Table of Content

  

20 December 2020
Volume 58 Issue 12

Evaluation of two doxorubicin-induced heart failure models and changes of cardiac function

ZHANG Shuying, WU Xiaofeng, GUO Limin, QIAO Wen, PENG Jieqiong, LI Daqing

Journal of Shandong University (Health Sciences). 2020, 58(12):  1-7.  doi:10.6040/j.issn.1671-7554.0.2020.0781

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Objective To evaluate the effects of two doxorubicin-induced heart failure models and changes of cardiac structure and function at different experiment stages. Methods Two doxorubicin-induced heart failure models were constructed. In the first model, rats received intraperitoneal injection of a cumulative dose of 15 mg/kg doxorubicin 6 times in 2 weeks ［2.5 mg/(kg·rat)］ and the cycle lasted for 4 weeks. In the second model, rats received intraperitoneal injection of a cumulative dose of 15 mg/kg doxorubicin 6 times in 6 weeks ［2.5 mg/(kg·rat)］ and the cycle lasted for 8 weeks. A total of 24 male Wistar rats were randomly divided into normal control group 1, doxorubicin model group 1, normal control group 2 and doxorubicin model group 2, with 6 rats in each group. Cardiac structure and function were detected using transthoracic echocardiography. Histopathology was evaluated using haematoxylin and eosin(HE)staining. Results Echocardiography showed left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)in the doxorubicin model group 1 were significantly lower than those in normal control group 1(P=0.025, P=0.032). Stained with HE, tissue sections showed cardiomyocyte hypertrophy, irregular texture of muscle fibers, and intracellular vacuolation in both models. Doxorubicin model group 1 had significantly increased intercellular collagen deposition than normal control group 1(t=4.455, P=0.002), and doxorubicin model group 2 had significantly increased intercellular collagen deposition than normal control group 2(t=2.220, P=0.060). In doxorubicin model group 1, cardiac structure and function showed a dynamic development at the middle and end stages of the cycle. During the whole cycle, the heart obviously dilatated, left ventricular systolic and diastolic functional parameters including mitral flow and movement velocity of mitral valve kept decreasing, while the right ventricular functional parameters, such as pulmonary peak flow velocity and velocity time integral, reduced in the middle stage, but increased in the end stage. Conclusion The first doxorubicin model is successfully establishes. During the whole cycle, cardiac structure dilates, left ventricular systolic and diastolic function continuously worsened, while the right ventricular function decreases in the middle stage but mildly improves in the end stage.

Mechanism of histone deacetylase SIRT1 inhibiting macrophages apoptosis via TLR4 signaling pathway

ZHANG Xiaolu, WANG Lili, CHEN Kaiming, LOU Xianzhi, ZHANG Man

Journal of Shandong University (Health Sciences). 2020, 58(12):  8-14.  doi:10.6040/j.issn.1671-7554.0.2020.0831

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Objective To observe the mechanism and specific inflammatory pathways of histone deacetylase SIRT1 involved in the regulation of atherosclerosis through histone epigenetics. Methods Rats with high-fat diet and carotid artery injury and oxidized low-density lipoprotein(oxLDL)exposed macrophages under different conditions were selected as the research subjects. Apoptosis, protein expression of SIRT1, histone H3(H3), histone H3 lysine 9-site acetylation(H3K9Ac)and inflammatory factors in rats and macrophages were observed by cells function acquisition or deletion experiments. Results Compared with the control rats and macrophages, rat models with carotid artery injury and oxLDL exposed macrophages had reduced protein expression of SIRT1, increased ratio of H3K9Ac/H3, increased apoptosis, and increased protein expressions of TLR4 and IL-1β(P<0.01). After treatment of SP600125(JNK pathway antagonist), IAXO-102(TLR4 pathway antagonist), LY294002(PI3K pathway antagonist), the phenomenon of SIRT1 reduction was reversed in IAXO-102 intervention macrophages(P<0.01); after treatment of SIRT1 stimulant, apoptosis was reduced accompanied by a decreasing in the ratio of H3K9Ac/H3 and protein expressions of TLR4 and IL-1β(P<0.01). The results were reversed after treatment of SIRT1 inhibitor(P<0.01). Conclusion Histone acetylation epigenetics is involved in the regulation of apoptosis, which is closely related to the occurrence and development of atherosclerosis. Apoptosis is worsened by a decrease in histone deacetylase SIRT1 and an increase in H3 acetylation, which promotes the development of atherosclerosis, and this process must be achieved through the TLR4 signaling pathway.

