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    Novel coronavirus article
    Analysis of clinical features and related factors of coronavirus disease 2019 in Shanghai
    QIU Cheng-hao1, LU Hong-zhou2, SONG Bing3, LING Yun2, LIU Xin-zhe1, ZHU Ting-ting1
    2020, 40 (05):  559-565. 
    doi: 10.3969/j.issn.1674-8115.2020.05.001

    Abstract ( 453 )   PDF (7961KB) ( 127 )  
    Objective · To explore the common clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected local patients in Shanghai and their related influencing factors. Methods · A total of 320 patients admitted to Shanghai Public Health Clinical Center from January to March 2020 and diagnosed as having coronavirus disease 2019 (COVID-19) were selected. Clinical data of the patients were collected to analyze their characteristics. Using the statistical operation formula of R language, the correlation analysis of hospitalization days, days of increased hypersensitive C-reactive protein concentration (allergic days), days of lung CT improvement (CT days), and days required for nucleic acid turning negative with the main clinical manifestations and laboratory data was carried out. The correlation factors affecting the above four variables were analyzed. Results · Among the 320 patients, the proportions of mild type, moderate type, serious type and critical type were 6.25%, 83.44%, 6.88% and 3.44%, respectively; 91.25% of them had a history of exposure to Hubei. The proportions of fever, cough, sputum and fatigue were 79.06%, 46.56%, 21.56% and 15.31%, respectively. Spearman correlation analysis showed that the concentrations of lactate dehydrogenase, interleukin-2 (IL-2) and IL-6 were positively correlated with the above four variables, respectively (all P<0.05), albumin concentration was negatively correlated with allergic days (P=0.018), and CD4+ cell count was negatively correlated with CT days and days required for nucleic acid turning negative (both P<0.05). Stepwise multiple linear regression analysis showed that procalcitonin (PCT) concentration was negatively correlated with hospitalization days, CT days and allergic days (both P<0.05), and disease type was positively correlated with hospitalization days, allergic days, CT days and days required for nucleic acid turning negative (all P<0.05). Conclusion · Moderate type is common in the local patients in Shanghai; fever, cough and fatigue are common symptoms, and most of the patients are accompanied by lung CT abnormalities. The therapeutic effect and prognosis of these patients are closely related to disease type, concentrations of PCT and IL-6, as well as CD4+ cell count.
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    Spatial-temporal distribution of coronavirus disease 2019 in Jingzhou City
    LIN Mao-wen*, LIU Tian*, TIAN Ke-qing, JIANG Hong, ZENG Min-min, WANG Li, YIN Jun, LEI Ruo-qian, YAO Meng-lei, HUANG Ji-gui
    2020, 40 (05):  566-572. 
    doi: 10.3969/j.issn.1674-8115.2020.05.002

    Abstract ( 503 )   PDF (7202KB) ( 356 )  
    Objective · To explore the spatial distribution and spatial-temporal clustering of coronavirus disease 2019 (COVID-19) in Jingzhou City. Methods · Data of COVID-19 cases in Jingzhou City from January 1 to March 12, 2020 were collected. Trend surface analysis, spatial autocorrelation and spatial-temporal scanning analysis were conducted to understand the spatial-temporal distribution of COVID-19 at town (street) level in Jingzhou City, and the spatial-temporal clustering characteristics of local cases and imported cases were compared. Results · Trend surface analysis showed that the incidence rate of COVID-19 in Jingzhou City was slightly “U” from west to east, slightly higher in the east, and inverted “U” from south to north, slightly higher in the south. Global autocorrelation showed that the incidence rate of COVID-19 in Jingzhou City was positively correlated (Moran's I=0.410, P=0.000). Local spatial autocorrelation analysis showed that the highly clustered areas and hot spot areas were mainly in Shashi District, Jingzhou District and the main urban area of Honghu City (Xindi Street) (P<0.05). Five clusters were found by spatial-temporal scanning of imported cases. The cluster time of the main cluster was from January 18 to February 3, 2020, and it was centered on Lianhe Street, covering 15 towns (streets) in Shashi District and Jingzhou District (LLR=174.944, RR=7.395, P=0.000). Five clusters were found by spatial-temporal scanning of local cases. The cluster time of the main cluster was from January 20 to February 24, 2020, which was located in Xindi Street, Honghu City (LLR=224.434, RR=16.133, P=0.000). Conclusion · Obvious spatial-temporal clustering of COVID-19 was found in Jingzhou City, and Shashi District, Jingzhou District and Honghu City were the most prevalent areas.
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    Innovative research team achievement
    Evaluation of effect of smoking on myocardial injury and prognosis in patients with acute ST-segment elevation myocardial infarction
    FENG Ze-hao1*, ZHANG Qing1*, CHAI Ye-zi1, SU Xuan1, SUN Bao-hang-xing1, LIU Qi-ming1, YAN Fu-hua2, JIANG Meng1#, PU Jun1#
    2020, 40 (05):  573-582. 
    doi: 10.3969/j.issn.1674-8115.2020.05.003

