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15 January 2019, Volume 47 Issue 1 Previous Issue    Next Issue

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Hepatic stellate cells are regulated by paracrine HGF from bone marrow mesenchymal stem cells in vitro LI Jing, ZHENG Xue, DING Xin, XIANG Hui, CHEN Wei-gang 2019, 47 (1):  1-5.  doi: 10.11958/20181206 Abstract ( 960 )   PDF (554KB) ( 3773 )   Objective To investigate the effects of paracrine hepatocyte growth factor (HGF) secreted by rat bone marrow mesenchymal stem cells on proliferation, apoptosis and activation of hepatic stellate cells after rat bone marrow mesenchymal stem cells (BMSCs) and hepatic stellate cells (HSCs) were co-cultured in vitro. Methods The whole bone marrow adherent method was used to isolate, culture and purify rat BMSCs, and HSCs were cultured. The semi-permeable membrane of six-well plate was used to establish a two-layer cell co-culture system with indirect contact. The study consisted of group H (HSCs were cultured alone), H-H group (HSCs and HSCs were co-cultured), M-H group (BMSCs and HSCs were co-cultured), M-H-C group (BMSCs and HSCs were co-cultured with c-met inhibitor). Cells in each group were cultured for 48 hours. BMSCs were identified and the apoptosis rate of HSCs was detected by flow cytometry. The proliferation of HSCs was detected by MTT assay, and the expression level of alpha smooth muscle actin (α-SMA) in HSCs was detected quantitatively by immunofluorescence confocal method. The concentration of HGF in the supernate of the coculture system was determined by ELISA. Results MSCs overexpressed positive surface molecules CD29 and CD90, and low expression of hematopoietic cell surface marker CD45. BMSCs could significantly inhibit the proliferation and activation of HSCs, and promote apoptosis of HSCs. The concentration of HGF in the supernate was significantly higher in M-H group than that in the other groups. Conclusion BMSCs can promote the apoptosis of HSCs, inhibit the proliferation and activation of HSCs through paracrine HGF in the co-culture of BMSCs and HSCs. Related Articles | Metrics

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Aurora-B-mediated phosphorylation of NPM1 promotes malignant phenotype of OS cells in vitro PI Wen-sen, LIU Jia-ming, HUANG Shan-hu, LIU Zhi-li 2019, 47 (1):  5-9.  doi: 10.11958/20181312 Abstract ( 781 )   PDF (793KB) ( 3799 )   Objective To investigate the effect of Aurora-B-mediated phosphorylation of nucleophosmin1 (NPM1) protein on the malignant phenotype of osteosarcoma (OS) cells. Methods Bioinformatic prediction was performed to investigate the expression level of NPM1 in sarcoma, and the potential relationship between Aurora-B and NPM1. OS cells (U2-OS and 143B）were transfected with LV/ShAurora-B, NC-LV/ShAurora-B, and co-infected by LV/ShAurora-B+NC LV/NPM1. Transwell invasion, Wound healing and CCK8 assays were performed to evaluate the malignant phenotype of OS cells. Results Bioinformatic prediction showed that NPM1 protein was overexpression in sarcoma tissues, and Aurora-B may mediate phosphorylation of NPM1. The Western blot results revealed that the expression levels of Aurora-B and pNPM1ser125 protein were significantly lower in cells infected with LV/ShAurora-B than those in cells treated with Lv/negative (P＜0.05). Interesting, the expression levels of NPM1 protein in cells infected by LV/ShAurora-B were similar to those in cells infected by NC-LV/ShAurora-B. The invaded cells, migration rate and the proliferation of OS cells were significantly reduced in cells down-regulated Aurora-B than those in negative group (P＜0.05). However, the inhibiting effect was partially restored by up-regulation of NPM1 in OS cells. Conclusion Aurora-B-mediated phosphorylation of NPM1 promotes malignant phenotype of OS cells in vitro. Related Articles | Metrics

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Effects of CHOP therapy on the expression of cyclic RNA circ_001569 and its downstream protein in T-cell lymphoma Hut 78 and HH cell lines KANG Qing-Wei, YAN Shu 2019, 47 (1):  10-13.  doi: 10.11958/20181297 Abstract ( 751 )   PDF (1159KB) ( 3923 )   Objective To explore the effect of CHOP therapy on the cyclic RNA and its downstream function proteins in T cell lymphoma cells. Methods Hut78 and HH cells were treated with cyclophosphamide (1 μmol / L), hydroxydaunorubicin (0.2 μmol/L), oncovin (1 μmol/L) or prednisone (1 μmol/L) for 24 h. Conventional cultured cells were used as control. The expression levels of circRNA_001569, miR-145 and BAG4 mRNA were detected by the qPCR method, and the expression of BAG4 was detected by qPCR and Western blot assay. Results Hydroxydaunorubicin and oncovin could decrease the expression levels of circRNA_001569, promote miR-145, and down-regulate the mRNA and protein expression level of BAG4 in Hut78 and HH cell lines. Conclusion CircRNA_001569 may play an important role in the course of CHOP therapy for T cell lymphoma. Related Articles | Metrics

