Tianjin Medical Journal

The protective effect of alpinetin on chondrocyte damage induced by lipopolysaccharide

DAI Wan-wu, HUANG Zu-quan, ZHANG Bo, DU Yong-jun, LI Xing-yan

2020, 48 (12): 1137-1141. doi: 10.11958/20201496

Abstract ( 1342 )

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Objective To explore the protective effect of alpinetin on lipopolysaccharide (LPS)-induced rat chondrocytes damage and its mechanism. Methods The chondrocytes from the knee joints of suckling rats were isolated and cultured. They were divided into control group, LPS induction group (model group) and LPS induction plus alpinetin treatment group (alpinetin group). LPS were used to induce inflammation in the model group and the alpinetin group. The alpinetin group was treated with different concentrations of alpinetin after LPS induction. The CCK-8 method was used to detect chondrocyte activity, and the inflammation protection was observed by fluorescein diacetate/propidium iodide (FDA/PI) staining, real-time PCR (qPCR) and immunofluorescence staining effect. Results CCK-8 suggested that when the concentration of alpinetin was 5 mg/L, the absorbance of chondrocytes was the highest. FDA/PI staining results showed that the number of live cells was reduced in the model group compared with that the control group, while the number of dead cells were increased. Compared with the model group, the number of live cells were increased in the alpinetin group, while the number of dead cells decreased. qPCR results showed that the expression levels of interleukin-1β (IL-1β), IL-6, inducible nitric oxide synthase (iNOS) , tumor necrosis factor (TNF-α) and human matrix metalloproteinase-13 (MMP-13) gene were decreased in the alpinetin group compared with those of the model group, while the expression level of type Ⅱ collagenase (Col2a1) was increased (P＜0.05). Immunofluorescence staining indicated that the expression level of IL-6 was significantly reduced in the alpinetin group compared with that of the model group. Conclusion Alpinetin can effectively protect the inflammatory damage of chondrocytes induced by LPS and promote the proliferation of chondrocytes, which provides a theoretical basis for the treatment of osteoarthritis.

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Effects of naringin on differentiation and polarization of osteoclasts

LIU Zhao-hui, MA Jian-xiong, TIAN Ai-xian, SUN Xiao-lei, ZHANG Yang, GUO Yue, MA Xin-long, △

2020, 48 (12): 1141-1145. doi: 10.11958/20202336

Abstract ( 959 )

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Objective　To investigate the effects of naringin on the differentiation and polarization of osteoclast. Methods　RAW264.7 cells were induced using culture media containing different concentrations of naringin (0 μg/L, 2 μg/L, 20 μg/L, 200 μg/L). The results of induction and expression levels of CK, MMP-9, integrin β3, c-src and p-src were compared between groups. Results　Compared with the control group, TRAP staining positive cell number was significantly reduced in the experimental group (P＜0.05). Compared with the control group, the mRNA expression levels of CK, MMP-9, integrin β3 and c-src were significantly reduced in 20 μg/L and 200 μg/L groups (P＜0.05), and the protein expression levels of CK, MMP-9, integrin β3 and p-src were also significantly reduced (P＜0.05). Conclusion　Naringin might inhibit the differentiation and polarization of osteoclast, and the effects might be related to the down regulation of integrin β3, c-src and p-src expressions.

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LncRNA-MALAT1 regulates the proliferation and apoptosis of colorectal cancer cells through the miR-142-3p/TEAD1 molecular axis

ZHANG Zhi-cheng, YANG Qing-quan

2020, 48 (12): 1146-1152. doi: 10.11958/20202143

Abstract ( 1064 )

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Objective　To explore the effect and related mechanisms of LncRNA-MALAT1 on the proliferation and apoptosis of colorectal cancer cells. Methods　The expressions of LncRNA-MALAT1 gene, miR-142-3p gene and TEAD1 protein in colorectal cancer cell lines and human normal colon epithelial cells were detected by Real-time PCR and Western blot experiments. Si-MALAT1 was transfected into HCT116 cells, and miR-142-3p inhibitor was co-transfected with si-MALAT1 into HCT116 cells on this basis. Real-time PCR and Western blot techniques were used to detect the expressions of LncRNA-MALAT1 gene, miR-142-3p gene, TEAD1 protein, Bax protein, Bcl-2 protein and Cyclin D1 protein in HCT116 cells. The level of cell proliferation was detected by CCK-8 assay, and the level of cell apoptosis in HCT116 cells was detected by flow cytometry. The dual luciferase experiment was used to detect the binding of LncRNA-MALAT1 and miR-142-3p, miR-142-3p and TEAD1 in HCT116 cells. Results　Compared with human normal colon epithelial cells, LncRNA-MALAT1 gene and TEAD1 protein were expressed at high levels and miR-142-3p gene was expressed at a low level in colorectal cancer cell lines. Silencing of LncRNA-MALAT1 could promote the expressions of miR-142-3p gene and Bax protein, inhibit the expressions of LncRNA-MALAT1 gene, Bcl-2 protein, Cyclin D1 protein and TEAD1 protein, inhibit the level of cell proliferation and promote the level of cell apoptosis in HCT116 cells. Co-silencing of miR-142-3p and LncRNA-MALAT1 could partially reverse the above regulatory effects. The binding of LncRNA-MALAT1 and miR-142-3p, miR-142-3p and TEAD1 in HCT-116 cells were detected by the dual luciferase experiment. Conclusion　LncRNA-MALAT1 could promote the expression of miR-142-3p target gene TEAD1, promote the capacity of proliferation in colorectal cancer cells, inhibit the level of apoptosis in colorectal cancer cells, and then promote the pathological process of colorectal cancer by binding to miR-142-3p.

