Table of Content

21 November 2019, Volume 40 Issue 6

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Application and progress of contrast-enhanced ultrasound in cerebral perfusion imaging

Cheng Linggang, He Wen

2019, 40(6):  813-817.  doi:10.3969/j.issn.1006-7795.2019.06.001

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Perfusion index is a commonly used indicator for assessing microcirculation in brain tissue. It has important applications in the evaluation of stroke, epilepsy, Alzheimer's disease and intracranial space-occupying lesions. Ultrasound contrast cerebral perfusion imaging technique features in real-time, convenience, less allergic reactions, and so on. The related research is increasing.

Correlation between conventional ultrasound and contrast-enhanced ultrasound and lymph node metastasis of papillary thyroid carcinoma

Jiang Bo, Luo Yukun, Zhang Yan, Tian Xiaoqi, Zhang Ying, Xie Fang, Song Qing, Tang Jie

2019, 40(6):  818-823.  doi:10.3969/j.issn.1006-7795.2019.06.002

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Objective To evaluate the correlation between the characteristics of ultrasound and contrast-enhanced ultrasound (CEUS) and lymph node metastasis of papillary thyroid carcinoma (PTC). Method A retrospective analysis was conducted on the patients who underwent surgery in the PLA General Hospital in 2018 due to suspicious single thyroid nodule. Routine two-dimensional ultrasound examination and CEUS examination were performed before surgery. Patients' age, gender, conventional ultrasound and CEUS characteristics of the lesions were recorded. The gold standard was based on the surgical pathological result. PTC nodules were divided into two groups according to the lymph node metastases (LNM) or not. Univariate and multivariate analyses were performed to compare the differences between ultrasonographic, CEUS characteristics and lymph node metastasis. Result A total of 293 nodules were enrolled in this study, which includes 134 nodules with LNM while 159 nodules without LNM. Univariate analyses shows statistically significant differences about patients' ages, gender, the maximum diameter of PTC nodule, echogenicity of the nodule, taller than wide, Color Doppler flow imaging(CDFI), capsule extension on ultrasound, ultrasound scanning suspicious LNM, enhancement pattern, homogeneity, wash-out speed, capsule extension on CEUS between the two groups. Logistic regression revealed that risk factors of cervical lymph node metastasis (CLNM) included young patients (P=0.008), male gender (P<0.001), large PTC nodule (P=0.017),rich blood flow in CDFI (P=0.034)and capsule extension on CEUS (P=0.033). Conclusion Some characteristics of ultrasound and CEUS are correlated with LNM of PTC, which may play a role in the prediction of LNM of PTC.

A study on the diversity ultrasonographic manifestations of carotid web: compared with histopathology

Ning Bin, Zhang Dong, Wang Lishu, Jin Jin, Gan Yuyang, Song Haiman, Yu Tengfei, He Wen

2019, 40(6):  824-828.  doi:10.3969/j.issn.1006-7795.2019.06.003

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Objective To observe the features of carotid web with plaque or thrombosis by ultrasound,compared with histopathology, in order to reduce missed diagnosis and misdiagnosis. Methods From June 2018 to may 2019,146 patients were enrolled who underwent carotid endarterectomy and preoperatively ultrasound examination in our hospital. The image of carotid artery stenosis was scanned and observed carefully to confirm the carotid web. If a carotid web structure was confirmed, associated plaques or thrombosis around was verified and measured. The echo characteristics, length, thickness and direction in the lumen, and floating in the carotid artery were recorded. Postoperative pathological analysis was performed.Results Postoperative pathology confirmed 19 cases of carotid web, 17 cases of which associated with atherosclerosis plaque and 2 cases with thrombosis. In these 2 cases, the lumen in one case was occluded, and the other case resulted in lumen stenosis. Compared with pathology, 16 cases of carotid artery web with plaque formation and 1 case of carotid artery web with thrombosis were correctly diagnosed by ultrasound before surgery, 1 case was misdiagnosed as plaque surface ulceration before surgery, and 1 case was missed diagnosed as the internal carotid artery occlusion due to the carotid web missed.Conclusion Ultrasound examination of carotid web with plaque or thrombosis has a high accuracy rate, but it is necessary to understand the disease, the gross specimen and histopathology before making a correct diagnosis.

Anti-cyclic citrullinated peptide antibody in rheumatoid arthritis: relation with bone erosion

Li Wenxue, Liu Fang, Zhu Jiaan, Liu Fang, Chen Zheng, Li Diancheng

2019, 40(6):  829-832.  doi:10.3969/j.issn.1006-7795.2019.06.004

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Objective To explore the relationship between the anti-cyclic citrullinated peptide (ACCP) antibody and bone erosion in patients with rheumatoid arthritis (RA). Methods One hundred and one RA patients were enrolled. Eighty-one of these patients were female, and 75 cases were ACCP positive. Gray scale (GS) and power Doppler (PD) ultrasound was performed to assess bone erosion, synovial hypertrophy, and PD signal. The bilateral wrists, I-V metacarpophalangeal joints, Ⅱ-Ⅲ metacarpophalangeal joints of the hands were detected by GS and PD ultrasound. Appropriate statistical analysis methods were used to analyze the difference of ultrasonographic characteristics in ACCP-positive and ACCP-negative patients, and explore the relationship of the ACCP antibody, disease duration with bone erosion. Results Bone erosion score in ACCP-positive patients was significantly greater than in ACCP-negative patients (P=0.009). No statistically significant difference was observed in synovial hypertrophy and PD signal between ACCP-positive patients and ACCP-negative patients. In RA patients with a disease duration >3 years, however, bone erosion score in ACCP-positive patients was significantly greater than that in ACCP-negative patients (P=0.01). Conclusion ACCP-positive RA patients with a disease duration >3 years had higher bone erosion score.

