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    Original article (Basic research)
    Analysis of four mutations and protein structure of glucose-6-phosphate dehydrogenase gene
    ZHU Zhi-xing1, 2, JI Wei3, GU Jian-lei1, 4, LÜ Hui1, 2, 4, TIAN Guo-li3
    2020, 40 (12):  1571-1578. 
    doi: 10.3969/j.issn.1674-8115.2020.12.001

    Abstract ( 376 )   PDF (10513KB) ( 106 )  
    Objective · To analyze the effect of glucose-6-phosphate dehydrogenase (G6PD) gene mutations on the structure and function of enzymes. Methods · A retrospective analysis of G6PD screening records of 205 103 neonates collected in the Shanghai Children's Hospital from 2014 to 2017 was performed. Wilcoxon test was used to analyze the enzyme activity and mutant genes. The software tools Psipred, SOPMA, and JPred4 were used to predict the secondary structure of the protein, and the 3D structure of G6PD was predicted based on the amino acid chain by SWISS-MODEL and modified by PyMOL and LigPlot+. Six different analysis software programs, including Mupro, SDM, CUPSAT, mSCM, DUET, and Dynamut, were utilized to compare protein stability of the wild-type with the mutant forms. PROVEAN was used to analyze the effect of amino acid changes on the enzyme. Results · Two hundred and thirty samples were positive for enzyme deficiency, of which 121 positive samples were genetically tested and eight mutations were identified. Three common mutations c.95A>G, c.1376G>T, and c.1388G>A were present, and c.1024C>T mutation was identified in 14 samples. These four mutations induced a change in protein structure, reduced protein stability, and had adverse effects on function. In addition, c.1388G was adjacent to the glycerol ligand binding region in the wild type structure, whereas the c.1388G>A mutation caused this residue further away from it. Conclusion · Four nonsynonymous mutations (c.95A>G, c.1376G>T, c.1388G>A and c.1024C>T) reduce the stability of the G6PD enzyme by changing the structure of the protein, in which the c.1388G>A mutation also affects the binding ability of the protein to the substrate.
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    Peripheral and central inflammatory changes in experimental periodontitis rats
    HU Yi1, 2, ZHOU Wei2, SONG Zhong-chen1, 2
    2020, 40 (12):  1579-1584. 
    doi: 10.3969/j.issn.1674-8115.2020.12.002

    Abstract ( 303 )   PDF (8477KB) ( 69 )  
    Objective · To observe the changes of peripheral and central inflammation in experimental periodontitis rats. Methods · An experimental periodontitis model was established by injecting lipopolysaccharide (LPS) of Porphyromonas gingivalis (P. gingivalis) into the gingival sulcus of SD rats. The pathological changes of periodontal tissue were observed with hematoxylin-eosin staining (H-E staining). The expression of interleukin-1β (IL-1β), IL-6 and IL-8 in peripheral blood, spleen and brain was evaluated by real-time PCR (RT-PCR). Immunohistochemical staining was used to observe the activation of microglia and astrocytes. Differences between groups were compared by using one-way ANOVA, and Tukey test was performed for further comparison between each 2 groups. Results · Sulcus-injection of P. gingivalis-LPS induced periodontitis-like pathologies in rats. Experimental periodontitis could increase the expression of inflammatory factors (IL-1β, IL-6, and IL-8) in the peripheral blood, spleen and brain of rats. Activation of microglial cells and astrocytes was observed in hippocampus of rats. Conclusion · The experimental periodontitis established by P. gingivalis-LPS sulcus injection could induce both peripheral and central inflammation. Inflammation could play an important role in the association between periodontitis and systemic diseases such as Alzheimer's disease.
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    Construction of retroviral small guide RNA expression vector for studying gene function of mouse T cells
    ZHAO Yan-na1, QIU Rong2, SHEN Nan1, TANG Yuan-jia1
    2020, 40 (12):  1585-1590. 
    doi: 10.3969/j.issn.1674-8115.2020.12.003

    Abstract ( 389 )   PDF (7572KB) ( 70 )  
    Objective · To construct retroviral small guide RNA (sgRNA) expression vector for studying gene function in mouse T cells. Methods · The short hairpin RNA (shRNA)-expressing retroviral vector MSCV-LTR-miR30-PIG (LMP) was digested with Xho1 and Sal1 to obtain the backbone of the retroviral vector. The lentiviral sgRNA vector was used as template for PCR amplification to obtain the U6-sgRNA-PGK-Puro-BFP fragment. The PCR fragment was then assembled into the retroviral vector backbone by homologous recombination. To verify the effectiveness of the system, sgRNA sequences targeting Il17a, Rorc and Irf4 were designed and cloned. CD4 T cells isolated from Cas9 transgenic mice were infected with individual sgRNA retrovirus and differentiated into Th17 cells. After cytokine intracellular staining, the percentage of Il17a positive population was detected by flow cytometry. Unpaired t test was used to compare the data of independent samples between the two groups. Results · ①The sgRNA retroviral vector was successfully constructed. ② The retroviral vector was used to successfully deliver sgRNA to CD4 T cells, which mutated Il17a gene. ③The percentage of Il17a positive population was significantly reduced in the Rorc-sgRNA and Irf4-sgRNA positive populations (P<0.05). Conclusion · The sgRNA retroviral vector is successfully used to deliver sgRNA to target cells. In addition, the results of Rorc and Irf4 gene knockout experiments prove that the system can be used for studying gene function in mouse T cells.
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    Effect of SIRT1 on H2O2-induced oxidative damage in human ovarian granulosa cells
    HE Bin, LI Qi-yue, HONG Ling, WU Yuan-yuan, TENG Xiao-ming, TANG Chuan-ling
    2020, 40 (12):  1591-1597. 
    doi: 10.3969/j.issn.1674-8115.2020.12.004

