Table of Content

    05 August 2017, Volume 37 Issue 8
    Degradation of eNOS induced by TNF-α in human umbilical vein endothelial cells
    2017, 37(8):  1067-1071. 
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    Objective To investigate whether intracellular protein degradation pathway play a important role in the decrease of endothelial nitric oxide synthase (eNOS) in human umbilical vein endothelial cells (HUVECs), Which is induced by tumor necrosis factor-alpha (TNF-α). Methods Establish a primary HUVEC culture methods, the HUVECs were incubated with concentration gradient group of TNF-α (0.01, 0.1, 1 and 10 ng/mL) under different time periods (24, 48 and 72 h). The HUVECs were pretreated with NH4Cl or treated with caspase inhibitor or MG-132 1.5 h prior to incubation for an additional 24 h with TNF-α. The expression of eNOS was detected via Western blot assay. Results Compared with the control group, treatment of the HUVECs with TNF-α (0.01-10 ng/ml) led to a dose-dependent reduction in the expression of eNOS. And treatment with TNF-α (1 ng/ml) reduced the eNOS expression in a time-depended manner. Compared with the TNF-α group, the protein expression level of eNOS was obviously increased in the co-working group of MG-123 and TNF-α. Conclusions TNF-α induced the degradation of eNOS through the ubiquitin-proteasome pathway.
    Immune modulation by mouse lymphocytes co-cultured with cord blood-derived multipotent stem cells in Alzheimer‘s disease model mice
    2017, 37(8):  1072-1076. 
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    Objective To investigate the immune modulation effect of lymphocytes co-cultured with human cord blood derived-multipotent stem cells(CB-SCs) and further to explore their therapeutic potential for Alzheimer’s Disease (AD) model mice. Methods CB-SCs were isolated from human cord blood. Lymphocytes were isolated from the spleens of AD model mice. The lymphocytes were co-cultured with CB-SCs or cultured alone for 72 h. AD model mice were divided into experimental group and control group randomly, and then the experimental group mice were administrated with lymphocytes co-cultured with CB-SCs and control group were administrated with lymphocytes cultured alone by caudal vein injection. Then, the behavior experiment was carried out. The CD4+CD25+Foxp3+Tregs were detected by flow cytometry. The protein expression of TNF-αand IL-10 in peripheral blood was detected by ELISA, The mRNA expression of TNF-α and IL-10 in brain tissue was detected by PCR. The amyloid-β(Aβ)plaques were detected by immunohistochemistry. Results 1) There is spatial learning and memory improvement on experimental group. 2) The Aβ plaques of experimental group were decreased compared to the control group. 3) The percentage of CD4+CD25+Foxp3+Tregs in peripheral blood and IL-10 level in plasma were higher in experimental group compared to those in the control group(P <0.05). The pro-inflammatory cytokines, TNF-α level in plasma of experimental group was lower than that in the control group(P <0.001). 4) The mRNA expression of IL-10 in brain was higher in experimental group compared to those in the control group(P <0.05), and the mRNA expression of TNF-α of experimental group was lower than that in the control group(P <0.05). Conclusion The lymphocytes co-cultured with CB-SCs have immunotherapeutic effect on AD model mice, which is mainly displayed with increasing proportion of Tregs and enhanced anti-inflammatory function of Tregs.
    Association of oxygen saturation of arterial hemoglobin with late-onset hypertension in Chinese Han population resided in the Daxinganling area
    2017, 37(8):  1077-1081. 
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    Objective To exposure the association of oxygen saturation of arterial hemoglobin (SaO2) with late-onset hypertension in the Chinese Han population located at the Daxinganling area. Methods A total participants were selected by convenience sampling methods from the Daxinganling area. All data were obtained from each person by the questionnaire and standard physical examinations as well as biochemical index measuring. SaO2 was measured noninvasively with finger pulse oxymetry, the reported SaO2 is the average of three readings taken 10 seconds apart. Results The results showed there are significant differences for SaO2 within the population of individuals, the mean SaO2 values was 97.71%±6.14%, with region from 88% to 100%(n=2128). There were association of SaO2 with sex, BMI and age. SaO2 level declined with BMI and age increasing. Particularly, it was found that the risk increasing to hypertension is marked association with SaO2 rapid drop. During the period from 40-50 years of age, SaO2 declined from 97.85% to 97.64%, The risk to hypertension increased more than 10 times (p<0.001). That implicated hypoxia might involve in the etiology of hypertension. Conclusion The preliminary results demonstrated the rapid decline of SaO2 with lapse of age may be one of the major risk factors to hypertension, it may be helpful to explain late-onset hypertension to some extent at least.
