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Table of Content

      
    10 April 2018
    Volume 56 Issue 4
    Clinical research advances on premature ovarian insufficiency
    CHEN Shiling, ZHOU Xingyu
    Journal of Shandong University (Health Sciences). 2018, 56(4):  1-7.  doi:10.6040/j.issn.1671-7554.0.2017.1293
    Abstract ( 896 )   PDF (1535KB) ( 267 )   Save
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    Premature ovarian insufficiency(POI)is a clinical syndrome manifested with significant decline or loss of ovarian activity before the age of 40 years, which has serious effects on the reproductive, physical and mental health of women. The causes of POI are involved with genetic factors, immunological factors and iatrogenic factors, and the etiology of most patients remains unclear. The fertility of POI patients dramatically decreases, but there is no satisfactory treatment so far. Hormone replacement therapy(HRT)is considered an effectively preventative and therapeutic option to manage complications related to POI. Although many researchers have focused on the mechanism, diagnosis and treatment of POI in recent years, much remains to be explored. This article will review the clinical research advances on POI.
    Activation and clinical application of mammalian primordial follicles
    ZHANG Hua, DAI Yanli, ZHANG Jiawei
    Journal of Shandong University (Health Sciences). 2018, 56(4):  8-17.  doi:10.6040/j.issn.1671-7554.0.2018.019
    Abstract ( 1369 )   PDF (2603KB) ( 279 )   Save
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    Mammalian ovaries consist of follicles as basic functional units of female reproduction. Unlike the stem cells contained in male testes, the follicle reserve is finite and un-renewable in adult life. In most mammalian species, primordial follicle pool established in early life determines the length of female reproductive lifespan. Most primordial follicles stay dormant after formation and only a limited number of primordial follicles are progressively recruited into growing pool through a process called follicle activation. Therefore, the number of primordial follicles in the ovary directly determines the fecundity of female, and the balance between dormancy and activation of primordial follicles maintains a proper reproductive lifespan in organisms. With the advances of genetically modified mouse models, the mechanisms of the formation and activation of primordial follicles have been revealed. Moreover, the in-depth understanding of the cellular and molecular mechanisms of primordial follicle activation lead to more efficient approaches to treat female infertility. In this review, the current state of studies and clinical applications of primordial follicles have been summarized.
    Advance in genetic study on oocyte maturation failure
    XIAO Hongmei
    Journal of Shandong University (Health Sciences). 2018, 56(4):  18-22.  doi:10.6040/j.issn.1671-7554.0.2018.206
    Abstract ( 1076 )   PDF (1747KB) ( 753 )   Save
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    Oocyte maturation has undergone a series of complex physiological changes and molecular regulation processes, such as meiosis resumption, germinal vesicle breakdown and expulsion of first polar body to acquire the potential of fertilization and development into a new individual. Oocytes cannot mature and be fertilized when the procedure above is impeded for various reasons, thus lead to human infertility. With the wide application of the second generation sequencing technology, the research of genetic etiology of developmental disorder and maturation arrest of human oocyte has 山 东 大 学 学 报 (医 学 版)56卷4期 -肖红梅. 卵母细胞成熟障碍研究进展 \=-made a breakthrough: several causal mutations of different genes leading to human oocyte maturation arrest have been identified recently. The methods and ideas of these researches are helpful to deepen the study of the genetic and molecular mechanisms of human oocyte maturation failure.
    Mitochondrial defects and premature ovarian failure
    TONG Chao
    Journal of Shandong University (Health Sciences). 2018, 56(4):  23-27.  doi:10.6040/j.issn.1671-7554.0.2018.032
    Abstract ( 953 )   PDF (1639KB) ( 435 )   Save
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    Premature ovarian failure(POF)is a severe reproductive disease leading to infertility which affects many women. However, its etiology is not clear. Mitochondria, the energy factory and center of metabolism, participates many cellular activities. Malfunctions of mitochondria are associated with POF. Mitochondrion is the only organelle that has its own genome in the mammalian cells. In the majority of species, mitochondria are transmitted maternally, which means that oocyte is the only carrier that passes mitochondrial DNA(mtDNA)to the next generation. Oocytes are large and have many copies of mtDNA. The mitochondria in oocytes have distinct morphology compared with that in the 山 东 大 学 学 报 (医 学 版)56卷4期 -佟超.线粒体异常与卵巢早衰 \=-somatic cells. These special features of mitochondria in ovary lead to special regulatory mechanisms. In this review, we discussed how the defects in mtDNA, mitochondrial protein homeostasis, and mitochondrial dynamics lead to ovarian dysfunction.
