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15 July 2016, Volume 44 Issue 7 Previous Issue    Next Issue
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Current thinking on the treatment of biliary atresia ZHANG Jinzhe 2016, 44 (7):  801-802.  doi: 10.11958/20160274 Abstract ( 1122 )   PDF (343KB) ( 4173 )   This article made a historic review on the treatment and diagnosis process of biliary atresia at home and abroad, and analyzed the problems of diagnosis and treatment on biliary atresia. The author points out that there is no registered system in domestic, which results in screening job has been unable to conduct substantive work for many years. The author also puts forward his own views about the postoperative influence factors including the time of Kasai operation, postoperative cholangitis, biliary cirrhosis and other issues, and suggests that improving the prognosis of children with biliary atresia needs the cooperation among national colleagues to work together. Related Articles | Metrics

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The etiology and treatment of cholangitis after Kasai operation in biliary atresia patients ZHAN Jianghua， WEI Yuanyuan 2016, 44 (7):  803-805.  doi: 10.11958/20160236 Abstract ( 1394 )   PDF (380KB) ( 4001 )   1 Tianjin Pediatrics Institute, Tianjin 300134, China; 2 Department of Pediatric Surgery, Tianjin Children’ s Hospital Related Articles | Metrics

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Comparison of clinical effects between pediatric living donor liver transplantation and deceased donor liver transplantation ZU Caihua, TENG Dahong, LI Junjie, GAO Wei, GUO Qingjun, MA Nan, CAI Jinzhen，SHEN Zhongyang, ZHANG Guoliang 2016, 44 (7):  806-809.  doi: 10.11958/20160273 Abstract ( 1176 )   PDF (370KB) ( 3883 )   To analyze and evaluate the efficacy of living donor liver transplantation (LDLT) and deceaseddonor liver transplantation (DDLT). Methods The clinical data of prognosis and influencing factors of 320 children with liver transplantation were analyzed retrospectively. The 320 children were divided into LDLT group (n=252) and DDLT group (n=68) based on their operation styles. In LDLT group, all donors to recipients were immediate relatives within three generation. In DDLT group, all livers were obtained from cardiac death or brain death donors. The survival and incidence of complications were observed between two groups. Results The 1-year, 2-year and 3-year cumulative survival rates for recipients were 95.1%, 93.5% and 93.5% in LDLT group, and 92.3%, 92.3% and 82.4% in LDLT group. There was no significant difference between the two groups (Log- rank χ2=0.69， P=0.41). During the follow- up period,14 cases died (5.56%) in LDLT group, in which 8 deaths due to respiratory complication, 3 deaths due to multiple organ failure, and 3 deaths due to graft failure. In DDLT donor group, 5 cases died (7.35%), in which 1 death due to respiratory complication, 2 deaths due to multiple organ failure, 1 death due to intra-abdominal hemorrhage, and 1 case of unknown cause of death. There were no significant differences in portal vein thrombosis (PVT), outflow tract obstruction, biliary tract complications and pulmonary infection between the two groups (P > 0.05). The ratio of hepatic artery thrombosis (HAT) was lower in LDLT group than that of DDLT group (1.98% vs. 10.29%， χ2=10.245， P < 0.01). Conclusion Living donor liver transplantation is an effective method to treat end-stage liver disease Related Articles | Metrics

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The function of TGF -β1 and Smad2 in liver fibrosis of Biliary atresia DING Meiyun, ZHAN Jianghua, ZHAO Li, ZHAO Linsheng, ZHANG Aihua 2016, 44 (7):  810-813.  doi: 10.11958/20150242 Abstract ( 1121 )   PDF (629KB) ( 4038 )   Objective To observe the expression and function of TGF-β1 and Smad2 in liver fibrosis of biliary atresia. Methods Liver biopsy specimens were collected from autopsy(normal group, n=5), congenital biliary dilatation (CBD group, n=10), biliary atresia patients who undergoing Kasai procedure (Early hepatic fibrosis group, n=19), liver transplantation(transplantation group, n=11) ,the first three groups were collected from January 2010 to July 2014 in Tianjin childrens’ hospital, the last group was collected from January 2013 to January 2014 in Tianjin first central hospital. The hematoxylin ＆ eosin staining were used to observe the degree of liver fibrosis of every single sample, immunohistochemistry were used to observe the expression of TGF-β1 and Smad2 in liver tissues of these samples. At the same time, Quantitative Real-time Polymerase Chain Reaction was used to test the mRNA quantitative of TGF-β1 and Smad2 between these samples. Results HE: That the autopsy group showed no fibrosis, the CBD group had mild fiber cells hyperplasia, the Kasai group had severe fibrosis and the transplantation group had significant pseudolobule in the hematoxylin ＆ eosin staining. IHC: TGF-β1 was expressed in the cytoplasm of hepatocytes、bile duct cells、lymphocytes and neutrophils. The value of TGF-β1 average optical density was highest in the Kasai group and it had significant difference between four groups (P < 0.05); Smad2 was expressed in the cytoplasm of hepatocytes、bile duct cells、lymphocytes, and there were no difference between these four groups（P＞0.05）. qRT-PCR: Both TGF-β1mRNA and Smad2mRNA was different between these samples(P<0.017). Conclusion In early stage of BA,TGF-β1 and Smad2 made a contribution to liver fibrosis until the formation of P-P,P-C desmosome structure. However, after that while BA fibrosis became more serious, the pro-fibrogenic function of TGF-β1 and Smad2 became less. Related Articles | Metrics

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The clinical experience of diagnosis and treatment of late vitamin K deficiency intracranial hemorrhage as the first symptom of biliary atresia WEI Zhongnan, ZHAN Jianghua, ZHANG Qingjiang, MA Xiao, SUN Ning, CAI Chunquan 2016, 44 (7):  814-816.  doi: 10.11958/20160238 Abstract ( 1314 )   PDF (350KB) ( 3943 )   Objective To investigate the surgical diagnosis and treatment of late vitamin K deficiency intracranial hemorrhage caused by biliary atresia. Methods Clinical data of six cases of biliary atresia with late vitamin K deficiency intracranial hemorrhage were collected in the Department of Neurosurgery of Tianjin Children’ s Hospital from January 2000 to December 2013. Data were analyzed to identify the biliary atresia as soon as possible in the treatment of intracranial hemorrhage and prolonged jaundice in children. Results Six cases (1 male, 5 female), mean age was (16.0±2.6) days, and were treated with external drainage of intracranial hematoma and infusion therapy. In the treatment, children were found jaundice exacerbation and doubted about biliary atresia. After consultation by general surgeons, children were transferred to the department of general surgery for further treatment at an average age of (29.1 ±1.2) days, and were diagnosed as biliary atresia by intraoperative cholangiography. Conclusion Pediatric neurosurgeon should have a sufficient understanding and make an early diagnosis to late vitamin K deficiency intracranial hemorrhage caused by biliary atresia, to avoid delaying the optimal treatment time of biliary atresia. Related Articles | Metrics

