Tianjin Medical Journal

Melatonin enhances the inhibitory effect of paclitaxel on T24 cell proliferation #br#

CHEN Huan, ZHU Jia-bin, ZHAO Xiao-jin, DONG Chuan-jiang, â³, DONG Zi-qiangâ³

2020, 48 (5): 353-357. doi: 10.11958/20182226

Abstract ( 852 )

PDF (1639KB) ( 4502 )

Abstract: Objective To observe the inhibitory effect of melatonin (Mel) and paclitaxel (PTX) on T24 bladder cancer

cells and to explore the underlying mechanism. Methods T24 cells were treated with Mel and PTX alone or in

combination. CCK-8 assay and plate colony formation assay were used to detect the proliferation inhibition or IC50 value of

Mel and PTX on T24 cells. The mRNA and protein levels of COX-2 in T24 cells were detected by RT-PCR and Western

blot assays. The promoter activity of NF-kB was detected by dual-luciferase reporter assay. Results Compared with the

PTX treatment alone, Mel can significantly enhance the inhibitory effect of PTX on T24 cell proliferation and decrease the

IC

50 value of PTX. The proliferation and colony formation ability of T24 cells were decreased significantly (Pï¼0.05).

Combination therapy with Mel and PTX could significantly reduce the protein and mRNA level of COX-2 and the promoter

activity of its related NF-kB signaling pathway. Conclusion Mel and PTX could synergistically inhibit the proliferation of

T24 bladder cancer cells, which may be related to the inhibition of NF-kB signaling pathway promoter activity and the

decrease of COX-2 expression in T24 cells.

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Study of IRX5 promotes invasive migration of hepatocellular carcinoma cells and the validation of its targeting relationship with miR-136-5p #br#

DAI Long-guang, ZHU Li-ying, SHEN Jie, QIAN Wen, ZHANG Jing-zhi, ZHU Jin-feng, XU Yong-jie, LIU Xin-lei, XU Wen, ZHU Ke-jing, ZHANG Ling, PAN Wei, LI Xing, △

2020, 48 (5): 358-363. doi: 10.11958/20192806

Abstract ( 664 )

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Abstract: Objective To investigate the effect of IRX5 on the invasion and migration of hepatocellular carcinoma

(HCC) cells and verify the targeted relationship between miR-136-5p and IRX5. Methods The SMMC7721 cells were

divided into empty plasmid (pcDNA3.1) group and overexpress IRX5 (pcDNA3.1-IRX5) group in the overexpression IRX5

experiment. For knockdown IRX5 experiment a negative control (sh-NC) group and knockdown IRX5 (sh-IRX5) group were

set up. The overexpression and knockdown efficiency rates of IRX5 were detected by Western blot assay. The effects of IRX5

on the invasion and migration of HCC cells were detected by wound healing assay and Transwell assay. miRNA and binding

sites of IRX5 were predicted by miRanda and Targetscan. The 3' untranslated regions (UTR) of IRX5 were amplified by PCR

and connected to pGL3-Control vector. To verified recombinant plasmid by enzyme digestion and gene sequencing methods.

The 293T cells were divided into four groups: IRX5-3'UTR-Wt+NC group, IRX5-3'UTR-Wt+miR-136-5p group, IRX5-

3'UTR-Mut+NC group and IRX5-3'UTR-Mut+miR-136-5p group in dual luciferase assay. The luciferase activity was

detected by dual luciferase reporter system. Results The expression level of IRX5 was significantly higher in the

overexpression IRX5 group than that of the empty plasmid group (P＜0.05). Compared with the negative control group, the

expression level of IRX5 was significantly reduced in the knockdown IRX5 group (P＜0.01). IRX5 promoted the invasion

and migration of HCC cells (P＜0.05). The IRX5-3'UTR-Wt and IRX5-3'UTR-Mut were successfully constructed. The

results of dual luciferase assay showed that miR-136-5p can reduce IRX5-3'UTR-Wt luciferase activity (P＜0.01), which

showed no effect on IRX5-3'UTR-Mut luciferase activity (P＞0.05). Conclusion IRX5 promotes the invasion and

migration of HCC cells. IRX5 acts as a target gene of miR-136-5p. miR-136-5p may inhibit the invasion and migration of

HCC cells through the 3'UTR of IRX5.

