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15 April 2018, Volume 46 Issue 4 Previous Issue    Next Issue

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Tissue-engineered intervertebral disc biphasic scaffolds prepared by poly (ɛ-caprolactone)/sodium alginate/chitosan materials LI Qi-feng1,2, XU Bao-shan2△, YANG Qiang2, MA Xin-long2, ZHANG Yang2, GUO Yue2, 2018, 46 (4):  337-340.  doi: 10.11958/20180103 Abstract ( 846 )   PDF (719KB) ( 3452 )   Abstract: Objective To evaluate the feasibility of a tissue-engineered novel intervertebral disc biphasic scaffold, which used poly (ɛ-caprolactone) (PCL), sodium alginate and chitosan as materials. Methods PCL was used as material of melt spinning preparation of oriented porous annular fibrosus (AF) scaffolds, and the hydrogel was injected into hollow AF central composite biphasic scaffolds. The size and porosity of the biphasic scaffolds were determined by stereomicroscope and scanning electron microscopy (SEM). The human umbilical cord stem cells were inoculated to the corresponding sites of scaffolds and cultured in vitro for 7 days. CCK-8 assay was used to assess cell proliferation. The compression modulus of the biphasic stent was measured. Results Stereomicroscope and SEM showed that the AF formed diamond-shaped porous structure, nucleus pulposus (NP) phase formed irregularity porous structure. AF and NP phase pore sizes were (225.6±3.9) μm and (205.5±5.2) μm respectively, and porosity rates were (74.17±0.39)% and (85.52±0.48)% respectively. SEM showed that cell adhesion to the rack surface and surrounding cells were secreted by extracellular matrix. Live/dead cell staining showed that the cells showed good activity on the scaffold without dead cells. CCK-8 proliferation assay showed that human umbilical cord stem cells showed good proliferative activity. In addition, biphasic scaffold showed impressive mechanical properties (173.24 ± 44.93) kPa. Conclusion The biomimetic biphasic disc stents prepared from polycaprolactone and hydrogels have good pore size, porosity and cell compatibility. Those materials’scaffolds are closely integrated with each other, have a three-dimensional good network structure, and are excellent mechanical properties. So it is an ideal vehicle for constructing intervertebral disc of tissue engineering. Related Articles | Metrics

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The construction of THP-1 cell line stably expressing GFP-LC3 protein LEI Lei1, HUANG Shan 1, YU Ming-hang1, LIU Zhi-qiang2, LIU Shi-wei3, LI Ting1, ZHAO Xiu-juan1, LI Ze-xing1△, WANG Xi1△ 2018, 46 (4):  341-344.  doi: 10.11958/20180074 Abstract ( 1511 )   PDF (581KB) ( 3638 )   Abstract: Objective To establish a stable GFP-LC3-expressed human acute monocytic leukemia cell line (THP-1). Methods The lentivirus plasmid system (pCDH-CMV-GFP-LC3-EF1α-puro) was constructed and transfected into 293T cells with transfection reagent. THP-1 cells were infected with lentivirus and then screened by puromycin. The GFP-LC3 protein expression in THP-1 cells was analyzed by Western blot assay and flow cytometry. Starvation and rapamycin induced autophagy were detected by confocal microscope and Western blot assay. Results The THP-1 cell line with stable expressing GFP-LC3 protein showed visible green fluorescence under inverted fluorescence microscope, as demonstrated by Western blot assay and flow cytometry. Moreover, starvation and rapamycin both could induce the formation of autophagosomes, which included LC3 aggregates and LC3 modification. Conclusion The THP-1 cell line with stable expression of GFP-LC3 protein is constructed efficiently by the lentiviral plasmid system, which provides a cell model for autophagy detection in monocyte-macrophage. Related Articles | Metrics

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Study of PESV intervened upstream activating factors of Hedgehog pathway on CML K562 cells Zhang Wei-feng, Yang Wen-hua△ 2018, 46 (4):  345-349.  doi: 10.11958/20180054 Abstract ( 891 )   PDF (486KB) ( 3556 )   Abstract: Objective To observe the effect of polypeptide extract from scorpion venom (PESV) on the upstream activating factors of Hedgehog pathway of K562 cells, and explore the molecular regulation mechanism. Methods K562 cells were cultured in vitro, and seeded in 24-well plates. Different concentrations of PESV (low dose 10 mg/L, middle dose 20 mg/L and high-dose 40 mg/L) were added to the experimental group, 20 μL was added to the control group, imatinib 2 g/L (20 μL) was given to the positive control group (GLEEVEC group) and saline 20 μL was given to the negative control group. Cells were cultured for 48 h. Real-time PCR and Western blot assay were used for detecting the expression of mRNA and fusion protein P210bcr/abl in BCR/ABL gene of K562 cells, and upstream activating factors and proteins Shh, Smo and Ptch of Hedgehog pathway. Results Compared with the negative control group, the expression of BCR / ABL gene mRNA and P210bcr/abl in K562 cells were inhibited in PESV groups (P＜0.05). Compared with the negative group, the expression levels of mRNA and protein in K562 cells were lower in the middle and high dose PESV groups (P＜0.05). There were no significant differences in the expression levels of Shh, Smo and Ptch between GLEEVEC group and the middle, high dose PESV groups， but which were increased in low dose PESV group (P＜0.05). Conclusion PESV can inhibit the expressions of BCRABL fusion gene and P210bcr/abl of K562 cells, which is related with the inhibiting the expression of the upstream activation factors of Hedgehog pathway, and thereby inhibiting the progression of chronic myeloid leukemia. Related Articles | Metrics

