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15 July 2020, Volume 48 Issue 7 Previous Issue    Next Issue

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Analysis of clinical characteristics of patients with COVID-19 in Tianjin YU Hong-zhi , SHAO Hong-xia , XING Zhi-heng , QIN Zhong-hua , FU Sha-sha , HU Song , WU Qi△ 2020, 48 (7):  577-582.  doi: 10.11958/20201093 Abstract ( 1215 )   PDF (933KB) ( 5951 )   Objective To explore the epidemiological, clinical and imaging characteristics of patients with novel coronavirus disease 2019 (COVID-19) in Tianjin. Methods The demographics, epidemiological, clinical data, laboratory tests and radiological characteristics of 135 COVID-19 patients hospitalized in Tianjin Haihe Hospital from January 21 to March 15, 2020 were retrospectively analyzed. The patients were divided into 2 groups according to the severity of illness: mild group (n=74) and severe group (n=61). The general data, clinical data and CT findings were compared between the two groups. Results In the 135 COVID-19 patients, 70 cases (51.9%) also had basic diseases. In the severe group, the comorbidity rate of arrhythmia was higher (P < 0.05), and the incidence rates of fever, fatigue, chest tightness and anorexia were higher (P < 0.05). There were 26 cases of cluster infection, involving 74 cases (54.8%). One hundred and twelve cases (83.0%) were confirmed by nucleic acid examination once. Among the 135 cases, 126 cases (93.3%) had symptoms at the time of onset, and the median time for nucleic acid to turn negative was 14 (10, 20) days. Nine cases (6.7%) were asymptomatic, with the median time 7.0 (5.5，13.0) days for nucleic acids shifted to the negative. Peripheral blood cells showed mainly lymphocyte decreased in 40 cases (29.6%), C-reactive protein (CRP) increased in 65 cases (48.1%), interleukin-6 increased in 57 cases (42.2%), D-dimer increased in 62 cases (45.9%), fibrinogen increased in 33 cases (24.4%), lactate dehydrogenase (LDH) increased in 36 cases (26.7%) and myoglobin increased in 9 cases (6.7%). Chest CT examination showed abnormalities in 127 cases (94.1%). The pathological changes were mainly distributed in the subpleural area in 122 cases (96.1%), among which ground glass density was the main manifestation in 106 cases (83.5%). In the severe group, bilateral lung involvement and the distribution of above 3 pulmonary lobes, ground glass and consolidation shadows were more common (all P <0.05). In most patients, the lesions can be absorbed by treatment, or a little fiber sliver was left. The 133 cases (98.5%) were eventually discharged after improvement, and 2 cases (1.5%) died. Conclusion The COVID- 19 in Tianjin area is mainly familial cluster, and most of them have basic diseases. The lymphocyte count is decreased obviously, and prognosis is favorable. Early chest CT examination can make up for the limitations of chest radiographs. It is recommended that chest CT examination and multiple nucleic acid tests of respiratory tract specimens should be carried out as soon as possible to achieve the early diagnosis and reduce missed diagnosis. Related Articles | Metrics

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Analysis of the correlation between clinical characteristics and disease severity in patients with novel coronavirus pneumonia ZUO Fang-tian, LI Chang-li, DONG Zhao-gang, CHANG Xin-hui, JIA Ming-ya, WEI Chao, ZHENG Xi-sheng△ 2020, 48 (7):  583-587.  doi: 10.11958/20200400 Abstract ( 1630 )   PDF (636KB) ( 5809 )   Objective To investigate clinical characteristics and their correlation with disease severity in patients with novel coronavirus pneumonia (NCP), and provide basis for rapid assessment of the disease and prediction of prognosis. Methods Data of NCP patients in Nanyang Central Hospital were collected. Patients were divided into severe group and non-severe group according to their clinical classification.The basic clinical data, laboratory and imaging examination results were compared between the two groups. Results In the 50 patients, there were 18 males (36%) and 32 females (64%), and the average age was (48.2±15.3) years. Patients included 39 non-severe cases (78%) and 11 severe cases (22%). Forty-one cases (82%) have been to Wuhan or have been in close contact with the people returning from Wuhan. Fever (98%) and fatigue (66%) were the most common clinical symptoms. Twenty-nine cases (58%) showed lymphocyte (LYM) decline, 48 cases (96%) showed multiple plaque shadows, interstitial changes or ground glass shadows in chest CT examination. The incidence of asthma, white blood count (WBC), neutrophils (NEU)%, procalcitonin (PCT), lactate dehydrogenase (LDH) and aspartate transaminase(AST) levels were higher in severe group than those in non-severe group, but OI and LYM% were lower in severe group than those of non-severe group (P＜0.05 or P＜0.01). WBC, NEU% and PCT were positively correlated with the disease severity, while LYM% was negatively correlated with the disease severity (P＜0.05). Compared with the non-severe group, NEU% was higher and LYM% was lower in the severe group (P＜0.05). The usage rates of hormones and gamma globulin were high, and patients received more ventilator support treatment in severe group. Forty-nine cases (98%) were cured and discharged from hospital. One case died in severe group, and the fatality rate was 2%. The median hospital stay was 13(11, 16) days. Conclusion Patients with NCP generally show fever, fatigue and decreased lymphocytes. The age and complications are not related to the severity of the disease. Levels of NEU% and LYM% are likely related to the severity of the disease. Related Articles | Metrics

