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15 November 2018, Volume 46 Issue 11 Previous Issue    Next Issue

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Expression of FABP5 and its prognostic role in renal clear cell carcinoma: An analysis based on the data-mining of public database GAO Xin, ZHANG Shu-fang△, HUANG Deng-gao, CAO Hui 2018, 46 (11):  1145-1150.  doi: 10.11958/20180999 Abstract ( 1084 )   PDF (919KB) ( 3727 )   Abstract: Objective To explore the expression of fatty acid-binding protein 5 (FABP5) gene and its prognostic significance in renal clear cell carcinoma. Methods Data of FABP5 were retrieved from Oncomine and GEO database, then the role of FABP5 in renal clear cell carcinoma was mined and analyzed. The DAVID database was used to analyze the function of differentially genes, and the prognosis analysis was analyzed by GEPIA. Results Totally, 445 different types of cancer studies about the expression of FABP5 were identified in the Oncomine database. The FABP5 expression was statistically significant in 63 of the studies, over-expressed in 32 (5 in renal carcinoma) and under-expressed in the other 24 (0 in renal carcinoma). There were 4 studies involved the expression of FABP5 in clear cell renal cell carcinoma and normal tissues. Compared with normal tissues, the expression of FABP5 was higher in renal clear cell carcinoma (P＜0.05). In addition, through further mining the data set GSE66271 of GEO database, the results showed that the expression of FABP5 was higher in renal clear cell carcinoma than that in normal tissue (P＜0.001). The results of GSE66271 microarray data analysis in GEO database showed that the expression of differential gene FABP5 was significantly higher in renal clear cell carcinoma than that of normal tissue (P＜0.01). DAVID functional analysis found that these differential genes mainly focus on the affectting transfer protein activity and protein digestion and absorption metabolic function. The overall mortality was higher in patients with over-expressed FABP5 (n=258), and the prognosis was better in patients with under-expressed FABP5 (n=258) analyzed by GEPIA using TCGA database and GTEx project (P=0.001 1). Conclusion FABP5 is highly expressed in renal clear cell carcinoma, and its expression is associated with poor prognosis of renal clear cell carcinoma, which might be an important therapeutic target of renal clear cell carcinoma. Related Articles | Metrics

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The effect of lentivirus-mediated overexpression of microRNA-155 on hepatoma cell HepG2 proliferation NIU Lian-jie1,ZHANG Ya-min2△, WU Zhao-guo1 2018, 46 (11):  1151-1154.  doi: 10.11958/20180721 Abstract ( 728 )   PDF (554KB) ( 3809 )   Abstract：Objective To investigate the effect of up-regulation of microRNA-155 (miR-155) on the proliferation of hepatoma cell line HepG2 by constructing lentivirus (LV) overexpressing miRNA-155. Methods The specific miR-155 overexpressing fragment was synthesized into the target sequence and cloned into the lentiviral vector pGCSHL-GFP. The recombinant miR-155-hRNA-LV and the negative control empty viral vector were transfected into HepG2 cells to establish stable overexpression miR-155 cell line. The miR-155 cells were divided into three groups including the overexpression group (H group), the negative control group (negative control, NC group) and the normal group (normal, N group). Real-time fluorescent polymerase chain reaction (qRT-PCR) was used to detect the expression levels of miR-155 and PTEN in three groups. Western blot assay was used to analyze relative expressions of PTEN, CyclinD1 and CyclinA1+A2 proteins in three groups. Cell proliferation-toxicity test (CCK-8) was used to detect cell proliferation. Results The expression of miR-155 was significantly higher in H group than that in NC group and N group. The expression of target gene PTEN was lower in H group than that in NC group and N group (both P＜0.05). The expression of PTEN protein was significantly lower in H group than that in NC group and N group, while the expressions of CyclinD1 and CyclingA1+A2 protein were significantly higher in H group compared with that of NC group and N group (both P＜0.05). CCK-8 results showed that the photometric values of the three groups began to differ at 12 h, and the luminosity values were significantly greater in H group than those of NC group and N group from 24 h to 72 h, but the difference was not statistically significant between NC group and N group. Conclusion Overexpression of miR-155 can promote the proliferation of HepG2 cells. Related Articles | Metrics

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The mechanism of QingYiTang or Turmeric for adjusting the intestinal microecology after severe acute pancreatitis HU Wei 1,LIU Hong-bin2， 3△, WANG Man-xue1,ZHANG Gui-xian2,LI Dong-hua3,ZHANG Yi 3 2018, 46 (11):  1155-1160.  doi: 10.11958/20180712 Abstract ( 1111 )   PDF (714KB) ( 3802 )   Abstract: Objective To explore the treatment mechanism of severe acute pancreatitis (SAP) by adjusting the intestinal microecology of QingYiTang or Turmeric. Methods According to the random number method， forty healthy Wistar rats with SPF grade were divided into four groups, with 10 rats in each group, respectively named the control group, the model group, the QingYiTang group, and the Turmeric group. Na-Fc was injected to induce SAP model rats, before the modeling, QingYiTang and Turmeric group were respectively given corresponding traditional Chinese medicine decoctionin by tragastric administration for 1 week. The pathological changes of colon and pancreas tissues were observed by hematoxylin-eosin (HE) staining. Feces from caecal segments of rats were collected, and changes of intestinal microbial flora were analyzed by 16S rDNA sequencing technique in four groups. Results (1) According to the pathological results, the intestinal tissue of model group showed edema of intestinal wall, epithelial defect and exfoliation of intestinal mucosa, widening of interstitial space under epithelium, a large number of inflammatory cells, such as PMN infiltration. Pancreatic tissues showed pancreatic acinar edema, necrosis, enlarged septa, a large number of PMN and other inflammatory cell infiltration. The QingYiTang and Turmeric groups showed reduced pancreatic injury and intestinal mucosa damage (P＜ 0.05). (2)The results of the microecology of intestinal flora showed that the richness of firmicutes (including clostridium and bacillus), and spirulina were effectively reduced in SAP rats, otherwise the richness of bacteroides (including bacteroides and bacteroides) and lactobacillus were increased. Conclusion QingYiTang and Turmeric can increase intestinal flora diversity and richness in SAP rats, regulate the microbial ecological balance, increase the amount of probiotic group, reduce harmful bacteria colonize ability, so as to achieve the protection of intestinal function. Related Articles | Metrics

