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    21 April 2010, Volume 31 Issue 2
    神经病学专题
    Relationship among Vessel Abnormalities, Computed Tomographic Perfusion Imaging and Prognosis in Hyperacute Cerebral Infarction
    MA Qing-feng;JIA Jian-ping;XUE Su-fang;HUANG Xiao-qin;YU Yue-yi;LU Jie;ZHANG Miao
    2010, 31(2):  149-153. 
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    Objective To investigate the relationship between vessel abnormality and computed tomographic(CT) perfusion imaging(CTP) as well as the role of vessel abnormality in evaluating prognosis of patients with hyperacute cerebral infarction. Methods Nonenhancement CT, CTP and CTA were performed on 75 patients with acute internal carotid system cerebral infarction within 6 hours of symptom onset. Large vessel stenosis or occlusions on infarction side were assessed. National Institute of Health Stroke Scale score(NIHSS), Barthel Index(BI) and modified Rankin Scale(mRS) were used as evaluation index for neurological function impairment and extent of disability in prognosis. These scores were assessed on the same day, 14th and 90th days after stroke onset respectively. Results ① Of these 75 patients, 29 had normal vessel, 11 had middle cerebral artery stenosis, 13 patients with middle cerebral artery occlusion, 6 had internal carotid artery stenosis, and 16 had internal carotid occlusion. ② There were significant differences among groups of occlusion, stenosis and normal vessels in terms of cerebral blood flow(CBF) area, cerebral blood volume(CBV) area, time to peak(TTP) area, relative CBF(rCBF) and relative CBV(rCBV), CTP parameters of vessel occlusion were significantly different from those of normal vessels. Only CBF area of vessel stenosis group significantly increased compared with normal vessels. The areas of CTPabnormalities(area of CBF, CBV and TTP) of vessel occlusion were significantly greater than those of vessel stenosis(P<0.05). ③ Only the NIHSS was significantly different among three groups at the onset day, patients with normal cerebral arteries have better value than patients with vessel stenosis or occlusion. NIHSS, BI and mRS were all different among the three groups at 14th and 90th days after stroke onset respectively, patients with normal cerebral arteries had better values than patients with vessel occlusion(P<0.05). Conclusion The vessel abnormalities on infarction side in patients with acute cerebral infarction is associated with ischemic areas in indicated by CTP parameters and can be used as an evaluation index for clinical prognosis.
    Cognitive Characteristics in Patients with the First-ever Lacunar Cerebral Infarction
    HAN Yue;JIA Jian-ping;ZHOU Ai-hong
    2010, 31(2):  154-159. 
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    Objective To investigate the characteristics and changes of the cognitive impairment in patients with the firstever lacunar cerebral infarction(LI). Methods Neuropsychological evaluation was conducted within 1 week(4.70±1.70)days, 1 month brain〔(32.71±4.54)days〕, 3 months〔(94.53±6.65)days〕, 6 months〔(177.30±9.21)days〕 and 12 months〔(364.29±7.94)days〕 after lacunar infarction for 64 patients. The scores were compared with the baseline and those of 78 healthy controls. The comprehensive neuropsychological evaluation battery included minimental state examination, Chinese version of Wechsler adult intelligence scale(digit span, picture arrangement, digit sign and block design), World Health Organization University of California-Los Angeles auditory verbal learning test, Rey complex figure test, stroop test, semantic category verbal fluency test, California card sorting test and clock drawing test, which contains tests for attention, memory, executive function, information processing speed, visuospatial and visuoconstructive function. Results Compared with healthy controls, significant difference was found on the memory, executive function, visuospatial and visuo-constructive function in acute stage of lacunar cerebral infarction. The cognitive function was improved significantly and returned to normal on the memory and most executive function since 1 to 3 months after attack. WAIS-RC digit span backwards subtest and most visuospatial and visuo-constructive function tests(figures copying and clock drawing test) was not improved during 12 months. Some of executive function (semantic category verbal fluency and California card sorting test) aggravated again at 12 months after attack. Information processing speed and attention were preserved through the course. Conclusion In acute stage of lacunar cerebral infarction, the cognitive impairment was extensive and severe. Most cognitive domains were improved in 1 to 3 months. Executive function, visuospatial and visuoconstructive function impaired irreversibly or aggravated again. The patients with cognitive impairment after lacunar cerebral infarction needed more attention and intervention early.
    Cytomegalovirus Infection Aggravates Atherogenesis in Apolipoprotein E Knockout Mice
    YI Li;TUO Hou-zhen;ZHAO Ri-guang;WANG De-xin;FENG Zi-jing
    2010, 31(2):  160-165. 
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    Objective Atherosclerosis plays an important role in the brain stroke. Cytomegalovirus(CMV) infection has been associated with atherosclerotic process. The goal of this study was to investigate whether murine cytomegalovirus(MCMV) infection is able to exacerbate the atherosclerotic process in atherosclerosis-susceptible mice. Methods The apolipoprotein E knockout(apoE-/-) mice kept on high fat feed were given low dosage of MCMV to mimic the latent stage of CMV infection in human. At 14. 18 and 24 weeks post infection, the area, number and type of atherosclerotic lesion and the intima/median ratio(I/M) were measured on aorta. The results were determined by means of a microscope coupled to a computer-assisted morphometry system. And the level of lectin-like ox-LDL receptor-1(LOX-1) mRNA in the arterial wall was measured by real-time PCR. The mechanism of MCMV infection on AS formation was investigated. Results In the chronic phase of the infection the area of lesion was significantly increased after MCMV infection in the apoE-/- mice. But with the increase of post-infection period, the role of MCMV on atherosclerosis reduced gradually. MCMV gB mRNA was not amplified by real-time PCR from the arterial wall. The specific IgG antibody level of MCMV in blood plasma and the content of virus DNA in salivary gland were not correlated with atherosclerotic lesions. At 14 weeks post infection, LOX-1 mRNA in arterial wall increased significantly in MCMV infected group. Conclusion MCMV may aggravate the atherosclerotic lesion in apoE-/- mice in the chronic phase of infection, and promote more severe type of atherosclerotic lesions. But it might not be the direct effects of MCMV on the local lesion of atherosclerosis. The increased expression of LOX-1 in arterial wall may be the mechanism through which MCMV aggravate the atherosclerosis.
