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15 September 2019, Volume 47 Issue 9 Previous Issue    Next Issue

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he effect of curcumenol on inflammatory factors in endometriosis model rats NIE Xiao-bo, MA Yi-kun, ZHAO Na, HU Bin, LIU Jiao, LIU Xiao-lan 2019, 47 (9):  913-917.  doi: 10.11958/20190727 Abstract ( 1070 )   PDF (677KB) ( 7367 )   Objective To study the effect of curcumenol on the inflammatory factors in peritoneal fluid of rats with endometriosis (EMS), and to explore its therapeutic mechanism. Methods Adult female SD rats were used to prepare EMS model by autotransplantation. The EMS model rats were randomly divided into model group and curcumenol group (20 mg/ kg), and another sham operation group was set up, 10 rats in each group. Rats in each group were given the drug by intragastric administration once a day for four weeks. After the last administration, the rats were anesthetized, and samples of the abdominal fluid were collected. Pathological morphology of ectopic endometrium in rats was observed. The contents of monocyte chemotactic protein-1 (MCP-1), macrophage migration-inhibitory factors (MIF), tumor necrosis factor-alpha (TNF)-α, interleukin (IL)-1β and IL-6 in peritoneal fluid were detected. The TNF-α expression in endometrial tissue was detected by immunohistochemistry, and the fibroblast growth factor 2 (FGF-2) mRNA expression was detected by real-time PCR. Results Compared to the model group, the ectopic endometrium atrophy was found in curcumenol group, the contents of MCP-1, MIF, TNF - α, IL-1β, IL-6 in the peritoneal fluid of rats and the TNF - α expression, the FGF-2 mRNA expression in endometrial tissues were significantly decreased in curcumenol group (P＜0.05). Conclusion The curcumenol can inhibit the inflammatory reaction in the peritoneal microenvironment, which may be related to its treatment effect on EMS. Related Articles | Metrics

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Differential oxidative stress reactions in sulfur mustard-induced acute pulmonary injury with equal toxicity dose in rats via different routes HU Xiao-xuan, YU Dan, XIE Jian-wei, XU De-feng, ZHONG Yu-xu 2019, 47 (9):  917-923.  doi: 10.11958/20190637 Abstract ( 685 )   PDF (1624KB) ( 5270 )   Objective To compare oxidative stress responses of two acute pulmonary injury models induced by a toxicity dose (1LD50) of mustard gas (SM) in rats through intraperitoneal and tracheal pathways. Methods Male Sprague Dawley rats were selected and randomly divided into the intraperitoneal SM group, the intraperitoneal propylene glycol group, the tracheal SM group, the tracheal propylene glycol group and normal group. The serum enzyme levels and proteins related expressions in alveolar septum were measured by ELISA and immunohistochemistry methods. Results Serum levels of superoxide dismutase, catalase and glutathion peroxidase at different time points were increased in the intraperitoneal SM group compared with those of tracheal SM group (P＜0.05). In the alveolar septum, the positive cells of CuZn-superoxide dismutase, Mn-superoxide dismutase, paraoxonase-1 and apolipoprotein-1 expression were increased in the intraperitoneal SM group compared with those of tracheal SM group (P＜0.05). Conclusion At a dose of SM (1LD50), there are differences in the oxidative stress responses at the molecular level in two rat models of acute pulmonary injury. The results suggest that the oxidative stress responses reduced by equal toxicity dose (1LD50) of SM in rats are related to the toxic pathway, and which provides an important theoretical basis for the application of antioxidants. Related Articles | Metrics

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Protective effect of necrostatin-1 on the ventilator-induced lung injury in rats DU Xue-ke, JING Ren, ZHANG Yun-xi, GE Wan-yun 2019, 47 (9):  924-927.  doi: 10.11958/20190382 Abstract ( 869 )   PDF (432KB) ( 3981 )   Objective To investigate the protective effect of necrostatin-1 on ventilator - induced lung injury in rats. Methods Forty SD rats were randomly divided into four groups (n=10 for each group), spontaneous respiration group (group C), normal tidal volume (VT) group (group N), high VT group (group H) and necrostatin-1 group (group Nec-1). All rats were intubated after tracheotomy. Group C maintained spontaneous breathing, group N, group H and group Nec-1 were given mechanical ventilation with respective tidal volume (8 mL/kg, 40 mL/kg and 40 mL/kg). The group Nec-1 was injected Nec- 1 intravenously (1 mg/kg) before mechanical ventilation. After 4 hours of ventilation, samples of bronchoalveolar lavage fluid (BALF) and lung tissues were harvested. The infiltrated total cells, the total protein, the amount of interleukin (IL-6, IL-1β) and tumor necrosis factor - α (TNF-α) in alveolar lavage fluid were measured. The wet/dry weight ratio (W/D) of lung tissues was calculated. The histopathological changes of lung tissues were observed. The mRNA and protein expressions of receptor interacting protein 1 (RIPK1), RIPK3 and nuclear transcription factor -κB p65 (NF-κB p65) in lung tissues were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction (RT-qPCR) and Western blot assay respectively. Results There were no significant differences in related indexes in alveolar lavage fluid and lung tissue between group C and group N. Compared with those in group C and group N, values were increased in group H including the infiltrated total cells, the total protein and the amount of IL-6, IL-1β and TNF-α in alveolar lavage fluid, the wet/dry weight ratio and the histopathological score of lung tissues, the mRNA and protein expression levels of RIPK1, RIPK3 and NF-κB p65 in lung tissues (P＜0.01). In group Nec-1 the related indexes in alveolar lavage fluid and lung tissue were significantly lower than those of group H (P＜0.01). Conclusion RIPK1/RIPK3/NF-κB signaling pathway is involved in rat ventilatorinduced lung injury, and Nec-1 plays a protective role in rat lungs of ventilator-induced lung injury. Related Articles | Metrics

