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15 April 2017, Volume 45 Issue 4 Previous Issue    Next Issue

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The progress of clinical precision medicine in castration-resistant prostate cancer WANG Hai-tao△ 2017, 45 (4):  337-341.  doi: 10.11958/20161460 Abstract ( 1199 )   PDF (397KB) ( 4044 )   Most prostate cancer (PCa) patients in China are diagnosed at an advanced stage. Many PCa patients are initially sensitive to hormonal therapy and experience temporary tumor regression, but nearly all of the patients finally reach a state of castration- resistant prostate cancer (CRPC). CRPC is difficult to cure and thus has poor prognosis. The identification of new therapies to treat CRPC remains an urgent need. Precision medicine is to develop the most appropriate individualized treatment for each patient based on the level of individual differences. Genomic, proteomics, metabolomics data, and other big data analysis methods are the essence of precision medicine. Precision medicine brings the hope to overcome cancer. In this review, we summarize the connotation of precision medicine in CRPC, the application of second generation sequencing and genome sequencing, and clinical molecular targeted therapy of CRPC as well as discuss clinical precision medicine for CRPC. Related Articles | Metrics

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The protective effects of dipeptidyl peptidase-4 inhibitor on AD-like neurodegenerative changes CHEN Shu-yi1, GUO Ai1, CHEN Yan-lin1, FU Rong-xia2, ZHAO Gang3, PENG Peng1, SONG Qi-jun1, DENG Yan-qiu1△ 2017, 45 (4):  342-348.  doi: 10.11958/20161595 Abstract ( 934 )   PDF (2027KB) ( 3600 )   Objective To explore the protective effects of dipeptidyl peptidase- 4 inhibitor (DPP- 4I) on AD- like neurodegenerative changes and its mechanism. Methods The human neuroblastoma cell line SH-SY5Y on the logarithmic phase was divided into six groups: control group (CON group, treated with PBS contained 1‰ DMSO for 12 h), wortmannin intervention group (W group, treated with 0.03 μmol/L wortmannin for 12 h), DPP-4I intervention group (DPP-4I group, treated with 10 μmol/L DPP-4I for 12 h), both DPP-4I and wortmannin intervention group (DPP-4I+W group, pre-treated with 10 μmol/L DPP-4I for 2 h, then 0.03 μmol/L wortmannin for 12 h), DPP-4I, wortmannin and Ex9-39 intervention group (DPP-4I+W+Ex9-39 group, pre-treated with 10 μmol/L Ex9-39 for 2 h, then 10 μmol/L DPP-4I for 2 h followed by 0.03 μmol/L wortmannin for 12 h), and Ex9-39 intervention group (Ex9-39 group, treated with 10 μmol/L Ex9-39 for 12 h). MTT assay was used to detect the cell vitality. Western blot assay was used to detect the level of total tau protein (tau-5) and phosphorylated tau at different sites (pSpS199/202, pT231 and pS396), the level of phosphorylated neurofilaments (NF-H, NF- M) and phosphorylation of critical enzyme in PI3K/Akt/GSK- 3β signaling pathway. Results (1) The cell vitality decreased, the levels of pSpS199/202, pT231, pS396 and NF-H/M increased significantly in W group than those in CON group. However, comparing with CON group, the above mentioned parameters reversed in DPP-4I group. Comparing with W group, the cell vitality increased and phosphorylated levels of above mentioned indices were decreased in DPP-4I+W group. (2) The cell vitality showed a decline trend while the levels of phosphorylation tau at three different sites and NF-H/M were higher in Ex9-39 group than those in CON group. Comparing with DPP-4I+W group, the results of the phosphorylated levels showed the same changes in DPP- 4I + W + Ex9- 39 group. (3) Comparing with CON group, the expression levels of phosphorylated PI3K, Akt and GSK3β increased significantly in DPP- 4I group, while those decreased in W group. Additionally, the expression levels of phosphorylated PI3K, Akt and GSK3β were significantly increased in DPP- 4I + W group than those in W group. Conclusion DPP-4I can enhance the level of GLP-1 and activate PI3K/Akt/GSK-3β insulin signaling pathway to improve the hyperphosphorylated tau and NFs induced by wortmannin, and to protect AD- like neurodegeneration. Related Articles | Metrics

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Preparation of ROS responsive nano prodrug and its anti-tumor activity in vitro HUANG Fan#, GAO Yang#, YANG Li-jun, REN Chun-hua, CHU Li-ping, ZHANG Yu-min△ 2017, 45 (4):  349-354.  doi: 10.11958/20170288 Abstract ( 702 )   PDF (1581KB) ( 4162 )   Objective To design and synthesize a novel paclitaxel loaded nanoparticle with reactive oxygen species (ROS) response, and characterize its structure, and investigate its stability, in vitro drug responsive release, cellular uptake and in vitro antitumor activity. Methods The PEG- 2S- PTX monomer was synthesized by coupling the hydrophilic polyethylene glycol (PEG) with hydrophobic paclitaxel (PTX) via a thioether chain (2S), and the prodrug nanoparticles (PEG- 2S-PTX NPs) were prepared by self-assembly. Meanwhile, using succinic anhydride (SA) as the linking group to synthesize the PEG-SA-PTX monomer and prepare the other prodrug nanoparticles (PEG-SA-PTX NPs) as control. The structures of PEG-2S-PTX and PEG-SA-PTX monomer were confirmed by 1H-NMR. The diameter and stability of the nanoparticles were detected by dynamic light scattering (DLS). The PTX release kinetics under oxidizing condition was detected by high performance liquid chromatography (HPLC) method. And the cellular uptake efficiency of nanoparticles by MCF-7 cells was observed by fluorescence microscope. The in vitro antitumor effects of nanoparticles were compared by MTT assay. Results PEG-2S-PTX and PEG-SA-PTX could both be self-assemble into nanoparticles with the diameter of (92.15±12.42) nm and (113.20±12.16) nm. PEG-2S-PTX NPs could rapidly release PTX under oxidative condition while PEG-SA-PTX NPs only showed weak responsiveness. PEG-2S-PTX NPs could be more rapidly taken up by MCF-7 cells compared with PEG-SA-PTX NPs. They both showed concentration dependent anti-tumor effects, but the cytotoxicity of PEG-2S-PTX NPs was stronger than that of PEG-SA-PTX NPs in the concentrations of 0.05, 0.1, 5, 10, 50 and 100 mg/L (P＜0.05). Conclusion As paclitaxel prodrug nanoparticles with ROS responsive ability, PEG-2S-PTX NPs can rapidly release PTX in response to ROS in tumor cells, and exhibit great anti-tumor activity in vitro. Related Articles | Metrics