Synthesis and evaluation of semiconductor polymer nanoparticles for photoacoustic imaging

Liu Juan, Hu Minxia, Ren Wei, Ma Teng, Zhu Qiang, Zhao Hanxue

2019, 40(6):  833-837.  doi:10.3969/j.issn.1006-7795.2019.06.005

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Objective To prepare semiconductor polymer nanoparticles (SPNs) for photoacoustic imaging. Methods SPNs was prepared by using poly(cyclopentadithiophene-alt-benzothiadiazole) according to nanoprecipitation method. The characteristics and biosecurity of the SPNs were assessed, and the photoacoustic imaging capability of SPNs was also evaluated in vivo. Results The mean size of SPNs was (61±3)nm, and its mean potential was (-38±2)mV. In vitro cytotoxicity test showed the reactive viability of Hela cell was not affected. The enhanced photoacoustic signal in vivo murine tumor model was achieved by using the SPNs under 680nm laser-activation. Conclusion The preliminary study developed a type of SPNs with small size, biosafety and stability. The stronger photoacoustic signals in murine tumor model were obtained by using the SPNs.

Relationship between fetal cardiac axis angle and congenital heart defects in the second trimester of pregnancy

Su Fangfei, Wang Jingjing, Yin Chenghong, Yue Wentao, Wu Qingqing

2019, 40(6):  838-841.  doi:10.3969/j.issn.1006-7795.2019.06.006

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Objective To explore the relationship between fetal heart axis angle and the fetal congenital heart disease (CHD) in the second trimester of pregnancy by measuring the angle of fetal heart axis. Methods There were 52 fetuses in the abnormal group and 104 in the control normal group were selected as the research objects, all the pregnant women were taken maternal and infant health records and taken standardized prenatal ultrasound screening in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from December 2017 to May 2019. According to the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) practice guidelines for sonographic screening examination of fetal heart, the fetal axis angle was measured in the four-chamber view of the fetus. Results There was no significant difference in maternal age and fetal age between the abnormal group and the control group (t=1.825、-0.928,P>0.05). The cardiac axis angle of abnormal group was (50.03°±24.02°), and that of control group was (42.64°±6.30°) respectively. The difference was statistically significant between the two groups (P<0.05). The proportion of abnormal axis was 30.77% (16/52) in abnormal group and 0.96% (1/104) in control group, with statistical significance (P<0.05). The risk of CHD in fetuses with abnormal axis angle increased by nearly 45 times, it suggested that the n abnormal fetal heart axis angle is closely related to CHD. Conclusion Abnormal fetal cardiac axis is closely related to fetal CHD and has certain value in CHD diagnosis. If abnormal fetal cardiac axis was identified by ultrasound screening, more attention should be paid to fetal cardiac examination.al cardiac axis was identified by ultrasound screening, more attention should be paid to fetal cardiac examination.

Two-dimensional speckle tracking technique for evaluating left atrial function after patent foramen ovale closure

Wang Yumeng, He Wen, Du Lijuan, Fu Qiang, Zhang Huiqin, Huang Wenyan, Li Yuanzi

2019, 40(6):  842-845.  doi:10.3969/j.issn.1006-7795.2019.06.007

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Objective To evaluate the effect of interventional therapy on left atrial function in patients with patent foramen ovale(PFO) using two-dimensional speckle tracking.Methods Totally 45 patients diagnosed with PFO from June 2018 to January 2019 in Beijing Tiantan Hospital, Capital Medical University, and underwent transcatheter closure of PFO were enrolled. All patients underwent transthoracic echocardiography before surgery, 1 d after surgery, and 1 month after surgery, and images were stored. The left atrial strain-time curve was obtained by two-dimensional speckle tracking technique. The overall longitudinal strain values of the left atrium in the reservoir phase, the conduit phase and the contraction phase were measured. The paired sample t-test was used to compare the differences between the overall longitudinal strain values at 1 d before operation, 1 d after operation and 1 month after operation. Results The overall longitudinal strain values of the left atrium on the postoperative first day were significantly lower than those before operation (P<0.05),but returned to normal after one month in 35 patients who were followed-up, with no significant difference between one month after surgery and that before surgery (P>0.05). Conclusion The closure of patent foramen ovale may has a transient effect on the left atrial mechanical function. The patient should be closely monitored within 1 month after operation.

