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15 July 2021, Volume 49 Issue 7 Previous Issue    Next Issue

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MicroRNA-141 promotes the proliferation of ovarian granulosa cells in polycystic ovary syndrome through PI3K/Akt/mTOR signaling pathway CHEN Jiao, ZHANG Yan, ZHONG Yuan-yuan 2021, 49 (7):  673-677.  doi: 10.11958/20210042 Abstract ( 708 )   PDF (492KB) ( 3858 )   Objective　To study the effect of microRNA-141 (miR-141) on the proliferation of ovarian granulosa cells and to explore its mechanism in the occurrence and development of polycystic ovary syndrome (PCOS). Methods　qPCR was used to detect the expression levels of miR-141 mRNA in 20 samples PCOS ovarian tissues, 20 normal ovarian tissue specimens, human ovarian granulosa cells KGN and human normal ovarian epithelial cells IOSSE80. KGN cells were divided into miR-141 minics group, LY294002+miR-141 minics group, rapamycin+miR-141 minics group, NC group and control group. The MTT method and the plate cloning experiment method were used to detect the cell proliferation and clone formation ability of each group, and the Western blot assay was used to detect the phosphatidylinositol 3-kinase (PI3K)/protein kinase (Akt)/mammalian rapamycin target protein (mTOR) signaling pathway related protein expression levels. Results　The expression level of miR-141 mRNA was significantly higher in PCOS ovarian tissue than that in normal ovarian tissue, and the expression level of miR-141 mRNA was significantly higher in human ovarian granulosa cells KGN than that in normal ovarian epithelial cells IOSE80 (P＜0.05). miR-141 mRNA expression levels were significantly higher in miR-141 minics group, LY294002+miR-141 minics group and rapamycin+miR-141 minics group than those in NC group and control group (P＜0.05). After transfection for 24, 48, 72 and 96 h, the OD values and clone formation rates were lower in LY294002+miR-141 minics group and rapamycin+miR-141 minics group than those of miR-141 minics group, but higher than those of NC group and control group (P＜0.05). After transfection, the expression levels of p-Akt and p-mTOR were lower in LY294002+miR-141 minics group than those in miR-141 minics group, but higher than those in NC group and control group (P＜0.05). The expression level of p-mTOR protein was significantly lower in rapamycin+miR-141 minics group than that in miR-141 minics group, and higher than that in NC group and control group (P＜0.05). Conclusion　miR-141 can promote proliferation of ovarian granulosa cells by activating the PI3K/Akt/mTOR signaling pathway. Related Articles | Metrics

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The inhibitory effect of CLEC5A on cell proliferation and metastasis in intrahepatic cholangiocarcinoma LIN Jie, WANG Wei-dong, OU Huo-hui, HE Wei, CHEN Jian-ping, MA Jing, ZUO Hai-bo, LIU Qing-bo 2021, 49 (7):  678-682.  doi: 10.11958/20210312 Abstract ( 867 )   PDF (1092KB) ( 3941 )   Objective　To detect the expression of CLEC5A in intrahepatic cholangiocarcinoma (ICC) tissues and analyze its effect on cell proliferation, apoptosis, migration and invasion of RBE cells. Methods　The expression levels of CLEC5A were assessed by immunohistochemistry (IHC) in 25 samples of ICC and adjacent normal tissues. RBE cells were transfected with lentiviral vector overexpressing CLEC5A, and qPCR was used to detect the expression levels of CLEC5A. CCK-8 was used to detect the proliferation, flow cytometric analysis was used to detect cell apoptotic proportion and cell cycle distribution, and Transwell assay was performed to detect cell migration and invasion in RBE cells. Results　IHC score was significantly lower in tumor tissues than that in the adjacent normal tissues (P＜0.05). Overexpression of CLEC5A inhibited cell proliferation, migration and invasion and induced cell apoptosis and led to G2/M phase arrestment in RBE cells (P＜0.05). Conclusion　CLEC5A is a potential ICC cancer suppressor gene, which may affect the development of ICC by regulating cell proliferation, metastasis and invasion. Related Articles | Metrics

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The protective effect of PCSK9 inhibitor on HUVECs injury induced by ox-LDL XU Jing-han, ZUO Jun-rong, HAN Chu-yi, LI Ting-ting, JIN Dong-xia, ZHAO Fu-mei, CONG Hong-liang 2021, 49 (7):  683-688.  doi: 10.11958/20210220 Abstract ( 837 )   PDF (790KB) ( 3905 )   Objective　To investigate the protective mechanism of PCSK9 inhibitor against oxidative low-density lipoprotein (ox-LDL) induced injury of human umbilical vein endothelial cells (HUVECs). Methods　HUVECs in logarithmic growth phase were divided into Control group (normal culture group), ox-LDL group (induced by 50 mg/L ox-LDL for 24 h) and PCSK9 inhibitor groups (low, medium and high dose of PCSK9 inhibitor). The low, medium and high dose of PCSK9 inhibitor groups were treated with 5, 10 and 20 μmol/L PCSK9 inhibitors for 24 h and then induced by 50 mg/L ox-LDL for 24 h. Cell activity was detected by CCK-8 assay, and cell survival rates were calculated. Transcription and secretion levels of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in supernatant of cell culture were determined by quantitative real time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). Cell apoptosis was detected by flow cytometry. The expression levels of apoptosis-related proteins (Bax, Bcl-2, Cleaved-Caspase-3) and nuclear factor-κB (NF-κB) signaling pathway related proteins were detected by Western blot assay. Results　Compared with the Control group, the cell survival rate was decreased, transcriptional and secretion levels of TNF-α, IL-6, MCP-1 were increased, apoptosis rate increased, pro-apoptotic proteins (Bax and cleaved Caspase-3) up-regulated, anti-apoptotic protein Bcl-2 down- regulated and phosphorylated NF-κB (p-NF-κB) expression increased in ox-LDL group. Meanwhile, the expression of NF-κB was up-regulated in the nucleus and down regulated in cytoplasm. Compared with ox-LDL group, the survival rates were increased in medium and high dose PCSK9 inhibitor groups after treatment with PCSK9 inhibitor. The transcription and secretion levels of TNF-α, IL-6, MCP-1 and apoptosis rate decreased. The results of Western blot assay showed that the expression levels of Bax and cleaved-Caspase-3 down-regulated, Bcl-2 up-regulated and p-NF-κB decreased. PCSK9 inhibitors down-regulated the expression of NF-κB in the nucleus and up-regulated the expression of NF-κB in cytoplasm of HUVECs induced by ox-LDL (P < 0.05). Conclusion　PCSK9 inhibitors can inhibit ox-LDL induced inflammatory response and cell apoptosis in HUVECs and play a protective role. Related Articles | Metrics

