Table of Content

21 May 2017, Volume 38 Issue 3

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Effects of botulinum toxin A combined with low dose gabapentin on the NK-1 receptor internalization at spinal cord dorsal horn in rats with incisional pain

Li Xueyang, Wang Yun, Sun Yuqing, Ma Danxu, Wu Anshi, Yue Yun

2017, 38(3):  331-335.  doi:10.3969/j.issn.1006-7795.2017.03.001

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Objective To evaluate the effects of botulinum toxin A combined with low dose gabapentin on the neurokinin-1 (NK-1) receptor internalization at spinal cord dorsal horn in rats with incisional pain. Methods Male Sprague-Dawley rats, weighing 280-300 g, aged 6-8 weeks, were used in the study. Rats were randomly selected and divided into 5 groups (n=9 each) using a random number table:control group (Control group), incisional pain group (Saline group), gabapentin group (GBP group), botulinum toxin A group (BoNT/A group), botulinum toxin A combined with gabapentin group (G+B group). At 24 h before operation, botulinum toxin A 0.5U (in 10 mL of normal saline) was injected intrathecally in BoNT/A group and G+B group. At 30 min before operation, gabapentin 50 mg was injected intrathecally in GBP group and G+B group. At 3 h after operation, 6 rats in each group were selected to measure the cumulative pain scores (CPS) and mechanical paw withdrawal threshold (PWT) in the right hindpaw; besides, 3 rats in each group were selected and sacrificed, and the lumbar segment (L4,5) of the spinal cord was removed for determination of the expression of NK-1 receptors in the spinal dorsal horn by immunofluorescence. Results Compared with Control group, the CPS was significantly increased, the PWT was significantly decreased, and the expression of NK-1 receptors in the spinal dorsal horn was significantly up-regulated in Saline group, GBP group, BoNT/A group and G+B group at 3 h after operation(P<0.05). Compared with Saline group, the CPS was significantly decreased, the PWT was significantly increased, and the expression of NK-1 receptors in the spinal dorsal horn was significantly down-regulated in BoNT/A group and G+B group at 3 h after operation (P<0.05), and no significant change was found in group GBP (P>0.05). Compared with BoNT/A group, the CPS was significantly decreased, the PWT was significantly increased, and the expression of NK-1 receptors in the spinal dorsal horn was significantly down-regulated in G+B group at 3 h after operation (P<0.05). Conclusion Low doses of gabapentin alone may have no effect on postoperative pain, but when it is coadministrated with BoNT/A, it can greatly enhance the analgesic effect of BoNT/A. The analgesic mechanism may be due to inhibition of the internalization of NK-1 receptor at spinal cord horn in a rat model of incisional pain.

cPKCγ membrane translocation plays roles in Herkinorin postconditioning against ischemia/reperfusion injury in MCAO mice

Cui Xu, Ji Fang, Shu Luowa, Li Junfa, Pan Chuxiong

2017, 38(3):  336-341.  doi:10.3969/j.issn.1006-7795.2017.03.002

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Objective To evaluate the effects of Herkinorin postconditioning against ischemia/reperfusion injury in middle cerebral artery occlusion (MCAO) mice and the role of conventional protein kinase Cγ (cPKCγ). Methods Healthy adult male C57BL/6 mice were randomly divided into five groups:control group (Naive), sham-operation group (Sham), ischemia for 1 h and reperfusion group (I/R), I/R and DMSO intraperitoneal injection group (I/R+D),I/R and 10 mg/kg Herkinorin intraperitoneal injection group (I/R+H). Neurobehavioral score, Pole test, Wire hang test, Cylinder test and Foot fault test were performed at 24 h and 7 d after reperfusion. Using MCAO induced ischemic stroke mouse model, cerebral infarct volume was evaluated with TTC staining, the cPKCγ membrane translocation levels were detected with Western blotting. Results MCAO induced ischemia/reperfusion injury resulted in increased neurobehavioral scores in mice. Compared with I/R group, neurobehavioral scores of I/R+H group were decreased significantly. Ischemia/reperfusion injury affected sensorimotor function. Pole test, Cylinder test and Foot fault test of I/R+H group were relieved significantly compared with I/R group (P<0.05,n=6). TTC staining showed that infarct volumes in I/R group were 31.44%±5.44% at 24 h and 23.44%±7.95% at 7 d, infarct volumes were decreased in I/R+H group (24 h:17.19%±3.23%,7 d:13.26%±2.71%) (P<0.05,n=6). Western blotting showed cPKCγ membrane translocation levels of ischemic core and peri-infarct regions in MCAO mice cortex were decreased significantly after ischemia for 1 h and reperfusion. Herkinorin alleviated the decrease of cPKCγ membrane translocation levels in cortex peri-infarct region (P<0.05,n=6). Conclusion 10 mg/kg Herkinorin could decrease neurobehavioral score, alleviate Pole test, Cylinder test and Foot fault test evaluation, decrease infarct volumes in MCAO mice. cPKCγ membrane translocation in cortex peri-infarct region may participate molecular mechanism of Herkinorin induced neuroprotection.