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Effects of Kasai surgery on living donor liver transplantation in the treatment of children biliary atresia LI Shanni*, WANG Kai*, MA Nan, MENG Xingchu, ZHANG Wei, SUN Chao, DONG Chong, WU Bin, HAN Chao, QIN Hong, GAO Wei 2016, 44 (7):  817-820.  doi: 10.11958/20160239 Abstract ( 1020 )   PDF (398KB) ( 4092 )   Objective To evaluate the effects of portoenterostomy (Kasai surgery) on living donor liver transplantation (LDLT) for children with biliary atresia (BA). Methods A total of 150 children with BA, who were treated with LDLT in our center from September 2006 to September 2014, were retrospectively analysed. The children were categorized into Kasai group (90 cases, 60% ) and non- Kasai (60 cases, 40% ) group, based on whether they had previously undergone Kasai procedure pre-LDLT. Clinical data, incidence of complications and accumulated survival rates were compared between twogroups. Results The ages of pediatric patients were 4.9-87.0 months. The patient age and height were significantly higher in Kasai group than those of non-Kasai group (P < 0.05). The serum bilirubin level was lower before surgery in Kasai group than that of non-Kasai group (P < 0.05). There were no significant differences in body weight, pediatric end stage of liver disease (PELD) score, graft to recipient body weight ratio (GRWR), operation time and blood loss between two groups (P > 0.05). Similarly, there were no significant differences in pulmonary infection, acute rejection, portal vein thrombosis, hepatic artery occlusion and biliary complications between the two groups (P > 0.05). The overall complication rate of post-LDLT was 61.1% in Kasai group, which was higher than that in non-Kasai group (43.3%,χ2=4.580, P=0.032). Totally, there were 7 cases (4.7%) died on post-LDLT, in which there were 6 cases (4.0%) in Kasai group including 5 cases of multiple organfailure and 1 case of severe pulmonary infection, and 1 case (0.7%) in non-Kasai group, who died of multiple organ failure due to preoperative gastrointestinal bleeding for emergency surgery. There were no serious complications and death in donors. The overall cumulative survival rates were 98.6%, 96.6%, 94.9% and 92.7% in 1 month, 1 year, 3 years and 5 years after LDLT, respectively. And there were no significant differences in survival rates in 1 month, 1 year, 3 years and 5 years between two groups (χ2=1.490, P=0.222) with the rates of 98.9%, 96.5%, 93.8%, 91.3% in Kasai group and 98.3%, 96.6%, 96.4%, 95.5% in non-Kasai group. Conclusion Performing Kasai procedure can acquire satisfied results to pediatric patients with BA pre-LDLT, without increasing the incidence of major complications and mortality post-LDLT. And the accumulated survival rate is not different in pediatric patients received Kasai surgery compared with that in non-Kasai patient. Besides that, Kasai surgery might postpone the time of receiving LDLT, benefit to the growth of children and reduce the jaundice of pre-LDLT. Related Articles | Metrics

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The expression and significance of integrin αvβ8, p38 and ERK1 /2 in the liver of children with biliary atresia GAO Ting1， ZHAN Jianghua2△， DING Meiyun1， Wei Yuanyuan 1 2016, 44 (7):  821-824.  doi: 10.11958/20160362 Abstract ( 995 )   PDF (1702KB) ( 4250 )   Abstract： Objective To investigate the expression and significance of integrin αvβ8, p38 and extracellular signalregulated protein kinase 1/2 (ERK1/2) proteins, which are TGF- β1 pathway related regulatory protein, in liver fibrosis of children with biliary atresia (BA). Methods Fifteen cases of BA (Kasai group) and 10 cases of congenital biliary dilatation (CBD group) were collected in Tianjin Children’ s Hospital. And liver biopsy specimens were collected in Tianjin first central hospital, including 10 cases of BA children who underwent liver transplantation due to liver failure after Kasai operation (liver transplantation group). The specimens of front part of the right lobe of the liver were taken for HE and immunohistochemistry (IHC) staining. The expressions of αvβ8, p38 and ERK1/2 in liver were observed by IHC staining in three groups of liver tissues. Results HE staining showed fibroblast hyperplasia occasionally in CBD group, portal area expansion, fibrous tissue proliferation and wide spread bridging fibrosis with few pseudo lobules in Kasai group. In transplantation group, portal area was widened, the degree of fibrosis was severe and bridging fibrosis generally formed resulted in pseudo lobules widely. Imunohistochemistry showed that the expressions of αvβ8 and ERK1/2 were weakly positive, and the expression of p38 was negative in CBD group. In Kasai group, the expressions of αvβ8, p38 and ERK1/2 proteins were all strongly positive in liver cytoplasm, biliary epithelial cells and vascular endothelial cell cytoplasm. In liver transplantation group the expressions of αvβ8, p38 and ERK1/2 proteins were all strongly positive. The semi-quantitative analysis showed that the expressions levels of αvβ8, p38 and ERK1/2 were significantly higher in Kasai and liver transplantation groups than those of CBD group (P < 0.05). There were no significant differences in expression levels of αvβ 8, p38 and ERK1/2 between Kasai group and transplantation group (P > 0.05). Conclusion The expressions of αvβ8, p38 and ERK1/2 are gradually increased in liver of BA with the process of fibrosis, which indicate that they may be involved in the process of BA liver fibrosis. Related Articles | Metrics

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Risk factor analysis of EB virus infection after liver transplantation in children with biliary atresia WANG Tiancheng1， ZHU Zhijun2△， SUN Liying2， WEI Lin2， QU Wei2， ZENG Zhigui2， LIU Ying2， HE Enhui3， ZHANG Liang4， WANG Yongcui1， WANG Yue1 2016, 44 (7):  824-828.  doi: 10.11958/20160450 Abstract ( 1102 )   PDF (373KB) ( 4148 )   To determine the prevalence and risk factors of Epstein- Barr virus (EBV) infection after pediatric liver transplantation for patients with biliary atresia. Methods Clinical data of 65 pediatric patients with biliary atresia, who underwent liver transplantation, were retrospectively analyzed. Patients were divided into EBV infection group(n=30) and non-EBV infection group (n=35). The univariate analysis was used to analyse the preoperative, intraoperative and postoperative data of patients included. The variables with a P ＜ 0.1 were included in the multivariate Logistic regression analysis of EBV infections after pediatric liver transplantation for patients with biliary atresia. Results A total of 30 cases (46.15%) of pediatric recipients showed EBV infection in 65 cases, of which 23 cases (76.67%) occurred within 3 months after operation. The univariate analysis showed that there were significant differences in the ratio of patients younger than 1 year preoperation, EBV serology D+/R-, acute rejection, the usage of mycophenolate mofetil and supratheraputic tacrolimus level between two groups (P＜ 0.05) . The type of graft (P=0.060), input quantity of red blood cell intraoperation (P=0.063) and factors mentioned above were included in the multivariate Logistic regression analysis. It revealed that donor EBV serology positive but recipient negative, acute rejection and supratheraputic tacrolimus level were risk factors of EBV infection for pediatric liver transplantation recipients with biliary atresia. Conclusion Donor EBV serology positive but recipient negative, acute rejection, supratheraputic tacrolimus level are closely related to EBV infection in pediatric recipients with biliary atresia after liver transplantation. Appropriate antiviral drugs should be adopted to prevent EBV infection in high risk patients. Related Articles | Metrics

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Study of the native liver survival of children with biliary atresia after kasai operation CHEN Yang,ZHAN Jianghua 2016, 44 (7):  829-833.  doi: 10.11958/20160237 Abstract ( 964 )   PDF (356KB) ( 4082 )   Biliary atresia (BA) is a kind of obstructive biliary disease, with progressive inflammation and fibrosis characteristics . Kasai portoenterostomy is the only method of treatment of biliary atresia, but 80% of the patients treated by kasai operation still need liver transplantation in the future. There are many factors, such as the types of BA，laparoscopic kasai surgery or traditional open surgery， patient’s age at surgery, condition of liver function, occurrence of cholangitis, jaundice clearance, using of steroids and central hospitalization to influent the native liver survival and to be reviewed as following below. Related Articles | Metrics