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Study on the function and mechanism of RPL15 in erythroid differentiation of K562 cells PENG Tao, ZHOU Wei-jun, ZHOU Dong-zhen, LI Hua, LAN Jin-zhi, LI Dan, ZHOU Yan-hua, SHU Li-ping 2021, 49 (7):  688-693.  doi: 10.11958/20210070 Abstract ( 476 )   PDF (1898KB) ( 4084 )   Objective　To study the expression changes of RPL15 during erythroid differentiation of K562 cells and to determine its effect on globin expression and erythroid differentiation. Methods　Erythroid differentiation of K562 cells was induced by hemin. The expression of RPL15 in K562 erythroid differentiation was detected by quantitative Real-Time PCR(qPCR) and Western blot assay. RNA interference (RNAi) technology was used for the inhibition of RPL15 expression in K562 cells. The expression of hemoglobin, erythroid differentiation-related genes and the expression of CD235a and CD71 in K562 cells were detected by tetramethyl benzidine staining, qPCR and flow cytometry. Results　In the process of erythroid differentiation of K562 cells, the mRNA and protein levels of RPL15 were up-regulated at first and then decreased. Compared with the control group, the interference with the RPL15 expression significantly decreased the positive rate of hemoglobin staining in K562 cells differentiated into erythroid at 24, 48 and 72 hours. The relative expressions of α-, β-, ε-, γ-globin and erythroid differentiation-related genes GATA1 and HSP70 were significantly down-regulated in erythroid differentiated K562 cells (P＜0.05). The relative expression of tumor suppressor gene P53 was significantly up-regulated (P＜0.01). Meanwhile, the proportion of CD235a+CD71+ K562 cells decreased significantly after RPL15 interference (P＜0.01). Conclusion　Inhibition of RPL15 expression can inhibit erythroid differentiation of K562 cells, suggesting that RPL15 is regulating the process of erythroid differentiation. At the same time, P53-related pathway, GATA1 and HSP70 may be involved in the regulation of erythroid differentiation by RPL15. Related Articles | Metrics

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Cannabidiol reduces CCl4-induced acute liver injury in mice by activating PPAR-γ SHU Yuan-hui, MA Run, XIE Na, LI Yao, WANG Yu-ping 2021, 49 (7):  694-698.  doi: 10.11958/20203056 Abstract ( 662 )   PDF (656KB) ( 3842 )   Objective　To explore the prevention and mechanism of cannabidiol (CBD) on carbon tetrachloride (CCl4)-induced acute liver injury in mice. Methods　Forty-two C57BL/6J male mice aged 6-8 weeks were divided into 5 groups according to the random number table method: control group (n=9), model group (n=9), CBD control group (n=9), glutathione (GSH) intervention group (n=6) and CBD intervention group (n=9). The CBD control group, GSH intervention group and CBD intervention group were intraperitoneally injected with CBD 5 mg/kg, GSH 200 mg/kg and CBD 5 mg/kg respectively. The control group and model group were injected with the same dose of normal saline. Two hours later, the model group, GSH intervention group and CBD intervention group were intraperitoneally injected with 20% CCl4 olive oil 5 mL/kg to establish the acute liver injury model. After 24 h, the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. HE staining was used to observe the pathological changes of mouse liver tissue. The activities of superoxide dismutase (SOD), malondialdehyde (MDA) and GSH were detected by liver tissue homogenate method. PPAR-γ and COX-2 protein expression levels in liver tissue were detected by Western blot assay. Results　Compared with the control group, the model group had severe cell damage and necrosis, ALT, AST, MDA and COX-2 levels were significantly increased in the model group (P＜0.05), and the SOD, GSH and PPAR-γ levels were significantly reduced (P＜0.05). Compared with the model group, liver pathological damages significantly reduced in the GSH intervention group and CBD intervention group, and ALT, AST, MDA and COX-2 levels were significantly reduced (P＜0.05), whereas SOD, GSH and PPAR-γ levels were significantly increased (P＜0.05). Conclusion　CBD can prevent CCl4 induced the acute liver injury in mice, which may be related to the activation of PPAR-γ, the inhibition of COX-2 expression and anti-inflammatory and antioxidant effects. Related Articles | Metrics

