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15 November 2016, Volume 44 Issue 11 Previous Issue    Next Issue

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Update in diagnosis and management of hypothyroidism during pregnancy SHAN Zhongyan△ 2016, 44 (11):  1297-1301.  doi: 10.11958/20161144 Abstract ( 1382 )   PDF (404KB) ( 4476 )   Hypothyroidism including overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) is the most frequent condition of thyroid dysfunction during pregnancy. The prevalence of SCH during pregnancy ranges from 3% to 5%. In contrast, OH has a prevalence of less than 1% . Currently, pregnancy- specific reference ranges for serum thyrotropin (TSH) and free thyroxin (FT4) are used in the clinical diagnosis of hypothyroidism during pregnancy. More levothyroxine dosage should be taken in pregnant women with OH diagnosed before pregnancy, whereas, pregnant women with newly diagnosed OH should immediately start on levothyroxine (L-T4) therapy to ensure that TSH reaches the target value as soon as possible. As for pregnant women with SCH, there has been a controversy regarding the benefit of L- T4 therapy in preventing adverse pregnancy-related outcome and the suggestion in national and international guidelines. However, recent studies have recommended L-T4 replacement in all SCH women during pregnancy regardless of whether TPO antibodies are positive or negative. This paper reviews the research status of OH and SCH related diagnosis and treatment in pregnancy. Related Articles | Metrics

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Clinical analysis of 18 cases of insulinoma and review of literature JIA Yanchun, HE Qing△, WEI Hongyan, YUAN Menghua, JIA Hongwei, LI Fengao, CUI Jingqiu, ZHENG Baozhong 2016, 44 (11):  1301-1304.  doi: 10.11958/20161036 Abstract ( 1094 )   PDF (353KB) ( 3674 )   Objective To analyze the clinical characteristics of insulinoma and evaluate the methods used in the diagnosis and treatment of insulinoma. Methods The clinical data of 18 patients with insulinoma were retrospectively analyzed from January 2008 to December 2015, which were combined with the domestic and foreign related literature for analysis and summary of diagnosis and treatment. Results All the 18 cases had Whipple triad syndrome. Unconsciousness was the most common syndrome due to hypoglycemia (15/18). Five of the patients were misdiagnosed. Fourteen cases had glucose tolerance- insulin release test, and 12 of them had hypoglycemia (blood glucose was below 2.78 mmol/L). Eight patients had a insulin/glucose ratio ＞0.4 in three hours, and 12 patients in 5 hours. Tumor was detected by several imaging techniques in different patients. The sensitivity rate for B ultrasound was 6/15, for plain CT was 1/6, for contract CT was 11/ 13, for perfusion CT was 2/3, for MRI was 10/12, for contract MRI was 5/5, for endoscopic ultrasonography was 1/1, for digital subtraction angiography (DSA) was 1/2, and for intraoperative ultrasonography (IOUS) was 2/2. All 18 patients were underwent surgical treatment, and no any patient was found episodes of hypoglycemia after surgery. Conclusion Consciousness is the most common symptom caused by insulinoma. The 5 h glucose-insulin release test is more meaningful than the 3 h test. Multiple inspection methods can be used for the clear localization of the tumors before operation. Surgery is still the most preferred treatment for insulinoma. Related Articles | Metrics

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The diagnositic significance of serum thyroid peroxidase antibody in patients with Graves disease and Hashimoto’ s thyroiditis REN Liping1, LU Zefen2, HE Qing3△, YU Jia4 2016, 44 (11):  1305-1307.  Abstract ( 861 )   PDF (1020KB) ( 3590 )   Objective To study the clinical significance of the serum thyroid peroxidase antibody (TPOAb) for the diagnosis of Graves disease (GD) and Graves with combined Hashimoto thyroiditis (GH). Methods Fifty-eight in-patients who were diagnosed as GD and underwent thyroidectomy in the Department of General Surgery at Tianjin Medical University General Hospital between January 2008 and December 2014 were enrolled in this study. Patients were divided into GD group (n=39) and GH group (n=19) according to the postoperative pathological results of the thyroid gland. The serum TPOAb titer and the degree of thyroid lymphocytic infiltration were compared between two groups. Results The preoperative serum TPOAb titer was obviously lower in GD group than that in GH group [60.0 (15.0， 317.0) IU/mL vs. 800.0 (231.6, 1000.0) IU/mL, P＜0.01]. The degree of thyroid lymphocytic infiltration was obviously lower in GD group than that of GH group (Z=4.334, P＜0.01). Conclusion The serum TPOAb titer and the degree of thyroid lymphocytic infiltration are higher in GH patients than those in patients with GD alone. Related Articles | Metrics

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Clinical features of cardiovascular disease patients with complicated subclinical hypothyroidism MIAO Li1, DING Jin2, YAN Tingzhi2, LIU Yingwu1, YAO Xiaomei2△ 2016, 44 (11):  1308-1310.  doi: 10.11958/20161136 Abstract ( 866 )   PDF (274KB) ( 3910 )   Objective To observe the clinical features in cardiovascular disease (CVD) patients with complicated subclinical hypothyroidism. Methods A total of 132 CVD patients hospitalized in Tianjin Third Central Hospital from January 2013 to June 2015 were included in this study. According to the thyrotropin (TSH) level, patients were divided into three groups: normal thyroid function group (0.27 mIU/L 0.05). Conclusion The female CVD patients with accompanied positive anti- TPO should be paid attention in clinical treatment. Related Articles | Metrics