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The role of Rho kinase in the protection effects of hydrogen on Caco-2 epithelial barrier against LPS in vitro MA Xiaoye, YU Yang, ZHANG Hongtao, XIE Keliang, YU Yonghao 2016, 44 (7):  834-838.  doi: 10.11958/20160025 Abstract ( 802 )   PDF (406KB) ( 3914 )   [Abstract] Objective To investigate the role of Rho kinase in the protection effects of hydrogen to intestinal epithelial barrier function against sepsis. Methods Caco-2 cells were cultured routinely, and divided into 6 groups randomly: control group, hydrogen-rich medium group, LPS-treatment group, hydrogen+ LPS-treament group, Y-27632 (ROCK inhibitor) treatment group and Y-27632+ LPS-treatment group. Hydrogen-rich medium group were treated with the 0.6mmol/L hydrogen-rich media. The concentration of LPS and Y-27632 were 100μg/ml and 25μmol/L separately. After the Caco-2 monolayer models were established, the transepithelial electrical resistance (TEER) values were measured regularly. When the TEER values reached 800Ω?cm2, the treatments were administered. Then TEER values were measured at 6h, 12h and 24h, and FITC-dextran permeability were detected at 24h. Cells were seeded on 6-well cell culture clusters. After cell density reached 80%~90%, treatments were given randomly. The real time-polymerase chain reaction (RT-PCR) was conducted to assess mRNA levels of ZO-1 and Rho kinase; ZO-1 and Rho kinase protein levels were detected with Western Blot. Results Compared with control group, TEER values of hydrogen-rich medium group elevated in 12h and 24h (P<0.05), no statistical significance in FITC-dextran permeability, neither in mRNA or protein levels of ZO-1 and ROCK (P>0.05); TEER values of Y-27632 treatment group at 6h, 12h and 24h elevated (P<0.05), FITC-dextran permeability did not change obviously (P>0.05), mRNA of ZO-1 increased and mRNA of ROCK decreased (P<0.05); the TEER values of LPS-treatment group reduced at 6h, 12h and 24h, FITC-dextran permeability increased markedly, mRNA and protein s of ZO-1 decreased, mRNA and protein s of ROCK increased (all P<0.05); compared with LPS-treatment group, TEER values in Y-27632+ LPS-treatment group rose significantly, FITC-dextran permeability decreased, mRNA s of ZO-1 increased, mRNA s of ROCK decreased (P<0.05); TEER values in hydrogen+ LPS-treament group increased, FITC-dextran permeability reduced markedly, protein s of ZO-1 increased, protein s of ROCK decreased (P<0.05). Conclusion Hydrogen can protect intestinal barrier function against sepsis, ameliorating the integrity of intestinal epithelium, reducing its permeability and increasing the s of tight junction proteins. The suppression of Rho kinase over reduced by LPS maybe involved in these protective effects of hydrogen. Related Articles | Metrics

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Expression of YY1 in lung cancer and its function on lung cancer cell lines WANG Yu, LIU Ben, QU Jinli, YU Xiao, FENG Nannan, QIAN Biyun 2016, 44 (7):  839-842.  doi: 10.11958/20160105 Abstract ( 1268 )   PDF (674KB) ( 3778 )   Abstract：ObjectiveTo investigate the gene of YY1 in lung cancer tissues and discuss its function in cell proliferation，migration and invasion.Methods The mRNA of YY1 in 235 lung cancer tissues and 62 adjacent tumor tissues were determined by real-time quantitative PCR. NSCLC cell lines were transfected with YY1 over- vector and negative control vector using Lipofectamine 3000. Proliferation of cells were measured by MTT in control groups and YY1 over- groups after 24h, 48h and 72h of transfection in A549 and H1299 cells. Wound-healing assay and Transwell assay were performed to investigate the effect of YY1 over on the invasion and migration of lung cancer cells.Results Compared to normal adjacent tissues(5.80±0.58)，the of YY1 was significantly lower in lung cancer tissues(5.07±0.58)(P<0.01)．There were significant differences in the levels of YY1mRNAbetween gender, smoking status,histology subtypeor clinical stages(P＜0.05). Furthermore, compared to controls, the over- ofYY1 in H1299 cells was found to suppress proliferation for 48h and 72h (P<0.01) and A549 cell for 72h(P<0.05). Wound-healing assay and Transwell assay showed the over of YY1 inhibited migratory and invasive capability of lung cancer cells (P<0.05).Conclusion YY1mRNA level is lower in lung cancer tissue than normal adjacent tissue and YY1 suppresses lung cancer cell proliferation, migration and invasion. Related Articles | Metrics

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Studies on the long non-coding RNA during the reprogramming of human pluripotent stem cells YU Qian, LIU Yali, FAN Yong 2016, 44 (7):  843-845.  doi: 10.11958/20160135 Abstract ( 690 )   PDF (461KB) ( 3702 )   Abstract: Objective To investigate the changes and roles of the Long non-coding RNA during the reprogramming of human induced pluripotent stem cells. Methods Using Agilent Human lncRNA (4 * 180K) chip to check the of lncRNA in somatic cells, induced pluripotent stem cells and embryonic stem cells. Compared with differentially expressed lncRNA in somatic cells and induced pluripotent stem cells, lncRNA may play an important role during the reprogramming of human pluripotent stem cells. Results The lncRNA profiles in induced pluripotent stem cells are similar to embryonic stem cells but are different from the somatic cells． 3156 differentially expressed lncRNAs are found between stem cells and somatic cells by cluster analysis. 222 differentially expressed lncRNAs are found between during the reprogramming process of human pluripotent stem cells by biological analysis. Conclusion lncRNA may play an important role in human pluripotent stem cell reprogramming process. Related Articles | Metrics

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The change of phosphorylated MAP-2 in hippocampus/amygdala and the influence of ginsenoside Rb1 on it in depressive rat model LIU Jigang, YUAN Yang2 ZANG Yu, LIU Hao 2016, 44 (7):  846-848.  doi: 10.11958/20150266 Abstract ( 1318 )   PDF (353KB) ( 3748 )   Objectvie To observe the effcet of ginsenoside Rb1 on phosphorylation of microtubule-associated protein 2 (pMAP-2) in hippocampus and amygdala of depressive rats. Methods Thirty male Wistar rats were randomly divided into control group, model group and treatment group. The depression animal model was produced by giving the rats chronic unpredicted mild stress. The of pMAP-2 protein and mRNA were detected by western blot and real-time PCR respectively. Results The of pMAP-2 protein and mRNA of model group were lower than that of control group, while the index was higher after treatment with bupleurum liver-coursing powder (P<0.05). Conclusion Effect of ginsenoside Rb1 antidepressant may induced by affect the phosphorylation of MAP-2 in hippocampus. Related Articles | Metrics