    Maintaining the genomic stability in pluripotent stem cells: the current progresses
    ZHENG Ping, ZHANG Weidao, LI Jingzheng
    Journal of Shandong University (Health Sciences). 2018, 56(4):  28-32.  doi:10.6040/j.issn.1671-7554.0.2017.1296
    Abstract ( 672 )   PDF (1251KB) ( 166 )   Save
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    Pluripotent stem cells(PSCs)are widely used as models in the field of developmental biology, and have great application prospects in cell-based regenerative medicine. Genomic stability is prerequisite for the clinical applications of PSCs. Compared to other differentiated cells, PSCs have unique features and higher ability in maintaining genomic stability with more complex DNA damage response. However, the underlying molecular mechanisms are still unknown. In this review, we summarized the current progresses in understanding the pathways and mechanisms how PSCs maintained the genomic stability.
    Research advances on the immunological pathogenesis and immunotherapy of premature ovarian failure
    QIN Yingying, ZHANG Xiruo
    Journal of Shandong University (Health Sciences). 2018, 56(4):  33-37.  doi:10.6040/j.issn.1671-7554.0.2017.1280
    Abstract ( 1097 )   PDF (1364KB) ( 758 )   Save
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    Premature ovarian failure(POF)is characterized by cessation of ovarian function in women younger than 40 years. It presents highly heterogeneous clinical phenotype and etiology, and greatly jeopardizes the fertility of patients. 山 东 大 学 学 报 (医 学 版)56卷4期 -秦莹莹,等.卵巢早衰的免疫学病因及免疫干预研究进展 \=-Variable causes and pathogeneses have been identified, including chromosome abnormalities, genetic mutations, autoimmune dysfunctions, and iatrogenic, metabolic or infectious factors, whereas a large proportion of causes still remain unknown. Autoimmune dysfunctions are involved in the pathogenesis of 10%-30% of POF cases, evidenced by autoimmune oophoritis complicated with other autoimmune disorders. However, the contribution of autoimmune deregulation to the pathogenesis of ovarian follicles depletion and dysfunction remains elusive. Reliable diagnostic or predictive biomarkers for ovarian autoimmunity are still unavailable at present. The efficacy of immunological interventions needs evidence-based medicine and high quality clinical trials to confirm.
    Clinical diagnosis of multiple morphological abnormalities of the sperm flagella
    YANG Shenmin, ZHANG Feng, LI Zheng
    Journal of Shandong University (Health Sciences). 2018, 56(4):  38-42.  doi:10.6040/j.issn.1671-7554.0.2018.006
    Abstract ( 1152 )   PDF (1393KB) ( 311 )   Save
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    Multiple morphological abnormalities of the sperm flagella(MMAF)are severe deformity of the sperm flagella. In patients with typical MMAF, the sperm tails are absent, short, curled, bent and irregular, leading to severe 山 东 大 学 学 报 (医 学 版)56卷4期 -杨慎敏,等.精子鞭毛多发形态异常的临床诊断 \=-impaired sperm motility. Under the transmission electron microscope, the defects of the central microtubule, disorders of fibrous sheath and outer dense fibrous, and absence of dynein arms appear in the transverse section of the flagellum. The genetic causes of MMAF have not been completely disclosed yet and remain the focus of clinical and translational research. Nowadays, there are still no standards and procedures for the clinical diagnosis of MMAF. In this review, we will focus on the diagnostic strategies of MMAF in order to provide a reference for its clinical diagnosis and treatment.
