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15 October 2018, Volume 46 Issue 10 Previous Issue    Next Issue

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Screening of the metabolic markers associated with breast cancer metastasis based on liquid chromatography-mass spectrometry technology WU Jing, YANG Rui, ZHANG Lei, KANG Hua, FAN Zhi-juan, LIU Shu-ye 2018, 46 (10):  1033-1038.  doi: 10.11958/20180486 Abstract ( 764 )   PDF (815KB) ( 4196 )   Abstract: Objective To screen the metabolic markers associated with breast cancer metastasis through metabonomics technology. Methods Serum samples from 100 patients with breast cancer and 50 healthy volunteers were collected. The metabolic profiles of serum specimens from breast cancer patients with metastasis, breast cancer patients without metastasis and healthy people were analyzed by high performance liquid chromatography combined with a LTQ Orbitrap XL mass spectrometer (HPLC-LTQ Orbitrap XL MS) platform, and then the data were analyzed by the pattern recognition methods and nonparametric test. Results The orthogonal partial least squares-discriminant analysis (OPLS DA) mode (R2=95.2%, Q2=86.7%) was constructed by the serum metabolic profiles of breast cancer patients with metastasis, breast cancer patients without metastasis and healthy people, which showed good discrimination ability and could identify eight metabolic markers including LPA［18∶1(9Z)/0∶0］, LysoPC(18∶0), LysoPC［20∶3(5Z,8Z,11Z)］, Choline, DHAP(18∶0e), (2R,3S)-Piscidic acid, Erucic acid, L-Dihydroorotic acid used to distinguish breast cancer metastasis. Conclusion The serum metabolic profiling obtained by metabolomic methods can be used to construct the discrimination mode and discover the metabolic biomarkers associated with breast cancer metastasis, which will provide the support and basis for the early diagnosis and treatment, prognosis evaluation, choice of drug therapy targets for breast cancer. Related Articles | Metrics

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The effect and mechanism of methyltransferase SETDB2 on the invasion and migration of hepatoma carcinoma JIA Long-mei, YIN Xiang-bao, ZENG Lei, CHEN Xin, RAO Yan-fei 2018, 46 (10):  1039-1044.  doi: 10.11958/20180237 Abstract ( 693 )   PDF (1103KB) ( 3884 )   bstract: Objective To investigate the effect of methyltransferase SETDB2 on the invasion and metastasis of live cancer and explore its mechanism. Methods Western blot, immunohistochemistry and Real-time PCR assays were performed to detect the expressions of SETDB2 protein and mRNA in liver cancer and the adjacent tissue specimens of 37 cases. The short hair pair RNA targeting SETDB2 (sh-SETDB2) and the corresponding empty vector (sh-NC) were transfected into MHCC97H cells. The invasion and migration ability of the two groups of cells were detected by Tanswell invasion assay and wound-healing assay. The gene chip was used to detect the expression of the altered genes after knocking down SETDB2. The mRNA expression of PTEN was detected by Real-time PCR. Western blot assay was used to detect the protein expressions of PTEN and H3K9me3. CHIP was used to detect the change of H3K9me3 in the promoter region of PTEN. The expression of PTEN was knocked down in shSETDB2-MHCC97H cells, and the invasion ability of cells was detected by the Tanswell invasion assay. Results (1) The results of Western blot and Real-time PCR assays showed that the expression levels of SETDB2 protein and mRNA were higher in the liver cancer tissues than those in the adjacent normal tissues. The expression level of SETDB2 was related to the histological grade and TNM stage of liver cancer. (2) The invasion and migration abilities were significantly lower in MHCC97H cells transfected with sh-SETDB2 than those in sh-NC group. (3) Microarray experiment, Western blot and Real-time PCR assays showed that PTEN was up-regulated after knocking down SETDB2. (4) The expression of H3K9me3 was decreased after knocking down SETDB2, and the appearance of H3K9me3 in PTEN promoter region was decreased as well. (5) Compared with the knockdown SETDB1, the invasive ability of cells was restored after both SETDB2 and PTEN were knocked down. Conclusion SETDB2 promotes the invasion and migration of hepatoma cells by downregulating the expression of PTEN. Related Articles | Metrics