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Biomimetic circumferential oriented polycaprolactone microfiber scaffold for annulus fibrosus tissue engineering DU Li-long, XU Bao-shan△, YANG Qiang, CHENG Zhao-jun, XU Hai-wei 2018, 46 (11):  1161-1166.  doi: 10.11958/20181572 Abstract ( 738 )   PDF (946KB) ( 3448 )   Abstract: Objective To investigate oriented polycaprolactone (PCL) microfiber scaffold for intervertebral disc (IVD) tissue engineering and verify the feasibility as a potential candidate for IVD tissue engineering. Methods A biomimetic circumferentially oriented microfiber scaffold was prepared by wet spinning method using PCL solution. The scaffold was investigated by stereomicroscope. The scanning electron microscopy (SEM) and micro-CT were used to determine the microstructure, porosity and fiber diameter of the scaffolds. The rabbit annulus fibrosus (AF) cells were isolated from IVD and seeded into the microfiber scaffold. The cell-scaffold complex was cultured for 14 days in vitro. The biocompatibility of the scaffold was evaluated by SEM and Live/dead staining. The cell attachment and infiltration were evaluated by phalloidin staining and DiI fluorescence labeling. The histology analyses of the cell-scaffold were examined by H&E staining, Safranin O staining, and type Ⅰ immunohistochemistry and immunofluorescence staining. Results The stereomicroscope images showed that the AF scaffold presented a ring structure similar to the native AF tissue. SEM and micro-CT revealed that the AF scaffold was 3D circumferentially oriented fiber structure without adhesion. The scaffold had a porosity of 69.33%± 6.67%, and the fiber diameter was (16.13±2.77) μm. SEM and phalloidin staining revealed that the AF cells spread along the fiber direction. The DiI-labeled images revealed that the AF cells grew into the inside of the scaffold after 14 days of culture. Histological staining showed that the AF cells grew inside the scaffold and spread along the microfiber direction and secreted AF-related extracellular matrix, which also oriented along the microfiber direction. Conclusion The biomimetic circumferential oriented PCL microfiber scaffold has high porosity and good biocompatibility, and could guide oriented growth of AF cells and orient deposition of AF-related ECMs. They are ideal scaffolds for the application of regeneration of IVD. Related Articles | Metrics

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Shenkang injection can inhibit the release of TNF-α, TGF-β1, VEGF and CTGF in the cultured mouse peritoneal mesothelial cells in vitro WANG Li 1,XIA Tian1△, ZHANG Hong-zhen2,LI Rong1 2018, 46 (11):  1166-1170.  doi: 10.11958/20180910 Abstract ( 912 )   PDF (607KB) ( 4200 )   Abstract: Objective To investigate the effect of Shenkang injection on levels of cytokines, such as tumor necrosis factor-alpha (TNF - α), transforming growth factor-beta 1 (TGF - β1), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) of mouse peritoneal mesothelium cells (MPMCs) cultured in vitro. Methods MPMCs were cultured and identified, and divided into blank control group (group A, DMEM), positive control group (group B, DMEM+140 mmol /L glucose), low (group C), medium (group D) and high (group E) doses of Shenkang injection groups (culture medium of B group + volume ratio 1%, 2%, 4% Shenkang injection). MPMCs and culture supernatamt were collected respectively after being cultured for 24 hours. The levels of TNF-α, TGF-β1, VEGF and CTGF in the supernatant were detected by enzyme-linked immunosorbent assay. The levels of mRNA transcription of these four cytokines were detected by real-time RT-PCR. Results Compared with group A, TNF-α, TGF-β1, VEGF and CTGF levels in culture supernatant and mRNA levels in cultured MPMCs were significantly increased in group B (P＜0.05). Compared with group B, after adding Shenkang injection to cell culture medium, all of TNF-α, TGF-β1, VEGF and CTGF induced by high- concentration glucose and mRNA levels in cultured MPMCs were decreased with a dose-dependent way. Conclusion A certain concentration of Shenkang injection can inhibit the expression and transcription of TNF- α, TGF-β1, VEGF and CTGF induced by high-concentration glucose in MPMCs. Related Articles | Metrics

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Study on NLRP3 inflammasome activation of alveolar macrophages in rat model of lung injury induced by PM2.5 GU Na1,ZHANG Gui-xian1,SHI Peng-cheng1,TAN Cheng1,LIU Wei-wei 1,ZHAO Xiu-mei 1,LIU Hong-bin1△, TIAN Ying-ze2,HU Zhi-jie1 2018, 46 (11):  1171-1175.  doi: 10.11958/20180802 Abstract ( 898 )   PDF (1472KB) ( 5018 )   Abstract: Objective To study the role of NLRP3 inflammasome activation of alveolar macrophages in lung injury induced by PM2.5. Methods Rats were made into the lung injury model by intratracheal instillation of high, medium and low doses (15, 10, 5 mg /kg respectively) of PM2.5 suspension collected by medium flow atmospheric sampler. Three days later, the bronchoalveolar lavage was performed, and the phagocytic function of the macrophages in bronchoalveolar lavage fluid (BALF) was measured by neutral red method. And the expression of NLRP3 in lung macrophages was observed by double-immunofluorescent labeling method. The rats were sacrificed, and the lungs were dissected to observe the severity of lung injury by HE staining. The expression of NLRP3 was observed by immunohistochemistry staining. The expressions of IL-18, IL-1β and Caspase-1 in lung tissues were detected by ELISA method. Results By intratracheal instillation of PM2.5, the phagocytic function of macrophages in BALF decreased. And lung injuries of the rats were obvious, manifesting as interstitial pneumonia, significantly widened alveolar septum, partial alveolar wall rupture, especially in the high dose group. The pathological scores of lung tissue were all significantly higher in three experiment groups than those in control group (P＜0. 05). The expressions of NLRP3 in lung tissue were higher in low, medium and high dose groups than those of the control group. The expressions of IL-18, IL-1β and Caspase-1 in lung tissue increased in different degrees. Conclusion The lung injury and inflammatory response caused by PM2.5 are related to the activation of NLRP3 inflammasome in alveolar macrophages in rats. Related Articles | Metrics