    Abstract ( 481 )   PDF (11859KB) ( 138 )  
    Objective · To investigate the influence of smoking on acute myocardial injury and long-term prognosis in the patients with ST-segment elevation myocardial infraction (STEMI) by cardiac magnetic resonance (CMR). Methods · Three hundred and forty-nine STEMI patients were retrospectively selected from a prospective cohort from May 2012 to August 2017, and were followed up for at least 2 years. The primary endpoint was a composite of all-cause death, reinfarction and stroke. The secondary endpoint was heart failure rehospitalization. The patients were divided into smoker group and non-smoker group according to the baseline status of smoking which was recorded at admission. The difference in the incidence of endpoint events was further analyzed in combination with the presence or absence of intramyocardial hemorrhage (IMH) between the two groups. Results · There were 221 patients in the smoker group, accounting for 63.3% of the total sample. The average age of onset in smokers were 4.66 years earlier than non-smokers. However, smokers showed a lower incidence of left ventricular thrombosis and lower levels of brain natriuretic peptide than non-smokers (P=0.023, P=0.000). There was no difference in the left ventricular ejection fraction between the two groups (P>0.05), but the smokers had a better end-systolic and end-diastolic volume index (P=0.019, P=0.007). Smokers and non-smokers had similar clinical outcomes of all-cause death, reinfarction and stroke (P>0.05). The incidence of heart failure rehospitalization in smokers was quite lower than that of the non-smokers, but this kind of protective effect disappeared after differences in baseline being adjusted (P=0.167). In the patients with IMH, smoking had a protective effect on primary endpoints (HR=0.266, P=0.008), but in the patients without IMH, smokers had a worse outcome of all-cause death and reinfarction than non-smokers (P=0.024). Conclusion · In patients with STEMI, smoking has no protective effect on long-term prognosis. When IMH appears in STEMI patients, smoking has a protective effect on all-cause death, reinfarction and stoke. However, in patients without IMH, smokers have a worse prognosis than non-smokers.
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    Original article (Basic research)
    Quality control of serum antibodies through the combination of phage display and next generation sequencing
    LAI Dan-yun1, HU Chuan-sheng2, QI Huan1, MA Ming-liang1, LI Hua2, TAO Sheng-ce1
    2020, 40 (05):  583-589. 
    doi: 10.3969/j.issn.1674-8115.2020.05.004

    Abstract ( 371 )   PDF (8087KB) ( 118 )  
    Objective · To establish a quality control system for serum antibodies and provide a quantitative standard for the quality control of serum autoantibody-based biomarker study. Methods · Sera from 50 healthy people were taken to prepare the samples and aliquoted. The aliquoted sera were stored at -80 ℃, -20 ℃, 4 ℃, 37 ℃, and 95 ℃ for a period of time. Samples were collected at different time points. The samples were incubated with Ph.D.-12, a phage display random peptide library. The phage-IgG complex was enriched through immunoprecipitation with protein G-coated magnetic beads. By sequencing the coding sequences of the displayed peptides, the sequence and frequency of the serum antibody-enriched peptides were determined. Using the frequencies of each enriched peptide, Shannon entropies were calculated for each sample. Shannon entropy was applied as an indicator to evaluate the quality of the serum autoantibodies. Results · With the increase of the treating temperature, the Shannon entropies of the sera gradually decreased, while there was no significant difference between the Shannon entropies of -20 ℃ and -80 ℃ . The Shannon entropy reached the lowest value after being treated at 95 ℃ for 10 min. At the same temperature, the Shannon entropies of the sera were inversely proportional to the length of the treating periods. Conclusion · It is practically applicable to decipher the profile of the serum antibody binding peptides, through the combination of a phage display random peptide library and next-generation sequencing. Shannon entropy can be calculated using the frequencies of each enriched peptide, and applied as an indicator to judge the overall quality of the serum antibodies.
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    Establishment of non-alcoholic steatohepatitis mouse model induced by Western diet combined with low-dose carbon tetrachloride
    KANG Jian-hua1, LI Ming-jie1, LUAN Pei-pei2, CHEN Yuan-wen3, PENG Wen-hui2, JIAN Wei-xia1
    2020, 40 (05):  590-597. 
    doi: 10.3969/j.issn.1674-8115.2020.05.005