Effect of cholinergic anti-inflammatory pathway on cerebral ischemia-reperfusion injury in the rat

Wang Xiao, Su Yue, Li Tianzuo, Zhao Binjiang

2017, 38(3):  342-347.  doi:10.3969/j.issn.1006-7795.2017.03.003

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Objective To investigate the protective effect of cholinergic anti-inflammatory pathway (CAP) via the M1 receptor agonist,the M2 receptor antagonist and the nAChR7 agonist. during cerebral ischemia-reperfusion injury in rats. Methods Twenty-five male healthy Sprague-Dawley rats were randomly divided into five equal groups:sham operation (Sham) group, ischemia reperfusion (I/R) group, methoctramine (MET) group, McN-A-343(MA343) group and choline(CHO) group. Rats were subjected to four-vessel occlusion (4-VO) global cerebral ischemia.by electrocauterization of the bilateral vertebral arteries, except Sham group. 15 min before ischemia-reperfusion, we administered intracerebroventricularly (i.c.v.) Methoctramine(500 ng/kg,10 μL), McN-A-343(500 ng/kg,10 μL) and Choline(500 ng/kg,10 μL) to MET group, MA343 group and CHO group, other groups receiving saline (0.9%). Then forebrain ischemia was induced by tightening of the clasps that around the common carotid arteries for 20 minutes, except Sham group. Blood and tissue samples were collected after reperfusion for 6 h in all groups. Tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels of hippocampus, heart, liver, lung,kidney and plasma were measured by radio-immunoassay(RIA).Apoptosis was detected by terminal deoxynucleotidyl-trallsferase meiated dUTP nick end labeling(TUNEL). Results Methoctramine and McN-A-343 could markedly inhibit the increase of TNF-α and IL-1βcontent in hippocampus, heart, liver, kidney and plasma after ischemia.Choline could also attenuated TNF-α and IL-1βexpression in hippocampus but could not inhibit them in heart, liver, kidney and serum. TNF-α and IL-1β levels in lung could not be suppressed by methoctramine, McN-A-343 or choline. Compared with I/R, the apoptotic cells in MET group, MA343 group and CHO group were significantly decreased. Conclusion It is indicated that CAP plays a potential role in alleviating local and systemic inflammatory response during cerebral ischemia-reperfusion injury. The mechanisms of anti-inflammatory were likely to suppress the expression of TNF-α and IL-1β.

Impact of sevoflurane and high concentration of oxygen on expression of caspase-3 and cognition of aged mice

Chen Bin, Liu Wei, Shi Zhiguo, Liu Tao, Zheng Hui

2017, 38(3):  348-351.  doi:10.3969/j.issn.1006-7795.2017.03.004

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Objective To investigate the impact of sevoflurane and high concentration of oxygen on expression of caspase-3 and cognitive function of aged mice. Methods Thirty three healthy male C57/BL6 elderly mice (14 months) were randomly divided into three groups:group of high concentration of oxygen (HO group, n=11):inhaling 100% oxygen for 4 h; high concentration of oxygen + sevoflurane group (HS group, n=11):taking in 100% oxygen with 2.5% sevoflurane for 4 h; control group (Con group, n=11):taking in air for 4 h. Cognitive function in the elderly mice was tested in the Morris water maze. Western blotting is used to test the expression of caspase-3 in hippocampus. Results Compared with Group Con, Group HO saw no difference in numbers of crossing the platform and Caspase-3 expression. Group HS crossed the platform less (P=0.023),and the caspase-3 expression of the group increased significantly(P=0.036).Conclusion Inhaling 100% oxygen had no impact on cognitive function in the elderly mice;Inhaling 2.5% Sevoflurane with 100% oxygen could increase expression of caspase-3, and it had close relations with the cognitive dysfunction of the aged mice.

Influence of general anesthesia combined with epidural block on liver and kidney function after liver resection

Cai Xiaofei, Niu Shaoning, Ding Qiao, Cheng Hao

2017, 38(3):  352-356.  doi:10.3969/j.issn.1006-7795.2017.03.005

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Objective To explore the influence of different anesthetic drugs for general anesthesia combined with epidural block on liver and kidney function after liver resection. Methods Totally 123 patients with liver resection were selected from Beijing Ditan Hospital who underwent general anesthesia combined with epidural block from October 2014 to October 2015. Patients were divided into three groups by simple random sampling. Forty-one patients were treated with sevoflurane as group A. Another 41 patients were treated with isoflurane as group B. Additional 41 patients were treated with propofol as group C. The result of liver and kidney function tests at different time points were compared among the three groups. Results After operation,alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), total bilirubin (TBiL), γ-glutamyltranspeptidase (γ-GT), urea nitrogen (BUN), serum creatinine (SCr), α1-microglobulin (α1-MG), albumin (ALB), lactic dehydrogenase (LDH) increased firstly and then decreased in each of the three groups(P<0.05). ALT, AST, ALP, TBiL, γ-GT, BUN, SCr, α1-MG, ALB, LDH at postoperative day 1, day 3 in group B were higher than those of group A(P<0.05). ALT, AST, ALP, TBiL, γ-GT, BUN, SCr, α1-MG, ALB, LDH at postoperative day 1, day 3 in group C were higher than those of group A and B(P<0.05). Conclusion In liver resection, sevoflurane, or isoflurane, propofol can be used for general anesthesia combined with epidural block. Sevoflurane showed less effect on liver and kidney function, and had more safety profile.

Influence of different neuromuscular blockade levels on intraoperative spinal cord monitoring

