might have negative effects on childrens physical and mental health. It is the responsibility and keen interests of all stakeholders, governments to parents, to ensure that the physical and mental impacts of the COVID-19 epidemic on children and adolescents are kept minimal. Related Articles | Metrics

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Aerosol transmission prevention of novel coronavirus in dental clinics RAN Shu-jun, LIANG Jing-ping 2020, 40 (3):  282.  doi: 10.3969/j.issn.1674-8115.2020.03.002 Abstract ( 1303 )   PDF (7143KB) ( 440 )   Corona virus disease 2019 (COVID-19), which broke out in Wuhan, HuBei in December, 2019, spread around the country in a short term. Some infected patients suffered severe acute respiratory syndrome. It has become a major public health event of international concern. COVID-19 patients are the main source of transmission and most people get infection easily, so the current main prevention method is interrupting the pathway of transmission. The dental treatments are very special becathese operations produce substantial aerosols and lead a high risk of cross-infection, which brings challenge for epidemic prevention and control. In this paper, the characteristics of aerosols and prevention methods of aerosol transmission in dental clinics are mainly discussed. Related Articles | Metrics

Innovative research team achievement

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Pathogenesis of CD8+ T cells in dextran sulfate sodium-induced murine acute colitis ZENG Qun-xiong, DENG Jun, SHEN Nan 2020, 40 (3):  286.  doi: 10.3969/j.issn.1674-8115.2020.03.003 Abstract ( 912 )   PDF (8782KB) ( 431 )   Objective · To investigate the role of CD8+ T cells in the pathogenesis of acute murine colitis induceddextran sulfate sodium (DSS). Methods · Wild type and CD8 knock-out (CD8-/-) mice with C57BL/6 background were given DSS with concentration of 2% (m/V). The body weight, colon length, pathological changes and disease activity of colitis were observed dynamically. The total RNA was extracted the distal colon of mice after induction for 10 d. The mRNA of inflammatory cytokines Il1b, Il6, Il17a, Ifng, Tnf, Il10 and Tgfb1 were detectedreal-time quantitative PCR. Colon tissue sections were stained with hematoxylin-eosin (H-E) and the changes of intestinal histopathology were evaluated, and the infiltration of CD8+ T cells in colon tissue was observedimmunofluorescence staining. The survival rate of mice was observed with 3% and 4% (m/V) DSS solution-induced colitis models. Results · After CD8-/- mice being induced2% DSS, the body weight decreased slowly and showed an increasing trend on the 9th day, while the pathological changes of colon tissues of CD8-/- mice were slight. The levels of Il1b, Il6, Il17a, Ifng and Tnf mRNA were lower than those of wild-type mice (P+ T cells in colonic lamina propria of wild-type mice with 2% DSS induction was higher than that of wild-type mice without DSS treatment (P0.001). The survival rates of wild-type mice induced3% and 4% DSS were 37.5% and 0, and the survival rates of CD8-/- mice were 66.7% and 100%, while the survival rates of CD8-/- mice receiving 3% and 4% DSS were higher than those of wild-type mice (P0.025, P0.001). Conclusion · CD8+ T cells can promote the development of murine acute DSS-induced colitis. Related Articles | Metrics

Original article (Basic research)

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Identification of hub genes and key pathways in breast cancersurvival-based bioinformatics analysis CHEN Si, LIU Chun-liang, ZHAO Qian, SUN Hai-peng, LIU Yun-xia 2020, 40 (3):  294.  doi: 10.3969/j.issn.1674-8115.2020.03.004 Abstract ( 1482 )   PDF (10479KB) ( 746 )   Objective · To identify hub genes and key pathways in breast cancerbioinformatics analysis that integrated gene data with clinical survival analysis. Methods · Three gene profilings downloaded Gene Expression Omnibus (GEO) were used to identify differentially expressed genes (DEGs) in breast cancer. Kaplan-Meier plotter was used to identify the DEGs that were significantly associated with overall survival in breast cancer. Gene Ontology (GO) function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed. Next, hub genes were identified the protein-protein interaction (PPI) network. Oncomine and the Human Protein Atlas (HPA) database were used to validate the of the hub genes. The s of hub genes in MDA-MB-231 cells and MCF-10A cells were detectedquantitative real-time PCR (qPCR). Results · Among the DEGs, 262 genes were significantly correlated with overall survival of breast cancer patients. The results of GO functional analysis and KEGG pathway analysis showed that these genes were associated with nuclear division, cell division and chromosome segregation, and were mainly enriched on the pathways such as cell cycle, FoxO signaling pathway and oocyte meiosis. PPI network construction identified ten hub genes. They were all highly expressed in breast cancer, which were validatedthe databases. The results of qPCR showed that 8 out of 10 hub genes were highly expressed in breast cancer cells. Conclusion · The hub genes and key pathways involved in the development of breast cancer are identifiedsurvival-based bioinformatics analysis, which are mainly associated with cell cycle regulation and cell division. Related Articles | Metrics