Analysis of features of atypical hyperplasia patients with postoperative pathologic upgrade

Huang Wenyang, Zheng Xiaojuan, Jiang Ying, Wang Shuzhen

2019, 40(6):  846-850.  doi:10.3969/j.issn.1006-7795.2019.06.008

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Objective To investigate high-risk factors and clinicopathological features associated with atypical hyperplasia(AH)patients with postoperative pathologic upgrade to endometrial cancer(ECa). Methods Clinicopathological data was obtained from 166 patients who underwent total hysterectomy for the treatment of AH (diagnosed by curettage) from January 2002 to December 2018 and were retrospectively analyzed. On the basis of the pathological evaluations post total hysterectomy,the patients were classified into two groups:ECa (74 cases) and AH (92 cases). The clinical features of the two groups were further analyzed to identify the high-risk factors responsible for the postoperative pathological upgrade to ECa. The pathologic features of patients was analyzed, who were diagnosed with AH by curettage but with postoperative pathologic upgrade to ECa after hysterectomy. Totally 325 patients diagnosed with ECa by curettage during the same period were set as the control. Results ECa was found in 74 of the 166 patients who underwent hysterectomy due to AH,with an incidence rate of 44.58%(74/166). Univariate analysis showed that advanced age,menopause,long-term abnormal bleeding,and endometrial thickening without hysteroscopy were high-risk factors associated with the postoperative pathological upgrade to ECa (P<0.05). Furthermore,advanced age,late menopause,endometrial thickening and long-term abnormal bleeding contributed mainly to the postoperative pathological upgrade to ECa, as suggested by multivariate analysis (P<0.05). All patients with postoperative pathological upgrade to ECa were endometrial adenocarcinoma,of which 91.89% (68/74) of the surgical pathological stages were stage Ia,and 74.32% (55/74) of the pathological grades were well differentiated. Conclusion ECa was found in 44.58% of patients with AH diagnosed by curettage,which led to pathological upgrade after hysterectomy. Advanced age,menopause,late menopause,long-term abnormal bleeding,premenopausal endometrial thickening, and postmenopausal curettage without hysteroscopy contributed to pathological upgrade to ECa. ECa found by postoperative pathological upgrade are usually endometrioid adenocarcinoma with high degree of tissue differentiation,early stage and good prognosis.

Clinical feasibility of endometrial sampler in the histological diagnosis of endometrial lesions

Jiang Ying, Zhai Yan, Wang Qiushi, Shi Xiao, Wang Shuzhen

2019, 40(6):  851-856.  doi:10.3969/j.issn.1006-7795.2019.06.009

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Objective To investigate the clinical feasibility of endometrial sampler in the diagnosis of endometrial lesions. Methods Prospective self-control method was applied to observe the reliability and feasibility of the endometrial sampler used in patients with endometrial biopsy indications, in compared with hysteroscopic endometrial biopsy subsequently. Endometrial tissue adequacy and histopathologic diagnoses were evaluated and compared between the two different sampling methods of endometrial biopsy in the same patient. The causes of biopsy failure and endometrial tissue inadequacy to make pathological diagnosis were also analyzed. Results The McNemar test for matched-pairs data about obtaining endometrial tissue shows the high consistency between the two groups(McNemar P=0.791).The coincidence rate of pathological diagnosis of endometrial tissue between the sampler and the curettage group was 92.56%. The overall diagnostic failure rates were 15.93%(29/182) and 14.28%(26/182)(χ²=0.193,P=0.770)for the sampler and the curettage group, respectively. The rates of none tissue obtained by the two methods were 13.18% (24/182)and 12.08%(22/182)(χ²=0.100,P=0.875),respectively. There was no significant difference in the quality of endometrial tissue obtained by the two sampling methods(χ²=0.188,P=0.910). Endometrial thickness was an independent risk factor for failure in the sampler group by multivariate analysis of high risk factors. The sampling failure rate in postmenopausal women in both groups was significantly higher than that in fertile women(both P<0.001). The failure rate in both curettage and sampler groups was 28.99% in postmenopausal patients. The failure rates of the two sampling methods were 1.77% and 3.54% for women of reproductive age,respectively. Conclusion Endometrial sampler was comparable to curettage in terms of tissue adequacy. The operation is simple, and patients have less pain. We definitively recommend the use of endometrial sampler in place of curettage for women of reproductive age and most menopause.

Clinical characteristics of the double primary malignant tumors of uterine corpus/breast

Wang Wei, Zhang Zihan, Zhai Yan, Sang Cuiqin, Wang Shuzhen

2019, 40(6):  857-862.  doi:10.3969/j.issn.1006-7795.2019.06.010

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Objective To investigate the clinical and pathological characteristics of the double primary malignant tumors of uterine corpus/breast. Methods A case-control study was performed for the clinical and pathological data of 29 patients with primary malignant uterine tumor and breast cancer (double cancers group) and 319 patients with only endometrial malignancy (single cancer group) who had visited Beijing Chaoyang Hospital during January 2004 to January 2015. Results Double cancers group showed a significantly higher percentage of patients with diabetes(χ²=8.02,P=0.007),family history of cancer(χ²=31.76,P<0.001),with other primary tumor(χ²=31.76,P<0.001),and type Ⅱ endometrial carcinoma(χ²=5.52,P=0.030) and poorly-differentiated cancer tissue (χ²=8.39,P=0.02)compared with endometrial malignant group. Endometrial cancer group had a significantly better overall survival compared with double cancers group (Log-rank=6.75,P=0.011). Stratified analysis showed that the group of double cancers with primary endometrial malignancy showed a significantly higher percentage of patients with type Ⅱ endometrial carcinoma (58.33% vs 11.76%) than that with primary breast cancer, with a significantly shorter interval between the two tumors (t=2.23,P=0.028). Conclusion The clinical and pathological characteristics of endometrial malignancy with primary breast cancer is different from that of only endometrial malignancy. The clinical and pathological characteristics of breast cancer with primary malignant uterine tumor is different from that of endometrial malignant with primary breast cancer.