    Cognitive Impairment in Optic Neuritis and Early Stage of Multiple Sclerosis
    PENG Jing-ting;ZHANG Xiao-jun;GAO Yu-hong;SUN Hou-liang;SUN Yan-bin;LU Yang;CHI Ke-mei
    2010, 31(2):  166-171. 
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    Objective To evaluate cognitive impairment in idiopathic demyelinating optic neuritis(IDON) and early stage of multiple sclerosis(MS). Methods A Consecutive group of 57 IDON patients were divided into 2 groups according to presence(IDON-A) or absence(IDON-N) of abnormal brain MRI. Twenty MS patients with the course of disease shorter than 5 years and minor physical disabilities(EDSS≤4 scores) were included as early MS group. A battery of neuropsychological tests were performed. Results Information processing speed, attention, verbal and spatial memory function in the IDON-A and MS groups were found worse than IDON-N and control groups(P=0.000, 0.001, 0.003, 0.018, 0.036). Executive function was statistically worse(P=0.000, 0.001, 0.036, 0.020) in IDON-A and MS groups than in control group, but not significantly different from IDON-N group. No significant differences were found between the IDON-N group and control group in almost all neuropsychological tests. Cognitive functions were weakly correlated with disease duration and EDSS scores. Conclusion Cognitive capacity damage, especially information processing speed, attention, verbal and spatial memory, executive function, can appear in very early stage of MS and even in clinical IDON stage.
    Effect of Herbal Penetration Therapy on Infusion Extravasation
    FAN Li-mei;QIAO Yu-chen;YANG Na;CAO Yu-ping;GAO Li
    2010, 31(2):  172-173. 
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    Objective To evaluate the clinical effects of herbal penetration therapy on infusion extravasation. Methods Sixty patients with infusion extravasation were treated with herbal penetration therapy with Wai Fu Fang, a decoction of traditional Chinese medicine which included cortex moutan, red peony root, mirabilite, and was decocted by dispensary of traditional Chinese medicine. Results The treatment was markedly effective in 50 of the 60 cases(83.3%) effective in 10(16.7%), and the total effective rate was 100%. Conclusion Herbal penetration therapy with Wai Fu Fang had a marked effect on infusion extravasation. The treatment was also convenient. The herbal penetration therapy should be popularized and applied in clinical practice.
    Analysis of Asymmetric Tongue Presentations of Patients with Acute Cerebral Infarction
    DONG Kai;LIU Ping;XU Min;MA Qing-feng;GAO Li
    2010, 31(2):  174-176. 
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    Objective To analyze the relationship between the asymmetric tongue presentation and paralysis in patients with acute cerebral infarction and to provide evidence for early diagnosis of cerebral infarction. Methods From march 2008 to february 2009, 200 patients seen in Xuanwu Hospital of Capital Medical University were enrolled in this study. The patients were classified into the following sympotom differentiation types: pyrophlegm, phlegmatic hygrosis, asthenia, and yin deficiency. The blood stagnation in sublingual veins, the tongue body and the coat of tongue were observed. Results In these cases, sublingual veins, the body and the coat of tongue were asymmetric. Conclusion In patients with acute cerebral infarction, the tongue presentations are asymmetric. Analyzing the relationships between tongue presentations and infarction location may be of some help in early diagnosis of paresis.
    Progresses in Studies on Molecular Genetics of Alzheimer's Disease
    BAI Ying-ying;JIA Jian-ping
    2010, 31(2):  177-182. 
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    Alzheimer's disease is a genetically complex disorder, and to date, three genes〔those that encode amyloid precursor protein(APP) and the presenilins(PS1 and PS2)〕 have been found to cause earlyonset familial AD and one genetic risk factor that encodes apolipoprotein E(APOE) lead to lateonset AD. In addition to the mutations in 4 known genes associated with AD, mutations in other genes may be implicated in the pathogenesis of the disease. A large number of studies that aimed to help uncover the remaining disease-related loci have been published in recent decades. The search continues for the discovery of additional genetic influences. Here we provide a review on some main AD candidate genes.
    儿科学专题
    Impact of Sulfur Dioxide on the Endoplasmic Reticulum Stress of Aortic Smooth Muscle Cells in the Spontaneously Hypertensive Rats
    ZHU Lu-lu;ZHAO Xia;TANG Chao-shu;DU Jun-bao;JIN Hong-fang
    2010, 31(2):  183-186. 