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The clinical feature and imaging analysis of patients with new coronavirus infection in Shijiazhuang ZHAO Lei , XUE Jian , WANG Yu-ling△, DAI Er-hei , XU Zun-gui , LI Ya-nan , DUN Zi-qian , GAO Hui-xia , RONG Yan-xiao , CHEN Can 2020, 48 (7):  588-591.  doi: 10.11958/20200360 Abstract ( 1133 )   PDF (855KB) ( 5047 )   Objective To investigate clinical features and imaging manifestation of patients with the COVID-19 infection in Shijiazhuang. Methods A total of 21 patients with COVID-19 admitted in the fifth hospital in Shijiazhuang from January 21 to February 10, 2020 were selected as the research subjects. The demographic characteristics, clinical data, laboratory indexes and pulmonary imaging characteristics of patients were retrospectively analyzed. According to the age, the patients were divided into two groups: group<45 years old (n=13) and group≥45 years old (n=8). The differences in the above indicators were compared between the two groups. Results Of the 21 COVID-19 patients, 14 were male (66.7%) and 7 were female (33.3%). There were 7 families with clustered incidence (n=19). Clinical signs included fever in 15 cases (71.4%), cough in 9 cases (42.9%) and no clinical symptoms in 5 cases (23.8%). Results of laboratory examination showed that T lymphocyte subsets CD3＋ decreased in 8 cases (38.1%), CD4+ decreased in 12 cases (57.1%), CD8+ decreased in 6 cases (28.6%), leukocyte decreased in 2 cases (9.5%), neutrophil decreased in 2 cases (9.5%), lymphocyte decreased in 5 cases (23.8%), and C-reactive protein (CPR) elevated in 10 cases（47.6%）. There were no significant differences in CD3+ , CD4+ , CD8+ , leukocyte count, neutrophil and lymphocyte and CRP levels between the two age groups (P＞0.05). Of the 21 patients with COVID-19, 3 cases showed no abnormalities in CT examination. The first imaging examination before admission included chest X-rays in 11 cases and lung CT imaging in 10 cases. There were 6 cases of false negative in chest X-ray examination (missed diagnosis rate 54.5%). The lung CT examination showed positive in all 11 cases. Conclusion The COVID-19 infected patients in Shijiazhuang are mainly family-clustered cases. The T lymphocyte subtypes decrease significantly. The early chest X-ray imaging is easily misdiagnosed for COVID-19 infection Related Articles | Metrics

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Evaluation of SARS-COV-2 nucleic acid in convalescent anal swabs of patients with coronavirus disease 2019 WANG Xiao-wu, ZHU Yi-lang, LI Tuan-tuan, GAO Yong△ 2020, 48 (7):  592-595.  doi: 10.11958/20200471 Abstract ( 2254 )   PDF (367KB) ( 4756 )   Objective To analyze the detection rate and clinical value of SARS-CoV-2 nucleic acid in anal swab specimen from the convalescent patients with novel coronavirus infection (COVID-19). Methods SARS-CoV-2 nucleic acid samples were detected in convalescent patients with COVID-19 including sputum, pharyngeal swabs and anal swabs specimens. The nucleic acid positive rates of three types of specimens were analyzed. Meanwhile, the nucleic acid detection rates of sputum and pharyngeal swab specimens were analyzed in patients with the positive nucleic acid of anal swab virus. Results A total of 156 samples were collected from 50 patients with COVID 19. The positive for SARS-CoV-2 nucleic acid was 8 (19.5%) in 41 sputum samples. The positive for SARS-CoV-2 nucleic acid was 6 (10.9%) in 55 throat swab samples. The positive for SARS-CoV-2 nucleic acid was 11 (18.3%) in 60 anal swab specimen. Among the 50 convalescent patients with COVID-19, sputum, pharyngeal swabs and anal swab samples were 8 cases (19.5%), 6 cases (12.0%) and 10 cases (20.0%), respectively. In 10 patients with positive anal swab detection, 9 cases were found negative in the respiratory tract specimens. Conclusion The positive detection rate of SARS-CoV-2 nucleic acid is higher in anal swab specimen than that of laryngeal swabs and sputum specimens of the convalescent patients with COVID-19. When SARS-CoV-2 nucleic acid is negative in respiratory tract specimens, the anal swab specimen should be detected in the recovery period, which can be used as leaving hospital standard or isolation standard. Related Articles | Metrics

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Changes of blood routine examination and lymphocyte subsets in patients with COVID-19 ZHU Yi-lang , XU Yuan-hong , WANG Xiao-wu , LI Mei , GAO Yong△ 2020, 48 (7):  596-598.  doi: 10.11958/20200588 Abstract ( 1955 )   PDF (344KB) ( 5219 )   Objective To investigate the changes of blood routine examination and lymphocyte subsets in patients with coronavirus disease 2019 (COVID-19). Methods Sixty-six confirmed COVID-19 patients admitted to Fuyang Second People's Hospital from January to February 2020 were included in this study.Fifty-six patients suspected but ultimately not diagnosed as novel coronavirus (SARS-CoV-2) infection were used as the control group. Changes of blood routine examination and lymphocyte subsets were compared between the two groups. Logistic regression analysis was used for analysing blood cytological factors of COVID-19 patients. Results Compared with the control group, white blood cell (WBC), neutrophils (NEU), lymphocytes (LYM), CD4+ T cells, CD8+ T cells, and B lymphocytes were all reduced in COVID- 19 group (P＜0.05). Logistic regression analysis showed that the higher levels of CD4+ T-lymphocytes were protective factor for SARS-CoV-2 infection (OR=0.997,95%CI:0.994-0.999). Spearman analysis showed that CD4+ T cells and LYM count were positively correlated (rs =0.829, P＜0.01). Conclusion COVID-19 can cause the decrease of peripheral blood T lymphocyte count in patients. T lymphocyte subsets provide relatively reliable reference for clinical diagnosis and treatment of SARS-CoV-2 infection. Related Articles | Metrics

