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    Basic research
    Phosphoproteomic analysis of concanavalin A-induced hepatocytes injury
    Zhuo-yi YANG, Hui CHEN, Si-yi BAI, Pameila PERHATI, Jing-li HOU, Yun-sheng YUAN
    2021, 41 (1):  1-7. 
    doi: 10.3969/j.issn.1674-8115.2021.01.001

    Abstract ( 275 )   HTML ( 23 )   PDF (2396KB) ( 155 )  
    Objective

    ·To study the changes of phosphorylation level of whole-cell proteins during the process of concanavalin A (ConA)-induced hepatocyte injury.

    Methods

    ·Mouse hepatocytes of AML12 cells and ConA (10 μg/mL) were co-cultured to induce a hepatocyte injury model. After 12 h, the total proteins were extracted and digested into peptides. The peptides were enriched by metal oxide affinity chromatography and detected by using high performance liquid chromatography-mass spectrometer. Identification and relative quantitative analysis of phosphorylation sites and peptides were performed using the Label free method. Proteins with a difference of more than two times of phosphorylation level of each site were screened. And the biological function enrichment analysis and protein interaction regulation network analysis were performed.

    Results

    ·In the ConA-induced AML12 cell injury model, a total of 11 200 phosphorylated modified peptides and 2 685 localizable and quantifiable peptides were identified. Among them, there were 82 differentially regulated phosphorylated modified peptides, corresponding to 77 proteins. These phosphorylated proteins were mainly related to protein binding and enzyme activities. And the main pathways were related to apoptosis and RAS kinase pathways.

    Conclusion

    ·AML12 cells undergo phosphorylation level change in ConA-induced liver cell injury and these differentially phosphorylated proteins may be related to liver cell apoptosis.

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    Application of CRISPR/Cas9-mediated homologous recombination to the functional study of disease-associated genetic variants located in non-coding region
    Ning XU, Tian ZHOU, Guo-jun HOU, Nan SHEN, Yuan-jia TANG
    2021, 41 (1):  8-15. 
    doi: 10.3969/j.issn.1674-8115.2021.01.002

    Abstract ( 298 )   HTML ( 18 )   PDF (4174KB) ( 148 )  
    Objective

    ·To take the systemic lupus erythematosus (SLE)-associated single nucleotide polymorphism (SNP) rs1978421 reported in the genome-wide association study (GWAS) as an example, and establish the research strategy for the functional study of disease-associated genetic variants located in the non-coding region through clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (CRISPR/Cas9) system.

    Methods

    ·Single guide RNA (sgRNA) was designed for SNP rs1978421. T7 endonuclease Ⅰ (T7E Ⅰ) experiment was used to verify the cleavage efficiency of sgRNA in HEK293T cells. The homologous recombinant template and expression plasmid of Cas9-green fluorescent protein (GFP)/sgRNA were transfected into U-937 cells by electroporation transfection method. GFP positive U-937 single cells were sorted by flow cytometry, and the cells were cultured for the following 14 days. Then the genotype identification was carried out. After the homologous recombinant cell clones were screened, quantitative real-time PCR (qPCR) was used to quantify the upstream and downstream genes of rs1978421 within 2 Mb and miR-146a, and the effects of different alleles of rs1978421 on the expression of miR-146a and its surrounding genes were analyzed.

    Results

    ·T7E Ⅰ assay showed that about 24% of the total rs1978421 sites in HEK293T were cleaved. In homologous recombination experiment of the U-937 cells, a total of 141 cell lines were obtained and only six were successful, while the ratio of homologous recombination was 4.3%. qPCR showed that there was no significant difference in the expression of miR-146a and the detected genes between wild type TT and homologous recombinant CC in the U-937 cells (all P>0.05).

    Conclusion

    ·SNP rs1978421 has no regulatory effect on the surrounding genes within 2 Mb and miR-146a. However, this study proves the feasibility of CRISPR-mediated homologous recombination technology for the functional study of SNP sites in the non-coding regions.

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    Association study of synaptotagmin 2 gene polymorphisms with schizophrenia in Chinese Han population
    Hong YANG, Xin-xin HUANG, Chao LIU, Qing-song LIANG, Hua YANG, Jian-biao ZHANG, Jian XU, Ying-yi WANG, Hai-su WU, Qin-yu LÜ, Zheng-hui YI
    2021, 41 (1):  16-22. 
    doi: 10.3969/j.issn.1674-8115.2021.01.003

    Abstract ( 246 )   HTML ( 2 )   PDF (1352KB) ( 469 )  
    Objective

    ·To investigate the relationship between synaptotagmin 2 (SYT2)gene and schizophrenia (SZ) in Chinese Han population.

    Methods

    ·TaqMan probe genotyping technique was used to detect 5 single nucleotide polymorphism (SNP) sites (rs6427957,rs907697,rs12564274,rs10800856 and rs61820945) of SYT2 gene in 478 SZ patients (SZ group) and 474 healthy controls (HC group). HaploView software, SHEsis and SNPstats online software were used to compare the alleles, genotypes, genotypes under different genetic models and haplotypes frequency distribution between the SZ group and HC group.

    Results

    ·The frequency distribution differences of rs10800856 allele and genotype were statistically significant between the SZ group and HC group, respectively (P=0.003, P=0.012). After Bonferroni correction, the allele frequency difference of rs10800856 site was still statistically significant (P=0.015), while the genotype frequency difference was not statistically significant. Under the dominant and additive genetic mode, the genotype frequency distributions of rs10800856 site were significantly different between the SZ group and HC group (P=0.004, P=0.005). After correction, the differences were still statistically significant (P=0.020, P=0.025). The frequency distribution of haplotype C-T-C, composed of rs12564274-rs10800856-rs61820945, between the SZ group and HC group was significantly different (P=0.009). After Bonferroni correction, the difference was still statistically significant (P=0.036).

