Journal of Shandong University (Health Sciences)

A reliable system to assess atherosclerosis model of Bama minipigs

YIN Ni, YANG Guanlin, JIANG Junwen, WANG Chuntian, WANG Fengyao, JIA Lianqun, GAO Xiaoyu, PAN Jiaxiang, LI Qin, LI Jia, FENG Yuanjie, GAO Yuzhu, ZHOU He, ZHANG Zhe

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 1-5. doi:10.6040/j.issn.1671-7554.0.2016.1301

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Objective To evaluate the feasibility, stability and safety of a coronary atherosclerosis model of Bama minipigs. Methods Bama minipigs were randomly assigned into control group(basic diet)and model group(high-fat diet combined with mechanical injury). In week 0, 24 and 48, both groups underwent coronary angiography, intravascular ultrasound(IVUS), electrocardiogram, serum lipid testing, inflammation factors testing, and pathological analysis 山东大学学报 (医学版)55卷7期 -尹妮,等.巴马小型猪冠状动脉粥样硬化模型的评价方法 \=-to evaluate the model. Results In week 24, compared with the control group, the model group had significantly increased total cholesterol(TC), triglycerides(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), oxidized low-density lipoprotein(ox-LDL), high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), vascular cell adhesion molecule-1(VCAM-1), monocyte chemotactic protein(MCP-1)and soluble P-selectin(SP-selectin)(P<0.05). There was no statistically significant difference between the two groups in ST segment depression in week 0 and 24(P>0.05). There was no statistically significant difference between the two groups in T waves in week 0(P>0.05), but there was statistically significant difference in T waves in week 24(P<0.05). In week 24 and 48, the model group showed significantly higher coronary stenosis rate than the control group. In week 48, the model group had higher intima/intima-medial thickness ratio than in week 24. Conclusion The in vitro and in vivo model is safe and feasible in the assessment of atherosclerosis.

Cardioprotective effects of allicin postconditioning on myocardial ischemia-reperfusion injury in rats

LIU Fang, QIAO Lei, CHEN Wenchao, YANG Lina

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 6-11. doi:10.6040/j.issn.1671-7554.0.2017.089

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Objective To explore the effects of allicin postconditioning on myocardial ischemia-reperfusion injury in rats. Methods A total of 18 Wistar rats were randomly allocated into 3 groups: ischemia reperfusion group(IR group), ischemic postconditioning group(IPO group)and allicin postconditioning group, with 6 rats in each group. Langendorff perfusion apparatus was used to build an isolated rat myocardial IR model. Isolated rat hearts were subjected to 30 min global ischemia followed by 60 min reperfusion after 20 min equilibrium. The left ventricular develop pressure(LVDP), the maximal ventricular pressure rise ratio during systolic period(+dp/dt_max), the maximal ventricular pressure decrease ratio during diastolic period(-dp/dt_max)and heart rate(HR)were recorded at the end of 20 min equilibrium and 60 min reperfusion separately. Heart perfusion transudate at the end of 20 min equilibrium and 60 min reperfusion were assessed to determine the activity of lactate dehydrogenase(LDH). Myocardium of left ventricle was detected to examine the activity of superoxide dismudase(SOD)and the contents of malondialdehyde(MDA). Results There was no difference in equilibrium hemodynamics observed among the groups(P>0.05). At the end of reperfusion, compared with IR group, the allicin postconditioning group showed significantly ameliorated functional recovery, 山东大学学报 (医学版)55卷7期 -刘芳,等.大蒜素后处理对大鼠心肌缺血-再灌注损伤的保护作用 \=-decreased activity of LDH, enhanced activity of SOD, and decreased contents of MDA(all P<0.05). At the end of reperfusion, HR was obviously slower in the allicin postconditioning group than in the IPO group(P<0.001). There was no statistically significant difference between IPO group and allicin postconditioning group in other indicators(P>0.05). Conclusion Allicin administration at the beginning of reperfusion can significantly reduce ischemia-reperfusion injury and improve cardiac function, with similar cardioprotective effect as IPO.

Expression of CSN5 and its correlation with the prognosis of gastric carcinoma

ZONG Shuai, XIAO Dongjie, LIU Hua, JIA Yanfei, MA Xiaoli, LI Huanjie, LI Ping, ZHENG Yan, WANG Yunshan

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 12-16. doi:10.6040/j.issn.1671-7554.0.2016.1655

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Objective To investigate the expression of CSN5 in gastric carcinoma(GC)and to determine the prognostic value of CSN5 for GC patients. Methods The genomic alternation of CSN5 was assessed using cBioportal analytical tool. CSN5 mRNA expressions in normal gastric cell line and GC cell line were determined using qRT-PCR. The differences of CSN5 mRNA expressions in gastric mucosa and GC tissues were analyzed based on Oncomine database and TCGA database. The association between CSN5 and prognosis of GC patients was determined with Kaplan-Meier plotter. The relationship between CSN5 expression and 5-year survival of GC patients was analyzed using Chen gastric statistics. Results CSN5 was mainly amplified in GC. The mRNA expression of CSN5 was significantly higher in cancer cell lines than in normal gastric cell line, and was significantly higher in GC tissues than in normal gastric mucosa. Patients with high expression of CSN5 had longer overall survival(OS)than those with low expression. Conclusion The expression of CSN5 is elevated in GC tissues, which is also positively correlated with OS of GC patients.

