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Table of Content

    05 September 2021, Volume 41 Issue 9
    Original Articles
    Reduction of carotid perfusion promotes inflammation of vascular endothelial cells in rabbits
    SHENG Yan, LI Xiu-mao, GUO Xin, XIE Qian, HUANG Ren-jie, SHENG Xin
    2021, 41(9):  1247-1252. 
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    Objective To study how does reduction of blood flow perfusion regulates cytoskeleton rearrangement and its relationship with inflammation during atherosclerosis (AS). Methods The carotid artery stenosis model was established by carotid cannula in New Zealand rabbits. The normal animals were set as control group, and animals in high-fat diet were set as high-fat group. The localization and expression of vascular inflammation-related proteins MCP-1, planar cell polarity signaling pathway-related proteins DVL2 and VANGL2, and cytoskeletal proteins BBS8 and γ-tubulin were determined by immunohistochemistry staining,qPCR and Western blot. Results The cannula group and high-fat group but not control group showed intimal hyperplasia.The localizations of DVL2 and VANGL2 were found mainly at the endovascular hyperplasia in the cannula group, while the positive localizations of them were hardly found in the other two groups. Moreover, the expressions of the seproteins have been significantly up-regulated in the cannula group as compared to that in the control or high-fat group. Conclusions Reduction of blood flow perfusion is involved in the early inflammation of AS by increasing expression of MCP-1, and regulates the BBS8 and γ-tubulin during the rearrangement of microtubule cytoskeleton.
    PTTG and p21 as prognostic biomarker in radiotherapy for non-functional pituitary adenomas
    LI Yang-fang, HU Hui-min
    2021, 41(9):  1253-1259. 
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    Objective To evaluate the predictive value of pituitary tumor transforming gene (PTTG) and cycle-dependent kinase inhibitor 1A (p21) in the prognosis of pituitary adenomas underwent radiotherapy. Methods A total of 89 postoperative patients with non-functional pituitary adenomas(NFPAs) treated by gamma knife radiosurgery (GKRS) from 2003 to 2013 were collected.The cases were divided into research and validation cohorts based on the radiosurgery operation time. According to the follow-up MRI, a decrease of tumor more than 20% was defined as radiosensitive; Expression of sixteen protein markers in pituitary adenomas was determined using a tissue microarray. Results Univariate analysis revealed that nucleus positive PTTG(HR:1.355; P<0.05 or HR:1.637; P<0.01) and cytoplasm high expression of p21(HR:1.174; P<0.01 or HR:1.378; P<0.01) were significantly correlated with radiation resistance in both research and validation group. In the research group, Kaplan Meyer (KM) curve analysis showed patients with nucleus negative PTTG (P<0.01) and cytoplasm low expression of p21(P<0.01) had a higher radiosensitivity, the same results were obtained in the validation group(PTTG,P<0.05; p21,P<0.01). Conclusions Patients with nucleus positive PTTG and cytoplasm high expression of p21 tend to be resistant to radiotherapy in pituitary adenomas; PTTG and p21 are prognostic protein markers associated with radiation resistance.
    Probiotics improve lipid metabolism of obese mice induced by high-fat and high-sucrose diet
    HUANG Ting, LI Zhen-zhen, BAI Yang, LIU Hui-shuang
    2021, 41(9):  1260-1265. 
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    Objective To study the effect of probiotics on lipid metabolism disorder in obese mice induced by high-fat and high-sucrose diet. Methods C57BL/6J mice were randomly divided into control group, model group (high-fat and high-sucrose feed), probiotics group (2×109 CFU probiotics), inhibitor group (AMPK inhibitor dorsomerphin, 10 mg/kg) and probiotics+inhibitor group, with 10 mice in each group.Hematoxylin-eosin (HE) staining was used to observe the pathological changes of liver tissue; Oil Red O staining was used to observe the accumulation of fat in liver tissue; Western blot was used to detect the expression of pathway proteins. Results Compared with control group, in model animals, lipid vacuoles were found in liver tissue, the nuclear staining was deepened, a large amount of fat accumulation and autophagy bodies were reduced, lipid metabolism indexes (TC, TAG,LDL) were raised. Expression of lipid metabolism protein SREBP-1c and mTOR phosphorylation were all increased(P<0.05); Lipid metabolism indexes HDL, expression of autophagy related protein LC3 and Beclin1 and AMPK phosphorylation of model group were inhibited(P<0.05). Compared with model group, the lipid vacuoles and fat accumulation in probiotics group were alleviated, and more autophagosomes were observed, TC, TAG, LDL, SREBP-1c expression and mTOR phosphorylation were decreased(P<0.05), expression of HDL, LC3 and Beclin1 and AMPK phosphorylation of probiotics group were higher (P<0.05); The number of lipid vacuoles increased and became larger, the accumulation of fat increased while the autophagy decreased, TC, TAG, LDL, SREBP-1c expression level and mTOR phosphorylation level were higher (P<0.05), expression of HDL, LC3 and Beclin1 protein and AMPK phosphorylation of inhibitor group were inhibited(P<0.05). The inhibitor group was compared with the model group, the probiotic+inhibitor group was compared with the probiotic group, the lipid vacuoles and fat accumulation in the liver tissue were higher, and the autophagy body counting was reduced, expression of TC, TAG, LDL, SREBP-1c and mTOR phosphorylation were higher (P<0.05), expression of HDL, LC3 and Beclin1 protein and AMPK phosphorylation were decreased(P<0.05). Conclusions Probiotics may activate AMPK pathway and then negatively regulate mTOR pathway, promote hepatocyte autophagy and improve lipid metabolism of obese mice induced by high-fat and high-sucrose diet.
