Table of Content

21 July 2017, Volume 38 Issue 4

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Progress in human ovarian tissue cryopreservation and transplantation

Li Yanglu, Ruan Xiangyan, Alfred O. Mueck

2017, 38(4):  485-491.  doi:10.3969/j.issn.1006-7795.2017.04.001

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The survival rate of cancer patients is increasing with the development of cancer treatment methods. However, gonadotoxic therapies have an irreversible impact on ovarian function. Effective fertility protection and improving the level of reproductive health have become a crucial problem that health care providers confront. Improvements of oocyte and embryo cryopreservation, and ovarian tissue cryopreservation and transplantation provide feasible options for women's fertility protection. This review discusses the common fertility protection methods, focusing on the important role of human ovarian tissue cryopreservation and transplantation for fertility protection.

Clinical predictive value of anti-Müllerian hormone and inhibin B in polycystic ovary syndrome

Wang Husheng, Ruan Xiangyan, Li Xue, Zhao Yue, Li Yanglu, Gu Muqing, Du Juan, Song Jinghua, Jin Fengyu, Alfred O. Mueck

2017, 38(4):  492-497.  doi:10.3969/j.issn.1006-7795.2017.04.002

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Objective The present study aimed to investigate the effects of inhibin B (INHB), anti-Mullerian hormone (AMH) and various endocrine indicators in patients with polycystic ovary syndrome (PCOS) and control group, and to explore the clinical predictive value of INHB and AMH and compare the characteristics of endocrine indexes in two groups.Methods A total of 567 PCOS patients and 53 normal subjects as a control group were enrolled. Fasting blood samples for hormones ［anti-Müllerian hormone(AMH), inhibinB(INHB), follicle-stimulating hormone (FSH),luteinizing hormone (LH), estradiol (E₂) and testosterone (T)］ were measured. Results The AMH concentration, LH, T and body mass index (BMI) in PCOS group were significantly higher than those in control group. The E₂ and FSH/LH were lower than those in control group, and the difference was statistically significant (P<0.05). The concentration of INHB in PCOS group was higher than that in control group, FSH level was lower than that in control group, and there was no significant difference between the two groups (P> 0.05). Receiver operating characteristic (ROC) curve analysis of serum AMH and INHB in prediction of PCOS showed that the area under the ROC curve (AUC) value of the serum AMH level was 0.814, with a cut-off value of 4.84 μg/L. The sensitivity and specificity were 84.48% and 69.81%, respectively. The AUC value of serum INHB was 0.575, with a cut-off value of 70.8 ng/L, and the sensitivity and specificity were 53.97% and 67.92%, respectively. AMH and INHB combined prediction (Parallel Test) polycystic ovary syndrome sensitivity was 90.29%, specificity was 54.92%. Conclusion The cut-off value of AMH predicted PCOS was 4.84 μg/L, and the cut-off value of INHB predicted PCOS was 70.8 ng/L. The sensitivity of combined detection (Parallel Test)of AMH and INHB was higher than that of AMH single test. The prediction of PCOS will have a very important guiding significance.

Analysis of endocrine and metabolic characteristics in patients with polycystic ovary syndrome in Beijing

Yin Dongmei, Ruan Xiangyan, Zhao Yue, Alfred O. Mueck

2017, 38(4):  498-503.  doi:10.3969/j.issn.1006-7795.2017.04.003

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Objective To analyze the clinical characteristics, sex hormones and lipid metabolism in patients with polycystic ovary syndrome (PCOS) in Beijing. Methods Totally 142 untreated PCOS patients were enrolled, and 48 age-matched healthy women were included as control group. Patients were diagnosed and grouped using the Rotterdam 2003 criteria. Based on the National Institutes of Health (NIH) guidelines, patients with PCOS were classified as: subtype-1, androgen excess+ ovulatory dysfunction (AE+OD)(n=40); subtype-2, androgen excess + polycystic ovarian morphology (AE+PCO)(n=10); subtype-3, ovulatory dysfunction + polycystic ovarian morphology (OD+PCO) (n=32); subtype-4, androgen excess + ovulatory dysfunction + polycystic ovarian morphology (AE+OD+PCO)(n=60). The screening panel consisted of a physical examination, weight and height measurement, ultrasonography of the ovaries, and measurements of hormone, glucose, lipid, and insulin resistance. Besides, endocrine and metabolic parameters were measured in all patients. Results In the PCOS group, body mass index (BMI), waist and hip ratio (WHR), total testosterone (T), luteinizing hormone (LH), LH/follicle stimulating hormone(FSH) ratio were higher than that of the control group with statistically significant difference (P<0.05). Total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), triglycerides (TG), apolipoprotein B (ApoB) levels, fasting insulin (INS), homeostatic model assessment of insulin resistance (HOMA-IR) and the ratio of ApoB to ApoA were significantly higher than those in the control group (P<0.05). Meanwhile, high density lipoprotein-cholesterol (HDL-C) and apolipoprotein A (ApoA) level were lower than the control group with statistically significant difference (P<0.05). The BMI, WHR, T and LDL-C of subtype-1 were higher compared to subtype-3, and TC and LDL-C were higher than subtype-2; the BMI, T and LDL-C of 4 subtypes were higher than the three other subtypes and T, LH and LH/FSH were higher than subtype-2 with statistically significant difference (P<0.05). There was no significant difference between subtype-2 and subtype-3 (P>0.05). Conclusion The incidence of central obesity, lipid metabolism disorders, insulin resistance and hyperinsulinemia in PCOS patients in Beijing was significantly higher than that in healthy women. Among the four subtypes of PCOS patients, this phenomenon maybe is most significant in subtypes 1 and 4 subgroups with both ovulation abnormality and hyperandrogenism, while subtypes with normal menstrual cycle or non-hyperandrogenic have more moderate metabolic changes, Distinction of the four subtypes should be made during clinical treatment and targeted therapy should be applied correspondingly.