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The effect of contrast agent-induced macrophage-derived exosomes on renal tubular epithelial cells and the intervention effect of glycyrrhizin

HAN Chong-ming, ZHANG Ying-ying, XU Zhao-long

2020, 48 (12): 1153-1158. doi: 10.11958/20201413

Abstract ( 779 )

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Objective To explore the effect of contrast agent-induced macrophage-derived exosomes on renal tubular epithelial cells and the intervention effect of glycyrrhizin. Methods THP-1 cells were stimulated with PBS, iohexol and iohexol+glycyrrhizin, respectively, and three kinds of exosomes (NC-Exo, CIN-Exo, CIN-GL-Exo) were obtained. Transmission electron microscopy was used to observe the morphology of exosomes. Western blot assay was used to detect the expression levels of CD63, TSG101 and calnexin. Fluorescent labeling method was used to detect the uptake of exosomes. HK-2 cells were randomly divided into 4 groups: Con group, NC-Exo group, CIN-Exo group and CIN-GL-Exo group. Western blot assay was used to detect the expression levels of HMGB1 in three exosomes, the expression levels of apoptosis-related proteins and HMGB1/TLR4/NF-κB signaling pathway related proteins in 4 groups of cells. Annexin Ⅴ-FITC/PI double staining method was used to detect the apoptosis rate of cells. Quantitative real-time PCR was used to detect the mRNA expression of inflammatory factors ［interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α］ in 4 groups of cells. Results The exosomes derived from THP-1 cells were round or round-like small vesicles, which expressed the marker protein CD63 and TSG101, but not the endoplasmic reticulum protein calnexin. DiR-labeled exosomes could be taken up by HK-2 cells. The expression level of HMGB1 was higher in CIN-Exo than that of NC-Exo and CIN-GL-Exo (P＜0.05). The apoptosis rate and the expression levels of Bax and Cleaved caspase-3 were higher in CIN-Exo group than those in Con group, NC-Exo group and CIN-GL-Exo group, while the expression level of Bcl-2 was lower than that in the other three groups (P＜0.05). The mRNA levels of IL-1β, IL-6 and TNF-α, and the expression levels of HMGB1, TLR4 and NF-κB were higher in CIN-Exo group than those in the other three groups (P＜0.05). Conclusion Contrast agents can induce apoptosis and inflammation of renal tubular epithelial cells through macrophage-derived exosomes, which may be related to the upregulation of exosome HMGB1 levels. Glycyrrhizin can inhibit this pathway and exert a protective effect.

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The protective effect of Yishen Tongluo Fang regulating PI3K/Akt pathway on the azoospermia/oligozoospermia model rats induced by cyclophosphamide#br#

LI Xun, CHEN Jian-she, MEN Bo, LI Hui, CHEN Xiang, ZHANG Hui, HAO Gao-li, FAN Li-peng, ZHANG Xing-hua, DONG Ya-zhou

2020, 48 (12): 1159-1164. doi: 10.11958/20201749

Abstract ( 621 )

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Objective　To investigate the regulatory effect of Yishen Tongluo Fang (YTF) on phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) pathway in azoospermia/oligozoospermia model rats induced by cyclophosphamide (CP), and its protective mechanism. Methods　Male SD rats were randomly divided into blank control group (intragastric administration of normal saline), model group (intraperitoneal injection of DMSO solution), PI3K/Akt pathway inhibitor LY294002 group (LY group, intraperitoneal injection of 0.3 mg/kg LY), YTF low dose group (3 g/kg YTF), YTF high dose group (12 g/kg YTF) and YTF+LY group (intragastric administration of 12 g/kg YTF + intraperitoneal injection of 0.3 mg/kg LY),10 rats in each group. Except for control group, rats in other groups were intraperitoneally injected with CP to establish azoospermia/oligozoospermia model. After 4 weeks of continuous administration, bilateral testicular tissues were taken and testis index was measured. The pathological changes of testis were observed by hematoxylin eosin (HE) staining. The mean seminiferous tubular diameter (MSTD) was measured by image analysis system, and the development of spermatogenic epithelial cells was evaluated by Johnsen score. The serum levels of sex hormone testosterone (T) and follicle forming hormone (FSH) were detected by enzyme-linked immunosorbent assay (ELISA). Western blot assay was used to detect the expressions of PI3K/Akt pathway protein and downstream target protein rapamycin target molecule (mTOR) protein in testis. The relative expression levels of indexes of spermatogonia proliferation, differentiation and spermatogenesis, such as basic fibroblast growth factor (bFGF), promyelocytic leukemia zinc finger (PLZF) and transmembrane tyrosine kinase receptor (C-kit), were also measured. Results　Compared with the control group, the level of testis index and T level decreased, FSH level increased, MSTD, spermatogenic cell development score and expression levels of bFGF, PLZF, C-kit, PI3K, p-Akt/Akt and mTOR protein in testis decreased in the model group (P＜0.05). Compared with the model group, the level of testis index and T level increased, FSH level decreased, MSTD, spermatogenic cell development score and expression levels of bFGF, PLZF, C-kit, PI3K, p-Akt/Akt and mTOR protein in testis increased in the YTF low and high dose groups (P＜0.05). The changes of the above indexes were more significant in the YTF high dose group than those in the YTF low dose group; while the changes of the above indexes in LY group were contrary to those in YTF low and high dose groups. There were no significant differences in changes of the above indexes between YTF+LY group and the model group. Conclusion　YTF may promote the proliferation and differentiation of spermatogonia and spermatogenesis by activating PI3K/Akt/mTOR pathway protein expression, and then improve spermatogenesis function in azoospermia/oligozoospermia rats.

