Table of Content

21 February 2012, Volume 33 Issue 1

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奖项介绍

This study was awarded with The Second Grade National Prize for Science and Technology Progress——Innovation and application of CT and magnetic resonance imaging techniques in ophthalmologic and otorhinolaryngologic diseases

XIAN Jun-fang

2012, 33(1):  1-4.  doi:10.3969/j.issn.1006-7795.2012.01.001

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This study was designed to improve CT and magnetic resonance imaging (MRI) in ophthalmologic and otorhinolaryngologic diseases. We systemically investigated the relationship between the ophthalmologic and otorhinolaryngologic anatomic structure and physiology, the anatomic variation and disease, and the disease and imaging sign. A system of CT and MRI examination methods in the ophthalmology and otorhinolaryngology was established. Based on CT and magnetic resonance imaging database of ophthalmologic and otorhinolaryngologic diseases, CT and MRI diagnostic system was established and CT and MRI features of common disease was revealed. We proposed and confirmed the mechanism that the defect of bony wall of the vessel within the temporal bone was responsible for pulsatile tinnitus. The neural-muscle distribution hypothesis for congenital complex strabismus was tested. In a word, the serial study promoted recognition, diagnosis, and treatment of ophthalmologic and otorhinolaryngologic diseases.

妇产科热点问题

Isolation and identification of side population cells in human cervical cancer and analysis of biological characteristics

SONG Jing-hua;WANG Ke-fang;LI Bin;ZHANG Jun

2012, 33(1):  5-10.  doi:10.3969/j.issn.1006-7795.2012.01.002

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Objective To isolate side population (SP) cells from human cervical cancer cells and to determine the characteristics of cancer stem cells, so as to investigate the feasibility of starting research on cervical cancer stem cells from the SP cells. Methods The human cervical cancer cells were obtained from fresh human cervical cancer tissue of 40 patients who were diagnosed as cervical cancer. Flow cytometry and Hoechst 33342 dye efflux assay were used to isolate SP cells and NSP cells from the cervical cancer cells. The proliferation and differentiation of the two sub-population cells were observed. The two sub-population cells were injected into nude mice subcutaneously to observe their tumorigenesis ability. The inhibition rates of SP and NSP cells were assessed after treatment with chemotherapy drugs (cisplatin) to evaluate the resistance. Results The proportion of SP cells excluding Hoechst 33342 dye in the human cervical cancer cells was 2.04%±0.93%, and the proportion of the SP cells was decreased with the the degree of reduction of differentiation(P<0.05). Cell growth curve indicated that proliferative capacity of the SP cells was better than the NSP cells (P<0.05). The SP cells demonstrated stronger tumorigenesis ability in nude mice. As few as 1×103 SP cells could give rise to new tumors in xenotransplantation, with a tumorigenesis ability 100 times as high as that of the NSP cells. The time of tumor formation was significantly reduced. After treatment with different concentrations of chemotherapy drugs (cisplatin) for 24h, the SP cells had significantly lower inhibition rate than the NSP cells (P<0.05). Conclusion Human cervical cancer cells contains a small subpopulation of cells excluding Hoechst 33342 dye. The more poorly the cell line differentiated,the fewer the proportion it contained. The SP cells has better proliferative capacity in vitro and stronger tumorigenicity than the NSP cells, with strongly resistant to chemotherapy drugs. The SP cells have the characteristics of cancer stem cells. So it can be applied to the cervical cancer stem cell research.

Expression of PGP 9.5,NGF and their relationship with dysmenorrhea in patients with adenomyosis

WANG Wen-li;DUAN Hua;ZHANG Ying;GUO Yin-shu;CHENG Jiu-mei

2012, 33(1):  11-15.  doi:10.3969/j.issn.1006-7795.2012.01.003

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Objective To study the expression of nerve fibers marked by protein gene product 9.5 (PGP 9.5) and nerve growth factor (NGF) in situ function layer and ectopic endometrium of adenomyosis (ADS), the relation between the expression of PGP 9.5, NGF and NOGO-B and dysmenorrhea, and the role of nerve fibers in adenomyosis and dysmenorrhea.Methods Thirty ADS patients were enrolled and the expression of PGP 9.5, NGF and in in situ function layer and ectopic endometrium were determined by immunohistochemical method. Normal endometrial tissue from 30 individuals and myometrium from 27 individuals was included as the control group. The relationship of dysmenorrhea score of ADS patients by visual analogue scales (visual analogue scale/score, VAS) and the above-mentioned factors were analyzed.Results In in situ endometrial function layer, PGP 9.5 was specifically expressed in ADS patients. The expressions of PGP 9.5, NGF in ADS in situ function layer and ectopic endometrial tissue were stronger.than those of control group(P<0.05). There was significant correlation between the expression of PGP 9.5, NGF and the degree of dysmenorrhea of ADS-E group (P<0.05), r=0.520, 0.688. The same with the expression of PGP 9.5 and NGF and the degree of dysmenorrhea of ADS-M group (P<0.01), r=0.543 and 0.503. Conclusion The special expression of PGP 9.5 in endometrial function layer of adenomyosis suggests that PGP 9.5 may be a new factor to diagnose adenomyosis. The high expression of PGP 9.5, NGF in adenomyosis suggested that the factors mentioned are positively correlated with dysmenorrhea.

