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Table of Content

    21 September 2018, Volume 39 Issue 5
    An event-related potential study of dysfunction of conflict monitoring in patients with schizophrenia
    Bian Zhiming, Wang Changming, Liu Chenyang, Zhang Xiujun, Ma Xin
    2018, 39(5):  625-629.  doi:10.3969/j.issn.1006-7795.2018.05.001
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    Objective To investigate the deficits of conflict monitoring function in patients with schizophrenia, and to understand the role of N270 in evaluating the cognitive functions of patients with schizophrenia. Methods Totally 14 schizophrenia patients and 20 healthy subjects were recruited. The electroencephalogram (EEG) data were recorded using EGI 128-channel EEG systems. Two consecutive faces were presented to the subjects to induce event-related potentials. The experimental task was to judge whether the two faces were the same or different. Results Face inconsistencies (conflict conditions) induced a conflicting negative wave, N270, but no N270 was observed under face matching conditions. Compare with the healthy group, the peak latency of the N270 component was significantly delayed at the O1, O2, P3, and P4 electrodes in the patient group, with no significant difference in amplitude between the two groups. Conclusion There was a significant abnormality in the incubation period of N270 in patients with schizophrenia, suggesting the defect in their conflict monitoring function. Schizophrenia may adopt a different processing mechanism for the conflict of information. N270 can serve as an objective indicator of the conflict handling capacity to evaluate the cognitive function of patients with schizophrenia.
    Effects of scopolamine on forced swimming behavior in rats and its possible action target
    Shi Dandan, Yang Jian, Zhang Jinniu, Wang Gang
    2018, 39(5):  630-635.  doi:10.3969/j.issn.1006-7795.2018.05.002
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    Objective To clarify the possible brain regions and targets to mediate antidepressant-like effects of scopolamine. Methods Sprague Dawley (SD) rats were randomly divided into scopolamine group and saline control group. The rats were intraperitoneally injected with scopolamine or equal volume saline. After 24 hours, open field test and forced swimming test were carried out to evaluate the effect of scopolamine on the behavior of rats. γ-Aminobutyric acid-A (GABA-A) receptor agonist Muscimol (1.25 μg)was stereotaxically injected into the medial prefrontal cortex (mPFC) of rats one hour before intraperitoneal injection of 25 μg/kg scopolamine. Behavioral effects were examined after 24 hours. 0.5 μg, 1 μg and 2 μg muscarinic acetylcholine receptor 2 (M2) receptor selective antagonist methoctramine (MCT) were respectively injected into the lateral ventricle of rats by the micro dosing system, while the control group was given 2 μL saline. Behavioral effects were examined after 24 hours. Results After 24 hours of intraperitoneal injection of scopolamine, the immobility time in rats was lower than that in the control group (P<0.05), while no statistical difference was observed in the total distance of the open field (P>0.05). In Muscimol+scopolamine group, the immobility time in rats was significantly higher than that in scopolamine group (P<0.01). No statistical difference was observed in the total distance in the open field test (P>0.05). Compared with lateral ventricle injection of saline, 0.5 μg MCT had no effect on the immobility time (P>0.05), 1 μg MCT could significantly reduce the immobility time (P<0.01), whereas 2 μg MCT could significantly increase the immobility time (P<0.05). Conclusion Scopolamine may exert antidepressant-like effects by blocking the M2 receptor of mPFC.
    Effects of the structured rehabilitation skills training program in the improvement of depressive symptoms and quality of life in patients with major depressive disorder
    Tang Lirong, Zheng Wei, Zhao Xiuqin, Ren Yanping, Xiang Yingqiang, Gao Yue, Xu Qiuyue, Ma Xin
    2018, 39(5):  636-640.  doi:10.3969/j.issn.1006-7795.2018.05.003
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    Objective To examine the effects of the structured rehabilitation skills training program on the improvement of depressive symptoms and quality of life in patients with major depressive disorder (MDD). Methods A total of 212 patients with MDD who met the inclusion criteria of this study were divided into two groups, namely intervention group (conventional treatment combined with the whole rehabilitation skills training program, n=102) and control group (conventional treatment combined with general health education, n=110). Depressive symptoms and quality of life were assessed using HAMD-17 (Hamilton Depression Rating Scale for Depression-17 item), WHOQOL-BREF (World Health Organization's Quality of Life Instruments-Abbreviated Version) at baseline and at every follow-up visit in 1 year(every 3 months). All outcomes were analyzed using SPSS 17.0 software. Results The difference between groups and intra-group differences of HAMD-17 total score and each factor score and total score of WHOQOL-BREF were statistically significant. HAMD-17 total score in intervention group are significantly lower than that in control group at 3nd, 6th, 9th and 12th month. Total score and each factor score of WHOQOL-BREF in intervention are significantly higher than that in control group at 6th, 9th and 12th month. Conclusion Skills training program for patients with major depressive disorder established in this study is mostly reasonable, and it is effective in improving depressive symptoms and life quality.