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The effect of total triterpenoids in guava leaves on retinal injury in diabetic rats

ZHANG Qiao, LUO Ying, LIU Xue-Zheng

2020, 48 (12): 1165-1168. doi: 10.11958/20201920

Abstract ( 831 )

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Objective To investigate the effect and its mechanism of total triterpenoids in guava leaves (TTPGL) on retina injury in diabetic rats. Methods The diabetes mellitus (DM) rat model was induced by intraperitoneal injection (IP) of streptozotocin (STZ, 55 mg/kg) in fifty male rats. After the model was induced successfully, the rats were numbered and divided into 5 groups according to the random number table method: diabetes group (DM group, intragastric administration of normal saline), TTPGL low-dose group (TTPGL-L group, 50 mg/kg intragastric administration), TTPGL medium-dose group (TTPGL-M group, 100 mg/kg intragastric administration), TTPGL high-dose group (TTPGL-H group, 200 mg/kg intragastric administration) and metformin group (Met group, 10 mg/kg, intragastric administration, positive control). Ten normal male SD rats were taken as control group (CON group, intragastric administration with normal saline). After twelve weeks, the expression of glial fibrillary acidic protein (GFAP), NF-κB and TNF-α in retina were detected by immunofluorescence or Western blot assay, and the density of RGC was detected by HE staining. Results After 12 weeks of intervention, compared with CON group, the blood glucose, the protein expression levels of GFAP, NF-κB and TNF-α were significantly higher, and the density of RGC was significantly lower in DM group (all P＜0.05). Compared with DM group, the protein expression levels of GFAP, NF-κB and TNF-α were decreased significantly, the density of RGC was increased significantly in TTPGL-M group, TTPGL-H group and Met group (all P＜0.05). There were no significant differences in the above indexes between DM group and TTPGL-L group (P＞0.05). Conclusion TTPGL has protective effect on RGC injury in diabetes state, and its mechanism may be related to the lowering blood glucose, down-regulating the expression of GFAP in retina and inhibiting inflammatory reaction.

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The expressions of CGRP and AchE in a rat model of functional defecation disorder

LI Xue, GENG Xue-si, CHENG Yi-cheng, LIU Wei, LIU Li-yang, LIU Reng-hai

2020, 48 (12): 1169-1174. doi: 10.11958/20201095

Abstract ( 580 )

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Objective To observe the expressions of calcitonin gene-related peptide (CGRP) and cholinesterase (AchE) in colon and rectum of the rat model of functional defecation induced by low fiber diet combined with local methylene blue anal injection, and explore the possible mechanism of the occurrence of functional defecation disorder. Methods SD rats were randomly divided into blank control group, low-fiber diet group, lidocaine group and model group. The blank control group was fed with ordinary feed, and the other groups were fed with low-fiber feed. The lidocaine group and model group were given 2 mL of 2% lidocaine and 0.1% methylene blue injection once around the perianal and perirectal space respectively on the 63rd day of rearing. Fecal characteristics, fecal quality and defecation function of rats were observed. ELISA was used to detect AchE content in colon and rectum of rats. Real-time PCR (qPCR) was used to detect the expressions of CGRP mRNA and protein in rat colon and rectum respectively. Immunohistochemistry and Western blot assay were used to evaluate CGRP protein expression. Results After perianal injection, compared with the blank control group, the stools were dry and hard, and dark brown in the low-fiber diet group and lidocaine group, and the quality of the stool was decreased in the model group. The simulated balloon discharge was longer in the model group than that of the other groups, and the resting pressure in colon and rectum was lower than that of the other groups. The AchE contents in the colon and rectum were lower in model group than those of the blank control group and low-fiber diet group (P＜0.05). The expression of CGRP mRNA in the rectum was increased than that of the blank control group, but there was no significant difference between the blank control group, low-fiber diet group and lidocaine group. The expression of CGRP mRNA in rectum was higher than that of the other groups. The expression of CGRP protein detected by immunohistochemistry was higher in model group than that of the other groups (P＜0.05), while the expression of CGRP protein detected by Western blot assay was not statistically significant between four groups. Conclusion The abnormal expressions of CGRP and AchE in rat colon and rectum may be related to the neural mechanism of functional defecation disorder.

