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28 April 2020, Volume 40 Issue 4 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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Experience of emergency department of large tertiary general hospital in coping with epidemic outbreak of COVID-19 YANG Zhi-tao, GAO Wei-yi, LIANG Jing, JING Feng, MAO En-qiang, CHEN Er-zhen 2020, 40 (4):  417.  doi: 10.3969/j.issn.1674-8115.2020.04.001 Abstract ( 930 )   PDF (7100KB) ( 328 )   Since December 2019, the coronavirus disease 2019 (COVID-19) has become one of the most significant infectious diseases in the world. The epidemic in China has been basically controlled through a series of prevention and control measures. But the number of confirmed cases and deaths in other countries and regions is still rapidly rising. In response to this major epidemic, the hospitals emergency management system is facing a great challenge, especially the department of emergency, which takes the responsibilities of the screening and diagnosis of fever patients as well as the emergency treatment of ordinary patients. Through two months of practice and exploration, our hospital has summarized some experiences in improving the emergency management system, establishing a peace and war integration mechanism, reorganizing medical resources, guaranteeing the deployment of supplies and optimizing information system, and has achieved the "zero infection" of medical staff, "zero misdiagnosis" and "zero cross-infection" of patients with COVID-19. Related Articles | Metrics

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Predicting the trend of the COVID-19 outbreak and timely grading the current risk level of epidemic based on moving average prediction limits HE Hao, HE Yun-ting, ZHAI Jing, WANG Xiao-jin, WANG Bing-shun 2020, 40 (4):  422.  doi: 10.3969/j.issn.1674-8115.2020.04.002 Abstract ( 1209 )   PDF (10240KB) ( 401 )   Objective · To establish a practical data-driven method that helps predict the evolutionary trend of the coronavirus disease 2019 (COVID-19) epidemic, track and prejudge the current risk classification of the epidemic area, and provide a quantitative evidence for precision prevention and control strategies. Methods · A moving average prediction limit (MAPL) method was established based on the moving average method. The previous severe acute respiratory syndrome (SARS) epidemic data was used to verify the practicability of the MAPL method for predicting epidemic trends and quantitative risk.tracking the COVID-19 outbreak epidemic data publicly reported since January 16, 2020, the MAPL method was used for timely epidemic trend prediction and the risk classification. Results · According to the MAPL analysis, the national epidemic of COVID-19 peaked in early February 2020. After active prevention and control in early stages, the overall epidemic situation in the country showed a downward trend mid-February to mid-March. Compared with Hubei Province, the number of new cases in non-Hubei region declined rapidly in mid-February, but then increased slightly. The analysis of imported cases since March showed that there was a medium to high level of epidemic import risk in the near future. It is recommended to take corresponding prevention and control measures to prevent the epidemic spreading again. Conclusion · The MAPL method can assist in judging the epidemic trend of emerging infectious diseases and predicting the risk levels in a timely manner. Each epidemic district may implement a differentiated precision prevention and control strategies according to the local classification of epidemic risk. Since March, attention should be paid to the prevention and control of imported risks. Related Articles | Metrics

Innovative research team achievement

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Expression and clinical significance of α1-antitrypsin in thyroid-associated ophthalmopathy WU Yu, LU Yi, SUN Rou, ZHANG Shuo, SUN Jing, ZHOU Hui-fang, FAN Xian-qun 2020, 40 (4):  430.  doi: 10.3969/j.issn.1674-8115.2020.04.003 Abstract ( 825 )   PDF (8328KB) ( 427 )   Objective · To investigate the and clinical significance of α1-antitrypsin (α1-AT) in tears of thyroid-associated ophthalmopathy (TAO) patients. Methods · Patients diagnosed with TAO at Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine January to December 2019 were included and divided into active TAO group (n33) and inactive TAO group (n22). Thirty eyes of 30 healthy volunteers were included (n30). Unstimulated tear samples were collected all subjects and the concentration of α1-AT was analyzedenzyme-linked immunosorbent assay (ELISA). Difference of α1-AT concentration among 3 groups was comparedusing Kruskal-Wallis H test. Mann-Whitney U test was performed for further comparison between each 2 groups. Correlationship between α1-AT concentration and clinical activity score (CAS) was analyzedSpearman relation. Statistical significance was accepted at a value of PResults · α1-AT was significantly higher in active TAO group than that in inactive TAO group and control group (both Pr0.846, P0.000). ROC curve showed that the optimal diagnostic cut off value of α1-AT was 939.48 ng/mL, and the sensitivity and specificity were 81.8% and 100% (AUC0.959, PConclusion · α1-AT is significantly elevated in the tears of active TAO patients. Tear α1-AT level has important value in the diagnosis of clinical activity of TAO. Related Articles | Metrics

Original article (Basic research)

