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10 March 2021
Volume 59 Issue 3
Effects of A151 on the polarization of BV-2 cells induced by glucose and oxygen deprivation and lipopolysaccharide
MIN Aoxue, ZHU Tianrui, ZHANG Feng, WANG Ranran, LI Xiaohong
2021, 59(3):  1-9.  doi:10.6040/j.issn.1671-7554.0.2020.1499
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Objective To investigate the effects of inhibitory oligodeoxynucleotide A151 on M1/M2 polarization of microglia by glucose and oxygen deprivation(OGD)and lipopolysaccharide(LPS). Methods The morphological changes of BV-2 cells treated with A151 were observed with inverted microscope. The cytokine content in supernatant and cytokine transcription levels were detected with ELISA and RT-PCR, respectively. The expressions of M1 and M2 surface markers in microglia and NLRP3 inflammasome were determined with Western blotting and immunofluorescence. Results A151 inhibited the morphological changes of BV-2 cells induced by LPS and OGD; downregulated the surface markers and highly-expressed cytokines of M1 microglia: inducible nitric oxide synthase(iNOS)、CD16/CD32、tumor necrosis factor-α(TNF-α)、interleukin-1β(IL-1β)(P<0.001); downregulated the transcription levels of TNF-α mRNA and IL-1β mRNA(P<0.001); upregulated the surface markers of M2 microglia and highly-expressed cytokines: arginase-1(Arg-1)、CD206、interleukin-10(IL-10)、 interleukin-4(IL-4)(PArg-1<0.001, PCD206<0.001, PIL-10<0.001, PIL-4=0.046); upregulated IL-10 mRNA and IL-4 mRNA transcription levels(P<0.001); down-regulated NLRP3 inflammasome expression(P<0.001). Conclusion By inhibiting the activation of NLRP3 inflammasome, A151 promotes the polarization of microglia induced by LPS and OGD from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, and plays a role in regulating inflammation.
Bioinformatic analysis of genes and molecular pathways associated with osteoarthritis synovitis
HUA Fang, ZHANG Weiwei, LYU Bo, XIN Wei
2021, 59(3):  10-17.  doi:10.6040/j.issn.1671-7554.0.2020.1075
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Objective To identify the differentially expressed genes(DEGs)associated with the progression of osteoarthritis synovitis by bioinformatic analysis. Methods The gene expression profiles of GSE55457, GSE55235 and GSE12021 were downloaded from the Gene Expression Omnibus(GEO)to screen related genes in the pathogenesis of osteoarthritis. After the DEGs were identified, heatmaps were drawn, and functional enrichment of GO and KEGG was analyzed. The protein-protein interaction network(PPI)was constructed with STRING and Cytoscape, top module was screened with MCODE plug-in unit, and hub genes were screened with cytoHubba plug-in unit. Results There were 72 upregulated genes and 151 downregulated genes in the GSE55457, GSE55235 and GSE12021 gene expression profiles. GO analysis showed DEGs were involved in leukocyte migration, response to glucocorticoid, glycosaminoglycan binding, endoplasmic reticulum lumen, and nuclear outer membrane. KEGG analysis revealed DEGs were involved in MAPK signaling pathway, osteoclast differentiation and TNF signaling pathway. The cytoHubba screened out 10 key genes, including IL6, TLR7, SELE, VEGFA, LDLR, JUN, MYC, CD44, SNAI1 and hnRNA1. Conclusion Bioinformatic analysis can help to discover the molecular mechanism and key genes of synovitis in patients with osteoarthritis.