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    Objective To explore the effect of sulfur dioxide(SO2) on the endoplasmic reticulum stress(ERS) in the aortic smooth muscle cells of spontaneously hypertensive rat(SHR). Methods Seven male WKY rats were used as WKY control group. Twelve male SHRs at the age of 4 weeks were randomly divided into SHR control group and SHR+SO2 donor(Na2SO3/NaHSO3) group, respectively. Five weeks later, the blood pressure was determined. SO2 content in the plasma was detected by reversephase high performance liquid chromatography with fluorescence detection(HPLC). The expressions of glucose-regulated protein 78(GRP78) and caspase-12 in the aortic smooth muscle cells were measured by immuohistochemistry. Results Compared with WKY control group, SO2 contents in the plasma were decreased, while the blood pressure and the expressions of GRP78 and caspase-12 in the aortic smooth muscle cells were increased in the rats of SHR control group significantly, respectively. Administration of SO2 donor increased the SO2 content in the plasma in the rats of SHR control group. Moreover, SO2 donor decreased the blood pressure and the expressions of GRP78 and caspase-12 in the aortic smooth muscle cells of SHR control rats. Conclusion SO2 might inhibit the activation of ERS in the aortic smooth muscle cells of hypertensive rats.
    Etiology and Differential Diagnosis of Admitted Children with Hypertension
    LIU Chong;DU Zhong-dong;LI Xia;DUAN Chao
    2010, 31(2):  187-191. 
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    Objective The prevalence of hypertension in children has been increasing over the past years. This study sought to summarize the clinical data of children who were admitted to Beijing Children's Hospital with a diagnosis of hypertension, and try to analyze the discriminating factors between primary hypertension and secondary hypertension. Methods All children with hypertension who were admitted to Beijing Children's Hospital during 2003 through 2007 were enrolled retrospectively. Data of medical history, physical examination and laboratory studies were recorded by a pediatric cardiologist. Hypertension was diagnosed according to the Chinese guideline for childhood hypertension and American national high blood pressure education program working group on high blood pressure in children and adolescents. Hypertension was classified as primary and secondary based on the etiology of hypertension. Data were analyzed by logistic regression with SPSS 11.5 software. Results A total of 304 children who met the inclusion criteria were included. Out of them, 146(48.0%) children were classified as primary hypertension, 158(52.0%) were secondary hypertension. Adolescents dominated as compared to other ages. Renal hypertension was the leading etiology in secondary hypertension, followed by hypertension due to endocrine system diseases, cardiovascular system and central nervous system. Between children with primary and secondary hypertension, time since onset of hypertension, diastolic blood pressure on admission, 24-hour average heart rate, gender, age, family history of hypertension, presences of dizziness, nausea and vomiting, melanin pigmentation, body mass index, serum uric acid, urine protein, ST-T changes on electrocardiogram, urea nitrogen(BUN), creatinine(Cr), standing serum level of renin activity
    and adiposis hepatica on ultrasound were significantly different(P<0.05). Binary logistic regression showed positive family history of hypertension(OR=8.897), age over 10 years(OR=10.176) and increased BMI(OR=19.256) were independent risk factors of primary hypertension, while ST-T changes on electrocardiogram(OR=0.0257), standing serum renin >6 μg/(L·h-1)(OR=0.0593) were risk factors of secondary hypertension. Conclusion Admission for hypertension is more prevalent in adolescents. Secondary hypertension is more common. Family history of hypertension, age above 10 years, increased BMI were risk factors of primary hypertension, while ST-T changes on electrocardiogram, serum renin at standing posture >6 μg/(L·h-1) were risk factors of secondary hypertension.
    Epstein Barr Virus associated Hemophagocytic Lymphohistiocytosis: A Retrospective Study of 78 Pediatric Cases in the Mainland of China
    JIN Ying-kang;XIE Zheng-de;DU Zhong-dong;YANG Shuang;SHEN Kun-ling
    2010, 31(2):  192-196. 
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    Objective To evaluate the clinical features of Epstein-Barr virus associated hemophagocytic lymphohistiocytosis(EBV-HLH) in children and to explore its prognosis and risk factors. Methods A retrospective study was performed on 78 pediatric patients with EBV-HLH who were admitted to Beijing Children's Hospital between 2003 and 2008. All patients' medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory and outcome information was collected. Statistical evaluation was conducted using multivariate and univariate analysis. Results The age of onset peaked between 1 and 2 years. EBV-HLH occurred mainly in the patients who were positive for IgG antibody to EBV nuclear antigen (70.5%). The overall fatality of the disease was 56.7%. Twelve of the 39 case(30.8%) died rapidly within 2 months after diagnosis. Multivariate analysis revealed that not receiving chemotherapy(P=0.002), ≥4 weeks of illness prior to diagnosis(P=0.004), and albumin levels <20 g/L(P=0.045) significantly predicted an increased risk of death. Conclusion EBV-HLH is a severe disease with a high fatality rate that occurs mainly after EBV reactivation. Early initiation of chemotherapy and timely diagnosis significantly improve survival rate. Practical strategies should focus on reducing the likelihood of early death.
    Evaluation of Effect of Four Education Forms for Hospitalized Diabetic Children at Different Age
    WANG Rui;JIANG Ping-ping;GONG Chun-xiu;CAO Bing-yan;YAN Gui-jie;LI Yu-chuan;LIU Li
    2010, 31(2):  197-200. 