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The effect of the secretome of adipose derived from mesenchymal stem cells on cerebral edema of rats after traumatic brain injury XU Chao1, LI Xiao-hong1, SHI Hong-jian2, WANG Jing1, WANG Li-na1, FU Feng1, ZHAO Wan-yong1, ZHU Xu1, 2018, 46 (4):  350-356.  doi: 10.11958/20171090 Abstract ( 881 )   PDF (452KB) ( 3876 )   Abstract：Objective To investigate the effect of adipose-derived mesenchymal stem cells (ASC-ST) on the secondary brain edema of rats after traumatic brain injury (TBI) and its potential mechanisms. Methods Seventy SD rats were randomly divided into three groups: Sham group (n=18), TBI group (n=26) and TBI + ST group (n=26). TBI models were established by electric cortical contusion impactor (eCCI). Rats from sham group only received the craniectomy without impact. Rats from TBI + ST group were injected with 0.2 mL ASC-ST and 0.1 mL normal saline, while rats from TBI group were injected with 0.3 mL normal saline through tail veins after TBI. The injection was persisted for 7 days. Modified neurological function scores (mNSS) were performed on 8 rats from TBI and TBI+ST groups at 3, 7 and 14 days after TBI. Six rats of each groups accepted magnetic resonance imaging (MRI) at 3, 7 and 14 days after TBI. The water content of brain was measured, and total RNA was exacted from brain tissue of the injured lesions. The mRNA expression levels of TNF-α, IL- 1β and IL-6 were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results At 14 and 21 days after TBI, rats from TBI + ST group got lower mNSS scores than those from TBI group (P＜0.05). At 3 days after TBI, compared with those in Sham group, the ADC values of ipsilateral cortex (IC) and contralateral cortex (CC) were higher in both TBI and TBI+ST groups (P＜0.05). At 7 days after TBI, the ADC values of IC and ipsilateral hippocampus (IH) were lower in TBI + ST group than those in TBI group (P＜0.05). At 14 days after TBI, ADC values of IC and CC were lower in TBI + ST group than those in TBI group (P＜0.05). At 3 and 7 days after TBI, the water content of brain tissue of TBI group was similar with TBI+ST group (P＞0.05). At 14 days after TBI, the water content of brain tissue was lower in TBI+ST group than that of TBI group (P＜0.05). At 3 days after TBI, the expression of IL-6 was extremely lower in Sham group than that in TBI and TBI+ST groups, while expression of TNF-α was higher in TBI+ST group than that in TBI and Sham groups, and expression of TNF-α was higher in TBI group than that of Sham group (P＜0.05). At 7 days after TBI, expressed levels of IL- 6 were lower in TBI+ST and Sham groups than those of TBI group, and the expression was lower in TBI+ST group than that in Sham group; The more mRNA expression of TNF-α was found in TBI group than Sham group, and more IL-1β than other groups; The more IL-1β expression was found in Sham group than TBI+ST group (all P＜0.05). At 14 days after TBI, both TBI+ST and Sham groups were found less mRNA of IL-6 than TBI group, TBI+ST group was found less TNF-α expression than other two groups, but the expression of IL-1β in TBI group was still higher than that in other groups (all P＜0.05). Conclusion ASC-ST can significantly reduce the brain edema of rats after TBI and improve the prognosis of neurological function by mitigating the inflammatory responses. It is a promising kind of biotherapeutic drug with high clinical value. Related Articles | Metrics

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Salubrinal improves the non-uniform settlement of tibial plateau in osteoarthritis through regulating osteoclast development GAO Zhe1, LI Xin-le1,2, LI Jie1,2, ZHANG Ping1,2△ 2018, 46 (4):  356-362.  doi: 10.11958/20180222 Abstract ( 944 )   PDF (926KB) ( 6334 )   Abstract: Objective To observe the therapeutic effect of Salubrinal on non-uniform settlement of tibial plateau in early osteoarthritis of surgery-induced mouse model. Methods Thirty mice were randomly equally divided into sham operation group (Sham), osteoarthritis group (OA) and osteoarthritis + Salubrinal group (OA + Sal). The OA model was established using surgery-removed medial meniscus of the knee joint in mice. Mice of OA + Sal group were injected subcutaneously with Salubrinal (1 mg/kg) for two weeks, Sham group and OA group were treated with isodose normal saline. Safranin O and tartrate-resistant acid phosphatase (TRAP) staining were used to observe the changes of histomorphology and the osteoclast activity in medial and lateral tibia plateau. The ability of formation, migration and adhension of osteoclasts from bone marrow-derived cells were evaluated to detect the development of osteoclasts. Results Compared with Sham group, the osteoclast development was significantly activated in OA group, and the osteoclast activity of subchondral bone was also increased. The OARSI score of articular cartilage and the proportion of calcified cartilage (CC/TAC) were obviously elevated (P＜0.05) in OA group. Interestingly, the medial tibial plateau B.Ar/T.Ar was increased significantly (P＜0.05), but the B.Ar/T.Ar and SBP were decreased significantly at lateral tibial plateau (P＜0.05) in OA group. Compared with OA group, the osteoclast development and subchondral osteoclast activity were significantly inhibited in OA + Sal group (P＜ 0.05). The OARSI score and CC/TAC were decreased (P＜0.05) in OA+Sal group. Moreover, the non-uniform changes of B. Ar / T. Ar and SBP were recovered apparently in the subchondral bone of the medial and lateral tibial plateau (P＜0.05). Conclusion Salubrinal plays a significant role in bone remodeling and non-uniform settlement of tibial plateau at early stage of osteoarthritis through regulating osteoclast development. Related Articles | Metrics