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miR-182-5p regulates pyroptosis involving liver ischemia reperfusion injury DU Chen-yang, SONG Hu, WANG Xing-xing, WANG Zhen, ZHANG Jian-jun 2018, 46 (10):  1045-1050.  doi: 10.11958/20180682 Abstract ( 714 )   PDF (727KB) ( 3490 )   Abstract：Objective To investigate the effect of miR-182-5p targeting FoxO3a-mediated pyroptosis on hepatic ischemia-reperfusion (IR) injury. Methods Liver ischemia-reperfusion models of mice were established. According to the random number table method, 40 mice were divided into 5 groups with 8 rats in each group respectively, sham group, IR groups (2 h group, 6 h group, 12 h group and 24 h group). The cell experiments were divided into two parts: (1) the hypoxia models were established and divided into control group and IR group. (2) Hypoxia/reoxygenation models were established and divided into control group, mimic group, inhibitor group and inhibitor+siRNA group. HE staining was used to observe the pathological changes of liver tissues after IR. Immunocytochemistry staining was used to detect the expression of FoxO3a in liver cells. qRT-PCR and Western blot assay were carried out to detect the expressions of miR-182-5p, FoxO3a, Caspase1, IL-1β and IL-18. The gene correlation between miR-182-5p and FoxO3a was analyzed. Immunofluorescent staining was used to detect the Caspase1 expression. ELISA kit was used to detect the expression of IL-1β and IL-18. CCK- 8 kit was used to detect changes of cell viability. Results The liver injury after IR treatment was increased in mice, and the injury was the most severe at 12 h-reperfusion. At the same time, the expression levels of FoxO3a, Caspase1, IL-1β and IL- 18 were increased (P＜0.05), and pyroptosis was induced. MiR-182-5p level in liver tissue was higher after IR treatment compared with that in sham group (P＜0.05). After IR treatment for AML12 cells in vitro, miR-182-5p expression was up regulated, FoxO3a expression was down-regulated, and caspase1 expression was increased (P＜0.05). Overexpression of miR-182-5p decreased the expression of FoxO3a. On the contrary, it increased the expression of FoxO3a, which in turn decreased the expression levels of Caspase1, IL-1β and IL-18. In the end, the viabilities of hepatocytes were increased (P＜ 0.05). Conclusion The activation of miR-182-5p can aggravate hepatic ischemia-reperfusion injury, while the inhibition of miR-182-5p can reduce hepatic ischemia-reperfusion injury. The mechanism may be related to miR-182-5p activating FoxO3a to activate hepatocellular pyroptosis, and further influence the expression of Caspase1, IL-1β and IL-18. Related Articles | Metrics

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Proteomic analysis of lipid rafts reveals the key effects of the accelerated-aging on hippocampus in SAMP8 mice ZHANG Xue-zhu, FU Yu, JIA Yu-jie, HAN Jing-xian, NIE Kun△ 2018, 46 (10):  1050-1054.  doi: 10.11958/20180800 Abstract ( 830 )   PDF (665KB) ( 3563 )   Abstract: Objective To explore the key cytological mechanism of Alzheimer’s disease in SAMP8 mice. Methods Two-month-old and 8-month-old SAMP8 mice were used as the accelerated-aging model of dementia, and 40 SAMR1 mice at the same age were used as the control group. The lipid rafts of hippocampus were extracted from young and adult mice for analysis using high performance liquid chromatography-tandern mass spectrometry (HPLC-MS/MS). The lipid raft proteome data were introduced into DAVID bioinformatics analysis tool, then Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were carried out. The results of bioinformatics analysis were verified by mitochondrial membrane potential and Morris water maze analysis. Results Compared with the control mice of SAMR1, the aged SAMP8 mice showed obvious cognitive impairment. GO analysis showed that the mitochondrial-related proteins decreased greatly in aged SAMP8 mice. KEGG analysis showed that the oxidative phosphorylation of mitochondria was greatly reduced in the hippocampus of SAMP8 mice. Mitochondrial membrane potential analysis showed that the mitochondrial membrane potential decreased significantly in the hippocampus of aged SAMP8 mice. Conclusion During aging, the most critical cellular change in hippocampus is the excessive decline of mitochondrial oxidative phosphorylation, which may be an important cellular mechanism of dementia in SAMP8 mice. Related Articles | Metrics

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Study on the feasibility of thoracic drainage with central venous catheter after uniportal video-assisted thoracoscopic bullectomy YANG Bo, LI Xiao-ping, YAN Xiao-long, WANG Wen-chen, LI Lei, ZHANG Liang, LI Ming-jiang, ZHANG Wei-dong 2018, 46 (10):  1055-1058.  doi: 10.11958/20180777 Abstract ( 734 )   PDF (363KB) ( 3821 )   Abstract: Objective To investigate the validity, security, feasibility and superiority of the clinical application of central venous catheter instead of traditional thoracic drainage tube in uniportal video-assisted thoracoscopic surgery (UVATS) based on the concept of enhanced recovery after surgery (ERAS). Methods The clinical data of 194 patients who underwent spontaneous pneumothorax in the Tianjin First Central Hospital from June 2013 to November 2016 were included in this study. Patients were divided into central venous catheter group (CVC group) and 28 F polyvinylchlorid chest tube group (28 F group), 97 cases in each group. Clinical effects, chest drainage volume and related complications were compared between the two groups. Results The hospital stay［(3.4±1.1) d vs. (5.9±1.7) d］, leave-bed time after operation［(4.7±0.7) h vs. (11.5±2.5) h］and remove drainage tube time［(34.9±5.4) h vs. (72.3±9.8) h］were significantly less in CVC group than those of 28 F group (P＜0.05). The pain score (3.1±1.4 vs. 7.0±2.5) and incidence of poor wound healing of drainage (100% vs. 93.8%) were also less in CVC group than those of 28 F group (P＜0.05). There were no significant differences in the complication of lung infection (1.0% vs. 3.1%), subcutaneous emphysema (4.1% vs. 2.1%) and persistent leakage (1.0% vs. 3.1%) between the two groups. Conclusion The application of the central venous catheter technology in uniportal video assisted thoracoscopic bullectomy is superior to the traditional thoracic drainage, and which is worthy of clinical promotion. Related Articles | Metrics

