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    24 August 2008, Volume 29 Issue 4
    特别关注
    Practice and Deliberation of Psychological Crisis Intervention
    Sha Sha;Zhang Wanqi;Zhong Xin;Zu Si;Yang Fengchi
    2008, 29(4):  409-411. 
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    From the point view of psychology and behavior,the paper summarizes the experience and analyzes the key links of crisis intervention in earthquake disaster areas,and concludes that it is necessary to improve the disaster mental work.Some general countermeasures are pointed out to crisis intervention to help release the refugees'mental pain.
    专题报道
    Linkage Analyses of 13q in Schizophrenia Complex Pedigrees
    Luo Jiong;Cai Zhuoji;Dong Fang;Hu Zhengmao;Jiang Tao;Nie Changjie;Huang Qing;Ling Sihai;Liu Min;Xia Kun;Wang Chuanyue
    2008, 29(4):  412-415. 
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    Objective To explore the genetic susceptibility loci on 13q of schizophrenia in Chinese pedigrees.Methods 4 multiplex schizophrenia pedigrees were collected.Blood samples were collected from the families and genomic DNA was extracted.7 microsatellite markers on 13q14-13q33 were evaluated.Linkage analyses were carried out by GENEHUNTER 2.1 software.Results The results of single point-point nonparametric linkage analyses are positive at 5 consecutive locus.The NPL score are 1.40,2.25,2.06,1.71 and 1.39 at D13S156,D13S170,D13S265,D13S159,and D13S158 respectively.A 50cM positive region was observed by multipoint nonparametric linkage analyses.Positive regions were also observed by single-point and multipoint parametric linkage analyses.Conclusion Loci on 13q22.1-13q33.1 may influence susceptibility to schizophrenia.
    Relationship between Speed of Self-face Recognition and Insight in Patients with Schizophrenia
    Jia Hongxiao;Zhu Hong;Han Shihui;Sui Jie;Mao Lihua;Ge Jianqiao;Zhang Jizhi;Jiang Zhenkang;Zhu Ying
    2008, 29(4):  416-419. 
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    Objective To investigate the relationship between insight and self-awareness of patients with schizophrenia using paradigm of self-face recognition(SFR).Methods 12 schizophrenic patients with insight,12 schizophrenic patients without insight and 12 healthy volunteer as control matched with age and education degree were measured by SFR,and the results were analyzed.Results The normal controls recognized their own face more quickly than the stranger's(P<0.05),and there was no difference between self face and famous face(P>0.05);however,there was no difference between self face and stranger' s face in schizophrenic patients(P>0.05),and patients without insight recognize their own face more slowly(P<0.05);there was difference in speed of self-face recognition between patients with and without insight(P<0.05),but no difference was found in stranger' s face and famous face recognition(P>0.05).Conclusion The results indicated that schizophrenic patients had self-disturbance,and insight might correlate with self-face recognition.
    Studies on Correlation between Psychiatric Symptom and Theory of Mind in Patients with Schizophrenia
    Gao Rui;Jia Hongxiao;Han Shihui;He Ruirong;Zhao Xin;Zhu Hong;Ge Jianqiao;Mao Lihua;Zhang Jizhi;Jiang Zhengkang
    2008, 29(4):  420-422. 
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    Objective To investigate the correlation between psychiatric symptom and theory of mind in patients with schizophrenia.Methods 40 patients with schizophrenia were measured with faux pas,comic strips and PANSS at base line,4th week,and 8th week.Results PANSS scores at 4th week and 8th week were obviously lower than that of base line(P<0.001).Compared with base line,Faux pas,correct number,correct response time,error number of comic strips in ToM task changed significantly at 4th week and 8th week(P<0.05).There were correlations between PANSS score and Faux pas,correct number,correct response time,error number of ToM task(P<0.05).Conclusion Tom impairment tested by faux pas and comic strips maybe the state marker of schizophrenia.
    Evaluation of Cognitive Functions and Its Corelation with Psychiatric Symptoms in Patients with Schizophrenia
    Wang Xue;Ren Yanping;He Jiali;Zhou Dongfeng
    2008, 29(4):  423-427. 
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    Objective To evaluate the cognitive function and its correlation with psychiatric symptoms in patients with schizophrenia.Methods Thirty-one patients with schizophrenia and thirty-one healthy person as control were evaluated by neuropsychological test,such as continuous performance test(CPT),wisconsin card sorting test(WSCT),stroop color-word test and repeatable battery for the assessment of neuropsychological status(RBANS),and the positive and negative syndrome scale(PANSS) in schizophrenic patients.Results The scores in all items of neuropsychological test except the A,B,C wrong numbers of Stroop color-word test in schizophrenic patients were significantly poorer than those in healthy controls(P<0.05).The correct time in CPT,the random wrong number in WSCT,word interference time and color interference time in Stroop color-word test,immediate memory score and total score in RBANS were significantly correlated with part of the scores in PANSS(P<0.05).Conclusion The memory,attention,executive performance and verbal function were impaired,and some cognitive function scores were significantly correlated with the psychiatric symptoms in patients with schizophrenia.
    Clinical Observation on Improving the Memory Impairment of Patients with Schizophrenia by Si Junzi Tang
    Zhou Fang;Jia Hongxiao;Tang Yunyi;Zhang Jizhi;Jiang Zhenkang
    2008, 29(4):  428-430. 
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    Objective To investigate the improving effects on memory impairment of patients with schizophrenia by Si Junzi Tang.Methods 60 patients with schizophrenia treated by chlorpromazine were divided into two groups,one was treated with herb mixture named Si Junzi Tang,and the other with placebo.WAIS memory scales and PANNS were examined before and at the end of treatment.Another 30 healthy persons as control were also examined with above memory test.Results Before treatment,the score of memory item in treatment group and placebo group was obvious lower than that of normal control group(P<0.01).For score of digits forward,digits backward,number memory,figural memory,recognition,reproduction,association,comprehension,and MQ,except accumulation,obvious improvement was demonstrated in treatment group comparing with before treatment of itself and with placebo group(P<0.05).While there was no difference of each memory item score before and after treatment in placebo group(P>0.05).Conclusion Si Junzi Tang has some improving effects on memory impairment of schizophrenic patients.