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    Objective To explore the effect of four education forms for hospitalized diabetic children at different age. Methods Totally 185 cases diagnosed as type 1 diabetes mellitus were recruited and were divided into two groups according to age, children and adolescents groups. All of them were taught the skills of subcutaneous insulin injection and were asked to fill in the questionnaire about insulin knowledge, and they accepted four education forms in a same order. Results The form of demonstration had the highest total acceptance rate(69.7%), while the rates of collective teaching, publicity album and games education were 40.0%, 30.0% and 51.9%, respectively. The acceptance rate of collective teaching in adolescents group was significantly higher than that of children group(P=0.016), and that of publicity album in adolescents group was also significantly higher than that of children group(P=0.005). There was no significant difference in the acceptance rate of demonstration education between the two groups(P=0.129). The acceptance rate of game education in children group was higher than that of adolescents group(P=0.017). Adolescents had higher acceptance rate of insulin injection than that of children group. Conclusion Different education forms suit different children, collective teaching and demonstration education is more suitable for adolescents, game education is more suitable for children. In order to reduce the complication of diabetes mellitus and improve the quality of their life, the care givers should choose proper health education forms for different children.
    Sequential Treatment Ameliorates Chronic Rejection in Rat after Orthotopic Small Bowel Transplantation
    LI Xiao-song;ZHU Wei-wei;QIU Xiao-hong;ZHANG Jin-zhe
    2010, 31(2):  201-205. 
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    Objective This study aimed to evaluate the effect of a sequential treatment on small bowel transplantation(SBT) allograft survival and attempted to elucidate the underlying mechanisms to prevent chronic rejection(CR). Methods Sequential treatment with rapamycin (Rapa) following a FK506 pretreatment was administered to control CR in rat orthotopic SBT model. The recipients were sacrificed for evaluation of CR by morphological and immunohistochemical analysis. The production of antidonor isotype specific antibody was quantified by flow cytometry. Results In control group, 79% recipients developed severe vasculopathy and parenchymal fibrosis and died of CR around 90 postoperative day. With sequential treatment, 91.7% recipients survived, showed reduced severity of vasculopathy, markedly reduced fibrosis in the mesentery, and inhibition of the production of the Th1 and Th2 associated isotype specific antibodies. Conclusion The sequential treatment was effective in the control of CR and dramatically prolonged rat allograft survival, and may contribute in a clinical setting towards better outcomes in SBT.
    Clinical Analysis on 21 Cases of Intracranial Hemorrhage in Children with Hemophilia
    SU Yan;WU Run-hui
    2010, 31(2):  206-209. 
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    Objective Among all the bleeding episodes in hemophilic patients, intracranial hemorrhage(ICH) is associated with the highest mortality and the largest possibility of longterm serious sequelae. Knowing the clinical characteristic, treatment protocol and prognosis of ICH in children with hemophilia in China can help clinician to early diagnosis and treatment in order to reduce ICH sequelae and mortality. Methods 21 hemophilic children with ICH, which were registered in Hemophilia Treatment Center of Beijing Children’s Hospital between December 2006 and May 2009, were reviewed retrospectively. Data was analyzed by SPSS 11.5. Results ① The mean age of ICH was 2.8 years old. 66% of patients were less than 3 years old. 90% of patients were moderate or severe disease, and 76% had head trauma before ICH. ② Hemophilia were diagnosed after ICH in more than 50% of patients. All patients were less than 3 years old and 82% were moderate or severe hemophilia. ③ ICH in 7(33%) patients which were all moderate or severe recurred. 43% of patients were hemophilia B and 57% of patients with recurring ICH had poor prognosis. ④ 3 patients were dead and 5 had sequelae. The dosage of replacement therapy was lower and the period was shorter in team of poor prognosis than in team of good prognosis. Conclusion ① The risk factors of ICH in hemophilic children include moderate or severe disease, age with less than 3 years old and head trauma before ICH. ② ICH may be the first symptom of hemophilia in hemophilic infants, especially in mild and moderate patients. ③ The patients with hemophilia B, moderate or severe disease have more chances of recurring ICH. Recurring ICH has poor outcomes. ④ Delaying treatment, low dosage and insufficient replacement therapy should lead to poor prognosis.
    The Diagnosis and Treatment of Horseshoe Kidney with Hydronephrosis in Children
    LI Ning;SUN Ning;HUANG Cheng-ru;BAI Ji-wu;ZHANG Wei-ping;TIAN Jun;XIE Xiang-hui;LI Ming-lei;SONG Hong-cheng
    2010, 31(2):  210-212. 
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    Objective To investigate the diagnosis and treatment of horseshoe kidney with hydronephrosis in children. Methods The clinical data of 19 children with horseshoe kidney with hydronephrosis were analyzed retrospect. Results From 1997 to 2008, 19 children(16 were male and 3 female, ages ranged from 8 months to 16 years, mean 7 years) with horseshoe kidney associated with hydronephrosis under went operation in our hospital. Crossed renal vessels were a main etiology. Intravenous pyelography(IVP) indicated that hydronephrosis was reduced 6~12 months after the operation, abdominal pain disappeared and no abnormalities were found during 6 months to 14 years follow-up periods. Conclusion Horseshoe kidney with hydronephrosis is more common in males, occuring much more commonly in school age children. Pyeloplasty performed by the transposition of crossing vessels and the AndersonHynes method showed satisfactory results.
    Emphasis on the Study of Non-Malignant Diseases Associated with EpsteinBarr Virus Infection in Children
    XIE Zheng-de;SHEN Kun-ling
    2010, 31(2):  213-216. 