    Effect of neural cell adhesion molecule on adhesion, migration and morphology of mouse BMSCs
    2017, 37(8):  1082-1087. 
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    Objective To explore the effect of neural cell adhesion molecule (NCAM) on adhesion, migration and morphology of mouse bone marrow-derived mesenchymal stem cells (BMSCs).Methods We isolated and cultured BMSCs from wild-type and NCAM gene knockout mice. The expression of NCAM was detected by Western blot and immunofluorescence. Wound healing and adhesion assays were used to detect cell migration and adhesion ability respectively. The morphological changes were observed and the expressings of protein β1 integrin, E-cadherin, β-catenin and N-cadherin were analysed by Western blot. Results The migration and adhesion of BMSCs were significantly reduced after NCAM gene knockout. Meanwhile, the expression of β1 integrin was lower than those in wild-type BMSCs (P<0.01). The morphology of NCAM gene knockout BMSCs changed from irregular to flattened, and expressed epithelial identification marker E-cadherin and β-catenin (P<0.05). However, the expression level of mesenchymal identification marker N-cadherin was decreased (P<0.01). Conclusions NCAM is involved in adhesion and migration of BMSCs via regulating the expression of β1 integrin. Furthermore, NCAM may negatively regulate the mesenchymal-epithelial transitions of BMSCs.
    Analysis of SAA proteins in renal tissue from patient with secondary amyloidosis by laser microdissection and mass spectrometry
    2017, 37(8):  1088-1093. 
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    Objectives To analyze serum amyloid protein A (SAA) subtype and amino acid mutation sequence of the renal biopsy specimens from patients with renal amyloidosis secondary to ankylosing spondylitis (AS) by laser microdissection combined with mass spectometry. Methods Kidney biopsy formalin-preserved paraffin-embedded (FFPE) specimen slices were stained by congo red, the positive areas of Congo red staining were selected by microdissection, after trypsin hydrolysis and filtration, peptide samples were subjected to liquid chromatography tandem mass spectrometry. Analysis softwares were used to evaluate the results, and the patient's amino acid sequence of SAA protein was compared to mutant amino acid sequence reported by literature or deduced from mutant SAA gene to determine whether there was a variation. Results SAA1 and SAA2 proteins with high abundance were identified by mass spectrometry, serum amyloid P and apolipoprotein E were also detected. No variation of SAA1 and SAA2 protein was detected. Conclusions The SAA1 and SAA2 proteins in AA amyloidosis secondary to AS were identified for the first time, which enriched the pathogenesis of amyloidosis secondary to AS and provided a new method for the accurate classification of AA amyloidosis.
    Puerarin attenuates the expression of HUVECs tissue factor and its inhibitor induced by ox-LDL
    2017, 37(8):  1094-1097. 
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    Objective To investigate the effects of puerarin on the expression of human umbilical vein endothelial cells (HUVECs) tissue factor (TF) and tissue factor pathway inhibitor (TFPI) induced by oxidized low-density lipoprotein (ox-LDL). Methods After HUVECs were incubated with different concentrations of puerarin and 50 mg/L ox - LDL, the expression of TF and TFPI mRNA and protein were detected by real-time fluorescent quantitative PCR and Western blot respectively. Results Compared with control, treatment with ox-LDL caused the augment of TF mRNA and protein expression (P<0.01), and the decrease of TFPI mRNA and protein expression. However, 50, 100, and 200 ?mol/L puerarin blunted the augment of TF mRNA and protein expression and weakened the inhibition of TFPI mRNA and protein expression induced by ox-LDL(P<0.01). Conclusion Puerarin reduced HUVECs TF and TFPI mRNA and protein induced by ox-LDL.
    Regulation of miR-328 on human umbilical vein endothelial cell induced by high glucose and its signaling mechanism in endothelial-mesenchymal transition
    2017, 37(8):  1098-1102. 