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Gene expression profiling and functional analysis of cerebral artery after experimental subarachnoid hemorrhage GAN Ning1, PAN Qin1, LIU Si-si1, REN Ke2, ZHOU Shuai3, DONG Hai-qing1, SONG Zhao-yan1, WANG Yi3△ 2017, 45 (4):  355-358.  doi: 10.11958/20170062 Abstract ( 832 )   PDF (412KB) ( 3527 )   Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondaryblood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5- day were used to validate the parts of differentially expressed genes by qRT- PCR. Results A total of 4 356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P- value＜0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2 + transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP- PKG signaling pathway, HIF- 1 signaling pathway, PI3K- Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT- PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS. Related Articles | Metrics

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Comparative study of in vitro anti-tumor activities of three different extracts of Pedicellus Melo WANG Lu1,2, TAO Zun-wei3△ 2017, 45 (4):  359-363.  doi: 10.11958/20170106 Abstract ( 836 )   PDF (567KB) ( 3658 )   Objective To study the antitumor effects of three different extracts from Pedicellus Melo on the proliferation of cancer cells in vitro, and discuss the possible mechanism. Methods Pedicellus Melo was extracted by water, 75% ethanol and 95% ethanol, respectively. The anti-cancer activities in vitro were detected by MTT assay on five tumor cell lines SGC- 7901, NCI-H460, SMMC-7721, K562 and L929 cells. Flow cytometry was used to detect the cell cycle and apoptosis of different cell groups. Results After 72-hour treatment with water, 75% ethanol and 95% ethanol extracts, inhibitory effects were found in five tumor cell lines, which showed dose-dependent manner on the proliferation of the cells. The IC50 values were significantly lower in the two ethanol extracts than those of water extract (P＜0.05) . And the IC50 values of 95% ethanol extract on SGC-7901, SMMC-7721, K562 and L929 cells were significantly lower than those of 75% ethanol extract (P ＜0.05). All the extracts were sensitive to SGC- 7901 cells. Apoptotic rates of SGC- 7901 cells treated with 95% ethanol extract of the concentrations of 0.4, 0.6 and 0.8 mg/L for 48 hours were (8.32±0.55)%, (11.06± 1.15)% and (12.25±1.51)%. The cell cycle was arrested in S and G2/M phases. Conclusion Results demonstrate that 95% ethanol extract of Pedicellus Melo has significant inhibitory effect on SGC-7901 cells in vitro, which may be related to the induced apoptosis and the inhibition of cell division. Related Articles | Metrics

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Effects of delayed mild hypothermia based on different time windows on the expressions of Bcl-2, Bax and Caspase-3 after traumatic brain injury in rats ZHAO Wan-yong, LI Xiao-hong, WANG Jing-jing, XU Chao, WANG Li-na, CHEN Jiang-long, ZHANG Sai, SUN Hong-tao△ 2017, 45 (4):  364-367.  doi: 10.11958/20170055 Abstract ( 686 )   PDF (842KB) ( 3668 )   Objective To explore the effects of delayed mild hypothermia (MHT) in different time windows on the expressions of Bcl-2, Bax and Caspase-3 in brain tissue of model rats with traumatic brain injury (TBI). Methods Thirtysix clean adult male SD rats were randomly divided into NT group (normal temperature), MHT 15 min group, MHT 2 h group and MHT 4 h group. TBI rat model was established by electronical controlled cortical injury device. The rats in the NT group were treated with normothermia (37 ℃) and the rats in the three hypothermia groups were implemented with low temperature (33.0±1.0) ℃ at 15 min, 2 h and 4 h for 6 h respectively after establishment of TBI model. The modified neurological senerity scores (mNSS), morphological changes in hippocampal CA1 areas, immunohistochemical staining and Western blot assay for Bcl-2, Bax and Caspase-3 were compared 3 days after TBI between the four groups. Results The neurological behavioral deficits were found in each group. Compared with the NT group, the mNSS were decreased in the three hypothermia groups (P < 0.01). The results of HE staining showed that the structure of neurons was regular and arranged neatly, and the number of neurons decreased with alleviated nuclear fragmentation and dissolution in hypothermia groups. Compared with the NT group, the expression of Bcl- 2 was upregulated, and the expressions of Bax and Caspase- 3 were downregulated in three hypothermia groups (P < 0.05). The above experimental results were superior in MHT15 min group to MHT 2 h group, and the therapeutic effect in MHT 2 h group was similar to MHT 4 h group. Conclusion The proper delayed mild hypothermia treatment could inhibit neuronal apoptosis and alleviate brain damage. Related Articles | Metrics

