Table of Content

21 August 2015, Volume 36 Issue 4

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MicroRNA and non-small cell lung cancer

Tan Xiaogang, Zhi Xiuyi

2015, 36(4):  519-524.  doi:10.3969/j.issn.1006-7795.2015.04.001

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Lung cancer has the highest world-wide cancer mortality. Current therapies for non-small cell lung cancer(NSCLC) patients are inefficient due to the lack of diagnostic and therapeutic markers. MicroRNAs(miRNAs) are a species of small non-coding single-stranded RNA of about 21 nucleotides that through partial sequence homology may interact with the 3'-untranslated region of target mRNA molecules. Recent evidence has shown that miRNA may function as tumor supressors or oncogenes, and alterations in miRNA expression may play a critical role in the initiation and progression of lung cancer. miRNAs are not only stable in paraffin embedded tissues and body fluids, but also in plasma and serum, which makes circulating miRNA a new kind of ideal biomarker that opens a new field for early molecular diagnosis of lung cancer, as well as for prediction of lung cancer survival and therapy.

Analysis of video-assisted thoracoscopic treatment of small solitary pulmonary nodules

Su Lei, Zhi Xiuyi, Zhang Yi, Xu Qingsheng, Qian Kun

2015, 36(4):  525-528.  doi:10.3969/j.issn.1006-7795.2015.04.002

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Objective To investigate the diagnosis and surgical treatment of solitary pulmonary nodules(SPN). Methods A total of 110 cases who experienced SPN-resection(48 male, 62 female) in our hospital, from January 2006 to December 2013, were retrospectively analyzed. All cases were confirmed by chest CT scan, 24 of whom underwent preoperative lesion location. Simple excision was performed in 14 cases, wedge resection in 62 cases, segmental resection in 6 cases, and lobectomy in 28 cases. Results There were 43 cases with malignant signs in the chest CT scan before operation. Postoperative pathology confirmed malignant nodules in 63 cases(57.3%), including 41 cases with primary lung cancer, non-small cell lung cancer(26 cases), 22 cases of metastatic tumor, 47 cases with benign nodules(42.7%). The sensitivity of CT diagnosis of malignant SPNs was 60.3%(38/63), the specificity was 89.4%(42/47). Conclusion The SPN imaging features play an important role in the judgment of clinicians. The risk factors of diameter greater than 10 mm, the SPN should undergo corresponding examination, diagnosis and treatment measures.

Application of CT-guided localization with medical glue injection in treatment of ground-glass opacity and pulmonary nodules with video-assisted thoracoscope surgery

Qian Kun, Zhi Xiuyi, Zhang Yi, Li Yan, Hu Mu, Li Jingkai, Shen Chong

2015, 36(4):  529-532.  doi:10.3969/j.issn.1006-7795.2015.04.003

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Objective To evaluate the clinical value of CT-guided localization with medical glue injection in treatment of ground-glass opacity(GGO) and pulmonary nodules with video-assisted thoracoscope surgery(VATS). Methods From December 2013 to November 2014, 10 patients with pure ground-glass opacity(pGGO) and 15 patients with solitary pulmonary nodule(SPN) underwent wedge resection or segmentectomy by VATS. All the patients were injected with medical glue by CT-guided localization before operation. Results CT-guided localization with medical glue was successful in all patients(100%). The time of puncturing was (17.1±6.1)min. There were 1 case of pneumothorax(4%), 5 cases of chest pain(20%) and 6 cases of cough(24%) respectively. The time of operation was (23.1±5.6)min in 10 patients with pGGO, 7 cases with adenocarcinoma were pathologically confirmed, 2 cases of atypical adenomatous hyperplasia, and 1 cases of adenomyosis. The time of operation was (20.4±5.9)min in 15 patients with SPN, 9 cases of adenocarcinoma, 1 case of carcinoma metastaticum, and 5 cases of nonmalignant disease. No conversion to thoracotomy was necessary in any patients and no VATS postoperative major complications occurred. Conclusion There are many advantages of the application, such as safety, simple and accuracy. It is a viable technique for pGGO and SPN localization.

Pattern of bone metastasis and treatment of Chinese patients with advanced non-small-cell lung cancer

Yao Shuyang, Wang Xin, Li Xiaoxue, Zhang Yi, Zhi Xiuyi

2015, 36(4):  533-536.  doi:10.3969/j.issn.1006-7795.2015.04.004

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Objective To investigate the characteristics of bone metastasis, prognosis and treatment strategies of non-small cell lung cancer(NSCLC) patients in China. Methods Totally 103 metastatic NSCLC patients with bone as the first metastatic organ seen between July 1, 2010 and Dec. 31, 2013 were retrospectively reviewed. Clinical pathologic characteristics and treatment outcomes were evaluated in the 103 cases. Results Median age of the patients was 59(32~82) years. Among them, 28 patient had bone metastasis as the only relapse site and the remaining were accompanied by involvement of other locations. Most bone metastases(95.1%) were osteolytic. Overall survival of NSCLC bone metastases without visceral metastases was significantly longer than bone metastases with visceral metastases(18 months vs 14 months, P=0.048). Most NSCLC bone metastases(77.7%) were treated with chemotherapy, the response rate was 32.5%, and the clinical benefit rate was 58.8%. In terms of time to progression, there was significant difference between patients who received first-line chemotherapy and those who received the first-line targeted therapy(P=0.000). Conclusion Patients just with bone metastases had better prognosis than bone metastases patients with visceral metastases. Patients with bone metastases should receive individualized anti-cancer treatment.