    Abstract ( 395 )   PDF (8912KB) ( 80 )  
    Objective · To investigate the effect and possible mechanism of silent information regulator 1 (SIRT1) on H2O2-induced oxidative damage in human ovarian granulosa cells. Methods · Human ovarian granulosa cells SVOG were treated with 0, 100, 250, 500, 1 000 μmol/L H2O2 for 4, 8, 12, 24 h, respectively. The cell viability was measured by CCK-8 method, and the appropriate H2O2 concentration and treatment time were used to establish the oxidative stress injury model of granulosa cells in vitro. The nuclear morphological changes after H2O2 treatment were observed with fluorescence microscope. The malondialdehyde (MDA) levels and superoxide dismutase (SOD) activities were detected by chemical chromatometry kits. Real-time quantitative PCR and Western blotting were respectively used to analyze the mRNA and protein levels of SIRT1, P66SHC (the 66 kDa Src homology 2 domain containing isoform) and B-cell lymphoma-2 (BCL-2). The changes of the above indicators were also assessed after SVOG cells were transfected with SIRT1 overexpression plasmid by liposome and treated with H2O2. Results · After treatment with 250 μmol/L H2O2 for 12 h, the SVOG cell viability decreased significantly (P=0.017), the cell nuclei shrank, the MDA level increased (P=0.001), the SOD activity decreased (P=0.006), and the expression of P66SHC increased with the decreased expression of SIRT1 and BCL-2 at mRNA and protein levels. After overexpression of SIRT1 and treatment with H2O2, the nuclei of SVOG cells returned to normal morphology, the MDA level decreased (P=0.038), the SOD activity increased (P=0.021), the expression of P66SHC decreased (P=0.002) and the expression of BCL-2 increased (P=0.013). Conclusion · SIRT1 can protect human ovarian granulosa cells from oxidative damage by down-regulating the expression of P66SHC and up-regulating BCL-2.
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    Transcriptional identification of potential biomarkers of lung adenocarcinoma
    ZHANG Wei-ran1, 2, LIN Xue-feng3, LI Xin2, ZHANG Hao2, WANG Meng2, SUN Wei2, HAN Xing-peng2, SUN Da-qiang1, 4
    2020, 40 (12):  1598-1606. 
    doi: 10.3969/j.issn.1674-8115.2020.12.005

    Abstract ( 375 )   PDF (10709KB) ( 115 )  
    Objective · To identify some related molecular markers for the diagnosis and treatment of lung adenocarcinoma by transcriptome analysis. Methods · The differentially expressed analyses were performed to identify the differentially expressed genes (DEGs), the differentially expressed miRNAs (DEMs), and the differentially expressed circRNAs (DECs). Functional and pathway enrichment analyses were conducted for DEGs, and the targets prediction for DEMs. Regulated network of the DEGs and DEMs was constructed, and some candidates were selected. The biomarkers obtained were verified by the Cancer Genome Atlas (TCGA) database and the qRT-PCR, and the correlation between their expression levels and overall survival and tumor stage were analyzed. Results · Sixty-one overlaps were contained in the 3 sets of DEGs in 3 gene expression profiles, which were enriched in 32 gene ontology (GO) terms and 10 pathways. Twenty-four DEMs were identified, and 612 miRNA-target pairs were screened out that the target genes were DEGs. In the circRNA microarray, 92 DECs were obtained. ADRA1A, hsa-miR-141-5p and hsa-miR-191-3p were important nodes in the network. TCGA and qRT-PCR results were consistent with the microarray analysis results, in addition, hsa-miR-191-3p was significantly correlated with tumor stage. Conclusion · ADRA1A, hsa-miR-141-5p, hsa-miR-191-3p, SFTPC, ITLN2 and SLC6A4 might be potential biomarkers of lung adenocarcinoma, and hsa-miR-191-3p might be associated with tumor progression.
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    Effect of curcumin on intestinal mucosal injury in a rat model of cardiac arrest and cardiopulmonary resuscitation
    WANG Li-feng, CHEN Jun-jie, LI Yong-ning, WANG Ling, WANG Lei, LI Xue-jiao
    2020, 40 (12):  1607-1613. 
    doi: 10.3969/j.issn.1674-8115.2020.12.006

