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15 April 2019, Volume 47 Issue 4 Previous Issue    Next Issue
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Monograph-Biliary Atresia and Liver Transplantation

Lectures
Cell and Molecular Biology
Experimental Study
Clinical Study

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Monograph-Biliary Atresia and Liver Transplantation

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Feasibility of viral vaccine in preventing biliary atresia ZHAN Jiang-hua1△, YU Chen2 2019, 47 (4):  339-342.  doi: 10.11958/20190525 Abstract ( 687 )   PDF (354KB) ( 3496 )   Biliary atresia (BA) is a common cause of obstructive jaundice in the infantile period, and also a severe hepatobiliary disease leading to liver failure. At present, the research on the etiology and pathogenesis of BA is continuing. But various signs show that perinatal viral infection plays an important role in the occurrence and development of BA, which may be the exact cause of BA. Therefore, this paper mainly discussed the feasibility of preventing BA from the view of virus vaccination, in order to provide a new perspective for reducing the incidence of BA. Related Articles | Metrics

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Clinical significance of evaluation of nutrition condition in patients with biliary atresia in the perioperative period ZHAN Jiang-hua△，WANG Li 2019, 47 (4):  342-345.  doi: 10.11958/20181411 Abstract ( 702 )   PDF (345KB) ( 3441 )   Biliary atresia (BA) is a severe hepatobiliary disease in the infantile period characterized by progressive inflammation of intrahepatic and extrahepatic bile duct and fibrous obstruction, which leads to cholestasis and progressive liver fibrosis. Current researches mainly focus on complication and native liver survival rate after Kasai procedure of BA children, while the value of nutrition condition of BA children in the perioperative period is always ignored. This article discussed the effect of nutrition condition on complication and native liver survival rate in the perioperative period after Kasai procedure and liver transplantation of BA children. We hope that it can be helpful to the clinical treatment of BA. Related Articles | Metrics

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The impact of ductal plate malformation on autologous liver survival in children with biliary atresia ZHANG Hui1, LIN Song2, XIONG Xi-qian3, YAN Xue-qiang3, YU Chen3, GAO Wei4, 2019, 47 (4):  346-350.  doi: 10.11958/20190643 Abstract ( 646 )   PDF (794KB) ( 3481 )   Objective To analyze the relationship between bile ductal plate malformation (DPM) and autologous liver survival in children with biliary atresia (BA). Methods A total of 40 BA children underwent Kasai operation in Tianjin Children’s Hospital and liver transplantation (LT) in Tianjin First Central Hospital from January 2008 to December 2017 were collected. Hepatic tissue samples at the time of Kasai operation and liver transplantation were stained with HE and CK19 immunohistochemistry. According to the existence of DPM in different periods during Kasai operation, patients were divided into without DPM group (n=27) and with DPM group (n=13), and without DPM group (n=17) and with DPM group (n= 23) during liver transplantation. The differences of autologous liver survival time were compared between different stage groups of children. Results The autologous liver survival time was 230.0 (190.5, 276.5) d and 336.0 (218.0, 757.0) d respectively in BA children with and without DPM during Kasai operation. The autologous liver survival time was 230.0 (185.0, 285.0) d and 527.0 (288.0, 817.0) d respectively in BA children with and without DPM during liver transplantation. The autologous liver survival time was significantly shorter in patients with DPM than that in patients without DPM either during Kasai operation or LT (P＜0.05). Conclusion Children with biliary atresia associated with bile ductal plate malformation can shorten their autologous liver survival time. Related Articles | Metrics

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Risk factors of early liver transplantation after Kasai procedure for biliary atresia GE Liang1, ZHAN Jiang-hua2△, GAO Wei3, YU Chen1, ZHAO Sheng-qiao1, XU Xiao-dan1, DOU Ran1 2019, 47 (4):  351-355.  doi: 10.11958/20190343 Abstract ( 751 )   PDF (394KB) ( 3556 )   Objective To explore the influencing factors of the survival time of autologous liver after Kasai procedure for biliary atresia(BA), and to find out the risk factors of early liver transplantation, so as to provide data of evidence-based medicine for BA treatment. Methods Data of 167 BA children underwent liver transplantation due to hepatic failure after Kasai procedure were retrospectively analyzed. According to the operation interval between Kasai procedure and liver transplantation, they were divided into G1 (≤6 months), G2 (＞6 months - 2 years) and G3 (>2 years) groups. Data of patient gender, patient age of Kasai procedure, jaundice clearance, cholangitis after Kasai procedure and liver function indexes before liver transplantation were compared between three groups. The χ2 test, variance analysis, Kruskal-Wallis H test and multiple logistic regression analysis were used to find out the influencing factors for the survival time of autologous liver, that is, the influencing factors of early liver transplantation. Results There were no significant differences in gender and age of Kasai procedure between the three groups. There was statistical difference in the clearance of jaundice between the three groups (P＜0.01), showing a gradually increase from G1 to G3. There was significant difference in the early cholangitis between the three groups (P＜0.05), which was lower in G3 group than that of G1 group. There was significant difference in the late cholangitis after surgery between the three groups (P＜0.01), which was higher in G2 group than that of G1 group. There was statistical difference in the incidence of frequent cholangitis between the three groups (P＜0.05), which was lower in G3 group than that of G2 group. Multiple logistic regression analysis showed that persistent jaundice was the risk factor for native liver survival after Kasai procedure. Conclusion Persistent jaundice and early cholangitis after Kasai procedure can reduce the native liver survival time, which is related to the early liver transplantation. Persistent jaundice is a risk factor for early liver transplantation after Kasai procedure. Related Articles | Metrics

