Journal of Shandong University (Health Sciences)

Brain-derived neurotrophic factor modulates intestinal barrier integrity in mice

ZHAO Dongyan, YU Yanbo, ZUO Xiuli

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 1-5. doi:10.6040/j.issn.1671-7554.0.2015.1340

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Objective To investigate the effects of brain-derived neurotrophic factor(BDNF)on intestinal barrier integrity in mice. Methods Ileal tissues and colonic tissues from BDNF^+/+ mice and BDNF^+/- mice were prepared. The intestinal epithelial structure was detected by transmission electron microscopy. Expressions and distributions of tight junction proteins(occludin and ZO-1)in the colonic mucosa were evaluated by immunohistochemistry. Expressions of tight junction proteins(claudin-1 and claudin-2)in the colonic mucosa were evaluated by Western blotting. Results Compared with BDNF^+/+ mice, BDNF^+/- mice displayed integral ileal epithelial barrier and impaired colonic mucosa integrity which was characterized by diminished microvilli, widened intercellular space and bacteria invasion in the colonic mucosa. BDNF^+/- mice also exhibited increased expression of claudin-2 and decreased expression of occludin, ZO-1 and claudin-1 in the colonic mucosa. Conclusion BDNF may play a role in regulating the colonic epithelial barrier in mice.

Expression and clinical significance of ARNT2 in gastric carcinoma

HAO Shuhua, JIA Yanfei, ZHENG Yan, MA Xiaoli, KONG Yi, LI Ping, ZONG Shuai, ZHANG Yao, WANG Yunshan

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 6-10. doi:10.6040/j.issn.1671-7554.0.2015.1247

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Objective To investigate the expression of aryl hydrocarbon receptor nuclear translocator 2(ARNT2)in human gastric carcinoma and its clinical significance. Methods The mRNA and protein expression levels of ARNT2 in normal gastric cell line and several gastric cancer cell lines were measured by quantitative real-time reverse transcription-polymerase chain reaction(qRT-PCR)and Western blotting. The expressions of ARNT2 protein in 61 cases of gastric cancer tissues and adjacent non-tumor tissues were detected by immunohistochemistry. Results The mRNA and protein expressions of ARNT2 in gastric cancer cell lines were significantly lower than those in normal gastric cell line. The positive expression of ARNT2 in gastric cancer tissues was lower than that in adjacent non-tumor tissues(32.79% vs 80.33%, P<0.05). Furthermore, ARNT2 expression was closely correlated with the differentiation of gastric cancer(P<0.05). Conclusion The expression of ARNT2 is lower in gastric cancer cells and tissues than in non-tumor cells and tissues, and is correlated with the differentiation of gastric cancer, which suggests that ARNT2 may participate in the occurrence and development of gastric cancer.

Role of human TIMP-2 protein in the migration and invasion of hepatocellular carcinoma cell

WANG Wei, CAO Yushan, SUN Daquan, HUANG Xiaoqiong, XU Guoqiang

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 11-17. doi:10.6040/j.issn.1671-7554.0.2016.132

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Objective To collect protein of human TIMP-2 through prokaryotic expression in vitro, and to explore its role in the migration and invasion of hepatocellular carcinoma(HCC)cell. Methods Total RNA was extracted from human hepatoma cell line SMMC-7721, and TIMP-2 cDNA was obtained with RT-PCR. The prokaryotic expression vector pGEX-TIMP-2 was constructed, and then transformed into Origami(DE3). The expressional product was purified with affinity chromatography and identified with Western blotting. The role of TIMP-2 in migration and invasion of HCC cells were detected with RNAi technology and adding extraneous TIMP-2 protein. The mRNA and protein expressions of endogenous TIMP-2 in HCC cells were detected with real-time fluorescence quantitative PCR and Western blotting after transfection with siTIMP-2. Results Adding of exogenous TIMP-2 suppressed the migration and invasion of HCC; knock-down of TIMP-2 enhanced the migration and invasion of HCC; conditioned medium of hepatic stellate cells promoted the migration and invasion of HCC, which could be inhibited by TIMP-2 protein. Conclusion The level of TIMP-2 protein in the microenvironment is closely related to the migration and invasion of HCC.