Approaching the igh risk patients with early stage non-small cell lung cancer: Sublobar resection, stereotactic ablative radiotherapy, or radiofrequency ablation？

Liu Baodong

2015, 36(4):  537-543.  doi:10.3969/j.issn.1006-7795.2015.04.005

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Sublobar(segmental or wedge) resection is the preferred approach for high-risk patients with clinical stage I non-small cell lung cancer. Nonoperative therapies, such as stereotactic ablative radiotherapy(SABR) or radiofrequency ablation(RFA) should be reserved for surgically inoperable patients. SABR and RFA may be clinically equivalent to sublobar resection for the high-risk patients because of lower procedural morbidity and more rapid return to normal function; However, this has not yet been determined in prospective studies.

A gonadotrophin-releasing hormone agonist(GnRHa) suppression protocol versus normal hormone replacement therapy(HRT) protocol in multiple implantation failed patients undergoing frozen-embryo transfer cycles

Fang Ying, Hong Liming, Yang Xiaokui

2015, 36(4):  544-547.  doi:10.3969/j.issn.1006-7795.2015.04.006

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Objective To investigate the clinical value of a gonadotropin-releasing hormone agonist(GnRHa) suppression protocol on multiple implantation failed patients undergoing frozen-embryo transfer(FET) cycles. Methods A total of 174 women undergoing FET cycles with a history of multiple implantation failure in our center from December, 2013 to December, 2014 were retrospectively analyzed. Patients were divided into two groups: 78 women in group A experienced a GnRHa suppression protocol, and 96 women in group B experienced a normal hormone replacement therapy(HRT). The clinical outcomes were compared between the two groups. Results Patients in the two groups had similar baseline characteristics, including duration of infertility, age, body mass index and basal endocrine level. There were no significant differences between the two groups in the number of transferred and high-quality embryos, the survival rate of frozen embryos, endometrial thickness, the implantation rate(22.8% vs 19.8%), clinical pregnancy rate(42.3% vs 37.5%), and early miscarriage rate(9.1% vs 11.1%). Conclusion This study found that the implantation rate and clinical pregnancy rate in the GnRHa suppression group experienced a tendency to increase in the patients with a history of multiple implantation failure, compared to the normal HRT group, but the difference was not statistically significant. A larger sample size may be needed for the further study.

Study of prognostic impact of progesterone receptor membrane component 1 (PGRMC1) in breast cancer patients

Zhang Ying, Ruan Xiangyan, Mi Xin, Wang Gangyue, Alfred O. Mueck

2015, 36(4):  548-552.  doi:10.3969/j.issn.1006-7795.2015.04.007

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Objective The aim of this study was to investigate the potential clinical prognosis significance of progesterone receptor membrane component 1(PGRMC1) for breast cancer patients. Methods Fifty cases of breast cancer patients were derived from the Beijing Obstetrics and Gynecology hospital, Capital Medical University from Jan. 2008 to Dec 2014. Clinical and pathological data in details, such as date of primary diagnosis date, age, histologic grade, tumor size, lymph node metastasis, and patient follow-up information were collected and retrospectively analyzed. Immunohistochemical staining were carried out manually to evaluated the expression of estrogen receptor α(ERa)、progesterone receptor(PR)、Ki67 and PGRMC1 in breast cancer samples. Results For all the 50 tissues, the hormonal receptor status was 48.0% ERα positive(n=24), 42.0% PR positive(n=21), 4% Ki67 positive(n=2). Of the samples, 70.0%(n=35) were PGRMC1 positive. The result showed one statistically significant correlation, between PGRMC1 and tumor size, lymph node metastas(OR=1.60, 95%CI: 1.11-2.29; OR=1.12, 95%CI: 1.02-1.23). The association between conventional clinicopathological features and prognosis in breast cancer patients were evaluated. PGRMC1 expression would be used as predictors of recurrence(P=0.011) and poor overall survival(P=0.028) in breast cancer patients in Cox's proportional hazard model. Conclusion The high PGRMC1 level was associated with poor disease free survival rate and overall survival rate. PGRMC1 might be a independent prognostic factor breast cancer in the future.