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Effects of TFPGL on Nrf2/HO-1 signaling pathway in kidneys of diabetic rats GAO Fei, ZENG Rui-xia, JIANG Dong 2019, 47 (9):  928-931.  doi: 10.11958/20190941 Abstract ( 779 )   PDF (636KB) ( 6166 )   Objective To investigate the protective effect and mechanism of total flavones of psidium guajava leaves (TFPGL) on kidneys of diabetic rats. Methods Twenty-four male SD rats were divided into control group, diabetic group and TFPGL treatment group by random number table method. The diabetic model was induced by single intraperitoneal (IP) injection of streptozotocin (55 mg/kg). After 12 weeks, samples of blood, urine and kidney tissues were collected to detect the changes of blood sugar (BS), blood urea nitrogen (BUN), urine protein/creatinine ratio (ACR) and serum creatinine (SCr). The pathological changes of kidney were detected by HE staining. The expressions of Nrf2 and HO-1 in kidney were detected by immunofluorescence, immunohistochemical staining and Western blot assay. Results Compared with the control group, BS, BUN, ACR and SCr were increased significantly in diabetic group, the expression of Nrf2 was increased, the expression of HO-1 was decreased (all P＜0.01). Compared with the diabetic group, the levels of BS, BUN, ACR and SCr were decreased significantly, while Nrf2 and HO-1 increased significantly in diabetic group after treatment with TFPGL (all P＜0.05). Conclusion TFPGL has a certain therapeutic effect on diabetic nephropathy in rats. Its mechanism may be related to the decreased blood sugar and activated Nrf2/HO-1 signaling pathway. Related Articles | Metrics

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Targeting effect of RGD-targeted ultrasound contrast agent in rats with stage 2 pressure injury wounds YAN Chang-shuai, CHEN Jiang-qiong, WANG Xiao-yi, HU Fang, ZHANG Jie 2019, 47 (9):  932-936.  doi: 10.11958/20181950 Abstract ( 587 )   PDF (1203KB) ( 3938 )   Objective To detect integrin αVβ3 expression in rat model of stage 2 pressure injury, and prepare arginineglycine-aspartic acid (RGD) - targeted ultrasound contrast agent (CA), thus exploring its targeting effect for skin lesions. Methods Thirty-six rats were randomly divided into experimental group and control group, with 18 rats in each group. Rats were established stage 2 pressure injury models by skin bridge method for experimental group, while rats of the control group did not do any treatment. After the model was formed, the pathological changes of skin tissue were observed by HE staining. The integrin αvβ3 was detected by immunohistochemistry. Then, the self-made RGD-targeted ultrasound CA and the blank counterpart were used to evaluate the wound in experimental group. Results HE staining showed that the damage reached the dermis layer in experimental group, and no damage was found in the control group. The expressions of integrin α Vβ3 were positive in the capillary endothelial cells and epidermal cells of the experimental group, and which were negative in the control group. The targeted adhesion value was significantly higher after injecting RGD-targeted ultrasound contrast agent in the experimental group than that of blank contrast agent group (P＜0.01). Conclusion The expression of integrin α Vβ3 is positive in the rat model of stage 2 pressure injury, suggesting that integrin αvβ3 can be used as a target site to prepare RGD-targeted ultrasound contrast agent. Integrin αVβ3 shows a good targeting effect and can be used as a new imaging method for diagnosing and treating pressure injury. Related Articles | Metrics

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The design and application of self-anchored lateral lumbar interbody fusion XU Bao-shan, LIU Yang, JIANG Hong-feng, LIU Yue, WANG Tao, LI Ning, XU Hai-wei, HUANG Hong-chao, JI Ning 2019, 47 (9):  937-942.  doi: 10.11958/20192202 Abstract ( 1090 )   PDF (764KB) ( 4229 )   Objective To evaluate the value and efficacy of self-anchored lateral lumbar interbody fusion (SA-LLIF), avoid posterior internal fixation and simplify the surgical procedure. Methods Eleven patients with lumbar degenerative disease treated in our hospital from March to June 2019 were enrolled in this study, including 3 males and 8 females (aged 55-76 years). All patients had low back pain and leg pain, which aggravated when standing and moving and alleviated or disappeared when staying in bed. The imaging results revealed that there were 7 cases of lumbar instability, 4 cases of spondylolisthesis (grade Ⅰin 3 cases, grade Ⅱ in 1 case), 2 of them with scoliosis and 2 with osteoporosis. The fusion level included L 2-3 in 1 case, L3-4 in 4 cases, L4-5 in 4 cases, L2-4 in 1 case and L3-5 in 1 case. Zero-profile self-anchored cage was used for lateral lumbar interbody fusion to avoid posterior internal fixation. After general anesthesia, the patient was in right decubitus position. The anterior edge of psoas major muscle was exposed through left small incision and extraperitoneal approach, the left side of the responsible intervertebral space was exposed by properly retracted psoas major muscle. After the intervertebral space was prepared, a suitable size of fusion cage filled with allograft was implanted. Two anchoring plates were inserted into the cage and the caudal and cephalic vertebral body, and the fusion cage was locked. The clinical efficacy was evaluated by visual analogue scale (VAS) and Oswestry dysfunction index (ODI). The lumbar lordosis (LL), disc height (DH), slippage rate (S) and sinking were evaluated by X-ray. Results The operation was performed successfully in all the 11 patients. The operation time was 65-110 minutes, with an average of (78.0±21.5) minutes. The intraoperative blood loss was 15-60 mL, with an average of (35.0 ± 23.2) mL. No severe complication such as nerve or blood vessel injury was occurred. The patients were encouraged to ambulated next day after operation with soft brace. The VAS score was significantly decreased from preoperative (6.2±0.8) to (1.70±0.5) after surgery, and ODI score was significantly decreased from (47.8%±14.9%) to (11.2%±3.2%). Postoperative X-ray showed that the spine alignment recovered satisfactorily, the LL recovered from (36.4°±10.2°) to (48.0°±10.7°), DH recovered from (8.3±2.5) mm to (13.3±3.3) mm, and the S recovered from (26.7%±4.4%) to (10.3%±5.3%). No cage displacement was found during follow-up, and sinking of cage was found in only one obesity woman. Conclusion SA-LLIF can provide immediate stability with good results, avoid posterior internal fixation. Related Articles | Metrics