    Abstract ( 440 )   PDF (10312KB) ( 116 )  
    Objective · To construct a non-alcoholic steatohepatitis (NASH) mouse model by the combination of Western diet (WD) and low-dose carbon tetrachloride (CCl4), and explore the time nodes of typical NASH pathological changes. Methods · Male 8-week C57BL/6 mice were fed WD and intraperitoneally injected with CCl4 at a dose of 2 μL/g of body weight per week to construct NASH models. At different time points, the fasting blood glucose, and the levels of triacylglyceride, glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase were tested; glucose tolerance was tested at the 24th week. Besides, the liver index was calculated and oil red O staining, Sirius red staining, hematoxylin-eosin staining and TUNEL test were conducted to evaluate liver pathological changes after liver sampling. Results · Between the control group and model group, there was no significant difference in fasting blood glucose and glucose tolerance test result, while the significant differences of liver index were observed at the 8th, 12th and 24th week (P<0.05). And at the 24th week, the levels of triacylglyceride, glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase were higher in the model group than those in the control group (P<0.05). According to the results of oil red O staining, Sirius red staining, hematoxylin-eosin staining and TUNEL test, in the model group, a large amount of small lipid droplets accumulation in the liver tissues was detected and hepatocytes were mainly in apoptotic state at the 8th week; large lipid droplets, hepatocellular ballooning and spot-like necrosis were observed, and hepatocyte apoptosis persisted at the 16th week; stage 3 fibrosis of liver was observed, and the number of spot-like necrosis increased but lipid droplets decreased, while hepatocytes were mainly in a proliferative state at the 24th week. Conclusion · The mouse model of NASH can be established successfully by WD combined with low-dose CCl4, which can simulate the pathologic features of NASH in a short time.
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    Therapeutic effects of albendazole on mice with artery stenosis and its mechanism
    LU Fang-fang1, YAO Jia-lu2, NIU Xiao-yin3, WENG Zhen4#, HE Yang1, 4#
    2020, 40 (05):  598-603. 
    doi: 10.3969/j.issn.1674-8115.2020.05.006

    Abstract ( 291 )   PDF (7563KB) ( 85 )  
    Objective · To investigate the effect of albendazole (ABZ) on mouse femoral arteries restenosis and explore its possible mechanism. Methods · Vascular smooth muscle cells (VSMCs) were cultured in vitro with 0.5 and 1 μmol/L ABZ, and evaluated for cell proliferation, migration, and apoptosis by MTT, Transwell assay, and Annexin V-PI staining flow cytometry, respectively; and Western blotting was also used for the analysis of phosphorylation mechanism of cytoskeleton proteins cofilin (CFL) and myosin light chain (MLC). Stenosis was established in the unilateral femoral artery of 10-week-old wildtype male C57BL/6 mice by perivascular cuff placement and high fat chow breeding for 4 weeks. After successful modeling, mice were randomly divided into control group (equal volume of solvent) and ABZ group (1.5 mg/d) for gavage, and femoral arteries were collected 4 weeks later for H-E histological analysis of intimal area, medial area, and intima/media (I/M) ratio to clarify the severity of restenosis. Results · Both 0.5 and 1 μmol/L ABZ could significantly inhibit the proliferation and migration of VSMCs (both P<0.05), while 0.5 μmol/L had no significant effect on the apoptosis of VSMCs. ABZ gavage could significantly reduce the neointimal area and I/M ratio in the restenosis mice, while there were no effects on the median area. Both 0.5 and 1 μmol/L ABZ treatment could significantly inhibit CFL dephosphorylation and MLC phosphorylation, which showed a concentration-dependent trend (both P<0.05). Conclusion · ABZ inhibits VSMCs migration and intimal hyperplasia, via affecting the phosphorylation of cytoskeleton protein CFL and MLC, thereby resulting in therapeutic effects on restenosis of mice.
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    Effect of medium frequency electrical stimulation on expression of neurotrophin-3 in rat masseter muscle
    LIU Zhen-qiao, CHEN Qing-qing, WANG Yu-rong
    2020, 40 (05):  604-608. 
    doi: 10.3969/j.issn.1674-8115.2020.05.007

    Abstract ( 327 )   PDF (6497KB) ( 101 )  
    Objective · To investigate the effect of medium frequency electrical stimulation on the expression of neurotrophin-3 (NT-3) in the mandibular protrusion of SD rats. Methods · Sixty male SD rats were randomly divided into three groups (n=20): blank control group, conditioned control group (treated with functional appliance, but without medium frequency electrical stimulation) and experimental group (treated with functional appliance and medium frequency electrical stimulation). Five rats in each group were sacrificed on the 3rd, 7th, 14th and 21st day to prepare the samples of masseter muscle. Immunohistochemistry and quantitative real-time PCR methods were used to detect the protein and mRNA expressions of NT-3 in the masseter muscle of rats. Results · The protein and mRNA expressions of NT-3 were increased firstly and then decreased in the conditioned control group and the experimental group, compared with those in the blank control group. Moreover, the protein and mRNA expressions of NT-3 in the conditioned control group were still higher than those in the blank control group on the 21st day (both P<0.05), while the protein and mRNA expressions of NT-3 in the experimental group almost returned to the normal level on the 21st day. Conclusion · Medium frequency electrical stimulation may accelerate the rate of neuromuscular reconstruction and shorten the time of functional orthopedic therapy in rats.
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    Role and mechanism of PRMT4 in genesis and progression of gastric cancer
    DOU Min1, 2, ZHENG Ying-xia2, HAN Li2, ZHAO Qian1
    2020, 40 (05):  609-618. 
    doi: 10.3969/j.issn.1674-8115.2020.05.008