Prevalence, characteristics and predictors of the metabolic syndrome in women with polycystic ovary syndrome

Wu Hongqin, Ruan Xiangyan, Lu Yongjun, Tian Xuanxuan, Zhang Ying, Cui Yamei, Zhao Yue, Du Juan, Li Yanglu, Diethelm Wallwiener, Alfred O. Mueck

2015, 36(4):  553-558.  doi:10.3969/j.issn.1006-7795.2015.04.008

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Objective To investigate the prevalence of metabolic syndrome(MS) and its components in women with polycystic ovary syndrome(PCOS), and analyze the ability of MS components to predict MS risk in PCOS patients. Methods A total of 180 women with PCOS participated in this study between December 2013 and July 2014. All of the subjects were examined for anthropometric, serum hormone level and biochemical parameters. We investigated the incidence of MS and its components, screening predictors for PCOS patients at high risk of MS. Results The prevalence of MS in PCOS patients was 43.89%. The prevalence in different age groups was 32.14% for 17-24 years, 39.53% for 25-29 years, 50.00% for 30-34 years and 80.00% for 35-39 years. The prevalence in different BMI groups was 10.00% for normal, 51.16% for overweight, 69.57% for obese and 85.71% for morbidly obese women. The age and BMI in PCOS patients with MS were higher than those of patients without MS(29.16±3.85 vs 27.47±3.81, P=0.004; 31.44±4.89 vs 24.29±4.87, P=0.000, respectively), the total testosterone level in two group was similar(P<0.05). The best predictors of metabolic syndrome in PCOS was HDL-C<1.29 mmol/L(sensitivity 91.14% and specificity 88.12%). Conclusion Women with PCOS have high risk for MS, age and the degree of obesity could be the main determinants of the prevalence of metabolic syndrome in different populations. The level of HDL-cholesterol could be a good predictor of the risk of MS in PCOS patients.

Diagnostic value of four serum lipoprotein ratios in patients with polycystic ovary syndrome for metabolic syndrome

Li Yanglu, Ruan Xiangyan, Cui Yamei, Zhao Yue, Wu Hongqin, Du Juan, Alfred O. Mueck

2015, 36(4):  559-566.  doi:10.3969/j.issn.1006-7795.2015.04.009

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Objective To investigate and compare predictive diagnostic value of the low density lipoprotein-cholesterol(LDL-C)/high density lipoprotein-cholesterol(HDL-C), apolipoprotein(Apo)B/ApoAI, triglyceride(TG)/HDL-C, total cholesterol(TC)/HDL-C ratios for metabolic syndrome(MS) in patients with polycystic ovary syndrome(PCOS). Methods A total of 441 patients with PCOS were included in this study, whose height, weight, waist circumference were measured. Fasting venous blood specimens were collected on their first to fifth day of menstrual cycle to measure their concentration of sex hormones and metabolic parameters. All patients were devided into two groups according to the international diabetes federation(IDF) diagnostic criteria: MS group and non-MS group. Differences between the two groups were compared, including age, blood pressure, BMI, waist circumference, waist-to hip circumference ratio, fasting glucose, fasting insulin, LDL-C, HDL-C, Lp(a), triglyceride, total cholesterol etc. Correlations between the 4 ratios and parameters in MS diagnostic criteria mentioned above were analyzed respectively. The whole patients were divided into 6 groups by the number of abnormal component, from 0 component to 5 components. The mean values of 4 ratios were compared between 6 groups. The diagnostic value of 4 ratios were determined and compared by ROC curves. Results Mean values of the 4 serum lipoprotein ratio were increased as increase in the number of abnormal components, and all of the ratios were significantly correlated with parameters in MS criteria. TG/HDL-C obtained the highest area under the curve(AUC) of 0.941 determined by ROC curves, suggesting that TG/HDL-C has the greatest diagnostic value of MS. The cutoff value of TG/HDL-C was set at 1.089, with the sensitivity of 0.864 and the specificity of 0.891. Conclusion TG/HDL-C has the best diagnostic value for MS among 4 ratios. Patients with PCOS whose TG/HDL-C ratio is over 1.089 should be informed about the risk of MS, and take medical intervention to prevent MS.

Clinical and endocrine characteristics among phenotypic expressions of polycystic ovary syndrome according to the 2003 Rotterdam consensus criteria

Zhao Yue, Ruan Xiangyan, Cui Yamei, Li Yanglu, Wu Hongqin, Du Juan, Zhang Ying, Tian Xuanxuan, Diethelm Wallwiener, Alfred O. Meuck