Plasma volume expansion for treatment of preeclampsia: a Meta analysis

LI Lin;TIAN Geng;CUI Man-hua

2012, 33(1):  16-19.  doi:10.3969/j.issn.1006-7795.2012.01.004

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Objective To evaluate effect of plasma volume expansion treatment for preeclampsia by Meta analysis. Methods A comprehensive literature search was performed at PubMed, Medline, Ovid, Embase, CNKI in English language for randomized controlled trials, hand search was also made to retrieve the current reference and research reports. Strict inclusion and exclusion criteria were applied to choose original research, and for quality assessment and data extraction, the software Revman 5.0 was used for the Meta analysis. Results A total of 5 reports met the inclusion criteria of, including a total of 297 patients. Meta analysis results suggest that the volume-expansion group, compared with non-expansion groups: 1 had no statistically significant difference in cesarean section rate, RR = 1.08, 95%CI: 0.96~1.22, P = 0.19, 2the difference in the rate of premature delivery was not statistically significant between two groups, RR = 0.91, 95%CI:0.26~3.22, P = 0.89. 3perinatal mortality rate had no significant difference between the two groups, RR = 1.65, 95%CI:0.77~3.54, P = 0.20.4the proportion of Apgar score <7 had no significant difference between the two groups, RR = 1.11, 95%CI:0.54~2.28, P = 0.77. 5the ratio of an additional drugs had no significant difference, RR = 1.91, 95%CI:0.90~4.05, P = 0.09. Conclusion The volume expansion does not improve the treatment of preeclampsia maternal cesarean section rate, perinatal mortality, Apgar score <7 and the application of an additional drug (magnesium sulfate and antihypertensive drugs) ratio.

Proteomics analysis of differential protein expression in serum of pregnant women with preeclampsia and acute phase protein

LIU Chong-dong;LU Qi;ZHANG Zhen-yu;DENG Hai-teng

2012, 33(1):  20-25.  doi:10.3969/j.issn.1006-7795.2012.01.005

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Objective To apply a novel proteomic method to analyze differential protein expression in serum and biomarkers in pregnant women with preeclampsia. Methods Sera from five pregnant women complicated with severe preeclampsia and five healthy pregnant controls were collected and mixed respectively. separated protein. Each mixture was treated with hydrophilic-lipophilic balance(HLB) and peptide ligand library beads (PLLBs) to remove highly abundant proteins and thus enriched less abundant proteins; the proteins from the elute were quantitatively arrayed by a combination of 1D gel -LC/MS/MS.Results Twenty-eight proteins in HLB and 51 proteins in PLLB were differentially expressed between preeclampsia and healthy pregnant women including IL -17F and coruleplasmin.Conclusion The result demonstrated that peptide ligand library combined with 1D gel-LC-MS/MS analysis is an effective method to identify expressed proteins in serum and inflammatory factor may be involved in the etiology of preeclampsia.

Comparative study on sonographic characteristics of placental chorioangioma

LI Jing-hua;GAO Feng-yun;LI Xiao-fei;WU Qing-qing

2012, 33(1):  26-29.  doi:10.3969/j.issn.1006-7795.2012.01.006

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Objective The common placental chorioangioma can be diagnosed by ultrasound examination. Alternatively, the aim of this study was to find the unusual sonographic characteristics for placental chorioangioma in order to raise the accuracy of prenatal diagnosis. Methods Clinical data of 20 patients with placental chorioangioma during pregnancy diagnosed in the hospital from January 2010 to June 2011 were analysed. According to prenatal ultrasonography [B-mode, 3D or color Doppler flow imaging,(CDFI)], clinical pathological characteristics and distinguishing from other placental tumors, unusual sonographic characteristics of placental chorioangioma were explored. Results Among 20 patients with placental chorioangioma during pregnancy, 10 patients(50%) were found to have definite the common ultrasound features;6 patients(30%) were discovered to have uncommon ultrasound features-smaller size of mass, CDFI: a strong signal showing blood flow into it;in 4 patients placental chorioangioma was misdiagnosed. Conclusion The common chorioangioma can be easily diagnosed by ultrasound examination, but sometimes some of placental chorioangioma was missed. Unusual sonographic characteristics of placental chorioangioma may help diagnose the unusual placental chorioangioma and raise the accuracy of diagnosis.

Pten gene mutation in tamoxifen-stimulated endometrium in postmenopausal breast cancer

GUO Lei;LI Wen-jun;MA Xue-lian;FENG Li-min

2012, 33(1):  30-35.  doi:10.3969/j.issn.1006-7795.2012.01.007

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Objective To investigate the influence of tamoxifen on the postmenopausal women and test an assumption whether tamoxifen can cause the endometrial cancer by pten. Methods With PCR-SSCP method, sequence analysis and RT-PCR method, the authors examined the correlation of pten mutation of nine exons in endometrium of postmenopausal women with breast cancer who were taking tamoxifen.Results PCR-SSCP of pten and sequence analysis showed that 4/33 cases (12.12％) of tamoxifen group and 5/22 cases (22.72％) of endometrial carcinoma group had mutation. There was no mutation in normal endometrium group. The differences of pten mutation rate was not significant between tamoxifen and carcinoma groups, and between tamoxifen and normal endometrium groups, but was significant between endometrial carcinoma and normal endometrium groups. Conclusion Pten gene mutation may be a diagnostic biomarker for the early event leading to the cancer.