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A retrospective clinical study on the relationship between Hashimoto’ s thyroiditis and papillary thyroid cancer OU Weidong1, WANG Junhong1△, ZHANG Zhiyu1, LIU Yanxiao1, LI Jin1, YU Yuanyuan1, 2016, 44 (11):  1311-1314.  doi: 10.11958/20160150 Abstract ( 1013 )   PDF (316KB) ( 3756 )   Objective To investigate the relationship of Hashimoto’ s thyroiditis (HT) and papillary thyroid cancer (PTC). Methods Clinical data of 6 234 patients with thyroid nodule operation were collected from January 2000 to June 2015. PTC was pathologically confirmed after operation in 1 016 cases. Patients were divided into PTC combined with HT group and PTC without HT group. The clinical features were compared and analyzed between two groups. Results (1) In 6 234 patients, 8.66% (540/6 234) patients were complicated with HT. Compared with patients without HT, there were more female patients, more younger patients and higher incidence of PTC in this group of patients. (P < 0.01). (2) In 1 016 patients with PTC, compared with patients without HT, there were more female patients combined with HT, more patients with lower average ages, and high incidence of age from 36 to 55 years old, multiple cancers were more common, higher proportion of small cancer (≤1 cm), and lower extracapsular extension ratio, lower rate of lymph node metastasis, and lower ratio of TNM stage Ⅲ/Ⅳ and lower BRAF mutation rate (P < 0.05 or P < 0.01). There was a positive correlation between the occurrence of HT and PTC (P < 0.01). Conclusion There is a positive correlation between the occurrence of HT and PTC. In patients combined with HT and PTC, there are more female ones, and whose prognosis are better. Related Articles | Metrics

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The combination of the TSH∶Tg ratio and TI-RADS for identification of benign and malignant thyroid nodules JIAO Yan, ZHAO Honggang, ZHANG Zuncheng△ 2016, 44 (11):  1314-1317.  doi: 10.11958/20160091 Abstract ( 1246 )   PDF (318KB) ( 4548 )   Objective To assess the efficiency of thyroid stimulating hormone (TSH): thyroid globulin (Tg) ratio and ultrasound thyroid imaging reporting data system (TI-RADS) for thyroid nodule evaluation in euthyroid patients. Methods A total of 156 patients with thyroid nodules hospitalized in the department of thyroid breast surgery from January to December 2015 were included in this study. There were 50 patients were diagnosed as papillary thyroid carcinoma, and 106 patients were benign thyroid nodules confirmed by pathological diagnosis after operation. The ratio of TSH:Tg was calculated in patients. The cut- off point was calculated using the receiver operating characteristic (ROC) curve analysis. The measurement value < tangent was 0 point, and the measurement value ≥ tangent was 1 point. TI-RADS diagnostic criteria was evaluated and calculated. The nodule in TI- RADS categories 1, 2 and 3 was 0 points, The nodule in TI- RADS categories 4a, 4b, 4c, 5 was 1, 2, 3, 4 points, respectively . The combination score was the sum of the TSH:Tg ratio score and TI-RADS score. Results The area under the receiver operating characteristic curves of the TSH:Tg ratio was 0.736. The sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 64.0%, 82.1%, 62.7%, 82.8%, 76.3%, respectively. The AUC of TI-RADS was 0.753, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 84.0%, 72.6%, 59.2%, 90.6%, 76.3%, respectively. The AUC of the combination of the TSH:Tg ratio and TI-RADS was 0.839, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 74.0% , 86.1% , 71.1% , 87.5% , 82.1% , respectively. Conclusion The combination diagnosis of the TSH:Tg ratio and TI-RADS for thyroid nodule evaluation in euthyroid patients is better than that of only one method, which is worth clinical popularizing and application. Related Articles | Metrics

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Investigation and analysis of thyroid function in Uygur pregnant women and neurocognitive development of their offspring in high risk area of iodine deficiency LIU Siqi1, KONG Siying1, LI Dongyang2, WANG Xiaowei3, Abulaiti3, WANG Shengyi1, 2016, 44 (11):  1318-1321.  doi: 10.11958/20161282 Abstract ( 930 )   PDF (326KB) ( 3750 )   Objective To evaluate thyroid function of pregnant women and neurocognitive development of their offspring after continuous iodine supplementation in Aksu of Xinjiang, and to provide the basis for further research. Methods This study included 35 non-pregnancies (non-pregnant group) and 165 pregnant women (pregnant group). There were 5 pregnant cases did not take the detection of SH and TH due to the loss of follow-up. Pregnant group was subdivided into three groups including pregnancy week 0- 13 (early stage group), pregnancy week 14- 27 (middle stage group) and pregnancy week 28- 40 (late stage group). The random urine samples of early morning and venous blood samples were collected in two groups to determine the urinary iodine concentration by the arsenic cerium catalytic spectrophotometry, and thyroid hormone levels (TSH, FT4, FT3, TT4, and TT3 were detected by immunochemiluminometric assay. Offsprings of pregnant group were followed up two years. Gesell scale was used to assess their neurocognitive function. Results The total MUIC of pregnant women was 196.7 (122.9,269.2) μg/L. There were 52 cases in pregnant group (32.5%) and 108 in nonpregnant group (67.5%) with total UIC ≤150 μg/L and ＞150 μg/L. The FT3 level was lower and TT4 and TT3 levels wereincreased at the early stage of pregnancy in pregnant group compared with those of non-pregnant group. FT4 and FT3 levels were decreased and TT4 and TT3 levels increased in the middle stage group and late stage group (P<0.05). FT3 level was higher at the early stage group than that of middle stage group and late stage group (P<0.05). There were no significant differences in the other indicators between three groups. The abnormal rates of thyroid were 8.75% (14/160) in pregnant group, of which 5.63% cases were subclinical hypothyroidism (9/160), 3.13% were Tg- Ab + (5/160). There was no overlapping cases between subclinical hypothyroidism and Tg-Ab+ cases. There were no patients with overt hypothyroidism, hyperthyroidism and hypothyroxinemia in pregnant group. The offsprings of uygur pregnant women in this tracing study showed a lower language quotient score, and abnormal rate of Gesell was 3.75% (3/80), and the suspicious rate was 12.50% (10/80), normal rate was 83.75% (67/80). Conclusion After two years or more of family eligible iodized salt consumption come to qualified， the pregnant women in township of Aksu show adequate iodine nutrition with no overt abnormality of thyroid function, which can be considered as a group of control group for the subsequent research. Related Articles | Metrics

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The harm of iodine excess and the related mechanism FENG Yanni, YAO Xiaomei△ 2016, 44 (11):  1322-1325.  doi: 10.11958/20161087 Abstract ( 1482 )   PDF (340KB) ( 3837 )   Iodine is a key element in the synthesis of thyroid hormones and maintaining the normal physiological function. The iodine excess can lead to hypothyroidism, hyperthyroidism and autoimmune thyroid diseases. Individuals have different susceptibility to iodine excess. Excessive oxidative stress and secondary immune response may be the potential mechanisms of thyrotoxicity induced by iodine excess. This review updates the epidemiological results of iodine excess, and recommended intake standards, which may be involved in iodine excess and the regulatory mechanisms and pathogenesis in body to counteract iodine excess. Related Articles | Metrics