2015, 36(4):  567-572.  doi:10.3969/j.issn.1006-7795.2015.04.010

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Objective To analyze the relative prevalence and the clinical and endocrine characteristics of each phenotype expressions of polycystic ovary syndrome(PCOS) according to the National Institutes of Health(NIH) and Rotterdan Consensus criteria definitions for PCOS. Methods Clinical, endocrine and metabolic data from 647 women with PCOS diagnosed according to Rotterdam criteria and NIH recommendations between Dec. 2014 and May 2015 were collected and divided into four different phenotypes. Results The severe PCOS phenotype defined as having oligo-ovulation(OO), hyperandrogenism(HA), and polycystic ovary(PCO), i.e., Group A, was the most common phenotype seen in 63.2% of the patients. Group B, defined as having OO and HA, was seen in 9% of the phenotype. Group C, defined as having HA and PCO, was seen in 15.6% and Group D, defined as having OO and PCO, was seen in 12.9%. The rate of clinical high androgen manifestation and hyperandrogenism was 87.8%, but hyperandrogenism, insulin resistance(IR) and triglyceride(TG) were significantly higher in Group A, followed by group B. Group C presented relatively milder clinical and endocrine alterations than group A and B, but had a higher luteinizing hormone/follicle-stimulating hormone(LH/FSH) than controls(P<0.05). Compared with controls, group D had similar body mass index(BMI), waist and hip circumferences, and Ferryman-Gallwey scores. Several biochemical indicator were similar across all PCOS phenotypes(P>0.05). Conclusion 1) The classification according to the revised 2003 consensus on diagnosis reflects the basic characteristics of PCOS. 2) Androgen levels are the major distinguishing endocrine feature differentiating phenotypic expressions of PCOS. Ovulatory PCOS and normoandrogenic phenotype represent the mild forms of classic PCOS, but the latter may have a different pathogenic pathway. So the choice of treatment should be individualized.

Effect of uterine fibroids on fetal growths and neonatal outcomes in twin pregnancies

Wang Hongmei, Dai Yinmei, Tian Yucui, Xue Zhifang

2015, 36(4):  573-577.  doi:10.3969/j.issn.1006-7795.2015.04.011

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Objective To prospectively estimate the effect of fibroids on fetal growths and neonatal outcomes in twin pregnancies. Methods Data of 46 twin pregnancies with fibroids delivered from June 2013 to December 2014 in Beijing Obstetrics and Gynecology Hospital, Capital Medical University who have already established their records were collected. And data were also collected from 63 twin pregnancies without fibroids as matched group. The monitoring parameters of ultrasounds in their early, middle and late pregnancy and neonatal conditions and obstetric outcomes were observed and recorded. Results Twin pregnancies with fibroids were more likely to be of advanced maternal age 〔(35.04±4.24)years vs (31.67±3.56)years, P=0.000〕, higher pre-pregnancy body mass index 〔(21.46±3.69)kg/m² vs (20.77±2.38)kg/m², P=0.009〕 and had lower amniotic fluid volume〔(3.14±0.55)cm vs (3.38±0.55)cm, P=0.001〕 in 11-14 weeks ultrasound compared with twin pregnancies without fibroids. However, other parameters of fetal growths in early, middle and late pregnancy, neonatal conditions and obstetric outcomes had no statistical significance between twin pregnancies with fibroids and those without fibroids. Conclusion Fibroids' effect on fetal growths and neonatal outcomes in twin pregnancies is not obvious. But twin pregnancy is a high risk factor for pregnancy and we should give more monitoring and management for twin pregnancy with fibroids, so that mothers and newborns get more reasonable and secure treatment.

Features and research progressions in triple negative breast cancer

Du Juan, Ruan Xiangyan

2015, 36(4):  578-582.  doi:10.3969/j.issn.1006-7795.2015.04.012

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Triple negative breast cancer(TNBC) is defined as one of the subtypes of breast cancer, which has been attracted much attention in recent years because of the aggressive behavior and inferior prognosis. This review summarizes clinical pathologic features, molecular biologic features and treatments of TNBC. Clinical pathologic features include epidemiologic, clinical and pathobiologic features. Molecular biologic features demonstrate the relationship between TNBC and basal-like breast cancer, breast cancer 1(BRCA1) and p53 gene. Treatments include surgery, neoadjuvant chemotherapy, high dose chemotherapy and targeted therapy. Further research in TNBC may provide more effective therapies.

Progress in research on possible role of progesterone receptor membrane component 1(PGRMC1) in the mechanism of breast cancer development

Zhang Ying, Ruan Xiangyan, Alfred O. Mueck

2015, 36(4):  583-587.  doi:10.3969/j.issn.1006-7795.2015.04.013

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Breast cancer is one of the most common leading cause of cancers death in women world-wide. But the mechanism of breast cancer development is still unclear. The only placebo-controlled study, the Women's Health Initiative(WHI) demonstrated that breast cancer risk mainly is dependent on the progestogen component since only in the combined estrogen/progestogen arm, but not in the estrogen-only arm this risk was seen to increase the risk. According to this finding, our previous investigation point towards an important role of progesterone receptor membrane component 1(PGRMC1) in hormone related breast cancer risk. This finding got great attention from the related field in the world. An editorial published in the journal Menopause raised the following questions: "Can the increase in breast cancer observed in the estrogen plus progestin arm of the Women's Health Initiative trial be explained by progesterone receptor membrane component 1? Can the PGRMC1 become to be a potential marker in the future? Will the women with high expression of PGRMC1 be breast cancer susceptible people?" We will review the results of related researches.