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The effect of Fushen recipe on peritoneal ultrafiltration function and VEGF-Notch signal pathway in uremic peritoneal dialysis rats YANG Bo, WANG Meng-meng, SUN Lin, ZHONG Ke, LI Jie, YANG Hong-tao 2021, 49 (7):  699-705.  doi: 10.11958/20203042 Abstract ( 786 )   PDF (1285KB) ( 3682 )   Objective　To explore the effects of Fushen recipe on the peritoneal ultrafiltration function and Notch1, delta- like ligand 4 (Dll4), Notch intracellular domain (NICD), hairy and enhancer of split homolog-1 (Hes1), vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2) in peritoneal tissues of uremic peritoneal dialysis rats. Methods　Fifty male SD rats were randomly divided into 5 groups: normal group, model group, Fushen recipe low dose group (model + Fushen recipe 324 g/L), Fushen recipe high dose group (model + Fushen recipe 648 g/L) and Celecoxib group (model + Celecoxib 1.8 g/L), with 10 rats in each group. The peritoneal dialysis solution was injected intraperitoneally regularly for 4 weeks. The rats were killed after the calculation of ultrafiltration volume by peritoneal balance test. The peritoneal tissues were taken for the observation of morphological changes of peritoneum by HE staining. The mRNA and protein expressions of Notch1, Dll4, NICD, Hes1, VEGF and VEGFR-2 were detected by real-time fluorescence quantitative PCR (qPCR) and Western blot assay, and the protein level of p-VEGFR-2 was detected by Western blot assay. Results　The peritoneal ultrafiltration volume was significantly lower in model group, Fushen recipe low-dose group, Fushen recipe high-dose group and Celecoxib group than that in normal group, while the peritoneal ultrafiltration volume was significantly higher in Fushen recipe high-dose group and Celecoxib group than that of model group and Fushen recipe low-dose group. The peritoneal ultrafiltration volume was significantly lower in Celecoxib group than that of Fushen recipe high-dose group (P＜0.05). The peritoneal HE staining showed that peritoneal neovascularization was significantly reduced in Fushen recipe low-dose and high-dose groups compared with that in model group. Compared with normal group, the expressions of Notch1, NICD, Dll4, Hes1 mRNA and protein were down-regulated in peritoneal tissue of model group, while the expressions of VEGFR-2, VEGF mRNA and VEGFR-2, p-VEGFR-2 and VEGF protein were significantly up-regulated (P＜0.05). Compared with the model group, the expressions of NCID, Hes1 mRNA and Notch1, NICD, Dll4 and Hes1 protein were up-regulated, while the expressions of VEGFR-2, VEGF mRNA and VEGFR-2, p-VEGFR-2 and VEGF protein were down-regulated in the Fushen recipe low-dose group (P＜0.05). The expressions of Notch1, NICD, Dll4, Hes1 mRNA and Dll4, Hes1 protein were up-regulated, while the expressions of VEGFR-2, VEGF mRNA and VEGFR-2, p-VEGFR-2, VEGF protein were significantly down-regulated (P＜0.05). In Celecoxib group, Notch1 mRNA and Notch1, Dll4 protein were up-regulated, while VEGFR-2 and VEGF mRNA and p-VEGFR2, VEGFR-2 and VEGF protein were significantly down-regulated (P＜0.05). Conclusion　Fushen recipe can improve peritoneal ultrafiltration function, which may be related to the up-regulation of Notch1, NICD, Dll4, Hes1 mRNA and protein expression in peritoneal tissue, and the down-regulation of VEGFR-2, VEGF mRNA and VEGFR-2, p-VEGFR-2 and VEGF protein expression. Related Articles | Metrics

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Effects of baicalin on arrhythmia and endoplasmic reticulum stress EMG stability of ventricular myocytes in rats with heart failure WANG Zhi, WANG Juan, XU Lei, ZHAO Dong-ming 2021, 49 (7):  706-713.  doi: 10.11958/20203090 Abstract ( 773 )   PDF (990KB) ( 3804 )   Objective　To investigate the effect of baicalin on arrhythmia and endoplasmic reticulum stress EMG stability of ventricular myocytes in rats with heart failure. Methods　Seventy-two male Wistar rats (6 weeks) were randomly divided into control group, model group, baicalin group and metoprolol group, with 12 rats in each group. The model group was given isoproterenol (ISO) subcutaneous injection of 5 mg/(kg·d), and the control group was given equal volume of 0.9% NaCl injection subcutaneously in the posterior neck for 7 days. Baicalin low, medium and high dose groups and metoprolol group were given baicalin [25, 50 and 100 mg/(kg·d)] and metoprolol 10 mg/(kg·d) respectively on the basis of the model group, while the control group was given the same volume of 0.9% NaCl injection for 4 weeks. At the end of 4 weeks, ECG and Doppler ultrasound were used to detect heart rate, incidence of premature ventricular contractions, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd). Serum levels of ST2 and BNP were detected by ELISA. The isolated Langendorff heart perfusion model was made by 6 rats in each group. The 90% time course of monophasic action potential (MAPD90), effective refractory period (ERP) of ventricular myocytes and the ratio of ERP / MAPD90 were recorded and measured. TUNEL staining was used to detect the apoptosis of ventricular myocytes. Western blot assay was used to detect the expression levels of Cx43, GRP78, IRE1 and CHOP protein. Results　Compared with the control group, the heart rate increased, LVESd and LVEDd increased, LVEF decreased, serum levels of ST2, BNP increased, ERP / MAPD90 decreased, AI value increased, GRP78, IRE1, CHOP expression increased and Cx43 expression decreased in the model group (all P＜0.05). Compared with the model group, the above indexes were significantly improved in baicalin low, medium and high dose groups, and showed a dose-dependent pattern (P＜0.05). Conclusion　Baicalin can improve ventricular arrhythmia and cardiac function in rats with heart failure induced by ISO. The mechanism may be related to the inhibition of endoplasmic reticulum stress apoptosis and the improvement of EMG stability. Related Articles | Metrics