    Dihydroartemisinin reduces lung injury in rats with hemorrhagic shock
    YANG Ning, WANG Da-wei, ZHAO Ya-bin, CHANG Dong-ge, HE Ying-ying
    2021, 41(9):  1266-1271. 
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    Objective To study the protective effect of dihydroartemisinin (DHA) on lung injury in rats with hemorrhagic shock (HS). Methods The rats were divided into sham operation group, model group (the left common carotid artery was treated by blood-letting, the blood volume was about 35% of the blood volume, the average arterial pressure dropped to 35~45 mmHg, and the Ringer's solution was resuscitated with twice the blood volume), DHA low- and high-dose groups (6 and 12 mg/kg DHA per day), dexamethasone group (10 mg/kg dexamethasone per day). Intervene was carried out continuously for 7 days. The wet weight/dry weight ratio(W/D) of the lung was measured.ELISA was used to determine the activity of myeloperoxidase (MPO), the level of IL-12, IL-1β and TNF-α in lung tissue. Hydroxylamine method was used to determine the activity of superoxide dismutase (SOD). The thiobarbituric acid colorimetric method was used to determine the malondialdehyde (MDA) level. HE staining was used to observe lung tissue pathology. Western blot was used to detect the relative expression of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), nuclear transcription factor κB (NF-κB) p65, and p-NF-κB p65 protein in lung tissue. Results Compared with the sham operation group, the lung W/D, MDA, IL-12, IL-1β, and TNF-α levels, MPO activity, relative expression of TLR4, MyD88 protein, p-NF-κB p65/NF -κB p65 were all significantly increased in the model group, but SOD activity was significantly decreased(P<0.05). Compared with the model group, lung W/D, lung tissue MDA, IL-12, IL-1β, and TNF-α levels, MPO activity, relative expression of TLR4, MyD88 protein, p-NF-κB p65/NF -κB p65 were significantly reduced in the low-dose and high-dose groups of DHA and the dexamethasone group, of which the SOD activity was significantly enhanced (P<0.05). The model group was infiltrated with a large number of inflammatory cells, the pulmonary interstitial edema was obvious, and the number of alveoli was significantly reduced. The above-mentioned pathological changes improved after intervention in DHA low- and high-dose groups and dexamethasone group. Conclusions DHA reduces pathological changes, edema, oxidative damage and inflammation of lung tissue after HS, inhibits the expression of TLR4, MyD88 and NF-κB phosphorylation, and shows a protective effect on lung injury.
    Involvement of miR-125b in human pancreatic ductal epithelial barrier affected by TRAF6
    WEI Bi-wei, GONG Ya-hui, SU Zhou, YANG Hui-ying, QIN Meng-bin, LIANG Zhi-hai
    2021, 41(9):  1272-1276. 
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    Objective To investigate the effect of tumor necrosis factor receptor-associated factor 6 (TRAF6) on barrier and targeted binding of miR-125b to TRAF6 in human pancreatic ductal epithelial cell line HPDE6C7. Methods TRAF6 expression HPDE6C7 cells were up-regulated by recombinant lentivirus infection. The protein expression of nuclear factor κB(NF-κB) pathway and tight junction were examined by Western blot, the permeability of monolayer HPDE6C7 cells was measured with Transwell cab to evaluate the epithelial barrier function, and the targeted binding of miR-125b to TRAF6 was identified by dual-luciferase reporter assay. Results After up-regulation of TRAF6 expression by HPDE6C7 cells, the protein level of NF-κB p65, TGFβ-activated kinase 1(TAK1) and TAK1-binding 1 (TAB1) was increased, and the protein level of occludin and claudin-1 was decreased(P<0.05), the permeability increased significantly (P<0.05). Dual-luciferase reporter assay confirmed that TRAF6 was the target gene of miR-125b. Conclusions TRAF6 potentially play a role in affecting the pancreatic ductal epithelial barrier by regulating the NF-κB signaling pathway, which may be inhibited by miR-125b targeted binding to TRAF6.
    Circ_0038467 targets at miR-182 for regulating S. pneumoniae (Sp)-induced injury of human alveolar epithelial cell line HPAEpiC
    LIU Qing, ZHANG Lei, ZHANG Li-yuan, WANG Shi-feng, ZUO Li-min
    2021, 41(9):  1277-1284. 
