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15 March 2012, Volume 40 Issue 3 Previous Issue    Next Issue
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论著
实验研究
短篇论著
心血管疾病论坛
临床论丛
循证医学


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论著

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The clinical values of two kinds of ACPA and RF for early diagnosis of RA Yi Wang 2012, 40 (3):  0-214 .  Abstract ( 1322 )   PDF (2035KB) ( 2568 )   【Abstract】Objective To evaluate the clinical values of two kinds of antibodies against citrullinated proteins/peptides, third-generation anti-cyclic citrullinated peptides (anti-CCP-3) and anti-mutated citrullinated vimentin (anti-MCV), and rheumatoid factor (RF) to early diagnosis of rheumatoid arthritis (RA). Methods Thirty Patients with early RA served as early RA group, 32 patients with osteoarthritis (OA) and ankylosing sporidylitis (AS) served as OA/AS group, and 30 healthy persons served as control group. The levels of anti-MCV, anti-CCP-3 and RF were determined. Results While RF≥30 IU/mL, anti-CCP-3＞12 RU/mL, anti-MCV≥20 U/mL served as the cut-off value for RA, anti-MCV tended to have the highest predictive value for RA, and the sensitivity of anti-MCV was 76.67%, the specificity of anti-MCV was 96.77%, and the accuracy of anti-MCV was 90.22%. The sensitivity of performing combinations of RF and anti-MCV tests was 83.33%, while the sensitivity of performing combinations of anti-MCV and anti-CCP-3 tests was 80.00%. The presences of anti-MCV, anti-CCP-3 and RF in early RA group were significantly higher than control group and OA/AS group respectively (P＜0.01), while the presences of anti-MCV, anti-CCP-3 and RF had no significant differences between control group and OA/AS group (P> 0.05). The levels of DAS28, ESR and CRP were lower after treatment in patients with RA (P＜0.01), while the levels of anti-MCV and RF were lower after treatment in patients with RA (P＜0.05). Conclusions Anti-MCV antibodies are valuable to early diagnosis of RA. Performing combinations of RF and anti-MCV tests and performing combinations of anti-MCV and anti-CCP-3 tests can increase the sensitivity of early diagnosis. Anti-MCV, anti-CCP-3 and RF can differentiate RA, OA and AS. Anti-MCV and RF are valuable for effect evaluation and activity evaluating in patients with RA. Related Articles | Metrics

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Investigation The Modification of Transthyretin For Diagnosis of Infectious Lung Disease 2012, 40 (3):  0-214 .  Abstract ( 901 )   PDF (2239KB) ( 1955 )   Objective: To investigated the role of transthyretin (TTR) level and its modification in serum and pleural fluid (PF) for diagnosis of infectious lung disease. Methods: (1) The level of Total protein (TP), albumin (ALB), triglycerides (TG), cholesterol (Cho), apolipoprotein A (Apo A), apolipoprotein B (Apo B ), lactate dehydrogenase (LDH), adenosine deaminase (ADA), glucose (GLU), and transthyretin protein (TTR) etc. were detected in serum and PF samples.(2) Chemically modified type and proportion of TTR proteins was analyzed by matrix-assisted laser ionization time of flight mass spectrometry (MALDI-TOF-MS). Results: (1) 8 components were significantly lower in PF than in serum, reduced order as follow: TG, Cho, TTR, ApoA, ApoB, TP, Alb and GLU , while the ADA was increased only, and LDH was no statistical differences; (2) Among protein indexs, TTR is the most significantly reduced one; (3) 2 types of modified TTR were detected in PF and serum of patients with infectious lung disease, while contrast with the healthy control group ,no cysgly-TTR was present. Conclusions: The cysgly-TTR was disappeared in both PF and serum, indicating that TTR modification may be an assistant for lung infection diagnosis. Related Articles | Metrics

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Awaking anaesthesia and intraoperative neurophysiological techniques in epilepsy surgery involved in the language areas 2012, 40 (3):  0-214 .  Abstract ( 1239 )   PDF (4158KB) ( 2007 )   Objective:To discuss the application of awaking anesthesia and neurophysiological techniques in epilepsy surgery involved in the language areas. Methods: The relationship between Epileptogenic lesions and (or) epileptogenic focus and the language areas were confirmed by preoperative assessments in 9 patients. Electrocardiography recordings were adopted to confirm the epileptiform discharge area, and then cortical electrical stimulation was performed to locate the language areas. According to the relationship between the language areas and epileptogenic lesions and (or) eileptogenic focus, we choose the appropriate surgical approach to protect the language areas and remove epileptogenic lesions and (or) eileptogenic focus. BCFC or MST has been used to deal with epileptiform discharge area. We evaluated language function and control of epilepsy postoperation.Results:There were 4 patients with language dysfunction after operations，and 3 of which was reversible within two weeks, but 1 patient was moderate motor aphasia. Patients were in a good control of epilepsy.7 patients were EngelⅠand 2 were EngelⅡ.Conclusion:Awaking anesthesia and intraoperative neurophysiological techniques were reliable and precise in epilepsy surgery involved in the language areas, which allow a maximum resection of the epileptogenic lesions and (or) epileptogenic focus and protection of language areas, which improve the life quality of patients. Related Articles | Metrics

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Effect of cardiopulmonary bypass on gut mucosal barrier function 2012, 40 (3):  0-214 .  Abstract ( 1127 )   PDF (2052KB) ( 1969 )   Related Articles | Metrics