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Effect of shRNA-mediated silencing EBF1 gene expression on the proliferation of lung cancer cell line A549 in vitro and in vivo

WANG Lin, LI Ding, QIN Ting-ting, REN Li△

2020, 48 (5): 364-369. doi: 10.11958/20192473

Abstract ( 939 )

PDF (1073KB) ( 5849 )

Objective: To study the effect of EBF1 gene knockdown on proliferation of lung adenocarcinoma A549 cells in vitro and in vivo, and to explore its mechanism.Methods: Immunohistochemistry and RT-PCR were used to detect the expression of EBF1 in lung cancer tissues and lung cancer cell lines. A recombinant retroviral shRNA expression vector was constructed and transfected into A549 cells according to the shRNA sequence of EBF1 designed by our lab. Knockdown of EBF1 gene was detected by RT-PCR and Western blot. MTT and BrdU staining were used to detect the effect of EF1-shRNA on the proliferation of A549 cells in vitro; the detection of the effect of ebf1-shRNA on the invasion and migration of A549 cells in vitro by Transwell and scratch experiments;flow cytometry was used to analyze the cell cycle of each group; subcutaneous inoculation of cells in axilla of nude mice was used to observe the effect of EBF1-shRNA on the tumorigenicity of A549 cells in nude mice; Western blot was used to detect the expression of CDK6, P21 and P27 proteins. Results: EBF1 was not expressed in stromal cells of adjacent tissues and lung cancer tissues, but in nuclei of NSCLC and SCLC cancer cells. EBF1-shRNA knockdown EBF1 gene expression effectively; knockdown EBF1 gene expression can inhibit the proliferation of A549 cells in vitro and in vivo, and block the cell cycle of experimental group at G1 phase; after knockdown EBF1 gene expression, CDK6 protein expression in experimental group cells decreases, while P21 and P27 protein increase. Conclusion: EBF1-shRNA can inhibit the proliferation of lung adenocarcinoma A549 in vitro and in vivo by blocking cell cycle in G1 phase, which involves the decrease of CDK6 expression and the up-regulation of P21/P27 expression.

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Relationship between changes of Ang II and TGF-β/Smads levels and renal fibrosis in SHR rats and the intervention effect of Enalapril

CHEN Wan-li, , LI Hui-hui, , ZHU Zhen-yu, , HUANG An-an, , LIU Zhan-biao, QI Xin△

2020, 48 (5): 370-374. doi: 10.11958/20193104

Abstract ( 710 )

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Abstract: Objective To investigate the effect of enalapril on angiotensin (Ang) Ⅱ and TGF-β/Smads in renal tissue
of spontaneously hypertensive rats (SHR). Methods A total of 20 male SHRs were randomly divided into model group and
enalapril group. Ten male Wistar Kyoto rats (WKY) were taken as control group. The dosage of enalapril was 1.05 mg/(kg·d),
once a day, for 10 weeks. The model group and the control group were given the same amount of normal saline. Blood
pressure was monitored every two weeks regularly. After 10 weeks animals were killed and tissue samples were collected.
Urease method was used to detect the blood urea nitrogen (BUN) content. Enzyme-linked immunosorbent assay (ELISA) was
used to detect the contents of Ang Ⅱ, serum cystatin C (CysC) and urinary microalbumin (mALB). Masson staining was used
to observe the renal pathological changes. Real-time PCR was used to detect the relative mRNA expressions of Ang Ⅱ ,
transforming growth factor β1(TGF-β1), Smad2, Smad3, CollagenⅠ and Collagen Ⅳ. Results Compared with the control
group, the systolic and diastolic blood pressures increased significantly in the model group and enalapril group (P＜0.05).
There were no significant differences in the systolic and diastolic blood pressures between the model group and enalapril
group (P＞0.05). After drug intervention, compared with the model group, the systolic and diastolic blood pressures
decreased significantly in enalapril group (P＜0.05). Compared with the control group, the levels of Ang Ⅱ, BUN, CysC and
urinary mALB were significantly increased in the model group (P＜0.05). A large number of blue collagen fibers were
deposited in renal tissue, and the relative mRNA expressions of Ang Ⅱ, TGF-β1, Smad2, Smad3, Collagen Ⅰ and Collagen
Ⅳ were significantly increased (P＜0.05). Compared with the model group, the level of collagen deposition was significantly
reduced in renal tissue, and the above indexes in serum and kidney decreased significantly in enalapril group (P＜0.05).
Conclusion Enalapril has a stable hypertensive effect on SHR, and it can alleviate renal fibrosis and improve renal injury
caused by hypertension by lowering Ang Ⅱ level and inhibiting the expression of TGF-β/Smads signaling pathway.

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Salubrinal treats the non-alcoholic fatty liver disease through eIF2α signaling pathway #br#

ZHANG Shi-qi, LIU Da-quan, LI Xin-le, ZHANG Ping, △

2020, 48 (5): 375-380. doi: 10.11958/20193736

Abstract ( 649 )

