Table of Content

05 February 2022, Volume 42 Issue 2

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Original Articles

Cognitive frailty increases the risk of falls of elderly in five years

YUAN Jing-lin, MA Ya-jun, LI Xiao-dong, JIANG Xiao-yan, WANG Xiao-feng, LI Shu-juan, ZHOU Xiao-mei

2022, 42(2):  201-207.  doi:10.16352/j.issn.1001-6325.2022.02.001

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Objective To explore whether cognitive frailty increases the risk of falls 5 years later in elderly Chinese population. Methods The data were collected from the Rugao Aging Cohort. Fried frailty phenotype was used to evaluate frailty. Those who met ≥3 of the five criteria were defined as frailty, those who met 1-2 criteria were defined as pre-frailty, and those who did not meet any criteria were considered to be robust. The revised Hasegawa Dementia Scale(HDS-R) was used to evaluate cognitive function. Excluding severe cognitive impairment (HDS-R≤10), the lowest quartile of scores was cognitive impairment. Those with both frailty and cognitive impairment were defined as cognitive frailty. Binary logistic regression was used to analyze frailty and falls risk at 5-year follow-up, and explore the effect of cognitive frailty (frailty plus cognitive function assessment) on falls risk. Results This study included 962 subjects with a mean age of 74.7±3.7 years at baseline, including 526 females. After 5 years of follow-up, 134 people experienced falls in the last year of following up . The incidence of falls was higher in female, illiterate and unmarried subgroups. Logistic regression analysis showed that the frail subjects at baseline were more likely to fall(OR=4.360,95% CI=1.955-9.722), and those with cognitive frailty had a higher risk of fall than those robust without cognitive impairment (OR=6.000,95% CI=1.935-18.603). After adjusting for covariates, the higher five-year falls risk for cognitive frailty remained statistically significant (OR=6.736,95% CI=1.897-23.922, P＜0.05). Conclusions Cognitive frailty is significantly correlated with a higher risk of falls after 5 years. The assessment of cognitive frailty is important for assessing the risk of falls in older adults.

Role of MVBs and IL-1β in the vascular calcification of type 2 diabetic rats

ZHENG Yang, WEI Hai-jun, SHEN Jia-ling, LIU Run-yu, LIU Yong, SUN Xiao-lei

2022, 42(2):  208-214.  doi:10.16352/j.issn.1001-6325.2022.02.003

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Objective To study the role of matrix vesicles bodies (MVBs) and interleukin-1β (IL-1β) in the vascular calcification of type 2 diabetic rats. Methods In vivo and in vitro vascular calcification models were developed by streptozotocin (STZ) plus vitamin D₃ in rats with high-fat diet and β-glycerophosphate and high-glucose medium in vascular smooth muscle cells (VSMCs), respectively. Calcium deposition was detected by PET/CT, Von Kossa staining or alizarin red S staining. The expression of runt-related transcription factor 2 (RUNX 2), annexin-Ⅵ and IL-1β were detected by immunofluorescence staining, real-time quantitative PCR or Western blot. Results The aortic artery of calcified rats and the in vitro VSMCs both showed obvious calcium deposits. Compared to the control group, the expressions of bone morphogenetic protein-2 (BMP-2) and RUNX 2 significantly increased in the calcification group (P＜0.01, P＜0.05). At the same time, the expression of annexin-Ⅵ and IL-1β was also significantly up-regulated (P＜0.01, P＜0.05) and there was a co-localization between them. Rapamycin reduced expression of RUNX-2, annexin-Ⅵ and IL-1β in the calcification group (P＜0.01). After the treatment of chloroquine, the expression of RUNX 2 weas slightly up-regulated and annexin-Ⅵ was high-expressed(P＜0.01). Conclusions Autophagy reduces the release of MVBs and the expression of inflammatory factor IL-1β and so thereby reduces aortic calcification in type 2 diabetic rats.