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The therapeutic effect of micheliolide on peritoneal effusion of H22 ascites tumor model mice HAN You-ming1,2, JIA Yong-sheng1, TONG Zhong-sheng1△ 2017, 45 (4):  368-371.  doi: 10.11958/20161384 Abstract ( 1137 )   PDF (902KB) ( 3763 )   Objective To investigate the therapeutic effect and mechanism of micheliolide (MCL) on peritoneal effusion in model mice with ascites tumor. Methods H22 ascites mouse model was established by i.p. injecting H22 cells (0.2 mL, about 2×107 cells) in 40 BALB/C mice. Mice were randomly divided into MCL group (n=20, 50 mg/kg MCL once a day for 7 days) and model group (n=20, 0.1 mL/d normal saline once a day for 7 days). The daily data of bodyweights, abdominal circumference and behavior of the mice were observed and recorded. Thirteen mice were sacrificed at 24 hours after the last administration, and tumor markers (CA199, CEA, serum ferritin, CA242, AFP) were detected by ELISA. HE staining was performed to observe the pathological changes of liver and ascites. The flow cytometry was used to detect the apoptosis of ascitic tumor cells in two groups. Results The bodyweights and abdominal circumference were decreased significantly in MCL group than those in model group from the day four of experiment (P < 0.05). Compared with the model group, the levels of CEA, CA242 and AFP were decreased in MCL group, while the serum ferritin was increased. At the same time, the degree of diffuse edema of hepatocytes in the lobules and ascitic tumor cells was decreased in MCL group than that in model group, but the apoptotic rate of ascitic tumor cells was elevated obviously in MCL group（P < 0.05） . Conclusion MCL has a significant inhibitory effect on H22 ascites tumor bearing mice, and the mechanism is mainly through the induction of apoptosis of liver cancer cells. Related Articles | Metrics

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The effect of brain natriuretic peptide on serum angiotensin-converting enzyme 2 levels in acute heart failure patients with reduced ejection fraction YAN Jie, ZHAO Hong, LIU Yan-jun, SU Peng-yu 2017, 45 (4):  372-376.  doi: 10.11958/20161435 Abstract ( 1108 )   PDF (370KB) ( 4448 )   Objective To investigate the effect of brain natriuretic peptide (BNP) on serum angiotensin- converting enzyme (ACE) 2 levels in acute heart failure patients with reduced ejection fraction (HFrEF). Methods A total of 106 patients with acute HFrEF were selected, and were divided randomly into control group and trial group. The control group was under routine treatment, while the trial group was under routine treatment combined with lyophiluzed recombinant human BNP for 24-hour. Cardiac functional parameters were measured by echocardiography both at the enrollment and the end of 7-day treatment. Serum levels of ACE2 and N-terminal pro-BNP (NT-proBNP) were determined using commercially available ELISA kits at the enrollment, the end of 24- hour treatment, and the end of 7- day treatment， respectively. Results A total of 103 patients with acute HFrEF were enrolled (control group=51, trial group=52). There were no significant differences in the use of drugs (e.g., aspirin) and serum biochemical indices (e.g. cardiac troponin I, creatinine) before treatment between these two groups. Compared to systolic blood pressure (SBP) at admission, SBP on the second day after treatment were significantly decreased in two groups (P ＜ 0.05). Compared to left ventricular ejection fraction (LVEF) at admission, LVEF values were significantly elevated on the seventh day after treatment in two groups (P ＜ 0.05). There were no significant differences in SBP, diastolic blood pressure (DBP), and LVEF at admission between these two groups (P ＞ 0.05); there were also no significant differences in DBP on the second day after treatment, and LVEF on the seventh day after treatment (P ＞ 0.05), while SBP was significantly higher on the second day after treatment in control group than that of trial group (P ＜ 0.05). Serum levels of NT- proBNP were decreased with the prolongation of time in two groups. Serum levels of ACE2 were decreased with the prolongation of time in control group, while were increased initially following decreased (which were still higher on the seventh day after treatment than that at admission) with the prolongation of time in trial group. Serum levels of NT-proBNP were higher after 2 days treatment or 7 days of treatment in control group than those of trial group, while serum levels of ACE2 were decreased after 2 days of treatment or 7 days of treatment in control group than those of trial group (P ＜ 0.05). Conclusion Patients with acute HFrEF may benefit from BNP by increasing serum ACE2 levels. Related Articles | Metrics