    Determination of Reboxetine Mesilate in Plasma by High Performance Liquid Chromatography with Ultraviolet Detection
    Zhang Jun;Li Wenbiao;Guo Guixin;Zhai Yimin;Guo Wei;Wang Chuanyue
    2008, 29(4):  431-435. 
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    Objective To develop a method for the determination of reboxetine mesilate in plasma by high performance liquid chromatography.Methods With maprotiline hydrochloride as the internal standard,1 mL plasma sample was extracted with 5 mL distilled diethyl ether and re-extracted with 0.2 mol·L-1 HCl 0.2 mL.The HCl phase was evaporated to dryness with N2 stream at 80 ℃~100 ℃,and the residues were dissolved with 50 μL mobile phase.The compounds were separated on an Inertsil ODS-3 column(GL Sciences,5 μm,4.6 mm×150 mm).The mobile phase was composed of acetonitrile-50 mmol/L sodium phosphate(pH=6)(40∶60,v/v) and vacuum filtered with 0.45 μmol/L micro filtration film.The flow rate of mobile phase was 0.6 mL·min-1.The UV detection wave length was 210 nm.Results The relationship of the peak height ratio of reboxetine mesilate to maprotiline vs.reboxetine mesilate concentration in plasma was linear within the range of 3.12~200 ng·mL-1,r = 0.999 7.The lowest detection limit was 0.5 ng and the lowest concentration detected was 2 ng·mL-1.The extraction recovery of reboxetine mesilate was 82.50%~86.08%.The within-and between-batch precisions were 2.02%~5.33% and 3.83%~8.50%,respectively.Conclusion The method is sensitive,precise,reproducible and specific,and can be used in the pharmacological research and therapeutic monitoring of reboxetine mesilate.
    Glycogen Synthase Kinase 3 and Bipolar Mood Disorder
    Li Xiaohong;Liu Min;Luo Xiaonian;Wang Gang
    2008, 29(4):  436-439. 
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    To understand the role of glycogen synthase kinase 3(GSK3) in drug treatment and development of bipolar affective disorder,we introdued the biological features and promotion in apoptosis of GSK3 first.Then,we also reviewed some works of GSK3 in therapeutic drugs and animal models with bipolar affective disorder.
    基础研究
    Morphological Observation of Hepatocyte Apoptosis of Rats with D-galactosamine/lipopolysaccharide-induced Acute Liver Failure
    Liu Xuhua;Duan Zhongping;Sun Yilin;Zhao Lili;Cai Qing;Lu Qiang;Zhang Jing;Wang Tailing
    2008, 29(4):  440-444. 
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    Objective To study liver ultrastructure in acute liver failure of rats and understand morphological characteristic of apoptosic cells in the particular environment.Methods Acute liver failure were induced by D-galactosamine/lipopolysaccharide intraperitoneal injection in Wistar Rats,Mortality and survival time were recorded,Ten rats were sacrificed at 4,8,and 12 hours after injection,respectively,Liver function tests and liver pathological changes were measured after treatment with D-galactosamine/lipopolysaccharide,cell apoptosis was detected by Tunnel assay.Ultrastruture changes were observed in 4,8 hours after treatment.Results 80% of rats died from liver failure,the mean survival time is 15.6±1.8 hours.The ultrastructure changes in 4 hours included swollen mitochondria,enlargement of endoplasmic reticulum,cytoplasmic inclusion bodies,condensation and margination of chromatin,as well as characteristic formation of intracellular apoptotic bodies.Hepatocyte apoptosis became significant at 8 hours after treatment,with different stages and different mitochondrial changes.Index of apoptosis was significantly higher in 8 hours group,in accordance with electronic microscopy results.Conclusion In D-galactosamine/lipopolysaccharide-induced acute liver failure rats,hepatocytes apoptosis were main histopathologic representation,which is similar with acute liver failure caused by hepatitis B virus in human.
    Comparison between Trypsinization and Collagenase Treatment in Passaging of Human Embryonic Stem Cells
    Zhu Wanwan;Wang Shuyan;Wu Di;Xu Yanling;Fu Linlin;Guan Yunqian;Zhang Yu
    2008, 29(4):  445-450. 
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    Objective Human embryonic stem cells(hESC) are typically passaged by two different enzymes,0.05% Trypsin-EDTA and Collagenase,type Ⅳ.The effect of the two enzymes on hESC cell viability,growth and genotype stability is to be analyzed.Methods We cultured hESC on mouse embryonic fibroblasts(MEF),digested and passaged the cells by the two enzymes,and then counted the cell survival rate,colony formation rate and total cell number.Furthermore,we identified the survival rate of human ES cells after passaging and cryopreservation,and the karyotype profile after more than 10 passages.Results We found that,passaged by trypsin,the cell colony was uniform,the colony formation rate was higher and total cell number increased faster than that of collagenase treatment.The two enzyme treatments were yield nearly the same survival rate after digestion or cryopreservation,and are able to maintain normal karyotype after more than 10 passages.Conclusion 0.05% Trypsin-EDTA and Collagenase type Ⅳ are both good choice in hES cells passaging,but suitable for different experiments.
    Comparative 2-DE Analysis of Protein Expression Profiles in Hela Cells with Different Extraction Protocols
    Sun Licui;Hu Jia;Zheng Junfang;Su Lei;He Junqi;
    2008, 29(4):  451-454. 
