Table of Content

  

10 November 2015
Volume 53 Issue 11

Preclinical Medicine
Medical Psychology
Clinical Medicine


Preclinical Medicine

Fat-derived adipokine disorder in high cholesterol diet rats

JIANG Fangjie, SHAO Shanshan, JING Fei, YU Chunxiao, ZHAO Jiajun

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  1-5.  doi:10.6040/j.issn.1671-7554.0.2015.185

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Objective To investigate the effects of high cholesterol diet on adipokines (leptin, adiponectin, resistin, visfatin and glypican4) levels in serum and visceral adipose tissue (VAT). Methods A total of 60 SD rats were randomly divided into normal diet group (NC, standard diet, n=30) and high cholesterol diet group (HC, high cholesterol diet, n=30). Blood samples and VAT were collected at week 0, 4, 12 and 18, respectively. The levels of fasting blood glucose and fasting serum insulin were measured, and insulin resistance values were calculated. Adipokines in serum and VAT were detected with enzyme-linked immunosorbent assays. Results At week 18, the serum visfatin and adiponectin in the HC group were significantly increased compared with those in the NC group (P<0.05); levels of leptin, visfatin, adiponectin, and glypican4 in VAT were significantly higher in the HC group than in the NC group (P<0.05); insulin resistance was also observed in HC group. Conclusion Long-term excessive cholesterol intake induces disorder of adipokine synthesis and secretion, and such disorder may be correlated to insulin resistance.

Effect of resistin with different levels on serum free fatty acid

LI Yan, WANG Yi, QIAO Xiuyun, ZHANG Li, SUN Jin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  6-9.  doi:10.6040/j.issn.1671-7554.0.2015.209

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Objective To elucidate the effects of resistin with different levels on serum free fatty acid (FFA) in intrinsic and extrinsic hyper-resistin models. Methods The extrinsic hyper-resistin models were established by infusion of rat recombinant resistin through the tail vein and defined as resistin group (RE group, n=8); the normal saline group (NS group, n=8) was defined as control. After high-fat diet, the rats with resistin levels higher than X^-±2s of resistin were defined as diet-induced hyper-resistinemia model group (HRE group, n=8) and those with resistin levels lower than X^-±s of resistin were defined as diet-induced normal resistin model group (NRE group, n=8); the normal control group (NC group, n=8) received standard feed at the same time. Concentrations of FFA with different resistin levels were detected. Results The levels of the serum FFA and insulin in RE group was higher than those in NS group (P<0.01). The level of FFA increased in HRE group than that in NRE group and NC group (P<0.01). Resistin levels were obviously correlated with serum FFA, insulin, glucose, insulin sensitivity index (ISI), weight and Lee index (P<0.01). Even after correction for insulin, glucose, ISI, weight and Lee index, the resistin level was still correlated significantly with FFA (r=0.615, P<0.01). Conclusion Both extrinsic and intrinsic hyper-resistin can induce higher FFA levels in rats. The hyper-resistin in rats may play an important role in lipid metabolism disorder.

Effects of trans-3,5,4'-trimethoxystilbene on the expressions of NO, ICAM-1 and NF-κB in human umbilical vein endothelial cells induced by lipopolysaccharide in vitro

FU Haiyan, HU Zhansheng, DU Hongyang

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  10-15.  doi:10.6040/j.issn.1671-7554.0.2015.255

