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15 December 2018, Volume 46 Issue 12 Previous Issue    Next Issue

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Effects of high salt concentration on the phenotypes and functions of VEGFR-3+ macrophages YU Fang-fang, YANG Guo-hong, LI Ming, TAO Yan-yan, WANG Xiu-juan, NIU Xiu-long, LI Yu-ming, ZHAO Ji-hong 2018, 46 (12):  1257-1262.  doi: 10.11958/20181323 Abstract ( 709 )   PDF (546KB) ( 4742 )   Objective To investigate the effect of high salt concentration on the phenotypes, lymphatic endothelial cell characteristics and functions of endothelial growth factor receptor (VEGFR)-3+ macrophages. Methods The VEGFR-3+subsets in mouse RAW264.7 macrophages were sorted by flow cytometry and divided into control group, low salt group (LS group, 20 mmol/L NaCl) and high salt group (HS group, 40 mmol/L NaCl). The viability of VEGFR-3+ cells was measured by CCK-8 method in different groups. Real-time PCR was used to detect the changes of VEGFR-3+ macrophage phenotypes and the mRNA expression levels of lymphatic endothelial cell markers after the intervention. Transwell assay was used to detect the migration of three groups. The phagocytosis ability was measured by flow cytometry. Results The levels of IL-1β, TNF-α, CCL2, VEGF-C and TonEBP mRNA were significantly increased in HS group compared with those of control group (P＜0.05). After 24 h and 48 h high salt intervention, the viability of VEGFR-3+ macrophages was significantly decreased in HS group compared with those of LS group (P＜0.05). Meanwhile, the migration and the phagocytosis ability were also significantly increased in HS group compared with those of control group (P＜0.05). Conclusion The VEGFR-3+ macrophages can migrate to M1-type macrophages and show lymphangiogenesis-promoting characteristics after high salt intervention, which provides a theoretical basis for our further study about the relationships between this subpopulation and lymphangiogenesis and cardiovascular diseases. Related Articles | Metrics

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Construction of prognostic predictive model of gastric cancer based on the cancer genome atlas WANG Ju, DOU Zhong-xia, JIANG Hong-wei, WANG Yong-qiang, GAO Xiao-ping, ZHANG Yong 2018, 46 (12):  1262-1266.  doi: 10.11958/20181254 Abstract ( 728 )   PDF (1124KB) ( 3869 )   Objective To construct the prognostic evaluation model for gastric cancer (GC) and identify biomarkers related to the initiation and prognosis of GC through bioinformatics analysis of TCGA dataset. Methods The transcriptome data of GC and corresponding clinical information (containing 375 GC samples and 32 para-carcinoma samples) were downloaded from the TCGA website and merged into a matrix. The differential expressed genes (DEGs) were screened between GC and adjacent normal tissues using R“edgeR”package, and Cox univariate and multivariate regression analyses were performed by R“survival”package, and the predictive signature model of GC prognosis was established. Combined with clinicopathologic parameters, the role of the gene signature in predicting prognosis of GC was validated. Results A total of 4 332 genes were regarded as DEGs based on“edgeR”package. Next, Cox univariate regression analysis screened 710 DEGs associated with prognosis, among which 25 DEGs were incorporated into Cox multivariate analysis on the threshold of P value＜0.001. Consequently, we obtained an 8 DEG (BCHE, INPP5J, VCAN, IGFBP1, CGB5, HP, PSG9,AFF2) predictive model for GC prognosis. Based on the median value of risk score, GC samples were divided into high and low risk groups. Kaplan-Meier survival curve indicated that the 5-year survival rates in high and low risk groups were 56.20% and 17.27%, respectively (P＜0.001). ROC curve confirmed the medium accuracy of the predictive model in GC prognosis. Furthermore, the 8 gene signature was proved to be an independent prognostic factor in GC when clinicalpathologic information was incorporated into the Cox multivariate regression model. Conclusion Prognostic evaluation model of gastric cancer based on bioinformatics method can become new indicators for prognosis of gastric cancer. Related Articles | Metrics