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Liraglutide promotes the reduction of blood pressure and drives the water and salt through in renal medulla of type 2 diabetes rats WANG Shaoqing1, MAO Nan, ZHOU Ping，WANG Li, GAO Fang1 WEI Yixun, FAN Junming, FU Ping 2016, 44 (7):  849-852.  doi: 10.11958/20150245 Abstract ( 1433 )   PDF (493KB) ( 4057 )   Objective To observe the effects of glucagon like peptide-1 (GLP-1) analogues liraglutide on expressions of nitric oxide synthase (NOS) and cyclo-oxygen-ase (COX)2 in renal medulla of type 2 diabetes rats, and the mechanism of its lowering blood pressure and promoting excretion of water and salt in kidney. Methods Type 2 diabetes model rats were generated by high-fat and high-sugar feeding for 8 weeks followed by intraperitoneal injection of streptozotocin (STZ). Subse⁃ quently, eighteen type 2 diabetes rats were divided into two groups: liraglutide treatment group (DMT) and diabetes group (DM). Twelve normal rats were divided into two groups: liraglutide treatment wild type group (WTT) and wild type group (WT). DMT and WTT groups were given liraglutide (200 μg/kg) by subcutaneous injection, DM and WT groups were given equivalent normal saline by the same way. The levels of blood glucose and blood pressure were detected at 0, 2, 4 and 6 weeks after treatment in groups of rats. Samples of urine were collected for detecting ion concentrations (K +, Na+ and Cl-) af⁃ ter treatment for six weeks. Rats were sacrificed and blood samples were collected for detecting ion concentrations (K +, Na+ and Cl-). The expression levels of NOS and COX2 mRNA and protein in renal medulla were detected by real-time PCR and Western blot assay. Results After treating with liraglutide, the values of blood glucose (F=5.933, P < 0.05) and blood pres⁃sure (F=22.070, P < 0.05) were gradually decreased in DMT group. After treatment with liraglutide for 6 weeks, the values of blood glucose (mmol/L:12.78±3.82 vs. 18.75±1.68) and blood pressure (mmHg:119.98±4.43 vs. 136.42±4.48) were signifi⁃ cantly decreased (P < 0.05) in DMT group than those of DM group (P < 0.05). There were no significant differences in the concentrations of K +, Na + and Cl- between the two groups. There were higher levels of K + (mmol/L:46.55±6.43 vs. 33.13± 9.71), Na+ (mmol/L: 56.33±8.83 vs. 41.20±7.25) and Cl- (mmol/L:159.81±25.06 vs. 71.44±12.99) in urine in DMT group than those of DM group (P < 0.05). The mRNA levels and protein expressions of NOS and COX2 in renal medulla were significant⁃ ly increased in DMT group than those of DM group (P < 0.05). Conclusion GLP-1 analogues liraglutide may enhance the expression of COX2 by increasing the expression of NOS to excrete water and salt, and decrease blood pressure. Related Articles | Metrics

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Effects of Iridoid on Spermatogenesis Functions of Nicotinamide-Streptozotocin Induced Type-2 Diabetic Mice CHEN Tong 2016, 44 (7):  853-856.  doi: 10.11958/20160275 Abstract ( 796 )   PDF (307KB) ( 3827 )   Abstract Objective： This study was aim to investigate the effects of iridoid on the spermatogenesis functions of type-2 diabetes induced by nicotinamide and streptozotocin. Methods：56 male C57BL mice were divided into seven groups (n=8) randomly: control; diabetic mice; diabetic mice administered glibenclamide (0.25 mg/kg); diabetic mice who received the iridoid(20 and 40mg/kg groups); and normal mice received iridoid(20 and 40mg/kg)groups. Diabetic model was induced by intraperitoneal?injection of streptozotocin (65 mg/kg) and nicotinamide (120 mg/kg). Glibenclamide and iridoid were orally feed for the next 28 days. 24 hours after the last treatment, blood samples, testis and the epididymis were obtained for testis, sperm analysis and hormonal tests. Results: Body and testicular weight, sperm count and viability, and LH, FSH, T levels were significantly decreased in diabetic group(p<0.05). The diabetic mice treated with 40 mg/kg of iridoid recovered from these reductions(p<0.05). Glibenclamide relieved hormonal and sperm reduction in diabetic mice group(p<0.05). Conclusions：These results suggests that the iridoid has anti-infertility effects in diabetic males mice. Related Articles | Metrics

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Effects of ACTH combined with Huaiqihuang on rat hypothalamic pituitary adrenal axis WANG Wenhong, ZHANG Bili, LIU Yan, LIU Yan, ZHAO Linsheng 2016, 44 (7):  857-860.  doi: 10.11958/20150278 Abstract ( 952 )   PDF (724KB) ( 3781 )   Objective To investigate the effects of adrenocorticotropic hormone (ACTH） combined with Huaiqihuang on hypothalamic pituitary adrenal (HPA) in rats. Methods Fifty rats were randomly divided into five groups according to the random number table method: normal control group (group A), prednisone group (group B), Huaiqihuang group (group C), ACTH group (group D) and combined treatment group (group E) with 10 rats in each group. Rats in group B, C, D and E were gavaged by acetic acid prednisone water solution 12.5 mg/(kg· d) for 4 weeks to establish HPA axis suppression model. Group A was given distilled water 10 mL/(kg· d) as control. Rats in group C and E were gavaged with Huaiqihuang 5 g/(kg· d) 30 minutes after intragastric administration of prednisone acetate. At the third week of the experiment, group D and E were subcutaneous injected with ACTH 200 µg/(kg· d). The serum cortisol levels were measured respectively at the start of the ex⁃ periment, 2 weeks and 4 weeks of experiment. Animals were sacrificed at the end of the experiment, and then weights of the pituitary, adrenal glands and the viscera index were calculated. The pathological changes of the pituitary and adrenal glands were observed by HE stainning. Results After 2 weeks, the serum cortisol levels were significantly lower in group B, C, D and E than those of group A (P < 0.05), suggesting that the model was successful. After 4 weeks, the serum cortisol levels were significantly higher in group C, D and E than those of group B (P < 0.05), and between the treatment group the value was group E > group D> group C (P < 0.05). At the same time, the weights of pituitary and adrenal gland and the viscera in⁃ dex were higher in the three groups than those of B group (P < 0.05). The HE staining showed that there were no significant changes in the distal part of the pituitary gland in five groups. The adrenal cortex zona was thinning and the structure was dis⁃ ordered in group B. There were different degrees of hyperplasia in group C, group D, and group E, which was the most obvi⁃ ous in group E. Conclusion ACTH combined with Huaiqihuang can promote adrenal cortex zona hyperplasia and cortisol secretion, which reduces the glucocorticoid induced inhibition of HPA axis in rats. Related Articles | Metrics

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Extracelluar pH influence high-phosphorus-induced VSMCs calcification mediated by BMP-2 Signaling Pathway ZHANG Huiran, XU Jinsheng△, GUO Liping, BAI Yaling, ZHANG Shenglei, ZHANG Junxia, CUI Liwen 2016, 44 (7):  861-864.  doi: 10.11958/20150117 Abstract ( 1167 )   PDF (1109KB) ( 3577 )   Abstract：Objective To explore the?effect of different?pH on calcification of rat vascular smooth muscle cells (VSMCs) through the bone morphogenetic protein2 (BMP-2) signaling pathway. Methods Healthy male SD rats aged?5-8-weeks were selected in the study.?VSMCs?from rat thoracic?aorta?were cultured?invitro,?and then identified?by?immunocytochemistry.?The?VSMCs?were randomly?divided into?4 groups by random sampling method: normal group(pH7.4), pH7.4+high phosphorus group, pH7.1+high phosphorus group, and pH7.7+high phosphorus group.Calcium deposition and ALP activity were measured by Alizarin red staining, quantification of calcium and enzyme linked immunosorbent assay.The of BMP-2, Smad1, Runx2 mRNA was detected by RT-PCR .Results Compared with the control group, the pH7.4+ high phosphorus group calcification staining, calcium content, alkaline phosphatase (ALP) activity and the of Runx2 mRNA average increased (P<0.05).While compared with the pH7.4+high phosphorus group, the pH7.1+high phosphorus group calcification staining, calcium content, alkaline phosphatase (ALP) activity and the of BMP-2, Smad1, Runx2 mRNA average decreased (P<0.05), and the pH7.7+high phosphorus group calcification staining, calcium content, alkaline phosphatase (ALP) activity and the of BMP-2, Smad1, Runx2 mRNA average increased (P<0.05).Conclusion Extracelluar acidic environment(pH7.1) can inhibit high-phosphotus-induced VSMCs calcification,whereas extracelluar alkaline environment(pH7.7) induce high-phosphotus-induced VSMCs calcification.The mechanism is presumably that VSMCs calcification is induced by influencing BMP-2 pathway, which may mediate the transdifferentiation of vascular smooth muscle cells. Related Articles | Metrics