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Prediction of prognosis in patients with advanced stage of NSCLC by combined plasma fibrinogen and D-dimer levels before treatment SHI Bo-wen, YUE Dong-sheng, SUN Bing-sheng, ZHANG Yu, LI Chen-guang, WANG Chang-li△ 2017, 45 (4):  376-380.  doi: 10.11958/20161482 Abstract ( 1023 )   PDF (424KB) ( 3997 )   Objective To retrospectively analyze the relationship between progression free survival (PFS) and overall survival (OS) in patients with non small cell lung cancer (NSCLC), and to detect the influence of plasma fibrinogen and D-dimer levels before treatment in the prognosis of advanced stage (stage ⅢB-Ⅳ) of NSCLC. Methods The study comprised 134 NSCLC patients with clear pathological diagnosis. All patients were grouped by plasma fibrinogen and D-dimer levels before treatment. We set the normal values of fibrinogen as ≤4 g/L and D-dimer as ≤500 μg/L（FEU). Patients with normal levels of fibrinogen and D- dimer were grouped into low risk group, patients with elevated fibrinogen or D- dimer were grouped into median risk group, and patients with both elevated values were grouped into high risk group. Chi-square test and one way ANOVA analysis were used to analyze the clinicopathologic features of different groups. The OS and PFS in different groups were analyzed by Kaplan- Meier analysis. Univariate analysis of PFS and OS were conducted. Then multivariate analysis was conducted with the Cox regression model in three groups. Results The clinicopathologic features showed no differences between different groups. There were significant differences in OS and PFS between high risk group and other groups. In the survival curves, the high risk group showed poor prognosis. The result of multivariate analysis showed that clinical stage (OS:RR=1.846, 95%CI 1.150-2.964， P=0.011; PFS:RR=1.762, 95%CI 1.190-2.609, P=0.005） and grouped by fibrinogen and D- dimer (OS:RR=1.415， 95% CI 1.050- 1.908， P=0.023； PFS： RR=1.373， 95% CI 1.070- 1.761， P=0.013) were prognostic factors for patients with NSCLC. Conclusion The plasma fibrinogen and D-dimer levels before treatment are closely related with the prognosis of NSCLC patients. And a high plasma fibrinogen and D-dimer levels before treatment are associated with poor prognosis in advanced stage of NSCLC patients. Related Articles | Metrics

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Retrospective study on rick factors of postoperative recurrence of primary spontaneous pneumothorax in 1 128 patients at a single center SHI Zhen-liang1, ZHANG Xun1, LI Yue-chuan2△ 2017, 45 (4):  381-384.  doi: 10.11958/20170010 Abstract ( 869 )   PDF (327KB) ( 3952 )   Objective To analyze rick factors for postoperative recurrence of spontaneous pneumothorax surgery. Methods The clinic characteristics of 1 128 patients who received spontaneous pneumothorax surgery in Tianjin Chest Hospital were collected from January 2009 to March 2015. The relationship between clinic characteristics and the pulmonary bullae was analyzed. Logistic regression analysis was used to assess factors affecting the postoperative relapse of spontaneous pneumothorax. Results The pulmonary bullae were found in 877 patients of 1 128 during the operation. The incidence of pulmonary bullae was significantly high in patients with age below 25 years compared with patients over 25 years (P＜0.05). The duration of surgery was significantly longer in patients with pulmonary bullae compared with that of patients without pulmonary bullae (P＜0.05). Postoperative recurrence occurred in 21 cases, with a recurrence rate of 1.86% . Logistic regression analysis showed that pulmonary bullae, pleurodesis without pleura friction, delayed drainage duration (＞ 3 d) were independent risk factors of postoperative recurrence for spontaneous pneumothorax (P＜0.05). Conclusion Pulmonary bullae, pleurodesis without pleura friction and delayed drainage duration are risk factors of postoperative recurrence for spontaneous pneumothorax, which should be paid more attention in clinic. Related Articles | Metrics

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Clinical analysis of 57 patients with popliteal venous entrapment syndrome WANG Guo-hua1, CHEN Xue-ming2, CHEN Zhi-nian1△, XIAO Ying1, ZHANG Jun-jing3 2017, 45 (4):  385-388.  doi: 10.11958/20160766 Abstract ( 1075 )   PDF (712KB) ( 3988 )   Objective To summarize the experience in diagnosis and treatment of popliteal vein entrapment syndrome (PVES). Methods A total of 57 patients with PVES were selected from the Department of Vascular Surgery in Xinxiang Central Hospital from March 2009 to October 2015. Of which 43 patients were severe stenosis of popliteal vein (stenosis degree >90%), and another 14 cases were with stenosis less than 90%. All the patients underwent ascending venography of low limb to confirm the clinical classification after admission. Forty-three cases with severe stenosis of the popliteal vein were treated with releasing popliteal vein of entrapment and stripping varicose veins. The static pressure and dynamic pressure of popliteal vein and foot dorsal vein were measured before and after operation. Another 14 patients were treated with medical circulation driven sock and medical therapy. Results The degrees of popliteal vein stenosis were more than 75% in all patients. The patients were divided into bove- knee stenosis (n=9), knee stenosis (n=18), and below- knee stenosis (n=30) according to the different parts of stenosis. Forty- three patients treated with surgery showed relief of leg swelling and pain, and ulcer healing. And the imaging examination showed that there were no obvious compression and stenosis of popliteal vein, and vascular filling was well. The static pressure and dynamic pressure of the popliteal vein and dorsal vein were lower than those before surgery (P < 0.05). The lower limb swelling and pain were relieved, and varicose veins of lower limbs were no longer continued to increase in 14 patients with conservative treatment. Conclusion PVES is easy to be misdiagnosed, which should be paid attention to, and satisfactory clinical results can be achieved by releasing popliteal vein of compression combined with stripping varicose veins in patients with serious symptoms ． Related Articles | Metrics