Treatment options for patients with non-atypical endometrial hyperplasia

Wang Shuzhen, Liu Wenting, Huang Wenyang, Zhang Yang, Zheng Jing, Jiang Ying

2019, 40(6):  863-867.  doi:10.3969/j.issn.1006-7795.2019.06.011

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Objective To investigate the treatment options for patients with non-atypical endometrial hyperplasia (EH) who present the abnormal uterine bleeding (AUB). Methods We retrospectively reviewed medical charts between June 2011 and June 2018 at a tertiary hospital and identified 394 cases of AUB with non-atypical endometrial hyperplasia. Results Totally 394 patients included 258 patients with simple EH and 136 patients with complex EH. The response of simple EH group to progesterone therapy was significantly better than that of complex EH group. The distribution of three different project of progesterone in the two groups was significantly different. The proportion of periodic progesterone in the simple EH group was significantly higher than that in the complex EH group.6 patients in the complex EH group had hysterectomy because of the progress or the persistence of the lesion,while none of the patients in the simple EH group. Hysterectomy:31 patients in the simple EH group and 35 patients in the complex EH group were treated with hysterectomy. Compared with the hysterectomy specimens,the diagnostic curettage (D&C) may be the underdiagnosis for complex EH. In the complex EH from D&C,two endometrial carcinoma and 8 cases of atypical hyperplasia were misdiagnosed. Conclusion D&C is safety and effective for most patients with EH,especially for simple EH. In clinical practice,any patients should be treated with progesterone,and the lesions should be closely monitored.

Establishment a mesenchymal stem cell line model derived from Klinefelter syndrome fetal umbilical cord

Luo Jianan, Yang Shufa, Yu Xiuyi, Liu Xin, Chen Zhenwen

2019, 40(6):  868-874.  doi:10.3969/j.issn.1006-7795.2019.06.012

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Objective We succeeded in establishing a mesenchymal stem cell line (Klinefelter's syndrome umbilical cord mesenchymal stem cells, KUMSCs) from Klinefelter syndrome (KS) fetal umbilical cord for the klinefelter's syndrome disease research. Methods Umbilical cords of aborted fetuses with Klinefelter syndrome were obtained from the clinical hospital. KUMSCs were isolated and expanded in vitro, and the analytical techniques included:quality detection, flow cytometry, karyotype analysis and cell differentiation experiments. Results The content of pathogens (bacteria, fungi, viruses, spirochetes, mycoplasma) and endotoxin of mesenchymal stem cells were all in line with the quality control standards, KUMSCs cells were positive for CD73, CD90, CD29, CD105 and CD44, negative for CD34, CD45 and human leukocyte antigen-DR(HLA-DR). Cell differentiation assay results indicate that KUMSCs can be induced to differentiate into adipocytes, osteoblasts. Conclusion These results indicate that a model of umbilical cord mesenchymal stem cells derived from KS has been successfully established, which can be applied to the experimental study of the pathogenesis and drug development of Klinefelter syndrome.

A functional laboratory biochemical model for the prediction of pulmonary fibrosis risk

Leng Dong, Li Guiqin, Wang Ying, Miao Ran, Chen Duo, Huang Xiaoxi

2019, 40(6):  875-880.  doi:10.3969/j.issn.1006-7795.2019.06.013

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Objective To determine promising indices for early diagnosis of pulmonary fibrosis (PF) by data extraction and analysis. Methods Biochemical data from patients with PF (n=29) and healthy controls (n=55) were collected and normalized by Z-score indexation and Log2 transformation,followed by principal component and Bayesian probit regression analyses. Signature parameters for PF were identified and used for discriminative function modeling and receiver operating characteristic analysis. Results The α-hydroxybutyric dehydrogenase (HBDH),lactic dehydrogenase,albumin,albumin:globulin ratio,prealbumin,and calcium parameters were significantly different between PF and healthy control samples (P<0.05),and discriminant functions of PF and health were constructed. HBDH was found to be the efficient parameter that could indicate the potential risk of PF. Conclusion This study is attempt to investigate PF serum biochemical characteristics by mining of clinical biochemical data. Discriminant functional model for predicting PF with signature biochemical parameters were constructed successfully.

Inhibition by Soufengshunqi decoction towards γδT17 of psoriatic mice which induced by imiquimod

Guo Xiaoyao, Di Tingting, Zhao Jingxia, Wang Yan, Xie Xinran, Zhai Chunyan, Liu Zhengrong, Meng Yujiao, Liu Yu, Guo Jianning, Zhang Lu, Wang Ning, Zhang Lei, Li Ping