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The influence of coronary heart disease on the development and prognosis of COVID-19 patients PENG Ming, LI Yu-kai, WANG Lan, XIAO Jie, CHENG Zhong△ 2020, 48 (7):  599-602.  doi: 10.11958/20200773 Abstract ( 1075 )   PDF (350KB) ( 5425 )   Objective To investigate the effect of coronary heart disease (CHD) on the development and prognosis of corona virus disease 2019 (COVID-19) patients. Methods Eighty cases of COVID-19 cured and discharged from our hospital were analyzed retrospectively, including 58 cases of common type, 14 cases of severe type and 8 cases of critical type. The patients were divided into two groups: 36 patients with CHD and 44 patients without CHD. The general data including age, sex, body mass index, blood oxygen saturation, heart rate, blood pressure, days of hospitalization, days needed for obvious improvement of pulmonary CT, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) medication and disease classification were compared between the two groups. The test results including white blood cell count (WBC), lymphocyte count (LYM), C-reactive protein (CRP), liver and kidney function were also compared between the two groups. Results Compared with the patients without CHD, the patients with CHD showed lower blood oxygen saturation, faster heart rate, longer hospital stay, longer days for improvement of chest CT and higher proportion of patients taking ACEI/ARB drugs (all P＜0.05). The levels of WBC and LYM were significantly lower in the patients with CHD than those without CHD, while the level of CRP was higher (P＜ 0.05). The proportion of severe and critical patients with CHD was significantly higher than that of patients without CHD, and the proportion of severe and critical patients with COVID-19 taking ACEI/ARB drugs was higher than that of patients without taking drugs (P＜0.05). Conclusion The condition of COVID-19 patients with CHD is more serious. ACEI/ARB drugs may aggravate the condition of patients with COVID-19. Related Articles | Metrics

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Coronavirus disease 2019 with only positive symptoms and signs in the early stage: a case report YUAN Lian-fang , LIU Li-li , FENG Yi 2020, 48 (7):  603-605.  doi: 10.11958/20200361 Abstract ( 715 )   PDF (430KB) ( 4894 )   Abstract: The coronavirus disease 2019 (COVID-19) is highly infectious and easy to be misdiagnosed and missed in the early stage, leading to the spread of the epidemic. Clinical data including blood routine test, chest computed tomography (CT) and viral nucleic acid detection were negative in some patients, they were finally diagnosed as COVID-19 because of their suspicious history of close contact, and in the subsequent tracking some of the patients showed positive images or laboratory test results. In this process, such patients may have the risk of infecting others, which should be given clinical attention. Here we report one case with normal initial blood routine examination, chest CT and viral nucleic acid detection, but diagnosed as COVID-19 in the later stage. This paper summarizes the experience of diagnosis and treatment of the case is summarized. Related Articles | Metrics

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Effects of cannabinoid receptor 2 agonist AM1241 on proliferation, activation and apoptosis of HSC-T6 cells induced by TGF-β1 LONG Cui-zhen , SHU Yuan-hui , HE Ping, , WANG Yu-ping, △ 2020, 48 (7):  606-610.  doi: 10.11958/20193580 Abstract ( 883 )   PDF (651KB) ( 5784 )   Objective To investigate the effects of cannabinoid receptor 2 agonist AM1241 on the proliferation, activation and apoptosis of rat hepatic stellate cells (HSC-T6) induced by TGF-β1 and the related mechanism. Methods HSC-T6 cells were treated with different concentrations of AM1241 (0, 20, 40, 80 and 160 μmol/L) for 24 hours. Cells of each group were given TGF-β1 (5 μg/L) simultaneously. The effect of AM1241 on the proliferation of HSC-T6 cells was detected by CCK-8 assay. HSC-T6 cells were divided into negative control group, TGF- β1 group, 30 μmol/L AM1241 group and 60 μmol/L AM1241 group. Flow cytometry was used to detect the effect of AM1241 on HSC-T6 apoptosis. HSC-T6 cells were divided into negative control group, TGF- β1 group and 30 μmol/L AM1241 group (according to CCK-8 assay). IC50 was calculated. The protein levels of α-smooth muscle actin (α-SMA), basic fibroblast growth factor (bFGF), apoptosis-related protein Bax, cleaved caspase-3 and phosphorylated c-Jun amino terminal kinase (p-JNK) were detected by Western blot assay. Results Compared with TGF-β1 group, AM1241 showed an inhibitory effect on the proliferation of HSC-T6 cells in a dose-dependent manner (P＜0.05). When IC50 of AM1241 was 27 μmol/L, the apoptosis rates of HSC-T6 were significantly higher in AM1241 groups (30 and 60 μmol/L) than those in TGF - β1 group, and it was significantly higher in 60 μmol/L AM1241 group than that of 30 μmol/L AM1241 group (P＜0.05). The protein levels of α-SMA and bFGF were significantly lower in 27 μmol/L AM1241 group than those in the TGF-β1 group (P＜0.05). The protein levels of Bax, cleaved caspase-3 and p-JNK were significantly upregulated in AM1241 group than those of the TGF-β1 group (P＜0.05). Conclusion The cannabinoid receptor 2 agonist AM1241 can inhibit the proliferation and activation of HSC-T6 cells induced by TGF-β1 and promote the apoptosis of HSC-T6 cells, which may be related to the JNK pathway. Related Articles | Metrics