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Abstract: Objective To investigate the effect of salubrinal on obesity-induced non-alcoholic fatty liver disease.
Methods Thirty female C57BL/6 mice were randomly divided into three groups: standard chow diet (SCD) group, high-fat
diet (HF) group and HF with salubrinal (HF+S) group. The HF and HF+S groups were given a high-fat diet (fat content:
60%). After 4-week obesity induction, salubrinal was subcutaneously injected for the next 4 weeks in HF+S group. During
the experiment, the changes in animal body compositions were measured regularly. Serum lipid parameters were examined
through venous blood. The abdominal subcutaneous fat, periuterine and perirenal fat, and liver were collected for wet mass
determination. The pathological changes of the liver tissues were observed by H&E and oil red O staining for investigating
the effect and mechanism of salubrinal on the hepatic steatosis. The expressions of proteins related to eIF2α signaling (Bip,
p-eIF2α, eIF2α, ATF4 and CHOP) were detected by Western blot assay. Results Compared to the SCD group, the serum
lipid level and the fat accumulation were increased in HF and HF+S groups. After treatment with salubrinal, the lipid
disorder was relieved. Also, the histological severity of hepatic steatosis in the liver was suppressed in response to salubrinal.
In addition, Western blot analysis showed that salubrinal inhibited endoplasmic reticulum stress by increasing the
expressions of Bip, p-eIF2α and ATF4 with a decrease level of CHOP. Conclusion Salubrinal can effectively alleviate
obesity and non-alcoholic fatty liver disease and regulate lipid metabolism by altering endoplasmic reticulum stress through
eIF2α signaling.

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The mechanism of osteoprotegerin involved in the calcification of vascular smooth muscle cells induced by β-glycerophosphate #br#

DOU Jian-xin, SUN Li-ping, LIU Chang-shan, WANG Xiu-jun, MING Yi, SU Liang△

2020, 48 (5): 380-384. doi: 10.11958/20193488

Abstract ( 526 )

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Abstract：Objective To investigate the mechanism of osteoprotegerin intervention on thecalcification of vascular

smooth muscle cells (VSMC) induced by β -glycerophosphate in rats. Methods Rat aortic smooth muscle cells were

isolated and cultured in vitro. Cells treated with PBS were used as the control group. Cells treated with 10 mmol/L β -

glycerophosphate for 10 days to induce the calcification were used as the calcified control group, while cells treated with β-

glycerophosphate and osteoprotegerin (OPG) in dose gradients (1, 4 and 8 μg/L) were used as the osteoprotegerin intervention

group. Alizarin red staining was used to detect the formation of calcified nodules. The content of calcium deposition was

measured by the o-cresolphthalein complexone method. The alkaline phosphatase activity was determined by the

colorimetric method. The protein expressions of Notch1/RBP-JK pathway were detected by Western blot assay. Results

Alizarin red staining showed that compared with the calcified control group, the calcified nodules of VSMCs were

significantly reduced in OPG intervention groups. Compared with calcification control group, the calcium content and ALP

activity decreased significantly in OPG intervention group in a dose-dependent manner (P < 0.05). In addition, compared

with calcification control group, the expression levels of Notch 1, RBP-JK, Jagged1 and Msx2 protein decreased significantly

in OPG intervention group (P < 0.05). Conclusion Osteoprotegerin is involved in the regulation of vascular calcification by

the down regulating the expression of Notch1/RBP-JK pathway protein.

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Finite element analysis of the treatment of unstable femoral intertrochanteric fractures with#br# bone cement augmented proximal femoral anti rotation nail in elderly #br#

HUANG Pei-zhen, CHEN Xin-min, ZHENG Li-qin, LIN Zi-ling△, DONG Hang, CAI Qun-bin

2020, 48 (5): 385-390. doi: 10.11958/20193661

Abstract ( 575 )

PDF (901KB) ( 3657 )

Abstract： Objective To explore the biomechanical difference between the treatment of unstable femoral
intertrochanteric fractures with common proximal femoral anti rotation nail and bone cement augmented proximal femoral
anti rotation nail. Methods A healthy volunteer was selected to import the CT data into the software of Mimics 19.0 and
Geomagic studio 2017 to extract and optimize the three-dimensional model of the right femur. The Solid works 2017 software
was used to draw the internal fixation model and assemble it with the femur model according to the standard operation
technology, and import it into Hypermesh 14.0 software in step format to cut the bone according to Evans V type of
intertrochanteric fracture. The part of the cancellous bone on the surface of the proximal spiral blade was redefined as the
bone cement component, which was stored as A and B models respectively. The material parameters, boundary conditions
and applied loads were set, which were stored as K files and imported into LS-DYNA software for solution. The blade
cutting, inversion and rotation of proximal femoral neck bone mass and Von Mises stress and displacement distribution were
observed. Results In the model of cement augmented proximal femoral anti rotation nail, the cutting degree of the screw
blade was lighter, the osteotomy and rotation angle of the femoral head and neck block were less, and the displacement of the
fracture end was less. Conclusion The treatment of Evans V type intertrochanteric fracture with bone cement augmented
proximal femoral anti rotation nail in elderly has better biomechanical effect than that of the common proximal femoral anti
rotation nail.