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    Objective The aim of this study is to compare protein expression profiles in two-dimensional electrophoresis analysis using different protein extraction protocols.Methods Total proteins were extracted from Hela cells with freezing-thaw,ultrasonic treatment,gentle shake treatment and 2-D clean up kit respectively.Samples were separated by two-dimensional electrophoresis,in which 300 μg of protein samples were applied to 7cm pH 3-10 NL immobilized pH gradient gel strips.Protein spots were visualized by modified colloidal CCB staining and then analyzed with Image Master 2D Platinum Software.Results Samples from freezing-thaw treatment exhibit fewer protein spots(400±) and more horizontal stripes on 2-DE maps.In contrast,more spots(700± and 800±) and fewer horizontal stripes were detected with ultrasonic or gentle shake treatment,and stripes were further reduced with 2-D clean up kit.However,2-D clean up kit detected less protein spots especially for low-abundance proteins,and addition of Destreak reagent to 2-D clean up kit can increase the efficiency of protein yield on the 2-D image(800±→900±).Conclusion Protein expression profiles of Hela cells in 2-DE analysis were obtained with few stripes and more protein spots after ultrasonic or gentle shake treatment to extract proteins.Combination of 2-D clean up kit with Destreak reagent for protein extraction can diminish horizontal stripes,especially in the alkaline end.
    Isoflurane Potency in Mice from the First and Second Parity
    Zheng Yi;Lu Jing;Wang Qian;Wang Jü;Chen Lü;Wang Guonian;Zhou Jianxin
    2008, 29(4):  455-458. 
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    Objective To determine the influence of parity on the potency of volatile anesthetics in mice.Methods 24 ICR/CD-1 mice(half male and half female) mated one another to compose 12 pairs of parents.Each pair was allowed to produce two succeeding litters.Reproductive characteristics were observed and documented,including litter size at birth,sex ratio at weaning,and neonatal mortality.Body weight was measured at birth,at the time of weaning,and at the time of anesthetic potency determination.At 65~75 days of age,median effective concentration(EC50) of inhaled isoflurane was measured in mice from the two parities by using a bracketing design.Loss of righting reflex was chosen as the successful induction of anesthesia.Results 104 and 109 offspring were obtained in the two parities for the determination of isoflurane EC50.There were no significant differences of reproductive characteristics and body weight across the two parities(P>0.05).Males were heavier than females at weaning and at EC50 determination(P<0.05).No significant differences were found in isoflurane EC50 across the parity,and across the sex within parity.Conclusion Volatile anesthetic potency was identical in mice from two succeeding parities.
    Quantitative Analysis of Sphingosine-1-phosphate in Biological Samples by HPLC
    Li Changyong;Jiang Xiangming;Yu Hao;Li Liying
    2008, 29(4):  459-462. 
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    Objective Sphingosine-1-phosphate(S1P) is a sphingolipid metabolite which has dual actions of both an intracellular second messenger and a ligand for a family of G protein-coupled receptors.It has been implicated in many and diverse biological processes,such as cell growth,cell survival,angiogenesis,cell migration and differentiation,and more recently,in the regulation of immune function.In the present study,the aim is to establish a method for the measurement of S1P from biological samples.Methods The method consists of two steps of sample pretreatment:the enzymatic dephosphorylation of sphingid-1-phosphate by alkaline phosphatase and the subsequent analysis of o-phthalaldehyde(OPA) derivatives of the liberated sphingid by high performance liquid chromatography(HPLC).Results We presented a very simple,fast,and sensitive method for determination of S1P in mice serum and liver tissue.The concentrations of S1P in these samples were(1.72±0.40)μmol/L and(150±25)pmol/g,respectively.Conclusion The method for the quantification of S1P by HPLC is essential to further investigate the possible role S1P in health and disease.
    Effect of Pentoxifylline on the Expressions of MMP-9 and TGFβ1 in Hepatic Tissue of Rats with Nonalcoholic Steatohepatitis
    Ren Yanlong;Sun Haimei;Zeng Xiaobei;Shang Hongwei;Zhang Hua;An Wei
    2008, 29(4):  463-466. 
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    Objective To investigate the effects of pentoxifylline(PTX)on the expressions of metalloproteinase-9(MMP-9) and transforming growth factor β1(TGF β1) in hepatic tissue of rats with nonalcoholic steatohepatitis(NASH).Methods Rat model of NASH was established by giving a fat-rich diet.Forty Sprague-Dawley rats were randomly divided into four groups,control group(n=10),12 week model group(n=10),16 week model group(n=10) and PTX-intervention group(n=10).The area of liver fibrosis was determined by Masson staining.The expression of MMP-9 and TGFβ1 were detected by immunohistochemistry.Results The results of immunohistochemical staining shown that the expression of MMP-9 was significantly higher in rats of model groups and PTX-intervention group than control group(P<0.05);The expression of TGFβ1 was higher in rats of 16 week model group and PTX-intervention group than control group(P<0.05);Comparing with the 16 week model group,the expression of TGFβ1 in PTX-intervention group decreased significantly(P<0.05).The fibrosis area of masson staining was higher in rats of model groups and PTX-intervention group than control group(P<0.05);The area in 16 week model group was higher than 12 week model group(P<0.05);Comparing with the 16 week model group,the area in PTX-intervention group decreased significantly(P<0.05).Conclusion PTX interventional reduced the content of TGFβ1,while that of MMP-9 expression was unchanged.These may improve the degree of hepatic fibrosis.PTX may be useful in the treatment of NASH and liver fibrosis.
    Studies on Enhancing Anoxia Endurance and Anti-fatigue Function of Oxygenated Water
    Bi Xiaoyu;Qi Na;Yin Zhaoxue;Wu Jinhua;Gao Lifang;Cao Lige;Wu Tao;Hu Zijing;Su Yilan;Chen Zhenliang
    2008, 29(4):  467-470. 
