Table of Content

21 April 2014, Volume 35 Issue 2

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Application and development of contrast-enhanced ultrasound imaging for head-neck vascular disease

Li Chen, He Wen

2014, 35(2):  145-149.  doi:10.3969/j.issn.1006-7795.2014.02.001

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Head-neck artery atherosclerosis disease is frequently observed, which may affects the quality of lives. At present, digital subtraction angiography(DSA), CT angiography(CTA) and magnetic resonance angiography(MRA) have been the mainly screening tests for assessing head-neck artery. DSA is the gold standard in the diagnosis of extracranial vascular stenosis, observing the surface of the plaque and ulcer plaque formation. High resolution MR imaging can identify the intraplaque components and assess vulnerability of plaque. But these methods are unable to visualize intraplaque neovascularization and arterial vasa vasorum(VV) directly. Contrast-enhanced ultrasound(CEUS) can identify and quantify intraplaque neovascularization, assess the vulnerability of carotid plaque. Similarly, DSA is the gold standard in the diagnosis of intracranial vascular diseases, but its invasiveness has certain risk and contrast allergic reaction occurs frequently, and contrast enhanced transcranial color-coded sonography(CE-TCCS) can visualize intracranial blood vessels and identify velocity and direction of the blood flow, making up for DSA. In this paper, the application and development of CEUS in head-neck vascular disease were reviewed.

Diagnosis value of contrast-enhanced ultrasound on pulmonary space-occupying lesions

Zhang Hongxia, He Wen, Cheng Linggang, Cai Wenjia, Li Shuo, Li Chen, Du Lijuan

2014, 35(2):  150-154.  doi:10.3969/j.issn.1006-7795.2014.02.002

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Objective To explore the value of contrast-enhanced ultrasound(CEUS) in diagnosis of pulmonary space-occupying lesions. Methods Forty patients with 40 pulmonary space-occupying lesions found by using computed tomography(CT) and/or X ray, visible at US, were enrolled in this study, including 38 peripheral pulmonary lesions and 2 central pulmonary lesions with obstructive atelectasis. Of the 40 patients, 25 were male and 15 female, the mean age was (64.8±12.5)years (range from 35 to 84 years). Firstly, the lesions' dimension, shape, echo and blood flow characteristic were recorded by traditional ultrasound, then CEUS was performed, and time to enhancement(TE), time to peak(TTP) and net enhancement(NE) were recorded. Finally, percutaneous puncture biopsy was performed under the guidance of ultrasound, taking care to avoid the no-enhanced necrotic areas displayed by CEUS, and all specimens were examined pathologically. Results All the 40 cases underwent percutaneous puncture biopsy, 1 case developed the complication of hemoptysis. In 40 lesions, 34 were malignant,of which 1 was indefinite by percutaneous puncture biopsy pathology but was confirmed as malignant tumor by pathology of specimen obtained via surgery, the other 6 were benign lesions. So the rate of final diagnosis using percutaneous puncture biopsy was 97.5%(39/40). TE was slightly shorter in malignant lesion group than in benign lesion group using CEUS〔(9.50±1.05)s & (10.85±1.67)s, respectively〕 and with no significant difference(P>0.05), however, a seriously short or delayed TE may be helpful for different diagnosis in pulmonary space-occupying lesions. There was no significant difference regarding NE and TTP between two groups(P>0.05 & P>0.05, respectively); Sixteen(47.1%) were discovered non-enhanced necrosis areas in 34 malignant lesions, and 3(50.0%) in 6 benign lesions(P>0.05). The time intensity curve(TIC) of different pulmonary space-occupying lesions was characterized by "ascending slowly and descending slowly" pattern. Conclusion CEUS is a valuable method for diagnosis and guiding percutaneous puncture biopsy in pulmonary space-occupying lesions.

Shear-wave ultrasound elasticity imaging in upper-limb muscle tone in Parkinson’s disease