Effects of primary ovarian insufficiency on glucose and lipid metabolism and biochemical parameters in patients

Li Xue, Ruan Xiangyan, Wang Husheng, Li Yanglu, Zhao Yue, Gu Muqing, Du Juan, Song Jinghua, Jin Fengyu, Alfred O. Mueck

2017, 38(4):  504-508.  doi:10.3969/j.issn.1006-7795.2017.04.004

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Objective To compare the endocrine and metabolic parameters of primary ovarian insufficiency (POI) patients with menopausal women and normal control group, and to analyze the differences of the endocrine indicators, glucose and lipid metabolism indicators and other biochemical indicators between POI group, menopausal women and normal control group,in order to increase the attention to the health status of patients with POI. Methods A total of 108 patients diagnosed with POI, 114 menopausal women and 63 normal women. Sex hormones, glucose and lipid metabolism, and other biochemical indicators were compared. The error of the relevant detection kit and the batch error is less than 3% to 5%. Results There was no significant difference in body mass index (BMI) among the three groups (P>0.05). There were significant differences between follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E₂) (P< 0.05 ). The levels of total cholesterol (TC), fasting insulin (FINS) and homeostasis model assessment of insulin resistance (HOMA-IR) in the POI group were significantly higher than those of the control group (P<0.05 ), high density lipoprotein-cholesterol (HDL-C) and testosterone (T) levels were significantly lower than those of the control group (P<0.05). Conclusion In this study, TC, FINS, HOMA-IR and HDL-C of POI patients had reached menopausal women (P<0.05). The clinicians should intervene and treat POI patients as soon as possible.

Investigation and analysis of sexual status of perimenopausal women in Beijing and its surrounding areas

Jin Fengyu, Ruan Xiangyan, Alfred O. Mueck, Liu Yulan, Du Juan

2017, 38(4):  509-514.  doi:10.3969/j.issn.1006-7795.2017.04.005

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Objective To investigate the prevalence and types of sexual dysfunction among perimenopausal women in Beijing and its surrounding areas, and to analyze the influencing factors of sexual function in perimenopausal women. Methods This was a cross-sectional study. The patients from Beijing and the surrounding areas were investigated with the Female Sexual Function Index Scale (FSFI) and Kupperman scale and self-made questionnaire. Results A total of 407 questionnaires were granted, and 308 valid questionnaires were collected and statistically analyzed. The effective rate of recovery was 75.6%. The overall incidence of menopausal female sexual dysfunction in the surrounding area of Beijing is 84.1%, sexual desire disorder, sexual arousal disorder, vaginal lubrication, orgasm, sexual pain and sexual satisfaction rate were 95.5%, 69.8%, 60.7%, 66.9%, 69.5% and 69.2%. Different age groups of perimenopausal women in 6 dimensions of sexual function index scores were significantly different (P<0.05). Conclusion The main factors affecting sexual function of perimenopausal women are age, menopause, hormone supplement, economic level and health status.

Endocrine characteristics of diminished ovarian reserve in Chinese women with polycystic ovary syndrome

Jin Jing, Ruan Xiangyan, Hua Lin, Tian Xuanxuan, Li Yanglu, Wang Lijuan, Zhao Yue, Alfred O. Mueck

2017, 38(4):  515-520.  doi:10.3969/j.issn.1006-7795.2017.04.006

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Objective To assess the prevalence of diminished ovarian reserve (DOR) in patients with polycystic ovary syndrome (PCOS) in China, and to investigate the endocrine characteristics of these patients.Methods Totally 338 PCOS women and 68 simple DOR women, who came to Department of Gynecological Endocrinology in Beijing Obstetrics and Gynecology Hospital between January 2015 and January 2017 were recruited.Age and menstruation of these patients were recorded. Body height, body weight, waist circumference, hip circumference, basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), testosterone(T),anti-Müllerian hormone (AMH) and baseline antral follicle count (bAFC) of these patients were measured. The differences of indices between PCOS with DOR,simple PCOS and simple DOR were analyzed with analysis of variance. Results (1) The prevalence of DOR in our Chinese PCOS patients was 16.9%.(2)In PCOS with DOR patients, the prevalence of basal FSH value>10IU/L, FSH/LH ratio>3,basal estradiol (E₂)>80 pg/mL and baseline antral follicle count (bAFC) fewer than four were 38.6%,35.1%,35.1% and 36.8%,respectively. The basal FSH and testosterone in PCOS with DOR patients were different from both simple PCOS and simple DOR patients(P<0.05). The basal estradiol, FSH/LH ratio,AMH in PCOS with DOR patients had significant differences from simple PCOS patients(P<0.05),while had no difference from simple DOR patients. (4)In simple PCOS patients,AMH had a positive correlation with testosterone(P<0.01).In PCOS with DOR patients, AMH had a negative correlation with FSH(P<0.01),while had a positive correlation with LH(P<0.01).In simple DOR patients, AMH had a negative correlation with age,FSH,LH and FSH/LH ratio(P<0.01).Conclusion The endocrine characteristics of PCOS with DOR patients are different from simple PCOS patients as well as simple DOR patients.