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Effects of pancreatic cancer cell soluble secretions on lipid metabolism in mice XIE Jun-muzi, TIAN Wen-cong, YUAN Xiang-fei, HU Li-juan, WANG Feng 2019, 47 (1):  14-19.  doi: 10.11958/20181114 Abstract ( 644 )   PDF (634KB) ( 3519 )   Objective To observe the effects of pancreatic cancer cell soluble secretions on lipid metabolism. Methods The conditioned media of pancreatic cancer cells were derived from serum-free media culturing pancreatic cancer cells for 24 h. The whole study included 2 sub-studies. In the first one, 37 BALB/c mice were randomly divided into control group (n=14)，Panc-1 group (n=10), MiaPaCa-2 group (n=6) and BxPC-3 group (n=7). The normal DMEM and conditioned media of 3 pancreatic cancer cell lines (Panc-1, MiaPaCa-2 and BxPC-3) were injected into mice in the corresponding group. The mice in each group received subcutaneous injection twice a day for 7 days. Body weight and food intake of each mouse were recorded. Blood levels of glucose, triglyceride and hepatic glycogen content were detected. Plasma insulin level was detected by ELISA. Inguinal fat pad and epididymal fat pad were weighed, and the expression levels of ATGL were detected by Western blot assay. The second sub-study consisted of 30 mice and were divided into 3 groups, control group (n=10), 1/2 M group (n=10) and M group (n=10). The normal DMEM and the different doses of MiaPaCa-2 cell conditioned media were injected into the corresponding groups of mice. Results In the first sub-study, the initial intake and body weight of mice decreased, and then recovered and tended to balance. Compared with the control group, the levels of plasma insulin and blood glucose increased, hepatic glycogen and triglyceride contents decreased, and the weight of BAT and WAT increased in MiaPaCa-2 group and BxPC-3 group (P＜0.05), but only triglyceride contents decreased in Panc-1 group (P＜0.05). The expression level of ATGL in adipose tissue was decreased in three pancreatic cancer cell media injection groups (P＜0.05). In the M group of second experiment, plasma insulin and glucose increased (P＜0.05), hepatic glycogen and triglyceride decreased (P＜0.05), BAT and WAT weights increased (P＜0.05), ATGL expression decreased (P＜0.05), only insulin level and fat depot weights increased in 1/2 M group (P＜0.05). Conclusion Injection of pancreatic cancer cell conditioned medium into mice can cause the dysregulation of lipid metabolism in vivo. In addition, the decreased insulin sensitivity, increased fat storage and impaired lipolysis are observed. Related Articles | Metrics

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Effects of moxibustion on inflammatory cell infiltration and CD11b expression in brain tissue of neonatal mice with hypoxic-ischemic encephalopathy XIAO Ai-jiao, XIAO Yi-sheng, OU-YANG Xin, HE Lin, .CHEN Ming-ren 2019, 47 (1):  19-22.  doi: 10.11958/20181383 Abstract ( 1048 )   PDF (1398KB) ( 3906 )   Objective To investigate the effects of moxibustion on inflammatory cell infiltration and CD11b expression in ipsilateral brain of a neonatal mouse model with hypoxic-ischemic (HI) brain injury. Methods Postnatal 7 d ICR mice were randomly divided into three groups: sham group (n=20), HI group (n=24) and moxibustion-treated group (n=20). For sham animals, only neck surgery was performed and the common carotid artery was not occluded and was not exposed to hypoxia. For HI animals, the common carotid artery was occluded and exposed to hypoxia, while for moxibustion-treated animals, moxibustion treatment (once a day for 35 minutes) was applied in addition to HI procedure. TTC staining was used to examine area of cerebral infarction in rats, HE staining was used to detect inflammatory cells, and immunofluorescent staining was used to examine the CD11b-positive cells in the ipsilateral brain. Results Mice in HI group showed larger infarct area, more cell loss, more inflammatory cells and more CD11b-positive cells in the ipsilateral brain than those in sham group, while mice in moxibuston-treated group showed smaller infarct area, less cell loss, less inflammatory cells and less CD11b -positive cells in the ipsilateral brain than those in HI group. Conclusion Moxibustion can decrease microglia infiltration and alleviate inflammation reaction, hence reducing brain injury after HI procedure. Related Articles | Metrics

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Effects of P-glycoprotein overexpression on the differentiation of INS-1 and rat pancreatic β cells CHEN Ya, GAO Ya-li, LI Dai-qing 2019, 47 (1):  23-26.  doi: 10.11958/20181124 Abstract ( 616 )   PDF (501KB) ( 4309 )   Objective To investigate the effect of P-glycoprotein overexpression on the differentiation of INS-1 cells and pancreatic β cells. Methods INS-1 cells were infected with adenovirus overexpressing P-glycoprotein. Ins2-abcb1b gene was randomly inserted into the rat islets, and P-glycoprotein overexpression model was successfully constructed. Empty adenovirus and wild-type SD rats were used as control groups. INS-1 cells and P-glycoprotein overexpression rats were used as experimental group. Total RNA was extracted both in INS-1 cells and rat islets. Transcription factors such as Abcb1b， Pdx1，Ins1，Ins2，Mafa，Mafb，Ngn3，Nkx6.1，Nkx2.2, Neurod1 and Pax6 were detected by real-time quantitative PCR. Results Compared with the control group，the transcription levels of Ngn3 and Mafb in INS-1 cells increased (P＜0.05), while Mafa decreased (P＜0.001). No significance was detected in other transcription factors. Unlike INS-1 cells, all of the transcription factors of islets were not affected (P＞0.05). Conclusion The overexpression of P-glycoprotein may dedifferentiate INS-1 cells, but has no effect on the differentiation of rat pancreatic beta cells. Related Articles | Metrics