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    Objective To investigate the effect of oxygenated water on anoxia endurance and anti-fatigue function in mice.Methods Mice were orally administered different doses of oxygenated water,survival time under anoxia,sodium nitrite poisoning or acute cerebral ischemia,loaded swimming time,serum urea nitrogen,plasma lactic acid content,and hepatic glycogen were determined.Results It was found that oxygenated water(2.4 mg/kg) could protract the anoxia survival time of mice under normal pressure(P<0.05).It could also significantly increase hepatic glycogen glycogen storage(P<0.05),decreased the rate of plasma lactic acid increase(P<0.05)and the area under curve(AUC) of plasma lactic acid(P<0.05)after exercise.Survival time under sodium nitrite poisoning or acute cerebral ischemia,loaded swimming time had the trend of prolong,the content of serum urea nitrogen also had the trend of descending.Conclusion Oxygenated water may enhance the ability of fatigue recovery and anoxia endurance function.
    Effect of Isoproterenol on Electrical Heterogeneity of L-type Calcium Current in Canine Ventricular Myocytes
    Gao Ying;Zhou Peng;Liu Xiulan;Yang Xinchun
    2008, 29(4):  471-474. 
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    Objective To examine the characteristic of L-type calcium current(ICa.L) in three distinct canine right ventricular myocytes and the response to isoproterenol.Methods Using whole-cell patch clamp techniques to examine the electrophysiological characteristics of ICa.L of myocytes enzymatically dissociated from canine right ventricular epicardial,midmyocardial,and endocardial,and to study the difference of current-voltage relations before and after using isoproterenol.Results The peak density of ICa.L(pA/pF) was-4.868±1.362(n=20),-3.594±0.544(n=20),-2.874±0.547(n=20)(F=33.493,P<0.05) in right ventricular(RV) epicardial,midmyocardial,and endocardial myocytes(P<0.01),respectively.Perfusion of Iso(0.5 μmol/L) increased peak ICa.L densities from-4.838±1.127(n=11) to-22.348±4.057(P<0.01) in RV epicardial myocytes,-3.726±1.051(n=11) to-17.992±4.159(P<0.01) in RV midmyocardial myocytes,-2.714±0.879(n=10) to-2.987±1.012(P>0.05) in RV endocardial myocytes.Conclusion Iso can significantly increase ICa.L densities peak on the Epi cells and M cells,but M cells and the Endo cells present no response to the drug.β-adrenergic agonists can reduce outward shift in the current active at the end of phase 1 of the right ventricular epicardial action potential.
    Influence of Dietary Supplementation of Purple Laver Porphyra yezoensis on Vascular Endothelial Function in Patients with Essential Hypertension
    Tang Yuping;Li Penggao;Xing Xiaoran;Yu Zhenqiu;Sun Liying;Xiao Zhongxin;Zhang Shuhua;Wu Huihui;Chu Jinhua;Li Weixin;Zhen Yaping
    2008, 29(4):  475-478. 
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    We have previously reported that dietary supplementation with purple laver(PL) Porphyra yezoensis,an edible red alga,for 28 days reduced the 24 hour ambulatory blood pressure(ABP) in 36 patients with essential hypertension(EH).However,the antihypertensive mechanism of PL remain obscure and the influence of PL on vascular endothelial function,an important factor in the development and the treatment of EH is also unclear.Thus,to elucidate the mechanisms,we investigated the influence of dietary supplementation with PL on the vascular endothelial function as represented by the levels of two vasoactive materials endothelin(ET),a potent vasoconstrictor,and nitric oxide(NO),a strong vasodilator.A total of 36 patients with EH(24 male,55.0±7.9 years old;12 female,50.5±7.1 years old) were divided into 2 groups in a blank controlled cross-sectional trial with supplementation of PL(45 g/d) for 28 days.After enrollment,all the subjects were asked to finish a questionnaire of their lifestyle and to sign a written informed consent according to the Declaration of Helsinki of the World Medical Association(Edinburgh revision,2000) and then were matched according to sex,age,and lifestyle and divided into two groups.There were no statistically significant differences between groups in terms of baseline demographic or clinical characteristics,blood routine,and lipid profile.During the study,subjects were instructed not to modify their daily lifestyle,such as changing their diet otherwise and exercise,except for taking the supplementary PL in the form of a 3 g-sheet with everyday meal for three times a day.After a 7-day run-in period,subjects were randomized to the purple laver(PL,45 g/d) or blank group for 28 days.After that,both groups entered a 7-day wash-out period and then crossed over to the alternate treatment for another 28 days.At the begining and the end of each treatment period,subjects were evaluated by 24 h ambulatory blood pressure(ABP) monitoring and by seated cuff blood pressure(BP) measurements at trough.Blood serum samples were collected and measured for lipid profile,endothelin(ET),and nitric oxide(NO) concentration before and after each treatment periods.As a result,PL significantly decreased ABP as compared with the blank and the baseline.Mean reductions in ABP for the two groups were(7.4±2.3)/(3.7±1.2)mmHg and(9.2±3.3)/(6.4±2.3) mmHg respectively,with significant reductions in ambulatory systolic blood pressure for both groups(P<0.05).Serum lipid profile was not significantly changed.However,serum ET concentration decreased(16.3±8.6)ng/L and(22.2±8.8)ng/L in the two groups respectively after consuming Porphyra yezoensis for 28 days(P<0.05).Meanwhile,serum NO concentration,as determined by nitrate/nitrite(NO2-/NO3-) concentration,significantly increased(15.8±5.8)μmol/L and(12.7±9.2)μmol/L respectively in the two groups(P<0.05).Moreover,the differences of ET and NO between the supplementation and the blank control group were both statistically significant(P<0.05).Furthermore,it should be noted that when the consumption of PL had been ceased for 28 days,serum ET and NO level also returned to their baseline level(101.5±13.2 ng/L and 63.9±13.9 μmol/L,respectively).In conclusion,our findings suggest that long-term dietary supplementation with PL can improve vascular endothelial dilatory function and then decrease 24 h ambulatory blood pressure in essential hypertensives.