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Effects of spine loading on learning and memory impairment of chronic cerebral ischemia in rat model WANG Zhao-nan1, LI Xin-le1, ZHANG Yun-long1, 2, LIU Da-quan1, 3, ZHANG Ping1, 3△ 2018, 46 (4):  363-367.  doi: 10.11958/20171504 Abstract ( 700 )   PDF (900KB) ( 3785 )   Abstract: Objective To investigate the effects of spine loading on learning and memory of rats with chronic cerebral ischemia. Methods Twenty- seven healthy male SD rats were randomly divided into sham operation group (Sham group), vascular dementia model group (VD group) and spine loading treatment group (VD+L group). There were nine rats in each group. The common carotid artery was only isolated but not ligated in sham group. VD model was established by permanent occlusion of bilateral common carotid arteries in VD group. Spine loading was applied per day for 5 weeks after VD model was established in VD + L group. After loading treatment, Morris water maze was used to test the ability of learning and memory. HE staining and Nissl staining were used to observe the pathological changes of cerebral cortex and hippocampal tissues. The expression of glial fibrillary acidic protein (GFAP) was assessed by immunohistochemistry. Results Compared with the VD group, the escape latency was significantly reduced, while the number of crossing platform and staying time were significantly increased in the VD + L group. After loading, the morphological structure and survival of neurons were significantly improved, and the number of hippocampal cells increased obviously. Loading also decreased the expression of GFAP in hippocampus and cortex. Conclusion Mechanical loading significantly improves the learning and memory impairment in rats with chronic cerebral ischemia and protects neurons after ischemia. The therapeutic effect may be related with the reduced pathological damage of hippocampus and cortical neurons and the inhibited activation of glial cells Related Articles | Metrics

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The effect of endoplasmic reticulum stress on ovarian follicular development in mice HUANG Ning, YU Yang△ 2018, 46 (4):  368-371.  doi: 10.11958/20180122 Abstract ( 826 )   PDF (550KB) ( 3901 )   Abstract: Objective To explore the effect of endoplasmic reticulum (ER) stress on ovarian follicular development in mice. Methods The model mice were divided into control group (n=4) and tunicamycin group (n=6). The endoplasmic reticulum stress activation was induced in mice by intraperitoneal injection of tunicamycin, which was the classical endoplasmic reticulum stress inducer. The marker gene HSPA5, CHOP and ATF4 related to unfolded protein response (UPR) were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR), and which was to identify whether ER stress was activated. H&E staining was used to determine the effect of endoplasmic reticulum stress on ovarian follicular development in mice. Results Compared with the control group, tunicamycin treatment significantly increased the expression of UPR related genes and significantly reduced the number of ovarian follicles. Conclusion The activation of endoplasmic reticulum stress significantly inhibits the mouse ovarian follicular development. Related Articles | Metrics

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Protective effects of astragaloside on isoproterenol induced myocardial hypertrophy in rats DUAN Li-ming, SUN Yu-hong, WANG Fang△ 2018, 46 (4):  371-375.  doi: 10.11958/20171106 Abstract ( 918 )   PDF (930KB) ( 5550 )   Abstract：Objective To investigate the protective mechanism of astragaloside on isoproterenol (ISO) induced myocardial hypertrophy in rats. Methods Twenty-four healthy SPF rats were randomly divided into 4 groups: astragaloside+ISO group [3 mg/(kg·d) ISO intraperitoneal injection, astragaloside 5 mg/(kg·d) gastric lavage], control group (equal volume of normal saline intraperitoneal injection, followed by equal volume of normal saline gastric lavage), ISO group [3 mg/(kg·d) ISO intraperitoneal injection, and normal saline gastric lavage] and astragaloside group [equal volume of normal saline intraperitoneal injection, astragaloside 5 mg/(kg·d) gastric lavage]. Six rats were included in each group and treated for 14 days. After treatment, the left ventricle of rats was taken, and the left heart index (left heart weight/ body weight) was calculated after weighing. The left ventricular tissue was isolated and the occurrence of myocardial hypertrophy was observed by HE staining to compare the myocardial cross-sectional area. Two chlorine fluorescence (DCF) probes to detect the generation rate of myocardial mitochondrial reactive oxygen species (ROS). The protein expression levels of rat myocardial NADPH oxidase 4 (NOX4) and atrial natriuretic peptide (ANP) were detected by Western blot assay. The mRNA expression of myocardial ANP was detected by real-time qPCR. Results Compared with the control group, the left heart index was significantly increased, the myocardial cross-sectional area enlarged, the ROS production rate of myocardial mitochondria increased, NOX4 protein, ANP mRNA and protein expression levels were significantly increased in ISO group (P＜0.05). Compared with the ISO group, the above indicators were significantly improved in ISO + astragaloside group, and the major performance included the reduced myocardial cross-sectional area, decreased ROS generation rate, significantly decreased NOX4 protein, ANP mRNA and protein expressions (P＜0.05). Conclusion Astragaloside has an exact protective effect on myocardial hypertrophy induced by ISO in rats, and which may be related with the decreased oxidative stress by astragaloside. Related Articles | Metrics

