Table of Content

21 June 2011, Volume 32 Issue 3

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传染病及相关慢性疾病研究进展

Identification of integrated hepatitis B virus mutations inhepatocellular carcinoma

ZHANG Ting;XU Qiang;YANG Zi-wei;JIANG Su-zhen;LU Feng-min;CHEN Xiang-mei;ZHUANG Hui

2011, 32(3):  313-317. 

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Objective To investigate the relevance of the basic core promoter(BCP) mutants of integrated hepatitis B virus(HBV) in liver tissues from patients with hepatocellular carcinoma(HCC).
Methods Alu repeat sequence polymerase chain reaction(Alu-PCR) and ligation-mediated(LM)PCR were used to identify the HBV integration in 40 pairs of HBV-related HCC tissues and adjacent non-tumorous liver tissues. The PCR products were purified and subjected to direct sequencing by ABI 3700 Auto sequencer. NCBI BLAST and Bio Edit software were used for analysis of HBV sequence.
Results In 40 HBsAg positive HCC samples, 26(65.0%) showed HBV integration in host genome, with a total of 37 different HBV integrated fragments. In adjacent liver tissues, 27(67.5%) showed HBV integration, and with a total of 68 different HBV integrated fragments in host genome. The HCC showed an average of 1.42 HBV integration events per tissue, which was significantly lower than that in adjacent liver tissues(2.52). Further sequence analysis revealed a tendency of increased A1762T/G1764A mutation frequency from adjacent liver tissues to HCC tissues, although the difference was not statistically significant.
Conclusion The high frequencies of HBV integration in both tumor and adjacent non-tumor tissues demonstrated again that hepatitis B virus integration occurred in early stage during HCC development. In addition, integrated hepatitis B virus DNA containing core promoter mutations at nucleotides 1762 and 1764 was also found both in hepatocellular carcinoma and adjacent tissues, with increasing frequency from adjacent tissues to HCC, suggesting the possibility that insertional mutagenesis resulting from hepatitis B virus integration could play a role in hepatocarcinogenesis in some patients.

HBV-related gene c18orf54 cloning and preliminary function

CHANG Lu-si;QIAO Yong;WEI Hong-lian;XIAO Fan;HAO Xiao-hua;ZHANG Ren-wen;CHENG Jun;WEI Hong-shan

2011, 32(3):  318-323. 

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Objective To express and purify the recombinant protein, and to prepare the c18orf54 specific rabbit polyclonal antibody.
Methods c18orf54 cDNA was ligated into the prokaryotic expressive vector pET-32a(+), and the resulting plasmid was transformed into E.coil BL21(DE3). The protein expression was induced with IPTG and the protein was analyzed with sodium dodecyl sulfate-polyacrylamide gel electrophoresis(SDS-PAGE) and Western blotting. The expressed product was purified using Ni⁺ affinity column chromatography. The recombinant protein was also confirmed with mass spectrometry. Then the purified C18ORF54 fusion protein was used to immunize New Zealand rabbits to gain polyclonal antibody. The specificity and potency of polyclonal antibody were evaluated by Western blotting and ELISA.
Results The C18ORF54 fusion protein was highly expressed. The protein was mainly in the inclusion body. ELISA indicated the titer of polyclonal antibody>1∶320 000. The high specificity was confirmed with Western blotting. Immunohistochemical staining of liver tissue showed that this glycosyltransferase was mainly scattered in cytoplasm of hepatocytes.
Conclusion The recombinant C18ORF54 fusion protein and the c18orf54 specific polyclonal antibody will be valuable tools for the investigation on the biological function of C18ORF54.

Mutation profiles of basic core promoter and precore and pres in patients with chronic hepatitis B virus infection and their clinical implications

ZHANG Xin#;WU Yan-ning#;ZHANG Da-ke;DONG Pei-ling;FAN Chun-lei;LI Lei;

2011, 32(3):  324-330. 

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ObjectiveTo analyze the mutation profiles and their implications of basic core promoter(BCP), precore(PC) and pres in patients with chronic hepatitis B virus(HBV) infection.
MethodsTotally 180 patients with chronic HBV infection were included. Of them, 13 were asyptomatic hepatitis B virus carriers(CC), 75 were chronic hepatitis(CH) patients, 62 and 30 were cases with HBV related liver cirrhosis(LC) or carcinoma(HCC). Serum HBVDNA was extracted using QIAamp DNA MiniKit and the BCP/PC and PreS genes were amplified with routine PCR. The gene sequence was directly measured using ABI377 DNA sequencing machine. If sequencing failed, cloning products were also sequenced. The bioinformatics were analyzed with SeqMan software.
ResultsMutation profiles of bcp/pc included nt 1753, nt 1762, nt 1764, nt 1776, nt 1803, nt1846 and nt 1896. The mutation frequency of nt 1762（nt 1764）in patients with CC, CH, LC and HCC were 7.7%, 68.0%, 72.7%（68.0%） and 90.9%（81.8%）, respectively. The frequency of G1896A mutation in HCC patients was 54.6%. A1762T+G1764A, A1762T+G1764A+G1896A or T1753A/C+A1762T+G1764A+
G1896A was 36%,11%,7%,respectively. The mutation frequency of A1727G in LC and HCC patients were 72% and 63%. There were more mutations in HBeAg negative patients（P=0.022）. G1776A and G1896A mutation were independently predicted HBeAg loss(P＜0.05). The deletion frequency of PreS1, PreS2 and PreS1+S2 were 41.2%, 58.8%, 29.4% in LC patients and 7.1%, 71.4%, 7.1% in HCC patients(P＜0.05).
Conclusion Mutations of A1727G, A1762T, G1764A and A1762T+G1764A and PreS deletion were more common in HBV related LC and HCC patients. G1776A and G1896A mutations were independently related to HBeAg loss. A1762T and G1764A mutations and PreS deletions may early predict HCC development, although this warrants further studies.