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The expression and its clinical significance of PLK1 in castration-resistant prostate cancer WANG Li-li1, WANG Hai-tao2△, HUO Bin2, LI Xin1, WANG Hao2, HOU Ding-kun2 2017, 45 (4):  389-392.  doi: 10.11958/20161446 Abstract ( 921 )   PDF (439KB) ( 5255 )   Objective To study the relationship between the expression level of PLK1 in castration-resistant prostate cancer (CRPC) tissues, and its relationship with pathological features. Methods Forty-four CRPC specimens including 28 samples from patients with prostate adenocarcinoma, 14 samples from patients with neuroendocrine prostate cancer (NEPC) and 2 samples from patients with other types of prostate cancer, and 10 normal prostatic hyperplasia specimens were collected from January 2010 to September 2016 in the Second Hospital of Tianjin Medical University. The expression levels of PLK1 in these tissues were detected by S- P immunohistochemistry. The relationship between PLK1 expression and pathologic factors was discussed. Results The positive expression of PLK1 was located in cytoplasm of carcinoma cells, and no express of PLK1 was found in benign prostatic hyperplasia tissues. The expression levels of PLK1 showed no significantly differences between different groups of age, local tumor invasion and regional nodal status, and the level of prostate-specific antigen (PSA, P＞0.05). The expression level of PLK1 in patients with Gleason score >8 was higher than that in patients with Gleason score≤8. The PLK1 expression level was positively correlated with Gleason score (rs=0.441， P＜ 0.05). Conclusion PLK1 protein is over-expressed in CRPC tissues, which can reflect the proliferation and differentiation of cancer cells and may be a potential marker of CRPC. Related Articles | Metrics

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The study of the theta oscillation characteristic for working memory in frontal lobe epilepsy ZHU Jing, LI Hua-juan, SONG Yi-jun△ 2017, 45 (4):  393-397.  doi: 10.11958/20170123 Abstract ( 1023 )   PDF (669KB) ( 3947 )   Objective To investigate the characteristic of theta oscillation in patients with frontal lobe epilepsy (FLE) by the analysis of multi-channel electroencephalographs (EEGs) during rest state and working memory(WM) maintenance. Methods The 19 FLE patients and 17 healthy subjects underwent EEG recording with 34-channel EEG machine during visual working memory task performance. The differences of behavioral results were analyzed between FLE group and controls. Short-time Fourier transform was used to calculate the power spectral density of different frequency bands in 34 channels. The theta power values during the retention period of working memory and rest state were compared between two groups. Results Compared with controls, reaction time of FLE increased significantly (P < 0.01) and accuracy decreased (P < 0.05). The power spectral density of theta band for FLE increased both in Fz and frontal region during rest state (P < 0.01). Compared with controls, the power spectral density of theta oscillation decreased significantly in the frontal region for FLE during WM maintenance. Conclusion Our results suggest that working memory in patients with FLE was impaired. The absence of theta oscillation during the WM delayde period may provide a possible neural mechanism for the working memory dysfunction in FLE. Related Articles | Metrics

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Morphological features of normal aortic arch LIU Hai-bing1, WANG Zan-xin2, WEI Min-xin2△ 2017, 45 (4):  397-401.  doi: 10.11958/20170213 Abstract ( 1219 )   PDF (518KB) ( 3938 )   Objective To retrospective study the morphological features of normal aortic arch in population of Tianjin area by computed tomography angiography (CTA). Methods From Jan 2016 to Dec 2016, 142 volunteers undergoing thoracic aorta CTA in our institution were retrospectively reviewed. In each patient, 10 measurements were made in GE AW4.6 workstation, including diameters, distances, and angles of branch vessels of aortic arch. SPSS statistical software was used to analyze data. Results The diameter of the origin of brachiocephalic trunk (BCT) D1 was (15.2 ± 3.0) mm, left common carotid artery (LCCA) D2 was (11.8±2.2) mm and left subclavian artery (LSA) D3 was (13.6±1.9) mm. The distance between the BCT and the LCCA (E1) was (4.0±2.5) mm, between the LCCA and the LSA (E2) was (8.2±3.7) mm. The angle between the BCT and arch (α) was 29.5°±14.4°, between the LCCA and arch (β) was 40.3°±17.5°, between the LSA and arch γ was 57.9°±21.6°. The angle formed by BCT, LCCA, and LSA(Φ) was 144.1°±10.1°. The distance between center of LCCA ostia and line between center of ostia of BCT and LSA (L) was (4.5±1.2 )mm. Values of D2 and D3 were larger in male than that in female. In the three age groups of 19-40 y, 41-60 y and ≥61 y, values of D1 increased gradually, while α and γ decreased gradually. When in the two age groups of 41-60 y and ≥61 y, values of D2, D3, E2 and L were significantly larger than those in the age group of 19-40 y, while Φ was smaller (P＜0.05). Conclusion The data obtained by this study on the diameter and angle of branching vessels arising from the normal aortic arch may provide support for various studies of endovascular repair of aortic arch. Related Articles | Metrics