    Observation on the Changes of the Tissue Hypoxia in the Rabbits During Graded Progressive Hemorrhage
    Zhang Yan;Jiang Hongxin;Chen Yue
    2008, 29(4):  479-482. 
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    Objective To understand the changes of the blood gas and the tissue hypoxia in rabbits during graded progressive hemorrhage.Methods The values of arteriovenous pH and PCO2 gradients(AVpH and AVPCO2) were compared with that of blood lactate in their relationship to changes in tissue oxygen delivery(DO2) in 10 rabbits during graded progressive hemorrhage.Results AVpH,AVH+ and AVPCO2 increased progressively as cardiac output(Qt) decreased,at the same time the blood lactate concentration increased.The relationship between cumulative blood loss,AVpH,AVH+,AVPCO2 and blood lactate concentration was biphasic;In the early stage of hemorrhage,AVpH,AVH+,AVPCO2 gradients and blood lactate concentration changed gradually and later these variables changed more rapidly.The inflection points in all cases were similar.The inflection point corresponds to the critical DO2(DO2-crit).Conclusion Rapidly expanding AVpH and AVPCO2 indicates the onset of tissue hypoxia,which may serve as a repress reliable parameters of tissue hypoxia during hypoperfusion.
    临床研究
    Determination of Plasma Levels of Tryptophan in Patients with Chronic Fatigue Syndrome
    Liu Zhandong;Wang Dexin;Zhang Ning;Li Ren;Chen Jun;Zhang Yongbo;Zhao Yaming;Xue Qiming
    2008, 29(4):  483-486. 
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    Objective To determine the changes in tryptophan levels in the chronic fatigue syndrome(CFS) patients.Methods The levels of tryptophan in the plasma of CFS patients were determined by HPLC.The patients and healthy persons were selected according to the CDC criteria.Results The levels of tryptophan in CFS(32.03±5.33)μmol/L increased significantly when compared those in controls(22.49±4.26)μmol/L.Conclusion Serotonergic dysfunction that initially came from the metabolitic disturbance of trytophan in the plasma might be one of the pathogenetic factors for CFS.
    Evaluation of Left Ventricular Function of Patients with Coronary Heart Disease by Using Real Time Three Dimensional Echocardiography
    Gao Jing;Hua Qi;Wang Cairong;Li Xiaohui;Gao Chengmei
    2008, 29(4):  487-489. 
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    Objective The effects of coronary heart disease on left ventricular(LV) function have been studied by various echocardiographic techniques(M-mode,2D echocardiography).These studies are hampered by a low accuracy of measurements because of geometric assumptions regarding LV shape.Real time three-dimensional echocardiography(RT-3DE) can overcome this limitation.Methods We detected 80 patients with coronary heart disease by 2D and RT-3D echocardiography.Each one was tested the feasibility of RT-3DE assessment of LV function.Conventional biplane Simpson rule(BSR) for LV function analysis was used as a reference.Paired t test was used for analysis of differences within the variations.Correlation analysis was performed for RT-3DE and 2DE measurements.Results All the patients were studied and in 70 of 80(87.5%) RT-3DE datasets were acquired.In 10 patients,the dataset was of insufficient quality and excluded from analysis.Correlation between BSR and RT-3DE for calculation of end-diastolic volume(EDV,r=0.875),end systolic volume(ESV,r=0.912) and for ejection fraction(EF,r=0.905) was moderate.2DE methods underestimated end diastolic and end-systolic volume,while overestimating ejection fraction.Conclusion RT-3DE is feasible for image acquisition during coronary heart disease,which opens the possibility for accurate and reproducible measurement of LV function.This may improve the assessment of the acute effect of coronary heart disease on LV performance,and guide therapeutic strategies.
    Effect of Simvastatin on High Sensitivity C-reactive Protein in Serum of Patients with Stable Coronary Artery Disease
    Wang Shan;Tan Jing;Hua Qi
    2008, 29(4):  490-492. 
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    Objective To explore the effect of simvastatin on high sensitivity C-reactive protein in serum of patients with stable coronary artery disease.Methods 34 patients with stable coronary artery disease at the age of 41~79 years old(26 males and 8 females,mean age at 64.4±11.3 years old) were given 20 mg/d simvastatin at night.The therapeutic course was 12 weeks.Fasting serum total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),high sensitivity C-reactive protein(hs-CRP) and other biochemistry data were examined before and after 4 and 12 weeks' treatment.Results After 12 weeks' treatment,TC,LDL-C,TG significantly decreased by 34.8%,46.1% and 24.7%,but HDL-C increased by 2.0% slightly.76.5% patients could reach Chinese standard level of LDL-C,and the Hs-CRP level decreased significantly(P=0.018).Conclusion The use of 20 mg/d simvastatin is efficacious at lowering LDL-C levels and allowing patients to achieve their goal to low cholesterol level,and may be beneficial to inhibiting inflammatory response in patients with stable coronary artery disease.
    Prognostic Value of IL-6 and Adhesion Molecule on In-hospital Mortality in Patients with ST-segment Elevation Acute Myocardial Infarction
    Fan Zhenxing;Hua Qi;Tan Jing;Liu Rongkun
    2008, 29(4):  493-496. 