    Augmentation of rTMS in the treatment of refractory schizophrenia
    Sun Congcong, Zhou Danna, Ning Fangping, Ma Liang, Yan Liqiong, Ren Yanping, Ma Xin
    2018, 39(5):  641-645.  doi:10.3969/j.issn.1006-7795.2018.05.004
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    Objective To explore the augmentation effect of repetitive transcranial magnetic stimulation in the treatment of refractory schizophrenia.Method< Fifty schizophrenia patients were included and were divided into low frequency (1Hz) treatment group of 26 cases and high frequency (10 Hz) treatment group of 24 cases. Each treatment group was further randomly divided into an experimental group and a control group. This study is a randomized, double-blind, controlled study, the control group was subjected to pseudo-stimulation. The clinical symptoms of the two groups of patients were evaluated and the therapeutic effects of the two groups were compared.Results A total of 53 patients who met the inclusion criteria were enrolled, and a total of 50 patients completed the study.After t test and χ2 test, there was no significant difference in the basic data between the two groups.Low frequency treatment:there was no statistically significant difference between the groups. High frequency treatment:There was no statistically significant difference between the groups There was a time difference in the scale scores for the 4th weekend for all patients in the group. High frequency treatment:There was no statistically significant difference between the groups, Three patients with 1Hz experimental group and two patients with 10 Hz experimental group complained of headache and numbness during the first treatment, other patients are not uncomfortable.Conclusion Repetitive transcranial magnetic stimulation combined with drug therapy has not been found to have an effect on positive and negative symptoms in patients with refractory schizophrenia.
    A study on the correlation about social supports and mental disorders
    Zhai Qian, Hu Changqing, Yang Li, Zhang Guofu, Wang Jingjing, Liu Min
    2018, 39(5):  646-650.  doi:10.3969/j.issn.1006-7795.2018.05.005
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    Objective To discuss the correlation between social support and mental disorders. Methods Use the Subjects Database (n=2 142) from Clinical data and Biological sample bank about Mental illness of Beijing Anding Hospital. The normal controls (n=111), schizophrenia (n=82) and mood disorders (depression and bipolar disorder) (n=119) were selected. The associations between social supports and mental disorders were discussed by comparing the data of Social Support Rating Scale (SSRS) (total scores and dimension scores) in three groups. The two study groups were divided into two sub-groups according to the number of episodes (≤ 2 times or>2 times). Compare the total scores and dimension scores (objective support, subjective support, and utilization of support) of the social support scale in sub-groups. Results The difference of total scores and dimension scores among the three groups were statistically significant (all P values<0.01). The differences of total score and dimension score between the control and schizophrenia groups and the control and mood disorder groups were statistically significant (all P values<0.01) respectively. However, the difference of total score and dimension score between the mood disorder group and schizophrenia group was not statistically significant (all P values>0.01). The differences of total score and dimension score between the two sub-groups of mood disorder group and the two sub-groups of schizophrenia group were statistically significant (all P values<0.01), respectively. Conclusion Schizophrenia and mood disorders patients have lower levels of social support and utilization of support than normal people. The more episodes, the poor social supports.
    Cognitive function of schizophrenia patients after modified electroconvulsive therapy based on neuropsychological and physiological assessment
    Liu Yi, Ren Yanping, Jiang Wei, Ma Xin
    2018, 39(5):  651-656.  doi:10.3969/j.issn.1006-7795.2018.05.006
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    Schizophrenia is a common chronic mental illness in psychiatry. The disease has a poor prognosis and is prone to recurrence, which places a heavy burden on families and society. There are various treatments for schizophrenia. In addition to medical treatment, modified electroconvulsive therapy (MECT) is the main treatment in physical therapy. Although MECT has many advantages in treatment, the cognitive side effects caused by MECT have been a difficult problem in the clinic. Most previous studies have suggested that MECT has a detrimental effect on cognitive function in patients with schizophrenia. But this traditional view has been challenged in recent years, and more and more studies have shown that MECT may improve its cognitive function on the basis of symptom relief. Based on this, we summarize the research on the impact of MECT on cognitive function in recent years, and then analyze its impact on cognition and possible mechanisms.
    Role of endoscopic ultrasound(EUS)-guided targeted biopsy in conventional endoscopic biopsy negative lesions
    Hao Xiaowen, Sun Xiujing, Li Peng
    2018, 39(5):  657-662.  doi:10.3969/j.issn.1006-7795.2018.05.007
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    Objective To evaluate the efficacy and safety of endoscopic ultrasound (EUS)-guided biopsy in the diagnosis of underlying malignancy in patients with suspicious esophageal and gastric cancer and negative mucosal biopsies. Methods A retrospective analysis was conducted in sixteen patients who have suspicious esophageal and gastric cancer but endoscopic biopsy was negative. EUS and EUS-guided biopsy were performed to all those patients from May 2016 to July 2018 in our hospital. Results Sixteen patients (5 male) aged 29-83 years[median (53.19±16.98) years] were included in this study. Malignancy was confirmed in 8/16 patients on histology, suspicious tumor cells were found in 3/16 patients (2 of the three patients were finally diagnosed as malignant tumor). The remaining five patients were diagnosed with benign diseases. EUS-guided biopsy showed a sensitivity of 100%, specificity of 83.3%, positive predictive value (PPV) of 90.9%, negative predictive value (NPV) of 100% and accuracy of 93.8%. The consistency of EUS-guided biopsy and final diagnosis was great (Kappa=0.86).There were no immediate or late complications. Conclusion EUS-guided targeted biopsy is a helpful and safe procedure in the diagnosis of esophageal and gastric tumors with negative endoscopic biopsies.