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Expression and clinical significance of MST1 in cervical cancer ZHENG Xiao-ying1, HAO Yun-tao2, ZHAO Shu-min1△, LIU Mei-na3, LIANG Xiu-jun1 2017, 45 (4):  402-405.  doi: 10.11958/20170063 Abstract ( 1265 )   PDF (594KB) ( 4526 )   Objective To investigate the expression and clinical significance of mammalian sterile 20-like kinase 1 (MST1) in cervical cancer. Methods Immunohistochemical method was applied to detect the expression level of MST1 protein in specimens of cervical cancer tissues (n=139) and pericarcinomatous tissues (n=20, with ≥4 cm distance from the primary tumor’ s edge). Western blot assay and qPCR were used to detect the protein and mRNA transcription expression levels of MST1 in 20 pairs of cervical cancer tissues and pericarcinomatous tissues, respectively. The correlation between MST1 expression, clinic pathological features and the prognosis were analyzed. Results MST1 was mainly expressed in cytoplasm. The positive expression rate of MST1 was significantly lower in cervical cancer tissues (27%, 38/139) than that in pericarcinomatous tissues (80%, 16/20, χ2=21.62, P < 0.01). The expressions levels of MST1 protein and mRNA were both lower in the cervical cancer tissues (P < 0.01). In cervical cancer, the positive expression rate of MST1 in Ⅰb+Ⅱa stage was higher than that of Ⅱb+Ⅳ stage (P < 0.05), the positive expression rate of MST1 in lymph node metastasis was lower than that of without lymph node metastasis (P < 0.05). Values of age, tumor size, histological type and differentiation degree showed no significant difference to positive expression rate of MST1. Moreover, the negative expression of MST1 displayed a significantly poorer overall survival time than that of positive expression of MST1 (Log- rank χ2=28.35, P < 0.01). Conclusion MST1 shows a lower expression in cervical cancer, which may be a new target for clinical treatment and prognosis of cervical cancer. Related Articles | Metrics

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Twenty cases of bronchial foreign bodies that are easily misdiagnosed as lung cancer ZHAO Yong， LI Guan-hua， ZHAO Xiao-yun， LI Yue-chuan△ 2017, 45 (4):  406-408.  doi: 10.11958/20161477 Abstract ( 920 )   PDF (748KB) ( 3604 )   Objective To analyze the clinical data of 20 young and middle-aged patients with bronchial foreign bodies who were hospitalized because of unknown lung shadow. Methods The clinical data of 20 confirmed cases, including history of aspiration, imaging examination results, bronchoscopy findings and therapeutic process were retrospectively analyzed. The outcome of bronchial foreign body granuloma in the airway was observed. Results ⑴100% of the 20 patients with an average age of (46.39±3.26) years were misdiagnosed before bronchoscope examination. (2) The results of chest CT showed that the 20 patients had bronchial stenosis or obstruction with pulmonary consolidation or atelectasis, of which 18 cases were on the right side and 2 on the left side. (3) According to the shape and size of the foreign bodies as well as the length of time of aspiration, the bronchial openings were blocked by foreign bodies in 10 patients, and the foreign bodies were taken out by foreign body forceps. The diagnosis was confirmed in 3-6 (average 4.40±0.92) months in 10 patients. Four patients were obstructed by foreign bodies and granulation tissue, which took 5-12 (average 8.25±2.86) months to diagnose, while in 6 cases, masses were found in tracheal cavity, which took 6-15 (average 10.17±2.85) months to diagnose. The latter 10 (4+6) patients were treated with endotracheal intubation to remove foreign bodies and granulation tissue. (4) After 24-72 hours of treatment, the symptoms of cough, expectoration and blood in the sputum were relieved, and no severe complications occurred in 20 patients. (5) About two weeks after bronchial foreign bodies were removed, the granulation tissue disappeared. Conclusion Foreign body aspiration on the right side is more common in the 20 young and middle-aged patients, and bronchoscope is the best means of diagnosis and treatment. Related Articles | Metrics

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The design and clinical application of cervical canal enlargement preserving posterior ligament composite with mobile microendoscopic discectomy technique XU Bao-shan, MA Xin-long, YANG Qiang, LIU Yue, JIANG Hong-feng, XU Hai-wei, JI Ning 2017, 45 (4):  409-412.  doi: 10.11958/20170180 Abstract ( 933 )   PDF (1046KB) ( 3475 )   Objective To provide a minimally invasive surgical treatment using mobile microendoscopy (mobile MED) for limited cervical spine canal stenosis. Methods Eleven patients were collected from February 2015 to February 2016 in Tianjin Hospital, including 6 males and 5 females, aged 51 - 77 years, mean (67.4 ± 7.6) years. Clinical treatment was performed on 11 patients of limited cervical spinal stenosis. The levels of stenosis included C3- 5 in 5 cases, C4- 6 in 4 cases, C5-7 in 2 cases. The working channel of mobile MED (MMED) can be tilted according to the need of operation. The design of surgical methods: the levels of stenosis were located with fluroscopy, through a posterior median 2.5 cm incision, the nachal ligaments was separated and the spinous process was reached. After a little dissection of paraspinal mascle, the working canal was inserted along the spinous process, and the target lamina was exposed. With MMED, the partial laminectomy was performed along the junction groove of lamina and articular process with high-speed burr, and flavum was exposed and resected with ultra-thin Kerisson, and the dural sac was well exposed. Then the working canal was inserted on the contralateral side along the spinous process, and the decompression was performed with the same method. After bilateral direct decompression, the spinous process and posterior ligament complex shift posteriorly with enlargement of spinal canal. The operation time and blood loss were recorded and the efficacy was followed- up. Results There was no serious complications such as neurological injury. The operation time ranged 80-120 min, with an average of (100±18) min. The intraoperative blood loss ranged (50- 120) mL, with an average of (80 ± 20) mL. Postoperative CT showed sufficient decompression and enlargement of the canal with the posterior shift of the spinous process and posterior ligament complex. The patients were followed up for 6-18 months. The alignment of cervical spine was well preserved on X-ray. The ODI decreased from 42.2±16.3 preoperatively to 6.2±4.3. The JOA score improved from 8.2 ± 3.3 preoperatively to 15.1±4.2 at the last follow-up. According to the improvement rate [(JOA-preoperative JOA) / (17-preoperative JOA)], the results were excellent in 5 cases, good in 5 cases, and effective in 1 case. Conclusion The cervical canal enlargement with mobile microendoscopic discectomy technique preserving posterior ligament composite provides a minimally invasive procedure for limited cervical stenosis with adequate decompression. Related Articles | Metrics

