Table of Content

    05 November 2019, Volume 39 Issue 11
    Axon abnormality in APPswe/PS1dE9 double-transgenic mice and its correlation with the Alzheimer’s disease
    Lai WEI Yan Zhang
    2019, 39(11):  1525-1529. 
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    Objective To study the axon abnormalities and possible underlying mechanisms on APPswe/PS1dE9 double-transgenic mice, as the model of Alzheimer’s disease (AD). Methods Taking advantage of RT-qPCR, the expression levels of netrin (netrin-1 and netrin-3) and DCC (DCC1 and DCC2) are determined in wild type mice and APPswe/PS1dE9 double-transgenic mice separately, while the changes of axon length in hippocampus neurons are calculated using immunocytofluorescence. Results Compared with wild type mice, the expression levels of netrin-1 (P<0.001), DCC1 and DCC2 (P<0.01) are all up regulated in APPswe/PS1dE9 double-transgenic mice. At the same time, the double transgenic mice show decrease in axon length in hippocampus neurons. Conclusions Abnormalities in axon are found in connection with AD, and interactions in netrin-1 and DCC can be responsible for this relationship.
    Protective effect of BDNF intervention in MSCs-derived exosomes against PC12 cells injury by H2O2 oxidative stress
    2019, 39(11):  1530-1536. 
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    【ABSTRACT】: Objective: To explore the protective effect of Marrow Stem Cells (MSCs) derived exosomes on PC12 injured by hydrogen peroxide in rats after intervention by BDNF. Methods: Rat MSCs were extracted by whole bone marrow adherent culture methods. The supernatant of cells was collected by adding BDNF into part of the medium for P3 generation and supernatant was also collected without BDNF intervention. Exosomes were isolated and purified by ultracentrifugation, and their morphology was observed and identified under transmission electron microscopy. Western blotting was used to verified the surface marker proteins CD9 and CD63. PC12 cells were divided into control group, simple injured group, MSCs exosome group, BDNF-MSCs exosome group. PBS was added to the medium of the first two groups, and corresponding exosomes (exosome protein concentration 50 microns /ml) were added to the latter two groups to pretreat them for 12h, and the last 3 groups were established cell damage models of oxidative stress by H2O2 on PC12. 10h later cell viability was detected by CCK8 method, ROS activity and SOD value were detected by kit, and Bcl-2 and Bax protein expression were detected by Western Blotting. Result: CD90 expression on the cell surface of P3 generation MSCs was positive. Exosomes were successfully extracted , a large number of irregular spheres or saucer-shaped vesicles with diameters of 40-100 nm were observed under transmission electron microscopy. The membranes were clear and relatively complete, and CD9 and CD63 proteins were positively expressed by Western Blot. Compared with simple injured group and MSCs exosome group, BDNF-MSCs exosome group had the highest cell viability, the highest SOD activity, the lowest ROS and the highest bcl-2 /Bax value. Conclusion: The protective effect of MSCs-derived exosomes after intervention by BDNF on oxidative stress injury induced by H2O2 on PC12 was better than that of MSCs-derived exosomes.
    HPV16E7 is up-regulated in cervical cancer tissues and promotes the proliferation of cervical cancer cell lines HeLa and C33A
    2019, 39(11):  1537-1542. 
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    Objective To investigate the expression level of HPV16E7 in cervical cancer and its’ mechanism in HeLa and C33A cell lines. Methods RT-qPCR and Immuohistochemical staining assays were used to detect the expression level of HPV16E7, CEA and CA125 in cervical cancer tissues and analyzed the correlation of HPV16E7 and CEA, CA125. RT-qPCR and ELISA assay were used to detect the expression level of HPV16E7, CEA and CA125 in cervical cancer serum. Western blot, MTT, colony formation, cell cycle and cell apoptosis assay were used to investigate the role of HPV16E7 in C33A (HPV-) and HeLa (HPV+) cells. Results The mRNA and protein levels of HPV16E7, CEA and CA125 in cervical cancer tissues and serum were up-regulated(P<0.05). The correlation of HPV16E7 and CEA, CA125 was positively relevant(P<0.05). HPV16E7 was up-regulated in HeLa cells and no expression in C33A cells. HPV16E7 promoted proliferation, cell cycle progress and inhibited cell apoptosis in HeLa and C33A cells. Conclusions Up-regulated HPV16E7 promotes malignant behavior in cervical cancer, which is positively related to CEA and CA125.
    Soybean isoflavone reduces cerebral ischemia-reperfusion injury in rats
    2019, 39(11):  1543-1547. 