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Establishment of OLETF rat model of metabolic syndrome with myocardial infarction and study on the mechanisms of oxidative stress ZHANG Yi, REN Meng-meng, FANG Tao, DI Yan-bo, CUI Xiao-xu, LIU Yong, He Jing, GUO Xin-tao, TIAN Feng-shi 2019, 47 (1):  26-31.  doi: 10.11958/20180551 Abstract ( 806 )   PDF (613KB) ( 3923 )   Objective To establish a stable, easily replicable, clinically relevant metabolic syndrome (MS) rat model of myocardial infarction, and explore the impact of MS on myocardial infarction. Methods Eighteen OLETF rats were used to establish the MS model，and 18 LETO rats were used as the control group. Rats were given high-fat diet and standard feed respectively. Model LETO rats and OLETF rats were randomly divided into sham operation group (sham group, MS-sham group) and myocardial infarction group (MI group, MS-MI group), 9 rats for each group. Echocardiography was used to measure left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), left ventricular fraction shortening (LVFS), and left ventricular ejection fractions (LVEF). The levels of glutathione peroxidase (GSH-Px), total antioxidant capacity (T-AOC), myeloperoxidase (MPO) and malondialdehyde (MDA) in myocardial tissue were determined by ELISA. Western blot assay and RT-PCR were used to detect protein and mRNA levels of thioredoxin (TRX) and thioredoxin interacting protein (TXNIP) of myocardial tissue. Results There were effects of MS and MI on LVEDD, LVESD, LVFS and LVEF in rats (P＜0.05). The interaction between the two groups showed effects on LVEDD, LVFS and LVEF in rats (P＜0.05). MS and MI showed effects on GSH-Px, T-AOC, MPO, MDA, and levels of TRX and TXNIP protein and mRNA in rat myocardial tissues (P＜0.05). The interaction between the two groups showed effects on T-AOC, MDA and mRNA levels of TXNIP in rat myocardial tissues (P＜0.05). Conclusion This model is simple and practical. The disruption of TRX system stability may be one of the endogenous mechanisms, by which MS aggravates oxidative stress levels and decreases left ventricular function of myocardial tissue. The mechanism of MS affecting left ventricular function in MI still needs further investigation. Related Articles | Metrics

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Lactobacillus acidophilus regulates NO and its oxidative mediator in atherosclerosis model rats WANG Yun-peng, ZHENG Wen-wu, XIA Meng, CHENG Ling, LIAO Shuang-hua, LI Dan, CHEN Yu-lu, LI Ya-fei 2019, 47 (1):  32-37.  doi: 10.11958/20181220 Abstract ( 808 )   PDF (719KB) ( 3837 )   Objective To investigate the effect of lactobacillus acidophilus on the expression of nitric oxide (NO) and its oxidative mediators, and to explore the anti-atherosclerosis mechanism of lactobacillus acidophilus. Methods Twentyfour male SPF rats were randomly divided into normal diet group, high-fat diet group and lactobacillus acidophilus group, with 8 rats in each group. The rats in the normal diet group were fed with normal diet, and the high-fat diet group was fed with high-fat diet + intraperitoneal injection of vitamin D3 + immune injury + FeSO4 to establish an atherosclerosis model. The rats in the lactobacillus acidophilus group were intragastrically administered with 0.5 mL of lactobacillus acidophilus per day (1×109 CFU/mL) on the basis of the high-fat diet. Rats were weighed at the 4th, 8th and 12th weekends. After 12 weeks of feeding, the serum was taken from abdominal aorta to detect the contents of oxidized low density lipoprotein (oxLDL), NO, arginine, arginase, and peroxynitrite (ONOO-). The aorta was isolated to observe the morphological change by HE staining. The expressions of eNOS and iNOS mRNA were detected by Real-time PCR, and the expressions of NF-κB p65 subunits were detected by Western blot assay. Results (1) There was no significant difference in body weight between the high-fat diet group and the lactobacillus acidophilus group during the whole experiment (P＞0.05), but both were significantly increased compared with those of the normal diet group (P < 0.01). (2) HE staining showed that the aorta formed a wide range of atherosclerotic lesions in the high-fat diet rats, and the aortic morphology was significantly improved in the lactobacillus acidophilus group. Only endothelial cell proliferation was found, and no smooth muscle cell necrosis was observed in this group. (3) Compared with normal diet group, the serum expressions of oxLDL, ONOO- , arginase, aortic iNOS mRNA and nuclear NF-κB p65 were increased in high-fat diet group (P＜0.01), and the serum arginine content and aortic eNOS mRNA expression levels were decreased (P＜0.01). While lactobacillus acidophilus can just reverse the above changes (P＜0.01). Conclusion Lactobacillus acidophilus may exert anti-atherosclerotic effects by regulating the expression of NOS, increasing NO bioavailability, and protecting endothelial function. Related Articles | Metrics