Du Lijuan, Cheng Linggang, Li Chen, He Wen

2014, 35(2):  155-158.  doi:10.3969/j.issn.1006-7795.2014.02.003

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Objective To investigate the Young's modulus of the biceps brachii and brachioradialis in Parkinson's disease(PD) with quantitative shear-wave ultrasound elasticity technique, and to observe the value of elastography in PD. Methods A shear-wave elasto-sonography(Aixplorer model, Supersonic Imaging, France) coupled with a linear array transducer array(4~15 MHz) was employed. Shear-wave ultrasound elasticity imaging of biceps brachii and brachioradialis longitudinal section were performed in 46 patients with Parkinson's disease〔mean age(47.9±2.8)years〕 in both sides and 31 healthy controls〔mean age(46.7±3.2)years〕 in right arm. The quantitative elasticity values were compared among the patients' symptomatic side, another side(non/mild symptom) and the controls. Results The Young's modulus of biceps brachii in symptomatic side, another side of patients and controls were(59.94±20.91)kPa, (47.77±24.00)kPa and(24.44±5.09)kPa, the mean elasticity modulu values of the biceps brachii longitudinal section of PD patients were greater in both sides than those of control group(P<0.05), and the mean value of the biceps brachii in symptomatic side was higher than that of another side(P<0.05). The mean Young's modulus of biceps brachii in symptomatic side, another side of patients and controls was(32.18±17.19)kPa, (28.41±13.19) kPa and(21.71±7.45)kPa, the mean elasticity modulus of the brachioradialis longitudinal section of PD patients were greater in both sides than those of control group(P<0.05), but there was no significant difference in the symptomatic side and another side of PD patients(P>0.05). Conclusion Shear-wave ultrasound elasticity imaging can find the characteristics of the elastic modulus of the biceps brachii and brachioradialis longitudinal section, providing a new method to assess the muscle tone in PD.

Comparison of color Doppler sonography and pathology in endometrial polyps

Zhang Ying, Zhang Dan, Li Yandong

2014, 35(2):  159-163.  doi:10.3969/j.issn.1006-7795.2014.02.004

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Objective To compare sonography image, hemodynamic characteristics and morphological changes of endometrial polypoid lesions and to discuss the value of sonography in diagnosis of endometrial polyps. Methods A total of 172 patients with a primary clinical diagnosis of endometrial polyps who underwent both transvaginal color Doppler sonography and pathology examinations were included. For sonography the lesion border, internal echo and distribution of blood signals were observed. The blood flow velocity and resistance index(RI) were measured. Lesions with clearly border and penetrate blood flow signals was the diagnostic criteria of endometrial polyps. For pathology, the structure and vascular supply of endometrial polyps were observed. Results Of the 172 patients, 68 cases had a pathological diagnosis of simple endometrial polyps, 3 cases of endometrial polyps were in combination with endometrial cancer, with 2 of them having malignant transformation, 63 cases of endometrial hyperplasia, 27 cases had secretory endometrium, 7 cases had proliferative endometrium, 3 cases had submucosal uterine fibroids, 1 case had endometritis. The agreement rate between sonography and pathology was 85.91%(61/71) for establishing the diagnosis of endometrial polyps, and 81.19%(82/101) for excluding the diagnosis. The total agreement rate was 83.14%. Conclusion Intrauterine lesions with penetrate or point-like flow is the diagnostic indications of endometrial polypoid lesions using sonography. Hysteroscopic biopsy has a significant role in differential diagnosis of benign and malignant polypoid lesions.

Posterior cerebral circulatory blood perfusion in patients with vertebral artery hypoplasia by CDFI

Guo Qiang, Tian Jiawei, Luo Weihua, Chen Daofang, Xu Fang, Shi Denggang

2014, 35(2):  164-167.  doi:10.3969/j.issn.1006-7795.2014.02.005

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Objective To extend our knowledge of the congenital disease, this study attempted to assess the diagnostic value of posterior cerebral circulation in vertebral artery hypoplasia(VAH) detected by color Doppler flow imaging(CDFI), as well as to provide hemodynamic data for posterior circulation ischemia in VAH. Methods Fifty-three patients with vertebral artery hypoplasia and 60 healthy controls confirmed by color Doppler sonography were enrolled into this study. Vertebral artery diameter(VAD), peak systolic velocity(PSV), end diastolic velocity(EDV), resistance index(RI), velocity-time integral(VTI) and heart rate(HR) were measured. Vessel areas and blood flow volume were calculated. Variation of the difference of the results between the case and control groups was analyzed to assess the effect of congenital VA hypoplasia on posterior circulation. Results A comparison between the case and control groups showed that the blood flow of posterior circulation in case group was lower compared with the control group(299.83±58.52) mL/min vs (351.26±49.17) mL/min(P<0.05). The average blood flow of dysplasia side was(47.57±18.41) mL/min. Diastolic velocity was(11.46±3.97) cm/s and the resistance index was(0.78±0.09). There was statistical different between the dysplasia side and the contralateral normal side, and between the case and control groups(P<0.05). Moreover, the posterior circulation flow in the case group was positively correlated with the vertebral artery diameter(R²=0.887 8), and negatively correlated with the resistance index(R²=0.849 4). Conclusion Obviously reduced cerebral blood flow was associated with VAH. In spite of the existence of uninjured side compensation, the total perfusion of posterior circulation was still lower than that of the control group. Color Doppler sonography not only images the congenital morphologic variations of vertebral artery but also evaluates the reduced blood flow of posterior circulation(i.e. posterior circulation ischemia), which might become one of the hallmarks of VAH.