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Predictive value of hs-CRP combined with D-dimer for subacute stent thrombosis in acute myocardial infarction patients after PCI YUAN Guang-yang, TIAN Feng-shi, LIU Yong, LIU Yun-de 2018, 46 (10):  1058-1062.  doi: 10.11958/20180662 Abstract ( 823 )   PDF (406KB) ( 3936 )   Abstract: Objective To investigate the value of hypersensitive C reactive protein (hs-CRP)-D-dimer, a combined indicator of hs-CRP and D-dimer, in predicting the occurrence of subacute stent thrombosis (SST) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Patients (n=9 261) undergoing PCI for AMI from January 2012 to January 2018 were enrolled in this study. Patients with postoperative SST were selected as SST group (n=72), and patients without SST were selected as control group (n=210) according to their age and sex ratio. Data of coronary heart disease risk factors (sex, age, body mass index, etc.), clinical data［systolic blood pressure, diastolic blood pressure, creatine kinase (CK), creatine kinase isoenzyme (CK-MB)］, results of angiography (disease vessels, stent malapposition) were compared between two groups. The index of P<0.1 in general data comparison was included in multivariate logistic regression analysis. ROC curves were used to analyze hs-CRP and D-dimer, and both hs-CRP and D dimer were assessed for the predictive value of SST. Results The postoperative D-dimer, hs-CRP, glucose, stent malapposition, and number of stents were significantly higher in the SST group than those in the control group. The left ventricular ejection fraction (LVEF) was significantly lower in the SST group than that in the control group (P＜0.05). Multivariate logistic regression analysis showed that the elevated D-dimer, hs-CRP and glucose, stent malapposition were independent risk factors for SST. LVEF ＞ 0.50 was a protective factor for SST. The combined index of hs-CRP and D dimer for hs-CRP-D-dimer was 0.875 under ROC curve, 14.28 for SST, with sensitivity of 77.8% and specificity of 80.5%. Conclusion D-dimer, hs-CRP, the elevated blood glucose and stent malapposition are independent risk factors for SST, LVEF>0.50 is a protective factor for SST. Hs-CRP-D-dimer, a combined diagnostic index of hs-CRP and D-dimer, is an ideal indicator for predicting the occurrence of SST after PCI in AMI patients, and which is worthy of clinical application. Related Articles | Metrics

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Evaluation of the effect of 30 degree angle dilated latent fixer on controlling exfoliated bleeding after PICC treatment JU Chen-xia, ZHUANG Mei-hua, WANG Xiao-wen, PAN Xue-fen△ 2018, 46 (10):  1063-1066.  doi: 10.11958/20180844 Abstract ( 783 )   PDF (503KB) ( 3465 )   Abstract：Objective To explore the effects of 30° - angled incision fixer on controlling the bleeding after ultrasonography guided peripherally inserted central catheter (PICC) operation. Methods Sixty hospitalized patients treated with PICC therapy during February 2016 to October 2016 were recruited. All participants were randomly divided into case and control groups, each group had 30 people. In case group, the skin was longitudinal incised with the help of 30°- angled incision fixer, while in control group, the skin was traditionally longitudinal incised with experience. The bleeding amount was compared during operation, the next day and the 7th day after operation between two groups. Results The bleeding amount was significantly decreased during operation and the next day after operation in case group compared with that of control group (P＜0.05), while no difference was observed in bleeding amount on the 7th day after operation between the two groups (P＞0.05). Conclusion The 30°-angled incision fixer could make the angle and depth of the incision more precise, thus could narrow the range of wound and reduce the bleeding amount, and it deserves to be popularized and used clinically. Related Articles | Metrics