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The safety evaluation of hepatitis B virus core antibody-positive grafts in pediatric liver transplantation SONG Zhuo-lun1,2, GAO Wei1,2△, LI Jing3, DONG Chong1,2, CHEN Jing1,2, MA Nan1,2, MENG Xing-chu1,2, SUN Chao 1,2, 2019, 47 (4):  356-359.  doi: 10.11958/20190730 Abstract ( 1081 )   PDF (342KB) ( 4326 )   Objective To observe the decline of post-operative hepatitis B virus surface antibody (HBsAb) titer and evaluate its influential factors in pediatric recipients receiving hepatitis B core antibody (HBcAb) positive grafts. Methods Sixty recipients who were operated in Tianjin First Center Hospital from September 2016 to December 2017 were enrolled in the study. The recipients were divided into three groups according to the changes of HBsAb titer three months after liver transplantation: group A (HBsAb titer > 1 000 IU/L, n=18), group B (200 IU/L ≤ HBsAb titer ≤ 1 000 IU/L, n=18) and group C (HBsAb titer < 200 IU / L, n=24). The donor and recipient characteristics, peri-operative data, post-operative complications, de novo hepatitis B along with graft and recipient survival rates were compared between three groups. Logistic analysis was used to analyze the influencing factors for HBsAb titer decline. Results The median follow-up time was 17.8 months for all recipients. One patient died of interstitial pneumonia in group C. One patient developed de novo hepatitis B in group C. No cases of recipient death and de novo hepatitis B in group A and B. There were no differences in de novo hepatitis B (χ2=1.525, P=0.466), and recipient survival rates between three groups (Log-rank χ2=1.665, P=0.625). Recipients receiving living-related grafts (OR=10.82, 95%CI: 1.17-100.50) and more than 400 mL plasma transfusion during operation (OR=6.25, 95%CI: 1.51-25.87) were risk factors for the decline of HBsAb titer after operation. Conclusion The graft type and intraoperative plasma transfusion influence the decline of HBsAb titer after transplantation. Related Articles | Metrics

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Advances in the study of exosomes and liver fibrosis in biliary atresia ZHAO Jin-feng1, ZHAN Jiang-hua2△ 2019, 47 (4):  360-364.  doi: 10.11958/20190707 Abstract ( 776 )   PDF (361KB) ( 3936 )   Biliary atresia (BA) is a serious disease of the hepatobiliary system in infants and children, which quickly worses into irreversible liver fibrosis and eventually leads to hepatic failure and death. Controling the liver fibrosis of BA patients with BA timely and effectively is the key to prolong or achieve their survival with autologous liver. Exosomes, as nano-scale vesicles containing special lipids, proteins and nucleic acids, have certain physiological and pathological functions, and regarded as a new way of communication between cells. In recent years, with increasing the research about exosomes, their function of regulating liver fibrosis of BA has been gradually concerned. And exosomes affect the fibrosis process as a carrier of the intercellular signal transmission: transfering or influencing fiber connective tissue growth factor or transforming growth factor beta 1, promoting the secretion of IL-17 indirectly, participating in Notch and Hedgehog (Hh) pathway relating to the process of liver fibrosis and regulating hepatic stellate cells’migration. In particular, it was reported that exosomes from adipose tissue-derived mesenchymal stem cells and human umbilical cord mesenchymal stem cells play a role in inhibiting liver fibrosis in vitro. This paper aims to review the relationship between exosomes and liver fibrosis of BA and provide a new direction for clinical therapy. Related Articles | Metrics

Lectures

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The theoretical basis and operational procedure of local instillation of amphotericin B into lungs by bronchoscopy FENG Jing1, WU Bo2, ZHANG Jing3, LI Cai-li1 2019, 47 (4):  365-367.  doi: 10.11958/20190583 Abstract ( 1049 )   PDF (338KB) ( 4435 )   Pulmonary fungal infections spread rapidly and need timely intervention of medication. Tissue necrosis and local pulmonary structural damage occur in a short period of time. If fungal infections are controlled by effective antifungal drugs or limited by the patient's autoimmune system, fibrous connective tissue and granulation tissue can be formed quickly. Amphotericin B is a polyene antifungal agent with a wide antifungal spectrum and strong effect. When intravenously applied， the concentration of amphotericin B commonly attained in lungs has only bacteriostatic effect on fungus, with high toxicity and adverse reactions. The absorption through the airway mucosa is low and slow and the irritation is not strong. According to these characteristics, local injection of amphotericin B via bronchoscopy has a great advantage, which is worthy of clinical promotion. Based on the guidelines and clinical experience, the theoretical basis and operation procedure of local instillation of amphotericin B into lungs by bronchoscopy are described in detail，including pharmacological mechanism, local dose, solution concentration and the detailed method of operation of it. Related Articles | Metrics