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Clinical analysis of autoimmune encephalitis of six cases MAO Shan, SONG Yi-jun△ 2018, 46 (4):  376-380.  doi: 10.11958/20171448 Abstract ( 1442 )   PDF (713KB) ( 3960 )   Abstract: Objective To analyze the clinical characteristics and prognosis of patients with autoimmune encephalitis (AE). Methods The clinical manifestations, laboratory examination, treatment methods and prognosis of patients admitted to our hospital were retrospectively analyzed. Results Of 6 AE patients in this study, one of them was diagnosed as anti-N methyl-D-aspartate receptor (NMDAR) encephalitis, two were anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis, and 3 were autoimmune perpheral encephalitis with antibody-negative. The main clinical manifestations were seizure (6/6), decreased consciousness (5/6), cognitive impairment in the decline of memory (4/6) and mental and behavioral abnormalities (3 / 6). All of them (6 / 6) had abnormal brain MRI signals, mainly with the involvement of the marginal system. The electroencephalogram (EEG) was characterized by diffuse slow wave rhythm, especially in temporal lobe (3/6). Cerebrospinal fluid examination showed the increased lactate dehydrogenase (4 / 6). Five patients received glucocorticoid therapy, three received intravenous immunoglobulin. All patients were improved and discharged, but all were left with epilepsy. Conclusion In patients with major clinical manifestations of epileptic seizures with decreased consciousness, cognitive dysfunction and mental and behavioral abnormalities, the possibility of AE should be vigilant. It is suggested that the use of glucocorticoid and intravenous immunoglobulin protein in the acute stage of AE for impact therapy, and should pay attention to control the seizures. Related Articles | Metrics

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The effects of KIBRA genetic polymorphism on brain functional connectivity: a fMRI study ZHANG Ning-nan-nan, ZHANG Zhang△ 2018, 46 (4):  381-385.  doi: 10.11958/20180025 Abstract ( 1290 )   PDF (447KB) ( 5248 )   Abstract: Objective To investigate the effect of renal brain expression protein (KIBRA) gene rs17070145 polymorphism on cognitive function score and brain functional connection density (FCD), and provide genetic and imaging indices for early identification of Alzheimer’s disease (AD). Methods Healthy Han young people in Tianjin were continuously collected from March 2015 to August 2015. A total of 267 participants with complete behavioral, genetic data and magnetic resonance imaging data, were recruited in this study. The KIBRA C/T alleles were genotyped. Participants were divided into C-allele carrier group (TC＋CC) and TT homozygous carrier group. The Chinese revised Wechsler memory scale and perseverative responses errors percentage in Wisconsin card sorting test were used to assess memory and executive function. After routing preprocessing steps for the resting state, the global FCD value was calculated, and then the differences between genotype groups were compared. Results There was a marginal difference in long term memory between different genotype groups (P=0.05). There were no significant differences in age, sex, education years and perseverative response error percentage between different genotype groups (P＞0.05). Compared to TT homozygous carrier group, the global FCD value in right occipital gyrus was increased in C-allele carrier group (P＜0.05). Conclusion The brain activity in occipital lobe could be affected by KIBRA gene polymorphism in Tianjin Han young people. The increasement of brain function activity in occipital lobe of C allele carriers may be a compensation for the poor performance of long term memory Related Articles | Metrics

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Patterns of theta oscillation underlying working memory deficits in temporal lobe epilepsy with depression DU Xue-yun, PAN Li-ping, REN Yan-ping, SONG Yi-jun△ 2018, 46 (4):  386-390.  doi: 10.11958/20180092 Abstract ( 996 )   PDF (1177KB) ( 3949 )   Objective To investigate the characteristic patterns of neural oscillation of working memory (WM) dysfunction in temporal lobe epilepsy (TLE) with depression. Methods TLE patients were divided into two groups: TLE with depression (n=10) and TLE without depression (n=10), according to the Beck depression inventory Ⅱ (BDI-Ⅱ) and the Hamilton’s Depression Scale (HAMD)-17 score. The matched healthy controls were also included in this study (n=10). The 34-channel EEGs were recorded in three groups of patients while they performed a visual WM task. The reaction time and accuracy were analyzed in there groups. For EEGs analysis, noises were removed from the original EEGs. Short-time Fourier transform (STFT) was used to obtain the time-frequency distribution and the principal frequency band and time period for determined WM. The topographical maps in the principal frequency band and time period were presented, respectively. The power was then compared quantitatively between three groups. Results Compared with controls, the WM task accuracy was decreased in TLE with depression group and TLE without depression group (P＜0.05). The reaction time was decreased in turn in TLE with depression group, TLE without depression group and control group (P＜0.05). In the working memory delay phase, the percent of theta power in the total energy percentage of 34 channel EEGs was significantly lower in TLE with depression group and TLE without depression group than that in control group (P＜0.01). The EEGs spectrum showed that theta power in frontal lobe (especially in Fz channel) was decreased in TLE with depression group compared with that of controls and TLE without depression group (P＜0.05). Conclusion Both TLE patients with and without depression have WM dysfunction. Moreover, the TLE patients with depression are more injured. The absence of theta oscillation in the frontal lobe is one of the potential neural mechanisms for WM dysfunction in TLE patients with depression. Related Articles | Metrics