2019, 40(6):  881-888.  doi:10.3969/j.issn.1006-7795.2019.06.014

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Objective To observe the effect of Soufengshunqi(SFSQ)decoction on the skin lesions induced by imiquimod(IMQ)in silver-like mice,and to explore its mechanism of action in psoriasis. Methods Forty BALB/c mice were shaved on the back. They were randomly divided into control group,IMQ group,Sofengshunqi decoction group and methotrexate(MTX)group by 5% (mass fraction) imiquimod. The back of the special cream is applied to induce a skin psoriasis-like IMQ. The lesion area and severity index (PASI) were observed and scored. Morphological changes and epidermal layer thickness of the lesions were observed under light microscope. Ki-67 was observed by immunofluorescence staining in mouse skin lesions. CD3+ T lymphocyte expression in the dermis of the lesions was detected by immunohistochemistry. The ratio of CD4+,CD8+,γδT+ and RORγt+ γδT+ cells in thymus and lymph node CD3+ T cells were detected by Western blotting. Expression of the phosphorylated-signal transduction and activators of transcription 3 (p-STAT3) was tested. Results Compared with the IMQ group,the PASI score and epidermal thickness of the skin of the SFSQ decoction group were significantly decreased,the spleen index (P<0.01),and the thymus index and lymph node index (P<0.01) were significantly lower than the IMQ group. The number of Ki-67 postive cells decreased (P<0.01). The expression of dermal CD3+ T cells was lower than that of the IMQ group (P<0.01). There was no significant difference in CD4+ T cells between lymph nodes and thymus CD3+ T cells but γδT+ and the proportion of RORγt+ γδT+ cells was significantly reduced. The expression of STAT3 related pathway protein P-STAT3 was decreased in the skin of SFSQ decoction group (P<0.01). Conclusion SFSQ Decoction may inhibit the secretion of IL-17A by inhibiting the expression of RORγt,thereby improving the change of psoriasis-like lesions induced by imiquimod in mice,suggesting the inflammatory response and related factors of SFSQ decoction. Its inhibitory effect may be one of its potential mechanisms for the treatment of psoriasis.

Classification prediction of lung squamous cell carcinoma and lung adenocarcinoma based on XGBoost

Leng Fei, Li Wei

2019, 40(6):  889-893.  doi:10.3969/j.issn.1006-7795.2019.06.015

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Objective To predict lung cancer subtypes of lung squamous cell carcinoma and lung adenocarcinoma,and identify the molecular markers. Methods In this study,mRNA expression of the two different cancer subtypes were studied. Genes with significant expression difference were selected,and extreme gradient boosting(XGBoost) algorithm was used to construct a model to predict subtype classification of lung cancer. Prediction performance was compared with logistic regression classification model and support vector machine (SVM) model. Results The results showed that the prediction accuracy based on XBGoost model was 96.55%,and the area under the curve(AUC) value was 99.04%,which was better than the Logistic regression classification model and support vector machine classification model. At the same time,11 genes were identified as molecular markers for the two subtypes. Conclusion There are significant differences between lung squamous cell carcinoma and lung adenocarcinoma at molecular level,which will assist clinicians in predicting disease subtypes.

Effect of estrogen on the proliferation and nude mouse tumorigenicity of endometrial carcinoma cells by mediating the expression of HOTAIR

Ma Xulan, Xia Di, Wang Huixiao, Jiang Ziwen, Dai Yinmei

2019, 40(6):  894-900.  doi:10.3969/j.issn.1006-7795.2019.06.016

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Objective To investigate the effect of estrogen on the proliferation and nude mouse tumorigenicity of endometrial carcinoma cells by mediating the expression of HOTAIR. Methods Lentivirus-mediated interference of HOTAIR expression shHOTAIR and negative control shNC were constructed and transfected into Ishikawa cells, the expression of HOTAIR was detected by qRT-PCR. Four groups were set up:control group (Ishikawa cells), E2 group (E2+Ishikawa cells), E2+shNC group (E2+shNC cells) and E2+shHOTAIR group (E2+shHOTAIR cells). qRT-PCR was used to detect the effect of E2 on the expression of HOTAIR in the four groups. The xenograft tumor model of nude mice treated with E2 and four groups Ishikawa cells of different expression of HOTAIR was constructed. The tumor formation time, the tumor formation rate and the growth curve of the xenograft tumor were recorded. The xenograft tumor was removed, whose volume and weight were measured. The pathological examination of the xenograft tumor was performed. Results The stable transfected cell lines with lentivirus-mediated interference of HOTAIR expression shHOTAIR and negative control shNC were successfully constructed, and the expression of HOTAIR was effectively inhibited (P<0.001). The relative expression of HOTAIR in E2 group was significantly higher than that of control group (P<0.001), and E2+shHOTAIR group was significantly lower than E2+shNC group (P<0.001). The xenograft tumor model of nude mice treated with E2 and four groups Ishikawa cells of different expression of HOTAIR was successfully constructed. The comparison of tumorigenic ability was as follows:E2 group>control group,E2+shNC group>E2+shHOTAIR group. The final volume (P<0.001) and final weight (P<0.001) of the xenograft tumor in E2 group were significantly higher than those in control group, and the final volume (P<0.01) and final weight (P<0.001) in E2+shHOTAIR group were significantly lower than those in E2+shNC group. The HE staining of the xenograft tumor was consistent with the pathological characteristics of endometrial carcinoma cells. Conclusion Estrogen promotes the proliferation and nude mouse tumorigenicity of endometrial carcinoma cells by up-regulating the expression of HOTAIR, which is expected to provide a new target for the treatment of endometrial carcinoma.