A study of evaluating normal and arrhythmic fetal cardiac function with spatio-temporal image correlation

Sun Lijuan, Wu Qingqing, Yao Ling, Zhang Tiejuan, Ma Yuqing, Wang Li, Li Xiaofei, Xuan Yinghua

2014, 35(2):  168-172.  doi:10.3969/j.issn.1006-7795.2014.02.006

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Objective To assess the application of spatio-temporal image correlation(STIC) for normal and arrhythmic fetal cardiac function examination from 21 to 32⁺⁶ gestational weeks. Methods Fetal heart ventricular end-diastole volumes(EDV) and end-systole volumes(ESV) were measured with STIC and virtual organ computer aided analysis(VOCAL) in 60 normal fetuses and 12 fetuses with isolated arrhythmia from 21 to 32⁺⁶ gestational weeks. The stroke volume(SV), cardiac output(CO) and ejection fraction(EF) of each ventricle were calculated with EDV and ESV.The normal reference values of EDV, ESV, SV, CO and EF of left and right ventricles were calculated with statistical methods. The correlation between cardiac parameters(including EDV, ESV, SV, CO and EF) and gestational age were analyzed. Every fetus had a follow-up outcome after birth. Results The cardiac functions of 60 normal fetuses: We obtained the normal reference values of EDV, ESV, SV and CO of left and right ventricles according to different gestational weeks(Table 1), which increased and had significant positive correlations with gestational age(P<0.001). The normal reference values of LVEF(left ventricular ejection fraction) and RVEF(right ventricular ejection fraction) were(55%-57%) and (53%-56%) respectively from 21 to 32⁺⁶ gestational weeks, which had negative correlations with gestational age(r=-0.41, -0.41, all P=0.001). The cardiac functions of 12 fetuses with isolated arrhythmia: The types of fetal arrhythmia included 7 cases with atrial premature beats, 2 cases with bradyarrhythmias, 1 case with atrial premature beat and atrial tachycardia, 1 case with atrial premature beat and atrioventricular block and 1 case with undefined type. EDV, ESV, SV, CO, LVEF(48%-66%) and RVEF(48%-64%) of 12 isolated arrhythmic fetuses were roughly normal according to normal reference values of different gestational weeks. All of 12 fetuses with isolated arrhythmia were full term deliveries, and healthy after birth. Conclusion STIC technique can accurately measure fetal ventricular volumes and evaluate fetal cardiac function.It is also helpful to assess arrhythmic fetal cardiac function.

Application of ultrasound and computed tomography angiography in the aortic dissection depending on the modified Stanford classification system

Yu Weidong, Du Guoqing, Tian Jiawei, Jiang Shuangquan, Di Zhixin, Wang Xudong

2014, 35(2):  173-178.  doi:10.3969/j.issn.1006-7795.2014.02.007

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Objective To evaluate the value of ultrasound and ultrasound combined with CTA in the assessment for modified Stanford classification system of aortic dissection. Methods Totally 128 cases of highly suspected acute dissection patients have been enrolled and examined by ultrasound and CTA respectively, and have been classified depending on the modified Stanford classification system. The modified Stanford classification system of aortic dissection includes the types of A1, A2, A3 and B1, B2, B3, which also includes two subtypes of S and C. According to the surgical findings, the diagnostic efficiency of ultrasound, CTA and combining both in the assessment for modified Stanford classification system of acute aortic dissection have been evaluated. Results The preoperative diagnostic sensitivity of ultrasound, CTA and combination of both in the assessment for modified Stanford classification system of acute aortic dissection is 76.5%, 91.3% and 100%, respectively; the specificity is 34.5%, 0.0% and 34.5% respectively; the accuracy is 72.7%, 82.0% and 93.8% respectively; the positive predictive value is 91.7%, 89.0% and 93.5% respectively; the negative predictive value is 15.6%, 0.0% and 100% respectively. The accuracy of diagnosing the subtypes A1S, A2S and A3S are 100% by ultrasound, but the subtype B3C is easily missed diagnosis; A1S, A1C and all subtypes of B by CTA were 100%, but for A2S and A2C were easily misdiagnosed. Combining ultrasound with CTA can increase the diagnostic accuracy significantly. Conclusion There are great value of ultrasound and CTA in clinical practice for assessment of modified Stanford classification of acute dissection, and combining ultrasound with CTA will contribute to increase significantly the sensitivity, accuracy, the positive predictive and the negative predictive value.

Value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14 weeks gestation

Liu Dongmei, Yang Min, Liu Yong

2014, 35(2):  179-183.  doi:10.3969/j.issn.1006-7795.2014.02.008

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Objective To explore the value of abnormal ductus venosus flow frequency spectrum in early detection of abnormalities at 11-14weeks gestation. Methods Totally 1 091 pregnant women at 11-14 weeks gestation were screened by the color Doppler ultrasound. The nuchal translucency were measured and the ductus venosus flow were evaluated. The following variables were measured: S-peak, D-peak, A-wave. Results The abnormal DV and NT were detected in 19/1 091(1.7%) and 26/1 091(2.3%), respectively. The occurrence rate of reversed flow during atrial contraction(RA) is 3.29%(36/1 091). The sensitivity, specificity, and positive and negative predictive values of abnormal DV flow and NT for determining increased test risk were 70.5%, 99.3%, 63.1%, 99.5% and 64.7%, 98.7%, 44%, 99.4%. The sensitivity of abnormal DV flow or NT for determining increased test risk was 82.3%. Conclusion Abnormal DV flow can provide an important information in the first trimester. When abnormal DV and NT were both positive, the risk of fetus abnormality increased.