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Principles for the application of diagnostic interventional pulmonology combined with pathogenic microbial metagenomics sequencing in pulmonary infection WU Bo1, FENG Jing2△, ZHANG Jing3, WANG Jia-hui2 2019, 47 (4):  368-370.  doi: 10.11958/20190835 Abstract ( 791 )   PDF (321KB) ( 4201 )   Pulmonary infection is one of the common infections, and the condition progresses faster in a short time. It can be life-threatening if the infection is not treated effectively. This article explains the application principles of diagnostic interventional pulmonology combined with microbial metagenomics sequencing (dIP+mMS) in pulmonary infection, including indications of dIP + mMS, common sampling methods, reasonable choices of different sampling methods and packaging methods, the selection of bronchoscopy, guided endoscopic technique and rapid on site evaluation (ROSE). In addition, the genetic materials should be extracted separately after obtaining the specimen, and sequenced together (cocktail method). Attention should also be paid to the application of systemic and local antimicrobial agents and the effects of different sampling sites on the result of dIP+mMS. Related Articles | Metrics

Cell and Molecular Biology

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The Inhibitory effect of insulin-like growth factor 1 on PC12 cell apoptosis induced by CoCl2 MA Ke1,2, XU Hui-you1,2, ZHAO Fei2, ZHANG Jian1,2, JIANG Ji-peng1,2, DAI Chen1,2, WANG Ren-jie2, CHEN Xu-yi2△ 2019, 47 (4):  371-376.  doi: 10.11958/20182240 Abstract ( 709 )   PDF (654KB) ( 3826 )   Objective To explore the effect and mechanism of insulin-like growth factor 1 (IGF - 1) on cobalt chloride （CoCl2) induced apoptosis of pheochromocytoma (PC12) cells. Methods PC12 cells in logarithmic growth phase were treated with 10, 20, 40 and 80 μmol/L CoCl2 solution and 100, 200, 400 μg/L IGF-1 solution. CCK-8 assay was used to detect cell viability, and the optimal intervention concentrations of CoCl2 and IGF-1 were obtained. According to the selected experimental conditions, PC12 cells were treated with CoCl2 to establish HIE cell model. The experimental cells were divided into control group, CoCl2 treatment group and IGF-1 + CoCl2 treatment group. After 24 h of preincubation in each group, CCK-8 assay was used to detect cell survival rate, TUNEL staining was used to detect the cell apoptosis, and Western blot assay was used to detect the protein expression levels of Bax, Bcl-2 and Caspase-3. Finally, IGF-1 inhibitor 2- methoxyestradiol (2-MeOE2) group and 2-MeOE2+IGF-1 group were added on the basis of the above experiments. Western blot analysis was performed to observe the effects of IGF-1, 2-MeOE2 and both of them on HIF-1α and Bax expressions in PC12 cells. Results CCK-8 assay showed that the optimal concentration of CoCl2 was 40 μmol / L, and the optimal concentration of IGF-1 was 200 μg/L. After 24 h of intervention with the concentration of above groups, the cell survival rate was significantly improved in IGF-1 + CoCl2 group compared with the CoCl2 group, and the number proportion of TUNEL (+) cells was significantly lower in the IGF-1 + CoCl2 group than that of CoCl2 group. The expression of anti-apoptotic protein Bcl-2 was up-regulated in the IGF-1 + CoCl2 group, and the expressions of apoptotic protein Bax, caspase-3 and HIF-1α were significantly down-regulated in the CoCl2+ IGF-1 group compared with the CoCl2 group (P＜0.05). However, after the pretreatment with 2-MeOE2, there were no significant differences in HIF-1α and Bax expressions between CoCl2 + 2- MeOE2 group and 2-MeOE2 + IGF-1 group, but they were significantly down-regulated compared with CoCl2 + IGF-1 group (P＜0.01). Conclusion IGF-1 can inhibit the apoptosis of PC12 cells induced by CoCl2, and its protective effect is related to the down-regulation of HIF-1α expression. Related Articles | Metrics

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Oxymatrine suppressed extracellular matrix expression in LTC-14 cells by down-regulating ZNF580 expression CHEN Kai1，ZHANG Qing2△, LIU Bai-qing1, CHEN Wei1, ZHOU Fang2, ZHANG Lan2, XIA Shi-hai1, XU Wei1 2019, 47 (4):  376-381.  doi: 10.11958/20181630 Abstract ( 576 )   PDF (542KB) ( 4233 )   Objective To probe the molecular mechanism and effect of oxymatrine (OM) on the secretion of extracellular matrix (ECM) in rat pancreatic stellate cell line LTC-14 induced by TGF-β1. Methods LTC-14 cells were divided into control group (LTC-14 cells in normal culture), TGF-β1 group (LTC-14 cells stimulated by 10 μg/L TGF-β1 for 12 h), TGF-β1+OM group (LTC-14 cells pretreated with 1 g/L OM for 30 min before TGF-β1 stimulation) and TGF-β1+ SiZNF850 group (LTC-14 cells were transiently transfected with ShRNA-ZNF580 plasmids for 24 h before TGF - β1 stimulation). After cultivation, cell supernatant was collected and total RNA and total protein were extracted. The expressions of Smad2, Smad3, ZNF580, α - SMA, MMP2 and TIMP1 were detected by Real-time PCR and Western blot assay. The secretion of ECM components, Col-I, Col-III, FN, TNF-α and IL-1β were detected by ELISA. Results The mRNA and protein expressions of Smad2, Smad3, ZNF580 and α-SMA were increased (P＜0.05), the expression ratio of MMP2/TIMP1 was down-regulated (P＜0.05), and the secretion of ECM components was increased in LTC-14 cells induced by TGF-β1 (P＜0.05). However, after OM intervention or ZNF580 gene knockdown, the mRNA and protein expressions of Smad2 and Smad3 were suppressed (P＜0.05), the mRNA and protein expressions of ZNF580 decreased, the expression ratio of MMP-2/ TIMP1 was up-regulated (P＜0.05), and the secretion of ECM components was reduced (P＜0.05). Conclusion Oxymatrine can reduce ECM secretion, increase ECM degradation and alleviate pancreatic fibrosis by inhibiting TGF- β1/ Smads/ZNF580 signaling pathway and blocking the activation of pancreatic stellate cells. ZNF580 may be a molecular target of OM in reducing pancreatic fibrosis. Related Articles | Metrics