Construction and functional analysis of circular RNA interaction network based on open chromatin in breast cancer

Zhang Yunxian, Wang Yamei, Zhou Ping

2019, 40(6):  901-910.  doi:10.3969/j.issn.1006-7795.2019.06.017

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Objective To identify some important circular RNAs (circRNAs) in breast cancer and the molecular biological processes in which they participate. Methods Genome-wide analysis of three breast cancer cell lines:Dnase Ⅰ hypersensitive sites sequencing data (DNase-seq) and assay for transposase accessible chromatin with high-throughput sequencing data, (ATAC-seq) of MCF-7, T-47D, MDA-MB-231,and screening out the corresponding activated circRNA on the sequence of the captured gene encoding were done. Then the activated circRNA gene was enriched and screened based on KEGG pathway. In this result, the activated circRNA gene shared in three cell lines was selected, and the interaction network of activated circRNA gene in breast cancer was constructed according to the molecular biological process of Gene Ontology. Results The expression regulatory network identified 111 key functional modules, which were mainly divided into regulation and response categories, and included some important signaling pathways. In the active circRNA gene interaction network, the activated circRNA gene with connectivity greater than 50 was defined as hub gene, and the corresponding circRNA of hub gene was defined as hub circRNA, including PTK2B, PDCD6IP, ABL1, EGFR, RHOA, MTOR, NRP1, ATR, CTNNB1, ILK, NF1, PRKCA, HNRNPK, MEF2C, PMAIP1, LYN, NR4A3, SRF, AREG, PML, PTK2, ROCK2, TGFBR2, VEGFA, DLG1, HRAS, ITGA2, CREB1, STAT3, RUNX2 and TIAM1.Conclusion Activated circRNA in the chromatin of breast cancer cells is mainly involved in positive and negative regulation of cell cycle, apoptosis, proliferation, differentiation and other important cellular biological processes, which indicates that circRNA plays an important role in the occurrence and development of breast cancer.

Clinical efficacy of lineal polypeptide injection combined with chemotherapy in triple-negative breast cancer patients

Bai Xiangdong, Hao Yating, Zhang Xinxue, He Qiang

2019, 40(6):  911-915.  doi:10.3969/j.issn.1006-7795.2019.06.018

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Objective To explore the effect of lineal polypeptide injection combined with chemotherapy on the clinical efficacy in patients with triple-negative breast cancer. Methods Eighty patients with triple-negative breast cancer at Shanxi Provincial Cancer Hospital from January 2014 to December 2017 were enrolled in the study and randomly divided into control group with 40 cases and experimental group with 40 cases. In comparison with the control group treated with conventional postoperative chemotherapy, the experimental group was given the additional lienal polypeptide injection on the basis of the control group. The immunological function and clinical efficacy were compared. Results After treatment, the Karnofsky functional status score of the experimental group was significantly higher than that of the control group(F=5.793,P=0.018), and the proportion of CD4⁺ (t=5.337, P<0.001), CD8⁺(t=9.874,P<0.001), natural killer cell (NK) (t=-7.460,P<0.001) and Treg cells(t=7.113, P<0.001) were all increased to different degrees. The progress-free survival period (PFS) of the experimental group was longer than that of the control group, and the difference between the two groups was statistically significant (P<0.05).However, there was no statistically significant difference in the rate of upper limb lymphedema (P>0.05). Conclusion Lineal polypeptide injection can effectively improve the immune function and enhance the general life of triple-negative breast cancer patients.

A multi-center prospective case series study on the treatment of allergic rhinitis by acupuncture of sphenopalatine ganglion

Zhang Peng, Yang Wei, Wang Kuiji, Tan Yi, Shang Xiaojuan, Shu Ning, Wang Xiang, Xu Shiwen, Sun Sanfeng, Zhao Xinyu, Yu Kun, Chen Luquan

2019, 40(6):  916-920.  doi:10.3969/j.issn.1006-7795.2019.06.019

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Objective To evaluate the clinical efficacy of acupuncture on sphenopalatine ganglion in the treatment of allergic rhinitis (AR). Methods Totally 222 patients with allergic rhinitis were enrolled in 7 sub-centers from April 2017 to June 2018. The baseline of the patients was the same among the sub-centers, once a week for 4 times. Total nasal symptom score (TNSS) and total nonnasal symptom score (TNNSS) were evaluated before treatment, 2, 3, 4 and 8 weeks, respectively. Rhinconjunctivitis quality of life questionnaire (RQLQ) was evaluated before treatment, 4 and 8 weeks. Results One of 222 patients was lost to follow-up. Totally 221 TNSS, 218 TNNSS and 213 RQLQ were included in the effective scale. The scores of patients' TNSS scale and TNNSS scale decreased continuously from the 2^nd week of acupuncture to the 8^th week (4 weeks after the end of treatment, the end point of observation). The scores of RQLQ scale decreased significantly at the 4^th week and continued to decrease to the 8^th week. The differences were statistically significant. One patient had mild adverse reaction of cheek swelling. During the 8-week observation period, the control rate of AR patients exceeded 80%. Conclusion Acupuncture of sphenopalatine ganglion is effective, safe and can be popularized in the treatment of AR. Further research will increase objective index evaluation, supplement observation of immediate effect of acupuncture, refine the types of possible adverse reactions, prolong the follow-up time, clarify the effect of different stimulation methods on AR treatment effect, standardize the acupuncture program, and optimize the patient's treatment experience.