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Effects of macrophage polarization on the activation of cardiac fibroblast WU Hui-juan , ZHANG Sheng-xi , YANG Xiao , HU Yin-ming , WANG Le-xun△, GUO Jiao 2020, 48 (7):  611-615.  doi: 10.11958/20200169 Abstract ( 1248 )   PDF (703KB) ( 5927 )   Objective To observe the effects of macrophage polarization supernatant on the activation of cardiac fibroblasts. Methods Bone marrow cells and cardiac fibroblasts of SD rats were extracted. Bone marrow cells were induced to M1 and M2 by treating with macrophage colony-stimulating factor (M-CSF), and cells were divided into M0 group (no stimulating factor), M1 group (100 μg/L LPS+10 μg/L INF-γ) and M2 group (20 μg/L IL-4). Different macrophages were co-cultured with cardiac fibroblasts, and different macrophage supernatants were collected to culture with cardiac fibroblasts. Immunofluorescence was performed to examine the fibrotic protein expression in cardiac fibroblasts. The mRNA levels of macrophage-specific molecules, fibrosis-related genes and signaling pathways were tested by real-time PCR. The fibrosis-related proteins and the activation of TGFβR and PDGFRs signal pathways were detected by Western blot assay.Results After treatment with M-CSF and stimulating factors, M1 macrophages and M2 macrophages were induced. Compared with the M0 group, the mRNA levels of Col1a1 and Col3a1 and the protein level of α-SMA were significantly decreased in the cardiac fibroblasts treated by the supernatant of M1 macrophage group (P＜0.05), while the mRNA levels of Col1a1 and Col3a1 and the protein levels of CCN2 and α-SMA were significantly increased in the cardiac fibroblasts treated by the supernatant of M2 macrophage group (P＜0.05).The phosphorylated protein level of PDGFRβ was significantly lower in the cardiac fibroblasts treated by the supernatant of M1 macrophage group than those in the cardiac fibroblasts treated by the supernatant of M0 macrophage group (P＜0.01), while phosphorylated PDGFRβ protein levels were significantly higher in the cardiac fibroblasts treated by the supernatant of M2 macrophage group than those in the cardiac fibroblasts treated by the supernatant of M0 macrophage group (P＜0.05). Conclusion M1 macrophage supernatant can inhibit the activation of cardiac fibroblasts, while M2 macrophage supernatant can activate cardiac fibroblasts. The inhibitory effect of M1 macrophages on fibrosis may be related to restraining the activation of PDGFRβ pathway. Related Articles | Metrics

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Screening of K-RAS mutation related lincRNA in colorectal carcinoma based on TCGA database BAI Xue, HE Ping△ 2020, 48 (7):  616-620.  doi: 10.11958/20192718 Abstract ( 994 )   PDF (1004KB) ( 5980 )   Objective To screen K-RAS mutation related key intergenic non-coding RNAs (lincRNA) in carcinoma of colon and rectum (CRC). Methods RNA-Seq and clinical data from the Cancer Genome Atlas (TCGA) were used to identify K-RAS mutation related lincRNA in CRC. The receiver operating characteristic (ROC) curves were used to analyze the relationship between differentially expressed lincRNA and the 5-year and 10-year survival rates of K-RAS wild-type or mutant patients. The key lincRNA was select. Kaplan-Meier survival curve was used to analyze the impact of the key lincRNA expression on the 5-year and 10-year survival rates of patients. The relationship between the key lincRNA and clinical characteristics was also analyzed. Results A total of 585 cancer tissue samples and 51 normal tissue samples were analyzed for RNA-Seq data. From the data, 6 452 lincRNAs were obtained, of which 85 were up-regulated and 40 were down-regulated. Twelve lincRNAs differentially expressed genes in K-RAS mutants were selected, among which AL390719.2 was the key prognosis lincRNA with K-RAS mutations. Survival analysis results showed that the expression of lincRNA AL390719.2 in the K-RAS mutant was related to the 10-year survival rate (Log-rank χ2 =10.740, HR=3.255, P= 0.002) and 5-year survival rate (Log-rank χ2 =11.720, HR=3.142, P=0.001) of patients. The expression of lincRNA AL390719.2 in the K-RAS wild type was not related to the prognosis (10-year: Log-rank χ2 =1.400, HR=0.822, P=0.221; 5- year: Log-rank χ2 =1.997, HR=0.774, P = 0.086). Patients with high expression of AL390719.2 showed a late clinical stage, and prone to lymph node metastasis and distant metastasis. Conclusion The high expression of lincRNA AL390719.2 is related to the poor prognosis and survival of K-RAS mutant CRC, which may be a new prognostic marker and therapeutic target of CRC. Related Articles | Metrics

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The effect and mechanism of miR-322 on high altitude pulmonary hypertension in rats ZHANG Feng-tao , LI Xiao-hong , WANG Jing-jing , SUN Hong-tao , CHEN Chong , CHEN Feng△ 2020, 48 (7):  621-624.  doi: 10.11958/20193959 Abstract ( 879 )   PDF (1296KB) ( 4329 )   Objective To explore the effect and mechanism of miR-322 on the occurrence and development of pulmonary hypertension at high altitude. Methods Forty SPF male rats were randomly divided into 4 groups (n=10): normoxic group (Normoxia), hypoxia group (Hypoxia), blank virus + hypoxia group (no load group) and miR-322 inhibition + hypoxia group (miR-322 group). The dead rats during the experiment were excluded, and eventually there were 10 rats in normoxic group, 9 rats in hypoxia group, empty load group and miR-322 group respectively. The pulmonary arterial oxygen partial pressure [p (O2)] and mean pulmonary artery pressure (mPAP) were measured. HE staining was used to observe the changes of lung tissue. The expression of α-SMA was observed by immunofluorescence. miR-322 and apelin mRNA gene expressions in rat lung tissues were detected by real-time PCR. The expression of apelin protein in rat lung tissue was detected by Western blot assay. Results There were no significant differences in p (O2), mPAP and indicators of lung tissues between hypoxia group and no-load group. Compared with the normoxic group, the relative expressions of mPAP, α- SMA, apelin protein and miR-322 were increased, and p (O2) was decreased in the hypoxia group (P＜0.05). The lung tissues were severely damaged and a large number of inflammatory cells infiltrated. Compared with hypoxia group, the relative expressions of mPAP and miR-322 were decreased in miR-322 group, the p (O2) in pulmonary artery and the relative expression of apelin protein increased, α-SMA and lung tissue damage decreased (P＜0.05). Conclusion The inhibition of miR-322 expression promotes the expression of apelin in rats with high altitude pulmonary hypertension and reduces the rise of high altitude pulmonary hypertension. Related Articles | Metrics