Time-intensity curve of contrast-enhanced ultrasound applied for differentiation of malignant from benign cervical lymph nodes

Li Jiangping, Ji Hongtao, Zhu Qiang, Ma Teng, Zhao Hanxue

2014, 35(2):  184-188.  doi:10.3969/j.issn.1006-7795.2014.02.009

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Objective To evaluate the value of the time-intensity curve(TIC) of contrast-enhanced ultrasound(CEUS) in differentiation of malignant from benign lymph nodes of the head and neck. Methods Eighty-five patients with enlarged cervical lymph nodes(85 lesions) were examined with CEUS. Of 85 nodes, 36 benign and 49 malignant lesions were proved histopathologically. Region of interest(ROI) was placed in whole lymph nodes, the most evident enhanced area of the cortex, the weakest enhanced area of the cortex, medulla-hilar area, and soft tissue next to the node, respectively. Eight TIC parameters(basic intensity, peak intensity, wash in slope, arrival time, time to peak, rise time, time from peak to one half, and mean transit time) were compared between malignant and benign nodes. Finally the malignant lymph nodes were evaluated by the ROC curve drawn with the rise time, and meanwhile the cut off value was obtained. Results The rise time of ROI that was placed on the most evidently enhanced area of the cortex of cervical lymph nodes was significantly shorter in malignant than benign lesions(P=0.041). Conclusion The rise time value obtained from most evidently enhanced areas of the lymph node cortex could help differentiate malignant from benign nodes of the head and neck.

Correlation study of the diaphragmatic motion and lung function with M-mode ultrasound

Li Mingqiu, Guo Ruijun, Zhang Pu, Chang Xiaohong

2014, 35(2):  189-193.  doi:10.3969/j.issn.1006-7795.2014.02.010

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Objective To evaluate the feasibility of detecting the diaphragmatic motion in the healthy adults and the chronic obstructive pulmonary disease(COPD) patients by using M-mode ultrasound and to explore the correlation of the diaphragmatic motion and lung function and the value of using M type ultrasound in observing the diaphragmatic motion. Methods The study enrolled 43 COPD patients of whom 21 were male and 22 female in Beijing Chaoyang Hospital from May 2011 to October 2011. This study also selected 43 healthy persons who were age, height and weight matched with the patients as the normal control group. M-mode ultrasonography was used to observe bilateral diaphragmatic moving range, time, acceleration in the COPD group and the normal control group. The pulmonary function tests including forced vital capacity(FVC), first second forced expiratory volume(FEV1) and their ratio FEV1/FVC were the main variables of observation. Results 1 For the normal control group, during quiet breathing the bilateral diaphragmatic moving range had no significant difference, while on deep inspiration the left diaphragmatic motion had a significantly larger magnitude as compared with the right side. 2 For COPD group and the normal control group, the lung function parameters, FEV1, and FEV1/FVC had a significant difference. 3 For COPD group and the normal control group, except the left acceleration time, the bilateral diaphragmatic muscle moving range, the right acceleration time, the bilateral acceleration had statistically significant differences during the quiet and deep breathing. 4 For COPD group and the normal control group, the diaphragmatic moving range had good correlation with FEV1, FVC and FEV1/FVC. Conclusion The application of M-mode ultrasound can sensitively show diaphragmatic motion. The ultrasound observation was real-time, noninvasive and dynamic which may have potential value of clinical application.

Repetitive transcranial magnetic stimulation in combination with paroxetine for major depressive disorder

Fang Meng, Ren Yanping, Liu Hui, Zhou Fang, Wang Gang

2014, 35(2):  194-199.  doi:10.3969/j.issn.1006-7795.2014.02.011

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Objective To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS) in combination with paroxetine for major depressive disorder. Methods In a 6-week, randomized, double-blind, sham-controlled trial, 48 patients with major depressive disorder were randomly assigned to receive real or sham rTMS for 2 weeks. During the 6 weeks, paroxetine was used at a fixed dose of 20 mg per day for all participants. Seven sites were set to conduct assessment of efficacy and adverse events in this study. Results The Montgomery-Asberg Depression Rating(MADRS), the 17-item Hamilton Depression Rating Scale(HAMD-17) and Hamilton Anxiety Rating Scale(HAMA) scores significantly decreased from baseline to the endpoint in both groups. No meaningful difference was observed between the two groups in general clinical effect. The mean time-to-onset was earlier by 3 days in Real group, but the difference was not significant. In the Real group, the scores of HAMD anxiety/somatic symptom factor significantly decreased on day10, 14 and 28; the scores of HAMA significantly decreased on day 10. The incidence of adverse events in both groups had no significant difference. Conclusion The combination of rTMS and paroxetine was effective and safe in treatment of MDD. The tendency of fast onset of effect was observed in the comprehensive intervention, which probably is beneficial to the patients with anxiety and somatic symptoms.

