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    Original article (Basic research)
    Using aptamer of sgc8 for diagnosis of acute leukemia
    XU Kang-li1, MA Ya-ni2, WANG Xiao-jin3, MIAO Yan-yan1, HAN Da1#, TAN Wei-hong1#
    2020, 40 (09):  1157-1167. 
    doi: 10.3969/j.issn.1674-8115.2020.09.001

    Abstract ( 529 )   PDF (12599KB) ( 134 )  
    Objective · To study the ability of aptamer sgc8 to recognize different bone marrow cells and evaluate its diagnostic value for acute leukemia (AL). Methods · 5-Carboxyfluorescein-labeled aptamer sgc8 and its control random library chain (Lib) were used to examine 83 clinical bone marrow samples by flow cytometry, and the difference between sgc8 and Lib of the positive percentages of each cell population was analyzed. Kruskal-Wallis test was used for statistical analysis. Results · In AL samples, sgc8 has a specific ability to recognize tumor cells in most of the acute T-cell acute lymphoblastic leukemia (T-ALL) and acute myeloid leukemia (AML) samples, and the ability of sgc8 to recognize tumor cells of various AML subtypes is different while there is no difference for the ability to recognize tumor cells of T-ALL subtypes. But sgc8 doesn’t show obvious recognition ability in acute B-cell lymphoblastic leukemia (B-ALL) samples. In normal bone marrow samples, sgc8 can specifically recognize the myeloid blast cellsbut not early B cells and other mature cell populations. Conclusion · The aptamer sgc8 has specific recognition ability in AML, T-ALL and normal bone marrow samples, and may have different diagnostic values for various AML subtypes, but it does not significantly recognize cells of B-ALL samples.
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    Gonadotropin-releasing hormone-antagonist up-regulate the proportion of uterine natural killer cells and enhance their toxicity during the implantation window period of mice
    ZHOU Wen-jie, XU Bu-fang
    2020, 40 (09):  1168-1173. 
    doi: 10.3969/j.issn.1674-8115.2020.09.002

    Abstract ( 299 )   PDF (6960KB) ( 76 )  
    Objective · To investigate the effects of gonadotropin-releasing hormone-antagonist (GnRH-ant) on the proportion and toxicity of mice uterine nature killer (uNK) cells during implantation window. Methods · Sixteen C57BL/6 mice were randomly divided into GnRH-ant group and control group, with 8 mice in each group. From the 3rd day of the estrous cycle, GnRH-ant (1.5 μg/100 g) was injected intraperitoneally into the mice of the GnRH-ant group for 7 days continuously, and the control group was injected with the same volume of normal saline at the same time point. On the 7th day, the mice of the two groups were injected with human menopausal gonadotropin (40 U/100 g). The next day, they were injected with human chorionic gonadotropin (100 U/100 g) and sacrificed after 48 h. The uterus tissues were taken out for primary digestion to obtain single-cell suspension. Flow cytometry was used to analyze the proportion of uNK cells and the expression levels of toxicity molecules perforin (Pf) and granzyme B (Gz-B). Results · Compared with the control group, the proportion of uNK cells in GnRH-ant group increased (P=0.000), the proliferation level increased (P=0.000), the apoptosis level decreased (P=0.004), and the expression of toxicity molecules Pf (P=0.000) and Gz-B (P=0.034) were up-regulated. Conclusion · GnRH-ant may up-regulate the proportion of uNK cells and enhance their toxicity in the implantation window period of mice.
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    Bioinformatics analysis of miRNAs in mild cognitive impairment due to Alzheimer's disease
    HE Hai-ning, ZHANG Wei, YAN Feng, SHI Yan-chen, WANG Jing-hua, XIAO Shi-fu#, WANG Tao#
    2020, 40 (09):  1174-1183. 
    doi: 10.3969/j.issn.1674-8115.2020.09.003

    Abstract ( 305 )   PDF (10461KB) ( 81 )  
    Objective · To analyze the expression profile of plasma microRNA (miRNA) in patients with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) by bioinformatics method, and explore its pathogenesis at the level of genetic regulation. Methods · Five MCI patients due to AD and five control participants were recruited. The plasma miRNA expression profiles were analyzed by miRNA microarray sequencing. Target genes of significantly up-regulated miRNAs were detected by TargetScan 7.2 database. The miRNA-gene interaction network of significantly up-regulated miRNAs was established by Cytoscape software, and the key miRNAs of the network were analyzed. The target genes of key miRNAs were analyzed by Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genome (KEGG) pathway analysis using R packages. Results · There are 13 up-regulated miRNAs in the plasma of MCI patients due to AD, and 5 of them were key miRNAs in miRNA-gene interaction network. Target genes of these miRNAs were mainly involved in biological process such as synaptic plasticity regulation, Wnt signaling pathway, synaptic vesicle transport and synaptic vesicle localization, as well as Ras signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway and glycolysis/gluconeogenesis pathway. Conclusion · Five up-regulated miRNAs in plasma of MCI due to AD may be the main regulators involved in the pathological mechanism of AD, which can be used as potential biomarkers for diagnosis of MCI due to AD.
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    Injectable hydrogel loaded with bone morphogenetic protein-2 microspheres for bacteriostasis and osteogenesis
    LIU Li-li1, CUI Wen-guo1, 2
    2020, 40 (09):  1184-1192. 
    doi: 10.3969/j.issn.1674-8115.2020.09.004