Pulsatilla saponin D combined with sorafenib against hepatocellular carcinoma cell invasion and metastasis

HE Wubin, SU Rongjian

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 18-22. doi:10.6040/j.issn.1671-7554.0.2015.610

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Objective To investigate the effect of Pulsatilla saponin D and sorafenib on the invasion and metastasis of human hepatoma cell line. Methods The human hepatoma cell line SMMC-7721 cells were divided into Pulsatilla saponin D group(11.9 μg/L), sorafenib group(2.15 μmol/L), combined group(Pulsatilla saponin D 11.9 μg/L+Sorafenib 2.15 μmol/L)and control group(ordinary culture). The inhibitory effects on the migration and invasion of SMMC-7721 cells were observed with MTT assay and Transwell chamber experiments. The effects on CD_44V6, VEGF-C, MMP-9 gene protein expressions were detected with immunocytochemistry. Results MTT assay showed that Pulsatilla saponin D, sorafenib, and combined therapy inhibited the proliferation of SMMC-7721 cells, and the 24 h inhibition rate was less than 15%. Transwell chamber experiments showed that the adhesion inhibition rate of the combined group displayed a synergistic effect compared with the monotherapy groups, but not in a time-dependent manner; the invasion and migration inhibition rate of the combined group were significantly higher than those of the monotherapy groups(P<0.01). Immunohistochemistry results showed that the combined group had lower CD_44V6, VEGF-C, and MMP-9 expressions than the monotherapy groups(P<0.05). Conclusion Pulsatilla saponin D and sorafenib synergistically inhibit the SMMC-7721 cell invasion and metastasis, and the combined effect of Pulsatilla saponin D and sorafenib is 山东大学学报 (医学版)54卷7期 -贺武斌,等.白头翁皂苷D联合索拉非尼对人肝癌细胞侵袭与转移的影响 \=-better than the single drug.

Anti-influenza virus activities of garlic oil in mice model in vivo

ZHENG Qianqian, LIU Ti, XIE Keqin, LIN Yi, LI Zhong, WANG Xianjun, BI Zhenqiang, WEN Hongling, SONG Yanyan, ZHAO Li

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 23-27. doi:10.6040/j.issn.1671-7554.0.2015.746

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Objective To investigate the effect of garlic oil on anti-influenza virus in mice in vivo. Methods The mice were given low, medium and high doses of garlic oil［25、50、100 mg/(kg·d)］ through the mouths, and divived into low, medium and high dose of garlic oil groups,then the flu virus was vaccinated. Meanwhile, the blank, virus, solvent and positive drug control groups were set up. Active state, body weight, lung, mortality and average survival time of mice were observed. Results Compared with the virus control group, the mice in the low, medium and high dose of garlic oil groups and positive drug control group had better states, higher body weights, less lung indexes, more relieved lung lesions and lower death rates; compared with the solvent control group, the survival time extended in the low, medium and high dose of garlic oil groups and positive drug control group(P<0.05). Conclusion Garlic oil has the anti-influenza virus activities to some degree in mice model in vivo.