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Study on the Expression of Chemokine CXCL12/CXCR4 in Non-small Cell Lung Cancer 2 2012, 40 (3):  0-214 .  Abstract ( 1165 )   PDF (9450KB) ( 1783 )   Objective: To investigate the relationship between the protein expression of chemokine CXCL12 and its receptor CXCR4 in tissues of non-small cell lung cancer(NSCLC ) and the clinical pathological features. Methods: Expression of CXCL12 and CXCR4 in NSCLC tissue(n =95) and benign tumor tissue(n=27) were detected by immunohistochemical staining. The relationship between CXCL12/CXCR4 protein expression and clinical pathologic features was also analyzed. Results: The high expression rates of CXCL12 and CXCR4 in NSCLC tissues with lymph node metastasis(67.2%、51.7%)were both significantly higher than those in NSCLC tissues without lymph node metastasis (35.1%、27.0%).Expression of CXCL12 and CXCR4 were closely associated with TNM stage(P<0.05),and the high expression rates in stage III were much higher than those in stage I. The high expression of CXCL12 and CXCR4 in control group(non-tumor tissues ) is much lower than that in NSCLC. There was no significant relationship between CXCL12 and CXCR4 expressions. We found no relationship between the positive rates of CXCL12 and CXCR4 and the age, gender, tumor size, histological type and degree of differentiation. Conclusion: Expression of CXCL12 and CXCR4 were associated with metastasis and TNM stage, and can be used to evaluate potential prognosis of the patients with lung cancer. Related Articles | Metrics

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Influence of raloxifene on VEGF、Ki-67、CD34 antigen expression in postmenopausal women with breast carcinoma 2012, 40 (3):  0-214 .  Abstract ( 990 )   PDF (2679KB) ( 2098 )   Objective: To exploring the influence of raloxifene on vascular endothelial growth factor (VEGF), Ki-67, CD34 antigen expression in postmenopausal women with breast carcinoma. Methods: Twenty postmenopausal patients with TMN stage II, estrogen receptor(+) breast cancer was involved in this research, and all of them took raloxifene 60mg/d for 21 days. Immunohistochemistry was carried out in tumor samples to evaluate VEGF, Ki-67, CD34 antigen expression prior to and following raloxifene treatment, respectively. Result: VEGF-positive expression rate was 85% prior to raloxifene treatment, while only 30% (χ2=12.38, P<0.01) following treatment; and the mean percentage of Ki-67-positive nuclei was (19.36±1.66)% and (12.24±1.42)% (t=2.86, P<0.01) prior to and following raloxifene treatment, respectively. The mean number of microvessels was 46.25±3.88 prior to raloxifene therapy and 23.64±1.53 (t=2.93, P<0.01) following therapy. Conclusion: Raloxifene has an effect of depressing cell proliferation activity and formation of new blood vessels in breast carcinoma tissue of postmenopausal women, and the effect might be achieve through depressing VEGF expression of tumor tissue. Related Articles | Metrics

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Clinical research of percutaneous transluminal angioplasty with ginkgo biloba extract in the therapy of patients with diabetes lower limbs artery block 2012, 40 (3):  0-214 .  Abstract ( 950 )   PDF (2100KB) ( 1889 )   Related Articles | Metrics

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Analysis on Relationship between Morning Urine Microalbuminuria/Urinare Creatinine and 24 h Urine Microalbuminuria in Type 2 Diabetes Mellitus 2012, 40 (3):  0-214 .  Abstract ( 1148 )   PDF (2098KB) ( 2157 )   Abstract Objective:To investigate the influential factors of morning urine microalbuminuria（MALB）/urine creatinine（Cr） and explore the feasibility of replacing 24-hour urine microalbuminuria protein （24hMALB ）monitoring by measuring morning urine MALB/ Cr in diagnosed type 2 diabetic patients. Methods :Morning urine sampales and 24-hour urine sampales were obtained from 179 type 2 diabetic patients, morning urine MALB,Cr, 24hMALB and other biochemical indicators were measured.All patients were divided into three groups according to the creatinine clearance rate（Ccr）.The correlation between MALB/Cr in morning urine and 24hMALB was analyzed.Results:① MALB/ Cr was positively correlated with age, body mass index, the duration of diabetes, 24hMALB,24-hour urine protein, systolic blood pressure , diastolic blood pressure,diabetic retinopathy. ②The duration of diabetes , systolic blood pressure , diabetic retinopathy is the independent risk factors of MALB/ Cr in morning urine of type 2 diabetes patients. ③The correlation between MALB/Cr and 24hMALB was statistical significance when Ccr≥25.66mL /min.Conclusion: Detection of MALB/Cr in morning urine can replace 24hMALB to evaluate diabetic nephropathy in type 2 diabetes patients. Morning urine MALB/Cr can be applied in population with different Ccr when Ccr≥25.66mL /min. Related Articles | Metrics

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Outcome of sinusitis in patients with artificial airway 2012, 40 (3):  0-214 .  Abstract ( 1005 )   PDF (2113KB) ( 2050 )   Objective We performed this study to investigate the outcome of sinusitis in patients who had removed artificial airway in the near future. Methods Patients who had undergone nasotracheal, orotracheal intubation and incision of trachea performed sinus computed tomography (CT) scans before removing intubation. And the patients who were diagnosed sinusitis rechecked sinus CT scans seven days postoperatively. Results 44 cases of radiologic sinusitis and 12 cases of infectious sinusitis were diagnosed before removing intubation. 22 of the 44 (50.00%) patients were recovered and 16 of the 44 (36.36%) patients were improved after rechecking with radiologic sinusitis. 2 of the 12 (16.67%) patients were recovered and 5 of the 12 (41.67%) patients were improved after rechecking with infectious sinusitis. 18 of the 38 (47.37%) patients were recovered and 14 of the 38 (36.84%) patients were improved with nasotracheal intubation. 3 of the 11 (27.27%) patients were recovered and 5 of the 11 (45.45%) patients were improved with orotracheal intubation. 2 of the 7 (28.57%) patients were recovered and 3 of the 7 (42.86%) patients were improved with incision of trachea. Conclusion With the complication of Artificial airway, infectious sinusitis is less frequent than infectious sinusitis. Most patients who were diagnosed sinusitis recovered or improved after removing intubation without treatment. Related Articles | Metrics