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Correlation between TLR4 gene and its methylation level in non-alcoholic steatohepatitis rats XU Hui-chao, GAO Yan, MENG Ya-nan, CHEN Hao, HAO Jian-heng, LIU Jin-fang, LIU Yang, MIAO Yu-chuan△ 2020, 48 (7):  625-629.  doi: 10.11958/20193587 Abstract ( 743 )   PDF (963KB) ( 3960 )   ：Objective To observe the expression of Toll-like receptor 4 (TLR4) gene and its methylation level in liver of non-alcoholic steatohepatitis (NASH) model rats, and explore the correlation between the two in the pathogenesis of NASH. Methods Twenty rats were randomly divided into normal group and model group,with 10 rats in each group. Rats in the normal group and the model group were fed with ordinary diet and high-fat and high-sugar diet. Rats were sacrificed after 24 weeks. The body weight and liver weight of the rats were measured. The serum samples and liver tissues were collected under low temperature conditions. The morphological staining was used to observe morphological changes,steatosis and inflammatory cell infiltration of hepatocytes. The serum levels of alanine aminotransferase (ALT), aspartic aminotransferase (AST),triglyceride (TG) and total cholesterol (TC) were detected by ELISA.The expression of CD68 protein in liver was detected by immunohistochemistry. The expression of TLR4 protein in liver was detected by Western blot assay. Real-time fluorescence quantitative PCR was used to detect the mRNA content of TLR4 in liver. Methylation of TLR4 gene in liver was detected by bisulfite sequencing PCR (BSP). Results Compared with the normal group，the volume of liver cells became larger, a large number of fat vacuoles appeared, and inflammatory cell infiltration was obvious; The liver index increased in the model group, the serum levels of AST,ALT,TG and TC increased significantly (P＜0.01). The expressions of TLR4 and CD68 protein increased significantly (P＜0.01). The mRNA content of TLR4 gene increased obviously (P＜0.01)， and its methylation level decreased (P＜0.01). Conclusion The expression of TLR4 gene is negatively correlated with its methylation level in the liver of NASH model rats. The reduction of TLR4 gene methylation level plays an important role in the pathogenesis of NASH. Related Articles | Metrics

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The protective effect of curcumin analogue H8 on the heart of diabetic rats ZHONG Chong-qi , SUN Wen-hui , YANG Jun-qiang , WANG Meng , SHANG Rui-zhu , ZHANG Mei-le , WEI Xiu-fang , YUAN Xiao-huan△ 2020, 48 (7):  630-634.  doi: 10.11958/20200081 Abstract ( 838 )   PDF (625KB) ( 6139 )   Objective To investigate the effect and mechanism of curcumin analogue H8 on cardiac structure and function in diabetic cardiomyopathy rats. Methods Twenty-four male SD rats were randomly divided into control group, model group and H8 group with 8 rats in each group. The model group and H8 group were given high-fat and high-sugar diet for 8 weeks and then intraperitoneally injected with streptozotocin (STZ) to establish the model of type 2 diabetes mellitus. H8 group was given H8 (6 mg/kg) for 4 weeks, while the control group and model group were given the same amount of sodium carboxymethylcellulose for 4 weeks. At the end of the 4th week, echocardiography was used to evaluate the cardiac structure and function of rats in each group. Then the rats were killed. The biochemical indexes, pathological changes of myocardium, lactate dehydrogenase (LDH), total superoxide dismutase (T-SOD) and malondialdehyde (MDA) contents in myocardium were measured. Results Compared with the control group, the left ventricular wall motion was weakened, ventricular remodeling was obvious, left ventricular ejection fraction (LVEF) and fractional shortening (FS) were decreased, blood sugar, total cholesterol and triglyceride levels were significantly increased, myocardial cell structure was disordered, the contents of LDH and MDA in myocardial tissues were significantly increased, and the content of T-SOD decreased significantly in the model group (P＜0.05). Compared with the model group, the left ventricular wall motion, ventricular remodeling, LVEF, FS and cardiac arrays were significantly improved, blood sugar, total cholesterol and triglyceride levels were significantly decreased, LDH and MDA in myocardial tissues decreased, the content of T-SOD increased significantly in the rats of H8 group (P＜0.05). Conclusion Curcumin analogue H8 has a protective effect on myocardial injury in diabetic rats. Its mechanism may be related to the inhibition of ventricular remodeling, improvement of cardiac function and reduction of blood glucose, blood lipid and oxidative stress factors. Related Articles | Metrics