    Abstract ( 355 )   PDF (11465KB) ( 256 )  
    Objective · To construct a novel antibacterial and injectable hydrogel (BMP/Gel/SH-Ag) loaded with bone morphogenetic protein-2 (BMP-2) microspheres, and investigate its biocompatibility, antibacterial properties and bone-promoting properties. Methods · The photocrosslinked gelatin microspheres loaded with BMP-2 were prepared by microfluidics. The microspheres were mixed with 4-arm thiol-terminated poly (ethylene glycol) (4SH-PEG) and crosslinked with Ag+ to prepare injectable sulfhydrylated PEG hydrogels (BMP/Gel/SH-Ag). The micromorphology of microspheres and hydrogels was observed by light microscope and scanning electron microscope. The drug release profile was investigated at 37 ℃ in a shaker (100 r/min). The injectability of BMP/Gel/SH-Ag was evaluated by injecting hydrogel using a syringe with a tip diameter of 0.5 mm. The antibacterial activity of BMP/Gel/SH-Ag against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) was evaluated by agar diffusion test. The biocompatibility of BMP/Gel/SH-Ag was verified by CCK-8, and the bone-promoting activity was evaluated by alkaline phosphatase (ALP) assay and calcium nodule staining in bone marrow mesenchymal stem cells (BMSCs). Results · Gelatin microspheres had smooth appearance and uniform particle size distribution (~ 350 μm). BMP/Gel/SH-Ag had porous microstructure and can be injected with a syringe needle with a diameter of up to 0.5 mm in diameter to produce hydrogel filament. The cumulative release of BMP-2 from BMP/Gel/SH-Ag was (81.8±3.6)% after being incubated for 8 d. BMP/Gel/SH-Ag had obvious inhibitory effect on S. aureus and E. coli. CCK-8 results showed that BMP/Gel/SH-Ag had good biocompatibility. BMP/Gel/SH-Ag can increase the expression of ALP and the content of calcium nodules in rat BMSCs. Conclusion · The BMP/Gel/SH-Ag has good performance in promoting osteogenesis and anti-infection.
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    Expression of lnc-MTBP-5 in colorectal cancer and its effect on cell invasion
    YAN Yu-qing, SHEN Chao-qin, CHEN Hao-yan, HONG Jie#, WANG Zhen-hua#
    2020, 40 (09):  1193-1201. 
    doi: 10.3969/j.issn.1674-8115.2020.09.005

    Abstract ( 299 )   PDF (10154KB) ( 105 )  
    Objective · To analyze the expression of lnc-MTBP-5 in colorectal cancer (CRC), and explore the effect of lnc-MTBP-5 on the invasion of CRC cells and its potential mechanism. Methods · Bioinformatics data from PRJNA218851 and PRJNA376161 data sets were extracted from the Sequence ReadArchive (SRA) database to screen CRC metastasis associated lncRNAs. The Cancer Genome Atlas (TCGA) was used to analyze the expression of lnc-MTBP-5 in CRC tissues and normal tissues, its relationship with the prognosis of patients, and its correlation with metastasis related factors. Quantitative real-time PCR (qPCR) was used to detect the expression of lnc-MTBP-5 in normal intestinal epithelial cells and CRC cells, as well as 53 CRC tissues and para-cancer mucosa. After lnc-MTBP-5 was down-regulated in CRC cells, CCK-8 assay, clone formation and Transwell assay were performed to observe the effect of lnc-MTBP-5 on the proliferation and invasion ability of CRC cells. Results · Lnc-MTBP-5 was associated with CRC metastasis. The expression of lnc-MTBP-5 was significantly increased in 5 CRC cell lines and CRC tissues. Compared with patients with low expression of lnc-MTBP-5, CRC patients with high expression of lnc-MTBP-5 were younger, had higher American Joint Committee on cancer (AJCC) staging, and were prone to metastasis. Lnc-MTBP-5 was positively correlated with CRC metastasis associated in colon cancer 1 (MACC1), mesenchymal to epithelial transition factor (MET) and cadherin-associated protein. After lnc-MTBP-5 was down-regulated, the invasion ability of CRC cells decreased. Conclusion · Lnc-MTBP-5 is up-regulated in CRC cell lines and CRC tissues, and it is negatively correlated with the prognosis of patients. Lnc-MTBP-5 can promote the invasion ability of CRC cells, which may be related to MACC1-HGF (hepatocyte growth factor)/MET pathway.
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    Inhibitory effect of toosendanin on gastric cancer cells BGC-823 by downregulating circDLST
    ZHANG Jing
    2020, 40 (09):  1202-1206. 
    doi: 10.3969/j.issn.1674-8115.2020.09.006