Analysis of differentially expressed proteins of cervical intraepithelial neoplasia tissues and normal cervix

HE Yue;WU Yu-mei;ZHAO Qun;WANG Xiao-li;CHEN Shuo;QIAN Xiao-hong;ZHANG Yu-xiang

2012, 33(1):  36-44.  doi:10.3969/j.issn.1006-7795.2012.01.008

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Objective To discuss protein markers expressed differentially in normal cervix and cervical intraepithelial neoplasia (CIN) tissues by means of proteomics, providing the new basis to CIN molecular pathogenesis study, clinical diagnosis and treatment. Methods Uterine cervical tissue specimens were collected from the patients between August 2008 and September 2009 in Department of Oncology of Beijing Obstetrics and Gynecology Hospital, from patients with CIN (n=23, CINⅠ 7, CINⅡ 8, CINⅢ 8) and normal cervix (n=9 as controls). Two-dimensional fluorescence difference in gel electrophoresis (2-D DIGE) and DeCyder software were used to find the differentially expressed protein-spots. Then matrix- assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF/TOF MS) was used to analyze the differentially expressed proteins and further to validate 3 strikingly differential proteins S100 calcium-binding protein A9(S100A9), eukaryotic elongation factor 1-alpha-1(eEF1A1)and pyruvate kinase M2 (PKM2) by database searching. Immunohistochemistry (IHC)(n=40, normal cervix 10、CINⅠ 10、CINⅡ 10、CINⅢ 10) and Western blotting (WB)(n=36,normal cervix=12、CINⅠ~Ⅱ 12、CIN Ⅲ~12)were used to verify the differently expressed proteins of S100A9, PKM2 and eEF1A1 between normal cervix and CIN tissues. Results CIN and normal cervix spectrometry were obtained by 2-D DIGE; and Appraisal 25 proteins successfully. IHC and Western blotting test results indicated that S100A9 protein was expressed in the cytoplasm, the expression in CIN levels were higher than that in normal group (P=0.010 ); eEF1A1 protein was expressed in cytoplasm and PKM2 protein was expressed in the nucleus, both the expressions of protein in CIN were lower than that in normal group (P = 0.352 and 0.000). Conclusion There are different protein expressions between CIN and normal cervix tissues. S100A9 protein may be regarded as a cancer marker associated with CIN; PKM2 proteins may be regarded as tumor suppression protein of CIN and the contents of these two differential proteins may help predict the development of CIN.

Analysis of the high risk factors of spontaneous premature labor

FENG Yi;LIN Li

2012, 33(1):  45-49.  doi:10.3969/j.issn.1006-7795.2012.01.009

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Objective To analyze the high risk factors of spontaneous preterm labor. Methods Retrospective analysis was made on 145 patients who had spontaneous preterm labor and 290 pregnant women with normal delivery at the same time. The indexes are analyzed by single and multiple factor Logistic regression with SPSS 11.5 software to analyze the high risk factors of spontaneous preterm labor. Results Negative affairs,fewer obstetric examination times, premature rupture of membranes,intrauterine infection, vaginitis during pregnancy, gestational diabetes mellitus (GDM) and multiple pregnancy are the highest risks for spontaneous preterm labor. Gestational BMI increase is the protective factor for spontaneous preterm labor. Conclusion The high risk factors of spontaneous premature labor are complex.

普通外科诊断与治疗

Impact of runoff on the prognosis of femoropopliteal angioplasty in patients with diabetes

TAN Zheng-Li;SONG Xi-tao;YU Zheng-ya

2012, 33(1):  50-54.  doi:10.3969/j.issn.1006-7795.2012.01.010

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Objective To evaluate the implication of runoff score on the primary patency of femoropopliteal angioplasty in patients with type 2 diabetes mellitus, using the Society for Vascular Surgery (SVS) criteria. Methods A retrospective review of a database of 37 patients with type 2 diabetes mellitus (41 legs) undergoing femoropopliteal angioplasty between 2006 January and December 2010 was made. Demographic characteristics and possible related diseases were recorded. Procedural angiograms were classified according to TASC Ⅱ criteria. SVS runoff scores were determined after the completion of the intervention and the primary patency were calculated. Cox proportional hazard model was used to determine if runoff score and other factors affected the outcome. Results Thirty seven patients(41 legs) were included. Among the 41 legs, 22 underwent bare metal stent implantation. Twenty two legs underwent tibial angioplasty successfully. According to TASC Ⅱ, the lesion severity scores were: TASC Ⅱ A 22 legs, TASC Ⅱ B 19 legs. Post-procedural runoff score: 1~3, 3 legs; 3.5~5, 7 legs; 5.5~7, 15 legs; 7.5~10, 16 legs. The median runoff score was 7 (ranged from 1 to 9.5). Follow-up time ranged from 1 month to 48 months (median 12 months). 95.1% patients were fully followed. Two patients were lost. The total primary patency rates at the 1, 3, 6 months and 1, 2, 3 years were 95.0%,92.5%, 92.5%,77.4%,65.3% and 45.5% respectively. By Cox regression analysis, post-procedural runoff score according to SVS criteria affected primary patency significantly (RR=1.857,P=0.003,95%CI:1.230~2.806). Conclusion Compromised runoff negatively affected the primary patency of femoropopliteal angioplasty. High post-procedural runoff score is a main risk factor related to loss of primary patency.