Plasma amino acids in CCl₄ induced cirrhosis in rats intervened by compound pollen nutrients

KONG Ming;SHI Hong-bo;CHEN Gong;ZHAO Jun;DING Mei;DUAN Zhong-ping;CHEN Yu

2011, 32(3):  331-336. 

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Objective To observe the changes of plasma amino acids in CCl₄ induced cirrhosis in rats intervened by compound pollen nutrients.
Methods Totally 45 SD rats were randomly divided into control group(n=10) and model group(n=35). The rats in the model group were given 40% CCl₄ sunflower seed oil solution(0.2 mL/100 g weight ) by intraperitoneal injection, twice per week for 12 weeks. In the 12th week, 32/35 rats in the model group were found to have liver cirrhosis confirmed by pathology, the rats in control group were all alive. Four rats in model and 3 in control group were sacrificed before the nutritional intervention and the levels of plasma amino acids were measured as baseline. The left 7 rats from control group were sacrificed at week 2 and 4 after the nutritional intervention; while the rest 28 rats in model group were randomly divided into 4 groups: Group 1(receiving normal dietary, n=7), Group 2(receiving compound pollen nutrients, n=7), Group 3(receiving high dose noveliver, n=7) and Group 4(receiving low dose noveliver, n=7). Rats of each group were sacrificed at week 2(3/7 rats) and 4(4/7 rats) respectively after the nutritional intervention and the levels of the plasma amino acids were measured for each group.
Results ① The baseline levels of plasma amino acids: the levels of branched-chain amino acids(BCAA) and aromatic amino acids(AAA ) in model group were lower than in control group, the ratio of BCAA/AAA were 1.48±0.05 and 1.48±0.13 respectively with no significant difference between two groups. ② At week 2: the levels of BCAA in Group 3 was higher than in Group 2 and 4; the levels of AAA in Group 2 and 3 were lower than those of the other 3 groups; the ratios of BCAA/AAA in control group, Group 1, 2, 3 and 4 were 1.54±0.11, 1.59±0.43, 1.82±0.11, 1.98±0.55 and 1.58±0.04 respectively, the ratios of Group 2 and 3 were higher than those of the other 3 groups. ③ At week 4: the levels of BCAA of Group 2, 3 and 4 were higher than that of the normal dietary group(Group 1); the levels of AAA in Group 2 and 4 were lower than those of the other 3 groups; the ratios of BCAA/AAA in control group, Group 1, 2, 3 and 4 were 1.44±0.14, 1.16±0.35, 1.40±0.24, 1.51±0.08, and 1.40±0.15 respectively, the ratios of Group 2, 3 and 4 were higher than that of the normal dietary group(group 1).
Conclusion The overall level of plasma amino acids in CCl₄ induced liver cirrhotic rats was lower than that of the rats in control group. Compound pollen nutrients tended to increase the level of plasma BCAA and the ratio of BCAA/AAA. Compared with Goup1, 2 and 4, the rats receiving high dose Noveliver(Group 3) had higher level of plasma BCAA and ratio. The intervention duration of 4 weeks achieved higher plasma BCAA level and ratio higher than that at 2 weeks. The results of the present study suggested that compound pollen nutrients may correct the imbalance of plasma amino acids in CCl₄ induced cirrhotic rats. The findings of the present study hopefully promote a better understanding of nutrient intervention in cirrhosis patients.

Detection of plasma lactic acid in HIV-1 infected children treated withanti-viral therapy and analysis of relevant factors

SHI Ying△;SUN Yu△;ZHANG Hong-hai;JI Yun-xia;QIAO Lu-xin;DING Wei;ZHANG Yu-lin;CHEN De-xi

2011, 32(3):  337-340. 

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Objective To investigate the detection of plasma lactic acid in HIV infected children treated with antiviral therapy and analyze its related influencing factors.
Methods Thirty-one HIV infected children who were treated with antiretrovirus therapy and 30 control children were chosen to detect their plasma lactic acid levels. The children’s basic information, therapeutic schedule and laboratory test results were all taken into account in analysis of the relationship with plasma lactic acid.
Results Plasma lactic acid of HIV infected children(2.32±0.60 mmol/L) were higher than control children(1.60±0.88 mmol/L)(P<0.01). There were no significant differences in plasma lactic acid levels between d4T group and AZT group. No significant differences were found in baseline CD4+T cell numbers, baseline viral load, sex, age and route of HIV transmission(P>0.05) between the two groups. No statistically significant differences were found among the groups(P>0.05).
Conclusion Peripheral blood lactic acid could reflect the mitochondrial toxicity of children receiving anti-retrovirus therapy and may become a new marker of mitochondrial toxicity testing.