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    Objective To investigate the effect of circular RNA 0038467 (circ_0038467) targeting at miR-182 on apoptosis and endoplasmic reticulum stress of alveolar epithelial cell line(HPAEpiC) induced by S. pneumoniae (Sp). Methods HPAEpiC cells were divided into control (NC) group (without any treatment), Sp group (Sp infection), Sp+si-NC group (Sp infection after transfection by si-NC), Sp+si-circ_0038467 group (Sp infection after transfection by si-circ_0038467), Sp+miR-NC group (Sp infection after transfection of miR-NC), and Sp+miR-182 group (Sp infection after transfection of miR-182 mimics), Sp+si-circ_0038467+anti-miR-NC group (Sp infection after transfection by si-circ_0038467 and anti-miR-NC), Sp+si-circ_0038467+anti-miR-182 group (Sp infection after transfection by si-circ_0038467 and anti-miR-182). The expressions of circ_0038467 and miR-182 were detected by RT-qPCR. Flow cytometry detected cell apoptosis; Western blot analyzed the expression level of B-cell lymphoma (Bcl-2), heavy chain binding protein (BIP), Bcl associated X protein (Bax) and CCAAT enhancer binding protein homologous protein (CHOP), cysteine protease 3 (caspase-3), and cleaved-caspase-3 proteins. The effects of circ_0038467 and miR-182 expression on HPAEpiC cell apoptosis and endoplasmic reticulum stress induced by S. pneumoniae were analyzed. Results The apoptosis rate of HPAEpiC cells, the expression of circ_0038467, Bax, caspase-3, cleaved-caspase-3, BIP and CHOP were significantly increased after Sp infection (P<0.05), whereas the expression of Bcl-2 was significantly decreased(P<0.05). After circ_0038467 inhibition or miR-182 over-expression, the apoptosis rate, expression of circ_0038467, Bax, caspase-3, cleaved-caspase-3, BIP and CHOP were significantly reduced (P<0.05), whereas Bcl-2 expression was significantly increased(P<0.05). miR-182 inhibition can attenuate the effect of circ_0038467 inhibition on Sp induced HPAEpiC apoptosis and endoplasmic reticulum stress (P<0.05). Conclusions Inhibition of circ_0038467 can attenuate Sp induced alveolar epithelial cell apoptosis and endoplasmic reticulum stress, and its mechanism is related to the targeted regulation of miR-182 expression.
    Silencing miR-26a alleviates myocardial ischemia-reperfusion injury in rats
    GONG Dan-dan, SUI Chun-xing, SHI Chen, LI Yue, JIANG Xiao-dong
    2021, 41(9):  1285-1290. 
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    Objective To investigate the effect of miR-26a on myocardial ischemia-reperfusion (I/R) injury in rats. Methods Rats were randomly divided into control group (n=20),I/R group (n=20) and siRNA group(n=20). Seven days before the establishment of I/R model, miR-26a siRNA was injected into tail vein to silence endogenous miR-26a. Ejection fraction (EF%) and shortening fraction (FS%) were measured by echocardiography.The infarct size was measured by TTC.The morphology of cardiomyocytes was detected by HE staining.TUNEL assay was used to detect the level of cardiomyocyte apoptosis.Western blot was used to detect the expression of Bcl-2 related X protein (Bax), caspase-3 and Rho/RhoA signaling pathway related proteins. Results The expression of miR-26a in I/R group was significantly higher than that in control group (P<0.05).The EF% and FS% of siRNA group were significantly improved (P<0.05).In siRNA group, the severity of myocardial infarction caused by I/R was significantly reduced, and the percentage of myocardial infarction area was increased from 43.08%±2.43% to 21.54%±1.82% (P<0.05).In siRNA group, the myofilaments were arranged orderly, the degree of myocardial necrosis was low, and the cell edema was significantly alleviated compared with I/R group.The level of cardiomyocyte apoptosis in siRNA group was significantly lower than that in I/R group (P<0.05),and the expression levels of Bax and caspase-3 were also significantly decreased (P<0.05).Inhibition of miR-26a could significantly reduce the expression of Rho/RhoA signaling pathway protein during I/R (P<0.05). Conclusions miR-26a silencing may inhibit I/R-induced cardiomyocyte apoptosis by reducing expression of Rho/RhoA signaling pathway protein.
    Thalidomide alleviates renal fibrosis of nephrotic syndrome mice
    GAO Hong-yu, ZHANG Guo-ying, LIU Qiu-ju, WANG Ye, ZHANG Li, CHEN Chao
    2021, 41(9):  1291-1296. 