    Abstract ( 528 )   PDF (11182KB) ( 125 )  
    Objective · To investigate the effect of protein arginine methyltransferase 4 (PRMT4) on the development and progression of gastric carcinoma and the underlying molecular mechanisms. Methods · The expression levels of PRMT4 in 32 specimens of gastric cancer and adjacent tissues were measured by immunohistochemistry technology. Public databases were used to analyze the expression of PRMT4 in gastric cancer and its effect on the survival of patients with gastric cancer. PRMT4 expressions of gastric cancer MGC-803 and MKN-45 cells were down-regulated by short hairpin RNA-mediated knockdown, and PRMT4 expression of gastric cancer SGC-7901 cells was up-regulated by using plasmid-mediated overexpression. Cell biology methods, such as MTT assay, colony formation assay, flow cytometry, and Transwell assay were used to study the effect of PRMT4 on proliferation, apoptosis, migration and invasion of gastric cancer cells. Luciferase reporter assay was used to detect transcription activity of endogenous transcription factor TCF (T cell factor) after PRMT4 silencing. The mRNA level changes of Wnt/β-catenin pathway downstream target genes after PRMT4 silencing were detected by real-time PCR. The protein level changes of Wnt/β-catenin pathway-related proteins after PRMT4 silencing and overexpression were detected by Western blotting. Results · PRMT4 was highly expressed in gastric cancer tissues. Patients with higher expression of PRMT4 had shorter survival than those with lower expression of PRMT4. The proliferation, colony formation, migration and invasion ability of gastric cancer cells were inhibited; the cell apoptosis was induced by silencing of PRMT4. The Wnt/β-catenin signaling pathway was also inhibited by PRMT4 knockdown. The proliferation, colony formation, migration and invasion ability of gastric cancer cells were induced; the cell apoptosis was inhibited by overexpressed PRMT4. The Wnt/β-catenin signaling pathway was also activated by PRMT4 overexpression. Conclusion · PRMT4 is highly expressed in gastric cancer. It can promote the growth, migration and invasion of gastric cancer cells through Wnt/β-catenin signaling pathway.
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    Original article (Clinical research)
    Effect of simplified cognitive behavioral therapy on generalized anxiety disorder
    ZHANG Li1, FANG Fang1, ZHU Zhi-pei2, 3, SHEN Yuan4, LIU Na5, LI Chun-bo3
    2020, 40 (05):  619-625. 
    doi: 10.3969/j.issn.1674-8115.2020.05.009

    Abstract ( 391 )   PDF (8822KB) ( 149 )  
    Objective · To explore the effect of simplified cognitive behavioral therapy (SCBT) on generalized anxiety disorder (GAD). Methods · GAD patients were recruited from Shanghai Hongkou Mental Health Center, Shanghai Putuo Mental Health Center, Tenth People’s Hospital of Tongji University, The Affiliated Brain Hospital of Nanjing Medical University and Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, who were divided into SCBT group, SCBT+medication group and medication group. The Generalized Anxiety Disorder Scale-7 (GAD-7) was used to assess the patients' generalized anxiety symptoms, Hamilton Anxiety Scale-14 (HAMA-14) to assess the patients' anxiety level, and Hamilton Depression Scale-17 (HAMD-17) to assess the patients' depression level. SCBT and/or medication were used. Three groups of patients were evaluated by single blind method. Variance analysis and χ2 test were used to compare the cure rate and the severity of anxiety and depression at different time points. Results · A total of 134 cases were included in the statistical analysis, 39 cases in SCBT group, 53 cases in SCBT+medication group, and 42 cases in medication group. There was no significant difference in gender, education level and marital status among the three groups, and there was significant difference in age (P=0.033). The cure rate of SCBT group was higher than those of SCBT+medication group and medication group (P=0.005). The scores of anxiety and depression of the three groups decreased with the prolongation of treatment time. Conclusion · SCBT can effectively alleviate the anxiety and depression symptoms of GAD patients, and has a better prognosis for GAD patients.
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    Effect of sublingual immunotherapy on functions of effector T cells and regulatory T cells
    DAI Fei, WEI Jin-jin, TANG Xin-yue, CHEN Zheng, LIN Lin
    2020, 40 (05):  626-632. 
    doi: 10.3969/j.issn.1674-8115.2020.05.010