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MicroRNA-375 inhibited proliferation and metastasis of hepatoma cell line SMMC-7721 by regulating autophagy WANG Xing-xing, SONG Hu, DU Chen-yang, WANG Zhen, ZHANG Jian-jun, SHEN Zhong-yang 2018, 46 (12):  1267-1272.  doi: 10.11958/20181137 Abstract ( 613 )   PDF (1111KB) ( 3873 )   Objective To investigate the effect of microRNA-375 (miR-375) targeting autophagy associated gene 14 (Atg14)-mediated autophagy on the proliferation and metastasis of hepatoma cells (SMMC-7721). Methods SMMC-7721 cells were divided into miR-375 mimics, miR-375 inhibitor and Atg14 interfering RNA treatment groups. Models with hypoxia for 1 h and reoxygenation for 6 h were established, and were divided into miR-375 NC group, miR-375 mimics group, miR-375 inhibitor group, siRNA NC group, Atg14 siRNA group and miR-375+Atg14 siRNA group. Targetscan was used to predict the genetic association between miR-375 and the Atg14. Fluorescence real-time quantitative PCR (QRTPCR) was used to detect the relative expressions of miR-375 and ATG14 mRNA in miR-375 NC group, miR-375 mimics group and miR-375 inhibitor group. Immunocytochemical staining was used to detect the expressions of N-Cadherin and β-catenin in the above three groups. The three groups of cells were transfected with GFP-RFP-LC3 adenovirus, and the formation of autophagosomes was observed by the fluorescence microscope. Plate cloning was used to detect the proliferation of liver cancer cells. The expressions of Atg14, P62, LC3Ⅰ, LC3Ⅱ, Beclin1, N-Cadherin, β-catenin and Vimentin were detected by Western blot assay. Results miR-375 gene was highly associated with the Atg14 gene. qRT-PCR showed that overexpression of miR-375 inhibited Atg14 mRNA expression, and conversely, it promoted Atg14 mRNA expression.Overexpression of miR-375 could inhibit the expression of N-Cadherin, increase the expression of β-catenin, and inhibit the proliferation of hepatoma cells (P＜0.01). On the contrary, the inhibition of miR-375 expression promoted the expression of N-Cadherin, decreased β-catenin expression and increased the proliferation of liver cancer cells (P＜0.01). Overexpression of miR-375 inhibited the expression levels of Atg14, LC3Ⅱ and Beclin1, and promoted the expression of P62 (P＜0.01).Conversely, it promoted the expressions of Atg14, LC3Ⅱ and Beclin1, and inhibited the expression of P62 (P＜0.01). By fluorescence microscope, the inhibition of autophagosome formation with overexpression of miR-375 was observed, while the inhibition of miR-375 expression promoted autophagosome formation (P＜0.01). Interfering with the expression of Atg14 enhanced the inhibitory effect of miR-375 on the proliferation and metastasis of hepatoma cells (P＜0.01). Conclusion The activation of miR-375 can inhibit the proliferation and metastasis of hepatoma cells, while the inhibition of miR-375 can promote the proliferation and metastasis of hepatoma cells. The mechanism may be related to miR-375 activating Atg14 to inhibit hepatocellular autophagy, and further influence the proliferation and metastasis of hepatoma cellsSMMC-7721. Related Articles | Metrics

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The inhibitory effects of norcantharidin on proliferation and apoptosis of melanoma M14 cells GAO Yang, CHENG Yi, REN Ming-yuan, YUE Yu-yang 2018, 46 (12):  1273-1276.  doi: 10.11958/20181063 Abstract ( 674 )   PDF (963KB) ( 3530 )   Objective To investigate the effects of norcantharidin on the proliferation and apoptosis related proteins Bax and Bcl-2 of human melanoma M14 cells. Methods Melanoma M14 cell line cultured in vitro was treated with concentrations of 50, 100 and 500 μg / L norcantharidin respectively, and untreated cells were used as control. Cell proliferation was detected by CCK-8 method after treatment for 24 h and 48 h. Morphology of cells was observed under inverted microscope. DAPI nuclear staining was used to observe the morphological changes of apoptosis under fluorescence microscope. The expressions of Bax and Bcl-2 were detected by Western blot assay. Results CCK-8 results showed that concentrations of 100 and 500 μg/L norcantharidin inhibited the proliferation of melanoma M14 cells after treatment for 24 h and 48 h (P＜0.05), and the higher the concentration, the more significant the inhibitory effect. The cells showed irregular contours, nucleus shrinkage, small volume, and poor cell adhesion of apoptosis changes under inverted microscope and fluorescence microscope. Western blot analysis showed that the relative expression of Bcl-2 decreased gradually with the increased concentration of norcantharidin (P＜0.05), and the relative expression of Bax increased gradually (P＜0.05).Conclusion Norcantharidin can inhibit the proliferation of melanoma M14 cells, and its mechanism may be related to the promotion of apoptosis. Related Articles | Metrics

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The protective effects of tetrahydrocurcumin on the treatment of pressure overload-induced CAO Xing, WANG Yu-ling, ZHAI Meng-en, MA Ji-peng, WANG Xiao-wu, FENG Jian-yu 2018, 46 (12):  1277-1281.  doi: 10.11958/20181077 Abstract ( 702 )   PDF (590KB) ( 3729 )   Objective To investigate whether tetrahydrocurcumin (THC) treatment could ameliorate pressure overloadinduced cardiac hypertrophy in adult C57BL/6 mice. Methods Twenty-four C57BL/6 mice were randomly divided into four groups (n=6 in each group): the Sham, THC group, transverse aortic constriction (TAC) group, and TAC+THC group. The mice were subjected to TAC to establish the cardiac hypertrophy mouse model. The mice in the Sham and THC groups were subjected to the same procedure without ligating aortic arch. After the procedure, the mice were administered with THC (120 mg·kg-1·d-1) through drinking water. Four weeks after TAC surgery, the heart function was detected in mice. The ratios of heart / body weight (HW / BW) and lung / body weight (LW / BW) were calculated, and the mean cross-sectional area of cardiomyocytes was calculated by HE staining. The collagen deposition degree of heart tissue was observed by Masson staining. The protein expression levels of α -myosin heavy chain (α -MHC) and β -myosin heavy chain (β -MHC) were detected by Western blot assay. The expression of atrial natriuretic peptide (ANP) mRNA was detected by real-time PCR(RT-PCR). Results Four weeks after TAC surgery, the mice were presented with symptoms of cardiac hypertrophy,including the increase in HW / BW, LW / BW, the mean cross-sectional area of cardiomyocytes, collagen deposition, the expression levels of β-MHC and ANP, and the decrease in cardiac function and α-MHC expression. Compared with the TAC group, THC treatment could significantly ameliorate pathological cardiac hypertrophy caused by TAC, improve cardiac function, increase α-MHC expression, and decrease HW/BW, LW/BW, the mean cross-sectional area of cardiomyocytes,collagen deposition and the expression levels of β-MHC and ANP (P＜0.05). Conclusion THC treatment could effectively attenuate pressure overload-induced pathological cardiac hypertrophy. Related Articles | Metrics