Relationship between progesterone-regulated microRNAs and breast cancer

Wang Lijuan, Yang Chun, Gu Muqing, Pierre Hardy, Ruan Xiangyan, Alfred O. Mueck

2017, 38(4):  521-525.  doi:10.3969/j.issn.1006-7795.2017.04.007

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microRNAs(miRNAs) are a class of small non-coding RNAs that regulate the expression of multicellular eukaryotic genes at post-transcriptional levels. miRNA mutations or abnormal expressions are associated with various human cancers. miRNAs can function as tumour suppressors and oncogenes. Progesterone receptors (PR) mediate response to progestins in the normal breast and breast cancer. Progesterone exposure is a recognized risk factor for postmenopausal breast cancer, especially synthetic progesterone. Several studies have shown that hormonal regulated miRNAs have an important role in hormone receptor mediated gene regulation. Progesterone regulated miRNAs can affect the expression of progesterone receptors and their activities. Therefore, further studies are needed to dissect the gene regulations and molecular mechanisms related to progestine, PR and miRNAs. The diagnostic, therapeutic and prognostic potential of these miRNAs in breast cancer should be further evaluated.

Current research studies of the relationship between miR-181a and breast cancers

Gu Muqing, Yang Chun, Wang Lijuan, Pierre Hardy, Jia Chanwei, Ruan Xiangyan

2017, 38(4):  526-529.  doi:10.3969/j.issn.1006-7795.2017.04.008

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MicroRNAs (miRNAs) are highly conserved non-coding single stranded RNAs. miRNAs participate in fundamental biological processes and pathophysiological processes by silencing their target mRNAs expression through binding to their 3' untranslated regions (3'-UTRs). Emerging studies have shown that alterations of miR-181a levels are involved in the initiation, progression and metastasis of human cancers. Some studies have indicated that miR-181a serves as tumor suppressors, and others have revealed the oncogenic roles of miR-181a. A growing number of evidence has linked the pathological role of miR-181a to breast cancer. Here, we specifically summarize the various published data of the links between miR-181a and breast cancers, and to explain the potential clinical application of miR-181a. miR-181a may be used as a clinically diagnostic biomarkers of breast cancer for early stage diagnosis, for evaluation of the chemotherapy sensitivity, and for directing the clinical treatment in patients.

Epidemiological study of “ESKAPE” infections in neurosurgery wards

Liu Jingzheng, Zheng Guanghui, Lyu Hong, Chen Yan, Ma Ruimin, Zhang Guojun

2017, 38(4):  530-534.  doi:10.3969/j.issn.1006-7795.2017.04.009

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Objective To explore the epidemiological features of six kinds of severe drug-resistant bacteria in patients with neurosurgery-induced infection in 2012-2016.Methods Six kinds of antibiotic resistant bacteria isolated from cerebrospinal fluid in patients with neurosurgery were collected from January 2012 to December 2016 in Beijing Tiantan Hospital Affiliated to Capital Medical University, and their epidemiological characteristics and drug resistance were analyzed. Results In the past 5 years, 2 250 isolates of pathogens in cerebrospinal fluid culture were isolated. Among them, the separation rate of six strains of pathogenic bacteria is 23.2%, accounting forKlebsiella pneumoniae, Acinetobacter baumannii and Staphylococcus aureus was higher than that of Enterococcus faecalis, Pseudomonas aeruginosa and Enterobacter spp. The resistance rate of MRSA was higher than 40.0%, and the resistance rate of carbapenem to Klebsiella pneumoniae and Acinetobacter baumannii was higher than 40.0%. Conclusion In the period of 2012-2016, six kinds of common nosocomial infection pathogens were more resistant to iatrogenic infection in the neurosurgical patients, especially the proliferation of drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus(MRSA), vancomycin resistant Enterobacteriaceae (VRE) and (carbapenem resistant Enterobacteriaceae (CRE), and the clinical selection of antibiotics for neurosurgery. The ESKAPE infection in neurosurgery ward is bad.

Study on the serum cystatin C in the elderly population with metabolic syndrome

Zhang Kun, Zhang Chanyuan, Chen Jian, Lu Binghuai

2017, 38(4):  535-540.  doi:10.3969/j.issn.1006-7795.2017.04.010

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Objective To investigate the change of serum cystatin C level and its relationship with metabolic syndrome (MS) main components and homeostasis model assessment of insulin resistance (HOMA-IR) in elderly population with MS. Methods A total of 404 Beijing elderly inhabitants (>60 years, age ranged 60-88 years) and 60 control persons (≤60 years, age ranged 35-60 years) without MS components were enrolled into the present study, and the data including MS components, fasting insulin (FINS), serum creatinine (SCr) and cystatin C were tested and some parameters such as HOMA-IR and estimated glomerular filtration rate (eGFR) were measured; according to MS criteria defined by Chinese Diabetes Society, the elderly subjects were divided in to MS and non-MS, and the groups with abnormal MS components, respecitively. Results Cystatin C indicated no significant differences between male and female(P>0.05), and higher in MS than in non-MS(1.10±0.25 vs 1.02±0.25, P<0.01). Furthermore, with the graded increase of MS components, serum cystatin C showed a progressive rise, with its sensitivity higher than that of SCr and eGFR; In addition, the multiple regression (Stepwise method) showed that the body mass index (BMI), triglyceride (TG) and HOMA-IR were also the independent influencing factors of serum cystatin C. Conclusion With the deterioration of the metabolic abnormality of the study population, serum cystatin C showed an increasing tendency and it may be taken as a screening marker of early nephropathy and a predicting index of cardiovascular disease (CVD) in MS population.