NR2B contributes to visceral hypersensitivity in irritable bowel syndrome via mBDNF

ZHANG Wenxue, XU Lidong, ZHANG Mingming, GUO Chuanguo, ZUO Xiuli

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 17-22. doi:10.6040/j.issn.1671-7554.0.2016.1674

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Objective In the nervous system, N-methyl-D-aspartate receptors(NMDARs)subunit NMDA receptor 2B(NR2B)is involved in visceral hypersensitivity. This study aims to investigate if colonic mucosal NR2B contributes to visceral hypersensitivity in irritable bowel syndrome via mature brain-derived neurotrophic factor(mBDNF). Methods A total of 32 participants were included. Colonic mucosal NR2B subunits and mBDNF expressions were detected. The relationship between the NR2B and mBDNF expressions was analyzed with Pearson correlation analysis. The relationship between mBDNF expression and abdominal pain scores was analyzed with Spearman correlation analysis. After administration of NMDARs agonist, NMDARs antagonist and NR2B subunit antagonist, the expression of mBDNF in cell culture supernatant was assessed with ELISA. Results NR2B and mBDNF expressions were significantly increased in colonic mucosa of IBS-D patients(NR2B: 90.22±30.79 vs 63.47±28.19, P=0.016; mBDNF: 89.91±20.95 vs 56.53±22.25, P<0.001). NR2B expression was positively correlated with mBDNF expression. Furthermore, mBDNF expression was positively correlated with abdominal pain scores. The activation of NMDAR induced mBDNF expression, which could be completely inhibited by NMDARs antagonist and NR2B subunit antagonist. Conclusion NR2B contributes to visceral hypersensitivity in IBS-D via mBDNF.

Effects of Sirtuin on hypoxia-induced proliferation of human umbilical cord-derived mesenchymal stem cells

WANG Kaimin, TAN Juanjuan, YAN Zhiqiang, LI Zhiqiang

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 23-30. doi:10.6040/j.issn.1671-7554.0.2016.1682

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Objective To explore the effect of hypoxia on Sirtuin(SIRT)protein expression in human umbilical cord-derived mesenchymal stem cells(hUC-MSCs). Methods hUC-MSCs were isolated and cultured by explant technique. The cells were further expanded and assessed for their morphology and phenotype by flow cytometry. The proliferation of hUC-MSCs under normoxia(21%O₂)and hypoxia(5%O₂)was evaluated by CCK-8; Cell cycle was analyzed by flow cytometry. Immunofluorescence assay was used to detect the location of SIRT(1-6)under normoxia and hypoxia 山东大学学报 (医学版)55卷7期 -王凯民,等.Sirtuin在低氧诱导人脐带间充质干细胞增殖中的作用 \=-conditions. Expressions of SIRT(1,2,5)under normoxia and hypoxia conditions for different times(24, 48, 72 h )were detected by Western blotting. Results hUC-MSCs were successfully isolated from umbilical cord. Flow cytometry showed that CD105, CD90, CD44 and CD29 were positive, while CD14, CD19, CD34, CD45 and HLA-DR were negative on hUC-MSCs. The proliferation of hUC-MSCs was enhanced under hypoxia compared with normoxia(all P<0.05). The cells fraction at S phase was also increased under hypoxia compared with normoxia condition after being cultured for 24 h and 48 h(all P <0.05). Immunofluorescence showed that no matter under hypoxia or nomoxia conditions, SIRT1 and SIRT6 were localized in the nucleus, SIRT2 was localized in cytoplasm, and SIRT3, SIRT4, SIRT5 were localized in mitochondria. Western blotting showed the expression of SIRT1 in hUC-MSCs increased under hypoxia after being cultured for 24 h and 48 h(all P<0.05). Similarly, the expression of SIRT5 was increased under hypoxia at all three time points(all P<0.05). The expression of SIRT2 in hypoxia was increased after being cultured for 24 h and 72 h compared with normoxic cells(all P<0.05), however, the expression of SIRT2 under hypoxia condition was lower than that under normoxia condition for 48 h(P<0.05). Conclusion Hypoxia can increase hUC-MSCs’ proliferation. The expressions of SIRT1, SIRT2, SIRT5 were affected by hypoxia, which implies that SIRT1, SIRT2, SIRT5 may be involved in the regulation of hypoxia induced proliferation of hUC-MSCs.