Functional analysis on the anti-HIV activity of TRIM5α

LI Lan;LU Qing-yu;ZHANG Sen-yan;WANG Xin-quan;WU Hao

2011, 32(3):  341-345. 

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Objective To study the function of anti-HIV activity of TRIM5α.
Methods The full-length cDNA encoding TRIM5α in American green monkey(AGM) was obtained using the reverse transcription polymerase chain reaction(RT-PCR) method after extracting the total RNA from vero cells. The cDNA fragments corresponding to the B30.2 and coiled coil region of TRIM5α from human, rhesus monkey, and AGM were amplified with routine PCR method and ligated into the expression vector pEGFP-C3. After fusion expression with green fluorescence, the cellular location of the protein was observed under fluorescent microscope. Pseudotyped viruses were generated by co-transfection of HIV Δenv-expressing plasmid and VSV-G-expressing plasmid. The anti-HIV activity of TRIM5α and its fragments were quantitatively tested by the inhibition of pseudotyped virus infection.
Results The plasmids expressing TRIM5α and its fragments fused with GFP tag were constructed successfully. The TRIM5α and its fragments from human, rhesus monkey, and AGM were all located in the cytoplasm, among which the hTRIM5α, rhTRIM5α, AGMTRIM5α, rh-TRIM5α CC/B30.2, AGM-TRIM5α CC/B30.2 were distributed as oligomer. But h-TRIM5α CC/B30.2 and TRIM5α B30.2 from different species were distributed evenly in the cytoplasm. The inhibition rate of pseudotyped virus infection was about 70% for rh-TRIM5α, AGM-TRIM5α, rh-CC/B30.2 and AGM-CC/B30.2, and that was less than 20% for h-TRIM5α and different species B30.2.
Conclusion TRIM5α CC/B30.2 domain of rhesus monkey and AGM could inhibit HIV-1. Reliable experimental data helping determine the TRIM5α functional domains were obtained.

Expression profiling of Mycobacterium tuberculosis Beijing genotype invadingTHP-1 cell line

LI Wei-min;HUANG Hai-rong;GAO Feng;LIU Yi;FAN Wei-xing;DAI Guang-ming;JIANG Guang-lu;SONG Xiao-yun;ZHAO Li-ping;FU Yu-hong

2011, 32(3):  346-351. 

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Objective To explore immunologic mechanism in pathogensis relevant to tuberculosis(TB), especially caused by Mycobacterium tuberculosis(M.tb) Beijing genotype by analyzing the different expression profile of cells infected.
Methods IS6110 DNA RFLP and Spoligotyping patterns of 265 M.tb Beijing Genotype isolates from a nationwide random survey for the epidemiology of TB in China in 2000 were calculated using the average linkage to get a central strain of M.tb Beijing genotype (referred to as M. tb Beijing genotype). THP-1 cells were infected with M.tb, M.bovis and M. tb Beijing genotype, the expression profile was analyzed using gene chips. Furthermore the results were evaluated by MAS system.
Results The central strain of M.tb Beijing genotype was determined on the maximum coefficient(0.514) by the formula. There were some different expression genes(tnf, tnfsf 9, pim-1, icam-1 and cd48) by THP-1 cell infected between M.tb H37Rv and M. tb Beijing genotype.
Conclusion The central strain of M.tb Beijing genotype was of Chinese representation. The result of microarray analysis of the infected cells was reliable and analyzable; 293 genes were common expressed from the THP-1 cell infected by M.tb H37Rv, M.bovis and the M. tb Beijing genotype.

Clinical significance of GA, FBG, HbA1c in evaluating hepatogenic diabetes carbohydrate metabolic disturbance

HE Yu-lan△;ZHAO Juan△;LIU Xue-mei;ZHANG Fen-yan;LI Juan;YU Hong-wei;WANG Jin-huan;MENG Qing-hua

2011, 32(3):  352-355. 

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Objective To compare the abnormal metabolism of glucose(fasting blood glucose, FBG; hemoglobin A1c, HbA1c and glycated albumin, GA) of patients with hepatogenic diabetes(HD) and patients with liver cirrhosis(LC), to estimate their significances in evaluating hepatogenic diabetes carbohydrate metabolic disturbance.
Methods Eighty-one patients from Beijing Youan Hospital were enrolled in this study, among whom 27 had definite diagnosis of hepatogenic diabetes and 54 patients with liver cirrhosis were enrolled into control group. Clinical data of the patients were collected during hospitalization, blood-test of FBG, HbA1c, GA were obtained in the next morning of admission.
Results GA and HbA1c in patients with hepatogenic diabetes were significantly higher than those of patients with cirrhosis(P<0.01). In the hepatogenic diabetes group, FBG was higher than 7.0 mmol/L in 18 cases(accounting for 66.7%), HbA1c greater than 6.5% in 96 cases(accounting for 22.2%); GA was higher than 16.87% in 25 cases(accounting for 92.6%). In cirrhosis group, FBG was higher than 7.0 mmol/L in 2 cases(accounting for 3.7%), HbA1c was higher than 6.5% in 1 case(accounting for 1.85% ), GA was higher than 16.87% in 14 cases(accounting for 25.9%).
Conclusion FBG and HbA1c had a high specificity in hepatogenic diabetes monitoring, but had a low sensitivity. While GA had a high sensitivity and low specificity. It would be more helpful when combining GA, FBG and HbA1c in hepatogenic diabetes monitoring.