Effects of Lycium barbarum seed oil(LBSO)on anti-inflammation in the aging Sertoli cells of mice(TM4 cells)

YANG Zhangjie, WANG Yuxin, CHEN Dongmei, ZHAO Shuai, HU Na, MA Lianghong, MA Huiming

Journal of Shandong University (Health Sciences). 2020, 58(12):  15-22.  doi:10.6040/j.issn.1671-7554.0.2020.1081

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Objective To investigate the effects of Lycium barbarum seed oil(LBSO)on anti-inflammation in the sub-acutely aging Sertoli cells of mice(TM4 cells)induced by D-Galactose(D-Gal)and to explore the mechanism. Methods TM4 cells were treated with different concentrations(50, 100, 150 and 200 mmol/L)of D-Gal for different periods(24 h, 36 h, 48 h)in vitro. The optimal intervention time and concentration of D-Gal were determined with CCK-8 and β-galactosidase staining to establish the TM4 aging model. The expressions of aging-related factors P16^INK4A, P21^Waf1/Cip1, H2A.X, and β-galactosidase were detected with Western blotting. The TM4 aging models were intervened with different concentrations(1%, 3%, 5%, 10%)of LBSO containing serum in advance, and the optimal concentration was determined with CCK-8. The expressions of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-10(IL-10), heme oxygenase-1(HO-1)and the relative expression of p-P65/P65 were detected with Western blotting. The expression of NF-κB was located with immunofluorescence(IF). Results The inhibition rate of TM4 cells was(14.890±0.892)% when cells were treated with D-gal at 200 mmol/L for 48 h(F=12.820, P=0.0040; t=17.230, P<0.001). β-galactosidase staining indicated when compared with control group, the stained cells had increased positive rate ［(63.000±9.388)% vs(11.390±2.959)%, t=5.243, t=5.243, P<0.001)］. The expressions of P16^INK4A(t=2.364, P=0.033), P21^Waf1/Cip1(t=2.908, P=0.011), γH2A.X(t=2.511, P=0.025)and β-galactosidase(t=2.299, P=0.037)significantly increased in the aging model. CCK-8 detection showed a significant increasing trend in cell activity when 3% LBSO containing serum interfered with aging model ［(1.941±0.021)vs(1.784±0.019), t=5.399, P<0.001］, while the expressions of P16^INK4A(t=7.211, P<0.001), P21^Waf1/Cip1(t=8.248, P<0.001), γH2A.X(t=4.145, P<0.001)and β-galactosidase(t=7.288, P<0.001)downregulated. Compared to the model group, after 3% LBSO intervention, TM4 cells showed decreased expressions of TNF-α(t=4.992, P<0.001), IL-1β(t=2.921, P=0.011), IL-6(t=4.985, P<0.001), and p-P65/P65(t=24.630, P<0.001), but increased expressions of HO-1(t=6.047, P<0.001)and IL-10(t=2.315, P=0.036). Conclusion LBSO containing serum at concentration of 3% has an obvious anti-inflammatory effect on aging TM4 cells. The possible mechanism is down-regulation of NF-κB inhibits the expressions of IL-1β, TNF-α and IL-6, but activates the expressions of HO-1 and IL-10.

miR-203 targeting Survivin to inhibit the proliferation, migration and invasion of ovarian cancer cells

WANG Baojin, ZHAO Xinxin, LI Xia, MA Qian, WANG Xinyue, SUN Yang, SHI Zhongna

Journal of Shandong University (Health Sciences). 2020, 58(12):  23-28.  doi:10.6040/j.issn.1671-7554.0.2020.0817

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Objective To investigate the effects of miR-203 targeting Survivin on the proliferation, migration and invasion of ovarian cancer cells SKOV3 and OVCAR3. Methods After miR-203 over-expressing group, Survivin over-expressing group and black control group of lentiviral vectors were constructed, the SKOV3 and OVCAR3 cells were transfected. After puromycin screening, the blank control group, miR-203 over-expressing group, Survivin over-expressing group, and miR-203 over-expressing plus Survivin group were established. The expressions of Survivin and epithelial-mesenchymal transition(EMT)-related proteins in each group were detected with Western blotting. The proliferation of cells was detected with MTT and plate clone formation assay. The cell migration and invasion were detected with Transwell assay. Results miR-203 over-expression inhibited the expressions of Survivin and EMT(P<0.05). MTT, plate clone formation and Transwell assay illustrated that, compared with the blank control group, the miR-203 over-expressing group had inhibited cell proliferation, migration, and invasion(P<0.05), while the Survivin over-expressing group reversed the inhibitory effects of miR-203(P<0.05). Conclusion miR-203 can inhibit EMT by targeting Survivin to inhibit the proliferation, migration, and invasion of ovarian cancer cells. The miR-203/Survivin/EMT axis is expected to be a new target for the treatment of ovarian cancer.