Yu Linlin, Wang Jun, Ma Yue, Guo Xiangyang

2017, 38(3):  357-360.  doi:10.3969/j.issn.1006-7795.2017.03.006

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Objective To compare the effects of different muscle relaxation levels (T1 response of the train-of-four (TOF) stimulation 5%-15% versus T1 response 45%-55% of baseline) the electrophysiological monitoring of the spinal cord during the spinal cord surgery, and then to explore the reasonable anesthesia program matched with electrophysiological monitoring.Methods Twenty-three patients undergoing selective spinal surgery with electrosurgical monitoring were enrolled in this study. Total intravenous anesthesia using propofol plus remifentanil and muscle relaxation provided by atracurium were maintained. Somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) were used to monitor the spinal cord function, and TOF stimulation at adductor pollicis muscle represented the muscle relaxation.The amplitude and latency of SEP and MEP were recorded at the level of NMB₁ (T1 5% to 15% base) and NMB₂ level (T1 45% to 55% base). Spontaneous breathing and severe motor motility under transcranial electrical stimulation were also recorded.Results There were no significant differences between the amplitudes and the latencies of SEP at different NMB levels(P>0.05). The latencies of MEP were similar under different muscle relaxation levels(P>0.05). The amplitudes of MEP had significant difference on the left upper limbs and the right lower limbs, whereas not on the left upper limbs and the right lower limbs. The incidence of severe motility at NMB₂ level was much higher than that at NMB₁ level (P<0.05). No spontaneous breathing was detected.Conclusion The use of muscle relaxant is not contraindicated during spinal surgeries that need intraoperative neurophysiology monitoring. For high risk spinal surgery, T1 response at 45%-55% of baseline may be the appropriate neuromuscular blockade level.

Comparison of the effect of Arndt endobronchial blocker and double-lumen tube on one lung ventilation in children

Liu Guoliang, Zhang Jianmin

2017, 38(3):  361-364.  doi:10.3969/j.issn.1006-7795.2017.03.007

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Objective To compare the effect of Arndt endobronchial blocker and double-lumen tube on one lung ventilation in children undergoing thoracic surgery.Methods Fourty children undergoing thoracic surgery were divided into Arndt endobronchial blocker group(Group A,n=20) and double -lumen tube group (Group D,n=20) randomly. Anesthetic management and lung isolation were performed according to a standardized protocol.The changes of MAP,HR,PetCO₂ and Paw were recorded at the following time point,intubation tube before(T₁),intubation tube(T₂),double lung ventilation(T₃),one lung ventilation(T₄).The intubation time,lung collapse time,one lung ventilation time,hypoxemia duration of surgery and adverse event and others were recorded. Results Arndt endobronchial blocker group compare with double-lumen tube group,the Paw and PetCO₂ were lower at the time of one lung ventilation (P<0.05); the intubation time was shorter (P<0.05); the time of lung collapse was longer (P<0.05); and the lung collapse score was higher (P<0.05). Conclusion Compared with inserting double-lumen tube blind, Arndt endobronchial blocker inserted by fiber bronchoscope can provide better one lung ventilation in children undergoing thoracic surgery.

Neuroprotective mechanism of sodium valproate and its application

Liu Quanle, Li Tianfu, Wang Baoguo

2017, 38(3):  365-371.  doi:10.3969/j.issn.1006-7795.2017.03.008

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As an inhibitor of histone deacetylases,sodium valproate is often used in the treatment of neuropsychiatric disorders such as antiepileptic treatment,schizophrenia and bipolar disorder. Sodium valproate can also affect the growth,mutation and apoptosis of neurons and play a neuroprotective effect. The mechanism of neuroprotection of sodium valproate is related to the regulation of neurotransmission and intracellular signaling pathways. Sodium valproate as a neuroprotective drug for the treatment of nerve injury and cognitive impairment remains to be further studied.

Relationship between white blood cell count and intra-operative no-reflow of acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Wu Qingqing, Hua Qi, Xue Song, Zhang Yinghua, Si Jin, Li Jing

2017, 38(3):  372-376.  doi:10.3969/j.issn.1006-7795.2017.03.009

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Objective To investigate the relationship between leukocyte count and Intra-operative no-reflow of acute ST-segment elevation myocardial infarction (STEMI) patients with percutaneous coronary intervention (PCI). Methods Two hundred and sixty-six acute STEMI patients were categorized into group A (without intra-operative no-reflow, n=242) and group B (with intra-operative no-reflow, n=24) according to the intra-operative no-reflow.Clinical data were compared between the two groups, including age,gender,hypertensive history,diabetes mellitus history,smoking status,blood pressure,heart rate,white blood cell count (WBC), low density lipoprotein-cholesterol (LDL-C), fasting plasma glucose (FPG), Killip class,the lesion count, and the incidence of in-hospital major adverse cardiovascular events (MACE) was also compared. Multivariate logistic regression analysis was used to analyze the influencing factors of intra-operative no-reflow of acute STEMI patients treated with primary PCI. Results The leukocyte count, serum creatinine,the incidence of Killip class ≥ three and in-hospital MACE in group B was significantly higher than that in group A. Multivariate Logistic regression analysis showed that,leukocyte count(OR 1.220,95%CI 1.064-1.399,P=0.004), Killip class(OR 4.617,95%CI 1.093-2.095,P=0.037)were independent risk factors of intra-operative no-reflow of acute STEMI patients treated by primary PCI. Conclusion leukocyte count was an independent risk factor of intra-operative no-reflow of acute STEMI patients treated by primary PCI.

Correlation between nutritional status and frailty in hospitalized elderly patients

Lyu Weihua, Wang Qing, Zhao Qinghua, Wu Wei, Zhai Xueliang, Zhang Shaojing, Fu Linlin

2017, 38(3):  377-380.  doi:10.3969/j.issn.1006-7795.2017.03.010

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Objective To explore the relationship between the nutritional status and frailty in hospitalized elderly patients and provide evidence for the nutritional intervention to improve the elderly frailty status. Methods A total of 371 elderly hospitalized patients aged 65 and over were selected and divided into non-frail, pre-frail and frail groups according to the Fried's Cardiovascular Health Study index (CHS index). Mini Nutritional Assessment-Short Form (MNA-SF)and biochemical methods were used to assess the nutritional status of patients, and to analyze the effect of nutritional status on frailty. Results From non-frail group to frail group, the MNA-SF score, hemoglobin, albumin levels decreased gradually and the difference was statistically significant (P<0.01). The malnutrition and risk of malnutrition incidence increased gradually, which were 12.4%, 38.3% and 58.0%, respectively. The difference was statistically significant (P<0.01). Spearman correlation analysis showed that MNA-SF score was negatively correlated with frailty (r=-0.426, P<0.01) and the malnutrition and risk malnutrition were positively correlated with frailty (r=0.405, P<0.01). Logistic regression analysis showed that the malnutrition increased the risk of frailty after adjusting for age, sex, hemoglobin, albumin, comorbidity, multiple drug use and other factors(OR=7.650, 95%CI:3.58=16.3, P<0.01). Conclusion There was a correlation between frail state and nutritional status in hospitalized elderly patients. The malnutrition is the important risk factor of the frail state.