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    Objective To investigate the effects of thalidomide on epidermal growth factor receptor (EGFR)/extracellular signal regulated kinase (ERK) signaling pathway and renal fibrosis of nephrotic syndrome mice. Methods The mice were randomly divided into control group and model group with 15 in each to prepare membranous nephropathy model, thalidomide group was given thalidomide solution 100 mg/kg, leflunomide group was given leflunomide solution 5 mg/kg per day for four weeks. The 24-hour urine protein (24 h-Upro) was measured before, after and 4 weeks after treatment; after 4 weeks of treatment, the biochemical indexes of mice in each group were detected by automatic biochemical analyzer; the levels of serum interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) were detected by ELISA.HE staining, Masson staining and periodic acid Schiff (PAS) staining were used to observe the renal pathological changes in each group; the expression of EGFR,ERK mRNAs and proteins were detected by RT-qPCR and Western blot. Results Compared with the control group, the 24 h-Upro in the model group was significantly increased (P<0.05). After 4 weeks of treatment,the glomerulus volume of the model group was larger, there were vacuolar lesions in the renal tubules, and the epithelial cells of the renal tubules had the deposition of eosinophilic protein, and the 24h-Upro, the contents of TC, TG, BUN and Scr in serum, the expression of IL-6, IL-8 and TNF-α in serum, the mRNA level of EGFR and ERK in renal tissue and the protein expression of p-EGFR/EGFR and p-ERK/ERK were all significantly higher(P<0.05). As compared with those in the model group, the above pathological symptoms in leflunomide group and thalidomide group were significantly reduced, and the 24 h-Upro, the contents of TC, TG, BUN and Scr in serum, the expressions of IL-6, IL-8 and TNF-α in serum, the mRNA level of EGFR and ERK in renal tissue, the protein expressions of p-EGFR/EGFR and p-ERK/ERK were all significantly lower (P<0.05). Conclusions Thalidomide may alleviate renal damage and inhibit renal fibrosis by inhibiting EGFR/ERK signaling pathway.
    miR-141-3p inhibits the migration and invasion of gastric cancer cell line AGS through targeting PDCD1
    HOU Nan, LIU Yuan, GAO Jun, WANG Jing
    2021, 41(9):  1297-1302. 
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    Objective To investigate the role of miR-141-3p on the migration and invasion of gastric cancer(GC) cells, and to reveal underlying molecular mechanism. Methods The expression of miR-141-3p in clinical tissue samples, normal gastric mucosal epithelial cell line(GES-1) and gastric cancer cell line(AGS) was detected by RT-qPCR. miR-141-3p mimic was transfected into AGS cells, and then the migration and invasion of cells were detected by Transwell assay. The luciferase reporter experiment was applied to detect potential biological effects of miR-141-3p by targeting at programmed cell death protein 1 (PDCD1). AGS cells that had over-expressed miR-141-3p were then infected with lentivirus PDCD1, and cell migration and invasion were subsequently detected. Results Compared with adjacent tissues and GES-1 cells, the expression of miR-141-3p in gastric cancer tissues and AGS cells was significantly decreased. Over-expression of miR-141-3p significantly inhibited migration and invasion of AGS cells. miR-141-3p negatively regulated PDCD1 expression by directly binding to the 3′-UTR of PDCD1 mRNA.Over-expression of PDCD1 reversed inhibitory effect of miR-141-3p over-expression on the migration and invasion of GAS cells. Conclusions miR-141-3p inhibits the migration and invasion of GC cells by down-regulating the target gene PDCD1.
    Lactobacillus rhamnoides alleviates liver graft-versus-host disease after transplantation of hematopoietic stem cell through regulating intestinal microbiota
    FANG Ting, LI Xiang, LIU Jie, WANG Hao
    2021, 41(9):  1303-1308. 
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    Objective To investigate the effect and mechanism of Lactobacillus rhamnosus GG strain(LGG) on liver graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Methods Mice were randomly divided into three groups, including control, GVHD (the donor-derived bone marrow and spleen cell suspension were reinfused through the tail vein), and LGG groups (LGG gavage after modeling, 200 μL/mouse, twice a week for 5 weeks). The pathological changes of liver tissues were observed by HE staining, the liver function and the levels of plasma cytokines IL-6, IL-18 and TNF-α were detected by ELISA, and the changes of intestinal microbiota were detected by PCR. Results Compared with mice in the control group, mice in GVHD group showed shorter survival time, obvious liver function damage and pathological changes, increased level of plasma cytokines IL-6, IL-18 and TNF-α (P<0.01) and decreased intestinal microbiota diversity(P<0.05). LGG treatment significantly alleviated the pathological changes induced by GVHD in the liver (P<0.05). Conclusions LGG can reduce the level of inflammatory factors in liver by regulating the intestinal microbiota, thereby alleviate GVHD in mice after HSCT, suggesting that LGG may be useful in the treatment of GVHD.
    Identifying of important sites of the conducting pore of nicotinic acetycholine receptor through two-electrode voltage-clamp
    XUE Fen-qin, LI Hua, LIU Li-na, XU Qing, XUE Bing, WEI Hua
    2021, 41(9):  1309-1312. 
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    Objective To detect the main amino acid sites in the ion-conducting pore of the human α7 nicotinic acetycholine receptor(α7nAChR) by two-electrode voltage-clamp. Methods The amino acids in the transmembrane region M2 of α7 nAChR subunit (from Leu248 to Ala258) were mutated to hydrophilic serine by site-directed mutagenesis. cRNA was synthesized in vitro and injected into Xenopus oocytes. After 1~3 days, the function of wild type α7 nAChR and its mutants were detected by two-electrode voltage-clamp. Results After the hydrophilic mutation on the second transmembrane domain, it was indicated that the mutations of the hydrophobic residues (L248,V252,L255 and L256) to hydrophilic ones significantly decrease the EC50 values of the receptor to agonist acetylcholine. The hydrophilic mutations of these four M2 residues resulted in a dramatic leftward shift of the dose-response curve and decrease desensitization. Moreover, the desensitization rate was positively correlated to the EC50 values in log scale. Conclusions The residues L248, V252, L256 and L255 in the transmembrane M2 of α7 nAChR are the main sites to construct the ion-conducting pore.