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The protective effect of astragalus polysaccharides on chronic renal failure in mice YANG Jie-ke, WANG Li, YU Qian-hui, DIAO Hui, FAN Jun-ming 2021, 49 (7):  713-718.  doi: 10.11958/20203157 Abstract ( 845 )   PDF (1682KB) ( 3856 )   Objective　To explore the protective effect of astragalus polysaccharide on chronic renal failure in mice and its potential molecular mechanism. Methods　The chronic renal failure mouse model was established by 5/6 nephrectomy in male Balb/c mice. They were randomly divided into the model group and astragalus polysaccharide intervention group (APS group) with 10 mice in each group. Another sham operation group was set up. After normal feeding for 7 weeks, the APS group was given astragalus polysaccharide 100 mg/(kg·d) gavage, and the remaining groups were given an equal volume of normal saline. Samples of stool, urine, blood, kidney and colon tissues were collected after 4 weeks. The creatinine (Scr), urea nitrogen (BUN) and 24 h urine protein were determined. After the tissues were fixed and embedded, the tissues were stained with HE and Sirius red for pathological analysis. Western blot assay and immunohistochemical staining were used to detect the tight junction protein-1 family (Claudin-1, Occludin-1, ZO-1) and p-NF-κB expression level. The enzyme-linked immunosorbent assay (ELISA) was used to detect the serum interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) concentration. The real-time fluorescent quantitative PCR was used to detect long-chain non compiled RNA (lncRNA) Arid2-IR, IL-1β, IL-6 and TNF-α expression changes and changes in the fecal flora of mice. Results　The blood Scr, BUN and 24 h urine protein were significantly decreased in the APS group than those of the model group. HE staining showed that the pathological damage of kidney and colon tissues were improved in the APS group compared with those of the model group. Sirius red staining showed that the degree of fibrosis was significantly improved in the APS group. Western blot assay and immunohistochemical staining showed that the expression of tight junction protein-1 family in colonic tissues was increased and the expression of p-NF-κB protein in renal tissues was decreased in the APS group compared with the model group. ELISA results showed that the levels of serum IL-1β, IL-6 and TNF-α were significantly decreased in the APS group compared with those of the model group. The relative expression levels of lncRNA Arid2-IR, IL-1β, IL-6 and TNF-α were significantly decreased in the APS group compared with those of the model group. The expression levels of lactic acid bacillus and bifidobacterium were higher in the APS group than those of the model group, while the relative expression level of E. coli decreased. Conclusion　Astragalus polysaccharide may regulate the intestinal flora of mice by regulating the lncRNA Arid2-IR/NF-κB signal axis, thereby repairing the intestinal barrier damage, maintaining the normal intestinal physiological environment and improving chronic renal failure. Related Articles | Metrics

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Analysis of risk factors related to the occurrence and stability of carotid plaque in middle-aged and elderly women GUO Dan-dan, CAO Li, ZHANG Kai, ZHOU Gui-ming 2021, 49 (7):  719-722.  doi: 10.11958/20203242 Abstract ( 1423 )   PDF (385KB) ( 3814 )   Objective　To explore the risk factors of carotid plaques in middle-aged and old women, and to analyze the factors affecting the occurrence and stability of plaque. Methods　From March 2016 to March 2018, middle-aged and old women aged 45-80 years old were selected from the General Hospital of Tianjin Medical University.Carotid artery ultrasonography was performed to observe the intima-media thickness and plaque characteristics. According to the presence or absence of plaque, the patients were divided into plaque group (n=403) and non plaque group (n=551). According to the characteristics of plaque, patients with plaque were divided into two groups: stable plaque group (n=305) and unstable plaque group (n=98). The clinical data, laboratory test results and carotid ultrasound results were collected. The influencing factors of carotid plaque formation were analyzed. Results　A total of 954 middle-aged and elderly women were included in this study, with an average of (62.24±13.24) years old. Compared with non plaque group, age, low density lipoprotein cholesterol (LDL-C) and systolic blood pressure were significantly higher in plaque group (P＜0.05). Logistic regression analysis found that age, LDL-C and menopause were independent risk factors of carotid plaque formation in middle-aged and elderly women. LDL-C was significantly lower in stable plaque group than that in unstable plaque group (P＜0.05). Analysis showed that the higher LDL-C was an independent risk factor for plaque stability. Conclusion　Age, LDL-C and menopause are related to the occurrence of carotid plaques in middle-aged and old women, and LDL-C level affects the stability of carotid plaques. Related Articles | Metrics

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Comparative analysis on clinical efficacy of artificial liver support system and glucocorticoid therapy for severe acute drug-induced liver injury LIU Shi-wei, LIANG Jing, TANG Fei, LIU Hua, LIU Lei, LIU Fang, WANG Feng-mei 2021, 49 (7):  723-726.  doi: 10.11958/20210367 Abstract ( 945 )   PDF (403KB) ( 3851 )   Objective　To compare and analyze the clinical efficacy and safety of artificial liver support system (ALSS) and glucocorticoid in the treatment of severe acute drug-induced liver injury. Methods　The clinical data of 120 patients with severe acute drug-induced liver injury were retrospectively analyzed. These patients were divided into ALSS group and glucocorticoid group according to different treatment methods, with 60 cases in each group. The liver function and adverse reactions were compared before and after treatment between the two groups. Results　The clinical symptoms were significantly improved after treatment in the two groups of patients. Compared with before treatment, the serum alanine transferase (ALT), aspartic acid transferase (AST), total bile acid (TBA) and total bilirubin (TBIL) were significantly reduced after treatment in the two groups (P＜0.05), and the prothrombin activity (PTA) was significantly increased (P＜0.05). The clinical effect of the ALSS group was more significant than that of the glucocorticoid group (P＜0.05). The total effective rate of the ALSS group was significantly higher than that of the glucocorticoid group (χ2=5.175, P＜0.05). There were no serious adverse reactions in the two groups, and the safety of these two methods were good. Conclusion　Both ALSS treatment and glucocorticoid treatment can effectively improve the clinical symptoms and liver function of severe acute liver damage. ALSS treatment is superior to glucocorticoids in effective time and efficiency in the treatment of patients with severe acute drug-induced liver damage, and has higher safety. Related Articles | Metrics