Value of genotyping test for human papillomavirus(HPV) in women under 30 years of age with cervical lesions

Lyu Hong, Kang Xixiong, Zhang Guojun

2015, 36(4):  588-591.  doi:10.3969/j.issn.1006-7795.2015.04.014

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Objective To explore the application value of genotyping test for human papillomavirus(HPV) in women under 30 years of age with cervical lesions, so as to provide evidences for cervical lesion screening in young women. Methods Totally of 985 young women under 30 years of age were assigned to physical examination group, verrucous lesion group, cervical inflammation group, cervical intraepithelial neoplasia(CIN) group and cervical carcinoma group by pathological or cytological test. An analysis was performed using genotyping test for human papillomavirus(HPV) , including 13 high-risk HPV types(16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68), 5 low-risk HPV types(6, 11, 42, 43 and 44) and 3 common HPV genotypes in Chinese(53, 66 and CP8304). Results The total detection rate of HPV was 21.42%(211/985). The detection rate was 25.38%(250/985) for high risk HPV, 3.76%(37/985) for low risk HPV and 24.17% for multiple infections. There was statistically significant difference between cervical intraepithelial neoplasia and cervical carcinoma groups with physical examination group. Conclusion HPV-DNA test is very important for young women and of great value on detecting cervical carcinoma and precancerous lesion.

Value of urinary neutrophil gelatinase-associated lipocalin determined at different time points in early diagnosis of cardiac surgery-associated acute kidney injury

Luan Haixia, Yuan Hui, He Jianxun, Ma Xu, Yao Xingrong, Zeng Xiaoli, Gui Yuan, Liu Yulei

2015, 36(4):  592-596.  doi:10.3969/j.issn.1006-7795.2015.04.015

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Objective To prospectively explore the value of urinary neutrophil gelatinase-associated lipocalin(uNGAL) determined at different time points in early diagnosis of cardiac surgery-associated acute kidney injury(AKI). Methods A total of 111 hospitalized patients undergone cardiac surgery were enrolled into this study from October 2011 to May 2012. The urinary samples were collected before cardiac surgery and at 0, 6, 12, 24, 48, 72 h after surgery, and uNGAL was immediately measured by ARCHITECT i2000. According to AKI criteria of Kidney Disease Improving Global Outcomes(KDIGO) clinical practice guidelines on AKI, the subjects were divided into the AKI group and non-AKI group. Results Twenty-four of the 111 patients developed acute kidney injury(21.6%). Compared with non-AKI group, the uNGAL level of AKI group was dramatically increased at 0 h after surgery〔54.20(9.60-452.10) vs 8.95(3.03-24.65), P<0.001〕, and was also significantly higher at 6 h after surgery〔35.50(10.60-80.10) vs 12.20(6.30-38.40), P<0.05〕. The 0h after surgery-to-baseline ratio of uNGAL was significantly higher in AKI group than in non-AKI group(2.72 vs 1.09, P<0.01). The area under the receiver operating characteristic(ROC) curve, the cutoff value, the sensitivity and specificity for 0 h uNGAL after surgery were 0.852(0.777-0.926, P<0.001), 28.25 ng/mL, 91.7% and 77.4%, for 6 h uNGAL after surgery were 0.650(0.500-0.651, P<0.026), 26.50 ng/mL, 50.0% and 65.1%, for 0 h uNGAL after surgery-to-baseline ratio were 0.752(0.642-0.862, P=0.001), 1.95, 93.3% and 64.5%, respectively. Conclusion The uNGAL can be used as an early biomarker for prediction of cardiac surgery-associated acute kidney injury(AKI). The uNGAL 0 h after surgery was the best point for diagnosis of AKI.

Values of ascites and plasma procalcitonin in diagnosis of liver cirrhosis with spontaneous bacterial peritonitis

Dang Yan, Zhang Lili, Lou Jinli, Chen Ming

2015, 36(4):  597-600.  doi:10.3969/j.issn.1006-7795.2015.04.016

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Objective To explore the clinical value of ascites and plasma procalcitonin examination in early diagnosis of liver cirrhosis with spontaneous bacterial peritonitis(SBP). Methods Totally 69 cirrhotic patients with ascites including 28 patients with spontaneous bacterial peritonitis and 41 patients without spontaneous bacterial peritonitis seen in Beijing Youan Hospital from August, 2014 to January, 2015 were studied. The levels of ascites and plasma procalcitonin of these patients were analyzed. Results The levels of procalcitonin, white blood cell counts in plasma and procalcitonin, white blood cell, polymorphonuclear leucocytes counts in ascites in SBP group were significantly higher than those in the non-SBP group(P<0.01). The procalcitonin levels in ascites and plasma were positively correlated(r=0.877, P<0.01). ROC curve analysis showed that the areas under curve of ascites and plasma procalcitonin were 0.919 and 0.820; meanwhile the best thresholds were 0.415 and 0.746 ng/mL respectively. Conclusion Detections of ascites and plasma procalcitonin have significant value for the early diagnosis of liver cirrhosis patients with spontaneous bacterial peritonitis, it has high sensitivity and specificity, and the diagnostic value of plasma procalcitonin is superior to ascites procalcitonin.