    Erastin induces cell apoptosis in human non-small cell lung cancer cell line A549
    JIANG Xue-dong, LI Wen-ya
    2021, 41(9):  1313-1317. 
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    Objective To explore whether erastin induces apoptosis and to investigate the molecular mechanism in A549 cells. Methods A549 cells were treated with erastin at different concentrations, with or without ROS scavenging agent N-acetyl-L-cysteine (NAC) and with or without apoptosis inhibitor (Z-VAD-FMK). Then iron content was measured with Iron Assay Kit, cell injure and apoptosis with CCK-8 and flow cytometry in A549 cells. Results Erastin induced the increase of iron content and followed by the injury of A549 cells. Erastin further induced apoptosis of A549 cells (P<0.05), which was inhibited by apoptosis inhibitor Z-VAD-FMK. Erastin induced an increase in peroxides (ROS) then followed by apoptosis(P<0.05), which was inhibited by the ROS scavenging agent NAC(P<0.05). Conclusions Erastin has an inhibitory effect on NSCLC A549 by inducing intracellular ROS production, which provides evidences for the pathogenesis, diagnosis and treatment of NSCLC.
    Evaluation of inflammation of perirenal adipose tissue in C57BL/6J mice with high-fat diet
    YANG Yong, LI Zi-yu, YANG Wei, LIU Yong
    2021, 41(9):  1318-1322. 
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    Objective To evaluate the inflammation of perirenal adipose tissue induced by high-fat diet in C57BL/6J mice. Methods Mice were randomly divided into normal diet group (control group, n=6) and high-fat diet group (HFD group, n=6). The mRNA expression of TNF-α, CD11c, IL-1β, IL-10, TGF-β1, CD206 in perirenal adipocytes were detected by RT-qPCR. The expressions of F4/80, CD68 and LCA in perirenal adipose tissue and renal parenchyma were detected by immunohistochemistry method. Results Compared with the control group, the mRNA expression by TNF-α and IL-1β in perirenal adipose tissue of mice in HFD group was increased(P<0.05); The expression of F4/80, CD68 and LCA in perirenal fat increased in HFD group(P<0.05). Conclusions High-fat diet induces inflammation in perirenal adipose tissue of C57BL/6J mice.
    Expression, activity measurement and structure prediction of spermatogenic regulator:recombinant human HSF5
    ZHONG Hong-li, XIAO Cheng-liang, SHI Xiang-rui, DAI Yu-jie, LIU Wei, ZHANG Qing-hua
    2021, 41(9):  1323-1328. 
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    Objective To obtain soluble expression of recombinant human heat shock transcription factor 5(rhHSF5) proteins and predict the structure of HSF5 bound to heat shock element. Methods The nucleotide sequence encoding the target gene was subcloned into expression vector pET-22b(+), followed by transformation into Escherichia coli BL21(DE3) strain and expression induction with IPTG. The rhHSF5 was purified using a Ni-NTA affinity column and gel filtration chromatography. A gel shift assay was carried out after the incubation of the purified rhHSF5 and an oligonucleotide containing a heat shock element. Structure prediction was done by means of homology modeling and molecular dynamics simulation. Results Soluble expression of rhHSF5 was achieved with high purity production. The purified rhHSF5 showed good binding activity with the heat shock element. A reasonable protein-DNA binding model was obtained. Conclusions The recombinant human HSF5 is produced in a soluble form with good yield and activity, which lays a solid foundation for mechanistic studies of this novel spermatogenesis regulator in the future.
    Clinical Sciences
    Application of the consciousness index (IoC1) combined with injury sensitive index (IoC2) in cesarean section under general anesthesia
    YUAN Bao-hong, LIU Xiao-nan
    2021, 41(9):  1329-1332. 
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    Objective To investigate the application of the consciousness index 1(IoC1) combined with injury sensitive index 2(IoC2) in cesarean section under general anesthesia. Methods Sixty patients underwent cesarean section under general anesthesia, ASA grade Ⅰ-Ⅱ, aged 18-42. They were randomized into control group (C group); in which depth of anesthesia and intensity of analgesia were evaluated by traditional monitoring, and consciousness index IoC1 combined with injury sensitive index IoC2 group (IoC group) in which IoC1 and IoC2 were used to guide by the depth of sedation and the intensity of analgesia. Mean arterial pressure (MAP) and heart rate (HR) were recorded. The incidence of the HR and MAP fluctuations≥±20% of the baseline, the dosage of propofol, the dosage of remifentanyl and neonatal Apgar score, anesthesia time, wake up time of the two groups were compared. Postoperative pain scores, nausea, vomiting, and intraoperative awareness were compared. Results Compared with the T0 time point, HR and MAP were significantly decreased in two groups at time point T1, HR and MAP in the C group were significantly increased at the time points T2 and T3, and significantly decreased at the end of the operation (T4) (P<0.05). HR and MAP in IoC group increased significantly only at the time point T2. Compared with C group, propofol dosage, remifentanil dosage and the recovery time in the IoC group were significantly reduced, and the incidence of HR and MAP fluctuations beyond 20% of the baseline, postoperative nausea and vomiting were significantly reduced (P< 0.05). Conclusions During the general anesthesia for cesarean section, the IoC1 and IoC2 can reflect the level of consciousness and degree of analgesia well. It can monitor the depth of anesthesia and guide the perioperative anesthesia better, shorten the recovery time of anesthesia, make hemodynamics more stable, reduce postoperative complications, and improve the quality of obstetric anesthesia.