Effect of non-intubated spontaneous ventilation anesthesia used in video-assisted thoracoscopic surgery: a Meta-analysis

MA Weijiang,WANG Gaojun,OUYANG Xun,ZANG Chenxi,LIU Xin

Journal of Shandong University (Health Sciences). 2020, 58(12):  29-37.  doi:10.6040/j.issn.1671-7554.0.2020.0454

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Objective To compare the efficacy of non-intubated spontaneous ventilation anesthesia and traditional general anesthesia with tracheal intubation used in video-assisted thoracoscopic surgery. Methods The databases like CNKI, Wangfang, VIP, CBM, PubMed, Embase and Cochrane Library were retrieved for original researches to compare the effect of non-intubated(experimental group)and intubated(control group)video-assisted thoracoscopic surgery. After evaluating the quality of the literatures, the satisfactory literatures were included and the research results were extracted. A Meta-analysis was performed on the operation time, intraoperative bleeding volume, lowest saturation of pulse oxygen(SpO₂)during surgery, intraoperative maximum end-tidal carbon dioxide(ETCO₂), postoperative duration of chest tube, postoperative hospital stays, postoperative total complication rate with RevMan5.3 software. Results A total of 27 studies and 2019 patients were enrolled into this study. The Meta-analysis results showed there was no statistical difference in operation time(SMD=-0.02,95%CI: -0.26-0.22,P=0.89)and lowest SpO₂ during surgery(SMD=-0.10,95%CI: -0.53-0.33,P=0.66)between the experimental group and control group. The intraoperative bleeding volume(SMD=-0.13,95%CI: -0.24 - 0.01,P=0.03), postoperative duration of chest tube(SMD=-0.48, 95%CI: -0.68 - 0.28, P<0.001), postoperative hospital stays(SMD=-0.69, 95%CI: -1.05 - 0.33, P<0.001), postoperative total complication rate(OR=0.42, 95%CI: 0.25-0.70, P<0.001)in experimental group was significantly decreased than those in control group; however, the maximum ETCO₂ in experimental group was higher than that in control group(SMD=1.23, 95%CI: 0.68-1.78, P<0.001). Conclusion Compared with traditional general anesthesia with tracheal intubation, non-intubated spontaneous ventilation anesthesia is safe and feasible with the advantages of shorter duration of chest tube, shorter postoperative hospital stay and fewer postoperative complication rate.

Value of indocyanine green fluorescence in thoracoscopic segmentectomy

ZHANG Yu, TANG Xing, MA Haitao, JIANG Wei

Journal of Shandong University (Health Sciences). 2020, 58(12):  38-42.  doi:10.6040/j.issn.1671-7554.0.2020.0453

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Objective To investigate the application value of indocyanine green(ICG)fluorescence in anatomical thoracoscopic segmentectomy. Methods The clinical data of 45 patients who underwent anatomical thoracoscopic segmentectomy by ICG fluorescence was retrospectively analyzed. The first appearance time, duration of fluorescence and duration of valid contrasting fluorescence were recorded. Results Apart from one patient with pulmonary emphysema, 44 patients(97.78%)showed clear demarcation lines after injecting ICG, with the first appearance time of(10.8±5.3)s and duration of(179.9±40.3)s. The mean duration of valid contrasting fluorescence was(121.1±15.2)s. All patients completed pulmonary segmentectomy successfully with the operation time of(95.7±30.2)min and bleeding volume of(51.8±16.3)mL. No obvious complications related to ICG was observed in surgery, while postoperative complications occurred in three patients. The mean drainage time was(3.6±1.8)d and the average hospitalization time was(6.6±2.1)d. All patients recovered well without recurrence at the end of follow-up, which averaged(14.5±8.7)months. Conclusion The ICG fluorescence technology is safe, accurate and convenient for identifying demarcation line. It contributes to the feasibility of the segmentectomy. Therefore, this technology is well worth promoting in clinic.