    Value of magnifying endoscopy with blue laser imaging in diagnosis of atrophy and intestinal metaplasia
    Wang Jinpeng, Zhai Huihong, Jiao Yue, Li Peng, Zhang Shutian
    2018, 39(5):  663-668.  doi:10.3969/j.issn.1006-7795.2018.05.008
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    Objective To determine the utility of magnifying endoscopy with blue laser imaging(ME-BLI) in diagnosis of atrophy and intestinal metaplasia(IM) among people with risk of atrophy and IM. Methods Patients with risk factors of atrophy or IM underwent ME-BLI from Feb 2017 to Dec 2017. Biopsy was obtained in both atrophic or intestinal metaplasia lesion and gastric mucosal without atrophy or IM. The sensitivity, specificity and accuracy in both atrophy and IM with ME-BLI were calculated. Results The sensitivity, specificity, accuracy, positive and negative predictive value was 93.40%, 71.96%, 79.02%, 62.26% and 95.65% in the diagnosis of atrophy with ME-BLI respectively. The sensitivity, specificity, accuracy, positive and negative predictive value was 100%, 92.07%, 95.94%, 92.31% and 100% in the diagnosis of intestinal metaplasia, respectively. Conclusion The sensitivity, specificity and accuracy with ME-BLI in detection of atrophy and IM were good.
    Value of endoscopic ultrasonography in evaluation of invasive depth in early gastric cancer and its related factors
    Sun Xiujing, Zhang Qian, Xing Jie, Zhu Min, Guo Junfeng, Cao Bin, Zhu Shengtao, Li Peng, Zhang Shutian
    2018, 39(5):  669-674.  doi:10.3969/j.issn.1006-7795.2018.05.009
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    Objective To investigate the role of endoscopic ultrasound (EUS) in assessing invasive depth of early gastric cancer (EGC) and the related factors influencing the accuracy of EUS. Methods The clinical data of 146 patients with EGC who were admitted to Beijing Friendship Hospital from June 2013 to December 2017 were retrospectively collected, including basic information (age and gender), endoscopic lesion characteristics (tumor location, size, morphology and invasive depth) and pathological features (invasive depth and differentiated types). The results of EUS were compared with pathology findings for invasive depth, and the related factors affecting the accuracy of EUS were analyzed. The rate comparison and univariate analysis were performed with the chi-square test, and multivariate analysis was performed with the Logistic regression model. Results The overall accuracy of EUS-determined invasive depth was 73.38%. The accuracy of diagnosis was associated with the tumor size, but not with the tumor location, morphology, and differentiated types. Multivariate analysis revealed that tumor size was independent risk factor affecting the accuracy of EUS in determining the invasive depth of EGC. Conclusion EUS is useful for evaluating the depth of early gastric cancer invasion. Tumor size could cause incorrect evaluation with its increasement.
    Clinical features and prognosis of drug-induced vanishing bile duct syndrome
    Geng Wenjing, Liu Hui, Fan Chunlei, Li Lei, Dong Peiling, Ding Huiguo
    2018, 39(5):  675-679.  doi:10.3969/j.issn.1006-7795.2018.05.010
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    Objective To analyze the clinical features and outcomes of the drug-induced liver injury (DILI) patients with vanishing bile duct syndrome (VBDS). Methods A total of 1010 patients with DILI were diagnosed clinically from January 2010 to December 2016. Of which, 267 patients underwent liver biopsy, 19 patients were diagnosed DILI with VBDS by histology. At the same time, 54 patients without VBDS were randomly enrolled as a control. The clinical data and outcomes of the two groups of patients were compared. Results In this study, VBDS accounted for 7.12% (19/267). Of DILI patients with VBDS, 73.68% (14/19) patients had cholestasis, 26.32% (5/19) had no jaundice. The majority of VBDS patients were developed to chronic liver injury(88.2% vs 35.2%)compared to those without VBDS. Those drugs included sex hormones drugs(n=2), non-steroidal anti-inflammatory drugs (n=3), immunomodulators drugs (n=3), antibiotics(n=3), herbal products(n=4), hair dye (n=1),proton pump inhibitor (n=1), and antipsychotics(n=1). VBDS patients had significantly higher than those without VBDS serum cholesterol(CHOL)[(8.4±3.9) vs (4.4±1.5)mmol/L], alkaline phosphatase (ALP)[(613.6±544.4)U/L vs (151.8±70.4)U/L], and glutamyl transpeptidase(GGT)[(631.2±472.8)U/L vs (228.7±174.4)U/L] (P<0.05). Conclusion Most DILI patients with VBDS have cholestasis. VBDS may be the pathological basis of patients' development to chronic DILI with poor prognosis.