    Abstract ( 290 )   PDF (5962KB) ( 117 )  
    Objective · To investigate the effect of toosendanin (TSN) on the growth and invasion of gastric cancer cells BGC-823 by regulating circDLST expression. Methods · After gastric cancer cells BGC-823 were exposed to different concentrations of TSN (0, 0.5, 1.0, and 2.0 μmol/L) for 24 h, quantitative PCR was used to detect the expression of circDLST. BGC-823 cells were transfected with the circDLST overexpression lentiviral vector or its control vector (CON), and then treated with 0.5 μmol/L TSN or PBS. So the cells were divided into circDLST+TSN group, CON+TSN group and CON+PBS group. The viability and invasive potential of BGC-823 cells were observed by MTT proliferation test and Transwell invasion assay. The subcutaneous transplanted tumor models were established by using circDLST-transfected cell line BGC-823 or the control cell line in nude mice, and then 200 μg/kg TSN or the same volume of PBS was injected intraperitoneally every day. So the mice were divided into circDLST+TSN group, CON+TSN group and CON+PBS group. Results · Compared with the control group (0 μmol/L), all 3 concentrations of TSN decreased the expression levels of circDLST in a concentration dependent manner (P<0.01). TSN could significantly reduce the cell viability, cell invasion and subcutaneous xenograft tumor growth (P=0.000), while circDLST overexpression reversed the inhibitory effect of TSN (P<0.01). Conclusion · TSN may inhibit the growth and invasion of gastric cancer cells BGC-823 by downregulating circDLST expression.
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    Original article (Clinical research)
    Analysis of the feature and influencing factors of anhedonia in schizophrenia
    YU Ling-fang1, FANG Xin-yu2, CHEN Yan1, WANG Dan-dan1, WANG Ye-wei1, WU Ze-nan1, LIU Rui-mei1, ZHANG Chen1
    2020, 40 (09):  1207-1212. 
    doi: 10.3969/j.issn.1674-8115.2020.09.007

    Abstract ( 379 )   PDF (8218KB) ( 72 )  
    Objective · To explore the feature and influencing factors of anhedonia in schizophrenia. Methods · A total of 71 schizophrenia patients and 50 healthy controls were recruited during December 2018 and December 2019. Positive and Negative Syndrome Scale (PANSS) was used for assessing psychotic symptoms. Temporal Experience of Pleasure Scale (TEPS) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were applied to the evaluation of anhedonia and cognitive function respectively for each subject. Results · The evaluation result of TEPS showed both anticipatory and consummatory pleasure scores were lowered in patients with schizophrenia than those in healthy people (P=0.000). Stepwise linear regression analysis showed that negative subscale score of PANSS (B=-0.895, P=0.002) and delayed memory score of RBANS (B=0.265, P=0.001) were associated with anhedonia in schizophrenia. Conclusion · Patients with schizophrenia exhibit anticipatory and consummatory anhedonia, both of which are influenced by negative symptoms and delayed memory in schizophrenia.
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    Value of transformation zone type in the evaluation of random biopsy among patients without visible lesions under colposcopy
    CANG Wei, HONG Zu-bei, GU Li-ying, DI Wen, QIU Li-hua
    2020, 40 (09):  1213-1217. 
    doi: 10.3969/j.issn.1674-8115.2020.09.008

    Abstract ( 354 )   PDF (5925KB) ( 78 )  
    Objective · To explore the value of cervical transformation zone (TZ) type in assessing whether a random biopsy should be used to diagnose high-grade squamous intraepithelial lesion (HSIL) among patients without visible lesions under colposcopy. Methods · A total of 517 patients who underwent colposcopy (without visible lesions) due to high risk subtype infection of human papillomavirus (HPV) or thinprep cytologic test (TCT) abnormality were enrolled. TZ types were identified, random biopsies were performed, and the value of TZ typeⅠ, Ⅱand Ⅲ in the diagnosis of HSIL was evaluated. Results · There were 517 cases without visible lesions under colposcopy. Three hundred and ninety-six of them were TZ type Ⅲ , and the detection rate of HSIL was 3.8% (15/396) by random biopsy, while one hundred and twenty one of them were TZ type Ⅰ and Ⅱ, and the detection rate of HSIL was 8.3% (10/121). Compared with the TZ type Ⅲ, the detection rate of HSIL in the TZ type Ⅰ and Ⅱ was significantly increased (P=0.000). Logistic regression showed that TCT abnormality, TZ typeⅠ and Ⅱ were the risk factors for HSIL detection in patients without visible lesions under colposcopy. Conclusion · Random multipoint biopsy can significantly increase detection rate of cervical HSIL when no visible lesion is visualized under colposcopy, particularly in women with abnormal TCT results or TZ type Ⅰ and Ⅱ.
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    Clinical value of domestic electromagnetic navigation system for precutaneous transthoracic needle biopsy: a randomized controlled trial
    TENG Jia-jun, NIE Wei, GAO Zhi-qiang, XU Jian-lin, SUN Jia-yuan, ZHONG Hua
    2020, 40 (09):  1218-1221. 
    doi: 10.3969/j.issn.1674-8115.2020.09.009