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Expression and clinical significance of MMP-7 in hepatic fibrosis of biliary atresia YU Chen, XIONG Xi-qian, ZHAN Jiang-hua, HU Xiao-li, GAO Wei 2019, 47 (1):  38-42.  doi: 10.11958/20181302 Abstract ( 1391 )   PDF (637KB) ( 4302 )   Objective To investigate the relationship of matrix metalloproteinase-7 (MMP-7) in liver tissue of biliary atresia (BA) with liver fibrosis and bile duct reaction, and explore the role of MMP-7 in the process of liver fibrosis and its clinical significance. Methods Data of 15 BA patients with liver biopsy in Kasai operation in our hospital from June 2017 to April 2018 were collected (G1 group)，and data of 41 patients with liver biopsy who underwent liver transplantation after Kasai operation from January 2015 to January 2016 were enrolled as transplantation group. The transplantation group was divided into two groups according to the interval time between Kasai operation and liver transplantation: G2 group (n=28, the interval time was less than 2 years) and G3 group (n=13, the interval time was more than 2 years). Hematoxylin-Eosin (HE) staining was used to observe the degree of liver fibrosis. Immunohistochemical staining was used to detect the expressions of MMP-7 and CK-19. Results (1) Immunohistochemical results showed that MMP-7 was mainly expressed in bile duct epithelial cells, hyperplastic bile ducts and hepatocytes around the portal area. With the progress of hepatic fibrosis, the expressions of MMP-7 were increased in biliary duct cells and hepatocytes, and which were strongly expressed in biliary duct cells than those of hepatocytes. Semi-quantitative analysis showed that the expression levels of MMP-7 were (0.068± 0.017) vs. (0.093±0.017) vs. (0.084±0.016) in the three groups (F=10.541，P＜0.001). CK-19 staining showed that bile duct reactions of three groups were (0.119±0.036) vs. (0.157±0.040) vs. (0.110±0.044) (F=7.296，P＜0.001). The expression levels of MMP-7 and CK-19 protein were significantly higher in G2 group than those of other two groups (P＜0.05). There was no significant difference between G1 and G3 groups (P＞0.05). (2) The liver fibrosis in the three groups were 2 (2, 3) vs. 4 (3, 4) vs. 4 (2, 4) (H=17.785, P＜0.001), and the fibrosis was significantly higher in the G2 group than that of other two groups (P＜ 0.017). (3) Correlation test showed that the expression of MMP-7 protein was positively correlated with the degree of liver fibrosis (rs=0.609, P＜0.001), but there was no correlation with bile duct reaction (r=0.007, P=0.962). Conclusion The expression of MMP-7 protein is highly expressed in liver tissue after Kasai operation, and it increases with the severity of liver fibrosis. MMP-7 may participate in the process of BA liver fibrosis and suggest that the survival of autologous liver is poor. Related Articles | Metrics

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Correlation between serum GDF-15, serum PⅠCP and PⅢNP in patients with chronic heart failure ZENG Chao, YU Pan-pan, LI Cai-hong, CHEN Wan-li, ZHU Zhen-yu, QI Xin 2019, 47 (1):  42-46.  doi: 10.11958/20181360 Abstract ( 688 )   PDF (462KB) ( 4747 )   Objective To detect the changes of serum growth differentiation factor 15 (GDF-15) and type Ⅰ procollagen carboxy terminal peptide (PⅠCP) and type Ⅲ procollagen amino terminal peptide (PⅢNP) in patients with heart failure, and to analyze the correlation between GDF-15, PⅠCP and PⅢNP, and to explore the guiding role of GDF-15 in ventricular remodeling in patients with heart failure. Methods A total of 219 patients with heart failure were enrolled. Patients were divided into heart function Ⅰ grade (n= 58), Ⅱ grade (n=39), Ⅲ grade (n=47), and Ⅳ grade (n=75) groups in accordance with New York Heart Association (NYHA). According to left ventricular ejection fraction (LVEF), the heart failure patients were divided into heart failure with reduced LVEF group (LVEF＜ 0.45, n=69) and heart failure with preserved LVEF group (LVEF≥0.45, n=150). And 32 healthy subjects were chosen as the control group. Serum levels of GDF-15, PⅠCP, and PⅢNP were measured by ELISA. Left ventricular end-diastolic diameter (LVEDD), left atrial (LA), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular ejection fraction (LVEF) were measured by echocardiography. The left ventricular mass index (LVMI) was calculated. And also the correlation between serum GDF-15 and PⅠCP, PⅢNP, NT-proBNP, LVEDD, LA, LVMI and LVEF were analyzed in patients with heart failure. Results Serum levels of GDF-15, PⅠCP, PⅢNP and NT-proBNP were significantly elevated in patients with heart failure (P＜ 0.05), and increased with the increasing NYHA classification. The serum levels of LA, LVEDD, LVMI, NT-proBNP, GDF-15, PⅠCP and PⅢNP were increased in turn in control group, HFpEF group and HFrEF group (P＜0.05). Serum GDF-15 levels were positively correlated with PⅠCP, PⅢNP, NT-proBNP, LA, LVEDD, and LVMI in patients with heart failure (rs=0.549, 0.533, 0.539, 0.393, 0.403, 0.485, P＜0.01), and negatively correlated with LVEF (rs=-0.568, P＜0.01). Conclusion Serum GDF-15 is associated with the severity of heart failure and may reflect ventricular remodeling in patients with heart failure. Related Articles | Metrics

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Curative effect of intracoronary injection of sodium nitroprusside on no-reflow phenomenon in elderly patients with STEMI treated by primary percutaneous coronary intervention SUN Xiao-qiang, LI Heng, HE Feng 2019, 47 (1):  47-50.  doi: 10.11958/20181139 Abstract ( 755 )   PDF (338KB) ( 3801 )   Objective To investigate the safety and efficacy of prophylactic injection of sodium nitroprusside in primary percutaneous coronary intervention (pPCI) without reflow in elderly patients with ST segment elevation myocardial infarction (STEMI). Methods A total of 185 elderly patients with STEMI were divided into sodium nitroprusside group (n= 92) and control group (n=93) with completely randomized design. All patients were treated with pPCI. Sodium nitroprusside group received sodium nitroprusside 200 μg immediately after opening coronary artery. Control group received equal amount of physiological saline. The incidence of no-reflow, the levels of troponin T (cTnT) and ejection fraction (EF), the incidence of major adverse cardiovascular events (MACE) during hospitalization and 1 year follow-up were compared between two groups, and the risk factors of no-reflow were analyzed. Results In nitroprusside group, the incidence of no flow and cTnT, CRP, and the number of stent were significantly lower and LVEF, EF were significantly higher than those in control group (P＜0.05). There were no significant differences in HbA1c, infarct related artery (IRA), TIMI grade, Gensini score, SYNTAX score and incidence of MACE during hospitalization between two groups (P＞0.05). In nitroprusside group, the incidence of MACE in 1-year follow-up was significantly lower than that in control group (P＜0.05). Logistic regression analysis showed that without injection of nitroprusside, diabetes and the high SYNTAX scores were independent risk factors for no reflow. Conclusion The application of sodium nitroprusside can significantly reduce the incidence of no flow and MACE in 1-year follow up in elderly patients with STEMI treated with pPCI，and which has good safety. Related Articles | Metrics