Effect of miR-203-3p targeted TREM1 gene on the regulation of TGF-β1/p38MAPK signaling pathway on the proliferation and apoptosis of renal tubular epithelial cells in lupus nephritis mice
LUO Huichen, HU Danhui, ZHANG Ji
2021, 59(3):  18-25.  doi:10.6040/j.issn.1671-7554.0.2020.1135
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Objective To investigate the effect of miR-203-3p on proliferation and apoptosis of renal tubular epithelial cells in lupus nephritis(LN)mice and its possible molecular mechanism. Methods Spontaneous LN mice(LN group)and wild-type C57BL/6 mice(NC group)were selected, 8 in each group, and the expression of miR-203-3p and triggering receptor expressed on myeloid cells-1(TREM1)protein in renal tissue were detected by qRT-PCR and Western blotting, respectively. The renal tubular epithelial cells of LN mice were isolated and transfected with miR-203-3p mimic and its negative control(miR-NC), then the expression of miR-203-3p in transfected renal tubular epithelial cells was detected by qRT-PCR; cell proliferation and apoptosis were detected by CCK-8 and flow cytometry; the levels of inflammatory factors TNF-α, IL-1β and IL-6 were detected by ELISA; the proteins expressions of TREM1, Bax, Bcl-2, TGF-β1, p-p38MAPK and p38MAPK were evaluated by Western blotting; the target relationship between miR-203-3p and TREM1 was assessed by dual luciferase reporter gene assay. Results Compared with NC group mice, the expression level of miR-203-3p in renal tissue of LN mice was significantly decreased(P<0.001), while the expression of TREM1 protein was significantly increased(P<0.001). Overexpression of miR-203-3p markedly inhibited the expression of TREM1 protein in renal tubular epithelial cells of LN mice(F=366.230, P<0.001), and the dual luciferase reporter gene experiment confirmed that TREM1 was the target gene of miR-203-3p. In addition, overexpression of miR-203-3p significantly inhibited the levels of TNF-α, IL-1β and IL-6 in tubule epithelial cells of LN mice(all P<0.01), promoted the cell proliferation(F24 h=14.841, F48 h=21.701, F72 h=29.893, P<0.001), inhibited its apoptosis(F=238.700, P<0.001), and up-regulated the expression of Bcl-2 protein(F=371.820, P<0.001), while down-regulated the proteins expression of Bax, TGF-β1 and p-p38MAPK(FBax=225.640, FTGF-β1=27.090, Fp-p38MAPK=103.250, P<0.001). Conclusion miR-203-3p can promote the proliferation and inhibit apoptosis of LN mice glomerular epithelial cells by targeting the down-regulation of TREM1 protein expression, which may be related to inhibition of TGF-β1/p38MAPK signaling pathway.
Oxymatrine ameliorates oxidative stress injury of HaCaT cells induced by hypoxia ischemia
LIU Shudan, ZHANG Feiyan, GUO Songlin, LIANG Xueyun, CHEN Dongmei
2021, 59(3):  26-34.  doi:10.6040/j.issn.1671-7554.0.2020.1557
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Objective To explore the protective effect of oxymatrine(OMT)on oxidative damage of keratinocytes in hypoxic-ischemic environment. Methods HaCaT cells cultured in vitro were divided into normal control(NC)group, hypoxia-ischemia(HI)group, low-dose OMT group(0.05 g/L)and high-dose OMT group(0.1 g/L). The proliferation and vitality of keratinocytes were detected with CCK-8 assay; the apoptosis was detected with Annexin V; the mitochondrial membrane potential was detected with mitochondrial membrane potential probe; the reactive oxygen species(ROS)level was detected with DCFH-DA fluorescent probe; the activities of superoxide dismutase(SOD), glutathione peroxidase(GSH-Px)and total antioxidant capacity(T-AOC)in the supernatant of HaCAT cells were determined with colorimetry; the expression levels of Caspase 3, Cleaved-Caspase 3, B lymphoma 2(Bcl-2)and TGF-β1/Smad3 signaling pathway were detected with Western blotting. Results Compared with the NC group, the HI group had reduced Ki67 positive rate [(13.52±2.89)%, P<0.001] and lower mitochondrial membrane potential(0.54±0.03, P<0.001), increased apoptotic cells(13.83±0.81, P<0.001)and ROS level(164.31±16.93, P<0.001), and reduced expression levels of GSH-Px(0.96±0.05, P<0.001), SOD(0.67±0.06, P<0.001)and T-AOC(1.90±0.02, P<0.001). Low-dose OMT treatment resulted in increased Ki67 positive rate [(57.98±9.81)%, P<0.001], higher mitochondrial membrane potential(0.81±0.04, P<0.001), reduced apoptotic cells(8.10±0.53, P<0.001), reduced ROS level(175.94±15.75, P<0.001), but enhanced expression levels of GSH-Px(1.04±0.05, P<0.001), SOD(0.86±0.04, P<0.001)and T-AOC(2.08±0.03, P<0.001). Western blotting showed that HI treatment increased the expression levels of TGF-β1(1.15±0.14, P=0.010)and p-SMAD3(0.13±0.03, P=0.112), and increased the relative expression levels of Caspase-3(0.37±0.045, P=0.001)and Cleaved-Caspase 3(0.54±0.03, P=0.108). Compared with HI group, low-dose OMT group had reduced relative expressions of TGF-β1(0.69±0.13, P=0.005), p-SMAD3(0.07±0.01, P<0.001), Caspase-3(0.21±0.041, P=0.006)and Cleaved-Caspase 3(0.29±0.054, P=0.016), but increased relative expression of Bcl-2(0.35±0.013, P=0.015). Between the low-dose and high-dose OMT groups, there were only significant differences in Ki67 positive rate(P<0.001), SOD activity(P<0.001)and Bcl-2 expression(P=0.045), and no differences in the other parameters(P>0.05). Conclusion Treatment with 0.05-0.1 g/L can reduce mitochondrial dysfunction, oxidative damage and apoptosis induced by hypoxia-ischemia by inhibiting TGFβ1/ Smad3 pathway, and thus protect the survival of keratinocytes.