    Conclusion

    ·In Chinese Han population, SYT2 may be the susceptibility gene of SZ, and rs10800856 site may be associated with the risk of SZ.

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    Effect of protease activated receptor 2 on colonic transport in chronic stress mice
    Han-yue FU, Xu HUANG, Hong-li LU, Wen-xie XU
    2021, 41 (1):  23-28. 
    doi: 10.3969/j.issn.1674-8115.2021.01.004

    Abstract ( 230 )   HTML ( 13 )   PDF (2356KB) ( 135 )  
    Objective

    ·To observe the effect of protease activated receptor 2 (PAR2) on colonic motility in chronic stress-treated mice, and investigate its mechanism.

    Methods

    ·The mice were treated with chronic heterogenous stress for 14 days to establish the chronic stress model. Western blotting was used to determine the expressions of PAR2, platelet-derived growth factor receptor α (PDGFRα) and small conductance calcium-activated potassium channel 3 (SK3 channel), while the effects of PAR2 agonist and SK3 channel antagonist on colonic motility were observed by isometric tension experiment. T-test was used for statistical analysis. Statistical significance was accepted at the value of P<0.05.

    Results

    ·Twenty-four hours after being treated by stress stimulation, the mice demonstrated a decrease of colonic transmission because the number of fecal pellets decreased significantly; simultaneously, the expression of PAR2 increased in the colon smooth muscle tissue of chronic stress-treated mice. The inhibition of colonic smooth muscle contractions by PAR2 agonist was more significant in the chronic stress-treated mice than that in the control ones. The expression of PDGFRα in colonic smooth muscle tissue of chronic stress-treated mice increased, but the expression of SK3 had no obvious change, compared with the control mice. The inhibition of colonic smooth muscle contractions by SK3 channel antagonist was not significantly different between chronic stress-treated mice and the control mice.

    Conclusion

    ·In the colons of chronic stress-treated mice, PAR2 activity and expression both increase, which may be responsible for the decrease of colonic motility.

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    Association study of non-coding variant of NOS1AP gene with schizophrenia
    Guo-qin HU, Qin-yu LÜ, Jing ZHAO, Ming-huan ZHU, Shun-ying YU, Zheng-hui YI, Jian CHEN
    2021, 41 (1):  29-34. 
    doi: 10.3969/j.issn.1674-8115.2021.01.005

    Abstract ( 232 )   HTML ( 18 )   PDF (1598KB) ( 88 )  
    Objective

    ·To clarify the correlation between nitric oxide synthase 1 adaptor protein (NOS1AP)gene and Han Chinese schizophrenia patients, and predict the changes in the secondary structure of RNA and protein caused by variation of NOS1AP gene positive polymorphism.

    Methods

    ·From October 2012 to December 2015, 333 patients with early onset schizophrenia (EOS) and 491 patients with non-early onset schizophrenia (non-EOS) were included from Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, and 901 healthy controls (HC) were selected from the staff of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine and the people receiving physical examination in the Physical Examination Center of Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University through recruitment. The rs12742393, rs4145621 and rs1415263 polymorphisms of NOS1AP gene were detected by TaqMan probe. The Hardy-Weinberg (H-W) equilibrium of the three polymorphism loci and the allele and genotype frequencies were analyzed by the SHEsis online software. The optimal genetic model analysis was carried out by the SNPstats online website. RNAfold and DNAstar softwares were used to predict the secondary structures of RNA and protein encoded by the significantly different polymorphism locus.

    Results

    ·The distribution of genotypes fit H-W equilibrium(P>0.05). There were significant difference in allele and genotype frequencies between EOS patients and HC subjects for rs12742393 after Bonferroni correction (P=0.012, P=0.039). Genetic model analysis found that the distribution of genotypes best fit the dominant genetic pattern (P=0.004). After the mutation of the A allele into the C allele for rs12742393, the secondary structures of RNA and protein encoded by the NOS1AP gene underwent important changes, resulting in the decrease in spatial stability.

    Conclusion

    ·The NOS1AP rs12742393 polymorphism has a major influence on susceptibility to EOS.

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    Therapeutic effects of the combination of fasudil and C-C chemokine receptor type 5-transducted mesenchymal stem cells on experimental autoimmune encephalomyelitis
    Yan-hua LI, Ya-ping YAN, Xiao-qin LIU, Guo-ping XI, Guo-bin SONG, Bao-guo XIAO, Cun-gen MA
    2021, 41 (1):  35-41. 
    doi: 10.3969/j.issn.1674-8115.2021.01.006

    Abstract ( 191 )   HTML ( 4 )   PDF (3168KB) ( 89 )  
    Objective

    ·To study the therapeutic effect of the combination of fasudil and C-C chemokine receptor type 5-transducted mesenchymal stem cells (CCR5-MSCs) on experimental autoimmune encephalomyelitis (EAE).

    Methods

    ·The mice immunized with myelin oligodendrocyte glycoprotein peptide fragment 35-55 (MOG35-55) were randomly divided into EAE model group (intraperitoneal injection of normal saline), fasudil intervention group (intraperitoneal injection of fasudil), CCR5-MSCs intervention group (nasal administration of CCR5-MSCs), and fasudil combined with CCR5-MSCs intervention group (intranasal administration of CCR5-MSCs, intraperitoneal injection of fasudil), with 8 mice in each group. The clinical score of EAE mice were checked every day after MOG35-55 immunization. All mice were sacrificed on the 28th day after the first immunization. The myelin integrity was observed by luxol fast blue staining. The production of neural stem cells and oligodendrocyte precursor cells in spinal cord tissue was analyzed by immunofluorescence staining. The expressions of neurotrophic factors in spinal cord tissue were detected by Western blotting.