Infectious diseases survey of estimated glomerular filtration rate in patients with liver cirrhosis and liver cancer of Beijing Youan Hospital, Capital Medical University from 2015 to 2016

Sun Haiqing, Lou Jinli

2017, 38(4):  541-545.  doi:10.3969/j.issn.1006-7795.2017.04.011

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Objective To analyze renal insufficiency and related factors in patients with liver cirrhosis and liver cancer, and to explain the importance of focusing on renal function in patients with cirrhosis, providing scientific basis for clinical medication. Methods The data of 4 040 patients with liver cirrhosis and liver cancer were analyzed statistically from November 2015 to November 2016 in Beijing Youan Hospital, Capital Medical University. Estimated glomerular filtration rate (eGFR) calculated by the formula recommended by The Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI) was used to assess the impaired renal function in the target population and the general factors affecting renal function was also analyzed. Results Patients with liver cancer accounted for 52% of 4 040 patients, and patients with liver cirrhosis accounted for 48%. Male patients were more than female patients, accounting for 79%, and the patients over the age of 50 were in majority, accounting for 79.6%. Of the 4 040 patients, 18.8% had varying degrees of renal insufficiency (eGFR<90 mL·min^-1·1.73 m^-2), approximately 68.6% of patients had mild renal insufficiency (60 mL·min^-1·1.73 m^-2-1·1.73 m^-2),23.5% had moderate renal insufficiency (30 mL·min^-1·1.73 m^-2-1·1.73 m^-2),7.9% of patients had severe renal insufficiency (eGFR<30 mL·min^-1·1.73 m^-2). 22.7% of patients over 50 years old showed renal insufficiency, the percentage was significantly higher than that under 40 years old (1.9%) and that between 40 years old and 50 years old (7.3%), the difference among the three groups was statistically significant (P<0.001). The proportion of renal insufficiency in male patients was lower than that in female patients (18.1% vs 21.1%, P=0.046). The proportion of renal insufficiency in out patients was lower than that in inpatients (10.7% vs 22.7%, P<0.001). The proportions of renal insufficiency in patients with alcoholic cirrhosis and liver cancer were significantly higher than those in patients with hepatitis B cirrhosis and hepatitis C cirrhosis(22.7%,18.1% vs 17.25, 16%, P=0.004). Conclusion The 4 040 cases of liver cirrhosis and liver cancer had milder renal insufficiency (60 < eGFR < 90 mL·min^-1·1.73 m^-2), and patients over the age of 50 years were in majority; inpatients may be more likely to develope kidney dysfunction than outpatients.

Effect of vascular injury on the expression of polymerase Ⅰ and transcript release factor in vascular smooth muscle and its mechanism

Chen Xueying, Yao Ye, Zhou Gaoshi, Tao Shiwan, Chen Zhaoyu, Tan Zhi

2017, 38(4):  546-552.  doi:10.3969/j.issn.1006-7795.2017.04.012

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Objective To investigate the role of polymerase Ⅰ and transcript release factor or Cavin-1 in vascular restenosis after vascular injury and its molecular mechanism. Methods 200-220 g Sprague Dawley(SD)male rats were randomly divided into sham and injury groups with injury groups establishing balloon injury models. Cellular content from carotid taken after the sham and balloon injuries were shown by hematoxylin and eosin staining. Expression Cavin-1 protein from above groups were determined by Western blotting and immunofluorescence. The Cavin-1 mRNA from above groups was detected by real-time RT-PCR, respectively. Immunochemical staining, Western blotting and Co-immunoprecipitation revealed ubiquitinated protein in carotid artery from sham and injury groups. Rat aortic smooth muscle cells were divided into: ①control group(CTRL);②CHX group rats were pretreated with cycloheximide (CHX, 25μmol/L) for 1 h;③CHX+MG group rats were pretreated with CHX (25μmol/L) for 1 h followed by treatment with MG 132(10 μmol/L)for additional 24 hours.④CHX+CQ group rats were pretreated with CHX (25μmol/L) for 1 h followed by treatment with chloroquin(CQ,50 μmol/L)for additional 24 hours.Expression Cavin-1 protein from above groups were determined by Western blotting. Results As for animal models, the carotid vascular wall became thicker after the balloon injury and the expression of Cavin-1 protein was significantly decreased(P<0.05) while real-time RT-PCR showed no significant difference of Cavin-1 mRNA between sham and injury groups. Ubiquitinated protein levels were higher in the injured carotid compared with sham group(P<0.05) As for cell experiment, expression of Cavin-1 was decreased significantly from CHX group compared with CTRL(P<0.05).CHX+MG group can reverse the above effects (P<0.05). Conclusion Expression of Cavin-1 protein from balloon injury carotid arteries were reduced, and its mechanism may relate to up-regulated ubiquitination degradation pathway.

Generation of oligodendrocyte progenitor cells from human peripheral blood mononuclear cells

Tang Xihe, Li Mo, Wang Shuyan, Li Pengyan, Zhang Y. Alex, Chen Zhiguo, Chen Hui

2017, 38(4):  553-558.  doi:10.3969/j.issn.1006-7795.2017.04.013

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Objective To generate oligodendrocyte progenitor cells (OPCs) from peripheral blood mononuclear cells by episomal vectors.Methods Peripheral blood of a donor was collected by venipuncture and then mononuclear cells (MNCs) were isolated by density-based centrifugal separation. After a short period of expansion, the isolated MNCs were transfected with three plasmids expressing OCT4, SOX2, KLF4, C-MYC, LIN28, NANOG, and cultured in chemical defined medium with small molecules. Results Sixty days later, the O4 oligodendrocyte progenitor cells appeared and could be expanded more than 60 passages. Conclusion The peripheral blood MNCs can be converted to oligodendrocyte progenitor cells by non-integrative plasmid vectors.