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The Application of ABS in Double-antibody Sandwich ELISA Method for Eosinophilia Cationic Protein 2012, 40 (3):  0-214 .  Abstract ( 936 )   PDF (2047KB) ( 1954 )   Objective Evaculate the effect of ABS on the test performance of the sandwich enzyme immunoassay of double antibodies kit (ELISA) for ECP . Methods 1. Biotinylation of monoclonal antibody against ECP. 2. The development of double antibodies ELISA kit for ECP. 3. The development of ELISA kit with biotin firstly coated. 4. The development of ELISA kit with avidin firstly coated. 5.The comparison of three methods. Result 1. The comparison of three methods:(1) The linear range、sensitivity and relative deviation of direct coating was 2.5~200 ng/ml, 2.75ng/ml ,11.5％，respectively. (2)Three factors of biotin-avidin coating test were 2.5~500 ng/ml、2.61ng/ml and 10.9％ ,respectively.(3) Three factors of avidin coating test was 2.5~500 ng/ml、2.68ng/ml and 11.9％ , respectively. 2.There was no significant difference among their reproducibility. Avidin coating test was the stablest method and antibody coating test was the simplest method, but its antibody dosage was the highest. Conclusion Biotin-avidin coating can elevate the linear range and sensitivity of the test and it could save antibody dosage and antibody coating time. Related Articles | Metrics

实验研究

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The mechanism analysis of temperature regulating proliferation of stem cells modified by tsSV40LT gene 2012, 40 (3):  0-214 .  Abstract ( 1089 )   PDF (10327KB) ( 1767 )   Objective:To study the mechanism of temperature control proliferation of the stem cells modified by tsSV40LT gene for establishing a basement on stem cells transplantation into injured brain area during hypothermia treatment. Methods: After transfecting plasmid containing temperature-sensitive simian virus 40 large T-antigen (tsSV40LT） into umbilical cord mesenchymal stem cells (UCMSCs), PCR method was used to detect gene integration. Then we cultured these UCMSCs modified by tsSV40LT in 33℃ and 37℃ incubators respectively. Immunofluorescence was used to detect proliferating cell nuclear antigen (PCNA) activity, telomerase activation analysis by PCR-ELISA telomerase detect kit, and cell cycle by flow cytometry. Then cell cycle regulating proteins, including Cyclin D1, CyclinE, CDK2, CDK4, CDK6, P16 and P21, were detected by western blot. The expression of nestin, neurone specific enolase (NSE) and glial fibrillary acidic protein(GFAP) were detected by immunofluorescence method. Results:The tsSV40LT gene was integrated into UCMSCs successfully. When cultured at 33℃ incubator, the new cell line displayed high proliferation activity, as well as its telomerase activation, highly expressed Cyclin D1, CyclinE, CDK2, CDK4 and CDK6, and lowly expressed P16 and P21, meanwhile, highly nestin, lowly NSE and GFAP. But when cultured at 37℃ incubator, the cell line showed a completely converse profile. Conclusion:The proliferation of stem cells can be regulated by temperature through effective tsSV40LT gene transfection, and that supports the clinical application of stem cells transplantation into injured brain area during hypothermia treatment. Related Articles | Metrics

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The Effects of LingQiJuanGan Liquor on Toll-like Receptor 4 in Rats with CCl4-induced Chronic Liver Injury 2012, 40 (3):  0-214 .  Abstract ( 1005 )   PDF (19278KB) ( 1782 )   Abstract Objective To dynamic observe the protective effects and mechanism of LingQiJuanGan(LQL) in rats with CCl4-induced chronic liver injury. Methods The chronic liver injury in rats was induced by 40% CCl4, the therapic group was given LQL by intragastric administration from the fourth week. Blood and liver were collected at the same time at the end of the 0, 4th, the 6th, the 8th and the 10th week. The level of serum endotoxin , tumor necrosis factor-α (TNF-α) and interleukin 1β( IL-1β) were detected. The expression of nuclear factor kappa B (NF-κB) and toll-like receptor 4(TLR4) protein in hepatic tissue were assayed by immunohistochemistry. The expressions of TLR4 mRNA in Kupffer cells(KCs) were measured by reverse transcriptase polymerase chain reaction (RT-PCR). Results Compared with the model group, LQL therapic group noticeable decreased the level of serum endotoxin , TNF-α and IL-1β（P <0.001）. LQL therapic group had lower expression of the TLR4 mRNA in KCs and NF-κB and TLR4 protein in hepatic tissue than that of model group（P <0.001）. A positive correlation was found between serum endotoxin levels and the expression of TLR4 mRNA in KCs（r=0.845, P<0.001） Conclusion The inhibition of expressions of TLR4 and endtoxin in chronic liver injury induced by CCl4 in rats may account for the anti liver inflammation effects of LQL. Related Articles | Metrics

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Study on co-culture of human Umbilical Cord Mesenchymal Stem Cells and rats’ Activated Schwann Cells yuhai zhu 2 2012, 40 (3):  0-214 .  Abstract ( 1019 )   PDF (6196KB) ( 2079 )   Abstract Objective：To study the influence of growth and differentiaion of human Umbilical Cord Mesenchymal Stem Cells when co-cultule with Activated Schwann Cells in vitro. Methods：Isolated and cultured human Umbilical Cord Mesenchymal Stem Cells and rats’ activated Schwann cells, co-culture these two types of cells by milicell inserts, Immunofluorescence staining of nestin and NF-200 were using to analysis the differentiation of hUCMSCs. Results：In milicell inserts layered co-culture conditions, hUCMSCs showed neuronal morphology gradually which was not happened in the control group; hUCMSCs expressed neural stem cell marker Nestin and neural marker NF200,while in the control group expression of Nestin was in a low level and NF200 was negative. Conclusion：hUCMSCs was able to transdifferentiate into neural cell, and neural differentiation can be induced by coculture with Activated Schwann Cells . Related Articles | Metrics