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Astaxanthin enhanced radiotherapy sensitivity of human lung cancer A549 cells transplanted in nude mice WU Chuntao1, YUAN Wei2, LIU Tienan3, ZHANG Jinji1, LI Changzai1, HU Baoshan 2016, 44 (7):  865-868.  doi: 10.11958/20150340 Abstract ( 1318 )   PDF (1214KB) ( 3773 )   Objective To observe the effect of astaxanthin on radiotherapy sensitivity of lung cancer A549 cells transplanted in nude mice. Methods Twenty BALB/c nude mice were divided into four groups: control group (mice were gavaged with pure water containing with 10% DMSO), astaxanthin group (mice were gavaged with astaxanthin suspension containing with 10% DMSO, astaxanthin was given to mice with the dose of 50 mg/kg on the first day, and every other day in the following days with a total of 7 times), radiotherapy group (mice were gavaged with pure water containing with 10% DMSO, the tumor site was given local radiotherapy with a dose of 5 Gy per time and the total dose was 15 Gy) and combination group (mice were given 50 mg/kg astaxanthin and radiotherapy with 15 Gy total irradiated dose). When the minor axis of the tumor reached 5 mm we began experiment. Tumor growth curve was measured by detecting the line of apsides every other day. Mice were killed on the second day after the last time of astaxanthin administration. Weights of tumor were measured by a balance and then tumor mass was processed into paraffin sections. Expressions of proliferating tumor cell antigen Ki-67, phosphorylated-signal transducers and activators of transcription (p-STAT3), and cell apoptosis (measured by terminal deoxynucleotidyl transferase mediated dUTP nick- end labeling, Tunnel) were detected by immunohistochemistry. Results Compared with control group, the transplanted tumor growth rate slowed down in other three groups (P < 0.05), and tumor growth was the most slowly in the combination group. Tumor weight, Ki-67 and p-STAT3 expressions were decreased gradually in turn in control group, astaxanthin group, radiotherapy group and combination group. The anti- tumor rate and percentage of cell apoptosis were increased gradually in turn. There was significant difference between groups by multiple comparison statistics(P < 0.05). Conclusion Astaxanthin enhances radiotherapy sensitivity of human lung cancer A549 cells in nude mice by down-regulating the expression of p-STAT3. Related Articles | Metrics

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Evaluation of coronary stenosis by using the gemstone spectral CTCA: A Phantom Study SU Yan， YANG Liping， HUANG Chong， GONG Lianggeng， YIN Jianhua， LIAN Luo， QIN Xiaohua， ZHAN Jinfeng， TU Weiping， FANG Xiangdong 2016, 44 (7):  869-873.  doi: 10.11958/20150415 Abstract ( 1127 )   PDF (543KB) ( 4182 )   Objective: To evaluate diagnosis accuracy for coronary stenosis from diameter measurements of different severities of stenosis by using gemstone spectral imaging（GSI）. Methods: Totally 3 different coronary artery models（internal diameter: 3.00 mm）with different severities of stenosis (residual lumen diameter ratio : 75%, 50%, 25%,) were placed in a pulsating cardiac phantom （ALPHA 1-VT PC, Fuyo Corporation, Japan）. The coronary phantom was scanned in 2 models: gemstone spectral imaging （GSI） and Axial scan model（AXIAL）. All the spectral imaging data were analyzed by using GSI viewer to reconstruct the VMS images （40～140keV by 10 keV interval） and AXIAL. CT values (HU) of the remained lumen from all different stenositc lumens were measured. The residual rate (%) was calculated by dividing the diameters of the remained lumen to normal lumen on the reformatted short axial images. One-Way ANOVA was used to compare the residual rate measurement difference between VMS. Student t test was used to compare the residual rate measurement difference between VMS and AXIAL. Bland-Altman test was used to compare the measured residual rates and the gold standard. P＜0.05was considered as significant differences. Results: There were no significant differences among the VMS diameter measurements（P>0.05）. From student t test, only significant difference between 70keV VMS and AXIAL was found on 50% stenosis（t =4.617，P＜0.042）. From the Bland-Altman test, residual rate measurement from 70keV VMS was more accurate than AXIAL by taking the real model stenosis rate as gold standard（t =14.560，P＜0.000）. In the mild severity of stenosis (75% of the residual lumen), GSI slightly underestimated the degree of stenosis, while AXIAL slightly overestimated the stenosis. The accuracy of the GSI measurement was slightly higher than that of AXIAL. Conclusion: VMS image (70keV) showed more accurate than AXIAL images on both diameter measurement and evaluation of the coronary stenosis rate. Related Articles | Metrics

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Assessment of the diffusion-weighted imaging for the pathology and renal function in IgA nephropathy SU Yan， YANG Liping， HUANG Chong， GONG Lianggeng， YIN Jianhua， LIAN Luo， QIN Xiaohua， ZHAN Jinfeng， TU Weiping， FANG Xiangdong 2016, 44 (7):  873-876.  doi: 10.11958/20150263 Abstract ( 1003 )   PDF (786KB) ( 3880 )   【Objective】To study the correlation between the diffusion-weighted imaging measurements and GFR, Katafuchi scores in IgA nephropathy. 【Methods】 Thirty-five patients with IgA nephropathy and twenty healthy volunteers were enrolled in this study. All of the subjects underwent studies on 3.0T MR scanner to obtain the diffusion-weighted imaging measurements. The glomerular filtration rate were calculated with 99Tcm-DTPA scintigraphy. We based the grades and the pathological damage scores of IgA nephropathy on the Lee classification and the Katafuchi system. To compare the ADC values between the control group and different grade of IgA nephropathy group. To analyse the correlation between the ADC values and GFR. To analyse the correlation between the ADC values and Katafuchi scores.【Results】The renal cortical ADC values were higher than medulla in both the control group and the IgA nephropathy group(p<0.05). There were statistically significant differences in renal cortical and medulla ADC values among the control group and the IgA nephropathy subgroup(p<0.05).But there was no significant difference in renal cortical ADC values between IgAN I group and the control group(p>0.05). There was a positive correlation between the renal cortical and medulla ADC values and the GFR values(p<0.05).Negative correlation was found between the renal cortical and medulla ADC values and the Katafuchi scores(p<0.05).【Conclusion】The diffusion-weighted imaging could reflect the physiological functions of the kidney. It was feasible for application on IgA nephropathy, which could be used for assessing the renal filtration function and the pathological damage. However, DWI lacked the sensitivity to early renal disease. Related Articles | Metrics