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Clinical manifestations, etiology and treatment of kidney disease combined with posterior reversible encephalopathy syndrome in children WU Xia, ZHANG Bi-li, WANG Wen-hong, CHEN Xin 2019, 47 (1):  51-54.  doi: 10.11958/20181128 Abstract ( 807 )   PDF (562KB) ( 3722 )   Objective To analyze clinical data of 4 cases of renal disease with reversible posterior encephalopathy syndrome (PRES), and improve the understanding of the disease. Methods Data of clinical manifestations, etiology and treatment of 4 cases of PRES hospitalized in our hospital from May 2014 - April 2018 were summarized and analyzed. Results Four cases were diagnosed with nephrotic syndrome. In 3 cases with headache, other clinical manifestations were found in 48 hours. There were convulsions in 4 children, including 1 case with acute kidney injury, 2 cases with liver function damage in the application of tacrolimus therapy. The tacrolimus blood concentrations increased in varying degrees. In 1 case, CYP3A5 gene was detected as hybrid mutant (AG), tacrolimus was decreased/stop. Clinical symptoms were quickly improved in 4 cases after active treatment. No recurrence of PRES was found in the follow-up period. Conclusion Headache is the first symptom of PRES. When nephrotic syndrome is associated with convulsion, it should be differentiated from PRES. Hyperperfusion caused by high blood pressure and tacrolimus induced endothelial injury can be the cause. The CYP3A5 gene detection should be performed as early as possible, to closely monitor liver function and tacrolimus blood concentrations in children with cytotoxic edema on cranial magnetic resonance imaging. Related Articles | Metrics

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Effects of sufentanil combined with nalbuphine on postoperative patient-controlled analgesia after gynecologic laparoscopic surgery SUN Zhen-tao, ZHU Ze-fei, ZHU Lin, ZHU Na-na, XIANG Dao, WANG Ning, CAO Ya-nan, HAN Xue-ping 2019, 47 (1):  55-58.  doi: 10.11958/20180900 Abstract ( 1092 )   PDF (342KB) ( 4126 )   Objective To observe the efficacy of patient-controlled intravenous analgesia (PCIA) using sufentanil supplement with nalbuphine on patients underwent laparoscopic total hysterectomy. Methods A total of 180 patients, age ranged from 18 to 65 year, BMI 18-25 kg/m2, ASA physical status Ⅰ-Ⅱ, undergoing laparoscopic total hysterectomy were selected. They were randomly divided into 3 groups (n=60 for each group): sufentanil group (group S), nalbuphine group (group N) and sufentanil supplement with nalbuphine group (group NS). PCIA pump was given at the end of the operation with 5 mL bonus loading. The total amount of PCIA was 100 mL, and which was programmed to deliver 0.5 mL each time with a lockout interval of 15min and the background infusion amount of 2 mL/h. In the group S, PCIA regiment composed of sufentanil 2 μg/kg and 10mg tropisetron in 100 mL of normal saline. In the group N, PCIA regiment composed of nalbuphine 2 mg/kg and 10 mg tropisetron in 100 mL of normal saline. In the group NS, PCIA regiment composed of sufentanil 1 mg/kg, nalbuphine 1 mg/kg and 10 mg tropisetron in 100 mL of normal saline. The VAS score and Ramsay score were recorded after the operation, and the number of effective compression of PCIA was also recorded. Adverse reactions were documented in details. Results There was no significant difference in general condition between the three groups (P＞0.05). There was no significant difference in VAS scores between the 3 groups at all time points (P＞0.05). PCIA press times were significantly more in group S than those of group N (P＜0.05). But there was no significant difference between group S and group NS (P＞ 0.05). Ramsay scores were higher in group N than those in group S and group NS (P＜0.05). But there was no significant difference between group S and group NS (P＞0.05). The incidence of nausea and vomiting were higher in group S than those in group N (P＜0.016 7), but there was no statistical difference in group NS compared with that of group S and group N (P＞ 0.016 7). The additional dose of tropisetron was higher in group S than that in group N and group NS (P＜0.05), but there was no statistical difference between group N and group NS (P＞0.05). Conclusion Nalbuphine supplement sufentanil has great efficiency for postoperative patient-controlled intravenous analgesia in laparoscopic hysterectomy. It not only can avoid the excessive sedative effect produced by large doses of nalbuphine, but also reduces the amount of sufentanil, thus reducing the incidence of nausea and vomiting, and the analgesic effect is satisfaction. Related Articles | Metrics