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Association of TGF-β1 and CTGF with Early Diabetic Nephropathy 2012, 40 (3):  0-214 .  Abstract ( 1107 )   PDF (3099KB) ( 2455 )   Abstract Objective:To investigate the effect of Transfoming growth factor-β1（TGF-β1） and Connective tissue growth factor（CTGF）in early stage of diabetic nephropathy. Methods:Murine diabetic models were induced with streptozotocin (STZ). We randomized rats into normal control group (NC) and diabetes group (DM). Measure the body weight every week, and the blood glucose every two weeks. All the rats were sacrificed after 8 weeks, a set of biochemical data and indicators related to renal function were detected in each group. At the same time, the liquid nitrogen frozen specimens from renal cortex were taken to use to analyze the level of TGF-β1、CTGF mRNA by the method of real time RT-PCR. The protein expression of TGF-β1 and CTGF were determined by immunohistochemistry. Results:Compared with NC group, the level of blood glucose, BUN, 24h urine and urinary microalbumin, KW/BW was significantly higher in DM group（P＜0.01）, but the level of Scr was significantly lower（P＜0.01）. The results of Real time quantitative PCR showed obvious increase of TGF-β1 and CTGF mRNA in DM group，as well as their protein expression, and the level of CTGF increased more significantly（P＜0.01）. Conclusion:The level of TGF-β1 and CTGF mRNA and expression of protein was significantly increased in diabetic nephropathy （DN），they are very important for evaluating the process of DN. Related Articles | Metrics

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Establish and Effective evaluation of different Indexes of severe hemorrhagic shock model on Unrestrained Conscious Rats 2012, 40 (3):  0-214 .  Abstract ( 917 )   PDF (2730KB) ( 1915 )   Abstract Objective: Establish severe hemorrhagic shock model On Unrestrained Conscious Rats, set up indexes and evaluate the validity of the indexes and the model to explore the severe hemorrhagic shock pathophysiology. Method: Thirty-Five Male Sprague-Dawley rats were hemorrhaged 65% of total blood volume via left Femoral artery on unrestrained consciousness, resulting in severe hemorrhagic shock model. They were randomly divided into three groups by different resuscitation fluids: NaCl (n=12), WB (whole blood) (n=12) and 6% HES (n=13). Measure the arterial pressure (Bp), respiratory rate (RR), Temperature (T), Arterial Blood Gas (ABG) and Lactic Acid (LD) at baseline, shock and 2 hours after resuscitation. Record f 24 and 48h survival after resuscitation. Results: Compared with the baseline, Bp,T,PH,PCO2,HCT and BE level of all rats decreased significantly(P<0.01); PO2, LD and SO2 level all increased significantly（P<0.01;P<0.05）. 2h after resuscitation, compared with NaCl, WB and 6%HES can improve the Bp, PH, PaCO2 and BE, decrease the LD level and improve the metabolic acidosis. Conclusion: (1) ABG, LD and survival can be as effective indexes of evaluating the severity and prognosis of severe hemorrhagic shock. (2) Severe hemorrhagic shock model On Unrestrained Conscious Rats has satisfactory reproducibility and effectiveness for the evaluation of anti-shock performance. Related Articles | Metrics

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The effect of chronic alcohol ingestion on TGF-β1 and bFGF mRNA of lung tissues in rats 2012, 40 (3):  0-214 .  Abstract ( 1178 )   PDF (8200KB) ( 1736 )   Objective To investigate the effect of chronic alcohol ingestion on lung interstitial tissue by detecting TGF-β1 and bFGF mRNA expression of lung tissue. Methods 20 male healthy Sprague-Dawley rats were randomly divided into non-ethanol(substitution of Maltose-Dextrin for EtOH) group(n=10) and ethanol(36% total calories) group(n=10). Lung tissues were extracted of all rats at 16 weeks after Lieber-DeCarli liquid diet. Histological change of lungs was evaluated by HE stain and transmission electron microscope(TEM).The mRNAs of transforming growth factor beta 1(TGF-β1) and basic fibroblast growth factor(bFGF) were detected by real time fluorescent quantitation polymerase chain reaction. Results In light microscope, the pulmonary inflammatory cell infiltrate score of alcohol group was significantly higher than that of the control group(Z=50， P<0.05). In TEM, mitochondrial membrane fused and fuzzy structure and collagen fiber deposition in cell compartment in different level were observed in alcohol group. The mRNA expressions of TGF-β1 and bFGF (34.74.±12.29,218.08±100.37) of alcohol group were both significantly increased compared with those of the control group(18.33±4.27,90.52±43.38,t=3.702,3.487,all p<0.05) Conclusion These findings suggested that chronic alcohol intake not only can cause alveolitis but also can cause lung interstitium disease by increasing the mRNA expressions of TGF-β1 and bFGF. Related Articles | Metrics

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The anti-tumor effect of oridonin on ovarian cancer in vitro and in vivo 2012, 40 (3):  0-214 .  Abstract ( 1107 )   PDF (3140KB) ( 2095 )   【Abstract】 Objective To investigate the effect and the mechanism of oridonin in the growth inhibition of ovarian cancer. Methods After human ovarian cancer cell line HO-8910PM was treated with different concentrations of oridonin, the cellular proliferation was detected by MTT assay. The flow cytometry was used to determine apoptosis in ovarian cancer cells. Western blot was used to detect the expression of NF-kB and XIAP in ovarian cancer cells. Furthermore, HO-8910PM cells were injected subcutaneously into nude mice to establish xenograft model. After 2 weeks of implantation, mice were randomized into 2 groups (n = 10): Control group, feed with 0.1% Dmethyl sulfoxide (DMSO) 0.2 ml; Test group, feed with oridonin at a dose of 40 mg/kgbw. All treatment lasted for three weeks, thrice per week. Six weeks after implantation, tumor weight and inhibition rate were evaluated respectively after the mice were sacrificed. Immunohistochemistry was used to detect the positive expression of Ki-67, NF-kB and XIAP in the tumors. Results The proliferation of ovarian cancer cells was inhibited significantly by oridonin. Apoptosis rate induced by the oridonin was markedly highter than that of control. The expression of NF-kB and XIAP were down-regulated in HO-8910PM cells after treatment of oridonin. The final tumor weight showed significant decrease in the test group compared with control. Furthermore, the positive expression of Ki-67, NF-kB and XIAP were decreased in tumors after administration of oridonin. Conclusion Oridonin exerts anti-tumor activity in ovarian cancer both in vitro and in vivo, which may be related to down-regulation of NF-kB and its regulated molecules such as XIAP. Related Articles | Metrics