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Expression and significance of PRR11 in gallbladder carcinoma SU Bao-wei, BAI Ming-hui, LIU Hai-chao 2018, 46 (10):  1067-1070.  doi: 10.11958/20180659 Abstract ( 687 )   PDF (509KB) ( 3652 )   Abstract: Objective To investigate the expression and significance of proline-rich protein 11 (PRR11) in gallbladder carcinoma. Methods The expressions of PRR11 were detected by immunohistochemistry SP method in gallbladder carcinoma and paracancerous tissues of 58 patients and samples of 49 cases of chronic cholecystitis. The relationship between staining results and clinicopathological parameters (types of tissues, Nevein stage of gallbladder carcinoma, lymph node metastasis and tissue differentiation) of gallbladder cancer was analyzed. Results The positive expression rate of PRR11 protein in gallbladder carcinoma was 55.2% (32/58), which was much higher than that in the adjacent tissue (25.9%, 15/58) and chronic cholecystitis (4.1%, 2/49, P < 0.01). There were significant differences in expressions of PRR11 between different stages of Nevein, different degrees of tissue differentiation and with or without lymph node metastasis (P < 0.05), but there was no significant difference in expression of PRR11 between age, gender and tissue classification. Conclusion PRR11 protein is highly expressed in gallbladder carcinoma tissues, but weakly expressed or not expressed in paracancerous tissues and chronic cholecystitis tissues, suggesting that PRR11 may be involved in the occurrence, invasion and metastasis of gallbladder carcinoma. Related Articles | Metrics

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Preliminary study on the analysis of proteinuria and hemoglobin for the prognosis in patients undergoing percutaneous coronary intervention WANG Jing, YUAN Yu-hua, JIA Ke-gang, CHAI Xiao-wen 2018, 46 (10):  1070-1074.  doi: 10.11958/20180313 Abstract ( 718 )   PDF (455KB) ( 3478 )   Abstract：Objective To investigate the predictive value of treatment outcome combined analysis of preoperative urinary protein and hemoglobin (HB) levels for percutaneous coronary intervention (PCI). Methods One thousand one hundred and ninety-five PCI patients were divided into six groups by qualitative determination of urine albumin and HB levels. The proteinuria was defined as normal (urine dipstick negative), mild (urine dipstick trace or + ), or heavy (urine dipstick≥++). A group: urine albumin negative, no anemia (n=701); B group: mild urine albumin (+), no anemia (n=247)；C group: heavy urine albumin (++～++++), no anemia (n=41); D group: urine albumin negative, anemia (n=134); E group: mild urine albumin, anemia (n=52)；F group: heavy urine albumin (++～++++ ), anemia（n=20). The prognostic factors of PCI patients were analyzed by Cox proportional hazards models. The prediction value of cardiac events after PCI was evaluated by the area under the ROC curve. Logistic model was carried out to get the fitting variable for ROC curve analysis. Kaplan Meier survival analysis was used to compare survival curves between groups with different levels of urine protein, different levels of hemoglobin, and joint analysis. Results There were significant differences in age, diabetes, myocardial infarction and left ventricular ejection fraction (LVEF) between six groups (P＜0.05). Multiple factors regression analysis showed that positive urine protein, anemia, and more than one vessel count of lesion were the risk factors for cardiovascular events after PCI surgery. The combination of urine protein and hemoglobin showed the highest Jordan index in the prognosis evaluation of PCI. The best cut-off value for predicting clinical adverse events of urinary protein was 0.125 g/L. The best cut-off value for hemoglobin was 130 g/L. Survival analysis showed there were significant differences in the cumulative survival rates between the anemia group and the non-anemia group, the negative urinary protein group, the positive + group, the positive≥++group (P＜0.05). The cumulative survival rate of F group with anemia and urinary protein-positive ≥++ was significantly lower than that of other groups. With the aggravation in urinary protein and appearance of anemia, the cumulative survival rate was gradually reduced in each level. Conclusion Preoperative urinary protein and hemoglobin are correlated with the prognosis of coronary heart disease in patients after interventional therapy, and their combined evaluation is of great significance in guiding clinical treatment Related Articles | Metrics

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A case of acute leukemia in adolescents with manifestation of hypercalcemia as the first symptom LU Hui, SUN Wei, GAO Guan-qi 2018, 46 (10):  1073-1075.  doi: 10.11958/20180763 Abstract ( 812 )   PDF (323KB) ( 3660 )   Abstract: Acute B-lymphocytic leukemia with hypercalcemia as the first symptom is clinically rare. This article reported a case of B-lymphocytic leukemia with hypercalcemia as the first manifestation and combined with hyperuricemia, and the patient was finally diagnosed by bone marrow puncture and other tests. The purpose of this article is to improve the clinical understanding of the complications of this disease. Related Articles | Metrics

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Evaluation of periodontal adverse factors on the treatment of chronic apical periodontitis by endodonic microsurgery HOU Tie-jing, SHAO Yong-xin 2018, 46 (10):  1075-1078.  doi: 10.11958/20180265 Abstract ( 877 )   PDF (535KB) ( 3754 )   Abstract: Objective To evaluate the effect of periodontal factors on chronic apical periodontitis treated by endodontic microsurgery. Methods A total of 83 patients with chronic apical periodontitis treated in Aoxin stomatological hospital at 2012-2015 were selected in this study. Clinical data, imaging examination and periodontal attachment loss (AL) were performed before the operation. Patients were divided into smoking group (n=37) and non-smoking group (n=46) according to the smoking history. After 1 year of follow-up, the effects of AL value and smoking on the therapeutic effect were analyzed through clinical and imaging findings. Results The therapeutic effective rate decreased significantly with the increase of the mesial-distal AL (97.6% vs. 86.4% vs. 73.6%, χ2=7.994，P=0.018). There was no significant difference in the effective rate between different buccal tongue to AL patients (82.6% vs. 84.0% vs. 97.1%, χ2=4.017, P＞0.05). The effective rate was significantly higher in non-smoking group than that of smoking group (97.8% vs. 78.3%, χ2=6.137, P=0.013). Conclusion Periodontal adverse factors can reduce the therapeutic effective rate of microperiapical surgery. Before operation, we should choose the indications according to the loss of periodontal attachment and smoking or not, in order to improve the survival rate of the teeth after operation. Related Articles | Metrics