    Clinical features of 12 multifocal gastroesophageal neoplasms
    Wang Canghai, Wu Jing, Liu Hong, Liu Kuiliang, Su Hui, Wei Nan
    2018, 39(5):  680-684.  doi:10.3969/j.issn.1006-7795.2018.05.011
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    Objective To study the clinical features of the patients with multifocal gastroesophageal neoplasms. Methods Analysis the patients with multifocal gastroesophageal neoplasms who were treated in our hospital from 2008 to 2018. Results Twelve patients were diagnosed with multifocal gastroesophageal neoplasms, with nine synchronous carcinoma and three metachronous carcinoma. Two patients with synchronous caricinoma were missed with endoscopy. Conclusion The accessory lesion of gastroesophageal was always early gastric cancer, which was prone to missed diagnosis. It's important to use narrow band imaging (NBI), magnify and chemical dying to avoid missed diagnosis.
    Inflammation and the expression of dopamine and 5-HT receptors in colonic mucosa of Parkinson's rats
    Zhang Yue, Li Yun, Zhang Xiaoli, Feng Xiaoyan, Quan Zhusheng, Zhu Jinxia
    2018, 39(5):  685-692.  doi:10.3969/j.issn.1006-7795.2018.05.012
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    Objective To report the distribution of dopamine (DA) and serotonin (5-HT) receptors in the colonic muscular layer and their potential role in the motility regulation in the Parkinson's disease (PD) model 6-hydroxydopamine (6-OHDA) rats, it is not clear their expressions in the colonic mucosa and correlation with the colonic mucosal dysfunction in the PD rats. The present study aims to investigate the distribution of DA and 5-HT receptors in the colonic mucosa, and the colonic mucosal inflammatory and permeability and the expression change of the DA and 5-HT receptors in the colonic mucosa in 6-OHDA rats. Methods Injection of 6-OHDA to the bilateral substantia nigras of rats, to make PD model (6-OHDA rats). Immunofluorescence (IF) and western blotting were used to observe the injection sites and the extent of DA neurons' injury. DA and 5-HT content was measured by high performance liquid chromatography-electrochemistry detection (HPLC-EDC). The mRNA and protein expression of DA receptors (D1, D2, D5) and 5-HT receptors (5-HT3, 5-HT4) was detected by Real-time PCR and Western blotting. Results In the 6-OHDA rats, the protein expression of tyrosine hydroxylase (the synthetic rate-limiting enzyme of dopamine) in substantia nigra was decreased (control:0.335±0.073, model:0.132±0.028, P<0.05), fecal water content was reduced[control:(0.119±0.005)%, model:(0.062±0.006)%, P<0.01] and the time of rotarod test was shortened[control:(35.330±3.148)s, model:(24.000±1.424)s, P<0.01], indicating the model is successful. Furthermore, the colonic transepithelial resistance was decreased[control:(73.750±4.024)Ω/cm2, model:(53.400±6.282)Ω/cm2, P<0.05], the mucosal fluorescein isothiocyanate (FITC)-dextran permeability was increased[at 60 minutes, control:(18.860±1.856)μg/L, model:(37.000±4.457)μg/L, P<0.01], and the TNF-α was also increased[control:(269.10±18.00)ng/g, model:(340.40±21.52)ng/g, P<0.05], suggesting a higher mucosal permeability and inflammation. In the colonic mucosa of 6-OHDA rats, the expression of D1[control:(0.728±0.132), model:(0.272±0.067), P<0.01] and D5 (control:0.721±0.036, model:0.543±0.051, P<0.05) were decreased, but the DA and 5-HT content, and the receptors D2, 5-HT3 and 5-HT4 had no significant alteration although 5-HT3 (control:0.078±0.016, model:0.103±0.034, P>0.05) had a increase tendency. Conclusion The present study demonstrates that 6-OHDA rats manifest a reduction of D1 and D5 expressions in colonic mucosa, and increase in colonic mucosal permeability and TNF-α level, which suggests a colonic mucosal inflammation. However, whether the reduction of colonic D1 and D5 is involved in the formation of mucosal inflammation in 6-OHDA rats needs to be further investigated.