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Effects of Saikosaponin d on differentially expressed genes CTLA-4, IL-10 and IL-17 in mice with autoimmune hepatitis HAO Jian-heng, CHEN Hao, GAO Yan, XU Hui-chao, GAO Yu-ting, MIAO Yu-chuan, HAO Hui-qin, LIU Yang 2020, 40 (3):  303.  doi: 10.3969/j.issn.1674-8115.2020.03.005 Abstract ( 737 )   PDF (9379KB) ( 391 )   Objective · To explore the effects of Saikosaponin d (SS-d) on autoimmune hepatitis (AIH)observing the changes of some differentially expressed genes screened with the Agilent-085631 gene chip in the liver of AIH mice. Methods · Forty healthy male SPF C57BL/6 mice were divided into chip group (n8) and SS-d treatment group (n32). The mice in the chip group were divided into the normal group and the model group [concanavalin A (Con A) was administered to the tail vein at a dose of 15 mg/kg] (both n4). The mice were sacrificed after 12 h. The differentially expressed genes of liver were screened, some of which were verifiedqRT-PCR. The SS-d treatment group was further divided into the normal group, the model group (treatment was the same with the chip group), SS-d low-dose group and SS-d high-dose group [according to the literature and pre-experiment results, 2.5 and 5.0 mg/kg dose of intraperitoneal injection of SS-d were given respectively, and 15 mg/kg of Con A was administered to the tail vein 8 h later] (all n8). After 12 h, total venous blood, liver total protein and total RNA of mice were collected. The levels of serum glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), interleukin (IL)-10 and IL-17 were detectedELISA, and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) was detectedWestern blotting. qRT-PCR technology was used to detect the mRNA levels of IL-10, IL-17 and CTLA-4. Results · A total of 11 512 differentially expressed genes were screened (up 5 189, down 6 323), which were related to 138 signal pathways. The qRT-PCR results of IL-10, IL-17 and CTLA-4 gene were consistent with the results of chip screening. Compared with the normal group, the serum levels of GPT and GOT in the model group increased, IL-17 mRNA level increased, IL-10 mRNA and CTLA-4 mRNA levels decreased, the content of serum IL-17 increased, the content of serum IL-10 decreased, and the level of CTLA-4 protein in the liver tissues decreased. Compared with the model group, the serum GPT and GOT levels of SS-d in the low-dose and high-dose groups decreased, IL-17 mRNA level decreased, the levels of IL-10 mRNA and CTLA-4 mRNA increased, the content of serum IL-17 decreased, the content of serum IL-10 increased, and the level of CTLA-4 protein in the liver tissue increased. Conclusion · Multiple signaling pathways are involved in the pathogenesis of AIH, and SS-d can alleviate the liver inflammation in AIH miceregulating the of IL-10, CTLA-4, and IL-17. Related Articles | Metrics

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Association analysis of single nucleotide polymorphisms in the promoter region of GAD1 and GABRB3 with schizophrenia in Chinese Han population LI Na, AN Yu, ZHANG Yong-lu, DING Zhi-jie, WU Bai-lin, LAN Xiao-ping 2020, 40 (3):  310.  doi: 10.3969/j.issn.1674-8115.2020.03.006 Abstract ( 1007 )   PDF (7747KB) ( 349 )   Objective · To investigate the correlation between the polymorphisms of locus in the promoter region of glutamate decarboxylase 1 (GAD1) gene and γ-aminobutyric acid (GABA)A receptor β-3 gene (GABRB3) and schizophrenia (SZ) in Chinese Han population. Methods · SNaPshot genotyping technique was used to detect the polymorphisms of rs3791878 and rs3749034 in the promoter region of GAD1 and rs4906902 in the promoter region of GABRB3 in 545 SZ patients (case group) and 624 healthy controls (control group). The distribution of alleles and genotypes under different genetic models between the case group and the control group in all samples were comparedSNPstats online software. The above analysis was also performed after the subjects were stratified according to gender. The correlation of G/T risk genotype of rs3791878 with the age of the first onset of male SZ was investigatedsurvival analysis. Results · Under over-dominant genetic model, the distribution of G/T risk genotype of rs3791878 showed statistically difference between the male SZ cases and male controls (P0.000), and the difference was still statistically significant after Bonferroni correction (P0.000). However, there was no significant difference in the distribution of alleles and genotypes under different genetic models of rs3749034 and rs4906902 between the case group and the control group in all samples (P>0.05), and there was also no significant difference in the distribution of alleles between the case group and the control group after them being stratified according to gender (P>0.05). Kaplan-Meier analysis showed that there was no significant difference between the age of onset of male SZ who carried G/T genotype in rs3791878 locus and that of male SZ who did not carry it (P0.603). Conclusion · The polymorphism of rs3791878 in the promoter region of GAD1 is significantly associated with the incidence of male SZ in Chinese Han population. Related Articles | Metrics