Clinical features and outcome regarding head and neck non-rhabdomyosarcoma soft tissue sarcoma in children

Duan Chao, Wang Shengcai, Jin Mei, Zhang Dawei, Zhao Wen, Wang Xisi, Zhao Qian, Tai Jun, Zhang Jie, He Lejian, Zhang Jianguo, Ni Xin, Ma Xiaoli

2019, 40(6):  921-926.  doi:10.3969/j.issn.1006-7795.2019.06.020

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Objective The purpose for this study was to explore the clinical presentation, treatment, survival and risk factors of head and neck non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) in pediatric patients. Methods The clinical data of head and neck NRSTS patients diagnosed between Oct.2012 and Feb.2018 were retrospectively studied. Clinical features, treatment and outcomes were analyzed. Results Eleven patients were enrolled in this study, including 7 boys and 4 girls, with a median age of 5.6 years. Including malignant rhabdoid tumors(n=3),synovial sarcoma(n=2), fibrosarcoma(n=3), malignant neurilemmoma(n=1), undifferentiated small round cell sarcomas with CIC-DUX4 fusion (n=1), and undifferentiated small round cell sarcomas (n=1). The primary site of the tumor including neck (n=4), scalp and facial soft tissue (n=3), oral cavity and oropharynx(n=3), and fossae infratemporalis (n=1). The diameter of the tumor ≥ 5 cm(n=6),<5 cm(n=5). Six patients had local lymph node metastasis, and 3 patients had distant metastasis. All patients(n=11) received systemic chemotherapy, radiation therapy was carried out in 3 patients, 4 patients received ¹²⁵I particle implantation, 4 patients did not receive any adjuvant radiation. Surgery was performed in 5 patients, and 6 patients only received biopsy. The follow-up time was 10-78 month, and median follow-up time was 19 month. The estimated mean survival time was (64.7±6.9) month (95%CI:51.1-78.2%). The 1-year overall survival was (88.9±10.5)%. Conclusion In this series, most of the pediatric head and neck NRSTS are nonmetastatic, and the short-term outcome is favorable. ¹²⁵I particle implantation is effective for local control, and improved systemic therapies are needed for patients with metastatic disease.

Quality evaluation of randomized controlled trials on the effect of fermentative cordycepic fungal powder on chronic obstructive pulmonary disease and interstitial lung diseases

Cui Ai, Cao Rui, Zhang Hui, Huang Liru, Yuan Xueyan

2019, 40(6):  927-937.  doi:10.3969/j.issn.1006-7795.2019.06.021

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Objective To evaluate the quality of randomized controlled trials (RCTs) for Fermentative Cordycepic Fungal Powder on chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILDs). Methods The electronic databases of Medline via PubMed, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure(CNKI), WANFANG data base and VIP were searched for human randomized controlled trial (RCT) and quasi-RCT by using the key words Fermentative Cordycepic Fungal Powder, COPD and ILDs. The quality was assessed by using recommended criteria by Cochrane Collaboration. The quality of each report was assessed by using the consolidated standards of reporting trials (CONSORT) checklist. Professional assessment of diagnostic criteria, interventions, and outcome indicator setting were accorded with clinical guidelines. Results Totally 126 were met the inclusion criteria, among them, 112 were related to COPD, and 14 were related to interstitial lung disease or silicosis with COPD. The quality of the research methodology (COPD correction rate 0%-35.7%; ILDs correction rate 9.1%-18.2%) and the quality of the reports of the reports in this group were defective and need to be urgently improved. The selected literature also has great defects in the confirmation of the diagnosis (COPD rational rate 42.3%;ILDs rational rate 78.6%), the setting up of treatment plans (COPD rational rate 28.8%;ILDs rational rate 14.3%), the parameters using to evaluate efficacy (COPD rational rate 50%;ILDs rational rate 64.3%) were also need to be improved. Conclusion The current literatures don't warrant the efficacy of the comprehensive treatment with fenebtable on the improvement of COPD and ILDs for the lack of decentness among current studies, and well-designed researches are needed to determine the aforementioned clinical significance.

Analysis of body mass index and the prognosis of secondary lymphedema in lower extremities

Su Wanchun, Sun Yuguang, Xia Song, Xin Jianfeng, Chang Kun, Shen Wenbin

2019, 40(6):  938-942.  doi:10.3969/j.issn.1006-7795.2019.06.022

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Objective To study the effect of body mass index (BMI) on the degree of swelling and prognosis of patients with secondary lymphedema of lower extremities. Methods Retrospective analysis of the clinical data of 96 patients with secondary lymphedema of lower extremities at Department of Lymph Surgery, Beijing Shijitan Hospital, Capital Medical University from October 2014 to March 2016.They were divided into normal group (BMI 18.5-23.9 kg/m²,25 cases), overweight group (BMI 24.0-27.9 kg/m²,38 cases) and obesity group (BMI ≥ 28.0 kg/m²,33 cases). The clinical data of preoperative and postoperative were compared among the three groups. Results There were no significant differences in the general data of the three groups (P>0.05). Circumference and volume difference between pre-operation and 6 months after operation were significantly different (P<0.001) in three groups. There was a significant difference in fat aspiration, preoperative volume difference, preoperative circumference difference, volume difference of 6 months after surgery and circumference difference of 6 months after surgery between the obesity group and the normal group. There was a significant difference in volume difference of 6 months after surgery,and circumference difference of 6 months after surgery between the overweight group and the normal group. Conclusion BMI is associated with the degree of swelling and prognosis of secondary lymphedema in the lower extremities, and is an important predictor of the severity and surgical outcomes.