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alues of different scores for diagnosing short-term prognosis of HBV-related acute-on-chronic liver failure CHEN Chen1,2,3,4, LI Jia2,4, ZHOU Li2,4, LU Wei1,3,4△ 2017, 45 (4):  413-417.  doi: 10.11958/20161038 Abstract ( 926 )   PDF (399KB) ( 3781 )   Objective To investigate the diagnostic values of model of end-stage with incorporation of serum sodium (MELD- Na) score, chronic liver failure- sequential organ failure assessment (CLIF- SOFA) score and APASL- ACLF research consortium score (AARC- ACLF) for evaluation of prognosis of hepatitis B virus related acute- on- chronic liver failure (HBV- ACLF). Methods A total of 72 consecutive patients with HBV- ACLF were included in the study and divided into two groups (group A and group B) according to the prognosis in three-month. Group A were included 29 patients with stable disease or better after medical treatment at least for 3 months, and group B included 43 patients who were dead after treatment or received liver transplantation as failure of medical treatment. When the patients were diagnosed as ACLF or after admission, the data were collected. Results of the laboratory examination were collected when the international normalized ratio (INR) was minimum. Data of total bilirubin (TBIL), prothrombin time (PT), INR, serum creatinine (Cr), serum sodium (Na), albumin (ALB), MELD-Na, CLIF-SOFA and AARC-ACLF scores were calculated respectively. The comparative analysis was performed. Areas under the receiver operating characteristic curve (AUC-ROC) of MELD-Na and CLIF-SOFA scores were used to assess the short-term prognosis in patients with acute-on-chronic liver failure. Results The values of TBIL, INR, MELD-Na, AARC-ACLF and CLIF-SOFA were significantly higher in group B than those in group A (P＜0.05). The serum level of Na was significantly lower in group B than that of group A (P＜0.05). The area under curve (AUC) values generated by the ROC curves was higher for CLIF-SOFA score (AUC 0.887) than that of MELD-Na score (AUC 0.764) (Z=2.255, P＜0.016 7). The AUC values generated by the ROC curves showed no significant differences between CLIF-SOFA score and AARC-ACLF score (AUC 0.825) or MELD-Na score and AARC-ACLF score (Z=1.361, 1.127, P＞0.016 7). The cut- off scores of MELD- Na, CLIF- SOFA and AARC- ACLF were 23.84, 8.50 and 8.50 respectively. Conclusion MELD- Na, CLIF- SOFA and AARC- ACLF scores have appreciable values to evaluate the prognosis in patients with HBV-related ACLF. AARC-ACLF is better than that of MELD-Na and CLIF-SOFA in assessing prognosis of HBV-related ACLF Related Articles | Metrics

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Establishment and evaluation of predictive diagnostic equation for smear negative tuberculosis meningitis LIU Jia-qing, ZHANG Li-xia△, SUN Hai-bai, QIN Zhong-hua, WU Min, GAO Ming, LI Yu-ming 2017, 45 (4):  418-422.  doi: 10.11958/20161094 Abstract ( 852 )   PDF (389KB) ( 3796 )   Objective To explore a rapid and accurate method for the diagnosis of smear negative tuberculosis meningitis (TBM). Methods Sixty-seven patients with TBM were selected from Tianjin Haihe Hospital from June 2014 to June 2016, and 118 patients with non-tuberculous meningitis (NTBM) in the same period were chosen as control group, including bacterial meningitis (BM) group (n=61) and viral meningitis (VM) group (n=57). The laboratory routine, biochemical and immune indicators were tested with the specimens of both the blood and cerebrospinal fluid of all the patients. The Logistic regression equation was established for the diagnosis of TBM, and the diagnostic efficacy of which was evaluated by the receiver operating characteristic curve (ROC). Results The predictive regression equations of the TBM with BM, VM and NTBM (BM + VM) were obtained when BM group was used as a control: PRE_BM=1/1 + e -(-5.298+0.196×ESAT- 6+ 0.119×CFP-10-2.968×PCT+2.206×ADA_CSF+ 0.705×GLU_CSF+ 0.093×LDH_CSF), PRE_VM=1/1+e-(-6.907+0.394×ESAT- 6-0.120× Na+2.633×ADA_CSF- 0.088×Cl_CSF) and PRE_NTBM=1/1+e-(0.683+0.099×ESAT-6+0.063×CFP-10-2.645×PCT +1.393×ADA_CSF+ 1.342×TbAb_CSF）respectively. When BM group was served as a control, the sensitivity, specificity, positive and negative predictive values of the regression for the diagnosis of TBM were 97.01% (89.63%- 99.64% ), 98.36% (91.20%- 99.96% ), 98.48% (91.84%- 99.96% ) and 96.77% (88.83%- 99.61% ), respectively.When VM group was served as a control, which were 94.03% (85.41%- 98.35% ), 94.74% (85.38%- 98.90% ), 95.45% (87.29%- 99.05% ) and 93.10% (83.27%- 98.09% ), respectively. When NTBM group was served as control, which were 94.03% (85.41% ~98.35% ), 90.68% (83.93%- 95.25% ), 85.14% (74.96%- 92.34% ) and 96.40% (91.03%- 99.01% ), respectively. Conclusion The predictive regression equation could be used as early diagnostic TBM with high sensitivity and specificity, which should be popularized in clinical practice, while, according to the higher negative predictive value, the negative results of which could be used to rule out of the TBM and non-empirical medication. Related Articles | Metrics