Clinical observation of PEG-rhG-CSF in preventing neutropenia in 80 patients with small cell lung cancer treated with concurrent chemoradiotherapy

ZHANG Xiqin, ZHU Shouhui, LIU Ning, WANG Yu, CHEN Jiazhen, HU Xudong

Journal of Shandong University (Health Sciences). 2020, 58(12):  43-46.  doi:10.6040/j.issn.1671-7554.0.2020.0925

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Objective To investigate the preventive effect of pegylated recombinant human granulocyte colony stimulating factor(PEG-rhG-CSF)on neutropenia in patients with small cell lung cancer(SCLC). Methods A retrospective analysis of 80 SCLC cases(observation group)who received concurrent chemoradiotherapy and prophylactic use of PEG- rhG-CSF in Shandong Cancer Hospital was conducted, and 80 controls without useing PEG-rhG-CSF were matched according to age, gender and other factors. The neutropenia was observed and compared between the two groups. Results After concurrent chemoradiotherapy, the leukocytes count decreased in both groups, which was(3.15±0.76)×10⁹ cells/L in the observation group and(1.82±0.77)×10⁹ cells/L in the control group (Z=-8.467, P<0.001). Before chemoradiotherapy, there was no significant difference in the absolute value of neutrophils between the two groups(Z=-1.543, P=0.123). After chemoradiotherapy, the number of neutrophils decreased to(1.89±0.52)×10⁹ cells/L in the observation group and(0.77±0.44)×10⁹ cells/L in the control group. The decrease in the observation group was lower than that in the control group (Z=-10.034, P<0.001). Conclusion PEG-rhG-CSF can prevent the decrease of leukocytes and neutrophils, but experiments with larger samples are still needed for proof.

Comparison of clinical efficacy of Qingfei Paidu decoction combined with western medicine in 43 cases and single western medicine in 46 cases in the treatment of COVID-19

YU Xueyuan, ZHANG Shuo, YAN Fangfang, SU Dezhen

Journal of Shandong University (Health Sciences). 2020, 58(12):  47-53.  doi:10.6040/j.issn.1671-7554.0.2020.0870

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Objective To retrospectively evaluate the clinical efficacy of Qingfei Paidu decoction in the treatment of coronavirus disease 2019(COVID-19)and to explore the possible mechanism. Methods A total of 89 COVID-19 patiests whose date of discharge ranged from Feb. 10 to Apr. 1, 2020 were selected in the infection ward of the East Hospital of Renmin Hospital of Wuhan University. According to whether Qingfei Paidu decoction was used, 89 cases were divided into basic treatment group(n=46)and combined treatment group(n=43). The paitents in basic treatment group were only given western medicine treatment, while those in combined treatment group were treated with modified Qingfei Paidu decoction on the basis of western medicine treatment plan. The changes of blood routine, C reactive protein(CRP), interleukin-6(IL-6), cellular immunity, biochemical series and coagulation series were compared between the two groups before and after treatment. The changes of lung CT, the time of nucleic acid turning negative, and the patients hospitalization time were collected. A pairwise or non-paired t test was used to compare numerical data with normal distribution; the counting data were described by relative numbers, and the differences between groups were tested by chi-square test. Results (1) After the treatment, the expression levels of neutrophil ratio(NEU%), CRP, IL-6, creatine kinase(CK), lactate dehydrogenase(LDH), fibrinogen(Fib)and fibrinogen degradation product(FDP)were decreased in the two groups(P<0.05); the counts of lymphocyte ratio(LYM%), CD3, CD4 and CD8 T cells were significantly increased in the two groups(P<0.05); the levels of serum creatinine(SCr)and D-dimer(DD)were decreased while the estimated glomerular filtration rate(eGFR)was increased in the combined treatment group(P<0.05). (2) Compared with the basic treatment group, the difference of CD3 and IL-6 before and after treatment in the combination treatment group was statistically significant(P<0.05). There was no difference in the degree of improvement of chest CT between the two groups. The length of hospital stay in the combined treatment group was shorter than that in the basic treatment group(P<0.01), and the nucleic acid conversion time was shorter without statistical difference. Conclusion (1) The level of inflammation is reduced, cellular immunity is enhanced, renal function is improved, and hypercoagulability is reduced in both the basic treatment group and combined treatment group. (2) Compared with the basic treatment group, modified Qingfei Paidu decoction can significantly reduce the level of IL-6 and increase the level of CD3 of COVID-19 patients. The treatment of integrated traditional Chinese medicine and western medicine can significantly inhibit the inflammatory reaction, enhance the bodys immunity, and shorten the length of hospitalization and nucleic acid negative time, which help to get a better clinical efficacy.