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    Objective The study is to investigate the rolel of miR-328 in endothelial mesenchymal transition (EndMT) induced by high glucose in human umbilical vein endothelial cells (HUVECs) and its signaling mechanism. Methods HUVECs were cultured in high glucose environment to induce EndMT; The recombinant lentiviruses were produced by miR-328 and antagomiR- 328 transfection of HUVECs. The experiment was divided into seven groups: normal glucose; mannitol group; high glucose; miR-328; miR-328 virus negative control; high glucose + U0126; miR-328 + U0126. Double immunofluorescent staining was used to determine expression of EndMT markers; Changes in miR-328 expression is examined by RT-qPCR; The expressions of typeⅠⅢ collagen, p-MEK1/2 and p-ERK1/2 are examined by Western blot. Results 1). Immunofluorescent staining showed that the HUVECs showed positive staining for CD31 and α-SMA in high glucose group. 2). Compared with the control group, the expression of miR-328 was up-regulated(p <0.05) in HUVECs treated by high glucose or miR-328. Compared with high glucose group or miR-328 group, miR-328 expression were less pronounced after treatment with U0126. 3). The expressions of typeⅠ/Ⅲ collagen increased in HUVECs treated by high glucose or miR-328 when compared with control group (p <0.05). Compared with high glucose group or miR-328 group, typeⅠ/Ⅲ collagen expressions were less pronounced after treatment with U0126. 4). The expressions of p-MEK1 / 2 and p-ERK1 / 2 were increased in HUVECs treated by high glucose or miR-328 in comparison to the control group (p <0.05); a lower expression of p-MEK1 / 2 and p-ERK1 / 2 were observed in U0126 group than in high glucose group or miR-328 group. Conclusion The phenomenon of EndMT in HUVECs is induced by high glucose, and the expression of miR-328 is increased at the same time; overexpression of miR-328 induced EndMT in HUVECs; miR-328 induced EndMT is related with MEK1 / 2-ERK1 / 2 signaling pathway.
    Epidural ropivacaine block increasing anesthetic potency of propofol
    2017, 37(8):  1103-1107. 
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    Objective The purpose of this study was to investigate the effects of epidural ropivacaine block combined with propofol intravenous anesthesia on CaMKII and ERK1/2 total protein (T-CaMKII and T-ERK1/2) and phosphorylation (p-CaMKII and p-ERK1/2) levels in the hippocampus and cortex of rats. Methods Rats were randomly assigned to three groups: group P(control, propofol intravenous anesthesia)、group PS( propofol and epidural normal saline) and group PR( propofol and epidural 0.5% ropivacaine). There were 8 rats in each group. Anesthesia were performed in 72 h after epidural catheter placement. The rats in group PR received 70 μL of 0.5% ropivacaine to achieve epidural block.1% propofol was infused through rats caudal vein. Propofol dosage for anesthesia induction was 12 mg/kg, for anesthesia maintenance was 40 mg/kg/h. Before the rats were decapitated,the depth of anaesthesia was assessed as either “light anesthesia” or “deep anesthesia” by checking of pinch withdrawal reflex, eyelid reflex and spontaneous rapid whisking of the vibrissae after propofol continuous infusion for 1 h. T-CaMKII/T-ERK1/2 and p-CaMKII/p-ERK1/2 in hippocampus and frontal cortex were examined by Western blot. Results 7 rats were assessed as “light anesthesia” and 1rat as “deep anesthesia” in group P; 6 rats were assessed as “light anesthesia” and 2 rats as “deep anesthesia” in group PS; In group PR, 1 rat was assessed as “light anesthesia” and 7 rats as “deep anesthesia”. Significant differences were seen among three groups (P<0.05). In hippocampus of rats, p-CaMKII(Thr286)(43.7±8.8)% and p-ERK1/2(32.4±7.9)% in group PR were significantly lower than those in group P (100%, P<0.05). Conclusions Epidural ropivacaine block could strengthen the depth of anesthesia achieved with propofol intravenous anesthesia. The decrease of the levels of p-CaMKII(Thr286) and p-ERK1/2 in hippocampus of rats may participate in the effects of epidural block.
    miR-10b overexpression promotes the proliferation of lung cancer cell line A549
    2017, 37(8):  1108-1112. 