Self-face recognition in schizophrenia patients with positive and negative symptoms

Zhu Hong, Jia Hongxiao

2014, 35(2):  200-204.  doi:10.3969/j.issn.1006-7795.2014.02.012

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Objective To investigate the self-disturbances of schizophrenia patients with positive and negative symptoms by using paradigm of self-face recognition(SFR). Methods Twenty-one patients with schizophrenia with positive syndrome, 21 schizophrenia patients with negative syndrome and 21 normal controls matched in age and education degree were measured by self-face recognition procedure, and the results were analyzed. Results The healthy controls recognized one's own picture faster than strangers' picture; the patients with negative symptoms recognized stranger's pictures faster than their own ones(P<0.05); there was no significant difference in the reacting time ratio on different pictures in patients with positive symptoms(P>0.05). Conclusion There was abnormality on self-face recognition in schizophrenia patients, compared to normal subjects. There were significant differences in self-disturbance between schizophrenia patients with positive syndromes and negative syndromes.

Efficacy and safety of low dosage risperidone added on valproate and citalopram in the treatment of acute bipolar depression

Wang Jian, Wang Gang, Ma Xin

2014, 35(2):  205-209.  doi:10.3969/j.issn.1006-7795.2014.02.013

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Objective To evaluate the augmentation efficacy and safety of low dosage risperidone, added on the usual treatment(valproate and citalopram) in the acute treatment of bipolar depression. Methods A total of 46 inpatients with a diagnostic criteria for acute depression episode with bipolar disorder according to DSM-IV-TR were first given valproate and citalopram treatment. The subjects who achieve little clinical response(i.e. reduction from baseline in total MADRS score by <50%) at the end of 2-week will enter into the randomized open-label 6-week treatment phase. The eligible subjects will be randomized to treatment with valproate & citalopram or valproate & citalopram & risperidone in a 1:1 ratio. Efficacy rating scales to be used in the study include MADRS, YMRS, BPRS(total score and positive subscale), CGI-S, and CGI-I. The evaluations of safety and tolerability include SAS, treatment-emergent mania, clinical laboratory tests, vital signs, ECG, and adverse events reports. Results At the end of treatment, the scores of MADRS, BPRS, GIC-I, and CGI-S in both treatment groups decreased significantly compared with the end of run-in period.There were statistically significant differences between groups in YMRS and CGI-I(P<0.05), but not in MADRS and BPRS(total score and positive subscale). At week 1 of randomized treatment period, the scores of BPRS positive subscale decreased sharply in the VPA+CIT+RIS group than those in the VPA+CIT group, the difference was statistically significant(P<0.05). At week 2 of randomized treatment period, the response rates of the VPA+CIT+RIS group was superior to the VPA+CIT group, the difference was statistically significant(P<0.05). It suggested that the time to response of the VPA+CIT+RIS group is shorter than that of the VPA+CIT group. Conclusion Both VPA+CIT+RIS and VPA+CIT are efficacious and well tolerated for the acute treatment of bipolar depression. For the treatment of psychosis and reducing the treatment-emergent mania, the VPA+CIT group was better than the VPA+CIT group.

Research progress in studies on the active ingredients of the traditional Chinese medicine with the neuroprotective effects

Zhuang Hongyan, Bi Wei, Jia Hongxiao

2014, 35(2):  210-213.  doi:10.3969/j.issn.1006-7795.2014.02.014

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An online search of Medline was undertaken to identify articles on studies on active ingredients of the traditional Chinese medicine(TCM) with neuroprotective effects.We summarized the activity and the mechanism of the ingredients in TCM, such as saponine, flavonoid, alkaloid and phenolic acid. TCM have advantage in the neuroprotective mechanism with multi-target and multi-channel, and there is a huge potential in the prevention and treatment of diseases of the nerve injury.

Differential expressions of α-synuclein and nitrated α-synuclein in colonic in different ages of cynomolgus monkeys

Yang Bin, Yang Weiwei, Li Xin, Liu Chengwei, Yu Shun

2014, 35(2):  214-218.  doi:10.3969/j.issn.1006-7795.2014.02.015

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Objective To explore the expressions of α-synuclein(α-syn) and nitrated α-synuclein(n-syn) in colonic in different ages of cynomolgus monkeys. Methods Immunohis-tochemistry was applied to measure the expressions of α-syn and n-syn in colonic in different ages of cynomolgus monkeys. Double immunofluorescent labeling was used to examine the co-localization of α-syn and n-syn. Results α-Syn and n-syn were colocalized in colonic of cynomolgus monkeys. α-syn and n-syn were expressed in colonic in different ages of cynomolgus monkeys. However, α-syn and n-syn expressions were the highest in colonic of old monkeys and the lowest in colonic of young monkeys. Conclusion α-Syn and n-syn are colocolized in colonic of cynomolgus monkeys and are the highest in colonic of old cynomolgus monkeys.