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The study on the relationship between serum level of interleukin-35 and disease severity of acute motor axonal neuropathy ZHU Si-yu, CHANG Sheng-hui, CHOU Li-sha, ZHANG Da-qi, LI Li-min, YANG Li△ 2018, 46 (4):  391-393.  doi: 10.11958/20171533 Abstract ( 912 )   PDF (310KB) ( 3679 )   Objective To investigate the significance of interleukin-35 (IL-35) level in patients with acute motor axonal neuropathy (AMAN) and explore the correlation of the serum IL-35 level with disease severity and prognosis. Methods The GBS disability score (GDS) was used to assess the disease severity at 2 weeks after admission in 30 patients with AMAN (group AMAN). Erasmus GBS outcome score (EGOS) was used to evaluate the prognosis of patients in 6 months. Thirty healthy volunteers was used as control group (group HCs). Serum concentration levels of IL-35 were measured by enzyme-linked immunosorbent assay (ELISA). The correlation of the serum level of IL-35 with disease severity and prognosis in AMAN patients was analyzed. According to the standard of IL-35 detection, AMAN patients were subdivided into low secretory group (＜0.13 μg/L) and secretory group (≥0.13 μg/L), and GDS and EGOS levels were compared between the two groups. Results The serum level of IL-35 was significantly lower in group AMAN than that in group HCs. The serum level of IL-35 was negatively correlated with GDS and EGOS (rs=-0.430 and -0.523, P＜0.05). Values of GDS and EGOS were higher in low secretory group than those in the secretory group. Conclusion The serum level of IL-35 may participate in the pathogenic process of AMAN. As a protective cytokine, the serum level of IL-35 can be used as an important biomarker for the severity and outcomes of AMAN. Related Articles | Metrics

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The significance of serum levels of HGF in children with mycoplasma pneumoniae pneumonia YE Jing1，2，LIU Chang-shan1△, WANG Zhi-hua2△ 2018, 46 (4):  394-396.  doi: 10.11958/20180012 Abstract ( 1774 )   PDF (314KB) ( 3736 )   Abstract：Objective To investigate the clinical significance of serum hepatocyte growth factor (HGF) in children with mycoplasma pneumoniae pneumonia (MPP). Methods A total of 107 children aged from 3-14 years old were enrolled in this study. Patients were consecutively hospitalized with pneumonia at the Department of Pediatrics, Tianjin Nankai Hospital and Traditional Chinese and Western Medicine Hospital from January 2014 to June 2015. The patients with pneumonia were divided into two groups: MPP group (n=65) and bacterial pneumonia group (n=42). Patients in MPP group was subdivided into two groups: severe MPP group (n=27) and non-severe MPP group (n=38). Thirty healthy children were used as control group in this study. The serum level of HGF was detected by ELISA. The serum levels of C reactive protein (CRP) and lactate dehydrogenase (LDH) were detected by an automated biochemistry analyzer in MPP patients. Results The serum levels of HGF were increased gradually in control group, MPP group and bacterial pneumonia group (ng/L: 4 174.3 ± 247.6, 6 507.1 ± 1 895.9 and 7 128.7 ± 1 990.2, P＜0.05). The serum levels of HGF, CRP and LDH were significantly higher in severe MPP group than those of non-severe MPP group (P＜0.05). Conclusion The serum level of HGF may play an important role in the pathogenesis of MPP in children, and which is connected to the severity of diseases. The higher levels of LDH and CRP suggest the severe MPP and macrolide-resistant. Glucocorticoid therapy should be given while the macrolide drugs are given. Related Articles | Metrics

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Preliminary experience of selective antegrade cerebral perfusion and balloon catheter occlusion of descending aorta and moderate hypothermic circulatory arrest in aortic arch surgery of acute type A aortic dissection ZHANG Shao-peng1, CHEN Tong-yun2, JIANG Nan2, CHEN Qing-liang2△ 2018, 46 (4):  397-400.  doi: 10.11958/20180406 Abstract ( 772 )   PDF (396KB) ( 3528 )   Objective To investigate the feasibility and effect of selective antegrade cerebral perfusion (SACP) and balloon catheter occlusion of descending aorta (BCOD) combined with moderate hypothermic circulatory arrest (MHCA) in the surgical of acute type A aortic dissection (AAAD). Methods The clinical data of 10 patients with AAAD underwent Sun’s surgery procedure in Tianjin Chest Hospital from December 2017 to January 2018 were retrospectively analyzed. All of the patients were treated with classic Sun’s surgery, and SACP+BCOD+MHCA (nasopharyngeal temperature 28 ℃) were performed in the surgery. Clinical date and postoperative outcomes of 10 consecutive patients were analyzed. Results All the 10 patients were improved or recovered from symptoms. The duration of circulatory arrest, cardiopulmonary bypass, cardiac ischemia and duration of operation were (8.75±1.48) min, (153.25±15.27) min, (94.62±12.24) min and (377.62± 32.71) min respectively. The autologous blood transfusion was (800.0 ± 86.6) mL, without allogenic erythrocytes injection. Acute renal failure occurred in 1 patient after operation, and no other significant complications occurred. Conclusion The classic Sun’s surgical procedure with SACP+BCOD+MHCA can shorten the duration of circulatory arrest and operation distinctly. The combination of these techniques results in shorter postoperative recovery time and fewer neurologic complications. Therefore, it is of certain clinical significance and worthy of further study. Related Articles | Metrics