Small-for-size graft and small-for-size syndrome

LIN Dong-dong;LU Shi-chun;LI Ning

2011, 32(3):  356-360. 

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Small-for-size grafts and small-for-size syndrome remain the greatest limiting factor for the expansion of living donor liver transplantation. Graft to recipient weight ratio less than 0.8% or the ratio of graft volume to standard liver volume of the recipient less than 40% is termed as small-for-size graft. A partial liver graft unable to meet the functional demands of the recipient results in liver failure characterized by development of coagulopathy, ascites, prolonged cholestasis and encephalopathy, often associated with pulmonary and renal failure, and frequently leads to death of the recipient in the absence of re-transplantation. This ill-defined clinical picture is termed “small-for-size syndrome”. The pathogenesis of small-for-size syndrome is related to graft size, underlying liver disease, regenerative response, vascular inflow and outflow, and recipient’s health status. Portal hypertension, venous pathology, and the arterial buffer response importantly contribute to early and late clinical and histopathologic manifestations of the small-for-size syndrome. The strategies to prevent and treat small-for-size syndrome include using larger graft and modulation of portal pressure and portal inflow. Modulation of portal inflow seems to be the key for successful adult living donor liver transplantation with smaller grafts.

Relationship between mitochondrial α-synuclein contents and oxidative stress levels in the rat brain

SUN Jiu-yan;LI Xin;LIU Guang-wei;CHENG Fu-rong;LI Yao-hua;YU Shun

2011, 32(3):  361-364. 

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Objective To study the relationship between mitochondrial α-synuclein(α-SYN) contents and oxidative stress levels in different rat brain regions and its association with selective damage of dopaminergic neurons in patients with Parkinson’s disease.
Methods Mitochondria were isolated using Percoll gradient centrifugation and mitochondrial α-SYN contents were measured using Western blotting and ELISA. Oxidative stress levels were evaluated by measuring oxidative malonaldehyde(MDA) and anti-oxidative indices total anti-oxidation capability(T-AOC), glutathione(GSH), glutathione peroxidase(GSH-PX) and superoxide dismutase(SOD) in brain tissues.
Results α-SYN contents were higher in PD vulnerable area such as olfactory bulb, striatum and hippocampus than in frontal cortex and cerebellum.
Conclusion Mitochondrial α-SYN contents are different in various rat brain regions but it is not related to oxidative levels.

Analysis of key clock genes expression in individual cells with multiplex nested reverse transcriptase-PCR

YUAN Yan-peng;GUAN Yun-qian;LIN Qing-ling;XUE Jin-hua;CAI Yan-ning

2011, 32(3):  365-370. 

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Objective To establish a highly sensitive multiplex nested reverse transcriptase polymerase chain reaction(RT-PCR) system for analysis of key clock genes expression in individual cells.
Methods Six key clock genes(bmal1, clock, per1, per2, cry1, cry2) and a housekeeping gene(βactin) were chosen and the nested primer pairs were designed using Oligo 6.0 primer analysis software. Sensitivity for multiplex nested PCR and RT-PCR was examined separately. And then the expression profiles of clock gene were examined in single cells collected with micromanipulator. Real-time PCR was used to test the general level of the clock gene expression. And then the clock gene expression profiles were compared between general level and single cell level.
Results One DNA copy of each gene could be detected with our multiplex nested PCR system. Four RNA copies of each gene could be detected with the multiplex nested RT-PCR system. The expression pattern of clock genes was distinct among individual NIH/3T3 cells. The expression pattern of per1 and per2 were distinct in general level. But the expression pattern of per1 was not distinct in single cell.
Conclusion A highly sensitive multiplex nested RT-PCR system examining clock genes was established. Molecular clock is poorly synchronized among individual NIH/3T3 cells, it was also proved that the expression pattern of clock gene was distinct between general level and single cell.

Fucoidan alleviates apoptosis by inhibiting cathepsin B and oxidative stress

ZHANG Gan-lin;ZHU Xiao-xin;LI Ping

2011, 32(3):  371-374. 

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Objective To study mechanism of Fucoidan in neurodegenerative disease by observing its effect on cathepsin B activities and oxidative stress.
Methods After 7 days’ differentiation by 50 μg·L-¹ nerve growth factor(NGF), PC12 cells were exposed to 0.5 mmol/L H₂O₂ for 30 min, and then treated with Fucoidan(10 mg·L^-1). The activities of superoxide dismutase(SOD) and reactive oxygen species(ROS) inside cells of each group were assayed. Cathepsin B activities inside cells were determined after being extracted from dPC12. Human liver cathepsin B activities were tested after being exposed to different concentrations of Fucoidan(0.1, 1, 10, 50, 100 mg·L^-1).
Results After oxidative stress, the activities of ROS inside cells increased to 185.2% of normal control, accompanied by lower SOD activities and higher activities of cathepsin B(236.7%) in cytoplasm. Fucoidan treatment decreased ROS levels without any effect on SOD; furthermore, Fucoidan could inhibit both dPC12 cytoplasm cathepsin B activities and human liver cathepsin B activities.
Conclusion Fucoidan’s suppression on cathepsin B activities contributes to its protective effect against oxidative stress which leads to cell apoptosis.