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The effect of acupuncture on inflammatory damage and miR-214 in stroke model rats

LI Chun-qin, DENG Han-bing, ZHANG Can, JIN Zu-min

2020, 48 (12): 1175-1179. doi: 10.11958/20200756

Abstract ( 839 )

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Objective To explore the effects of acupuncture on inflammatory damage and microRNA (miR)-214 in stroke model rats. Methods Modified Longa thread suppository method was used to establish 36 rat models of stroke. After successful modeling, rats were randomly divided into model group, acupuncture group (acupuncture at Yanglingquan and Quchi points) and positive control group (0.4 mg/kg nimodipine). Twelve rats were used as the sham operation group. Longa score was used to evaluate the behavior of rats. The volume of cerebral infarction was measured by 2,3,5-triphenyltetrazolium chloride (TTC) staining. Hematoxylin eosin (HE) staining was used to observe the coronary region of the brain of rats. The level of miR-214 in brain tissue was detected by real-time fluorescence quantitative PCR (qPCR). Western blot assay was used to detect the phosphatase and tensin homologous deletion gene on chromosome ten (PTEN), threonine protein kinase (AKT), phosphorylated AKT (p-AKT), nuclear factor κB (NF-κB) and interleukin-6 (IL-6) proteins in the coronary region of rat brain. Results Compared with the sham operation group, the inflammatory cell infiltration and fibrosis were severe in the model group. Longa score, cerebral infarction volume, miR-214 level, p-AKT/AKT, IL-6 and nuclear NF-κB protein levels increased (P＜0.05). PTEN and cytoplasmic NF-κB protein levels decreased (P＜0.05). Compared with the model group, the inflammation and fibrosis were reduced in the acupuncture group and positive control group. Longa score, miR-214 level, p-AKT/AKT, nuclear NF-κB and IL-6 protein levels decreased, and cerebral infarction volume decreased in the acupuncture group (P＜0.05). PTEN and cytoplasmic NF-κB protein levels increased (P＜0.05). Conclusion The acupuncture can reduce the inflammatory damage of cerebral coronary brain tissue by inhibiting miR-214 and downstream signal pathways in stroke model rats.

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The predictive value of preoperative nutritional status score for postoperative PSA #br# progression in patients with oligometastatic prostate cancer#br#

WANG Wei, HUA Li-xin, DING Liang, LI Peng-chao

2020, 48 (12): 1180-1184. doi: 10.11958/20201663

Abstract ( 1108 )

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Objective　To investigate the clinical value of preoperative controlling nutritional status (CONUT) score in postoperative prostate specific antigen (PSA) progression in patients with oligometastatic prostate cancer (OPC). Methods　From January 1, 2016 to December 31, 2018, 102 patients with OPC who underwent laparoscopic radical prostatectomy in our hospital were included. Serum albumin concentration, peripheral blood lymphocyte count and total cholesterol concentration were measured 3 days before operation, and CONUT score was calculated. The data of body mass index (BMI), PSA level, T stage, N stage, positive margin and ADT were collected. Receiver operating characteristic (ROC) curve was drawn to determine the cut-off value of CONUT in predicting PSA progression. The differences of clinical characteristics in patients with different CONUT scores were analyzed. Cox regression was used to analyze the factors influencing PSA progression. Kaplan-Meier method was used to draw survival curve and analyze the relationship between CONUT score and PSA progress. Prostate specific antigen progression-free survival (PSA-PFS) was calculated. Results　 Until December 31, 2019, 62 of 102 patients showed PSA progression. The cut-off value of CONUT score in predicting the progression of PSA in OPC patients was 3 points. There were significant differences in Gleason score, T stage and positive margin between low CONUT group (＜ 3 points, 50 cases) and high CONUT group (≥ 3 points, 52 cases, all P＜0.01). Cox regression analysis showed that CONUT score ≥ 3 was an independent risk factor for the prognosis of patients with OPC (HR = 2.982, 95%CI: 1.706-5.213, P＜0.01). The survival analysis showed that PSA-PFS was significantly shorter in high CONUT group than that in low CONUT group (P＜0.01). Conclusion　CONUT score can be an effective predictor for PSA progression in patients with OPC, and ≥ 3 points indicate the risk of PSA progression.

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The clinical value of windowed pleural biopsy

BAI Yue, CAO Qun, LANG Li-li, NIU Rong, LI Ying-ping

2020, 48 (12): 1184-1186. doi: 10.11958/20201552

Abstract ( 711 )

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Objective　To evaluate the indications, surgical techniques and economic effects of windowed pleural biopsy. Methods　The clinical data of 74 patients with pleural biopsy in the Department of Thoracic Surgery, Gansu Provincial Cancer Hospital from June 2016 to June 2020 were retrospectively analyzed. There were two groups according to different surgical methods. In windowed biopsy group, there were 29 patients (18 males and 11 females). In thoracoscopic biopsy group, there were 45 patients (27 males and 18 females). The intra-operative blood loss, operation time, postoperative pain score, postoperative complications and surgical costs were compared between the two groups. Results　No perioperative patients died. Intra-operative blood loss, operation time and operation cost were significantly lower in windowed biopsy group than those of the thoracoscopy biopsy group (P＜0.01). The postoperative pain scores were lower in the windowed biopsy group than those in the thoracoscopic biopsy group (P＜0.05). There was no significant difference in postoperative complication between the two groups (P＞0.05). Conclusion　The windowed pleural biopsy can reduce surgical trauma, shorten the operation time, lower the postoperative pain score and significantly reduce the cost of surgery.