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The expression levels and clinical significance of SIRT1 mRNA and protein in adipose tissue of obese patients LI Li1, ZHAO Yanli2, LIU Chuanliang3, YU Wangying4 2016, 44 (11):  1326-1329.  doi: 10.11958/20160404 Abstract ( 918 )   PDF (436KB) ( 3589 )   Objective To explore expression levels of SIRT1 mRNA and protein in adipose tissue of obese patients, and its clinical significance in the treatment of obesity. Methods A total of 105 patients in our hospital were selected and divided into obesity group (BMI≥23 kg/m2) and control group (18.5 kg/m2 ≤BMI＜23 kg/m2) according to body mass index (BMI). SIRT1 mRNA expression levels in adipose tissue (collected from peritoneum) were detected by quantitative PCR method in two group. SIRT1 protein expression levels of adipose tissue were detected by enzyme- linked immunosorbent (ELISA) in two groups. The relationships of SIRT1 expression, BMI, total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG) and insulin resistance (HOMA- IR) were analyzed between two group. Results SIRT1 mRNA and protein levels were significantly lower in obesity group than those of normal group (P＜0.05). The values of TC, TG, FPG, FINS and HOMA-IRinadiposetissueweresignificantlyhigherinobesitygroupthanthoseofnormalgroup(P＜0.05).Theproteinexpression level of SIRT1 was positively correlated with values of TC, TG, FPG, FINS and HOMA-IR (r=-0.391, -0.941, -0.184, 0.215 and -0.990, P<0.05). Conclusion SIRT1 mRNA and protein expression levels in adipose tissue are significantly reduced in obesity patients than those of control group. There is a close relationship between SIRT1 protein level and obesity index, which has certain guidance for clinical treatment of obesity. Related Articles | Metrics

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The inhibition of autophagy suppresses proliferation and metastasis of lung cancer cells via down-regulation of HER2 FENG Yuanyuan1, WU Hongshan2, ZHANG Zhihong2, LONG Xinhua2, ZHOU Yang2, 2016, 44 (11):  1330-1333.  doi: 10.11958/20160610 Abstract ( 749 )   PDF (494KB) ( 3571 )   Objective To investigate whether the down-regulation of HER2 can inhibit the autophagy of cells and influence the proliferation and metastasis of lung cancer cells. Methods The 5 μmol/L of autophagy inhibitor (3-MA) and 10 μmol/L of HER2 inhibitor (Neratinib) were used to treat human lung cancer A549 cells. Western blot assay was used to detect the protein expressions of HER2, Beclin-1 and LC3B (Ⅱ/Ⅰ) in A549 cells. Wound healing and Transwell invasion methods were used to detect the invasion and migration ability of A549 cells. MTT assay was performed to evaluate the cell proliferation. Results Western blot analysis showed that the protein expressions of HER2, Beclin-1 and LC3B (Ⅱ/Ⅰ) were significantly declined in A549 cells treated with Neratinib and 3-MA for 24 h compared to cells in control group. The cell proliferation, migration and invasion ability were significantly decreased in A549 cells treated with Neratinib and 3-MA thanthoseofcontrolcells.Conclusion TheinhibitionofHER2proteincansuppresstheautophagyandproliferationofA549cells. Related Articles | Metrics

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Effects of MK801 on proliferation, apoptosis and migration of colorectal cancer cells XIE Dongbing1, MENG Jianyu2, GUO Yuting3?,REN Xia4, LI Xue1 2016, 44 (11):  1334-1337.  doi: 10.11958/20160486 Abstract ( 1069 )   PDF (1055KB) ( 4026 )   Abstract：Objective To explore the expression of the N- methyl- D- aspartate receptor type 1 (NMDAR1) in the colorectal cancer cells (CRC), and to examine the effects of NMDAR1 antagonists MK801 on proliferation, apoptosis and migration of colorectal cancer cell line HT-29 and SW116 cells. Methods The immunocytochemistry method was used to examine the expressions of NMDAR1 in HT-29 and SW116 cells. MTT assay was used to detect the effects of MK801 (62.5, 125.0, 250.0, 500.0, 1 000.0, 2 000.0 μmol/L) on the proliferation of HT-29 and SW116 cells. The flow cytometry was used to analyze the effect of MK801 (2 000 μmol/L) on cell apoptosis of HT-29 and SW116 cells. Wound healing assay was used to detect the effect of MK801 (50 μmol/L) on the migration of HT- 29 or SW116 cells. Results The NMDAR1 was expressed in both HT- 29 and SW116 cells, and mainly in the cytoplasm. MTT assay showed that there were inhibitory effects of different concentrations of MK 801 (62.5, 125.0, 250.0, 500.0, 1 000.0, 2 000.0 μmol/L) on the proliferation of HT- 29 cells, and inhibitory effects of different concentrations of MK801 (500.0, 1 000.0, 2 000.0 μmol/L) on SW116 cells, in a time- dependent manner. For 24, 48 and 72 h, the inhibitory effects of MK801 on proliferation rates of HT-29 and SW116 cells were increased with the increased concentrations of MK801. MK801 showed an effect to induce cell apoptosis in HT- 29 and SW116 cells, and mainly for early apoptosis. Wound healing assay indicated that MK801 inhibited the cell migration of HT-29 and SW116 cells. Conclusion Results suggest that there is expression of NMDAR1 in colorectal cancer cells. The NMDAR1 antagonist MK801 can inhibit the proliferation, induce cells early apoptosis and inhibit cells migration. It may be a new generation of antitumor drugs. Related Articles | Metrics