    Abstract ( 326 )   PDF (8174KB) ( 75 )  
    Objective · To investigate the effect of sublingual immunotherapy (SLIT) on the functions of effector T cells (Teff) and regulatory T cells (Treg) under allergic rhinitis (AR) condition. Methods · Peripheral blood mononuclear cells (PBMC) were obtained from 20 AR patients who were recruited from Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital North of Fudan University before and after the 24- and 30-month treatments of SLIT. The percentages of Teff and Treg in CD4+ T cells in PBMC were examined and the contents of calcium release-activated calcium channel modulator 1 (ORAI1) protein and Ca2+ mean fluorescence intensity (MFI) in PBMC were measured. Then, Teff and Treg after the 30-month treatment were cultured in vitro, and were evaluated for the expression of ORAI1 protein and concentrations of interleukin-4 (IL-4) and IL-10 in the cultures. Lentivirus vector (lenti) that encoded short hairpin RNA against ORAI1 (lenti-ORAI1) was prepared and transfected into Teff and Treg, and then Ca2+ MFI in Teff and Treg and concentrations of IL-4 and IL-10 in the cultures were assessed again. Results · The percentage of Teff in CD4+ T cells in PBMC reduced gradually after the 24- and 30-month treatments (P=0.000, P=0.027); however, the percentage of Treg was increased (P=0.000, P=0.008). The expression of ORAI1 protein (P=0.000, P=0.003) and Ca2+ MFI (P=0.000, P=0.000) in Teff were also decreased gradually after the 24- and 30-month treatments; however, the expression of ORAI1 protein (P=0.000, P=0.007) and Ca2+ MFI in Treg were enhanced (P=0.000, P=0.000). ORAI1 protein was expressed in these two types of cells cultured in vitro. Furthermore, Ca2+ MFI in them (P=0.004, P=0.000) and IL-4 (P=0.009) and IL-10 (P=0.000) in the cultures were all decreased after the transfection of lenti-ORAI1. Conclusion · SLIT can control functions of Teff and Treg through regulating the expression of ORAI1 protein.
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    Safety and efficacy of focused low-intensity pulsed ultrasound therapy for the treatment of knee osteoarthritis
    JIA Lang1, TAN Bo-tao1, CHEN Jin-yun2
    2020, 40 (05):  633-638. 
    doi: 10.3969/j.issn.1674-8115.2020.05.011

    Abstract ( 407 )   PDF (9305KB) ( 136 )  
    Objective · To investigate the safety and efficacy of focused low-intensity pulsed ultrasound (FLIPUS) therapy on the patients with knee osteoarthritis (KOA). Methods · A total of 100 subjects with KOA from August 2018 to August 2019 in the Department of Rehabilitation Medicine at the Second Affiliated Hospital of Chongqing Medical University were sequentially randomized into group A and group B. Among them, FLIPUS was adopted to treat the 50 patients in group A, and the diclofenac sodium was adopted to treat the other 50 patients in group B. Visual analogue scale (VAS), Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne index (LI) were used to evaluate knee joint pain, the structure and function of the affected knee joint, and the severity of the affected knee joint at baseline, on day 3, day 6 and day 10 after treatment respectively. The knee range of motion (KROM) and maximum walking speed (MWS) were used to evaluate the knee joint movement and walking function at baseline and on day 10 after treatment respectively. Results · There were on significant differences between two groups with respect to KOA evaluation indexes (P>0.05). Compared with those in group B, patients in group A showed significant improvements in VAS and WOMAC scores on day 6 and day 10 after treatment (P=0.021, P=0.000; P=0.005, P=0.001). Meanwhile, patients in group A had higher LI scores than those in group B on day 10 after treatment (P=0.000). In addition, patients in group A showed significant improvements in MWS (P=0.006) and non-significant improvements in KROM (P=0.064) on day 10 after treatment. Conclusion · FLIPUS is a safe and effective treatment modality for relieving pain and improving the functions of patients with KOA.
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    Clinical significance of geranylgeranyl diphosphate synthase expression levels in patients with acute respiratory distress syndrome
    WANG Xiao-xia1, XU Tian-xiang2, LÜ Tang-feng3, XU Wu-jian3, LIU Jian-bo1, SONG Yong3
    2020, 40 (05):  639-645. 
    doi: 10.3969/j.issn.1674-8115.2020.05.012

    Abstract ( 367 )   PDF (8530KB) ( 95 )  
    Objective · To investigate the clinical significance of geranylgeranyl diphosphate synthase (GGPPS) by detecting its expression levels in the peripheral blood mononuclear cells of patients with acute respiratory distress syndrome (ARDS). Methods · The GGPPS mRNA expression levels in peripheral blood mononuclear cells of patients with ARDS were compared with those of healthy controls, by using quantitative reverse-transcription polymerase chain reaction. The GGPPS protein expression levels in the peripheral blood mononuclear cells were detected by Western blotting. The differential expression of GGPPS in survivors and non-survivors of ARDS was also examined. The correlations between GGPPS and clinical indicators of ARDS were tested by using Spearman’s coefficients. Results · The mRNA and protein expression levels of GGPPS in the peripheral blood mononuclear cells of patients with ARDS were significantly higher than those of healthy controls (P<0.05), and these levels increased with the aggravation of ARDS (P<0.05). Moreover, the expression levels of GGPPS mRNA and protein were significantly higher in the patients who succumbed to ARDS than those in the survivors (P<0.05). The elevated level of GGPPS mRNA was correlated with the elevated acute physiology and chronic health evaluationⅡ(APACHE Ⅱ ) score (r=0.862, P=0.000), elevated sequential organ failure assessment (SOFA) score (r=0.719, P=0.023), lower oxygenation index (r=-0.821, P=0.000), elevated C-reactive protein (r=0.758, P=0.024), and elevated white blood cells (r=0.761, P=0.015). Conclusion · The elevated expression level of GGPPS in the peripheral blood mononuclear cells is associated with greater disease severity and poorer prognosis in patients with ARDS. Based on these observations, GGPPS is expected to serve as an appropriate biomarker to assess the severity of ARDS.
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    Application of 18F-FDG PET/CT-guided percutaneous biopsy to differential diagnosis of peritoneal thickening diseases
    WANG Hai-yan, YOU Zhi-wen, SHOU Yi, MENG Qing-yuan, CHEN Hui-qian, ZHAO Jun
    2020, 40 (05):  646-650. 
    doi: 10.3969/j.issn.1674-8115.2020.05.013