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Phenformin promotes A549/DDP cell apoptosis by affecting mitochondrial function HOU Yong-wang, CHANG Jiao, WANG Yan-hui, REN Li 2019, 47 (4):  382-386.  doi: 10.11958/20181840 Abstract ( 726 )   PDF (1212KB) ( 3653 )   Objective To investigate the possible mechanism of phenformin inhibiting proliferation and promoting apoptosis of A549/DDP cells. Methods MTS assay was used to detect the cell viability of A549/DDP cells treated with cisplatin and phenformin. The treatment group was treated with phenformin (2.5 mmol/L), and control group was treated with phosphate buffer saline (PBS). MTS assay was used to detect the effect of phenformin on the proliferation of A549/DDP cells. The colony formation ability was detected by colony formation assay. Flow cytometry was used to detect the effects of phenformin on apoptosis, reactive oxygen species (ROS), mitochondrial mass (Mitotracker) and calcium ion (Rhod-2) in A549/DDP cells. The real-time quantitative PCR was used to detect mitochondrial DNA (mtDNA), and ATP was detected by ATP kit. The effect of phenformin on mitochondrial oxidative phosphorylation complex was detected by Western blot assay. Results Compared with the cisplatin group, the cell viability ratios of A549/DDP cells were decreased at 24 h and 48 h in the phenformin group (P＜0.05), but there was no significant difference in the viability at 24 h and 48 h of A549 cells between the two groups. The viability of A549/DDP cells treated with cisplatin 48 h was high compared with that of A549 cells, but there was no significant difference in the viability of 24 h. The viability of A549/DDP cells treated with phenformin was significantly lower than that of A549 cells (P＜0.05). Compared with the PBS group, the proliferation rate and colony formation of A549/DDP cells decreased at 24 h and 48 h in the phenformin group, while the apoptosis rate and the ROS level increased (P＜0.05). Mitotracker, Rhod-2, mtDNA and ATP were also decreased (P＜0.05). The NDUFB8 protein in complex I, the SDHB protein in complex II, and the MTCO1 protein in complex IV were significantly decreased (P＜0.05). Conclusion (1) A549/DDP cells are more sensitive to phenformin than A549 cells, but more resistant to cisplatin than A549 cells. (2) Phenformin inhibits proliferation and promots apoptosis of A549/DDP cells by increasing intracellular ROS, decreasing mitochondrial mass, calcium ion and mtDNA and inhibiting mitochondrial oxidative phosphorylation complex, and reducing ATP production. Related Articles | Metrics

Experimental Study

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Effects of ERK inhibitor on myocardial ischemia reperfusion injury and energy metabolism dysfunction in rats after cardiopulmonary resuscitation TAO Ran1, XIE Lu2, ZHENG Jun-hui1, TAN Xiao-feng1, LI Nuo1, QIN Tao1, YANG Ye-gui1, CHEN Meng-hua1△ 2019, 47 (4):  387-390.  doi: 10.11958/20190108 Abstract ( 713 )   PDF (1479KB) ( 3676 )   Objective To investigate the effects of ERK inhibitor PD98059 on cardiac energy metabolism and myocardial ischemia reperfusion injury in rats after cardiac arrest / cardiopulmonary resuscitation (CA / CPR). Methods Thirty-six rats were randomly divided into three groups: Sham group (n=6), PD98059 (PD) group (n=15) and model (CA) group (n=15). Rat model of CA/CPR in PD and CA groups was established by induction of ventricular fibrillation (VF) by electrical stimulation of the esophagus. Sham group was given operation only. After the restoration of spontaneous circulation (ROSC), PD group was given intravenous injection of PD98059 (0.3 mg / kg) immediately, CA group was given the same amount of normal saline. Survival was observed for 24 h. Serum samples were collected 24 h after resuscitation to detect troponin I. Meanwhile, myocardial tissue samples were collected for hematoxylin-eosin (HE) staining and ATP content determination. Western blot assay was used to detect the level of ERK and phosphorylation of ERK (p-ERK). Results After 24 h, the survival was 6 for Sham group, 6 for CA group and 13 for PD group. The serum level of troponin I was increased in CA and PD groups than that of Sham group, and which was decreased in PD group than that of CA group (P＜ 0.05). The cardiac tissue ATP content was significantly higher in PD group than that of CA group (P＜0.05), and the degree of myocardial pathological injury was significantly less in PD group than that of CA group. Compared with Sham group, the expression of myocardial p-ERK was significantly increased in CA and PD groups. The expression of myocardial p-ERK was significantly decreased in PD group than that of CA group (P＜0.05). Conclusion The treatment with ERK inhibitor PD98059 can improve the myocardial energy metabolism dysfunction and alleviate the myocardial ischemia reperfusion injury after cardiopulmonary resuscitation. Related Articles | Metrics