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Clinical efficacy of radiofrequency ablation assisted open surgery in the treatment of spinal metastases of clear cell renal cell carcinoma LIU Le-le, WANG Guo-wen△, HAN Xiu-xin, ZHANG Chao, REN Zhi-wu, LI Li-li, XU Yao 2018, 46 (11):  1176-1180.  doi: 10.11958/20181018 Abstract ( 1226 )   PDF (411KB) ( 4169 )   Abstract: Objective To investigate the outcome of the combination of radiofrequency ablation (RFA) and open surgery for treating spinal metastases in clear cell renal cell carcinoma (CCRCC). Methods From April 2009 to October 2013, 31 CCRCC cases with spinal metastases were reviewed retrospectively in the present study, including 24 males and 7 females, with an average age of (55.3±10.5) years (range, 35~71 years). All the patients were divided into two groups based on the received treatment, including combinative treatment group (received the combinative treatment of RFA and surgery, n=13) and surgery group (received surgery without RFA application, n=18). Blood loss and intra-operative time were compared between the two groups. Pain levels were assessed by visual analogue scale (VAS). Neurologic deficit was evaluated by Frankel grade, and function was classified by Karnofsky Score (KPS). The quality of the life was assessed by EORTC QLQ-C30 (Version 3.0) questionnaire. Survival time was also analyzed after treatment. Results The period of follow-up ranged from 10 to 50 months with the average of (26.65±1.96) months. The blood loss was (1 488.46±629.87) mL in combinative treatment group, which was significantly less than that in surgery group (2 050.00±726.19) mL (P＜0.05). The intra-operative time (221.54 ± 79.04) min was significantly reduced in the combinative treatment group than that of surgery group (291.11±95.29 min, P＜0.05). VAS scores significantly decreased 3 months and 6 months after treatment in the two groups (P＜0.01). The proportion of Frankel grade (Grade D and E) increased from 53.8% (pre-operation) to 84.6% (post-operation) in the combinative treatment group (P＜0.05), while surgery group showed the significant change from 66.7% (pre-operation) to 88.9% (post-operation, P＜0.01). Compared with pre-operative KPS score, the proportion of KPS score (80-100) increased by 38.4% and 27.8% 3 months after operation in combinative treatment group and surgery group, respectively. The functional state improved significantly after treatment is both groups (P＜0.05). Conclusion The combination of RFA and surgery is a safe and efficacy treatment strategy for clear cell renal cell carcinoma patients with spinal metastases, which can significantly reduce the blood loss and intra-operative time in surgery. Related Articles | Metrics

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Association study of ORAI1 gene rs3741596 single nucleotide polymorphism and Kawasaki disease BA Shuang1,ZHANG Hong-yan2△ 2018, 46 (11):  1181-1185.  doi: 10.11958/20180803 Abstract ( 667 )   PDF (799KB) ( 4253 )   Abstract: Objective To investigate the relationship between single nucleotide polymorphism (SNP) at the calcium release-activated calcium modulator 1 (CRACM1/ORAI1) gene rs3741596 and the susceptibility of Kawasaki disease (KD), and KD merged coronary artery lesions (CALs). Methods Forty-six children diagnosed as KD and twenty-five health children were enrolled in this study. All subjects in case group were divided into CAL group and NCAL group according to the presence of CALs. Polymerase chain reaction (PCR) and direct sequencing were applied to detect the SNPs of ORAI1 gene rs3741596 in all subjects, and then further statistical analysis was conducted. Results ORAI1 gene rs3741596 SNP was detected in all subjects. There were no significant differences in the genotype distribution and allele frequency between the KD group and health control group (χ2 =0.712 and 0.499, P＞0.05). While, there were significant differences in the genotype distribution and allele frequency between the CAL group and NCAL group (χ2 =6.524 and 6.891， P＜0.05). The KD patients with G allele increased the risk of CALs (OR=5.444， 95%CI： 1.386-21.380). Conclusion The ORAI1 gene rs3741596 SNP may have no correlation with KD susceptibility, while it is related with the susceptibility to CALs in KD patients. Related Articles | Metrics

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Comparative analysis of clinical and imaging features of "Y" shape and half "Y" shape medullary infarction FU Lang-hua1,HAN Xiao2,SONG Yi-jun1△ 2018, 46 (11):  1185-1188.  doi: 10.11958/20180537 Abstract ( 1329 )   PDF (398KB) ( 3823 )   Abstract：Objective To investigate the clinical and imaging features of the "Y" shape and half "Y" shape medullary infarction in patients with medullary infarction. Methods The clinical and imaging findings of 11 patients with medial medullary infarction (MMI) in the ventral, middle and dorsal (VMD) parts of the medulla oblongata were retrospectively analyzed. Results There were 11 MMI patients with VMD involvement in this study. Of them there were 6 cases with bilateral infarction, showing the "Y" shape and 5 patients with unilateral infarction, showing half "Y"-shape. In "Y"-shaped group, the most common symptoms and signs were drinking cough or dysphagia (6 cases), dizziness or vertigo (5 cases), limb weakness (5 cases), dysarthria (5 cases), sensory disorders (5 cases) and central respiratory disorders (3 cases). In the half "Y" shape group, the most common symptoms and signs were dizziness or vertigo (5 cases), limb weakness (4 cases), dysarthria (4 cases) and sensory impairment (4 cases). There was a significant difference in the proportion of dysphagia and dyspnea between the two groups. The congenital variation of vertebral artery was more common in two groups of patients (n=3 for both groups). In addition to respiratory failure, the outcomes of MMI patients were favorable. Conclusion The frequency of dysphagia and respiratory failure is much higher in patients with "Y"-shaped medullary infarction compared with that in patients with half "Y"-shaped infarction of medulla oblongata. Vertebral artery variation with one-sided superiority is an important anatomical basis for MMI patients with VMD involvement at the same time. Related Articles | Metrics