Clinical outcomes of hepatic artery bypass reconstruction in liver transplantation using allogenic iliac artery

LAI Wei;LIU Yuan;LU Shi-chun;LI Guan-yin;LI Chuan-yun;WU Ju-shan;DUAN Bin-wei;DAI Chuan-zhou;ZENG Dao-bing

2012, 33(1):  55-58.  doi:10.3969/j.issn.1006-7795.2012.01.011

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Objective To learn the clinical outcomes of hepatic artery bypass reconstruction of liver transplantation (LT) using allogenic iliac artery on special occasions. Methods The clinical data of 427 patients who received LT from 2004 to 2010 in our liver transplantation center were reviewed retrospectively and the methods and clinical outcomes of hepatic artery bypass reconstruction of LT using allogenic iliac artery were analyzed. Results Hepatic artery bypass reconstruction were successfully performed 13 times in 12 cases by using allogenic iliac artery; 11 times were allogenic iliac artery-recipient’s abdominal aorta bypass, 1 time was allogenic iliac artery-recipient’s splenetic artery bypass,1 time was allogenic iliac artery-recipient’s left common iliac artery bypass; 4 times of hepatic artery bypass reconstruction were performed because of the second LT, 9 times of the reconstruction were performed because of useless of recipients’ hepatic artery (including one living donor LT, LDLT). Time consumption of hepatic artery bypass construction was ranged from 90 to 120 minutes. The grafts survival time was (511.8±573.9) days (range from 2 to 1 577 days, median 270 days), the recipients survival time was (554.5±606.1) days (range from 2 to 1 577days, median time 317 days). There were no complications related to hepatic artery bypass reconstruction in the follow-up period. Conclusion Hepatic artery bypass reconstruction of LT using allogenic iliac artery on special occasions is a safe and effective method, but the preexisting comorbidities and poor situations of recipient may lead to poor survival after LT.

Clinical application of laparoscopic versus open surgery in treatment of colorectal cancer and its effects on human immune function.

CAO Guang;TAO Zhen-zhou;WU Ji-xiang

2012, 33(1):  59-62.  doi:10.3969/j.issn.1006-7795.2012.01.012

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Objective To compare the effects of different surgical methods in treatment of colorectal cancer and on immune function. Methods From June 2006 to January 2011, 123 cases of colorectal cancer were treated in the department, 40 of whom received open surgery, and 42 patients received abdominal lifting laparoscopic surgery and 41 patients received carbon dioxide pneumoperitoneum laparoscopic surgery. The therapeutic efficacy, operation time, blood loss, the first exhaust time, the length of specimen and the total number of lymph nodes were compared. In addition, the serum level of IgA, IgM, IgG, C-reactive protein (CRP) in peripheral blood were assayed by ELISA, which might reflect the effects of different surgery on human immune function.Results In abdominal lift laparoscopic group, pneumoperitoneum laparoscopic group and open surgery group, the operation time was (188.7±23.3)min, (192.5±24.0)min and (185.9±30.8)min, the length of specimen was (20.6±1.9)cm, (21.5±3.0)cm and (21.7±3.2)cm, the total number of lymph nodes dissected was (15.3±4.3,14.8±3.4 and 16.8±5.6) and there was no significant difference in the aspects mentioned above (P>0.05). However, the intraoperative blood loss [(194.0±79.0)mL, (187.1±80.9 )mL, (231.2±67.6)mL] and the first exhaust time after operation [(46.9±9.3)h, (49.1±10.3)h, (64.1±13.4)h], both showed significant different (P<0.05). In addition, the three groups of patients had no significant deviation in IgA、IgG, IgM and CRP before operation. But three days after operation, IgM (0.69±0.15;1.15±0.48;0.98±0.42) and CRP(58.75±10.74;39.38±14.48;44.53±11.08) had significant difference. Conclusion Among the three groups, there was no significant difference in the number of lymph nodes dissected, operation time and the length of specimen. However, in the aspect of blood loss, the first exhaust time, IgM and CRP that reflect the immune response, the two laparoscopic groups were better than the open surgery group.