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Comprehensive therapeutic effect of traditional treatment combined with accommodation training in amblyopia children of refractive abnormalities FENG Xin-yuan, NAN Li, TIAN Lu 2021, 49 (7):  727-730.  doi: 10.11958/20210052 Abstract ( 451 )   PDF (373KB) ( 3771 )   Objective　To evaluate the effect of traditional treatment combined with accommodation training in amblyopic children with different ages, different refractive states, different refractive types and different severity. Methods　A total of 83 children (112 eyes) with amblyopia were enrolled in the amblyopia training room of our hospital. All children were treated with traditional treatment combined with accommodation training under the premise of refractive correction, and children with monocular amblyopia were treated with covering therapy at the same time. According to different ages, different refractive types, different refractive states and amblyopic severity, the clinical therapeutic effects of amblyopic children were analyzed in different groups. Results　Among 83 cases (112 eyes), 33 children (44 eyes) were preschool age, 50 children (68 eyes) were school age, 47 children (49 eyes) were anisometropia and 36 (63 eyes) were ametropia. There were 5 children (6 eyes) of hyperopia, 67 (88 eyes) of hyperopic astigmatism and 11 (18 eyes) of myopic astigmatism. Forty-four eyes were mild amblyopia, 65 eyes were moderate amblyopia and 3 eyes were severe amblyopia. The total effective rate of amblyopia was 91.1% (102/112 eyes). The improvement of best corrected visual acuity (BCVA) was significantly higher in the preschool age group than that in the school age group (P＜0.05). The improvement of BCVA was significantly higher in the anisometropia group than that in the ametropia group (P＜0.05).The total effective rate was significantly higher in the hyperopic astigmatism group than that of the myopic astigmatism group and the simple hyperopia group (P＜0.01), but there was no significant difference in the total effective rate between the myopic astigmatism group and the simple hyperopia group. The therapeutic effect was significantly better in the mild group than that of the moderate group and the severe group (P＜0.01), but there was no significant difference between moderate group and severe group. The BCVA improvement was significantly higher in the severe group than that in the other two groups (P＜0.01), where as the changes of BCVA was significantly higher in the moderate group than that of the mild group (P＜0.01). Conclusion　Traditional amblyopia treatment combined with accommodation training can effectively improve the visual acuity of children. The BCVA improvement increases significantly in preschool age, anisometropia, moderate and severe amblyopia children. The effective rate of hyperopic astigmatism is high, and the mild group has good curative effect. Related Articles | Metrics

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The diagnostic value of miR-155 combined with ultrasound in lymph node metastasis of differentiated thyroid carcinoma XU Wei-guo, QUAN Jiang-tao, ZHOU Juan, ZHANG Zhi-lin, LIAO Yang, CHEN Rui 2021, 49 (7):  731-735.  doi: 10.11958/20203017 Abstract ( 938 )   PDF (459KB) ( 3824 )   Objective　To investigate the value of microRNA-155 (miR-155) combined with ultrasound in the diagnosis of lymph node metastasis in differentiated thyroid carcinoma. Methods　A total of 112 patients with differentiated thyroid cancer who were treated in our hospital were selected as thyroid cancer group, and 30 patients with nodular goiter in the same period were selected as benign control group. Real time quantitative PCR (qPCR) was used to detect the relative expression of miR-155 in serum and tissue in the two groups of patients. The relationship between the expression of miR-155 in serum and tissue of patients with differentiated thyroid cancer and clinical pathological parameters was analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of preoperative ultrasound and serum miR-155 for lymph node metastasis of differentiated thyroid cancer. Results　The relative expressions of miR-155 in serum and tissue were significantly higher in thyroid cancer group than those in benign control group (P＜0.01). The relative expression levels of miR-155 in serum and tissue were significantly higher in patients with lymph node metastasis, tumor size＞2 cm and TNM stage Ⅲ+Ⅳ than those in patients without lymph node metastasis, tumor size≤ 2 cm and TNM stageⅠ+Ⅱ (all P＜0.05). ROC results showed that ultrasound and serum miR-155 had certain diagnostic value for lymph node metastasis of differentiated thyroid carcinoma. The area under the curve was 0.839 (95%CI: 0.760-0.919) and 0.837 (95%CI: 0.763-0.912), respectively. But the missed diagnosis rate and misdiagnosis rate were more than 10%. The combined application of the two methods could further improve the diagnostic value of lymph node metastasis of differentiated thyroid cancer, the area under the curve was 0.912 (95%CI: 0.851-0.973), and the missed diagnosis rate and misdiagnosis rate were also reduced to less than 10%. Conclusion　The serum miR-155 combined with ultrasound has high diagnostic value for the lymph node metastasis of differentiated thyroid carcinoma, which has certain clinical application value. Related Articles | Metrics

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Imaging analysis of patients with temporomandibular joint disorder before and after repositioning splint treatment GUO Jun, CAO Jing, LI Cheng, LI Ze-kui, GAO Si-wen, ZHANG Juan 2021, 49 (7):  735-741.  doi: 10.11958/20203347 Abstract ( 1302 )   PDF (885KB) ( 3745 )   Objective　To apply Cone-Beam CT (CBCT) and MRI to analyze the imaging differences of patients with temporomandibular joint disorder (TMD) before and after the anterior repositioning splint (ARS), and to explore the clinical effects of ARS in the treatment of TMD. Methods　A total of 86 TMD patients were collected and divided into ARS group (n=60) and non ARS group (n=26). The non ARS group used muscle function training for six months, and the ARS group was treated with ARS for 6 months with the cooperation of muscle function training. The average maximal mouth opening (MMO), joint snapping percentage, pain visual analogue scale (VAS), CBCT three-dimensional data of temporomandibular joint, joint disc length and disc-condyle distance measured under MRI scan of TMD patients were analyzed before and after treatment in the two groups. The changes in bone quality and morphology of the condyle before and after treatment were analyzed in the ARS group (20 patients) and the non-ARS group with degenerative joint disease (10 patients). Results　Compared with the non ARS group, the MMO increased and the joint snapping and pain VAS decreased after treatment in the ARS group (P＜0.05). Results of CBCT showed that the horizontal angle of the condyle decreased, the anterior joint space narrowed and the posterior joint space widened (P＜0.05). There were no significant differences in the supra-joint space, the anteroposterior diameter of the condyle, the internal and external diameter between the two groups (P＞0.05). Compared with the non ARS group, 20 patients with degenerative joint disease showed a significant improvement in condyle bone quality after ARS treatment in the ARS group, and the bone change score decreased (P＜0.05). MRI results showed that there was no significant difference in the length of the joint disc before and after treatment in the ARS group (P＞0.05), whereas the length of the joint disc was significantly shorter after treatment than that in the non ARS group (P＜0.05). Conclusion　CBCT and MRI can confirm the clinical effect of ARS on the position and morphology of the condyles and articular discs in TMD patients. Related Articles | Metrics