Effects of carbon monoxide releasing molecule-3 on the osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells

LI Jingyuan, SONG Ling, LIN Song, SONG Hui

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 31-37. doi:10.6040/j.issn.1671-7554.0.2017.198

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Objective To investigate the effects of carbon monoxide releasing molecule-3(CORM-3)on the osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells(BMSCs). Methods The BMSCs were divided into 2 groups, group A and group B. Group A was subdivided into osteogenic group, 100 μmol/L CORM-3 group, 200 μmol/L CORM-3 group, 400 μmol/L CORM-3 group and control group. Group B was subdivided into osteogenic 山东大学学报 (医学版)55卷7期 -李景媛,等.不同浓度一氧化碳释放分子-3对大鼠骨髓间充质干细胞成骨分化的影响 \=-group, 100 μmol/L CORM-3-osteogenic group, 200 μmol/L CORM-3-osteogenic group, 400 μmol/L CORM-3-osteogenic group and control group. The mRNA and protein expressions of Runx2 and OPN were detected with Real-time PCR and Western blotting. The cell mineralization was determined with alizarin red staining. Data obtained were analyzed with SPSS 19.0 software. Results CORM-3 at concentrations of 100 μmol/L and 200 μmol/L could significantly promote the proliferation of BMSCs(P=0.034, P<0.001). The mRNA expressions of Runx2 and OPN in 200 μmol/L and 400 μmol/L CORM-3-osteogenic groups were significantly higher than those in the osteogenic group on day 7(Runx2: P=0.005, P=0.006; OPN: P=0.010, P=0.028). Meanwhile, the protein expressions of Runx2 and OPN on day 7 and cell mineralization on day 21 in 200 μmol/L and 400 μmol/L CORM-3-osteogenic groups were enhanced compared with the osteogenic group, and the 200 μmol/L group had better results than the 400 μmol/L group. Conclusion CORM-3 may promote osteogenic differentiation of BMSCs and 200 μmol/L is the suitable concentration.

Preliminary study of tissue distribution and safety of HSV-2 DNA vaccine in mice

JIAO Fengping, ZHANG Haitao, ZHAO Yinghui, TIAN Zhaoju, YANG Shulin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 38-42. doi:10.6040/j.issn.1671-7554.0.2016.856

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Objective To investigate preliminarily the tissue distribution and safety of HSV-2 DNA vaccine pc-P6-gBCTL-TBK-1 in mice. Methods The recombinant plasmid pc-P6-gBCTL-TBK-1 was injected into BALB/c mice with 100 μg per mouse for three times at every other week. Heart, liver, spleen, kidney, lung, brain, blood and muscle tissues of immune mice were collected at 24 h, 7 d, 21 d, 35 d and 49 d after inoculation, then total DNAs of tissues were extracted, and the tissue distribution of plasmid DNA and the possibility of integration with host genome were detected by PCR assay. Results At 24 h, 7 d, 21 d and 35 d after the last immunization, the plasmid DNA was detected in heart, liver, spleen, kidney, lung, brain and muscle tissues. At 49 d after the last immunization, the plasmid DNA was detected only in muscle tissue. The gel-purified genomic DNA was detected negative by PCR assay. Conclusion The plasmid pc-P6-gBCTL-TBK-1 can spread quickly to the heart, liver, spleen, kidney, lung, brain, blood and muscle tissues of the mice. With the extention of time, the plasmid DNA only distributes in muscle tissue of vaccination, and the DNA does not integrate with the host genome, which suggests that the plasmid is safe.

Development and evaluation of chitosan gene nanoparticles loaded with recombinant plasmid pVAX1/Tat PTD-endostatin

ZHANG Xinke, CHEN Hongyuan, YANG Ying, LI Yan, WANG Fengshan

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 43-48. doi:10.6040/j.issn.1671-7554.0.2017.086

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Objective To develop chitosan gene nanoparticles loaded with recombinant plasmid which contains endostatin(Es)gene and evaluate its in vitro inhibitory effects on HUVEC cells. Methods pVAX1 was taken as the expression vector. PCR combined with double restriction enzyme digest method was used to construct recombinant plasmids pVAX1/Tat PTD-Es. Chitosan nanoparticles loaded with plasmids were prepared by ion cross-linking method. Agarose gel electrophoresis experiment was employed to screen the best prescription of nanoparticles. The shape, Zeta potential and size distribution of nanoparticles were evaluated. After nanoparticles were transferred into HUVEC cells, ELISA method was used to detect the expression of Tat PTD-Es, and CCK-8 was explored to determine the inhibitory effect on HUVEC. In ELISA and CCK-8 experiments, Lipofectamine^TM2000 loaded with pVAX1/Tat PTD-Es was used as positive control. Results The recombinant plasmid pVAX1/Tat PTD-Es was constructed successfully. The Zeta potential of chitosan nanoparticles loaded with recombinant plasmid was(14.3±1.6)mV, the size distribution was(145±12)nm. The concentration of Tat PTD-Es in HUVEC supernatant was(182.5±16.3)ng/mL. CCK-8 results showed that chitosan nanoparticles loaded with pVAX1/Tat PTD-Es had inhibitory effects on HUVEC cells and the inhibitory rate 山东大学学报 (医学版)55卷7期 -张新科,等.载pVAX1/Tat PTD-endostatin壳聚糖纳米基因载体的构建与体外活性评价 \=-in 72 h was(53.4±5.4)%(Z=-2.611, P=0.008). Conclusion Chitosan nanoparticles loaded with recombinant plasmid pVAX1/Tat PTD-Es can be transferred into HUVEC cells, and have distinct inhibitory effects on the proliferation of HUVEC cells.