Establishment of pyrosequencing method to detect isocitrate dehydrogenase 1 mutations

Wang Danhui, Cai Yanning, Zhang Yanli, Gao Jie, Yang Caixia

2014, 35(2):  219-224.  doi:10.3969/j.issn.1006-7795.2014.02.016

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Objective The present study aimed to establish a pyrosequencing method for IDH1 mutation examination, and quantify the sensitivity of this method. Furthermore, we tried to compare the differences between the direct sequencing and pyrosequencing for IDH1 mutation examination. Methods Plasmids carrying either wide-type or mutant IDH1 gene were constructed, and used to optimize the pyrosequencing method. The exact amount of mutant plasmids mixed with wide-type plasmids were served as templates for the pyrosequencing reaction to quantify the sensitivity of pyrosequencing based mutation examination. Both direct sequencing and pyroquencing methods were used to detect IDH1 mutations in 96 gliomas. Results Pyrosequencing detected as low as 2 % IDH1 mutation mixed in wide-type gene. Among the 96 glioma samples examined, 32.3% of the samples were identified as carrying IDH1 mutations based on direct sequencing, while 74.0% based on pyrosequencing method. Conclusion Pyrosequencing is a reliable and sensitive method in detecting IDH1 mutation, which is suitable for molecular diagnosis.

Neuroprotective effect of R(+)-pramipexole on brain injury following transient focal cerebral ischemia in rats

Yin Jie, Yan Feng, Luo Yumin, Li Sen, Liu Kejian, Zhao Yongmei

2014, 35(2):  225-230.  doi:10.3969/j.issn.1006-7795.2014.02.017

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Objective To study the effect of R(+)-pramipexole on reactive oxygen species(ROS) production and brain injury in transient focal ischemic rats and to investigate the neuroprotective effects of R(+)-PPX on cerebral ischemic injury and explore the preventive and therapeutic methods for ischemic cerebrovascular disease. Methods Thirty male Sprague Dawley rats were divided randomly into three groups: Sham group(n=10), middle cerebral artery occlusion group(MCAO, n=10) and MCAO+ R(+)-PPX group. MCAO operation was performed by using suture method. The rats underwent right MCAO for 90 min. The heart rate, mean arterial blood pressure(MABP) and rectal temperature were monitored to keep in normal range during the operation. At 6 h or 24 h after reperfusion, brains were removed and dyed with 2, 3, 5-triphenyltetrazolium chloride to measure the infarct volume. H2DCF-DA was used to detect ROS in the penumbra of the brain. Results 1) There was no statistical difference in heart rates, MABP and rectal temperature among sham, MCAO and MCAO+R(+)-PPX group rats. 2) No infarction was observed in the brain of sham group rats whereas the brain infarct volume in both MCAO group and MCAO+ R(+)-PPX group increased significantly at 6 h to 24 h after reperfusion(P<0.05). The infarct volume of both MCAO group and MCAO+R(+)-PPX group showed time-dependent increasing tendency(P<0.05). At 6 h after reperfusion, the brain infarct volume in MCAO+R(+)-PPX group rats decreased significantly compared with that of MCAO group rats(P<0.05) while the brain infarct volume in MCAO+ R(+)-PPX group rats showed no statistical difference compared with that of MCAO group rats at 24 h after reperfusion(P>0.05). 3) No penumbra was observed in the brain of sham group rats. The number and fluorescence intensity of H2DCF-DA-positive cells in the penumbra of MCAO group and MCAO+R(+)-PPX group rats from 6 h to 24 h after reperfusion showed time-dependent increasing tendency(P<0.05). At 6 h after reperfusion, the number of H2DCF-DA-positive cells and fluorescence intensity in the penumbra of MCAO+R(+)-PPX group rats decreased significantly compared with that of MCAO group rats(P<0.05) while the number of H2DCF-DA-positive cells and fluorescence intensity in the penumbra of MCAO+R(+)-PPX group rats showed no statistical difference with that of MCAO group rats at 24 h after reperfusion(P>0.05). Conclusion A single administration of R(+)-PPX could decrease ROS production, reduce infarct volume in MCAO rats at early reperfusion time(6 h). The effect of R(+)-PPX on cerebral ischemic injury deserves further study.