Evaluation of the therapeutic effect of Rex shunt in the treatment of cavernous transformation of the portal vein in children

WANG Junfeng, LIU Qian, SUN Xiaogang, LI Jinliang, XU Jialong, LÜ Qigang, MA Nan, WANG Ruoyi

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 28-32. doi:10.6040/j.issn.1671-7554.0.2016.191

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Objective To evaluate the therapeutic effect of Rex shunt in the treatment of cavernous transformation of portal vein(CTPV)in children. Methods A retrospective review of the preoperative, intraoperative and postoperative clinical data of 15 children with CTPV who underwent Rex shunt was conducted. Results Preoperative color-flow Doppler ultrasound and computed tomography angiography(CTA)portography confirmed CTPV in all patients. Intraoperative portography showed intrahepatic portal vein branches were patent. Extrahepatic portal vein branches were anastomosed to left portal vein(LPV)or umbilical vein in the Rex shunt and the portal pressure significantly decreased post-shunt(P<0.01). Doppler ultrasound showed the shunts were patent in 13 cases and obstructed in 2 cases 1 week postoperatively, thus the success rate of operation was 86.7% in total. Hepatic pathology indicated 1 of the 2 failure cases was chronic active hepatitis, and the other was hepatitis complicated with cirrhosis. During the follow-up of 33.3±10.9 months, the 2 failure cases did not restore patency by means of anticoagulant and antiplatelet treatment, while the shunts kept patent in the rest 13 cases. The blood flow velocity and diameter of LPV significantly increased after surgery 山东大学学报 (医学版)54卷7期 -王军锋,等.门静脉左支血管转流术治疗小儿门静脉海绵样变性的疗效评估 \=-(P<0.01). Postoperative blood count obviously increased(P<0.05). The degree of gastroesophageal varices were significantly mitigated postoperatively(P<0.01). Hepatic pathology and patients’ age had a significant influence on the operative effectiveness(P<0.05). Conclusion Rex shunt is effective in treating CTPV, and has advantages of simple operation, few operative trauma and rapid recovery over the bypass, thus it can be the first choice for the treatment of CTPV in children. It is suggested to be performed at the early stage without liver lesions.

Association of serum testosterone level and non-alcoholic fatty liver disease in male patients with T2DM

LIN Dong, GUAN Qingbo

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 33-37. doi:10.6040/j.issn.1671-7554.0.2015.1355

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Objective To investigate the correlation between serum total testosterone(TT)and non-alcoholic fatty liver disease(NAFLD)in male patients with type 2 diabetes mellitus(T2DM). Methods A total of 199 male patients with T2DM were enrolled in the study. According to results of abdomen ultrasound, the subjects were divided into NAFLD group and non-NAFLD group. The NAFLD group was further divided into mild subgroup and moderate-severe subgroup according to the severity of NAFLD. The TT level was measured using electrochemiluminescent method. The other serological indicators were measured by Olympus automatic biochemistry analyzer. The correlation of TT and NAFLD was analyzed. Results The TT level of NAFLD group was lower than that of non-NAFLD group［3.29(2.54-4.21)vs 4.91(3.48-5.99), P<0.01］. The TT level of the moderate-severe subgroup was lower than that of the mild subgroup(3.06±1.11 vs 3.65±1.45, P=0.049). Conclusion Male T2DM patients with low TT level are at high risk of NAFLD. Low TT level is an independent risk factor for NAFLD in T2DM male patients.

Expression of apoptosis-related genes in peripheral blood mononuclear cells of patients with HBV infection and the relationship with chronicity of hepatitis B

ZHANG Kun, ZHAGN Xiaoguo, CUI Xingxing, CHEN Shijun

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 38-42. doi:10.6040/j.issn.1671-7554.0.2015.828

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Objective To investigate the different apoptosis pathways of peripheral blood lymphocytes cells(PBMCs)and their roles in the chronicity of HBV infection. Methods The study included 9 chronic asymptomatic HBV carriers(ASC), 48 patients with chronic hepatitis B(CHB), 24 patients with liver cirrhosis(LC)and 20 normal controls(NC). The mRNA expressions of apoptosis-related genes(FAS、CASP8、CYCS、CASP9、CASP3)in PBMCs were examined with real time fluorescent quantitative PCR, and the protein expressions in plasma were detected with enzyme linked immunosorbent assay(ELISA). Results The mRNA expressions of apoptosis-related genes were higher in CHB and ASC groups, as compared to NC and LC groups(P<0.05); there was no difference between CHB group and ASC group(P>0.05); the expressions were higher in LC group than in NC group(P<0.05). The protein expressions of apoptosis-related genes in CHB and ASC groups were higher than in NC and LC groups(P<0.008 3); there was no difference between CHB and ASC groups(P>0.008 3); the expressions were higher in LC group than in NC group(P<0.008 3). Conclusions HBV infection can induce the apoptosis of PBMCs, with extrinsic and intrinsic pathways involved. The apoptosis of PBMCs plays an important role in the chronicity of HBV infection.