Effects of Songlingxuemaikang (SLXMK) on blood pressure level and glucolipid metabolism in patients with mild essential hypertension

Sun Xipeng, Ding Cuntao, Zhou Yaqun, Zhu Weiwei, Tan Jing, Li Jing, Hua Qi

2017, 38(3):  381-385.  doi:10.3969/j.issn.1006-7795.2017.03.011

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Objective To investigated the effects of Songlingxuemaikang (SLXMK) on blood pressure level and glucolipid metabolism in patients with mild essential hypertension. Methods We enrolled 90 patients with mild essential hypertension in Xuanwu Hospital from January 2016 to December 2016. To evaluate the effects of SLXMK, the 90 patients were randomly assigned at a 2:1 ratio into 2 groups:the SLXMK group (500 mg per capsule, 4 500 mg/d, n=60) and the losartan potassium group (50 mg per table, 50 mg/d, n=30). The total study period was 12 weeks, and all patients maintained a stable diet and life-style during this period.Results After 12 weeks treatment, there was no interaction effect between the treatment methods of blood pressure level and glycometabolism parameters and duration (P>0.05). In the SLXMK group, plasma lipid levels significantly improved and there was interaction effect between the treatment methods and duration (P<0.05).Conclusion In conclusion, SLXMK could effectively improve plasma lipid levels in patients with mild essential hypertension.

Assessment of left ventricular systolic function with automated mitral annular tracking in coronary atherosclerotic heart disease

Li Jing, Gao Jing

2017, 38(3):  386-390.  doi:10.3969/j.issn.1006-7795.2017.03.012

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Objective To examine the clinical application of automated mitral annular tracking for assessing left ventricular systolic function in coronary atherosclerotic heart disease (CAD). The automated mitral annular tracking technology and improved Simpson method and left ventricular angiography method measured the correlation between left ventricular systolic function. Methods The subjects were 110 cases include 47 healthy volunteers and 63 cases of patients with coronary heart disease. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), cardiac output (CO), left ventricular ejection fraction (LVEF), stroke index (SI) and cardiac index (CI) were detected by automated mitral annular tracking and modified Simpson method in the apical window at 4-chamber, respectively. All parameters were compared between the two ways and were determined with the correlation analysis. Thirty cases of CAD patients with left ventricular angiography were associated with automated mitral annular tracking measure for analysis. The left ventricular angiography, automated mitral annular tracking, modified Simpson method were used to measure the difference between left ventricular indicators. Results The r of EDV, ESV, SV, CO, LVEF, SI and CI were 0.838, 0.917, 0.611, 0.579, 0.648, 0.514 and 0.541 between automated mitral annular tracking and modified Simpson method in normal subjects. The r of EDV, ESV, SV, CO, LVEF, SI and CI were 0.875, 0.912, 0.693, 0.664, 0.725, 0.688 and 0.684 between automated mitral annular tracking and modified Simpson method in CAD. The r of EDV, ESV, SV, CO, LVEF, SI and CI were 0.850, 0.920, 0.627, 0.604, 0.711, 0.617 and 0.631 between automated mitral annular tracking and modified Simpson method in all subjects. The r of EDV, ESV, SV, CO, LVEF, SI and CI were 0.842, 0.892, 0.651, 0.614, 0.709, 0.616 and 0.630 between automated mitral annular tracking and left ventricular angiography in 30 CAD. Mitral valve ring automatic tracking technology and modified Simpson method and left ventricular angiography for left ventricular function indicators measuring no statistical difference. Conclusion Automated mitral annular tracking showed a good correlation with modified Simpson method and left ventricular angiography for assessing left ventricular systolic function. Automated mitral annular tracking method and the above two methods had no significant differences in left ventricular systolic function measurement. Automated mitral annular tracking method is a simple and accurate method to evaluate left ventricular systolic function.

Pre-hospital cardiac catheterization laboratory activation by WeChat in community hospital for seamless transfer bypassing emergency department in patients with acute myocardial infarction

Wang Guozhong, Hua Qi, Liu Zijing, Hao Minghui, Xu Rong, Zhang Libin, Chen Wenming, Guo Jincheng

2017, 38(3):  391-396.  doi:10.3969/j.issn.1006-7795.2017.03.013

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Objective To evaluate the impact of pre-hospital cardiac catheterization laboratory (CCL) activation by WeChat group in community hospital without percutaneous coronary intervention (PCI) capability for seamless transfer bypassing emergency department on reperfusion time in ST-segment elevation myocardial infarction (STEMI) patients. Methods A regional collaborative network based on Wechat group was developed, consisting of a PCI center,emergency medical service (EMS) and over 20 Non-PCI capacity hospitals. One hundred STEMI patients with pre-hospital 12-lead electrocardiogram transmission and confirmed by teleconsultation via WeChat, initially seen in a community or non-PCI-capable hospital were enrolled in this retrospectively study from July 2015 to July 2016. Two groups were divided:CCL group had 48 patients taken by EMS and transferred directly to CCL, control group had 52 patients who transferred by EMS to emergency department before CCL arrival. FMC2D times,D2D times and mortality rate in hospital between two groups were compared. Results The baseline clinical data and angiographic features among 2 groups were similar (all P>0.05).Compared to control group, CCL group has shortened FMC2D time (98.0 min vs 151.4 min,P<0.001), shortened D2D time (21.7 min vs 54.0 min,P<0.001). More patients in CCL group meet the standard of guideline for FMC2D time(60.4% vs 25.0%,P<0.001). There was no difference of the Mortality rate (4.17% vs 3.85%, P>0.05) in hospital between two groups. Conclusion Direct transfer of STEMI patients to the CCL for primary PCI was associated with shorter FMC2D and D2D time and results in a greater proportion of patients meeting guideline recommendations.