    Total saponins of Panax ginseng promoting the anticancer activity of 5-Fluorouracil by mediating NK cell activity
    MA Ranran, HAN Chen, WANG Zhaoxia, WANG Zhaopeng, GAO Yuxin, ZHOU Shuping, ZHANG Yueying, LI Xiaobing, LIU Hengyao, WANG Hengxiao
    Journal of Shandong University (Health Sciences). 2018, 56(4):  43-50.  doi:10.6040/j.issn.1671-7554.0.2017.1010
    Abstract ( 653 )   PDF (13507KB) ( 11 )   Save
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    Objective To explore the inhibitory effects of total saponins of Panax ginseng(TSPG)combined with 5-fluorouracil(5-Fu)on orthotopic transplantation tumors and the mechanism. Methods The orthotopic transplantation tumor models were established and randomly divided into 4 groups: model group, TSPG group, 5-Fu group and TSPG+5-Fu group. After 14 days, the livers were harvested and tumors were separated. The tumor weight, volume and tumor inhibition rate were determined. The pathological changes were observed with HE staining. The infiltration of NK cells in tumor tissues was observed with immunohistochemical method. The proportions of NK cells in the liver and spleen were assessed with flow cytometry. The mRNA expressions of perforin and granzyme B in tumor tissues were detected with real-time PCR. Results Compared with the model group, the other groups had significantly lower/smaller tumor volume and weight(P<0.05)and more obvious necrosis. The infiltration of NK cells increased in the TSPG group(P<0.05). The proportions of NK cells in the liver and spleen, and the mRNA expressions of perforin and Granzyme B increased in the TSPG group and TSPG+5-Fu group(P<0.05). Conclusion TSPG promotes the antitumor effects of 5-Fu, which may be explained by the increased number of NK cells and cytotoxity.
    Rapamycin improved pulmonary artery hypertension via modulating the phenotypes of macrophages
    WANG Bo, XUE Jiang, LIU Aihong, ZHAI Ruirui, WANG Yibiao
    Journal of Shandong University (Health Sciences). 2018, 56(4):  51-57.  doi:10.6040/j.issn.1671-7554.0.2017.850
    Abstract ( 770 )   PDF (4413KB) ( 249 )   Save
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    Objective To study the effect of rapamycin(RAP)modulating macrophage phenotypes on pulmonary artery hypertension(PAH)and the correlated mechanism. Methods Thirty male Sprague-Dawley rats were randomly divided into the control, PAH and PAH+RAP groups, ten in each group. PAH rat model was induced by left pneumonectomy(PE)and monocrotaline(MCT). Five days after PAH model establishment, the control group and the PAH+RAP group received an intramuscular injection of solvent and RAP for thirty days, respectively. The mean pulmonary artery pressure(mPAP)and right ventricular hypertrophy index(RVHI)were measured in each group via the right cardiac catheter. The degrees of macrophages infiltration and the proliferation of pulmonary arteriolar smooth muscle cells 山 东 大 学 学 报 (医 学 版)56卷4期 -王波,等.雷帕霉素调控巨噬细胞表型改善肺动脉高压 \=-were evaluated by immunohistochemistry, the expression of α-SMA protein was detected by Western blotting, and the expression levels of M2 macrophages was detected by immunofluorescence. The expression levels of TNF-α, IL-1, IL-6 and IL-10 mRNA in each group were detected by RT-PCR. Macrophages were cultured in vitro and treated with LPS+INF-γ, IL-4, and LPS+INF-γ+RAP, respectively; the cells were divided into the blank control group, LPS+INF-γ group, IL-4 group, and LPS+INF-γ+RAP group accordingly. The phenotypes of macrophages were detected by flow cytometry, and the mRNA expression levels of the inflammatory factors were dected by RT-PCR. Results PHA rat models were established successfully. The mPAP, RVHI, α-SMA protein expression level, macrophage infiltration degree and mRNA expression levels of inflammatory factors TNF-α, IL-1β, IL-6, and IL-10 in PAH group were higher than those in the control group(all P<0.05). The mPAP, RVHI, α-SMA protein expression level, and mRNA expression levels of inflammatory factors TNF-α, IL-1β, IL-6, and IL-10 in PAH+RAP group were lower than those in PAH group(all P<0.05). The expression level of M2-type macrophages in PAH+RAP group was higher than that in PAH group(P<0.05). CD86 positive macrophages percentage and mRNA expression levels of TNF-α, IL-1β, IL-6, and IL-10 in LPS+INF-γ group were higher than those in the blank control group in vitro(all P<0.05). CD86 positive macrophages percentage and mRNA expression levels of TNF-α, IL-1β, IL-6, and IL-10 in LPS+IFN-γ+RAP group were lower than those in LPS+INF-γ group(all P<0.05). Conclusion PAH occurrence is accompanied with macrophage infiltration and expression level increase of inflammatory factors. RAP improves PAH via reducing inflammatory response partly depending on inducing the macrophages transformation into M2.