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The effects of magnoflorine on depression-like behavior in chronic unpredictable mild stress mice and its effect on LSD1 modification in brain CAO Bing-yan1, LIU Yi-jie2, WU Li-li2, FEI Qiao-man2, YANG Bing2, ZHANG Ling2, QIAO Wei1△ 2019, 47 (4):  391-394.  doi: 10.11958/20181474 Abstract ( 620 )   PDF (1296KB) ( 4050 )   Objective To explore the mechanism of the effect of magnoflorine on the behavior of mice with depression caused by chronic unpredictable mild stress. Methods The ICR mice were randomly divided into normal control group (control group), positive depression group (PG group), high dose of magnoflorine group (MH group) and low dose of magnoflorine group (ML group). Depression mouse model was established by chronic unpredictable mild stress method. The behavioral changes of mice were detected. The expressions of lysine specific demethylase 1 (LSD1) mRNA and protein in brain of mice were detected by real-time quantitative PCR, Western blot assay and immunohistochemistry. Results Magnoflorine improved the depression in mice. Compared with the PG group, the motionless time of tail suspension and motionless time of forced swimming were significantly shorter in the MH group and the ML group (P＜0.05). Real-time quantitative PCR and Western blot assay showed that there was no significant difference in LSD1 mRNA expression between the PG group and the control group. The protein expression was significantly decreased (P＜0.05). The expressions of LSD1 mRNA and protein were significantly increased in the ML group compared with those of control group (P＜0.05). Compared with the PG group, the expressions of LSD1 mRNA and protein were significantly increased in the ML group (P＜0.05). The results of immunohistochemistry showed that the number of positive cells in brain was decreased in the PG group compared with that of the control group, while it was increased in the ML group compared with that of PG group. Conclusion LSD1 may play an important role in the treatment with magnoflorine for depressed mice. Related Articles | Metrics

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Experimental study of ligustrazine on improving renal damage in diabetic nephropathy rats by inhibiting the PI3K/Akt/mTOR pathway and inducing autophagy ZHONG Juan1, CHEN Jing2, QING Yao1, WU Shu-yue1, ZHONG Qing-rong1△ 2019, 47 (4):  395-400.  doi: 10.11958/20181506 Abstract ( 686 )   PDF (966KB) ( 4380 )   Objective To investigate the effects of ligustrazine (TMP) on the ratio of urine microalbumin to urinary creatinine (UACR), renal pathological changes, PI3K / Akt / mTOR signaling pathway and autophagosome marker protein LC3B in diabetic nephropathy (DN) rats. Methods The DN rat model was established by streptozotoein (STZ) peritoneal injection. DN model rats were randomly divided into model group, the low, middle and high dose of TMP groups, and irbesartan group. In addition, the normal rats were served as the normal group (n=12 for each group). After 8 weeks of intervention respectively, urine creatinine was determined by enzymatic method, urinary microalbumin was determined by immunoturbidimetry, and UACR was calculated. Kidney tissues were fixed with formaldehyde, hematoxylin-eosin (HE) and periodic acid-schiff (PAS) staining were performed. The protein expressions of p-PI3K, PI3K, p-Akt, Akt, p-mTOR, mTOR, and LC3B in the kidney tissues were detected by Western blot assay and immunohistochemistry (n=6 for each group). Results Compared with the model group, the increase of UACR was inhibited and the pathological changes in kidney were significantly ameliorated after treatment with TMP, especially in the middle and high dose groups, UACR were significantly lower than that of model group (P＜0.05). There was no significant difference in UACR between the middle and high dose groups and irbesartan group (P＞0.05). Moreover, the protein levels of p-PI3K, p-Akt and p-mTOR were decreased, while the expression of LC3B and the ratio of LC3B - Ⅱ/LC3B - Ⅰ were increased in TMP groups than those of model group. Conclusion TMP can reduce the increase of UACR and improve the pathological changes of kidney in DN rats. The molecular mechanisms that drive the therapeutic effects of TMP may involve in the inhibition of PI3K/Akt/mTOR signaling pathway to consequently promote renal autophagy. Related Articles | Metrics

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Effects of pulsed radiofrequency to dorsal root ganglia on pain threshold and the activation of spinal gliocytes in inflammatory pain model rats LIU Jing-zhi, SHI Ke-mei, WANG Xiao-juan, LI Quan-bo, WANG Hui-xing, FU Qiang, QIN Li-yuan 2019, 47 (4):  400-403.  doi: 10.11958/20181158 Abstract ( 605 )   PDF (373KB) ( 3493 )   Objective To evaluate the effect of pulsed radiofrequency (PR) of dorsal root ganglion (DRG) on the expression of astrocyte marker GFAP and microglia maker OX42 in spinal cord of rats with inflammatory pain. Methods Thirty-two male SD rats were randomly divided into 4 groups (n=8 for each group), including control group (group C), inflammation pain group (group IP), pulsed radiofrequency group (group PR) and inflammation pain combined with pulsed radiofrequency group (group IP+PR). Pulsed radiofrequency surgery on L4-L5 DRGs was performed at 4 days after IP model. Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before (d0) and 1, 3, 5, 7 days (d1, d3, d5, d7) after IP model. The rats were sacrificed after the last measurement of pain threshold, and protein expressions of GFAP and OX42 in the L4-L6 spinal segment in four groups of rats were detected by Western blot assay. Results Compared with group C and group PR, MWT and TWL were decreased in different time points after IP model in group IP and group IP+PR (P＜0.05). Compared with group IP, MWT and TWL were increased in group IP+PR after pulsed radiofrequency (P＜0.05). The protein expressions of GFAP and OX42 were up-regulated in group IP and group IP+PR compared with those of group C and group PR (P＜0.05). Compared with group IP, GFAP and OX42 protein expressions decreased in group IP+PR (P＜0.05). Conclusion The pulsed radiofrequency of DRGs can alleviate the hyperalgesia and inhibit activation of astrocyte and microglia in spinal cord of inflammatory pain rats. Related Articles | Metrics