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    Objective The aim of the present study is to assess the prognostic value of serum interleukin-6(IL-6),soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1) and soluble P-selectin(sP-selectin) on in-hospital mortality in patients with ST-segment elevation acute myocardial infarction(STEMI).Methods The single-centre study enrolled 263 consecutive patients with STEMI.Data on patients' histories,comorbidity,presenting features and reperfusion treatments were collected.In all patients a venous blood sample was taken within 6 hours after symptom onset.Serum levels of IL-6,sICAM-1,sVCAM-1 and sP-selectin were measured by ELISA method.The relation among these inflammatory factors,clinical characteristics and in-hospital mortality were observed and analyzed by SPSS 11.5 package.Results A total of 18 patients died during hospitalization,with a mortality rate of 6.84%.Patients of death group were substantially older than those survival(70.06 vs 60.44,P<0.001),had a higher incidence of hypertension(P<0.016) and diabetes mellitus(P<0.043),and a lower body mass index(BMI)(P<0.034).The proportion of female in death group was higher(P<0.048).Serum levels of IL-6 in death group were higher than those in survival group(P<0.001).No significant difference of sICAM-1,sVCAM-1 and sP-selectin levels between the two groups was found.ROC curve analysis to predict the risk for in-hospital mortality showed a prognostic accuracy of IL-6(AUC 0.787,95% CI:0.678~0.897,P<0.001),the optimal cutoff value was 7.082 ng/L.Predictors of in-hospital mortality at multivariable logistic analysis were IL-6 levels and age(P=0.019 and 0.049,respectively).Conclusion IL-6 levels and age were related to in-hospital mortality of ST-segment elevation acute myocardial infarction,both are independent predictor of in-hospital death in patients with STEMI.
    Changes in Plasma BNP and Its Correlation with Cardio Function in Patients with Predialysis Chronic Kidney Diseases
    Li Guogang;Liu Huilan;Xue Fei;Tan Yanguo
    2008, 29(4):  497-500. 
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    Objective In order to assess the diagnostic value of BNP for high blood-volume and cardiac function,we detect the changes of plasma brain natriuretic peptide(BNP) in patients with predialysis chronic kidney diseases(CKD).Methods Plasma BNP concentrations were measured in 152 CKD patients and 32 healthy control subjects.The CKD patients were divided into four groups according to the glomerular filtration rate(GFR) by Cockcroft's formula:CKD-Ⅰ and Ⅱ;CKD-Ⅲ,CKD-Ⅳ,and CKD-Ⅴ groups.Echocardiographic examinations were performed to determine the cardiac structure and function.The inferior vena caval diameter were measured.Results Median plasma BNP concentrations increased with declining estimated GFR in CKD Groups(P<0.05);Spearman correlation showed that the BNP level was positively correlated with LVDd,LVDs and the width of postcava,but negatively correlated with LVEF.Conclusion BNP is a sensitive marker for monitoring the condition of cardiac function in CKD patients.
    Study on the Distributed Lag Model for Incidence of Colon Cancer of Beijing Urban Area
    Shen Mo;Qu Chenxu;You Weicheng;Zhang Lian;Wang Tao
    2008, 29(4):  501-504. 
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    Objective To investigate the distributed-lag effect of red meat consumption on the incidence of colon cancer by establishing distributed lag model in Beijing urban area.Methods Incidence of colon cancer in Beijing urban area during 1982~2005 obtained from the Tumor Registration Office and the consumption amount of red meat per year per person in Beijing urban area during 1978~2006 were collected from published statistical annual books.The distributed lag model of incidence of colon cancer was established with these data and the incidence rate could be estimated for the future.Results The amount of red meat per year per person is related to the incidence of colon cancer with a lag period of 14 years.Conclusion The distributed lag model with risk factor is an effective model to estimate the tendency of incidence of colon cancer.The consumption amount of red meat affects the incidence of colon cancer in Beijing urban area started from 5 and the maximal effect became obvious in 14 years.
    Application and Clinical Significance of End-tidal Carbon Dioxide Tension Monitoring in Stable and Acute COPD Patients
    Liu Shanshan;Liu Xuebai;Li Cuiping;Zhou Xiumei;Liu Jianqun;Zhang Xueqin;Gao Junxia;Ma Jie;Yan Ju
    2008, 29(4):  505-507. 
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    Objective To investigate the correlation and clinical value between PetCO2 and PaCO2 in stable and acute chronic obstructive pulmonary diseases(COPD) patients.Methods Fifty persons were tested in our study,20 healthy persons as control(A group) and 30 COPD patients.30 COPD patients were divided into two groups,acute COPD patients(B group,fore-treatment) and stable COPD patients(C group,post-treatment).The value of PetCO2 and PaCO2 were measured at the same time,and then calculate the value of ADCO2.Results 1) The value of PaCO2 and ADCO2 in B and C groups were significantly higher than those in A group(all P<0.01).Compared with A group,the value of PetCO2 in B group decreased significantly(P<0.01),but no significant changes in PetCO2 value was found in C group(P>0.05).Compared with B group,the value of PetCO2 in C group increased significantly,and the value of PaCO2 and ADCO2 in C group decreased significantly(all P<0.01).2) PetCO2 was significantly correlated with PaCO2 in both A and C group(r=0.95 and 0.56,all P<0.01).Conclusion PetCO2 can be used to judge the change of PaCO2 in normal and stable patients of COPD,but it is not very sensitive and can not be used directly to judge the change of PaCO2 in acute patients of COPD.ADCO2 can be used to reflect the severity of acute COPD patients.
    Clinical Features of Moyamoya Disease and Analysis on Its Cranial MRA and DSA
    Liu Jun;Yu Xueying;Chen Yaliang
    2008, 29(4):  508-511. 