短篇论著

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The Expression of the Granzym B mRNA in Peripheral Blood Mononuclear Cells and its Clinical Signisicance in Severe Preeclamptic Patients 2012, 40 (3):  0-214 .  Abstract ( 970 )   PDF (1429KB) ( 1941 )   Objectives】: To dectect the Expression of the Granzym(Gzm) B mRNA in Peripheral blood mononuclear cells of preeclamptic patients. Methods: 32 cases of preeclampsia and 32 cases of normal pregnancy were selected as in random. RT-PCR is adopted to detect the expression of Gzm B mRNA in the peripheral blood mononuclear cells and its correlation with mean arterial pressure was analyzed in severe preeclamptic patients. Results:(1) The expression of Granzym mRNA level in severe preeclampsia group was 1.297±0.239， significant higher than those of control group 0.792±0.210， t=8.963 ,P<0.001. (2)Correlation analysis: The mean blood pressure in severe preeclampsia group was (133±5) mm Hg(1mmHg=0.133 kPa).There was significant positive correlation between level of Gzm B mRNA in PBMC and mean blood pressure in severe preeclamptic patients(r=0.693，P<0.001.).Conclusion: Expression of Granzym B was significantly increased in severe preeclampsia , and was of significant positive correlation with the mean blood pressure. Granzym B may participate in the pathogenesis of severe preeclampsia. Related Articles | Metrics

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Expression of angiopoietin-2 with the relationship between pathology and clinical features in colorectal carcinoma zhilan-Ma 2012, 40 (3):  0-214 .  Abstract ( 1016 )   PDF (6477KB) ( 2031 )   Abstract :Objective To study the expression of Angiopoietin-2(Ang-2)protein in colorectal carcinoma and evaluate the relationship between Ang-2 protein level and pathology and clinical features. Methods Expression of Ang-2 was examined in 54 patients with colorectal carcinoma and 18 patients with adjacent normal tissues and 20 patients with normal tissues with immunohistochemical technique. Results The positive rate were 77.78%、27.78%和30.00%；Compared the expressions of Ang-2 in colorectal carcinoma tissue with adjacent normal tissue and benign colorectal lesion tissue, there were all significant differences (??=14.890,14.618,P<0.05); The positive expression rates of Ang-2 were significantly correlated with depth of invasion, lymph node metastasis, distant metastasis and clinical stage (r=0.490,0.337,0.338,0.386, P<0.05) in carcinoma patients;With sex,age,nationality,occupation,history of benign desease and family history of cancer,tumor location ,size and degree of differentiation were not related(P>0.05). Conclusion Expression of Ang-2 protein in colorectal cancer may occur in the development ,invasion and metastasis play an important role. Related Articles | Metrics

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Reevaluation of the diagnostic value of d-dimer for aortic dissection 2012, 40 (3):  0-214 .  Abstract ( 1504 )   PDF (1378KB) ( 1893 )   Objective　To investigate the diagnostic value of d-dimer levels in acute aortic dissection(AAD). Methods　D-dimer levels, C reaction protein and troponin I were tested in all the emergency patients, including 29 patients with aortic dissection confirmed by double source computed tomographyand/or aortic angiography . 30 acute myocardial infarction(AMI) patients in the same period served as control group. Results　D-dimer levels in the aortic dissection group was higher than acute myocardial infarction(807.52±660.78μg/L vs 232.93±115.20μg/L, P<0.01), but four of twenty nine AAD patients were negative, sensitivity is 86.21%. Five of thirty AMI patients showed a slightly elevation of D-dimer. CRP level elevated in both AAD group and AMI group, and AAD group’s CRP level was higher, but there was no statistical significant. Troponin I usually was negative in AAD group, unless AAD patients combined with coronary disease or dissection extended to coronary artery. Conclusion　D-dimer test is helpful for AAD diagnosis, but a negative D-dimer test result couldn’t exclude acute aortic dissection. Combine with troponin I, D-dimer is useful to differentiate between AAD and AMI. CRP is not usefulness in the differential diagnosis of AAD. Related Articles | Metrics

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Relationship between Clinical Characteristics and EURO Score and SYNTAX Score in Patients with Unprotected Left Main Disease 2012, 40 (3):  0-214 .  Abstract ( 1056 )   PDF (1349KB) ( 1933 )   Abstract Objective: To investigate the characteristics of patients with unprotected left main artery(UPLMA) disease and their relationship to EUROscore, coronary SYNTAXscore score.Methods: Clinical data of 75 patients’ with UPLM disease were retrospectively collected between January 2006 and July 2010 from the Department of Cardiology, Tianjin Chest Hospital. EUROscore, SYNTAXscore and their relationship with clinical characteristes were investigated.Results: SYNTAX Score is correlated with the EUROscore (r = 0.368, P<0.05), LVEF(r=-0.282，P<0.05); and LVDD(r=0.281，P<0.05).Conclusion：Both SYNTAXscore and EUROscore can serve as risk assessment in patients with left main disease. Related Articles | Metrics