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Effect of indoxyl sulfate on proliferation and of inflammatory cytokines and ROS in human periodontal ligament cells XIA Xin-yi, CHEN Hui-wen, HU Yi, SONG Zhong-chen 2020, 40 (4):  437.  doi: 10.3969/j.issn.1674-8115.2020.04.004 Abstract ( 762 )   PDF (8182KB) ( 420 )   Objective · To explore the effects of Indoxyl sulfate (IS) on proliferation activity, of inflammatory factors and reactive oxygen species (ROS) in human periodontal ligament cells (hPDLCs). Methods · The primary hPDLCs were culturedusing tissue explant method in vitro. MTT assay was employed to evaluate the effect of IS on proliferation activity of hPDLCs. The mRNA and protein s of IL-1β, IL-6, and IL-8 were detectedusing real-time PCR and ELISA assay. DCFDA fluorescence probe was used to detect intracellular ROS and ROS in the cytoplasm under fluorescence microscope. Results · The viability of hPDLCs was inhibitedIS at the concentration of 125 μmol/L on 24, 48 and 72 hours. The inhibitory effect was presented in a dose- and time- dependent manner. IS could upregulate the mRNA and protein of inflammatory cytokines including IL-1β, IL-6 and IL-8 as well as promote ROS in hPDLCs. Conclusion · IS may play an important role in the association between chronic kidney diseases and periodontitis through inhibiting the activity of hPDLCs, promoting the of inflammatory cytokines and increasing intracellular ROS level. Related Articles | Metrics

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Quantification of human plasma 7α-hydroxy-4-cholesten-3-one and bile acidsUPLC-MS/MS GE Kun, QU Chun, JIA Wei, ZHAO Ai-hua 2020, 40 (4):  443.  doi: 10.3969/j.issn.1674-8115.2020.04.005 Abstract ( 1074 )   PDF (7701KB) ( 503 )   Objective · To develop a quantitative method of 7α-hydroxy-4-cholesten-3-one (C4), cholic acid (CA) and chenodeoxycholic acid (CDCA) in human plasma. Methods · After extraction of C4, CA and CDCA with acetonitrile plasma, they were quantified with standard curve correctedthe internal standards based on Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Results · The limits of detection (LOD) of C4, CA and CDCA were 0.16, 0.02 and 0.04 nmol/L respectively; All three metabolites had good linear relationships (correlation coefficients R2 were over than 0.998). The relative standard deviations (RSDs) of repeatabilities were below 3.0%. The RSDs of inter-day and intra-day precision were less than 6%, and the RSDs of stabilities at 4 °C were below 10% within 7 days. The average added recoveries of C4, CA and CDCA were 97.7%, 113.3% and 105.0%, respectively. Conclusion · This method is of high detective sensitivity, good precision and stability, which meets the quantitative requirements of plasma biological samples. Related Articles | Metrics

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Synergistic chemo-photothermal therapy of castration-resistant prostate cancersingle-walled carbon nanotube SONG Xu-jia, ZHANG Shi-jun, Lü Wen-xin, HUANG Lin, ZHANG Yan, WU Ming-gui, XIE Shao-wei 2020, 40 (4):  450.  doi: 10.3969/j.issn.1674-8115.2020.04.006 Abstract ( 803 )   PDF (9213KB) ( 310 )   Objective · To study the synergistic effect of chemo-photothermal on castration-resistant prostate cancer (CRPC) for enhancing the efficacy of chemotherapysingle-walled carbon nanotubes (SWCNTs). Methods · High-purity SWCNTs were used as the drug carrier. Firstly, SWCHTs were truncated (shorten SWCNTs, s-SWCNTs)mixed acid solutions. At the same time, a large amount of -COOH were introduced onto the surface of s-SWCNTs. Secondly, the polyethylene glycol (PEG) with amino terminated was successfully modified onto s-SWCNTs through amido linkage in N-hydroxysuccinimide and 1-(3-dimethylaminopropyl)-3-ethyl-carbodiimide hydrochloride solutions to endow s-SWCNTs with water solubility and biocompatibility. Finally, docetaxel (DTX) was successfully loaded through nano-deposition method and π-π stacking on the surface of s-SWCNTs. Thus a nanosystem with both chemotherapy and photothermal properties was established. The chemo-photothermal therapy synergistic inhibition on CRPC cell line C4-2 in vitro and the anti-tumor effect in vivo were evaluated. Results · Fourier transform infrared spectrum and zeta potential test showed that -COOH was successfully introduced onto s-SWCNTs, and the amount of -COOH was 0.412 mol per gram of SWCNTs determinedautomatic conduct metric titration. The UV absorption spectrum showed that DTX was successfully loaded onto the nanosystem.monitoring the UV absorption of the dialysate, DTX could be loaded onto SWCNTs up to 1.35 mg per gram of s-SWCNTs. Under the stimulation of acidic conditions, DTX could be rapidly released the surface of the nanosystem. The in vitro cell viability and in vivo anti-tumor experiment showed that DTX combined with photothermal had a synergetic effect on killing C4-2 cells than any single treatment model. Conclusion · DTX-loaded s-SWCNTs nanosystem with high stability and photothermal effect can inhibit the growth of CRPC cells and the tumor growth in mice bearing CRPC. The nanosystem with synergistic effect of chemotherapy and photothermal therapy could be used in the treatment of prostate cancer which is resistant to chemotherapy drugs. Related Articles | Metrics