Comparison of DNA hypermethylation of tumor suppressor genes as diagnostic biomarkers in screening and auxiliary detection of breast cancer: an indirect comparison Meta-analysis

Liu Di, Zhao Zhongyao, Sun Qi, Wang Youxin

2017, 38(4):  559-565.  doi:10.3969/j.issn.1006-7795.2017.04.014

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Objective To assess the comparative efficacy of diagnostic accuracy of DNA methylation biomarkers for the screening and detection of breast cancer, we conducted an indirect comparison Meta-analysis of published reports. Methods Databases including the Cochrane Library, PubMed, EMbase, Chinese BioMedical Literature Database (CBM), Web of Science, China National Knowledge Infrastructure (CNKI) and WanFang Data were searched to collect the diagnostic trials on the Meta-analysis of aberrant DNA hypermethylation for breast cancer published until October 2016. The indirect comparison Meta-analysis was used to evaluate the diagnostic value of the included genes, and the Meta-analysis was conducted via Review manager 5.3 software. Results Ten Meta-analysis of 130 original studies were included. In summary of Meta-analysis, compared with others gene, methylation of phosphatase and tensin homolog gene (PTEN) ［iodds ratio (OR)=66.16 (24.48-178.82)］, methylation of Runt-related transcription factor 3 gene (RUNX3) ［OR=28.88 (15.48－54.25)］ had greater risk in breast cancer. Although breast cancer 1 gene (BRCA1) ［OR=2.11 (1.88－2.35)］ was the smallest risk for breast cancer, the weight of BRCA1 gene was up to 57.1% in all the Meta. According to the sensitivity, compared with others gene, RUNX3 ［0.62 (0.56－0.67)］ was the largest, followed by fragile histidine triad protein gene (FHIT) ［0.59 (0.54－0.63)］, but the specificity of RUNX3 ［0.95 (0.91-0.97)］ was greater than FHIT ［0.65 (0.61－0.69)］. Comprehensive sensitivity and specificity of ten genes, the largest value of RUNX3 in the diagnosis of breast cancer was found. Conclusion We advocate that RUNX3 and BRCA1 gene methylation can be used in the screening and auxiliary detection of breast cancer.

Chemiluminescence immunoassay for Golgi protein 73 in human serum and its clinical application

Bai Jing, Zhang Lijun, Zhan Yutao, Guo Duo, Liu Xiangyi

2017, 38(4):  566-571.  doi:10.3969/j.issn.1006-7795.2017.04.015

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Objective To detect serum Golgi protein 73(GP73) by chemiluminescence immunoassay(MP-CLIA) and further investigate its clinical applications with a variety of clinical samples including hepatocellular carcinoma (HCC), liver cirrhosis and hepatitis. Methods In our study, the serum GP73 level was measured among healthy controls and patients groups by MP-CLIA. The MP-CLIA and ELISA method were evaluated in HCC diagnosis by means of calculating the area under the receiver operating characteristic (ROC). We also measured serum GP73 and alpha-fetoprotein (AFP) in 50 cirrhosis and 69 HCC patients and further compared the effectiveness GP73 and AFP of clinical diagnosis for HCC. We investigated the early diagnosis value of serum GP73 by comparing with different pathological stages of 69 HCC. We also compared the serum GP73 level of healthy controls with that of other benign liver diseases and other cancers. Results It was shown that there was no statistical difference (P>0.05) as to the ROC between the above two methods. It was also shown that the levels of serum GP73 were statistically significant among HCC group, liver cirrhosis group and control group (P<0.05). Serum GP73 level in T1, T2, T3, and T4 stage of HCC were 1.88nmol/L, 2.72nmol/L, 3.22nmol/L and 3.44 nmol/L, respectively. The concentration of serum GP73 in early stage of HCC was significantly different from advanced stage of HCC and liver cirrhosis (P<0.05). As a result, there were also statistical differences of serum GP73 between control group and autoimmune hepatitis, fatty liver, hepatitis, high-risk for HCC group as well as other cancer groups, respectively (P<0.05). Conclusion By clinical preliminary verification, GP73, whose level enhanced in the serum from HCC patients by MP-CLIA, is proved to be a sensitive serum marker in early diagnosis for HCC.

Influence of sampling methods and gender on eleven blood biochemical indicators in adult Wistar rat

Tian Mi, Jiang Xueyun, Cao Lige, Luo Kui, Xue Bing

2017, 38(4):  572-575.  doi:10.3969/j.issn.1006-7795.2017.04.016

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Objective To establish the influence of different sampling methods and gender on 11 biochemical indicators in Wistar rat. Methods The blood of adult Wistar rats (17 males and 17 females) were collected from caudal vein, abdominal aorta and inferior vena cava, then 11 biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase(AST), urea nitrogen (BUN), glucose (GLU), total protein (TP), albumin(ALB), creatinine (Cr), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were analyzed by 7180E Automatic Biochemical Analyzer. Means comparison were performed byt-test or Mann-Whitney U-test depending on the distribution of the data. A value < 0.05 was regarded as statistical significance.Results In female rats, significant variation was observed on the value of GLU, TP and Cr between caudal vein and inferior vena cava serums; and significant difference was observed on the values of GLU, TP, ALB, Cr, TG, TC and HDL-C between caudal vein and abdominal aorta serums. In male rats, the value of ALT, AST, GLU, TP and Cr were significantly different between caudal vein and inferior vena cava serums; and significant difference was observed on the values of ALT, AST, GLU, TP, ALB, TG, TC, HDL-C and LDL-C between caudal vein and abdominal aorta serums. Between male and female rats, the value of AST, TC and LDL-C were significantly different in caudal vein serum; and significant variation on the value of TP, ALB, Cr, TG, TC and LDL-C were found; and the value of TP, ALB, Cr, TC and LDL-C were statistically different. Conclusion Researchers should pay more attention to the variation of biochemical indicators caused by the different sampling methods and gender in Wistar rat.