Expression of P-glycoprotein in the colonic mucosa of ulcerative colitis patients and its clinical significance

FU Zhenmei, MA Mingze

Journal of Shandong University (Health Sciences). 2020, 58(12):  54-59.  doi:10.6040/j.issn.1671-7554.0.2020.0753

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Objective To detect the expression of P-glycoprotein(P-GP)in the colonic mucosa of patients with ulcerative colitis(UC)before and after hormonotherapy, explore its correlation with the peripheral endotoxin and D-lactic acid levels, and investigate its association with UC. Methods Previously untreated UC patients(n=102)and healthy controls(n=31)were selected. The expression of P-GP in the colonic mucosa of UC patients before and after treatment, and that of healthy controls were detected with immunohistochemistry. The peripheral endotoxin and D-lactic acid levels were detected with ELISA and ultraviolet spectrophotometry respectively. Results Before hormonotherapy, the peripheral endotoxin ［(0.67±0.58)vs(18.15±0.73), P<0.01］ and D-lactic acid level ［(1.75±1.25)vs(10.85±1.94), P<0.05］ of UC patients were higher than those of healthy controls, while the expression of P-GP was lower(P<0.05). Two months after hormonotherapy, the total positive rate and strong positive rate of UC patients were significantly higher than the rates before therapy(P<0.05). The peripheral endotoxin and D-lactic acid levels before and after hormonotherapy were negatively correlated with P-GP expression. Conclusion The impaired intestinal barrier and increased intestinal permeability in UC patients may be related to the low expression of P-GP in intestinal mucosa. The P-GP expression may be correlated with the pathogenesis of ulcerative colitis.

Application of ultrasound-guided electrocorticography monitoring in the microsurgical treatment of epilepsy secondary to cerebral arteriovenous malformation

SUN Yongfeng, LIU Huizhao, LI Yuhuan, SHI Lei, YUAN Jun, ZHONG Jianwei

Journal of Shandong University (Health Sciences). 2020, 58(12):  60-64.  doi:10.6040/j.issn.1671-7554.0.2020.0822

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Objective To explore the role and value of ultrasound-guided electrocorticography(ECoG)monitoring in the microsurgery of epilepsy secondary to cerebral arteriovenous malformations(cAVM). Methods The clinical data of 18 patients with epilepsy secondary to cAVM treated with microsurgery were retrospectively analyzed. During operation, the complete resection of cAVM and epileptogenic zone was under ultrasound guidance and ECoG monitoring. Results Intraoperative ultrasound could clearly show the position, boundary, feeding artery and drainage veins of cAVM; it could identify the surgical remnants so as to guide complete resection of cAVM vascular mass. ECoG could monitor the epileptic discharges and thus reduce injury on brain function. During the follow-up of more than 2 years, no neurological dysfunction or seizure occurred. The efficacy reached Engel I in all cases. Conclusion Intraoperative ultrasound guidance can accurately locate cAVM and determine its feeding artery and residual conditions, guide complete resection; ECoG monitoring determines epileptogenic zone, and further guides the scope of resection. Intraoperative ultrasound guidance combined with ECoG monitoring can effectively reduce complications and brain injury, and significantly improve the therapeutic effects.

Effects of different anesthesia depths on the cerebral oxygen metabolism indexes in 150 patients undergoing brain surgery

LIU Yuanyuan, WANG Pei, CHU Haichen

Journal of Shandong University (Health Sciences). 2020, 58(12):  65-71.  doi:10.6040/j.issn.1671-7554.0.2020.1065

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Objective To analyze the effects of different anesthesia depths on the cerebral oxygen metabolism indexes in patients undergoing brain surgery. Methods A total of 150 patients undergoing brain surgery in our hospital during Sep. 2018 and Sep. 2019 were randomized into 3 groups, with 50 patients in each group. The narcotrend index(NTI)was 47-56, 37-46, and 27-36, respectively, in groups A, B and C. The narcotrend stage(NTS)was D1, D2, and E0, respectively, in groups A, B and C. During the operation, intravenous anesthesia was induced and maintained, propofol was used to adjust and maintain different anesthesia depths, and the amounts of anesthetic drugs used in each group were recorded. The blood rheology and cerebral oxygen metabolism indicators of each group were measured before anesthesia induction(T0), before tracheal intubation(T1), immediately after tracheal intubation(T2), start of surgery(T3), end of surgery(T4)and extubation(T5). Data collected were analyzed with two-factor analysis of variance. Results (1) Anesthetic drugs and dosages: among propofol, remifentanil, and cisatracurium besilate, only the average dosage of propofol had a statistically significant difference among the 3 groups, and the dosage increased as the depth of anesthesia increased(1294.88±37.45, 1354.8±44.56, 1589.02±43.81, F=682.810, P<0.001). (2) Hemorheological indexes: the mean arterial pressure(MAP)and heart rate(HR)decreased with the depth of anesthesia. As the time of anesthesia prolonged, MAP showed an upward trend in group A, and a downward trend in groups B and C; HR showed an upward trend in group A, and an upward trend and then a downward trend in groups B and C(P<0.05). (3) Cerebral oxygen metabolism indexes: as the depth of anesthesia increased, the measured values of jugular bulb venous oxygen saturation(SjvO₂)and arterial oxygen content(CaO₂)showed an upward trend, while the measured values of difference of arteriovnous oxygen(Da-jvO₂), cerebral oxygen extraction ratio(CERO₂)and arterial blood oxygen partial pressure(PaO₂)showed a downward trend; as the time of anesthesia prolonged, the measured values of SjvO₂, CaO₂ and PaO₂ showed an upward trend, while the measured values of Da-jvO₂ and CERO₂ showed a downward trend(P<0.05). Conclusion D1, D2 and E0 depths of anesthesia can maintain a stable state of intraoperative hemodynamics in patients with cerebral surgery, promote the relatively stable balance of cerebral oxygen supply and brain metabolism within the compensation range. Deep anesthesia program can reduce the degree of brain tissue damage and intraoperative cerebral oxygen metabolism imbalance.