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CXCL9 mRNA in ovarian tumor tissue and its relations with prognosis and characteristics of immune microenvironment GAO Jing-ze, WU Xia 2020, 40 (4):  457.  doi: 10.3969/j.issn.1674-8115.2020.04.007 Abstract ( 798 )   PDF (8697KB) ( 345 )   Objective · To investigate the effects of CXCL9 (C-X-C motif chemokine ligand 9) mRNA on the overall survival of ovarian cancer patients, and to explore its relations with immune-related pathways and gene in tumor microenvironment, so as to reveal the significance of CXCL9 in the prognosis of ovarian cancer. Methods · Kaplan-Meier method was used to analyze the relationship between CXCL9 mRNA and the survival of ovarian cancer patients in The Cancer Genome Atlas (TCGA) database. Gene Set Enrichment Analysis (GSEA) was used to assess the biological function of CXCL9 mRNA in ovarian cancer. The correlation of CXCL9 mRNA with cluster of differentiation 8A (CD8A) and immune checkpoint mRNA was analyzed. Results · The high of CXCL9 mRNA was significantly associated with better prognosis in patients with ovarian cancer. GSEA showed that CXCL9 mRNA was enriched in the immune response-related pathway. In addition, Pearson correlation analysis showed that CXCL9 mRNA was positively correlated with the mRNA of CD8A and immune checkpoint. Conclusion · The high of CXCL9 mRNA in ovarian tumor tissue is a good predictor of prognosis, and the mRNA of CXCL9 may be closely related to the recruitment of lymphocytes tumor margin to the tumor microenvironment to exert the function of anti-tumor immune response. Related Articles | Metrics

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Effect of mTORC1 on intestinal group 3 innate lymphocytes function LIU Jian-yue, SHEN Lei 2020, 40 (4):  464.  doi: 10.3969/j.issn.1674-8115.2020.04.008 Abstract ( 796 )   PDF (8237KB) ( 398 )   Objective · To investigate the effect of mechanistic target of rapamycin complex 1 (mTORC1) on group 3 innate lymphoid cells (ILC3) function. Methods · Intestinal lamina propria leukocytes (LPL) of C57BL/6 wild type mice were stimulatedrapamycin, the specific inhibitor of mTORC1 signaling pathway, in vitro, and then quantity and function of ILC3 were detectedflow cytometry. Next, purified ILC3 mice intestinal LPL were sortedflow cytometry. After the activation of ILC3 with IL-23, mRNA levels of Rorc (the gene encoding retinoic acid receptor related orphan receptor, i.e. RORγt), Il22 and Rptor (the gene encoding key component protein of mTORC1, i.e. Raptor) were detectedreal-time qPCR. For further study, a genetically engineered momodel specifically knocked out Raptor in ILC3 was constructed. Effects of mTORC1 loss on the quantity and function of ILC3 as well as gut structure were detectedflow cytometry, real-time qPCR and hematoxylin-eosin staining. Results · The total ILC3 number had no change, but the secretion of IL-22ILC3 reduced after stimulation with rapamycin. Il22, Rorc and Rptor mRNA levels were upregulated simultaneously in ILC3 after activation with IL-23. In addition, there was no significant difference in the numbers and proportions of total ILC3 and ILC3 subsets as well as gut structure in Raptor-deficient mice, but the cytokine IL-22 secretion level of ILC3 significantly decreased in these mice. Conclusion · Loss of mTORC1 function inhibits ILC3 secreting IL-22 but has no effect on the intestinal structure and intestinal ILC3 development, which reveals the positive regulation of mTORC1 signaling on intestinal ILC3 function. Related Articles | Metrics