Feasibility study of low tube voltage and hybrid iterative reconstruction algorithm at MSCT:Experimental analysis of evaluating radiation dose and image quality on excretory phase images of infant swine urography

Hu Bin, Chen Jingjing, Xu Wenjian, Xu Qi, Li Xiaofei

2017, 38(4):  576-579.  doi:10.3969/j.issn.1006-7795.2017.04.017

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Objective To optimize the scanning parameters for CT with lower radiation dose on the infant pigs' urinary which mimicks the baby's urinary of human being.Methods Five pigs were undertaken CT scan with the conventional 120 kV,80 kV and 80 kV with a hybrid iterative reconstruction algorithm. The estimated effective radiation of each protocol was compared with via the student t test. Scores and the contrast-to-noise-ratio(CNR)of the 120 kV,80 kV,and hybrid iterative reconstructed 80 kV images were evaluated. Results The effective radiation was 71% lower during CT excretory phase scanning with the 80 kV protocol than with the 120 kV protocol. There was no significant difference in the CNR of any of the regions of interest between 80 kV with iterative reconstruction and 120 kV(P>0.05). There was no significant difference in the quality of images obtained from the conventional 120 kV scanning and low dose group of 80 kV with iterative reconstruction scanning images.Conclusion A low tube voltage and the hybrid iterative reconstruction algorithm can dramatically decrease radiation with adequate image quality in normal infant pigs' uninary excretory phase scanning.

Expression of microRNA-221 in chronic myeloid leukemia and its mechanism

Qin Na, Li Guangbo, Guo shuxia, Zhang Xiaojuan

2017, 38(4):  580-585.  doi:10.3969/j.issn.1006-7795.2017.04.018

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Objective MicroRNAs (miRNAs, miRs) have emerged as critical regulators of tumor cell proliferation. This paper is to investigate how miR-221 is involved in the process of chronic myeloid leukemia (CML) and its working mechanisms.Methods Quantificational real-time polymerase chain reaction,qRT (qRT-PCR) was used to measure the expression of miR-221 in CML patients and control patients. K562 cells were transfected with miR-221 mimics, inhibitors, or negative controls. MTT assay was used to determine cell viability. Flow cytometry was used to measure the cell apoptosis and cell cycle. Bioinformatics was used to predict the target gene of miR-221, the qRT-PCR and Western blot were used to determine the expression of p27^Kip1 expression. Results The expression of miR-221 was increased significantly in the bone marrow cells in CML patients compared with control patients. Overexpression the miR-221 significantly increased cell vitality and promoted cell proliferation and G1-to-S phase transition of the cell cycle in K562 cells, while inhibition of miR-221 rescued the results. p27^Kip1 is the important target gene regulated by miR-221, the inhibition of the miR-221 promoted the p27^Kip1 expression, while miR-221 overexpression decreased the p27^Kip1 expression. Conclusion Our study suggested that miR-221 may be an oncogenic miRNA by inhibiting the protein expression of p27^Kip1 in CML.

Effects of Pseudomonas aeruginosa lipopolysaccharide on biofilm of Candida albicans

Deng Juan, Sun Wei, Ma Liyan, Su Jianrong

2017, 38(4):  586-591.  doi:10.3969/j.issn.1006-7795.2017.04.019

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Objective To explore the inhibitory effects of Pseudomonas aeruginosa lipopolysaccharide on Candidas albicans biofilms. Methods ［(2,3-bis-(2-methoxy-4-nitro-5-sulphophenyl)-2H-tetrazolium-5-carboxanilide,XTT］ reduction assay was used to elucidate the effect of Pseudomonas aeruginosa lipopolysaccharide on biofilm formation of Candida albicans,and inverted microscope was used to observe the morphological changes of Candida albicans biofilms; expression analysis of Candida albicans hypha specific genes was done by quantitative real time polymerase chain reaction(PCR). Results The data showed that Pseudomonas aeruginosa lipopolysaccharide inhibits Candidas biofilm formation,and the expressions of HWP1, ALS1,ALS3,ECE1,SAP4 were downregulated 8.3 to 12.8 times,1.1 to 3.0 times,2.0 to 4.6 times,1.3 to 3.8 times and 6.2 to 7.6 times. Conclusion Pseudomonas aeruginosa lipopolysaccharide modulated Candida albicans biofilm formation by inhibiting the hyphal development.

Relationships between OGTT 1-h plasma glucose levels and insulin sensitivity and pancreatic β cell function in subjects with normal glucose tolerance

Zhu Lili, Chen Zhe, Liu Xin, Yu Na, Pan Qingrong

2017, 38(4):  592-596.  doi:10.3969/j.issn.1006-7795.2017.04.020

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Objective To evaluate the relationships between oral glucose tolerance test (OGTT)1h plasma glucose levels (1-h PG) and insulin sensitivity and pancreatic β cell function. Methods A total of 177 individuals without diabetes mellitus from Beijing Chaoyang Hospital were enrolled in the study from June 2015 to June 2016, all of them undertook a 75 g OGTT, and then we examined the correlation between 1-h PG and insulin sensitivity and pancreatic β cell function. Results In the normal glucose tolerance (NGT) 1-h≥ 8.6 mmol/L group, fasting plasma glucose,1-h PG,1-h insulin and steady-state homeostasis model assessment of insulin resistance (HOMA-IR) were significantly higher than that in the NGT 1-h<8.6 mmol/L group, but dynamic insulin sensitivity index (Matsuda index) and insulin secretion index (ΔI₃₀/ΔG₃₀ and ΔI₆₀/ΔG₆₀) were significantly lower than that in the NGT 1 h<8.6 mmol/L group. There were no differences in fasting plasma glucose, 1-h PG, 1-h insulin, HOMA-IR, Matsuda index, ΔI₃₀/ΔG₃₀ and ΔI₆₀/ΔG₆₀ between the NGT 1-h≥ 8.6 mmol/L group and IGT group. It showed that 1-h PG negatively correlated with ΔI₃₀/ΔG₃₀ and Matsuda index by using multivariable linear regression model.Conclusion Among individuals with NGT, those with 1-hour OGTT glucose ≥8.6 mmol/L show lower insulin sensitivity and impaired β cell function. OGTT 1-h PG is associated with insulin sensitivity and β cell function.