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Objective To explore the effects of trans-3,5,4'-trimethoxystilbene (TMS) on the expressions of NO, intercellular adhesion molecule-1 (ICAM-1) and nuclear factor-κB (NF-κB) in human umbilical vein endothelial cells (HUVEs) induced by lipopolysaccharide (LPS) in vitro. Methods The cell viabilities influenced by the different concentrations of TMS were assessed by CCK-8 assay. The cells were divided into the control group (CON group), LPS group, low-concentration TMS plus LPS group, medium-concentration TMS plus LPS group, high-concentration TMS plus LPS group and ammonium pyrrolidine dithiocarbamate (PDTC) plus LPS group. HUVEs were pretreated with the different concentrations of TMS and 10 μmol/L PDTC, and then were stimulated with 0.1 μg/mL LPS. After incubation, the level of NO was determined by Griess assay. The mRNA expressions of ICAM-1 and NF-κB p65 were detected by Real-time PCR, the protein expressions of ICAM-1, NF-κB p65 and IκBα by Western blotting assay, and the protein expressions of ICAM-1 and NF-κB p65 by immunocytochemetry assay. Results There was little effect of low-concentration TMS (5 or 10 μmol/L) on the cell viability, but the cell viability decreased significantly when treated with high-concentration TMS (50 or 100 μmol/L) in time- or concentration-dependent manners. Griess results showed that the level of NO in the low-, medium- and high-concentration TMS plus LPS groups and PDTC plus LPS group decreased compared with that in LPS group (P<0.05). The results of Real-time PCR and Western blotting showed that compared with LPS group and CON group, there were significant difference of mRNA and protein expressions of ICAM-1 and NF-κB p65 in medium-concentration TMS plus LPS group and PDTC plus LPS group (P<0.05; P<0.01). Furthermore, there were nuclear expressions of NF-κB p65 protein in medium-concentration TMS plus LPS group, PDTC plus LPS group and LPS group except for CON group. The protein expression of IκBα decreased significantly in LPS group compared with that in CON group (P<0.01), and those in medium-concentration TMS plus LPS group and PDTC plus LPS group were lower than those in CON group (P<0.05). Immunofluorescence assay showed there were hyperfluorescence of ICAM-1 in LPS group but weakened fluorescence in medium-concentration TMS plus LPS group and PDTC plus LPS group. There were no fluorescence of NF-κB p65 in CON group, cell nucleus hyperfluorescence in LPS group, and weakened fluorescence in medium-concentration TMS plus LPS group and PDTC plus LPS group with no cell nucleus expression. Conclusion TMS can inhibit LPS-mediated NO, ICAM-1 and NF-κB p65 expressions in HUVEs in vitro, and the inhibition of ICAM-1 may be affected through NF-κB cell pathway.

Effects of cholecystokinin-octopeptide on endoplasmic reticulum stress induced by LPS in mouse monocyte RAW264.7 cells

DUAN Lin, ZHANG Xiaojing, YU Panpan, YU Feng, LIU Wei, SONG Ning

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  16-20.  doi:10.6040/j.issn.1671-7554.0.2014.880

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Objective To investigate the effects of cholecystokinin-octopeptide (CCK-8) on ER stress (ERS) induced by lipopolysaccharide (LPS) in mouse monocyte RAW264.7 cells. Methods RAW264.7 cells were divided into control group, LPS group, CCK-8 grpup, devazepide group(DEV group), CCK-8+LPS group, and DEV+CCK-8+LPS group. The active form of X-box binding protein 1(XBP1s) mRNA expression was assayed by RT-PCR, glucose regulating protein 78 (GRP78) and C/EBP homologous protein (CHOP) protein expressions were determined by Western blotting, and IL-1β expression levels were measured by ELISA. Results Compared with control group, the expressions of XBP1s mRNA and GRP78 and CHOP protein in LPS group increased (P<0.05); cmpared with LPS group, the expressions of XBP1s mRNA and GRP78 and CHOP protein in CCK-8+LPS group decreased (P<0.05); compared with CCK-8+LPS group, the expressions of XBP1s mRNA and GRP78 and CHOP protein in DEV+CCK-8+LPS group increased (P<0.05). The changes of IL-1β contents showed the same trend as that of CHOP expression (P<0.05). Conclusion CCK-8 exerts an anti-inflammatory effect by inhibiting LPS-induced ERS and decreasing the expression of IL-1β in RAW264.7 cells.

Changes of serum biochemical indexes and ultrastructure in ventricular myocardium of rats exposed to EMP

LI Baofeng, ZHANG Ying, XIA Hong, REN Dongqing, GUO Guozhen

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  21-24.  doi:10.6040/j.issn.1671-7554.0.2015.139