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The effect of cell administration route of bone marrow mesenchymal stem cells on the regulating immune rejection against heart allograft in mice GONG Yong-quan, CAO Jian-bin, WEI Cheng-xin△, LI Fu-li, HUANG Wei-jia 2018, 46 (12):  1282-1285.  doi: 10.11958/20181175 Abstract ( 760 )   PDF (507KB) ( 4027 )   Objective To investigate the effect of cell administration route of bone marrow mesenchymal stem cells on regulating immune rejection against heart allograft. Methods Donor hearts from BALB / c mice were heterotopically transplanted into the neck of C57 mice. The recipient animals were randomly divided into 4 groups with 12 animals in each group. In group A, 30 μL cell suspension containing 1×106 eGFP-BMSCs was injected into the animals through heart graft ascending aorta immediately after heart transplant procedure. In group B, the same dose of cell suspension was injected into animals through heart graft right ventricle cavity at the same time point. In group C, the same dose of cell suspension was injected into the heart muscle directly. Group D was control group and no treatment was received. Four mice were sacrificed in each group at post-operative day 7, and the heart grafts were harvested. Green fluorescence cells were detected under microscope and the heart graft histology was evaluated by HE staining. The proportion of macrophages in the heart graft infiltrating leukocytes was measured using flow cytometry. The remaining 8 mice were monitored for heart graft survival.Results At day 7 after transplantation, the eGFP+ cells were only detected in the heart graft of group A. The pathological examination found that the immune rejection was inhibited in group A with less interstitial infiltration and focal heart muscle damage. In group B and C, multifocal lymphocytic infiltration with myocardial cell degeneration and necrosis was observed in the interstitium of transplanted heart. In group D, large number of white blood cells infiltrated in all the graft, and normal myocardial structure disappeared. Flow cytometry analysis showed that highest macrophages cell proportion was found in the graft infiltrating leukocytes in group A compared to those of other groups. Cardiac survival time was significantly longer in group A than that of other groups. Conclusion BMSCs can alleviate cardiac allograft rejection. Intra-arterial injection is the best compared to intravenous and intra-myocardial injection route. The related mechanism may be the longer BMSCs survival and the higher macrophages infiltration in heart graft. Related Articles | Metrics

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Effects of salvianolic acid B on Nrf-2 and HO-1 of renal tissue in rats with diabetic nephropathy MING Jian-song, WANG Xiao-xue, YUAN Yu-hua 2018, 46 (12):  1286-1290.  doi: 10.11958/20180963 Abstract ( 657 )   PDF (459KB) ( 5502 )   Objective To observe the effects of different doses of salvianolic acid B on nuclear transcription factor NFE2-related factor 2 (Nrf-2) and heme oxygenase 1 (HO-1) in kidney of diabetic nephropathy (DN) model rats. Methods Forty SPF male Sprague-Dawley rats were randomly divided into control group (not modeled), model group, low dose of salvianolic acid B (10 mg/kg) and high dose of salvianolic acid B (20 mg/kg) groups. Rats of DN model were prepared by intraperitoneal injection of streptozotocin (STZ, 40 mg / kg) combined with high-sugar and high-fat diet. After modeling,salvianolic acid B treatment group was given the corresponding dose of medicine, and the control group and model group were given equal volume of olive oil intragastrically for 6 weeks. At the end of the treatment, samples of 24-h urine were collected from each group of rats for the detection of 24-h urine protein content. The blood glucose, serum creatinine, total cholesterol and triglyceride levels were measured by eyeball blood. The expressions of Nrf-2 and HO-1 protein and mRNA in renal tissues were detected by reverse transcriptase PCR (RT-PCR) and Western blot assay. PAS staining was used to observe the degree of renal tissue lesion in each group. Results Compared with the control group, the 24-h urine protein,blood glucose, serum creatinine, total cholesterol and triglyceride levels were significantly increased, and the expression levels of Nrf-2, HO-1 protein and mRNA in renal tissues were also significantly increased in the model group (P＜0.05).The pathological changes in renal tissue were significantly increased by PAS staining. Compared with the model group, 24-h urine protein, blood glucose, serum creatinine, total cholesterol and triglyceride levels were significantly decreased in the low and high doses of salvianolic acid B groups. The contents of cholesterol and triglyceride were significantly decreased, and the expression levels of Nrf-2 and HO-1 protein and mRNA in renal tissues were significantly increased (P＜0.05). Thepathological changes in renal tissue were significantly decreased by PAS staining. And the effect of salvianolic acid B was dose dependent. Conclusion A certain dose of salvianolic acid B can up-regulate the expression of Nrf-2 and HO-1 in renal tissues and resist oxidative stress. Related Articles | Metrics