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Analysis of related factors of stage I lung adenocarcinoma with lymphovascular invasion REN Shuai, SUN Da-qiang, ZHU Jian-ping, JI Lin-lin, LI Xin, DU Lin 2019, 47 (1):  59-62.  doi: 10.11958/20181138 Abstract ( 2758 )   PDF (318KB) ( 4142 )   Objective To investigate the related factors of stage Ⅰ pulmonary adenocarcinoma with lymphovascular invasion. Methods Clinical data of 229 patients with stage Ⅰ lung adenocarcinoma treated by surgical treatment and pathologically diagnosed as stage Ⅰ lung adenocarcinoma in Tianjin Chest Hospital from January 2016 to May 2018 were retrospectively analyzed. The patients were divided into two groups: lymphovascular invasion group and non-lymphovascular invasion group, and the influencing factors of lymphovascular invasion for lung adenocarcinoma in stage Ⅰ were analyzed. Results The univariate factor analysis showed that pulmonary adenocarcinoma in stage Ⅰ with lymphovascular invasion was related to diameter of tumor, lepidic pattern, acinar pattern, papillary pattern, micropapillary pattern, pleural invasion, preoperative neutrophil-lymphocyte ratio (NLR) and preoperative carcinoembryonic antigen (CEA, P＜0.05). Multivariate Logistic regression analysis showed that diameter of tumor ≥ 2.2 cm, micropapillary pattern ≥ 12.8% and pleural invasion were the risk factors for lymphovascular invasion. Conclusion Attention should be paid to the risk factors of lymphovascular invasion in clinic, such as tumor diameter, micropapillary pattern and visceral pleural invasion. And the patients with lymphovascular invasion should be treated as early as possible so as to prolong their survival time. Related Articles | Metrics

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Prognosis and analysis of associated factors in 102 patients with diffuse axonal injury LI Min-tao, JIA Zhu-ting, DOU Lian-feng, MA Hui-li, CHEN Xi, LI Jian-jun, SUN Sheng-fang 2019, 47 (1):  63-66.  doi: 10.11958/20180982 Abstract ( 1037 )   PDF (328KB) ( 3618 )   Objective To investigate the prognosis of 102 patients with diffuse axonal injury (DAI) and analyze the related factors. Methods A total of 102 DAI patients hospitalized in our hospital from January 2016 to January 2018 were divided into survival group (n=70) and death group (n=32) according to the 6-month survival after injury. The extended Glasgow outcome score (GOS-E) was used to describe the prognosis of patients who were survival at 6 months after injury, and these patients were subdivided into dependent group (n=8) and independent group (n=59). The chi-square test and Fisher's exact method were used to determine the factors associated with prognosis including mortality and dependence of patients. Results The new injury severity score (NISS) was (46.83 ± 10.69) for 102 patients at admission. The 63.7% of these DAI patients (65 / 102) were classified as mild or moderate DAI, and 36.3% of patients (37 / 102) were severe DAI. Patients with mild to moderate DAI showed higher survival rate and lower dependence rate on life than patients with severe DAI (P＜0.05). The incidence of abnormal blood glucose, abnormal SpO2 and pupillary abnormality were higher in the death group at admission than those in the survival group (P＜0.05). During hospitalization, the incidence of other complications, cerebral hemorrhage (ICH) and abnormal blood pressure were higher in the death group compared with those of survival group, but the proportion of early DAI signs on CT was lower in death group (P＜0.05). In the dependent group, ICU hospitalization, infection, continued sedative drug use, other complications and ICH were higher than those in the independent group (P＜0.05). Conclusion (1) The more severe the injury of DAI patients, the higher the mortality rate and dependence. (2) There are high incidence of abnormal blood glucose, SpO2 abnormality and pupillary abnormality at admission and high incidence of blood pressure abnormalities, early DAI signs on CT, ICH, and other complications during hospitalization in patients in the death group. (3) Patients in the dependent group show a high proportion of ICU hospitalization, infection, continued sedative drug use, other complications and ICH during hospitalization. Related Articles | Metrics

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Bioinformatics analysis of the effect of miR-126 on the progression of male patients with laryngeal cancer WEI Mei, WANG Xiao-yu, DU Jian-qun, LIN Peng 2019, 47 (1):  67-72.  doi: 10.11958/20181135 Abstract ( 729 )   PDF (568KB) ( 3624 )   Objective To acquire theoretical data for studying the mechanism of miR-126 in male patients with laryngeal cancer, and predict and analyze the target gene of miR-126. Methods The cancer Genome Atlas (TCGA) database was analyzed for specific effects of miR-126 on male patients with laryngeal cancer. And then the target gene of miR-126 was predicted by target gene databases of male patients with laryngeal cancer. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment was analyzed by DAVID database. Results The high expression of miR-126 was beneficial to increase the overall survival (OS) of patients with laryngeal cancer. And the higher expression of miR-126 was found in normal tissue. Seven of 58 target genes (DNMT1, GRIN2B, L2HGDH, PIK3R2, PTPN7, SIRT1, TWF1) worked in effecting the overall survival of patients with laryngeal cancer. GO enrichment analysis found that target genes constituted the heterochromatin, and involved in cell metabolism. KEGG pathway enrichment analysis found that PIK3R2 and SIRT1 took part in cell metabolism and apoptosis by AMPK and FoxO signal pathways. Conclusion MiR- 126 could improve the OS of male patients with laryngeal cancer, which is achieved by regulating gene expression, cell metabolism and apoptosis. Related Articles | Metrics