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Effects of minocycline pretreatment on apoptotic mechanism and expression of Ngb protein in rats with spinal cord injury CHEN Meng1△, MA Wei-jun1, MA Quan1, LIU Sheng1, WANG Ai-le2 2019, 47 (4):  404-408.  doi: 10.11958/20182183 Abstract ( 609 )   PDF (872KB) ( 3453 )   Objective To investigate the effect of minocycline (MINO) on expressions of apoptotic proteins Bcl-2, Bax, Caspase-3 and expression of Ngb in rats with spinal cord transection injury. Methods A total of 36 healthy adult male Wistar rats were randomly divided into Sham group, spinal cord injury (SCI) group and MINO group, with 12 rats in each group. Rats in Sham group were only exposed spinal cord without transecting. SCI group and MINO group were established the T3-4 spinal cord segment transection injury model. MINO group was given intraperitoneal injection of minocycline (90 mg/kg) once a day for 5 consecutive days before operation. While SCI group and Sham group were given equal volume of normal saline once a day for 5 consecutive days. After 22 days of operation, all the rats were killed. Immunohistochemical stainning and Western blot assay were used to determine the expressions of Bcl-2, Bax and Caspase-3 proteins. Hoechst staining was used to analyze the positive cells of apoptosis. Ngb protein expression was detected by immunofluorescence method. Results Compared to Sham group, the expressions of Bcl-2, Bax, Caspase-3 and apoptotic cells were increased in SCI group, and the fluorescence intensity of Ngb increased significantly (P＜0.05). Compared to SCI group, the expression of Bcl-2 was obvious increased in MINO group (P＜0.05) while the expressions of Bax and Caspase-3 were decreased and the number of apoptotic cells decreased significantly (P＜0.05). The mean fluorescence intensity of Ngb was significantly higher in MINO group than that of SCI group. Conclusion Minocycline can inhibit apoptosis and increase neuroglobin expression by downregulating the expressions of Bax and Caspase-3, upregulating the expression of Bcl-2 in SCI rats. Related Articles | Metrics

Clinical Study

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The effect of postoperative chemotherapy on the prognosis of patients with stage ⅡA - ⅢB breast cancer without pCR after the complete cycle of neoadjuvant chemotherapy LIU Mei, ZHANG Min, ZHI Xiang-cheng 2019, 47 (4):  409-413.  doi: 10.11958/20182100 Abstract ( 978 )   PDF (400KB) ( 3995 )   Objective To investigate the effect of postoperative chemotherapy on the prognosis of patients with stage ⅡA-ⅢB breast cancer who did not receive pathological complete response (pCR) after the complete cycle of neoadjuvant chemotherapy. Methods Clinical data of 208 breast cancer patients with stage Ⅱ A - Ⅲ B and without pCR after the complete cycle of neoadjuvant chemotherapy were retrospectively analyzed, including 81 patients underwent postoperative chemotherapy (supplemented chemotherapy group) and 127 patients without supplemental chemotherapy (no supplemented chemotherapy group). The 3-year overall survival rate, 3-year disease-free survival rate and factors affecting recurrence and metastasis were analyzed in two groups of patients. Results With a median follow-up of 40 months, the disease-free survival rate was 76.9% (160/208), and the 3-year overall survival rate was 88.9% (185/208) in whole group. The diseasefree survival rate was improved in supplemental chemotherapy group than that of no supplemented chemotherapy group (87.7% vs. 72.4%, P＜0.05). There was no significant difference in the 3-year overall survival rate between supplemental chemotherapy group and the no supplemented chemotherapy group (94.2% and 92.1%, respectively, P＞0.05). Univariate analysis showed that estrogen receptor (ER) status, pregnancy hormone receptor (PR) status, human epidermal growth factor receptor 2 (HER-2) status and postoperative adjuvant chemotherapy were the influencing factors for disease-free survival (P＜0.05). Multivariate analysis showed that no postoperative chemotherapy (HR=2.044, P=0.033) and HER-2 positive (HR=3.418, P＜0.001) were independent risk factors affecting the poor prognosis of patients with disease-free survival. Conclusion Postoperative chemotherapy can improve the disease-free survival rate of patients with stage ⅡA-ⅢB breast cancer who have not received pCR after the complete cycle of neoadjuvant chemotherapy. The prognosis of patients with positive HER-2 is even worse. Related Articles | Metrics