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    Objective To investigate the clinical characteristics,imagery display and their correlation with moyamoya disease(MMD).Methods We summarized retrospectively a total of 113 cases with moyamoya disease,who hospitalized,and diagnosed by digital subtraction angiography(DSA) and magnetic resonance angiography(MRA) in Beijing Tiantan Hospital.All subjects were divided into teenager group(<20 years old,total 31 cases) and adult group(≥20 years old,total 82 cases).Results Onset age of patients with moyamoya disease present two peaks in present study,10~14 and 35~39 years old respectively.Among 31 subjects in teenager group,there were 15 subjects with ischemic stroke(48.4%),which was dominant,8 subjects with hemorrhagic stroke(25.8%),5 subjects with epileptic seizure repeatedly(16.1%).Among 82 subjects in adult group,there were 41 subjects with hemorrhagic stroke(50%),36 subjects with ischemic stroke(43.9%).Both DSA and MRA displayed bilateral lesions,in which we could find abnormal vascular networks just like smog.In teenager group,occlusions of bilateral middle cerebral artery(64.5%)and anterior cerebral artery(61.3%)were dominant.In adult group,occlusions of bilateral internal carotid artery(45.1%)and middle cerebral artery(46.3%)were dominant.In addition,there were 5 cases with occlusions of posterior cerebral artery and one case with vertebral artery stenosis.Conclusion Morbidity in adult group was higher than in teenager group.Ischemic stroke often occured in children with MMD,while hemorrhagic stroke often occured in adult group.DSA is diagnostic golden standard for MMD,which could accurately display site and degree of injured blood vessel.MRA is being applied more and more extensively to clinical because of its superiority,including non-invasive,non-radioactivity and no demand contrast medium,and so on.In addition,MRA also could reflect the condition on brain parenchyma and intracranial blood vessel from both morphology and function,which was first selected examination means for screening,diagnosis and follow-up of MMD.Furthermore,some scholars think that transcranial doppler(TCD) could be one of method to screen stenosis and occlusion of cerebral arteries,which could detect patients with moyamoya disease in earlier period and apply to follow-up.
    Clinical Studies on 182 Cases of Neurosurgical Patients with Percutaneous Dilative Tracheostomy without the Assistance of Bronchoscopy
    Wu Yuanxing;Meng Ze;Wang Qiang;Shi Guangzhi;Zhang Zheng;Zhao Lihong;Zheng Yi;Chen Guangqiang;Zhou Jianxin
    2008, 29(4):  512-515. 
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    Objective To evaluate the feasibility and safety of 182 patients underwent percutaneous tracheotomy using the guide wire dilation forceps(GWDF) techniques and the Percutwist technique without the assistance of bronchoscopy in intensive unit from the year 2002~2006.Methods 182 patients underwent the Percutaneous Dilative Tracheostomy(PDT) in ICU of Tiantan hospital.Most of them are transferred from the neurosurgical department of our hospital.A 3 months' follow-up visit was performed(except the dead cases).The first 152 patients underwent PDT by using the GWDF techniques Kit,and the remaining 30 patients underwent PDT by using the PercuTwist tracheotomy Kit.Results All the cases have a successful cannulation.Non of them was conversed to the conventional open tracheostomy technique.The mean operating duration of GWDF was 4~5 minutes.The mean operating durations of Percutwist was 8.5 minutes,the duration of practician was 6~7 minutes and the duration of unpratician was about 10 minutes in Percutwist technique.Overall,the two most common complications were peristomal hemorrhage in 6 cases and wound infection in 2 cases.1 cases of pneumoderma was found.During the 3 months' follow-up visit,there were no complications of pneumothorax,tracheo-esophageal fistula,symptomatic tracheal stenosis and operating-related death.No symptomatic tracheal stenosis was found.The total complication rate of PDT in our ICU was 4.95%.The total complication rate abroad was 6.23%.11 cases dead form other reasons which was not relate to PDT.The incidence of complications were similar to the relevant domestic and abroad literatures,some complications were even lower than the literatures abroad.The absence of serious complications such as pneumothorax symptomatic tracheal stenosis and pneumomediastinum are attributable to identify the anatomic landmark strictly,ensure the smooth gliding movement of the J guide wire in each step of the operation,never use brute force downward to the trachea.Conclusion The PDT without the assistance of bronchoscopy is feasible and safe.The operator should be careful,obey the contraindication strictly,improve the techniques and skills,never use brute force downward to the trachea.The severe complications of the PDT were not relate to the use or not use of the bronchoscopy.If the PDT kit can be improved to adapt the circumstance of non bronchoscopic assistance,it will be more popular.
    Surgical Management of Diastematomyelia with Osseous Divide and Scoliosis
    Cui Shaojie;Wei Ronggui;Bai Xiaojun;Jia Yunfeng;Shi Tiejun;Yang Zhifeng
    2008, 29(4):  516-517. 
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    Objective To determine the pre-operation investigation,position calculating,surgical method and purpose of diastematomyelia with osseous divide and scoliosis.Methods Clinical studies,including surgical choices and operative methods,on 74 diastematomyelia patients with osseous divide and scoliosis were reviewed.Results All patients achieved a satisfactory result by osseous divide resection and lumbosacral dural sac plasty.Such surgical process makes patients in a good condition to accept further scoliosis instrumentation.Primary nerve damage symptoms were lightened or eliminated in some patients.Conclusion Before surgical instrumentation all scoliosis patients should have spinal X-ray,CT and MRI examination to determine if diastematomyelia accompanying osseous divide.Sole diastematomyelia do not need any treatment.Patients with diastematomyelia and osseous divide should accept osseous divide resection and lumbosacral dural sac plasty before spinal instrumentation operation,which is the most important for young patients in growing stage.
    Laparoscopic Vaginal Reconstruction Using An Ileal Segment: A Retrospective Report of 72 Cases
    Wei Changsheng;Wu Jixiang;Liang Jiexiong
    2008, 29(4):  518-520. 