Assessent of portal vein based on a novel virtual monoenergetic algorithm in dual-energy CT

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

2019, 40(6):  943-947.  doi:10.3969/j.issn.1006-7795.2019.06.023

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Objective To explore the effect of a novel virtual monoenergetic plus imaging (Mono+) reconstruction algorithm on image quality in portal venography by dual energy CT (DECT) imaging. Methods sixty patients who received abdominal DECT were retrospectively included. Mono+ images were reconstructed at 40,50,60,70, 80, 90 and 100 keV levels. Contrast to noise ratio (CNR),signal to noise ratio (SNR),image quality scores of the main stem of portal veins of 40-100 keV Mono+ images were compared to standard linearly blended M_0.5 images (50% 100 kV, 50% 140 kV)with paired t-test. Results Mono+ DECT series showed a statistically superior CNR at 40,50, 60 and 70 keV compared to M_0.5 images for the main stem of portal vein(P<0.05). SNR of Mono+ images was consistently significantly higher at 40, 50, 60,70 and 80 keV compared to M_0.5 for the main stem of portal vein(P<0.05).The image quality score of Mono+ 40-70 keV series for the main stem of portal vein was significantly better than that of M_0.5 group (P<0.05).The CNR and SNR of Mono+ 40 keV series for the main stem of portal vein were 3.57 times and 1.53 times as much as those of M_0.5 images, respectively.Conclusion Mono+ is a very promising algorithm which is able to overcome noise limitations. Compared to linearly blended images(M_0.5) Mono+ reconstructions at 40 keV levels of portal venography in dual energy CT significantly improved quantitative image quality.

Clinical observation of transcranial direct current stimulation in the treatment of mild to moderate senile depression

Wang Jianping, Gui Peijun, Xie Ying

2019, 40(6):  948-952.  doi:10.3969/j.issn.1006-7795.2019.06.024

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Objective To investigate the clinical efficacy of transcranial direct current stimulation (tDCS) in the treatment of mild to moderate senile depression.Methods From January 2018 to December 2018, forty patients with mild to moderate senile depression were selected from the Department of Rehabilitation Medicine, Beijing Friendship Hospital, Capital Medical University. They were randomly divided into observation group and control group (20 cases each). The observation group was treated with tDCS and the control group was treated with pseudo-stimulation of the same stimulation site and time. The 24-item Hamilton Depression Scale (HAMD), the Geriatric Depression Scale (GDS) and Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the depression and cognitive improvement of the two groups before and after treatment.Results There was significant difference in the changes of HAMD and GDS between the two groups before and after treatment. The level of observation group was significantly better than that of the control group (P<0.05), and there was no significant difference in MOCA score (P> 0.05).Conclusion tDCS can significantly improve the depressive symptoms of patients with mild to moderate senile depression, which is worthy of clinical promotion.

Immunotherapy for the treatment of glioma

Chen Feng, Zheng Xiaohong, Li Wenbin

2019, 40(6):  966-971.  doi:10.3969/j.issn.1006-7795.2019.06.028

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Gliomas are the most common type of primary brain tumors in the central nervous system and one of the most devastating tumors. After surgery,radiotherapy and chemotherapy,the overall survival is still very short. In recent years,cancer immunotherapy has achieved significant success in the treatment of solid tumors,however,its use in gliomas is not universal. This review discussed the immunotherapy and latest progress in glioma study.

Research progress on the correlation between the function of gut macrophages and inflammatory bowel disease and intestinal tumors

Wang Tiantian, Gao Chenchen, Li Lisheng, Xu Jingdong

2019, 40(6):  972-981.  doi:10.3969/j.issn.1006-7795.2019.06.029

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Macrophage (Mφ) is differentiated from mononuclear cells (Mo) in the blood, and it can be polarized into M1Mφ,M2Mφ and Mreg. Mφ can identify and eliminate pathogens. Mφ is involved in innate and acquired immunity, as it accumulates in the immune defense system. With a complex mechanism, Mφ protects the gut from inflammatory damage through producing anti-inflammatory cytokines. Mφ also plays a vital role in maintaining gastrointestinal homeostasis. More importantly, the imbalance of Mφ function may induce some intestinal diseases such as inflammatory bowel disease and gastrointestinal tumor. In short, the effect of Mφ on intestinal health should not be underestimated.

Discussion on the strategy of accurate manuscript selection in Journal of Capital Medical University——based on the analysis of top 10 highly cited papers published (2015-2019)

Mu Meng, Zhang Junmin

2019, 40(6):  982-985.  doi:10.3969/j.issn.1006-7795.2019.06.030

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In order to optimize the source structure of Journal of Capital Medical University and explore high-quality authors, this study analyzes and summarizes the basic situation of articles published in Journal of Capital Medical University (2015-2019). Based on the analyzed of the top ten papers downloaded and cited, manuscript selection strategy of the Journal of Capital Medical University were discussed. The result will provide some help for topic selecting and column planning, make further improvement on the quality of Journal of Capital Medical University.