Association between nonalcoholic fatty liver disease and chronic kidney disease: a retrospective cohort study

SHEN Zhenwei, JI Xiaokang, WANG Qinglian, LI Jie, XUE Fuzhong, LIU Jing

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 43-49. doi:10.6040/j.issn.1671-7554.0.2015.1001

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Objective To explore the effect of nonalcoholic fatty liver disease(NAFLD)on the incidence of chronic kidney disease(CKD). Methods A retrospective cohort study was conducted using the data of regular physical examinations derived from the Health Management Center of Shandong Provincial Hospital. Participants who had physical examinations ≥3 times during 2005 and 2010 and whose renal function was normal at the first examination were included. Comparisons of the baseline characteristics between the participants with and without NAFLD were conducted with Student-t test or Pearson chi-square test. The cumulative incidences of CKD were estimated using Kaplan-Meier method for subjects with and without NAFLD at baseline respectively. Log-rank test was adopted to identify the difference between groups. Firstly, univariate Cox regression models were used to explore the association between the hazard of 山东大学学报 (医学版)54卷7期 -申振伟,等.非酒精性脂肪肝与慢性肾脏病关系的回顾性队列研究 \=-CKD and the relevant factors such as demographic characteristics and biochemical measures. Further, multiple Cox regression model was used to estimate the effect of NAFLD on the incidence of CKD after adjusting these potential confounders. Results The cohort included 10 775 subjects and 34 878 person-years(average 3.24±0.99 years per person)were followed up. There were 1 068 CKD cases during the study period, and the incidence was 30.62/1 000 person-years. The cumulative CKD incidence of subjects with NAFLD at baseline was significantly higher than that of without NAFLD(22.76 vs 12.07, P<0.01). After adjusting the factors including age, gender, body mass index, systolic blood pressure, fasting blood-glucose, triglyceride, high density lipoprotein, hemoglobin, thrombocytocrit, hypertension, diabetes, metabolic syndrome and history of coronary heart disease, the HR of NAFLD to non-NAFLD on CKD was 1.20(95% CI: 1.05-1.38, P=0.01). Conclusion The existence of NAFLD was confirmed to be one independent risk factor for CKD in Chinese population. This finding will be helpful for prevention of CKD.

Quantitative analysis of spectral CT imaging on hypervascular hepatic metastasis and hepatocellular carcinoma

YUE Qianqian, WANG Xinyi, YANG Zhiqiang, JIANG Shu

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 50-55. doi:10.6040/j.issn.1671-7554.0.2016.058