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The influence of chest pain center establishment on treatment for patients with ST-segment elevation myocardial infarction WANG Zuo-lan, FENG Na-na, CHE Jing-jin△ 2018, 46 (4):  400-405.  doi: 10.11958/20171165 Abstract ( 779 )   PDF (385KB) ( 3578 )   Abstract: Objective To investigate whether the establishment of chest pain center (CPC) can improve the rescue efficacy in the treatment of patients with ST-segment elevation myocardial infarction (STEMI). Methods A series of consecutive acute STEMI patients (n=274) within 12 hours after symptom onset were screened, who were admitted in the 2nd Hospital of Tianjin Medical University between November 1, 2015 and January 1, 2017. According to the time of the establishment of CPC (June 1, 2016), patients were divided into the group before the establishment of CPC (early group, n= 140) and the group after the establishment of CPC (late group, n=134). Data of door-to-double dual antiplatelet therapy (D DAPT) time, door-to-heparin (D-H) time, door-to-balloon (D-to-B) time, symptom onset to door (SO-Door) time, total ischemia time, the results of coronary angiography, the major adverse cardiovascular events (MACE), the average length of hospital stay and hospital expenses were compared between two groups. Results Compared with the early group, data of D DAPT time, D-H time, D-to-B time, SO-Door time and total ischemia time were significantly shorter in the late group (all P＜0.01). LVEF was significantly higher, but the rate of Killip class Ⅲ/Ⅳand the level of NT-proBNP were lower in the late group than those of the early group (P＜0.05). The ratio of infarct related artery reperfusion was increased (41.1% vs. 25.8%, P=0.016), while the proportion of patients with stent implantation was decreased (77.5% vs. 90.0%, P=0.008) in the late group. The incidences of acute heart failure and death were significantly decreased during hospitalization (both P＜0.05). In addition, the average of hospitalization expenditure and length of hospital stay were significantly lower in the late group. Multivariable Logistic regression analysis showed that long SO-Door time, anterior myocardial infarction and hypertension were independent risk factors of in-hospital MACE in patients. Conclusion The establishment of the chest pain center, which is aimed to shorten the total ischemia time, can improve rescue efficiency of STEMI, reduce the risk of the in-hospital death and heart failure, and save medical resources. Related Articles | Metrics

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Large sample analysis of Doppler ultrasound in diagnosing fetal intrauterine hypoxia GUO Lin-na, CHAI Yi-qing, HUANG Fan, WU Zhong-yu, CHEN Xu, ZHANG Zhi-kun△ 2018, 46 (4):  406-410.  doi: 10.11958/20170970 Abstract ( 966 )   PDF (523KB) ( 3802 )   Abstract: Objective To evaluate the clinical value of Doppler ultrasonography in the diagnosis of fetal intrauterine hypoxia in different gestational weeks of late pregnancy. Methods From January 2016 to December 2016, 1 017 neonates without intrauterine hypoxia (normal group, including 347 cases of 28-31+6 weeks, 360 cases of 32-36+6 weeks, 310 cases of 37-41+6 weeks) and 218 neonates with intrauterine hypoxia (hypoxia group, including 47 cases of 28-31+6 weeks, 82 cases of 32-36+6 weeks, 89 cases of 37-41+6 weeks) were subjected to a prenatal examination and hospital delivery at 28-41+6 weeks in our hospital. The colour Doppler ultrasound was used to detect hemodynamic index of umbilical artery (UA) and middle ce⁃ rebral artery (MCA), including resistance index (RI), pulsation index (PI) and systolic peak velocity diastolic velocity ratio (S/ D) in the prenatal stage in all subjects. Results (1) The UA blood flow parameters decreased with the increase of gestation⁃ al age in late pregnancy without intrauterine anoxia. With UA-S/D>3.0 as diagnostic criteria, the fetal hypoxia specificities were 94% and 99% for 32-36+6 weeks and 37-41+6 weeks, but the fetal hypoxia specificity was 67% for the diagnosis of 28- 31+6 weeks. (2) The blood flow parameters of MCA decreased with the increase of gestational age, and which was decreased significantly over the full pregnancy term in late pregnancy without intrauterine anoxia. MCA-RI<0.6, PI<1.6 and S/D<4.0 were used as criteria for the diagnosis of intrauterine fetal hypoxia, the fetal hypoxia specificities were 99% and 98% in 28- 31+6 weeks and 32-36+6 weeks. However, the specificity of fetal hypoxia was only 24% in 37-41+6 weeks. (3) In the late preg⁃ nancy, UA blood flow parameters were significantly increased, and the blood flow parameters of MCA were significantly re⁃ duced in intrauterine hypoxia fetal. The UA-S/D>3.28 was used as the standard to diagnose the intrauterine hypoxia in 28- 31+6 weeks, Youden index increased to 0.76. The MCA index showed no diagnostic significance for intrauterine hypoxia in full-term pregnancy. Conclusion The hemodynamic parameters of UA and MCA have their own changing rules in late pregnancy at different gestational weeks, which should be combined with the diagnosis to improve the diagnostic accuracy of intrauterine hypoxia. Related Articles | Metrics

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Comparison of surgical effects and postoperative quality of life in patients with rectal cancer treated by low ligation and high ligation of inferior mesenteric artery HE Jun-feng, ZHANG Ming-jin△, ZHAO Cheng-gong, LI Ye-yun, WANG Shi-chen, LIU Peng, CHEN Shang-chuan 2018, 46 (4):  411-415.  doi: 10.11958/20171373 Abstract ( 980 )   PDF (395KB) ( 3530 )   Abstract: Objective To compare the surgical effects and quality of life in patients with rectal cancer treated by lower ligation and high ligation of inferior mesenteric artery (IMA). Methods A total of 94 patients with rectal cancer were divid⁃ ed into low ligation group (low ligation of IMA, n=50) and high ligation group (high ligation of IMA, n=44) according to the li⁃ gation mode of IMA. The clinical data, incidence of operative complications and defecation function were compared between the two groups. The two groups of patients were followed up for 3 years after the operation. The tumor metastasis rate, recur⁃ rence rate, 3-year survival rate and scores of European organisation for research and treatment of cancer (EORTC) and quali⁃ ty of life questionnaire (QLQ-C30) were compared between two groups. Results (1)There were no significant differences in operation time, intraoperative blood loss, the number of dissected lymph nodes, the number of dissected IMA root lymph nodes and hospital stay between the two groups (P＞0.05). The anal exhaust time was shorter in low ligation group than that of high ligation group (P＜0.05). (2)The incidence of anastomotic leakage was lower in low ligation group than that of high li⁃ gation group (P＜0.05). There was no significant difference in the incidence of the other operative complications between two groups (P＞0.05). (3)The defecation function scores were increased at 3 months, 6 months and 1 year after operation in two groups (P＜0.05). The defecation function scores were better at 3 months and 6 months after operation in low ligation group than those in high ligation group (P＜0.05). (4)There were no significant differences in the 3-year overall survival rate, tumor metastasis rate and recurrence rate between the two groups (P＞0.05). (5)The quality of life scores were increased at 6 months, 1 year, 2 years and 3 years after operation in two groups (P＜0.05), and the quality of life score at 6 months after op⁃ eration was higher in the low ligation group than that of the high ligation group (P＜0.05). Conclusion The curative effect of low ligation of IMA is similar to that of high ligation of IMA in the treatment of rectal cancer. However, the former has little effect on the defecation function and can improve the short-term quality of life of patients. Related Articles | Metrics