    Results

    ·Compared with the other three groups, the clinical score of EAE in the fasudil combined with CCR5-MSCs intervention group was lower (P=0.000, P=0.007, P=0.005), and the demyelination was reduced (P=0.000, P=0.009, P=0.008). The production of neural stem cells and oligodendrocyte precursor cells in spinal cord tissue was increased (all P=0.000), and the expression of brain-derived neurotrophic factor, glial cell-derived neurotrophic factor, nerve growth factor, and neurotrophin-3 increased (all P=0.000).

    Conclusion

    ·Fasudil combined with CCR5-MSCs is more effective than fasudil or CCR5-MSCs in the treatment of EAE, which may be related to the induction of remyelination and the production of the neurotrophic factor.

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    Different expression levels of exosomal miR-200a in peritoneal dialysis effluent from patients with different peritoneal transport characteristics and prediction of its biological function
    Yan TONG, Jun-yan FANG, Hai DENG, A-hui SONG, Pu LI, Ying-li LIU
    2021, 41 (1):  42-48. 
    doi: 10.3969/j.issn.1674-8115.2021.01.007

    Abstract ( 234 )   HTML ( 1 )   PDF (2527KB) ( 123 )  
    Objective

    ·To extract and identify the exosomes in peritoneal dialysis effluent (PDE), compare the different expression levels of PDE exosomal miR-200a in patients with different peritoneal transport characteristics, predict the potential target genes of miR-200a and analyze the related biological processes.

    Methods

    ·Twenty stable peritoneal dialysis (PD) patients were divided into two groups, i.e., H group (high/high average) and L group (low/low average) according to the values of peritoneal equilibration test (PET). Overnight PDE 500 mL from each patient was collected, concentrated, and ultracentrifuged to obtain exosomes. Transmission electron microscope (TEM), nanoparticle tracking analysis (NTA) and Western blotting were used to identify and characterize the exosomes. Exosomal miRNAs were extracted and the expression levels of PDE exosomal miR-200a in the two groups were determined by real-time quantitative PCR. The relations between exosomal miR-200a levels and PET values or ultrafiltration volume (UF) were analyzed. The target genes of miR-200a were predicted by Targetscan, miRmap and miRWalk, and DAVID was used to perform gene ontology (GO) enrichment analysis.

    Results

    ·The exosomes extracted from concentrated PDE by ultracentrifugation exhibited a round and bilayer membrane-enveloped vesicle structure under TEM with the diameters ranging from 50-150 nm. The exosomes also expressed the particular molecular marker CD9 and CD63. The relative expression level of PDE exosomal miR-200a in L group was higher than that of H group. The expression levels were negatively correlated with PET values (r=-0.871, P=0.000) and positively correlated with 4 h UF (r=0.448, P=0.048). But there was no relationship between miR-200a and 24 h UF (r=0.355, P=0.125). Bioinformatic results showed that there were 679 target genes of miR-200a that could be predicted by all the three databases. GO analysis suggested that these genes not only participated in positive regulation of mesenchymal cells proliferation, but also focused on ion binding, especially metal cation binding.

    Conclusion

    ·Exosomes indeed exist in PDE. The relative expression level of exosomal miR-200a is higher in the PDE from the patients with low peritoneal dialysis transport characteristics. The relative quantity of miR-200a is negatively correlated with the values of PET and positively correlated with 4 h UF. There are abundant potential target genes of miR-200a, indicating that it may affect the peritoneal transport characteristics by different biological processes.

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    Clinical research
    Change of cortisol level in umbilical cord blood of neonates delivered by gestational diabetes mellitus mothers and its influence on offspring health
    Ya-jie ZHU, Hui LIN, Xi CHEN, Yi-ran ZHAO, Xin-mei LIU, He-feng HUANG
    2021, 41 (1):  49-54. 
    doi: 10.3969/j.issn.1674-8115.2021.01.008

    Abstract ( 272 )   HTML ( 6 )   PDF (1645KB) ( 160 )  
    Objective

    ·To investigate the effect of gestational diabetes mellitus (GDM) on the cortisol level in neonatal umbilical cord blood, and explore the effects of high perinatal cortisol exposure on neonatal health status at preschool-period.

    Methods

    ·A total of 170 mothers and their full-term neonates were selected, including 66 cases in GDM group and 104 cases in normal glucose tolerance (NGT) group. The umbilical cord blood from the newborns of the two groups was collected to measure the concentrations of cortisol and adrenocorticotropic hormone (ACTH). SPSS software was used to analyze the effect of GDM on cortisol and ACTH levels in the neonatal umbilical cord blood. Multiple linear regression model was used to analyze the influencing factors of cortisol level in the umbilical cord blood. Pearson χ2 method was used to analyze the effects of perinatal high cortisol on the health status of offspring at preschool-period, and binary Logistic regression model was used to analyze the influencing factors of preschool-period obesity.