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    Objective To explore the expression of microRNA-10b (miR-10b) in patients with non-small cell lung cancer (NSCLC) and adjacent tissues, and to investigate the effect of miR-10b on the malignant change of lung cancer cell A549 by regulating the expression of Kruppel-like factor 4 (KLF4). Methods 40 patients with NSCLC were selected and used in situ hybridization, with detection of lung cancer and adjacent tissues of miR-10b expression; lung cancer cell A549 transfected miR-10b mimics, changes of CCK-8 assay was used to detect the proliferation of lung cancer cells; real time PCR and Western blot were used to examine the cell KLF4 mRNA and protein levels; soft agar colony formation assay was used to detect the expression of miR-10b on the proliferation of lung cancer cell A549 tumor malignant. Results Lung cancer A549 cells and lung cancer tissue of miR-10b expression were higher than that of normal lung epithelial 16HBE cells and cancer adjacent tissues; overexpression of miR-10b analogue in A549 cells, KLF4 protein levels decreased significantly, KLF4 mRNA level was not changed significantly; miR-10b expression significantly increased the growth of A549 cells. Conclusion The distribution of miR-10b in different cell types and tissues may be different, which may promote the proliferation and malignancy of lung cancer cells by inhibiting the expression of KLF4.
    Effect of sleeve gastrectomy on intestinal barrier of obesity rats fed with high-fat diet
    2017, 37(8):  1113-1116. 
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    Objective To investigate the effect of sleeve gastrectomy on the intestinal barrier of obesity rats fed with high-fat diet. Methods 30 obesity rats fed with high-fat diet were randomly divided into three groups including common diet group (CD, n=10), sham operation group (SO, n=10) and sleeve gastrectomy group (SG, n=10). The lactulose/ mannitol ratios (L/M) in 24-hour urine and endotoxin levels in portal vein were evaluated four weeks after surgery. The levels of tight junction proteins including claudin-1 and occludin in intestinal mucosa were analyzed by western blot. Results The body weight of SG group was significantly decreased than those of CD group (P <0.001) and SO group (P <0.001) four weeks after surgery. The L/M ratio in 24-hour urine of SG group was significantly lower than those of CD group (P <0.001) and SO group (P <0.01). The endotoxin level in portal vein of SG group was significantly lower than those of CD group (P <0.01) and SO group (P <0.05). The claudin-1 level in intestinal mucosa of SG group was significantly higher than those of CD group (P <0.001) and SO group (P <0.01) four weeks after surgery. The occludin level in intestinal mucosa of SG group was significantly higher than those of CD group (P <0.001) and SO group (P <0.001). Conclusions Sleeve gastrectomy can reduce body weight, L/M ratio in 24-hour urine and endotoxin level in portal vein of obesity rat fed with high-fat diet and increase the levels of claudin-1 and occludin in intestinal mucosa.
    Over-expressed miR-449a inhibits proliferation and induces apoptosis of SH-SY5Y cells in vitro
    xiao yanXU
    2017, 37(8):  1117-1121. 
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    Objective To explore the effects of miR-449a on the proliferation and apoptosis in human neuroblastoma SH-SY5Y cells. Methods Transferred miR-449a mimics to SH-SY5Y cells by LipofectamineTM2000 as experimental group. Set up blank and negative control group. Cell growth was measured by CCK8 assay, the cell cycle and apoptosis were detected by flow cytometry. Relative expression levels of c-Myc, Bax/ Bcl-2 were detected by Western blot. Results Compare to blank and negative control cells, the proliferation of miR-449a mimics SH-SY5Y cells were decreased(P<0.05). Flow cytometry showed that over-expressed miR-449a resulted in an increase of G0/G1 phase and apoptotic cells. The expression of c-Myc showed significant difference (P<0.05), Expression of pro-apoptotic protein Bax was increased, and that of anti-apoptotic protein Bcl-2 was decreased differentially (P<0.05). Conclusions miR-449a over-expression can inhibit cell proliferation by regulating cell cycles and induce apoptosis mainly through regulating Bcl-2 family proteins expression in SH-SY5Y cells.
    Inhibitory effect and mechanism of 5-FU in TGF-β1-induced human intrahepatic biliary epithelial - mesenchymal transition
    2017, 37(8):  1122-1127. 