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The diagnostic efficiency of MRC combined with fecal calprotectin in the activity of ulcerative colitis MENG Xiang-lu, , SUN Ji-wei , WANG Huan , DAI Li-mei , ZHAO Shao-li , ZHAO Yu-meng , FENG Ling-ling , WANG Wen-hong△ 2020, 48 (7):  635-641.  doi: 10.11958/20192763 Abstract ( 1075 )   PDF (604KB) ( 4441 )   Objective To evaluate the diagnostic value of magnetic resonance colonography (MRC) combined with fecal calprotectin (FC) in the activity degree of ulcerative colitis (UC). Methods Forty-one patients with active UC were collected as the case group, and they were subdivided into mild and moderate active group (n=12) and severe active group (n= 29) according to the mayo endoscopic score(MES).During the same period, 32 healthy subjects were used as the control group. According to MES, 192 sections of intestine after colonoscopy were divided into normal segment group (n=39), mild and moderate active segment group (n=45) and severe active segment group (n=108). The thickness and the signal intensity anterior and posterior enhanced of the intestinal wall of each segment were measured, and edema of the intestinal wall, enlarged lymph nodes or comb sign were evaluated. The simplified MRC index (MRC-S) was obtained by Logistic regression analysis. The ROC curve was drawn to analyze the optimal threshold value of MRC-S for the diagnosis of intestinal segment lesions. FC concentration was measured in control group and case group. ROC curve was used to analyze the optimal threshold value for FC diagnosis of lesion activity. The diagnostic efficacy of MRC-S, FC and their combination were analyzed on UC lesion activity. Results The mean value or occurrence frequency of MRC parameters were higher in the mild and moderate group and severe active bowel group than those in the normal bowel group (P＜0.05). There were no significant differences in intestinal wall thickness between the severe active bowel group and the mild and moderate active bowel group. The diagnostic values of MRC-S in both active (MRC-S≥1) and severely active (MRC-S≥2) bowel lesions were higher (AUC was 0.979 and 0.881, respectively). The diagnostic values of FC were higher in both active (FC≥92.9 μg/g) and severely active (FC≥3 003.8 μg/g) UC patients (AUC was 1.000 and 0.958, respectively). MRC-S combined with FC showed obvious diagnostic specificity for patients with severe active UC (91.7%). Conclusion Both MRC-S and FC have a high value in the diagnosis of the disease activity in UC patients.The combination of the two of them can further improve the specificity of diagnosis. Related Articles | Metrics

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Comparison of the predictive values of different SYNTAX scores on the clinical outcome of patients after coronary artery bypass grafting ZHANG Zi-yue , LIU Yu-jie△, ZHANG Ying , ZHOU Jia 2020, 48 (7):  641-646.  doi: 10.11958/20193145 Abstract ( 809 )   PDF (485KB) ( 4728 )   Objective To evaluate the predictive values of SYNTAX score (SS) and SYNTAX score Ⅱ (SS-Ⅱ) for the long-term outcomes of patients after coronary artery bypass grafting (CABG). Methods Data of 308 consecutive patients underwent CABG were collected in this study. The SS and SS-Ⅱ scores were calculated for each patient. Patients were stratified into low, middle and high score groups according to the tertiles of SS and SS-Ⅱ. The major adverse cardiovascular events (MACE) were followed up for patients. Kaplan-Meier was used for survival analysis. ROC curve and Cox regression analysis were used to evaluate the predictive values of SS and SS-Ⅱ for MACE. Results At a median follow-up of 63 months, the cumulative incidence of MACE was 30.5%. According to either SS or SS-Ⅱ, there were significant differences in MACE, repeat revascularization and non-fatal myocardial infarction between the three groups (P＜0.01). There were significant differences in the cumulative survival rates of non-MACE between three groups (P＜0.01). SS (AUC=0.664) and SS-Ⅱ (AUC=0.751) were reliable predictors of MACE. The predictive effect of SS-Ⅱ for MACE was significantly higher than that of SS (Z=2.296，P＜0.05). Multivariate Cox regression analysis showed that SS (HR 2.577 for the middle group; HR 4.428 for the high group) and SS-Ⅱ (HR 2.343 for the middle group; HR 5.108 for the high group) were risk factors for MACE. Conclusion Both SS and SS-Ⅱ are correlated with MACE in patients after CABG, and they are predictors for evaluating the long-term prognosis of patients with coronary heart disease treated with CABG. The predictive value of SS-Ⅱ for MACE is better than that of SS. Related Articles | Metrics

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Clinical analysis of 21 primary non-Hodgkin's lymphoma of the tonsil CAO Li-hong , ZHAO Xue , LI Yao , WANG Jian-ling△ 2020, 48 (7):  647-650.  doi: 10.11958/20200754 Abstract ( 835 )   PDF (1095KB) ( 4241 )   Objective To investigate the clinical and pathological features, treatment and prognosis in primary nonHodgkin's lymphoma (NHL) of the tonsil. Methods Data of 21 patients with tonsil NHL treated in Tianjin Medical University General Hospital from Jan 2007 to Jan 2014 were retrospectively analyzed. Results A total of 21 cases of original tonsil NHL accounted for 2.6% (21/807) of pathological diagnosis of tonsil surgery during the same period. There were 13 males and 8 females, the mean age was（50.8±12.9）years old. The unilateral disease were 19 cases (90.5%). The pathological classification: 20 cases (95.2%) were B-cell subtype including diffuse large B-cell lymphoma (DLBCL) 13 cases (61.9%), follicular lymphoma (FL) 4 cases (19.0%) and mucosa associated lynmphoid tissue (MALT) 3 cases (14.3%); 1 case was T-cell subtype (4.8%). According to the Ann-Arbor standard, 18 cases (85.7%) were stage Ⅰ-Ⅱ, 3 cases (14.3%) were stage Ⅲ - Ⅳ . The 5 year survival of stage Ⅰ - Ⅱ patients was 71.4%, of stage Ⅲ - Ⅳ patients was 0%. Conclusion Primary tonsil NHL is rare and the prognosis at early stages is good. The key to improve the 5-year survival rate is to pay attention to the early diagnosis and treatment of the disease. Related Articles | Metrics