Modified cervical-parotid approach in the resection of upper benign tumors in the parapharyngeal space

WU Hao, XU Ke, HAN Liang, XU Feifei, WANG Dongqin, DA Peng, YIN Yong

Journal of Shandong University (Health Sciences). 2020, 58(12):  72-76.  doi:10.6040/j.issn.1671-7554.0.2020.0838

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Objective To investigate the efficacy of modified cervical-parotid approach in resection of upper benign tumors in the parapharyngeal space. Methods A total of 7 patients were enrolled. Preoperative imaging showed big-sized, dumbbell-shaped tumors with unclear boundary. The modified cervical-parotid approach was adopted. After the main trunk and temporal branch of the facial nerves were identified, the upper part of the tumors was separated through the anterior cartilage of the external auditory canal, the posterior margin of parotid gland and the upper part of temporal branch. The tumors were then isolated and removed from the submaxillary region. During the procedure, the superficial lobe of the parotid gland was preserved, and only the necessary facial nerve branches were dissected. Results All tumors were completely removed in one stage operation. Postoperative pathology showed pleomorphic adenoma in 6 cases and schwannoma in 1 case. The hemorrhage volume was less than 300 mL. Mild peripheral facial paralysis occurred in 1 patient, who returned normal 14 days later. All patients had satisfactory cosmetic outcomes. Conclusion The modified cervical-parotid approach can remove the tumors safely and completely, reduce the exposure of facial nerves and superficial lobe of the parotid gland, and reduce the incidence of postoperative neuropathic complications and parotid pitting changes.

Correlations of microRNA-103 and microRNA-107 expressions with the clinical characteristics and prognosis of 120 cases of sepsis

YANG Zhen, ZHANG Yanmin, WANG Qianqian, CHEN Huimin, FENG Qiang, ZHOU Shaoying

Journal of Shandong University (Health Sciences). 2020, 58(12):  77-85.  doi:10.6040/j.issn.1671-7554.0.2020.0110

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Objective To evaluate the predictive values of plasma microRNA(miR)-103 and miR-107 for septic death, and their correlations with disease severity as well as prognosis. Methods A total of 120 sepsis patients who received treatment in our hospital during Jan. 2016 and Jun. 2019(sepsis group)were enrolled and their plasma samples were collected within 24 h after enrollment; meanwhile, 120 contemporaneous healthy controls(HC group)were recruited and their plasma samples were collected. Plasma miR-103 and miR-107 expressions were detected with reverse transcription-quantitative polymerase chain reaction. Several plasma inflammatory cytokines were detected with enzyme-linked immune sorbent assay. In sepsis patients, clinical characteristics were collected and 28-day mortality rate was calculated. The supportive diagnostic value for sepsis was analyzed with receiver operating characteristic(ROC)curve. The associated factors of sepsis death were analyzed with multivariate Coxs regression model. Results The sepsis group had reduced miR-103 and miR-107 expressions than HC group. The miR-103 and miR-107 expressions could serve as supportive indexes for sepsis diagnosis, and their area under curve(AUC)was 0.893(95%CI: 0.854-0.933)and 0.941(95%CI: 0.913-0.968), respectively. In sepsis group, miR-103 and miR-107 expressions were negatively correlated with acute pathologic and chronic health evaluation II score, sequential organ failure assessment score, serum creatinine, C-reactive protein, tumor necrosis factor-α, interleukin-1β, interleukin-6 and interleukin-8, while positively correlated with albumin. Moreover, miR-103 and miR-107 expressions decreased in septic deaths compared to septic survivors. Multivariate Coxs regression analysis revealed that miR-103 expression was an independent factor for 28-day mortality risk of sepsis patients. Conclusion Reduced miR-103 and miR-107 expressions are correlated with sepsis incidence, as well as disease severity and 28-day mortality.