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    Objective To investigate the inhibitory effect of 5-FU on human intrahepatic biliary epithelial cells with TGF-β1-induced mesenchymal transition, and to explore the mechanism. Methods The primary epithelial cells from human intrahepatic bile ducts were cultured, the cells were identified by immunofluorescence staining. The cells were randomly divided into 3 groups: normal control group, TGF-β1 group and TGF-β1+5-FU group. The expression of CK-19, E-cadherin, vimentin and α-SMA protein were measured by immunofluorescence staining and Western blot assay. Western blot was used to detect the expression levels of TGF-β1. Real-time PCR to detect mRNA expression of TGF-β1,Ⅰand collagen type Ⅲ. Results The primary epithelial cells of intrahepatic bile ducts were successfully cultured. In TGF-β1 group, the protein expression levels of vimentin, α-SMA and the mRNA expression levels ofⅠand collagen type Ⅲ were significantly higher than that of normal control group(P<0.05), the protein expression levels of CK-19 and E-cadherin protein were lower than that of normal control group(P<0.05), TGF-β1 protein and mRNA expressions were significantly higher compared with that of normal control group(P<0.05). In TGF-β1+5-FU group, the protein expression levels of CK-19 and E-cadherin protein were higher than that in normal control group(P<0.05), the protein expression levels of vimentin, α-SMA and the mRNA expression levels of collagen type Ⅲ were significantly lower than that of TGF-β1 group(P<0.05), while there was no significantly difference in collagen typeⅠmRNA between the two groups(P>0.05), TGF-β1 protein and mRNA expressions were significantly lower compared with that of normal TGF-β1 group(P<0.05). Conclusions 5-FU could inhibit TGF-β1-induced biliary epithelial - mesenchymal transition with down-regulated expression of TGF-β1.
    Predictors of chronic post-thoracotomy pain in rats
    2017, 37(8):  1128-1132. 
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    Objective A rat model of chronic post-thoracotomy pain is used to study whether acute pain and pre-operative DNIC can predict chronic pain and how DNIC changes when pain maintains. Methods Rats were randomly divided into three groups:naive group,sham group and model group. DNIC was constantly assessed in individual rats, along with each animal’s mechanical hyperalgesia and cold allodynia after thoracotomy. Results In model group, the incidence rate of chronic post-thoracotomy pain was 55%(11 of 20), which was named CPTP group, and the other 9 rats without chronic pain was defined as non-CPTP group. The pre-operative DNIC was significantly weaker in CPTP group with lower mechanical threshold on 6 days after surgery and higher cold sensitivity on 6 days after surgery comparing with non-CPTP group. In the acute pain phase (day 3), DNIC was decreased in both CPTP group and non-CPTP group compared with pre-operative period. Besides, DNIC was recovered in non-CPTP group while kept impaired in CPTP group on 21 days after surgery. Conclusions Pre-operatively assessed DNIC efficiency and acute post-operative pain intensity were two independent predictors for CPTP. DNIC was decreased both in acute pain and chronic state, while returned to normal when pain sense was normal.
    Effect of PER2 on proliferation, apoptosis and clock gene expression in human oral squamous cell carcinoma SCC15 cells
    2017, 37(8):  1133-1139. 
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    Objectives To discuss the effect of alter-expressed PER2 on proliferation, apoptosis and other clock genes expression in human oral squamous cell carcinoma SCC15 cells. Method Short hairpin RNA interference was used to knockdown PER2 effectively in SCC15 human oral squamous cell carcinoma cells. Flow cytometry analysis was used to testify the cell proliferation and apoptosis. Quantitative real-time PCR was used to testify the mRNA expressions of PER3, BMAL1, DEC1, DEC2, CRY2, TIM, RORα, NPAS2, PER1 and REV-ERBα. Results The proliferation was enhanced and apoptosis was decreased obviously after PER2 knockdown in SCC15 cells (P<0.05). The mRNA expressions of PER3, BMAL1, DEC1, DEC2, CRY2, TIM, RORα and NPAS2 were significantly down-regulated, and the mRNA expressions of PER1 and REV-ERBα were significantly up-regulated (P<0.05). Conclusions Clock gene PER2 plays an important role in regulating other clock genes of the clock gene network in cancer cells, PER2 knockdown can enhance proliferation and recede apoptosis of cancer cell.