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Relationship between Hyperuricemia and Metabolic Syndrome 2012, 40 (3):  0-214 .  Abstract ( 1121 )   PDF (1378KB) ( 2190 )   [Abstract] Objective To investigate the relationship of hyperuricemia(HUA) with obesity, hypertension, hyperglycemia and lipid disorder. Methods 2734 employees were given a physical examination about blood uric acid, fasting plasma glucose and blood fat, the results were compared and analysed. Results The prevalence of HUA(21.7%) and MS(21.2%) in age≥40 group was significantly higher than that in age＜40 group(13.6%、10.6%).The prevalence of MS in normal blood uric acid group was significantly higher than that in HUA group( 13.6% VS.17.9%, P＜0.05 ) .Moreover, the prevalence of the components of MS(obesity, hypertension, hyperglycemia and lipid disorder) in HUA group was higher than those in normal blood uric acid group (P＜0.05 ). Conclusion The prevalence of HUA and MS increased with aging, HUA closely related with MS and was one of risk factors. Related Articles | Metrics

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Clinic study of BNP for differential diagnosis in patients with syncope Yi-Jun YU 2012, 40 (3):  0-214 .  Abstract ( 602 )   PDF (1365KB) ( 1813 )   Objective: To discuss the clinic value of BNP for differential diagnosis in patients with syncope. Method: Eighty-five patients with syncope were divided into cardiac syncope group and non-cardiac syncope group according to many examine. BNP were mensurated for two groups. Result: BNP in cardiac syncope group was 342.8±208.5pg／ml and BNP in non-cardiac syncope group was 52.3±34.4pg／ml. BNP levels had significative statistics difference in two groups. At a cutoff of 150 pg/ml, BNP showed a sensitivity of 87.5%, a specificity of 66.0% and a negative predictive value of 89.7% for the diagnosis of cardiac syncope. Conclusion: BNP levels had important clinic significance for the differential diagnosis of cardiac syncope and non-cardiac syncope. Related Articles | Metrics

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The Effect of Serum Leptin in Chronic Obstructive Pulmonary Disease(COPD) Patients during Malnutrition Cured by Powder ShenLingBaiShu 2012, 40 (3):  0-214 .  Abstract ( 1151 )   PDF (1413KB) ( 2191 )   Abstract: Objective To investigate the effect of serum leptin and BMI in COPD patients during malnutrition cured by powder ShenLingBaiShu. Methods In a 6-month clinical program,78 COPD patients was divided into 2 groups randomly,in the clinic group with the powder ShenLingBaiShu and in the control group.Before and after the investigation,all of the patients were tested with diagnosis serum leptin and BMI. Results After 6-month therapy,it is considered that the clinic group’s resulted function on the COPD patients’ diagnosis, serum leptin and BMI,all have prominence improvement than the control group. Conclusion Powder ShenLingBai- Shu could improve the COPD patients’ serum leptin and BMI level and improve quality of life. Related Articles | Metrics

心血管疾病论坛

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A study on the association of the polymorphism of endothelial nitric oxide synthase gene T786C with essential hypertension liangrong liang rong 2012, 40 (3):  0-214 .  Abstract ( 561 )   PDF (2133KB) ( 1955 )   Objective To investigate the association of the polymorphism of eNOs gene T786C with essential hypertension.Methods Two hundred and sixty-six patients with EH and matched controls were selected.Polymerase chain reaction combined with restriction enzyme digestion was used to detect the polymorphism of eNOs gene.Results (1) There was no significant difference noticed in genotype distribution for the eNOs gene T786C genotype between hypertensive groups and controls.SBP and DBP of patients with C allele of eNOs gene were higher than those of TT genotype,but the differences were not significant.(2)Positive effect of the T786C mutant genotypes on SBP was significant in the drinkers and men. Conclusion Although the polymorphism of eNOs gene T786C did not seem to play an important and direct role in the pathogenesis of EH it might have indirect effects through certain risk factors. Related Articles | Metrics

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Effects of Atorvastatin on Serum Concentration of PAPP-A and C-reative Protein Levels with Acute Coronary Syndrome 2012, 40 (3):  0-214 .  Abstract ( 1031 )   PDF (2061KB) ( 1908 )   Abstract：Objectives To investigate the effects of atorvastatin on selllm concentration of PAPP—A and c-reative protein(CRP) levels in patients with acute coronary syndrome．Methods We measured the serum concentrations of PAPP-A、CRP levels before and after treatment with atorvastatin 20mg、10mg in 105 ACS cases and 90 cases of control group．Results PAPP-A and CRP levels in patients with ACS were significantly higher than control group patients before intervention. There was obvious difference of PAPP-A、CRP levels in atorvastatin 20mg group and atorvastatin 10mg group after one week treatment(P＜O．05). Conclusions PAPP-A and CRP levels in patients with ACS were significantly greater than control group. Atorvastatin can significantly reduce the PAPP-A and CRP levels in ACS patients, especially in atorvastatin 20mg group. Related Articles | Metrics

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Analysis of Angiographic Characteristics and Treatment of 430 subjects of Reccurrenct Angina after Coronary Artery Bypass Grafting 2012, 40 (3):  0-214 .  Abstract ( 941 )   PDF (3410KB) ( 1875 )   Objectives To investigate the angiographic characteristics and risk factors that affect graft patency underwent coronary artery bypass graft（CABG）.Methods Investigate from August 2005to May 2006,430 ptatients after CABG underwent coronary arteriograph (CAG) in our hospital due to recurrence of angina.There are 324 males and 106 females. Result The average age is (63.6±8.93) years. The average duration from CABG to CAG was (46.9±31.8) months.There are 1133 grafts , including 260 LIMA grafts,861 SVG 19 RA grafts and 1RIMA graft. Graft failure was found in 21.5%(56/261) of the IMA,32.4% (279/861)of the SVG,81.8%（8/11）of RA grafts. The patency rate of LIMA was higher the SVG(P<0.05) .There are different in patency rate of graft that to different target vessel. The rate of re-percutaneous intervention of off-pump was higher on-pump(P＜0.05).In LIMA group and SVG group, the patency rate of grafts of which the diameter of the target vessel is more than and equal to2.0mm higher than that of target vesel 2.0mm(P＜0.05). Multifactorial logistic regression analysis showed the LP(a),VLDL,diabetes were risk factors of the failure of SVG, HDL was protect factor. Most patients of SVG failure accepted drug treatment. There are no significant different between percutaneous intervention of SVG and self-vession(P>0.05). Conclusion Many factors affect the patency of grafts, select reasonable strategy of surgery and drug treatment was contribute to reduce the failure rate of grafts. Related Articles | Metrics