Identification of differentially expressed genes in cervical carcinoma after radiotherapy

BAI Jing, LIU Na, DING Li, LEI Li, NI Rui, YAN Shao-chun, SHAO Guo

2022, 42(2):  215-220.  doi:10.16352/j.issn.1001-6325.2022.02.002

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Objective To study the effect of radiotherapy on gene expression in cervical cancer tissues and to find the role of differentially expressed genes in sensitivity and resistance to radiotherapy. Methods The patients all received the same radiotherapy as follows: total pelvic external radiation 45 Gy/25 f,intracavitary brachytherapy 5-6 Gy/f with total dosage as 5-6 f.The specimens were collected before treatment and by the end of treatment.High-throughput analysis of gene expression was performed before, during and after irradiation; real-time PCR and Western blot was applied to identify the genes related to radiation sensitivity and tolerance. Results Bioinformatics analysis showed an increased expression of DNA damage genes.The expression of DNA damage related genes GADD45 was increased as found by real-time PCR and Western blot. Conclusions Radiotherapy changes the gene expression in cervical cancer tissues and the increase of GADD45 expression may play an important role in radiotherapy.

Identification of bio-functions of cancer stem-like cells and differentially expressed membrane proteins in side population cells from human epithelial ovarian cancer cell lines

YIN Jie, PAN Ling-ya, WEN Yi-ping, HUANG Hong, ZENG Jing, LI Xiao-ying, HAN Tian-tian, JIN Ying, LI Yan

2022, 42(2):  221-227.  doi:10.16352/j.issn.1001-6325.2022.02.004

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Objective To validate the stemness bio-function of side population (SP) cells from epithelial ovarian cancer cell lines and to detect the differentially expressed cellular membrane proteins in SP cells. Methods SP cells of human ovarian cancer cell lines SKOV3 and A2780 which secreted bisbenzimide Hoechst33342 and located as side population were sorted by flow cytometry. Bio-functions of stemness of SP cells were validated. Through stable isotope labeling by amino acids in cell culture (SILAC), differentially expressed membrane proteins in SP cells were detected. Results SP cells of SKOV3 and A2780 were sorted successfully. The ratio of SP cells was about 0.5% and increased significantly through repeated sorting. SP cells differentiated into non-SP (NSP) cells. Stemness of SP cells was validated in vitro, including cell clone forming, resistance to cisplatin and paclitaxel in NOD/SCID mice. SILAC technique was used to detect differentially expressed membrane proteins in SP cells. Results showed that 1 561 and 1 989 differentially expressed proteins were detected respectively in SKOV3 and A2780 SP cells. Among those significantly up-regulated proteins in SKOV3 SP cells, 12 proteins were also up-regulated in A2780 SP cells. On the contrary, 13 proteins were down-regulated both in SKOV3 and A2780 SP cells. Conclusions SP cells of human epithelial ovarian cancer cells show stemness. And differently expressed membrane proteins in SP cells were detected which would be the base of further screening surface biomarker of ovarian cancer stem-like cells.

RNA binding protein PCBP1 regulates hESC pluripotency through modulating mRNA export

XU Jia-yue, YANG Jia-bin, CHEN Zhong-yang, YU Jia, MA Yan-ni

2022, 42(2):  228-234.  doi:10.16352/j.issn.1001-6325.2022.02.027

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Objective To investigate the biological function of RNA binding protein polycytosine-binding protein 1 (PCBP1) in the maintenance of pluripotency of human embryonic stem cells (hESC) and to explore the new mechanism of regulating hESC pluripotency. Methods PCBP1 knockdown technology was used to detect the clonogenicity. The alkaline phosphatase staining profile and the expression of pluripotency/differentiation marker genes were detected by qPCR. Meanwhile, the nucleus and cytoplasm of hESC were isolated for RNA sequencing, and the nucleoplasmic changes of RNA generated by PCBP1 knockdown were analyzed by multi-level analysis. Results PCBP1 knockdown significantly inhibited clonogenesis of human embryonic stem cells (P＜0.01) and reduced the RNA level of pluripotency related genes (P＜0.01). The expression of differentiation related genes increased(P＜0.01)that significantly affected the overall nucleoplasmic distribution of RNA in hESC and the nucleoplasmic distribution of mRNA related to embryonic development and cell differentiation. Conclusions PCBP1 regulates hESC pluripotency by regulating the expression of pluripotency/differentiation marker genes and the nucleoplasmic localization of mRNA.