    Clinical feature and post-operative prognosis analysis of infective endocarditis patients with acute kidney injury
    2017, 37(8):  1140-1145. 
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    Objective To analyze the clinical features and prognosis of patients with infective endocarditis (IE) and acute kidney injury (AKI), and evaluate the effect of timely operation on prognosis of renal function. Methods Clinical data of 45 cases of IE and AKI who were admitted in Peking Union Medical College Hospital from January 2010 to May 2016 were retrospectively reviewed; among them 8 cases underwent renal biopsy and the pathologies were analyzed. Patients were divided into Operation group (22 cases) and Non-operation group (23 cases), and the clinical data and prognosis were compared. Results The ratio of male to female was 2.46: 1 and the average age was 48.3±16.6. 35.6% of cases were detected with basic valve diseases and the congenital valve diseases were the most common type. The most frequently infected valves were mitral valve (46.7%), aortic valve (28.9%) and prosthetic valve (8.9%) ordinally. The most common pathogenic bacteria were streptococcus (46.7%) and staphylococcus (35.6%). Some rare and special pathogen could also be found in these cases. In 8 cases underwent renal biopsy, 3 cases were diagnosed as crescentic nephritis, 2 cases were diagnosed as focal proliferative glomerulonephritis and mesangial proliferative glomerulonephritis respectively, 1 case was diagnosed as acute interstitial nephritis. C3 sedimentation was the most common phenomenon found in immunofluorescence. There was no significant difference between the baseline data of Operation and Non-operation groups, and neither was the survival rate. However, renal function recovered better in Operation group (P<0.05): the serum creatinine declined remarkably in 7 days (P<0.05) and 30 days (P<0.01)post operation, compared with the peak valve before operation. Conclusions The background valve diseases and pathogen have been changed in IE compared with traditional description. Crescentic nephritis is not rare in renal pathologic manifestation when parenchymal lesion is developed after the onset of IE. Timely operation can improve the renal prognosis in patients with IE and AKI.
    Establishment and characterization of paclitaxel-resistant gastric cancer cell HGC-27/PTX
    2017, 37(8):  1146-1151. 
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    Objective To establish the paclitaxel-resistant gastric cancer cell(HGC-27/PTX) and investigate the changes of characteristics before and after resistance, as well as the possible resistant mechanisms. Methods The paclitaxel-resistant gastric cancer cell HGC-27/PTX was established by increasing paclitaxel dose gradually and intermittently. The IC50 (50% inhibitory concentration) and cell cycle were determined by CCK-8 assay and flow cytometry, respectively. The differentially expressed genes (DEGs) and signaling pathways were analyzed using RNAseq. Results The establishment of HGC-27/PTX cells lasted 9 months, and the sensitivity of paclitaxel of HGC-27/PTX cells was significantly lower than parental cells (P<0.05). Compared to parental cells, the morphology of HGC-27/PTX cells was slightly different, and the proportion of S and G2/M phase was obviously increased (P<0.01). A total of 274 DEGs were identified between the resistant and parental cells with 130 genes up-regulated and 144 genes down-regulated. DEGs were significantly enriched in extracellular matrix (ECM)-receptor interaction (P<0.001) and PI3K-Akt signaling pathways (P<0.05), which could provide evidences for reversing paclitaxel resistance. Conclusions The paclitaxel-resistant gastric cancer cells HGC-27/PTX was established with stable culture in vitro, which provided an ideal model for future study on the mechanism of drug resistance.
    Characteristics and risk factors of lethal peritoneal dialysis related peritonitis
    2017, 37(8):  1152-1156. 