    Expression of FBP1 in granulosa cells of PCOS patients with hyperandrogenism and its significance
    SHU Xin, WANG Qun, HUANG Tao, ZHAO Shigang, SHI Yuhua, LIU Hongbin
    Journal of Shandong University (Health Sciences). 2018, 56(4):  58-63.  doi:10.6040/j.issn.1671-7554.0.2017.998
    Abstract ( 804 )   PDF (1037KB) ( 119 )   Save
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    Objective To explore the expression and significance of FBP1 in ovarian granulosa cells in patients with polycystic ovary syndrome(PCOS). Methods A total of 28 PCOS patients with hyperandrogenism(hyperandrogenism group), 72 PCOS patients without hyperandrogenism(non-hyperandrogenism group)and 58 healthy controls(control group)were enrolled. The expressions of FBP1 in the ovarian granulosa cells of the three groups were examined with real-time quantitative reverse transcription PCR(qRT-PCR). The correlation between FBP1 and androgen-related indicators was analyzed. The patients age, body mass index(BMI)and related hormones were analyzed. Results The hyperandrogenism group had higher incidence of obesity, hypertensive disease, hyperglycemia, metabolic syndrome and morbidity than the non-hyperandrogenism and control groups(P<0.05). The mRNA expression of FBP1 was higher in the hyperandrogenism group than that in the non-hyperandrogenism group(P=0.038)and control group(P=0.002). There was positive correlation between dehydroepiandrosterone sulfate(DHE-S)and the mRNA expression of 山 东 大 学 学 报 (医 学 版)56卷4期 -舒心,等.多囊卵巢综合征高雄激素血症患者颗粒细胞FBP1基因的表达及影响 \=-FBP1 in the hyperandrogenism group(r=0.470, P=0.021). Conclusion High expression of FBP1 is associated with hyperandrogenism of PCOS and DHE-S, and may be involved in the pathogenesis of PCOS hyperandrogenism through follicular microenvironment.
    Clinical treatment value of preimplantation genetic screening for unexplained repeated implantation failure
    ZHANG Dandan, XIE Hongqiang, WU Qianqian, LI Hongchang, ZHU Yueting, LU Juanjuan, JIANG Wenjie, YAN Junhao
    Journal of Shandong University (Health Sciences). 2018, 56(4):  64-69.  doi:10.6040/j.issn.1671-7554.0.2017.1105
    Abstract ( 701 )   PDF (956KB) ( 105 )   Save
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    Objective To evaluate the clinical results of preimplantation genetic screening(PGS)in patients with unexplained recurrent implantation failure(uRIF). Methods A total of 140 patients diagnosed as having uRIF were collected and 189 transfers after referral were analyzed(95 circles in PGS group, 94 circles in control group); 72 patients who underwent PGS were included in the PGS group, while 68 non-PGS patients were included in the control group. All the subjects were divided into two subgroups by age(<35 years, ≥35 years), and the clinical outcome were compared. Results After referral, the implantation rate(P=0.001)and clinical pregnancy rate(P=0.045)per transfer were significantly higher in the PGS group than those in the control group. There were no significant differences between the two 山 东 大 学 学 报 (医 学 版)56卷4期 -张丹丹,等.植入前遗传学筛查对不明原因反复种植失败患者的临床治疗价值 \=-groups in abortion rate, live birth rate of the first transfer, cumulative live birth and twinning rates. Among women aged ≥35 years, the implantation rate(P=0.003)and clinical pregnancy rate(P=0.027)per transfer were significantly higher in the PGS group than those in the control group, and there were no significant differences between the two groups in abortion rate, ongoing pregnancy rate, live birth rate of the first transfer and cumulative live birth(P>0.05). However, among women aged <35 years, no significant differences were found between two groups in the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, abortion rate, live birth rate of the first transfer and cumulative live birth(P>0.05). Conclusion PGS can improve the implantation rate and clinical pregnancy rate among patients over 35 years old with uRIF.