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Correlation between epicardial adipose tissue volume and the severity and prognosis of coronary atherosclerosis SHEN Lei, LI Xiao-hui, LIAO Min-lei 2018, 46 (10):  1079-1083.  doi: 10.11958/20171489 Abstract ( 787 )   PDF (411KB) ( 3543 )   Abstract: Objective To investigate the relationship between epicardial adipose volume (EATV) and the severity and prognosis of coronary atherosclerosis. Methods The clinical data of 170 patients underwent percutaneous coronary intervention (PCI) and 58 patients without coronary artery stenosis were analyzed. Patients who accepted PCI were divided into low score group (n=108), middle score group (n=30) and high score group (n=32) according to Gensini score system. Data of EATV were evaluated. The differences in clinical data were analyzed between groups. Gensini scores and the number of diseased vessels in patients were observed by Pearson’s method, and receiver operating characteristic curve (ROC) were used to evaluate the value of EATV in the prognosis of PCI. Results The body mass index (BMI), primary diseases (hypertension and diabetes), triglyceride (TG), low density lipoprotein (LDL-C) and EATV were significantly higher in the coronary heart disease patients than those of patients with non-coronary heart disease (P＜0.05). There were significant differences in LDL-C and EATV between the low, middle, and high Gensini groups (P＜0.05), in which the LDL-C level and EATV level were significantly higher in high Gensini group than those of other two groups (P＜0.05). There were significant differences in the number of diseased vessels between three groups (P＜0.05). EATV was positively correlated with Gensini score (r=0.853, P＜0.05). The relationship between the number of diseased vessels and EATV was three or more lesions>two-vessel disease>single-vessel disease (P＜0.05). One years after PCI, the incidence of new coronary artery lesions was 10%. EATV was higher in these patients than that of patients without new coronary artery disease (P＜0.05). The area under the ROC curve was 0.626 (95% CI: 0.512 - 0.740), the sensitivity was 88.2%, the specificity was 40.5%, and cutoff value was 124.70 cm3. Conclusion EATV is positively correlated with the severity of coronary arteriosclerosis, which can be used as a reference for diagnosis. When EATV is greater than 124.70 cm3 the incidence of neovascularization increases in patients within 1 year after PCI. Related Articles | Metrics

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The disease activity and serum ferritin in patients with clinically amyopathic dermatomyositis of rapidly-progressive interstitial lung disease: a report of two cases and literature review WANG Jie-rui, CUI Liu-fu, SHU Rong, SONG Hai-cheng, WANG qiang-qing 2018, 46 (10):  1083-1086.  doi: 10.11958/20180826 Abstract ( 978 )   PDF (653KB) ( 3943 )   Abstract: Objective To summarize the experience of diagnosis and treatment of clinical data of 2 dead cases with clinically amyopathic dermatomyositis (CADM) and rapidly-progressive interstitial lung disease (RP-ILD). Methods The clinical manifestations, laboratory and imaging examination results, diagnosis and treatment of 2 dead cases with CADM of RP-ILD treated in our hospital from February, 2015 to January, 2018 were analyzed retrospectively. The clinical characteristics, treatment plan and cause of death were summarized. Results The 2 dead cases with CADM of RP-ILD were tested positive for the anti-melanoma differentiation-associated gene 5 (MDA5) antibody. The SF level was significantly increased in the 2 patients at admission, but the CT scan-chest only indicated the mild inflammation. With the progressively exacerbation of the patient respiration, the SF level was increased progressively, and the chest imaging progressed. The combination of hormone, tacrolimus and cyclophosphamide were given for treatment in the two patients. The 2 patients died of respiratory failure at 66 days and 61 days respectively. Conclusion The high SF level reflects the deterioration in patients with DM of ILD associated with anti-MDA5 antibody. In determining the progression of the disease, the SF level has earlier diagnostic value than chest CT scan. Related Articles | Metrics