Value of laboratory indicators for clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease complicated with Mycoplasma pneumoniae infection

Qu Pei, Xu Xinmin, Zhao Miaomiao, Li Juan, Song Shujing, Guo Jie, Hua Wenhao

2015, 36(4):  601-603.  doi:10.3969/j.issn.1006-7795.2015.04.017

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Objective To investigate the value of laboratory indicators in clinical diagnosis and treatment of the patients with severe hand, foot and mouth disease(HFMD) commplicated with enterovirus 71(EV71) and Mycoplasma pneumoniae infection. Methods The data of 100 cases with HFMD and 50 cases with non-HFMD were collected in Beijing Ditan Hospital from March 2014 to August 2014. Real-time fluorescence quantitative PCR(RT-PCR) method was used to test the DNA in stool samples and obtained qualitative results. Passive agglutination test was performed to detect Mycoplasma pneumoniae antibody titers in serum. Then, we analyzed the possibility of Mycoplasma pneumoniae infection in HFMD group and non-HFMD group, and explored the correlation of EV71 infection complicated with Mycoplasma pneumoniae infection and the severity of HFMD. Results The positive rate of Mycoplasma pneumoniae infection in the severe HFMD group(76%) was significantly higher than that in the mild HFMD group(48%, χ²=8.319, P=0.004). Conclusion Close teention should be paid to severe HFMD patients with the EV71 infection complicated with Mycoplasma pneumoniae infection. This is critically important for reducing the severity of HFMD.

Role of histamine in regulation of barrier function in human keratinocytes

Duan Su, Jiao Jian, Zhang Luo

2015, 36(4):  604-609.  doi:10.3969/j.issn.1006-7795.2015.04.018

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Objective We try to investigate the role of histamine in regulation of barrier function of human keratinocytes by testing the changes of trans-epithelial resistance(TER) and paracellular flux of primary human keratinocytes in vitro stimulated by histamine. Methods We cultured primary human keratinocytes from healthy and atopic dermatitis(AD) individuals in the presence and absence of histamine, histamine receptor blocker for 96 hours in air-liquid interface(ALI) culture systems. The epithelial barrier function was evaluated by measuring TER and FITC-Dextran paracellular flux. Results Histamine decreased the barrier integrity of human keratinocytes in ALI cultures by impairing TER increase and increasing the paracellular flux to Fitc-Dextran in a dose- and time-dependent manner. There was a statistically significant difference between histamine stimulated group and un-stimulated group. Histamine 1 receptor(H1R) antagonist could block the effect of histamine to TER and Ca²⁺ ionophore ionomycin could induce the similar effect to TER with histamine with statistical significance. Conclusion Our findings that histamine impairs human keratinocytes barrier function might contribute to the pathogenesis of chronic skin inflammatory diseases such as AD and might indicate a possibility for clinical therapeutic strategy.

Establishment of a simple method for separation, culture and identification of mouse peripheral blood monocyte/macrophage

Yang Lin, Tian Lei, Xie Jieshi, Li Liying

2015, 36(4):  610-613.  doi:10.3969/j.issn.1006-7795.2015.04.019

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Objective The aim of this study is to separate, cultivate and identify mouse peripheral blood monocyte/macrophages(PBM) in L929-conditioned medium. Methods Mouse PBM was isolated by centrifugation, and cultured with L929-conditioned medium for 7 days. PBM was identified by immunofluorescence and flow cytometry(FCM). Results PBM display the immunophenotype of monocyte/macrophage and with phagocytic function. Conclusion It was a simple method for separation, culture and identification of mouse PBM in vitro.

Association between blood glycans and glucose of metabolic syndrome

Cao Kai, Wang Youxin, Liu Xiangtong, Tao Lixin, Guo Jin, Song Manshu, Yu Xinwei, Yang Jinkui, Wang Wei, Guo Xiuhua, Yang Guangran, Wei Wenbin

2015, 36(4):  614-617.  doi:10.3969/j.issn.1006-7795.2015.04.020

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Objective To explore the association between blood glycans and glucose of metabolic syndrome. Methods Subjects are split into two groups according to glucose level(below 5.6 mmol/L is defined as normal). Wilcoxon rank sum test is applied to make comparison of glycan level between two groups and Logistic regression is applied to make sure the impact factors of blood glucose. Results GP5, GP11 and A2 are statistically significant with P value under 0.01. Conclusion GP5, GP11 and A2 are the impact factors of blood glucose.