    Abstract ( 434 )   PDF (6788KB) ( 123 )  
    Objective · To investigate the clinical value of 18F-flurodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) -guided percutaneous biopsy in peritoneal thickening of unknown origin. Methods · Ten cases of peritoneal thicken of unknown origin including 4 males and 6 females were analyzed. After 18F-FDG PET/CT examination, the peritoneal thickening regions with high 18F-FDG uptake were selected for the target areas. Percutaneous biopsy was operated under the guidance of the same PET/CT machine. Results · All lesions were successfully obtained by one-time puncture without serious complications, and histopathological diagnosis revealed that 7 cases were malignant, including 4 cases of peritoneal metastasis and 3 cases of lymphoma. The remaining cases were 1 case of pseudomyxoma, 1 case of tuberculosis and 1 case of inflammatory lesions. The accuracy of biopsy was 100%. Conclusion · 18F-FDG PET/CT-guided peritoneal percutaneous biopsy is a safe and effective method, and may play an important role in differential diagnosis and treatment management.
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    Effect of laryngeal mask and endotracheal tube ventilation on gastric insufflation during general anesthesia with ultrasound evaluation
    GAO Hong-mei1, BAO Yang1, LI Shu-yun1, YIN Su-qing2, ZHU Ling2, YANG Li-qun2
    2020, 40 (05):  651-655. 
    doi: 10.3969/j.issn.1674-8115.2020.05.014

    Abstract ( 343 )   PDF (6435KB) ( 108 )  
    Objective · To observe the correlation between streamlined liner of pharynx airway (SLIPA) and gastric insufflation. Methods · Seventy patients who underwent elective general anesthesia in Jiading District Central Hospital Affiliated to Shanghai University of Medicine & Health Sciences from September 2017 to May 2018 were included. They were randomly divided into SLIPA group (S group, n=35) and endotracheal tube group (T group, n=35). The gastric antrum ultrasonography was performed at four time points before induction, immediately after intubation (insertion of laryngeal mask), before extubation (laryngeal mask), and immediately after extubation (laryngeal mask), to measure the cross sectional area (CSA) of gastric insufflation. Gastric intake was assessed by ultrasonic measurement of CSA and "comet tail sign" in ultrasound imaging. Pulse oxygen saturation (SpO2), end-tidal pressure of carbon dioxide (PETCO2), peak inspiratory pressure (PIP) and CSA were recorded and compared at the corresponding time points. Results · There was no significant difference in gastric insufflation rate between the two groups during anesthesia (P=0.894). There was no significant difference in SpO2 at each time point between the two groups (all P>0.05). At the end of surgery, PETCO2 in group S was significantly higher than that in group T (P=0.000). Conclusion · Compared with endotracheal tube, the SLIPA does not increase gastric insufflation during general anesthesia.
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    Long-term results of minimally invasive direct coronary artery bypass
    XU Hong*, ZHU Peng-xiong*, ZHOU Yan-zai, QIU Jia-pei, LIU Jun#, ZHAO Qiang#
    2020, 40 (05):  656-661. 
    doi: 10.3969/j.issn.1674-8115.2020.05.015

    Abstract ( 381 )   PDF (6702KB) ( 95 )  
    Objective · To summarize the experiences and follow-up results of minimally invasive direct coronary artery bypass (MIDCAB) for treating coronary atherosclerotic cardiopathy for 10 years and to evaluate the long-term effects of MIDCAB. Methods · The patients who underwent MIDCAB at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from February 2009 to May 2019 were collected. According to whether the patients achieved complete revascularization (CR) or underwent hybrid coronary revascularization (HCR), the cases were divided into 3 groups: incomplete revascularization (IR) + optimal medical therapy (OMT) group, MIDCAB (CR) group and HCR (CR) group. The Kaplan-Meier (K-M) curve was used to analyze the long-term survival and the freedom from major adverse cardiac and cerebrovascular events (MACCE) of patients. Results · A total of 425 patients were enrolled in the study, with a median follow-up of 39.9 months (18.2-81.1 months). The hospital stay in the HCR (CR) group was significantly prolonged compared with the other two groups (P=0.000). The perioperative mortality (P=0.000), perioperative myocardial infarction (MI) rate (P=0.000), perioperative MACCE rate (P=0.000), cardiac troponin I (cTnI) levels in 48 h (P=0.011), long-term mortality (P=0.000), long-term MI rate (P=0.002), and long-term MACCE rate (P=0.005) in the IR + OMT group were significantly higher than those in the other two groups of patients who had CR. The overall 10-year survival rate and freedom from MACCE estimated by K-M curves were 80.9% (95%CI 73.1%-88.7%) and 70.5% (95%CI 62.1%-78.9%), respectively. The long-term survival (P=0.000) and freedom from MACCE (P=0.001) in IR+OMT group were significantly lower than those in the other two groups. Conclusion · MIDCAB has good long-term effects on patients with coronary atherosclerotic cardiopathy. Patients undergoing MIDCAB should complete CR, and IR can significantly affect the long-term prognosis of patients.
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    Analysis of clinical features and prognostic factors of meconium peritonitis
    WANG Peng-peng, ZHU Xiao-dong, XIE Wei
    2020, 40 (05):  662-665. 
    doi: 10.3969/j.issn.1674-8115.2020.05.016