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Role of single-site umbilical laparoscopy in the treatment for inguinal incarcerated hernia in children WANG Li, LI Guibin, SONG Lianjie, QIU Yun 2016, 44 (7):  877-879.  doi: 10.11958/20150268 Abstract ( 875 )   PDF (282KB) ( 3721 )   Objective To evaluate clinical effect of single-site umbilical laparoscopy in the treatment for inguinal incarcerated hernia in children. Methods Retrospective reviews were conducted for the clinical data of the 105 children of inguinal incarcerated hernia during January 2010 to August 2014. According to different operative approach, single-site laparoscopic surgery group(SLS ,n=56) and open surgery group(OS，n=49) were assigned and compared .The follow –up period was 6-36 month. Results Operation underwent successfully in both groups .The average operative duration had significant difference , which was (33.73±4.41)min for OS versus (25.13±4.82)min for 48 cases in SLS(p<0.01) ; the operative duration of other 8 cases in SLS was(32.25±2.18)min, because of discovery occult inguinal hernia and treating bilateral hernia. The average operative blood loss was (3.18±2.90)ml for OS versus (1.73±0.88)ml for SLS(p<0.01).The hospitalization duration was (4.22±1.16)d for OS versus (3.50±0.97)d for SLS(p<0.01). The postoperative complication were 24.5% for OS and 8.9% for SLS. Conclusion Single-site umbilical laparoscopy is safe and efficacious for inguinal incarcerated hernia in children .It offers many advantages such as mini-invasiveness , quick recovery ,fewer complication and discovery of occult inguinal hernia. Related Articles | Metrics

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The study of intervention effects under different patterns of ASD children LIANG Ying, LI Nan, GUO Yuanyuan, YAO Yanbin, LIU Gongshu 2016, 44 (7):  880-883.  doi: 10.11958/20150405 Abstract ( 879 )   PDF (305KB) ( 3874 )   [Abstract] Objective: The purpose of the study was to explore the influence of age-difference on intervention of autism spectrum disorder (ASD). Methods: 101 children aged from 12-48 months newly diagnosed ASD were randomly to different intervention. The intervention data was recorded including time and methods. C-PEP and social adaptive behavior scale were used to test the development quotation (DQ) both before and after intervention. Results: The significant statistical differences were found using C-PEP scale in the professional group, while no statistical differences in the no-professional group or home intervention group. Statistical differences were found between groups in imitation, consciousness, cognition, and total DQ. Conclusions: Significant progress was made in standard intervention. Related Articles | Metrics

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Application of optic coherent tomography in assessing visual performance of idiopathic macular epiretinal membrane patients MENG Bin, JI Ang, NIU Hongxia, YAN Lijuan, CHEN Xu, PENG Ying, ZHANG Chenguang 2016, 44 (7):  884-887.  doi: 10.11958/20160177 Abstract ( 955 )   PDF (534KB) ( 3778 )   Abstract：Objective Correlation analysis among retinal deformation degree and retina thickness of macular fovea(RT) and visual acuity(BCVA) in idiopathic macular epiretinal membrane patients. Methods The 66 eyes(56 patients)with idiopathic epiretinal membrane were included in this study, all the patients had undergone examination of visual acuity(LogMAR chart)，ocular fundus and OCT,all patients were divided into three groups according to retinal deformation degree, the RT value was measured manually .Data were analyzed using SPSS 19.0. SNK tests were undergone on BCVA and RT among three groups;PEARSON tests were undergone between RT and BCVA respectivel in three groups. Results There was significant difference on RT among three groups(averages respectively were 311.95±51.78um, 447.13±41.95um and 560.00±58.23um),the same result on visual acuity in three groups(averages respectively were 0.78±0.16 , 0.38±0.12 and 0.27±0.14)( P＜0.05). Statistic analysis revealed that BCVA was not related to RT in light Group(P>0.05),but was related to RT in medium Group and serious group (P＜0.05)．Conclusion The retinal deformation degree and RT are two objective indicators to assessing visual performance of idiopathic macular epiretinal membrane patients, Operation should be took when RT is more than 400 μm. Related Articles | Metrics

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The relationship between the incidence of melasma with estrogen gene polymorphism BAI Zhao 2016, 44 (7):  887-891.  doi: 10.11958/20150292 Abstract ( 978 )   PDF (531KB) ( 3843 )   Objective: To investigate the relationship between estrogen gene polymorphism and the incidence of melasma. Methods: 56 cases of chloasma blepharoplasty plastic surgery patients (case group) and 39 cases of normal control group of people with different estrogen receptor immunohistochemistry, polymerase reaction-restriction fragment length polymorphism (PCR -RFLP) technical Analysis two group of ERα gene PvuⅡ and XbaⅠ restriction site polymorphisms and RsaⅠ and AluⅠ restriction site polymorphism ERβ gene, investigate the incidence of estrogen and melasma serious relationship score. Results: Immunohistochemistry showed that part of the case group dermal fibroblasts and endothelial cells were positive for of ERα and ERβ, while the control group was weak ; Spearman correlation analysis showed that the relationship between ERα and melasma score (r = 0.462 , P = 0.017); the relationship between ERβ and melasma score (r = 0.512, P = 0.002); ERα gene XbaⅠ genotype distribution in the two groups was significant difference (P <0.05), with xx genotype reference exposure to X allele (Xx + XX) OR = 2.23 (95% CI: 1.41 ~ 3.89, P <0.05), ERβ gene AluⅠ genotypes were significantly different in the two groups difference (P <0.05 ), with aa genotype reference, exposed to the A allele (AA + Aa) OR = 1.58 (95% CI: 1.21 ~ 4.29, P <0.05), RsaⅠ genotype distribution in 2 groups were statistically difference (P <0.05), with reference rr genotype, exposure to R allele (RR + Rr) OR = 2.37 (95% CI: 1.19 ~ 6.33, P <0.05). Conclusion: The incidence of melasma XbaⅠ ERα gene genotype, ERβ gene AluⅠ, RsaⅠ genotype polymorphisms, gene mutations increase the risk of onset of melasma, where Xx, Aa and RR genotype susceptibility to diseases. Related Articles | Metrics

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The expression and clinical significance of hsa-miR-144 in esophageal squamous cell carcinoma LIU Shangguo, QIN Xiuguang, ZHAO Baosheng, WANG Tianyun, QI Bo， LI Hanchen 2016, 44 (7):  892-895.  doi: 10.11958/20150122 Abstract ( 707 )   PDF (303KB) ( 3752 )   Objective The aim of this study was to detect the of hsa-mir-144 in esophageal squamous cell carcinoma, and to investigate the relationship between clinicopathological features and prognosis. Methods RT-qPCR(Real-time quantitative reverse transcription polymerase chain reaction) method was used to detect the of hsa-mir-144 in 46 esophageal squamous cell carcinoma tissue and adjacent normal tissue. Combining with the clinical follow-up data, Kaplan–Meier method was used to analyze the survival．Results Comparing with internal reference U6，the amount 0.97(0.22–24.48)×10-6 of hsa-mir-144 in esophageal squamous cell carcinoma was lower than that 8.60(0.089–258.2)×10-6 in adjacent normal tissue, the difference was statistically significant (Z= –2.221, P<0.05). Expression of hsa-mir-144 was correlated with the lymph node metastasis (Z= –2.758，P<0.05)and pathologic stage(Z=7.737，P<0.05)，and it was not correlated with the sex, age of the patients and the size, location, differentiation degree, invasion depth of the tumor (all P＞0.05). Survival analysis indicated that lymph node metastasis, invasion depth of the tumor and pathologic stage were the influencing factors of prognoses (all P<0.05), but the of hsa-mir-144 was not correlated with the prognoses(P＞0.05). Conclusion The of hsa-mir-144 was lower in esophageal squamous cell carcinoma tissue, there was significant influence on the occurrence， development and prognosis of esophageal squamous cell carcinoma，it may serve as a new molecular marker. Related Articles | Metrics