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Evaluation of a custom transcriptome sequencing library construction reagent with a small amount of cell input DING Lei, GAO Cai-xia, LIU Zhao-yuan, CHEN Lei 2020, 40 (4):  472.  doi: 10.3969/j.issn.1674-8115.2020.04.009 Abstract ( 781 )   PDF (7890KB) ( 316 )   Objective · To verify the feasibility of replacing the expensive commercial reagent SMART-Seq v4 Ultra Low Input RNA Kit (hereinafter referred to as TaKaRa reagent) with a reagent (hereinafter referred to as DIY reagent) which was madeourselves based on the SMART (switching mechanism at 5 end of RNA template) technology. Methods · Four 8-week-old C57BL/6 female mice were randomly divided into two groups. One group did not receive any treatment as a control, and the other group was intraperitoneally injected with 1 mL of 4% thioglycollate broth to induce peritoneal macrophages. After 72 hours, RNA was extracted the peritoneal macrophages. cDNA library construction was performed with DIY reagent and TaKaRa reagent respectively. Finally, bioinformatics analysis was performed to compare the RNA sequencing results after of different library construction reagents different aspects, such as data quality, gene differential analysis, and KEGG (Kyoto encyclopedia of genes and genomes) pathway analysis. Results · The results of bioinformatics analysis showed that the sample processedthe DIY reagent and TaKaRa reagent were both of good data quality, and the two reagents had comparative capability in transcripts capture. Gene coverage of the sequences both showed consistent uniformity. On top of these, the results of differential gene analysis and gene pathway analysis were consistent. Conclusion · Considering relatively great reduction in experimental cost for library construction, the DIY reagent can replace expensive commercial reagent for library construction experiments with a small amount of cell input. Related Articles | Metrics

Original article (Clinical research)

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Study on the prognosis of intravenous thrombolysis in patients with ischemic strokethyroid-related hormones and antibodies XU Jing-han, HE Xin-wei, LI Qiang, BAO Guan-shui 2020, 40 (4):  478.  doi: 10.3969/j.issn.1674-8115.2020.04.010 Abstract ( 692 )   PDF (7462KB) ( 351 )   Objective · To explore the association between thyroid-related hormones and antibodies and the prognosis of ischemic stroke patients treated with intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA). Methods · A total of 213 consecutive patients with ischemic stroke who underwent rt-PA intravenous thrombolysis in the Department of Neurology, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, were retrospectively included May 2012 to August 2018. Thyroid-related hormones and antibodies were tested on admission, and assessment of intracranial hemorrhage (ICH) was conducted 24 hours after thrombolysis. Functional outcomes were assessedmodified Rankin Scale (mRS) after 3 months of follow-up. The relationship between thyroid-related hormones and antibodies and the prognosis (including functional outcome and ICH) was analyzedlogistic regression analysis. Results · In univariate regression analysis, free triiodothyronine (fT3), total triiodothyronine, (tT3) and total thyroxine (tT4) levels were associated with poor functional prognosis (P0.000, P0.028, P0.000) and fT3, and free thyroxine (fT4) levels were associated with ICH (P0.008, P0.014). However, after adjustment for other variables, low fT3 levels were independently associated with poor prognosis (OR0.35, 95%CI 0.138-0.890, P0.027), and both fT3 and fT4 levels had nothing to do with ICH. In addition, fT3 was negatively correlated with stroke severity (r-0.291, P0.000). Conclusion · Low fT3 levels are associated with stroke severity and functional outcome. Related Articles | Metrics

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Analysis of the correlation between blood pressure fluctuation and hemodialysis-related complications in patients with maintenance hemodialysis ZHU Min-xia, ZHANG Wei-ming, NI Zhao-hui, CAI Hong, LU Jia-yue, LIU Shang, ZHAN Ya-ping 2020, 40 (4):  484.  doi: 10.3969/j.issn.1674-8115.2020.04.011 Abstract ( 957 )   PDF (7391KB) ( 391 )   Objective · To explore the correlation between blood pressure fluctuation and chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with maintenance hemodialysis (MHD). Methods · Jan. 2009 to Apr. 2015, 433 MHD patients in Hemodialysis Center of Renji Hospital, Shanghai Jiao Tong University School of Medicine were included, and their clinical data, treatment parameters during dialysis, lab examination indexes and drug applications were collected. According to the difference value of systolic blood pressure (SBP) during dialysis period, all the patients were divided into high fluctuation group of blood pressure (|△ SBP| ≥ 10 mmHg, n234) and low fluctuation group of blood pressure (|△ SBP|n199). The blood pressure fluctuation and its relationship with dialysis adequacy, bone metabolism indicator and nutrition indicator were analyzed between the two groups. Results · Compared with the low fluctuation group of blood pressure, the patients in the high fluctuation group of blood pressure took higher proportion of β receptor blockers and Vit D, higher level of serum P and intact parathyroid hormone (iPTH), higher dialysis age, and lower Kt/V, ultrafiltration volume, body mass index (BMI) and serum albumin (ALB) level (all PPKt/V and ALB were protective factors. Conclusion · Blood pressure fluctuation in MHD patients during dialysis period is significantly correlated with CKD-MBD, nutritional status, dialysis age and dialysis adequacy. Related Articles | Metrics