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The correlation between body mass index, parathyroid hormone and 25-hydroxyvitamin D in patients with type 2 diabetes LI Yan1, LIU Jia2, WANG Guang2△ 2018, 46 (4):  415-418.  doi: 10.11958/20171386 Abstract ( 854 )   PDF (358KB) ( 4187 )   Abstract: Objective To explore the correlation between body mass index (BMI), parathyroid hormone (PTH) and 25- hydroxyvitamin D [25(OH)D] in patients with type 2 diabetes mellitus (T2DM). Methods A total of 110 patients with T2DM were selected in Beijing Chaoyang Hospital. According to the BMI level, patients were divided into normal weight group (BMI 18.5-23.9 kg/m2, n=24), overweight group (BMI 24.0-27.9 kg/m2, n=47) and obesity group (BMI≥28.0 kg/m2, n=39). Data of age, gender, smoking history, BMI, abdominal circumference and hip circumference were recorded in three groups of patients. Fasting peripheral blood samples were collected in early morning, and serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), serum albumin (ALB), urea nitrogen (BUN), serum creatinine (Cr), serum calcium (Ca2+ ), serum phosphorus (P), free fatty acids (FFA), fasting blood glucose (FPG) and fasting insulin (FINS) were detected by automatic biochemical analyzer. The glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. The high sensitivity C-reactive protein (hs CRP) was detected by latex enhanced immunoturbidimetric method. The PTH and 25(OH)D were detected by immunochemical method. The homeostasis model assessment-insulin resistance (HOMA-IR) index was calculated. The estimated glomerular filtration rate (eGFR) was calculated according to the modification of diet in renal disease (MDRD) formula. The levels of PTH, 25(OH)D and other indicators were compared between three groups. The correlation of BMI and other indicators were analyzed by multiple linear stepwise regression. Results The abdominal circumference, hip circumference and FINS were significantly higher in overweight group than those in normal weight group (P＜0.05). The abdominal circumference, hip circumference, PTH, FINS and HOMA-IR were significantly higher in obesity group than those in normal weight group (P＜0.05). Compared with overweight group, abdominal circumference, hip circumference, hs CRP and PTH were significantly higher in obesity group (P＜0.05). Multiple linear stepwise regression analysis showed that BMI was positively correlated with hip circumference (β=0.293), abdominal circumference (β=0.060), FINS (β=0.026) and PTH (β=0.019). Conclusion There is a significant association between higher BMI and PTH in patients with T2DM, but the relationship with 25(OH)D remains to be further studied. Related Articles | Metrics

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A case of Xp21 contiguous gene deletion syndrome XIN Qing-gang1, ZHAO Peng1△, CAI Chun-quan2 2018, 46 (4):  419-421.  doi: 10.11958/20180021 Abstract ( 1927 )   PDF (628KB) ( 3890 )   Abstract: The clinical manifestations of Xp21 contiguous gene deletion syndrome are related to the extent of gene deletion, which can be manifested as mental retardation, adrenal insufficiency, glycerol kinase deficiency and progressive myodystrophy. This male 9-month-old infant suffered from psychomotor retardation, pseudomuscular hypertrophy of triceps surae, myogenic lesion, hypertriglyceridemia, and high level of glycerol in urine. His mother was detected with chromosome microarray analysis (CMA), which revealed the same Xp21 deletion. Therefore the child was diagnosed as Xp21 contiguous gene deletion syndrome. When there are similar progressive muscular dystrophy in male infants under 3 years of age, attention should be paid to the Xp21 contiguous gene deletion syndrome, and the serum triglycerides testing is very important. High-precision CMA can accurately detect the deletion of fragment and provide a basis for the diagnosis of this disease. Related Articles | Metrics

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A case report of inherited Fanconi syndrome diagnosed by gene analysis GU Jie1#, ZHU Ruo-xin2#, LI Dong3△ 2018, 46 (4):  422-426.  doi: 10.11958/20180011 Abstract ( 1032 )   PDF (518KB) ( 4007 )   Corresponding Author E-mail: lidong430@126.com Abstract: Inherited Fanconi syndrome is a kind of rare hereditary disorder, usually affecting kidney proximal tubule, kidney, liver and bones. HNF4A gene mutation is one of genetic causes with unclear pathogenicity mechanisms, leading to loss of nutrients and electrolyte disturbances due to kidney proximal tubule reabsorption defect. There are only a few cases reported in China on the clinical and genetic studies of inherited Fanconi syndrome. There is rarely a genetically diagnosed case report. In this study, the proband was a 16-year-old boy. HNF4A gene sequencing was performed, and a heterozygous mutation c.187C>T (p.R63W) was detected in the HNF4A gene, which was not detected in proband’s parents. The patient was diagnosed as inherited Fanconi syndrome by clinical and genetics. The patient was treated with L-carnitine, coenzyme Q10, acidosis correction, liver and kidney protectant and vitamin D supplement, and therapy of improved mitochondrial func⁃ tion. The patient was followed up, and the clinical symptoms were improved. Related Articles | Metrics