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Comparison of arthroscopic assisted closed reduction guider guided internal fixation and open reduction for the treatment of tibiofibular fracture WANG Lei, WEI Zeng-bo, YANG Jian-lei, LI Ji-xin, CHEN De-sheng, LIU You-jun, BIAN Hua, GONG Xue 2019, 47 (9):  943-947.  doi: 10.11958/20190880 Abstract ( 957 )   PDF (903KB) ( 4696 )   Objective To explore the surgical method of arthroscopic-assisted closed reduction and internal fixation guided by guider for patellar fracture, and compare it with classic open reduction Kirschner wire and wire tension band internal fixation to evaluate its clinical efficacy. Methods From January 2016 to January 2018, 30 cases of arthroscopic assisted patellar fracture closed reduction and cannulated screw internal fixation were completed by using a self-developed patellar closed reduction guide apparatus (arthroscopic assisted closed reduction guide group). From March 2015 to May 2017, 30 cases of traditional open reduction Kirschner wire and steel wire tension band internal fixation were selected (open reduction group). The operation incision size, operation time, postoperative pain score, fracture healing time, Lysholm knee joint score and other evaluation results were compared between the two groups. Results Both groups were followed up for 12 to 18 months. All fractures were healed with a healing rate of 100%. The operation incision size, postoperative pain score, fracture healing time and Lysholm knee joint score index were significantly better in arthroscopic assisted closed reduction guide group than those of open reduction group (P＜0.05). Conclusion Arthroscopic assisted closed reduction hollow nail internal fixation using the closed reduction guider developed by the author has the advantages of minimal invasion and accuration and has good clinical effect compared with the classic open reduction Kirschner wire and wire tension band internal fixation. Related Articles | Metrics

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Association between interleukin-35 polymorphisms and the risk of cognitive impairment in patients with coronary heart disease SHI Ying, YANG Zi-cong, LIU Hai-run, XUE Yan, ZHANG Shu, HUANG Xin-shun, LU Jian-yong, LIU Ling 2019, 47 (9):  947-952.  doi: 10.11958/20190956 Abstract ( 648 )   PDF (404KB) ( 5579 )   Objective To explore the association between interleukin-35(IL-35) polymorphisms and the risk of cognitive impairment in patients with coronary heart disease (CHD). Methods A total of 349 patients diagnosed as CHD in our hospital from February 2015 to October 2016 were enrolled in our case-control study. The cognitive function was evaluated by mini-mental state examination (MMSE). Patients were divided into control group (n=205) and cognitive impairment group (n=144) according to the MMSE results. Sequenom Mass array was used to analyze the genotypes of IL-35 SNPs (rs582054, rs2243115, rs428253, rs583911, rs568408 and rs4740), and ELISA was used to detect the plasma level of IL-35, while other parameters were examined by standard protocol in the laboratory of the People’s Hospital of Guangxi Zhuang autonomous region. The binary Logistic regression model was used to reveal the associations between IL-35 polymorphisms and the risk of cognitive impairment in CHD. Results There was no significant difference in plasma level of IL-35 between two groups [42.26 (17.19, 203.06) ng/L vs. 40.60 (22.69, 105.65) ng/L, Z=0.384, P＞0.05]. No significant association was found between IL-35 polymorphisms and the risk of cognitive impairment in CHD patients. After the adjustment of risk factors, no significant association was found between IL-35 polymorphisms and the risk of cognitive impairment in CHD patients. Conclusion There is no relationship between IL-35 polymorphisms and the risk of cognitive impairment in CHD patients. It is still necessary to expand the sample size and explore its mechanism in the future. Related Articles | Metrics