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Effects of procyanidins on immune function in cyclophosphamide - induced immunosuppression mice KONG Ni, LIU Chao, YANG Fang-hao, ZHANG Teng-yuan, WANG Bao-kun, GAO Hui-jie 2018, 46 (12):  1291-1294.  doi: 10.11958/20181203 Abstract ( 628 )   PDF (344KB) ( 4269 )   Objective To investigate the immunoregulation effect of Proantho Cyanidins (PC) and its effect on the expressions of TNF-α and IL-10 in immunosuppression mice. Methods Forty institute of cancer research (ICR) mice were randomly divided into four groups: control group, cyclophosphamide (Cy) model group, PC high-dose (100 mg/kg) group and PC low-dose (80 mg/kg) group. After 7 days, the thymus and spleen index, the content of serum hemolysin and the delayed type hypersensitivity (DTH) were analyzed. The expressions of TNF - α and IL-10 in peripheral blood were detected by ELISA. RT- qPCR was used to detect the changes of TNF-α and IL-10 mRNA expressions in mouse spleen cells. Results The application of procyanidins increased the thoracic spleen index, the serum hemolysin level and the level of delayed type hypersensitivity in mice. The level of IL-10 was decreased, and the level of TNF-α was increased in procyanidin group. The mRNA expression of TNF-α in spleen cells was increased, and the expression of IL-10 mRNA was decreased. Conclusion Procyanidins could improve the immune function, which is likely to be accomplished through the regulation of the cytokines TNF-α and IL-10. Related Articles | Metrics

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Spectrum of gene mutation and clinical significance in myeloid malignancy patients with ASXL1 mutation TENG Guang-shuai, WANG Ying-shao, XU Jing, DU Chen-xiao, WANG Yan, CHEN Ya-fang, SHENG Meng-yao, BAI Jiao-jiao, ZHANG Lei, ZHOU Yuan, YANG Feng-chun, BAI Jie 2018, 46 (12):  1295-1299.  doi: 10.11958/20181088 Abstract ( 2975 )   PDF (691KB) ( 4736 )   Objective To study the spectrum of gene mutation and its clinical significance in myeloid malignancy patients with ASXL1 mutation. Methods The 112-gene targeted sequencing was used to analyze 1 335 patients with myeloid malignancies. The impact of gene mutation on clinical characteristics and prognosis of patients with ASXL1 mutations was analyzed. Results There were 138 (9.2%) patients with ASXL1 mutation including myelodysplastic syndromes (MDS, n=52, 37.68%), myeloproliferative neoplasms (MPN, n=29, 21.01%), MDS/MPN (n=10, 7.25%), and acute myeloid leukemia (AML, n=47, 34.06%). Eighty-nine mutation genes were found in 138 patients, and 96.4% (133) of the patients were accompanied by more than one gene mutation. Among them, epigenetic genes were 55.8% (77 / 138), signal transduction pathway gene, spliceosome 65.9% (91/138), transcription factor 36.9% (51/138), and cell cycle and apoptosis related genes 18.8% (26 / 138). The most common co-mutation genes were RAS 25.4%, SETBP1 21.7%, FAT1 18.8%,CREBBP 15.9% and TET2 15.2%. Compared with patients with ASXL1+RAS-, patients with ASXL1+RAS+ showed a worse prognosis, with decreased hemoglobin and platelet, increased chromosome karyotype abnormality rate, and significantly lower survival. There were no significant differences in the clinical features and prognosis between patients with SETBP1,FAT1, CREBBP and TET2 mutation combined with ASXL1. Conclusion We provide a comprehensive overview of the spectrum, clinical associations and prognostic relevance of gene co-mutations with ASXL1 in patients with myeloid malignancies. Patients with co-mutation of ASXL1 and RAS pathway gene have a worse prognosis. Related Articles | Metrics