    Results

    ·Compared with the NGT group, the cortisol level of neonatal umbilical cord blood in the GDM group was higher and ACTH level was lower (both P<0.05). Multiple linear regression analysis showed that maternal gestational times, and blood glucose at 1 h and 2 h after 75 g oral glucose tolerance test (OGTT) were the independent influencing factors of neonatal umbilical cord blood cortisol level (all P<0.05). The follow-up results showed that the offspring with higher perinatal cortisol level had higher pre-school obesity rate (P=0.009). Binary Logistic regression analysis confirmed that neonatal umbilical cord blood cortisol level ≥ 192.00 ng/mL was an independent risk factor of preschool-period obesity (OR=4.714, P=0.016).

    Conclusion

    ·Maternal GDM can cause the increase of neonatal umbilical cord blood cortisol level. High perinatal cortisol exposure can increase the risk of preschool-period obesity in the offspring. GDM may cause long-term diseases in the offspring through perinatal high cortisol exposure.

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    Predictive value of soluble interleukin-2 receptor and tumor necrosis factor in disease activity of lupus nephritis
    Guan-wen HUANG, Ji-wen BAO, Zi-yang LI, Min-fang ZHANG, Wen-yan ZHOU, Qin WANG, Zhao-hui NI, Ling WANG
    2021, 41 (1):  55-61. 
    doi: 10.3969/j.issn.1674-8115.2021.01.009

    Abstract ( 213 )   HTML ( 2 )   PDF (1670KB) ( 120 )  
    Objective

    ·To investigate the correlations of soluble interleukin-2 receptor (sIL-2R) and tumor necrosis factor-α (TNF-α) with lupus nephritis (LN) and their predictive values in disease activity of LN.

    Methods

    ·This was a cross-sectional study. From January 2018 to December 2018, 40 patients who underwent kidney biopsy and was diagnosed as having LN and 68 healthy controls in Renji Hospital, Shanghai Jiao Tong University School of Medicine were included. Clinical characteristics and laboratory parameters were collected and serum sIL-2R and TNF-α were measured. Serum sIL-2R and TNF-α were compared between the LN group and the control group. The correlations of sIL-2R and TNF-α with laboratory parameters of LN were evaluated by Spearman analysis. Further, the LN patients were divided into the active group and the non-active group. The predictive values of sIL-2R and TNF-α were evaluated by Logistic analysis and receiver operating characteristic (ROC) curve.

    Results

    ·Serum sIL-2R and TNF-α levels were significantly higher in the LN group than those in the control group (all P<0.05). Positive correlations were observed between sIL-2R and systemic lupus erythematosus disease activity index-2000 (SLEDAI-2K), 24 hours urine total protein (24h-UTP), anti-double stranded DNA antibody (anti-dsDNA), serum creatinine and high sensitive C-reactive protein (h-CRP) (all P<0.05), while a negative correlation was found between sIL-2R and C3 (P=0.002). Meanwhile, TNF-α positively correlated with SLEDAI-2K, 24h-UTP, serum creatinine and h-CRP, whereas no significant correlation was found between TNF-α and anti-dsDNA or C3. 24h-UTP, anti-dsDNA, serum creatinine, sIL-2R and TNF-α were significantly higher (all P<0.05) and C3 was lower in the active group than those in the non-active group of LN (P=0.000). Anti-dsDNA (OR=1.025) and sIL-2R (OR=1.011) were predictive factors of disease activity of LN (all P<0.05) and the area under ROC curve of their combination of prediction was 0.957 (P=0.000).

    Conclusion

    ·Serum sIL-2R and TNF-α levels increase in LN patients and are correlated with the disease activity of LN. Combining anti-dsDNA and sIL-2R can predict the disease activity of LN effectively.

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    Correlation between quantitative electroencephalogram features and CT perfusion imaging parameters in acute ischemic stroke
    Xiu-ying LIU, Rui-fang LAN
    2021, 41 (1):  62-65. 
    doi: 10.3969/j.issn.1674-8115.2021.01.010

    Abstract ( 171 )   HTML ( 0 )   PDF (1007KB) ( 97 )  
    Objective

    ·To investigate the correlation between early quantitative electroencephalogram (QEEG) features and brain CT perfusion imaging parameters in the patients with acute ischemic stroke (AIS), and analyze the correlation between QEEG features and National Institutes of Health Stroke Scale (NIHSS) score.

    Methods

    ·Ninety-two patients with AIS admitted to the First People's Hospital of Qinzhou from March 2014 to June 2016 were enrolled. All the patients were given emergency CT perfusion imaging to determine the ischemic lesion areas. And then they were monitored by electroencephalogram for at least 2 h. The assessment by using NIHSS was performed after admission. Cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were obtained from CT perfusion imaging. α wave index, θ wave index, δ wave index, slow wave index, α/δ power ratio (ADR), (δ+θ)/(α+β) power ratio and brain symmetry index (BSI) were obtained from QEEG analysis. With Pearson linear correlation analysis, the correlation between CT perfusion imaging parameters and QEEG features in the ischemic lesions, the correlation between CT perfusion imaging parameters and NIHSS score, and the correlation between QEEG features and NIHSS score were analyzed.

    Results

    ·The AIS patients had decreased CBF, prolonged MTT and TTP, increased δ wave index, slow wave index and BSI, and decreased ADR and DTABR in the ischemic lesion areas than those in the contralateral regions. The differences were statistically significant (all P<0.05). MTT was positively correlated with δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with ADR and DTABR (all P<0.05); TTP was positively correlated with δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with ADR and DTABR (all P<0.05); the NIHSS score was positively correlated with MTT, TTP, δ wave index, slow wave index and BSI (all P<0.05), and negatively correlated with CBF, ADR and DTABR (all P<0.05).

    Conclusion

    ·There exists correlation between QEEG features and CT perfusion imaging parameters in the patients with AIS. Early recording of the patients' QEEG features can help assess the changes of ischemic lesions and neurological deficits and realize dynamic monitoring.