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    Objective To study the molecular mechanism of protective effects of soybean isoflavones (SI) on cerebral ischemia-reperfusion (I/R) injury in rats. Methods Rats were randomly divided into sham operation group (sham), ischemia-reperfusion group (I/R), soybean isoflavones (SI) intervention group(50, 100 and 200 mg/kg) . 2,3,5-triphenylte-trazolium chloride (TTC) staining method was used to detect the cerebral infarction volume. HE staining was used to detect the pathological changes of brain tissues. The activity of superoxide dismutase SOD and the contents of IL-6, TNF-α, cAMP were measured by ELISA. Western blot was used to detect the level of p-ERK1/2. Results The I/R group had obvious infarct foci compared with the sham group (p<0.05), but the cerebral infarct volume significantly decreased after SI intervention(100 and 200 mg/kg) (p<0.05), respectively. In model group, cell gap was widened and nucleus became pyknosis. After the intervention of SI group, the pathological changes of cells were improved. Compared with the sham group, the activity of SOD and the content of cAMP in I/R group were significantly reduced, but after SI intervention (100 and 200 mg/kg), the activity of SOD and the content of cAMP were increased ( p<0.05). Compared with the sham group, the content of IL-6 and TNF-α in I/R group increased, but they were decreased after intervented with SI (100 and 200 mg/kg) ( p<0.05). Compared with the sham group, the expression of p-ERK1/2 in the model group was increased, and the expression of p-ERK1/2 was decreased after SI intervention (100 and 200 mg/kg) (p< 0.01). Conclusion SI can effectively improve oxidative stress and inflammatory response induced by I/R in rats. It is suggested that the protective mechanism of SI on cerebral I/R in rats may be related to the antioxidant and inflammatory reaction of SI.
    Angiotensin II type 1 receptor autoantibodies up-regulate TXNIP and lead to apoptosis of rat islet β cell line
    2019, 39(11):  1548-1555. 
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    Objective Whether Angiotensin II type 1 receptor (Ang II -1R) autoantibody induces islet cell apoptosis by affecting thioredoxin - interacting protein (TXNIP) Methods In cultured rat islet cell line INS-1 cells, and the survival rate of cells was detected using the cell counting kit-8(CCK-8), the results showed 10-6 mol/L of Ang II -1R autoantibody concentration and 24 h were optimal concentration and time point; Under the above conditions, cell apoptosis and the expression of apoptotic protein was respectively detected by flow- cytometry and Western blot; the effect of Ang II -1R autoantibody on the mRNA and protein level of TXNIP was detected by Real-time PCR and Western blot. Results The results showed that Ang II -1R autoantibody decreased the activity of INS-1 cells in dose- and time-dependent manner; the apoptosis of cell was significantly increased in the Ang II -1R autoantibody group, compared with control group. TXNIP mRNA level and protein expression were also increased by Ang II -1R autoantibody treatment. After RNA interference silenced TXNIP expression of INS-1 cells, the expression of TXNIP was down-regulated, and apoptosis was also reduced. After using AT1R antagonist telmisartan (TM), the up-regulation of TXNIP and apoptosis induced by Ang II -1R autoantibody were inhibited. Conclusions Ang II -1R autoantibody can induce apoptosis of islet cells by up-regulating TXNIP expression, which may provide a new target for the prevention and treatment of patients with Ang II -1R autoantibody positive diabetes.
    Effect of isocitrate dehydrogenase 1 on the inflammation in intrahepatic cholangiocarcinoma
    2019, 39(11):  1556-1560. 
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    Objective To investigate the correlation between isocitrate dehydrogenase 1 (IDH1) R132H mutation and the inflammation reaction in intrahepatic cholangiocarcinoma (ICC) and to explore the effect of IDH1 mutation on ICC. Methods The clinicopathological characteristics of 131 ICCs were summarized and Sanger sequencing was used to detect IDH1 (R132) mutation in these cases. The inflammation reaction was analyzed in these samples by HE staining. The Cre-LoxP system was performed to construct IDH1 R132H intestinal tissue-specific mutant mice. The hepatic bile duct in the mutant mice was isolated and determined by HE staining if there is inflammation reaction. The supernatant was collected after the intervention of the mutant IDH1 metabolite 2-hydroxyglutarate (2-HG) on THP-1 macrophage cell line. ELISA assay was used to detect tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in the supernatant, which are markers of M1 and M2 subtypes of macrophage, respectively. Results Sequencing revealed that 15.3% (20/131) tumors had R132H IDH1 mutation. HE staining showed that inflammatory cell infiltration increase in the IDH1 mutant group compared with the IDH1 wild-type group(P<0.01)and there was similar result in IDH1 (R132H) intestinal tissue-specific mutant mice(P<0.05). Dihydroxyglutaric acid (2-HG), the metabolite of the mutant IDH1 (R132H), can induce interleukin10 (IL-10) to increase significantly(P<0.01), which was the marker of M2 subtypes of macrophage. In contrast, there was no obvious difference for TNF-α, which was the marker of M1 subtypes of macrophage. Conclusions The mutation of IDH1 can induce the inflammation reaction in ICC and promote THP-1 polarization toward M2, which may provide a basis for understanding the correlation between IDH1(R132) mutation and ICC and supply a promising therapeutic strategy for ICC patients.