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Bioinformatics analysis of ulcerative colitis and its malignant complications and screening of potential therapeutic drugs XIA Shou-bing, XU Chun-jie, JIANG Chun-hui, GU Lei, SUN Long-ci, XU Qing 2020, 40 (3):  317.  doi: 10.3969/j.issn.1674-8115.2020.03.007 Abstract ( 1252 )   PDF (9925KB) ( 603 )   Objective · To explore the pathogenic genes and potential drug therapeutic targets of ulcerative colitis and its malignant complicationsa variety of bioinformatics analysis. Methods · Four profiling datasets (GSE13367, GSE9452 and GSE36807 as UC group, and GSE37283 as UCN group) downloaded the Gene Expression Omnibus (GEO) database were jointly analyzed to identify the differential genes. Key genes related to ulcerative colitis and its malignant complications were obtainedsubsequent immunoassay and gene correlation analysis, and a number of small molecule drugs with potential therapeutic effects were screenedLINCS L1000 database. Results · Eighty-six and 253 significant differentially expressed genes were identified respectively in the differential gene analysis of UC group and UCN group. The scoring analysis of the node genes in protein-protein interaction (PPI) network of UC group showed that the core gene of the network was CXCL8. KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis indicated that CXCL8 mainly participated in the recruitment of neutrophils in IL-17 signaling pathway, and three small molecule drugs (butein, levocetirizine, pseudoephedrine) for CXCL8 were found based on the screening results of LINCS L1000 database. Conclusion · The core differentially expressed gene CXCL8 may be a new drug target for the treatment of ulcerative colitis and its malignant complications. The three screened small molecule drugs may have potential treatment effect on ulcerative colitis and its malignant complications. Related Articles | Metrics

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Effect of deuterium depleted water combined with platelet-rich plasma on wound healing of diabetic ulcer in rats WANG Xiang-qi, ZHAO Chao-ran, XIONG Ai-bing 2020, 40 (3):  326.  doi: 10.3969/j.issn.1674-8115.2020.03.008 Abstract ( 943 )   PDF (9514KB) ( 442 )   Objective · To observe the effect of deuterium depleted water combined with platelet-rich plasma on wound healing of diabetic ulcer in rats, and to explore its possible mechanism. Methods · Male SD rats were randomly divided into two groups, normal control group (group A, n20) and diabetic group (n80). Rats in the diabetic group were fed with high-fat diet for 4 weeks, and the rat diabetic ulcer model was replicatedintraperitoneal injection of streptozotocin (STZ) + skin full-thickness resection; then randomly divided into diabetic model group (group B), platelet-rich plasma group (group C), deuterium depleted water group (group D), and deuterium depleted water combined platelet-rich plasma group (group E), with 18 rats for each group. Group A with common feed was fed for 4 weeks after intraperitoneal injection of an equal volume of citric acid-sodium citrate buffer + skin full-thickness resection to replicate the normal ulcer model. The animals were sacrificed after treatment for 3, 7 and 14 d, and the random blood glucose was measured at each corresponding time point. The wound surface and wound margin tissue were taken to observe the wound healing and local histomorphology of each group. The contents of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the wound tissue of each group were detectedenzyme-linked reaction adsorption method. Results · Random blood glucose in group D and group E was lower than that before intervention. The inflammatory response of the wounds in each diabetic group was slower than that in group A. The granulation ripening effect of group E was faster than that of group B, C, and D. The effect was best in each intervention group, and the neovascularization and fibroblasts appeared earlier and in large quantities. The content of TIMP-1 in group A was significantly higher than that in group B, C, D and E (PPPPPConclusion · Deuterium depleted water can promote the healing of diabetic ulcer wounds. Deuterium depleted water combined with platelet-rich plasma can significantly promote the healing of diabetic ulcer wounds, which may be related to the decrease of random blood glucose, the increase of TIMP-1 and the inhibition of MMP-9 . Related Articles | Metrics