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Clinical effects of skin care products containing epidermal growth factor on the sensitive skin barrier function CHANG Gui-zhen, ZHAO Rui-zhi, YING Shuang, ZHANG Xiao-yan, XIA Di, ZHOU Wan-ting, GAO Heng-yu, ZHANG Li-tao 2019, 47 (1):  72-75.  doi: 10.11958/20181381 Abstract ( 1198 )   PDF (379KB) ( 3791 )   Objective To evaluate the effects and adverse reactions of external skin care products containing epidermal growth factor (EGF) on physiological functions of sensitive skin. Methods First, 30 patients with sensitive skin received patch test to detect contact allergy. The external skin care products containing EGF were used twice a day for 28 days according to recommended dose (0.4-0.5 mL). A non-invasive skin test was done before the trial and on the day 7, 14, 21 and 28 during the trial to evaluate the physiological function of skin. The lactic acid, the recovery of skin lesions and safety of the product were evaluated at the same time. Results The results of 30 patch tests were positive. The water content of the stratum corneum and the oil content of the skin began to increase at 14 days after treatment, and the pH value decreased (P＜0.05). The transepidermal water loss (TEWL), lactic acid test and the skin lesion improvement score showed a decreasing trend at 21 d, 7 d and 7 d, respectively (P＜0.05). The positive rates showed a decreasing trend after 7d, 14 d, 21 d and 28 d treatment (P＜0.001). Seven subjects whose lactic acid stimulation test were still positive after 28 d included 2 cases of nickel (++ ), 2 cases of 1 tested item (+ ), 1 case of 4 tested items (+ ) and 2 cases of 5 tested items (+ ). The improvement rate of skin lesions showed an increasing trend (P=0.058). There were 2 cases with 5 tested items (+) and 2 cases with 4 tested items (+ ) in 4 subjects with no significant improvement in skin lesions for 28 days. No side effects occurred before and after treatment, and none of the patients fell off. Conclusion Skin care products containing oligopeptide-1 (EGF) are effective, safe and helpful for recovering the skin barrier function in patients with sensitive skin. Related Articles | Metrics

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Vertebrobasilar dolichiectasia: a case report and literature review MU Wei-hang, SONG Yi-jun 2019, 47 (1):  76-78.  doi: 10.11958/20180993 Abstract ( 883 )   PDF (528KB) ( 4755 )   Vertebrobasilar dolichiectasia (VBD) is a rare and varied cerebrovascular disease that is still in exploring. VBD is a clinical symptom caused by congenital development, acquired factors or two factors acting on the intracranial segment of vertebral artery and/or basilar artery, resulting in significant ectasia, elongation, tortuosity, angular displacement, or compression of peripheral nerves or tissues. This paper reported 1 case of frequent dizziness, whose main clinical manifestations were posterior circulation infarction, mainly cerebellar and medulla oblongata. After strict examination, the patient was diagnosed as VBD, and the relevant literature was reviewed. Related Articles | Metrics

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Two case reports of intracranial collision tumors CHENG Yi-feng, XU De-sheng, LIU Dong, REN Yi, YIN Shao-ya 2019, 47 (1):  79-81.  doi: 10.11958/20181319 Abstract ( 817 )   PDF (667KB) ( 3774 )   Intracranial collision tumors are rare in clinic. Preoperative diagnosis is difficult. Diagnosis is mainly based on postoperative pathological results. Two cases of intracranial collision tumors located in cerebellum and sellar region were treated by posterior median approach and pterional approach respectively. The cerebellar collision tumor was completely resected, and the pathological result was the collision of metastatic tumor and meningioma. The patient died of multiple metastatic multiple organ failure 14 months after operation. The sellar region tumor was subtotal resected. The pathological result was a collision of meningioma and pituitary adenoma. Symptoms of upper eyelid lifting were alleviated, and no recurrence was found after 1 year follow-up. Related Articles | Metrics

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A case of CRT-D in the treatment of dilated cardiomyopathy complicated with complete left bundle branch block hyperreactivity XIE Qing-qing, CUI Li, CAO Yue-juan 2019, 47 (1):  82-85.  doi: 10.11958/20181205 Abstract ( 1038 )   PDF (524KB) ( 3827 )   A case of dilated cardiomyopathy complicated with complete left bundle branch block was reported. After admission, the patient was treated with cardiotonic, dilatation, diuresis, inhibition of myocardial remodeling, improvement of myocardial metabolism and so on. The patient was with recurrent ventricular fibrillation during hospitalization and poor heart function, and the patient's symptoms improved significantly after CRT-D (cardiac resynchronization therapy-defibrillator) implantation. Followed up for nearly 2 years, echocardiography showed that left ventricular end diastolic dimension reduced from 70mm to 42 mm, left atrium dimension reduced from 34 mm to 30 mm, and left ventricular ejection fraction increased from 0.35 to 0.62. The patient was generally in good condition and no restrictions on daily activities, which was the CRT-D hyperreactivity. The reason for this patient's hyperreactivity might be that CRT-D has corrected the progressive enlargement of the heart caused by conduction block. Related Articles | Metrics

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Cardiac arrest caused by foudroyant type I diabetes mellitus: a case report and literature review CHU Qing-yu, HE Jia-tong, JIA Shan-yi, ZHAO Bin 2019, 47 (1):  85-87.  doi: 10.11958/20181096 Abstract ( 743 )   PDF (365KB) ( 3630 )   Foudroyant type 1 diabetes mellitus (FT1DM) is a subtype of type I diabetes, which is rare and dangerous in clinic. The pathogenesis of FT1DM is that the function of β cells in pancreas islet is severely damaged in a short period of time. The prognosis is extremely poor and the mortality rate is high. Its etiology and pathogenesis are unknown, which maybe related to many factors such as heredity, environment and autoimmunity. The author analyzed the clinical data of a cardiac arrest caused by FT1DM, in order to attract the attention of clinicians and avoid misdiagnosis. Related Articles | Metrics