    Pargyline and oxaliplatin synergistically inhibits proliferation of breast cancer cell line MDA-MB-231
    2019, 39(11):  1561-1567. 
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    Objective: To study the effect of combine treatment of LSD1 inhibitor pargyline and oxaliplatin on the proliferation of MDA-MB-231 cells and to evaluate the potential value of oxaliplatin combined with pargyline in the treatment of human triple negative breast cancer. Methods: CCK-8 method was used to analyze the effects of LSD1 inhibitor pargyline alone or combine with oxaliplatin on cell growth. Histone H3K4me2 methylation modification and protein expression of Bcl-2, Bax, cytochrome C, E-cardherin and LSD1 was detected with Western blotting. Apoptosis was analyzed with annexin V/PI double staining. Results: Pargyline could significantly inhibit MDA-MB-231 cells growth in a time and dose dependent manner. 1 mmol/L pargyline dramatically inhibited demethylase activity of LSD1 on histone H3K4me2 in MDA-MB-231 cells, meanwhile protein expression of LSD1 was not disturbed in 1 mmol/L pargyline treated MDA-MB-231 cells. Pargyline combined with oxaliplatin displayed a synergistic inhibitory effect on MDA-MB-231 cells growth. Oxaliplatin alone could induce apoptosis in MDA-MB-231 cells which was identified with increased protein expression of Bax, down-regulated protein expression of Bcl-2 and the translocation of cytochrome C from mitochondria to cytoplasm. Furthermore, 1 mmol/L pargyline alone could not induce apoptosis, but significantly pormoted oxaliplatin-induced MDA-MB-231 cells apoptosis. LSD1 over-expression partially reversed the promoting role of pargylineon oxaliplatin-mediated MDA-MB-231 cells proliferation inhibition. Conclusions: Combination of pargyline and oxaliplatin synergistically inhibits MDA-MB-231 cells proliferation, and pargyline promotes oxaliplatin-induced apoptosis and proliferation by inhibiting LSD1.
    Down-regulating uPAR inhibits migration and invasion of highly invasive human bladder cancer cell line T24
    2019, 39(11):  1568-1573. 
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    Objective To study the effect of urokinase-type plasminogen activator receptor (uPAR) gene expression on the migration and invasion of human bladder cancer cell line T24 in vitro and the possible mechanism. Methods uPAR siRNA, Rictor siRNA, PTEN siRNA and NC siRNA were designed, synthesized and transfected into bladder cancer T24 cells using transient transfection, separately,setting as siuPAR, siRictor, siRictor + siuPAR, siuPAR + siPTEN and NC groups. Expression levels of mRNA and protein were respectively detected by real-time quantitive PCR (RT-qPCR) and Western blot. Cell migration assay and Transwell invasion assay were used to testify the migration and invasion of uPAR-silencing T24 cells. Results uPAR mRNA and protein levels of highly invasive bladder cancer T24 cells showed higher than less aggressive RT4 cells(P < 0.05). After T24 cells were transfected with uPAR siRNA, phosphorylation of serine-473, an mammalian target of rapamycin complex 2 (mTORC2) target, in extracellular regulated protein kinase B (Akt) was significantly downregulated(P < 0.05). On the other hand, silencing uPAR also down-regulated migration and invasion of T24 cells(P < 0.05). Moreover, Akt-S473 was neither phosphorylated by uPAR nor mTORC2 in PTEN-negative T24 cells. Instead, silencing uPAR gene derepressed Akt-S473 phosphorylation(P < 0.05). Conclusions Silencing uPAR down-regulates migration and invasion of bladder cancer cell. The possible mechanism is proposed that uPAR might work as mTORC2 upstream regulator in T24 cells.
    Analysis of clinical and gene mutation characteristics in four patients with short chain acyl-CoA dehydrogenase deficiency
    2019, 39(11):  1574-1577. 