Effect of high-sensitive C-reactive protein on vascular endothelial function in patients with essential hypertension

Zhou Yaqun, Ding Cuntao, Sun Xipeng, Li Jing, Zhu Weiwei, Hua Qi

2017, 38(3):  397-400.  doi:10.3969/j.issn.1006-7795.2017.03.014

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Objective To investigate the relationship between inflammation factor and endothelial function in essential hypertensive patients. Methods We continuedly enrolled 111 hypertensives from the Xuanwu Hospital Capital Medical University under the strict inclusion criteria. The Endo-PAT2000(Itamar Medical Inc.Caesarea) noninvasive testing equipment of vascular endothelial function measured reactive hyperemia index (RHI) which evaluate vascular endothelial function and arterial stiffness were operated in morning fasting adoption.Patients are divided into two groups:high high-sensitivity C-reactive protein(hs-CRP) group (hs-CRP>2.78,n=42),low hs-CRP group (hs-CRP ≤ 2.78,n=69). We also recorded age, blood pressure, history of smoking, fasting blood check hs-CRP. Results Systolic blood pressure and pulse pressure in high hs-CRP group were significantly higher than in low hs-CRP group.The pearson correlation analysis indicated that, RHI is negatively associated with hs-CRP(r=-0.247, P=0.010).Conclusion RHI gradually declined with the elevation of inflammation factor levels in hypertensives, and there is a linear correlation between them, which hinted that they may be associated with hypertensives endothelial injury. Further longitudinal studies are needed to better understand the causal relationship between endothelial function and inflammatory cytokines.

Effects of glucose and lipid metabolism on vascular endothelial function in patients with essential hypertension

Ding Cuntao, Zhou Yaqun, Sun Xipeng, Li Jing, Zhu weiwei, Hua Qi

2017, 38(3):  401-405.  doi:10.3969/j.issn.1006-7795.2017.03.015

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Objective To investigate the effects of glucose and lipid metabolism on endothelial function in patients with essential hypertension.Methods A total of 111 patients with essential hypertension were consecutively enrolled in this study from January 2016 to December 2016 in Xuanwu Hospital. All the patients were tested for biochemical indexes and vascular endothelial function tests to get blood glucose, blood lipid and reactive hyperemia index. According to the size of reactive hyperemia index (RHI) is divided into RHI normal group (n=63, RHI>1.67) and low RHI group (n=48, RHI<1.67). Application of correlation analysis and multiple linear regression to analyze the correlation between blood glucose and blood lipid and RHI in patients with essential hypertension. Results The levels of age, gender, smoking rate and other indicators were no statistical difference in the two groups (P>0.05). The levels of systolic blood pressure (SBP), glucose (GLU), glycosylated hemoglobin (HbA1c), low density lipoprotein-cholesterol (LDL-C) in low RHI group were significantly higher than those in normal RHI group (P<0.05). Pearson correlation analysis showed that RHI was negatively correlated with SBP, GLU, HbA1c and LDL-C (P<0.05). Multivariate linear regression analysis showed that RHI was negatively correlated with SBP, GLU and LDL-C. Conclusion Hyperglycemia and hyperlipidemia increase the vascular endothelial dysfunction in patients with essential hypertension.

Research progress in the association between frailty and cognitive impairment

Hao Dandan, Li Fang

2017, 38(3):  406-410.  doi:10.3969/j.issn.1006-7795.2017.03.016

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Rapid demographic changes with increasing percentage of old age, particularly in our country, will lead to larger number of elderly being at risk of dependent. Moreover, larger economical and medical burden will be brought for caring more and more dependent older people. Two of the most common causes of dependent are frailty and cognitive impairment. A number of studies have showed that frailty increases the risk of future cognitive decline and that cognitive impairment increases the risk of frailty. It is suggested that cognition and frailty interacted within a vicious cycle associated with ageing. This article reviews frailty, cognitive impairment, and the association between frailty and cognitive impairment. Some of the mechanisms that potentially underlying this relationship is discussed as well.

Expression and cellular distribution of dopamine receptors in the rat colonic submucosal plexus

Zhang Yue, Li Yun, Zhu Jinxia, Zhao Wenming

2017, 38(3):  411-416.  doi:10.3969/j.issn.1006-7795.2017.03.017

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Objective Dopamine (DA) plays an important role in the regulation of intestinal motility, secretion and mucosal barrier by binding to its receptors. It has been shown that submucosal neurons are involved in the regulation effect of DA on the mucosa function. However the expressions of DA receptors in submucosal neurons are not clear. The aim of the present study is to investigate the distribution of DA receptors in vasoactive intestinal peptide (VIP) neurons and cholinergic neurons in the submucosa. Methods The mRNA and protein expression of DA receptors was measured by RT-PCR and Western blotting. Immunofluorescent double labeling of DA receptors with submucosal VIP neurons and cholinergic neurons were observed under confocal laser scanning microscope. Results Both the mRNA and protein of DA receptors D₁, D₂ and D₅ were expressed in the colonic submucosal layer. In the submucosal plexus, D₁ positive VIP-positive neurons accounting for 58.94%±2.245%, D₂ for 52.03%±9.384%, and D₅ for 86.21%±2.902%. The number of D₅ positive neurons was significantly higher than that of D₁ and D₂. In the submucosal plexus, D₁ positive cholinergic neurons accounted for 87.75%±7.307%, D₂ for 88.50%±8.761%, and D₅ for 89.25%±10.75%, and the distribution of the three types of DA receptors in the cholinergic neurons had no significant difference. Conclusion DA receptors D₁, D₂ and D₅ are expressed in the submucosal layer of the rat colon. And they all are distributed in the submucosal VIP and cholinergic neurons, and D₅ expression was higher than D₁ and D₂ in VIP-positive neurons. Our study provides a morphological basis for the regulation of DA on the colonic mucosal function.