Analysis of risk factors about the prognosis in the critically ill patients of emergency room

Wang Tao, Wang Shuo, Tang Ziren, Li Chunsheng

2017, 38(4):  597-603.  doi:10.3969/j.issn.1006-7795.2017.04.021

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Objective To investigated the biological indicators and evaluation scales of critically ill patients for predicting the prognosis of 28-day in a university hospital emergency room. Methods A prospective investigation was done in the emergency room of Beijing Chao-Yang Hospital, Capital Medical University from January 2014 to May 2015, and 28-day mortality was recorded. Monitor vital signs, blood biochemical, coagulation, arterial blood gas analysis, lactic acid, C-reactive protein and other laboratory indicators in admission of 24 hours. Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ), simplified acute physiology score Ⅱ (SAPS Ⅱ), sepsis-related organ failure assessment system (SOFA) and the mortality in emergency department sepsis (MEDS) score were evaluated. Results A total of 2 089 patients were involved in, and were divided into two groups by 28-day prognosis: survival (n=1617) and dead (n=472). No significant difference of age, gender, body mass index and disease composition were found between the two groups(P>0.05). APACHEⅡ、SAPSⅡ、SOFA and MEDS scores of the survival and dead groups were 11.64±4.33 vs 20.87±5.46, 25.23±8.67 vs 42.96±12.97, 6.28±4.54 vs 10.98±5.89 and 1.86±1.80 vs 4.90±3.97 respectively, significant differences were found between the two groups (P<0.001).C-reactive protein and lactic acid were increased significantly (P<0.001 vs the survival group. The risk factors of poor prognosis, which were increased APACHE Ⅱ, MEDS, SAPS Ⅱ and lactic acid, were confirmed by Logistic analysis. The predicting power of APACHE Ⅱ was confirmed by ROC curve further; the sensibility and specificity were 88.38% and 82.93% respectively. Conclusion In the four scoring systems, the APACHE Ⅱ score was the most predictor of the 28-day prognosis in critically ill patients, and the biologic index of blood lactic acid could be used as an independent risk factor for the 28-day prognosis of critically ill patients.

Changes of the aetiologies of cirrhosis and its complications in north China

Wang Zheng, Ding Huiguo, Chen Yuhan, Li Lei, Fan Chunlei, Dong Peiling

2017, 38(4):  604-608.  doi:10.3969/j.issn.1006-7795.2017.04.022

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Objective To investigate the prevalence changes of aetiologies and complications of liver cirrhosis in northern China. Methods In this retrospective study, we identified cases of the demographic information and complications of patients with cirrhosis who were firstly hospitalized between December 31, 2013 to January 1, 2002. Two years were defined as a stage, to clarify the prevalence of the etiology of cirrhosis and complications in north China. Results Total 12 948 cirrhosis inpatients were included in this study during 12 years. Of them, male was accounted 69.02% and female 30.98%. The average age of all of the patients was (51.29±11.81) years (from7 to 93 year). Hepatitis B virus/hepatitis C virus (HBV/HCV) and alcoholic liver cirrhosis were most male, and autoimmune, drug-induced and non-alcoholic related cirrhosis were predominantly female. The hospitalized patients with cirrhosis were gradually increased. HBV related cirrhosis had fallen from 86.72% to 78.65% (P<0.01), however, HCV related cirrhosis had increased from 8.07% to 19.27% (P<0.01). The alcoholic, autoimmune and cryptogenic cirrhosis were respectively increased from 7.68% to 16.52%, from 2.65% to 10.0% and from 0.72% to 5.27% (P<0.01). The non-alcoholic fatty liver cirrhosis accounted for 3.76%. Ascites is the most common complication accounted for 66.34%, simple ascites and gastrointestinal bleeding constituent ratio decreased, while more than 2 complications increased in cirrhostic patients. Conclusion Hospitalized cirrhotic patients are increased. A significant increased constituent ratio of HCV, alcoholic, autoimmune and nonalcoholic cirrhosis are observed. The constituent ratio of ascites, gastrointestinal bleeding remained a major complication, are decreased.