Randomized comparison of the pathologic changes of lymph node between mastoscopic and conventional axillary lymph node dissection

LUO Cheng-yu;JI Xiao-xin;LIN Hua;YANG Qi;ZHANG Jian;LIU Bao-yin;GUAN Chen

2012, 33(1):  63-67.  doi:10.3969/j.issn.1006-7795.2012.01.013

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Objective To study the pathologic changes of lymph node between mastoscopic and conventional axillary lymph node dissection.Methods A group of 200 consecutive patients with operable breast cancer were prospectively randomized to undergo axillary lymph node dissection by mastoscopic or conventional approach. The total lymph node numbers, ratio of metastatic lymph node, mean lymph nodes harvested, mean lymph node size and pathologic changes of lymph node were compared. Results There was no significant difference (P>0.05) between the two groups regarding the total lymph node numbers(1 781 in mastoscopic group vs 1 737 in conventional group), ratio of metastatic lymph node(11.9％vs 13.4％), mean lymph nodes harvested(17.8±5.8 vs 17.4±4.9), mean lymph node size (0.33 vs 0.38 cm). The morphologic changes included rupture of the membrane of lymph node, hemorrhage in lymph node, capsular detachment and fragmentation. The change was 6.8% for the mastoscopic group versus 6.2% for the conventional group in total 3 518 lymph nodes in the two groups (P>0.05). Conclusion Compared with conventional axillary lymph node dissection, mastoscopic axillary lymph node dissection by liposuction did not affect the pathologic characteristics of lymph nodes. It did not cause more injury to lymph nodes. This operation is safe and useful in the oncology.

Early goal-directed fluid resuscitation for severe acute pancreatitis in early stage

CHEN Hong;SUN Jia-bang;ZHU Yan;JIA Jian-guo;LI Fei;LIU Da-chuan

2012, 33(1):  68-73.  doi:10.3969/j.issn.1006-7795.2012.01.014

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Objective Appropriate and timely initial fluid resuscitation in severe acute pancreatitis (SAP) is critical. The aim of this retrospective study was to evaluate the effects of difference between fluid therapy on an early goal-directed approach to resuscitation basis and the standard fluid therapy of adequate resuscitation on the prognosis of SAP. Methods The clinical data of SAP patients admitted to surgical intensive care unit within 72 hours after onset of symptoms between January 2000 and January 2010 were analyzed retrospectively. A total of eighty patients with a confirmed diagnosis of SAP were divided into two groups based on whether adopting the early goal-directed fluid resuscitation strategies or not. Patients admitted between January 2000 and December 2004 did not adopt the early goal-directed fluid resuscitation strategies, therefore, were allocated into standard fluid therapy group (n=34); the other patients admitted between January 2005 and January 2010 adopted the early goal-directed fluid resuscitation strategies and were allocated into early goal-directed fluid therapy group (n=46). With the exception of the fluid therapy strategies, the patients in the two groups received standard treatment for SAP. The acute physiology and chronic health evaluation Ⅱ score (APACHEⅡ) and multiple organ dysfunction score (Marshall), rate of multiple organ dysfunction syndrome (MODS) within the first week of hospital admission, pancreatic infection, and in-hospital mortality were compared between the two groups. Results Compared with the standard fluid therapy group on day 3 after admission, APACHEⅡ score and Marshall score decreased significantly in the early goal-directed fluid therapy group (APACHEⅡ score: 8.22±3.89 versus 11.35±4.27, P=0.017; Marshall score: 4.48±2.21 versus 6.82±3.15, P=0.021, respectively). In addition, patients in the early goal-directed fluid therapy group experienced a trend toward lower rate of MODS within the first week of hospital admission, pancreatic infection and in-hospital mortality (rate of MODS: 52% versus 62%,P=0.393;rate of pancreatic infection: 37% versus 44%,P=0.653;in-hospital mortality: 17% versus 24%,P=0.576, respectively) that did not reach statistical significance.ConclusionAlthough early goal-directed fluid therapy for SAP in acute response stage may have ameliorated the patient’s condition and improved outcome to a certain degree, carefully designed clinical trials should be performed in a randomized controlled manner to assess the role of such fluid resuscitation in SAP.

Analysis of imaging characteristics, treatment and prognostic factors of primary abdominal cocoon

LI You-guo;SONG Mao-min;BAI Ri-xing;ZHENG Jian-wei;YUAN Hui-sheng

2012, 33(1):  74-78.  doi:10.3969/j.issn.1006-7795.2012.01.015

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Objective To investigate the imaging characteristics and prognostic factors of primary abdominal cocoon.Methods The clinical features, CT information, treatment and prognosis of patients with primary abdominal cocoon in Beijing Tiantan Hospital from January 2000 to December 2009 were retrospectively analyzed.Results All 6 patients showed an obstruction. Abdominal plain X-ray showed intestinal loop expansion of product gas and liquid gas plane in the small bowel. Abdominal CT examination showed a conglomeration of multiple small bowel loops encapsulated in a thickened capsule. Abdominal ultrasound examination showed some expansion of small bowel and 4 patients showed a small amount of ascites. Five patients had barium meal examination, all demonstrated barium slowly moved through the distal ileum, with one of the 5 patients showing stenosis in the distal ileum, another one showed complete obstruction. Laparotomy revealed that all or part of the small intestine was wrapped by a layer of dense gray tough fibrous membrane and the omentum was absent. All the patients underwent partial fiber membrane cystectomy, adhesion lysis, etc., 1 case underwent partial small bowel resection. All patients were cured.Conclusion Gastrointestinal imaging and abdominal CT examination has important diagnostic value for primary abdominal cocoon. Surgery is a safe and effective treatment.