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    Objective To investigate the clinical and gene mutation characteristics of short chain acyl-CoA dehydrogenase deficiency(SCADD) in Qingdao area. Methods The acylcarnitine levels in the blood of 283104 neonates from newborns screening program were measured by tandem mass spectrometry. The suspected SCADD neonates were diagnosed by retrospective analysis of the urine organic acids and short chain acyl-CoA dehydrogenase (ACADS) gene mutation characteristics. Results Four cases of short chain acyl-CoA dehydrogenase deficiency(SCADD)were diagnosed, with an incidence of 0.0014%(1/70776). There was no obvious abnormality in clinical manifestations. The results showed blood butyl carnitine (C4) levels and the ratios of C4 to acetylcarnitine (C2) and propionyl carnitine (C3) increased. Urinary organic acids were analyzed in 4 cases, all of which ethyl malonate acid was increased [8.41~36.34 mg/g creatinine (reference value 0~6.20mg/g creatinine)], two patients were accompanied by increased lactic acid and one subiect with increased pyruvic acid. A total of 7 mutations were detected in the ACADS gene. Four are known mutations, three are not reported mutations, all of them are missense mutations. The 4 patients were all compound heterozygous mutations: c.1031A>G/c.989G>A;c.1186G>A/c.1195C>T;c.1031A>G/c.445A>T;c.1130C>T/ c.1157G>A。Common mutation was c.1031A>G(25%). The ACADS genotype was not significantly correlated with the concentrations of ethyl malonate acid and C4. Dietary guidance was provided to the SCADD patients. No clinical symptoms and normal physical and intellectual development occurred during the follow-up period. Conclusions The diagnosis of SCADD can be confirmed by the screening of neonatal blood mass spectrometry and gene sequencing. Early diagnosis of neonates without clinical symptoms and the prognosis is good.
    Effect of BRAFV600E mutation on expression of VEGF and MMP-9 in papillary thyroid carcinoma
    2019, 39(11):  1578-1582. 
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    Objective To investigate the relationship between BRAFV600E mutation in PTC and the expression of various molecular markers and the clinicopathological characteristics of the tumor. Predict that BRAFV600E mutation is an indicator of poor prognosis. Methods The BRAFV600E mutation was detected by real-time PCR, and the expressions of galectin-3, cyclin D1, VEGF and MMP-9 were detected by immunohistochemistry. Results Of 104 PTC patients, 71 cases (68.3%) were BRAFV600E mutation (+). These cases had significantly larger sizes, higher tumor T stage, were more likely to invade the thyroid epithelium and lymph node metastasis, and the expression of VEGF and MMP-9 was up-regulated(P<0.05). Binary Logist regression analysis showed that ,the cases with BRAFV600E mutation (+) had significantly higher expression of VEGF protein, larger tumor diameter, and higher T stage of the tumor, more likely to invade the thyroid epithelial tissue(P<0.05). Conclusions PTC with BRAFV600E mutation has a higher invasive and metastatic potential.
    Clinical characteristics and gene mutation analysis of a genealogy with Dubin-Johnson syndrome
    2019, 39(11):  1583-1586. 
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    Objective To analyze the clinical features and gene mutations of Dubin-Johnson syndrome(DJS). Methods Clinical features and gene testing results in two children with Dubin-Johnson syndrome were retrospectively analyzed. Results The proband is a 5 years old girl, and his younger sister is 3 years old, both of them had jaundice and direct bilirubin is high,but liver function is normal. Their parents are health. Genetic analysis found the two patients had Compound heterozygosis. One come father ,nonsence mutation of c.3811 C>T(p.Arg1271Stop)in ABCC2 gene, another come from mother, missense mutation of c.4024T>C(P.Ser1342Pro) in ABCC2 gene. ABCC2 mutations cause clinical symptoms by affecting the multidrug resistance-associated protein 2(MRP2). Conclusions ABCC2 is the pathogenic gene of Dubin-Johnson syndrome, and its hereditary types is autosomal -recessive inheritance.
    Icariin inhibits proliferation, migration and invasion of MGC803 cell line by down-regulating metastasis-associated protein 2
    2019, 39(11):  1587-1591. 
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    Objective To investigate the mechanism of icariin inhibiting proliferation, migration and invasion of MGC803 cells by regulating MTA2. Methods Cell viability of MGC803 cells after treatment with multiple concentrations of icariin was detected by MTT assay. Migration, invasion and the protein expression of MMP-2, MMP-9 and MTA2 in MGC803 cells were detected by Transwell and Western blot, respectively. Transfection MTA2 siRNA into MGC803 cells, and detecting cell viability, migration and invasion. Cell viability, migration and invasion of MGC803 cells after transfection of pcDNA-MTA2 combined with icariin were detected by MTT assay and Traswell, respectively. Results Icariin at different concentrations could effectively inhibit viability of MGC803 cells. Migration, invasion and the protein expression levels of MMP-2, MMP-9 and MTA2 of MGC803 cells after treatment with 200μmol/L icariin were decreased. Knockdown MTA2 can inhibit cell viability, migration and invasion. Overexpression of MTA2 partially reverses the inhibitory effect of icariin on the viability, migration and invasion of MGC803 cells. Conclusions Icariin can inhibit proliferation, migration and invasion of gastric cancer by regulating the expression of MTA2, MMP-2 and MMP-9.
    miR-409-3p -targeted oncogene ELF2 inhibits proliferation of non-small cell lung cancer cell line A549
    2019, 39(11):  1592-1596. 