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    Application of ultrasound-guided cervical vagal block combined with thoracic paravertebral block in thoracoscopy
    Chen CHENG, Kun FAN, Ying ZHANG
    2021, 41 (1):  66-69. 
    doi: 10.3969/j.issn.1674-8115.2021.01.011

    Abstract ( 202 )   HTML ( 0 )   PDF (1465KB) ( 73 )  
    Objective

    ·To evaluate the safety and effectiveness of ultrasound-guided cervical vagal block combined with thoracic paravertebral block in resection of pulmonary bullae by thoracoscopy.

    Methods

    ·Forty patients, scheduled for the resection of pulmonary bullae by thoracoscopy in the East Branch of Shanghai Sixth People's Hospital, Shanghai Jiao Tong University from Jan. 2019 to Feb. 2020, were randomly divided into two groups (n=20 each): general anaesthesia with double lumen tube (GA+DLT) group and non-intubated nerve block anaesthesia (NINBA) group. The GA+DLT group was treated with combined general anaesthesia and patient controlled intravenous analgesia (PCIA). In the NINBA group, cervical vagal block and thoracic paravertebral block were performed under the guidance of ultrasound, and 40 mL of 0.5% ropivacaine was given. Intraoperative cough, intraoperative hemorrhage, intraoperative hypoxemia, operation time, postoperative chest distress, visual analogue score (VAS) of sport, incidence of nausea and vomiting, time of parecoxib sodium use, postoperative hospital stay and Bruggermann Comfort Score (BCS) were recorded. SPSS 19.0 software package was used for statistical analysis. The data were expressed as x±s with t test for group comparison, and χ2 test was used for qualitative data.

    Results

    ·There was no hypoxemia and cough in the two groups, and there was no significant difference in blood loss and operation time. The VAS of sport of the NINBA group was lower than that of the GA+DLT group (P=0.008); the time of using parecoxib sodium of the NINBA group was less than that of the GA+DLT group (P=0.000); the BCS of the patients in the NINBA group was significantly higher than that of the GA+DLT group (P=0.020). Compared with the NINBA group, the incidence of postoperative nausea and vomiting was higher in the GA+DLT group.

    Conclusion

    ·Ultrasound-guided cervical vagal block combined with thoracic paravertebral block can be safely and effectively used in the resection of pulmonary bullae by thoracoscopy.

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    Application of UE visual laryngoscope combined with Seeing Optical Stylet to tracheal intubation in obese patients
    Xin MA, Yi-meng XIA, Qiu-wei FAN
    2021, 41 (1):  70-73. 
    doi: 10.3969/j.issn.1674-8115.2021.01.012

    Abstract ( 239 )   HTML ( 1 )   PDF (1004KB) ( 60 )  
    Objective

    ·To investigate the application of UE visual laryngoscope combined with Seeing Optical Stylet to oral tracheal intubation in obese patients.

    Methods

    ·Forty-five obese patients from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine requiring oral tracheal intubation under general anesthesia were selected and divided into three groups randomly from January to May in 2020: the UE visual laryngoscope intubation group (group A), the Seeing Optical Stylet intubation group (group B) and UE visual laryngoscope combined with Seeing Optical Stylet intubation group (group C), with 15 cases in each. General characteristics, Mallampati classification, tracheal intubation time, and one time success rate of tracheal intubation were documented. Also, mean arterial pressure (MAP) and heart rate (HR) were recorded at different time points, including before anesthesia induction (T1) and 1 (T2), 3 (T3), 5 (T4) and 10 (T5) minutes after tracheal intubation. On the second day after surgery, the intubation complications like coughing, hoarseness, sore throat and tissue damage were observed.

    Results

    ·There were no significant differences in general features among the three groups. Group C has the shortest tracheal intubation time (P=0.007, P=0.001). The fluctuation of MAP (P=0.006, P=0.031) and HR (P=0.013,P=0.042) at T2 in goup C were significantly shorter than the other two groups. Moreover, the incidence of sore throat decreased remarkably in group C compared with group B (P=0.010).

    Conclusion

    ·UE visual laryngoscope combined with Seeing Optical Stylet is recommended in tracheal intubation for obese patients under general anesthesia, which has an advantage of rapid intubation, stable haemodynamics during intubation and fewer complications.

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    Effect analysis of fast track surgery combined with video-assisted thoracoscopic and laparoscopic resection of esophageal cancer in elderly patients
    Dong-lei ZHANG, Hua-bing WEI, Li-huang ZHOU, Xiao-zhe QIAN
    2021, 41 (1):  74-77. 
    doi: 10.3969/j.issn.1674-8115.2021.01.013

    Abstract ( 213 )   HTML ( 2 )   PDF (1027KB) ( 83 )  
    Objective

    ·To analyze the clinical effect of fast track surgery (FTS) combined with thoracoscopic and laparoscopic resection of esophageal cancer on elderly patients and provide evidence for clinical application.

    Methods

    ·The data of 38 elderly patients with esophageal cancer who were hospitalized in the Department of Thoracic Surgery, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine from May 2016 to May 2019 were collected. According to the perioperative treatment method, they were divided into FTS group (19 cases) and control group (19 cases). The FTS group was treated with FTS method and the control group was treated with traditional intervention method. The postoperative pain score, retention time of thoracic duct and catheter, recovery of gastrointestinal function, hospitalization time and complications of the two groups were compared.