    Abstract ( 299 )   PDF (5052KB) ( 149 )  
    Objective · To evaluate the clinical value of the electromagnetic navigation system for precutaneous transthoracic needle biopsy. Methods · A prospective randomized controlled trial was carried out. One hundred and thirteen patients who needed to have lung nodule biopsy were divided into two groups according to the random number table: the auxiliary puncture group (n=57) adopting the electromagnetic navigation system for precutaneous transthoracic needle biopsy, and the conventional operation group (n=56) adopting the traditional CT-guided transthoracic needle biopsy. The operation process of the two groups was completed by junior doctors under the supervision and guidance of senior doctors. The time of puncture, the number of CT scan, and postoperative complications were observed and compared between the two groups. Results · There was no significant difference in operation time between the auxiliary group and the conventional group [(26.7±8.0) min vs (25.0±7.8) min, P=0.261)]. There was no significant difference in the number of CT scan between the two groups (4.9±2.7 vs 5.1±2.7, P=0.810). There was no significant difference in the incidence rate of pneumothorax (15.8% vs 19.6%, P=0.592) and bleeding (17.5% vs 14.3%, P=0.636) between the two groups. Conclusion · The domestic electromagnetic navigation system for precutaneous transthoracic needle biopsy can safely and effectively assist clinicians to complete lung biopsy.
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    Prediction of functional connectivity of fronto-limbic network in the outcome of subjects with clinical high-risk for psychosis
    ZHU Tian-yuan1, SHEN Meng-ting1, XU Li-hua1, ZHANG Tian-hong1, ZHANG Jian-ye2#, WANG Ji-jun1, TANG Ying-ying1#
    2020, 40 (09):  1222-1228. 
    doi: 10.3969/j.issn.1674-8115.2020.09.010

    Abstract ( 383 )   PDF (9227KB) ( 54 )  
    Objective · To explore the role of functional connectivity (FC) within the fronto-limbic network in predicting the onset of psychosis in the subjects with clinical high-risk for psychosis (CHR). Methods · A total of 164 CHR subjects and 89 healthy controls (HC) who underwent resting-state functional MRI were recruited. FCs between frontal [medial prefrontal cortex and bilateral orbitofrontal cortex (OFC)] and limbic (bilateral hippocampus and bilateral amygdala) brain regions at baseline were calculated. CHR subjects were further divided into 3 subgroups, i.e., CHR converters (CHR-C) group, symptomatic CHR (CHR-S) group and remitted CHR (CHR-R) group according to clinical outcome after one-year follow-up. The FCs of fronto-limbic network were compared between the groups and among the subgroups, and their interaction with brain regions, as well as their correlations with positive and negative symptoms were analyzed. Results · There was no significant main effect of group (P=0.110), but a significant interaction of subgroups and brain regions (P=0.049). CHR-C group had lower FC between bilateral OFC and bilateral amygdala than HC group and CHR-R group (all P<0.05). The FCs between left OFC and left hippocampus in the three CHR subgroups were all lower than that in HC group (all P<0.05). In addition, the FC between left OFC and right amygdala was positively correlated with the severity of negative symptoms in CHR-C group, while the FCs between left OFC and bilateral hippocampus and between right OFC and left hippocampus were negatively correlated with the severity of positive symptoms in CHR-C group. Conclusion · The decrease of OFC-hippocampus connectivity may be common in the subjects with CHR, while the decrease of OFC-amygdala connectivity may predict CHR subjects will convert to schizophrenia in the later stage.
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    Preliminary study on motion artifacts removal of coronary CT angiography using generative adversarial network
    ZHANG Lu1, CHEN Qiang2, JIANG Bei-bei1, DING Zhen-hong2, ZHANG Li3, XIE Xue-qian1
    2020, 40 (09):  1229-1235. 
    doi: 10.3969/j.issn.1674-8115.2020.09.011