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    Objective The effects of miR-409-3p on the proliferation of non-small-cell lung cancer cell strain A549 were detected. Methods The control group was A549 cells of human non-small cell lung cancer cell line cultured under normal conditions. On the basis of the control group, the experimental group used chemical synthesis miR-409-3p mimetic and Liposome transfection to construct miR-409-3p high-expression lung cancer A549 cell strain; The expression of miR-409-3pmRNA, cell proliferation by MTT, apoptosis and cycle by flow cytometry after 48 H were observed. Results The expression of miR-409-3p mimic increased significantly in A549 cells after transfection, but decreased significantly in the control group. The percentage of total apoptosis was(22.66±4.61) %, which was significantly higher than that of the control group[ (7.78 ±1.95) %, P & lt; 0.05] :: The G0/G1 phase was(40.21±5.37) <UNK>, significantly lower than the control group cells[ (56.09± 5.22) %, P & lt; 0.05] The double fluorescence reporting system showed that the oncogene ELF2 was the target gene of miR-409-3p. After the expression of miR-409-3p mimic, the level of endogenous ELF2 protein expression decreased significantly. Conclusion MiR-409-3p may inhibit the proliferation and promote apoptosis of non-small cell lung cancer cells A549 by regulating the transcription level of ELF2.
    Sevoflurane inhibits proliferation, migration and invasion of human breast cancer cell line MCF-7
    2019, 39(11):  1597-1602. 
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    Objective To study the effects of sevoflurane on proliferation, migration and invasion of human breast cancer cell line MCF-7 and its mechanism. Methods Western blot was used to detect the expression of high migration rate group 1 (HMGB1) in MCF-7 cells; miR-34a group (transfected miR-34a mimics), miR-NC group (transfected miR-NC), sevoflurane treatment + Anti-miR-NC group (transfected anti-miR-NC) and sevoflurane treated + anti-miR-34a group (transfected anti-miR-34a) were transfected into MCF-7 cells by liposome method. qRT-PCR was used to detect the expression of miR-34a in each group; MTT assay was used to detect cell proliferation; transwell assay was used to detect cell migration and invasion; and dual luciferase reporter gene assay was used to detect cellular fluorescence activity. Results Compared with control, the expression of miR-34a was significantly increased in 1.7% of sevoflurane-treated cells (P < 0.05), HMGB1 expression was significantly decreased (P < 0.05), and cell proliferation, migration and invasion were significantly down-regulated. (P <0.05); overexpression of miR-34a inhibited proliferation, migration and invasion of MCF-7 cells. Knockdown of miR-34a reduced the inhibitory effect of sevoflurane on proliferation, migration and invasion of MCF-7 cells. miR-34a significantly reduced the cytofluoroactivity of wild-type HMGB1 and negatively regulated the expression of HMGB1. Conclusion Sevoflurane can inhibit the proliferation, migration and invasion of human breast cancer cell line MCF-7.
    Therapeutic efficacy of triamterene or indomethacin in patients with Gitelman syndrome
    2019, 39(11):  1603-1606. 
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    Objective To analyze the efficacy of triamterene or indomethacin in patients with Gitelman syndrome (GS). Methods We retrospectively studied the clinical data and therapeutic efficacy of 16 patients diagnosed with GS in Peking Union Medical College Hospital from the year of 2013 to 2019. Eight patients were treated with triamterene, five patients were treated with indomethacin, and three patients were treated with both of them successively. Results Fatigue and flaccid paralysis were the first symptoms in most patients. All patients were characterized by moderate-severe hypokalemia, hypomagnesemia. Most patients had a low urinary calcium excretion, a high plasma renin activity, and metabolic alkalosis. Treatment with triamterene or indomethacin significantly increased serum potassium concentration by (0.35±0.33) mmol/L(P<0.01)and (0.46±0.48) mmol/L(P<0.05),respectively . Four patients became normokalemic with triamterene treatment, and two patients with the treatment of indomethacin. Conclusion Patients with GS usually present with typical clinical manifestations. Triamterene or indomethacin is effective for these patients.