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Diagnostic value of chest CT for interferon-gamma release assay negative pulmonary tuberculosis LI Nan, XING Zhi-heng, SUN Xin, QIN Zhong-hua, XIE Yi, CHEN Chen, LI Xiao-jun 2019, 47 (9):  953-957.  doi: 10.11958/20182194 Abstract ( 1525 )   PDF (552KB) ( 4405 )   Objective To evaluate the diagnostic value of chest CT for interferon-gamma release assay negative pulmonary tuberculosis. Methods A total of 126 patients were collected from the Department of Respiratory and Tuberculosis of Tianjin Haihe Hospital from January to June 2018, including 28 cases of confirmed tuberculosis and 98 cases of non-tuberculosis. All patients were tested negative by T-Spot.TB test. Using chest CT plain scan, 126 patients were graded into 0-3 grades, and the diagnostic value of each grade for tuberculosis was evaluated. Results Compared with the non-diagnosed patients, chest CT showed that the lesions were mainly located in the posterior apical segment of the upper lobe and the dorsal segment of the lower lobe in patients with confirmed diagnosis. The main manifestations were tree bud sign, core nodules of lobules, large nodules and consolidation of lobules. The three class score was used as the standard diagnosis of pulmonary tuberculosis. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 60.7%, 89.8%, 83.3%, 63% and 88.9%. The two class score was used as the standard diagnosis, they were 100%, 78.6%, 83.3%, 57.1% and 100%. The one class score was used as the standard diagnosis, they were 100%, 60.2%, 69.0%, 41.8% and 100%. Conclusion Chest CT scoring system can screen false negative subjects in T-Spot. TB test and can effectively improve the detection rate of tuberculosis. Related Articles | Metrics

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Expression and clinical significance of TIPE2 and TF in T2DM patients with vascular complications XIONG Shi-long, WU Yi-xing, GONG Fang, HE Wei 2019, 47 (9):  958-962.  doi: 10.11958/20190674 Abstract ( 835 )   PDF (391KB) ( 4765 )   Objective To investigate the expression levels of tumor necrosis factor-α induced protein 8 like-2 (TIPE2) and tissue factor (TF) mRNA in peripheral blood mononuclear cells (PBMCs) and changes of plasma levels of tumor necrosis factor-α (TNF-α) and TF in patients with type 2 diabetes mellitus (T2DM), and to explore the correlation between them and vascular complications. Methods A total of 78 patients diagnosed as T2DM and admitted to Panyu district, the 2nd Affiliated Hospital of Guangzhou Medical University from May 2015 to May 2016 were included in this study. Patients were divided into two groups according to whether they were combined with vascular complications: 42 cases in simple T2DM group and 36 cases in T2DM combined with vascular complication group (T2DM + V). Forty healthy people in healthy physical examination at the same period were enrolled in this study as the control group (CON). Data of age and gender were recorded in three groups. The glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. Fasting peripheral blood samples were collected in early morning, and serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by automatic biochemical analyzer. The expression of TIPE2 and TF mRNA in PBMCs were detected by RT-PCR, and plasma levels of TF and TNF-α were tested by ELISA. All these indicators were compared, and the correlation of TIPE2 mRNA with TF mRNA, plasma TF and TNF-α were analyzed between the three groups. Results There were no significant differences in age, gender, TC, TG, HDL-C and LDL-C between three groups (P＞0.05). Values of serum HbA1c increased in turn in CON group, T2DM group and T2DM+V group. PBMCs TIPE2 mRNA expressions decreased in turn, and the expressions of TF mRNA increased in turn in CON group, T2DM group and T2DM+V group (P＜0.05). The plasma levels of TF and TNF-α were increased in turn in CON group, T2DM group and T2DM+V group (P＜0.05). TIPE2 mRNA expression were negative correlated with TF mRNA and TNF-α in T2DM+V group (r=-0.340, -0.342, P＜0.05). Conclusion The occurrence and development of T2DM vascular complications are correlated with increased TIPE2 and decreased TF. Related Articles | Metrics

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Diagnosis and treatment of spontaneous splenic rupture in 13 cases WANG Bin, ZHU Xin-guo, JIANG Lin-hua, YAO Yi-zhou 2019, 47 (9):  962-965.  doi: 10.11958/20191083 Abstract ( 792 )   PDF (355KB) ( 3915 )   Objective To investigate the clinical manifestation, diagnosis and treatment of spontaneous splenic rupture. Methods Patients with splenic rupture treated by the department of general surgery of the First Affiliated Hospital of Soochow University from January 2007 to December 2018 were collected. Data of patients with spontaneous splenic rupture were analyzed including the etiology, clinical manifestations, auxiliary examination, treatment and postoperative pathology retrospectively. Results A total of 187 cases of splenic rupture were treated during this period, among them 13 cases (6.95%) were spontaneous splenic rupture. The main clinical manifestations were sudden left upper abdominal pain without obvious inducement. All the laboratory tests showed different degrees of low hemoglobin. Splenic rupture with hemoperitoneum was diagnosed by B ultrasound or CT examination. After conservative treatment failed, 1 patient underwent splenectomy, 1 patient underwent laparoscopic splenectomy after emergency DSA embolization for hemostasis, and all the other 11 patients underwent emergency splenectomy. There were 6 cases of malignant tumor, 1 case of thrombotic splenomegaly, 3 cases of congestive splenomegaly and 3 cases of idiopathic splenic rupture. Twelve patients were discharged successfully, and one patient died after automatic discharge due to the postoperative hemorrhage. Conclusion Spontaneous splenic rupture has insidious clinical manifestations and dangerous conditions, requiring active surgical treatment. Pathological spleen is a common cause of spontaneous splenic rupture, and splenectomy is recommended. Related Articles | Metrics