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Analysis of maternal clinical risk factors for different degrees of small for gestational age infant HU Xu-lin, CHEN Yan, XIA Hong-ping, ZHANG Yong-jun 2020, 40 (4):  489.  doi: 10.3969/j.issn.1674-8115.2020.04.012 Abstract ( 690 )   PDF (6227KB) ( 587 )   Objective · To explore the pregestational and gestational risk factors associated with small for gestational age infant (SGA)different degrees. Methods · Mothers and single newborns delivered at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine September 2013 to December 2016 were included. Multivariate Logistic regression was used to analyze the correlation between maternal pregnancy and pre-pregnancy risk factors and the occurrence of SGAdifferent degrees. Results · There were no statistically significant differences in maternal age, number of birth, education level, incidence of preterm birth and fetal sex in SGA. Maternal body mass index (BMI), gestational hypertension and accepting assisted reproduction were significantly correlated with SGA (all PConclusion · Maternal low BMI and hypertension are the risk factors of moderate SGA and accepting assisted reproduction are the risk factors of severe SGA, and the risk factors of SGAdifferent degrees are not the same. Related Articles | Metrics

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Exploring the relationship between blood glucose and arteriosclerosis based on propensity score matching DONG Jiao-jiao, TANG Lan, SUN Yan-li, YAO Xiao-qian, WANG Jing, WANG Yong-hong, PENG Bin 2020, 40 (4):  494.  doi: 10.3969/j.issn.1674-8115.2020.04.013 Abstract ( 665 )   PDF (6554KB) ( 495 )   Objective · To explore the relationship between blood glucose and arteriosclerosis with cardio-ankle vascular index (CAVI) as the indicator of arteriosclerosis. Methods · 2016 to 2018, a total of 8 547 participants aged 18 years and above who completed physical examinations in the Physical Examination Center of the First Affiliated Hospital of Chongqing Medical University were selected to collect CAVI and other relevant biochemical indicators. Based on fast blood glucose (FBG) and history of diabetes, the subjects were divided into normal blood glucose group and hyperglycemia group. The 1:1 propensity score matching was used to match the gender, age, blood pressure, blood lipids, and body mass index to balance the covariates between the groups. The matched data were analyzedLogistic regression and restricted cubic spline (RCS) to explore the relationship and the dose-effect relationship between FBG and CAVI. Results · A total of 1 463 pairs completed propensity score matching, and the covariates between the two groups were balanced after matching. Logistic regression analysis showed that hyperglycemia was a risk factor of CAVI (OR1.63, 95% CI 1.36-1.95). The RCS curve of FBG and CAVI abnormal risk showed an upward trend, i.e., as FBG increased, the risk of CAVI abnormalities increased. Conclusion · As the fasting blood glucose increases, the risk of arteriosclerosis also increases. Related Articles | Metrics

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Application of social skills training to outpatients with schizophrenia LUAN Feng-huan, YE Hui-ling, XU Lu, FAN Qing, SONG Li-sheng 2020, 40 (4):  500.  doi: 10.3969/j.issn.1674-8115.2020.04.014 Abstract ( 890 )   PDF (6082KB) ( 403 )   Objective · To investigate the effect of social skills training on the improvement of sociability and social adaptability of outpatients with schizophrenia. Methods · Thirty-eight cases of patients met ICD-10 diagnostic criteria received social skills training once a week for 12 weeks; Social Skills Checklist (SSC) and Social Adaptive Functioning Evaluation (SAFE) were conducted before and after the training assessment respectively. The patients were divided into different groups according to the levels of mental disability based on Social Disability Screening Schedule (SDSS) before training, and the effect of social skills training were compared among the groups. Results · The scores on conversation, conflict resolution and build relationships ability and total scores in SSC decreased after social skills training (P0.000 in all) . The scores on basic life skills, advanced life skills, communication skills and social skills, as well as the total score in SAFE decreased after training (PConclusion · Social skills training can effectively improve the social skills and social adaptability of outpatients with schizophrenia. Related Articles | Metrics

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Placebo effect in primary insomnia: a meta-analysis PAN Sheng-ke, LI Hui, WEI Yan-yan, YAO Pei-fen, LI Hua-fang 2020, 40 (4):  505.  doi: 10.3969/j.issn.1674-8115.2020.04.015 Abstract ( 997 )   PDF (8631KB) ( 390 )   Objective · To investigate the clinical efficacy and degree of impact of placebo in the patients with primary insomnia. Methods · Databases including PubMed, Cochrane, and Embase were searched. The Consolidated Standards of Reporting Trials (CONSORT) was used as a reference standard for enrollment and evaluation. The objective and subjective sleep assessment indicators were collected before and after placebo treatment. Meta-analysis was performed using RevMan 5.3 and Comprehensive Meta-Analysis V2 softwares. Results · A total of 17 articles (18 studies) were included in the systematic review, and the total sample size was 1 980. These indicators were analyzedage subgroups (adults and elderly adults). The objective indicators showed that the number of awaking was only statistically different in elderly adults group (P0.043), while the latency period of sleep, wakefulness time after sleep onset and total sleep time were statistically different in both groups (P-0.414. Subjective indicators showed that the subjective total sleep time, subjective wakefulness time after sleep onset, and subjective number of awaking were statistically different in both groups (PP0.000). The absolute value of total effect range was 0.289-0.474. Conclusion · Placebo in the patients with primary insomnia can improve objective and subjective sleep assessment indicators, but the effect is small. Related Articles | Metrics