Application of Solitaire FR stent in the optimized treatment of acute cerebral artery occlusion

YAN Jinxiang, MENG Lei, DONG Yanan, ZHANG Aijun, YUE Hongsheng, LI Bo, ZHONG Liangjun, BAI Aiguo

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 49-54. doi:10.6040/j.issn.1671-7554.0.2017.156

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Objective To explore the effectiveness and safety of Solitaire FR stent in the optimized treatment of acute cerebral artery occlusion(ACAO). Methods Data of 36 ACAO cases treated with Solitaire FR stent mechanical thrombectomy during Jan. 2013 and Dec. 2016 were retrospectively analyzed. The recanalization rate was assessed with mTICI score, the clinical outcome was evaluated with NIHSS score, and the clinical efficacy and safety were determined with modified Rankin Score(mRS). Results Altogether 33 patients achieved successful recanalization(TICI 2b-3), 2 patients had partial recanalization(mTICI 2a), and 1 patient had slight recanalization(mTICI 1). The NIHSS score was significantly lower after operation(P<0.05). The 90-day mRS indicated satisfactory prognosis. The mRS was 0 in 5 patients, 1 in 24 patients, and 2 in 4 patients. One patient was loss of follow-up, and 2 patients died during the follow-up. No vessel occlusion or asymptomatic cerebral hemorrhage were observed in the other 33 patients. 山东大学学报 (医学版)55卷7期 -颜进项,等.优化救治流程与Solitaire FR支架在治疗急性脑动脉闭塞中的应用 \=- Conclusion Endovascular therapy of acute cerebral artery occlusion is safe and effective, but the indications and contraindications should be strictly observed.

A dosimetric analysis of cervical metastases between radioactive ¹²⁵I seeds implantation and external beam radiation therapy

CAO Qianqian, JIANG Yuhua, LI Yuliang, YANG Ruijie, LIU Lu, ZHANG Xile, WANG Junjie

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 55-60. doi:10.6040/j.issn.1671-7554.0.2016.1098

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Objective To compare the gross tumor volume(GTV)and dose distributions for organs at risk(OAR)between external beam radiation therapy(EBRT)and low-dose rate(LDR)brachytherapy in the treatment of cervical vertebral metastases, in order to provide the basis for clinical treatment. Methods A total of 10 patients were randomly selected. Three-dimensional conformal radiotherapy(3D-CRT)planning was a single forth one with two oblique radiation fields. Intensity modulated radiotherapy(IMRT)planning included five equal radiation fields, and 2-arc volumetric-modulated arc radiotherapy(VMAT)was adopted. The images from Oncentra treatment planning system(TPS)were delivered to Prowess TPS to formulate LDR brachytherapy pre-operative simulation plan. Results For the same dose of spinal cord, the biologically effective dose(BED)of D90 and D95 of LDR were(184.15±25.84)Gy and(161.45±26.35)Gy. When the fraction scheme was 2 Gy/f, the D₉₅ BED of VMAT, IMRT and 3D-CRT were(120.52±10.66)Gy,(119.19±10.91)Gy and(96.24±28.65)Gy. When the fraction scheme was 3 Gy/f, the 山东大学学报 (医学版)55卷7期 -曹倩倩,等.放射性¹²⁵I粒子植入与外放疗治疗颈椎转移瘤剂量学对比分析 \=-D₉₅ BED 3 Gy/f of VMAT, IMRT and 3D-CRT were(122.19±7.54)Gy,(122.37±8.19)Gy and(95.94±24.70)Gy. All parameters complied with the normal distribution, P=0.00 after paired t test. There was no statistical difference in V₅ of the mucosa among VMAT, IMRT and LDR(P=0.16, 0.34), and V₅ of the mucosa of 3D-CRT was higher than that in LDR(P=0.00). The V₃₀ and D_mean of LDR were less than those of 3D-CRT, VMAT and IMRT, statistically(P=0.00). Other parameters of the thyroid gland, parotid gland and mandible were significantly different between LDR and 3D-CRT, VMAT and IMRT(P=0.00). Conclusion When the fraction schemes were 2 Gy/f and 3 Gy/f, 3D-CRT, IMRT and VMAT had lower GTV doses than LDR, which could protect the OARs at the same time. Therefore, as to the cervical vertebral metastases after EBRT, LDR is a good choice for salvage treatment.