A method for preparation of single cell suspension to detect the infiltration of inflammatory cells in mouse aorta by flow cytometry

Tian Cui, Ren Hualiang, Nie Hao, Wang Xia, Jiang Xue, Li Fangda, Wang Hongxia

2015, 36(4):  618-621.  doi:10.3969/j.issn.1006-7795.2015.04.021

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Objective To set up an effective method using flow cytometry technology to detect the infiltration of inflammatory cells in murine aorta by preparation of single cell suspensions. Methods Osmotic mini pumps with angiotensin Ⅱ(1 000 ng·kg^-1·min^-1) were implanted subcutaneously into mice for 3 d. The mice were sacrificed immediately after anesthesia, and the thoracic and abdominal aorta was cut off immediately after it was taken out. The vascular tissue of mice was digested with the digestive enzyme to prepare single cell suspension for flow cytometry analysis. Results 5×10⁵ cells/mL could be isolated from each vascular tissue of mouse, and more intact cells and better viability were found in the single cell suspension; The results of flow cytometry showed angiotension Ⅱ treatment increased the number of neutrophisl, T lymphocyte cells and macrophages in the aorta. Conclusion This method is a simple, effective, stable and reliable one for the preparation of single-cell suspension of murine aorta, which will help to study the infiltration of inflammatory cells in murine aorta.

Polymorphisms in the TIRAP gene has no correlation with pediatric tuberculosis in a Chinese Han children

Xiao Jing, Xie Lanpin, Dong Yakun, Wang Xiaoming, Sun Lin, Qi Hui, Shen Adong

2015, 36(4):  622-629.  doi:10.3969/j.issn.1006-7795.2015.04.022

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Objective Although the Toll-like receptors(TLRs) are responsible for the recognition and response to pathogen ligands, increasing evidence suggests that the family of five cytosolic Toll/IL-1 receptor(TIR) adaptor proteins also play a crucial role in the specificity of the response. To explore the potential role of the TIRAP gene in the susceptibility to TB among members of the Chinese Han Children, we evaluated the association of tag single nucleotide polymorphisms(SNPs) in the TIRAP gene with the risk for TB. Methods We collected 339 TB children and 392 healthy controls in our case-control study and used MassARRAY for genotyping. DNA samples were extracted using the standard salting-out procedure. Results Five tag SNPs were selected. We excluded 2 SNPs(rs563011 and rs8177400), the allelic detection rate of the first one is less than 95% and the AA genotype of the second one is zero. We did not find any statistical significance of distribution analysis of three SNPs of TIRAP genes(rs1786704, rs8177375, rs8177352) in TB group and control group with analysis of alleles, genotypes and haplotypes of SNPs(P>0.05). Conclusion SNPs of TIRAP genes were not associated with TB in Chinese Han children.

Analysis of related factors of coronary artery calcification in maintenance hemodialysis patients

Xu Fengbo, Sun Yi, Wang Yinna, Cheng Hao

2015, 36(4):  630-633.  doi:10.3969/j.issn.1006-7795.2015.04.023

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Objective To observe the level of coronary artery calcification in maintain hemodialysis(MHD) patients and explore the relationship between calcium and phosphorus metabolism, fibroblast growth factor 23(FGF23), fetuin-A and coronary artery calcification. Methods Fifty-four MHD patients were enrolled in this study. Phosphate, calcium in their serum were determined. The level of FGF23 and fetuin-A in serum were detected by the method of ELISA. The degree of coronary artery calcification was detected by 64 slice spiral CT and the coronary artery calcium score(CCS) was calculated.The patients were divided into CCS≤400 group and CAC>400 group according to the CCS. Results (1) The mean CCS in 54 MHD patients is 826(P₂₅~P₇₅ is 144~2044). The patients of more than 0 points accounted for 94.44%, more than 100 points accounted for 79.63%, more than 400 points accounted for 59.26%. (2) The FGF23 and age in CCS≤400 group was lower than CCS>400 group. The proportion of coronary disease in group CCS≤400 is lower than that in group CCS>400. The duration of dialysis, calcium, phosphorous, uric acid, albumin, parathyroid hormone, fetuin-A has no significant difference between the two groups. (3) Logistic regression analysis revealed that the level of FGF23 and age was the influencing factor of coronary artery calcification in MHD patients. Conclusion The degree of coronary artery calcification in MHD patients is serious, and the elevation of FGF23 is relevant to the coronary artery calcification.

Effects of sevoflurane on MAC and expression of protein PARP-1 in different encephalic regions of neonatal rats

Xie Sining, Ye Hong, An Lixin, Li Junfa

2015, 36(4):  634-639.  doi:10.3969/j.issn.1006-7795.2015.04.024

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Objective To measure the sevoflurane minimum alveolar concentration(MAC) and to investigate the effect of sevoflurane anesthesia on the expression of poly(ADP-ribose)polymerase-1(PARP-1) protein in various brain regions in 7-day postnatal mice. Methods One hundred neonatal Sprague-Dawley(SD) rats(7 days postnatal, P7) were selected in this study. The sevoflurane MAC was determined in littermates(aged 7 days, n=10) using tail-clamp stimulation in a bracketing study design. At the end of anesthesia with different concentration gradient and duration gradient of sevoflurane, arterial blood samples from left ventricular of 3 random rats of each anesthesia maintenance were obtained immediately for blood gas analysis, and choose the maximum concentration and duration to keep the normal respiratory parameters. Then the neonatal mice were randomly divided into three different groups: the control group(A), the sham anesthesia group(B), and the anesthesia group(C), the expression contents of PARP-1 protein in different brain regions were tested by Western blotting 6 hours after exposure. Results The sevoflurane MAC of the 7 days mice was(2.64±0.12)%, 0.8MAC and 4 h anesthesia was set as the most suitable concentration rate and the anesthesia duration, respectively. Compared to the group A(100%), the PARP-1 expression in the hippocampus(270±22)%, the cortex of the temporal lobe(160±15)%, and the cortex of the frontal lobe(165±8)% of the group C was significantly increased(P<0.05), however, the PARP-1 expression in the thalamus(115±26)% was not statistically significant between the Goup A and C. The parameters of the Group B was not significantly different with Group A(P>0.05). Conclusion The sevoflurane MAC of the 7 days mice was 2.64%. 0.8 MAC sevoflurane anesthesia for 4 h may induce neuron apoptosis in cortex and hippocampus of the 7-days mice brain, and especially in hippocampus area.