    Value of VTQ and VTIQ on differentation of benign and malignant breast masses
    LI Liang, GE Na, SUN Xiao, LI Jie, ZHU Jiang, LI Zhongliang
    Journal of Shandong University (Health Sciences). 2018, 56(4):  70-75.  doi:10.6040/j.issn.1671-7554.0.2017.1184
    Abstract ( 944 )   PDF (3927KB) ( 47 )   Save
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    Objective To compare the diagnostic value of two elastography techniques, virtual touch tissue quantification(VTQ)and virtual touch tissue imaging quantification(VTIQ), in differentiating benign breast masses from malignant ones. Methods A total of 102 patients in Qilu Hospital of Shandong University with 136 nodules were evaluated by conventional ultrasound, VTQ and VTIQ. Shear wave velocities(SWVs)of breast masses were measured by VTQ and VTIQ. The receiver operating characteristic(ROC)curves of VTQ SWVVTQ and VTIQ SWVmax, SWVmin and SWVmean were used to assess the value on differentiating benign and malignant masses. Areas under the curve(AUC)of the four groups were compared. The sensitivity, specificity, accuracy, positive predictive value(PPV)and negative predictive value(NPV)of the four measurements were respectively calculated. Results Pathologically, 94 breast masses were benign and 42 were malignant. Significant differences of SWVmax, SWVmin, SWVmean and SWVVTQ between 山 东 大 学 学 报 (医 学 版)56卷4期 -李良,等.两种声触诊组织定量技术鉴别乳腺包块良恶性的价值 \=-benign and malignant groups were found(P<0.05). Of all these four measurements, the SWVmean was the most valuable measurement(AUC=0.91), the diagnostic sensitivity of SWVmax was the highest(83.0%), and the diagnostic specificity of SWVmean was the strongest(95.2%). Conclusion VTQ and VTIQ have good diagnostic performance on distinguishing malignant breast masses from benign ones. VTIQ SWVmean shows better diagnostic performance than SWVVTQ.
    Clinical characteristics and influencing factors of sleep disorders in patients with Parkinsons disease
    GUO Pei, LI Xiuhua, ZHANG Xiaotao, HE Tianqi, ZHU Meijia, TANG Jiyou, ZHAO Zhangning, MAO Fei
    Journal of Shandong University (Health Sciences). 2018, 56(4):  76-80.  doi:10.6040/j.issn.1671-7554.0.2017.1020
    Abstract ( 937 )   PDF (935KB) ( 133 )   Save
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    Objective To investigate the characteristics and influencing factors of sleep disorders(SD)in patients with Parkinsons disease(PD). Methods A total of 50 PD patients with SD(PD-SD group)and 50 PD patients without SD(PD-NSD group)were included, according to the diagnostic criteria of The Third Edition of the International Classification of Sleep Disorders, Parkinson Disease Sleep Scale(PDSS), Insomnia Severity Index(ISI), Epworth Sleepiness Scale(ESS)and polysomnography(PSG). The Hoehn-Yahr(H-Y)score was graded. The levels of serum high-sensitivity C-reactive protein(hs-CRP), serum iron(SI), serum ferritin(SF)and transferring(TRF)were detected and analyzed between the two groups. Results Comparied with PD-NSD group, the PDSS score, total sleep time, sleep efficiency(SE), proportion of rapid eye movement(REM)stage, non-rapid eye movement(NREM)stage 2, NREM stage 3, and SI were shorter or lower in the PD-SD group(P<0.05); the ESS score, ISI score, course of disease, total arousal time, sleep latency(SL), proportion of NREM stage 1, apnea-hypopnea index(AHI), periodic 山 东 大 学 学 报 (医 学 版)56卷4期 -郭配,等.伴有睡眠障碍帕金森病患者的睡眠特征及其影响因素 \=-limb movement index(PLMI), hs-CRP and TRF were longer or higher in the PD-SD group(P<0.05). Multiple stepwise analysis showed that the IS level influenced the PDSS and ESS scores, and the hs-CRP level influenced the ISI score. Conclusion Sleep disturbances in PD-SD patients are characterized by disordered sleep structure, decreased sleep quality, severe insomnia, daytime sleepiness, respiratory disorder during sleep, abnormal sleep behaviors and parasomnias. The sleep disorders of PD-SD patients may involve inflammatory reaction and iron metabolism disturbance.