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A case report of Stevens-Johnson syndrome induced by ceftizoxime SHEN Li, WANG Cheng△, JIANG Yi-guo, JI Shi-liang 2018, 46 (10):  1087-1089.  doi: 10.11958/20180627 Abstract ( 680 )   PDF (440KB) ( 3652 )   Abstract: Stevens-Johnson syndrome is an acute bullous lesion involving skin and mucous membrane, usually caused by infection or drugs. The mortality rate can be as high as 10%. In this article, one case of Stevens-Johnson syndrome caused by ceftizoxime was reported, the diagnosis and treatment of the patient were reviewed, and the relevant literatures were analyzed to improve the understanding of the disease. Related Articles | Metrics

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A case of benign recurrent aseptic meningitis HU Yue-mei, ZHU Li-ying, SONG Yi-jun△ 2018, 46 (10):  1090-1092.  doi: 10.11958/20180270 Abstract ( 873 )   PDF (433KB) ( 3916 )   Abstract：Benign recurrent aseptic meningitis is also known as Mollaret meningitis (MM). MM is a syndrome characterized by recurrent bouts of meningitis including recurrent headaches, nuchal rigidity, fever, and increased cells in cerebrospinal fluid. MM was first reported by Mollaret in 1944. It is a rare disease of central nervous system. One case of benign recurrent aseptic meningitis was hospitalized and treated in our department. The result of lumbar puncture showed no evidence of bacterial growth. Enhanced magnetic resonance imaging (MRI) showed high signal of meninges, suggesting that more attention should be paid to the application of enhanced MRI in the individual diagnosis of MM. Related Articles | Metrics

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Analytical methods and application of LC-MS/MS for quantification of sitagliptin in human plasma LIU Shan-shan, XIA Yuan-yuan, LIU Jing-yuan, GENG Ya-jie, WEI Guang-li, SI Duan-yun 2018, 46 (10):  1096-1101.  doi: 10.11958/20180795 Abstract ( 818 )   PDF (951KB) ( 3744 )   Abstract: Objective To develop a liquid chromatography-tandem mass spectrometry (LC-MS / MS) method for quantification of sitagliptin in human plasma, and to apply it for the pharmacokinetics study of sitagliptin in human. Methods The plasma sample was precipitated by CleanertPPT and sitagliptin-d4 was used as the internal standard (IS). Chromatographic separation was performed on a Diamonsil C18 column (100 mm×4.6 mm, 5 μm). Mobile phase consisted of methanol and a mixture of 10 mmol/L ammonium formate-methanol-formic acid (90∶10∶0.1) at a flow rate of 0.5 mL/min. The validation was performed in terms of selectivity, residue, linear range and lower limit of quantitation, precision and accuracy, matrix effects and recovery, and stability. The main pharmacokinetic parameters (Tmax, Cmax, AUC0-t and T1/2) were observed in healthy people after oral administration of sitagliptin tablets. Results Sitagliptin and sitagliptin-d4 (IS) were ionized with an ESI source and operated in positive ion mode. The detected ions were m/z 408.0→235.2 (sitagliptin) and m/z 412.1→239.0 (sitagliptin-d4). This validated LC-MS/MS method yielded a good linearity over the range of 0.5-1 000 μg/L (R2=0.99), and the lower limit of quantitation (LLOQ) was 0.5 μg/L. The intra and inter-assay precisions (RSD) were within the range of 0.83%~12.80%, and the accuracy (RE) was less than ± 10.0%. The pharmacokinetic parameters, Tmax, Cmax, AUC 0-t and T1/2 were (2.44±1.29) h, (375±138) μg/L, (2 915±585) h·μg/L and (11.10±2.41) h. Conclusion This LC-MS / MS method is simple, sensitive, rapid and suitable for pharmacokinetics study of sitagliptin in human being. Related Articles | Metrics

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The efficacy of febuxostat in the treatment of chronic kidney disease with hyperuricemia and its influence in renal function: a Meta-analysis GONG Shu-hao, LU Wan-jun, OUYANG Liu-rong, WANG Ying△ 2018, 46 (10):  1102-1107.  doi: 10.11958/ 20180796 Abstract ( 1045 )   PDF (677KB) ( 4182 )   Abstract：Objective To investigate the efficacy of febuxostat in hyperuricemic patients with chronic kidney disease and its influence in renal function. Methods All randomized controlled trials (RCTs) that focus on the efficacy of febuxostat and its effect on renal function in hyperuricemic patients with chronic kidney disease were screened from CNKI, CBM, WanFang, VIP, Embase, Pubmed, OVID and Cochrane library clinical controlled trials database. Data were extracted by two independent researchers, and the control of quality was evaluated from the modified Jadad rating scale. Meta analysis was then undertaken through RevMan 5.3 software. Results A total of 12 RCTs were obtained, including 1 031 patients with chronic kidney disease and hyperuricemia. Patients were divided into febuxostat group (n=516) and control group (n= 515). Meta-analysis results showed that the effects of febuxostat were significantly better than those of control group including serum uric acid (MD=-61.28, 95%CI: -67.68- -54.88, P ＜ 0.001), serum creatinine (MD=-31.51, 95%CI: -36.25- -26.76, P＜0.001), blood urea nitrogen (MD=-2.14, 95%CI: -2.87- -1.41, P＜0.001) and eGFR after treatment (MD=4.13, 95%CI: 1.67-6.58, P=0.001). There was no significant difference in the incidence of adverse reactions between the febuxostat group and the control group (OR=0.55, 95%CI: 0.15-1.92, P=0.35). Conclusion The current clinical evidences show that febuxostat has a better effect on the treatment of hyperuricemic patients with chronic kidney disease. Related Articles | Metrics