Treatment of pancreatic cystic neoplasm

WANG Ya-jun;SUN Jia-bang;LI Fei

2012, 33(1):  79-83.  doi:10.3969/j.issn.1006-7795.2012.01.016

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Pancreatic cystic neoplasm is mainly divided into three types, serous cystic neoplasm (SCN), mucinous cystic neoplasm (MCN) and intraductal papillary mucinous tumor (IPMN). SCN is mostly benign, rarely malignant, and mostly microcystadenoma. Classic appearance of SCN is honeycomb-like structure. MCN has obvious malignant tendency, mostly larger and separated cyst. The characteristic of IPMN is connection with the pancreatic duct which is usually dilatation. Imaging features of the cyst is the main evidence to identify the type of the cystic tumor. It should also be differentiated from solid pseudopapillary tumor (SPT) and pseudocyst. All the cystic tumors of pancreas, including those already got a clear diagnosis and small lesion without obvious symptoms or smaller IPMN of branch-type, should be treated with surgery. The majority can get long-term survival with complete tumor resection. Specific surgical approach should be based on tumor location, histological type, the relationship with the main pancreatic duct, the surgeon experience and the systemic situation of the patients.

基础研究

Measurement of redox potentials of cysteine/cystine and reduced glutathione/oxidized glutathione in plasma by high performance liquid chromatography

YANG Hui-min;ZHU Jia-wei;ZHAO Chen-long;ZHANG Chen-guang;ZHANG Hong;ZHAO Wen-ming

2012, 33(1):  84-88.  doi:10.3969/j.issn.1006-7795.2012.01.017

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Objective The systemic redox imbalance can lead to the occurrence of oxidative stress, which is closely associated with tumor, aging and various diseases. The redox potentials (E_h) measuring the poise of thiol/disulfide redox couples such as cysteine/cystine (Cys/CySS) and reduced glutathione/oxidized glutathione (GSH/ GSSG) in plasma are useful indicators of systemic oxidative stress and other physiological states. This study describes a rather sensitive new method to determine the levels of Cys/CySS and GSH/GSSG in plasma. Methods After removal of the red blood cells and proteins in rats’ blood, iodoacetate was used to alkylate free thiols, followed by derivatization with dansyl. The levels of Cys/CySS and GSH/GSSG were separated by HPLC and the corresponding redox potentials(E_h) were caculated by Nernst equation. Results With high sensitivity and accuracy, this method can be used simultaneously to detect the levels of both Cys/CySS and GSH/GSSG in plasma and to calculate the corresponding redox potentials(E_h). Conclusion The study provides a more convenient and effective method to detect the redox environment of plasma that might be helpful for the diagnosis of clinical diseases related to oxidative stress.

Investigation of chiral recognition between two kinds of β-cyclodextrin and phencynonate by tandem quadrupole mass spectrometry

LIU Zhi-qi;WANG Min-gang;LIU Ying;LI Yu-hang;XUE Ming

2012, 33(1):  89-93.  doi:10.3969/j.issn.1006-7795.2012.01.018

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Objective To investigate the stereoselectivity recognition of β-cyclodextrin or 2,3,6-tri-o-methyl-β-cyclodextrin as the chiral selector with phencynonate, a novel chiral anticholinergic agent. Methods β-Cyclodextrin or 2, 3, 6-tri-o-methyl-β-cyclodextrin was mixed with phencynonate in equal volume and formed the complexes, respectively. The samples were injected directly to the tandem quadrupole mass spectrometry. In positive ion mode, the relative abundances and the combination rate of β-cyclodextrin or 2, 3, 6-tri-o-methyl-β-cyclodextrin with phencynonate isomer complex were analyzed. Results 2,3,6-Tri-o-methyl-β-cyclodextrin had strong recognition ability of stereoselectivity to chiral phencynonate isomers, but the chiral recognition ability of β-cyclodextrin to phencynonate isomers was not significant.Conclusion There is markedly stereoselective interaction between 2,3,6-tri-o-methyl-β-cyclodextrin and phencynonate.

Research of the normal syndrome element of psoriasis vulgaris by latent structure theory

XU Wen-jie;WANG Tian-fang;LIU Wei-hong;WU Xiu-yan;ZHANG Hui-na;ZHANG Guang-zhong;ZHANG Lian-wen;JIANG Chun-yan;CHEN Wei-wen;LIU Wa-li;QU Xing;WANG Ping;LI Ping

2012, 33(1):  94-98.  doi:10.3969/j.issn.1006-7795.2012.01.019

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Objective To find out the normal syndrome elements and symptoms of psoriasis vulgaris by using latent structure theory. Methods The symptoms of psoriasis vulgaris patients were collected by a uniform form, psoriasis vulgaris database was established and the data were copied into the database. The data were analyzed by constructing a Psoriasis Vulgaris latent structure model, and the results were explained by professional knowledge of Chinese Medicine. Results The latent structure model of psoriasis vulgaris had 43 latent variables and 111 latent categories. By using the Chinese medicine theory, it was concluded that the syndrome-elements of location of psoriasis vulgaris were: blood, liver, kidney, and spleen; the syndrome-elements of nature of disease of psoriasis vulgaris were: heat of blood, blood stasis, blood deficiency, dry because of blood deficiency, yang deficiency, qi deficiency, yin deficiency, dampness and heat. Conclusion The research used latent structure to analyze the data by no supervising, found latent structure is similar to the Chinese medicine theory. It is more objective and is a good way to do the syndrome standard research work. The research gave some support to establish standard for syndrome diagnosis of psoriasis vulgaris.