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Association between vitamin D levels and the severity of community-acquired pneumonia QI Li △, TIAN Yong-hong 2018, 46 (11):  1189-1192.  doi: 10.11958/20180961 Abstract ( 982 )   PDF (353KB) ( 3934 )   Abstract: Objective To evaluate the serum vitamin D (Vit D) deficiency in hospitalized patients with community- acquired pneumonia (CAP), and to investigate its association with clinical outcomes and disease severity. Methods A total of 96 CAP patients admitted to our hospital from June 2016 to February 2018 were selected in this prospective study. The general characteristics, clinical data and biochemical indexes in 48 hours of admission were measured in 96 CAP patients. The patients were divided into three groups by serum levels of 25-hydroxyvitamin D ［25(OH)D]: <10 µg/L group (n=46), 10~ 20 µg / L group (n=30) and ≥20 µg / L group (n=20). All these indexes were compared between three groups. Logistic regression analysis was used to investigate the relationship between 25(OH)D and the severity of CAP. Results In total 96 CAP patients there were 76 patients (79.2%) with Vit D deficiency, [25(OH)D<20 µg/L]. Prevalence of severe deficiency of Vit D ［25(OH)D<10 µg/L］ was far more (63.6%) in high-risk CAP patients (CURB-65 score 3-5) than that of low-risk CAP patients (39.7%, CURB-65 score 0-2). And when serum 25（OH）D <10 µg/L, the risk of developing high-risk CAP was 4.247 times of those with 25（OH）D≥20 µg/L (95%CI:1.041-17.337， P=0.044). Conclusion Hospitalized CAP patients have low Vit D status, and which is associated with the severity of CAP. The risk of aggravation is significantly higher in CAP patients with severe Vit D deficiency. Related Articles | Metrics

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Clinical application of pneumatic artificial larynx for voice rehabilitation after total laryngectomyClinical Application of Pneumatic Artificial Larynx for Voice Rehabilitation after Total Laryngectomy WU Dong-qing1,2,SUN Shi-ming2△, CAO Li-hong2,WAN Lang1,ER Pu-chun3 2018, 46 (11):  1192-1196.  doi: 10.11958/20180643 Abstract ( 1160 )   PDF (540KB) ( 3756 )   Abstract: Objective To explore the structure, use and clinical application of the pneumatic artificial larynx, and to provide the reference for clinical application for patient’ s better voice rehabilitation. Methods For 15 laryngeal cancer patients underwent total laryngectomy, the pneumatic artificial larynxes developed by ourselves were applied for voice rehabilitation. The structure, pronunciation principle and application effect of the pneumatic artificial larynxes were studied. The hearing distance method, voice subjective auditory-perceptual evaluation method (GRBAS scale) and voice handicap index (VHI) scale were used to assess the pronunciation effect. And the patients were followed up. Results Fifteen cases basically could communicate as normal after training for one week. Evaluation of pronunciation effect: 14 cases (93.33%) reached level Ⅰ to level Ⅱ evaluated by hearing distance method, 15 patients were 0 to 1 points, except for one case with 2 points (with voice weakness A) evaluated by GRBAS scale. The total scores of VHI scale were significantly lower after two- week pronunciation training compared with one-week pronunciation training in 14 patients (P＜0.01). There was a significant correlation between function (F), physiology (P) and emotion (E) after one week pronunciation training. There was no significant correlation between F, P and E after two-week pronunciation training. Follow-up results showed that 12 cases could speak fluently and clearly, reaching the success rate of 85.7% excluding one case died because of tumor recurrence. Conclusion The application of pneumatic artificial larynx can make the patient without larynx to speak clearly and fluently, and maintain the original linguistic features. The method is easy to operate and has high success rate, and the longer training time, the better the pronunciation effect is, which is worthy of clinical promotion for application. Related Articles | Metrics

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Clinical analysis of 263 cases of uncomplicated twin pregnancy in a single center for 5 years WANG Jing, NAN Yan-rong△, MA Xiao-juan 2018, 46 (11):  1197-1200.  doi: 10.11958/20180647 Abstract ( 834 )   PDF (340KB) ( 4237 )   Abstract: Objective To investigate the clinical characteristics and neonatal outcomes of 263 cases of uncomplicated twin pregnancy treated in the Affiliated Hospital of Yan'an University. Methods From January 2013 to December 2017, 263 cases of uncomplicated twin pregnancy were collected and divided into dichorionic diamniotic (DCDA) twin pregnancy group (n=206) and monochorionic diamniotic (MCDA) twin pregnancy group (n=57). The general data, pregnancy and perinatal complications and neonatal outcomes were compared between the two groups. Results In DCDA group, the natural conception rate was 69.9%, and the assisted reproductive conception rate was 30.1%, which was statistically significant compared with those of MCDA group (93.0% and 7.0%, P＜0.05). There were 123 cases with preterm delivery in DCDA group accounted for 59.7% (123/206), and 42 cases with preterm delivery (73.7%) in MCDA group. The incidence of neonatal adverse outcomes was 36.5% (148/405) in DCDA group, which was significantly lower than that of 49.1% (55/112) of MCDA group (P＜0.05). The incidence of neonatal asphyxia was significantly lower in DCDA group (10.1%, 41/405) than that in MCDA group (17.0%, 19/112, P＜0.05). Meanwhile, the conversion rate to neonatal intensive care unit (NICU) was significantly lower in the DCDA group (42.0%, 170/405) than that of MCDA group (53.6%, 60/112, P＜0.05). There were no significant differences in the incidence of neonatal respiratory distress syndrome (NRDS), pathological jaundice and infection between the two groups (P＞0.05). Conclusion For uncomplicated twin pregnancy cases, the standardized pregnancy management should be carried out according to DCDA or MCDA, and the timing of delivery should be individualized. Related Articles | Metrics