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Analysis of the value of memory predominant hemisphere in patients undergoing temporal lobe epilepsy surgery by using propofol as an alternative Wada test HE Li-bing, WU Jiang, ZHAO Huan-ping, GUO Tao, ZHAO Lei, WANG Ya-nan, ZHANG Pei-sheng, LIANG Hai-feng 2018, 46 (12):  1300-1303.  doi: 10.11958/20181570 Abstract ( 789 )   PDF (322KB) ( 3607 )   To evaluate the value of propofol as an alternative to the Wada test for memory dominance hemisphere. Methods From February 2012 to December 2016, the Wada test was successfully completed in the Department of Functional Neurosurgery of Hebei People’s Hospital, and 64 patients with temporal lobe epilepsy were treated surgically. The memory quotient (MQ) of patients with temporal lobe epilepsy was measured by the revised Wechsler Memory Scale of China before and after operation. The difference of memory function was compared between one week before operation and six months after operation. Results All patients completed the test with an average MQ of 96.06 ± 5.54,including average long-term memory (29.28 ± 2.92), average short-term memory (57.12 ± 4.25) and average instantaneous memory (9.65±1.49). Compared with the normal norm, the MQ (81.04±7.29 vs. 100) and short-term memory (48.18 ±7.56 vs.60) were lower in patients with temporal lobe epilepsy (P＜0.05). Forty-seven patients with hemispheric dominance of memory were treated surgically. Wechsler’s memory test was performed again 6 months after operation. There was no significant difference in MQ before and after operation (95.94±5.83 vs. 95.45±5.78) between the two groups (P＞0.05). There were also no significant differences in long-term memory (29.04±3.19 vs. 28.45±2.83), short-term memory (57.28±4.26 vs.57.55±4.10) and instantaneous memory (9.62±1.54 vs. 9.45±1.56) before and after operation between the two groups (P＞0.05). Conclusion The study confirms that the Wada test with propofol substitution could be used to determine the dominant hemisphere of memory in patients with temporal lobe epilepsy and could be used as a method for preoperative evaluation of temporal lobe epilepsy. Related Articles | Metrics

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Association between glycosylated hemoglobin and non-alcoholic fatty liver disease in adults GUO Yi-rui, LIU Ying, YANG Yan, ZHANG Li 2018, 46 (12):  1304-1307.  doi: 10.11958/20180780 Abstract ( 893 )   PDF (366KB) ( 3483 )   Objective To investigate the association between glycosylated haemoglobin (HbA1c) and nonalcoholic fatty liver disease (NAFLD) in adults. Methods A total of 11 943 subjects were selected from the health examination adults in Tianjin First Central Hospital from January to December 2017. Data included physical examination and blood biochemical index detection. The differences of NAFLD prevalence between age and gender were calculated using the age composition of the national population in 2010 as the standard population. One-way ANOVA was applied to the comparison of multiple groups, and the comparison of the rate was carried out by chi-square test. Logistic regression model was used to assess the relationship between HbA1c and NAFLD. Results A total of 5 651 (49.44%) subjects fulfilled the diagnostic criteria of NAFLD, and the standardized prevalence of NAFLD was 40.46%. The prevalence of NAFLD was significantly higher in subjects with serum HbA1c level (HbA1c≥6.5%) than those with serum HbA1c level (6.0%≤HbA1c＜6.5%) and serum HbA1c level (HbA1c＜6.0%) (75.60% vs. 69.35% vs. 44.60%, P ＜0.05). The prevalence of NAFLD increased with the progressively higher serum HbA1c levels in subjects under 70 years old (P＜0.05). Stepwise logistic regression analysis showed that the risk factors for NAFLD were increased in the subjects of Quartile 3 (5.5%≤HbA1c＜5.8%) (odds ratio 1.41,95% confidence interval 1.220-1.631) and Quartile 4 (HbA1c≥5.8%) (odds ratio 2.003, 95% confidence interval 1.714-2.342) as compared with the subjects of Quartile1(HbA1c＜5.2%) after adjusting for the related factors including age, gender and body mass index. Among the population with HbA1c＜6.0%, the risk factors for NAFLD were increased in the subjects of Q3 (5.4%≤HbA1c＜5.6%) (odds ratio 1.267,95% confidence interval 1.087,1.477) and Q4 (5.6%≤HbA1c＜6.0%) (odds ratio 1.557, 95% confidence interval 1.339-1.811) as compared with the subjects of Q1(HbA1c＜5.2%). Conclusion The elevated levels of HbA1c in adults are independent risk factors of NAFLD. Related Articles | Metrics

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Clinical observation of persistent cough after thoracoscopic lobectomy for preserved inferior pulmonary ligament in video-assisted thoracic surgery JI Lin-lin, LI Xin, ZHU Jian-ping, REN Shuai, SUN Da-qiang 2018, 46 (12):  1308-1309.  doi: 10.11958/20180975 Abstract ( 1149 )   PDF (503KB) ( 3674 )   Objective To investigate the effect of preserved inferior pulmonary ligament in video-assisted thoracic surgery (VATS) upper lobectomy on persistent cough. Methods A total of 100 lung cancer patients were selected in this study from June 2017 to April 2018, according to the adopt standardization. All of the patients were divided into two groups:the division group and the preservation group according to the operation mode. The division group included 50 patients (19 left, 31 right), and the preservation group also included 50 patients (18 left, 32 right). Patients in two groups were investigated by Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC). The postoperative dead space ratio was analyzed between two groups. Results There was no significant difference in dead space ratio after surgery between two groups of patient. And different degrees of cough were found in two groups. In patients with left lung operation,the preoperative score of LCQ-MC was significantly higher than postoperative score, but there was no significant difference in postoperative score of LCQ-MC between the two groups (P > 0.05). In patients with right lung operation the postoperative score of LCQ-MC was significantly higher in the preservation group than that of the division group (P < 0.05), and cough were relieved in the preservation group (P < 0.05). Conclusion Preserved inferior pulmonary ligament in VATS right upper lobectomy can reduce the persistent cough after surgery. Related Articles | Metrics