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Objective To evaluate the value of the spectral CT quantitative analysis in the differential diagnosis of hypervascular hepatic metastasis(HVHM)and hepatocellular carcinoma(HCC). Methods A total of 47 patients with hepatic malignant tumors undergoing spectral CT scan were divided into HVHM group(n=20)and HCC group(n=27). The monochromatic image sets, iodine-based material decomposition images and water-based material decomposition images were obtained, and the spectral parameters of lesions, normal hepatic tissues and aorta were measured. Then the normalized iodine concentrations(NIC), lesion-normal parenchyma iodine concentration ratio(LNR), iodine concentration difference(ICD)between the arterial phase and portal venous phase, and the slope of spectral curve were calculated. Independent samples t test and ROC were applied to analyze the quantitative parameters. Results Differences of the NIC, LNR and slope of spectral curve were not statistically significant(P>0.05)during arterial phase. Statistically significant differences of the NIC, LNR and slope of spectral curve were found between the HVHM 山东大学学报 (医学版)54卷7期 -岳倩倩,等.富血供肝脏转移瘤与肝细胞肝癌的能谱CT成像定量分析 \=-group and the HCC group(P<0.05)during portal venous phase: NIC=0.59±0.08, 0.45±0.10; LNR=1.17±0.22, 0.92±0.16; the slopes of spectral curve=1.85±0.49, 1.18±0.34, respectively. Differences of ICD between the HVHM group and the HCC group were not statistically significant(P>0.05), and ICD were(0.54±0.39)g/L,(0.45±0.39)g/L, respectively. Differences of water(iodine)concentration in arterial and portal venous phase between the lesions were not statistically significant(P>0.05). The slope of spectral curve in the portal venous phase had the highest diagnostic efficiency in differentiating HVHM from HCC. Conclusions HVHM and HCC have different spectral characteristic parameters and spectral curves during portal venous phase. Spectral CT imaging provides a new multi-parameter quantitative analysis imaging method for differentiating HVHM and HCC.

Effect of cognitive-behavioral therapy plus hypnosis in controlling cancer-related fatigue in gastric cancer patients receiving chemotherapy

DONG Xiuhong

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 56-59. doi:10.6040/j.issn.1671-7554.0.2015.518

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Objective To explore the effect of cognitive-behavioral therapy plus hypnosis to reduce cancer-related fatigue(CRF)in gastric cancer patients undergoing chemotherapy. Methods A total of 60 gastric cancer patients undergoing chemotherapy were randomly assigned to 2 groups: observation group(n=30)and control group(n=30). All patients adopted FOLFOX4 chemotherapy scheme. On day 1 of the treatment, the observation group underwent cognitive-behavioral therapy plus hypnosis, while the control group was provided with routine health education. The intervention was performed once a day, twice in each chemotherapy cycle. The score of FACIT-F, levels of TNF-α, IL-1β and IL-6 were measured at baseline, 5 days and 2 months after chemotherapy. Results There were no differences between the 2 groups in fatigue and FACIT-F score before chemotherapy(P>0.05). After chemotherapy, the FACIT-F scores of both groups decreased, and the control group had larger margin of decrease(P<0.01); the levels of TNF-α, IL-1β and IL-6 in both groups increased, and the control group had a larger margin of increase(P<0.05). Two months after chemotherapy, the observation group had higher FACIT-F score and higher levels of TNF-α, IL-1β and IL-6 than the control group(P<0.01). Conclusion Cognitive-behavioral therapy plus hypnosis is able to reduce TNF-α, IL-1β and IL-6 levels, and control fatigue in patients undergoing chemotherapy for gastric cancer. Therefore, it may serve as a promising auxiliary treatment for chemotherapy.

Metabolomics analysis of colorectal cancer based on GC-TOF-MS

YU Fei, LIU Shaozhuang, ZHONG Mingwei, HUANG Xin, JIAO Jie, HU Sanyuan, YU Wenbin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 60-68. doi:10.6040/j.issn.1671-7554.0.2016.013

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Objective To explore the metabolic differences of cancer tissues, adjacent mucosa and normal mucosa in patients with colorectal cancer(CRC). Methods A total of 25 CRC patients were selected and the 3 kinds of tissues were taken from each patient. Gas chromatography time-of-flight mass spectrometry(GC-TOF-MS)platform was used for metabolomics analysis. The tissues were compared among each other, and principal components analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were used to analyze the data. Differential metabolites were mapped in the KEGG database to search for the related metabolic pathways. Results Compared with the normal mucosa, 47 metabolites were found different(P<0.05, q<0.05)in cancer tissues, and galactose metabolism, pentose phosphate pathway, glutamate and glutamine metabolism, glutamate, alanine and aspartate metabolism changed significantly(P<0.05). In the adjacent mucosa, 3 metabolites were found different(P<0.05, q<0.05), and galactose metabolism changed significantly(P<0.05). A total of 34 metabolites were found different(P<0.05, q<0.05)between the cancer tissues and the adjacent mucosa, and pentose phosphate pathway, glutamate and glutamine metabolism, glutamate, alanine and aspartate metabolism changed significantly(P<0.05). Conclusion The glucose metabolism and amino acid metabolism are changed in CRC tissues.