    A congenital generalized lipodystrophy patient complicated with critical central neurological involvement due to BSCL2 mutations
    DING Juan,MA Ming-sheng,QIU Zheng-qing
    2021, 41(9):  1333-1337. 
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    Objective To retrospectively analyze the clinical data of a patient with congenital generalized lipodystrophy (CGL) type 2 caused by BSCL2 mutation. Methods The clinical data of a patient with CGL was analyzed, including clinical features, laboratory data. The next generation sequencing was adopted to inspect gene mutations associated with CGL. Sanger sequencing was used to verify the pathogenic mutations. Treatment and follow-up were given to the patient. Results Patient manifested as lacking of subcutaneous fat,hepatomegaly,acanthosis nigricans,developmental retardation,epilepsy,ataxia and neurodegeneration. The levels of serum liver enzyme, triacylglyceride(TAG) and fasting insulin increased. Multiple types of seizures were detected by electroencephalogram (EEG). Gene sequencing revealed homozygous mutations of BSCL2,c.782dupG inherited from his parents respectively. The patient failed to respond to the treatment with diet control, metformin and lamotrigine, and neurologic function deteriorated gradually. Conclusions CGL2 caused by BSCL2 base repeat mutation may have serious and lethal nervous degeneration in addition to typical lipodystrophy.
    Mini Reviews
    Discussion on development strategy and progress of mesenchymal stem cell products from pharmacy perspective
    LI Xiao-jing,WANG Li,ZHAO Chun-hua,LIU Ren-min,MA Sheng-jun,LI Guang-yao,REN Shao-da
    2021, 41(9):  1338-1341. 
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    The stem cell products has been transforming from research into drug therapy, which will benefit from traditional pharmaceutical ideas. Taking mesenchymal stem cells(MSCs) products as an example, this paper discusses the problems restricting the development of stem cell products from the perspectives of various pharmaceutical disciplines, such as medicinal chemistry, pharmaceutics, pharmaceutical analysis and pharmacokinetics, so as to provide a new strategy and pathway for the development of stem cell products in the future.
    Research progress on molecular mechanism of the interaction between autophagy and apoptosis
    ZHANG Yang, SUN Wan-wan, LU Li-dan, FENG Xiao-ling
    2021, 41(9):  1342-1346. 
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    Autophagy and apoptosis are two different physiological phenomena, however they are closely related in function. This paper introduces the classification and process of autophagy and apoptosis, and discusses the effects of some key regulatory proteins in the formation of autophagosome and the dual role of apoptosis and anti-apoptosis proteins on autophagy and apoptosis, so as to explore the relationship between autophagy and apoptosis, and to provide theoretical basis for further study of autophagy and apoptosis related diseases.
    Research progress on the role of N6-methyladenosine (m6A) RNA modification in reproductive system diseases
    ZHANG Yan, ZHU Meng-wen, LIU Tong, YANG Sheng, LIANG Ge-yu
    2021, 41(9):  1347-1351. 
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    N6-methyladenosine (m6A) RNA modification is a post-transcriptional modification occurring on the 6th N atom of RNA adenine (A), regulating the structure, stability, splicing, output, translation and decay of mRNA, and thus extensively affecting the life processes of various organisms.This paper summarized the role and mechanism of various m6A methylase in the occurrence and development of reproductive system diseases and breast caner, in order to provide new basis for early diagnosis, treatment and improved prognosis of reproductive system diseases and breast caner.
    Research progress on the role of TRIB3 in obesity pathogenesis
    LI Yan,LIU Tao-di,ZHOU Hao-le
    2021, 41(9):  1352-1355. 
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    Tribbles homolog 3(TRIB3,TRB3) is a kind of protein kinase inhibitors involved in a variety of biological processes like apoptosis, stress response, transcription and transcriptional regulation. Obesity is a chronic metabolic disease caused by many factors including lifestyle, endocrine and drug factors. Abnormal expression of TRIB3 in vivo may be involved in the development of obesity, with expansion of adipose tissue and visceral fat leading to metabolic disorders, organ dysfunction, male infertility, various chronic diseases, and increased mortality. Therefore, exploring the mechanism of TRIB3 in obesity may provide new ideas for the diagnosis and treatment of obesity.
    Body donation in China: yesterday, today and tomorrow
    ZHANG Han-lin, WANG Nai-li, ZHANG Di, LIU Run-zhu, CUI Huan,TANG Ke-yun, CAO Cheng-gang, MA Chao
    2021, 41(9):  1356-1359. 