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    Epstain-Barr virus(EBV) is an important tumor-related virus, infects over 90% of the world's adult population. EBV is also associated with a wide variety of malignancies including nasopharyngeal carcinoma(NPC), Hodgkin and nonHodgkin lymphomas, gastric carcinoma, posttransplant lymphoproliferative disorder(PTLD). This review introduced laboratory diagnostic assays of EBV infection, and focused on clinical feature and diagnostic guidline of non-malignant diseases associated with EBV infection in children(including infectious mononucleosis, chronic active Epstein-Barr virus infection, EpsteinBarr virus-related hemophagocytic lymphohistiocytosis syndrome). Fields of these diseases needed further research were also introduced.
    The Role of 5-HT3/4 Receptor in the Endogenous Dopamine-regulated Gastric Motility in Rats
    MI Xin-liang;LI Yun;GUO Hua;XU Jing-dong;ZHENG Li-fei;ZHANG Xiao-hui;ZHANG Yue;ZHU Jin-xia
    2010, 31(2):  217-221. 
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    Objective To study the role of 5-HT3/4 receptor in the endogenous dopamine-regulated gastric motility in rats, and investigate the mechanism of the gastroparesis in Parkinson's disease. Methods Substantia nigra dopaminergic neurons of the SD rats were damaged by injecting 6-hydroxydopamine(6-OHDA) in the brain substantia nigra. In this 6-OHDA treated rat model, the central dopamine content decreased while the endogenous gastrointestinal dopamine content was increased. The power lab signal acquisition system was used to record the constriction of the strip of rat gastric longitudinal muscle. Semi-quantitative RT-PCR method and Western blotting analysis for 5-HT3/4 receptor in the gastric corpus in control and 6-OHDA treated rats were performed. Results The basal gastric motility in 6-OHDA treated rats was significantly weaker than the control group. 5-HT-evoked motility was significantly reduced in the amplitude of contraction in 6-OHDA treated rats. The real-time PCR results showed that the mRNA level of 5-HT3/4 receptors in the gastric corpus was significantly enhanced in 6-OHDA treated rats. The Western blotting results however showed that the protein level of 5-HT4 receptor, not 5-HT3 receptor, in the gastric corpus was descent in 6-OHDA treated rats. Conclusion The 5-HT4 receptor downregulation may contribute to the decrease of gastric motility in 6-OHDA treated rats.

    基础研究
    Effect of 5-HT2ARB on the Myocardial Damage Caused by Acute Brain Injury and on Endogenous Norepinephrine and 5-hydroxytryptamine
    GUO Cai-xia;ZHANG Li-ke;LU Ling-qiao;SUN Yi-lin;DU Feng-he
    2010, 31(2):  222-227. 
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    Objective To understand effects of norepinephrine(NE), 5-hydroxytryptamine(5-HT) and 5-HT2AR on myocardial damage occurred after acute brain injury(MDABI) through studying role of 5-HT2ARB in the MDABI and its effect on endogenous NE and 5-HT and to provide further insights into the relationship between the brain and the heart, and the prevention and treatment of MDABI. Methods A rat model of acute brain injury(ABI) was established. ECG, cardiac function(CF), creatine kinase MB(CK-MB) in serum and morphologic changes in myocardium were measured to indicate the degree of myocardial damage. NE and 5-HT in plasma and myocardium were detected by high performance liquid phase chromatography with electrochemical detection(HPLC-ECD). Expression of 5-HT2AR was determined by RT-PCR and real-time RT-PCR. There were four groups in the experiment including normal, sham, ABI and 5-HT2ARB group,with 8 rats in each group. Indicators were observed 24 hours after ABI. Results The cardiac abnormalities after acute brain injury included abnormal ECG increased(P<0.05); ventricular systolic and diastolic dysfunction included ±dp/dtmax and left ventricular developed pressure(LVDP) decreased(P<0.05), left ventricular diastolic end pressure(LVDEP) increased(P<0.05); CK-MB increased(P<0.05). Degeneration, necrosis and hemorrhage of myocardium were observed under light and electronic microscope. NE in plasma and myocardium and plasma 5-HT increased significantly(P<0.05). 5-HT2ARB was beneficial in reducing degree of MDABI and could reduce myocardial NE(P<0.05). Conclusion ABI can lead to myocardial damage. It maybe happen through increasing 5-HT to activate 5-HT2AR. 5-HT2ARB can reduce the MDABI.
    Effects of MAPKs Inhibitors on AQP4 Expression after Scratch Wound in Cultured Rat astrocyte
    SHI Zhong-fang;ZHAO Huan-ying;YUAN Fang;HAN Ming;LU Yang
    2010, 31(2):  228-232. 
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    Objective Aquaporin 4(AQP4) is the predominant water channel protein in the brain, and plays important roles in the development of brain edema. However the mechanisms regulating changes of AQP4 expression after brain injury are not known. In this study, we investigated the change of AQP4 expression in cultured rat astrocyte after scratch injury and explored the effects of pretreatment with mitogenactivated protein kinases(MAPKs) inhibitors. Methods Secondary cultured astrocyte at 10 days were used to prepare scratch injury model, the morphologic change of astrocyte was observed through phase contrast microscope, and immunostaining of antiglial fibriliary acidic protein(GFAP) was performed. Meanwhile, the AQP4 mRNA level in astrocyte was determined by real-time fluorescent quantitative reverse transcription polymerase chain reaction. Results Without injury the cultured astrocyte were uniformly thin and flat, while 12 h after scratch injury, the astrocyte became irregularly shaped and the cell processes along the margin of the wound extended to the cellfree area. Also,the immunostaining showed stronger GFAP staining at 12 h after injury, and hypertrophic astrocyte occurred. The level of AQP4 mRNA in astrocyte decreased significantly at 12 h after scratch injury(P<0.05), which was antagonized by pretreatment with ERK inhibitor U0126, p38 MAPK inhibitor SB203580 and JNK inhibitor SP600125 respectively(P<0.05). Conclusion Our results demonstrate that scratch injury on astrocyte directly down-regulated AQP4 mRNA expression, and MAPKs inhibitors can antagonize the response. These findings suggest that MAPKs signal transduction pathway may be involved in the regulation of AQP4 expression after injury.