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Objective To explore the changes of serum biochemical indexes and characteristics of ventricular myocardium injuries in rats exposed to electromagnetic pulse (EMP) irradiation. Methods A total of 48 male SD rats were randomly divided into control group (n=24), and EMP irradiation group (n=24) which was exposed to EMP irradiation (200 kV/m). The right atrium blood was obtained 12, 24, 48, and 96 h after the rats were irradiated. The K⁺, Na⁺, ALT and AST levels were analyzed by coulter automatic biochemical analyzer. All rats were sacrificed and the left ventricular myocardia were collected for observation under transmission electron microscope. Results The levels of K⁺ and Na⁺ markedly decreased 24 h after EMP irradiation (P<0.05). The level of ALT significantly increased 12, 24, and 48 h after irradiation, and returned to normal 96 h after irradiation (P<0.01, P<0.05). The level of AST remarkably increased 12, 24, 48 and 96 h after irradiation (P<0.01, P<0.01). Ultrastructure of left ventricular myocardium obviously changed 12 h after irradiation and the changes reached the peak 24 h after irradiation, which were characteristic of dilatated sarcoplasmic reticulum, swollen mitochondria with cristae loss and vacuolization, and broadened space between intercalated. These changes improved 48 h after irradiation, and disappeared 96 h after irradiation. Conclusion EMP can cause K⁺, Na⁺, ALT and AST turbulence, and reversible injury of ventricular myocardium in rats.

IgG expression in laryngeal squamous cell carcinoma and its clinical significance

JIANG Chunfan, ZHANG Qin, LIANG Jinjun, WANG Guiying, FU Wenrong

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  25-31.  doi:10.6040/j.issn.1671-7554.0.2014.885

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Objective To investigate the IgG expression in laryngeal squamous cell carcinoma (LSCC), compare it with IgG of B lymphocytic origin, and explore its possible clinical significance. Methods IgG expression in LSCC cells was detected with immunohistochemistry and in situ hybridization. Heavy chains and light chains of IgG were detected with laser guided microdissection coupled with RT-PCR. VDJ rearrangement of IgG heavy chain variable region 1 was assessed with sequencing and BLAST. The correlation between IgG expression and the pathological parameters was assessed by statistics. Results Igγ, Igκ and Igλ were detected in the same cell of LSCC, characteristic of peripheral distribution at cancer nests. IGHG1 mRNA expressions were co-localized with Igγ in the cancer cells. The mRNAs of IGHG1, Igκ and Igλ were detected in LSCC cells by RT-PCR. VDJ rearrangement occurred when the heavy chains were synthesized, but it presented a monotonous pattern and a small quantity of point mutations, the ratios of which were 2.03%-3.67%. IgG expressions were much stronger in the cases of low differentiation, Ⅲ-Ⅳ stages or lymph node metastasis. Conclusion IgG is expressed in LSCC cells, which has unique VDJ rearrangement different from IgG of B lymphocytic origin. IgG derived from LSCC cells is significantly associated with stages, grades and lymph node metastasis.

Antioxidant activities of aqueous extract from peony (Paeonia suffruticosa Andr.) flower

LI Zhaoping, CHEN Liyong, YIN Yingchao, XU Guifa

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  32-36.  doi:10.6040/j.issn.1671-7554.0.2015.252

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Objective To explore the anti-oxidative effect of aqueous extract from peony flower. Methods The total flavonoid content in aqueous extract was determined by the AlCl₃ colorimetric method,and the total phenolic content was determined by the Folin-Ciocalteu method. The in vitro antioxidant abilities of peony flower aqueous extract were estimated by ABTS and DPPH radical scavenging activity. Its in vivo antioxidant ability was evaluated according to the superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities, and malondialdehyde (MDA) content in serum and liver tissue of mice model with peroxidation induced by gastric gavage of 50% ethanol (12 mL/kg) for one time. Results The flavonoid content of aqueous extract from peony flower is (15.81±2.66) mg rutin/g and total phenolic acid content is (46.63±5.05) mg gallic acid/g. Extracts showed potent antioxidant activity according to ABTS, DPPH free radical scavenging method. Oral administration with high dose of aqueous extract of peony flower [500 mg/(kg·d)] for 30 days significantly improved activity of antioxidant enzymes (P<0.05) and reduced the content of MDA (P<0.05) in serum and liver tissue of the ethanol-induced peroxidation mice model. Conclusion The peony flower extracts with high total phenolic and flavonoid content possess remarkable antioxidant capacity.