    Abstract ( 349 )   PDF (5287KB) ( 194 )  
    Objective · To analyze the clinical features of meconium peritonitis (MP) and the related factors influencing its prognosis. Methods · Fifty-four patients with MP who received surgical intervention at department of pediatric intensive care unit , Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from May 2006 to May 2018 were retrospectively reviewed, and divided into complication group (n=24) and non-complication group (n=30). Risk factors of the two groups after operation were analyzed, including general condition, prenatal diagnosis and preoperative value of C-reactive protein (CRP), independent-samples t test, χ2 test or Fisher’s exact test. Results · Compared with the non-complication group, days of admission and operation after birth were longer; the gestational age and the birth weight were lower (all P<0.05) in the complication group; the CRP value of the complication group was higher than that of the non-complication group (P=0.048). The prenatal diagnosis percentage of the non-complication group was higher than that of the complication group (P=0.039). However, there was no statistical significance in gender, Apgar score, surgical procedure, delivery type and prenatal ultrasound findings. Conclusion · Prenatal ultrasound detection with MP and early surgical treatment can improve the prognosis, and the preoperative inflammation level has a certain predictive value for the prognosis of children.
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    Original article (Public health)
    New grey correlation and degree of structure variation analysis of hospitalization cost of childhood pneumonia
    ZHU Wei-jun1, MA Jin1, CUI Wen-bin2, YUAN Su-wei1
    2020, 40 (05):  666-670. 
    doi: 10.3969/j.issn.1674-8115.2020.05.017

    Abstract ( 406 )   PDF (6724KB) ( 197 )  
    Objective · To understand the structural changes and related reasons of the average cost of hospitalization of childhood pneumonia in Shanghai, and to propound related policy suggestion. Methods · New grey correlation and degree of structural variation analysis were used to research the average cost of hospitalization of 22 543 children with pneumonia from 2015 to 2018 in a children's specialized hospital in Shanghai. The average cost included 5 categories, i.e. medicine cost, material cost, examination and laboratory cost, labour cost and bed occupation cost. The relational degree and structural changes between each average cost and the average cost of hospitalization were discussed. Results · The new grey correlation analysis showed that the relational degree sort order of each average cost from the highest to the lowest were average examination and laboratory cost (γ3=1.000 0), average medicine cost (γ1=0.862 5), average bed occupation cost (γ5=0.845 1), average labour cost (γ4=0.796 8) and average material cost (γ2=0.786 3). The degree of structure variation analysis showed that the contribution rate of structure variation (CSV) sort order of each average cost in 2015-2018 from the highest to the lowest were average medicine cost (CSV1=36.22%), average bed occupation cost (CSV5=27.65%), average examination and laboratory cost (CSV3=13.91%), average material cost (CSV2=13.78%) and average labour cost (CSV4=8.44%). The average medicine cost and average material cost were negative variation. Conclusion · The average examination and laboratory cost and average medicine cost are the main factors that influenced the average cost of hospitalization of childhood pneumonia. The proportion of the average labour cost is relatively low. It is suggested that the cost structure like raising labour charges and optimizing diagnosis and treatment process should be further adjusted in order to control the growth of medical costs.
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    Review
    Progress of application of tactile imaging to pelvic floor dysfunction
    QIU Yu, WU Qing-kai, HUANG Cheng-sheng
    2020, 40 (05):  671-673. 
    doi: 10.3969/j.issn.1674-8115.2020.05.018

    Abstract ( 415 )   PDF (5135KB) ( 192 )  
    Elastic imaging is a technique for converting the elastic modulus of soft tissues to real-time computer images. As one of the branches of elastic imaging, tactile imaging is distinguished by the feature of pressing directly against the surface of soft tissues. It is a mature option to diagnose diseases in urology, general surgery, gynecology and obstetrics. In recent years, tactile imaging, especially vaginal tactile imaging, has been used to evaluate female pelvic floor dysfunction diseases. This review is about tactile imaging and its application to the field of pelvic floor dysfunction.
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    Recent advance in association of galectin-3 with atrial fibrillation
    YANG Xin-ying1, GAO Yi2, MIAO Cong-liang3, DING Xiao-ying4, HONG Jiang1, 3
    2020, 40 (05):  674-678. 
    doi: 10.3969/j.issn.1674-8115.2020.05.019