    Results

    ·The postoperative pain of the FTS group was significantly lower than that of the control group. The retention time of thoracic duct [(2.9±0.9) d vs (6.3±1.4) d], the retention time of catheter [(1.7±0.5) d vs (5.2±1.6) d], the recovery time of gastrointestinal function [(2.5±0.6) d vs (6.6±2.1) d] and the hospitalization time [(14.7±3.1) d vs (20.6±3.8) d] of the patients in the FTS group were shorter than those in the control group (all P<0.05).

    Conclusion

    ·FTS combined with thoracoscopic and laparoscopic esophagectomy can effectively relieve the postoperative pain of elderly patients, shorten the hospitalization time, and accelerate the recovery of patients.

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    Public health
    Analysis of prevalence, mortality and disability-adjusted life year rate of diabetes in Chongqing City
    Xian-bin DING, De-qiang MAO, Yan JIAO, Li-ling CHEN, Jie XU
    2021, 41 (1):  78-81. 
    doi: 10.3969/j.issn.1674-8115.2021.01.014

    Abstract ( 253 )   HTML ( 4 )   PDF (1106KB) ( 242 )  
    Objective

    ·To analyze the prevalence, mortality and disability-adjusted life year (DALY) of diabetes in Chongqing City, and provide the evidence for the prevention and treatment of diabetes.

    Methods

    ·The data of diabetes death cases of Chongqing recorded in National Death Registration System in 2018 and the data of diabetes prevalence of Chongqing in 2018 obtained according to Chronic Diseases and Nutrition Monitoring Scheme of Chinese Residents (Trial) were collected and sorted out. SPSS 25.0 software was used to calculate the mortality, standardized mortality, prevalence, standardized prevalence, years of life lost (YLL) rate, years live with disability (YLD) rate and DALY rate of diabetes in Chongqing.

    Results

    ·In 2018, the diabetes mortality and standardized mortality were 16.20/100 000 and 8.82/100 000 in Chongqing, respectively. The mortality of diabetes in women was higher than that in men (χ2=3.99, P=0.045). In 2018, the prevalence and standardized prevalence of diabetes among residents with the age of 15 and above were 17.90% and 9.25%, respectively in Chongqing. The prevalence of diabetes in men was higher than that in women (χ2=18.12, P=0.000). The rates of YLL, YLD and DALY of diabetes in Chongqing were 2.99‰, 7.44‰ and 10.43‰, respectively. The proportions of YLL rate and YLD rate in DALY rate were 28.67% and 71.33%, respectively.

    Conclusion

    ·The disease burden of diabetes in Chongqing is serious, and the mortality and prevalence of diabetes are high. The YLD rate accounts for more than 70% of DALY rate.

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    Survey of perception on fertility preservation of male cancer patients
    Feng-chun ZHANG, Shuo-yuan ZHANG, Tian-en CHEN, Hai-yan XU, Yue MA, Zhao-nan LIU, Ying-chun XU
    2021, 41 (1):  82-88. 
    doi: 10.3969/j.issn.1674-8115.2021.01.015

    Abstract ( 184 )   HTML ( 2 )   PDF (1132KB) ( 78 )  
    Objective

    ·To analyze the perception of fertility preservation of the male patients with malignant tumors consulted in Grade-A tertiary hospitals in China through questionnaires.

    Methods

    ·From January 1st, 2018 to December 31, 2018, responses from the male cancer patients (≤50 years old) who had been treated in Renji Hospital, Shanghai Jiao Tong University School of Medicine were collected through a questionnaire survey.

    Result

    ·There were 212 male patients diagnosed with malignant tumor with a median age of (34.4±0.5) years in the current study. Among them, 61 (28.8%) were childless, 27 (12.7%) had a brief comprehension of fertility preservation, 28 (13.2%) intended to do fertility preservation, and 87 (41.0%) were aware that chemotherapy and radiotherapy might affect their fertility. Moreover, 27 patients who approximately understand fertility preservation got this knowledge from various ways. Nineteen of them (70.4%) were informed from doctors, 5 (18.5%) from media and 6 (22.2%) from internet. Male patients who have kids tended to refuse fertility preservation (P=0.000). Patients younger than 25 years old in the group were more likely to have children (P=0.046). Those with bachelor degree or above (P=0.006), and those with the desire to preserve fertility (P=0.010) were more likely to understand fertility preservation. Therefore, receiving chemo-radiotherapy (P=0.013) or not as well as having children (P=0.044) or not were two main reasons influencing patients' willingness to choose fertility preservation.

    Conclusion

    ·At present, the majority of male patients with cancer lack of the knowledge of fertility preservation, which may be due to the low literacy level of patients and inadequate publicity of medical workers. Consequently, medical staffs need to enhance the propaganda of fertility preservation, in case that patients with fertility intention lose the chance of reproduction .

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    Review
    Review of proteomic study of protein SUMOylation
    Qiang-qiang XIONG, Jun TU, Jun-ru LI, Jin-ke CHENG, Jian-hong ZUO, Ya-lan CHEN
    2021, 41 (1):  89-94. 
    doi: 10.3969/j.issn.1674-8115.2021.01.016

    Abstract ( 286 )   HTML ( 6 )   PDF (1585KB) ( 122 )  

    Small ubiquitin-related modifier (SUMO) exists widely in all eukaryotic cells, which is involved in many signal transduction and metabolism pathways. Systematic identification of SUMOylated proteins is helpful to reveal the function and mechanism of SUMOylation from an overall perspective. At present, it is difficult to identify the SUMOylation sites, and how to study the SUMOylated proteins on a large scale has not been determined. This paper systematically analyzes the proteomic studies of protein SUMOylation in mammalian cells. On the basis of summarizing the research methods and achievements, the mutation mode and enrichment mode of SUMO are analyzed in detail, and then the ideal methods for systematic identification of SUMOylation sites in cells and tissues are concluded.