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Clinical characteristics and antimicrobial resistance analysis of 204 strains of carbapenem resistant pseudomonas aeruginosa YANG Jing1,LONG Li 2,YANG Ya-min1,YIN Jun-mei 2,ZHANG Fu-yu2,TIAN Jie2 2018, 46 (11):  1201-1205.  doi: 10.11958/20180856 Abstract ( 1138 )   PDF (374KB) ( 3537 )   Abstract: Objective To analyze clinical distribution, patients factors and drug resistance of 204 strains of carbapenem resistant pseudomonas aeruginosa (CRPA), and to provide scientific basis for clinical rational and effective use of antimicrobial agents. Methods The VITEK-2 Compact automatic microbial analysis system was used for bacterial species identification and drug sensitivity test of isolated 204 strains of CRPA in our hospital from January 2017 to December 2017. The clinical distribution and specimen sources were analyzed. The influence of different factors on the detection rate of CRPA was compared between groups of patients. The differences of drug resistance of isolated strains were compared between the respiratory tract and non-respiratory tract specimens, and between intensive care unit (ICU) and ordinary ward. Results There were 97 strains of CRPA in ICU and 107 strains of CRPA in ordinary ward in total 204 strains of CRPA. The specimens were mainly from respiratory tract, accounting for 169 strains (82.84%). The rest was from non- respiratory tract, accounting for 35 strains (17.16%). The detection rates of CRPA were significantly higher in patients with underlying disease, use of antibacterial agents for nearly 90 days, invasive procedures, and the detection time of bacterial strains was＞48 hours after admission than those in patients with no underlying disease, no antibacterial drug use for nearly 90 days, no invasive operation, and the detection time of bacterial strains was ≤48 hours after admission (P＜0.01). The drug resistance rates to ceftazidime and ciprofloxacin were significantly lower in the respiratory specimen group than those in the non-respiratory specimen group (P＜0.05), and there were no significant differences in drug resistance rates to 12 remaining antibacterial agents between two groups of patients (P＞0.05). The drug resistance rates were significantly lower in isolated strains of ticacillin/clavic acid, cefoperazone/shubatan, amikacin, cefepime and gentamycin in the ordinary ward than those in ICU (P＜0.05), and there were no significant differences in drug resistance rates of the 9 remaining antibacterial agents (P＞0.05). There were no significant differences in the drug resistance rates between imipenan and meropenem in 204 strains of CRPA (P＞0.05). Conclusion The infection of CRPA occurs frequently in hospital. The drug resistance situation is equally severe in ICU and ordinary ward, and in the respiratory system and non- respiratory system. It should be caused clinical attention. Related Articles | Metrics

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Distribution and drug sensitivity of carbapenem-resistant Enterobacteriaceae isolated from children LI Chan, CHEN Nan 2018, 46 (11):  1205-1208.  doi: 10.11958/20180798 Abstract ( 1262 )   PDF (341KB) ( 3480 )   Abstract: Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae (CRE) of 2013-2017-year clinically isolated from children in our hospital, and to provide a basis for control and treatment of infections caused by such bacteria. Methods The VITEK 2 Compact automatic microbiological identification drug sensitive instrument was used to carry on the drug sensitivity test to this kind of bacterium, and refer to the CLSI-M100 standard to carry on the drug sensitivity experiment. WHONET5.6 software was used for the result analysis, and χ2 test was used to carry out statistical analysis. Results From 2013 to 2017, 687 strains of CRE were isolated clinically, and the detection rate was 10.64%. The strains were Klebsiella pneumoniae (302 strains), Escherichia coli (213 strains) and Proteus (72 strains). The detection rate of CRE showed an upward trend in 5 years. The specimens were mainly from urine (38.14%) and respiratory tract (30.13%). The resistant rates of CRE strains to aminoglycoside and quinolone antimicrobial agents were < 30%, but which of other beta-caprolactam drugs were more than 70%. Conclusion The strain of CRE shows increasing trend in children’ s infection, and most of them are multi-drug resistant strains. Related Articles | Metrics

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Clinical usefulness of 18 F-FDG PET/CT in patients with elevated SCC antigen after treatment of uterine cervix squamous cell cancer SHI Wen-jie, WANG Xiao-jie， MAO Yuan-yuan, SONG Shen 2018, 46 (11):  1209-1212.  doi: 10.11958/20180609 Abstract ( 1054 )   PDF (386KB) ( 5440 )   Abstract: Objective To investigate the diagnostic value of 18 F - fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in uterine cervix squamous cell cancer patients with squamous cell carcinoma antigen （SCC-Ag） elevation after treatment. Methods Data of 52 cervical squamous cancer patients with elevated SCC-Ag (>1.5 μg/L) after surgery and/or radiotherapy and chemotherapy were retrospectively analyzed．18 F-FDG PET/CT was used for full body scanning to show the recurrence and / or metastasis in patients. The diagnostic efficiency of PET / CT in the recurrence and/or metastasis of cervical squamous cell carcinoma was evaluated according to pathological and (or) follow-up results. The follow-up period was 6 to 12 months. Results There were positive 18 F-FDG PET/CT findings in 44 patients and negative 18 F-FDG PET/CT findings in 8 patients. There were 3 false-positive and 1 false-negative cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnostic efficiency of PET/CT were 97.6% (41/42), 70.0% (7/10)， 93.2% (41/44)， 87.5%(7/8) and 92.3%(48/52) respectively. The diagnostic results of 18 F-FDG PET/CT are highly consistent with histopathological and (or) clinical follow-up results (Kappa value=0.732，P＜0.01). Conclusion 18 F-FDG PET /CT can reliably identify and accurately detect the recurrence and (or) metastasis of cervical squamous cancer in patients with elevated SCC-Ag after treatment, which has important clinical application value. Related Articles | Metrics