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Study on the relationship between follicular fluid 25-(OH) D level and in vitro fertilization oocyte development and clinical outcome in secondary infertile women

JIA Xin-zhuan, WANG Cong-min, LIU Er-huan, ZHANG Na, WEI Lan

2020, 48 (12): 1187-1192. doi: 10.11958/20201804

Abstract ( 674 )

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Objective　To explore the relationship between follicular fluid 25-(OH) D level and in vitro fertilization (IVF) oocyte development and clinical outcome in secondary infertile women. Methods　The total of 192 women with secondary infertility undergoing IVF were selected as the research objects. According to the causes of secondary infertility, patients were divided into four groups: tubal factor group (58 cases), endometriosis group (45 cases), polycystic ovary syndrome group (47 cases) and ovarian reserve deficiency group (42 cases). The level of 25-(OH) D in follicular fluid was measured by ELISA. One hundred and ninety-two subjects were divided into two groups according to the cluster analysis of 25-(OH) D levels in follicular fluid, including 121 cases in group A and 71 cases in group B. The levels of hormones in peripheral blood including estradiol, progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured by chemiluminescence immunoassay. The number and diameter of follicles were measured by vaginal ultrasound. Embryo evaluation was performed on the 3rd day (D3) and the 5th day (D5) of culture. The relationship between 25-(OH) D level in follicular fluid and IVF oocyte development (the normal fertilization rate, D3 quality embryo formation rate, D5 quality blastocyst formation rate) and clinical outcome (clinical pregnancy rate) was analyzed. Results　There were no significant differences in follicular fluid 25-(OH) D levels between four groups of patients. The level of 25-(OH) D in follicular fluid was significantly higher in group B than that of group A (P＜0.05). The number of large follicles and the levels of estradiol and progesterone were significantly higher in group B than those in group A (P＜0.05). The normal fertilization rate, D3 quality embryo formation rate, D5 quality blastocyst formation rate and clinical pregnancy rate were significantly higher in group B than those in group A (P＜0.05). Conclusion　In secondary infertility women treated with IVF, the high level of follicular fluid 25-(OH) D is more likely to produce large follicles and high-quality embryos, and their clinical pregnancy rate is also higher.

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The clinical significance of serum calcium binding protein S100A12 for the severity of #br# mycoplasma pneumonia in children #br#

ZHOU Si-fang, GE Ming-gai, ZHANG Qin, HU Yang-tao, LEI Da-wei, CAI Li

2020, 48 (12): 1192-1195. doi: 10.11958/20201986

Abstract ( 825 )

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Objective　To investigate the clinical significance of serum calcium-binding protein S100A12 for the severity of mycoplasma pneumoniae pneumonia (MPP) in children. Methods　A total of 100 cases of MPP admitted to the department of pediatrics of the third hospital of Nanchang were selected from January 2018 to June 2019. According to the severity of the disease, they were divided into mild MPP group (n=60) and severe MPP (SMPP, n=40) group. Twenty healthy children examined in our hospital during the same period were selected as the control group. Serum samples were collected. White blood cell count (WBC), neutrophils (N%), lymphocytes (L) and C-reactive protein (CRP) levels were detected. Serum levels of calcium-binding protein S100A12 were detected by ELISA. The differences of S100A12 in the acute and recovery stages were compared between MPP group and SMPP group. The correlation between S100A12 and the severity of MPP wasanalyzed. The ROC curve was used to analyze the clinical value of S100A12 in predicting severe MPP. Results　compared with the control group, serum levels of S100A12 were significantly increased in the acute phase of MPP group and SMPP group (P＜0.01). The serum level of S100A12 in the acute phase was significantly higher in SMPP group than that of MPP group (P＜0.05). There were no significant differences in the serum levels of S100A12 in the recovery phase between MPP and SMPP groups and control group (P＞0.05). Correlation analysis showed that S100A12 was positively correlated with the severity of MPP (rs=0.824, P＜0.01). ROC curve analysis showed that the area under the curve of S100A12 was 0.916 (95%CI: 0.843-0.962), the optimal threshold was 827.64 μg/L, the sensitivity was 95.00% and the specificity was 83.33%. Conclusion　The elevated S100A12 level can predict the severity of MPP in children.