    Abstract ( 332 )   PDF (9859KB) ( 71 )  
    Objective · To observe the effect of curcumin on intestinal ischemia/reperfusion (I/R) injury in the rats after cardiopulmonary resuscitation (CPR), and explore the mechanism. Methods · Twenty-four healthy male SD rats were randomly divided into 4 groups, namely control group (Sham group, n=6), curcumin group (Cur group, n=6), intestinal I/R injury after CPR group (I/R group, n=6), and curcumin+intestinal I/R injury after CPR group (Cur+I/R group, n=6). Tracheal and femoral artery and vein catheterization were carried out after anesthesia in the 4 groups. The cardiac arrest/CPR model was established by asphyxiation in I/R group and Cur+I/R group, while not in the other two groups. Curcumin (100 mg/kg) was injected intraperitoneally 1 min before CPR in Cur+I/R group. Meanwhile, equivalent curcumin was injected intraperitoneally in Cur group, and equivalent dimethylsulfoxide was injected in Sham group and I/R group. Venous blood samples were collected 6, 12 and 24 h after recovery of spontaneous circulation (ROSC) to detect the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). The rats were sacrificed 24 h after ROSC, and the concentrations of malondialdehyde (MDA) and glutathione (GSH) and the activity of superoxide dismutase (SOD) in the intestinal tissues were measured. The pathological changes of intestinal tissues were observed by hematoxylin-eosin staining. The apoptosis of intestinal mucosal epithelial cells was detected by TUNEL assay. Hypoxia-inducible factor-1α (HIF-1α) and caspase-3 expressions in the intestinal tissues were detected by Western blotting. Ultrastructural changes of the intestinal tissues were observed by using transmission electron microscopy. Results · The concentrations of TNF-α and IL-6 in Cur+I/R group at 3 time points were lower than those in I/R group (all P<0.05), while higher than those in Sham group (all P<0.05). The MDA content in Cur+I/R group was lower than that in I/R group (P<0.01), while higher than that in Sham group (P<0.01). The SOD activity and GSH concentration in Cur+I/R group were higher than those in I/R group (both P<0.05), while lower than those in Sham group (both P<0.01). The expression of HIF-1α protein in Cur+I/R group was significantly higher than that in I/R group (P<0.01), but lower than that in Sham group (P<0.01). The expression of caspase-3 protein in Cur+I/R group was significantly lower than that in I/R group (P<0.01), while higher than that in Sham group (P<0.01). Pathological observation showed that ileal
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    Original article (Clinical research)
    Changes and significance of coagulation indexes in pregnant women with gestational diabetes mellitus
    GUO Yan-yan, GUO Fei, LI Tong, LI Yu-chen, HUANG He-feng, LIU Xin-mei
    2020, 40 (12):  1614-1617. 
    doi: 10.3969/j.issn.1674-8115.2020.12.007

    Abstract ( 321 )   PDF (5972KB) ( 94 )  
    Objective · To explore the changes of blood coagulation parameters before delivery and their correlation with blood glucose. Methods · The basic clinical data and blood samples were collected from 132 pregnant women with GDM and 160 healthy pregnant women who were near labor in the third trimester. The levels of blood glucose and coagulation-related indicators, including the values of oral glucose tolerance test (OGTT) at 0, 1 and 2 h, activated partial thromboplastin time (APTT), thrombin time (TT), pro-thrombin time (PT), D-dimer, fibrinogen (FIB) and international normalized ratio (INR), were detected, and the statistical analysis was carried out. Results · The levels of FIB and INR in the GDM group were significantly higher than those in the control group (P=0.003, P=0.005). There were no significant differences between the two groups on the levels of APTT, TT, PT, and D-dimer (all P>0.05). The level of FIB was significantly positively correlated with the values of OGTT at 1 h (P=0.000) and 2 h (P=0.000), and the level of FIB had no correlation with the value of OGTT at 0 h (P=0.505). There was no correlation between the level of INR and all the OGTT values (all P>0.05). Conclusion · Plasma FIB levels of GDM women were significantly increased before delivery, and FIB was significantly positively correlated with the values of OGTT at 1 h and 2 h.
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    Relationship between serum interleukin-6 level and depressive symptoms in schizophrenia
    WEN Wan-jun1, CHEN Ye1, QIN Zong-hou1, LÜ Wang-qiang2, TANG Wei3, LU Wei-hong4, FAN Wei-xing2, ZHANG Chen4
    2020, 40 (12):  1618-1620. 
    doi: 10.3969/j.issn.1674-8115.2020.12.008