Bioinformatic analysis of adenocarcinoma at esophagogastric junction and mutation sites screening of Involucrin gene

LYU Xue, LI Xue-wei, YANG Ting, ZHENG Jin-xiu, ZHU Zi-he, YANG Tao, XU Jun

2022, 42(2):  235-242.  doi:10.16352/j.issn.1001-6325.2022.02.028

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Objective To detect the gene mutations in patients with Adenocarcinoma at esophagogastric junction(AEG) and to analyze the effect of Involucrin (IVL) mutation on the biological function of tumor cells. Methods Whole exome sequencing was performed on cancerous and paired adjacent normal tissues from 22 AEG patients in Shanxi province. IVL was selected for further investigation of mutation sites. Esophagus cancer data from TCGA were divided into three groups based on IVL mutations. Differentially-expressed genes were screened and proceeded via Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Cell proliferation and migration assays were performed to evaluate the effect of over-expression of IVL on KYSE 150 cells. Mutant IVL oligopeptides were synthesized and used to evaluate the binding activity with TGase1. Results Five IVL mutation sites were identified in 22 AEG. GO annotation indicated that these mutations were related to the epithelial differentiation and activity of cell differentiation regulation. KEGG analysis demonstrates that IVL mutations are associated with cAMP signaling pathway. IVL over-expression inhibits the proliferation and migration of esophageal cancer cells(P＜0.05). In addition, Q439H mutant IVL oligopeptides shows lower binding affinity to TGase1 than wild-type oligopeptides. Conclusions The seventh amino acid mutation in IVL repeat motif does weaken IVL binding to TGase1. This mutation may affect tumor-related biological processes and signaling pathways.

Effects of prednisone acetate on renal function, renal inflammation and AMPK/SIRT1 signaling pathway in diabetic nephropathy rats

DENG Jiu-hong, ZHENG Chao, WANG Sheng-yao, WANG Xin-yi

2022, 42(2):  243-248.  doi:10.16352/j.issn.1001-6325.2022.02.006

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Objective To explore the effect of prednisone acetate on renal function, renal inflammatory response and AMP-activated protein kinase (AMPK)/silent information regulator 1 (SIRT1) signaling pathway in diabetic nephropathy (DN) rats. Methods Twelve rats were randomly selected as the control group, and the remaining rats were given high-sugar and high-fat diet supplemented with intraperitoneal injection of streptozotocin (STZ) to construct a DN rat model. The successful model rats were randomly divided into model group, prednisone acetate low (6.25 mg/kg), high (12.5 mg/kg) dose groups, prednisone acetate + CC group (prednisone acetate 12.5 mg/kg+AMPK inhibitor compound C 0.2 mg/kg), with 12 animals in each group. Each group was given corresponding treatment, once a day for 4 weeks. The general state of rats was observed, and the fasting blood glucose (FBG), 24-hour urine microalbumin (U-mAlb), blood creatinine (SCr), blood urea nitrogen (BUN), serum interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected; the pathological changes of renal tissue were observed with hematoxylin eosin (HE) staining and periodate schiff (PAS) staining; The expression of proteins related to the renal tissue AMPK/SIRT1 signaling pathway was detected with Western blot. Results Prednisone acetate can improve the general state of DN rats, reduce FBG, 24 h U-mAlb, serum SCr, BUN, IL-1β, IL-6 and TNF-α levels, and renal tissue acetylation nuclear factor-κB p65 (ac-NF-κB p65)/NF-κB p65 and monocyte chemotactic protein-1 (MCP-1) protein expression (P＜0.05), increase phosphorylated AMPK(p-AMPK)/AMPK and SIRT1 protein expression (P＜0.05), improve kidney disease; compound C could significantly weaken the protective effect of prednisone acetate on DN rats. Conclusions Prednisone acetate can reduce renal inflammatory response and protect renal function in DN rats. Its mechanism may be related to the activation of AMPK/SIRT1 pathway to inhibit the activation of NF-κB.

miR-125 attenuates LPS-induced transition of colorectal epithelial cells into cancer cells through targeting SMAD4