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Value of contrast-enhanced ultrasound quantitative analysis in differential diagnosis of benign and malignant breast intraductal lesions WANG Mei-yu, ZHANG Yi-feng, CHEN Jie, ZHENG Li 2020, 40 (4):  514.  doi: 10.3969/j.issn.1674-8115.2020.04.016 Abstract ( 707 )   PDF (7257KB) ( 327 )   Objective · To evaluate the value of contrast-enhanced ultrasound quantitative analysis in the differential diagnosis of benign and malignant breast intraductal lesions. Methods · A retrospective analysis was made on the characteristics of conventional ultrasound and the time-intensity curve (TIC) of contrast-enhanced ultrasound (CEUS) of 71 breast intraductal lesions in 63 patients, which were surgically resected and pathologically confirmed in Shanghai Tenth People′s Hospital January 2016 to December 2018. The parameters of CEUS perfusion in the lesion area were obtained. Independent sample t test was used to analyze the differences of quantitative parameters between benign and malignant lesions. The receiver operating characteristic (ROC) curve was used to evaluate the value of conventional ultrasound, quantitative analysis of CEUS and their combination for the differential diagnosis of benign and malignant intraductal lesions of breast. Results · There were 42 benign lesions and 29 malignant lesions. Among the quantitative parameters of CEUS, time to peak (t2.072, P0.042), peak intensity (t-2.629, P0.011), rise slope rate (t3.015, P0.004) and the area under the curve (AUC) (t3.308, P0.001) were statistically significant. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the ROC curve of conventional ultrasound were 31.03%, 90.48%, 66.20%, 69.20%, 65.50% and 0.608. Those of quantitative analysis of CEUS were 75.86%, 71.43%, 73.24%, 64.70%, 81.10% and 0.776. And those of their combination were 86.21%, 97.62%, 92.96%, 96.15%, 91.11% and 0.943. Conclusion · Conventional ultrasound is of limited value in the diagnosis of breast intraductal lesions, and quantitative analysis of CEUS is of great significance in differentiating benign malignant breast intraductal lesions. The combination of conventional ultrasound and quantitative analysis of CEUS can significantly improve the diagnostic value. Related Articles | Metrics

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Obesity and related metabolic indicators among 270 vegetarians in Shanghai QU Lei, CUI Xue-ying, XIE Lu-yao, WANG Bian, TANG Qing-ya, SHEN Xiu-hua 2020, 40 (4):  519.  doi: 10.3969/j.issn.1674-8115.2020.04.017 Abstract ( 847 )   PDF (8390KB) ( 369 )   Objective · To explore the obesity rate and related metabolic status of vegetarians in Shanghai and to compare with omnivores. Methods · A total of 270 vegetarians were recruited in Shanghai, and 270 omnivores were matched with 1:1 as a control group. General information and food intakes were collectedquestionnaires and food frequency questionnaires, respectively. Height, weight, waist circumference (WC), blood lipid, blood pressure, blood sugar and serum uric acid were collected and compared between vegetarians and omnivores. After controlling confounding factors such as age, gender, exercise time, and total energy, generalized estimation equation was used to analyze the association between vegetarian diet and various indicators. Results · Compared with omnivores, the body mass index (BMI) and WC of vegetarian were significantly lower (both P0.000). Compared with omnivores, the overweight or obesity diagnosedBMI and the central obesity diagnosedWC were significantly lower in vegetarians (10.0% vs 24.4%, P0.000; 2.2% vs 12.6%, P0.000), so were the total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, systolic blood pressure, fasting blood glucose, fasting insulin and female serum uric acid in vegetarians (all P0.000). After adjusting for age, gender, exercise time, sedentary time, total energy and other confounding factors, multivariate binary Logistic analysis of generalized estimating equation showed that vegetarians had significantly lower risk of overweight or obesity (OR0.355, 95% CI 0.211-0.598, P0.000) and of central obesity (OR0.131, 95% CI 0.046-0.376, P0.000). Multivariate linear regression analysis of generalized estimating equation showed that vegetarians had lower levels of total cholesterol (β-0.430 mmol/L, 95% CI -0.573 - -0.288, P0.000), high density lipoprotein cholesterol (β-0.151 mmol/L, 95% CI -0.201 - -0.101, P0.000), low density lipoprotein cholesterol (β-0.278 mmol/L, 95% CI -0.385 - -0.171, P0.000), fasting blood glucose (β-0.144 μmol/L, 95% CI -0.204 - -0.083, P0.000), and female serum uric acid (β-14.387 μmol/L, 95% CI -23.339 - -5.434, P0.000). Conclusion · Overweight or obesity in vegetarians, especially central obesity, is significantly lower than that in omnivores. Vegetarians have lower blood lipids, blood sugar and serum uric acid levels than omnivores. Vegetarian diet is an independently protective factor for obesity. Related Articles | Metrics