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The Characteristics and Influences of Recurrent Acute Myocardial Infarction on 1 Year Outcomes 2012, 40 (3):  0-214 .  Abstract ( 650 )   PDF (3353KB) ( 2216 )   Abstract Objectives：To investigate the characteristics of recrurrent myocardial infarction(MI) and the influences of prior MI on the outcomes of patients with myocardial reinfarction(Re-MI). Method: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study, which consisted of consecutive acute MI patients survived from 10 major PCI centers in Korea from November 2005 to April 2008. 10,384 patients survived from hospitals were enrolled, among which 934 (8.99%) patients presented with Re-MI. We investigated the clinical outcomes between Re-MI patients and those with first-onset of MI (first-AMI group, n=9450) within 12-month followup.Results: The baseline characteristics are largely unfavorable in Re-MI group over first-AMI group. Patients in Re-MI group are older than those in first-AMI group (63.91±12.48 vs 62.54±12.56 years，p<0.05) with worse cardiac function(KillipIII/IV, 17.77% vs 10.28%，p<0.05), more prior revascularization history(p<0.001). Angiographic findings also demonstrate unfavorable characters in Re-MI group, such as more multivessle disease(p<0.001), less successful PCI results(p<0.001),et al. Patients with prior MI have worse clinical outcomes than first-AMI group in 12-month mace(ORunadjusted:1.481, 95% CI: 1.222-1.796, P<0.001) even after adjusted by age, killip’s grade, treatment et al(ORadjusted:1.409, 95% CI: 1.114-1.782, P<0.01).Conclusion: Patients with recurrent MI presented with worse baseline characteristics and more severe coronary artery conditions, which might lead to insufficient revascularization and relate to a higher risk of MACE on 1year followup. Related Articles | Metrics

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The Electrophysiological Characteristics and Radiofrequency Catheter Ablation in Patients with Atrial Tachycardia Originating from the Non-coronary Aortic Sinus or its Adjacent Tissue 2012, 40 (3):  0-214 .  Abstract ( 1377 )   PDF (20995KB) ( 1766 )   Abstract Objective: To investigate electrophysiological characteristics and radiofrequency catheter ablation in patients with atrial tachycardia(AT) originating from the non-coronary aortic sinus(NAS) or its adjacent tissue.Methods: Ten patients[6 female,4 males,the age from 50 to 71,mean age(58.1±6.1)years]with paroxysmal AT for (4.7±2.6)years were included. After ATs were induced by atrial or ventricular stimulation,the activation mapping was performed during AT to identify the earliest activation in the right atria and the NAS,meanwhile to analyzed the surface electrocardiogram features of the AT and the sinus rhythm,finally radiofrequency ablation application was delivered in NAS.Results:ATs with mean cycle length of (318.3±50.1)ms were easily reproducibly induced and terminated by atrial pacing in all 10 patients.Regular activation mapping in atria showed that a relative earlier atrial activation was located at the top of the His bundle of the anteroseptal region in the right atria,and failed to terminated AT.Through puncture femoral artery,mapping in the NAS demonstrated that an earlier atrial activation preceded the atrial activation at the surface electrocardiogram by(55.8±5.6)ms.ATs were terminated less than 10 seconds during the first or second radiofrequency ablation.All 10 patients were free of AT without antiarrhymic drugs during a follow-up of(12.5±5.3)months.No complications occurred in anyone of the 10 patients.The P′ wave duration(73.1±3.8)ms during AT was significantly shorter than the P wave duration(92.3±5.1)ms during sinus rhythm(P<0.05).Conclusion:Mapping and ablation from the NAS can be used as a new approach when failed to radiofrequency ablation at the His bundle of the anteroseptal region. The P′ wave duration during AT originating from the NAS or its adjacent tissue was significantly shorter than the P wave duration during sinus rhythm.By this characteristic can we select NAS as a reference when the AT was failed to ablate. Related Articles | Metrics

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P-wave Configuration of the Atrial Tachycardia to Predict the Site Origin 2012, 40 (3):  0-214 .  Abstract ( 1192 )   PDF (11550KB) ( 1748 )   Abstract Objectives:This study sought to construct an algorithm to differentiate left atrial from right atrial tachycardia foci on the basis of surface electrocardiograms (ECGs). The present study therefore sought to analyze P wave configuration in patients with atrial tachycardia who underwent successful catheter ablation, Our goal was to differentiate ectopic foci originating in left or right atrium on the basis of surface ECG findings. Methods: A total of 37 patients with atrial tachycardia due to either abnormal automaticity or triggered rhythm underwent detailed atrial endocardial mapping and successful radiofrequency ablation of a single atrial focus. To calculate the PRI index ( PR interval/PP interval) evaluated the variation of conduction upon the atrioventricular and to calculate the PCI index ( P width/PR interval) evaluated the variation of conduction in atrial.Results:In 29 patients, the tachycardia was located in the right atrium,and 8 was in the left atrium.Analysis of P wave configuration showed that leads aVL and V1 were most helpful in distinguishing right atrial from left atrial foci. The amplitude of lead II III and aVF are prominently larger in left atrial tachycardia. The PCI values which was located in coronary sinus, Nor-coronary sinus and lateral wall are 0.23, 0.26 and 0.24. There is significant less than other sites of tachycardia, P <0.05. The PRI and PCI values of right atrial appendage, and right superior pulmonary veins are mostly in all sites (p<0.05), 0.49 and 0.55 in right atrial appendage, 0.51 and 0.43 in posteroinferior right atrium, and right superior pulmonary veins are 0.47 and 0.53. Conclusions: 1) P waves in lead I and aVL were most helpful in distinguishing right atrial from left atrial foci. 2) Leads II, III and aVF were helpful in providing clues for differentiating superior from inferior foci. 3) PCI and PRI index was helpful to predict site of tachycardia origin. Related Articles | Metrics