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Clinical study of bronchial asthma-chronic obstructive pulmonary disease overlap with depression LIU Guo, ZHANG Xiang-yan, ZHANG Cheng 2019, 47 (4):  414-417.  doi: 10.11958/20181612 Abstract ( 886 )   PDF (350KB) ( 4938 )   Objective To investigate the risk factors for bronchial asthma-chronic obstructive pulmonary disease overlap (ACO) complicated with depression. Methods A total of 141 stable ACO patients (included 60 cases in ACO group, 59 cases in stable COPD group and 22 cases in asthma group) hospitalized in our hospital from January 2017 to January 2018 were included in this study. Hamilton depression scale (HAMD)-17 questionnaire survey was conducted in ACO group, COPD group and asthma group. The percentage of forced expiratory volume in the first second (FEV1% pred) and the modified British medical research association dyspnea scale (mMRC) were measured in three groups of patients. According to HAMD-17 score, ACO group was divided into non-depression group (HAMD-17 score ≤ 7, n=15) and depression group (HAMD-17 score > 7, n=45). The possible risk factors of depression were analyzed in ACO patients. Results The HAMD-17 scores were significantly higher in ACO group than those in the COPD group and asthma group (P＜0.05). The proportion of depressive patients with mMRC ≥ 2 and FEV1% pred＜50% was higher than that of nondepressive patients (all P＜0.05). Logistic regression analysis showed that mMRC≥2 and FEV1%pred＜50% were independent risk factors for depression in ACO patients. Conclusion The severity of depression is more serious in the ACO patients than that in the COPD and the asthma patients. We should pay attention to screening depression in ACO patients. Related Articles | Metrics

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The role and significance of NOD2, TNF-α, MMP-9 and Caspase-3 in the pathogenesis of premature rupture of the membranes SONG Chun-hong1, MA Qian2, ZHEN Juan1, XU Hong1, LIU Yang1, BI Xue-jie1△ 2019, 47 (4):  417-420.  doi: 10.11958/20181809 Abstract ( 619 )   Objective To investigate the relationship between the expressions of nucleotide-binding oligomerization domain-containing 2 (NOD2), matrix metalloproteinase -9 (MMP-9) and activated Caspase-3 in the fetal membranes and TNF-α level in amniotic fluid from women with premature rupture of the membranes (PROM)． Methods Thirty pregnant women with term premature rupture of the membranes (tPROM), 30 cases of preterm premature rupture of the membranes (pPROM) and 30 cases of healthy term pregnancy (control group) were enrolled in the experiment. Immunohistochemistry was used to detect the location of NOD2, MMP-9 and activated Caspase-3 in the fetal membranes. Western blot assay was performed to analyze the expression levels of the three proteins. ELISA was used to detect the level of TNF-α in amniotic fluid. The relationship between the levels of the four proteins was also analyzed. Results The expression levels of NOD2, MMP-9 and activated Caspase-3 in fetal membranes and the level of TNF-α in amniotic fluid were significantly higher in PROM groups than those in control group (P＜0.05). The levels of NOD2 and TNF-α were significantly higher in pPROM group than those in tPROM group (P＜0.05). There were no significant difference in the levels of MMP-9 and activated Caspase-3 between tPROM group and pPROM group. Furthermore, the level of NOD2 was positively correlated with the levels of TNF-α, MMP-9 and activated Caspase-3 (P＜0.01). Conclusion The elevated expression levels of NOD2, TNF- α, MMP-9 and activated Caspase-3 play an important role in PROM. NOD2, TNF-α, MMP-9 and activated Caspase-3 may play associative roles in the process of PROM. Related Articles | Metrics

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Relationship between serum AST/ALT ratio and prognosis of Budd-Chiari syndrome ZHANG Yan-qiao-zi, YU Na-na2, XU Kai 2019, 47 (4):  421-424.  doi: 10.11958/20181958 Abstract ( 779 )   PDF (367KB) ( 3800 )   Objective To analyze the relationship between preoperative serum alanine aspartate aminotransferase / aminotransferase (AST / ALT) ratio and prognosis of patients with Budd-Chiari syndrome (BCS). Methods Data of 280 patients with BCS admitted to the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The median value of AST/ALT ratio (0.75) was used for grouping. There were 142 cases in group AST/ALT ratio ≤ 0.75 and 138 cases in group AST/ALT ratio > 0.75. All patients underwent interventional surgery and followed up for at least 5 years. According to the recurrence of follow-up results, the relationship between preoperative serum AST / ALT levels and recurrence was analyzed retrospectively. Results There were significant differences in gender, Child-Pugh grade of liver function and recurrence rate between the two groups. The mean vascular patency time were 45 (37, 52) and 40 (21, 49) months for AST/ALT ratio ≤ 0.75 group and AST/ALT ratio >0.75 group. The mean vascular patency time was significantly shorter in AST/ALT ratio > 0.75 group than that of AST/ALT ratio ≤ 0.75 group (Z=2.159，P＜0.05). The cumulative patency rates were 94.4%, 76.8% and 64.1%, respectively in AST / ALT ratio ≤0.75 group for 1, 3 and 5 years. The cumulative patency rates were 90.6%, 68.1% and 58.7% in AST/ALT ratio > 0.75 group for 1, 3 and 5 years, respectively. The 5-year cumulative patency rate was significantly lower in patients with AST/ALT>0.75 group than that of patients with AST/ALT≤ 0.75 group (Log-rank χ2=4.372，P＜0.05). Multivariate Cox regression analysis showed that the liver function of Child-Pugh classification (C) patients were easy to relapse BCS. Conclusion AST/ALT ratio is associated with recurrence of BCS after interventional therapy. Child-Pugh classification of liver function is an independent risk factor for the prognosis of BCS. Related Articles | Metrics