Clinical Medicine

Efficacy and safety of dabigatran etexilate versus warfarin in antithrombotic therapy for nonvalvular atrial filbrillation

LÜ Yanhong, GAO Haiqing, QIU Jie

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  37-40.  doi:10.6040/j.issn.1671-7554.0.2015.147

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Objective To compare the efficacy and safety of dabigatran etexilate with warfarin for thromboembolism prevention in patients with nonvalvular atrial fibrillation. Methods A total of 166 patients with nonvalvular atrial fibrillation were identified as dabigatran etexilate group (110 mg, twice daily) and warfarin group (target international normalized ratio, 2.0~3.0). The efficacy and safety of the two drugs were compared in regard to stroke or systemic embolism and major bleeding outcomes during a follow-up of 6 months. Results In the thromboembolism events, there was no significant difference between dabigatran etexilate group and warfarin group (0.0% vs 1.2%, P>0.05). The rate of bleeding was 4.82% in the dabigatran etexilate group, as compared with 6.02% in the warfarin group (P>0.05). Conclusion There are similar thromboembolism and bleeding rates in patients with nonvalvular atrial fibrillation between dabigatran etexilate and warfarin.

Initial palliative repair of pulmonary atresia with ventricular septal defect by rehabilitating right ventricle to pulmonary artery connection

FENG Zhiyu, GUO Rui, YANG Yanliang, LI Haiming, DONG Mingliang, XU Huihui, LIU Yimin, GUO Kai, WANG Guangzhen, WANG Hui

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  41-45.  doi:10.6040/j.issn.1671-7554.0.2015.404

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Objective To assess the efficacy and safety of right ventricle to pulmonary artery connection as an initial procedure in patients with pulmonary atresia and ventricular septal defect. Methods Clinical data of 8 patients (mean age 3.2±4.7 months, range 10 days-11 months) with pulmonary atresia, ventricular septal defect and pulmonary artery hypoplasia (McGoon ratio 0.94±0.27) treated during Nov. 2013 and Jan. 2015 were retrospectively reviewed. Connection of right ventricle to pulmonary artery was constructed to rehabilitate the anterior blood flow. All patients were carefully followed up with echocardiography at 3-month intervals after the procedure. When pulmonary artery achieved satisfactory growth and McGoon index was considered adequate ratio reached the criterion of curative resection, a complete repair was performed. Results No early deaths occurred. During the follow-up of 3 to 10 months (mean 8.5±3.1 months), significant pulmonary artery growth was obtained (McGoon ratio 1.21±0.35, P=0.01) in all patients. One case whose McGoon ratio reached 1.63 after 13 months received complete repair. Another case with severe cyanotic spells 12 months after the initial palliation whose McGoon ratio was 1.27 also underwent anatomic repair. Postoperative recovery was uneventfully with satisfactory haemodynamics. At the last visit, the cardiac function was grade Ⅰ in New York Heart Association. The other 6 patients were still awaiting complete repair with a satisfactory pulmonarytree growth at last evaluation. Conclusion Early rehabilitating anterior blood flow by connecting right ventricle and pulmonary artery yields a relatively low morbidity and mortality, with good functional results in patients with pulmonary atresia, ventricular septal defect and hypoplastic native pulmonary arteries. Ultimately, significant pulmonary artery growth can be obtained and this strategy allows complete repair in majority of patients.

Clinical efficacy of atorvastatincalcium combined with ezetimibe in the treatment of coronary atherosclerosis with hyperlipidemia

RONG Chunli, YAO Wenjing, YANG Qian, LI Ruyi, CAO Dongping, LIU Meixia, PENG Yingxin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  46-49.  doi:10.6040/j.issn.1671-7554.0.2015.531

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Objective To investigate the clinical efficiency and safety of atorvastatincalcium combined with ezetimibe for treating coronary atherosclerosis with hyperlipidemia. Methods A total of 82 cases of coronary atherosclerosis with hyperlipidemia treated in our hospital during May 2013 to Feb. 2014 were collected and divided into two groups. Patients in single drug group (n=41) were treated with atorvastatincalcium only, while patients in the combined drug group (n=41) received atorvastatincalcium and ezetimibe. After 12 weeks, lipid contents of the two groups were compared. Results Before the treatment, the values of TC, TG, HDL-C, LDL-C, and CRP in the two groups were not significantly different (P>0.05). After the treatment, the values of TC, TG, LDL-C, CRP in the two groups were markedly reduced and HDL-C was remarkably increased than before (P<0.05), and the improvement was greater in the combined drug group (P<0.05). The standard rate of LDL-C was 78.05% in combined drug group, which was notably higher than that of the single drug group (53.66%) (P<0.05). There were no differences in liver and renal function between the two groups before and after treatment (P>0.05). Conclusion Atorvastatincalcium combined with ezetimibe has significant lipid-lowering effect in treating coronary atherosclerosis with hyperlipidemia, and does not increase the burden on liver and kidney.