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The clinical analysis of metformin in the treatment of obese children with hyperinsulinemia JIANG Li-hong1,ZHU Kai-kai 2,ZHENG Rong-xiu1,YANG Qing-yan1,LIU Ge-li 1△ 2018, 46 (11):  1213-1216.  doi: 10.11958/20180400 Abstract ( 2015 )   PDF (361KB) ( 3748 )   Abstract: Objective To investigate the clinical effect of metformin combined with lifestyle intervention in obese children with hyperinsulinemia. Methods A total of 82 obese children treated in the Department of Pediatric endocrine of our hospital from January 2015 to December 2016 were selected in this study. All of them were diagnosed as hyperinsulinemia. All cases were treated with metformin in addition to lifestyle guide to adjust their dietary structure and enhance exercise for one year. Clinical anthropometric indicators including height, weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist-height ratio (WHtR) were measured before treatment and 3 months, 6 months and 12 months after treatment. Blood biochemical indexes were compared before and after treatment with metformin. Results (1) After 12 months of metformin treatment, BMI, WC, WHR and WHtR were all decreased compared with those before treatment. (2) The insulin levels were decreased significantly at all time points in 6 months compared with those before treatment. Levels of FINS, 1 h-INS and 2 h-INS were further reduced after 12-month treatment (P＜0.05). (3) After 6 months of metformin treatment, insulin resistance index (HOMA-IR), function of pancreatic beta-cell (HOMA-β) and area under curve of insulin were decreased whereas the whole body insulin sensitivity index (WBISI) increased (P＜ 0.05). The value of HOMA-IR continued to decline and WBISI continued to rise after 12-month treatment (P＜0.05). There was no significant difference in first-phase insulin secretion index (ΔI30/ΔG30) before and after treatment. Conclusion On the basis of adjusting the diet structure and strengthening the exercise, metformin can reduce BMI, improve insulin sensitivity and reduce insulin resistance in children with hyperinsulinemia. Related Articles | Metrics

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The short-term result of Toric orthokeratology for correction of myopic teenagers with moderate to high astigmatism ZHANG Shu-xian, ZHANG Ying, YANG Xiao-yan, LI Li-hua△ 2018, 46 (11):  1217-1221.  doi: 10.11958/20180686 Abstract ( 1356 )   PDF (509KB) ( 3910 )   Abstract: Objective To investigate the short term result of Toric orthokeratology (ortho-k) in correcting myopic teenagers with moderate to high astigmatism. Methods A total of 30 patients (58 eyes) who were treated in our hospital were included in this study. All patients met the inclusion criteria, and their average age were 10.62 yrs (8-14 years old), with myopia of (-0.75)-(-5.00) D and astigmatism of (-1.50)-(-3.00) D. All of the patients were fitted with Toric ortho-k. The patients were followed up for 1 day, 1 week, 1 month and 3 months since commencement of lens wear, and then they were examined for uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, corneal curvature and corneal topography. Results The success rate of first lens fitting was 96.55%. The myopia, astigmatism and uncorrected visual acuity were changed significantly（P＜0.05） in 1day, 1 week， 1 month and 3 months compared with the baseline. After 3-month lens wearing, the myopia decreased by an average of (3.74 ± 0.88) D, reduced 98.7%; and the astigmatism decreased by an average of (1.68±0.55) D, achieved 80.8% reduction. The uncorrected visual acuity was up to the best corrected visual acuity before wearing the lens, the difference showed no statistically significant. Moreover, there were significant differences in flat K， steep K and cylinder of corneal topography at each time point (P＜0.05). Besides, the surface regular index and surface asymmetry index of corneal topography failed to show the significant difference. Finally, no significant corneal pigment ring, corneal microcapsule edema, corneal epithelial exfoliation and corneal infection, or other adverse events were observed during lens wearing. Conclusion Toric orthokeratology is a safe and effective correction treatment for myopic teenagers with moderate to high astigmatism. Related Articles | Metrics