    Role of α-synuclein in microglia inflammation and phagocytosis
    Gong Xiaoli, Liu Mengru, Wang Le, Liu Yang, Zhang Ting, Sun Ying, Wang Xiaomin
    2018, 39(5):  693-698.  doi:10.3969/j.issn.1006-7795.2018.05.013
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    Objective Our study observed the effect of α-synuclein (α-syn) on inflammation and phagocytosis of microglia which are the resident immune cells in central nervous system. Methods Primary microglia cultured in vitro were treated by different concentrations of α-syn or lipopolysaccharides (LPS). Then the changes of phagocytosis of microglia were observed by fluorescent microspheres and fluorescent staining with clusters of differentiation 68 (CD68) proteins.The expression of inflammatory factors,tumor necrosis factor-α (TNF-α) and interleukin-1 beta (IL-1β), were detected by reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) to observe the α-syn induced inflammatory response. Results Twenty-four hours after α-syn stimulation, the number of microspheres that ingested in cells and CD68 expression increased significantly, similar to that with LPS treatment. However, both the changes of transcription level of inflammatory factors, TNF-α and IL-1β, and the release of TNF-α stimulated by α-syn were much lower than those by LPS. Conclusion α-syn can significantly enhance the phagocytosis of microglia, but has little effect on inflammatory response.
    Separation, purification and identification of mouse bone marrow neutrophils
    Yang Lin, Tian Lei, Zhou Xuan, Yang Le, Li Liying
    2018, 39(5):  699-703.  doi:10.3969/j.issn.1006-7795.2018.05.014
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    Objective For separation, purification and identification of mouse neutrophils from bone marrow. Methods Mouse bone marrow neutrophils were separated by density gradient centrifugation. Immunofluorescence and High Content Screening were used to detect the expression of Ly6G. Phorbol 12-myristate 13-acetate (PMA) was used to induce the expression of myeloperoxidase(MPO) released by neutrophils by immunofluorescent staining. Results After the mouse bone marrow cells were purified with Histopaque©-1077, Histopaque©-1119, the cells expressed Ly6G. High Content Screening was used to detect the expression of MPO, as demonstrated by the increased expression of MPO (3.26±0.22) stimulated by 100 nmol/L PMA for 2 hours. Conclusion It was a simple method for separation, purification and identification of mouse neutrophils from bone marrow.
    Pathological mechanism study on the colitis mice model
    Yang Min, An Guo, Zhao Wei, Ma Yuanyuan
    2018, 39(5):  704-709.  doi:10.3969/j.issn.1006-7795.2018.05.015
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    Objective To study the pathological and immune mechanism in the ulcerative colitis(UC) mice induced by dextran sodium sulfate (DSS) that could be provide clue for the treatment. Methods We feed the mice with DSS solution for one, three, five days and the solution without DSS was as control group. Immunohistochemistry was used to detect pathological feature in colon tissues of mice; real-time PCR was performed to investigate immune factors expression. Results Via DSS solution to feed the mice with a variable of times, mouse weight decreased, length of colon shortened and spleen of mice enlarged, gradually. The result from HE staining on the colon tissues of mice with 5 days DSS feeding showed that enterelcosis existed; MPO staining demonstrated that neutrophile granulocyte widely invaded. In addition, inflammatory factor and inflammatory associated factors including tumor necrosis factor-α (TNF-α), interleukin-1α (IL-1α), IL-1β, IL-6,[chemokine(C-X-C motif) ligand 1,CXCL-1], CXCL-2 and cyclooxygenase-2 (COX-2) were significantly increased. Conclusion Using DSS solution to feed the mice with 5 days formed UC model infiltrating with a lot of inflammatory factors and chemokines, indicating occurrence and progression of UC are associated with infiltrating inflammatory factors and inhibiting these factors may control disease.
    Research on monitoring synthesis systems of aspirin with sodium acetate as the catalyst by ultraviolet absorption and derivative spectrometry
    Shao Jianqun, Tang Jingcheng, Xu Yanxia, Zhang Feng
    2018, 39(5):  710-714.  doi:10.3969/j.issn.1006-7795.2018.05.016
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    Objective To research on monitoring synthesis systems of aspirin with sodium acetate as the catalyst. Methods Each standard work curve of aspirin and salicylic acid were established with second derivative value against concentration at the wavelengths of 289 nm and 308 nm. Under different temperatures, the real-time content of aspirin and salicylic acid in synthesis reaction system were monitored. Results When the reaction temperature was 45,55,65 and 75℃, the complete reaction times were about 20, 10, 4 and 3 min individually. Conclusion The length of the synthesis of aspirin reaction time was significantly shorter with the higher reaction temperature by using sodium acetate as catalyst. The ultraviolet absorption and derivative spectrometry can be achieved on the monitoring and judging aspirin synthesis reaction endpoint.
    Bio-informative analysis of severe intrauterine adhesion related gene
    Liu Xin, Duan Hua, Cheng Jiumei, Chen Fang, Xu Qian
    2018, 39(5):  715-720.  doi:10.3969/j.issn.1006-7795.2018.05.017
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    Objective To detect the mechanism in molecular level of severe intrauterine adhesion(IUA). Methods Thirteen severe IUA tissues and thirteen normal uterus tissues were abtained.Three samples of each group were tested by gene chip.Ten remained samples of each group were used to verified the results of the gene chip by RT-PCR. Then the target genes were subjected to gene ontology and pathway analysis by Go database and Kyoto Encyclopedia of Genes and Genomes (KEGG). Results A total of 1 425 mRNA species were differentially expressed in IUA tissue versus normal uterineus tissue. Of these, 731 mRNAs were highly expressed and 694 mRNAs were lightly minimally expressed in IUA tissues. Further functional analysis showed the function of these gene are involved in signal transduction,multi cell organism development,cell-cell adhesion,cell differentiation,monocyte activation et al.The further analysis indicated the expression level of some mRNAs such as COL16A1, ADAM-9,CDH2, LOX were consistent with the results of gene chip. Conclusion We can use the method of bio-informative analysis to study the data obtained from the gene chip. There are mRNAs that may play a role in the expression and function of extracellular matrix during the formation of IUA.