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The relationship between thyroid hormone abnormality and DIO1 gene polymorphism in children with dental fluorosis

JIN Xiang, CUI Yu-shan, CAO Li-chun

2020, 48 (12): 1196-1200. doi: 10.11958/20201868

Abstract ( 932 )

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Objective　To analyze the relationship between thyroid hormone abnormality and type 1 selenodeiodinase gene (DIO1) gene polymorphism in children with dental fluorosis. Methods　From June 2018 to June 2019, 169 children aged 7-12 years were randomly selected from the historical water fluoride area and non-water fluoride area of Tianjin to test the level of dental fluorosis. Urine samples were collected and the level of urinary iodine was determined by As3+-Ce4+ catalytic spectrophotometry. Blood samples were collected, TSH, FT3 and FT4 were detected by chemiluminescence, and the gene polymorphism of DIO1 rs2294512 was detected by sequenom SNP. The role of DIO1 gene polymorphism in dental fluorosis and thyroid hormone abnormality was studied by multivariate Logistic regression analysis after genotyping of DIO1. Results　The level of FT3 was higher in children with dental fluorosis (P＜0.05), and the level of FT4 was lower (P＜0.05). The abnormal rate of FT3 was as high as 40.0% in dental fluorosis group, and which was higher than that of normal children (P＜0.05). The abnormal rate of FT4 was reduced to 3.33%, and which was lower than that of normal children (P＜0.05). Among the children with DIO1 AA genotype, the incidence of dental fluorosis was more likely to lead to higher FT3 (OR=6.357, 95%CI: 1.808-22.347, P=0.004).　Conclusion　The FT3 level of dental fluorosis children with AA genotype of DIO1 gene rs2294512 is more likely to be higher.

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Clinical efficacy of inhaled N-acetylcysteine in the treatment of acute sinusitis

LI Shu-hua, ZHAO Xiao-long, DENG Wei, JIANG Zhen-hua

2020, 48 (12): 1201-1204. doi: 10.11958/20200835

Abstract ( 4035 )

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Objective　To observe the effect of inhaled N-acetylcysteine nebulization in patients with acute sinusitis, and its influence on the inflammatory factors and immune factors. Methods　A total of 164 patients with acute sinusitis were selected and divided into experimental group (n=82) and control group (n=82) by random number table. The control group was treated with conventional drugs, and the experimental group was treated with conventional drugs combined with N-acetylcysteine nebulized inhalation. Chemical luminescent immunoanalysis was used for the detection of serum levels of TNF-α, IL-6, IL-8 and IL-10 before and after treatment. The scattering immunoturbidimetric assay was used for the detection of immune factor levels (IgG, IgA and IgM). The visual analogue scale (VAS) scores, Lund-Kennedy scores in nasal endoscopy and treatment effect were also compared between the two groups of patients. Results　Compared with before treatment, the levels of TNF-α, IL-6, IL-8 and IL-10 in the two groups were significantly reduced, the levels of IgG, IgA, and IgM were increased, and the scores of VAS and Lund-Kennedy were significantly reduced. The changes of the above indicators in the group were more significant than those in the control group (P＜0.05). The total effective rate of treatment in the experimental group was significantly higher than that in the control group (P＜0.05). During the treatment period, all patients had no adverse reactions such as nausea, vomiting, rash, pruritus, and no complications such as intraorbital infection, optic neuritis, blindness, intracranial infection, etc. Conclusion　The inhalation of N-acetylcysteine in the treatment of acute rhinosinusitis is safe and effective, and which is worthy of clinical promotion and application.

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Prevalence and management of perioperative pain in patients undergoing sacral #br# tumor resection#br#

ZHANG Qing-fen, WU Ya-qing, FENG Yi

2020, 48 (12): 1205-1210. doi: 10.11958/20202358

Abstract ( 1220 )

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Objective　To investigate the prevalence and management of perioperative pain in patients undergoing sacral tumor resection, and identify potential ways, in which pain management can be improved. Methods　The clinical data of 215 patients undergoing sacral tumor resection from January 2018 to December 2019 were collected. The main observation indicators included postoperative pain and postoperative opioid consumption, and secondary indicators included preoperative pain, analgesic regimes during and after surgery, length of hospital stay after surgery and surgery complications. Results　In 215 patients, there were 126 patients (58.6%) presented with chronic pain and forty nine patients (22.8%) required opioids preoperatively. Opioid-only analgesia was the mainstay of analgesia modality during and after surgery. On the first day after surgery, 112 patients (53.3%) suffered from moderate-severe pain. Postoperative pain severity was not associated with preoperative pain, tumor location or surgery procedures (P＞0.05). The postoperative opioid dosage was positively correlated with the pain severity (P＜0.05). By the 7 days after surgery, 42.3% of patients still required opioids, and the proportion decreased to 26.0% by discharge. The length of hospital stay after surgery was positively related with postoperative pain severity (P＜0.05). Compared with patients who were not on preoperative opioids, patients on preoperative opioids required higher doses of opioids in the first 7 days after surgery (P＜0.05), and the proportion of patients required opioids 7 days after surgery and at discharge were increased (P＜0.05). Conclusion　Patients undergoing sacral tumor resection have a higher incidence of preoperative pain, severe postoperative pain and a large demand for opioids. It is necessary to further optimize the analgesia mode and improve the quality of postoperative analgesia management.