Effect of Shexiangbaoxin pills on expression of renal angiotensin Ⅱ receptor subtypes in rats with heart failure

LIU Fei;LI Yan-fang;CAO Fang-fang;ZHANG Ling-ji;BAI Xue-yuan;LV Yang

2012, 33(1):  99-102.  doi:10.3969/j.issn.1006-7795.2012.01.020

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Objective To explore the effect of Shexiangbaoxin pills (SXBXP) on expression of renal angiotensin Ⅱ receptor(ATR) subtypes in rats with heart failure.Methods Eighty male Wistar rats were randomly divided into control group (group A, n=10) and sham operation group (group B, n=10). The heart failure model was established successfully in 35 of the rest 60 male Wistar rats. The 35 heart failure model rats were randomly divided into four group: heart failure model group (group C, n=9), medicine control group (group D, n=8), small dose of SXBXP group (group E, n=9) and large dose of SXBXP group (group F, n=9). The mRNA levels of ATR subtypes of renal cortex were measured by reverse transcription polymerase chain reaction (RT-PCR) in each group. Results Compared with group A, expression of AT₁R and AT₁R showed no significant difference in group B(P>0.05), compared with group B, expression of AT₁R was increased significantly in group C(P<0.05), expression of AT₁R was decreased significantly in group C(P<0.01). Compared with group C, expression of AT₁R was decreased significantly in group D, E and F(P<0.05), expression of AT₁R was increased significantly in group D, E and F(P<0.01). Compared with group E, expression of AT₁R was decreased significantly in group F(P<0.05). Conclusion SXBXP regulated the expression of renal ATR subtypes, including the downregulation of AT₁R and the upregulation of AT₁R in rats with heart failure, and it is also effective to protect renal function and improve heart failure, especially large dose of SXBXP.

Determination and significance of the concentration of urokinase-type plasminogen activator in serum in late-onset Alzheimer's disease

XIANG Shao-tong;XU Shu-wen;LI Dong-feng

2012, 33(1):  103-106.  doi:10.3969/j.issn.1006-7795.2012.01.021

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Objective To study the association between the levels of urokinase-type plasminogen activator (uPA) in serum and late-onset Alzheimer's disease (LOAD). Methods ELISA was adopted to determine the concentration of uPA in serum of the 44 LOAD sufferers and 40 subjects from the control group. The polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP) technique was used in detecting the polymorphism of the P141L polymorphisms of urokinase plasminogen activator gene (PLAU) in all cases, and to analyze the concentration of the uPA of different genotypes. Results The difference in the concentration of uPA in blood serum between the LOAD group and the control group was not significant (P>0.05), either was the difference among the singulorum degree of LOAD groups and the control group (P>0.05). The concentration of uPA in C/C genotype group and C/T genotype group were both higher than T/T genotype group, and the difference among the three groups was significant statistically (P<0.01). Conclusion The uPA level of LOAD sufferers in serum cannot be taken as the biomarker for the diagnosis of AD. Neither can it reflect the degrees of dementia. The concentration of uPA in T/T genotype group is lower than that in C/T and C/C group, indicating that the C→T mutation in exons 6 of PLAU gene may reduce the level of uPA, which might provide a new ideas to research on pathogenesis of AD.

Study on determining of total polyphenols content in agrimonia pilosa ledeb. by the spectrophotometry

LI Qian;LIU Zi-jin;YE Yan-bin;XIA Ying;ZHANG Feng

2012, 33(1):  107-110.  doi:10.3969/j.issn.1006-7795.2012.01.022

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Objective To propose a method to determine the total polyphenols in agrimonia pilosa ledeb. Methods Folin-Ciocalteus reagent and gallic acid as the standard were used to determine the total polyphenols in agrimonia pilosa ledeb by the spectrophotometry. 0.5mL of Folin-Ciocalteus reagent and 1.7mL of 20% Na₂CO₃ solution were added into 10mL volumetric flask which contained the certain amounts of agrimonia pilosa ledeb sample. The reaction continued of 90 min at room temperature, and then determined absorption value at 660nm and 760nm. Results The mass concentrations of polyphenols in the interval of 0~10.4 mg/L were linearly related to the absorption values. The standard curve at 760nm was y=0.091 8x+0.012 9, R²=0.999 3 and the recovery of total polyphenols was 98.4%~99.8%. The standard curve at 660nm was y=0.084 7x-0.002 6, R²=0.999 7 and the recovery of total polyphenols was 101.2%~101.9%. Conclusion It showed good precision, repeatability and recovery to determine total polyphenols both at 760 nm and 660nm. This research provided a reference for quantitative analysis total polyphenols of agrimonia pilosa ledeb.