    Abstract ( 449 )   PDF (8693KB) ( 90 )  
    Objective · To investigate the ability of generative adversarial network (GAN) to remove motion artifacts in coronary CT angiography (CTA) images. Methods · Subjects who underwent single-cardiac-cycle multi-phase CTA were included and divided into training and test group. The middle segment of the right coronary artery (RCA) was investigated because its motion artifact is the most prominent among all coronary branches. The patch image of the vessel with motion artifacts was extracted, and paired images without artifacts were considered as reference. The GAN model was established according to the training group. In the test group, vessel images were segmented out of the surrounding tissues by using ITK-SNAP software, including the vessel with artifacts, GAN-generated images and reference images. The Dice coefficients of the vessel with artifacts vs reference image (dice1) and GAN-generated images vs reference image (dice2) were calculated. By comparing the difference between dice1 and dice2, GAN’s ability in removing motion artifacts was evaluated. Results · Ninety subjects were included. Seventy-one (11 000 images) were randomly selected as the training group, and the other 19 (3 006 images) were as the test group. Based on subjects, dice1 and dice2 of the middle segment of RCA were 0.38±0.19 and 0.50±0.23, respectively (P=0.006). Based on images, the values of the middle segment of RCA were 0.38±0.20 and 0.51±0.26, respectively (P=0.000). Conclusion · GAN can significantly reduce the motion artifacts of CTA in the middle segment of RCA and has the potential to act as a new method to remove motion artifacts of coronary CTA images.
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    Clinical value of fibroblast growth factor 19 in predicting gastrointestinal dysfunction in children with sepsis
    TANG Xiao-meng1, 2, REN Yu-qian1, XIONG Xi1, 2, MIAO Hui-jie1, SHAO Lu-jing1, 2, CUI Yun1, ZHANG Yu-cai 1, 2, WANG Chun-xia1, 2
    2020, 40 (09):  1236-1242. 
    doi: 10.3969/j.issn.1674-8115.2020.09.012

    Abstract ( 312 )   PDF (8935KB) ( 70 )  
    Objective · To assess the potential value of fibroblast growth factor 19 (FGF19) as predictors of gastrointestinal dysfunction in children with sepsis. Methods · A prospective study was conducted, and 101 pediatric patients diagnosed with sepsis and admitted to the pediatric intensive care unit (PICU) at Shanghai Children's Hospital, Shanghai Jiao Tong University were enrolled from January 2018 to December 2018. Eleven cases with missing serum FGF19 were excluded, and 90 cases were analyzed in this study. According to whether gastrointestinal dysfunction occurred in patients with sepsis during PICU hospitalization, patients were divided into two groups, including sepsis-associated gastrointestinal dysfunction group (n=32) and sepsis without gastrointestinal dysfunction group (n=58). Serum FGF19 level was determined on PICU admission. The difference of serum FGF19 levels between the two groups were compared by using Mann-Whitney U test, and multivariate Logistic regression analysis was used to assess the association of FGF19 level with sepsis-associated gastrointestinal dysfunction. Results · The total PICU mortality rate was 12.2% (11/90). There was a tendency for increased PICU mortality in patients with sepsis-associated gastrointestinal dysfunction compared with patients without gastrointestinal dysfunction, but without statistical significance (18.8% vs 8.6%, P=0.160). Serum FGF19 levels were significantly decreased in patients with sepsis-associated gastrointestinal dysfunction compared with patients without gastrointestinal dysfunction [48.4 (27.7, 95.6) μg/mL vs 77.6 (45.8, 151.2) μg/mL, P=0.046]. The results of receiver operating characteristic (ROC) curve analysis showed that the area under ROC curve (AUC) for FGF19 predicting gastrointestinal dysfunction in pediatric patients with sepsis was 0.636 (95%CI 0.515–0.757), which was similar to the predictive capacity of procalcitonin [AUC=0.683 (95%CI 0.562–0.804), P=0.597]. In addition, serum FGF19 levels lower than 60 μg/mL on PICU admission indicated an increased risk of gastrointestinal dysfunction in pediatric patients with sepsis. Conclusion · Serum FGF19 is a novel predictor of gastrointestinal dysfunction in pediatric patients with sepsis.
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    Establishment of a prognostic scoring model for the breast cancer patients with spinal metastasis
    HE Qin, ZHANG Wei-bin, SHEN Yu-hui
    2020, 40 (09):  1243-1248. 
    doi: 10.3969/j.issn.1674-8115.2020.09.013

    Abstract ( 292 )   PDF (7947KB) ( 60 )  
    Objective · To explore the prognostic factors for the breast cancer patients with spinal metastasis, and establish a prognostic scoring model. Methods · A total of 160 breast cancer patients with spinal metastasis in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2008 to January 2016 were retrospectively identified. The clinical characteristics and prognosis were analyzed by univariate and multivariate survival analysis to explore the prognostic factors. And then a prognostic scoring model was developed according to the regression coefficient for each independent prognostic factor. Results · The 160 breast cancer patients with spinal metastasis whose average age was 56.8 years (range 22-82 years) were identified, and the median follow-up was 40 (24, 55) months. The multivariate Cox analysis showed that the patients' general condition, hormone receptor expression, visceral metastasis, and serum carbohydrate antigen 125 (CA125) level significantly influenced survival (P<0.05). According to the regression coefficients, a survival prediction scoring model comprising these factors was established, which ranged from 0 to 6 points. Three risk groups with different prognoses were identified : low risk group (0-1 point), intermediate risk group (2-4 points), and high risk group (5-6 points). Conclusion · The general condition, hormone receptor expression, visceral metastasis, and serum CA125 level were independent prognostic factors for the breast cancer patients with spinal metastasis. And the prognostic scoring model comprising these four clinical factors can effectively predict the patients' prognoses.
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    Clinical observation of gastric emptying rate in patients with diabetes
    JIANG Yi-hong1, LIU Wei1, ZHOU Huan1, XU Hua1, MA Jing1, 2
    2020, 40 (09):  1249-1255. 
    doi: 10.3969/j.issn.1674-8115.2020.09.014