Effects of hypoxia on the function of smooth muscle cells from different orders of pulmonary arteries

Guo Huan, Wang Wang, Sun Ran, Liu Jie, Wang Jun

2014, 35(2):  231-236.  doi:10.3969/j.issn.1006-7795.2014.02.018

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Objective To explore the effects of hypoxia on the proliferation and migration of rat pulmonary artery smooth muscle cells(PASMCs) isolated and cultured from different orders of pulmonary arteries. Methods The pulmonary artery branches were gently isolated from male Sprague-Dawley rats(250-350 g) from Capital Medical University and eventually cut into three groups according to the vascular grading: the proximal pulmonary arteries(pulmonary trunk and the first order branches of the intrapulmonary arteries), the middle pulmonary arteries(second to third order intrapulmonary arteries), and the distal pulmonary arteries(forth to fifth order intrapulmonary arteries). Primary PASMCs were cultured from the pulmonary arteries and α-smooth muscle actin(α-SMA) in the cells was identified by immunofluorescence. PASMCs were cultured under normoxia(DMEM+2%FBS, 5%CO₂, 21%O₂, 37 ℃) and hypoxia(DMEM+2%FBS, 5%CO₂, 3%O₂, 37 ℃). Cell proliferation was quantified by using 0.5 g/L methyl thiazolyl tetrazolium(MTT) assay. Western blotting was used for detecting the protein expression level of proliferating cell nuclear antigen(PCNA) in PASMCs. Wound healing test was explored to assess the migration function of the cells. Results Cells isolated from different orders of pulmonary arteries from rats tended to be long spindle and grew in the "peak-valley" mode under microscope. Immunofluorescence results showed that all of the three groups of cells are positively express α-SMA which is a marker of smooth muscle cells. Under physiological condition(normoxic), three groups of PASMCs have the similar ability of proliferation and migration. While after incubation under hypoxia(3%O₂, 48 h), all cells from the three groups showed increased proliferation ability(assessed by MTT and PCNA expression) as well as the migration ability. Moreover, compared to the proximal pulmonary arteries, PASMCs from the middle and distal pulmonary arteries showed much more sensitive to hypoxia stimulus. Conclusion These results suggest that PASMCs from middle and distal pulmonary arteries have higher ability of proliferation and migration than those from proximal under hypoxia condition. This will help to give us some information about the possible mechanism of different responses of different orders of pulmonary arteries under the same pathophysiological stimulus.

Investigation of genes co-regulated by Notch-1 intra-cellular domain and CBF-1 at transcription level in the whole genome of human pancreatic cancer BxPC3 cells

Wang Lange, Zhang Yuxiang

2014, 35(2):  237-242.  doi:10.3969/j.issn.1006-7795.2014.02.019

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Objective Looking for the potential genes co-regulated by Notch-1 intra-cellular domain(NICD) and CBF-1 at transcription level in the whole genome of human pancreatic cancer cell BxPC3 cells; investigating characteristics of those genes such as distribution, functions and classification; suggesting the potential functions and regulatory pattern of Notch signalling pathway based on the data obtained. Methods Chromatin immuno-precipitation(ChIP) coupled with Illumina/Solexa-platform based high-throughput sequencing was employed to illustrate the profile of synergistic transcription between NICD and CBF-1 at genome-wide level in human pancreatic cancer BxPC3 cells. Results 1) The numbers of qualified reads for NICD and CBF-1 samples are 14 287 722 and 14 289 280, 11 782 027 and 11 711 920 of which are uniquely matched with human reference genome, respectively. 2) The numbers of peaks for NICD and CBF-1 samples are 385 and 492; the peak region covers 318 344 bp and 383 768 bp, each of which accounts for 0.01% of whole genome. 3) Regardless of NICD or CBF-1 samples, most peaks scatter at intergenic and intronic region and only less than 5% of them locate in exonic region. 4) 150 out of 385 peaks for NICD samples and 287 out of 492 peaks for CBF-1 samples can be uniquely matched with a human gene, 93 of which are the same between two groups. 5) The details of those genes, such as names, locations and functions, were indicated by gene ontology(GO) analysis and gene database mining. Conclusion More unknown genes co-regulated by NICD and CBF-1 at transcription level were discovered in human pancreatic BxPC3 cells; the distribution, functions and classification of them were demonstrated; the potential functions and regulatory pattern of Notch signalling pathway were implied based on the data obtained.