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Study on the association of genetic polymorphisms of folic metabolic enzymes and male sperm abnormality #br#

WANG Zhi-qiang, SHAN Wen-sheng△, TIAN Xin, LIU Chun-hui, SUN Qing-mei, YU Guo-qiang, LIU Xiao-wen

2020, 48 (5): 391-395. doi: 10.11958/20190814

Abstract ( 914 )

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Abstract: Objective To investigate the relationship between genetic polymorphisms of folic metabolic enzymes and
male sperm abnormality or adverse pregnancy. Methods A total of 929 males of Han nationality treated in Gansu
Provincial Maternity and Child-Care Hospital from January 2017 to December 2017 were selected as the research objects.
The patients were divided into the dysspermia group (290 cases of sperm abnormality), adverse pregnancy group (198 cases
of unexplained adverse pregnancy) and control group (441 cases of healthy people without adverse pregnancy). Genotypes of
MTHFR C677T, A1298C and MTRR A66G sites were detected in three groups of patients. Results The genotype
frequencies of MTHFR C677 TT, MTRR A66 AG and GG were significantly higher in dysspermia group and adverse
pregnancy group than those of control group (P＜0.05). The genotype frequency of MTHFR A1298C CC was significantly
higher in adverse pregnancy group than that of control group (P＜0.05). Multivariate Logistic regression showed that MTHFR
C677 TT, MTRR A66 AG and GG genotypes were independent risk factors for sperm abnormality (P＜0.05). MTHFR C677
TT, MTHFR 1298 CC and MTRR A66 AG and GG genotypes were independent risk factors for adverse pregnancy (P＜0.05).
Conclusion The genetic polymorphisms of MTHFR C677T and MTRR A66G may contribute to male sperm abnormality
and adverse pregnancy. MTHFR C677 TT, MTRR A66 AG and GG may be independent risk factors for male sperm
abnormality and adverse pregnancy.

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Effects of dexmedetomidine combined with anesthesia on postoperative analgesia and cellular immune function in lung cancer patients #br#

LI Guo-li, GAO Xiao-ru, WANG Wei, ZHANG Yue, CAO Liang, LI Fu-long, TENG Jin-liang△

2020, 48 (5): 396-401. doi: 10.11958/20192855

Abstract ( 860 )

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Abstract：Objective To explore the effects of dexmedetomidine combined with sufentanil anesthesia on the analgesic
effect and immune function of patients with lung cancer resection. Methods A total of 120 patients with lung cancer who
were admitted to our hospital from July 2017 to July 2019 were randomly divided into single group and composite group, with
60 patients in each group. After surgical resection, the patient-controlled analgesia (PCIA) was performed by intravenous
infusion of sufentanil alone in the single anesthesia group and sufentanil combined with dexmedetomidine in the composite
anesthesia group. Visual analogue pain score (VAS) and comfort score (BCS) were performed at 1, 6, 12, 24 and 48 h after
the surgery to evaluate the analgesic effect in the two groups. In addition, the proportion of immune cells and the expression
levels of immune factors in the peripheral blood were measured before and at 12, 24, 48 h, 1 week and 2 weeks after surgery
in the two groups. Results (1) VAS and BCS scores were significantly lower in the composite group than those in the single
group (P＜0.05). (2) Compared with the same period in the single group, the proportions of NK cells, CD3+ T cells and CD4+/
CD8+ were significantly increased in the composite group at 12, 24 and 48 h after surgery (P＜0.05). The CD8+ cells were
significantly lower at 12, 24 and 48 h after surgery in the composite group (P＜0.05). IFN-γ contents were significantly
lower at 12, 24 h, 48 h and 1 week after surgery in the composite group than those of the single group (P＜0.05), while IL-10
levels were significantly higher than those of the single group (P＜0.05 or P＜0.01). There was no significant difference in
the incidence of postoperative complications between the two groups (P＞0.05). Conclusion Dexmedetomidine combined
with sufentanil PCIA has better analgesic effect and higher postoperative comfort in patients after radical operation. Most
importantly, the compound anesthesia can improve the immune function.

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Analysis of psychosocial factors in patients with pelvic organ prolapse and depression #br#

LIU Pan-pan, XING Wen-long, ZHANG Gui-qing△

2020, 48 (5): 402-405. doi: 10.11958/20193907

Abstract ( 611 )

PDF (380KB) ( 3526 )

Abstract: Objective To explore the psychosocial factors in patients with pelvic organ prolapse and depression.
Methods A total of 199 patients with pelvic organ prolapse screened from a certain population in Xinjiang were randomly
selected in this study. The depressive symptoms were assessed by Hamilton depression scale (HAMD-24). For 199 patients,
62 cases were accompanied by depressive symptoms (depression group), and 137 without depression symptom (nondepression group). Hamilton anxiety scale (HAMA-14), Eysenck personality questionnaire (EPQ), Simplified coping style
questionnaire (SCSQ) and Social support rating scale (SSRS) were used to evaluate two groups of patients. Results
Depression was found in 31.2% of patients with pelvic organ prolapse. There were statistically significant differences in
anxiety, neuroticism, negative coping and subjective support scores between the depression group and the non-depression
group (P＜0.05). It was found that anxiety and neuroticism were risk factors for patients of pelvic organ prolapse combined
with depression (OR=1.691 and 1.819). Conclusion Medical staff should pay attention to the psychological intervention of
the related factors of patients with pelvic organ prolapse and depression, improve the mental health of patients, and promote
conservative treatment and surgical treatment of pelvic organ prolapse.