ZENG Di, ZHANG Cong-min, GUO Jin-pei, ZHANG Nan, MA Er-min

2022, 42(2):  249-254.  doi:10.16352/j.issn.1001-6325.2022.02.025

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Objective To investigate potential roles of miR-125 and SMAD4 in lipopolysaccharide (LPS)-induced colorectal epithelial cells transformed to cancer cells. Methods Cell viability of HCoEpiCs cells exposed to LPS for 24 h was evaluated by CCK-8 assay.CyclinD1,c-myc,Bcl-2,miR-125,and SMAD4 were measured by q-PCR in LPS-induced colorectal epithelial cells malignant transformation.Plane cloning and soft agar colony formation assay were used to identify the result of malignant transformation.Synthetic miR-125 mimic and inhibitor were used to mediate the expression of miR-125 in the 40th passage of LPS-induced HCoEpiCs cells.The activity of miR-125 in the region of SMAD4 3′-UTR was detected by the double luciferase gene report. Results Cell viability was signifi- cantly repressed by 10 μg/mL LPS.The expression of miR-125 was increased in the 40^th passage of LPS-induced HCoEpiCs cells,but the level of SMAD4 was down-regulated.The level of SMAD4 and c-myc were decreased when miR-125 was over-expressed in HCoEpiCs cells.Meanwhile,compared to the control group,the activity of SMAD4 3′-UTR-wild was repressed by miR-125 mimic, but no significant change was observed in the 3′-UTR-mut cells. Conclusions LPS-induced colorectal epithelial cells might be inhibited to transform to cancer cells through miR-125 binding to SMAD4.

Interference with ADAM17 inhibits proliferation of human cervical cancer cell line HeLa

ZHANG Chun-li, QI Jie-hua, HUAN Yu, WU Shou-le, CAI Xu-shan

2022, 42(2):  255-259.  doi:10.16352/j.issn.1001-6325.2022.02.005

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Objective To investigate the effect of ADAM17 on proliferation of cervical cancer cells in vitro and its mechanism. Methods The specific shRNA against ADAM17 was transfected into HeLa cells. Western blot and RT-qPCR were used to examine the interference efficiency. The relative rates of proliferation were determined by CCK-8 assay. The migration and invasion were evaluated by scratch test and Transwell test.Western blot was used to detect the protein expression of PCNA, EGFR, p-EGFR, ERK and p-ERK in each group. Results The expression of ADAM17 mRNA and protein were decreased in HeLa cells transfected by sh-ADAM17(P＜0.05).ADAM17 had no effect on migration and invasion of cervical cancer cells,but ADAM17 interference significantly inhibited the proliferation of cervical cancer HeLa cells(P＜0.05). The expression of PCNA, p-EGFR and p-ERK protein was down-regulated(P＜0.05). Conclusions Interfering with ADAM17 can inhibit the proliferation of human cervical cancer cell line HeLa, which may be related to EGFR/ERK signaling pathway.

Down-regulation of lncRNA DNM3OS enhances radiotherapy sensitivity of human rectal cancer cell line SW-480 by targeting miR-193a-3p

LIU Ming-sheng, CHEN Wen-chao, CAI Ying-chang

2022, 42(2):  260-267.  doi:10.16352/j.issn.1001-6325.2022.02.012

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Objective To explore the effect of lncRNA DNM3OS on the proliferation, apoptosis and radio-sensitivity of rectal cancer SW-480 cells and its molecular mechanism. Methods The samples from cancerous tissues and adjacent tissues of 30 rectal cancer patients were selected and the expression of DNM3OS and miR-193a-3p was detected by RT-qPCR; Transfected the inhibited DNM3OS expression vector or over-expression miR-193a-3p vector into SW-480 cells and co-transfect DNM3OS and inhibited miR-193a-3p expression vector into SW-480 cells and then irradiated them with 4 Gy rays; Cell colony formation experiment was applined to detect cell radio-sensitivity; methyl thiazolyl tetrazolium assay (MTT) was used to detect cell proliferation inhibition rate; flow cytometry was used to detect cell apoptosis; The targeted regulation of DNM3OS and miR-193a-3p were examined by dual luciferase reporter gene assay. Results The expression of DNM3OS in rectal cancer tissue was higher than that in adjacent tissues and the expression of miR-193a-3p was lower than that in adjacent tissues (P＜0.05). After inhibiting DNM3OS expression or over-expression of miR-193a-3p, SW-480 cell proliferation inhibition rate and apoptosis rate was increased(P＜0.05); after radiation, cell survival score was decreased and cell proliferation inhibition rate as well as apoptosis rate were increased (P＜0.05). DNM3OS targeted and regulated miR-193a-3p, and interference with miR-193a-3p expression reversed the effect of inhibiting lncRNA DNM3OS expression on the proliferation, apoptosis and radiosensitivity of rectal cancer SW-480 cells. Conclusions Down-regulation of expression of lncRNA DNM3OS can inhibit the proliferation of SW-480 cells by up-regulation of miR-193a-3p, thus to promote cell apoptosis and enhance cell radio-sensitivity.