Impacts of different iodine deliver rates with constant total iodine load on CT images of inferior phrenic artery

GONG Fengling, YU Peng, CHEN Weibin, MA Chunmei, ZHANG Huiying

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  50-54.  doi:10.6040/j.issn.1671-7554.0.2015.369

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Objective To explore the impacts of different iodine deliver rate (IDR) with constant total iodine load on CT images of inferior phrenic artery (IPA). Methods A total of 60 patients abdominal CT angiography were randomly divided into 3 groups (20 patients in each group): group A: iodine concentration 300 mgI/mL, injection rate 5 mL/s, IDR 1 500 mgI/s; group B: iodine concentration 350 mgI/mL, injection rate 4.3 mL/s, IDR 1 505 mgI/s; group C: iodine concentration 370 mgI/mL, injection rate 4.3 mL/s, IDR 1 591 mgI/s, and the total iodine load was 350 mgI/kg. The display and image quality of different branches of IPA in each group were recorded. The CT values of the first and second grade of right IPA (RIPA) were measured. Results There was no statistical significance in the image quality of different branches and CT values of RIPA between group A and B (P>0.05). The display of grade three and above branches of IPA and image quality of group C were significantly higher than those of group A and B (P<0.05). The CT values of the first and second grade of RIPA in group C were higher than those in group A and B (P<0.05). Conclusion When the total iodine load is kept constant, the increase of IDR can obviously promote the IPA enhanced degree and image quality, which is conducive to the display of grade three and above branches of IPA.

Changes of thrombosis molecular markers and their clinical values in type 2 diabetic patients with low extremity fractures

QIN Xiangde, YANG Chunyun, ZHANG Yuan, NI Yihong, YU Chao, FENG Xiaoli, XU Chengwei

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  55-58.  doi:10.6040/j.issn.1671-7554.0.2015.577

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Objective To explore the effects of fracture on the activity of blood coagulation in patients with type 2 diabetes mellitus and the relationship between fracture and thrombotic diseases. Methods A total of 90 patients with type 2 diabetes mellitus and lower limb fracture (diabetic and fracture group), 90 patients with type 2 diabetes (diabeticgroup) and 90 healthy controls with comparable of sex, age and body mass index (control group) were recruited. The contents or activity of plasma fibrinogen (Fib), D-dimer (D-dimer), von willebrand factor (vWF), platelet membrane glycoprotein 140 (GMP-140), prothrombin fragment 1+2 (F1+2), thrombin activation of fibrinolysis inhibitor(TAFI) and tissue factor pathway inhibitor (TFPI), were compared. Results In the diabetic and facture group, the values of Fib, D-dimer, vWF, GMP-140, F1+2 and TAFI were (5.3±1.4) g/L, (1 350.1±88.3) ng/mL, (161.9±6.6) IU/dL, (21.8±2.5) μg/L, (1.6±0.5) nmol/L and (30.5±3.8) μg/mL, respectively. In the diabetic group, the values were (4.1±1.2) g/L, (880.5±35.6) ng/mL, (123.6±5.5) IU/dL, (18.9±2.3) μg/L, (1.3±0.3) nmol/L, (28.3±2.9) μg/mL, respectively. In the control group, the values were (2.5±0.6) g/L, (145.7±22.5) ng/mL, (96.8±4.5) IU/dL, (13.8±2.1) μg/L, (0.8±0.2) nmol/L, (26.4±2.5) μg/mL, respectively. The values of the former two groups were significantly higher than those of the control group, and the values of the diabetic and fracture group were higher compared to those of the diabetic group (F=141.70, 10 396.17, 3 072.95, 277.67, 116.05, 277.67, P<0.001). The plasma TFPI activity of the former two groups was lower than that of the control group (16.2±1.3, 17.3±2.1, 18.5±2.7, U/mL). And it was the lowest in the diabetic and fracture group (F=26.68, P<0.001). Conclusion Fractures can lead to blood clotting activity and high coagulation state in diabetic patients, thus such patients are prone to thromboembolic disorders.