    Abstract ( 279 )   PDF (9565KB) ( 61 )  
    Objective · To compare the gastric emptying rate in course-matched patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), and to explore the impact of gastric emptying rate on premeal insulin therapy design in patients with T1DM. Methods · The gastric half-emptying time (T50) and clinical data of 16 patients with T1DM and 32 course-matched patients with T2DM treated at the Department of Endocrinology and Metabolism, Renji Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to June 2014 were analyzed, retrospectively. The T50 and clinical data of the course-matched patients with T1DM and T2DM were compared. The impact of T50 on premeal insulin therapy design in patients with T1DM was analyzed. Results · The T50 of patients with T1DM was significantly longer than that of the course-matched patients with T2DM (P=0.013). T1DM patients with delayed gastric emptying rate tended to shorten the time between insulin injection and meal than those with normal gastric emptying rate. Conclusion · The gastric emptying rates of patients with T1DM are slower than those of the course-matched patients with T2DM. Measurement of gastric emptying rate not only detects abnormal gastric emptying rate in patients with diabetes but also guides the choice of premeal insulin therapy, optimizes glycemic control and avoids large glucose fluctuations in patients with TIDM.
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    Clinical characteristics and risk factors of male patients with alcohol-induced psychotic disorders
    MA Yin-zhu*, LU Guang-hua*, ZHONG Na, WANG Hai-hong, HE Shen, ZHAO Xue, JIANG Hai-feng , WANG Zhen
    2020, 40 (09):  1256-1262. 
    doi: 10.3969/j.issn.1674-8115.2020.09.015

    Abstract ( 277 )   PDF (7806KB) ( 45 )  
    Objective · To explore the clinical characteristics and risk factors of male patients with psychotic disorders caused by alcohol. Methods · The clinical data of 52 male inpatients with alcohol use and related disorders treated in the Department of Addiction of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from May 2018 to December 2019 were collected. There were 19 cases of alcohol-induced psychotic disorder (alcohol-induced psychosis disorder, AIPD) group and 33 cases of non-AIPD group. The risk factors of AIPD were obtained by regression analysis. Results · AIPD patients had a higher incidence of hallucinations (47.4%) and delusions of murder (47.4%). Compared with non-AIPD groups, Logistic regression analysis of AIPD patients showed that vitamine B12 (VB12) serum level (P=0.011, OR=0.995) and total cholesterol serum level (P=0.039, OR=1.874) were associated with the occurrence of AIPD. Conclusion · Patients with AIPD have psychiatric symptoms mainly consisting of hallucinations and delusions of murder. When patients’ laboratory tests show abnormal serum VB12 and serum total cholesterol levels, attentions should be paid to the occurrence of AIPD.
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    Application of 3D-CT reconstruction technology to predicting difficult airway in patients with odontogenic infections
    SONG Qiao, YAN Jia, ZHOU Ren, ZHANG Lei#, JIANG Hong#
    2020, 40 (09):  1263-1269. 
    doi: 10.3969/j.issn.1674-8115.2020.09.016