Expression of apolioprotein A1 and its correlation with the malignant degree of colorectal cancer

Hu Huihui, Meng Qian, Zhang Man

2014, 35(2):  243-247.  doi:10.3969/j.issn.1006-7795.2014.02.020

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Objective To investigate the expression of apolipoprotein A1 in the serum of different stage and grade patients with colorectal polyp and cancer. We also collected the serum of patients with clinical distant metastasis of colorectal cancer, to find the relationship among apolipoprotein A1 expression and the colorectal tumor aggression and migration. Methods We collected the samples from 59 cases of colorectal tumor patients from Beijing Shijitan Hospital. The patients with colorectal cancer were classified according to the differentiation and invasion of cancer cells by pathologists. The expression of serum apolipoprotein A1 was quantitative identified by immunoturbidimetry and semi-quantitative by Western blotting. SPSS statistical analysis software was used for analyzing the results, P<0.05 was thought to be statistically different. Results The expression of serum apoliopoprotein A1 was lower expressed in the low differentiation of colorectal cancer compared with polyp, high differentiation and middle differentiation groups(P=0.035, P=0.028, P=0.028). Apoliopoprotein A1 was not correlated with the stage and metastases of colorectal cancer. Conclusion The serum apolipoprotein A1 was correlated with the grade of colorectal cancer. Apoliopoprotein A1 could play as a tumor marker for colorectal cancer.

Clinical study of Zi Gui Nv Zhen capsule to treat the sterility caused by thin endometrium

Wang Haiwen, Ruan Xiangyan

2014, 35(2):  248-252.  doi:10.3969/j.issn.1006-7795.2014.02.021

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Objective To evaluate the effectiveness of Zi Gui Nv Zhen capsule on the sterility due to thin endometrium. Methods One hundred and eleven sterility patients with thin endometrium were randomly divided into two groups: observation group of 59 cases and control group of 52 cases. The control group was treated with estradiol valerate. Besides the treatment given to the control group, patients of observation group were given Zi Gui Nv Zhen capsule for treatment. Endometrium thickness, endometrial spiral artery blood flow pulsation index(PI) and endometrial spiral artery blood flow resistance index (RI), luteal phase serum estradiol(E2) and progesterone(P) of after ovulation were observed. Results Observation group proportion of type A endometrium of patients with endometrial thickness increased significantly(P<0.05) compared with the control group. Uterus artery RI in ovulation day of patients who took Zi Gui Nv Zhen capsule was significantly lower than that of the control group(P<0.05), and uterine artery PI was significantly lower than that of the control group(P<0.05). The herbal medicine may reduce uterine artery PI and RI, reduce the uterine artery blood flow resistance and increase the uterine artery blood flow, thus increase blood supply of endometrium, and enhance the receptivity of endometrium. That is beneficial to early embryonic implantation and development. Clinical pregnancy rate of the observation group increased significantly compared to the control group(P<0.05). Conclusion Taking oral Zi Gui Nv Zhen capsule and estradiol valerate treatment on daily basis can enrich the blood supply to the uterus, improve endometrial thickness and type, as well as the receptivity of endometrium; increase the luteal phase of progesterone and estrogen levels, and improve the function of corpus luteum, so as to increase the clinical pregnancy rate.

Correlation between oral hygiene habits and oral carcinogenesis

Zhao Xiang, Sun Zheng, Ge Huabing

2014, 35(2):  253-256.  doi:10.3969/j.issn.1006-7795.2014.02.022

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Objective To explore the correlation between oral hygiene habits and oral carcinogenesis. Methods "Oral Cancer Risk Factors Questionnaire" was carried out for 109 oral cancer patients and 109 healthy normal control patients. Data was analyzed to sieve the independent influence factors with OR and 95% confidence intervals. Results The difference of brushing tooth index of oral health group and oral cancer group(4.37±1.85 vs 3.26±2.16) was significant(t=4.076, P=0.000). The difference of regular supragingival scaling rate between two groups(4.6% vs 18.3%) was significant(χ²=10.166, P=0.001). The difference of denture comfort rate between two groups(77.2% vs 59.1%), also was significant(χ²= 3.825, P=0.050). By using binary Logistic regression, the independent influence factors were brushing tooth index, OR=0.776, 95%CI for OR(0.673, 0.895) and regular supragingival scaling, OR=0.255, 95%CI for OR(0.091, 0.721). Conclusion Oral hygiene habits can affect the incidence of oral cancer.

Neurofibromatosis type 2 gene mutation and its expression and tumors of digestive system

Zhang Ning, Huang Jian

2014, 35(2):  257-260.  doi:10.3969/j.issn.1006-7795.2014.02.023

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NF2(neurofibromatosis type 2, NF2)gene mutation is one of the hallmark of neurofibromatosis type 2 familial cancer syndrome. Recent studies have shown NF2 mutation and its expression may be associated with the pathogenesis of digestive system tumors. In this paper, we review the recent advances of NF2 gene mutation and its expression in digestive system tumors.

Application of SpyGlass single-operator cholangioscopy system in biliopancreatic disease

Xu Changqin, Li Peng, Zhang Shutian

2014, 35(2):  261-264.  doi:10.3969/j.issn.1006-7795.2014.02.024

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Although endoscopic retrograde cholangiopancreatography is considered as the gold standard to manage biliary disorders with the advances of endoscopy, it has its own limitations. The single-operator cholangioscopy(SOC) system(SpyGlass) has its own advantages compared with traditional Cholangioscopy. It is a great step toward intraductal visualization and therapy.