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Cone reconstruction of Ebstein’ s anomaly in children XUE Lan-gang, LU Wan-li, GUO Zhi-peng, LIU Gang, WANG Xiu-li, LI Xin, HUANG Hui, CHEN Wan-xing, ZHANG Ying, LIU Zhi-gang△ 2018, 46 (11):  1222-1225.  doi: 10.11958/20180865 Abstract ( 998 )   PDF (351KB) ( 3647 )   Abstract: Objective To summarize the cone reconstruction of Ebstein’ s anomaly in children. Methods The clinical data of 12 consecutive children (under 14 years old) underwent cone reconstruction in our hospital from August 2013 to October 2017 were retrospectively analyzed. There were 4 males and 8 females, aged (6.8 ± 4.2) years, with body mass (24.1±11.8) kg, were included in this cohort. According to Carpentier’ s classification, 1, 7 and 4 patients were classified as A, B and C types, respectively. The combined deformities included 8 atrial septal defect, 2 patent ductus arteriosus, 1 pulmonary stenosis and 1 mitral regurgitation. There were 3 patients with moderate tricuspid regurgitations and 9 patients with severe tricuspid regurgitations. There were 4 patients with cyanosis. According to NYHA classification, 4, 7 and 1 patients were classified as Ⅱ, Ⅲ and Ⅳdegree respectively. Results No death occurred in this cohort. Among these patients, 11 received successful cone reconstruction and 1 underwent tricuspid valve replacement due to failure of valvuloplasty. There were 2 patients received distal fenestrations of the cone, 2 received valvular augmentations by autologous pericardium, 2 received artificial chordae tendineaes and 2 received bidirectional Glenn shunts respectively. During (24.4±17.0)-month-follow up, no death or reoperation occurred. Among the 11 patients who successfully underwent cone reconstruction, there were 2 cases of tricuspid regurgitation (no regurgitation) and 2 cases of micro-regurgitation, 3 cases of mild-moderate regurgitation, 1 case of moderate regurgitation. And there were 10 cases of grade Ⅰ and 1 case of grade Ⅱ cardiac function. The tricuspid regurgitation and cardiac function were significantly improved after operation compared with those before operation (P＜0.05). Conclusion The proper application of targeting surgical techniques based on individualized characteristics is the key point of Cone reconstruction. Related Articles | Metrics

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The clinical value of urinary NGAL in the diagnosis and treatment of acute renal injury after neonatal asphyxia ZHANG Ying1,ZHANG Bi-li 2△, WANG Dan1 2018, 46 (11):  1226-1229.  doi: 10.11958/20180997 Abstract ( 810 )   PDF (389KB) ( 3600 )   Abstract: Objective To investigate the clinical value of urine neutrophil gelatinase-associated lipocalin (uNGAL) in the diagnosis and treatment of acute kidney injury after neonatal asphyxia. Methods A prospective study was conducted in the neonates hospitalized in our hospital for perinatal asphyxia from September 2016 to September 2017. According to whether acute kidney injury (AKI) occurred within 1 week after birth, they were divided into AKI group and non AKI group. Urine NGAL levels in 24 h after birth and serum levels of creatinine (Scr) and urea nitrogen (BUN) in 1 week after birth were detected and compared between two groups. The ROC curve was drawn to analyze the diagnostic value of uNGAL within 24 h after birth in AKI in neonatal asphyxia. Results A total of 114 cases of neonatal asphyxia were included in this study. There were 39 cases complicated with AKI, and the incidence was 34.2%. The incidence of AKI was 27.2% (24/88) in mild asphyxia group, which was significantly lower than that of the severe asphyxia group (57.69%, 15/26, P＜0.05). There were no significant differences in Scr and BUN levels of 24 h after birth between AKI group and non AKI group. Values of uNGAL and uNGAL/Ucr in 24 h after birth were significantly higher in AKI group than those of non AKI group (P＜0.05). In AKI group, there were 16 cases inⅠstage (crisis), 14 cases in Ⅱstage (damage) and 9 cases in Ⅲ stage (failure). There was significant difference in uNGAL in 24 h after birth between different stages of AKI patients. With the aggravation of AKI, the level of uNGAL gradually increased (P＜0.05). The ROC curve of AKI in neonatal asphyxia diagnosed by uNGAL within 24 h after birth was drawn. The area under the ROC curve (AUC) was calculated to be 0.842 (95%CI: 0.770-0.915, P＜0.01), the cut-off value was 118 μg/L, and the sensitivity was 87.2% and the specificity was 94.7%. Conclusion The uNGAL is a sensitive and specific index for early diagnosis of AKI after neonatal asphyxia. The increased level of uNGAL can reflect the severity of renal injury. Related Articles | Metrics

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The distinguish of dome and dart T waves between children suffered from congenital heart disease and healthy children GUO Jin 2018, 46 (11):  1230-1232.  doi: 10.11958/20180881 Abstract ( 2067 )   PDF (629KB) ( 3652 )   Abstract: Objective To investigate the distinguish of dome and dart T waves between children suffered from congenital heart disease and healthy children. Methods Data of 114 children with ECGs of dome and dart T waves were retrospectively analyzed. According to echocardiography these children were divided into two groups, congenital heart disease group (n=71) and healthy group (n=43). The amplitude and the waveforms of dart T wave were measured and compared between two groups. Results In contrast to healthy group, congenital heart disease group showed a significantly higher dart T wave. The proportion of amplitude of dart T wave was higher than dome T wave in congenital heart disease group than that of healthy group (52.11% vs. 18.60%). There were no significant differences in the height and morphology of dart T wave between different kinds of congenital heart diseases (P＞0.05). Conclusion Dome and dart T waves can be observed in ECGs of children with congenital heart disease and healthy children. The dart T wave is prominent in congenital heart disease, and the dart wave is higher than the dome wave. Related Articles | Metrics

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Primary pleuropulmonary synovial sarcoma:a case report and literature review ZHOU Xiao-lei 1,WEI Jin-xing1,FENG Fei-fei 2,ZHANG Man-lin1△ 2018, 46 (11):  1233-1235.  doi: 10.11958/20181017 Abstract ( 778 )   PDF (586KB) ( 3479 )   Abstract: Primary pleuropulmonary synovial sarcoma (PPSS) is a rare chest tumor. Clinical data of a case with PPSS confirmed pathologically were retrospectively analyzed. The clinical manifestation, imaging and pathological features of PPSS were reviewed. The diagnosis, treatment and prognosis of PPSS were discussed. Related Articles | Metrics