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Clinical observation and prognosis of patients with patent foramen ovale closure via transseptal approach CAO Yue-cheng, XIAN Hai-ying, SHI Qiu-lin, WANG Jin-xing, WANG Xiao-xiang, YE Jie, CHEN Deng-feng 2019, 47 (9):  971-974.  doi: 10.11958/20190948 Abstract ( 1743 )   PDF (374KB) ( 3870 )   Objective To investigate the safety, efficacy and prognosis of transcatheter closure of patent foramen ovale in patients with patent foramen ovale (PFO) by transatrial septum (AS) puncture. Methods From August 2016 to December 2017, 21 patients underwent transcatheter closure of PFO through foramen ovale in the Department of Cardiology of Hengshui People’s Hospital and the Department of Cardiology of Renmin Hospital of Wuhan University were selected as AS puncture group, and 30 patients with PFO who underwent interventional occlusion through foramen ovale in the same period were selected as control group. The effective occlusion rate, complications, occurrence and prognosis of cardiovascular and cerebrovascular events in PFO occlusion were observed. Results The success rate of transcatheter PFO occlusion was 100%. The average operation time was longer in the AS puncture group than that in the control group (78.0 min±13.4 min vs. 49.2 min±11.9 min). There were no significant differences in the incidences of operative complications during operation and 3 days after operation between the two groups. During the follow-up from 1 to 18 months after operation, there was 1 case of severe residual shunt in the AS puncture group, and the effective occlusion rate was 95.2%. There was no significant difference in the effective occlusion rate between the two groups. There were no significant differences in the main end point events (stroke, peripheral thromboembolism and death) and secondary study end events (new atrial fibrillation, myocardial infarction, PFO related rehospitalization and bleeding) between the two groups. The results of Kaplan-Meier (Log-Rank test) showed that there was no significant difference in the survival rate of ischemic events between the two groups during the follow-up period. Conclusion There are no significant differences in clinical efficacy, complications and ischemic eventsfree survival rate between PFO occlusion via transatrial septum puncture and conventional approach to foramen ovale, and it can be used as a safe technical supplement after the failure of conventional approach. Related Articles | Metrics

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External validation of nomogram for predicting the probability of urosepsis progressed from ureteral calculi HU Ming, YANG Yun-jie, ZHAO Zhen-hua, SHI Ming, XU Xun, ZHANG Zhan-ying, GUAN Li-xian, FENG Quan-yao 2019, 47 (9):  975-978.  doi: 10.11958/20182210 Abstract ( 1022 )   PDF (459KB) ( 3904 )   Objective To determine whether the nomogram for predicting the probability of urosepsis progressed from ureteral calculi was generally applicable to clinical practice. Methods The clinical data of 317 patients with ureteral calculi in our department from January 2016 to December 2016 were collected in this study. A total of 29 patients with urosepsis were selected into the urosepsis group, and the other 288 patients without urosepsis in the same period were selected into the non-urosepsis group. Using the prediction model developed before, the probability of urosepsis was predicted by gender, functional solitary kidney, average CT value of hydronephrosis, urine WBC count and urine nitrite in two groups, and the difference between the predicted and observed probabilities was compared. The discrimination and calibration of the prediction model were validated by using ROC and GiViTI calibration curve belts, respectively. Results The area under ROC curve (AUC) was 0.874 (95%CI: 0.804-0.945), suggesting that the prediction model could distinguish the patients with urosepsis. The 95%CI region of GiViTI calibration belt did not cross the 45-degree diagonal bisector line (P=0.176). Therefore, the prediction probability of the model was consistent with the actual probability, which suggested that prediction model had strong concordance performance. Conclusion The accuracy of the model in predicting the risk of urosepsis in ureteral calculi is improved, and it was helpful to improve the early identification and screening ability of those high-risk patients. Related Articles | Metrics

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The predictive values of expressions of HIF-1α and Survivin in rectal cancer tissues for tumor regression after neoadjuvant chemoradiotherapy SI Zhi-long, LI Yun-qi, HU Bo, GUI Hua-wei, XIAO Fei 2019, 47 (9):  979-982.  doi: 10.11958/20190600 Abstract ( 613 )   PDF (547KB) ( 3621 )   Objective To investigate the expressions of hypoxia-inducible factor-1α (HIF-1α) and apoptotic inhibitory protein Survivin in rectal cancer tissues and their predictive values for tumor regression after neoadjuvant chemoradiotherapy. Methods A retrospective analysis was performed on 83 rectal cancer patients who underwent total mesorectal resection (TME) after neoadjuvant radiotherapy and chemotherapy in our hospital from April 2014 to August 2018. Immunohistochemical method was used to detect the expressions of HIF-1α and Survivin in tumor tissues. Spearman rank correlation test was performed to analyze the relationship between HIF-1α and Survivin expressions. AJCC-TRG scoring system was employed to evaluate the effect of tumor regression after radiotherapy and chemotherapy. The relationship between tumor regression and HIF-1α/Survivin was analyzed. Results Immunohistochemistry showed that the positive expression rates of HIF-1α and Survivin in cancer tissues were 61.4% (51/83) and 67.5% (56/83), respectively. Expressions of HIF-1α and Survivin were positively correlated, and the spearman correlation coefficient was rs=0.587 (P＜0.001). The total effective rate of patients after neoadjuvant therapy was 55.4% (46/83), with 13 cases of complete withdrawal, 33 cases of moderate withdrawal, 20 cases of mild withdrawal and 17 cases of non-withdrawal. Analysis showed that the expressions of HIF-1α and Survivin were correlated with tumor regression. The effective rate of patients with HIF-1α (+)/Survivin (+) was 35.3% (12/34), which was significantly lower than that of other groups. Conclusion There is a positive correlation between the expressions of HIF-1α and Survivin in rectal cancer tissues. The expressions of HIF- 1α and Survivin can provide a basis for predicting the regression effect after neoadjuvant chemoradiotherapy in rectal cancer. Related Articles | Metrics