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    Objective To analyze the characteristics of lethal peritoneal dialysis related peritonitis and to define the risk factors. Methods All patients who developed PD related peritonitis between Jan. 1999 and May 2015 in PUMCH were included.Clinical profiles were collected. Patients were divided into mortality group(n=16) and non-mortality group(n=182) according to whether peritonitis causing mortality. Baseline clinical profiles were compared between two groups. Cox regression analysis was used to define the risk factors for mortality. Results White blood cells [(10.2±6.3)×109/L vs (5.8±1.8)×109/L , P<0.05] increased, but serum albumin[(25.2±8.5)g/L vs (34.0±6.3)g/L, P<0.05] and potassium concentration [(3.5±0.9)mmol/L vs (4.5±1.0)mmol/L, P<0.05] decreased at the time of lethal peritonitis compared to the baseline. Organism cultures were positive in half of the patients as bacteria (31.2%), fungus (12.5%)and mycobacterium tuberculosis (6.25%). Multiple cox regression analysis identified cardiovascular disease as the independent risk factor for peritonitis related mortality (HR 9.318,95% CI 1.875-46.305, P<0.01). Conclusions Peritonitis happened on patients with cardiovascular disease may cause mortality.
    Perioperative blood management of patients with Marfan syndrome undergoing scoliosis surgery
    2017, 37(8):  1157-1160. 
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    Objective To investigate the anesthesia and perioperative blood management of patients with Marfan syndrome (MS) undergoing scoliosis surgery. Methods The clinical data of MS patients underwent scoliosis surgery from January 2013 to December 2015 in Peking Union Medical College Hospital were collected and compared with patients received the same surgery but without MS. Perioperative information and data on anesthesia and blood management were analyzed. Results Compared with control group, MS patients were found with more preoperative comorbidities with statistical significance, including eye disease, echocardiographic abnormalities, and ventilatory defects. MS patients had significantly more blood loss, more intraoperative and postoperative allogeneic and autologous blood transfusion. The operation time, anesthesia time, and length of postoperative hospital stay were all significantly longer in MS patients. Conclusions MS patients are common with multi-system involvement and comorbidities. Considering the high risk of perioperative bleeding, the anesthesia and blood management for MS patients undergoing scoliosis surgery should be with extra caution. Blood management should be applied and appropriate invasive monitoring methods should be considered when necessary.
    Diagnosis and treatment of patulous Eustachian tube
    2017, 37(8):  1166-1169. 
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    Based on extensive research of anatomy and physiological function of the Eustachian tube, the authors review the literatures to determine the mechanism of patulous Eustachian tube (PET). The purpose of this review is to summarize the current knowledge on the patulous Eustachian tube, present the current diagnostic protocols for PET and determine the comparative efficacy of variable treatments for this condition. In addition, development prospects are summarized in this article.
    Origin and characteristics of c-kit+ cells and their differentiation towards cardiovascular cells
    2017, 37(8):  1170-1174. 
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    c-kit+ cells are mainly derived from bone marrow and cardiac tissue. The cells include various subpopulations. Recent studies have shown that c-kit+ cells are a kind of ideal cells of transplantation therapy for myocardial infarction. However, there is a great debate on the differentiation efficiency of c-kit+ cells towards cardiomyocytes and endothelial cells. Therefore, it is necessary to evaluate the potential of c-kit+ cell differentiation and explore the effects of different developmental stages and microenvironments on differentiation of c-kit+ cells again. These studies could be significant for increasing efficiency of c-kit+ cell transplantation in repairing the infarcted myocardium.
    Factors influencing conditioned pain modulation and chronic pain
    2017, 37(8):  1175-1178. 
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    As a new laboratory test for evaluation of endogenous pain inhibition, conditioned pain modulation (CPM) deficiency means dysfunction of endogenous pain inhibitory systems and higher incidence of chronic pain. Age, psychological factors and physical activity all seem to influence the individual CPM effect. A standard CPM testing way has an important role in comparison between different researches.
    Progress of research on parathyroid hormone-related protein on bone metabolism
    2017, 37(8):  1179-1183. 
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    PTH-related protein (PTHrP) is an abundant factor in bone which shows paracrine, endocrine, autocrine functions combined with PTHrP receptor and plays an important role on bone metabolism. Rencent years have witnessed that PTHrP plays a significant therapeutic effect on osteoporosis and exhibits some new functions.
    Research progress on the mechanism of microRNA in papillary thyroid carcinoma
    2017, 37(8):  1184-1189. 
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    microRNAs (miRNAs) are a class of small non-coding, single-stranded RNAs, which regulate gene expression by binding messenger RNA (mRNA). Thyroid cancer is the most common endocrine cancer. Papillary thyroid carcinoma (PTC) is a common type of thyroid cancer, and its incidence has increased dramatically worldwide. Recent evidence suggests that miRNAs play an important role in thyroid carcinogenesis, development and prognosis, especially in PTC.