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Relationship between coronary lesion and left ventricular function in patients with fragmented QRS and non-ST elevation acute myocardial infarction #br#

XU Yan-ling, YU Yi-jun, GU Li, WU Hui-jun, ZHENG Wei, ZHOU Zhi-yun, GU Ye△

2020, 48 (5): 406-410. doi: 10.11958/20200112

Abstract ( 652 )

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Abstract: Objective To investigate the relationship between the fragmented QRS (fQRS) and the degree of coronary
artery lesion and left ventricular function in patients with non-ST elevation acute myocardial infarction (NSTEAMI).
Methods Data of 183 patients with NSTEAMI who underwent coronary angiography in the department of cardiology of our
hospital from January 2018 to October 2019 were retrospectively analyzed. According to the presence of fQRS (two or more
adjacent leads) on the resting ECG, patients were divided into fQRS group (n=84) and nfQRS group (n=99). The clinical
characteristics, coronary angiography data and echocardiography were analyzed between the two groups. Results The blood
biochemical indexes such as cTnI, CK, CK-MB, LDH, TC, TG, LDL-C, Scr and hs-CRP were significantly increased in
fQRS group compared to those of nfQRS group (P＜0.05). Gensini score and NT-proBNP value were significantly higher,
LVEF was significantly lower, in fQRS group than those in nfQRS group (P＜0.01). Logistic regression analysis showed that
the higher cTnI, CK-MB and Gensini score, and the lower LVEF were risk factors for fQRS in NSTEAMI patients. The fQRS
group was then divided into two subgroups. The Gensini score of the lead number > 3 and the proportion of coronary artery
lesion＞3 were significantly higher than those with the lead number≤3 group. Conclusion For NSTEAMI patients with
fQRS on the ECG, especially those with more leads of fQRS, the coronary artery lesion is more serious, the left ventricular
function is worse and myocardial ischemia is more severe.

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Relationship between the expressions of NOD1, SIRT1, IL-1β and MMP-3 in women with premature rupture of the membranes #br#

SONG Chun-hong, YANG Rong-juan, ZHEN Juan△, WU Sha, HAN Yan-jie

2020, 48 (5): 411-414. doi: 10.11958/20193974

Abstract ( 488 )

PDF (545KB) ( 3849 )

摘要：目的探讨胎膜早破（PROM）胎膜组织核苷酸结合寡聚化结构域受体 1（NOD1）及沉默配型信息调节蛋白
1（SIRT1）的表达与羊水中白细胞介素（IL）-1β、基质金属蛋白酶 3（MMP-3）水平的相关性，为深入了解胎膜早破的发
病机制并寻找可能的监测及治疗方法提供指导。方法 90例妊娠妇女分为 3组：足月胎膜早破（tPROM）组、未足月
胎膜早破（pPROM）组及正常足月妊娠（正常对照）组，每组各 30例。胎膜组织 NOD1与 SIRT1表达部位及含量测定
采用免疫组织化学法及 Western blot，羊水中 IL-1β、MMP-3水平检测采用 ELISA方法，分析 NOD1、SIRT1与羊水 IL-
1β及 MMP-3表达的相关性。结果 PROM组 NOD1、IL-1β及 MMP-3表达高于正常对照组（P＜0.05），SIRT1表达低
于正常对照组（P＜0.05）。pPROM 组 NOD1、IL-1β、MMP-3 表达高于 tPROM 组（P＜0.05），tPROM 组与 pPROM 组
SIRT1表达差异无统计学意义（P＞0.05）。胎膜组织 NOD1表达与羊水 IL-1β及 MMP-3水平呈正相关（P＜0.01）；胎
膜组织 SIRT1 表达与羊水 IL-1β 及 MMP-3 水平呈负相关（P＜0.01）。结论胎膜组织中 NOD1 及羊水中 IL-1β 及
MMP-3表达水平升高、胎膜组织中 SIRT1表达水平降低与胎膜早破发生相关，且 4种因子在胎膜早破发病中存在相
关性。

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Clinical features and prognostic analysis of newly diagnosed multiple myeloma with extramedullary disease #br#

FU Qing-hua, XIA Bing, YANG Hong-liang, XU Wen, ZHAO Hai-feng, YU Yong, ZHAO Zhi-gang, WANG Ya-fei, WANG Xiao-fang△

2020, 48 (5): 415-420. doi: 10.11958/20193032

Abstract ( 868 )

PDF (502KB) ( 4073 )