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A method of axillary vein puncture using sole anatomical landmark:a preliminary clinical study for pacemaker leads ZHAO Peng, ZENG Shan, TIAN Zhi-yu, WANG Ying 2019, 47 (9):  983-986.  doi: 10.11958/20190916 Abstract ( 651 )   PDF (501KB) ( 3696 )   Objective To evaluate the clinical value of a novel method of axillary vein puncture using sole anatomical landmark. Methods A total of 96 consecutive patients referred for pacemaker implantation were enrolled and randomly divided into axillary vein puncture group (n=48) and subclavian vein puncture group (n=48). The junction point of medial and middle third of the clavicle was located as the sole landmark in axillary vein puncture group. Deflected lateral 45° from sagittal line, an 18-guage needle’s tip was laid on the point, and the hub was identified as puncture entry point. The needle was directed to the landmark at approximately 30°~45° relative to the body’s surface. The standard methods of subclavian vein puncture were applied in the other group. The vein puncture time, adjustment puncture ratio under X-ray, success rates of blind puncture and total puncture and complications associated with puncture were compared between the two groups. Results Compared with subclavian vein puncture group, there were longer puncture time (min: 3.35±0.97 vs. 2.74±0.90， P＜0.01) and more ratio of adjustive puncture under X-ray (22.91% vs. 8.33%, P＜0.05) in axillary vein puncture group. There were no significant differences in success rates of blind puncture (70.83% vs. 81.25%) and total puncture (93.75% vs. 89.58%) between the two groups (P＞0.05). No vascular complications were found in axillary vein puncture group, and four cases of complications associated with puncture were observed in subclavian vein puncture group. Conclusion The method of axillary vein puncture using sole anatomical landmark has high success rate, less complications and high clinical applicability. Related Articles | Metrics

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A case report of incidental bladder paraganglioma with bladder carcinoma RAO Wen-yu, XIAO Lu, RAN Can, LIU Jun, LIANG Bo, FENG You-gang 2019, 47 (9):  987-989.  doi: 10.11958/20191333 Abstract ( 1537 )   PDF (877KB) ( 3464 )   Paraganglioma of the urinary bladder, which arises from the chromaffin tissue of the sympathetic nervous system in locations of the bladder, is also termed to as extra-adrenal pheochromocytomas. Bladder paraganglioma is a rare bladder tumor, however, the report of bladder paraganglioma co-existing with bladder urothelial carcinoma is even rare. We report one case of special bladder paraganglioma with bladder carcinoma. Herein we sought to review the literatures on praganglioma of the urinary bladder and bladder carcinoma in order to further illustrate the presentation, treatment options and outcomes of patients diagnosed with these tumors. Related Articles | Metrics

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The role of Midkine in tumor development and its application as biomarkers HOU Sha-sha, LI Ning, MENG Zhao-wei, TAN Jian 2019, 47 (9):  990-993.  doi: 10.11958/20192316 Abstract ( 662 )   PDF (332KB) ( 3582 )   Midkine (MK) is a new heparin-binding growth factor. It was named after the initial expression of mouse embryonic kidneys in the second trimester of pregnancy. MK is highly expressed in a variety of malignant tumor tissues and plays an important role in the occurrence, development and metastasis of tumors, which can promote the process of cancer cell proliferation, migration and tumor angiogenesis, and affect the prognosis of tumor patients, while its expression is low or even undetectable in normal tissues or adjacent tissues. Significantly, because it is a soluble cytokine, the elevated MK is readily apparent in the blood and other body fluids such as urine and cerebrospinal fluid (CSF), making MK a relatively convenient, accessible, non-invasive and inexpensive biomarker for population screening and early disease detection. MK has already proven to be a biomarker that can significantly improve detection, management and treatment of cancer. This article reviews the research status of MK and tumor development, prognosis and its application in biomarkers. Related Articles | Metrics

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Progress in research of clonal evolution of acquired aplastic anemia DING Yu-bin, TANG Yu-feng, TANG Xu-dong 2019, 47 (9):  994-997.  doi: 10.11958/20190062 Abstract ( 705 )   PDF (322KB) ( 3954 )   Acquired aplastic anemia (AA) is an immune-mediated bone marrow failure disease. Clonal hematopoiesis can be seen in hematopoietic stem cells in more than 70% of AA patients. Common somatic mutations such as the deletion of PIGA gene and HLA allele in AA may be closely related to its immunopathological mechanism. Older age, shortened telomeres in leukocytes and HLA class Ⅰ risk alleles in AA may promote clonal evolution. The course, gene mutation and cytogenetic abnormalities of AA play a key role in the transformation of AA to myelodysplastic syndrome (MDS). Based on the latest research progress of AA cloning evolution and the report of the 60th Annual Conference of American Society of Hematology, this paper reviews the origin, selection and evolution of AA clone. The influencing factors of AA clone evolution and the risk factors of AA transforming into MDS are discussed emphatically. Related Articles | Metrics