Association analysis of brain metastases after prophylactic cranial irradiation in local disease small cell lung cancer: a bicenter study

ZENG Haiyan, LI Rui, SUN Xindong, XIE Peng, MENG Xue, FAN Bingjie, LI Wanlong, YUAN Shuanghu

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 61-66. doi:10.6040/j.issn.1671-7554.0.2016.1606

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Objective To explore the risk factors for brain metastases(BM)after prophylactic cranial irradiation(PCI)and to develop a hazard model to guide the clinical practice in local-disease small cell lung cancer(LD-SCLC). Methods The clinical data of 257 LD-SCLC cases treated during July 2003 and June 2014 were retrieved. BM free survival(BMFS)and overall survival(OS)were estimated using Kaplan-Meier method. High risk factors and the 山东大学学报 (医学版)55卷7期 -曾海燕,等.局限期小细胞肺癌患者预防性脑照射后脑转移的关联分析:双中心研究 \=-hazard model for BM were identified using Cox regression analyses. Results During the median follow-up of 34 months, BM occurred in 47(18.3%)patients. Univariate analyses indicated that performance status(PS)(P=0.040)and thoracic radiotherapy schedule(P=0.001)were associated with BM. Multivariate analyses showed that PS>1(P=0.017), thoracic hyperfractionated accelerated radiotherapy(HART)(P=0.004), and long duration of radiotherapy(SER)(P=0.035)were independent risk factors for BM, and surgery(P=0.035)was the independent protective factor for BM. In addition, surgery and thoracic radiotherapy biological effective dose(BED)were independent protective factors for OS, while age≥60 yr, PS>1 and PCI above standardized dosage were independent risk factors for OS. Conclusion Poor PS, thoracic HART and long SER are independent risk factors for BM after PCI in LD-SCLC. High dose of PCI does not prolong BMFS but shortens OS.

Clinical significance of preoperative red blood cell distribution width in peripheral blood of patients with esophageal cancer

HAN Fuyan, CHENG Shiqing, WANG Zhaobao, JU Ying

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 67-72. doi:10.6040/j.issn.1671-7554.0.2016.1279

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Objective To evaluate the clinical significance of preoperative red blood cell distribution width(RDW)in the peripheral blood of patients with esophageal cancer. Methods Clinical data of 284 patients with esophageal cancer undergoing radical resection during July 2010 and June 2011 were retrospectively analyzed. Another 125 healthy volunteers were collected as controls for comparative analysis. The patients were divided into high and low RDW groups according to RDW cut-off value based on receiver operating characteristic curve(ROC). The clinicopathological parameters were compared between the two groups. The parameters associated with increased RDW were analyzed using Logistic regression analysis. The RDW changes before and after surgery were evaluated. Results The median RDW value was significantly higher in the esophageal cancer group than in healthy control group(P<0.001). RDW was associated with age, gender, distance metastasis and tumor stage(P<0.05), but not with other pathological parameters(P>0.05). Logistic regression analysis revealed that old age and distance metastasis were significantly associated with increased RDW(P<0.05). The RDW value after surgery was significantly higher than that before surgery and the difference was statistically significant. Conclusion RDW can be used as an indicator of clinical diagnosis and condition assessment for patients with esophageal cancer.

Hypophosphatemia during long-term adefovir dipivoxil therapy in patients with hepatitis B virus infection

LIU Qiuxia, WANG Lei, LIU Feng, QU Yundong, YE Qian, QIAN Yu, ZHANG Yuan, ZHANG Lixin

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 73-78. doi:10.6040/j.issn.1671-7554.0.2016.1063

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Objective To assess the cumulative incidence of hypophosphatemia caused by long-term treatment with adefovir dipivoxil(ADV)in patients with hepatitis B virus(HBV)infection and to explore the risk factors. Methods The patients who received ADV monotherapy or ADV plus lamivudine(LAM)for more than 1 year were recruited. Serum phosphate level, serum creatinine and estimated glomerular filtration rate(eGFR)were evaluated. Cumulative incidences of hypophosphatemia were calculated with Kaplan-Meier method. Results Of the 243 cases involved, 171 were chronic hepatitis B(CHB)and 72 were liver cirrhosis(LC). During a median treatment duration of 66(12-120)months, 24 patients developed hypophosphatemia. The cumulative incidences of hypophosphatemia for CHB and LC cases during 2-10 years were 0.6%, 0.6%, 0.6%, 3.2%, 6.2%, 11.2%, 14.2%, 14.2%, 19.9%, and 1.5%, 3.3%, 7.9%, 10.4%, 13.7%, 23.9%, 32.3%, 49.3% and 49.3%, respectively(χ2=6.685, P=0.010). Multivariate analysis identified LC(HR=2.886, P=0.020)and ADV plus LAM(HR=2.661, P=0.010) 山东大学学报 (医学版)55卷7期 -刘秋霞,等.慢性HBV感染患者长期服用阿德福韦酯与肾性低磷血症的相关因素 \=-as independent predictors of hypophosphatemia. Conclusion Long-term treatment of hepatitis B with ADV or ADV plus LAM can potentially cause hypophosphatemia. LC patients treated with ADV plus LAM are more likely to develop hypophosphatemia.