    Endoscopic and clinical characteristics of heterotopic gastric mucosa in duodenum
    Meng Ying, Zhou Yanhua, Li Peng
    2018, 39(5):  721-725.  doi:10.3969/j.issn.1006-7795.2018.05.018
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    Objective To analyze 65 cases of heterotopic gastric mucosa (HGM) in duodenum and investigated the endoscopic and clinical characteristics of HGM in duodenum. Methods Clinical and endoscopic data about 65 patients with pathology-confirmed HGM in duodenum admitted to our hospital from July 2015 to August 2016 were retrospectively analyzed. Results HGM of duodenum was mainly located on the anterior wall of duodenal bulb. The morphology was mainly divided into 3 types:the single or multiple polypoid hyperplasia type in 47 patients (72.3%), clustered nodule type in 11 patients (16.9%), flat elevated type in 6 patients (9.2%). One patient (1.5%) had congestive erythematous lesion, which like duodenitis. Polypoid hyperplasia type was often misdiagnosed as duodenal polyp, while flat elevated type was difficult to be distinguished from tumor and submucosal tumor in duodenum. And it is meaningful to distinguish the atypical HGM via using endoscopic ultrasound (EUS) and magnifying endoscopy with narrow-band imaging (M-NBI). Endoscopic polypectomy is still the main method of clinical treatment in HGM. Conclusion There are many kinds of endoscopic manifestations of duodenal HGM. Combined with histological examination and endoscopic findings, misdiagnosis should be reduced. Magnifying endoscopy with narrow-band imaging may be the new and useful method in differentiating HGM in duodenum.
    Clinical analysis of 167 patients with primary hyperparathyroidism
    Wang Xin, Liu Yaqi, Cui Aimin, Zhang Ziqin, Li Xiaoyu, Bai Nan
    2018, 39(5):  726-731.  doi:10.3969/j.issn.1006-7795.2018.05.019
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    Objective To analyze the clinical features of primary hyperparathyroidism (PHPT) patients, reduce the diagnosis and treatment of the crossroads and complications. Methods Retrospective analysis of the patients with primary hyperparathyroidism diagnosed from January 2010 to March 2018 in Department of General Surgery of Beijing Jishuitan Hospital, general information, clinical manifestations and treatment, preoperative image location examination, reoperation data analysis and intraoperative specimen, postoperative pathology, parathyroid hormone (PTH) analysis, etc. Results The number of cases of primary hyperparathyroidism has increased year by year, and can be derived from clinical multi-disciplinary departments.According to their clinical manifestations, bone type and bone kidney type are common, each accounted for 53.2% and 24.6%, of which have a history of fracture 30 cases, accounting for 18%, Orthopedic surgery was performed in 24 cases, accounting for 14.4%, of which 2 or above orthopaedic surgery in 5 cases, accounting for 21% of orthopedic surgery patients. Patients with orthopedic events (fractures or suspected bone tumors) had significantly different PTH values than other patients (P=0.003).Eleven patients were not first operation, accounting for 6.6%, of which 5 were former ectopic parathyroid surgery, which accounted for 45.5% of reoperation. There was a significant difference in preoperative PTH among the parathyroid gland hyperplasia group,the parathyroid carcinoma group and the adenoma group (P<0.05). There was no significant difference in the wet weight between the three groups.Conclusion The clinical early diagnosis should be paid attention to PHPT patients, screening of patients with fracture, bone deformity or osteoporosis should be strengthened.It is difficult to determine the preoperative benign or malignant and PTH was significant. We should combine preoperative imaging and intraoperative rapid PTH detection technique to achieve accurate positioning, improve the success rate of operation, avoid multiple surgeries, or repeatedly explore during operation. For patients with recurrent disease, ectopic lesions or parathyroid carcinoma metastasis should be considered.
    Analysis of 24 cases of postoperative infection after parastomal hernia repair
    Zhao Fenglin, Liu Yiting, Chen Jie
    2018, 39(5):  732-735.  doi:10.3969/j.issn.1006-7795.2018.05.020
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    Objective To investigate the reasons of postoperative infection after parastomal hernia repair, to summarize the prevention and treatment of infection. Methods A retrospective analysis was made on the clinical data of 24 cases who were receiving the treatment of infection after parastomal hernia repair in Beijing Chaoyang Hospital, Capital Medical University, from January 2007 to December 2015. Results A total of 24 cases suffered from infection, 5 of them suffered from intestinal fistula, 3 of them suffered from patch infection, 16 of them suffered incision infection. All of them received clinical recovery by reasonable and effective treatment, no hernia recurrence and no death were found. Conclusion Many factors can cause postoperative infection after parastomal hernia repair, if infection happened, individualized treatment should be needed.