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    Research status and prospect of transcranial focused ultrasound stimulation in treatment of psychiatric disorders
    Zhao-lin ZHAI, Deng-tang LIU
    2021, 41 (1):  95-98. 
    doi: 10.3969/j.issn.1674-8115.2021.01.017

    Abstract ( 324 )   HTML ( 12 )   PDF (1001KB) ( 226 )  

    As a non-invasive neuromodulation technique, transcranial focused ultrasound stimulation has the advantages of safety, high focused accuracy, deep penetration depth and easy compatibility with the synchronous recording of neuroimaging. Transcranial focused ultrasound stimulation has been used in the treatment of essential tremor, Parkinson's disease, brain tumors, etc. However, the progress in the area of psychiatry is still limited. The current research status of transcranial focused ultrasound stimulation in the treatment of psychiatric disorders is reviewed in this article, including the analysis of difficulties in its application and the prospect for the future direction.

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    Research progress of sedative-hypnotics abuse and the interventions
    Yu-jian YE, Na ZHONG, Min ZHAO
    2021, 41 (1):  99-102. 
    doi: 10.3969/j.issn.1674-8115.2021.01.018

    Abstract ( 239 )   HTML ( 3 )   PDF (994KB) ( 162 )  

    For the fast-action, reliable efficacy and high safety, sedative-hypnotics have become the first-line drugs for insomnia, anxiety, epileptic seizure and alcohol-dependence withdrawal treatment. Rational use of such drugs has important application value in clinic. However, abuse or misuse might lead to adverse consequences such as memory impairment and increased risk of accidental injury. There have been some studies aiming at patients or prescribers to reduce the risk of overuse of sedative-hypnotics. This article reviews the prevalence of sedative-hypnotics abuse and corresponding interventions, with a view to providing the evidence of rational application as well as the basis for the subsequent researches on sedative-hypnotics.

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    Progress in histone modification and targeted intervention in diabetic nephropathy
    Meng-di JIANG, Wen ZHANG
    2021, 41 (1):  103-107. 
    doi: 10.3969/j.issn.1674-8115.2021.01.019

    Abstract ( 211 )   HTML ( 1 )   PDF (1071KB) ( 153 )  

    The management of diabetic nephropathy is grim, and its pathogenic mechanism is complicated. Epigenetics is gaining attention due to the discovery of "metabolic memory". Pathological changes of diabetic nephropathy include podocyte lesion, mesangial matrix change, epithelial-mesenchymal transition, etc. And its pathogenic mechanism involves processes such as oxidative stress, end-products of glycosylation, autophagy and apoptosis. As important parts of it, histone acetylation, methylation, ubiquitination and other modifications are widely involved in the above processes. Drugs targeting histone modification under experimental conditions have obtained positive results. This article reviews progresses of the histone modification and targeted treatment in the pathogenesis of diabetic nephropathy.

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    Research progress in perioperative microcirculation
    Nai-lu YAN, Han LU, Bu-wei YU
    2021, 41 (1):  108-111. 
    doi: 10.3969/j.issn.1674-8115.2021.01.020

    Abstract ( 252 )   HTML ( 0 )   PDF (944KB) ( 118 )  

    With the development of science and technology, more and more attention has been paid to perioperative microcirculation management. In anesthesia, with the influence of anesthetics, non-anesthetic drugs, surgery, fluid therapy and other factors, microcirculation disorder exists in humans. The benefits of fluid therapy for microcirculation have been more popular than other factors. Anesthesiologists or experts in intensive medical all have ever put forward the concept of microcirculation-oriented fluid therapy or fluid resuscitation, which lacks a large number of clinical studies. At present, the sidestream dark field technology can realize the bedside, non-invasive and real-time monitoring of body microcirculation, and it safely comes into practice in clinical background. It helps monitor the state of microcirculation timely, and thus it's believed that the microcirculation and prognosis of patients can be improved by adjusting the category of fluid and controlling the infusion speed and fluid volume. Microcirculation-oriented fluid therapy will undoubtedly become an important direction of anesthesia management in the future. This article reviews the relative research progress in perioperative microcirculation.

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    Progress in serological noninvasive diagnostic methods for non-alcoholic fatty liver disease
    Chao SANG, Dan-dan LIANG, Guo-xiang XIE, Wei JIA, Tian-lu CHEN
    2021, 41 (1):  112-117. 
    doi: 10.3969/j.issn.1674-8115.2021.01.021

    Abstract ( 281 )   HTML ( 4 )   PDF (1180KB) ( 165 )  

    Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease, along with the prevalence of obesity and metabolic syndrome. Non-alcoholic fatty liver will progress to non-alcoholic steatohepatitis (NASH), NASH-related liver fibrosis and liver cirrhosis, and even hepatocellular carcinoma. Accurate assessment and early intervention are conducive to clinical burden reduction and disease control. Although being the "golden standard" for diagnosing NAFLD, the clinical application of liver biopsy is limited due to well-known limitations and significant complications. Serological testing, as a noninvasive method, has been well-recognized among researchers and clinicians. The understanding of the pros and cons and the application ranges of various methods and indexes is helpful for clinical applications, including providing more diagnosis approaches, improving diagnosis power, relieving pain of patients, and saving medical resources. This article reviews the advances in serological noninvasive diagnostic methods for NAFLD.