A clinical research on occlusive techniques for partial splentic embolization combined with radiofrequency ablation for hypersplenism due to portal hypertension

DU Futian, DU Yunlong, LIN Hongfeng

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 79-83. doi:10.6040/j.issn.1671-7554.0.2016.1619

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Objective To observe the clinical efficacy of partial splentic embolization(PSE)technique combined with laparoscopic radiofrequency ablation(RFA)in the treatment of hypersplenism in patients with portal hypertension. Methods A total of 69 patients with portal hypertension and hypersplenism were treated with PSE combined with laparoscopic RFA(n=26, group A)and splenectomy(n=43, group B). The clinical outcomes were analyzed and compared. Results No procedure-related death occurred in group A. The major complications were left upper abdominal pain(16 cases), fever(10 cases)and pleural effussion(1 case). No procedure-related death occurred in group B either. The major complications included fever(29 cases), abdominal cavity hemorrhage(3 cases), pleural effusion(7 cases), and portal vein thrombosis(6 cases). The incidence of postoperative complications was significantly lower in group A than in group B. Conclusion Splenic artery embolization combined with laparoscopic radiofrequency ablation has good curative effect and important clinical value in the treatment of hypersplenism in patients with portal hypertension. It is a safe, effective and minimally invasive.

Diagnostic value of three-dimensional reconstruction in cystic duct variation based on VTK

DOU Ruixin, XUE Minna, LI Guohua

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 84-88. doi:10.6040/j.issn.1671-7554.0.2016.996

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Objective To investigate the diagnostic value and clinical significance of three-dimensional visualization system implemented by Visualization Toolkit(VTK)for cystic duct variation. Methods Data of 160 cases with biliary tract diseases were retrospectively analyzed. Diagnosis of cystic ductal variation by magnetic resonance cholangiopancreatography(MRCP)was proceeded respectively by using the traditional maximum density projection(MIP)and three-dimensional visualization system assist, and compared with the results of the operation which was used as the golden standard. Results Totally 81 cases of cystic ductal variance were detected by the three-dimensional visualization system which were consistent with the operation results without significant difference(κ=0.950, P=1.000). Only 51 cases were detected by MIP combined with thin-layer image, and the difference with the operation results were statistically significant(κ=0.477, P<0.001). Among 39 cases of the cystic duct variation forward and backward to the hepatic duct which is difficult to be definitely diagnosed, 12 cases and 27 cases were detected by the three-dimensional visualization system, which were consistent with the operation results without significant difference(κ=0.880, P=1.000). However, using MIP combined with thin layer 24 cases and 15 cases were detected, and the difference with the operation results was statistically significant(κ=0.246, P=0.004). Conclusion Three-dimensional visualization system implemented by VTK has the ability to improve the detection rate in the diagnosis of cystic duct variation, which 山东大学学报 (医学版)55卷7期 -窦瑞欣,等.基于VTK实现三维重建在胆囊管变异中的诊断价值 \=-not only makes up for the deficiency of accurate display of MIP to the space adjacent relations, but also help to understand the cystic duct anatomic variation before operation and avoid bile duct injury in cholecystectomy.

Significance of lymphocytes and DSA monitoring for acute rejection diagnosis on the early stage of kidney transplantation

ZHENG Jin, ZHANG Jiangwei, WANG Xuzhen, KUANG Peidan, HE Xiaoli, XUE Wujun

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 89-94. doi:10.6040/j.issn.1671-7554.0.2016.1307

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Objective To analyze and monitor lymphocytes ratio, donor specificity antibodies(DSA)and non-donor specificity antibodies(NDSA)levels for acute rejection(AR)diagnosis on the early stage of kidney transplantation. To provide reliable basis for clinical prevention of rejection reaction, early diagnosis of rejection, formulate reasonable individualized immunosuppressive therapy and evaluate therapeutic effect. Methods A total of 454 patients who accepted kidney transplantation in our department from January 2014 to June 2016 were enrolled in this study. Recipients lymphocytes ratio, DSA, and NDSA were monitored with flow cytometry and Luminex. Data were analyzed statistically by SPSS17.0 software. Results Within 6 months after transplantation, 33 cases(7.3%)occurred AR(AR group)and 421 cases had stable allograft function(SF group). The CD4⁺T/CD8⁺T ratio(2.81±0.85 vs 1.39±0.94, t=7.336, P<0.001)and B cell percentage［(15.79±3.53)% vs(10.2±3.04)%, t=4.986, P<0.001］ were significantly higher in the AR group than the SF group. The HLA antibody medium fluorescent intensity(MFI)of the AR group was gradually increased one week after transplantation and had an obviously difference with that of the SF 山东大学学报 (医学版)55卷7期 -郑瑾,等.肾移植术后早期淋巴细胞及DSA监测在诊断移植排斥反应中的意义 \=-group(P<0.05). The average value of MFI was 7 559±1 496 in the AR group and it was decreased statistically after treatment(5 023±996)(t=13.853, P<0.001). AR occurrence was 3.1%(11/357)and 14.5%(12/83)in DSA-/NDSA- and DSA-/NDSA+ recipients, respectively. For DSA+/NDSA+ recipients, AR occurrence was 71.4%(10/14)which was significantly higher than DSA-/NDSA- and DSA-/NDSA+ recipients(P<0.001). Conclusion Monitoring CD4⁺T/CD8⁺T ratio, B lymphocyte percentage and serum DSA/NDSA levels could assist in the diagnosis and the early warning of AR.