Original article (Clinical research)

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Analysis on sleep quality and characteristics of depression patients with different degrees of anxiety TANG Ye-zhou, SHI Yi-fan, HUANG Yu-xin, ZHAO Ya-juan, FU Hao, HUANG Jia, WANG Yong 2020, 40 (3):  333.  doi: 10.3969/j.issn.1674-8115.2020.03.009 Abstract ( 1059 )   PDF (7450KB) ( 446 )   Objective · To compare the sleep quality of depressive patients with and without anxiety symptoms. Methods · Hamilton Depression Scale-17 (HAMD-17), Hamilton Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index Scale (PSQI) were used to assess the level of patients depression, anxiety and sleep quality. The HAMA scores of patients ranged 0 to 6 were in the anxiety-free group, 7 to 13 in the anxiety-prone group, and 14 or more in the anxiety group. Results · The PSQI scores of the group with anxiety were higher than those of anxiety-prone group and anxiety-free group (both P0.000). Partial correlation analysis showed that, after controlling HAMD-17 scores, the correlation between HAMA scores and PSQI scores reduced gradually with the increase of anxiety level. The multiple linear regression analysis showed that sleep disorder was still an independent risk factor for depression after controlling HAMA score. Sleep latency, sleep time, hypnotics and daytime dysfunction were independent predictive factors of HAMD-17 score (all PConclusion · In patients with depressive disorder, the severity of sleep disorder increases with the increase of anxiety level. In the case of comorbidity anxiety, sleep disorder is still an independent risk factor for depressive disorder, and the relationship between depressive symptoms and sleep disorder indicators of different dimensions suggests that sleep disorder plays a comprehensive role in the pathogenesis of depressive disorder. Related Articles | Metrics

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Early diagnosis and prognostic evaluation value of miR-133a in patients with acute myocardial infarction TANG Dong-juan, XUE Xiao-mei, HE Bin 2020, 40 (3):  339.  doi: 10.3969/j.issn.1674-8115.2020.03.010 Abstract ( 997 )   PDF (8346KB) ( 429 )   Objective · To investigate the value of serum miR-133a in early diagnosis and the assessment of 30-day incidence of cardiovascular adverse events in patients with acute myocardial infarction (AMI). Methods · Ninety patients with acute chest pain within 6 h were included, and 63 cases of AMI, 13 cases of unsangina pectoris (UAP) and 14 cases of control (chest pain of other causes) were finally diagnosed. The levels of troponin I (cTnI), creatine kinase MB (CK-MB) and myoglobin (Mb) were measuredelectrochemical fluorescence. Quantitative real-time PCR (qPCR) was used to detect the of miR-133a in the serum of patients immediately after admission and 24 h after percutaneous coronary intervention (PCI). The Gensini score of patients who underwent coronary angiography was recorded. The incidence of cardiovascular adverse events was observed within 30 days. Spearman correlation analysis, multivariate Logistic regression analysis and receiver operator characteristic curve (ROC curve) were used to analyze the corresponding data. Results · The of miR-133a in the AMI group was significantly higher than that in the UAP group and the control group (both PPCI 0.716-0.917), and the AUC of 30 days cardiovascular adverse event was 0.700 (95% CI 0.535-0.865). Conclusion · The of miR-133a in patients with AMI is significantly increased, which is expected to be a biomarker for early diagnosis of AMI. The level of miR-133a in serum may be related to the severity of coronary artery disease and short-term prognosis. Related Articles | Metrics

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Level of intolerance of uncertainty and related factors in patients with anxiety disorders CUI Hui-ru, LI Wei, PANG Jiao-yan, LI Hui, LI Chun-bo 2020, 40 (3):  346.  doi: 10.3969/j.issn.1674-8115.2020.03.011 Abstract ( 1198 )   PDF (6496KB) ( 898 )   Objective · To investigate the level of intolerance of uncertainty (IU) and possible related factors in the patients with anxiety disorders. Methods · The patients’ diagnosis was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM- Ⅳ ). Thirty-five cases of generalized anxiety disorder (GAD), 15 cases of panic disorder (PD) and 31 healthy controls (HC group) were recruited at the same time. IU level was assessedusing the Chinese version of Intolerance of Uncertainty Scale (IUS). The characteristics of anxiety symptoms, depressive symptoms and body perception were assessedHamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Body Perception Questionaire (BPQ), respectively. Results · The IU levels of both GAD group and PD group were significantly higher than those of HC group (P0.000). There was no significant difference in IU levels between GAD group and PD group (P0.491). The IU levels of GAD patients were positively correlated with HAMA-somatic anxiety (r0.377, P0.025) and BPQ-awareness (r0.342, P0.044). Conclusion · The patients with anxiety disorders have elevated IU levels, compared with healthy people. Possibly, somatic anxiety and body perception-awareness are related factors to IU in GAD patients. Related Articles | Metrics