    Abstract ( 309 )   PDF (4913KB) ( 97 )  
    Objective · To explore the relationship between serum interleukin-6 (IL-6) level and depressive symptoms in schizophrenia. Methods · A total of 239 patients with schizophrenia treated with olanzapine alone for more than 2 years were enrolled. Calgary Depression Scale for Schizophrenia (CDSS) was used to evaluate the depression level of the patients, and they were divided into depression group and non-depression group. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the mental symptoms of patients. Serum IL-6 levels were measured by enzyme linked immunosorbent assay (ELISA), and the differences between the two groups were compared. Pearson correlation analysis was used to analyze the relationship between serum IL-6 level and CDSS score. Results · According to the results of CDSS, the patients were divided into depression group (119 cases) and non-depression group (120 cases). Compared with the non-depression group, the PANSS negative symptom subscale score and serum IL-6 level of patients in the depression group were higher (P=0.028, P=0.000). Pearson correlation analysis showed that serum IL-6 level was positively correlated with CDSS score in the depression group patients (r=0.42, P=0.000). Conclusion · The increase of serum IL-6 level may be related to the occurrence of schizophrenia with depression symptoms.
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    Analysis of distribution and culture results of pathogens in sputum and bronchoalveolar lavage fluid from patients with pulmonary infection
    QIN Rong1, 2, HE Ping1, ZHANG Yi-hao2, WANG Yan-chun3
    2020, 40 (12):  1621-1626. 
    doi: 10.3969/j.issn.1674-8115.2020.12.009

    Abstract ( 441 )   PDF (8279KB) ( 78 )  
    Objective · To analyze the distribution of pathogens (fungi and bacteria) in sputum (SP) and bronchoalveolar lavage fluid (BALF) from patients with pulmonary infection, and explore the value of the two kinds of lower respiratory tract specimens in the diagnosis of clinical infection. Methods · The culture results of SP and BALF specimens from patients with pulmonary infection in the Department of Clinical Microbiology of Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine from January 2018 to June 2019 were retrospectively studied. The time interval between the two specimens was less than 24 h. Statistical description and consistency test were used to compare and analyze the distribution of pathogens between the two specimens. Results · Among the 313 patients with pulmonary infection, the positive rate of bacterial culture in BALF specimens was 27.55% (73/265) and that of fungal culture was 16.61% (49/295); the positive rate of bacterial culture in SP specimens was 25.38% (67/264), and that of fungal culture was higher [26.13% (75/287)]. From the positive culture of pathogens, the culture results of BALF and SP specimens were basically consistent. Based on the pathogens culture results of the 313 patients, the overall consistency rate of the qualitative results of BALF and SP specimens was 75.08% (235/313). Among them, the consistent rate of fungal detection was 79.09% (227/287) with significant consistency (P=0.000, Kappa=0.390), and the consistent rate of bacterial detection was 90.91% (240/264) with significant consistency (P=0.000, Kappa=0.767). Conclusion · Under certain conditions, SP culture should be given priority in clinical practice to avoid invasive examination of BALF. However, when SP culture results are not consistent with clinical judgment, especially in suspicious invasive pulmonary fungal infection, the BALF should be checked in time to identify the pathogenic infection.
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    Analysis of influencing factors of frailty syndrome in elderly patients with stable coronary artery disease
    LI Xin*, LIANG Xin-yue*, FANG Ning-yuan, WANG Hai-ya
    2020, 40 (12):  1627-1631. 
    doi: 10.3969/j.issn.1674-8115.2020.12.010

    Abstract ( 306 )   PDF (7208KB) ( 161 )  
    Objective · To analyze the influencing factors of frailty syndrome in elderly patients with stable coronary artery disease (SCAD). Methods · A total of 101 SCAD patients (aged≥60 years) hospitalized in the Department of Geriatrics and Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from March to September, 2019, were selected. The comprehensive geriatric assessment was used to evaluate the health status and complications of the patients. According to patients’ frailty status evaluated by the Fried frailty phenotype, the patients were divided into frailty group and non-frailty group. Multivariate Logistic regression model was used to analyze the influencing factors of frailty syndrome in elderly patients with SCAD. Results · Among 101 elderly patients with coronary heart disease, 53 cases were complicated with frailty syndrome. There were statistically significant differences in age, Charlson comorbidity index (CCI), the proportion of sleep disorders, falls in the past year, history of multiple drug use, grip strength, Gensini score, cystatin level, brain natriuretic peptide (BNP) and serum creatinine (Scr) levels between the two groups (all P<0.05). Multivariate Logistic regression analysis showed that Gensini score (β=0.027, SE=0.012, P=0.028) and grip strength (β=-0.076, SE=0.030, P=0.012) were the influencing factors of elderly SCAD patients complicated with frailty syndrome. Conclusion · Elderly patients with SCAD are prone to be complicated with frailty syndrome. The Gensini score and grip strength measurement will help clinicians identify and intervene in frailty syndrome early.
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    Expression of IL-1β, IL-6 and TNF-α in sulcular fluid of peri-implantitis
    CHEN Hui-wen1, HU Yi 1, ZHANG Wei-ping2, CHEN Jing-yi2#, SONG Zhong-chen1#
    2020, 40 (12):  1632-1636. 
    doi: 10.3969/j.issn.1674-8115.2020.12.011