Abstract: Objective To analyze the clinical characteristics and prognosis of newly diagnosed multiple myeloma (MM)
patients with different types of extramedullary disease (EMD). Methods Data of gender, age, immunoglobulin type, DS
stage, ISS stage and other clinical characteristics of 99 MM patients with EMD who were admitted to our hospital and had
complete clinical data were retrospectively analyzed. The survival analysis and prognostic analysis on patients with different
types of extramedullary diseases were performed, and the prognostic significance of different therapeutic regimens was
explored. Results There were no significant differences in clinical characteristics between MM patients with the bonerelated EMD (bEMD, n=57) and strict EMD (sEMD, n=42, P＞0.05). The two types of extramedullary diseases were mainly
found in ribs (42.1%) and soft tissues (50.0%) respectively. There were significant differences in median OS time (45 months
vs. 15 months, P＜0.05) and median PFS (20 months vs. 10 months, P＜0.05) between bEMD group and sEMD group. It was
found that age≥60 years (HR=2.333, 95%CI:1.025-5.309, P＜0.05),β2-MG≥2.7 mg/L (HR=4.361, 95%CI:1.304-14.587,
P＜0.05) and mutation of TP53 (HR=3.697, 95%CI:1.015-13.469,P＜0.05) were independent prognostic factors affecting
OS in EMD patients. The median PFS (49 months vs. 9 months, P＜0.05) and median OS (79 months vs. 12 months, P＜0.05)
of patients with sequential ASCT after bortezomi-induced chemotherapy in the sEMD group were statistically significant
compared with those without ASCT. Conclusion The prognosis of MM patients with sEMD is worse than that of bEMD
patients. The sequential autologous hematopoietic stem cell transplantation with bortezomib chemotherapy may prolong the survival and improve prognosis of patients with sEMD.

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Expression and significance of Reg Ⅳ in breast cancer and its specific molecular subtypes #br#

SONG Shan-shan, NIE Yan-hong, ZHANG Chun-fang, LIN Hai-Yue, ZHANG Qiang, CHEN Hao△

2020, 48 (5): 421-426. doi: 10.11958/20192651

Abstract ( 747 )

PDF (897KB) ( 5368 )

Objective We aimed to investigate the expression of Reg IV in breast cancer and specific molecular subtypes. The relationships between Reg IV and clinical pathological features were also analyzed. Methods 75 cases of normal breast tissues and 140 cases of malignant breast cancer, which including 30 cases of LA type, 50 cases of LB type, 30 cases of HER-2+ type, and 30 cases of TNBC type, were involved in the current study. EnVison immunohistochemistry was used to detect the expression of Reg IV. Real-time quantitative PCR and biological databases were used to analyze Reg IV protein mRNA and the association with clinical pathological features. Results The expression of Reg IV mRNA and protein was higher in malignant breast cancer compared with normal breast tissues (P＜0.05). The level of Reg IV in non TNBC was higher than that in TNBC (P＜0.05). Additionally, Reg IV up-regulation was related to positive ER, PR and HER-2 (P＜0.05), instead of Ki-67 and EGFR. Reg IV was also significantly associated with age, tumor size, TNM stage and prognosis (P＜0.05), but no significantly correlated with lymph node metastasis, histological grade and position. Conclusion Our research demonstrated that Reg IV may play an important role in malignant breast cancer, especially in non TNBC. Reg IV may be a promising biomarker for the prognosis of breast cancer patients.

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Study of balloon-assisted enteroscopy in treating Peutz-Jeghers syndrome polyp with intussusception #br#

ZHANG Tong-zhen, XIAO Nian-jun, SUN Tao, ZHANG Yan-shuang, NING Shou-bin△

2020, 48 (5): 426-429. doi: 10.11958/20193585

Abstract ( 692 )

PDF (368KB) ( 3626 )

Abstract: Objective To assess therapeutic efficacy and safety of balloon assisted enteroscopy (BAE) for treatment of
Peutz-Jeghers polyps (PJP) with intussusceptions, and to explore the critical factors that affect the choice of treatment for
PJP with intussusception. Methods The clinical data of patients identified as PJP intussusception were collected at the Air
Force Medical Center from January 2013 to June 2019. Forty-eight patients were finally enrolled according to the inclusion
and exclusion criteria. The ration of male to female was 28∶20, and the mean age was (20.6±9.2) years old. The success rate,
the incidence of complications and other clinical data,such as age, gender, history of surgeries, clinical symptoms, diameter
of lead polyps, the number of intussusceptions, and the longest length of single intussusception were analyzed. Case control
study was performed to compare the different indexes between patients in pure enteroscopic treatment group and surgical
treatment group. Results The overall effective rate of BAE treatment of PJP with intussusception was 83.3% (35/42), and
the postoperative complication rate was 2.4% (1/42). Thirty-five patients that were treated successfully by BAE were
classified as the BAE group, and 13 patients treated with surgery were classified as surgery group. There were no statistically
significant differences in gender, history of surgeries, positive rate of PJS family history, average diameter of lead polyps and
number of intraoperative polyps between the two groups. The average age was smaller in BAE group than that in surgery
group. The proportion of patients with no or mild clinical symptoms was higher in the BAE group than that in surgery group.
The number of intussusception was less in the BAE group than that in surgery group, and the longest length of single
intussusception was shorter than that in surgery group (P＜0.05). Conclusion BAE is safe and effective in the management
of PJP with intussusception, which can be used as the first-line treatment for PJP with intussusception coinciding incomplete
intestinal obstruction.