Expression and function of miR-25-3p in endometrial cancer

SHI Li, MA Jing, ZHAO Xiwa, GUAN Yingxia, ZHAO Lianmei, SHAN Baoen

Journal of Shandong University (Health Sciences). 2020, 58(12):  86-91.  doi:10.6040/j.issn.1671-7554.0.2020.0906

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Objective To investigate the expression of miR-25-3p in endometrial cancer tissues, and to explore its effects on the proliferation, migration, invasion and apoptosis of KLE cells. Methods A total of 40 patients with endometrial cancer treated during Jan. and Dec. 2018 were enrolled. The cancer tissues and adjacent tissues were collected, and the miR-25-3p expressions were detected with Real-time PCR. After KLE cells were transfected with miR-25-3p mimics, they were divided into overexpression group and control group, whose miR-25-3p expressions were detected with Real-time PCR. The proliferation, migration, invasion and apoptosis of the two groups of KLE cells were detected with flow cytometry, Transwell assay, matrigel invasion assay, and Annexin v-PI double staining assay, respectively. Results The expression of miR-25-3p was 0.38±0.91 in cancer tissues and 0.17±0.51 in the adjacent tissues, and the difference was statistically significant (t=12.28, P=0.003). Flow cytometry showed the proliferation index was(59.41±0.78)% in the overexpression group and(40.69±0.78)% in the control group, and the difference was statistically significant(G0G1 phase: t=12.504, P<0.001; S phase: t=6.902, P=0.020; G2M phase: t=4.203, P=0.014; PI phase: t=12.475, P<0.001). Transwell assay showed the number of migration cells was 28.54±1.73 in the overexpression group and 19.21±1.62 in the control group, and the difference was statistically significant(t=8.404, P=0.001). Matrigel invasion assay showed the number of invasion cells was 36.66±1.53 in the overexpression group and 17.66±1.53 in the control group, and the difference was statistically significant(t=15.234, P<0.001). Annexin v-PI double staining assay showed the apoptosis rate was(2.75±0.58)% in the overexpression group and(4.81±0.31)% in the control group, and the difference was statistically significant(t=5.443, P=0.006). Conclusion miR-25-3p is highly expressed in endometrial cancer tissues. Overexpression of miR-25-3p promotes the proliferation, migration and invasion but inhibits the apoptosis of KLE cells.

Application of ERAS in day hernia surgery for children aged 1 to 3 years

WANG Bo, XIONG Ying, NI Zhifu, QU Zhenfan

Journal of Shandong University (Health Sciences). 2020, 58(12):  92-96.  doi:10.6040/j.issn.1671-7554.0.2020.0670

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Objective To explore the application of enhanced recovery after surgery(ERAS)in pediatric day hernia surgery for children aged 1 to 3 years. Methods The clinical data of 1 100 children(1-3 years old)with inguinal hernia treated with day surgery during July. 2018 and Sep. 2019 were retrospectively analyzed. The children were divided into the ERAS group(n=550)and control group(n=550). The difference in the distribution of basic characteristics were compared between the two groups with Mann-Whitney U and Chi-square test. The postoperative indexes were compared with Chi-square test and binary Logistic regression analysis. Results There were no significant differences in age, gender and weight between the two groups(P>0.05). The ERAS group was better in hunger score, VAS score, Ramsay sedation score and postoperative complications than the control group(P<0.01). Logistic regression analysis showed that the control group had significantly higher risk of postoperative complications than the ERAS group(OR=4.41, 95%CI: 1.475-13.204). Conclusion ERAS has more advantages over standardized treatment in day hernia surgery, and it is worth popularizing in clinical practice.