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Comparison of multi-modality MR enterography and CT enterography in the diagnosis of small bowel tumor ZHUANG Xiao-zhao, FU Li-li, LI Chang-qing, XING Zeng-bao, CAI Qin-lei 2018, 46 (12):  1312-1315.  doi: 10.11958/20181288 Abstract ( 1036 )   PDF (484KB) ( 4046 )   Objective To compare the application value of multi-modality MR enterography and CT enterography in the diagnosis of small bowel tumor. Methods From March 2016 to March 2017, sixty patients who were suspected with small bowel tumor in our hospital were selected as the subjects. The CT and MR images were read by two qualified imaging physicians. The morphology, lesion sites (duodenum, proximal ileum, distal ileum, proximal jejunum, distant jejunum) and the range of involvement were analyzed, and the results were compared with those of surgery and endoscopic biopsy.Results Thirty-three patients (35 cases of small intestinal tumor lesions) were confirmed (5 cases of aden carcinoma, 6 cases of lymphoma, 18 cases of stromal tumor, 3 cases of neuroendocrine tumors, 2 cases of cavernous hemangioma and 1 case of lipoma) in 60 patients treated by surgery and endoscopic biopsy. The specificity, sensitivity and accuracy of CT in the diagnosis of small bowel tumor were 100% (27/27), 90.9% (30/33) and 95.0% (57/60) respectively, and MR were 100% (27/27), 97% (32/33) and 98.3% (59/60) respectively. The diagnostic efficacy was similar for both. Conclusion Both multimodality MR enterography and CT enterography are effective diagnostic methods for small bowel tumor diseases, which are worthy for clinical application. Related Articles | Metrics

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Effect of vitamin D on serum markers of iron metabolism in patients with non-alcoholic fatty liver disease LIU Zhi-ping, ZHANG Jin-hua, WANG Xiang-ning, XU Ying 2018, 46 (12):  1316-1318.  doi: 10.11958/20180847 Abstract ( 694 )   PDF (312KB) ( 4115 )   Objective To investigate the effects of vitamin D on serum iron (SI), ferritin(SF) and hepcidin (Hepc) in patients with nonalcoholic fatty liver disease (NAFLD). Methods There were 186 patients with NAFLD in this study. All these patients were divided into two groups according to the level of serum 25-hydroxyvitamin D3 [25(OH)D3)], deficient group (25(OH)D3≤20 μg/L, n=115) and non-deficient group (n=71). The age, gender, body mass index (BMI), blood pressure,serum lipids, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), SI, SF and Hepc were compared between the two groups. The correlations between 25(OH)D3 and serum markers of iron metabolism were analyzed. Results There was no significant difference in SI between the two groups (P＞0.05). The levels of BMI,FINS, SF, Hepc and HOMA-IR were significantly higher in deficient group than those of non-deficient group (P＜0.05). The pearson correlational analysis showed that 25(OH)D3 was negative related to SF (r=-0.328), Hepc (r=-0.314) and HOMA-IR (r=- 0.293, P＜0.05). Conclusion The deficiency of vitamin D causes iron overload in patients with NAFLD, and aggravates insulin resistance. Related Articles | Metrics

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Risk factors of carbapenem-resistant Escherichia coli urinary tract infections CHEN Wei, YANG Bin, CAO Yang 2018, 46 (12):  1319-1323.  doi: 10.11958/20181073 Abstract ( 842 )   PDF (384KB) ( 3693 )   Objective To investigate the drug resistance of carbapenem resistant Escherichia coli (CREco), and the risk factors of carbapenem-resistant CREco urinary tract infection. Methods Data of 120 cases with urinary tract infection occurred in the second hospital of Tianjin Medical University from January 2015 to December 2017 were collected, and the results of those urine cultures were Escherichia coli. A case-control study was conducted, and 24 patients with CREco infection were divided into the case group. The controls were selected among patients with carbapenem sensitive CREco infection in the same ward at the same time and were matched with CREco cases for gender and age. The number of control patients was four times than that of case group. The resistance of pathogenic bacteria to 18 kinds of antimicrobial agents were compared between the two groups. The risk factors of CREco urinary tract infection in the inpatients in our hospital were investigated. Results Patients with CREco infection showed strong resistance to ampicillin and other 11 antimicrobial agents, and the drug resistance rate was higher than 70%. The drug resistance rates of 14 other antimicrobial agents except ampicillin, gentamicin, compound sulfamide and tigecycline were significantly higher than those in CSEco group (P＜0.05).Multivariate regression analysis showed that patients with indwelling catheters (OR=5.719, 95%CI: 2.084-15.697, P＜0.01)and the longer hospitalization time before detection (OR=9.325, 95%CI: 1.962-44.330, P＜0.01) were both the independent risk factors of CREco urinary tract infection in inpatients. Conclusion The CREco resistance of urinary tract infection in inpatients is severe. Indwelling catheters should be strictly observed the standardized operation and clinical indications. It is important to short the time of hospitalization and decrease the exposure in the hospital environment, which may help to reduce the risk of urinary tract infection caused by CREco. Related Articles | Metrics