Evaluation of combined detection of sHLA-G, PGR and GPR in the diagnosis of gastric cancer

DING Juan, ZHENG Guixi, DU Lutao, YIN Zuohua, ZHANG Jian, WANG Chuanxin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  59-63.  doi:10.6040/j.issn.1671-7554.0.2015.837

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Objective To detect the expressions of pepsinogens (PGI and PGII), gastrin-17 (G-17) and sHLA-G in patients with gastric cancer or precancerous lesion, and to evaluate the efficiency of combined diagnostic index of PGR (PGI/II), GPR (G-17/PGI) and sHLA-G in these patients. Methods The levels of PGs were detected in 50 healthy volunteers, 46 patients with atrophic gastritis, 50 patients with gastric intraepithelial neoplasia, 36 patients with early gastric cancer and 74 patients with advanced gastric cancer by chemiluminescent microparticle immunoassay, and the levels of G-17 and sHLA-G were detected by ELISA. Logistic regression and ROC curve were used to establish a new diagnostic panel for gastric cancer using the combined diagnosis biomarkers PGR, GPR and sHLA-G. Results Reduced PGR and increased GPR and sHLA-G were detected in patients with early and advanced gastric cancer, compared with healthy volunteers, patients with gastric intraepithelial neoplasia and atrophic gastritis (all P<0.001). The ROC-AUC of sHLA-G and PGR were 0.846 (95%CI, 0.760-0.910) and 0.835 (95%CI, 0.748-0.902) respectively, which were significantly higher than those of GPR (0.716, 95%CI, 0.617-0.802). The new diagnostic model of gastric cancer was logit (Y)=0.41+0.03×sHLA-G-5.90×PGR, and the ROC-AUC of the new variable Y in thediagnosis of gastric cancer was 0.924 (95%CI, 0.853-0.967), which was higher than that of sHLA-G and PGR (P<0.05). Conclusion The combined detection of sHLA-G and PGR is helpful in the diagnosis of gastric cancer, which can serve as a useful supplement to traditional tumor markers.

Effect of lansoprazole and exenatide on gastrin and oxyntomodulin in patients with type 2 diabetes

LI Hanbing, GAO Yanyan, LI Li, CAO Caixia, XIAN Yuxin, WANG Jing, NIU Jiapeng

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  64-68.  doi:10.6040/j.issn.1671-7554.0.2015.338

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Objective To observe glucose and lipids levels, body composition and insulin sensitivity before and after the treatment of exenatide and lansoprazole in type 2 diabetes mellitus (T2DM) patients, and to explore the effects of lansoprazole on the serum gastrin and oxyntomodulin (OXM). Methods Fifty-four obese patients with T2DM were randomly divided into combined treatment group (n=27) and exenatide group (n=27). Therapeutic plan of combined treatment group: 10 μg exenatide (subcutaneous injection one hour before breakfast and dinner) plus 15 mg lansoprazole were applied based on the original scheme; therapeutic plan of exenatide group: 10 μg exenatide (subcutaneous injection one hour before breakfast and dinner) was applied based on the original scheme. After 8 weeks of treatment, the changes in weight, body composition, blood pressure, fasting blood glucose (FBG), serum lipids, hepatic and renal functions, fasting insulin, glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), serum gastrin and OXM were measured. Results Body weight, body composition, low densith lipoprotein (LDL), FBG, HbA1c, HOMA-IR and systolic pressure decreased significantly after treatment in both two groups (P<0.05). Comapred withexenatide group, gastrointestinal discomfort was alleviated, serum gastrin level increased [(160.76±8.93) vs (95.30±6.01) ng/L, P<0.05], FBG [(8.06±2.33) vs (8.51±2.71)mmol/L, P<0.05] and HbA1c[(7.79±0.78) vs (7.87±0.81)%, P<0.05] levels decresed in combined treatment group. The changes of ALT, AST, uric acid (UA), serum creatinine (Scr), blood urine nitrogen (BUN), high density lipoprotein (HDL) and OXM in two groups had no statistical differences (P>0.05). Correlation regression analysis showed that the decrease of HbA1c was associated with the increase of gastrin after treatment of exenatide and lansoprazole(r=-0.302, P<0.05). Conclusion Lansoprazole can alleviate gastrointestinal discomfort caused by exenatide in the early stage and reduce the blood glucose levels in obese T2DM patients, which may be related to the increase of gastrin. However, lansoprazole may have not any effects in the changes of oxyntomodulin.