Periodontal ligament stem cells regulate the functions of macrophages in vitro
ZHANG Ludan, DING Xiaoling, CUI Shuyue, CHENG Chen, WEI Fulan, DING Gang
2021, 59(3):  35-40.  doi:10.6040/j.issn.1671-7554.0.2021.0176
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Objective To explore the effects of periodontal ligament stem cells(PDLSCs)on the phenotypes and functions of macrophages. Methods After PDLSCs were isolated and cultured, the expression profiles of STRO-1, CD146 and CD90, as well as the multipotent differentiation capabilities were detected. After macrophages were isolated from peripheral blood, they were cocultured with an equal amount PDLSCs in Transwell co-culture condition at 37 ℃ and 5% CO2, which were set as the experimental group. Macrophages cultured alone were set as the control group. After 3d co-culture, the expression profiles of CD14+CD206+ macrophages were examined by flow cytometry. After 24 h co-culture, macrophages were obtained, fluorescein isothiocyanate labeled dextran was added. Then, after 30 min incubation, the phagocytosis rate of macrophages was detected with flow cytometry. After 3 d co-culture, the supernatant was collected, and the concentrations of IL-10, IL-6 and TNF-α were determined with enzyme-linked immunosorbent assays. Results PDLSCs displayed fusiform fibroblast-like morphology, positive for the mesenchymal stem cells surface markers including STRO-1, CD146 and CD90, and could differentiate into bone cells and lipid cells. Compared with the control group, the experimental group had significantly increased expression of CD14+CD206+macrophages [(38.73±6.32)% vs(8.39±2.71)%, t=127.7, P=0.004 9), unchanged phagocytosis rate of macrophages [(36.7±5.1)% vs(38.6±4.3)%, t=3.904, P=0.159 6], elevated level of IL-10 [(382.5±18.2)pg/mL vs(198.5±11.4)pg/mL, t=76.36, P=0.000 3], but decreased levels of IL-6 [(453.1±70.42)pg/mL vs(936.7±49.9)pg/mL, t=53.12, P=0.011 5)and TNF-α [(64.9±11.3)pg/mL vs(131.7±19.3)pg/mL, t=51.48, P=0.000 6]. Conclusion PDLSCs are capable of converting macrophages into M2 phenotype without affecting the phagocytic functions. Meanwhile, they can stimulate the secretion of IL-10 but inhibit the secretion of IL-6 and TNF-α.
Identification of heparin and heparan sulfate by HILIC-MS/MS
LIU Dongke, WANG Fengshan
2021, 59(3):  41-47.  doi:10.6040/j.issn.1671-7554.0.2020.1448
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Objective To establish a hydrophilic interaction chromatography-mass spectrometry(HILIC-MS/MS)method for simultaneous determination of 8 disaccharides in heparin and heparan sulfate after digestion by heparinase Ⅰ, Ⅱ and Ⅲ, and to provide method and data references for the identification of heparin and heparan sulfate. Methods A PC HILIC column(4.6 mm×250 mm, 5 μm)was used and gradiently eluted with 10 mmol/L ammonium acetate aqueous solution(A)and 10 mmol/L ammonium-90% acetonitrile(B)at the flow rate of 0.9 mL/min, column temperature of 40 ℃ and injection volume of 10 μL. The contents of the 8 disaccharides of heparin and heparan sulfate produced by enzymatic digestion were determined by electrospray ionization source and multi reaction monitoring mode and were compared with each other. Results The linear relationships of the 8 components were good in the range of measured molar concentrations(r2>0.996 0), and the average recovery were 90.34%-99.62%, RSD were 4.7%-6.7%. The results showed that the disaccharides composition and proportion of heparin and heparan sulfate were significantly different. In heparin, ΔUA2S-GlcNS6S(TriS)accounted for about 69.8% on average, while in heparan sulfate, ΔUA-GlcNAc(0S)accounted for about 51.0%. Conclusion The method established in this paper is simple, fast, accurate and reliable with high sensitivity, strong specificity, good stability, and can be used as one of the determination and identification methods for heparin and heparan sulfate.