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Progress in diagnosis and treatment of familial hypercholesterolemia JIANG Li-hong, Liu Ge-li 2019, 47 (9):  998-1002.  doi: 10.11958/20190581 Abstract ( 796 )   PDF (370KB) ( 3987 )   Familial hypercholesterolemia is an autosomal dominant inherited disorder of lipoprotein metabolism. It is a common genetic cause of premature atherosclerotic cardiovascular disease. Although the terminal adverse events of this disease occur frequently in middle-aged and elderly people, the damage to the blood vessels begins in the fetal period. Most patients with familial hypercholesterolemia are caused by mutations in the low density lipoprotein receptor (LDLR), apolipoprotein B (APOB) and proprotein converting enzyme subtilisin 9 (PCSK9). For children, the level of low density lipoprotein cholesterol (LDL-C) is more than 5 mmol/L after dietary control for three months, which is highly suggestive of the disease. Early detection of patients can be achieved by cascade screening for index patients. Statin therapy from childhood can improve vascular function. Therefore, early diagnosis and early intervention are important for improving prognosis. This article reviews the etiology, diagnosis, treatment and screening of the disease. Related Articles | Metrics

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Progress in research on primary headache disorders in childhood WU Bo, CAI Chun-quan, ZHANG Yu-qin, ZHANG Rui-ping 2019, 47 (9):  1003-1008.  doi: 10.11958/20190653 Abstract ( 851 )   PDF (504KB) ( 5092 )   Primary headache disorders in childhood mainly include migraine, tension headache and cluster headache. Children who present with headaches are common in the neurological clinic. It is generally believed that its pathogenesis is a combination of genetic and environmental factors. Repeated episodes of headaches seriously affect the physical and mental health of children and bring great burdens to their families, schools and society. Some children may have started out with chronic daily headache. Primary headache disorders may continue into adulthood. Therefore, it is extremely important to diagnose and treat the primary headache in children. Physiological and psychological interventions should be offered for children with primary headaches. A multidisciplinary approach, including drugs, psychology and sociology, is required. Children with primary headaches need to improve lifestyles and avoid predisposing factors. Effective management for the primary headache requires a multi-pronged approach. This article reviews the clinical manifestations, the diagnosis and treatment of primary headache disorders in childhood. Related Articles | Metrics

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Study on the activity of human SREBP1 promoter based on dual luciferase reporter system YANG Nian, LI Chen, LI Hong-liang, ZHENG Yan, FANG Shu-hua, WANG Xuan-bin, ZHAO Ya-wei 2019, 47 (9):  897-902.  doi: 10.11958/20190215 Abstract ( 611 )   PDF (1043KB) ( 4063 )   Objective To construct a dual luciferase reporter expression vector of sterol regulatory element-binding protein 1 (SREBP1) gene and to screen natural active inhibitors for SREBP1 targets. Methods The bioinformatics approaches were applied to predict and analyze the promoter region of SREBP1 from 5′ upstream 5 000 bp regulatory region. The dual luciferase reporter expression vector was constructed by Gibson Assembly method. The recombinant plasmid pGL3- SREBP1-pro and control plasmid pRL-SV40 were co-transfected into HepG2 cells. The inhibitory effects of the transcriptional activity of SREBP1 with or without natural active inhibitors were detected. Results There were promoter sequences and transcription factor binding sites in the 5′ upstream 2 000 bp region of SREBP1. The recombinant plasmid was confirmed as a positive clone by enzyme digestion and sequencing. The plasmid was transiently transfected in HepG2 cells to detect promoter activity of SREBP1 by dual luciferase reporter system, and transcriptional activity of SREBP1 was further verified by natural active inhibitors. Conclusion The pGL3-SREBP1-pro dual luciferase reporter expression vector is successfully constructed and its activity is confirmed, which can be further used for the screening of natural active inhibitors for SREBP1 targets. Related Articles | Metrics

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Silencing hnRNP A2/B1 induced cell apoptosis via Bcl-2/Bax in cervical cancer CaSki cells CAI Tong, XU Xiu-ying, FANG Wen 2019, 47 (9):  902-906.  doi: 10.11958/20190959 Abstract ( 509 )   PDF (624KB) ( 4867 )   Objective To investigate the effect of silencing hnRNP A2/B1 on the proliferation and apoptosis of cervical cancer CaSki cells and the relative mechanism. Methods hnRNP A2/B1 stably silencing CaSki cell line was established and divided into three groups. The cells with hnRNP A2 / B1 target silencing were used as the CaSki-shRNA group, the negative vector was used as the negative control group (CaSki-NC). The blank control group (CaSki) was not treated. Quantitative real-time PCR (qRT-PCR) and Western blot assay were used to detect the mRNA and protein expression levels of hnRNP A2/B1. Cell proliferation and colony formation capacity were determined by MTT assay and plate formation assay. The apoptosis was detected by flow cytometry. Western blot assay was performed to reveal the expressions of apoptosisrelated proteins Bcl-2 and Bax. Results The results of qRT-PCR and Western bolt assay confirmed that the mRNA and protein expressions of hnRNP A2/B1 decreased significantly in the CaSki-shRNA group compared with those of CaSki group and the CaSki-NC group. In the CaSki-shRNA group, the proliferation and colony forming ability of CaSki cells decreased, the apoptosis increased and the expression of Bcl-2 was significantly downregulated and Bax was upregulated (P＜0.01). There was no significant difference between CaSki group and CaSki-NC group (P＞0.05). Conclusion Silencing hnRNP A2/B1 can inhibit the proliferation in cervical cancer CaSki cells and may induce cell apoptosis via Bcl-2/Bax Related Articles | Metrics