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Clinical study on changes of homocysteine, folate and vitamin B12 serum levels in neonates with different clinical index of neonatal hypoxic ischemic encephalopathy Na LI Xiao-Jun LIU WANG Dan GUO Jing 2016, 44 (7):  895-897.  doi: 10.11958/20160014 Abstract ( 1024 )   PDF (285KB) ( 3908 )   Abstract: Objective To determine whether high serum homocysteine (Hcy) and low folate and vitamin B12 levels are correlated with the clinical index of neonatal hypoxic ischemic encephalopathy(HIE). To provide the reference for the diagnosis and treatment of neonatal patients with HIE. Methods Totally 94 cases of neonatal patients with HIE(32 mild，40 moderate, and 22 severe) treated by Tianjin children's hospital from April 2010 to April 2011 were enrolled.The control group is 20 cases of neonatal patients with neonatal swallowing syndrome over the same period.The serum levels of Hcy, folate and vitamin B12 were compared between four groups. Results The serum levels of Hcy, folate and vitamin B12 have statistical differences in four groups (P＜0.05). Compared with the control group, there were higher levels of Hcy and lower levels of folate and vitamin B12 in HIE groups. The Hcy levels in HIE groups increased with the deterioration of HIE. Serum levels of vitamin B12 in severe group are lower than those in the moderate group（P＜0.05）. Condusions The Hcy serum levels of neonatal patients with HIE have certain reference value in the assessment of the severity of HIE. To give timely supplementary folate and vitamin B12 neonatal patients with HIE may play an active role in the process of the treatment. Related Articles | Metrics

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Comparison of clinical efficacy of minimally invasive transthoracic device closure and traditional repair with ventricular septal defect in infants jian chen LIU Jianshi 2016, 44 (7):  898-901.  doi: 10.11958/20160038 Abstract ( 1089 )   PDF (359KB) ( 4017 )   Abstract:Objective Comparison of the treatment effects of minimally invasive transthoracic device closure and traditional surgery in infant with VSD. Methods Retrospective analysis the data of 91 cases of VSD in infant under 6 years old from October 2013 to February 2015 in the Department of cardiac surgery in Tianjin Chest Hospital. According to the operation mode, patients were divided into minimally invasive transthoracic device closure of VSD (closure) group (n=13) and traditional VSD repair under CPB (repair) group (n=78). In the preoperative cardiac ultrasound was used to determine the type of VSD, the distance from the margin of VSD to aortic and tricuspid valve，Pulmonary artery pressure and other cardiac malformations. Intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, ICU residence time, hospitalization time and cost, etc.. The patients were followed up for 12~18 months to collect arrhythmia, hemolysis，valve regurgitation and residual shunt of VSD. Results There were no operative mortality in 91 patients. In closure group 1 case were converted to traditional repair under CPB. The closure group was significantly less than that of the repair group in the time of ICU residence and hospitalization［(13.2±11.7) h vs. (77.2±55.8) h，(10.0±3.2) d vs. (15.8±6.7) d，P＜0.05］. In closure group 1 case(7.7%)underwent median sternotomy and CPB，all cases in repair group were median sternotomy and CPB. The infusion amount of suspended red blood cells and plasma and the time of mechanical ventilation the closure group were less than those in the repair group (P<0.05). There was no significant difference between the 2 groups in the cost of hospitalization and the incidence of complications during early postoperative and the follow-up period, including arrhythmia, VSD residual shunt, valve regurgitation, hemolysis, etc.(P>0.05). Conclusion In the comparison of the recent clinical curative effect of VSD treatment in infants , the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair. Long term effects need to be further observed and followed up. Related Articles | Metrics

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Correlation of homocysteine level and cerebral apoplexy in the patients with type 2 diabetes mellitus Dong ZHANG, ZHANG Jiming 2016, 44 (7):  902-905.  doi: 10.11958/20160054 Abstract ( 1047 )   PDF (345KB) ( 4147 )   Abstract: Objective To explore the correlation of serum homocysteine (Hcy) level and cerebral apoplexy in the patients with type 2 diabetes mellitus (T2DM),providing a reference for the screening of stroke. Methods A total of 144 patients with T2DM were selected as observation group,30 healthy people were as healthy control group(group C).The patients of observation group were divided into two groups, group A without cerebral apoplexy and group B with cerebral apoplexy. The level of serum Hcy in all subjects was detected by enzymatic cycling assay and the carotid intima-media thickness (IMT) of all patients was checked using color Doppler echocardiography.The level of Hcy between observation group and control group as well as each subgroup of observation group was compared, and its correlation with IMT was also analyzed. Results The levels of Hcy and HbA1C in group A and B were higher than those in group C ,and they in group B were higher than group A （P<0.05).The levels of Hcy were positively correlated with HbA1c levels、age、gender、high density lipoprotein and creatinine (P＜0.05). The incidence of increased Hcy in the patients with carotid stenosis(IMT moderate and severe-stenosis groups ) was dramatically higher than in IMT mild and normal group（P=0.034）.The level of Hcy was IMT severe-stenosis group ＞IMT moderate-stenosis group ＞IMT mild-stenosis group（P＜0.001）. Pearson correlation analysis displayed that the level of Hcy was positively correlated with IMT(P＜0.001). Conclusion The level of Hcy can influence the incidence of cerebral apoplexy in patients with T2DM. The high level of Hcy is closely related to the occurrence and progression of atherosclerosis ,conducive to early prevention，intervention and prognostic assessment of cerebral apoplexy. Related Articles | Metrics

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Clinical analysis of phacoemulsification combined with goniosynechialysis for the treatment of angle-closure glaucoma with cataract PEI Jinyun, LIN Yu, YANG Haiyan 2016, 44 (7):  906-909.  doi: 10.11958/20160373 Abstract ( 818 )   PDF (321KB) ( 3908 )   Objective To investigate the clinical effects of phacoemulsification combined with goniosynechialysis on the treatment of primary angle-closure glaucoma (PACG) with cataract. Methods The retrospective review included 71 patients (98 eyes) with PACG and cataract treated in Tianjin Huanghe Hospital. Patients were underwent phacoemulsification and intraocular lens implantation combined goniosynechialysis. Among these patients, there were 21 males (30 eyes) and 50 females (68 eyes). Patients ranged in age from 53 to 94 years old, everage (73.94±6.43) years old. They were divided into acute angle-closure glaucoma with cataract group (47 patients, 64 eyes) and chronic angle-closure glaucoma with cataract group (24 patients, 34 eyes). The visual acuity, intraocular pressure (IOP), anterior chamber angle, anterior chamber depth (CCT), topical and oral medications and surgical complications were observed before and after surgery in two groups. All the patients were followed up for 6 months. Results At the end of follow-up, postoperative visual acuity, IOP, CCT, anterior chamber angle and IOP-lowing medicine (topical and oral medications) were all improved in the two groups compared with those of preoperative levels (all P < 0.01). There were no statistical differences in preoperative or postoperative average visual acuity, IOP and anterior chamber angle between two groups (all P > 0.05). Values of CCT were significantly higher before and after operation in chronic angle-closure glaucoma with cataract group than those of acute angle-closure glaucoma with cataract group (P < 0.05). No drug-control rate of intraocular pressure was 76.5% (26/34) for chronic angle-closure glaucoma with cataract group than that of acute angle-closure glaucoma with cataract group (100%, 64/64). There was no need on topical medication in acute angle-closure glaucoma with cataract group. There were 14 eyes had corneal edema and 8 eyes appeared iris fibrous exudation in two groups, while no other serious complications. Conclusion For patients with PACG and cataract, the combined surgery of phacoemulsification and goniosynechialysis is a safe and effective therapy that can improve visual acuity and reduce IOP with fewer complications． Related Articles | Metrics