Comparision of the therapeutic effects of laparoscopic surgery and open surgery on primary bladder diverticula

XU Jialong, SUN Xiaogang, WANG Junfeng, LIU Qian, MA Nan, LI Dianguo, CHEN Weixiu, LI Jinliang, WANG Ruoyi

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 95-99. doi:10.6040/j.issn.1671-7554.0.2016.1706

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Objective To compare the therapeutic effects of laparoscopic surgery and open surgery on primary bladder diverticula. Methods The data of 22 patients with primary bladder diverticula enrolled from September 2009 to July 2016 were retrospectively reviewed. Twelve patients underwent open bladder diverticulectomy(open surgery group), ten patients underwent laparoscopic diverticulectomy(laparoscopy group). The operation time and operative hemorrhage of the two groups were compared with independent sample t test. The pre-operative and post-operative urodynamics were separately compared with paired-samples t test.The numerical variations of voiding detrusor pressure and maximum pressure flow in the two groups were compared with separate variance estimation t test. Results The operation time in laparoscopy group was longer than that in open surgery group(P<0.05). The operative hemorrhage in laparoscopy group was less than that in open surgery group(P<0.05). The follow-up time of open surgery group was(13.6±4.0)months. The follow-up time of laparoscopy group was(13.6±5.7)months. The post-operative voiding detrusor pressure was lower than that in pre-operation in both groups(P<0.05). The maximum pressure flow increased after the operation in both groups(P<0.05). Urine flow curve was improved after the operation. The numerical variations of voiding detrusor pressure and maximum pressure flow pre-operation and post-operation in both groups showed no statistical difference(P>0.05). Pre-operative ipsilateral vesicoureteric refluxes disappeared after the surgery. There were 山东大学学报 (医学版)55卷7期 -徐加龙,等.经腹腔镜手术与开放手术治疗原发性膀胱憩室临床效果比较 \=-no recurrence of bladder diverticula. The patients were asymptomatic in the follow up. Conclusion There is no difference between the therapeutic effect of laparoscopic bladder diverticulectomy and open surgery.Laparoscopic bladder diverticulectomy is an ideal way of minimally invasive surgery, with small trauma and less bleeding.

Photoselective vaporization of the prostate for the treatment of benign prostatic obstruction in patients with Parkinsons disease

CUI Meng, ZHENG Jilu, TIAN Sinan, LI Lianjun, ZHANG Qi, JIN Xunbo, WANG Muwen

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 100-102. doi:10.6040/j.issn.1671-7554.0.2017.104

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Objective To study the efficacy and safety of photoselective vaporization of the prostate(PVP)for the treatment of BPO in patients with PD. Methods A total of 20 patients with PD(excluding MSA)who underwent PVP for BPO were enrolled from July 2008 to May 2016. The average age was(69.85±3.12)years. The average IPSS was 23.40±5.89 and the average Qmax was(5.75±1.71)mL/s. All patients were diagnosed as BPO with PD for dysuresia. Paired t test for comparison was used to evaluate the efficacy of PVP between the groups. Results All 20 patients underwent the surgeries successfully. The average operation time, IPSS and Qmax at the 3 months after surgery were(66.3±13.10)minutes, 7.10±2.59 and(14.03±4.40)mL/s, respectively. Mild urge urinary incontinence occurred and voiding symptoms were improved after pelvic floor muscle training in 4 patients. Conclusion PVP is a safe and effective treatment for BPO in patients with PD.