    基础研究
    Effects of ZuoGuiWan and YouGuiWan on the Expression of IL-10 and TGF-β in Central Nervous System of Experimental Autoimmune Encephalomyelitis Rats
    FAN Yong-ping;SONG Li-jun;YE Ming;ZHOU Li;WANG Lei;GONG Hai-yang
    2010, 31(2):  233-240. 
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    Objective To observe the immunohistochemical expression of interleukin-10(IL-10), transforming growth factor-β(TGF-β) in brain and spinal cord tissue, and explore the mechanism of nourishing kidney-Yin(Zuo Gui Wan) and invigorating kidney-Yang(You Gui Wan)in rats with experimental autoimmune encephalomyelitis(EAE). Methods Lewis rats were immunized with the myelin basic protein(MBP). Totally 120 Rats were randomly divided into Normal-group, EAE-group, prednisone-group, Zuo Gui Wan group and You Gui Wan group after immunization with 24 rats in each. Rats in normal-group and EAE-group were given normal saline by gastric gavage, 3 mL/d; rats in prednisone-group were treated with suspension of prednisone after clinical signs developed, 5 mg/(kg·d-1); rats in Zuo Gui Wan group were treated with suspension of Zuo Gui Wan, 2 g/(kg·d-1), and rats in You Gui Wan group were treated with suspension of You Gui Wan, 3 g/(kg·d-1). On days 15 and 27 post immune, the rats were sacrificed and the immunohistochemical staining was performed on the sections of brain and spinal cord. Results On day 15 post immune, the expression of IL-10 in brain tissue of Zuo Gui Wan group and You Gui Wan group were significantly higher(P<0.01) than that in EAE-group. The expression of IL-10 in spinal cord tissue of ZuoGuiWan group was significantly higher than that in EAE-group(P<0.05). The expression of TGF-β in brain tissue of You Gui Wan group and prednisone-group were significantly higher(P<0.05) than that in EAE-group. The expression of TGF-β in spinal cord tissue of You Gui Wan group was significantly higher than that in EAE-group(P<0.05). On day 27 post immune, expression of IL-10 in spinal cord tissue of prednisone-group, Zuo Gui Wan group and You Gui Wan group was significantly higher(P<0.01) than EAE-group. The expression of TGF-β in spinal cord tissue of Zuo Gui Wan group was significantly higher than that in EAE-group and prednisone-group(P<0.05). Expression of IL-10 in spinal cord tissue of EAE-group, prednisone-group, Zuo Gui Wan group and You Gui Wan group was significantly higher(P<0.05) than that on day 15 post immune, the expression of TGF-β in spinal cord tissue of Zuo Gui Wan group was higher than that on day 15 post immune(P<0.05). Conclusion Both Zuo Gui Wan and You Gui Wan have the effect of upregulating the immunohistochemical expression of IL-10 and TGF-β in central nervous system of EAE rats, promoting the recovery from the disease, their effects are better than those of prednisone. But You Gui Wan could only promote the expression of TGF-β in both brain and spinal cord tissue in acute stage(15 d) of EAE rats, and Zuo Gui Wan could promote the expression of TGF-β in spinal cord tissue in recovering stage(27 d).
    Comparison between Different Methods to Extract Mitochondria and Its Effects on Mitochondria Content and Activity
    WU Yuan;DONG Ling-yue;AN Wei;AN Yun-qing
    2010, 31(2):  241-244. 
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    Objective To compare different methods for extracting mitochondria and its effects on mitochondria content and their activity. Methods Pulilai kit, sucrose gradient centrifugation and Pierce mitochondria extraction kit were used to extract mitochondria and quantify their concentration, activity and contamination. Results Pulilai kit yielded higher concentration of mitochondria proteins than two other methods(P<0.05) when the same amount of cells were used. Western blotting was used to evaluate the amount of cytosolic protein contaminant and mitochondria protein cytochrome c from mitochondria fraction. The result suggests that using Pulilai kit can yield lower concentration cytosolic protein contaminant and higher concentration of cytochrome c from mitochondria fraction than the other two methods. At the same time, ATP content of mitochondria extracted by the method of Pulilai kit was the greatest. Conclusion Pulilai kit is better than sucrose gradient centrifugation and Pierce mitochondria extraction kit for mitochondria extraction.
    Expression of IL-17BR in Human Blood Vascular Endothelial Cell and Asthmatic Airways Mucosa
    FAN Yi-qiang;WANG Wei;LV Zhe;XU Qing;MENG Qiu;SUN Ying;AN Yun-qing;
    2010, 31(2):  245-250. 