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case report of one adult with de Winter syndrome and literature review QI Jian-li 1,ZHAO Kai 2△, LI Yong-jian2,GAO Sheng2 2018, 46 (11):  1236-1238.  Abstract ( 753 )   PDF (756KB) ( 3642 )   Abstract：The electrocardiogram (ECG) characteristics of some patients with acute coronary syndrome (ACS) are not typical and very susceptible to be misdiagnosed. De Winter syndrome is one of the most dangerous type of ACS, which should be considered as an equal risk of ST segment elevation myocardial infarction. Emergency coronary angiography should be urgently performed to complete revascularization as soon as possible to prevent serious adverse cardiovascular events. We report a case of a 77-year-old male patient with De Winter syndrome, whose initial complaint was acute chest pain. The result of ECG showed changes of De Winter sign. It has been associated with proximal occlusion of the left anterior descending (LAD) coronary artery, even though there was no abnormal sign of myocardial injury markers. Timely reperfusion therapy by means of primary percutaneous coronary intervention (PCI) was the preferred treatment for patients with De Winter syndrome. The subsequent clinical course was uneventful. Related Articles | Metrics

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Non-ossifying fibroma of the patella: report of one case SUN Jing-tao 2018, 46 (11):  1239-1240.  doi: 10.11958/20180830 Abstract ( 934 )   PDF (991KB) ( 3552 )   Abstract: The incidence of non-ossifying fibroma is very low, and it occurs mostly in the metaphysis of the long bone distance from the epiphyseal plate of 3-4 cm, especially in tibia, femur and fibula. However, it is rarely reported in the patella at home and abroad. This article analyzed the examination and operation of a case of patellar non-ossifying fibroma, and reviewed the manifestations, pathological features and prognosis. Related Articles | Metrics

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Research progress of in situ self-assembling peptides in diagnosis and treatment of tumors and bacterial infections ZHANG Cong-rou, HUANG Fan, LIU Jian-feng, YANG Li-jun△ 2018, 46 (11):  1241-1245.  doi: 10.11958/20180971 Abstract ( 816 )   PDF (378KB) ( 3854 )   Abstract: Tumor and bacterial infections are seriously endanger human health. Therefore, it is urgent to develop effective theranostic methods to overcome these two types of diseases. In-situ self-assembling peptides can target to in-situ aggregation of lesions induced by certain specifically high-expressed substances at the lesion site and form stable nanostructures through self-assembly, thereby facilitating the accurate diagnosis and effective therapy of diseases. The therapeutic effect and the reduced toxic side effects on normal tissues make the in-situ self-assembling peptides a kind of medical material with broad application prospects in the diagnosis and treatment of diseases. This article reviews the research progress of in situ self-assembling peptides in the diagnosis and treatment of tumor and bacterial infections. Related Articles | Metrics

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Advances in research of Bcl-2 inhibitors in AML targeting therapy LI Yue-yang, TIAN Chen△ 2018, 46 (11):  1245-1248.  doi: 10.11958/20180978 Abstract ( 1377 )   PDF (335KB) ( 3914 )   Abstract：Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Induction chemotherapy is still a first-line treatment for AML. However, due to the high toxicity of AML-induction chemotherapy and the characteristics of high failure rate and high recurrence rate, chemotherapy is limited in patients with AML. In recent years, the treatment of desitabine and azacytidine has been deeply studied in the epigenetic therapy of AML, which has shaken the status of induction chemotherapy in patients with AML. With the development of AML biology, more and more targets have been found to affect the biological process of AML. The targeting drugs for AML can be classified into three categories. The first type is mutant site inhibitors, such as FLT3 and IDH inhibitors. The second type is inhibitors that regulate metabolism or signaling pathway, such as Bcl-2 antagonists and epigenetic drugs. And the third category is targeted cytotoxic drugs. The most promising drugs for AML-targeted treatment were inhibitors regulating metabolism or signaling pathway reported in the 2017 American Society of Hematology Annual meeting. Clinical trial report of Venetoclax, a Bcl-2 inhibitor, won the best abstract of this meeting. This article reviews the progress of Bcl-2 inhibitors in the treatment of AML. Related Articles | Metrics

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Clinical significance of left ventricular false tendon ZHANG Mei-juan1,WANG Pei-xian2△ 2018, 46 (11):  1249-1252.  doi: 10.11958/20180749 Abstract ( 1529 )   PDF (364KB) ( 4243 )   Abstract：Left ventricular false tendon (LVFT) refers to the fibrous cord like structure of the left ventricle except the chordae tendineae that normally connects the papillary muscle to the mitral valve. LVFT is a congenital variation of the left ventricle, which developed from the inner myocardium of embryonic heart. LVFT consists of a variety of fibrous tissues, myocardial tissues, blood vessels originating from coronary branches, and Purkinje fibers originating from the left bundle branch conduction system. Echocardiographic examination often requires nonstandard sectional imaging, and its detection rate is much lower than that of autopsy. LVFT has been considered an anatomical variation without clinical significance for a long time, but with the progress of clinical studies, it is found that LVFT is not only related to harmless heart murmur, but also can inhibit left ventricular over-remodeling. In this review, we summarize the structure, function and clinical significance of LVFT. Related Articles | Metrics

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Recent research progress of pyroptosis WANG Xing-xing1,SONG Hu1,DU Chen-yang1,WANG Zhen2,ZHANG Jian-jun2△ 2018, 46 (11):  1252-1256.  doi: 10.11958/20180776 Abstract ( 1258 )   PDF (375KB) ( 4306 )   Abstract：Pyroptosis is a pro-inflammatory form of programmed cell death, and which is dependent on the activity of the caspases acid-specific proteases. Coupling of the amino-terminal and carboxy-terminal linkers of gasdermin D (GSDMD) by caspases, the latter is displaced onto the membrane and perforated, inducing moisture penetration, cell swelling and release of inflammatory factors, which is followed by pyroptosis. The morphological features, occurrence and regulation mechanisms of pyroptosis are different from other cell death modes, such as apoptosis and necrosis. It is an important natural immune response in body and plays an important role in fighting infections and diseases. A more in-depth study of pyroptosis can recognize its role in related diseases and provide new therapeutic ideas for clinic treatment. Related Articles | Metrics