Significance of IRX5 mRNA in the diagnosis and prognosis of colorectal cancer

LIU Tong, ZHANG Xin, WANG Chuanxin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 69-74. doi:10.6040/j.issn.1671-7554.0.2015.1146

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Objective To investigate the expression and clinical significance of iroquois homeobox(IRX5)mRNA in colorectal cancer(CRC). Methods Expressions of IRX5 mRNA were analyzed in 17 cases of inflammatory bowel diseases, 48 cases of hyperplastic polyp, 54 cases of colorectal adenoma, 142 CRC cases and 142 paired adjacent non-tumorous tissues by quantitative real-time polymerase chain reaction(RT-qPCR). The correlation between IRX5 mRNA expression and prognosis was analyzed. Results IRX5 mRNA expression was significantly elevated in the CRC group when compared with other groups(all P<0.001). In CRC, up-regulation of IRX5 mRNA expression was significantly correlated with tumor size, lymph node metastasis, and distant metastasis(all P<0.05). CRC patients with high IRX5 mRNA expression had poorer disease-free survival(DFS)and overall survival(OS)than those with low IRX5 mRNA expression(log-rank test, P<0.001). Further multivariable Cox regression analysis suggested that increased expression of IRX5 mRNA was an independent prognostic indicator for CRC(P=0.020, HR=1.863, 95%CI=1.101-3.152). Conclusion IRX5 mRNA expression is elevated in CRC, and associated with malignancy and prognosis of CRC, indicating that it may serve as a useful diagnostic and prognostic predictor.

Correlation between TLR4, MyD88 and ERK1/2 expressions and EBV infected colorectal cancer

CAO Kai, WANG Chaoqun, ZHENG Maojin, WU Yongping

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 75-79. doi:10.6040/j.issn.1671-7554.0.2015.1131

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Objective To explore the correlation between toll-like receptor 4(TLR4), myeloid differentiation primary response gene 88(MyD88)and extracellular signal-regulated protein kinases 1 and 2(ERK1/2)expressions and Epstein-Barr virus(EBV)infection in colorectal cancer. Methods Epstein-Barr virus-encoded small RNA(EBER)expression was detected by in situ hybridization using microarray chips containing tissues from 336 cases of colorectal cancer and 103 cases of normal mucosa. The correlation between EBER expression and clinicopathological parameters and prognosis of colorectal cancer was analyzed. Additionally, TLR4, MyD88 and ERK1/2 expressions were detected using SP immunohistochemistry. The correlation between these three factors and EBV infection in colorectal cancer was analyzed. Results TLR4, MyD88, ERK1/2 and EBER expressions were increased in the 336 cases of colorectal cancer compared to the controls(P<0.05). EBER expression was positively correlated with the female gender, serosal infiltration, lymph node metastasis and clinical TNM stages Ⅲ and Ⅳ(P<0.05). Prognostic analysis of the 336 cases of colorectal cancer demonstrated that EBER expression was closely associated with low disease-free survival and overall survival rates(P<0.05). In addition, TLR4, MyD88 and ERK1/2 were expressed in 22(P=0.025), 25(P=0.028)and 19(P=0.092)of the 25 EBER-positive colorectal cancer tissues, respectively. Conclusion EBV infection is closely associated with the progress of colorectal cancer, particularly in female patients, and represents an independent risk factor for the prognosis. Upregulation of TLR4 and MyD88 expressions may play an important role in EBV infected colorectal cancer.