Determination of cyclic adenosine 3′, 5′-monophosphate in fructus jujubae by high performance liquid chromatography

GAO wen;DING Zhao-yi;XU fei;GUO Jian-qiang

2011, 32(3):  375-378. 

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Objective To establish the method of determination of cyclic adenosine 3′, 5′-monophosphate(cAMP) in fructus jujubae by high performance liquid chromatography(HPLC).
Methods HPLC analysis was carried out using MGC18(4.6 mm×250 mm, 5 μm). The mobile phase was 0.05 mol/L KH₂PO₄-methanol(90：10-10：90), Grade-Washing, the flow rate was 1.0 mL/min, Detected wavelength was set at 254 nm, column temperature was 30 ℃.
Results The linear range for c-AMP was 15.6~500 ng(r=1.000), the average recovery was 100.35%±1.58%, RSD was 1.58%.
Conclusion The method is rapid and accurate with good reproducibility which is used for the quality control of c-AMP in jujubae.

High sensitive method for the detection of aflatoxins in extract from Chinese medicinal herb

ZHAO Shu-rui;XU Yan-xia;XU Fei;GAO Wen

2011, 32(3):  379-383. 

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Objective To establish a rapid method of high performance liquid chromatography(HPLC) plus precolumn derivatization for the determination of aflatoxins(AFT) in Chinese medicine herbal extract.
Methods The Chinese medicinal herbs were extracted with methanol and the extract was cleaned up with a solid phase extraction column. The analytes were eluted on C18 column with different proportion(15%~30%) acetonitrile, water gradient elution.
Results The spiked recoveries were 90%~103.2%. The AFT limits of detection were 0.09 ppb(G1), 0.02 ppb(B2), 0.03 ppb(B1), 0.04 ppb(G2). The results were lower than those of the previous study.
Conclusion The modified method was validated by the analysis of a certified reference material and shown to be useful for the determination of aflatoxins in herbal samples of high acidity.

The inhibitory effect of nimesulide and aspirin on esophageal squamous cell carcinoma cell lines with or without cyclooxygenase-2 expression

ZHOU Qiao-zhi;MENG Xin-ying;ZHU Sheng-tao;ZHANG Shu-tian

2011, 32(3):  384-387. 

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Objective To investigate the inhibitory effect of nimesulide and aspirin on esophageal squamous cell carcinoma(ESCC) cell lines with or without cyclooxygenase-2 expression.
Methods The human ESCC cell lines EC109 and TE-1 were used in this study. Cox-2 expression was detected by Western blotting. After 72 hours treatment with nimesulide and aspirin, the cell growth inhibition was determined by MTT assay, the cell cycle arrest and apoptosis detected by flow cytometry.
Results Cox-2 protein expression was observed in EC109, but not in TE-1. Nimesulide suppressed proliferation of EC109 from 0.05 mmol/L to 0.4 mmol/L in a dose-dependent manner, while only 0.4 mmol/L nimesulide showed this effect in TE-1. Nimesulide exerted cell cycle arrest in the G₀/G₁ phase with induction of apoptosis, but had no effect on TE-1. Aspirin suppressed proliferation of EC109 as well as TE-1 in a dose-dependent manner and promoted apoptosis in both cell lines.
Conclusion The inhibitory effect on ESCC cell lines may be influenced by COX-2 expression for nimesulide, but not for aspirin. Non-selective COX-2 inhibitor may exert inhibitory effect on tumor proliferation via COX-2 independent pathway.

Association between large arterial stiffness and creatinine clearance rate in patients with essential hypertension

TAN Jing;HUA Qi;WEN Jing;XING Xiurong;LIU Rongkun;YANG Zheng

2011, 32(3):  388-391. 

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Objective To study the association between large arterial stiffness and creatinine clearance rate(Ccr) in patients with essential hypertension.
Methods Automatic pulse wave velocity(PWV) measuring system was applied to examine carotidfemoral PWV(CFPWV) as the parameter reflecting aortic arterial stiffness. 644 hypertensive patients aged 18~82 years(340 males and 304 females, mean age 52 years) with plasma creatinine<178 mmol/L were recruited in the study. Ccr was estimated by using the Cockcroft-Gault formula.
Results CFPWV increased gradually in patients with Ccr≥60 mL/min, 90 mL/min＞Ccr≥60 mL/min and Ccr＜60 mL/min(all P<0.01). CFPWV and Ccr were inversely and significantly correlated(P<0.001). A stepwise multiple regressive analysis demonstrated that CFPWV had significant independent influence on lower Ccr.
Conclusion Increased arterial stiffness occur in parallel with the decline in renal function in patients with essential hypertension, and which could reflect target organ damage of hypertension.

Effects of protein kinase C-β inhibitor LY333531 on the protein expression of nicotinamide dinucleotide phosphate oxidase and superoxide dismutase in diabetic kidney

GAO Xia;YE Feng;ZHOU Chi-yan;LIU Hui-min;XU Yuan;XIA Zheng-yuan;LEI Shao-qing;

2011, 32(3):  392-396. 