    Application of skin sympathetic reflex, anal sphincter electromyography and blink reflex in the diagnosis of Parkinson's disease
    2019, 39(11):  1607-1611. 
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    Objective To investigate the value of skin sympathetic reflex, anal sphincter electromyography and blink reflex in the diagnosis of Parkinson's disease. Methods Fifty patients with Parkinson's disease were selected from Jinhua Central Hospital, according to the evaluation of neurologic function, the patients were divided into two groups: no autonomic nerve dysfunction (PD-NAS) group(thirty-five cases)and autonomic nervous dysfunction (PD-AS) group (fifteen cases). Another fifty healthy health examiners were selected as the control group. Parkinson's autonomic symptoms were scored in all groups, and skin sympathetic reflex, anal sphincter electromyography and blink reflex were measured at the same time. The correlation between Parkinson's autonomic symptom score and skin sympathetic reflex, blink reflex and anal sphincter electromyograms were analyed. Results The average score of SCOPA-AUT in PD-AS group was significantly higher than that in PD-NAS group (P < 0 05), and it was also significantly higher than that in control group (P < 0 05). The skin sympathetic reflex (SSR) of patients in PD-AS group was prolonged the latency and decreased the amplitude compared with the control group (P<0.05). The mean time and polyphasic percentage of motion unit of anal sphincter during slight contraction(MUAP) in PD-AS group were significantly higher than those in PD-NAS group, the difference was statistically significant (P<0.05). In the PD-AS group, the latency of R2 and R2' waves was longer than that of the PD-NAS group (P<0.05). In PD-AS group, the amplitude of SSR in upper and lower extremities was positively correlated with the latency of SSR in the upper and lower extremities (P<0.05), and the SCOPA-AUT score was positively correlated with the average duration of MUAP and the percentage of multiphase waves (P<0.05). Conclusions Skin sympathetic reflex, blink reflex and anal sphincter EMG can reflect the severity of autonomic dysfunction in patients with Parkinson's disease and provide a basis for early diagnosis of Parkinson's disease.
    Application of Tibetan version of Minnesota Living with Heart Failure Questionnaire (MLHFQ) for heart failure patients
    2019, 39(11):  1612-1617. 
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    Objective To develop an Tibetan version of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and and validate it for the patients with congestive heart failure(CHF). Methods The English version of MLHFQ was translated into Tibetan . It consisted of the following processes: forward translation → the first conference→ backward translation → the second and the third conferences → pilot test → final version. A prospective study, which involved 80 patients with chronic heart failure on the first day of hospitalization, was conducted in the People's Hospital of the Tibet Autonomous Region. All patients in the control group and CHF patients included in the reliability study were retested approximately 7 days after the initial administration of the Tibetan version of MLHFQ. Content validity was evaluated by Content Validity Index (CVI). Internal consistency and repeatability were evaluated by Cronbach's ɑ and Intra-Class Correlation Coefficient (ICC). To assess the applicability of the data in factor analysis, Kaiser-Meyer-Olkin (KMO) sampling sufficiency measurements and Bartlett spherical tests were tested. If applicable, the structural validity of the Tibetan version of MLHFQ was evaluated by exploratory factor analysis. Results All the questions in the Tibetan version of the questionnaire had a good cultural relevance. In order to adapt to the Tibetan expression, question 8 and 11 had been revised.The effective rate of the questionnaire was 100% (160/160). The content validity index of the expert group evaluation was 0.96. All items in the questionnaire were Cronbach'sα> 0.70, ICC are all >0.6 calibration items - total correlation coefficient was 0.204-0.774. Kaiser-Meyer-Olkin (KMO) sampling adequacy measurement = 0.80 indicated that the sample size in this study is sufficient. Bartlett's sphericity test result (χ2=1124.8, p <0.001) indicated the display data was suitable for factor analysis, and the factor analysis results suggested that the Tibetan version of MLHFQ has a structural validity consistent with the original English scale.Conclusion: The Tibetan version of the MLHFQ had good validity and reliability to evaluate the quality of life of Tibetan patients with chronic heart failure.
    Factors affecting quality of life after radiotherapy in patients with cervical cancer
    2019, 39(11):  1618-1622. 