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    Anatomical dissection course relies much on cadavers. Body donation is a main source of cadavers used in anatomical dissection course in China. Since 1970s, body donation programs have been gradually established, supporting the anatomical dissection courses and the training of medical students. This article reviews the development of body donation programs in China and relevant researches from the following five aspects: very early stage, ethics and laws, data collection and questionnaire survey, humanistic care and humanistic education challenges and countermeasures. This article may pave a way for further development of body donation programs in China and for researches in the future.
    Research progress of clinical effects of anti-Ro52/TRIM21 antibody in connective tissue diseases
    YAN Ting-ting, XUE Jing
    2021, 41(9):  1360-1365. 
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    Anti-Ro52 autoantibody, also known as anti-TRIM21 autoantibody, is one of the widespread autoantibodies in connective tissue diseases(CTD). It was first detected in the patients of Sjgren's syndrome(SS), which had long been considered as an unknown component of anti-SS/Ro autoantibodies. With the development of molecular biology technology, antibodies against Ro52 are considered as independent auto-antibodies. However, there is still some uncertainty about the clinical applications. Recent studies have found that various connective tissue diseases can be positive for anti-Ro52 antibodies alone or in combination with other ones, leading to clinical manifestations or prognosis heterogeneity.
    Acromegaly and hypertension
    WANG Shu-chang, ZHU Hui-juan, PAN Hui
    2021, 41(9):  1366-1370. 
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    Acromegaly is usually caused by pituitary adenomas that secrete growth hormone (GH). The disease is prone to be complicated with hypertension and thus aggravates the state of the illness and increase the disease burden. This paper summarized the prevalence, clinical characteristics, pathophysiological mechanism, diagnosis and treatment of hypertension in patients with acromegaly and potential influence of the disease control on acromegaly on hypertension, in order to deepen the understanding of the disease and provide evidence for good prevention and control of hypertension in patients with acromegaly.
    Medical Education
    Evaluation of precision teaching based on APP for online self-learning in joint diagnostic ultrasound
    WANG Ming, ZHAO Chen-yang, WEI Yao, GUI Yang, ZHAO Rui-na, WANG Ruo-jiao, YANG Meng
    2021, 41(9):  1371-1375. 
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    Objective To evaluate the use of online self-learning application(APP) for precision teaching in joint diagnostic ultrasound. Methods Twelve sonographers were divided into three groups(4 in each) based on their experience in ultrasound diagnosis. At first, all of them were approached to the training courses in self-learning APP to study “the joint diagnostic ultrasound scoring system”. After that, they were admitted to “the ultrasound images assessment platform” in-APP to perform the ultrasound score on 140 small joints with inflammatory rheumatic diseases. The overall agreement rate(%) and intraclass correlation coefficients(ICC) values were calculated to analyze the assessment results among the three groups(%/ICC). A questionnaire survey was also administered at the end of the study via the APP to determine the ease of use of self-learning APP. Results A good interobserver agreement was reached among the three groups(65.2%~67.7%/0.49~0.97). In detail, the best interobserver results were found for the detection of Power Doppler Ultrasound(PDUS) synovitis(74.40%~81.70%/0.91~0.94) and tenosynovitis/paratenonitis in all joints(87.50%~93.80%/0.97~0.98). Good ICC values was found for the detection of Grayscale Ultrasound(GSUS) synovitis, but the agreement rate in this region was poor(45.10%~47.80%/0.58~0.74). For the presence or absence of erosions, moderate agreement rate was calculated, however, the ICC values among the three groups were poor(66.70%~77.80%/0.44~0.58). Regarding agreements in the finger joint regions, lower agreement results were found in both of MCP3(61.1%~71.3%) and PIP2/3 joints(57.4%~63.9%), and a variable agreement rates were found for wrist joints (64%~80%). The majority of survey respondents indicated favorable receptivity to the online self-learning APP(75%) including finding it helpful to improve the learning efficiency and interests (91.7%). Furthermore, a more accurate definition about the joint ultrasound score, standardization of image acquisition and adequate dynamic ultrasonography were advised to further improve interobserver agreements. Conclusions The online self-learning APP can be used as an effective tool in joint ultrasound training. A detailed analysis of the assessment results based on the feedback information from the trainees can help to further optimize and improve the teaching process to realize the precision teaching in joint diagnostic ultrasound.
    Innovation examples of electrocardiograph teaching mode in the time of big data
    ZENG Di, CHEN Yan, LI Jun, LI Yan, LIU Xiong-tao
    2021, 41(9):  1376-1378. 
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    The development of a platform of clinical electrocardiograph(ECG) big data and diversified internet teaching resources brings opportunities to explore the innovation of ECG teaching mode supported by big data. By analyzing current problems of traditional ECG teaching, this article puts forward three examples of ECG teaching innovation on ECG big data platform: sequential teaching combined with theory and practical training, heuristic teaching based on ECG vector theory and self-directed learning, and expounds their implementation strategies.
    Methods innovation in courses with ideological-political elements for master postgraduates of basic medicine
    ZHANG Li-xia, JIANG Shu-jun, YANG Jing, PANG Min, ZHAO Guang-tao, LI Ya-na,TIAN Geng, NI Yan-bo
    2021, 41(9):  1379-1382. 