临床论丛

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Clinical analysis of bronchial artery embolization for the treatment of hemoptysis 2012, 40 (3):  0-214 .  Abstract ( 1000 )   PDF (3456KB) ( 1893 )   Abstract: objective: to summarize the clinical value of bronchial arterial embolization (BAE) of treating severe haemoptysis. Methods: selecting 45 cases with haemoptysis, retrospectively analyzed bronchial arteriography embolization of the abnormal bronchial arterial that hemorrhage with gelatin sponge or spring bolt . Results: 96% of all the 45 cases were hemostatic immediately postoperative ,did not appear serious embolizational complication. Conclusion: the bronchial arterial embolization of severe haemoptysis is an relatively effective and safe method of minimally invasive. Related Articles | Metrics

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The analyze for postpancreaticoduodenectomy severe hemorrhage 2012, 40 (3):  0-214 .  Abstract ( 1231 )   PDF (1338KB) ( 1884 )   Abstract: Object Although postpancreaticoduodenectomy hemorrhage (PPH) is the most lifethreatening complication following pancreatic surgery, standardized rules for its management do not exist. To analyze and study clinical courses and outcome of PPH after major pancreatic surgery. Methods Between 2000 and 2009, 295 patients operated on for periampullary neoplasia were included in a prospective database. A risk stratification of PPH according to the following parameters was performed: severity of PPH classified as mild (drop of hemoglobin concentration <30 g/L) or severe (>30 g/L), time of PPH occurrence (early, first to fifth postoperative day; delayed, after sixth day), coincident pancreatic fistula, intraluminal or extraluminal bleeding manifestation, and presence of “complex” vascular pathologies (erosions, pseudoaneurysms). Success rates of management were analyzed as well as PPH-related overall outcome. Results Prevalence of PPH was 6.4% (n=19). Mild PPH was 47.4%(n=9), Severe PPH was 52.6% (n=10), “Sentinel” bleed was 26.3%(n=5). Extraluminal PPH was 21.1%(n=4), Intraluminal PPH was 73.6%(n=14), Extraluminal and intralumina PPH was 5.3% (n=1). Pancreatic fistula prior to PPH was 31.6%(n=6). Treatment-related overall success rates were 84.2%(n=16), included observational monitoring 5, interventional endoscopy 1, interventional radiology 5, and relaparotomy 5. PPH-related overall mortality of 15.8% (n =3) was closely associated with 1) delayed PPH occurrence; 2) the occurrence of pancreatic fistula; and 3) vascular pathologies, ie, erosions and pseudoaneurysms. Conclusion Early PPH was mainly due to surgical technical failures. Prognosis of delayed PPH depends mainly on the presence of preceding pancreatic fistula. Decision making as to the indication for nonsurgical interventions or relaparotomy should consider time of onset, presence of pancreatic fistula, vascular pathologies. Related Articles | Metrics

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Clinical Analysis of 42 Cases of Infantile Cytomegalovirus Pneumonia 2012, 40 (3):  0-214 .  Abstract ( 1138 )   PDF (1706KB) ( 2137 )   [Abstract] Objective To investigate the clinical features of infantile cytomegalovirus (CMV) pneumonia. Methods Retrospective analysis the clinical data of fourty-two cases infantile CMV pneumonia. Results Infants within 6 months were more common in CMV pneumonia , manifested in varying degrees of fever, cough, sputum, wheezing, often with different degrees of liver damage, combined with low agammaglobulinemia,recurrent lower respiratory tract infections, anemia, rickets and so on. Intravenous ganciclovir were safe and effective, without severe side effects. In some resistant cases intravenous gamma globulin had good effect. Conclusions Infantile pneumonia combined with recurrent lower respiratory tract infections , immunocompromised , especially those with hepatic dysfunction should be considered of CMV pneumonia. Ganciclovir is effective in the treatment of CMV pneumonia. Refractory cases supplemented with intravenous gamma globulin. Related Articles | Metrics

循证医学

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Diagnostic Value of f/tPSA versus PSAD for TPSA Gray Zone Prostate Cancer：A Meta — analysis 2012, 40 (3):  0-214 .  Abstract ( 1061 )   PDF (3091KB) ( 2053 )   Objective：To systematically assess the diagnostic value of f/t PSA and PSAD for prostate cancer in patients with tPSA level of 4-l0 ng/ml. Method：We retrieved the studies about f/t PSA and PSAD in the diagnosis of prostate cancer from the databases of Cochrane library，PubMed，Chinese Biomedical Literature Database，and so on. Quality of included trials was assessed according to QUADAS items. The software MetaDisc1.4 was used for data analysis. Result：A tota1 of 7 researches involving 1013 patients were included. Respectively, the pooled accuracy indicators of sensitivity, specificity of f/tPSA and PSAD were 0.78,0.54and 0.79,0.57.the area under curve of SROC curve of f/tPSA and PSAD were 0.7761 and 0.7821,Q index were 0.7153 and 0.7204．Conclusion：When the tPSA is 4-10ng/ml, f/t PSA and PSAD for prostate cancer diagnosis was no significant difference, both for the diagnosis of prostate cancer has important clinical value. Related Articles | Metrics