    Abstract ( 332 )   PDF (6857KB) ( 68 )  
    Objective · To investigate expressions of interleukin (IL) -1β, IL-6 and tumor necrosis factor-α (TNF-α) in sulcular fluid of peri-implantitis. Methods · Twenty-four patients with implant restoration were selected, including 12 patients in the peri-implantitis group and 12 patients in the peri-implant health group. Twelve healthy persons with healthy gingival tissues were taken as the control group. The levels of IL-1β, IL-6 and TNF-α in gingival crevicular fluid were detected by enzyme-linked immunosorbent assay. The correlations between the expressions of these cytokines and the amount of gingival crevicular fluid or the probing depth were analyzed. Results · The levels of IL-1β, IL-6 and TNF-α in the peri-implantitis group were significantly higher than those in the control group (all P<0.05). The expression levels of IL-1β and IL-6 in the peri-implantitis group were significantly higher than those in the peri-implant health group (both P<0.05). The level of TNF-α in the peri-implantitis group was positively correlated with the probing depth (r=0.600, P=0.039). Conclusion · The levels of IL-1β, IL-6 and TNF-α in gingival crevicular fluid are highly expressed in patients with peri-implantitis. The expression of TNF-α is positively correlated with the probing depth.
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    Application of quantitative 99mTcO4- SPECT/CT in determination of thyroid volume and SUV in Graves' disease
    WAN Liang-rong, HUANG Gan, LIU Jian-jun
    2020, 40 (12):  1637-1640. 
    doi: 10.3969/j.issn.1674-8115.2020.12.012

    Abstract ( 344 )   PDF (6006KB) ( 63 )  
    Objective · To investigate the feasibility of single-photon emission computed tomography/computed tomography (SPECT/CT) quantitative imaging in the determination of SUV uptake and thyroid volume in patients with Graves' disease. Methods · Sixty-four Graves' disease patients were selected, including 21 males and 43 females, aged (44.1±14.1) years. All subjects were tested for serum FT3 and FT4 levels, as well as 131I rate at 2 h and 24 h. All patients underwent neck SPECT/CT and planar imaging after intravenous injection of (5.5±0.5)mCi [(204.2±16.8) MBq] 99mTcO4- radiograph. Thyroid quantitative SUVmean, SUVmax and three-dimensional thyroid volume (Vol3D) of Graves' disease patients were determined by 40% threshold method, and the correlation between SUVmean, SUVmax and serum thyroid hormone levels, 131I rate was analyzed. Vol3D and Vol2D thyroid volume were measured by Xeleris workstation (GE Healthcare) and conventional formulas, respectively, analyzed and compared. Results · The quantitative values of SUVmean and SUVmax in patients with Graves' disease were (262.5±110.2) g/mL and (471.4±192.1) g/mL, respectively. There was no significant correlation between serum thyroid hormone levels (FT3 and FT4), SUVmean and SUVmax (all P>0.05). There was week correlation between iodine uptake rate and SUVmean, SUVmax (all r >0 and all P=0.000). In addition, there was a positive correlation between thyroid Vol3D and Vol2D (r=0.853, P=0.000). Conclusion · Quantitative imaging of 99mTcO4- SPECT/CT for the determination of three-dimensional thyroid volume and quantitative uptake of SUV is simple and feasible, providing clinical basis for the diagnosis and treatment dose assessment of Graves' disease, which has important clinical diagnostic significance.
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    Correlation between childhood trauma and schizophrenia symptoms
    REN Yan-yan, LÜ Qin-yu, YANG Wei-li, WANG Zhen
    2020, 40 (12):  1641-1645. 
    doi: 10.3969/j.issn.1674-8115.2020.12.013

    Abstract ( 294 )   PDF (6330KB) ( 258 )  
    Objective · To explore the relationship between different dimensions of childhood trauma and positive and negative symptoms of schizophrenia. Methods · A total of 124 patients with schizophrenia were recruited at Shanghai Mental Health Center. Childhood trauma was evaluated by the Early Trauma Inventory Short Form (ETI-SF), and psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). Pearson correlation analysis and Gaussian graphical model (GGM) were used to examine the relationship between 4 dimensions of ETI-SF and the scores of 3 subscales or total 30 items of PANSS. Results · There was a significant correlation between subscales of positive symptoms and physical abuse (r=0.29, P=0.000) or emotional abuse (r=0.21, P=0.024) after controlling age, sex and other confounding factors. All dimensions of ETI-SF were related to different items of positive symptom scale. GGM results also verified that physical and emotional abuse were strongly correlated with the positive symptoms in schizophrenia. In addition, the degree centrality value of active social avoidance was the biggest through the whole network. Conclusion · Childhood trauma is related to positive symptoms of schizophrenia. Physical abuse and emotional abuse are significantly related to the positive symptoms. Active social avoidance plays an important role in the whole network.
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    Original article (Public health)
    Validity and reliability of Acquired Capability for Suicide Scale in medical undergraduates
    WANG Su-ping1, 2, WANG Yi-chen2, 3, GONG Rui-jie1, 4#, GE Yun5, CAI Yong 1#
    2020, 40 (12):  1646-1651. 
    doi: 10.3969/j.issn.1674-8115.2020.12.014