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    This paper reports the organization and implementation of courses with ideological-political elements for postgraduates by means of questionnaires and interviews, and puts forward suggestions on improving the quality and learning outcomes of ideological-political courses, enhancing teachers awareness of courses with ideological-political elements and capacity building, establishing a curriculum reform system for courses with ideological-political elements, and paying attention to the synergistic effect between ideological-political elements and the relevant courses, so as to provide reference for the revision of syllabus,curriculum standard and remodeling of ideological-political courses.
    Application of objective structured clinical examination(OSCE) in the assessment of anesthetic residents
    RUAN Xia, LI Xu, GONG Ya-hong, YU Chun-hua, TAN Gang, HUANG Yu-guang
    2021, 41(9):  1383-1386. 
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    Objective To set up methods of objective structured clinical examination (OSCE) for application in the assessment of clinical competencies of residents trainees in standardized training of anesthesiology. Methods Designed OSCE assessment stations, including writing medical records, training standardized patients, as well as creating forms for assessment scoring. All third-year residents attended the OSCE in 2018 and 2019. At the end of the exams, the residents' performance was evaluated according to the preset score forms. Results Six stations were set up for OSCE, including oral examination, endo-tracheal intubation, spinal anesthesia, deep vein catheterization, cardiopulmonary resuscitation and preoperative interview, the OSCE lasted for 70 minutes. Totally 44 residents took part in OSCE and all passed examination. Compared with the results of oral exam, clinical skills and preoperative interview, the results showed that the score of clinical skills was significantly higher than that of oral exam and preoperative interview (P<0.01), the score of oral exam was significantly lower than that of preoperative interview station (P<0.01). There were moderate positive correlations between oral exam and clinical skill, clinical skill and preoperative interview, and between oral exam and preoperative interview. Conclusions Clinical competence of anesthetic residents can be assessed by OSCE in multiple aspects, which provides an effective examination method for residents training in anesthesiology.
    Evaluation of Scientific Research Competencies of ultrasound residents from different grades or different education backgrounds
    TAO Xi-xi, WANG Ming, WANG Ya-hong, SU Na, LI Jian-chu, YANG Meng
    2021, 41(9):  1387-1391. 
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    Objective This study analyzed the ultrasound residents' Scientific Research Competencies to provide basis for training program for capacity building of scientific research. Methods This study conducted a self-reported questionnaire by the ultrasound resident trainees in Peking Union Medical College Hospital, in order to define their Scientific Research Competencies based on different grades or education backgrounds. Results The result showed that there were differences between the resident trainees from different grades or with different education backgrounds in terms of Research Competencies. The ranking of average scores of the resident trainees from different grades were,from high to low, the third year, the first year and second year (256±48, 231±28, 214±48). And the ranking of average scores of the trainees with different education backgrounds were, from high to low, clinical post-doctoral fellows, graduate students, and standardized training residents (294±18, 236 ±33, 214±42). The results of detailed research capacity, all resident trainees were lack of the capacity of research design and fund application, paper writing, and learning research knowledge by reading. Conclusions It is suggested that hospitals need to provide hierarchical guidance to residents in order to improve their Scientific Research Competencies to meet the requirement of modern medical science.
    Comparison and enlightenment of higher medical education between China and the United States
    ZHAO Jun, ZHANG Rong-hua, PAN Hui, LUO Lin-zhi
    2021, 41(9):  1392-1395. 
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    This paper compared the curriculum system of Harvard Medical School, Ohio State University School of Medicine, Peking Union Medical College and Zhejiang University School of Medicine, analyzed the characteristics of different medical teaching modes and summarized the direction of medical education reformation. The author hopes that through introducing the reform experience of each category, this paper may provide a reference for the reformation of high medical education in China.
    Human anatomy combined with physical examination: a survey on the course reform
    LI Ming-xia, QIAN Jun, LU Xin, MA Chao, WANG Nai-li, ZHANG Di
    2021, 41(9):  1396-1402. 
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    Objective To investigate the attitude of 8-year-program clinical medical students in Peking Union Medical College (PUMC) towards current anatomy course and their perspective on introducing physical examination into anatomy course, and to raise feasible reform strategy. Methods Survey on WeChat platform through wenjuanxing(wjx) questionnaires was performed among 4th, 5th, 6th, 7th, 8th grade students in PUMC. Results 216 qualified questionnaires were collected. 207 (95.8%) and 196 (90.7%) students identified with the importance of anatomy course and agreed to introduce physical examination into anatomy course, respectively. Two major problems were considered existing in current anatomy course, the lack of feasible ways to review in later stage (149, 69.0%) and poor connection between anatomy and clinical courses leading to poor retention of the knowledge (143, 66.2%). 65 (30.1%) preferred online course and 151 (69.9%) preferred traditional offline course to offer the new course. Conclusions Most clinical medical students in different learning stage in PUMC approve to introduce physical examination into anatomy course. Related educational reform of anatomy course is necessary. The new combined course should be offered mainly in traditional offline way, combined with online content.