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The effect of perioperative anesthesia management on alanine aminotransferase recovery in patients with liver cancer WEI Jin, YU Ling, TAN Hong-yu△ 2020, 48 (7):  650-653.  doi: 10.11958/20193933 Abstract ( 789 )   PDF (379KB) ( 5143 )   Objective To explore the related factors of anesthesia that affect the recovery of alanine aminotransferase (ALT) in patients after hepatectomy. Methods Clinical data of 177 liver cancer patients underwent hepatectomy were retrospectively collected. Patients whose ALT returned to normal or less than the preoperative baseline on the fifth postoperative day were classified as ALT recovery group (n=78). Patients whose ALT did not return to normal and was higher than the preoperative baseline were classified as ALT un-recovery group (n=99). Single factor analysis and binary Logistic regression were conducted to screen out the independent risk factors of ALT recovery. Results The median value of ALT, central venous pressure (CVP) and lactate were lower in ALT recovery group on the fifth day after operation than those in the ALT un-recovery group. The proportion of patients with resection range exceeding 3 liver segments and postoperative body temperature ＜ 35.5 ℃ was lower in the ALT recovery group than that of the ALT un-recovery group, while the proportion of patients with operation time ≤ 180 min was higher in the ALT recovery group than that in the ALT un-recovery group (P＜ 0.05). Binary Logistic regression showed that higher postoperative lactate level (OR=1.526，95%CI: 1.105-2.107), lower CVP (OR=1.170，95%CI: 1.017-1.346) and resection range exceeding 3 liver segments (OR=2.487，95%CI: 1.185-5.216) were independent risk factors of ALT recovery. Conclusion The increased value of lactate after surgery, the decreased value of CVP and large range of hepatic resection may affect the recovery of ALT in patients with liver cancer. Related Articles | Metrics

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EC50 and EC95 of ropivacaine for ultrasound-guided llioinguinal, lliohypogastric and genitocrural nerve block in aged patients with inguinal hernia SUN Yi, WANG Hai-yun, HUA Wei△, ZHAO Ming-shu 2020, 48 (7):  654-656.  doi: 10.11958/20193828 Abstract ( 792 )   PDF (760KB) ( 4627 )   Objective To determine the median effective concentration (EC50) and 95% effective concentration (EC95) of ropivacaine for ultrasound-guided llioinguinal, lliohypogastric and genitocruralnerve block in aged patients with inguinal hernia. Methods Thirty-five male patients, American Society of Anesthesiologists physical status Ⅱ or Ⅲ, body mass index 19-27 kg/m2 , aged 65-79 yr, scheduled for elective unilateral tension-free inguinal hernia repair were included in this study. Patients received an ultrasound-guided llioinguinal, lliohypogastric, and genitocrural nerve block. After successful location 10 mL ropivacaine was injected at each puncture point. The sensory block of the areas innervated by the nerves were assessed by pin-prick test. The painless of the areas innervated by target nerves (VAS=0) at the beginning of operation was regarded as the effective block. The concentration of ropivacaine was determined by Dixon up-and-down method. The initial concentration was 0.3%. When the block was effective, the next patient was given the low first-order concentration, on the contrary, the patient was given the high first-order concentration. The ratio between the adjacent concentrations was 1∶1.1. The EC50, EC95 and their 95% confidence interval (CI) were calculated by probit analysis. Results Eighteen (51.4%) in a total of 35 patients received a successful nerve block.The EC50 of ropivacaine was 0.263% (95%CI: 0.248%-0.280%) and the EC95 was 0.348% (95%CI: 0.323%-0.371%). Conclusion The EC50 and EC95 of ropivacaine for ultrasound-guided llioinguinal, lliohypogastric and genitocrural nerve block are 0.263% and 0.348% in aged patients with inguinal hernia respectively. Related Articles | Metrics

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Establishment and evaluation of a predictive model for probability of death in patients with pulmonary tuberculosis during directly observed treatment short-course XIE Yi, , HAN Jing , YU Wei-li , HOU Zhi-li, , WU Qi, △ 2020, 48 (7):  657-661.  doi: 10.11958/20200111 Abstract ( 831 )   PDF (437KB) ( 4238 )   Objective To establish and evaluate a mathematical model for predicting the probability of death in patients with pulmonary tuberculosis (TB) during directly observed treatment short-course (DOTS) and to provide evidences for reducing TB-related mortality． Methods Retrospective cohort analysis was used to collect the basic information, disease characteristics and treatment outcomes of 7 032 TB patients from National TB Management Information System in Tianjin from 2014 to 2017. The multivariate and unconditional Logistic regression analysis was used to select the variables, and establish a predictive model for probability of death in patients with pulmonary TB during DOTS. The goodness of fit of the predictive model for probability of death was evaluated by Hosmer-Lemeshow test, and the receiver operating charactenstic (ROC) curve was constructed to assess the performance of the prediction model. Results There were 6 711 living cases (survival group) and 321 dead cases (death group) in 7 032 TB patients during DOTS, and the mortality rate was 4.56%. Multivariate Logistic regression analysis showed that male (OR=1.922), older age (OR=1.062), retreatment of tuberculosis (OR=1.539), first sputum bacteria positive (OR=1.936), delayed seeking medication (OR=1.401) and human immunodeficiency virus (HIV) positive (OR=4.153) were independent risk factors of mortality in the TB patients. The Logistic regression equation was established as follows: Logit (P) =ln [P/(1-P)] = 0.653X1 +0.061X2 +0.431X4 +0.661X5 + 0.337X6 +1.424X9-9.191. The values of area under the ROC curve were 0.806 (95%CI：0.784-0.828). The best critical point of prediction probability was 0.054, the sensitivity was 76.36% and the specificity was 81.58%. Conclusion As a predictive model for probability of death in the TB patients during DOTS, its fitting degree and prediction efficiency of the Logistic regression model are better, and the model has better prediction value. Related Articles | Metrics