    Abstract ( 357 )   PDF (8523KB) ( 54 )  
    Objective · To develop Acquired Capability for Suicide Scale and examine its reliability and validity in medical undergraduates. Methods · Convenient sampling was used. One thousand one hundred and eight medical students were selected and assessed with Acquired Capability for Suicide Scale, forty-two of which were reassessed after 2 months. SPSS 20.0 and AMOS 22.0 were used for analysis. Pearson correlation coefficient and content validity index (CVI) were used to examine the content validity; factor analysis and independent sample t-test were used to examine construct validity and differentiated validity. Reliability was assessed by internal consisitent reliability (Cronbach's α), split-half reliability (Spearman-Brown coefficient) and retest reliability (intraclass correlation coefficient, ICC). Results · The average score of Acquired Capability for Suicide Scale of the total 1 094 participants was (21.02±10.86). Three hundren and eight participants (28.15%) had suicide ideation, 68 had suicide attempt, and 38 used to have suicide behavior. Item-level CVIs (I-CVIs) were all higher than 0.80, and scale-level CVI (S-CVI) was 0.97. The correlation coefficients (r) of each subscale and its items ranged from 0.842 to 0.916. Kaiser-Meyer-Olkin (KMO) statistic was 0.691 and P value of Bartlett Test of Sphericity was less than 0.001, so the result showed the data was suitable for factor analysis. Principal component analysis and the maximum variance orthogonal rotation were used to extract 3 common factors with eigenvalue ≥ 1. The cumulative variance contribution rate was 76.01%. Each fitting index of the modified confirmatory factor analysis showed that the model fitted well [χ2/df=3.652, root mean square error of approximation (RMSEA)=0.070, comparative fit index (CFI)=0.977, goodness of fit index (GFI)=0.979, normed fit index (NIF)=0.969, incremental fit index (IFI)=0.977], and all the factors' loadings were over 0.6. The total score of suicide attempt group (33.85±11.42) was higher than that of non-suicide attempt group (27.60±9.35) (t=4.621, P=0.000), and the total score of suicide behavior group (36.18±12.60) was higher than that of non-suicide behavior group (27.97±9.37) (t=3.870, P=0.000). The Cronbach’s α coefficient of Acquired Capability for Suicide Scale was 0.794, the Spearman-Brown coefficient was 0.729, and ICC was 0.846. Conclusion · Acquired Capability for Suicide Scale includes 3 dimensions: self-perceived suicidal ability, impulsivity and tolerance of pain. The validity and reliability of Acquired Capability for Suicide Scale was good among Chinese medical undergraduates. The scale can be used to identify whether an individual, especially the people with suicide ideation, has the ability to commit suicide.
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    Hypertension control in Jiading, Shanghai and its relevant factors
    HU Zhe1*, FENG Qing1*, DENG Xue-qin1, HE Yan1, LI Ming-chun1, DONG Chen-jie2, HU Jing-fen3, ZHANG Nan3, GAO Yan4, CHU Shao-li1, YANG Hui1#, CHEN Xin1#
    2020, 40 (12):  1652-1655. 
    doi: 10.3969/j.issn.1674-8115.2020.12.015

    Abstract ( 282 )   PDF (5990KB) ( 81 )  
    Objective · To investigate the hypertension control and relevant factors in Jiading, Shanghai, and make some suggestions for the management of hypertension. Methods · The data was derived from the May Month Measurement study, from May to September 2017. The seated blood pressure of adults aged 18 years or above were measured three times with 1-minute interval. All values were recorded. Demographic information, including age, gender, body height, and current smoking and alcohol intake, the presence of comorbid diseases, such as diabetes, coronary artery heart disease (CHD) and stroke or transient ischemic attack (TIA) and the use of antihypertensive and lipid lowering drugs, were collected as well as waist and hip circumferences were measured. Logistic stepwise regression was used to analyze the relevant factors of unawareness, untreated and uncontrolled of hypertension. Results · A total of 9 992 participants were included in the analysis, the mean age of whom was (50.3±16.2) years, with males accounting for 56.2%, and the mean blood pressure was 125 mmHg/76 mmHg (1 mmHg=0.133 kPa). The proportion of hypertension was 31.6%, and the rates of awareness, treatment and control of hypertension were 64.7%, 59.3% and 40.1%. The older hypertensive participants had better awareness and treatment [+10 years, unawareness: OR=0.77, 95%CI 0.71–0.83, P=0.000. untreated: OR=0.77, 95%CI 0.71–0.83, P=0.000]. The situation in male was worse (vs female, unawareness: OR=1.42, 95%CI 1.19–1.69, P=0.000. untreated: OR=1.27, 95%CI 1.06–1.52, P=0.009. uncontrolled: OR=1.24, 95%CI 1.02–1.51, P=0.034). Individuals with diabetes (unawareness: OR=0.36, 95%CI 0.22–0.61, P=0.000. untreated: OR=0.52, 95%CI 0.34–0.80, P=0.003), using lipid-lowering drugs (unawareness: OR 0.20, 95%CI 0.11–0.36, P=0.000. untreated: OR=0.25, 95%CI 0.15–0.42, P=0.000), with CHD (unawareness: OR=0.27, 95%CI 0.12–0.59, P=0.001. untreated: OR=0.30, 95%CI 0.15–0.58, P=0.000), and with stroke or TIA (unawareness: OR=0.35, 95%CI 0.17–0.72, P=0.004. untreated: OR=0.38, 95%CI 0.20–0.71, P=0.002) had better awareness and treatment, and patients with CHD were better controlled than ones without CHD (OR=0.63, 95%CI 0.42–0.95, P=0.026). Conclusion · The rate of awareness, treatment and control of hypertension in Jiading, Shanghai is not ideal, especially in male and the youngers. The rate of awareness, treatment and control in patients with cardiovascular diseases is higher, which suggests the importance of blood pressure measurement and public education.
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    Review
    Advances in DNA methylation mechanism of antipsychotic-induced metabolic syndrome
    XIANG Si-ying, LI Ning-ning, XU Yi-feng#, CHEN Jian-hua#
    2020, 40 (12):  1656-1659. 
    doi: 10.3969/j.issn.1674-8115.2020.12.016