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    Objective To investigate the expression of IL-17BR(IL-25R) from human vascular endothelial cell(HUVEC) and bronchial biopsies of asthmatics compared with controls. Methods Immunocytochemical method was employed to detect the expression of IL-17BR in cultured human umbilical vein endothelial cells(HUVEC). Reverse transcription-polymerase chain reaction (RT-PCR) and real-time quantitative PCR were used to study the diversification of IL-17BR gene expression in HUVEC cultured with or without rhIL-25. Avidin-biotin complex(ABC) method was employed for detecting IL-17BR immunoreactivity in bronchial biopsies. Results Immunocytochemistry showed that HUVEC constitutively expressed IL-17BR. PCR showed that the expression of IL-17BR mRNA was upregulated by its ligand, IL-25 (1 μg/L). The increased number of IL-17BR immunoreactive cells were found in the bronchial biopsies of asthmatics, whereas extremely few cells of the normal controls were positive for IL-17BR. Conclusion IL-17BR is constitutively expressed in HUVEC and airways bronchial mucosa and increases in asthmatic airways. It suggests that the IL-17BR positive cells in human bronchial vascular endothelial cells and airways mucosa may participate in the pathogenesis of asthma through interaction of IL-25 with its receptor.

    基础研究
    Experimental Research on the Effects of a Traditional Chinese Medicine Complex 912 for Injection on Serum Cytokine Levels in the Multiple Organ Dysfunction Syndrome Animal Model
    REN Tian-hua;ZHANG Shu-wen
    2010, 31(2):  251-254. 
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    Objective To study the effect of traditional Chinese medicine complex 912 for injection on the serum cytokine level of the multiple organ dysfunction syndrome(MODS) animal model. Methods Thirtytwo oneyearold male healthy piglets with body weight 20~25 kg were used for this study. Standard Escherichia coli(17 million/kg) was injected into right jugular vein slowly. Five hours after the injection all the animals developed MODS, and these MODS model animals were randomly divided into the following two groups: 912 complex treatment group and normal saline control group. Serum endotoxin and cytokines including tumor necrosis factor(TNF), interleukin1(IL1), interleukin6(IL6), interleukin10(IL10), and nitric oxide(NO) were determined at 1 h, 3 h, 5 h and 7 h after treatment. Results The serum cytokines decreased 3 h after treatment with 912 complex injection, and were lower than those of the normal saline control group at the same time points. Conclusion These finding provide the experimental basis for further study on treatment of MODS with traditional Chinese medicine 912 complex injection.
    Effect of Different pH on the Solubility and Structure of Aspirin Observed by Using 1H-nuclear Magnetic Resonance
    ZHENG Mei-qing;WANG Yu-ji;WU Jian-hui;ZHANG Jin-lu
    2010, 31(2):  255-257. 
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    Objective Aspirin as a commonly used antithrombotic drug has low solubility in saline. In this study the effects of different pH on the structure of aspirin were observed by using the 1H nuclear magnetic resonance(1HNMR) technique. Methods In order to improve the solubility of aspirin, the experiments were conducted with adding different alkaline and acidic solution dropwise into the aspirin saline solution until it is completely dissolved, and the effects of different alkaline and acidic solution on the structure of aspirin were analyzed through 1HNMR. Results The 1HNMR data showed that among all the alkalic solutions tested, only the 1% NaHCO3 could improve the solubility of aspirin in saline but did not change the structure of aspirin. Conclusion 1HNMR technique can be used in biological activity evaluation for drugs.
    临床研究
    Meta-analysis on the Relationship between HPV Infection and Esophageal Cancer in Chinese Population
    CAO Bang-wei;YU Jing-lin;HE Huan;LI Shen-tao;ZHAO Yu-liang
    2010, 31(2):  258-263. 
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    Objective Human papillomavirus(HPV) infection is considered an important risk factor in esophageal cancer development, but the results of epidemiological studies among people in China exhibited great difference. Thus, a rigorous systematic evaluation from the available epidemiologic data is necessary to reveal the association between the esophageal cancer and HPV infection, particularly, highrisk HPV types(16 and 18) infection in the Chinese population. Methods The associated researches of China's HPV infection and esophageal cancer were retrieved by the internet technology in the CNKI, Pubmed, and other databases. The data from case-control studies published in literature between 1982 and 2009 were collected. Meta analysis was performed to evaluate the association between the HPV infection and esophageal cancer by using the Revman 5.0 and Stata 10.0 software. Simultaneously, Egger's test was used to evaluate the publication bias. Results In a total of 19 papers, 20 casecontrol studies were included. In the meta-analysis of the 19 papers, the result showed HPV infection in Chinese population was associated with esophageal cancer(combined OR value was 3.30, 95% CI: 2.13-5.11) by the calculation with random effect model(REM). The Egger's test showed that there was no significant publication bias(P=0.160). Within the sub-group analysis on the high and low incidence areas of esophageal cancer, HPV detection methods, different settings of the control group, the results had presented the existence of esophageal cancer risk(P<0.05). Conclusion Although the diversity in esophageal cancer incidence in different areas, the different settings of the normal control group, and the different methods to HPV detection, the high-risk HPV types(16 and 18) infection and esophageal cancer still showed a significant association in susceptibility.
    Clinical Features and Treatment Strategy of Brain Arteriovenous Malformations in Elderly Patients
    YANG Li-jun;SHU Bo;WANG Shuo;ZHAO Ji-zong;Cao Yong
    2010, 31(2):  264-267. 