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    Brief original article
    Expression of breast cancer susceptibility gene 1 protein in brain gliomas and its influence on the sensitivity of temozolomide
    Xiao-jun ZHAO, Zhi-gang QIAO, Ting-yu LIANG, Yan-ling AN
    2021, 41 (1):  118-122. 
    doi: 10.3969/j.issn.1674-8115.2021.01.022

    Abstract ( 198 )   HTML ( 1 )   PDF (1577KB) ( 109 )  
    Objective

    ·To investigate the expression of breast cancer susceptibility gene 1 (BRCA1) protein in brain glioma tissue and its influence on the sensitivity of temozolomide (TMZ).

    Methods

    ·A total of 104 patients with brain glioma (study group) who underwent surgical resection in the Department of Neurosurgery, Shanxi Provincial Cancer Hospital from January 2010 to December 2017 were collected. And 30 patients with head injury (control group) who underwent internal decompression surgery were collected. The BRCA1 protein expressions in brain tissues of the two groups were detected by immunohistochemistry. The relationship between BRCA1 protein expression and the clinicopathological characteristics of brain glioma patients was analyzed by χ2 test. The survival rate of the glioma patients with BRCA1 protein positive or negative expression was calculated by Kaplan-Meier method, and the difference between the positive patients and the negative patients was tested by Log-Rank method. The U251 cells were randomly divided into three groups, and transfected with shRNA-BRCA1 silencing vector (sh-BRCA1 group), shNC-BRCA1 empty expression vector (sh-NC group) and blank control phosphate buffer saline (Blank group), respectively. The transfection efficiency of the three groups was detected by quantitative PCR (qPCR). CCK-8 method was used to detect proliferative activity of U251 cells in the three groups and the sensitivity of TMZ.

    Results

    ·Immunohistochemistry showed that 23 of the 30 control tissues were BRCA1 positive, with a positive expression rate of 76.67%, while 33 of the 104 glioma tissues were positive, with a positive expression rate of 31.73%; the difference in the positive expression rates between the two groups was statistically significant (P=0.009). In the study group, the expression of BRCA1 protein in the tumor tissues with pathological grade Ⅰ~Ⅱ was significantly higher than that in the tumor tissues with pathological grade Ⅲ~Ⅳ (P=0.022), and there was no significant correlation between BRCA1 protein expression and the patient's age, gender and pathological type. There was no significant difference in the survival rates between BRCA1 positive and negative patients. The results of in vitro studies showed that the BRCA1 mRNA expression level in the sh-BRCA1 group was significantly lower than those in the sh-NC group (P=0.037) and the Blank group (P=0.035). After transfection and 48 and 72 h of cell culture, the cell proliferation activity of the sh-BRCA1 group was higher than those of the Blank group (P=0.043, P=0.037) and the sh-NC group (P=0.046, P=0.037); when the TMZ concentration was 100 and 200 μmol/L, the cell proliferation activity of the sh-BRAC1 group was higher than those of the sh-NC group (P=0.041, P=0.040) and the Blank group (P=0.038, P=0.042).

    Conclusion

    ·BRCA1 protein is lower expressed in brain glioma, and the positive expression of BRCA1 is related to the tumor pathological grade, but not related to the patient's age, gender, pathological type and survival rate. Inhibition of BRCA1 expression can reduce the sensitivity of brain glioma cells to TMZ.

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    Case report
    A case report of fundus hemorrhage in recurrent acute myeloid leukemia
    Ting QIU, Jing JIN, Yuan-yue CUI, Lei SONG, Xie LI, Ji-fang QU
    2021, 41 (1):  123-125. 
    doi: 10.3969/j.issn.1674-8115.2021.01.023

    Abstract ( 228 )   HTML ( 2 )   PDF (1771KB) ( 68 )  

    A 16-year-old female patient was admitted to hospital because of "gradual decline in visual acuity for more than 4 months". Ocular fundus examination revealed yellowish old hemorrhage in the macular area of both eyes, and fresh hemorrhage in the superficial retinal layer of the right eye. The patient had a history of bone marrow recurrence with previous acute myeloid leukemia (AML). After bone marrow transplantation in the Department of Hematology and Oncology, the patient's vision was improved and fundus hemorrhage was absorbed. Before the diagnosis of relapse of AML, the patient's vision had declined, but she did not go to the ophthalmology clinic in time. For leukemia patients, doctors are recommended to carry out adequate education for possible extramedullary symptoms and suggest regular ophthalmology consultations. If concomitant symptoms occur, it is suggested that multidisciplinary doctors should cooperate in diagnosis and treatment in order to obtain better therapeutic effect, restore visual function and improve the quality of life of patients.

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    Klinefelter syndrome combined with diabetes mellitus: a case report and literature review
    Song-tao ZHANG, Yuan-yuan XIAO, Hui GUO, Qing-ge GAO, Li WEI
    2021, 41 (1):  126-128. 
    doi: 10.3969/j.issn.1674-8115.2021.01.024

    Abstract ( 208 )   HTML ( 7 )   PDF (876KB) ( 66 )  

    Klinefelter syndrome (KS) is a chromosomal abnormality that is described to be one of the most common reasons for male infertility. The clinical symptoms of this disease are not typical in childhood, and it can also be accompanied by metabolic syndrome in adolescence and adulthood in addition to sexual developmental abnormalities. A case of KS with elevated blood glucose as the chief complaint was reported in this article. He was diagnosed as having diabetes mellitus in the beginning and then diagnosed as having KS complicated with type 2 diabetes mellitus after medical history inquiry and further examinations. The case suggests that clinicians need to improve their understanding of KS in order to provide diagnosis and treatment in time.

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