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Objective To study the effects of protein kinase C(PKC)-β inhibitor LY333531 on nicotinamide dinucleotide phosphate(NADPH) oxidase and superoxide dismutase(SOD) in diabetic kidney.
Methods Twenty-four male SD rats were randomly assigned to control group, diabetic group and diabetic with LY333531〔1 mg/(kg·d)〕 treatment group. After the treatment with LY333531 for four weeks, the levels of blood glucose, kidney weight/body weight, 24-hour urinary albumin, creatinine clearance rate(Ccr), free 15-F2t-Isoprostane, total antioxidant concentration and SOD activity were measured. The subunits P22phox and P67phox of NADPH oxidase, Cu/Zn-SOD and Mn-SOD protein expression were analyzed by Western blotting.
Results The levels of blood glucose, kidney weight/body weight, 24-hour urinary albumin, creatinine clearance rate, 15-F2t-Isoprostane in plasma and kidney, total antioxidant concentrations in plasma, the protein expression of P22phox and P67phox were all increased, but the levels of total antioxidant concentrations in kidney, SOD activity in plasma and kidney, Cu/Zn-SOD and Mn-SOD protein expression were significantly decreased in diabetic group as compared with control group(P<0.05). The treatment with LY333531 significantly prevented all these changes except for blood glucose and MnSOD protein expression.
Conclusion The PKC-β inhibitor LY333531 may protect early diabetic kidney from oxidative injury by inhibiting NADPH oxidase activation and expression, and restoring SOD activity by improving the expression of Cu/Zn-SOD subunit.

B-type natriuretic peptide in cardiorenal syndrome

ZHAO Na-xin;CHEN Hai-ping

2011, 32(3):  397-400. 

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Objective To study the relationship between B-type natriuretic peptide(BNP) and cardiorenal syndrome, so as to provide additional theoretical basis for clinical treatment.
Methods Totally 216 patients with acute or chronic heart failure were enrolled. Those without kidney dysfunction were enrolled into a group named simple heart failure group(113 cases) and those with kidney dysfunction were assigned into the group named cardiorenal syndrome group(103 cases). The blood concentration of BNP and N-terminal prosoma of B-type natriuretic peptide(NT-ProBNP) were determined by using fluorescence immunoassay(FIA) in patients. The 30-day mortality was determined by following-up.
Results Compared with patients of simple heart failure group, those with cardiorenal syndrome had a higher level of BNP and NT-ProBNP, 334.00(180.50~628.00)pg/mL vs 794.00(509.00~1 620.00)pg/mL(P<0.01), 22.51(13.09~35.26)ng/mL vs 32.62(21.10~61.24)ng/mL(P<0.01) separately. Compared with patients of simple heart failure group, those with cardiorenal syndrome had a higher 30-days mortality, 7.1% vs 24.3%( P<0.01).
Conclusion The decompensation of BNP may lead to the progress of cardiorenal syndrome. Patients with heart failure combined with kidney dysfunction have poor prognosis, and have a significantly increased mortality in short term.

Application of mesh versus nonmesh surgical patch in the laparoscopic repair

WANG Ming-gang;CHEN Jie;SHEN Ying-mo;ZHU Yi-lin;YANG Shuo

2011, 32(3):  401-403. 

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Objective To explore the efficacy, safety, complication and shrinkage of mesh and non-mesh surgical patch in the application of transabdominal preperitoneal prosthetic（TAPP）.
Methods Data of 60 cases with primary inguinal hernia treated with the laparoscopic TAPP herniorrhaphy in our department during Jan 2009 to Jul 2009 were reviewed. The patients were randomized in to two groups to receive mesh and the non-mesh surgical patches in the operation, respectively, and the patients were followed up for 9~14 months. Analysis of the data, including operation duration, postoperative length of stay, cost of hospitalization, postoperative complication, chronic pain, foreign body sensation, recurrence rate and shrinkage.
Results It showed that in all of the 60 cases the TAPP was finished, there was no significant difference in operation duration, postoperative length of stay, cost of hospitalization and the occurrence of hematoma between the 2 groups. The chronic pain sensation occurred in 1 case(3.3%) of non-mesh group, which was lower than the surgical mesh group(3 cases, 10%), the foreign body sensation occurred in 2 cases(6.7%) of the non-mesh group, which was lower than the surgical mesh group(5 cases, 16.7%). The measurement of the meshes’ diameter was used to calculate the shrinkage by the ultrasound(post operation 1, 3, 6, 9 months). From the second month after the operation，less shrinkage of non-mesh group than the surgical mesh group was seen(P<0.05).
Conclusion The non-mesh patch was more effective and safe than the mesh in TAPP, the non-mesh patch could reduce the occurrence of chronic pain and foreign body sensation, caused less shrinkage.

Evaluation of optic canal decompression in treatment of fibrous dysplasia of skull base

ZHANG Jia-liang;ZHAO Shang-feng;LIU Hao-cheng;ZHANG Tian-ming;FU Ji-di

2011, 32(3):  404-407. 