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Toxic effects of silica nanoparticles on myocardial mitochondria LIANG Baolu, YANG Man, WU Peng, LI Yanbo, JING Li△, SUN Zhiwei 2016, 44 (11):  1338-1342.  doi: 10.11958/20160476 Abstract ( 1310 )   PDF (801KB) ( 3590 )   Objective To investigate the toxic effects and mechanisms of silica nanoparticles on myocardial mitochondrial. Methods The Balb/c mice were intratracheally instilled with silica nanoparticles (40 nm) at three doses of 7, 21 and 35 mg/kg every three days for a total of 5 times. Control group was given the same volume of normal saline. The transmission electron microscope was used to observe the ultrastructure of myocardial mitochondria. By measuring the concentration of ATP，the effect of silica nanoparticles on the function of myocardial mitochondria was evaluated. Through the detection of the ability of anti O2-·in the myocardial tissue, the antioxidant capacity of mitochondria in cardiac muscle was evaluated. The expression levels of cytochrome coxidase subunit 1 (COX1) and succinate dehydrogenase subunit a (SDHA) were detected by Western blot assay. Results The results showed that silica nanoparticles at high dose can damage the structure of myocardial mitochondrial, which induced swelling of mitochondria， mitochondrial cristae disorder disappeared and even mitochondrial fusion. Silica nanoparticles (21 and 35 mg/kg) can induced the decrease in functions of mitochondria. Silica nanoparticles (7 and 21 mg/kg) can enhance the myocardial antioxidant capacity. But high dose of silica nanoparticles can induce the decrease in the myocardial antioxidant capacity. Silica nanoparticles (21 mg/kg) induced mitochondrial biosynthesis, but high dose of silica nanoparticles (35 mg/kg) inhibited mitochondrial biosynthesis. Conclusion Silica nanoparticles (35 mg/kg) can induce the production of O2-· and decrease the antioxidant capacity of mitochondria, which leads to the damage of the function and structure of the mitochondria and inhibits the mitochondria biosynthesis. Related Articles | Metrics

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The effect of cigarette smoke exposure on ATPase enzyme activity in testis of male rats ZHANG Jing, ZHONG Chunxue, HUANG Yunfei, ZHANG Chen△, HE Lijuan, ZOU Ying 2016, 44 (11):  1343-1346.  doi: 10.11958/20160545 Abstract ( 1085 )   PDF (397KB) ( 3870 )   Objective To explore the effect of cigarette smoke exposure on testis structure and ATPase enzyme activity in testis of rats. Methods Seventy adult male SD rats were randomly divided into the control group (10 rats) and the low, medium, high- dose groups (20 rats in each group, which received the exposure of 10, 20, 30 sticks of cigarettes respectively). The experimental group was exposed to cigarette smoke for 30 min per day. Each dose group was exposed for six weeks and twelve weeks (10 rats each time). The body weights in each group were recorded during the experiment. At the end of the experiment, testes of rats were removed, and the testicular tissue structure was observed by HE staining. Na +-K +- ATPase enzyme and Ca2+-ATPase enzyme activity of testicular tissue of rats were detected by enzyme-linked immunosorbent assay. Results With the increasing of exposure doses, the body weights of rats decreased (P < 0.05). The microstructure changes of testis were observed in the experimental group, and with the increasing of exposure time and exposure dose, the damage was gradually worse. After 6- week exposure, the Na +- K +- ATPase enzyme activity of testicular tissue was significantly lower in high dose group than that of rest of three groups (P < 0.05), and the Ca2 +-ATP enzyme activity was significantly lower than that of the control group (P < 0.05). The activities of Na +-K +-ATPase enzyme and Ca2 +-ATPase enzyme in testicular tissue were significantly decreased in the low, medium and high-dose groups than those of control group after being exposed for 12 weeks (P < 0.05). Conclusion Cigarette smoke exposure can retard the weight gain, cause the testis tissue damaged and decrease the activities of Na+-K +-ATPase enzyme and Ca2+-ATPase enzyme in testis of male rats. Related Articles | Metrics

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The pathogenesis of oxidative stress damage to mitochondrial membrane and electrophysiological dysfunction of ischemia reperfusion injury of hepatocytes in rats JIN Tao1, WANG Xingqiang2, LIU Chao3△ 2016, 44 (11):  1347-1351.  doi: 10.11958/20160500 Abstract ( 830 )   PDF (348KB) ( 3674 )   Objective To explore the pathogenesis of oxidative stress damage to mitochondrial membrane and electrophysiological dysfunction of ischemia reperfusion injury of hepatocytes in rats. Methods Seventy rats were randomly divided into three experimental groups: sham operation (SHAM) group, warm hepatic ischemia/reperfusion (wI/R) group and cold hepatic ischemia/reperfusion (cI/R) group. Blood samples were collected for the detection of alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor- α (TNF-α) and interleukin (IL) -1 β levels. Bile samples were collected for the detection of glucose and γ-glutamyl transferase (GGT) levels. And liver samples were collected for the detection of malondialdehyde (MDA) and superoxide dismutase (SOD). Flow cytometry was used to detect mitochondrial membrane potential. The mitochondrial respiratory chain complex was examined using ELISA to assess ischemia reperfusion injury of hepatocytes in rats. Results The results indicated that ALT, AST, GLU, GGT, TNF-α, IL-1β and MDA levels were increased significantly in the wI/R group and cI/R group than those in SHAM group (P＜0.01), and those indexes were significantly higher in cI/R group than those of wI/R group (P＜0.05). The SOD level was significantly lower in wI/R group and cI/R group than that in SHAM group, which was significantly higher in wI/R group than that of cI/R group (P＜0.01). Compared with SHAM group, ratios of mitochondrial membrane potential were significantly decreased at 0, 1 and 12 h I/R in wI/R group and cI/R group (P＜0.01). The activity of mitochondrial membrane potential was gradually recovered with time in wI/R group and cI/R group (P＜0.01). There were no significant differences in mitochondrial respiratory chain complexes Ⅲ and Ⅳ between 0 h and 72 h in SHAM group. The activity of mitochondrial respiratory chain complexes was increased at 72 h than that of 0 h in wI/R group and cI/R group (P＜0.01). The activity of mitochondrial respiratory chain complexes Ⅲ was decreased ordinally at 0 h and 72 h, and the activity of mitochondrial respiratory chain complexes Ⅳ was increased ordinally in SHAM group, wI/R group and cI/R group (P＜0.01). Conclusion Mitochondrial membrane potential is significantly decreased after ischemia reperfusion injury, and the activity of mitochondrial respiratory chain complexes is significantly decreased as well, which might be the pathogenesis of oxidative stress damage to mitochondrial membrane and electrophysiological dysfunction of ischemia reperfusion injury of hepatocytes in rats. Related Articles | Metrics