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Analysis of clinicopathological features and prognosis of young patients with breast cancer in different age groups YE Xin, ZHOU Xiao-yun, YANG Li, WANG Jie, HE Qi 2020, 40 (3):  351.  doi: 10.3969/j.issn.1674-8115.2020.03.012 Abstract ( 935 )   PDF (8535KB) ( 471 )   Objective · To explore and analyze the differences of clinicopathological features and prognosis and influencing factors in young breast cancer patients in different age groups. Methods · A total of 277 female breast cancer patients with invasive ductal carcinoma under 40 years old who were diagnosed and treatedoperation at the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine Jan. 2010 to Dec. 2018 were retrospectively analyzed. The patients were divided into two groupsthe age of 35 years old, i.e. aged ≤ 35 group and aged >35 and ≤ 40 group. The differences of clinicopathological features were compared between the two groups, including histological classification of cells, tumor size, lymph node metastasis, estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor-2 (HER2) , the of Ki-67, the degree of intravascular invasion, pathological stage and molecular subtype. The prognostic differences and influencing factors of the two groups were analyzed. Results · There were no significant differences in histological classification of cells, tumor size, lymph node metastasis, ER , PR , HER2 , the of Ki-67, the degree of intravascular invasion, pathological stage and molecular subtype between the two groups. The 3-year disease-free survival (DFS) of the patients in the aged ≤ 35 and >35 and ≤ 40 group were 89.66% and 95.03%, respectively, and there was no significant difference. There was no statistically significant difference in the 3-year DFS among the four molecular subtypes between the two groups. Cox proportional hazards model showed that intravascular invasion and lymph node metastasis were the independent risk factors of DFS. Conclusion · >35 and ≤ 40 year-old breast cancer patients and ≤ 35 year-old breast cancer patients have similar clinicopathological features and prognosis, so the same treatment strategy should be given. Related Articles | Metrics

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Study on risk factors analysis and prediction model of difficult airway NI Hong-wei, HE Guang-bao, GAO Hong-mei, ZHU Yi-jun, SHI Dong-ping, HANG Yan-nan 2020, 40 (3):  358.  doi: 10.3969/j.issn.1674-8115.2020.03.013 Abstract ( 1010 )   PDF (5228KB) ( 532 )   Objective · To explore the risk factors of difficult airway (DA) and establish its prediction model. Methods · May to Oct. 2018, 211 patients were selected for elective surgery under general anesthesia in Jiading District Central Hospital, and their basic data such as age, sex, height, weight, body mass index (BMI) were collected. Conventional airway assessment indicators were evaluated, including the modified Mallampati test (MMT), cervical mobility, inter-incisor distance and thyromental distance. Ultrasound was utilized to measure the distance between the skin and thyroid cartilage (DST), the distance between the thyroid cartilage and epiglottis (DTE) and the distance between the skin and epiglottis (DSE) in the parasagittal plane. The first laryngoscope was used to observe the laryngeal state of the patients, and Cormack-Lehane (CL) grade was performed. Logistic regression model was used to analyze the influencing factors that might caDA, establish the best model to predict DA, and carry out risk assessment and judgment on the indexes and their coefficients in the model. Results · Forty-four patients were classified as CL grade Ⅲ or Ⅵ. Logistic regression analysis showed that the best model for predicting DA was determinedsex, BMI, DSE and MMT. The sensitivity and specificity of the diagnostic value of the optimal model were 90.9% and 90.4%, and the area under the receiver operator characteristic curve was 0.934. Conclusion · The prediction model determinedfour risk factors of sex, BMI, DSE and MMT can evaluate DA more comprehensively and effectively. Related Articles | Metrics