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Application of dexmedetomidine in tourniquet lower limb surgery in elderly patients with #br# type 2 diabetes mellitus#br#

CHEN Qian-xiu, LI Tian-mei, LIU Xing

2020, 48 (12): 1210-1213. doi: 10.11958/20200716

Abstract ( 1030 )

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Objective To investigate the impact of dexmedetomidine (DEX) on serum neuron-specific enolase (NSE), oxidative stress, inflammatory response and postoperative cognitive function after lower limb tourniquet surgery in elderly patients with diabetes. Methods A total of 96 elderly patients with type 2 diabetes mellitus who underwent lower extremity surgery under selective general anesthesia tourniquet were randomly divided into DEX group and control group by using a random number table method, 48 cases in each group. After induction of general anesthesia, the DEX group was pumped with 0.5 μg/kg DEX within 15 min, followed by an infusion of 0.5 μg/(kg·h) until 30 min before the end of the operation. The control group was pumped with the same volume of normal saline. The serum levels of malonaldehyde (MDA), NSE，tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected by thiobarbituric acid and enzyme-linked immunosorbent assay (ELISA) before using the tourniquet, 30 min, 24 h and 72 h after releasing the tourniquet. The mini-mental state examination (MMSE) was used to evaluate cognitive function 1 d before operation, 1 d and 3 d after operation. The awake time, extubation time and adverse reactions were recorded in the two groups. Results Compared with before using the tourniquet, the level of NSE increased from 24 h after releasing the tourniquet in both groups, while the levels of MDA, TNF-α and IL-1β increased from 30 min after releasing the tourniquet (P＜0.05). Compared with the control group, the level of NSE decreased from 24 h after tourniquet release in the DEX group, while the levels of MDA, TNF-α and IL-1β decreased from 30 min after tourniquet release (P＜0.05). Compared with 1 day before surgery, MMSE scores were decreased at the 1 d and 3 d after surgery in both groups (P＜0.05). Compared with the control group, MMSE scores increased at the 1 d and 3 d after surgery in DEX group (P＜0.05). There were no significant differences in wake time, extubation time and incidence of adverse reactions between the two groups. Conclusion Dexmedetomidine can reduce serum NSE, reduce oxidative stress and inflammation response, and improve postoperative cognitive function on lower limb tourniquet surgery in elderly patients with diabetes.

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The relationship between colon cancer tumor size and lymphovascular invasion#br# measured by enhanced CT#br#

MOU An-na, PU Hong, YIN Long-lin, ZHANG Tian-yue, LI Hang

2020, 48 (12): 1214-1218. doi: 10.11958/20201373

Abstract ( 2732 )

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Arthroscopic single tibial tunnel technique for tibial avulsion fracture of the anterior cruciate ligament: short-term outcomes

FANG Xiao-hui, YUAN Xiao-qing, WU Yi-xiong, LI Gui-jun, GAO Li-bo, HU Hui-dong, GAO Lei

2020, 48 (12): 1218-1222. doi: 10.11958/20201246

Abstract ( 628 )

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Objective　To investigate the short-term clinical outcomes of arthroscopic single-tibial tunnel knotless suture anchor fixation in the treatment of tibial avulsion fracture of the anterior cruciate ligament (ACL). Methods　Twelve patients with ACL tibial avulsion fractures were included in the study, including 7 males and 5 females, with an average of (44.8±14.3) years (range 27-71 years). There were 8 cases caused by bruise, 2 cases of traffic accident and 2 cases of sports injuries. According to Meyers-McKeever classification criteria: 9 cases were type Ⅱ and 3 cases of type Ⅲ. There were 2 cases of meniscus injury and 2 cases of lateral collateral ligament injury. Under the arthroscopy, two Orthocord sutures were used to reduce the fracture, knotless suture anchor was screwed into the tibial tubercle through the single tibial tunnel to tighten the Orthocord sutures to reduce the ACL tibial fracture. X-rays and CT scan were used to evaluate fracture reduction and healing. Drawer test and Lachman test were used to evaluate knee joint stability. International Knee Documentation Committee (IKDC) score and Lysholm score were used to evaluate knee function after operation. Results　All patients successfully completed the operation without complications such as wound infection, joint infection or deep vein thrombosis. All patients were followed up 5-18 months (mean, 12.6 months±4.9 months). The anterior drawer test and Lachman test were negative for all patients after operation. At last follow-up, the X-ray film and CT scan showed that all cases achieved bone healing. The IKDC score improved from (39.17±3.56) points before surgery to (90.33±1.61) points after operation (P＜0.01). The Lysholm joint scores improved from (42.92±1.96) before surgery to (93.08±1.88) points after operation (P＜0.01). Conclusion　The method of Orthocord sutures passing through single tibial tunnel combined with knotless suture anchor under arthroscopy have the advantages of minimally invasive, reliable fixation and no metal implants.