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Effects of heat-sensitive moxibustion on the expression of CD11b in cortex of focal cerebral ischemia-reperfusion injury model rats GONG Lili1, ZHANG Hao1, XIE Bin1, OUYANG Xin2, XIAO Aijiao1△ 2016, 44 (11):  1351-1355.  doi: 10.11958/20160554 Abstract ( 813 )   PDF (515KB) ( 3690 )   Objective To observe the effect of heat-sensitive moxibustion on the expression of CD11b in focal cerebral ischemia/reperfusion (I/R) injury model rats. Methods Fifty-one male SD rats were randomly divided into three groups, sham- operated group (n=10), I/R injury group (n=14) and moxibustion group (n=27). According to changes of tail temperature before and after moxibustion, moxibustion group was subdivided into non heat-sensitive moxibustion group (n= 13) and heat- sensitivel moxibustion group (n=14). Focal cerebral ischemia- reperfusion injury was induced by middle cerebral artery occlusion for 2 hours and reperfusion for 3 days. Behavioral performance was tested using neurologic deficit scores. Tail-flick latency was determined with tail flick analgesia meter. Infarct areas were examined using TTC staining, and cortical expression of CD11b was measured using immunohistochemical staining. Results After 3 d of operation, the tail- flick latency was significantly shorter in non heat- sensitive moxibustion group (9.32 ± 1.11) s and heat- sensitive moxibustion group (8.69±0.51) s than that of model group (12.21±1.04) s. The area of cerebral infarction was smaller in non heat-sensitive moxibustion group (20.59±2.25)% and heat-sensitive moxibustion group (13.18±3.50)% than that in model group (32.22 ± 14.20)% . Compared with model group, the expression of CD11b was significantly decreased in non heatsensitive moxibustion group and heat-sensitive moxibustion group (P＜0.05). Conclusion Heat-sensitive moxibustion can reduce the damage of cerebral inchemia-reperfusion, which might be through decreasing expression of CD11b. Related Articles | Metrics

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The intervention effect of diammonium glycyrrhizinate on the formation of basilar artery aneurysm in rabbits GUI Zheng, WANG Ziwen, ZHANG Pengfei, ZHAO Wenke, YU Yaoyu△ 2016, 44 (11):  1356-1358.  doi: 10.11958/20160102 Abstract ( 787 )   PDF (1268KB) ( 3672 )   Objective To explore the mechanism and intervention effects of diammonium glycyrrhizinate (DG) on the formation of intracranial aneurysm (IA) in rabbits. Methods Forty New Zealand rabbits were randomly divided into four groups: control group, IA group, normal saline (NS) group and DG group, 10 rabbits for each group. Except for the control group, rabbits in other three groups were operated with bilateral common carotid artery ligation to produce basilar artery aneurysm formation model. DG group was injected intravenously with DG［20 mg/(kg·d)］ from the first day to the seventh day after operation, NS group was given same volume of normal saline, while IA group was injected nothing. The expressions of NF-κB and MMP-9 were detected by immunohistochemical staining, while α-SMA was stained with immunofluorescence. Results The expressions of NF- κB and MMP- 9 were significantly higher in IA group and NS group than those of control group, while α-SMA expression was significantly lower than that of control group (P < 0.01). There were no significant differences in expressions of NF-κB and MMP-9 between IA group and NS group (P＞ 0.05). The expressions of NF-κB and MMP-9 were significantly lower in DG group than those of IA group and NS group (P＜ 0.05). The expression of α- SMA was significantly higher in DG group than that of IA group and NS group (P＜0.05). Conclusion DG can downregulate the expression levels of NF- κB and MMP- 9 in intracranial aneurysm, suppress inflammatory in artery wall and reduce the pathological changes and have intervention effect on intracranial aneurysm formation. Related Articles | Metrics

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Application of the double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis of low rectal cancer YAN Wei, LI Songming, LI Rui, ZHANG Jiayue, CEN Yanzeng, LENG Jinli, LAI Yanhua, HE Hongyan, YANG Tao△ 2016, 44 (11):  1359-1362.  doi: 10.11958/20160087 Abstract ( 973 )   PDF (577KB) ( 3663 )   Objective To investigate the feasibility and safety of the double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis of low rectal cancer. Methods A total of 650 cases with low rectal cancer treated in our hospital from January 2009 to December 2014 were retrospectively collected and divided into control group (n=220), stoma group (n=205) and drainage group (n=225). The control group was received Dixon (low rectal anterior resection), the stoma group was treated with Dixon and ileostomy, while the drainage group was underwent double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis. The operation time, bleeding volume, the period of anal exhaust after operation and hospital expenses were compared between three groups. Postoperative follow- up was performed, and anastomotic leakage, postoperative infection and other complications were analyzed. Results There were no significant differences in the operation time, bleeding volume and the period of anal exhaust after operation between three groups (P > 0.05). The hospital stay and expenses were shorter and lower in drainage group than those in stoma group (P < 0.05). In addition, there were no significant differences in wound infection, pelvic infection, and pulmonary infection between three groups (P > 0.05). All patients were followed up, and the mortality, the recurrence rate and metastasis rate were not significantly different between three groups (P > 0.05). Conclusion The application of double cavity casing negative pressure drainage is likely to reduce the incidence of anastomotic leakage in Dixon, while the effect needs to be confirmed by large clinical trial， at the same time, patients enjoy shorter hospital stay, fewer suffering and lower expense of hospitalization. Related Articles | Metrics