    Medium-term follow up the anterior knee pain of mobile and fixed bearing total knee arthroplasty without patella replacement
    Qiang Hua, Wang Guodong, Guo Ai, Zhao Erhong
    2018, 39(5):  736-740.  doi:10.3969/j.issn.1006-7795.2018.05.021
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    Objective Evaluate the medium-term anterior knee pain result of total knee arthroplasty (TKA) using mobile-bearing (MB) and fixed-bearing (FB) prosthesis.Methods The patients who suffer from osteoarthritis or rheumatoid arthritis and receiving TKA with MB and FB prosthesis during 2006-2009 were followed up,then divided them into two corresponding groups(Group MB,Group FB). All the patients were not be replaced the patella.The postoperative anterior knee pain incidence,Knee Society Function Score,Patellar Score and the Anterior Knee Pain Score were collected,which were compared with preoperation and with another group. The Anterior-Posterior, lateral and Merchant position X-ray pictures were taken to evaluate the patella position.Results 63 patients,85 knees were followed up. The MB group contain 31 patients,45 knees,the mean follow-up period was (5.9±1.1) years(3.9-7.6 years).The FB group contain 30 patients,40 knees,the mean follow-up period was (6.4±1.3) years(34.2-8.1 years).The postoperative scores were significantly higher than preoperation,but there are no differences between the two groups,as well as the anterior knee pain incidence.No patella dislocation or subluxation were found in the postoperative X-ray examination. Conclusion Both mobile-bearing and fix-bearing TKA can relieve anterior knee pain effectively and recovery knee function,the medium-term clinical results are satisfactory.But comparing with FB,the application of the MB prosthesis did not improve the anterior knee pain more.
    Effects of terlipressin on perioperative renal protection inpatients with liver cirrhosis and portal hypertension
    Ding Qiao, Yue Yun, Cheng Hao
    2018, 39(5):  741-746.  doi:10.3969/j.issn.1006-7795.2018.05.022
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    Objective To explore the effects of terlipressin on perioperative renal protection in patients with liver cirrhosis and portal hypertension splenectomy. Methods Forty-two American Society of Anesthesiologists (ASA) Ⅱor Ⅲ patients(28 male,14 female) aged 18-65 Year weighing 44-85 kg were randomly divided into 2 groups (n=21 each):terlipressin group and control group.In terlipressin group 2 mg of terlipressin was added to 50 mL of normal saline (NS) and was continuously infused at 10 mL/h from beginning of operation until the end of the operation,while in control group NS was infused instead of terlipressin. Three days after the incidence of acute kidney injury(AKI) and renal index. Blood and urine samples were taken before operation(T1 baseline),after operation(T2) and on the first and third day after operation(T3,T4) for determination of urinary N-acetyl-β-D-glucosidase (NAG), β2-microglobulin(β2-MG), microalbuminuria(Malb),α1-microglobulin(α1-MG),blood urea nitrogen(BUN), serum creatinine (SCr), blood β2-MG and serum cystatin C(CysC) concentration, glomerular filtration rate (GFR), urine,diuretic use in the urine.Results Two groups of patients did not occur AKI after the operation. Various renal function indicators has no statistically significant difference in the group except the diuretics were significantly lower at T2 in terlipressin group than in control group(P<0.05).But there were still some differences between the two groups when comparison was respectively made inside the groups.The GFR in the experimental group T4 was significantly increased than that of T1, while the control group have no significantly difference (P<0.01).Postoperative renal function indexes between groups, the urine β2-MG were significantly increased at T2 and T3 as compared with the baseline at T1 in control group(P<0.01),but there was no statistical difference in the experimental group. Conclusion Intravenous infusion of terlipressin may have the potential to improve the postoperative GFR in patients with liver cirrhosis and portal hypertension splenectomy, but the results still can not determine the protective effect of renal function perioperatively.