Multiple serous effusion complicated with Warburg effect: a case report of diffuse large B-cell lymphoma and literature review

HAN Kangkang, CUI Liwei, PENG Cheng, XUE Yuwen, XIAO Wei

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 80-87. doi:10.6040/j.issn.1671-7554.0.2016.026

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Objective To explore the clinical diagnosis and treatment of a case of diffuse large B-cell lymphoma(DLBCL), presenting as multiple serous effusion complicated with Warburg effect. Methods Clinical data of a DLBCL case were retrospectively analyzed. A 51-year-old male was admitted due to abdominal pain and distension for 1 month, and right chest pain for 7 days. CT scan, PET-CT scan and thoracoscopy were conducted. Databases including CKNI and Pubmed were searched for relevant studies published during 2010 and 2016 with key words such as “large B-cell lymphoma, hypoglycemia, lactic acidosis, tumor”. Results CT scan showed pleural effusion and ascites, and echocardiography suggested slight pericardial effusion. PET-CT scan indicated high uptake ratio of 18-fluoro-2-deoxyglucose(18-FDG)of both bilateral pleura and peritoneum. Blood glucose tests showed the patient had low sugar at a minimum of 1.17 mmol/L, while blood lactic acid was abnormally high. The LDH in pleural effusion was 5 158 U/L, and CA-125 was 3 251 U/L. Cytological examination of pleural effusion found lymphoblasts and prolymphocytes. Thoracoscopic biopsy of the pleura confirmed the diagnosis of DLBCL. Remission was observed after 3 cycles of chemotherapy. Totally 605 studies involving 3 981 DLBCL patients were included in the literature review. Of all cases, 山东大学学报 (医学版)54卷7期 -韩康康,等.多浆膜腔积液、Warburg效应——弥漫性大B细胞淋巴瘤1例报告并文献复习 \=-108 presented serous effusion, and 30 involved multiple serous cavities. Of the 15 cases presenting both hypoglycemia and lactic acidosis, 13 were NHL cases(4 were confirmed DLBCL; 3 were Burkitt lymphoma; 2 were T cell lymphoma, and 4 were not mentioned). Conclusion DLBCL characterized by multiple serous effusion complicated with Warburg effect is rather rare in clinical practice. Thoracoscopy is effective for the diagnosis and differentiation of similar lymphomas presenting multiple serous effusion.

Clinical effect of milrinone atomization inhalation on treating severe pneumonia complicated with heart failure of neonates and infants

XU Tianyi, WU Ping, WANG Ailing, CHEN Liping

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2016, 54(7): 88-90. doi:10.6040/j.issn.1671-7554.0.2015.730

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Objective To discuss the curative effect and security of milrinone atomization inhalation on treating severe pneumonia complicated with heart failure in noenates and infants. Methods A total of 240 cases with severe pneumonia complicated with heart failure in the fourth Peoples Hospital of Jinan City from 2012 to 2015 were randomly divided into control group and observation group, 120 in each group. The control group was treated with digitalis, diuretic, and other conventional therapies; on this basis, the observation group was treated additionally with milrinone atomization inhalation. Changes of the clinical efficacy and cardiac function indexes of the two groups were observed. Results After 5 days of treatment, clinical symptoms, signs and cardiac function indexes were improved significantly in the two groups. The improvement of cardiac function indexes in the observation group was better than that in the control group. The difference of clinical efficacy and cardiac function indexes before and after the treatment in the two groups were statistically significant(P<0.05). Conclusion On the basis of routine treatment such as digitalis and diuretic therapy, milrinone atomization inhalation can reduce the pulmonary circulation resistance, cardiac preload and afterload, thus effectively improve the heart function in noenates and infants with severe pneumonia complicated with heart failure.

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