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Treatment of the perilous placenta previa patients with placenta implantation by abdominal aorta balloon occlusion: a Meta-analysis ZHENG Ming-jian, GU Jian-ping, XU Wen-jian, SHI Wan-yin, LU Jing-yuan 2018, 46 (10):  1108-1113.  doi: 10.11958/20180655 Abstract ( 730 )   PDF (705KB) ( 3877 )   Abstract：Objective To evaluate the safety and efficacy of abdominal aorta balloon occlusion in the treatment of perilous placenta previa (PPP) patients with placenta implantation. Methods The literature data were retrieved from the electronic databases of PubMed, Cochrane Library, Web of Science and EMbase. The retrieval time was from the database construction to March 2018. Two reviewers independently screened literature extracted data and evaluated the quality of the included studies according to the inclusion and exclusion criteria. Then, Meta-analysis was performed by RevMan 5.3 software. Results Finally, 6 retrospective cohort studies involving 515 patients (342 cases in balloon group and 173 cases in control group) were included. The results of Meta-analysis showed that the intraoperative blood loss was less in the balloon group than that of the control group (SMD=-0.51, 95%CI:-0.80- -0.23, P=0.000 4), and the hysterectomy rate was lower in the balloon group than that of the control group (OR=0.40, 95%CI: 0.21-0.74, P=0.003). But there were no significant differences in the amount of packed red blood cell transfusion (SMD=-0.23, 95%CI: -0.54 - 0.07, P=0.13) and the length of postoperative hospitalization (SMD=- 0.23, 95%CI: - 0.12-0.58, P=0.20) between the two groups. The associated adverse reactions of abdominal aorta balloon occlusion included hematoma of the puncture point and arterial/vein thrombosis. The above complications were all relieved after conservative treatments. Conclusion The treatment of PPP patients with implantation by abdominal aorta balloon could decrease the amount of bleeding during the operation, reduce the hysterectomy rate, and has no serious related complications. However, the above conclusions still need more high quality and large sample studies to futher verify. Related Articles | Metrics

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A meta-analysis of risk factors for prolonged mechanical ventilation following coronary artery bypass grafting WANG Zi-yu, FU Qiang, WANG Shu-ying, ZHANG Bin, LIU Jun-ling, SUN He-yuan, YAN Wei-qing 2018, 46 (10):  1114-1121.  doi: 10.11958/20180692 Abstract ( 692 )   PDF (1154KB) ( 3752 )   Abstract: Objective To systematically evaluate the risk factors of prolonged mechanical ventilation after coronary artery bypass grafting. Methods PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials. gov, CNKI, Wanfang and VIP were systematically searched for case-control studies or cohort studies on factors associated with prolonged mechanical ventilation following coronary artery bypass grafting. According to Cochrane system evaluation method, the quality of the research literatures meeting the inclusion criteria was evaluated. The adjusted odds ratio (OR) and 95%CI were extracted, and the RevMan5.3 software was used for Meta analysis. Results Seven literatures were included in the study, including 5 336 patients. The correlation between prolonged mechanical ventilation following coronary artery bypass grafting and demographic factors was studied, including age, gender, body mass index, preoperative factors (left ventricular ejection fraction, chronic obstructive pulmonary disease and renal dysfunction), intraoperative factors (operative time) and postoperative factor (reoperation). Meta-analysis revealed that older age (OR=1.06, 95%CI: 1.05-1.07), female (OR=1.92, 95%CI: 1.37-2.68), renal dysfunction (OR=2.35, 95%CI: 1.41-3.90), longer operative time (OR=1.50, 95%CI: 1.22-1.85) and reoperation (OR=9.56, 95%CI: 3.65-25.00) were the independent risk factors for prolonged mechanical ventilation after coronary artery bypass grafting, and higher left ventricular ejection fraction (OR=0.97, 95%CI: 0.95-0.99) was the protective factor. There was insufficient evidence to confirm the correlation between body mass index (OR=0.95, 95%CI: 0.68-1.32), chronic obstructive pulmonary disease (OR=3.94, 95%CI: 0.68-22.81) and prolonged mechanical ventilation after coronary artery bypass grafting. Conclusion Results suggest that older age, female, preoperative lower left ventricular ejection fraction, preoperative renal dysfunction, longer operative time and reoperation are the independent risk factors for prolonged mechanical ventilation after coronary artery bypass grafting. This study provides theoretical support for the prevention and risk prediction model of prolong mechanical ventilation after coronary artery bypass grafting. Related Articles | Metrics