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Effects of intranasal dexmedetomidine on preventing breakthrough pain of epidural labor analgesia JI Tian-zhen, LI Rui, ZHU Hai-juan, LIU Hong-xia, ZHANG Ye 2021, 49 (7):  742-747.  doi: 10.11958/20210237 Abstract ( 857 )   PDF (473KB) ( 3678 )   Objective　To investigate the effect of intranasal dexmedetomidine on preventing breakthrough pain of epidural labor analgesia. Methods　Full-term primigravida with singleton fetus and ASA physical status Ⅰ or Ⅱ (n=100) were randomly assigned to control group and intranasal dexmedetomidine group (observation group). The 0.8 µg/kg of dexmedetomidine or equal volume normal saline were administered intranasally 20 minutes after epidural analgesia for observation group and control group, respectively. The incidence of breakthrough pain, the duration from epidural analgesia to the first onset of breakthrough pain, the frequency of patient controlled epidural analgesia (PCEA), the total dosage of analgesics, the maternal satisfaction with analgesia and the duration of labor phrase were recorded. The effect of intranasal dexmedetomidine on breakthrough pain of epidural labor analgesia was evaluated. The VAS scores, the Ramsay scores and FHR before epidural analgesia (T0), and after epidural analgesia at 1 h (T1), 2 h (T2), 3 h (T3), 4 h (T4), full cervical dilation (T5), fetal disengagement (T6), Apgar scores of neonates and umbilical artery blood gas analysis were recorded in the two groups to assess the effect of maternal and neonatal safety. Results　A total of 91 parturients aged 20 to 36 years were included in this study. Compared with the control group (n=45) , the incidence of breakthrough pain was significantly reduced, the duration from epidural analgesia to the first onset of breakthrough pain was significantly prolonged, the frequency of PCEA and the total dosage of analgesics was significantly reduced, the maternal satisfaction with analgesia was significantly increased, the VAS scores were significantly decreased at T1~3 and the Ramsay scores were significantly increased at T1~3 in the observation group (n=46, P＜0.05). There were no significant differences in the duration of labor phrase, FHR, Apgar scores of neonates, umbilical artery blood gas analysis and the adverse reactions between the two groups (P＞0.05). Conclusion　Intranasal dexmedetomidine for epidural labor analgesia can reduce the incidence of breakthrough pain, delay the first onset of breakthrough pain, decrease the dosage of local anesthetic, and have no obvious adverse effects on parturients and newborns. Related Articles | Metrics

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Clinical observation of Danhong injection in the treatment of chronic obstructive pulmonary disease with CKD and hypoxemia HE Yuan, LI Dong-sheng, LI Yue-hong 2021, 49 (7):  747-751.  doi: 10.11958/20210408 Abstract ( 721 )   PDF (435KB) ( 3804 )   Objective　To study the clinical effect of Danhong injection combined with conventional treatment in chronic kidney disease (CKD) with hypoxemia chronic obstructive pulmonary disease (COPD). Methods　Clinical data of CKD patients with hypoxemian COPD were retrospectively analyzed. There were 50 cases in the conventional treatment group and 50 cases in the Danhong injection group. The conventional treatment group was given the treatment of diuresis, detumescence, anti-inflammation, cough and phlegm, anti-spasmodic and anti-asthma. The Danhong injection group was given intravenous Danhong injection for 14 days on the basis of conventional treatment. Before and after the treatment, the change of indexes including arterial blood gas analysis, renal function and liver function were compared between the two groups. The total score of traditional Chinese medicine (TCM) syndromes, the effective rate of treatment, the improvement of hypoxemia and the safety of treatment were evaluated before and after treatment. Results　After treatment, compared with the conventional treatment group, p(O2) was increased in Danhong injection group, while p(CO2), blood β2, CYS-C and the total score of TCM syndromes were decreased in Danhong injection group (P＜0.05). In the Danhong injection group, blood urea nitrogen (BUN), β2-MG, CYS-C and the total score of TCM syndromes were decreased after treatment (P＜0.05). The therapeutic effect of Danhong injection group was superior than that of conventional treatment group (Z=2.268, P＜0.05). The improvement rate of hypoxemia was significantly higher in the Danhong injection group (56.00%) than that in the conventional treatment group (30.00%, χ2=4.889, P＜0.05). There were no significant differences in related indexed of liver function before and after treatment between the two groups (P＞0.05). Conclusion　Danhong injection can improve renal function, hypoxic environment and clinical symptoms in CKD patients with hypoxemia COPD. Related Articles | Metrics