Comparison of the efficacy of escitalopram alone and with Qi Yang Yu Xin Dan Fang in the treatment of female depression with sexual dysfunction

WANG Wei, YANG Yongqin, MI Guolin

Journal of Shandong University (Health Sciences). 2020, 58(12):  97-101.  doi:10.6040/j.issn.1671-7554.0.2020.0470

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Objective To retrospectively analyze the curative effect of Qi Yang Yu Xin Dan Fang on female depression with sexual dysfunction. Methods A total of 62 female patients with depression and sexual dysfunction were selected, including 31 cases in the control group(escitalopram 20 mg/d)and 31 cases in the experimental group(Qi Yang Yu Xin Dan Fang plus escitalopram 20 mg/d). The Hamilton Depression Scale(HAMD-17), Hamilton Anxiety Scale(HAMA-14), sexual function index(FSFI), Treatment Emergent Symptom Scale(TESS)and prolactin results were collected at baseline and at the end of the 2nd, 4th and 8th week after administration. Results Analysis showed that HAMD scores, HAMA scores, FSFI scores and PRL indexes had statistical significance in group effect, time effect and interaction effect(P<0.05). At the end of the 8th week, the total effective rate of antidepression(87% vs 62%, P<0.05)and sexual dysfunction(65% vs 47%, P<0.05)were higher in the experimental group than in the control group; there was no significant difference in the incidence of adverse reactions between the two groups(16.1% vs 19.4%, P>0.05). Conclusion Escitalopram combined with Qi Yang Yu Xin Dan Fang can effectively improve the symptoms of depression and anxiety, reduce prolactin level and improve sexual function in female patients with depression and sexual dysfunction.

Psychological capital and research motivation in 206 nursing postgraduates

AN Yan, WANG Lyu, CHEN Cancan, FAN Xiuzhen

Journal of Shandong University (Health Sciences). 2020, 58(12):  102-108.  doi:10.6040/j.issn.1671-7554.0.2020.0523

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Objective To explore the status quo of the research motivation of nursing postgraduates and to investigate their psychological capital, academic control and research motivation so as to provide evidence for improving their research motivation. Methods A total of 206 nursing postgraduates were recruited and surveyed with Research Motivation Scale, Positive Psycap Questionnaire and Academic Control Scale. Data collected were analyzed with independent sample t-test, Pearson correlation and bootstrap method with SPSS 24.0 and PROCESS macro. Results The scores of intrinsic research motivation, extrinsic research motivation and failure avoidance motivation were 3.52±0.55, 3.69±0.57 and 2.87±0.64, respectively, all of which were above the average level, and the extrinsic research motivation was primary(52.9%). Pearson correlation analysis showed that psychological capital had a moderate positive correlation with intrinsic research motivation(r=0.459, P<0.01), a low degree of positive correlation with extrinsic research motivation(r=0.249, P<0.01), and a low degree of negative correlation with failure avoidance motivation(r=-0.222, P<0.01). Moreover, academic control had a moderate positive correlation with intrinsic research motivation(r=0.424, P<0.01), a low degree of positive correlation with extrinsic research motivation(r=0.320, P<0.01), but no correlation with failure avoidance motivation. Furthermore, there was a low degree of positive correlation between psychological capital and academic control(r=0.389, P<0.01). Mediating effect analysis showed that academic control played a mediating role among psychological capital and intrinsic and extrinsic research motivation(95%CI: 0.051-0.169, 0.022-0.146), and the mediating effects were 25.6% and 34.0%, respectively. Conclusion Academic control mediates the effect of psychological capital on research motivation. Nursing educators should adopt targeted intervention strategies to improve the research motivation of nursing postgraduates by improving their psychological capital and cultivating academic control.

Association between serum uric acid variability and risk of coronary heart disease in Shandong Province

LIU Congcong, CHEN Xiaolu, SI Shucheng, WANG Bojie, LI Yunxia, LI Wenchao, YUAN Tonghui, XUE Fuzhong

Journal of Shandong University (Health Sciences). 2020, 58(12):  109-116.  doi:10.6040/j.issn.1671-7554.0.2020.1036

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Objective To explore the association between serum uric acid(SUA)variability and the risk of coronary heart disease(CHD)in Shandong Province. Methods Based on the Big Data Platform of Health Care in Shandong Province, the CHD incidence cohort of people aged 30 to 80 years was constructed. The association between CHD risk and variability independent of the mean(VIM), average real variability(ARV)and coefficient of variation(CV)was analyzed with Cox proportional hazards model. Results During the median follow-up of 8.50 years, 1 931 new CHD cases were diagnosed, including 1 420 males and 511 females, with an incidence density of 10.60/1000 person-year. After age, gender, systolic blood pressure, fasting plasma glucose, body mass index, triglycerides, high-density lipoprotein, low-density lipoprotein, average uric acid level and the number of follow-up were adjusted, HR for VIM were 1.03(95%CI: 0.90-1.19, P=0.674), 1.18(95%CI: 1.03-1.35, P=0.018)and 1.32(95%CI: 1.16-1.51, P<0.001)for quartiles 2 to 4, respectively. When ARV and CV were used for SUA variability, the results were similar to those of VIM. Conclusion High levels of SUA variability are risk factors of CHD.