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    Objective To investigate the quality of life and its influencing factors incervical cancer patients undergoing radiotherapy. Methods This study included 205 patients with cervical cancer diagnosed and treated by Peking Union Medical College Hospital from December 2013 to December 2018. The Clinical Assessment of Cancer Therapy-Cervix V4.0 (FACT-Cx V4) was used to assess the quality of life of patients, and collect demographic data including age, education, marital status, family status, occupation, etc.; treatment data including clinical stage, treatment, etc., using Mann-Whitney U test and Kruskal -Wallis test and other statistical methods to analyze the impact of various factors on the quality of life of patients with cervical cancer. Results The total quality of life of patients with cervical cancer who were included in the study was 109(93,123), including 18(15,21) for physical status, 20(17,23) for social/family status,18(16,20)for emotional status, 16(11,21) for functional status, 37(32,42) for additional attention.Age (p<0.05), end of radiotherapy (p<0.01), family status (p<0.01) and marital status (p<0.01) were factors influencing the quality of life of patients with cervical cancer undergoing radiotherapy. Conclusions The quality of life of patients with cervical cancer undergoing radiotherapy is affected by many factors. The complications related to radiotherapy should be actively treated, and the education and rehabilitation guidance should be strengthened to improve the quality of life of patients.
    Correlation of perceived stress and coping with depression in patients with inflammatory bowel disease
    2019, 39(11):  1623-1626. 
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    Objective To investigate the correlaton between perceived stress and coping style and depression in patients with inflammatory bowel disease (IBD). Methods A total of 173 subjects were investigated by the Chinese version (PSS-C), the self-rating anxiety scale (SAS) and the simple coping style questionnaire (SCSQ). Data was collected between July 2018 to December 2018 in digestive department of Peking Union Medical College Hospital. Results The total score of perceived stress was (25.23 ± 6.01) ; The average score of positive coping style was (1.79 ± 0.62) ,negative coping style was (1.24 ± 0.56); the level of depression was (53.43 ± 9.64) . There was a correlation between the score of perceived stress and the positive coping style (r=0.253, P<0.01) and depressive symptoms of patients (r=0.323, P<0.01). Conclusion Medical staff should give attention to the management of emotion and stress among IBD patients. Effective measures should be developed to promote them take more positive coping styles in face of disease and improve their quality of life.
    Buprenorphine transdermal patch reduces perioperative opiate consump-tion in thoracoscopic surgery
    2019, 39(11):  1627-1630. 
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    Objective To observe the clinical effect and safety of buprenorphine transdermal patch for analgesia after thoracoscopic surgery. Methods 100 patients with stage I lung cancer undergoing thoracoscopic surgery were randomly divided into observation group (51 cases) and control group (49 cases). The observation group was treated with buprenorphine transdermal patch for postoperative analgesia, while the control group was treated with oxycodone paracetamol for postoperative analgesia. Both groups were treated with parecoxib sodium for combined analgesia. The postoperative pain, satisfaction with analgesia and the occurrence of adverse reactions were observed in both groups. Results Within 3 days after operation, the degree of resting pain and motor pain in observation group was lower than that in control group (P < 0.001), the amount of morphine converted in observation group was much lower than that in control group (P< 0.001), and the satisfaction of patients in observation group was higher than that in control group (P < 0.001). The overall incidence of adverse reactions in the control group was higher than that in the observation group (P< 0.001). Conclusions Buprenorphine transdermal patch has good analgesic effect after thoracoscopic surgery and can reduce the amount of opioids used in perioperative period.
    Correlation between the pathway of ferroptosis and Huntington's disease
    2019, 39(11):  1634-1638. 
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    It is found in recent years that ferroptosis is a kind of regulatory cell death induced by iron dependent lipid peroxidation and reactive oxygen species (ROS) . It is involved in many clinical diseases such as tumor, nervous system illness and ischemia-reperfusion injury. Huntington's disease (HD) is an important neurodegenerative disorder. This article Huntington's disease. This article describes the definition and characteristics of ferroptosis and its different pathways. At the same time, since ferroptosis is involved in the development of HD, it also focuses on the HD treatment for ferroptosis .
    Advances in research on the relationship between VCAM-1 and VLA-4 interactions and tumors
    ruofei ruofeiFeng
    2019, 39(11):  1639-1643. 
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    The late antigen 4(VLA-4) and the vascular cell adhesion molecule 1(VCAM-1) are ligands to each other, and the late antigen 4 can specifically bind to the first domain or the fourth domain of the vascular cell adhesion molecule1,and six linear amino acid sequences found in domain 1 and domain 4 of vascular cell adhesion molecules, and this sequence plays a crucial role in the specific binding of the two.Advanced antigen-4 and vascular cell adhesion molecule-1 are highly expressed in many diseases and are inextricably linked to the pathogenesis of many diseases.
    Research progress of tumor-associated macrophages in development and treatment of gastric cancer
    Ying-Jing ZHANG Jian-chun -YU
    2019, 39(11):  1644-1648. 
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    Gastric cancer is one of the malignant tumors with highest morbidity and mortality in the world. With the development of treatments, the survival of patients has been significantly improved. Tumor-associated macrophages (TAMs) are the important part of the tumor microenvironment, which involved in the regulation of gastric cancer cell growth, invasion, immune escape and chemotherapy resistance. In addition, TAMs have shown great potential in evaluating prognosis and targeted therapy for gastric cancer.