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Study on local immune status in women with cervical persistent infection of high-risk human papillomavirus ZHANG Ling1,2, SONG Hualin1, QU Pengpeng2△ 2016, 44 (11):  1363-1366.  doi: 10.11958/20160549 Abstract ( 1434 )   PDF (639KB) ( 4600 )   Objective To explore the changes of cervical local cytokines Th1, Th2 and Th17 in the process of high risk human papillomavirus (HR- HPV) persistent infection and their relationship with cervical lesions. Methods A total of seventy married women who were referred to colposcopy clinic in our hospital from November 2015 to January 2016 were included in this research. According to the HR-HPV infection status and pathological results, patients were divided into four groups: the cleared group (n=16), no squamous intraepithelial lesion group (NSIL, n=18), low-grade squamous intraepithelial lesion group (LSIL, n=18) and high-grade squamous intraepithelial lesion group (HSIL, n=18). The NSIL group, LSIL group and HSIL group were merged into the persistent infection group, while the LSIL group and HSIL group were amalgamated into the diseased group. The concentrations of interleukin-2 (IL-2), IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor (TNF) and γ- interferon (IFN- γ) in vaginal douche were measured by BD cytometric bead array. The changes of the above cytokines and the relationship between Th2/Th1 and Th2/Th17 were analyzed according to the severity, persistent status and disease status. Results The levels of IL-6 increased significantly with the severity of disease (P < 0.05), while the levels of IL-2 were decreased significantly in LSIL group and HSIL group compared with those of the cleared group and NSIL group (P < 0.05). The other cytokines showed no significant differences between the four groups (P > 0.05). Compared with the cleared group, the level of IL-6 increased and IL-2 decreased in persistent infection group, which showed a same results in the diseased group compared with NSIL group. The more serious of the diseases, the higher levels in Th2/Th1 and Th2/Th17. Conclusion The persistence of HR-HPV infection and the occurrence of cervical intraepithelial lesion are closely related with the cervical local immune microenvironment. Related Articles | Metrics

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The expression and clinical significance of plasma miR-486 and miR-499 in patients with lung cancer YANG Yang1, 2, YANG Qing3, JIA Youchao2, LI Xiaofang2, YANG Hua2, ZHANG Qian2, PENG Xinyu4, ZANG Aimin2△ 2016, 44 (11):  1367-1370.  doi: 10.11958/20160528 Abstract ( 1026 )   PDF (336KB) ( 3807 )   Objective To explore the expression levels of miR- 486 and miR- 499 in the plasma of lung cancer patients, and analyze their expression differences in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Methods Blood samples were collected in 35 patients with lung cancer (21 NSCLC and 14 SCLC) and 30 healthy persons (control group). The real-time quantitative PCR was used to detect the expression levels of plasma miR-486 and miR-499 in two groups. The plasma levels of miRNA- 486 and miRNA- 499 and their correlation with various clinical features in NSCLC and SCLC patients were analyzed. The receiver operating characteristic curves（ROC）of miRNA expressions were analyzed. The area under a curve（AUC） , threshold and the sensitivity and specificity were calculated. Results The expression levels of miR-486 and miR-499 were significantly lower in NSCLC and SCLC groups than those of the control group（P<0.05). There were no significant differences in the expression of miR- 486 between different clinical features in NSCLC group. For the late cancer TNM staging, the tumor differentiation was lower, and the miR-499 expression level was lower (P<0.05). In SCLC group, for the late cancer staging, there was a lower expression level of miR- 486. There were no significant differences in the expressions of miR- 499 between different clinical features. The miRNA- 486 AUC in the diagnosis of lung cancer was 0.83(95% CI: 0.73- 0.93), the sensitivity and specialty rates were 90.0% and 68.6% respectively, and the best diagnostic value was 1.02. The miRNA-499 AUC in the diagnosis of lung cancer was 0.75 (95% CI: 0.62- 0.88), the sensitivity and specialty rates were 60.0% and 94.3% respectively, and the best diagnostic boundary value was 0.18 for lung cancer. Conclusion The plasma expression levels of miR-499 and miR-486 are down-regulated in lung cancer patients, which suggest a poor prognosis and can be used as potential screening and prognostic indicators for lung cancer. Related Articles | Metrics

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Analysis on the clinical data of breast cancer in women aged 35 years and younger CUI Fang1, LIU Hong1△， LU Su1, YU Chenhua1, SONG Jia2， FANG Zhiyi1 2016, 44 (11):  1371-1376.  doi: 10.11958/20160229 Abstract ( 835 )   PDF (440KB) ( 3663 )   Objective To analyze the clinical and pathological characteristics and prognosis of breast cancer in women aged 35 years and younger. Methods The clinical data of 105 breast cancer patients (≤35 years) who received comprehensive standardized treatment in our hospital in 2008 were retrospectively analyzed. And the clinical data of 103 breast cancer patients aged 65-70 years treated in our hospital during the same year were chosen as control group. Results During the follow- up period, local recurrence and metastasis were found in 25 patients (23.8% ), and dead in 17 cases (16.2%) in young group. In elderly group, local recurrence or metastasis were found in 8 patients (16.2%) and dead in 9 cases (8.7%). Compared with elderly group, the primary tumor diameter was large, the histological grade was high and the mutation rate of P53 was higher in the younger group (P < 0.05). The 5-year disease-free survival rate was lower in the young group than that of the elderly group (76.2% vs. 92.2% , Log- rank χ2=9.799， P=0.002). There was no significant difference in the 5-year overall survival rate between the two groups (83.8% vs. 91.3%, Log-rank χ2=2.758, P=0.097). Cox multivariate analysis showed that tumor diameter and axillary lymph node metastasis were independent prognostic factors influencing 5- year disease- free survival rate in young group. The positive expression of P53 and axillary lymph node metastasis were independent prognostic factors influencing 5-year overall survival rate in young group. Conclusion Our study indicates that the histological grade of breast cancer is higher and the prognosis is even worse in young patients. Therefore, young women with the high risk of breast cancer need to be targeted for prevention and screening strategies to develop individualized treatment programs. Related Articles | Metrics