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Objective To retrospectively analyze the effect of optic canal decompression in 36 patients of fibrous dysplasia from August 1998 to August 2007.
Methods Endocrine examination, ophthalmologic examination and computed tomographic(CT) examination were applied to evaluate the patients preoperatively. All the patients in this group received surgery of transcarnial optic canal decompression under microscope.
Results The pathological diagnosis of each case was fibrous dysplasia. All the patients had CT scan and reconstruction in bone window. Twenty-one cases had unilateral optic canal stenosis, 15 cases had bilateral optic canal stenosis. Eighteen cases had MRI, main part of lesion was in anterior and middle fossa, and slight or medium enhancing after injection of contrast medium. All the patients were followed up from 3 months to 7 years, 38 months in average. Twenty sides(19 cases) had visual improvement 1 week after surgery, 21 sides(15 cases) had no change in eye sight; 2 sides(2 cases) had visual deterioration. One case had Rollet’s Syndrome, 1 case became blind after surgery. Cases who were blind before surgery had no improvement after the treatment. Follow-up after surgery (more than 1 year) in the improved group and stable group showed that 1 case and 3 cases respectively had visual deterioration.
Conclusion Transcranial optic canal decompression showed more satisfactory effects in those who suffered visual acuity impairment caused by fibrous dysplasia in cranial-orbital area.

Risk factors of perioperative mortality in patients undergoing off-pump coronary artery bypass grafting

LU Jia-kai;DONG Xiu-hua;QING En-ming;WANG Yi-jun;REN Fa-cheng;WANG Xue-yong;LIANG Xiao-ping;WU Xian-hong;WANG Cheng-bin;WANG Hui-min;WANG Rong

2011, 32(3):  408-413. 

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Objective To determine the risk factors of perioperative mortality in patients undergoing off-pump coronary artery bypass grafting surgery(OPCABG).
Methods The perioperative data of 2 379 patients undergoing OPCABG were investigated based on the selfmade perioperative OPCABG database. The specific risk factors were identified by univariate analysis and multiple logistic regressions.
Results Totally 32 patients died perioperatively, the average mortality rate was 1.3%(male: 19/1 830; female: 13/549). Univariate analysis demonstrated that perioperative continuous renal replacement therapy; preoperative ejection fraction less than 40%, intraoperative ventricular fibrillation, emergent OPCABG, intraoperative intra-aortic balloon pump, gender, previous myocardial infarction, and age were risk factors contributing to postoperative mortality. Multivariate analysis demonstrated that postoperative continuous renal replacement therapy, preoperative ejection fraction less than 40%, emergent case and gender were the independent predictors of perioperative mortality in patients undergoing OPCABG.
Conclusion Perioperative continuous renal replacement therapy, preoperative ejection fraction less than 40%, emergent case and gender were the independent predictors of postoperative mortality in patients undergoing OPCABG. An intensive perioperative renal protection, adequate cardiac functional support, improving the quality of perioperative management to emergent and women patients are important aspects for the outcome improving to patients undergoing OPCABG surgery.

Diagnosis and treatment of ovarian tumor during pregnancy

ZHOU Lian-e;WANG Xiang-ping

2011, 32(3):  414-416. 

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Objective To explore the characteristics, diagnosis and treatment of ovarian tumor during pregnancy.
Methods A retrospective analysis of 59 cases of ovarian tumor during pregnancy was carried out from January, 2002 to December, 2009.
ResultsAll cases were diagnosed as benign tumors, majority of which were mature cyst teratoma, accounting for about 89% of the 59 cases. Most patients were symptom-ree.
Conclusion Ultrasound examinations have limitations in the diagnosis of ovarian tumor during pregnancy, CA₁₉₉ levels have some value in the diagnosis of mature cyst teratoma. Suitable treatment does not influence the outcome of the pregnancy. The value of CA₁₂₅ levels in distinguishing benign from malignant disease remains uncertain and needs further studies.

Effects of marvelon and mifepristone on peri-menopausal uterine bleeding and sex hormones

SUN Min-ling

2011, 32(3):  417-420. 

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Objective To observe the effect of marvelon and mifepristone on sex hormones and perimenopausal dysfunctional uterine bleeding(PDUB) in patients with PDUB.
Methods Totally 100 cases of patients with PDUB were randomly divided into treatment group and control group. The control group was treated using mifepristone starting from the third day after diagnostic curettage, and the treatment group was treated using marvelon from the third day after diagnostic curettage. The levels of serum sex hormones, including follicle stimulating hormone(FSH), luteinizing hormone(LH) and estradiol(E₂), were detected by radioimmunoassay. The time to control of the bleeding and complete stop of bleeding in the two groups was recorded, the adverse reaction was observed. The clinical efficacy was evaluated at the end of follow-up.
Results The total clinical effective rate of the marvelon group was 98.0%, which was significantly higher than that of the control group(88.0%)(P<0.05). After treatment, the FSH, LH and E2 levels of the treatment group significantly decreased compared with the control group(P<0.05); The FSH, LH and E₂ levels of the control group between the prior-treatment and posttreatment was no significant difference(P>0.05); After treatment, the thickness of endometrium of the treatment group was(4.04±0.41) mm, that of the control group was(6.69±0.78) mm, the difference was significant(P<0.05). After treatment, the endometrium of the treatment group was normal, while in control group the endometrium of 11 cases still had simple hyperplasia, the pathological results of the two groups were significantly different(P<0.05). There was no obvious adverse reaction in the two groups.
Conclusion The marvelon in treatment of PDUB can inhibit the release of serum FSH, and prompt the declining of endogenous E₂ and LH. It is effective, safe, reliable and worthy of clinical application.


Evaluation of the effect of Yunnan Baiyao on postoperative swelling after the extraction of the mandibular impacted third molar

DONG Hui;GUO Ting-ting;ZHOU Xia;FENG Chun-li;XIA Deng-sheng

2011, 32(3):  421-425. 