    Application of smart teaching based on "rain classroom" in teaching of human anatomy
    2019, 39(11):  1649-1652. 
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    It has taken place great changes for the traditional teaching mode because of smart teaching based on "rain classroom" into the classroom. Human anatomy is an important basic medical course, and the traditional teaching is faced with dilemmas such as boring, low learning enthusiasm and poor teaching effect. With the application of "rain classroom" in human anatomy teaching, it can fully mobilize students' learning enthusiasm and initiative through pushing the learning objectives and other preview contents before class; it also can significantly increase the interaction between teaching and learning, create active the classroom atmosphere, and improve the rate of students raising their heads in class; it helps students to consolidate the knowledge in time as well by sending the review content and exercises after class. Smart teaching based on "rain classroom" can obviously improve the teaching quality of human anatomy through the evaluation of teaching effect.
    Subjects distribution and trends of postgraduate clinical medical education in China
    2019, 39(11):  1653-1657. 
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    Objective It is aimed to find out the research subjects characteristics and trends of postgraduate clinical medical education, in order to provide references for education practice and management. Methods Based on WanFang Database, related articles were retrieved. The quantity, distribution and evolvement trends of different research subjects were analyzed by bibliometrics. Results There were 41 topics from 8 sub-fields in the research field of postgraduate clinical medical education. The number of research literature has increased significantly, especially after 2012. Conclusions The research on postgraduate clinical medical education has been developing rapidly in China. And postgraduate cultivation is a hot research subject, which could be guided for educational studies.
    Application of problem-based clinical research training mode in gastroenterology ward
    Wen YOU Shuang LIU Gechong Ruan Ji Li
    2019, 39(11):  1658-1661. 
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    Objective To investigate the practical effect of applying problem-based learning (PBL) teaching pattern to the clinical research training in gastroenterology ward at Peking Union Medical College (PUMC) and look into problems existing in current research training, so as to explore more efficient scientific research training models. Methods A questionnaire-based research was conducted among 19 medical students who participated in the clinical research training in gastroenterology ward. The difference between pre-training and post-training were analyzed. Results This training has increased the number of students involved in research by six. Compared with pre-training, students are more interested in research training and think it is less difficult. 57.89% of the students hope to improve their paper writing ability through research training, and 36.84% hope to improve their ability in experimental design. The trainees believe that this training is of great help to the improvement of the two abilities. In terms of output, 23 papers have been officially accepted or published in the course of this training, including 2 SCI papers and 20 domestic core journal papers. Conclusions Through this training, students have improved their scientific output and scientific research ability, but there are still problems in effect evaluation and further implementation. Faced with the increasing requirement on students' scientific research ability, it is necessary to further explore a more efficient and practical teaching mode.
    Evaluation of situational simulation teaching on standardized training of first aid skills for resident
    2019, 39(11):  1662-1665. 
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    Objective: To asess the effect of situational simulation teaching on first-aid skills training for residents in standardized training. Methods: A total of 90 resident participants were randomly divided into two groups .Situational simulation teaching group have 45 residents,while the other 45 residents as traditional teaching. The first-aid skills cardiopulmonary resuscitation (CPR) and defibrillation training were conducted according to the 2015 American Cardiopulmonary Resuscitation Guidelines. Score and evaluation between two groups are compared at the completion of the teaching and after 3 months. Results: At the end of the first-aid skills teaching, the scores of situational simulation teaching group(91±3) was higher than traditional teaching group (80±6). After 3 months, compared with the traditional teaching group (84 ± 3),the scores of situational simulation group (93±4) was higher too, the difference between the two groups was significant (P <0.05). Conclusions: situational simulation teaching was effective in first-aid skills of resident standardized training,and the short-term and long-term teaching effects are better than traditional teaching.
    Concerns in hospital website construction
    2019, 39(11):  1666-1668. 
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    With the development of the mobile internet and the wide application of the new media technology, the development of the hospital official network construction is challenging. The multi-dimensional new media layout of the official network, the APP and the WeChat public number is widely used in the domestic large public stand hospital, thus the research on the development of the single-angle development by the construction of the hospital official network is not suitable. What is badly needed is the comprehensively evaluation of the development trend and the characteristics of the new media to solve the problem of directionality of the construction of a hospital official network. This paper analyses the confusions and proposed solutions in the construction process by taking the construction of the official network of Peking Union Medical College Hospital (PUMCH) as an example, and provides a reference for designing the framework of a hospital official network and optimizing the function of a hospital website.