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The influence of programmed intermittent epidural bolus and continuous epidural infusion on fever during delivery ZHANG Xue-yin, CHEN Li-jian 2021, 49 (7):  752-756.  doi: 10.11958/20202487 Abstract ( 437 )   PDF (406KB) ( 3756 )   Objective　To investigate the effect of programmed intermittent epidural bolus (PIEB) and continuous epidural infusion (CEI) on fever during delivery. Methods　A total of 180 cases of full-term, singleton and head primiparous were selected and divided into PIEB group and CEI group according to the random number table method, with 90 cases in each group. Both groups used a loading dose (0.125% ropivacaine + 0.4 mg/L sufentanil) 10 mL, and the analgesic pump 0.08% ropivacaine + 0.4 mg/L sufentanil. Pulsed administration was started 30 minutes after the loading dose in PIEB group, with an interval of 30 minutes, and the pulsed dose was 10 mL/h. The CEI group was given the background dose continuously after the loading dose injection. In both groups, the amount of PCEA was 5 mL, and the lock time was 30 min. The visual analogue scale (VAS) and fever of uterine contraction pain were recorded before analgesia, 1, 2, 3, 4, and 5 hours after analgesia, during delivery, 1 hour and 2 hours after delivery in the two groups. At the same time, the maternal oxytocin usage during analgesia, labor time, analgesic time, artificial membrane rupture ratio, analgesic drug dosage, PCEA compression ratio, labor analgesic effect satisfaction score and adverse reactions were collected. The birth weight, Apgar score at 1 and 5 minutes after birth, and fever 1 hour after birth of newborn were recorded. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) expression levels before analgesia, during delivery and 24 hours after delivery. Results　The VAS scores of pain at 1 to 5 hours after analgesia and during delivery were lower in the PIEB group than those in the CEI group (P＜0.05). The incidence of fever at 4 to 5 hours after analgesia, during delivery, 1 hour after delivery and 2 hours after delivery was significantly lower in the PIEB group than that in the CEI group (P＜0.05). The PCEA compression demand ratio and the total amount of epidural analgesics were significantly lower in the PIEB group than those in the CEI group, and the analgesic effect satisfaction score was significantly higher in the PIEB group than that of the CEI group (P＜0.05). The expression levels of serum IL-6 and TNF-α were significantly higher after delivery analgesia than before the analgesia in the two groups (P＜0.05), and the serum IL-6 and TNF-α expression levels were significantly lower during delivery and 24 hours after delivery in the PIEB group than those of the CEI group (P＜0.05). Conclusion　PIEB can reduce the incidence of fever during childbirth, reduce inflammation and have a good analgesic effect. Related Articles | Metrics

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The study on changes of body fluid in patients with primary liver cancer LIU Xin, LI Li 2021, 49 (7):  756-759.  doi: 10.11958/20203264 Abstract ( 566 )   PDF (380KB) ( 3953 )   Objective　To observe the changes of body fluid distribution in patients with primary liver cancer (PLC) and to provide the basis for nutritional evaluation of PLC patients. Methods　Eighty patients with PLC were divided into group A, group B and group C according to the Child-Pugh classification of liver function. Twenty-four healthy people were included as normal control group (group N). The total body water (TBW), extracellular water (ECW), intracellular water (ICW), edema index (ECW/TBW) and body cell mass (BCM) were measured by bioelectrical impedance method. Results　In PLC patients, ICW and BCM insufficiency accounted for 37.5% (30/80), ECW abnormality accounted for 42.5% (34/80), and edema (ECW/TBW＞0.39) accounted for 85% (68/80). The proportion of edema patients was significantly higher in group B and group C than that in group A (P＜0.05). All patients in group C showed edema. The proportion of patients with abnormal ICW and BCM increased with the deterioration of liver function (P＜0.05). The content of intracellular water adjusted by ideal weight was significantly lower in group C than that of the control group (P＜0.05). There was no significant difference in ECW/BW and ECW/TBW between the case groups (P＞0.05), but which were higher in the case groups than that of the normal control group (P＜0.05). There were no significant differences in ICW, ECW, ECW/SW and BCM between the case groups and the normal control group (P＞0.05). Conclusion　The number of functional cells is gradually consumed in patients with primary liver cancer, and the abnormal distribution of intracellular and extracellular water in body is common, leading to the increase of edema index. It is suggested that rational nutrition therapy should be carried out as soon as possible. Related Articles | Metrics

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Establishment and evaluation of the revised clinical T staging model for patients with gastric cancer GUO Shi-wei, DONG Yin-ping, WU Zi-zhen, LIU Yong, WANG Xue-jun, ZHANG Ru-peng, LIANG Han, DENG Jing-yu 2021, 49 (7):  760-764.  doi: 10.11958/20202506 Abstract ( 712 )   PDF (469KB) ( 3717 )   Objective　To establish a new clinical T staging model for patients with gastric cancer (GC) and to evaluate its predictive effect, so as to provide the basis for improving the predictive value of clinical T staging. Methods　A total of 227 GC patients underwent radical surgery in our hospital were enrolled in this study. Among them, 102 cases were pT1-pT2 gastric cancer, 125 cases were pT3-pT4 gastric cancer. All patients underwent endoscopic ultrasonography (EUS) and multi-slice spiral computed tomography (CT) examination before operation. Univariate analysis was used to compare the clinical and pathological data, including gender, age, tumor location, Borrmann classification, CT based T staging, the layers of tumor invading the gastric wall under EUS and the maximum short diameter of longitudinal section of tumor under EUS, between pT1-pT2 and pT3-pT4 patients. According to the clinical experience, CT-based T staging and the layers of tumor invading the gastric wall under EUS were included to establish the traditional conventional clinical T staging model (CCTSM). Multivariate Logistic regression analysis was used to further evaluate the risk factors of pT3-pT4 after univariate analysis, and the significant variables were included in the revised clinical T staging model (RCTSM). The receiver operating characteristic (ROC) curve was constructed to assess the performance of two prediction models. Results　The corresponding Logistic regression equation was Logit (P)= -2.599+2.409× CT based T staging + 2.553× the layers of tumor invading the gastric wall under EUS. The results of univariate analysis and multivariate Logistic regression analysis showed that CT based T3-T4 staging (OR=12.528, 95%CI: 4.347-36.109), the 5th layer of tumor invading the gastric wall under EUS (OR=7.533, 95%CI: 2.539-22.353), the longer maximum of the short diameter of tumor longitudinal section under EUS (OR=31.084, 95%CI: 8.681-111.307) were independent risk factors of pT3-pT4 stage in the GC patients. The Logistic regression equation of the revised clinical T staging model was established with these three variables: Logit (P)= -7.884+2.528× CT based T staging + 2.019× the layers of tumor invading the gastric wall under EUS + 3.437×the maximum short diameter of longitudinal section of tumor under EUS. The clinical value of the RCTSM in predicting pT3~pT4 was better than that of the CCTSM (AUC: 0.952 vs. 0.891, Z=3.870, P＜0.01). In the lymph node positive subgroup, the predictive value of the RCTSM was also better than that of the CCTSM (AUC: 0.916 vs. 0.864, Z=2.058，P＜0.05). Conclusion　The RCTSM can better predict the pathological T staging in patients with gastric cancer and provide reliable basis for individualized treatment of GC patients. Related Articles | Metrics