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The research development of CD4+ T cells and their molecular regulatory mechanism in aplastic anemia ZHANG Shan, SONG Xin-long, WANG Ai-di, XIE Dong-jie, ZHANG Le, LIU Bao-shan△ 2018, 46 (10):  1123-1126.  doi: 10.11958/20180738 Abstract ( 1311 )   PDF (339KB) ( 3781 )   Abstract: CD4+ T cells can differentiate into a variety of auxiliary T cells (Th cells) and regulatory T cells (Treg) after the stimulation of antigen, which is an important part of human immune system. With the further study of aplastic anemia and CD4+ T cells, it is found that the imbalance of CD4+ T cell subsets, hyperfunction and bone marrow injury caused by abnormal activation of cytokines are important causes of the pathogenesis of aplastic anemia. Therefore, the study of cell differentiation and regulation of CD4+ T cells and the analysis of the mechanism of CD4+ T cells in aplastic anemia can provide therapeutic ideas for the recovery of cell subpopulation balance in patients with aplastic anemia. In this paper, the effects of CD4+ T cell immune abnormalities on the mechanism and treatment of aplastic anemia were discussed from the aspects of CD4+ T cells and related cytokines. Related Articles | Metrics

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Research progress of chimeric antigen receptor -T cells in the treatment of multiple myeloma DONG Qian-qian, WU Wei-wei, ZHANG Xi-you, CHEN Feng, LI Dan-dan 2018, 46 (10):  1127-1131.  doi: 10.11958/20180816 Abstract ( 718 )   PDF (376KB) ( 3840 )   Abstract: Chimeric antigen receptor T cell (Car-T) is a kind of new targeted therapy. With the continuous progress of basic and clinical research, more and more target antigens have been found, making the possible indications for Car-T gradually expanded. Multiple myeloma (MM) is still considered an incurable disease, Car-T immunotherapy based on genetic engineering and targeted therapy is becoming a new approach for treating relapsed and refractory MM. This article briefly reviews the recent progress of this field Related Articles | Metrics

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The progress of miRNA in the pathogenesis of immune thrombocytopenia ZHAO Hai-feng, KAN Yu-tian, WANG Xin-yuan, ZHANG Yi-zhuo 2018, 46 (10):  1131-1134.  doi: 10.11958/20180786 Abstract ( 736 )   PDF (327KB) ( 3518 )   Abstract：Immune thrombocytopenia (ITP), one of the most common bleeding disorders, is characterized by clinical manifestations of skin mucosa and internal bleeding and by decreased platelet count due to auto-antibody mediating the platelets destruction and insufficient platelet production. The exact etiology of ITP is still unclear so far. To fully understand the pathogenesis of ITP not only has important theoretical significance but also may provide a new strategy for the treatment of the disease. MicroRNA (miRNA) is a class of small non-coding RNAs with a length of 19-22 nucleotides. It is involved in the occurrence and development of many diseases by regulating its target genes. At present, there are more and more studies on the role of microRNAs in the pathogenesis of ITP. In this review, the progress of miRNA in the pathogenesis of ITP in recent years was summarized Related Articles | Metrics

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The role of heart-type fatty acid-binding protein in cardiovascular diseases WANG Cui-hua, LIU Yan-gong, ZHENG Ming-qi 2018, 46 (10):  1135-1139.  doi: 10.11958/20180698 Abstract ( 1174 )   PDF (366KB) ( 5030 )   Abstract: Heart-type fatty acid-binding protein (H-FABP) is a small molecular protein, which is mainly expressed in heart and plays a key role in mitochondrial β oxidation through partitioning of long-chain fatty acids toward the mitochondria. Nowadays, H-FABP is clinically used for the early diagnosis of persistent myocardial injury and acute myocardial infarction (AMI). More and more studies have showed that H-FABP is closely related to the diagnosis and prognosis of acute coronary syndrome, heart failure and arrhythmia. Related Articles | Metrics

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The mechanism of cardiac injury induced by radiotherapy and its progress of prevention and treatment CHI Hong-yu, CAO Yue-juan 2018, 46 (10):  1140-1144.  doi: 10.11958/20180650 Abstract ( 1386 )   PDF (454KB) ( 3952 )   Abstract: Radiotherapy is one of the main treatments for malignant tumors, and is widely used today, such as breast cancer, esophageal cancer, lung cancer, mediastinal tumors, and Hodgkin's disease. Patients undergoing radiotherapy are susceptible heart damage of prolonged periods of X-ray irradiation for a long time, causing varying degrees of radiological heart disease (RIHD). RIHD may involve any structure of heart, so cardiac complications become life-threatening diseases in cancer survivors. The effective clinical management and prevention are still quite challenging. This article reviews the manifestation, pathogenesis, monitoring of cardiac related indexes and progressin prevention and treatment of cardiac injury in patients after radiotherapy. Related Articles | Metrics