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A case report of dysenteric Reiter’s syndrome in children LIU Zhu-feng, ZHANG Bi-li, WANG Wen-hong 2019, 47 (1):  88-89.  doi: 10.11958/20181452 Abstract ( 874 )   PDF (284KB) ( 4220 )   Reiter’s syndrome is a special type of reactive arthritis characterized by the triad of arthritis, urethritis and conjunctivitis. According to the different types of precursor infections, they can be divided into sexually transmitted and dysenteric types. Children with this disease are rare, and clinicians are not well aware of it and are prone to misdiagnosis and missed diagnosis. This paper retrospectively analyzed the pathogenic characteristics, clinical manifestations, treatment and outcome of Reiter's syndrome in a 20-month-old girl infected with bacillary dysentery to improve the understanding of the disease. Related Articles | Metrics

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A case report of anal fistula secondary to gangrene pyoderma with ulcerative colitis DU Xiao-yan, LI Ling 2019, 47 (1):  90-93.  doi: 10.11958/20181433 Abstract ( 954 )   PDF (599KB) ( 4208 )   Anal fistula secondary to gangrenous pyoderma (PG) with ulcerative colitis (UC) is rare, and its related treatments are rarely reported. This article reports a case of anal fistula caused by gangrenous pyoderma with ulcerative colitis. The continuous application of hormone combined immunosuppression was ineffective. The symptoms were improved after using biological agents. Related Articles | Metrics

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Imaging findings of Currarino syndrome CHEN Jing, WANG Chun-xiang, CAI Chun-quan 2019, 47 (1):  94-97.  doi: 10.11958/20181317 Abstract ( 1400 )   PDF (345KB) ( 4535 )   Currarino syndrome (CS) is a rare disease. Because of its variety of clinical manifestations, some patients show atypical clinical manifestations, and even no early clinical symptoms in the early stage. It is easy to cause misdiagnosis and missed diagnosis. With the development of imaging technology, X-ray, gastrointestinal radiography, CT and MRI can provide different diagnostic information for the diagnosis of CS. Different imaging methods have their own advantages and limitations. The combination of multiple imaging methods plays an important role in the diagnosis of CS. This article reviews the etiology, clinical features and imaging findings of CS, in order to develop the understanding and make an early diagnosis of CS. Related Articles | Metrics

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Advances in the study of everolimus combined with fulvestrant for the treatment of hormone receptor-positive advanced breast cancer PAN Teng, HU Yun-hui, LIU Jing-jing, ZHANG Jin 2019, 47 (1):  98-103.  doi: 10.11958/20180794 Abstract ( 897 )   PDF (389KB) ( 3627 )   Breast cancer is a classic hormone-dependent tumor, so endocrine therapy is a major treatment for hormonereceptor -positive [HR (+ )], human-epidermal-growth-factor-2-negative [HER-2 (- )] and advanced breast cancer. Traditional endocrine drugs, such as tamoxifen, aromatase inhibitors (AI) and fulvestrant, have been widely used in advanced (locally advanced or metastatic) postmenopausal patients. However, for this subtype of breast cancer patients, after the appearance of targeted drug, such as mammalian target of rapamycin (mTOR) inhibitors and cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors, the choice of endocrine therapy has been expanded. There has been various combination of targeted drugs and endocrine therapy. This article aims to explore the application of mTOR inhibitor everolimus combined with fulvestrant in the treatment of AI-resistant estrogen-receptor-positive［ER (+)］/ HER-2 (-) advanced breast cancer. Related Articles | Metrics

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Application progress of ultrasound microbubble in diagnosis and treatment of cardiac diseases TAN Yan-di, ZHAO Yun, ZHOU Jun 2019, 47 (1):  104-108.  doi: 10.11958/20181016 Abstract ( 729 )   PDF (375KB) ( 4152 )   Ultrasound microbubbles have been widely used in contrast echocardiography because of their advantages of non-invasion, high-safety, and real-time dynamic imaging, providing valuable information for the diagnosis of heart diseases. With the development of molecular research，targeted imaging and gene therapy of ultrasound microbubbles have been deeply studied in animal experiments, which provides a new direction for the future diagnosis and treatment of cardiac diseases. This paper reviews the application of ultrasound microbubbles in the diagnosis and treatment of cardiac diseases. Related Articles | Metrics

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The Progress of MRI in the diagnosis of placenta accreta in the middle and third trimester of pregnancy ZHANG Zhan, KANG Li-qing 2019, 47 (1):  108-112.  doi: 10.11958/20180902 Abstract ( 923 )   PDF (371KB) ( 4240 )   Placenta accreta is a critical disease in obstetrics. Prenatal diagnosis depends on imaging examination and has a positive effect on treatment and prognosis of diseases. MRI can be an important supplement for B-ultrasound examination in the diagnosis of placenta accreta in middle and late pregnancy. MRI diagnosis of placenta accreta is recommended at 24-30 W gestation. The common imaging changes include the thinning of myometrium or the interruption of T 2 low signal band at the interface between uterus and placenta, heterogeneity of placental signal intensity and T2 abnormal dark interplacental bands, placental hemorrhage, abnormal uterine bulging, placental bulging, placenta recess, shortening of the uterine cervix. The role of disorganised vasculature of placenta can not be ignored. The diagnosis of the depth of placenta accreta, the accretion area and the atypical site (non-caesarean scar) are the difficult point and direction of the study. Related Articles | Metrics