miR-30b promotes cell apoptosis of diffuse large B-cell lymphoma

XU Qiao-ling, YING Jiang-shan, CUI Ran, ZHANG Ning

2022, 42(2):  268-273.  doi:10.16352/j.issn.1001-6325.2022.02.024

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Objective To study the mechanism of miR-30b by regulating fragile histidine triad gene(FHIT) on cell activity diffuse large B-cell lymphoma(DLBCL). Methods The tumor paraffin specimens of DLBCL patients and the paraffin markers of lymph node hyperplasia at the same time were selected from the Shanghai Minhang District Tumor Hospital (February 2017-June 2019) and divided them into the DLBCL group and the control group. DLBCL cells were divided into the WW group (DLBCL non transfected group), WZ group (DLBCL transfected NC group )and ZR group (DLBCL transfected miR-30b group). RT-qPCR method was used to detect miR-30b expression; Western blot was used to detect FHIT protein expression; colorimetric method was used to detect caspase-3 activity; Flow cytometry was used to detect DLBCL cell apoptosi and Transwell method was applied to detect cell invasion. Results The expression of miR-30b and FHIT in the control group was significantly higher than those in the DLBCL group (P＜0.05); the expression of miR-30b, FHIT and caspase-3 in the ZR group was higher than those in the WW and WZ groups (P＜0.05) The apoptosis rate of ZR group was time-dependently higher than that of WW and WZ groups(P＜0.05); the counting of DLBCL cell invasion in ZR group was significantly less than that of WW and WZ groups (P＜0.05). Conclusions After miR-30b transfection, the apoptosis of diffuse large B-cell lymphoma cells increases and the counting of invasion cells decreases. The mechanism of this result may be related to the enhancement of miR-30b, FHIT, and caspase-3 level.

Effect of dihydromyricetin on regulatory B cells in experimental colitis mice

LI Xiao-li, CHEN Hui-ling, WANG Xiao-chun, HAN Ti-yun, ZHANG De-kui

2022, 42(2):  274-281.  doi:10.16352/j.issn.1001-6325.2022.02.026

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Objective To explore effects of Dihydromyricetin (DHM) on experimental colitis and regulatory B cells(Breg) of mice. Methods The mice were randomly divided into control group, DSS group, DSS⁺DHM group and DSS⁺ mesalazine group (4% DSS for 7 days). After 7 days, the mice were respectively gavaged with water (0.2 mL/d),DHM (40 mg/kg·d) and mesalazine (520 mg/kg·d) for 7 consecutive days and the disease activity index (DAI) was continuously recorded. The animals were sacrificed on the 14th day and the colon length was measured. The colon tissue sections were microscopied with HE staining. CD19⁺B lymphocytes and Breg(CD19⁺CD5⁺CD1d⁺) were determined by flow cytometry in splenic single cell suspension; real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the relative mRNA level of IL-10,TGF-β,IL-6 and IFN-γin spleen cells. The effect of DHM on the proliferation of spleen cells was measured by CCK8. DHM (40 μmol/L) was selected to act on the spleen cell suspension for 24 h. flow cytometry was used to detect the ratio of Breg (CD19⁺CD5⁺CD1d⁺). Results Compared with the normal group, DAI and pathological score of DSS group were significantly higher, and the colon length was significantly decreased(P＜0.05); The proportion of CD19⁺ B cells vs. Breg (CD19⁺CD5⁺CD1d⁺) was significantly decreased, the inflammatory factors were significantly increased, and the anti-inflammatory factors were obviously decreased (P＜0.05). Compared with DSS group, DSS⁺DHM group and DSS⁺Mesalazine group significantly reversed the situation (P＜0.05); It was fond in vitro experiment that DHM significantly promoted the proliferation of spleen cells and Breg (P＜0.05). Conclusions DDHM has obvious therapeutic effect in experimental colitis mice, which may be related to the promotion of Breg proliferation and of secretion of anti-inflammatory factors IL-10 and TGF-β.