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Correlation between serum chemokine CXCL16, CD36 and vulnerable carotid plaques with cerebral infarction JI Jiyu, SI Huili, WANG Hong△ 2016, 44 (11):  1377-1380.  doi: 10.11958/20160745 Abstract ( 906 )   PDF (369KB) ( 4092 )   Objective To investigate the relationship between serum chemokine CXCL16 and CD36 in vulnerable carotid atherosclerosis plaques with large artery atherosclerosis (LAA)-stoke. Methods Fifty patients with LAA-cerebral infarction and carotid vulnerable plaque (infarction group), 50 patients with carotid vulnerable plaque (plaque group) and 50 healthy subjects in the same period (control group) were included in this study. The cervical vascular color ultrasonic inspection was performed in three groups. Data of body mass index (BMI) were calculated in three groups. Levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL- C), high density lipoprotein cholesterol (HDL- C) and fasting blood glucose (FBG) were also detected in three groups. The enzyme linked immunosorbent assay (ELISA) was used to detect the serum levels of CXCL16 and CD36 in three groups. Logistic regression analysis was used to analyse the influence factors of LAA-cerebral infarction. Results Levels of BMI, TG, TC, LDL-C and FBG were higher, and the level of HDL-C was lower in infarction group and plaque group than those in control group. Levels of TG, TC, LDLC and FBG were significantly higher in infarction group than those of plaque group, and levels of BMI and HDL-C were significantly lower in infarction group than those in plaque group (P<0.05). Both serum levels of CXCL16 and CD36 showed significantly increased trend in control group, plaque group and infarction group. Multivariate Logistic regression analysis showed that the higher levels of TG, LDL-C, FBG, CXCL16 and CD36 were the independent risk factors for large artery atherosclerotic cerebral infarction. Conclusion Serum chemokine CXCL16 and CD36 can be used as a clinical marker of vulnerable carotid plaques. Joint detection of CXCL16 and CD36 can predict the occurrence of LAA-cerebral infarction. Related Articles | Metrics

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The influence of dialysis frequency and interval on calculation of Kt/V ZHU Huimin1, ZHAO Xinju2, ZUO Li2△ 2016, 44 (11):  1381-1383.  doi: 10.11958/20160381 Abstract ( 1358 )   PDF (365KB) ( 4022 )   Objective To compare the influence of the urea generation factor (GFAC) modification on spKt/V, balanced Kt/V (eKt/V) and standardized Kt/V (stdKt/V), where eKt/V and stdKt/V were estimated from spKt/V. Methods Ninety- five hemodialysis patients who were dialyzed except three times per week or not 2- day preceding interdialysis interval for 3/week from the Peking University People's Hospital were included in this study. The value of spKt/V1 was estimated using GFAC=0.008, and eKt/V1 and stdKt/V1 were estimated. Using modified GFAC, spKt/V2, eKt/V2 and stdKt/ V2 were estimated. The spKt/V1, eKt/V1 and stdKt/V1 were compared with spKt/V2, eKt/V2 and stdKt/V2. Results There were significant differences between spKt/V1 and spKt/V2 (1.538±0.357 vs. 1.504±0.341), eKt/V1 and eKt/V2 (1.525±0.315 vs. 1.495±0.301), stdKt/V1 and stdKt/V2 (2.298±0.230 vs. 2.279±0.230), respectively (P<0.01). Conclusion Using GFAC= 0.008 in equation for patients who were not matched the urea kinetic model could overestimate spKt/V, and hence, using the modified GFAC based on the dialysis schedules and the day of blood drawn can be more accurately to estimate the spKt/V, eKt/V and stdKt/V. Related Articles | Metrics

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The characteristics of herpes simplex virus shedding in 142 cases of subclinical genital herpes ZHANG Jing1, HUANG Xi1, MENG Jian1, WANG Liping2, WEI Jiao1, JIANG Dongxiang1, CHENG Peihua1Δ 2016, 44 (11):  1384-1386.  doi: 10.11958/20160696 Abstract ( 1548 )   PDF (281KB) ( 7500 )   Objective To study the characteristics of shedding herpes simplex virus (HSV) in patients with subclinical genital herpes, and provide basis for clinical therapy. Methods A total of 142 patients with subclinical genital herpes were obtained in our hospital from June 2014 to June 2016. The fluorescent quantitation polymerase chain reaction was used to detect the HSV-DNA, and enzyme linked immunosorbent assay (ELISA) was applied to check the type of serum IgG. The effects of age, gender, antibody types, disease courses and occurrence frequency on the positive rate of HSV DNA shedding were analyzed. Results The positive rate of HSV-DNA in 142 patients was 49.3%, and females showed significantly higher HSV shedding rate than males (P < 0.05). There was no significant difference in HSV shedding rate between patients with serum HSV-Ⅰ IgG++HSV-Ⅱ IgG+ and patients with HSV-Ⅱ IgG+ alone, while both of which showed higher HSV shedding rate than those of patients with HSV- Ⅰ IgG + alone. Patients with short infection period (≤6 years) showed significantly higher HSV shedding rate than patients with longer infection period (>6 years). HSV shedding rate in patients with high frequent occurrence was found to be significantly higher than that in patients with low frequent occurrence (P < 0.05). In patients who showed short infection period (≤6 years), the HSV shedding rate was found significantly higher in frequent patients (recurrence ≥ 6 times/year) than that in few occurrence patients (recurrence < 6 times/year). There was no significant difference in HSV shedding rate in patients with recurrent occurrence when they went through more than 6 years’ HSV infection (P > 0.05). More patients with positive HSV- Ⅱ IgG were found in female than that in male (P < 0.05). Conclusion In patients with subclinical genital herpes, HSV shedding rate is closely related to gender, serum antibody type, disease course and recurrent occurrence. Related Articles | Metrics

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Antimicrobial resistance and virulence gene profiling of Salmonella enterica serovars Braenderup ZHAO Zhan, XIA Linlin, LIU Xiaoxia, YANG Jie, WU Xiaomei, ZHANG Lijuan, JIA Yuchi, WANG Yubao△ 2016, 44 (11):  1387-1390.  doi: 10.11958/20160630 Abstract ( 959 )   PDF (397KB) ( 3610 )   Objective To investigate antimicrobial resistance and virulence gene profiles of clinically isolated nontyphoidal Salmonella enterica serovars Braenderup (S. Braenderup). Methods Clinical date of patients with acute diarrhea from two teaching hospitals in our city were collected from April to October of 2012 to 2014. Salmonella from stool samples was screened by culture, and identified by biochemical, PCR and serotype methods. Isolates of S. Braenderup were examined with antibiotic susceptibilities. PCR amplification was used for representative genes of Salmonella pathogenicity islands (SPI) 1-5 and SPI regulator. Results Among 153 non-repetitive NTS isolates in the three years, 8 isolates (5.23%) of S. Breanderup were identified. All 8 isolates were positive with invA gene. The resistance rate to nalidixic acid was 100%, and the same with the intermediate resistance rate to ciprofloxacin and levofloxacin. But they were susceptible to other antimicrobial agents. The 8 isolates were positive with the representative genes of SPI 1-5 and regulators (sitC, hilA, sseL, sifA, mgtC, siiE, sopB and phoP). Conclusion Clinical isolates of S. Braenderup in Tianjin are resistant to fluoroquinolones and harbored genes of SPI 1-5 and regulator, and which can threaten public health. Continuous surveillance and research should be carried out in our city. Related Articles | Metrics