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Relationship between aggressive behavior in patients with bipolar disorder and DRD4 gene polymorphism and personality characteristics YANG Dao-liang, LIU Han, WU Yu-jie, DU Wen-yong, JI Wei-dong, CHEN Xuan-xuan 2020, 40 (3):  362.  doi: 10.3969/j.issn.1674-8115.2020.03.014 Abstract ( 1102 )   PDF (7776KB) ( 739 )   Objective · To explore the relationship between aggressive behavior, dopamine receptor D4 (DRD4) exon Ⅲ 48 bp variable number tandem repeat (VNTR) and personality characteristics in patients with bipolar disorder. Methods · January 2015 to December 2018, 173 patients with bipolar disorder were selected Shanghai Changning Mental Health Center, Shanghai Jingan Mental Health Center, Shanghai Xuhui Mental Health Center, and Shanghai Jiading Central Hospital. According to the score of Modified Overt Aggression scale (MOAS), 173 patients were divided into aggressive behavior group (research group) and non-aggressive behavior group (control group). General survey and the temperament and personality questionnaire (Temperature and Character Inventory, TCI) were carried out, respectively. The polymorphism of DRD4 gene were genotypedthe polymerase chain reaction-restriction fragment length polymorphism method. Genetic equilibrium test of genotype Hardy-Weinberg and the difference of genotype frequency between the two groups were analyzedusing SHEsis software. The relationship between aggression behavior and DRD4 gene polymorphism and personality traits in bipolar disorder patients was analyzedχ2 test and t test. Results · There was no significant difference in the general data between research group and control group (P>0.05). Six alleles and nine genotypes of DRD4 exon Ⅲ 48 bp VNTR were detected. The most common alleles in the two groups were four repeat alleles. There were statistical differences in the frequency distribution of genotypes and alleles of DRD4 exon Ⅲ 48 bp VNTR between the two groups (P0.040, P0.018). The scores of novelty seeking and harm avoidance in the research group were higher than those in the control group (P0.026, P0.000), while the scores of cooperativeness and self-directedness were lower than those in the control group (both P0.000). Patients with long repeat alleles had significantly higher scores in novelty seeking and harm avoidance, and lower scores in cooperativeness, compared with patients with short repeat alleles (P0.000, P0.006, P0.038). Conclusion · Aggressive behavior in patients with bipolar disorder may be associated with DRD4 exon Ⅲ 48 bp VNTR. In bipolar disorder, patients with aggressive behavior have unique personality characteristics in impulsiving, novelty-seeking, exploring, being afraid of uncertainty, revengeful, behaving himself and so on. Patients with long repeat alleles have more significant personality abnormalities. Related Articles | Metrics

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Application of sequential pattern mining to assessment of psychological crisis intervention skills DONG Min-ye, JIA Zhi-ying, DONG Sheng-jie, SHI Zhen-su, LI Guo-hong 2020, 40 (3):  368.  doi: 10.3969/j.issn.1674-8115.2020.03.015 Abstract ( 873 )   PDF (7117KB) ( 387 )   Objective · To explore the application of sequential pattern mining to the field of mental health, and analyze the role of the courses in improving the crisis intervention skills of mental health service personnel. Methods · The learning log data recordedthe online learning platform was used for sequential pattern mining, and the activity map was used to visually analyze the learning paths of learners with different learning performances. Results · In each case study, the number of high-frequency sequences of learners with different learning performance had significant differences, which were high-performance group > medium-performance group > low-performance group. In the crisis intervention consultation learning process, the high-performance group learners had the most diverse learning paths; the medium-performance group lacked the mastery of the several specific steps of the six-step model of crisis intervention, and the learning path integrity was poor; the low-performance group did not have a complete learning path. Conclusion · Diversified crisis intervention strategies are conducive to the smooth progress of the consultation process. Learners with different learning performance should develop corresponding skills development strategies according to their learning characteristics. Related Articles | Metrics

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Progress of genetics and diagnosis of primary dystonia WU Jing-ying, LIU Xiao-li, CAO Li 2020, 40 (3):  373.  doi: 10.3969/j.issn.1674-8115.2020.03.016 Abstract ( 1027 )   PDF (9699KB) ( 495 )   Dystonia is one kind of dyskinesia characterizedabnormal movement and/or posture causedpersistent or intermittent muscle contraction. It also has distinguished features of repeatability and modeling, and can be induced or aggravatedrandom movements. Dystonia causedhereditary factors is named as primary dystonia. Currently, 28 phenotypes have already been found in primary dystonia. Development of genetic technology has largely promoted the discovery of genetic mechanisms. Even so, many patients still have different genetic and clinical features these phenotypes. Diagnosis of primary dystonia is quite challenging. Clinical manifestations, imaging examinations, electromyography, gene testing and other examinations should be taken into acfor systematic diagnosis. This article reviews the genetic progress and diagnostic strategies of primary dystonia, aimed at providing help for further clinical practice and scientific research. Related Articles | Metrics