    Abstract ( 307 )   PDF (6719KB) ( 91 )  
    Schizophrenia patients are more likely to develop metabolic syndrome which is related to the interactions between gene and environment. Antipsychotic drugs, the main treatments, can change the DNA methylation level of related genes and then influence the efficacy and adverse effects of drugs. This article reviews the relationship between DNA methylation and schizophrenia with metabolic syndrome.
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    Advances in magnetic resonance imaging study of bipolar Ⅰdisorder
    YANG Tao, CHEN Jun, FANG Yi-ru
    2020, 40 (12):  1660-1664. 
    doi: 10.3969/j.issn.1674-8115.2020.12.017

    Abstract ( 272 )   PDF (8700KB) ( 60 )  
    The brain structural and functional impairment in affective and cognitive circuits has been detected in bipolar disorder (BD) patients; however the specific neuroimaging mechanism of BD is still inconsistent. One of the reasons may be the sample heterogeneity caused by subtypes of BD. Bipolar Ⅰdisorder (BD- Ⅰ ) is one of the BD types with the highest prevalence and the most typical symptoms. It may be better to reveal the mechanism of BD and explore targeted treatment through research focusing on BD- Ⅰ patients. This article reviews the magnetic resonance imaging (MRI) studies about BD- Ⅰ in recent 5 years to better know about advances in this field and explore the potential research directions.
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    Clinical application of receptor tyrosine kinase inhibitors to acute myeloid leukemia
    DONG Xin-yi1, FAN Qiu-yue1, QIU Shu-han1, ZHOU Jia-yao1, LU Ying2
    2020, 40 (12):  1665-1671. 
    doi: 10.3969/j.issn.1674-8115.2020.12.018

    Abstract ( 343 )   PDF (11255KB) ( 98 )  
    Receptor tyrosine kinases (RTKs) control the basic activities of cells including proliferation, cell cycle, apoptosis, metabolism and so on. Accordingly, abnormal activation caused by mutations of RTKs plays an important part in the formation and development of tumor. For the past few years, the receptor tyrosine kinase inhibitors (rTKI) developed for RTKs have progressed rapidly and achieved good results in clinical treatment in various tumor types, such as chronic myelogenous leukemia, non-small cell lung cancer, breast cancer and so on. As for acute myeloid leukemia (AML), approval and clinical application of inhibitors against Fms-like tyrosine kinase 3 (FLT3) significantly improve prognosis in patients with FLT3 mutations, which is vital for the treatment of AML. The clinical application of rTKI to AML is summarized in this review, providing a reference for the treatment of AML.
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    Research progress of adipose-derived mesenchymal stem cell and its extracellular vesicles in osteogenesis
    CUI Ya-qi, BAI Yu-bing, XU Yi-chen, TAN Xin-chen, LI Meng-ying, JIA Hao
    2020, 40 (12):  1672-1676. 
    doi: 10.3969/j.issn.1674-8115.2020.12.019

    Abstract ( 328 )   PDF (8152KB) ( 72 )  
    Adipose-derived mesenchymal stem cells (ADMSCs) are a kind of multipotent stem cells which are isolated from the adipose tissue. They can induce the differentiation of osteoblasts under certain treatment, and are important in the repair of osseous tissue. Research has found that ADMSCs can induce the differentiation of MSCs in the direction of osteogenesis by secreting cytokines and extracellular vesicles and activating GF-β/BMPs, Wnt and other signaling pathways. Research has also found that applying ADMSCs and their extracellular vesicles to the clinical treatment of osteoporosis has low extraction cost, high safety and good application prospect, compared with bone marrow-derived mesenchymal stem cells. This review intends to summarize the major patterns and molecular mechanisms of ADMSCs in inducing osteogenic differentiation and further discusses the advantages and prospects of applying ADMSCs and their extracellular vesicles to the clinical treatment of osteoporosis.
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    Research progress in progesterone resistance mechanism and novel treatment of endometrial cancer
    SHEN Cai, TENG Yin-cheng
    2020, 40 (12):  1677-1682. 
    doi: 10.3969/j.issn.1674-8115.2020.12.020