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Characterization of Mycobacterium tuberculosis isolates from Cangzhou by spoligotyping CAO Xinrui1, LI Yanan2, GAO Huixia2, ZHANG Zhi2, DAI Erhei2△ 2016, 44 (11):  1391-1393.  doi: 10.11958/20160071 Abstract ( 968 )   PDF (389KB) ( 3502 )   Objective To identify the genetic polymorphism and molecular epidemiological characteristics of Mycobacterium tuberculosis (TB) clinical isolates in Cangzhou, and explore the association between genotypes and drug resistance phenotypes. Methods Mycobacterium tuberculosis isolates were collected from TB patients treated in the Cangzhou Infectious Disease Hospital, and corresponding clinical data were also collected. The genomic DNA was extracted. Spacer oligonucleotide typing (spoligotyping) was applied to genotype the isolates. Drug susceptibility testing of first- line anti- TB drugs (streptomycin, isoniazid, rifampin, ethambutol) was performed using the BACTECTMMGITTM960 liquid medium. Cluster analysis was done by BioNumerics 5.0. Data was analyzed by Graphpad Prism 5.0 software. Results Of the 154 patients, 109 were male and 45 were female. And 121 patients were treated for the first time, 33 were retreatment, 34 had smoking history, 12 were complicated with diabetes mellitus. Fourty-eight strains (31.2%) were resistant to at least one of streptomycin, inoniazid, rifampicin and ethambutol. Initial drug resistance rate was 22.3% and acquired drug resistance rate was 63.6%. The drug resistance rate was significantly higher in retreatment patients than that of new cases. The Beijing family strain accounted for 91.6% of all isolates and the non- Beijing family strain accounted for 8.4% . There were no significant differences in gender, treatment history, smoking history and diabetes history between patients with the Beijing genotype and patients with non- Beijing genotype. Conclusion Mycobacterium tuberculosis in Cangzhou exhibits high genetic diversity. The Beijing genotype is the predominant no association with drug resistance. Related Articles | Metrics

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Meta analysis of the efficacy and safety of triple and double antithrombosis strategies in patients with PCI LI Heng, HAN Congcong, REN Taojun, XU Yanmin△ 2016, 44 (11):  1394-1399.  doi: 10.11958/20160694 Abstract ( 1241 )   PDF (697KB) ( 3608 )   Objective To compare the efficacy and safety of double antiplatelet treatment strategy (DAPT, aspirin, clopidogrel) and triple antiplatelet strategy (aspirin, clopidogrel and warfarin) in patients with oral anticoagulants (OAC). Methods PubMed, Cochrane and Embase database were searched, and the information from January 1966 to April 2016 was collected. The efficacy and safety of antithrombotic drugs in patients with OAC were compared. At the same time, supplemented data searched by hand were collected and included into references. RevMan 5.1 software was used in this Meta analysis. The primary endpoint events were all cause mortality, and the secondary endpoints included ischemic stroke, major bleeding events, myocardial infarction and in- stent thrombus formation. Results A total of 16 studies including 7 083 patients (triple antiplatelet treatment 3 330, double antiplatelet treatment 3 753) in this analysis. The median followup period was 1.6 years, and the average age was 73.2 years. Meta analysis showed that there was no significant difference in all cause mortality rate between dual antiplatelet strategy and triple antithrombotic strategy [OR（95%CI) =0.94（0.79-1.13)， P=0.54] , no significant difference in myocardial infarction incidence rate [OR（95%CI） =1.21（0.92-1.59)， P=0.16], and no significant difference in in-stent thrombosis events between dual antiplatelet strategy and triple antithrombotic strategy [OR （95%CI） =1.02（0.55-1.90)， P=0.94]. Compared with dual antiplatelet strategy for patients, the triple antithrombotic strategy can significantly reduce the risk of ischemic stroke [OR（95%CI)=0.44（0.30-0.63)， P＜0.001], and increase major bleeding events [OR（95%CI） =1.31（1.07-1.61)， P=0.008]. Conclusion In review of the application of OAC and DAPT in patients with indications of the anti thrombosis strategy, triple antithrombotic strategy can reduce the risk of stroke, and increase the risk of bleeding. Related Articles | Metrics

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Research advances in pulmonary diseases induced by nanomaterials and their mechanism SUN Xiaoyi, LI Yanbo△, GUO Caixia△ 2016, 44 (11):  1400-1405.  doi: 10.11958/20160580 Abstract ( 1015 )   PDF (399KB) ( 3749 )   With the rapid development of nanotechnology, nanomaterials play an important role in many fields, such as materials, industry, environmental protection, military, medicine and other fields with their unique physical and chemical properties. The production and use of nanomaterials make them inevitablely to enter the ecological system. People can be exposed to nanomaterials through environmental, occupational and medical approaches. Respiratory system is the most important way for nanoparticles to enter the human body. A number of studies have confirmed that nanomaterials can cause damage to lungs by oxidative stress, inflammation, and ion disorders, which can induce granulomatous lesions, pulmonary fibrosis, asthma, chronic obstructive pulmonary disease, and even lung cancer. The relationship between nanomaterial exposure and pulmonary diseases, and also the related mechanism in pulmonary toxicity of nanomaterials have been reviewed in this paper. Related Articles | Metrics

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Research progress in the disease-related EPCR gene polymorphisms LIANG Yanbing1, QIN Yueqiu2, LIAO Pinhu1△ 2016, 44 (11):  1405-1408.  doi: 10.11958/20160849 Abstract ( 1379 )   PDF (318KB) ( 4122 )   As an important part of the protein C anticoagulant system, endothelial protein C receptor (EPCR) plays a critical role in the process of anti- coagulation and anti- inflammation. The presence of EPCR single nucleotide polymorphism (SNP) affects the levels of soluble endothelial protein C receptor (sEPCR), and susceptibility to varieties of diseases. This article reviews the relationship between EPCR gene polymorphisms and thrombotic diseases， malaria， sepsis and other diseases. Related Articles | Metrics