TiRobot-assisted percutaneous screw fixation in unstable pelvic ring fractures

LIU Huashui, DUAN Shengjun, JIA Fengshuang, LIU Shidong, CHEN Hua, WANG Yeben, JIA Tanghong, ZHAO Guohui, ZHU Liming, LIU Mincen

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 103-109. doi:10.6040/j.issn.1671-7554.0.2017.237

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Objective To explore the clinical efficacy of TiRobot-assisted percutaneous screw fixation in the treatment of unstable pelvic ring fractures. Methods The clinical data of 16 patients with unstable pelvic ring fractures treated with TiRobot-assisted percutaneous screw fixation of posterior and anterior pelvic ring during Nov. 2016 and Feb. 2017 were retrospectively reviewed, including the screw placement, operation time, X-ray number, incision length, blood loss, healing time, and postoperative functions. Results The average operation time was 65 minutes, average X-ray number was 14, average length of incision was 2 cm, and average blood loss was 35 ml. All screws were inserted in the accurate site, and no screw penetrated through bone cortex. All wounds were primary healing. No iatrogenic injury on blood vessels, nerves and organs occurred. During the followed-up of 3-6 months(average 4.2), no delayed union or malunion was observed. The Majeed score in the last follow-up visit averaged 86.7 points. Conclusion TiRobot-assisted percutaneous screw placement is minimally invasive in the treatment of unstable pelvic ring fractures, with advantages of precise and safe operation, short operation time, small trauma, and small radioactive damage.

Evaluation and analysis of the physical factors for the twinkling artifact: a preliminary study

WANG Meng, WANG Cheng, ZHANG Yingchun, LI Jie, SUN Xiao, SHI Dandan, SHANG Mengmeng, NING Song

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 110-114. doi:10.6040/j.issn.1671-7554.0.2016.1358

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Objective To evaluate the value of ultrasonic characteristics, the roughness of the urinary stones and machine settings in the formation of the twinkling artifact. Methods Constructing the experimental model by the sandpaper and the urinary stones respectively. In the sandpaper model part, ultrasonic output characteristics were changed by regulating the mechanical index in the IU 22 machine and the ultrasonic angle; the intensity of the twinkling artifact were compared and evaluated seperately by the correlation analysis and paired t test respectively. In the urinary stone model part, the stones were divided into the rough group, the mid-rough group and the smooth group according to the difference of the surface roughness. The display of the twinkling artifact in different groups were compared under the diverse conditions including the default and optimized settings by repeated measures ANOVA, and the correlation analysis was performed between the twinkling artifact intensity and the roughness. Results In the sandpaper model part, the intensity of the color Doppler twinkling artifact was in obvious proportion with the mechanical index(r=0.938, P<0.001). And when the Doppler angle of the color box was tilted, the number of the color pixels in the scanning 山东大学学报 (医学版)55卷7期 -王蒙,等.彩色多普勒闪烁伪像相关物理因素的评估分析 \=-condition decreased significantly(P<0.05). In the urinary stone model part, there existed significant difference among different groups and obvious interaction between the urinary stone roughness and the machine settings on the twinkling artifact intensity(P<0.001). The twinkling artifact intensity was improved under the optimized machine settings compared with that of the default conditions in the urinary stones with the same roughness. However, under the same machine settings, a direct proportion relationship was found between the twinkling artifact intensity and the urinary stone roughness with the coefficient being 0.80 and 0.83 respectively(P<0.001). Conclusion Both the sandpaper phantom and urinary stone phantom showed that the formation of the twinkling artifact are affected by the ultrasonic charateristic index, the surface roughness of the urinary stones and the machine settings. Grasping the related factors on the intensity of the twinkling artifact was useful for its clinical applications.

Characteristics of homosexual behaviors and relationship between high-risk sexual behaviors and seeking sex partners through the internet in men who have sex with men among university students

ZHENG Jietao, ZHANG Xiaofei, L(¨overU)Cuixia, FU Jihua, MA Wei

JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES). 2017, 55(7): 115-123. doi:10.6040/j.issn.1671-7554.0.2017.016

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Objective To understand the characteristics of sexual behaviors and relationship between seeking sex partners through the internet and high-risk sexual behaviors in men who have sex with men(MSM)among university students in a city. Methods A survey was conducted in MSM among college students who were recruited through convenience sampling in a city of Shandong Province, China. The relationship between seeking sex partners through the internet and high-risk sexual behaviors was analyzed with multivariate Logistic regression analysis. Results A total of 300 valid questionnaires were collected. Among the participants, the average age of the first male-to-male sex was(17.6±1.8)years old; 7.7% had two or more male sex partners last week; 35.7% did not use condoms and 5% was involved in group sex in last male-to-male sex; 6.7% had commercial sex for money or drugs. About 86% of the participants seek sexual partners via the internet. Multivariate Logistic regression analysis showed negative relations between seeking sexual partners through the internet and having two or more male sex partners (OR=0.28, 95%CI=0.11-0.73) 山东大学学报 (医学版)55卷7期 -郑杰滔,等.高校学生男男性行为特征及其高危性行为与互联网交友的关联 \=-and commercial sex(OR=0.22, 95%CI=0.07-0.66). Conclusion High-risk sexual behaviors are common among university MSM students. University MSM students who seek sexual partners through the internet have less high-risk sexual behaviors than those who seek sexual partners via non-internet ways.

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