Cannabinoid receptor 1 mediated the migration of human neutrophil-like cell line dHL60

Fan Xiaoting, Tian Lei, Yang Lin, Li Liying

2017, 38(3):  417-422.  doi:10.3969/j.issn.1006-7795.2017.03.018

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Objective To investigate the effect of cannabinoid receptors (CBs) on migration of human neutrophil-like cell line dHL60. Methods HL60 cell was cultivated in vitro and stimulated by dimethylsulphoxide (DMSO) to differentiate into neutrophil-like cells (dHL60), RT-PCR was used to detect the CD11b mRNA expression as a differentiation marker. Western blotting and agarose gel electrophoresis were used to detect the expression of CB1 and CB2. Boyden chamber was used for cell migration assay. Filamentous actin (F-actin) stained with phalloidin was examined by high content analysis. Results In this study, we present evidence that dHL60 significantly expressed CB1 and CB2; the treatment of ACEA (agonist of CB1) caused an increase in dHL60 migration and F-actin remodeling, the pharmacological inhibition of CB1 markedly attenuated ACEA-induced migration; the treatment of JWH133 (agonist of CB2) has no effect on migration and F-actin remodeling. Conclusion CB1 mediated the migration of human neutrophil-like cell line dHL60.

CM-DiI labeling human bone marrow mesenchymal stem cells and was used in identifying BNDF expressing cell after transplantation

Zhao Chunsong, Zou Haiqiang, Li Xiaobo, Yan Xiaoming, Guan Yunqian, Zhang Yu

2017, 38(3):  423-430.  doi:10.3969/j.issn.1006-7795.2017.03.019

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Objective To observe whether the CM-DiI carried by human bone marrow mesenchymal stem cells (BM-MSC) after labeling will contaminate the surrounding cells in vitro and in vivo and be used in identifing brain derived neurotrophic factor (BDNF) production. Methods The human bone marrow derived mesenchymal stem cells were labeled by CM-DiI at different concentrations and the labeling percentages were observed. The CM-DiI labeled human BM-MSCs were co-cultured with green fluorescence protein (GFP) labeled 293T cell for 7 days. Then the contamination of 293T cells by CM-DiI was observed. The cerebral ischemia rat model received CM-DiI labeled human BM-MSCs intravenously transplantation, the overlapping of red fluorescence with host neurons and brain derived neurotrophic factor BDNF in the host brain were observed. Results The human BM-MSCs could be successfully labeled by CM-DiI at 1 000, 200,100, and 20 nmol/L. The concentrations of 1 000 and 200 nmol/L reached more than 98% labeling percentages which were significantly higher than that labeled by 100 and 20 nmol/L(P<0.01). After 7 days co-culture of GFP labeled 293T cells, the CM-DiI labeled human BM-MSCs didn't contaminate the 293T cells. Three days after transplantation, the CM-DiI labeled human BM-MSCs migrated into the infarct area of brain ischemia rats, but didn't bring any red fluorescence into the host cells. CM-DiI labeled human BM-MSCs could be double labeled by BDNF. Conclusion CM-DiI could label human BM-MSCs effectively. The 200 nmol/L CM-DiI labeled human BM-MSCs will not contaminate the surrounding cells both in vitro and in vivo. The CM-DiI (200 nmol/L) labeling can be used in identifying transplanted BM-MSCs which are expressing BDNF.

Alloantigen immune tolerance and its mechanism in mice immunized with the ultraviolet radiation immature dendritic cells

Guo Yixian, Zhang Lanfang, Sun Xuejing, Wan Suigui, Xia Changqing

2017, 38(3):  431-438.  doi:10.3969/j.issn.1006-7795.2017.03.020

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Objective To induce alloantigen immune tolerance between C3H mice and Balb/c mice by infusing the ultraviolet B(UVB) radiation immature dendritic cells (imDC) and and study the immunological mechanisms of this process.Methods ①The authors induced alloantigen tolerance in C3H mice (H-2k) by intravenous injecting ultraviolet B (UVB) irradiated Balb/c immature dendritic cells (UVB-Balb/c imDC) derived from the cultures of Balb/c bone marrow cells. ②Detection of immune tolerance induced regulatory T cells, interleukin-10 (IL-10) and interferon-γ (IFN-γ) in mice in order to study the tolerance mechanism. Results ①C3H mice immunized with UVB-Balb/c imDC can produce immune tolerance to Balb/c antigens and can not produce anti-Balb/c antibody. ②C3H mice immunized with UVB-Balb/c imDC can not clear the Balb/c spleen cells in vivo. ③The T cells of C3H mice immunized with UVB-Balb/c imDC can secrete more IL-10 and produce more FOX-P3⁺ regulatory T cells than the control group in vitro. Conclusion ①Immunization of C3H mice with UVB-Balb/c imDC allows C3H mice to fully tolerate Balb/c antigen. ②The possible cause of immune tolerance to Balb/c antigens in C3H mice is due to the increased secretion of IL-10 from T cells and the production of more FOX-P3⁺regulatory T cells.