Effect of different ovulation induction regimens for endometrial preparation on the outcome of frozen-thawed embryo transfer among 603 women with polycystic ovary syndrome
GONG Xiaoshu, WU Richao, LI Xiufang, PAN Ye, WANG Ze, SHI Yuhua
2021, 59(3):  48-54.  doi:10.6040/j.issn.1671-7554.0.2021.0050
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Objective To compare the effects of different ovulation induction regimens on pregnancy and maternal and infant outcomes among women with polycystic ovary syndrome(PCOS)during frozen-thawed embryo transfer. Methods Totally 603 frozen-thawed embryo transfer cycles were analyzed by a retrospective study in PCOS population from February 2017 to May 2020. According to the different ovulation induction regimens, the patients were divided into 3 groups: the letrozole group(n=30), the human menopausal gonadotropin(HMG)group(n=344), and the letrozole plus HMG group(n=229). Meanwhile, live birth rate, clinical pregnancy rate, implantation rate, miscarriage rate, the incidence of maternal and infant complications were compared among three groups, respectively. Results There were no significant differences among groups in live birth rate, clinical pregnancy rate, implatation rate, miscarriage rate as well as the incidence of maternal and infant complications(P>0.05). Multivariate Logistic regression analysis also showed no significant differences in live birth rate, clinical pregnancy rate and miscarriage rate among the three groups after adjusting for body mass index(BMI), infertility years, luteinizing hormone(LH), testosterone(To)and anti-millertube hormone(AMH). Conclusion In PCOS patients, different ovulation induction regimens will not affect the pregnancy outcomes and the incidence of maternal and infant complications of frozen-thawed embryo transfer, and appropriate ovulation induction regimens should be selected based on patients conditions during clinical practice.
Effects of chronic endometritis on the pregnancy outcomes of patients with endometriosis-associated infertility
LIANG Yanchun, YE Haihua, LU Limei, DAI Yujing, CHENG Qianyi, CHOI Unleng, ZENG Hanqiu, CHEN Xinghuan, WANG Xing, WEI Yajing, YANG Ruyu
2021, 59(3):  55-59.  doi:10.6040/j.issn.1671-7554.0.2020.1614
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Objective To investigate the risk factors of chronic endometritis(CE)in patients with endometriosis-associated infertility(EAI), and to explore the effects of CE on the pregnancy outcomes of such patients. Methods Patients undergoing laparoscopic and hysteroscopic surgery for infertility during June 1, 2018 and June 1, 2019 were collected. All cases were laparoscopically diagnosed and pathologically confirmed as endometriosis. According to the two different diagnostic criteria of CE, patients were divided into CE group and non-CE group. Risk factors of CE were analyzed. The cumulative pregnancy rates of the two groups at different time periods after surgery were compared. Results When ≥1 CD138 positively stained plasma cells observed in endometrial stroma under one high power field was used as the diagnostic criterion, the prevalence of CE in patients with EAI was 82.79%(101/122); fallopian tube adhesion(P=0.008)was the risk factor. When ≥5 CD138 positively stained plasma cells observed was used as the diagnostic criterion, the prevalence of CE was 54.1%(66/122); other gynecologic diseases(myoma, polycystic ovarian syndrome, etc.)(P=0.002)were the risk factor. Whatever the criterion was, after standardized antibiotic treatment, 6, 9 and 12 months after surgery, the differences in the cumulative pregnancy rates in patients with CE and without CE were not statistically significant(P>0.05). Conclusion The prevalence of CE in patients with EAI is high; fallopian tube adhesion and complicated gynecologic diseases are the risk factors of CE in such patients. Standardized antibiotic treatment can improve the pregnancy outcomes.