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Analysis on the prevention of osteoporosis in middle-aged and elderly residents of Shanghai community WANG Feng-wei, SHEN Qiu-ming, SHI Yue, ZHANG Shu-xian, WANG Hu-wen, CHANG Rui-jie, YANG Ying-hua, WAN He-ping, SHEN Tian, CAI Yong 2020, 40 (4):  525.  doi: 10.3969/j.issn.1674-8115.2020.04.018 Abstract ( 641 )   PDF (7275KB) ( 310 )   Objective · To investigate the correlation between knowledge, self-efficacy and prevention management behaviour of osteoporosis among middle-aged and elderly community residents in Shanghai, based on the knowledge, attitude, and practice (KAP) theory. Methods ·using convenient sampling, a cross-sectional study was conducted to obtain information of 2 058 residents 20 communities in Shanghai, concerning socio-demographics, osteoporosis knowledge scale, osteoporosis self-efficacy scale and osteoporosis prevention management behaviour scale questionnaires. The structural equation model was applied to correlation analysis and path analysis. Results · A total of 2 001 valid questionnaires were collected, the average age being (62.12±12.08) years; female osteoporosis prevention self-management behaviour (17.25±5.35) was shown to be better mens (t3.78, PF26.93, Pt3.89, PF8.66, Pβ0.27, 95% CI 0.22-0.32; β1.01, 95% CI 0.92-1.11). Path analysis showed that relevant knowledge (β0.169, Pβ0.410, PConclusion · Male, low education, no family history of osteoporosis and low income are the risk factors for the decrease of osteoporosis prevention and management behaviour. Related Articles | Metrics

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Advances in second near-infrared fluorescent nanoprobes-based in vivo imaging for biomedical applications CHEN Mo, CHEN Jun, CHEN Shi-yi 2020, 40 (4):  530.  doi: 10.3969/j.issn.1674-8115.2020.04.019 Abstract ( 1113 )   PDF (6957KB) ( 536 )   Besides the advantages of high sensitivity, non-invasive, and real-time imaging that the general optical imaging technologies have, the second near-infrared (1 000–1 700 nm) in vivo imaging is regarded as one of the most promising optical imaging technologies in clinical application at present due to its advantages such as low autofluorescence background, deep tissue penetration and clear imaging. In the second near-infrared imaging system, the fluorescence probe is the most critical technical difficulty and the current research hotspot. Thereinto, due to the unique physical and chemical properties of nanomaterials, the second near-infrared fluorescent nanoprobe is an ideal contrast agent for the current second near-infrared optical imaging technology. The reported inorganic materials that can be used as the second near-infrared fluorescent nanoprobes include quantum dots, rare earth nanoparticles, and single-walled carbon nanotubes, and the reported organic materials are mainly conjugated polymers. In this paper, the research progresses of the second near-infrared fluorescence nanoprobes mentioned above are reviewed into better understand their application to the field of biomedicine, and promote the further research and clinical application of the second near-infrared in vivo imaging to the biomedical field. Related Articles | Metrics

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Effect of RNA N6-methyladenosine on immunoregulation ZHU Xu-ying, LIN Qi-sheng, NI Zhao-hui 2020, 40 (4):  534.  doi: 10.3969/j.issn.1674-8115.2020.04.020 Abstract ( 1092 )   PDF (7542KB) ( 545 )   N6-methyladenosine (m6A) is the most prevalent and abundant post-transcriptional RNA modification in eukaryotes. m6A is a dynamic and reversible process catalyzedm6A methyltransferase complex and demethylase. m6A is involved in the regulations of gene and biological processes. Recently, researches have discovered that m6A plays a vital role in the differentiation and regulation of immune cells, which could provide a new idea for the research and therapy of immune-related diseases. The present article reviews the recent progresses of m6A in immunoregulation. Related Articles | Metrics