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The value of HPV E6 /E7 mRNA test and HPV DNA test in triage of patients with atypical squamous cells: a systematic review and Meta-analysis

LU Lu, YU Hui-ping, CHENG Jian

2020, 48 (12): 1223-1229. doi: 10.11958/20200653

Abstract ( 1251 )

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Objective　To evaluate and compare the diagnostic value of HPV E6/E7 mRNA test and HPV DNA test in classifying population of atypical squamous cells of undetermined significance (ASCUS) by systematic review and Meta-analysis. Methods　MEDLINE, EMbase, Cochrane Library, WanFang, Web of Science, VIP and CNKI database were electronically searched, and studies on HPV E6 /E7 mRNA test and HPV DNA test in classifying patients with ASCUS， and data were collected from January 1, 2010 to December 31, 2019. Literatures were independently screened by two reviewers. After extracting data and evaluating the risk of bias of included studies, Meta-Disc1.4 software and Stata12.1 were used for meta-analysis. Results　A total of 15 studies including 4 019 ASCUS patients were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of HPV E6 /E7 mRNA test were 0.85 (95%CI: 0.82-0.87), 0.61 (95%CI: 0.59-0.63), 2.40 (95%CI: 1.98-2.92), 0.28 (95%CI：0.23-0.33) and 9.21 (95%CI: 6.72-12.62), respectively. Those of HPV DNA test were 0.91 (95%CI: 0.89-0.93), 0.43 (95%CI: 0.41-0.45), 1.59 (95%CI: 1.38-1.83), 0.24 (95%CI: 0.16-0.35) and 7.12 (95%CI: 4.51-11.26), respectively. The areas under the curve (AUC) of HPV E6/E7 mRNA test and HPV DNA test for detecting CINⅡ+ were 0.847 and 0.760 respectively. Conclusion　Compared with HPV DNA test, HPV E6/E7mRNA test has a higher clinical value in classifying patients with ASCUS, and it shows a high specificity in cervical lesions with CINⅡ+ in the ASCUS population.

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Research progress of PD-1/PD-L1 inhibitors combined with other immune checkpoint inhibitors in the treatment of triple negative breast cancer

CUI Yu-heng, ZHAO Shao-rong, LIU Jing-jing, ZHANG Jin

2020, 48 (12): 1230-1235. doi: 10.11958/20200705

Abstract ( 1162 )

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The poor prognosis of patients with triple-negative breast cancer (TNBC) is related to its high systemic metastasis rate, insensitivity to conventional treatment and easy development of drug resistance. With the continuous exploration of anti-tumor mechanism of immune system and immune characteristics of TNBC, immune checkpoint inhibitors represented by programmed cell death protein 1 (PD-1) and programmed death protein ligand 1 (PD-L1) provide new treatment options for TNBC. However, the effect of PD-1/PD-L1 inhibitor monotherapy is not ideal. Therefore, this article aims to explore the application of PD-1/PD-L1 inhibitors combined with other immune checkpoint inhibitors with different mechanisms in the treatment of TNBC patients.

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Research progress on the molecular biological mechanism of long non-coding RNA regulating angiogenesis after ischemic stroke

LI Xiao, ZHOU Shuang, ZHAO Chen

2020, 48 (12): 1236-1239. doi: 10.11958/20201067

Abstract ( 797 )

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Long non-coding RNA (lncRNA) is mainly distributed in the nucleus and cytoplasm. It mainly regulates the translation process and targeted transport of proteins. It has more types and more complex functions than other non-coding RNAs. Recent studies have shown that lncRNA may play an important role in the pathological process of stroke. This article reviews the research progress of the molecular biological mechanism of lncRNA regulating angiogenesis after stroke to clarify the role of lncRNA in angiogenesis of ischemic stroke.

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Research progress on the inhibition of cardiac remodeling by Sacubitril/Valsartan

DUAN Xiao-rui, LI Guang-ping

2020, 48 (12): 1240-1243. doi: 10.11958/20200785

Abstract ( 1590 )

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Cardiac remodeling is an important pathophysiological basis for the occurrence and development of cardiovascular disease and is closely related to the prognosis of patients. LCZ696 is an angiotensin receptor neprilysin inhibitor, which acts on both renin-angiotensin-aldosterone system (RAAS) and natriuretic peptide system. It is mainly used in the treatment of heart failure with decreased ejection fraction. Recent studies have shown that compared with renin-angiotensin system inhibitor (RASI), LCZ696 can significantly inhibit cardiac remodeling and improve cardiac function and prognosis in different types of cardiovascular diseases. This article reviews the mechanism and research status of the inhibitory effect of LCZ696 on cardiac remodeling.

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Research progress on the relationship between TMAO of new biomarkers and #br# cardiovascular diseases#br#

WANG Jie, GAO Jing

2020, 48 (12): 1244-1248. doi: 10.11958/20200333

Abstract ( 1471 )

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The relationship between gut microbiota and its metabolites and cardiovascular disease is a hot topic in cardiovascular research. It has made great progress in the basic and clinical research of gut microbiota in regulating cardiovascular physiology and disease progress. Some studies at home and abroad have shown that metabolite trimethylamine-N-oxide (TMAO), the gut microbiota, has become a key factor affecting the development of cardiovascular disease. In recent years, clinical studies on the relationship between TMAO and development and prognosis of cardiovascular diseases have also made some achievements. Plasma TMAO levels can be used as new biomarkers for the risk stratification, diagnosis and prognosis of cardiovascular diseases in the future, and the prediction of the occurrence of cardiovascular disease and the major cardiovascular events (MACE). This paper reviews the research progress of TMAO as a new biomarker and potential therapeutic target for cardiovascular diseases.

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