    Comparison of the characteristics of inpatients’ disease distribution in a tertiary hospital in Shandong Province in 2006 and 2016
    HE Dongyang, SUN Jiyao, WANG Meng, WANG Jian, HUANG Guo
    Journal of Shandong University (Health Sciences). 2018, 56(4):  81-86.  doi:10.6040/j.issn.1671-7554.0.2017.1274
    Abstract ( 618 )   PDF (2630KB) ( 83 )   Save
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    Objective To compare the characteristics of inpatients’ disease distribution in a tertiary hospital in Shandong Province in 2006 and 2016. Methods The related data were classified according to ICD-10 based on the discharge diagnosis. The changes of disease constitution ratio, number of inpatients, and length of hospital stay were analyzed with descriptive statistics and χ2 test, correlation coefficient, and t-test, respectively. Results The number of inpatients in 2016 was 3.53 times of that in 2006. The changing trends of monthly number of inpatients in 2006 and 2016 were consistent(r=0.930). The male to female ratio decreased from 1.05∶1 in 2006 to 0.92∶1 in 2016. The number of inpatients aged 60 or above increased by 8%. The constitution ratio of the top 10 systemic diseases changed significantly in 2006 and 2016(P<0.001). Diseases of the digestive, genitourinary and nervous systems and puerperal diseases increased in rank, while diseases of the respiratory system decreased in rank. In 2016, lung cancer, thyroid carcinoma and epilepsy accounted for a large proportion and increased sharply. Conclusion The number of inpatients with chronic diseases increased rapidly and the constitution ratio of diseases changed obviously. Health resources should be allocated reasonably based on the new features of disease distribution.
    Cone beam computed tomography on the anatomical structure of maxillary first molars root canal
    HAO Xinyu, LI Jianhua, ZHANG Jing, NIE Xiaokun, XIONG Shijiang
    Journal of Shandong University (Health Sciences). 2018, 56(4):  87-91.  doi:10.6040/j.issn.1671-7554.0.2018.157
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    Objective To explore the anatomical structure of the root canal of maxillary first molars with cone beam computed tomography(CBCT). Methods The CBCT data of 753 maxillary first molars were reviewed to observe the anatomical structure of the root canal system. Results Of all 753 maxillary first molars, 616(81.81%)had 4 canal roots, including 612(81.27%)MB2 and 4(0.53%)DB2; 135(17.93%)had 3 canal roots, 2(0.27%)had 2 canal roots; no single canal root was observed. Of all mesiobuccal canal roots, 383(51.00%)molars were type Ⅲ, 143(19.04%)were type Ⅴ, 136(18.11%)were type Ⅰ, and only a few molars were other types. Of all distobuccal canal roots, 747(99.47%)molars were type Ⅰ, and 4 belonged to the other types. All(100%)palatal canal roots were type Ⅰ. As to the length of the canal root, 1976(87.55%)were 7.1-12.0 mm, 178(7.89%)were 12.1-18.0 mm, and 103(4.56%)were 4.1-7.0 mm. Conclusion The root canal system of the maxillary first molar is complex and changeable. The anatomical structure of various root canals can be effectively observed with CBCT to provide the basic information for clinical treatment.