Study on psychology of medical college students of national defense with Symptom Check List 90(SCL-90)

LI Tao;LI Li-ping

2012, 33(1):  111-114.  doi:10.3969/j.issn.1006-7795.2012.01.023

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Objective To understand psychological health status of medical college students of national defence to provide scientific basis for teaching of national defence students and life management.Methods Totally 174 medical college students of national defence were tested with Symptom Check List 90 (SCL-90). Results The national defence students’ psychological health conditions were better than national military norm, but was not outstanding as compared with local college students’ psychological health norm.Conclusion It is necessary to develop all-around psychological health education for national defence students and design appropriate psychological health education mode according to aptitude, so that their psychological quality could be improved.

临床研究

Investigation on the situation of secondary prevention in elderly patients with acute myocardial infarction

XU Min;GUO Jin-cheng;HUA Qi

2012, 33(1):  115-120.  doi:10.3969/j.issn.1006-7795.2012.01.024

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Objective To investigate the situation of the secondary prevention and analyze the influencing factors on secondary prevention and explore the relationship between secondary prevention and major adverse cardiac events (MACE) among the elderly patients after acute myocardial infarction (AMI). Methods In this retrospective study, a total of 107 hospitalized elderly survivors (73 male, 34 female) with ST-segment elevation myocardial infarction (STEMI) were enrolled from October 2009 to July 2010 in Beijing Lube Hospital, the mean age was 66.54±6.19 (60 to 84) years. All the cases were followed up in clinic in January 2011,follow-up time was 6 to 15 months.According to the situation of secondary prevention, 107 cases were divided into two groups: good secondary prevention group (45 cases) and poor secondary prevention group (62 cases). The influencing factors on secondary prevention were analyzed and the incidence of MACE of the two groups were compared.Results The situation of secondary prevention of 42.1% of patients was well. A stepwise logistic regression analysis further suggested the following independent predictors to secondary prevention: the degree of receiving health education (OR=9.14,95%CI: 1.57~53.31), type of medical insurance(OR=9.32, 95%CI:1.80~48.22). The incidence of MACE and clinical events of good secondary prevention group was significantly lower than the poor secondary prevention group (8.9% vs 40.3%, 17.8% vs 57.8%, P﹤0.05). Conclusion The secondary prevention in elderly patients with acute myocardial infarction after discharge is not optimistic, and there was a wide gap to the guideline of AMI. The type of medical insurance and the degree of receiving health education were independent variables to predict the secondary prevention. Good secondary prevention can significantly reduce major adverse cardiac events.

Clinical effects of minimally invasive microscopic surgery on lumbar disc herniation

KANG Wei-bo;Maimaiti·Aiyireti;ZENG Zheng

2012, 33(1):  121-125.  doi:10.3969/j.issn.1006-7795.2012.01.025

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Objective To evaluate the efficiency of surgical treatment of lumbar disc herniation by microsurgical lumbar discectomy (MSLD). Methods A clinical review was conducted on the two surgical methods for single segment lumbar disc herniation (LDH) from April 2007 to June 2010, one group of 30 patients who underwent microsurgical lumbar discectomy (MSLD) and the other of 30 patients who underwent open lumbar discectomy (OLD). The factors considered included the length of skin incision, the operative time, volume of intraoperative bleeding, duration of hospitalization, pre- and postoperative assessment based on the criteria of Japanese Orthopaedic Association (JOA) Scores, visual analog scale (VAS), and the Oswestry disability index (ODI). Results The mean length of skin incision was (2.8±0.8)cm and (5.5±1.8)cm, the operative time was (57.0±16.9) min and (72.0±30.5) min, the blood loss was (85.0±33.0) mL and (110.0±48.0) mL, the hospitalization time was (10.2±2.5) days and (12.2±3.6) days for MSLD and OLD respectively. All had significant difference (P<0.01). Three months after the operation, the improvement rate of JOA was 85.3%±8.3％ and 84.9%±7.6％ for MSLD and OLD respectively. The improvement rate of VAS score was 86.4%±1.9％.and 84.4%±2.1％ for MSLD and OLD respectively. The improvement rate of ODI score was 81.5%±6.3％ and 80.8%±5.6％ for MSLD and OLD respectively. None showed any significant difference (P>0.05). Conclusion MSLD has advantages of little cut, little bleeding, clear surgery field, safety, little hurt to nerve root and dura mater. But skilled operation requires a relatively long period of microsurgery training as foundation.

综述

Gasotransmitter hydrogen sulfide and ischemic reperfusion

WANG Xin-bao

2012, 33(1):  130-135.  doi:10.3969/j.issn.1006-7795.2012.01.028

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Recently hydrogen sulfide (H₂S) is considered the third gasotransmitter and exerts important biological effects in mammals. Studies found that H₂S could reduce ischemia reperfusion injury in heart, lung, liver, kidney and intestine. The mechanisms were related to opening of ATP sensitive kalium channel, reducing free radical formation, and inhibiting cell apoptosis and inflammation. The present article reviewed the effect and mechanisms of H₂S on ischemic reperfusion.