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The clinical study of Nice knot and skin distractor in the treatment of small and medium-sized skin and soft tissue defects CHEN Tao, LIU Li-yin, MA Xin-long, MA Jian-xiong, YU Run-ze, YU De-fu 2021, 49 (7):  765-768.  doi: 10.11958/20210297 Abstract ( 811 )   PDF (862KB) ( 3789 )   Objective　To explore whether the Nice knot can replace the skin distractor in repairing small and medium-sized skin and soft tissue defects by comparing the Nice knot with the skin distractor in the repair of small and medium-sized skin and soft tissue defects. Methods　A total of 60 patients with various small and medium sized skin and soft tissue defects were selected from July 2019 to June 2020. All of skin and soft tissue defects were caused by trauma. According to the treatment methods, the patients were divided into 2 groups, with 30 patients in each group. The patients in group A were treated with Nice knot, and both sides of the wound were fixed with elastic plaster. The suture was tightened every 3 days until the wound healed. The patients in group B were treated with a skin distractor. The operative time, amount of blood loss, operation cost, healing time, wound healing grade A and B rates, wound healing rate 14 days after surgery, VSS score and good and good rate of wound scar were compared between the 2 groups. Results　There were no significant differences in operative time, intraoperative blood loss and wound healing time between the two groups. The operative cost was significantly higher in group B than that of group A (P < 0.01). There were no statistical significances in grade A and grade B wound healing rate, wound healing rate 14 days after surgery, postoperative VSS score and good scar healing rate between the two groups. Conclusion　Nice knot in the treatment of small and medium-sized skin and soft tissue defects has lower cost and lower requirements for medical conditions. It can replace the skin distractor to repair small and medium-sized skin and soft tissue defects. Related Articles | Metrics

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The diagnostic value of urine microRNA-21 expression combined with 3D-US for bladder urothelial carcinoma WANG Lin, XUAN Zhi-dong, ZHANG Ying, LIU Yong-rong, LI Chao, JIANG Li-ning 2021, 49 (7):  769.  doi: 10.11958/20203656 Abstract ( 835 )   PDF (453KB) ( 3787 )   Objective　To investigate the clinical value of microRNA-21 (miR-21) expression in urine combined with three-dimensional ultrasound imaging (3D-US) in the diagnosis of urinary urothelial carcinoma (BUC). Methods　The urine samples of 78 BUC patients (the case group) and 80 patients with benign urinary tract diseases (the control group) were collected. The expression level of miR-21 in urine was detected by real-time quantitative PCR (qPCR). The relationship between miR-21 level and clinicopathological characteristics was analyzed. The 3D-US examination was performed, and receiver operating characteristic (ROC) curve was used to analyze the clinical value of urine miR-21 and miR-21 combined with 3D-US for BUC diagnosis. Results　The relative expression level of miR-21 in urine was significantly higher in case group than that of control group (P＜0.01). The content of urine miR-21 was significantly higher in the infiltrating group than that in the non-infiltrating group, and the expression of urine miR-21 was significantly higher in the high-grade group than that in the low-grade group (P＜0.05). ROC curve analysis showed that the sensitivity and specificity of urine miR-21 expression combined with 3D-US were 94.87% and 96.25% in the diagnosis of urothelial carcinoma, and Youden index was close to the result of cystoscopy. Conclusion　The upregulated expression of miR-21 in urine of BUC patients may be related to tumor progression. Urine miR-21 combined with 3D-US can be used as an effective and non-invasive diagnostic method for screening BUC. Related Articles | Metrics

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Research progress of Notch signaling pathway in liver fibrosis ZHANG Wang, WAN Yi-peng, ZHU Xuan 2021, 49 (7):  773-777.  doi: 10.11958/20210539 Abstract ( 887 )   PDF (405KB) ( 3825 )   Hepatic fibrosis is considered as a kind of repair response of liver to various chronic injury factors. Progressive liver fibrosis can lead to the development of cirrhosis and even hepatocellular carcinoma. Current researches have indicated that liver fibrosis is reversible. Several signaling pathways are involved in the occurrence and development of liver fibrosis, among which Notch signaling pathway plays a critical role in liver fibrogenesis. In this paper, the research progress of Notch signaling pathway in liver fibrogenesis is reviewed. Related Articles | Metrics

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Research progress on the differentiation mechanism of aortic valve interstitial cells YOU Wan-ning, LAI Yong-jie 2021, 49 (7):  778-784.  doi: 10.11958/20210352 Abstract ( 1040 )   PDF (435KB) ( 3897 )   Heart valve fibrosis and calcification are two impartant pathological changes of valvular heart diseases (VHD). The differentiation of valve interstitial cells (VICs) from fibroblast like phenotype to myofibroblast like phenotype or osteoblast like phenotype is considered as the milestone event of the early pathological changes of VHD. Aortic valves are the major target organs in VHD development. In recent years, studies on the differentiation of VICs were mainly focused on aortic valve derived cells. In this paper we summarize the recent findings on the differentiation of VICs, aim to provide a comprehensive background for the development of novel prevention and treatment strategies for VHD. Related Articles | Metrics