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The characteristics of imaging, bronchoscopy and rapid on-site evaluation in patients with primary tracheobronchial adenoid cystic carcinoma #br#

TAO Mei-mei, ZHANG Nan, ZOU Heng, ZHOU Yun-zhi, MA Hong-ming, GAO Hong, WANG Hong-wu△

2020, 48 (5): 430-433. doi: 10.11958/20193243

Abstract ( 622 )

PDF (690KB) ( 3748 )

Objective: To investigate the CT and bronchoscopic characteristics of primary tracheobronchial adenoid cystic carcinoma, and to analyze the cellular morphologic features and diagnostic accuracy. Methods: A retrospective analysis was performed with 56 patients finally diagnosed primary tracheobronchial adenoid cystic carcinoma. All patients accepted chest CT scan and interventional bronchoscopy under general anesthesia．All patients were sampled for ROSE and pathological analysis. Results: Based on CT scan, the lesions of 56 patients located in trachea、main bronchus and segmental bronchus, were Abstract:Objective To investigate chest computerized tomography (CT) and bronchoscopic characteristics of primary
tracheobronchial adenoid cystic carcinoma (ACC), and to analyze the cellular morphologic features of rapid on-site
evaluation (ROSE) and diagnostic accuracy. Methods A retrospective analysis was performed with 56 patients diagnosed
as primary tracheobronchial adenoid cystic carcinoma. All patients accepted chest CT scan and interventional bronchoscopy
under general anesthesia．All patients were sampled for ROSE and pathological analysis. Results Based on CT scan, the
lesions located in trachea, main bronchus and segmental bronchus in 56 patients. The lesions were classified into localized
(28/56) and diffused (28/56) types. According to growing patterns, the lesions could be divided into three types: broadly basal
intraluminal nodules or masses (30/56), thickening type with infiltration along the wall (18/56) and intraluminal and outside
growing pattern (8/56). Bronchoscopic findings showed that eccentric constriction of the local lumens because of endoluminal
growth of ACC (67.86%) and circumferential stenosis because of diffuse thickness of mucosa (32.14%). The surface of the
lesion was smooth, but the surface blood vessels were abundant. ROSE showed that there were characteristic pink staining
spheric matrix and purple blue staining tumor cells at the same time. The diagnostic accuracy of ROSE was 92.9% (52/56).
Conclusion The CT and bronchoscopic features of primary tracheobronchial adenoid cystic carcinoma are characteristic,
and the accuracy of ROSE is high, which can be used as the basis for preliminary diagnosis.

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Analysis on coronary lesions and clinical characteristics of acute myocardial infarction in patients of different ages

2020, 48 (5): 434-438. doi: 10.11958/20193622

Abstract ( 512 )

PDF (391KB) ( 3581 )

Objective To analyze the coronary lesions and clinical features in AMI(both STEMI and NSTEMI) patients among different age groups. Methods The clinical data of 547 patients with AMI who admitted in the Second Hospital of Tianjin Medical University during January 2011 to December 2017 were retrospectively analyzed. The patients were divided into youth group (18 to 65 years old, n=176), middle-aged group (66-79 years old, n=176) and old group (80 to 99 years old, n=158). General information, laboratory examination results, Gensini score, infarction areas and coronary artery lesions were compared among three groups. Results The average age of 547 AMI inpatients enrolled was 68.5±12.8 years old. Women in the youth group were the least in the three groups（P＜0.01）. And the smoking rate of the old group was the lowest, while the middle-aged group was lower than that of the youth group（P＜0.01）. And there was no significant difference in the proportion of diabetes mellitus and hypertension among three groups（P＞0.05）. There was statistically significant difference in BUN, AST, WBC, NEU, RBC, Hb, PLT, LDL, HDL, TG and TC in the three groups, respectively(P＜0.01), while there was no statistically significant difference in SCr and ALT（P＞0.05）. The Gensini score was higher in the old group than in the other two groups, and the elderly with a score of more than 80 points were significantly richer than the youth and middle-aged groups（P＜0.01）, but the difference between the latter two groups was not statistically significant（P＞0.0167）. Most of patients in youth group were single vessel or two vessels disease, while middle-aged group and the old group were mostly multivessel disease. There was significant difference in the proportion of anterior wall and posterior wall infarction among the three groups（P＜0.01）, but there was no significant difference in inferior wall, lateral wall and right ventricular infarction（P＞0.05）. Conclusion There is significant difference in coronary lesions and clinical features of patients with acute myocardial infarction in different ages. And appropriate prevention and treatment should be selected for patients with myocardial infarction in different ages.