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Research progress in involvement of inflammatory cells in formation of coronary collateral circulation CHEN Shuai, DING Feng-hua, DAI Yang, LU Lin, SHEN Ying, SHEN Wei-feng 2020, 40 (3):  380.  doi: 10.3969/j.issn.1674-8115.2020.03.017 Abstract ( 778 )   PDF (7622KB) ( 461 )   There are abundant anastomotic branches among the branches of coronary artery. When the main coronary artery is occluded, the coronary collateral circulation is formed, which increases the local perfusion of ischemic myocardium and reduces the area of myocardial infarction. There are two main forms of coronary collateral circulation: arteriogenesis and angiogenesis. When coronary artery occlusion occurs, different types of inflammatory cells are recruited into the collateral circulation formation area, which plays an important role in coronary collateral circulation formation. This article discusses the effects of different types of inflammatory cells on the formation of coronary collateral circulation, and further describes the contributory factors of poor coronary collateral circulation formation in diabetic patients. Related Articles | Metrics

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Aberrant RNA N6-methyladenosine modification causes tumorigenesis, progression and metastasis of malignant tumorsaffecting cancer stem cells ZHU Zheng-yang, WANG Cheng, JIANG Chen-yi, ZHAO Fu-jun 2020, 40 (3):  385.  doi: 10.3969/j.issn.1674-8115.2020.03.018 Abstract ( 809 )   PDF (9561KB) ( 421 )   RNA N6-methyladenosine (m6A) modification is one of the most pervasive epigenetic modifications that correlate with gene , regulateda variety of methylases, demethylases and reader proteins. m6A has been found crucial during cancer progression, aberrant changes of which contribute to tumorigenesis and metastasis. It’s also been reported to be influential on chemotherapy and radiotherapy resistance of malignant tumorsinducing cancer stem cells (CSC) generation and enhancing post-therapy damage resistance, thus causing the progression or recurrence. In this review, we review the regulation of RNA m6A modification and focus on recent advances in functions of dysregulated m6A modification in the pathogenesis of cancer progression and recurrence. In addition, we also discuss the possible participation of CSC in this process combining current perspectives on the chemotherapy and radiotherapy resistance mechanism of CSC. Related Articles | Metrics

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Research progress of mechanism of IL-37 in rheumatoid arthritis HUANG Run-qi, WANG An-ni, CHEN Guang-jie 2020, 40 (3):  391.  doi: 10.3969/j.issn.1674-8115.2020.03.019 Abstract ( 1056 )   PDF (7441KB) ( 469 )   Rheumatoid arthritis (RA) is a chronic progressive autoimmune disorder, the mechanism of which is not clear yet. Cytokines play a key role in the pathogenesis of RA. Recent studies on cytokine involvement in autoimmune diseases have found that, as a new member of interleukin-1 (IL-1) family, IL-37 can participate in the regulation of signaling pathway and play its anti-inflammatory roleextracellular binding to membrane receptor and intracellular complex formation. Studies have shown that the level of IL-37 in healthy people is extremely low and overexpressed in RA patients, and the serum level of IL-37 in RA patients is positively correlated with the level of pro-inflammation cytokines such as tumor necrosis factor-α (TNF-α), IL-6 and IL-1α, the level of C reactive protein and 28-joint disease activity score (DAS28). However, IL-37 treatment can alleviate the inflammation and pathological symptoms of collagen-induced arthritis (CIA) mice, which indicates that IL-37 has anti-inflammatory effect via negative feedback. The specific anti-inflammatory mechanism may be related to mothers against decapentaplegic homolog 3 (SMAD3) pathway and nuclear factor kappa-B (NF-κB) pathway. This article reviews the structure and of IL-37, the receptor and its signal pathway and the function and its mechanism in RA, which provides references for the further study of IL-37 and RA. Related Articles | Metrics

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Research advances in role of m6A methylation modification in hematological malignancies ZHU Yu-qian, WU Ling-yun 2020, 40 (3):  396.  doi: 10.3969/j.issn.1674-8115.2020.03.020 Abstract ( 1086 )   PDF (9133KB) ( 502 )   N6-methyladenosine (m6A) has been identified as the most common epigenetic modification of eukaryote mRNA. It can not only mediate multiple processes of RNA metabolism such as RNA splicing, translation and decay under the catalytic regulation of m6A-related enzymes, but also affect the development of bone marrow hematopoiesisregulating the self-renewal, proliferation and differentiation of pluripotent stem cells in the hematopoietic microenvironment of bone marrow. In recent years, many studies have reported that m6A methylation modification plays an important role in the development and progression of hematological malignancies. Targeting inhibition of m6A-related factors contributes to increase the sensitivity of patients with hematological malignancies to therapeutic drugs. This review describes the biological characteristics and hematopoietic regulation mechanisms of m6A methylation modification, and its role in the pathogenesis of hematological malignancies. Related Articles | Metrics