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The values of Rockall, Blatchford and AIMS65 scoring systems in the diagnosis and treatment of patients with acute upper gastrointestinal bleeding LIU Hui-ling1, LUO Yan1△, LI Chang-ping2, MEI Mei1, CHEN Jing1, SU Fang1, ZHANG Yan1, CHEN Yan-li1 2017, 45 (4):  423-427.  doi: 10.11958/20161472 Abstract ( 1102 )   PDF (515KB) ( 4198 )   Objective To compare the predictive values of Rockall, Blatchford and AIMS65 scoring systems in the prognosis of patients with acute upper gastrointestinal bleeding (AUGIB). Methods A total of 130 patients with AUGIB in our hospital were enrolled in this study from August 2014 to August 2016 . Three kinds of scoring systems including Rockall, Blatchford and AIMS65 were used to evaluate the risk classification of the patients. Patients were followed up for 2 months. The incidence rates of re-bleeding and death within 2 months after admission were observed. Data of prognosis in patients with AUGIB were compared between the three scoring systems in the prognosis of patients with AUGIB, including the risk classification and the prediction accuracy of re-bleeding and death. Results There were no significant differences in the re- bleeding rate and fatality rate between the groups divided by Rockall and Blatchford scoring systems (P＞0.05). According to the grouping results of AIMS65 scoring system, the re-bleeding rate of low-risk group was lower than that in high risk group (1.45% vs. 13.11%, P=0.01), but there was no significant difference in fatality rate between the two groups (P＞0.05). The values of area under the curve (AUC) of predicting re- bleeding rates by using Rockall, Blatchford and AIMS65 scoring systems were 0.625 8, 0.691 0, and 0.724 1, and the values of AUC of predicting fatality rates were 0.703 1, 0.796 9, and 0.703 1 by using receiver operating characteristic curve (ROC) analysis. There were no significant differences between them (P＞0.05). The values of AUC of predicting re-bleeding rates by using the risk grading calculation by Rockall, Blatchford and AIMS65 scoring systems were 0.618 9, 0.613 9 and 0.725 4 (P＞0.05). But the values of AUC of predicting fatality rates were 0.621 1, 0.664 1 and 0.769 5 (P＜0.01). Conclusion The operation method of AIMS65 scoring system is simple and convenient, which is applicable to a wide range of patients with AUGIB. In the prediction of re-bleeding and mortality, AIMS65 scoring system has high accuracy and stability, which is worthy of promoting in clinical application. Related Articles | Metrics

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Research progress of CX3CL1-CX3CR1 and the pathogenesis of sepsis PENG Ding-wei1, QIN Yue-qiu2, LIAO Pin-hu2△ 2017, 45 (4):  428-431.  doi: 10.11958/20170042 Abstract ( 905 )   PDF (328KB) ( 4633 )   Sepsis has poor prognosis, and its pathogenesis is not clear. Chemokine CX3CL1 (Fractalkine, FNK) has many functions such as chemotaxis, adhesion and mediate immune injury. CX3CR1 is the only receptor of CX3CL1 and participates in the development of sepsis. Here we review the structure, biological function and possible mechanism of CX3CL1 and CX3CR1 in the pathogenesis of sepsis. Related Articles | Metrics

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Application progress of exercise electrocardiography test in the diagnosis and treatment of coronary artery disease CAO Ze-long, LIU Gang△ 2017, 45 (4):  432-436.  doi: 10.11958/20161456 Abstract ( 895 )   PDF (352KB) ( 3534 )   With the improvement of people’ s living standard and changes of their lifestyle, the incidence of coronary artery disease (CAD) has increased quite significantly, which has attracted great concern. Examination methods for CAD are more and more advanced, while the cost of inspection is rising. As a traditional test, the exercise treadmill test (ETT) is convenient, safe, and cheap. ETT can be conducted in almost every hospital as it doesn’ t need advanced equipments. The values of some new evaluation indexes for diagnosis and prognosis of CAD are reviewed in this article. Related Articles | Metrics

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Application of hydrogen in cancer treatment WANG Dong-chang, ZHANG Yu, WANG Li-fei, CHEN Gang△ 2017, 45 (4):  436-440.  doi: 10.11958/20161473 Abstract ( 1306 )   PDF (450KB) ( 4323 )   Cancer is a leading cause of death worldwide. Although a variety of cancer therapies, such as surgical resection and local ablation, chemoembolization, radiotherapy, and systemic chemotherapy, have developed rapidly in recent years, the curative effect and 5 year-survival rate of cancer remain to be unsatisfactory. In recent years, with the deepening basic research of hydrogen, its role on the treatment of various diseases including cancer has attracted an increased attention. Hydrogen can promote the apoptosis of colon cancer cells, and which combined with 5- fluorouracil has a synergistic effect and can reduce the renal toxicity induced by cisplatin, without affecting its anti-tumor effect. Hydrogen can alleviate the side effects of radiotherapy, significantly improve the quality of life for patients with liver cancer, and does not affect the effect of radiotherapy. Hydrogen application provides a new therapeutic approach to the treatment of cancer. The specific mechanism of hydrogen in cancer treatment needs further study. This article reviewes the research progress of the role of hydrogen on the treatment of cancer, including antioxidant, anti-inflammatory, adjuvant chemoradiotherapy, and the regulation of signaling pathways. Related Articles | Metrics