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Twin pregnancy with noncompaction of the ventricular myocardium: a case report #br#

XIAO Fan, FAN Zhuo-ran, HUA Shao-fang△

2020, 48 (5): 438-441. doi: 10.11958/20193905

Abstract ( 642 )

PDF (397KB) ( 3991 )

Abstract：Cardiovascular disease is an important cause of maternal death with non-obstetric factors. Noncompaction of
the ventricular myocardium (NVM) is a rare congenital cardiomyopathy. The serious complications are heart failure,
arrhythmia, and thromboembolism. Transthoracic echocardiography is the main diagnostic method. At present, the main treatment method of pregnancy combined with NVM is control symptom by medication. Meanwhile, the safety of mother and
infant should be considered. It is considered appropriate to terminate pregnancy by cesarean section. This article analyzed
the diagnosis and treatment of three cases of pregnancy with NVM and one case of twin pregnancy with NVM reported in our
hospital, hoping to improve the clinical cognition and diagnosis of this disease during pregnancy.

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Prognostic and diagnostic significance of circRNA low-expression in gastric cancer patients: A meta-analysis #br#

LIU Yun , ZHANG Man-ling, PENG Hong-jiao, SHI Zhao-hong△

2020, 48 (5): 442-448. doi: 10.11958/20192821

Abstract ( 707 )

PDF (756KB) ( 5925 )

Objective To systematically evaluate the role of the low expression level of circRNA in the diagnosis and
prognosis of gastric cancer. Methods The English databases including PubMed, EMbase and Web of Science were
systematically searched with the search time from the establishment of the database to June 2019. All eligible studies
associated with circRNA and prognosis or diagnosis in gastric cancer were included. Three researchers independently
screened the included studies, extracted data and evaluated the quality. The Stata 14.0 software was used for Meta-analysis.
Results A total of 20 relevant studies were eligible, including 9 on prognosis and 16 on diagnosis. As for
clinicopathological parameters, the low expression of antineoplastic circRNAs showed a significant association with poor
clinicopathological features. For the prognostic values, high-regulated antineoplastic circRNAs showed the favorable impact
on overall survival (HR=0.37, 95% CI: 0.29-0.48). The results revealed a sensitivity of 0.73 (95%CI: 0.66-0.79), a
specificity of 0.77 (95% CI：0.68-0.84), and an AUC of 0.81(95% CI: 0.77-0.84) for gastric cancer diagnosis with circRNAs.
Conclusion The low expression of circRNA has certain value in the prognosis and diagnosis of gastric cancer, but it still
needs more high-quality clinical research to further confirm.

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Research progress on neuroinflammation related to traumatic brain injury #br#

SONG Ge, LIU Xiao-yin, SHI Xin-yu, YE Yi-chao, ZHANG Sai △

2020, 48 (5): 449-454. doi: 10.11958/20193631

Abstract ( 741 )

PDF (410KB) ( 4216 )

After the trauma brain injury occurs, the immediate neurologic damage is produced by the traumatic forces.
This primary injury triggers a secondary wave of biochemical cascades together with metabolic and cellular changes, called
secondary neural injury. The neuroinflammatory response following traumatic brain injury is known to be a key injury factor
that can drive ongoing neuronal injury.Neuroinflammation involves cellular and molecular regulatory mechanisms including
the activation of glia (microglia and astrocytes), the releasing of inflammatory mediators within the brain, and the subsequent
recruitment of peripheral immune cells. Understanding the recent progress of inflammatory pathophysiology in TBI is crucial
for the development of more effective therapeutic strategies.

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Research progress of miR-27a in gynecological tumors

LI Pu, DU Xiao-qin

2020, 48 (5): 455-459. doi: 10.11958/20192931

Abstract ( 695 )

PDF (357KB) ( 4338 )

MicroRNAs (miRNAs)，a class of endogenous small non-coding RNAs, generally regulate gene expressions
at post-transcriptional level through mRNA degradation or translation inhibition. miRNAs are involved in multiple
physiological or pathological processes. miRNA can regulate the expression of oncogene and tumor suppressor gene to
participate in the development of tumor. Different types or different stages of tumors show distinct miRNA expression
profiles, which imply the potential applications of miRNAs. miR-27a is located at human chromosome 19 and shows
dysregulated expressions in endometrial cancer, ovarian cancer, cervical cancer and many other diseases. In this review, we
summarized the research progress of miR-27a in human gynecological tumors, providing novel insights on the development
of tumor biomarkers or therapeutic agents.

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Progress in the relationship between intestinal flora and its metabolites with cardiovascular diseases #br#

HUO Xing-yu, GENG Jie△

2020, 48 (5): 460-464. doi: 10.11958/20193425

Abstract ( 874 )

PDF (404KB) ( 5571 )

Cardiovascular disease, as a disease with high mortality and disability rates, is a constant threat to human
health. In recent years, with the continuous development of research, it has been reported that intestinal flora and its
metabolites are also involved in the occurrence and development of cardiovascular diseases (including atherosclerosis, heart
failure and hypertension). By improving the composition of intestinal flora and its metabolites can improve the progression of
cardiovascular diseases. This treatment has become a new target for the treatment of cardiovascular diseases. In this paper,
the composition of intestinal flora, the role of intestinal flora metabolites and the relationship between intestinal flora and its
metabolites and atherosclerosis, heart failure, hypertension and other diseases were reviewed.

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