    Effects of bioelectrical impedance test frequency on quantitative assessment of breast cancer associated lymphedema
    Xu Quan, Liu Yujie, Pan Yu, Zheng Xiuyuan, Liu Jingmin, Sun Xiaohua, Zou Lili, Ma Lina, Yan Hongsong
    2018, 39(5):  747-751.  doi:10.3969/j.issn.1006-7795.2018.05.023
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    Objective To detect the bioelectrical impedance at different frequencies of lateral upper limbs in patients with breast cancer associated lymphedema, analyzed the influence of bioelectrical impedance test frequency on quantitative evaluation of lymphedema,which provided the basis for the quantitative evaluation of bioelectrical impedance technology in clinical application in breast cancer associated lymphedema.Methods A total of 30 patients with breast cancer associated lymphedema were randomly selected, and the multifrequency bioelectrical impedance analyzer was used to detect the biological resistance values of upper extremity with different frequencies. The difference of mean circumference and bioelectrical impedance between the upper limb of the healthy side and the affected side were compared and the correlation between the mean circumference difference of the upper limbs and the impedance difference at different frequencies was analyzed.Results There was a significant difference of the circumferential diameter and the impedance under different frequency between the healthy side and the affected side (P<0.05);A significant positive correlation was found between the average circumferential diameter and the impedance difference under 50 kHz of the affected side and the healthy side of the upper limb (r=0.453,P=0.023).The percentage of affected limb impedance under 50 kHz increased significantly higher than the percentage of limb circumference increased (P<0.01).Low frequency bioelectrical impedance can be used for sensitive and quantitative evaluation of breast cancer associated lymphedema, which is consistent with traditional circumference measurement. Conclusion It indicates that low frequency bioelectrical impedance has important application value in quantitative assessment of lymphedema.
    Effect of nutritional intervention on intestinal barrier in patients with end-stage liver disease
    Bi Yanzhen, Chen Yu
    2018, 39(5):  759-764.  doi:10.3969/j.issn.1006-7795.2018.05.026
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    The intestine plays an important barrier function, apart from the functions of digestion, absorption and secretion. Most patients with end-stage liver disease have impaired functions of intestinal barrier, leading to bacterial translocation and endotoxemia, which further aggravates liver injury. Malnutrition is also a common complication of patients with end-stage liver disease. The nutritional status of patients directly affects the occurrence, development and prognosis of liver disease. Maintaining the function of the intestinal barrier through nutritional intervention has important clinical significance for the treatment of end-stage liver disease. This review is intended to summarize the latest progresses in this area.
    Discovery of cancer therapy by inhibition of negative immune regulation-the 2018 Nobel Prize in Physiology or Medicine
    Wen Mingjie, Yu Minghang, Wang Xi
    2018, 39(5):  765-769.  doi:10.3969/j.issn.1006-7795.2018.05.027
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    In October 1, 2018, The Nobel Assemble at Karolinska Institute awarded the Nobel Prize in Physiology or Medicine to Drs. James P. Allison and Tasuku Honjo for their discovery of cancer therapy by inhibition of negative immune regulation.
    Harnessing the power of evolution:directed evolution of enzymes and binding protein & Phage display-Introduction of Nobel prize in Chemistry 2018
    Cao Lixue
    2018, 39(5):  770-777.  doi:10.3969/j.issn.1006-7795.2018.05.028
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    The power of evolution is revealed through the diversity of life. The Nobel Prize in Chemistry 2018 was awarded to Frances H. Arnold, George P. Smith and Sir Gregory P. Winter for the way they have taken control of evolution and used it for the greatest benefit to humankind. Enzymes developed through directed evolution are now used to produce biofuels and pharmaceuticals, among other things. Antibodies evolved using a method called phage display can combat autoimmune diseases, and in some cases, cure metastatic cancer. This article overviewed their research discoveries with the highlighted significance.
    The 2018 Lasker Awards(Ⅰ)-Basic Medical Research and Special Achievement in Medical Science
    Niu Huan, Cheng Shan, Ding Wei
    2018, 39(5):  778-782.  doi:10.3969/j.issn.1006-7795.2018.05.029
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    On September 11, 2018, the winners of Lasker Awards 2018 were announced. The Albert Lasker Basic Medical Research Award honored to molecular biologist C. David Allis from Rockefeller University and biochemist Michael Grunstein from the University of California. The two scientists have elucidated how gene expression are influenced by chemical modification of histones. Their discovery unveiled a previously hidden layer of gene control, therefore, established a novel field of the epigenetic control of gene expression.The 2018 Lasker Koshland Award for Special Achievement in Medical Science honored Joan A. Steitz, a molecular biologist and biochemist at Yale University. She contributed the leadership as well as a role model in biomedical science, predominantly in RNA biology.
    The 2018 Lasker Awards(Ⅱ)
    Wei Changwei, Yue Yun, Wu Anshi
    2018, 39(5):  783-790.  doi:10.3969/j.issn.1006-7795.2018.05.030
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    In September 11, 2018, the list of winners of the year's Lasker Awards were released. The Albert Lasker Basic Medical Research Award honors C. David Allis from Rockefeller University and Michael Grunstein from University of California, Los Angeles, for discoveries elucidating how gene expression is influenced by chemical modification of histones. The 2018 Lasker-DeBakey Clinical Medical Research Award honors John B. Glen (retired from AstraZeneca), who discovered and developed propofol, a chemical whose rapid action and freedom from residual effects have made it the most widely used agent for induction of anesthesia in patients throughout the world. The 2018 Lasker-Koshland Award for Special Achievement in Medical Science honors Joan Argetsinger Steitz from Yale University, for her discoveries in RNA biology, generous mentorship of budding scientists, and vigorous and passionate support of women in science.