Non-magnifying narrow band imaging for histologic prediction of diminutive colorectal polyps

CHEN Zhaosheng, WU Honglei, ZHOU Chengjun, GUO Jianqiang

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  69-72.  doi:10.6040/j.issn.1671-7554.0.2015.216

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Objective To evaluate the significance of colonoscopy with non-mangnifying narrow band imaging (NM-NBI) in predicting the pathological histology of diminutive colorectal polyps. Methods A total of 293 lesions detected by white light colonoscopy were enrolled in this study. These lesions were predicted as neoplastic (adenoma or cancer) or non-neoplastic based on narrow-band imaging international colorectal endoscopic (NICE) classification, which were compared with the results of pathology. The sensitivity, specificity, positive and negative predictive values, and accuracy were evaluated. Results In the differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 92.14%, 81.05%, 81.64%, 91.85% and 86.35%, respectively. Conclusion For most diminutive colorectal polyps, colonoscopy with NM-NBI has potential to replace pathological diagnosis and reduces costs related to post-polypectomy pathologic examinations and polyp removal.

Clinical analysis and type distribution of human papilloma virus among gynecologic outpatients

LI Chen, CHENG Yufeng, LI Ailu

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  73-76.  doi:10.6040/j.issn.1671-7554.0.2015.312

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Objective To explore the infection rate and characteristics of human papilloma virus (HPV) among gynecologic outpatients, distribution of HPV types, and the relationship between HPV and cervical neoplasms. Methods Flow-through hybridization and gene chip ttechnique was employed to detect HPV genotypes of 5 869 gynecologic outpatients. Results The total infection rate was 23.6%, the detection rate of HR-HPV and LR-HPV was 19.6% and 6.7%, respectively. The most common type of HPV was HPV16, followed by 52, 11, 58, 6, 18, 53 and 33. Of the 1,385 HPV cases, 72.1% acquired single subtype of HPV, 21.3% had two different subtypes, and 6.6% had more than three different subtypes. HPV infection rate in patients with cervical cancer (91.7%) was significantly higher than that in patients with cervicitis (χ²=207.426, P<0.001) and healthy controls (χ²=252.211, P<0.001). HPV16,18, 31, 33, 58 and 45 were most commonly found in patients with cervical cancer. HPV infection rate was significant (χ²=36.486, P<0.01) in different age groups, the highest (32.5%) was in women under 25 years old, followed by 28.4% in women above 50 years old. Conclusion Among gynecologic HPV outpatients, most were infected with HR-HPV, some with LR-HPV, and a few with both HR- HPV and LR-HPV or with multiple HPV. There were obviousregional differences and characteristics of HPV type distribution in different population groups. The highest rate of HPV infection was in patients with cervical cancer. HPV 16, 18, and other HR- HPV were found to be closely related with cervical lesions and cervical cancer. Women under 25 and above 50 years old were high-risk groups.

Effect of double-lumen-tube or bronchial blocker used for one-lung ventilation on PetCO₂ and PaCO₂

YANG Xiaomei, FANG Ningning, YI Wenbo

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  77-79.  doi:10.6040/j.issn.1671-7554.0.2015.262

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Objective To assess the effect of double-lumen-tube (DLT) and bronchial blocker for one-lung ventilation on partial pressure of end-tidal carbon dioxide (PetCO₂) and arterial partial pressure of carbon dioxide (PaCO₂). Methods Thirty patients were randomly assigned to DLT group (n=15) and BB group (n=15). After anesthesia induction, DLT or BB was intubated into the trachea. After one-lung ventilation, the values of PetCO₂ and PaCO₂ were recorded and analyzed. Results Compared with BB group, the PetCO₂ value was higher, the PaCO₂ value was lower, and the correlation between PetCO₂ and PaCO₂ was better in DLT group. Conclusion Compared with BB, DLT was better at exhalation of CO₂.