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    Objective To analyze clinical features and treatment strategy of brain arteriovenous malformations(AVMs) in elderly patients(age≥60 y). Methods A retrospective survey of 25 cases of brain AVMs in elderly patients diagnosed from March 1997 to September 2008 in Beijing Tiantan Hospital was undertaken. The clinical features, treatment and outcomes were analyzed along with a systematic review of literature. The median follow-up period was 50 months(4~120 months). Results In this series the median age of patients was 65.2 years; the male: female ratio was 2.6∶1; the most common primary symptoms was intracranial hemorrhage(68.0%). Seven cases were treated conservatively when diagnosed, of whom hemorrhage at AVMs or recurrent hemorrhage occurred in 4 patients (57.1%) during the follow-up; 7 patients selected stereotactic radiosurgery, after radiosurgery hemorrhage at AVMs occurred in 3(42.9%); 5 patients were treated with endovascular embolization of feeding arteries of AVMs, in 2(40%) the arteries were embolized completely, of whom 1 died due to cerebral infarction after embolism, the other 3 were embolized partially; 11 patients took microneurosurgical resection, 2 died because of postoperative hemorrhage and cerebral infarction respectively , others achieved satisfactory outcomes. Conclusion Elderly patients with brain arteriovenous malformations had a high incidence of hemorrhage compared with younger ones. Microneurosurgerical removal of AVMs can achieve satisfactory postoperative outcomes. Age itself is not a limiting factor for the surgical excision of AVMs.
    Analysis of Relationship between High-sensitivity C-reactive Protein and Carotid Atherosclerosis in Hypertensive Patients
    LI Jing-wei;DU Feng-he;XU Xiu-ying
    2010, 31(2):  268-271. 
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    Objective To study the relationship between serum high-sensitivity C-reactive protein(hsCRP) level and carotid atherosclerosis in elderly patients with essential hypertension. Methods The serum concentrations of high-sensitivity C-reactive protein(hsCRP) were measured in ninety-five elderly patients with essential hypertension. A color doppler ultrasound system was used to investigate the intimal-medial thickness(IMT) of common carotid artery(CCA) and the plaque of carotid artery. Results Serum hsCRP was significantly higher in the group with carotid atherosclerosis(CA) than in the group without CA〔(5.42±5.53) vs (2.78±3.22)mg/L, P=0.007〕. Conclusion Serum high-sensitivity C-reactive protein level is associated with carotid atherosclerosis in elderly patients with essential hypertension. Inflammatory response might play an important role in the pathogenesis of carotid atherosclerosis in patients with essential hypertension.

    Transvaginal Myomectomy Analysis of 25 Cases
    QIAN Rui-ya
    2010, 31(2):  272-275. 
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    Objective To investigate the feasibility, operation outcome and safety of a new approach to myomectomytransvaginal myomectomy. Methods A series of 25 patients with uterine fibroids were treated with transvaginal myomectomy from March 2004 to April 2009. The related clinical data were analyzed. Results Transvaginal myomectomy was successfully completed in 24 patients; Pelvic abscess occurred in 2 cases. The mean number of fibroids was 1.56±0.71pieces (1~6 pieces). The mean operation time was 68±31.5 min, The estimated blood loss was176±168.5 ml. The mean length of interval between two consecutive bowel movements was 1.6±0.4 days. The average hospital stay was 8.6±4.7 days. The postoperative complication rate was 40%. Conclusion The postoperative complication rate of transvaginal myomectomy was high. Patients must be selected for this technique carefully, and the operators should have a certain degree of transvaginal operation skills.

    Preliminary Study on the Factors Affecting the BI-RADS Classification of Mammary Gland Density by Mammography
    WANG Jie;QI Xiao-dong;GAO Hai-feng;MA Xiang-jun
    2010, 31(2):  276-279. 
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    Objective To analyze the factors influencing BI-RADS classification of breast density under mammography. Methods Six hundred and fifty-two patients who underwent mammography during January 2008 to October 2008 at the Haidian Maternal and Child Health Hospital were analyzed using American college of radiology(ACR) proposed breast imaging reporting and data system(breast imaging reporting and data system, BI-RADS) 2003 forth edition. The relationship between the mammary gland density rating and the menopausal status, body mass index(BMI)was assessed. ResultsThere were significant difference in BMI, menopausal status and the mammary gland density among the women of different BIRADS classification groups(P<0.01 for all these comparisons). Conclusion Abnormal mammographic findings were relatively more frequently seen in the premenopausal, high-BMI and high breast density women. For such population health education and regular health check-up are needed.

    Therapeutic Effect of Low-dose Recombinant Tissue-type Plasminogen Activator on Acute Myocardial Infarction
    DING Shun-jin;LI Yan
    2010, 31(2):  280-281. 
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    Objective To evaluate the therapeutic effect of recombinant tissuetype plasminogen activator(rTPA) on acute myocardial infarction. Methods 72 cases with acute myocardial infarction were treated by lowdose rTPA(50 mg) through 90 min vein injection, the clinic values of blood vessels recanalization, side effects and mortality were observed. Results Reperfusion rate of infarct related vessels was 75%, sixweek mortality was 4.17%, bleeding rate was 14.17%. Conclusion It is safe and efficient of low-dose rTPA on acute myocardial infarction.

    Summary of Frequently Asked Questions & Experiences in the Primary Check and Approval of an Article by the Editor in Journal of Capital Medical University
    MU Meng;ZHANG Jun-min;CHEN Rui-fang;WANG Cui-ying;LI Xiao-fei
    2010, 31(2):  282-284. 
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    The primary check and approval of an article by the editor is directly related to the quality of a journal. This paper,briefly introduced the main components of the primary check and approval of an article by the editor in Journal of Capital Medical University. The frequently asked questions is analyse and evaluation of manuscripts in 2009, on which the author is based to make recommendations for authors to ensure quality improvement of the journal.