Evaluation of right ventricular function in patients with right coronary artery chronic total occlusion combined with old inferior wall myocardial infarction

Zhang Qi, Chen Zhenwen

2017, 38(4):  609-614.  doi:10.3969/j.issn.1006-7795.2017.04.023

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Objective To investigate the changes of right ventricular function in patients with right coronary artery (RCA) chronic total occlusion(CTO)combined with old inferior wall myocardial infarction(OIWMI) with two-dimensional echocardiography and to explore its clinical significance. Methods We studied 28 consecutive patients with RCA-CTO accompanied by OIWMI in Beijing Anzhen hospital, from June 2013 to October 2015. The patients were divided into the coronary collateral circulation(CCC) group and non-CCC group according to the results of coronary angiography. Echocardiography was performed in order to measure the right ventri cular fractional area change(RVFAC), tricuspid annular plane systolic excursion(TAPSE), myocardial performance index (MPI). Doppler echocardiography was used to measure tricuspid value diastolic blood flow velocity (E, A peak), this Dopplor measurement of tricuspid annulus diastolic velocity (e' and a'). The clinical features, interventional treatment, postoperative cardiovascular adverse events and average hospital stay were observed. Results Patients in the non-CCC group had lower TAPSE and RVFAC and a higher MPI, E/A ratio and E/e' ratio, it was suggested that the right ventricular systolic and diastolic function of non-CCC group were lower than those in the CCC group(P<0.05). Comparison of the two groups of interventional surgery, severe arrhythmia occurred in 0 cases in the CCC group and 8 cases(44.4%) in the non-CCC group, the difference was statistically significant(P<0.05). Postoperative severe arrhythmia occurred in the CCC group was 0 case and 7 cases(38.9%) in the non-CCC group, the difference was statistically significant(P<0.05). Comparison of the average number of hospital days in both groups, the average length of stay was longer in non-CCC group(P<0.05). Conclusion In patients of RCA-CTO combined with OIWMI, the poorly developed coronary collaterals have worse RV functions. Preoperative two-dimensional echocardiography can be used to evaluate the difference between the CCC group and non-CCC group and has a certain clinical significance.

Study of the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung

Pan Shouqiang, Zhang Yi

2017, 38(4):  615-619.  doi:10.3969/j.issn.1006-7795.2017.04.024

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Objective To investigate risk factors of the malignant space-occupying disease with benign computed tomography (CT) graph on upper lobe-back segment of lung, so as to provide theoretic basis for clinical diagnosis. Methods Retrospective study of the 139 patients with the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung,from Department of Thoracic Surgery, Xuanwu hospital, Capital Medical University and Department of Thoracic Surgery, Pinggu Hospital, Friendship Hospital, Capital Medical University, from January 1, 2011 to December 31st, 2016. The incidence rates of each year were calculated. We compared the clinical data of patients and used Logistic regression to analyze the risk factors in our study. Results Incidence rates of the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung in each year were 8.33%, 11.11%, 19.05%, 26.92%, 34.38%, 40.00% respectively. Logistic regression showed the risk factors OR (95%CI) of the malignant space-occupying disease with benign CT graphy on upper lobe-back segment of lung were: ages 1.123(1.038-1.215), smoking 5.951(1.778-9.919), right space-occupying diseases 3.547(1.104-10.397), positive single-photon emission computed tomography (SPECT) agglomeration 3.565(1.096-11.598), abnormal related marks of lung cancer ［carcino-embryonic antigen (CEA), cytokeratin protein fragment 21-1 (CYFRA21-1), neuron specific enolase (NSE)］ 18.638 (4.974-29.843), 7.357(2.265-13.010), 7.639(3.107-14.697). Conclusion The incidence rates of the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung in each year were high, and doctors should pay more attentions to considerate risk factors such as ages, smoking, right space-occupying diseases, positive SPECT agglomeration as well as abnormal related marks of lung cancer when they diagnose. Early detection and early treatment can improve the survival of patients.

Comparison of intravenous contrast-enhanced ultrasound and transvaginal color Doppler sonography in diagnosis

Ren Meijie, Yang Jingchun, Du Lan, Wu Jing

2017, 38(4):  620-625.  doi:10.3969/j.issn.1006-7795.2017.04.025

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Objective To evaluate the value of intravenous contrast-enhanced ultrasound in diagnosis of endometrial polyps (EPs) by comparison with transvaginal color Doppler sonography (TCVD). Methods Eighty five cases were studied by Transvaginal color doppler sonography and intravenous contrast-enhanced ultrasound (CEUS), respectively, confirmed by pathology and comparing the two results. Results In the two groups of CEUS, the sensitivity was 82.8%, 94.1%, specificity was 90.9%, 72.7%, the diagnostic coincidence rate was 85.0%, 88.9%, all of these were higher than those of TVCD group, there was significant differences between two methods(P<0.05). 56 cases conformed to the pathological diagnosis, 53 cases showed the enhancement pattern was centrifugal enhancement, 3 cases was overall enhancement, intensity appeared variously. The difference of start time, peak time, and clear time between EPs and endometria were no significant difference between two groups each other(P＞0.05).Conclusion CEUS is valuable in diagnosis EPs.

Role of intraoperative neuromonitoring of recurrent laryngeal nerve in thyroid and parathyroid surgery

Ling Yuwei, Kang Hua

2017, 38(4):  626-630.  doi:10.3969/j.issn.1006-7795.2017.04.026

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The recurrent laryngeal nerve(RLN) injury is one of the important complications during the thyroid and parathyroid surgery, which can result in hoarseness and dyspnea. Intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve has already become the effective method to protect the recurrent laryngeal nerve during the thyroid and parathyroid surgery, which has developed from invasive electrode to noninvasive endotracheal intubation with electrode, and standardized procedures of IONM was proposed. Furthermore, the continuous intraoperative neuromonitorying (C-IONM) and the standardized monitoring procedure of external branch of superior laryngeal nerve (EBSLN) has been accepted by an increasing number of surgeons. The probable damage mechanisms are gradually demonstrated through IONM. It is an effective technique that IONM could be to assist surgeons to recognize RLN and reduce the risk of recurrent laryngeal nerve injury during thyroid or parathyroid surgery, especially in complicated operations and reoperations.It will be of great importance in the aspect of improving the operation procedure, making staged secondary/completion procedure strategy, and the development of low-volume surgeons.