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Safety of anticoagulants and antiplatelet drugs in patients with recurrent spontaneous abortion during pregnancy SUN Si, ZHAO Ai-min 2020, 40 (3):  402.  doi: 10.3969/j.issn.1674-8115.2020.03.021 Abstract ( 954 )   PDF (9433KB) ( 348 )   Recurrent spontaneous abortion (RSA) is defined as the loss of at least two consecutive pregnancies before the 28th week of gestation. RSA is a complicated pathological condition causedmultiple factors including genetic abnormalities, anatomical factors, endocrine disorders, immune abnormalities, prethrombotic state (PTS) and infection factors. Studies have suggested that anticoagulation and antiplatelet therapy could significantly improve the pregnancy outcomes of RSA patients with PTS and autoimmune abnormalities. Frequently used anticoagulants and antiplatelet drugs are heparin, heparinoid, warfarin, aspirin and clopidogrel. However, the maternal and fetal safety after the of these drugs during pregnancy has long been concerned. Safety of anticoagulants and antiplatelet drugs in patients with recurrent spontaneous abortion during pregnancy is reviewed. Related Articles | Metrics

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Flexible ureteroscopy combined with holmium laser lithotripsy for infants with upper urinary tract calculi: single-center experience of 32 cases LI Peng-ju, ZHONG Liang, SUN Jie 2020, 40 (3):  408.  doi: 10.3969/j.issn.1674-8115.2020.03.022 Abstract ( 764 )   PDF (7614KB) ( 425 )   Objective · To estimate the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy in the treatment of upper urinary tract calculi in infants aged 3 years old and below. Methods · January 2016 to March 2019, the cases of infants aged 3 years old and below who were treated with flexible ureteroscopy combined with holmium laser lithotripsy for upper urinary tract calculi in Department of Urology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine were collected. The double J (DJ) stents were placed in the cases for 0.5-3 months, followedflexible ureteroscopy combined with holmium laser lithotripsy after urinary tract infection was controlled. OLYMPUS flexible ureteroscope and 200 μm holmium laser fiber were used in the operation. Holmium laser power was 20-30 Hz/0.5-1.0 J according to the size and hardness of the stones, and then DJ stent was retained after retraction of the ureteroscope to finish the operation. Results · A total of 32 infants aged 3 and below with upper urinary tract stones were included in the study, including 21 males and 11 females, and the median age was 26 months (7-36 months). All 32 cases were successfully treated with flexible ureteroscopy combined with holmium laser lithotripsy. Among them calculi in 22 cases were removed after one operation, and the calculi-free rate after one operation was 68.8%. The median duration of operation was 53 min (15-110 min); the median hospitalization after operation was 3 d (2-12 d); the median days of DJ stent removal after operation was 60 d (18-100 d). Urinary tract infection occurred in 4 cases, and high fever with urinary tract infection occurred in 2 cases. Anti-infection and other symptomatic treatments were given respectively to improve the symptoms. Conclusion · Flexible ureteroscopy combined with holmium laser lithotripsy is effective and safe in the treatment of upper urinary tract calculi in infants, which can be widely used in clinic. Related Articles | Metrics

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Report of 15 cases of single-port video-assisted thoracoscopic surgery for pulmonary sequestration CAO Min, FU Yu-jie, ZHAO Xiao-jing 2020, 40 (3):  413.  doi: 10.3969/j.issn.1674-8115.2020.03.023 Abstract ( 944 )   PDF (5078KB) ( 553 )   Objective · To investigate the feasibility of single-port video-assisted thoracoscopic surgery (VATS) for pulmonary sequestration. Methods · Fifteen cases with intralobar pulmonary sequestration in Renji Hospital, Shanghai Jiao Tong University School of Medicine January 2014 to December 2018 were reviewed. All the cases had underwent lobectomysingle-port VATS, including 13 cases of left lower lobectomy and 2 cases of right lower lobectomy. Results · Pleural adhesion was found in 11 of the 15 cases. Lobectomy was successfully performedsingle-port VATS in 12 cases. Three cases were transferred to multi-port VATS becaof severe pleural adhesion. There was no case conversed to thoracotomy in the study. There was no mortality and complication during the perioperative period. For the 15 cases, the operation time was (96.7±27.8) min, the bleeding volume was (75.3±45.5) mL, the postoperative intubation was (5.2±2.0) d and the postoperative hospital stay was (6.2±2.2) d. Conclusion · Single-port VATS treatment for pulmonary sequestration is safe, effective and feasible. Related Articles | Metrics