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Research progresses in transcutaneous vagus nerve stimulation GU Nan-nan, LI Chun-bo 2020, 40 (4):  539.  doi: 10.3969/j.issn.1674-8115.2020.04.021 Abstract ( 2552 )   PDF (6104KB) ( 1263 )   The vagus nerve is involved in the regulation of human inflammation, mood and pain. Stimulation of the vagus nerve has assured therapeutic effects on intracepilepsy and refractory depression. On the surface of the human body, the ear is the only area in which vagal afferent fibers distribute. According to the "bottom-up" mechanism of the signal processing, the central nervous system can be modulatedstimulating the peripheral nerve. Therefore, stimulation of the vagus nerve can regulate the activities of brain stem, thalamus, cerebral cortex and other related areas to produce therapeutic effects. Transcutaneous vagus nerve stimulation is a safe, low-cost, non-invasive physical therapy modified vagus nerve stimulation. This review focuses on the regulation of organ functiontranscutaneous vagus nerve stimulation and its application to diseases treatment. Related Articles | Metrics

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Causes of impacted maxillary incisors and progresses in orthodontic treatment CHOI Yu-hsin, YANG Xin, WU Jian-yong 2020, 40 (4):  543.  doi: 10.3969/j.issn.1674-8115.2020.04.022 Abstract ( 908 )   PDF (8152KB) ( 523 )   An impacted tooth is a tooth that cannot erupt normally when its eruption is blocked or it is erupted in the wrong direction and position. The most commonly impacted teeth is the third molar, while in the anterior region, the most common is the maxillary canine, followedthe maxillary central incisor and the maxillary lateral incisor. In recent years, the treatment of impacted maxillary incisors often uses open and closed eruption techniques with traction. Although most of the prognosis is good, traction difficulties, root resorption and alveolar bone loss are often encountered in the case of root dilacerations. This article reviews the progresses in the treatment of impacted maxillary incisors. Related Articles | Metrics

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Research progress on the promoting effect of interleukin-11 on tumors PAN De-shen, LI Deng, SHAO Yi 2020, 40 (4):  548.  doi: 10.3969/j.issn.1674-8115.2020.04.023 Abstract ( 1628 )   PDF (8498KB) ( 590 )   According to the lastest statistics, the overall morbidity and mortality of cancer in China still show an upward trend compared with historical data. An in-depth understanding of the molecular mechanisms of tumorigenesis and development is important to formulate future treatment strategies. Interleukin 11 (IL-11) is a member of cytokines that traditionally promote megakaryocyte maturation and regulate immune activity. In recent years, the promoting effect of IL-11 on tumor has been gradually discovered. This review mainly expounds that IL-11 is regulatedtransforming growth factor-β/drosophila mothers against decapentaplegic protein (TGF-β/Smad) pathway, and may play a role in tumorigenesis, drug resistance, metastasis and tumor microenvironment through signal transduction pathways such as Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway and phosphatidylinositol 3 kinase/protein kinase B (PI3K/AKT) pathway, and explores the application prospect of interfering IL-11 signal transduction in tumor therapy. Related Articles | Metrics

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Effect of modified holmium laser enucleation of the prostate on sexual function in the treatment of benign prostatic hyperplasia GU Ben-hong, QIAN Hai-ning, MENG Kai, YANG Deng-ke, CHENG Shu-jie, LI Dong 2020, 40 (4):  554.  doi: 10.3969/j.issn.1674-8115.2020.04.024 Abstract ( 1125 )   PDF (7429KB) ( 414 )   Objective · To study the effect of modified holmium laser enucleation of the prostate (HoLEP) on sexual function in patients with benign prostatic hyperplasia (BPH). Methods · The clinical data of 167 middle-aged and elderly patients with BPH treatedmodified HoLEP Feb. 2017 to Oct. 2018 were retrospectively analyzed. According to the status of sexual activity after operation, the patients were divided into study group who had sex (65 cases) and control group who had no sex (102 cases). The risk factors of sexual activity after operation in the two groups were analyzed. The changes of erectile function and ejaculatory function in the study group before and after operation were recorded and analyzedinternational index of erectile function (IIEF-5) score, erection hardness score (EHS) model and ejaculatory function questionnaire. Results · There were no significant differences between the two groups in the stress urinary incontinence, postoperative hospitalization time, weight of enucleated prostate, crush time, total prostate specific antigen, preoperative urinary retention and enucleation time. The patients in the study group were younger than those in the control group (P0.000). There were no significant differences in IIEF-5 score and EHS in the study group before and 1, 3, 6 months after operation. There were no significant differences in shorten ejaculation latency, ejaculation pain and ejaculation with or without semen in the study group before and after operation, but the patients of decreased semen volume increased 41.82% (23/55) to 92.73% (51/55) (P0.000). Conclusion · Age is a risk factor in BPH patients, whether there is sexual activity after modified HoLEP or not. The modified HoLEP has no significant effect on erectile function, but the effect on ejaculatory function is the decrease of ejaculated semen volume. Related Articles | Metrics