Study on the relationship of hypertension in older Han adults with leptin receptor gene rs1137100 and rs1137101 polymorphism

Wu Jinghuan, Zhuo Qin, Tian Yuan, Ma Yanning, Cui Lu, Piao Jianhua, Yang Xiaoguang

2017, 38(3):  439-445.  doi:10.3969/j.issn.1006-7795.2017.03.021

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Objective To explore the relationship of hypertension in older Han adults with leptin receptor gene rs1137100 and rs1137101 single nucleotide polymorphism (SNP). Methods The genotypes of rs1137100 and rs1137101 and the allele frequency of 267 older Han adults with hypertension and 255 healthy subjects were determined by the Taqman method. Blood concentrations of lipids, fasting serum glucose, leptin and insulin of those subjects were measured. Association of genotypes of leptin receptor gene SNPs with hypertension was analyzed. Results The hypertension group had higher body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), serum total cholesterol (TC) and the low density lipoprotein cholesterol (LDL-C) levels than that of the healthy group, while the leptin level was significantly lower than that of the healthy group. The GG, AA, GA genotypes distribution and the allele frequency of rs1137100 and rs1137101 were similar between the two groups. In rs1137100, GG and GA genotype had lower TC and LDL-C level than that of AA genotype. In rs1137101, GG and GA genotype had lower TC and LDL-C level than that of AA group; GA+AA group had higher TC and LDL-C level than that of GG group. When comparing with the GG genotypes, the Logistic analysis showed that GA and AA genotypes in rs1137100 had similar risk for hypertension and the OR values were 0.88 (95%CI:0.59-1.28) and 1.15 (95% CI:0.78-1.70), respectively.The GA and AA genotypes in rs1137101 had similar risk for hypertension when comparing with the GG genotypes, and the OR values were 0.90 (95% CI:0.59-1.38) and 1.11(95% CI:0.72-1.71), respectively. Conclusion The rs1137100 and rs1137101 polymorphism are not significantly associated with the prevalence of hypertension in older Han adults.

Analysis of relationship between primary hyperparathyroidism and thyroid diseases

Xiu Lei, Jiang Tao, Fu Yueyue

2017, 38(3):  446-450.  doi:10.3969/j.issn.1006-7795.2017.03.022

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Objective In order to investigate the occurrence of thyroid diseases in primary hyperparathyroidism (PHPT), and analyze the relationship between them. Methods We collected 84 admission cases which were diagnosed as PHPT from 2010 to 2014 in Beijing Shijitan Hospital of the Capital Medical University. Then we analyzed the morbidity of concomitant thyroid diseases and thyroid function. Results Totally 84 cases were diagnosed as PHPT both by surgical and pathological diagnosis. The largest thyroid disease was nodular goiter (62/74),which included 25 single thyroid nodule (33.8%),37 multiple thyroid nodules (50.0%). Besides, 12 cases accompanied medullary thyroid carcinoma (16.2%). Patients with PHPT had low level of total tetraiodothyronine (TT4) and free tetraiodothyronine (FT4)(P<0.05). TT4 and FT4 negatively correlated with serum parathyroid hormone (PTH) (P<0.05). Conclusion Concomitant thyroid diseases in patients with PHPT are arresting. Patients with PHPT have low level of TT4 and FT4, which may be closely related to PTH. We recommend the routine use of ultrasound in patients with PHPT to detect any concomitant thyroid diseases and thus determine the best surgical strategy.

Clinical application of concentrate growth factors combined with bone substitute in site preservation of maxillary anterior region

Lin Shichen, Duan Shaoyu, Zhu Jing, Song Wanhong, Yang Lian, Sun Dandan

2017, 38(3):  451-456.  doi:10.3969/j.issn.1006-7795.2017.03.023

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Objective To evaluate the clinical effect of site preservation by using concentrate growth factors (CGF) combined with Bio-oss bone powder in maxillary anterior region. Methods Thirty-two maxillary anterior teeth of 26 patients that should be extracted were randomly divided into two groups. For CGF group(16 cases), CGF combined with Bio-oss was implanted into teeth extraction socket, then covered the socket with CGF membrane; for control group(16 cases), teeth extraction socket was placed with hemostatic sponge after scoraping. Cone beam computed tomography (CBCT) should be taken after 6 months, then compared with preoperative, observed and measured the change of width and height of the alveolar bone at extraction site. Results In CGF group, the heights of labial and palatal bone plates between 6 months after surgery and preoperative were no statistically significant (P>0.05), and the widths between 6 months after surgery and preoperative were statistically significant (P<0.05). In control group, the heights of labial and palatal bone plates and the widths between 6 months after surgery and preoperative were statistically significant (P<0.05). The differences of changes between the two groups were statistically significant (P<0.05). Conclusion CGF combined with Bio-oss being used for preservation of teeth extraction site, which may effectively keep the width and height of alveolar ridge, it is favorable for implanting and repairing.