    Abstract ( 305 )   PDF (8186KB) ( 111 )  
    Atrial fibrillation is a common cardiac arrhythmia encountered in the clinical practice with a complex pathological mechanism, which is closely related to structural remodeling such as atrial fibrosis. Galectin-3 (Gal-3) is the only chimeric member of the galectin family and is considered as a biomarker of fibrosis; therefore, it may be involved in atrial remodeling in the patients with atrial fibrillation. This article reviews literatures on the association of Gal-3 with atrial fibrillation.
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    Review of brain mechanism of abnormal semantic processing in major depression disorder
    YE Hui-ling, LÜ Na, FAN Qing
    2020, 40 (05):  679-682. 
    doi: 10.3969/j.issn.1674-8115.2020.05.020

    Abstract ( 375 )   PDF (6021KB) ( 154 )  
    Major depression disorder (MDD) is a serious mental illness with high disability rate and high recurrence rate, accompanied by cognitive impairment including language processing. This article reviews neurophysiological evidences of abnormal semantic processing in MDD patients in recent years. Electrophysiological data indicates that abnormal semantic processing in the patients begins in the early stages of perceptual processing and persists in subsequent cognitive processing stages with hemispheric lateralization. Brain imaging studies show that the patients have abnormal activation levels in the medial prefrontal cortex and inferior frontal gyrus. The current research paradigms cannot separate semantic processing from other cognitive processes, and more research is needed.
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    Research progress of mitochondrial Lon protease and its related diseases
    YANG Shuo-yao1, 2, QI Zi-yi3, XIANG Jun4
    2020, 40 (05):  683-687. 
    doi: 10.3969/j.issn.1674-8115.2020.05.021

    Abstract ( 430 )   PDF (7628KB) ( 310 )  
    Lon protease (LON) is a highly conserved ATP-dependent serine protease, which is responsible for the decomposition and elimination of abnormal proteins. As an important executor of intracellular environment stability, LON can degrade misfolded and damaged proteins together with proteasome to ensure the high quality of proteins in vivo, especially in the maintenance of mitochondrial function. At the same time, the physiological function of LON also has an important effect on cell survival under various stresses. Recent studies have shown that the abnormal expression or activity of LON is involved in the occurrence and development of many diseases such as neurodegenerative diseases, diabetes mellitus, myocardial ischemia, cerebral ischemia and tumors. This review focuses on the structure and the function of LON, the relationship between abnormal expression and diseases, and the research progress of LON activity intervention, in order to provide ideas for clinical diagnosis and treatment of related diseases.
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    Recent advances in the risk factors, diagnosis and evaluation of renal calculus
    ZHOU Yue-ling, DING Feng
    2020, 40 (05):  688-692. 
    doi: 10.3969/j.issn.1674-8115.2020.05.022

    Abstract ( 385 )   PDF (8193KB) ( 176 )  
    Renal calculus is a common disease of urinary system. Calculus formation is associated with dietary factors, genetics, comorbidities, microorganism environment, modulators in the urine and many other factors. It has become a kind of chronic metabolic condition which needs multi-disciplinary treatment. Imaging, metabolic evaluation and calculus analysis provide a variety of tools for calculus diagnosis and evaluation. As the first-line imagine examination recommended by guidelines, CT has advantages in distinct sectional anatomy with high sensitivity and specificity, and dual-energy CT makes it possible to discriminate different calculus compositions noninvasively. The 24-hour urine test can help predict the risk of renal calculus. This article reviews recent research progresses in the risk factors, diagnosis and evaluation of renal calculus.
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    Research progress of the mechanism of rituximab in the treatment of focal segmental glomerulosclerosis
    JI Yin-hong, REN Hong
    2020, 40 (05):  693-697. 
    doi: 10.3969/j.issn.1674-8115.2020.05.023

    Abstract ( 477 )   PDF (8281KB) ( 127 )  
    Rituximab (RTX), as a monoclonal antibody of CD20 acting on B cell epitopes, has been applied to the field of kidney since 2005, and has become a research hotspot in the clinical treatment of glomerulonephritis. At present, in addition to its clinical safety and efficacy, some researchers are still committed to explore the mechanism of RTX in the treatment of renal diseases, trying to find out whether there is a specific target in renal tissue. In this paper, the mechanism of RTX in the treatment of focal segmental glomerulosclerosis is reviewed.
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    Case report
    Redo cardiac surgery with cardiopulmonary bypass after renal transplantation: a case report
    NI Yin-kai, ZHAO Jin-long, FU Liang, LU Zhe-xin, CHEN Zong-hui, LI Feng
    2020, 40 (05):  698-700. 
    doi: 10.3969/j.issn.1674-8115.2020.05.024

    Abstract ( 301 )   PDF (3478KB) ( 151 )  
    A 71-year-old man was admitted to hospital due to chest tightness and shortness of breath for more than half a year. Echocardiography suggested severe mitral regurgitation and tricuspid regurgitation. The patient underwent repair of atrial septal defect under cardiopulmonary bypass in 1983 and right kidney transplantation in 2010 due to renal failure. Mitral and tricuspid biovalve replacement was performed on the patient in 2019. No obvious infection and acute renal insufficiency occurred after the operation, and no abnormality was found in the artificial mitral valve and tricuspid valve on echocardiography. The patient was discharged successfully. There are few reports of cardiopulmonary bypass for renal transplant patients, especially for the second time. This case and perioperative management can provide reference for other surgeons.
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