Clinical features and prognostic factors of cutaneous malignant melanoma in Shandong Province: report of 61 cases

ZHANG Min, MU Xiaonan, MA Weiyuan, DANG Ningning, ZHANG Nan

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  80-84.  doi:10.6040/j.issn.1671-7554.0.2015.317

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Objective To investigate the clinical features and prognostic factors of cutaneous malignant melanoma (CMM) in Shandong Province. Methods Clinical data of 61 CMM cases treated during Jan. 2009 and Dec. 2014 were retrospectively reviewed. The survival rates were calculated with Kaplan-Meier method and compared with log-rank test. The independent prognostic factors were evaluated with Cox regression multivariate analysis. Results The 1-year, 3-year and 5-year survival rates of the 61 patients were 82.0%, 23.0%, and 16.4%, respectively. The 5-year survival rate was significantly associated with clinical staging (P<0.01), ulceration (P<0.01), and operation (P<0.01). Clinical staging was the independent prognostic factor. Conclusion Clinical staging is the independent risk factor for poor survival rate in patients with CMM in Shandong Province.

Efficacy of long-pulsed 1 064 nm Nd:YAG laser in the treatment of moderate to severe acne complicated with post-acne erythema

LI Pingping, LIANG Wei, ZHANG Zhen, LI Ying, GAO Jing, MA Yue

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  85-88.  doi:10.6040/j.issn.1671-7554.0.2015.507

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Objective To elucidate the efficacy and safety of long-pulsed 1064nm Nd:YAG laser in the treatment of moderate to severe acne complicated with post-acne erythema. Methods A total of 20 cases of moderate to severe acne complicated with post-acne erythema were recruited, who were treated with long-pulsed 1 064 nm Nd:YAG laser. The laser parameters were: 25~30 J/cm², 3.0 Hz, 20~40 ms pulse duration, 6.0 mm spot size. All patients were treated once a week for 8 weeks. Pictures of acne lesions were taken and the numbers were recorded before and after treatment. Results Of all 20 cases, 17 were cured, and 3 were improved. The total effective rate was 100%. The number of acne lesions was significantly reduced (P<0.05). Meanwhile, the texture of the skin was improved, and more than 90% patients were satisfied. The treatment effect of early inflammatory lesions was better than that of acne erythema (P<0.05). The side effect was transient erythema after treatment. Conclusion s Long-pulsed 1 064 nm Nd:YAG laser is safe and effective in the treatment of moderate to severe acne with acne erythema. It is a new therapeutic approach for acne and persistent post-acne erythema.

Medical Psychology

Reliability and validity of Chinese version of Acculturative Stress Scale

ZHANG Cancan, SU Yonggang, ZHANG Hongjing

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2015, 53(11):  89-94.  doi:10.6040/j.issn.1671-7554.0.2015.221

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Objective To develop a Chinese version of Acculturative Stress Scale for International Students (ASSIS), and to test its reliability and validity. Methods Chinese version of ASSIS, General Health Questionnaire-28 (GHQ-28) and Positive and Negative Affect Schedule (PANAS) were used to investigate 342 Chinese students from a university of Shandong province. Results The correlation between each item of the ASSIS and its scale was significant (r=0.417 to 0.788, P<0.01). Critical ration had reached significant level (P<0.01), with good item discrimination. Exploratory factor analysis produced 5 factors: perceived discrimination, fear, home sickness, stress due to change and perceived hate, which accounted for 62.51% of the variance. Reliability analysis confirmed that Cronbach s α coefficient of the ASSIS was 0.928, and Cronbach s α coefficient of the 5 subscales ranged from 0.765 to 0.867. The correlation between subscales was 0.507 to 0.805 (P<0.01). The spearman correlation coefficients among the ASSIS and the GHQ-28, PANAS were significant (r=-0.228 to 0.433, P<0.05, P<0.01). There existed statistical differences among different groups of students in different dimensions (P<0.05). Conclusion The Chinese version of ASSIS has good reliability and validity in application to Chinese students.