Resting state functional MRI, DTI and PWI in the Alzheimer's disease

Wang Zhiqun, Li Kuncheng

2015, 36(4):  640-644.  doi:10.3969/j.issn.1006-7795.2015.04.025

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Alzheimer's disease(AD) is characterized as cognitive and memory decline. Mild cognitive impairment(MCI) is the early stage of AD. The pathophysiology of AD is not very clear. In the present article, we reviewed the previous neuroimaging study of AD. By using the new MRI techniques including resting state functional MRI(fMRI), diffusion tensor imaging(DTI) and perfusion weighted imaging(PWI), we can acquire deep understanding of the pathophysiology of AD from the prospect of function, structure and perfusion.

Effects of TongXie-YaoFang formula on serotonin and chromogranin a related transport mechanism of ion channels in colonic mucosa in diarrhea-predominant irritable bowel syndrome

Zhang Shengsheng, Yang Cheng

2015, 36(4):  645-648.  doi:10.3969/j.issn.1006-7795.2015.04.026

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Diarrhea-predominant irritable bowel syndrome(D-IBS) is a clinically common functional intestinal disease and it brings inconvenience to patients' live and work. TongXie-YaoFang(TXYF) formula, as a famous ancient prescription of Traditional Chinese Medicine, can significantly reduce the abdominal pain and diarrhea of D-IBS patients, thereby to improve the quality of their live and work. However, the exact mechanism is unclear. This article explores the influence of TXYF formula on ion channels of colon mucous membrane in D-IBS from the perspective of 5-HT and chromogranin A(CGA) related ion channel transport mechanism in order to provide reliable basis for subsequent clinical and basic research.

Research progress of functional dyspepsia in Chinese medicine

Zhang Shengsheng, Li Xiaoling

2015, 36(4):  649-653.  doi:10.3969/j.issn.1006-7795.2015.04.027

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Functional dyspepsia is a most common functional gastrointestinal disease affecting people's daily life. The etiology and pathogenesis of FD has not been fully elucidated. Western medicine diagnostic typing remains controversial while Chinese medicine treatment of FD shows great advantage.

The perioperative protection in HIV/AIDS patients with fracture in China: a systematic review

Cai Juan, Zhang Qiang, Xiao Jiang, Yang Fangyu, Li Chunmei, Zhang Hongyu

2015, 36(4):  654-658.  doi:10.3969/j.issn.1006-7795.2015.04.028

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The objective for this review was to elucidate the perioperative protective measure in HIV/AIDS patients with fracture in China. In pre-operative period, high active antiretroviral therapy(HAART) must be initiated as an important measure to reduce the incidence of occupational exposure, and healthcare workers should wear face masks and gloves when performing medical practice. In operative period, based on the characteristics of occupational exposure in operations, we took some measures to reduce the risk of occupational exposure, including bilayer gloves, eye mask, disposable waterproof gown, and slippers with foot-strap, advised to minimize the use of sharp or electrical instruments and argon knifes, and advised contactless operation as far as possible to reduce opportunity of occupational exposure. Once occupational exposure occurred in surgical operation, post exposure prophylaxis must be taken immediately. We established perioperative protective measures with Chinese characteristics based on research on orthopedic surgery process in human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) patients, which helped reduce the risk of occupational exposure in orthopedic surgery.

MR imaging research situation of HBV related multistep hepatocarcinogenesis and the latest progress

Zhang Yanyan, Li Hongjun

2015, 36(4):  659-662.  doi:10.3969/j.issn.1006-7795.2015.04.029

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The development of Hepatocellular carcinoma(HCC) is described either as de novo hepatocarcinogenesis or as a multistep process , and it is important to diagnosis accurately and differential diagnosis the multi-step hepatocarcinogenesis nodules using the imaging technology. The purpose of this paper is to summarize the specificity and regularity of the magnetic resonance(MR) imaging characteristics for the cirrhotic nodule, and to realize the early diagnosis and differential diagnosis of the cirrhotic regenerative nodules.

2015 the Seventh International Symposium on Postmenopausal Women and Gynecological Endocrinology Issues Conference Announcement

2015, 36(4):  672-672. 

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