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One case of eosinophilia caused by mosapride QI Hong-wu, ZHAO Cai-xia, LIU Yan-song 2018, 46 (12):  1324-1326.  doi: 10.11958/20180695 Abstract ( 1479 )   PDF (426KB) ( 3540 )   Mosapride, as a gastroprokinetic agent, has a low incidence of adverse reactions, especially the reports of eosinophilia are extremely rare. A case of convalescent brainstem hemorrhage in our hospital was reported. After nasal feeding of mosapride citrate dispersible tablets, eosinophils increased. The patient was cured and discharged after treatment with antianaphylaxis and discontinuation of mosapride. As a common clinical drug, mosapride should be alert to the possibility of drug allergy reaction if eosinophilia occurs. Related Articles | Metrics

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Clinical analysis of cortical blindness after cerebral angiography LIANG Chao, YANG Qun-fu, WANG Feng-ju, LIU Zhen-bo 2018, 46 (12):  1327-1329.  doi: 10.11958/20181050 Abstract ( 874 )   PDF (417KB) ( 4056 )   Objective To discuss the diagnosis, the pathogeny and the corresponding prevention measures of the cortical blindness caused by cerebral angiography. Methods A retrospective analysis was made for the clinical data of the 3 cases of postoperative cortical blindness from 2 467 cases of cerebral angiography in our hospital during January 2002 to December 2017. The pathogenesis and treatment of cortical blindness were discussed in combination with literature analysis.Results The incidence of cortical blindness was 0.12% (3/2 467) in cerebral angiography. The symptoms of 3 patients were alleviated within 5 days after comprehensive treatment including fluid replacement, alleviation of vasospasm, anti-brain edema, corticosteroids, neural nutrition and hyperbaric oxygen. There were no related complications in the 2 follow-up weeks. Conclusion Cortical blindness is a rare complication of cerebral angiography. But most patients can be cured through symptomatic treatment. Related Articles | Metrics

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The efficacy of chimeric antigen receptor T-cell immunotherapy in B-cell lymphoma: Meta-analysis ZHANG Xi-you, LI Dan-dan, CHEN Feng, SONG Qing-kun, ZHONG Xiao-song 2018, 46 (12):  1330-1335.  doi: 10.11958/20180819 Abstract ( 715 )   PDF (653KB) ( 3997 )   Objective To investigate the efficacy of chimeric antigen receptor T-cell (Car-T) in the treatment of Bcell lymphoma, and provide a theoretical basis for more rational and efficient application of Car-T therapy. Methods English literature from Pubmed database and the Cochrane library database were comprehensively retrieved. A quantitative and comprehensive analysis was conducted for eleven literatures regarding Car-T in the treatment of B-cell lymphoma that were published from the establishment of database to January 2018. The response rate was used as the indicator of outcome.The subgroup analysis was performed according to the age, pathological type, target antigen, costimulatory molecule and conditioning chemotherapy. Meta-analysis was used to summary the response rate. Results The total response rate of CarT in the treatment of B cell lymphoma was 75% (95%CI: 0.67-0.84). The combined response rates of the factors were 80%(age＜65 group, 95%CI: 0.73-0.87), 88% (age≥65 group, 95%CI: 0.78-0.98), 81% (diffuse large B-cell lymphoma group,95%CI: 0.74-0.87), 79% (non diffuse large B-cell lymphoma group, 95%CI: 0.68-0.89), 77% (CD19 target antigen group,95%CI: 0.68-0.87), 69% (non CD19 target antigen group, 95%CI: 0.47-0.91), 78% (CD28 costimulatory molecule group,95%CI: 0.71-0.84), 73% (non CD28 costimulatory molecule group, 95%CI: 0.62-0.84), 78% (Cy / Flu conditioning chemotherapy group, 95%CI: 0.72-0.84), and 69% (non Cy / Flu conditioning chemotherapy group, 95%CI: 0.50-0.88)respectively. Conclusion Car-T has a high response rate on B-cell lymphoma. Subgroup analysis shows that the quite high response rates are achieved in patients with over 65 years of age, pathological type diffuse large B-cell lymphoma, target antigen CD19, costimulatory molecule CD28 and conditioning chemotherapy Cy/Flu (cyclophosphamide +fludarabine). Related Articles | Metrics

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Summary of the symposium on minimally invasive spinal surgery of the Third Annual Meeting of the Chinese Medical Education Association XU Bao-shan 2018, 46 (12):  1336-1341.  doi: 10.11958/20181865 Abstract ( 559 )   PDF (438KB) ( 3620 )   In recent years, minimally invasive spinal surgery technology has developed rapidly, but at the same time, there are many controversies. The third annual meeting of the Minimally Invasive Spinal Surgery Working Group of the Chinese Medical Education Association focused on seven hot issues: the selection of percutaneous vertebroplasty and kyphoplasty and the amount of bone cement perfusion; the selection of percutaneous transforaminal endoscopic and microendoscopic discectomy for sequestered disc herniation; the minimally invasive surgical strategy for degenerative scoliosis; minimally invasive options for lumbar spinal stenosis; the choice of microscopy and endoscopy for cervical disc herniation; minimally invasive strategies for degenerative lumbar spondylolisthesis; and the choice of endoscopic and open surgery for thoracic spinal stenosis. The characteristics, advantages and limitations of various minimally invasive techniques have fully discussed, and some consensus has been reached, which is beneficial to development and application of various minimally invasive techniques. Related Articles | Metrics