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The design and clinical application of MED-TLIF with mobile microendoscopic discectomy technique. XU Baoshan, MA Xinlong, YANG Qiang, LIU Yue, JIANG Hongfeng, XU Haiwei, JI Ning 2016, 44 (7):  910-913.  doi: 10.11958/20160212 Abstract ( 914 )   PDF (673KB) ( 3662 )   Objective: To evaluate the feasibility and clinical efficacy of microendoscopic discectomy-transforaminal lumbar interbody fusion (MED-TLIF) with mobile microendoscopic discectomy (MMED) technique. Methods: The MMED include outer working canal and inner operating canal, and large working canals and endoscopic chisel were fabricated for this operation. Operation was designed as follow: the pedicles and index level were located with fluoroscopy, and a 2.5cm incision was made between pedicle punctures sites on the side with prominent symptom. Working canal was inserted and the facet was exposed, the inferior articular process and medial part of superior articular process were resected. The disc and cartilage endplates were curettage, and the intervertebral space was released and tested. The inner operating canal was removed and the interbody space was grafted and supported with suitable cage. Percutaneous pedicles screws were inserted and the residual displacement was evaluated under fluoroscopy, followed by the install of connecting rods, reduction and fivation. Fifty-six patients of lumbar stenosis with instability (32 cases) and spondylolisthesis (1 degree in 15 cases and 2 degree in 9 cases) were treated by this technique, and the index levels included L4/5 in 32 and L5S1 in 24 patients. The operation data and follow-up results were recorded and evaluated. Results: Surgery was successful in all patients, with no nerve injury or conversion to open surgery. The mean operative time was 120 min (range, 90–180 min), with a mean blood loss of 150 ml (range, 50–250 ml). The post-op X-ray and CT scans showed improvement of spinal alignment with mean reduction ratio of 72%. Patients were followed up for 12 to 36 months, the ODI score decreased from 50.1±11.2 pre-op to 5.8±5.6, VAS of lumbar decreased from 7.1±4.2 to 1.1±1.1 and VAS of leg decreased from 4.1±2.5 to 0.9±0.9 at final follow-up. The clinical results were excellent in 36 cases, good in 20 according to the MacNab scale. Conclusion: MED-TLIF can easily performed with MMED technique, with sufficient decompression and reduction, providing satisfactory results with less invasive procedure. Related Articles | Metrics

Drug Clinical Evaluations

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Treatment Effects of?Trimetazidine on coronary artery bridge ZHANG Jianyan, GUO Zhaozeng, ZHANG Tao, MA Xuejiao, CAO Yuejuan 2016, 44 (7):  914-916.  doi: 10.11958/20150145 Abstract ( 1117 )   PDF (301KB) ( 3809 )   Objective To observe the treatment effects of trimetazidine on myocardial bridge. Methods A total of 76 patients with clinical symptoms, such as different degree of chest tightness, palpitations, breath shortness, chest pain, were diagnosed as coronary myocardial bridge by coronary angiography and divided into 2 groups randomly. While control group (n=40) were given beta-blockers or (and) calcium antagonistas routine treatment, treatment group (n=36) were given routine treatment and trimetazidine, 20mg every time, tid. Chest pain times per week, exercise tolerance, anxiety and depression scores, total ischemic burden in 24h and walking distance in 6min, were observed in 2 groups during follow-up of 12 weeks. Results Compared with control group, those of treatment group were all improved. Conclusion Treatment based on conventional treatment combined with trimetazidine is safe and effective, can further improve myocardial energy metabolism and exercise tolerance, improves the clinical effect and the life quality of patients Related Articles | Metrics

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Comparison and analysis of the adherence of pulmonary rehabilitation in patients in different periods of chronic obstructive pulmonary disease LI YUECHUAN 2016, 44 (7):  917-920.  doi: 10.11958/20150328 Abstract ( 1024 )   PDF (373KB) ( 3846 )   Objective To explore the differences and infection factors of adherence of pulmonary rehabilitation(PR) in different periods of chronic obstructive pulmonary disease(COPD) patients. Methods The 304 patients were randomly distributed into two groups,including stable COPD with PR group(n=178) which perform PR after exacerbation and remain stable for 12 weeks,and AECOPD with PR group(n=126) which perform PR instantly after acute phrase.The course of PR is 12 weeks According to the adherence definition(practical time of accompolish PR programm > 70% of that planned time),we divided into good time-adherence group(n=115) and bad time-adherence group(n=189).Comparison of practical-perform time of PR, proportion of good time-adherence and PR quitting between two groups.Basic data of patients were collected and analyzed and independ infection factors of adherence was analyszed through binary logistic regression.Results The practical-perform time of PR, proportion of good time-adherence in stable COPD with PR group were higher than AECOPD with PR group while the PR quitting proportion was lower than AECOPD with PR group.Compare with AECOPD PR group,the income level and 6MWD were hingher in stable COPD PR group;and the age,proportion of tabacco-exposed,MRC scores and CAT scores were lower in Stable COPD group.Older-age, tabacco-exposed, higher MRC and CAT scores are danger factors for PR adherence, while the higher income level and longer 6MWD are protective factor for PR time-adherence in patients with COPD(P<0.05）. Conclusion The time adherence of COPD patients who undergo pulmonary rehabilitation was disappointing,especially postexacerbation.Good adherence would be expected in younger age, non tabacco-exposed, higher income level and better health-related quality of life. Related Articles | Metrics

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The clinical applications and research progresses of pulmonary hypertension by using cardiac magnetic resonance Zhang Zhang， ZHANG Ningnannan 2016, 44 (7):  921-924.  doi: 10.11958/20160051 Abstract ( 706 )   PDF (378KB) ( 3791 )   Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) has been an accurate and reproducible tool to assessment of RV morphology and function, which are important factors in the prognosis of patients with PH. The aim of this study is to review the clinical applications and research progresses of PH evaluation by using CMR. Related Articles | Metrics

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Current research of the mechanism of estrogen on osteoclasts SUN Xiaolei, ZHAO Zhihu, MA Xinlong 2016, 44 (7):  925-928.  doi: 10.11958/20160070 Abstract ( 1061 )   PDF (352KB) ( 4724 )   Estrogen involved in the process of postmenopausal osteoporosis and the main functional cell is osteoclasts. However, the action mechanism of estrogen on the osteoclasts is unclear. Here we demonstrate the estrogen can affect the osteoclasts in three aspects: morphology and structure, apoptosis of osteoclasts and preosteoclasts to give an overall explanation for the estrogen to the osteoclasts. Related Articles | Metrics