Association analysis of cerebral artery Doppler index and serum EGF level with arteriosclerosis and cognitive impairment in 60 patients with Parkinsons disease
LI Ning, WANG Cuilan, ZHANG Yurong
2021, 59(3):  61-66.  doi:10.6040/j.issn.1671-7554.0.2020.1125
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Objective To analyze the association of cerebral artery Doppler index and serum epidermal growth factor(EGF)level with arteriosclerosis and cognitive impairment in 60 patients with Parkinsons disease(PD). Methods A total of 60 PD patients treated during Jun. 2017 and Dec. 2019 were selected and divided into the arteriosclerosis group(n=22)and non-arteriosclerosis group(n=38). Another 60 healthy controls were enrolled as the control group. Transcranial Doppler(TCD)was performed in all subjects. Serum EGF level was measured with enzyme-linked immunosorbent assay. Cognitive status was assessed with Montreal Cognitive Assessment Scale(MoCA). The pulsatility index(PI)and resistance index(RI)of basilar artery(BA)and middle cerebral artery(MCA), and serum EGF level were compared among the groups. The correlation among the total MoCA score, Doppler index and serum EGF level was explored with Spearman analysis. Risk factors related to cognitive dysfunction of PD were analyzed with Logistic regression. Results The RI and PI of BA and MCA in the three groups were significantly different, among which the RI and PI of the sclerosis group were higher than those of the non-sclerosis group and the control group(F=5.244, 9.745, 4.674, 10.465; P=0.007, <0.001, 0.011, <0.001).There were significant differences in serum EGF levels and MoCA scores among the three groups, in which each index of the sclerosis group was significantly lower than that of the non-sclerosis group and the control group, the non-sclerosis group was significantly lower than that of the control group(F=54.289,38.788; P<0.001). Spearman correlation analysis showed that MoCA score was negatively correlated with RI and PI of BA(r=-0.402, -0.436, P<0.05), RI and PI of MCA(r=-0.422, -0.477, P<0.05), but positively correlated with serum EGF level(r=0.667, P<0.05). Univariate analysis showed that cerebral arteriosclerosis(P=0.016), RI and PI of MCA(P=0.005, P=0.003)and BA(P<0.001, P<0.001), and EGF(P<0.001)were associated with cognitive impairment(P<0.05). Binary Logistic regression analysis showed that cerebral arteriosclerosis(OR=2.361, 95%CI=1.247-3.907), RI of MCA(OR=1.988, 95%CI=1.025-3.855), PI of MCA(OR=2.489, 95%CI=1.086-5.703)and serum EGF(OR=0.312, 95%CI=0.168-0.580)were independent risk factors of cognitive dysfunction in PD patients. Conclusion PI and RI of MCA and BA as well as serum EGF level are correlated with cerebral arteriosclerosis and mild cognitive impairment in PD patients, among which PI and RI of MCA, serum EGF level and cerebral arteriosclerosis are independent risk factors of cognitive impairment in PD patients.
Relationship between methylation of tumor suppressor genes SOCS1 and SOCS3 and remission and prognosis of 80 acute myeloid leukemia patients
ZHANG Xiaohui, LUO Jianmin, SUO Xiaohui, SUN Guofeng, LI Jing
2021, 59(3):  67-73.  doi:10.6040/j.issn.1671-7554.0.2020.1734
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Objective To explore the relationship between SOCS1 and SOCS3 methylation, remission and prognosis of acute myeloid leukemia(AML). Methods The methylation and expressions of SOCS1 and SOCS3 in 80 AML patients and 20 healthy controls were detected with RT-qPCR, MS-PCR and Western blotting. The chromosome karyotypes were determined with R+G banding method. The AML group was subdivided into SOCS1 methylation group(n=39)and SOCS1 non-methylation group(n=41), SOCS3 methylation group(n=44)and SOCS3 non-methylation group(n=36). The age, sex and AML typing were compared. The gene mutation, karyotypes, complete remission rate and AML prognosis stages were compared among the two-gene methylation group(n=29), single-gene methylation group(n=25)and double-unmethylation group(n=26). Results The AML group had higher methylation rates of SOCS1 and SOCS3 genes than the control group(48.75% vs 0, 55% vs 0), and the mRNA expressions were lower [SOCS1: 0.080(0.003, 1.090)vs 1.677(0.422, 1.972); SOCS3: 0.140(0.002, 1.044)vs 2.395±1.540](P<0.001). In AML patients, the mRNA and protein expressions of SOCS1 and SOCS3 methylation groups were lower than those in non-methylation groups and control group(P<0.001). The positive rate of WT1/ABL in SOCS1 and SOCS3 methylation groups was higher than that in non-methylation groups(χ2=9.674, P=0.008). The SOCS1 and SOCS3 methylation groups had a lower therapy remission rate than the non-methylation groups(χ2=10.583, P=0.005). Analysis of gene methylation and prognosis revealed that methylation of SOCS1 and SOCS3 was correlated with poor molecular abnormalities(χ2=6.137, P=0.046). Double unmethylation of SOCS1 and SOCS3 was correlated with good cytogenetics(χ2=6.675, P=0.036)and molecular abnormalities(χ2=9.693, P=0.008)of AML. Conclusion Methylation of SOCS1 and SOCS3 genes can cause gene silencing, which is associated with poor remission and prognosis of AML.