The feasibility of bispectral index for monitoring the depth of anesthesia in patients undergoing craniotomy: comparison of non-intracranial tumor surgery

Zhang Haijing, Jian Minyu, Zhang Liyong, Jing Longnian, Peng Yuming, Han Ruquan

2017, 38(3):  457-460.  doi:10.3969/j.issn.1006-7795.2017.03.024

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Objective To compare the difference of bispectral index (BIS) between intracranial tumor and non-intracranial tumor patients under general anesthesia with the same target-controlled infusion (TCI) propofol and to investigate the feasibility of BIS to monitor the sedation level of intracranial tumor patients under general anesthesia.Methods Twenty-five patients scheduled for elective intracranial tumor resection by under general anesthesia were enrolled in the study, ASA I-Ⅲ. And 25 subjects with spinal tumors were included as controls. We placed BIS sensor on the frontal area. The patients were anesthetized with the same TCI propofol and BIS values were collected before the induction of anesthesia, after incision, craniectomy, dura opening,during tumor resection,hemostasis,spontaneous eye opening. We compared the difference of BIS between intracranial tumor and non-intracranial tumor group. Results At the same Cp,BIS values were not statistically different between intracranial tumor group and non-intracranial tumor group:before induction of anesthesia(93.0±4.2 vs 92.8±4.1);after incision(39.3±7.28 vs 38.6±6.7); craniotomy (39.0±7.2 vs 39.1±6.1); dura opening(37.4±7.1 vs 39.7±7.4); during tumor resection (38.8±8.2 vs 39.9±5.5); hemostasis(39.9±11.0 vs 41.5±5.2); spontaneous eye opening(81.2±5.8 vs 80.8±4.6). Conclusion The BIS values can accurately reflect the actual level of consciousness of intracranial tumor patients under general anesthesia with TCI propofol.

Study of the correlation between biomarkers of Alzheimer's disease in aqueous humor and age in normal people

Lu Yan, Li Zhen, Wu Yue, Zhang Jian, Jiang Huizhong, Wang Ningli

2017, 38(3):  461-464.  doi:10.3969/j.issn.1006-7795.2017.03.025

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Objective To evaluate the correlation between biomarkers of Alzheimer's disease in aqueous humor and age in normal people. Biomarkers of Alzheimer's disease including amyloid β(Aβ), Tau protein, amyloid precursor protein(APP).Methods Aqueous humor was obtained from 116 patients undergoing routine cataract surgery and was divided into 4 groups as follows:A group (age<60 years old,n=25),B group (age from 60 to 69 years old, n=30),C group (age from 70 to 79 years old, n=32), D group (age ≥ 80 years old, n=29).Quantitative analysis of Aβ40,Aβ42,Tau protein, APP in the aqueous humor was evaluated via Elisa method.Results There was no significant difference in the expression levels of Aβ40,Aβ42, Tau, APP among the 4 groups(P>0.05).Conclusion The content of Aβ40,Aβ42, Tau, APP in aqueous humor had no association with age in normal people.

Comparison of drug-eluting stents and cutting balloon in the management of in-stent restenosis

Sun Shuai, Zou Meiping, Liu Qiang, Weng Jianxin

2017, 38(3):  465-469.  doi:10.3969/j.issn.1006-7795.2017.03.026

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Objective To evaluate and compare the efficacy of drug-eluting stents (DES) and cutting balloon (CB) for the management of in-stent restenosis (ISR). Methods The immediate and (6.0±1.4) months follow-up angiographic outcomes of 124 patients with ISR who were treated by drug eluting stents and cutting balloon were analyzed in this retrospective study. Results Baseline characteristics and angiographic profile were similar between these two groups. There was no statistically significant difference between two groups both in acute post procedure minimum lumen diameter (2.54±0.45 vs 2.67±0.48 mm, P>0.05) and diameter stenosis (23.5% vs 21.8%, P>0.05) between DES and CB groups. At six-month follow-up study, however, the DES group showed significantly larger in the minimum lumen diameter (1.86±0.63 mm) than the CB group(1.34±0.71 mm) (P<0.01), and the diameter stenosis in the DES group was lower than that in the CB group(39.2% vs 47.8%,respectively,P<0.05).Furthermore, the recurrent restenosis rate as well as lumen loss in the DES group (4.1% and 0.52±0.48 mm, respectively) were significantly lower compared with those of CB group (9.8% and 0.74±0.53 mm, respectively with P<0.01). Conclusion Drug-eluting stents is comparable with cutting balloon in terms of immediate outcomes but superior to the latter in terms of efficacy at 6-month follow-up.

Prognostic value of fragmented QRS complexes in patients with acute anterior myocardial infarction treated with percutaneous coronary intervention

Gao Dequan, Jia Wenfang, Xie Yachuang, Liu Mingtao, Dong Xinbo, Fang Xuehua, Li Xiaotao

2017, 38(3):  470-474.  doi:10.3969/j.issn.1006-7795.2017.03.027

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Objective To evaluate the prognostic value of fragmented QRS complexes in patients with acute anterior myocardial infarction treated with percutaneous coronary intervention.Methods A total of 213 patients with acute anterior myocardial infarction treated with percutaneous coronary intervention were included in this retrospective study. Patients were divided into 2 groups according to the presence or absence of fragmented QRS complex at discharge. Fragmented QRS complexes refer to various RSR' patterns (≥ 1 R' or notching of S wave or R wave) with or without Q wave in 2 or more contiguous leads corresponding to a major coronary artery territory on the routine 12-lead electrocardiograms (ECGs).Results The follow-up period was similar in both groups (P=0.319). During the 1-year follow-up, the incidence of major composite endpoint event was significant difference between the two groups in this study (P=0.001). The rate of all-cause death was 7.48% for the fragmented QRS complex group and 0.94% for the non-fragmented QRS complex group (P=0.019). Cardiac death rate was 5.61% in the fragmented QRS complex group and 0.94% in the non-fragmented QRS complex group(P=0.098). The incidence of acute coronary syndrome and coronary artery revascularization were similar between the two groups during 1-year follow-up. The incidence of heart failure was also similar between the two groups.Conclusion In patients with acute anterior myocardial infarction who underwent percutaneous coronary intervention, the incidence of major composite endpoint event was significantly higher in patients with fragmented QRS complex than those without fragmented QRS complex. The all-cause mortality rate was significantly increased in patients with fragmented QRS complex.