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The influence of TGF-β1 on cell invasiveness, cell metastasis and the expression of IL-22 in colorectal cancer cell line RUAN Hong-xun, QIN Xiao-ning, HUANG Wei, LI Meng, ZHAO Jing, REN Peng-tao, HAO Ying-hao, LIN Lin 2019, 47 (9):  907-912.  doi: 10.11958/20190311 Abstract ( 685 )   PDF (1247KB) ( 5204 )   Objective To investigate the effect of transforming growth factor β 1 (TGF-β1) on invasion, metastasis and expression of interleukin 22 (IL-22) protein of colorectal cancer cell line. Methods The colorectal cancer HCT116 cells were treated with different concentrations of TGF-β1 (0, 5, 10, 15, 20, 30, 50 μg/L) for 24 and 48 hours. The hyperplasia of HCT116 cells was detected by CCK-8 assay. The colorectal cancer HCT116 cells were divided into control group and TGF- β1 treated group. Transwell invasion and migration assay and Wound-healing assay were used to detect the effect of TGF-β 1 on the invasion and migration of HCT116 cells. RT-PCR was used to detect the effect of TGF-β1 on the expressions of TGF - β1 and IL-22 mRNA in HCT116 cells. Immunocytochemistry and Western blot assay were used to detect the expressions of TGF-β1, IL-22, STAT3 and E-cadherin protein in HCT116 cells. Results CCK-8 results show that there were no significant differences in the optical density (OD) values of HCT116 cells between different TGF-β1 concentration treatment groups (0, 5, 10, 15, 20, 30, 50 μg/L) after stimulation with TGF-β1 solution for 24 and 48 hours (P＞0.05). The invasive ability, migration ability and migration distance of cells were significantly increased after treatment with TGF- β1 (10 μg/L) for 48 hours (P＜0.01). The expression of TGF-β1 mRNA was significantly higher but the expression level of IL- 22 mRNA was significantly lower in TGF - β1 treated group than those in the control group (P＜0.01). The results of immunocytochemistry and Western blot assay showed that the expressions of TGF-β1 and STAT3 protein were significantly higher in TGF-β1 treated group than those in the control group, and the expressions of IL-22 and E-cadherin protein were significantly lower in TGF-β1 treated group than those in control group (P＜0.05). Conclusion TGF-β1 may promote the invasion and migration of HCT116 cells, but the effect on the proliferation of HCT116 cells is not obvious. TGF-β1 may inhibit the expression of IL-22 protein in HCT116 cells. Related Articles | Metrics

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Predictive values of MIP-1α and DFR on venous thromboembolism in elderly bedridden patients TIAN Ding-yuan, DANG Lian-sheng 2019, 47 (9):  966-970.  doi: 10.11958/20190518 Abstract ( 592 )   PDF (425KB) ( 5020 )   Objective To study the expression and predictive value of macrophage inflammatory protein-1α (MIP-1α) and D-dimer / fibrinogen (DFR) ratio in elderly patients with venous thromboembolism (VTE). Methods A total of 129 suspected VTE patients over 65 years of old were enrolled in the study. According to compression ultrasonography (CUS) and CT pulmonary angiography (CTPA), patients were divided into non-DVT group (n=76), DVT group (n=34) and pulmonary thromboembolism (PTE) group (n=21). Fresh blood samples were collected from patients before the anticoagulant therapy. Data of blood routine test and clotting indicators were collected, and neutrophil count/lymphocyte count ratio (NLR) was calculated. The plasma level of D-dipolymer was measured by immunoturbidimetry. The plasma level of fibrinogen was determined by the solidification method, and DFR ratio was calculated. The expression level of MIP-1α was detected by ELISA, and the expression level of MIP-1α mRNA was detected by real-time PCR. The predicted value of some indicators for VTE was analyzed by plotting ROC curve. Results The levels of D-dimer, age-adjusted D-dimer and DFR were significantly higher in PTE group and DVT group than those in non-DVT group (P＜0.05). There was no significant difference in fibrinogen between the three groups. The serum levels of MIP-1α were significantly higher in DVT group and PTE group than those in non-DVT group, and compared with DVT group, the serum level of MIP-1α was lower in PTE group (P＜0.05). The relative expression of MIP-1α mRNA was significantly higher in DVT group and PTE group than that in nonDVT group (P＜0.05). Levels of D-dimer, age-adjusted D-dimer, DFR, MIP-1α showed certain diagnostic values for elderly VTE, and the diagnostic efficiency of age-adjusted D-dimer (AUC=0.864) was the best one. DFR (AUC=0.853) was comparable to that of the traditional D-dimer (AUC=0.851). The predictive value of MIP-1α (AUC=0.739) for VTE was a common result. NLR showed no diagnostic value for VTE (P＞0.05). Conclusion The age-adjusted D-dimer is an ideal diagnostic marker for the diagnosis of VTE in the elderly. DFR and MIP-1α can be used as a method to diagnose VTE. MIP- 1α may be a new indicator for evaluating venous thrombosis and unstable shedding. Related Articles | Metrics