Evaluation of the efficacy and complications of endoscopic treatment of 240 cases of upper gastrointestinal submucosal tumors
LUO Yingshu, LI Bin, XU Changqin, JIANG Junmei, XU Hongwei
2021, 59(3):  74-80.  doi:10.6040/j.issn.1671-7554.0.2020.1446
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Objective To explore the clinical characteristics of upper gastrointestinal submucosal tumors(SMT)and clinical factors affecting postoperative complications and hospitalization costs of SMT patients. Methods The clinical data of 240 SMT patients treated in Shandong Provincial Hospital during Jan. 2012 and Jun. 2019 were collected, and the clinical characteristics, pathological types, treatment modalities and therapeutic effects were analyzed. Results The patients included 101 male(42.1%)and 139 female(57.9%), mean age 54.19 years, and mean size of SMT 1.12 cm. The tumors were located in the esophagus in 57 cases(23.8%), in the gastroesophageal junction in 17 cases(7.1%), in the stomach in 163 cases(67.9%), and in the duodenum in 3 cases(1.3%). Endoscopic submucosal dissection(ESD)was performed in 69 patients(28.8%), endoscopic submucosal excavation(ESE)in 117 patients(48.8%), endoscopic full-thickness resection(EFR)in 28 patients(11.7%), and submucosal tunneling endoscopic resection(STER)in 26 patients(10.7%). The main pathological types were leiomyoma(117, 49.2%)and stromal tumor(78, 32.8%). Altogether 237 patients(98.8%)were successfully treated, with 90.4%(217/240)en bloc resection rate. The mean operation time was 58.37 minutes, hospital stay 10.07 days, and hospitalization costs 35 830.3 yuan. Complications were observed in 17 patients(7.1%), 10(4.2%)of whom relieved after conservative treatment and 7(2.9%)received active interventions such as endoscopic hemostasis, gastrointestinal decompression and puncture drainage. No death or long-term complications occurred. Operation time ≥55 min and SMT≥2 cm were the risk factors of postoperative complications; meanwhile, operation time ≥55 min, SMT≥2 cm, failure of en bloc resection and use of OTSC increased hospitalization costs. Conclusion Endoscopic resection is a safe and effective treatment modality of SMT. Early detection, early treatment and short operation time are effective ways to reduce the incidence of postoperative complications and hospitalization costs.
Effects of drinking Yin-Jiu-Shu on liver metabolizing enzymes in 30 healthy volunteers
XIANG Lin, CHEN Lamei, WANG Jingwen, LI Haiming, LI Haoyu, WANG Ju, FAN Yuchen, WANG Kai
2021, 59(3):  81-85.  doi:10.6040/j.issn.1671-7554.0.2020.1633
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Objective To explore the effects of a plant beverage, Yin-Jiu-Shu, on liver metabolizing enzymes. Methods A total of 30 healthy volunteers were enrolled. Before, 30 min, 60 min and 120 min after Yin-Jiu-Shu were administered, 5 mL pf venous blood was collected, and plasma was immediately separated to detect the levels of alcohol dehydrogenase(ADH), acetaldehyde dehydrogenase(ALDH), glutathione(GSH), glutathione S-transferase P1(GSTP1), and glutathione S-transferase M3(GSTM3)using enzyme-linked immunosorbent assay(ELISA). Results After Yin-Jiu-Shu was administered, the plasma levels of ADH, ALDH, GSH, GSTP1, GSTM3 significantly increased at 30 minute point(P=0.014), 120 minute point (P=0.016), 60 minute point(P=0.031), 30 and 60 minute points (P=0.046, P=0.012), 30 and 60 minute points(P=0.008, P=0.039), respectively. Conclusion Yin-Jiu-Shu can improve the levels of alcohol metabolism related enzymes and antioxidants, which might be its underlying mechanism to promote alcohol metabolism and protect liver.
Application of progressive core stability training in 30 stroke patients
DAI Yong, YIN Xinwei, HUANG Huai, Xin Ranran, LI Xinya, QIAN Qiwen, YE Yunxia
2021, 59(3):  86-91.  doi:10.6040/j.issn.1671-7554.0.2020.1611
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Objective To explore the effects of progressive core stability training(PCST)on the pulmonary rehabilitation of stroke patients. Methods The clinical data of 60 stroke patients were retrospectively analyzed. The patients were divided into the core stability training group(CST group, n=30)and PCST group(n=30). Pulmonary function data were assessed with portable lung function tester; trunk function and quality of life were assessed with Berg Balance Scale, Trunk Disorder Scale and Modified Barthel Index; incidences of adverse events such as falls, sprains and pressure sores were recorded. Results There were no significant differences in the general data, respiratory function index, BBS, TIS and MBI scores between the two groups before treatment(P>0.05). After 6 weeks of treatment, the key respiratory function index, BBS, TIS and MBI scores improved significantly in both groups(P<0.05). Intergroup comparison showed the PCST group had more significant improvement than the CST group in MIP [(68.04±8.11)vs(62.46±8.41)cmH2O], PEF [(7.48±0.44)vs(6.91±0.20)L/min], BBS [(45.44±5.65)vs(38.69±5.12)], TIS [(16.81±2.48)vs(15.35±2.07)] and MBI [(70.04±5.72)vs(62.00±8.18)](P<0.05). There were no adverse events during training in either groups. Conclusion Able to improve patients respiratory function, motor function and quality of life, PCST is more effective in promoting pulmonary rehabilitation of stroke patients, and is worth popularizing in clinical practice.