    Exosomes are the pioneer of tumor in surviral advantage
    2017, 37(8):  1190-1194. 
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    Exosomes are secreted by living cells, which have the lipid bilayer and a large number of inclusions. We have found that exosomes derived from tumor cells play a crucial role in the development of tumor. Tumor-derived exosomes not only act as the messenger between tumor cells, but also perform as a carrier that affects the normal cells far away. Moreover, it has been reported to play positive role in the proliferation, differentiation, metastasis and immune resistance of tumor cells.
    Analysis of the application effect of micro classroom in the experimental teaching of diagnostics
    2017, 37(8):  1195-1198. 
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    Objective Analysis of the teaching effect of the micro-classroom in the experimental teaching of diagnostics. Methods In the 50 classes of undergraduate clinical specialty of 2014 level of guangdong medical mniversity, 2 classes were selected as the control group (n = 67) by random number table method, and 2 classes were selected as the experience group (n=65) in the same way. The results of theoretical knowledge and clinical skills were calculated. Two groups of students on the recognition of two kinds of teaching methods were evaluated. The data of two groups were compared using t-test and chi-square test. Results The results of the theoretical knowledge and clinical skills of the experimental group were significantly higher than the control group (P< 0.05). There was a significant difference between the two groups (P< 0.05), which was found to be able to deepen the understanding of theoretical knowledge, to improve the ability of clinical skills operation, to cultivate clinical thinking and to mobilize the enthusiasm of independent learning. Conclusions Micro classroom teaching can significantly improve the quality of experimental teaching of diagnostics.
    Application of clinical skills training specification in gynecologic oncology teaching
    2017, 37(8):  1199-1201. 
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    Clinical skills training is a key factor for improvement of the quality of clinical teaching. Developing highly purposed clinical skills training specification is an important step to enhance the quality of gynecologic oncology clinical teaching. Based on its importance, a‘four steps" training strategy, "known groups - building specification - train of thought - make a request" is developed and used by Dept.of Obsterics and Gynecology,the 3rd Affiliated Hospital, Kunming Medical University. It guides students to achieve "the basic theory, basic knowledge and basic skills" through a comprehensive way, and it also encourage students with highly learning initiative of gynecologic oncology clinical skills. On the other side, in the clinical skills training will lead teachers to develop their thinking and enhance the enthusiasm of teaching. This method provides a new sight for gynecologic oncology clinical skills training in a new manner.
    Status and training of preoperative anesthetist visit in anesthesia residents
    2017, 37(8):  1202-1205. 
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    Objective To investigate the resident performance on preoperative anesthetist visit in Beijing hospitals, thereby providing introduction for further training. Methods A self-designed questionnaire was distributed to the anesthesia residents who were receiving anesthesia residency training in Beijing through WeChat. The questionnaire covers geographic data of the residents, information on preoperative visit and existing training program. Results 160 questionnaires were reclaimed. History-taking and physical examination were not comprehensive in many residents, the nature of surgery was not evaluated by most residents. And the ability of risk assessment and risk informing were not competent in many residents. The most desired training methods for preoperative visit were scenario simulation and bedside observation. Conclusions Scenario simulation with standard patient may have a promising prospect in preoperative anesthetist visit training.
    The role of teaching feedback in improving the quality of eight-year program clinical medical students’ surgery courses
    2017, 37(8):  1206-1210. 
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    Feedback for teaching refers to the mutual transmission and interaction of various information between teaching and learning in teaching process, and is the inevitable result and objective existence of teaching in which teachers and students participate. Effective feedback for teaching is characterized by timely, comprehensive and authentic. Teachers can continuously modify teaching behavior through the feedback of students; the feedback of teaching by students is reflected in examination performance, which really reflects the idea that teaching benefits teachers as well as students. Clinical comprehensive course of eight-year program medical students is an important bridge between basic medicine and clinical medicine, and the foundation of teaching clinical medicine. Feedback for teaching was applied in students of academic year 2011 from the Department of Surgery of Clinical College in Beijing Union Medical College, and teaching approach was adjusted in time, contributing to good teaching effectiveness.