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Objective To evaluate the effect of oral administration of Yunnan Baiyao on the reduction of postoperative pain, swelling and trismus after the extraction of the mandibular impacted third molar.
Methods According to the completely random double-blind design, 48 enrolled patients were divided into experimental and control groups equally. Patients were orally administered with Yunnan Baiyao capsules or placebo capsules for 8 days, starting from 3 days before the operation. Three-dimensional facial scans of patients were performed in the preoperative and postoperative first day, third and fifth day respectively, and the facial three-dimensional images were reconstructed. Using reverse engineering software, the facial swelling degree, pain intensity and trismus in different time points were quantified and analyzed.
Results There were no statistical significance in trismus，pain intensity and swollen volume between the two groups. The facial swelling thickness and swelling degree had significant statistical differences between the two groups.
Conclusion Oral administration of Yunnan Baiyao capsules in the perioperative period can prevent and reduce the facial swelling after the extraction of the mandibular impacted third molar.

Noninvasive parameters for diagnosing esophageal and/or gastric fundus varices in patients with liver cirrhosis

LI Qin;SU Qiang;WANG Jing;LI Hui-hui;MA Ying-jie;ZHAO Zhi-hai;QIAN Lin-xue;CAO Bang-wei;JIA Ji-dong;WANG Bao-en

2011, 32(3):  426-430. 

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Objective To investigate noninvasive parameters or model for diagnosing esophageal and/or gastric fundus varices in patients with liver cirrhosis.
Methods Data of 58 patients with liver cirrhosis caused by hepatitis B were collected, 34 patients had esophageal and/or gastric varices. All patients were classified according to Child-Pugh grade(32 Child-Pugh-A, 13 Child-Pugh-B, 13 Child-Pugh-C). The laboratory Variables including coagulation factors and liver function tests were performed. Spleen thickness and portal vein width were measured on ultrasonography. Endoscopy was used to detect the esophageal and/or gastric fundus varices.
Results Patients with liver cirrhosis were divided into varices group and non-varices group, differences in platelet, prothrombin time activity(PTA), activated partial thromboplastin time，coagulation Factors Ⅱ, Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, fibrinogen, D-dimer，liver function factors(prealbumin, albumin, total bilirubin, total bile acid, cholinesterase), spleen thickness, and portal vein width between two groups were statistically significant(P<0.05). Through Logistic regression analysis, PTA, portal vein width, spleen thickness were the factors which help discriminating esophageal and/or gastric fundus varices existing or not in patients with liver cirrhosis, Logit P=12.280×portal vein width＋2.901×spleen thickness-0.145×PTA-17.746, predicting accuracy was 68.0%, sensitivity was 69.2%, specificity was 66.6%. Patients classified into ChildPugh A were also divided into varices group and nonvarices group, differences in PTA, D-dimer, coagulation factor Ⅱ, Ⅸ, platelet，spleen thickness, portal vein width between two group were statistically significant(P<0.05).
Conclusion PTA, portal vein width, and spleen thickness may help discriminate presence or absence of esophageal and/or gastric fundus varices in patients with liver cirrhosis.

Occurrence and influencing factors of recurrent respiratory tract infection in children aged 3~6 years in Pinggu District of Beijing

LIU Wei-hong;XU Wen-jie;ZHANG Hui-na;LIU Guo-zhong;ZHENG Jun;DING Dan-dan;HU An-ning;LI Ping

2011, 32(3):  431-435. 

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Objective To explore the occurrence and influencing factors of recurrent respiratory tract infection of children aged 3 to 6 years old in Pinggu District, Beijing.
Methods Children aged 3~6 years from 4 kindergartens of Pinggu District were selected by random sampling and surveyed by questionnaire from January to December, 2008. A database was established by Epidata 3.1 and the data were analyzed by using χ² test t-test and logistic regression by SPSS 13.0.
Results The incidence of recurrent respiratory tract infection of children aged 3~6 years in Pinggu District was 18.7%, the most important influencing factors of the disease are: health of pregnant women, allergic history of the parents, prematurity and asthma history of children.
Conclusion Recurrent respiratory tract infection is associated with multiple factors, comprehensive measures should be taken to prevent and treat the disease.

临床研究

Investigation of B-mode ultrasound screening of fatty liver among employees of a factory in tianjin

WU Qiang;ZHOU Xuan;WANG Xiu-yun;ZHOU Bing;YU Chun-quan;YIN Li-qun;HENG Ming-li;WANG Hong-wu

2011, 32(3):  436-438. 

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Objective To understand the staff health condition of a factory in Tianjin, especially the prevalence of fatty liver.
Methods Totally 4 912 workers who work in a factory in Tianjin received physical examination and laboratory tests. Fatty liver was detected by B-ultrasound, and compared with the normal reference values of the instrument.
Results In total 4 912 workers, 4 845 received the B ultrasonic examination, accounting for 98.6 %. The result was normal in 2 916 workers, abnormal in 1 929 workers, 832 of them showed changes indicating fatty liver, accounting for 17.2% of the effective data(832/4 845). The detection rate of fatty liver in male was higher than in that in female(χ²=146.467, P=0.01).
Conclusion Health education on fatty liver should be enhanced, and more attention should be paid to prevent and control fatty liver.