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Advances on aplastic anemia infection WU Yu-hong, SHAO Zong-hong 2018, 46 (12):  1342-1346.  doi: 10.11958/20181103 Abstract ( 704 )   PDF (370KB) ( 3692 )   Aplastic anemia (AA) is a bone marrow failure syndrome with pancytopenia. Infection is the main cause of death in AA patients. As the immune compromise state in patients with AA is different from that of patients with neutropenia induced by chemotherapy, the infection caused by them is also different. Chronic granulocytic reduction is the most serious risk factor for invasive fungal and bacterial infections. The recovery of neutrophils can significantly improve survival. The supportive therapy during granulocytopenic period can play a significant role in protection. The most common invasive fungal infections are Aspergillus species, Candida spp., Zygomycetes, and Fusarium spp. Pathogenic bacteria associated with bacterial infection of AA patients include Staphylococcus species, Enterococcus, Staphylococus aureus, Clostridium spp,Micrococcus, alpha-hemolytic streptococci, Listeria monocytogenes and Bacillus cereus. Gram-negative bacteria include Escherichia coli, Salmonella, Bacteroides fragilis, Klebsiella oxytoca, Klebsiella pneumonia, Aeromonas hydrophilia,Pseudomonas aeruginosa, and Vibrio vulnificus. Viral infections are relatively rare, but herpes viruses, community-acquired respiratory virus infections and viral hepatitis A, B and C can occur in AA patients. Related Articles | Metrics

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Advances in noninvasive prenatal diagnosis of monogenic disorders SHI Yun-fang, ZHANG Ying 2018, 46 (12):  1347-1351.  doi: 10.11958/20181134 Abstract ( 854 )   PDF (381KB) ( 3969 )   Non-invasive prenatal diagnosis (NIPD) based on the analysis of cell-free fetal DNA (cffDNA) in maternal plasma has been applied in clinical practice for more and more monogenic conditions. NIPD allows parents with high risk pregnancies the option of safer testing with a maternal blood sample rather than invasive prenatal diagnosis that carries a small miscarriage risk. In some countries the NIPD method has been used to diagnose some single gene disorders, and it does not need to be verified by invasive prenatal diagnosis. This paper mainly reviews the research progress and challenges of NIPD. Related Articles | Metrics

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Advances in the role of myeloid derived suppressor cells in the pathogenesis of hepatocellular carcinoma ZHANG Xin-yu, YAN Hui-min 2018, 46 (12):  1352-1356.  doi: 10.11958/20181167 Abstract ( 639 )   PDF (335KB) ( 3845 )   Myeloid derived suppressor cells (MDSCs) are immunosuppressor cells that have attracted much attention and play a role in regulating immune response. Recently, accumulating evidence has demonstrated that MDSCs are closely related to the development and prognosis of hepatic cancer. Multiple factors in the microenvironment of hepatic cancer affect the expansion, activation and recruitment of MDSCs, while MDSCs promote tumor growth and metastasis by downregulating antitumor immune response or inducing immune tolerance. The study on effect of MDSCs on immune escape of hepatic cancer will provide new clues for early detection, diagnosis and immunotherapy of hepatic cancer. Related Articles | Metrics

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Surgical treatment of secondary hyperparathyroidism in patients with chronic kidney disease AN Hong, PANG Yi, XU Hui, MENG Xiang-chao 2018, 46 (12):  1357-1362.  doi: 10.11958/20180991 Abstract ( 695 )   PDF (417KB) ( 3630 )   Secondary hyperparathyroidism (SHPT) is a common complication of chronic kidney disease (CKD).Physiologically，it is characterized by excessive synthesis and secretion of parathyroid hormone and excessive hyperplasia of parathyroid cells，causing multiple systemic diseases such as myocardium, skin，bone，hematopoietic system and lipid metabolism，which seriously affects the quality of CKD patients. This article summarizes the pathogenesis, surgical treatment and interventional treatment of SHPT in the literature at home and abroad. It aims to increase the understanding of secondary hyperparathyroidism in chronic kidney disease and improve the quality of life of patients with CKD, and to better complete the diagnosis and treatment of SHPT diseases. Related Articles | Metrics

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Research progress on targeted therapy of triple negative breast cancer LIU Lei, ZHANG Jin 2018, 46 (12):  1363-1368.  doi: 10.11958/20181045 Abstract ( 855 )   PDF (378KB) ( 4820 )   As a subtype of breast cancer, triple negative breast cancer (TNBC) is characterized by poor prognosis. In the case of chemotherapeutic drug resistance, local recurrence and distant metastasis always occur rapidly due to lack of other effective treatments. Therefore, clinical research on new therapeutic target and targeted therapy of TNBC has become a hot spot. This paper focused on the current research progress of TNBC targeted therapy, including PARP inhibitors, antiangiogenesis, anti-epidermal growth factor receptor, androgen receptor antagonists, immune checkpoint inhibitors and PI3KAKT-mTOR inhibitors, in order to find out the most likely to be the direction of targeted therapy for future development. Related Articles | Metrics