    Abstract ( 358 )   PDF (9990KB) ( 82 )  
    The incidence of endometrial cancer among Chinese women has increased year by year with a younger trend in morbidity age. Young patients with early endometrial cancer are increasingly demanding fertility preservation. At present, progesterone therapy is still the first choice of fertility-sparing treatment, and has achieved good results. However, progesterone resistance and adverse reactions have also become the main reasons for the failure of progesterone therapy in some patients. Therefore, understanding the mechanism of progesterone resistance and exploring coping methods has guiding significance in the fertility-sparing treatment for early endometrial cancer patients. This article reviews the mechanism of progesterone resistance, the new treatment methods to solve progesterone resistance (such as hysteroscopy), and the significance of molecular typing of endometrial cancer in predicting progesterone resistance.
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    An update on the cell origin of retinoblastoma
    SHI Han-han, WANG Shao-yun, JIA Ren-bing
    2020, 40 (12):  1683-1686. 
    doi: 10.3969/j.issn.1674-8115.2020.12.021

    Abstract ( 347 )   PDF (7657KB) ( 93 )  
    Retinoblastoma is the malignant intraocular tumor most commonly happened on children, especially the children under 3 years old. It may lead to blindness, eyeball removal and even death, which severely threaten the safety and quality of children’s life. Exploring the origin of tumor cells is conducive to the reveal of the pathogenesis as well as the guidance on diagnosis, classification and treatment of retinoblastoma. Based on the studies on retinal development, three theories regarding the cell origin of retinoblastoma, namely the origin of retinal precursor cells, the origin of cone cells and the origin of horizontal cells or Müller glia cells have lately been proposed. This article reviews and summarizes the research of the origin cells in retinoblastoma.
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    Brief original article
    Construction of assessment tool for radiation-induced skin ulcer
    LIU Cheng-wei, LIU Yi-fan, HUANG Yao, WANG Qi, NI Peng-wen, XIE Ting
    2020, 40 (12):  1687-1692. 
    doi: 10.3969/j.issn.1674-8115.2020.12.022

    Abstract ( 292 )   PDF (7164KB) ( 45 )  
    Objective · To initiate an assessment tool for radiation-induced skin ulcer and reach a standardized assessment for clinical use, so as to contribute to the determination of optimal therapy depending on the assessment. Methods · A questionnaire was designed by reviewing the literatures, referring to the logic of assessment tools of wound diseases including diabetic foot ulcer, pressure injury and lower extremity vascular ulcer, and discussing within the research group. Sixteen experts in wound healing were engaged in the consultation over two rounds of Delphi method. The expert concordance coefficient and expert positive coefficient as well as expert authority coefficient was analyzed by checking the feedback. The reliability of experts' consultation, as well as the coordination and scientificity with assessment tool were analyzed statistically. Then the assessment tool for radiation-induced skin ulcer was established. Results · Thirteen of 16 experts responded over the two rounds consultation. The established assessment tool for radiation-induced skin ulcer contains 2 first-level indicators, 10 second-level indicators and 35 third-level indicators. Within the two rounds of consultation, the positive coefficient were 87.50% and 100% respectively. The expert authority coefficient was 0.937. The Kendall's coefficient of concordance for two rounds consultation were 0.231 and 0.147 respectively (χ2=131.977 and χ2=87.849, P<0.05). Conclusion · Experts showed high enthusiasm toward this research, and had reliable authority. The expert evaluation opinions were well coordinated, thus the results were credible. The established assessment tool for radiation-induced skin ulcer was verified to be scientific and reliable. The tool is easy to be used in clinic. By use of this assessment tool, the therapeutic plan of radiation-induced skin ulcer could be made in a more standardized way.
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    Case report
    A case report of fulminant myocarditis in a pregnant woman and literature review
    LIU Zhong-na, JIANG Rong-zhen, HUANG Ya-juan, TENG Yin-cheng
    2020, 40 (12):  1693-1696. 
    doi: 10.3969/j.issn.1674-8115.2020.12.023

    Abstract ( 294 )   PDF (5194KB) ( 103 )  
    A 32-year-old patient(G3P1)was admitted to the hospital due to“fever accompanied by heart palpitations for 2 d” after 30+6 gestational weeks. Serum troponin I (cTnI) was 1.356 μg /L (↑), and creatine kinase MB(CK-MB) was 10.4 μg /L (↑). Electrocardiogram showed sinus tachycardia (heart rate 112 beats/min), and ST segment elevation (Ⅱ ,Ⅲ , aVF and V3-V6 J point upward shift type). The patient had a history of "cold" 1 month ago. Among the multidisciplinary consultation, continuous renal replacement therapy and extracorporeal membrane oxygenation mechanical circulation support followed up. The patient was given caesarean section under general anesthesia after stable condition. After that, the patient was discharged from the hospital. There are few reports on pregnancy combined with fulminant myocarditis. The clinical data and treatment of this case can provide reference for clinicians.
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