Correlation analysis of acetylcholinesterase activity and inflammatory factors of 45 elderly patients with postoperative delirium
XING Zhiqun, LI Dejun, ZHAO Bao, XU Chunyang, JI Hongsheng
2021, 59(3):  92-97.  doi:10.6040/j.issn.1671-7554.0.2020.1502
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Objective To analyze the relationship among plasma acetylcholinesterase activity, inflammatory factors and postoperative delirium in patients who underwent noncardiac surgery. Methods A total of 106 patients transferred to SICU after non-cardiac surgery under general anesthesia during Oct. 2016 and Dec. 2017 were divided into the postoperative delirium group(n=45, case group)and control group(n=61). Delirium was assessed twice daily with the Confusion Assessment Method-Intensive Care Unit(CAM-ICU). The relationship among postoperative delirium, acetylcholinesterase activity and inflammatory factors such as leukocytes procalcitonin(PCT), C-reactive protein(CRP), IL-1β and IL-6 were analyzed. Results There were no statistical difference in baseline data between the two groups, while the APACHE Ⅱ score, PCT, acetylcholinesterase activity and IL-1β were statistically different(P<0.05). Binary Logistic analysis revealed that APACHE Ⅱ score(OR=1.131, 95%CI: 1.011-1.268, P=0.032), and IL-1β (OR=4.209, 95%CI: 1.528-11.592, P=0.005)were independent risk factors of postoperative delirium, while increased acetylcholinesterase activity(OR=0.678, 95%CI: 0.519-0.886, P=0.004)was a protective factor. Conclusion Postoperative delirium in elderly patients is closely related to the severity of disease. IL-1β and decreased acetylcholinesterase activity are independent risk factors of postoperative delirium. Treatment of inflammation and improvement of acetylcholinesterase activity are beneficial to prevent or reduce the occurrence of postoperative delirium, which provides a new idea for the clinical diagnosis and treatment strategies.
Correlation between plasma D-dimer and metastasis in 109 cases of bladder cancer
GAO Jinmei, ZHANG Xianglian, LIU Tieju
2021, 59(3):  98-102.  doi:10.6040/j.issn.1671-7554.0.2020.1440
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Objective To explore the correlation between plasma D-dimer and metastasis of bladder cancer. Methods The clinical data of 109 patients with bladder cancer admitted to the Urology Department of The Second Hospital of Tianjin Medical University during Nov. 2018 and Oct. 2020 were respectively analyzed. The patients were divided into metastatic group(n=31)and non-metastatic group(n=78 cases)based on the presence of lymph nodes and/or distant metastasis detected by imaging and pathological examinations. Results of routine blood tests were also collected and analyzed. The independent risk factors of metastasis were analyzed with multivariate Logistic regression model. The diagnostic efficacy of plasma D-dimer of metastasis was evaluated with receiver operating characteristic(ROC)curve. Results The median level of D-dimer was 1.37 mg/L in the metastatic group and 0.53 mg/L in the non-metastatic group. Multivariate Logistic regression showed that elevated plasma D-dimer level might be an independent risk factor of metastasis [OR(95%CI): 9.542(3.521, 25.935), P<0.05]. The area under the ROC curve was 0.857(P<0.05), and the cut-off point of plasma D-dimer under the maximum Youden index was 1.16 mg/L. The sensitivity, specificity, false negative value and false positive value of D-dimer of bladder cancer metastasis were 65%, 94%, 35% and 6%, respectively. Conclusion Elevated plasma D-dimer level may be an independent risk factor of metastasis of bladder cancer.
Abnormal hyperlipidemia during pregnancy: a report of 2 cases and literature review
LONG Yuhan, LUO Xia, JIANG Jie
2021, 59(3):  103-106.  doi:10.6040/j.issn.1671-7554.0.2021.0104
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Objective To analyze 2 cases of abnormal hyperlipidemia during pregnancy and review the related literature, so as to provide reference for clinical work when dealing with similar situations. Methods Clinical data of 2 cases of abnormal hyperlipidemia during pregnancy admitted to the Department of Obstetrics, Qilu Hospital of Shandong University was reviewed. Results One case was complicated with diabetes and hyperbileacidemia, and had a cesarean section at 33+1 weeks of pregnancy due to placental abruption. Another case was combined with gestational diabetes mellitus(GDM), and a cesarean section was performed at 40+1 weeks for a giant baby. The Apgar scores of the two newborns were normal after birth, and no hyperlipidemia occured. Conclusion Pregnant women with abnormal hyperlipidemia should be paid close attention to their blood lipids, blood sugar, liver and kidney function and other indicators, as well as the occurrence of pancreatitis and placental abruption. Hyperlipidemia itself is not an indication for cesarean section, but if placental abruption occurs, cesarean section is required to terminate the pregnancy.