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Expressions of SIRT1, SIRT2 and IL-37 in ectopic endometrium of patients with endometriosis ZHANG Hong-xia1, REN Chun-e2, WANG Xiao-jing1, ZHANG Yong1, WANG Gui-li2△ 2019, 47 (4):  425-427.  doi: 10.11958/20181755 Abstract ( 765 )   PDF (1230KB) ( 4216 )   Objective To explore the differences of expressions of sirtuin1 (SIRT1), sirtuin2 (SIRT2) and interleukin - 37 (IL-37) in normal endometrium and ectopic endometrium. Methods Endometrial specimens were collected in 30 patients with endometriosis and 30 without endometriosis. Immunohistochemical staining was used to detect expressions of SIRT1, SIRT2 and IL-37 proteins. Results The positive expression rates of SIRT1, SIRT2 and IL-37 proteins in ectopic endometrium were 33.0%, 20.0% and 36.7% respectively, which were significantly lower than those of normal endometrial tissues (SIRT1 90%, SIRT2 86.7%, IL-37 86.7%, P＜0.05). There were no significant differences in expresssions of SIRT1, SIRT2 and IL-37 in endometrium between different menstrual cycles (P＞0.05). Conclusion The results suggest that the expression levels of SIRT1, SIRT2 and IL-37 in ectopic endometrium are low, suggesting that there may be inflammatory reaction in ectopic endometrium in patients with endometriosis. Related Articles | Metrics

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Primary malignant melanoma of ovarian mature teratoma: a case report and literature review LI Mei-yue, TIAN Wen-yan, ZHANG Xu-hong, YAN Ye, SHENG Yan, GUO Fei, WANG Ying-mei△, XUE Feng-xia 2019, 47 (4):  428-430.  doi: 10.11958/20190155 Abstract ( 653 )   PDF (720KB) ( 3832 )   Primary malignant melanoma of ovary is rare clinically, with high malignancy and poor prognosis. This article retrospectively analyzed a case of primary ovarian malignant melanoma with mature teratoma. The patient showed abdominal distension, and the pelvic magnetic resonance imaging showed a large cystic solid mass in the pelvic cavity, and a large amount of fluid in the pelvic and abdominal cavity. Surgical treatment was given. Histopathological result was confirmed as primary ovarian malignant melanoma with mature teratoma. The patient died of multiple orgon failure after 4 months of followed-up. This paper reviewed the relevant literature to improve the understanding of the disease. Related Articles | Metrics

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Research progress of CREB in angiogenesis, anti-apoptosis and lung cancer LIU Xiao, DUAN Yong, ZHANG Yan-liang 2019, 47 (4):  431-435.  doi: 10.11958/20182109 Abstract ( 743 )   PDF (365KB) ( 5152 )   cAMP-response element binding protein (CREB) has been widely studied as a transcriptional factor in the field of long-term memory formation and the development and treatment of various malignant tumors. This review summarized the research progress of CREB gene in neovascularization, cell proliferation and anti-apoptosis, and the relationship between CREB geen and the carcinogenic process of nicotine and tumors (especially lung cancer) in order to provide references for future research of CREB family proteins. Related Articles | Metrics

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Recent research progress of the relationship between estrogen receptor and depression MU Dao-zhou1, HU Gui-fang2, CHEN Lei3, ZHANG Tong4△ 2019, 47 (4):  436-439.  doi: 10.11958/20181496 Abstract ( 750 )   PDF (347KB) ( 3420 )   Estrogen exerts antidepressant effects mainly through estrogen receptors. Presently, estrogen receptor α (ERα), estrogen receptor β (ERβ) and G-protein coupled estrogen receptor (GPER) have been studied a lot. The three kinds of estrogen receptors play different roles in the antidepressant effects, and GPER may be related to the rapid antidepressant effects of estrogen. It is important to fully understand the different effects of estrogen receptors in order to find new targets for the treatment of depression, fully play the antidepressant effects of estrogen and reduce side effects. Related Articles | Metrics

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Research advances on trimethylamine N-oxide of metabolite of gut flora and heart failure GUO Pan1,2, FENG Jin-ping3△, FENG Chao3, CHEN Shu-tao3 2019, 47 (4):  440-444.  doi: 10.11958/20181917 Abstract ( 874 )   PDF (392KB) ( 4969 )   Intestinal flora and its metabolites are inextricably associated with the development of heart failure (HF)."Gut hypothesis in HF" indicates that patients with cardiovascular diseases encounter gut flora imbalance and bacterial translocation, which can trigger systemic inflammatory response and eventually promote the progression of heart failure. Studies showed that a higher concentration of trimethylamine N-oxide (TMAO), a kind of intestinal metabolites, could induce the occurrence of cardiovascular adverse events through a variety of mechanisms (such as intensifying myocardial fibrosis, ventricular remodeling and progress of coronary plaque, aggravating water-sodium retention and systemic inflammatory response), and which is closely related to the survival and prognosis of patients with HF. These patients could benefit from the reducing TMAO. This article reviews the research advances of the relationship between intestinal flora or TMAO and heart failure. Related Articles | Metrics

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Research progress on the correlation between PM2.5 and acute myocardial infarction QIN Xue-ting1，2, ZHANG Mei2△ 2019, 47 (4):  444-448.  doi: 10.11958/20180941 Abstract ( 677 )   PDF (408KB) ( 3692 )   PM2.5 refers to particulate matter with aerodynamic diameter less than 2.5 mm in the environment. It is one of the most important air pollutants in China. Acute myocardial infarction (AMI) is a severe ischemic heart disease, in which the coronary artery is completely or incompletely occluded, leading to acute necrosis of the local myocardium and endangering the life of patients. In recent years, many scholars have found that PM2.5 can affect the occurrence and outcome of AMI. This article reviews the role of PM2.5 in the occurrence, development and possible pathogenesis of AMI, in order to improve the understanding of PM2.5 in various aspects and to reduce the incidence of AMI. Related Articles | Metrics