    Abstract ( 278 )   PDF (9014KB) ( 68 )  
    Objective · To evaluate the application of 3D-CT airway reconstruction images to predicting difficult airway in patients with odontogenic infections. Methods · A retrospective analysis was performed on patients with odontogenic infections who were treated by incision and drainage under general anesthesia at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from August 2017 to July 2019, and patients who were evaluated as difficult airway receiving awake tracheal intubation were selected as the case group (n=27). From the “Hospital Inpatient System”, patients who were evaluated as non-difficult airway receiving fast induction were selected as the control group (n=27). Maxillofacial CT scans of all the patients were collected. The Dolphin Imaging software version 11.9 Premium was used to perform 3D-CT reconstruction of the airway. The upper airway was divided into oropharynx and hypopharynx, and the oropharynx was divided into velopharynx and glossopharyngeal. The indicators such as airway volume, median sagittal area, minimal cross-sectional area, and thickness of pharyngeal soft tissue were collected. The indicators of the difference between the two groups were compared and selected. Logistic regression analysis was conducted to investigate the association of these factors with difficult airway. Results · The volume of velopharynx and hypopharynx, the median sagittal area of velopharynx, oropharynx and hypopharynx, the mean cross-sectional area of velopharynx and hypopharynx, the minimal cross-sectional area and its lateral dimension of oropharyngeal of patients in the case group were significantly smaller than those of the controls (P<0.05). Thickness of pharyngeal soft tissue in the most inferior-anterior point of the second and the third cervical vertebrae of patients in the case group was significantly higher than that of the controls (P<0.05). The Logistic regression analysis showed that the median sagittal area of velopharynx, oropharynx and hypopharynx, the volume and mean cross-sectional area of hypopharynx, and thickness of pharyngeal soft tissue in the most inferior-anterior point of the second and the third cervical vertebrae of patients were related to difficult airway in patients with odontogenic infections (P<0.05). Conclusion · Airway 3D-CT reconstruction can clearly show the airway anatomy of patients with odontogenic infections. The median sagittal area of pharynx, the volume and mean cross-sectional area of hypopharynx, and thickness of pharyngeal soft tissue in the most inferior-anterior point of the second and the third cervical vertebrae may will be used as predictors of difficult airway in patients with odontogenic infections.
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    Comparison of outcomes after thrombectomy in patients with embolic stroke of undetermined source and cardiogenic stroke
    LIU Yi-sheng1, ZHAN Yan-li2, PAN Hui1, YIN Jia-wen1, HU Yue1, CAI Xue-li2#, LIU Jian-ren1#
    2020, 40 (09):  1270-1276. 
    doi: 10.3969/j.issn.1674-8115.2020.09.017

    Abstract ( 258 )   PDF (8635KB) ( 53 )  
    Objective · To compare the baseline characteristics and treatment outcomes of mechanical thrombectomy in patients with intracranial arterial occlusion caused by embolic stroke of undetermined source and cardiogenic stroke. Methods · Retrospective analysis was made on ESUS and CS patients in registration databases who received thrombectomy in two stroke centers, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine and Lishui Central Hospital, Zhejiang University from November 2012 to April 2019. T-test and Mann-Whitney U test were used to compare the measurement data, χ2 test and Fisher's exact test were used to compare the counting data, and the independent prognostic risk factors were analyzed by Logistic regression. Results · In all, 117 participants were eventually enrolled, including 30 (25.6%) with ESUS and 87 (74.4%) with CS. Compared with the CS group, the ESUS group was significantly younger (mean ages, 64 years vs 75 years, P=0.003) with lower median baseline NIHSS scores (12 vs. 15, P=0.020), lower median NIHSS scores at 24 h (10 vs 12, P=0.033) and lower median MRS scores at 90 days (2 vs 4, P=0.015). The rates of successful recanalization were similar. Logistic regression analysis showed hypertension (OR=0.264, 95%CI 0.099-0.704, P=0.008) and baseline NIHSS scores (OR=0.758, 95%CI 0.673-0.853, P=0.000) were independent risk factors affecting prognoses. Conclusion · Compared with CS, ESUS patients are relatively younger and have milder neurological dysfunction at onset and better prognoses; however, both groups have high mortality rates. The successful recanalization rates for mechanical thrombectomy are similar. The baseline NIHSS score and hypertension are independent prognostic risk factors.
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    Review
    Effect of maternal vitamin A deficiency during pregnancy on neurodevelopment of offspring
    ZHANG Yi-jing1, 2, XU Jian1, 2
    2020, 40 (09):  1277-1282. 
    doi: 10.3969/j.issn.1674-8115.2020.09.018

    Abstract ( 282 )   PDF (8903KB) ( 66 )  
    Vitamin A (VA) is a fat-soluble vitamin with all-trans-retinoic biological activities. In addition to maintaining the normal functions of the eye, skin, immune, and reproductive systems, VA is also widely distributed in brain tissues, and important to the generation and differentiation of neural progenitor cells in the developing nervous system. Pregnant women are susceptible to vitamin A deficiency (VAD). Retinoic acid, the active form of VA, is very important to the brain development of offspring. This article reviews the literatures of maternal VAD during pregnancy, summarizing the risk factors of maternal VAD during pregnancy, and the research findings of the effects of maternal VAD during pregnancy on offspring neurodevelopment based on both human studies and animal experiments, and the possible underlying mechanisms by which maternal VAD affects the development of embryonic layers, brain structures, hippocampal synaptic transmission, and the biological clock in offspring.
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    Progress of histone variant macroH2A1 in tumor proliferation
    ZHANG Ming-da, FENG Hai-zhong
    2020, 40 (09):  1283-1287. 
    doi: 10.3969/j.issn.1674-8115.2020.09.019

    Abstract ( 356 )   PDF (7106KB) ( 85 )  
    Histone variants confer chromatin unique properties and also participate in the regulation of genetic expression through specific deposition and removal machineries. macroH2A1 is one of histone variants and has been found implicating in female X chromosome inactivation and transcriptional repression. However, recent marcoH2A1 has been reported to suppress tumor proliferation through regulating cellular senescence and metabolism under specific situations. The paper reviews the roles of macroH2A1 in tumorigenesis and the molecular mechanisms in regulating genetic expression based on current research progress.
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    Advances in study of regulation of tumor immune inflammatory microenvironment by cancer-associated fibroblasts
    ZHAO Wei-guang, LIU Zhi-hong
    2020, 40 (09):  1288-1293. 
    doi: 10.3969/j.issn.1674-8115.2020.09.020