Activated phosphoinositide 3-kinase δ syndrome caused by a mutation in PIK3CD gene: a case report and literature review
HUANG Xiuli, LIU Bingju, SUN Lifeng
2021, 59(3):  107-112.  doi:10.6040/j.issn.1671-7554.0.2020.1386
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Objective To explore the clinical features, gene mutations and treatment in patient with activated phosphoinositide 3-kinase δ syndrome(APDS). Methods The data of one patient who was diagnosed as APDS were retrospectively analyzed,and the related literatures were reviewed. The clinical features, gene mutations and treatment were summarized. Results The patient, a 9-year old Chinese girl, was hospitalized in Shandong Provincial Hospital Affiliated to Shandong First Medical University because of “recurrent cough for eight years, chronic diarrhea for three years and abnormal liver function for two years”. CT scan of the chest and abdomen demonstrated that she had hepatomegaly, splenomegaly, right middle lobe bronchiectasis and lymphoid hyperplasia, and the lung tissue in the middle lobe of the right lung was not dilated completely. The immunological features were inverted CD4+/CD8+ index, normal IgG level and increased IgM level. Sanger sequencing of PIK3CD gene confirmed a de novo mutation c.3061G>A(p.E1021K), which confirmed the diagnosis of APDS1. The child received IVIG and rapamycin treatments and experienced obvious improvement in diarrhea, lymphoproliferation, hepatomegaly, and splenomegaly. Recurrent respiratory infections were not occurred. The Wanfang Medical Database, CNKI Database and Pubmed Database were searched by keywords such as “activated phosphoinositide 3-kinase δ syndrome”“activated PI3Kδ syndrome” “PIK3CD”“PIK3R1”“APDS”. A total of 285 patients were reported all over the world, in which 43 patients were Chinese including this patient. There was only one patient with APSD2 type. Compared with the overseas patients, the incidence of bronchiectasis and higher IgM level of APDS patients in China was higher. No patients combined with malignant tumors. The hotspot mutations were c.3061 G>A(p. E1021K)in APDS1 and c.1425+1 G>(A, C, T)(p.434-475del)in APDS2, respectively. Conclusion APDS is a rare primary immunodeficiency disease characterized by antibody deficiency mainly. The patients have recurrent respiratory infections, bronchiectasis, non-neoplastic lymphoid hyperplasia, chronic diarrhea, autoimmune diseases, malignant tumor, developmental delay, CD4+/CD8+ inversion, high IgM level and variable IgG levels. IVIG can reduce respiratory tract infections and rapamycin was beneficial in the treatment of non-neoplastic lymphoproliferative. Hematopoietic stem cell transplantation can significantly improve clinical status and immune function.
Sexual orientation disclosure and HIV testing uptake among men who have sex with men: chain mediating effect of HIV testing social norms and self-efficacy
LIN Yuxi, LI Chuanxi, WANG Lin, MA Wei
2021, 59(3):  113-119.  doi:10.6040/j.issn.1671-7554.0.2020.1586
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Objective To explore the relationship among sexual orientation disclosure, social norms, self-efficacy and uptake of human immunodeficiency virus(HIV)testing among men who have sex with men(MSM). Methods Participants were recruited in 11 cities of Shandong Province during Aug. and Dec., 2019, and were investigated with an anonymous online survey. The chain mediating effect was analyzed with non-parametric bootstrap method with bias correction. Results Among 924 participants, 37.1%(343/924)disclosed their sexual orientation to health professionals and 83.8%(774/924)had received HIV testing. Spearman correlation analysis showed that there was significantly positive correlation between sexual orientation disclosure, HIV testing social norms, HIV testing self-efficacy and HIV testing uptake(P<0.05). Bootstrap test showed that between sexual orientation disclosure and HIV testing uptake, the mediating effect of HIV testing self-efficacy was 0.163(95%CI: 0.075-0.283), and the chain mediating effect of HIV testing social norms and self-efficacy was 0.022(95%CI: 0.006-0.052). Conclusion It is necessary to carry out MSM sexual orientation disclosure intervention and improve HIV testing social norms and self-efficacy to promote HIV testing uptake among MSM in China.