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A case report of apocrine carcinoma with extramammary Paget disease JI Xiao-ming1, XU Jia-chun2, GAO Hui1△ 2018, 46 (4):  426-428.  doi: 10.11958/20171484 Abstract ( 1021 )   PDF (908KB) ( 3766 )   Abstract：Apocrine carcinoma with extramammary Paget disease is rare clinically. Clinical data about a case of apocrine carcinoma with extramammary Paget disease were retrospectively analyzed. The case was found on May 2013 in Tianjin Public Security Hospital. This article discussed the clinical conditions, histopathological changes and immunohistochemistry staining characteristics of apocrine carcinoma with extramammary Paget disease. Related Articles | Metrics

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Acute myocardial infarction in the acute phase of Kawasaki disease in a school-aged boy: a case report LI He1, CHENG Ji2, YIN Jing1△, HU Jian1 2018, 46 (4):  429-431.  doi: 10.11958/20171417 Abstract ( 805 )   PDF (456KB) ( 3570 )   Abstract: Kawasaki disease (KD) is a common systemic vasculitis of children, mainly involving coronary arteries. Since it was first reported in 1967, the cause of the disease is still unknown. This article reports a case of a 8-year-old school-aged boy with a giant coronary artery aneurysm (CAA) combined with myocardial infarction (MI) in the acute phase of KD. Related Articles | Metrics

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Research progress of biliary atresia cell destruction and repair XIONG Xi-qian1, ZHAN Jiang-hua2△ 2018, 46 (4):  432-435.  doi: 10.11958/20180081 Abstract ( 946 )   PDF (355KB) ( 3575 )   Abstract：Biliary atresia (BA) is a serious digestive system disease caused by the obliteration of intrahepatic and extrahepatic biliary system of infancy. Without prompt treatment, BA can cause biliary cirrhosis and ultimately develop to liver failure, leading child death. Bile duct epithelial cells are destroyed, leading to the formation of gradually narrowed bile duct lumen, and fiber cords are main pathological change of BA. The bile duct epithelial cells are not only the passive victims, but also the potential effect in biliary pathology. At present, with the deepening of the study of BA bile duct epithelial cells at home and abroad, some progress has been made in the destruction and repair of biliary epithelial cells. This article reviews the relationship between epithelial mesenchymal transformation (EMT), the changes in structure of bile duct, bile duct epithelial cell damage, bile duct proliferation and repairing, and hepatic fibrosis. Related Articles | Metrics

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The role and its mechanism of miRNA in the pathogenesis of diffuse large B cell lymphoma KAN Yu-tian, Zhang Yi-zhuo, Zhao Hai-feng△ 2018, 46 (4):  436-439.  doi: 10.11958/20171186 Abstract ( 865 )   PDF (325KB) ( 3609 )   Abstract：MicroRNA (miRNA) is short endogenous non-coding RNAs with the length of 22 nt, it regulates the expression of target genes by binding to the 3′ UTR of mRNA and inducing either miRNA degradation or translational repression. Researchers have found that miRNA regulate a wide range of biological processes, including cell development, differentiation, proliferation and apoptosis. miRNA performs its tumor suppressor or oncogenic function by regulating the expression of target genes and correspondingly regulating the signaling pathways. Diffuse large B cell lymphoma (DLBCL)， the most common B-cell non-Hodgkin lymphoma, is a kind of diseases with an extremely heterogeneity in the clinical manifestation, morphology, immunophenotype, and genetic characteristics. In this review, we summarized the target and signaling pathway of miRNA in the pathogenesis of diffuse large B cell lymphoma in recent years, and its application value in clinical staging, typing, prognosis evaluation and treatment strategies. Related Articles | Metrics

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Research progress on the regulation mechanism of long chain noncoding RNA in osteoarthritis XIAO Yu, LIU Jun△ 2018, 46 (4):  440-443.  doi: 10.11958/20170884 Abstract ( 855 )   PDF (344KB) ( 4652 )   Abstract: With the aging of the population, the incidence of osteoarthritis (OA) is increasing, and which often leads joint pain, limited movement, articular cartilage tissue inflammation and progressive degeneration. At present, the clinical ef⁃ fect of conventional therapy is not ideal, and it is often needed to be solved by surgery. In recent years, long chain noncoding RNA (lncRNA) has been found to be involved in a variety of mechanisms in the pathogenesis of OA, including inflammatory factors, mechanical factors and cell apoptosis. And specific micro RNA (miRNA) mediates the regulation of each process. Therefore, the study of target gene therapy for differentiated lncRNA is becoming more and more in-depth, hoping to find an effective method for human OA treatment. Related Articles | Metrics

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The research progress of Adropin in coronary heart disease FENG Li-juan1, GAO Jing2△ 2018, 46 (4):  444-448.  doi: 10.11958/20171311 Abstract ( 956 )   PDF (449KB) ( 3900 )   Abstract: Since the first discovery of Adropin in the study of insulin resistance in mouse model by Kumar et al in 2008, more and more evidence has been shown that Adropin is closely related to coronary heart disease (CHD). Adropin plays an important role in the development of CHD, which involves in energy metabolism, insulin resistance and vascular endothelial protection. This paper reviews the research progress on the relationship between Adropin and CHD, and provides a reference for the risk prediction and prevention in CHD. Related Articles | Metrics