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Meta-analysis of long-term follow-up of hybrid coronary artery revascularization and coronary artery bypass grafting in the treatment of multiple coronary artery disease YAO Bo-chen , BAI Yun-peng , REN Min , JIANG Nan , WANG Lian-qun , GUO Zhi-gang△ 2020, 48 (7):  662-669.  doi: 10.11958/20193274 Abstract ( 688 )   PDF (813KB) ( 3926 )   Objective To systematically evaluate the long-term efficacy and complications of hybrid coronary artery revascularization (HCR) and coronary artery bypass grafting (CABG) in the treatment of the multiple coronary artery disease. Methods The databases of Embase, PubMed, Web of Science, Cochrane Central Registry of Controlled Trials (Central), Wanfang Data and China Knowledge Network were systematically searched. The documents that met the inclusion criteria were screened, and the odds ratio (OR) and 95% confidence interval (CI) were calculated. RevMan 5.3 software was used for meta-analysis. Results Nine articles were included in the study. A total of 4 030 subjects were included, of which 1 142 were treated with HCR and 2 888 were treated with conventional CABG. Postoperative mortality (OR=0.72, 95%CI: 0.54- 0.96) and major cardiovascular and cerebrovascular events (MACCE, OR=0.54, 95%CI: 0.35-0.82) were lower in HCR group than those of CABG group in the mid- and long-term follow-up. There were no significant differences in the revascularization (OR=0.90, 95%CI: 0.61-1.34) and the incidence of angina (OR=0.51, 95%CI:0.18-1.41) between the two groups. In the midterm follow-up, the incidence of MACCE was lower in the HCR group than that in the conventional group (OR=0.31, 95%CI: 0.15-0.66), while there were no significant differences in the mortality (OR=0.79, 95%CI: 0.52-1.22),revascularization (OR=0.90, 95%CI: 0.61-1.34) and the incidence of myocardial infarction angina (OR=0.71, 95%CI: 0.05- 9.46) between the two groups. In the long-term follow-up, the postoperative mortality (OR=0.67, 95%CI: 0.54-0.96) and the incidence of myocardial infarction angina (OR=0.32, 95%CI: 0.15-0.68) were significantly lower in HCR group than those of the CABG group. There were no significant differences in MACCE (OR=0.72, 95%CI: 0.43-1.21) and revascularization (OR= 0.93, 95%CI: 0.60-1.45) between the two groups. Conclusion Compared with CABG, HCR can reduce the medium-term MACCE, long-term all-cause mortality and myocardial infarction/angina pectoris in patients with multi-vessel coronary artery disease. Related Articles | Metrics

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Research progress on the role of STAT5 in tumors ZHAO Yu, ZHANG Jun-ling, FENG Guo-xing, FAN Sai-jun△ 2020, 48 (7):  670-676.  doi: 10.11958/20192852 Abstract ( 1449 )   PDF (503KB) ( 5646 )   Signal transducer and activator of transcription 5 (STAT5) is a member of signal transducer and activator of transcription family, which has two highly homologous subtypes: STAT5A and STAT5B. STAT5 is widely involved in various biological processes such as cell proliferation, differentiation, apoptosis, senescence, hematopoiesis and immunity. The dysregulation of STAT5 is closely related to the occurrence and development of malignant tumors such as leukemia, breast cancer, prostate cancer, melanoma and thyroid cancer. STAT5 can also affect tumor radiotherapy and chemotherapy as well as prognosis of patients. Nowadays, STAT5 has become a key target for cancer treatment. Targeting STAT5 could increase the radiosensitivity of prostate cancer, head and neck cancer and other tumors, which provided a new strategy for tumor treatment. This article reviews the role of STAT5 in several malignant tumors and strategies of targeting STAT5. Related Articles | Metrics

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Overview of detection techniques for neutrophil extracellular traps CHEN Yu-nian , GU Bing , LI Hua-nan△ 2020, 48 (7):  676-681.  doi: 10.11958/20193431 Abstract ( 1530 )   PDF (441KB) ( 4252 )   Abstract：Neutrophil extracellular traps (NETs) are a newly recognized structure in recent years, which is involved in the pathogenesis of autoimmune diseases, thrombosis and inflammatory reaction. NETs can be induced to different forms of reticular structure by a variety of trigger factors and can be quantified by various techniques. According to the different subjects, the analysis methods include morphological observation, detection of cell free DNA and neutrophil elastasemyeloperoxidase, citrullinated histone and other protein components. In this paper, the advantages and disadvantages of these detection techniques are summarized, which will provide useful reference for the further development of the application of NETs in the early diagnosis and prognosis judgment of related diseases. Related Articles | Metrics

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Research progress of biodegradable magnesium alloys for fracture fixation and bone repair materials JIANG Hong-feng , CHEN Min-fang△, LIU De-bao 2020, 48 (7):  682-688.  doi: 10.11958/20200320 Abstract ( 871 )   PDF (481KB) ( 3496 )   In recent years, biodegradable magnesium-based alloys are showing great potential to be used as a new class of materials and are attracting much attention owing to their characteristics of biodegradation and good osteogenesis inductivity, biocompatibility and other biofunctional properties. These advantages make them promising candidates for fracture fixation and bone repair applications. This paper summarizes the advantages, history, challenges and the recent research progress of biodegradable magnesium-based alloys for orthopedic application. Related Articles | Metrics