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    Objective The surgical management of the congenital absence of vagina(Mayer-Rokitansky-Kuster-Hauser syndrome) and male-to-female transsexuals are a complex problem which refered to a significant technical challenge.The methods used for vaginoplasty induce including the split-thickness skin graft,full-thickness skin graft,and inverted penile skin flap.However,these procedures are not entirely satisfactory in cases of reconstructed vaginal stenosis,inadequate vaginal length,or poor lubrication.The small intestine,ascending colon,and sigmoid colon can be used in the intestinal flap method.Herein we present our successful experience with laparoscopy for vaginal reconstruction by the use of a modified ileal segment according to the Monti principle.At the same time,we compared with the difference between laparoscopic vaginal reconstruction and laparoscopic assisted vaginal reconstruction.Methods We analyzed the results of all 72 patients who underwent laparoeopic ileal vaginoplasty in Beijing Anzhen Hospital between February of 2004 and September of 2006.Results All the operations were successful.The mean operating time had not significance difference between total laparoscopic vaginoplasty and laparoscopic assisted ileal vaginoplasty(P>0.05).Conclusion Our results have confirmed the feasibility of laparoscopic perineal neovagina construction by ileal colpoplasty,total laparoeopic or laparoscopic assisted.Isolated ileal segments provided excellent tissue for vaginal replacement.
    Clinical Observation on the Therapeutic Efficacy of Silensor in Obstructive Sleep Apnea Syndrome
    Li Dongmei;Lai Suiping;Zhen Huichun;Hu Chonghai
    2008, 29(4):  521-523. 
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    Objective To observe the therapeutic efficacy of silensor in obstructive sleep apnea syndrome(OSAS).Methods 17 patients with OSAS were treated with mandibular advancement appliance named silensor and re-examined by PSG monitoring equipment at night.The changes in the sleep disorder indexes were analyzed.The upper airway structure were determined by CT before and after treatment.Results 17 patients responded to the appliance therapy.There were significant increases in upper airway area from 0.82 to 1.70 cm2 and in upper oral-pharynx area from 1.24 to 1.93 cm2 at average.However,the HI,Apnea index and AHI significantly decreased(P<0.05).Conclusion The silensor is an effective alternative that could benefit the patients with mild OSAS.
    Target Controlled Infusion of Propofol in Patients Undergoing Ureter Retrogression Lithotripsy
    Fang Bo;Wei Wei;Tian Ming
    2008, 29(4):  524-527. 
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    Objective To estimate the feasibility and safety of intravenous anesthesia by using target controlled infusion with propofol and sufentanil in patients undergoing ureter retrogression lithotripsy(URL) with holmium laser.Methods Thirty patients(ASA Ⅰ-Ⅱgrade),scheduled for URL,were randomly divided into two groups.All the patients received sufentanil 0.1 μg·kg-1,3 minutes later,and then were administered by target controlled infusion of propofol.The target concentrations were 3 μg·mL-1 in group 1(G1,n=15)and 4 μg·mL-1 in group 2(G2,n=15),respectively.Operations began as soon as the effect site concentration achieved plateau.Bispectral Index(BIS) was controlled under 60 by propofol bolus delevery.In addition,when the operation was disturbed because of body movement,a few dosage of propofol would be delevered.Mask positive pressure ventilation was applied when pulse oxygen saturation(SpO2) was lower than 90%.Blood pressure,heart rate,SpO2 and BIS value were monitored.Other parameters such as sedation grade(RAMSAY),complications,total dosage and frequency of propofol bolus injection,time for recovery would also be compared between the two groups.Results The sedation grades of the two groups were both 4-5.BIS were 59±10 and 56±13,and there were no statistical difference between G1 and G2 groups.The incidence of mask ventilation were 2/15 in G1 and 8/15 in G22:P=0.02)respectively;the incidence of body movement were 5/15 in G1 and 1/15 in G22:P=0.08);time to open eyes with command was(2.8±1.1)minutes in G1 and(8.3±3.0)minutes in G2;time for recovery of directional judgment was(7.6±1.9)minutes in G1 and(15.6±2.2)minutes in G2;total dosage of propofol given were(225.5±77.7)mg in G1 and(342.5±72.6)mg in G2;all of the 5 parameters mentioned above were statistically different between the two groups(P<0.01).Each patient had no memory during the operation.Conclusion The combined anesthesia of propofol and sufentanil in two groups are both good for URL,whereas there was less side-effects in the group with target concentration of 3 μg·mL-1 than the other.
    Professor Fa-zi Cong's Clinical Experience in Treatment of Luteal Phase Defect-induced Infertilitas Feminis by Menstrual Cycling Therapy
    Yang Hong
    2008, 29(4):  528-530. 
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    Professor Fa-zi Cong has worked as a clinician of Traditional Chinese Medicine(TCM) for more than fifty years and made great achievement in the treatment of luteal phase defect(LPD)-induced infertilitas feminis.In this manuscript,we collected Professor Cong's idea that the LPD-induced infertilitas feminis could be healed by menstrual cycling therapy according to the TCM differentiation of symptoms and diseases.During regulating menstrual cycle of patient by the TCM differentiation of Chinese herb usage,the following key points should be referred:the critical time of menstrual cycle,the basal body temperature(BBT) curve,and the adjustment on meals.
    奖项介绍
    Focusing on the First Kavli Prize in Neuroscience
    Zhang Ting;Wang Xiaomin;
    2008, 29(4):  536-539. 
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    On May 28,2008,seven pioneering scientists who have transformed human knowledge in the fields of neuroscience,neuroscience and astrophysics have become the first recipients of the Kavli prizes.The 2008 Kavli Prize in Neuroscience was awarded jointly to Pasko Rakic,of the Yale University School of Medicine,US,Thomas Jessell,of Columbia University,US,and Sten Grillner,of the Karolinska Institute in Sweden,who collectively have deciphered the basic mechanisms that govern the development and functioning of the networks of cells in the brain and spinal cord.