    Abstract ( 399 )   PDF (8582KB) ( 117 )  
    Cancer-associated fibroblasts (CAFs) are a major population that resides in the tumor microenvironment. Multiple soluble molecules secreted by CAFs remodel the extracellular matrix, thus promoting tumor growth, invasion and metastasis. It is now considered that CAFs play an important role in the regulation of tumor immunity, in which an increasing number of molecular mechanisms of tumor microenvironment remodeling are being discovered. This article reviews the molecular markers of CAFs, the crosstalk between CAFs and tumor cells or immune cells, as well as the progress on therapeutic targeting of CAFs.
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    Advances in Philadelphia chromosome-like acute lymphoblastic leukemia
    LI Chao, MI Jian-qing, WANG Jin
    2020, 40 (09):  1294-1301. 
    doi: 10.3969/j.issn.1674-8115.2020.09.021

    Abstract ( 350 )   PDF (12233KB) ( 260 )  
    Philadelphia chromosome-like acute lymphoblastic leukemia (BCR-ABL1-like ALL) is a newly defined ALL subtype in 2009. It is Philadelphia chromosome (Ph)/BCR-ABL1-negative and characterized by a set of gene expression profile which is highly similar to that of Ph/BCR-ABL1-positive ALL. However, there is no definitive unified diagnostic criteria yet. BCR-ABL1-like ALL is generally resistant to chemotherapy, with a high relapsed rate and poor prognosis. It harbors a diverse range of genetic alterations that affect cytokine receptor and/or signal transduction pathway of tyrosine kinase. Overexpression of CRLF2, JAK-STAT pathway abnormalities and ABL-class gene rearrangements are the most common. These genetic aberrations could be therapeutic targets. Both in vitro and in vivo experiments and clinical data support the efficacy of targeted therapy. Beside conventional multi-drug chemotherapy, the combination of targeted therapy, cellular immunotherapy and allogeneic hematopoietic stem cell transplantation is promising to improve the prognosis of BCR-ABL1-like ALL. In this paper, the research status of BCR-ABL1-like ALL is described from five aspects: definition, diagnosis, clinical characteristics, molecular biological characteristics and treatment.
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    Progress in biomarkers of multiple system atrophy
    ZHU Lin, LIU Jun
    2020, 40 (09):  1302-1307. 
    doi: 10.3969/j.issn.1674-8115.2020.09.022

    Abstract ( 277 )   PDF (9853KB) ( 75 )  
    Multiple system atrophy is a neurodegenerative disease, which is characterized by a combination of autonomic failure, Parkinsonian features, pyramidal and cerebellar dysfunction, and is poorly reactive to levodopa. Few biomarkers with high sensitivity or specificity have been applicable in the diagnosis of multiple system atrophy, making it a challenge to correctly diagnose this disease. Therefore, some researches combined several biomarkers to improve the diagnosis accuracy. Apart from those in body fluid, progress has been made in new biomarkers of neuroimaging and pathology. In this review, the advances in the identification of biomarkers of multiple system atrophy are summarized, and some candidate biomarkers that worth more investigation, including proteins and miRNAs in blood or cerebrospinal fluid, parameters in molecular and functional imaging, and pathologic features of peripheral tissue are described .
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    Techniques and methods
    Use of REDCap in data collection and data management of birth cohort study
    OUYANG Feng-xiu1, TAYIER Reyilai1, CHEN Lei2, FAN Pian-pian1, ZHANG Jun1, WANG Wei-ye1
    2020, 40 (09):  1308-1314. 
    doi: 10.3969/j.issn.1674-8115.2020.09.023

    Abstract ( 270 )   PDF (8702KB) ( 83 )  
    Objective · To introduce how to build a data platform of data collection and data management for multi-center birth cohort study by using REDCap. Methods · After the REDCap electronic data capture system was installed and set up, the electronic case report forms (eCRFs) were programmed to collect data in multi-centers. The rules of data quality control were programmed, and different levels of user right for access to data platform were assigned to the data managers and data clerks based on their role in research project. Results · With REDCap system being installed, the example project was created, and a series of eCRFs were established for each stage of preconception, pregnancy and childhood through follow-up. After intensive testing to improve and achieve a stable data platform, standardized trainings were provided to data-related team. The REDCap eCRFs were then put in use online. By assigning different user right of access to data platform, data entry can be from multi- research centers and survey sites. This REDCap data platform supported the cohort project on data collection and data management. Conclusion · The data platform established by using REDCap provides strong support to birth cohorts on data collection and data management. This example project of data platform can be applied to other epidemiological studies.
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