Hepatocyte-specific Sirt1 deficiency exacerbates liver inflammation of mice

YANG Jia-hui, ZHAO Wei, XIE Xiang-hong, LI Chun-mei, LIU Xiao-jun, YAO Hong

2022, 42(2):  282-285.  doi:10.16352/j.issn.1001-6325.2022.02.007

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Objective To investigate the effect of deletion of Sirtuin type 1(Sirt1) gene on liver inflammation of mice and its mechanism. Methods The body weight of C57BL/6J male mice and liver specific Sirt1 deficiency (Sirt1-LKO) male mice were recorded weekly. The sensitivity of inflammatory response was tested by intraperitoneal injection of 20 mg/kg LPS. The survival curve was used to reflect the sensitivity of mice to inflammatory response.The expression of inflammatory factors was detected by Western blot and q-PCR. Results Compared with control wild type mice, Sirt1-LKO mice showed significantly reduced body weight (P＜0.05). In addition, The survival curve was shown by kaplane Meier diagram,Sirt1-LKO mice showed lower sensitivity to LPS (P＜0.05).The protein level of NF-κB in primary liver cells of Sirt1-LKO mice was increased (P＜0.05),Tnfα and IL6 of NF-κB downstream target genes were up-regulated(P＜0.05). Conclusions Hepatocyte-specific Sirt1 deletion aggravates liver inflammation response in mouse model.

Correlation between non-breathing-related sleep fragmentation and asymptomatic cerebral small vessel disease

LI Li, LU Zi-yi, LIU Jia-ling, LIU Li-mei

2022, 42(2):  286-290.  doi:10.16352/j.issn.1001-6325.2022.02.008

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Objective To investigate the potential correlation between non-breathing-related sleep fragmentation and cerebral small vessel disease(CSVD). Methods A total of 124 cases were collected from patients hospitalized in Second Affiliated Hospital of Dalian Medical University from September 2019 to September 2021. After completing the cerebral magnetic resonance plain scan(MRI+MRA+DWI+FLAIR)and risk factor screening, the patients completed the mobile sleep respiration monitoring,cardiopulmonary coupling map(CPC), excluding respiratory related sleep disorders, patients with CSVD were taken as the experimental group (70 cases) and patients without CSVD as the control group (54 cases). Sleep monitoring data between the two groups were compared,including total sleep time (TST), sleep latency (SL), stable sleep duration (stable), unstable sleep duration (unstable),rapid eyes movement duration(REM), arousal index(ArI), sleep efficiency (SE) and apnea hypopnea index (AHI). Results ArI in the experimental group (30.00±10.06 times) was significantly higher than that in the control group (25.61±9.42 times)(P＜0.05). The median AHI in the experimental group was 5.75(2.65-9.10)times/hour, significantly higher than that in the control group(P＜0.05). The median duration of Stable was 45.75(19.38-91.13) min in the experimental group,remarkably lower than 76.50(35.5-102.9) min in the control group(P＜0.05). The median Stable proportion in the experimental group was 12.70%(6.23%-22.50%), markedly lower than that in the control group, 19.4%(8.78%-27.90%)(P＜0.05). After adjusting for age, hypertension, and diabetes, ArI was an independent risk factor for CSVD (OR=1.098, 95% CI:1.022-1.180)(P＜0.05). Conclusions Non-breathing-related sleep fragmentation increases the risk of asymptomatic CSVD.

Clinical Sciences

Mediating effect of hope level between depression and psychological resilience in patients with advanced lung cancer

PAN Rui-li, MA Qian-hui, XU Yan, WANG Meng-zhao, WANG Su-e, GUAN Yu-xia

2022, 42(2):  291-295.  doi:10.16352/j.issn.1001-6325.2022.02.009

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Objective To explore the mediating effect of hope level in the depression and psychological resilience of patients with advanced lung cancer, in order to provide a theoretical basis for interventions to improve the depression state of patients. Methods Across-sectional survey was conducted in 202 patients with advanced lung cancer who were admitted to the Department of Respiratory Medicine of PUMCH from October 2019 to December 2020, using the Herth Hope Scale, Connor-Davidson resilience scale (CD-RISC) and a self-designed questionnaire on patient general condition and disease characteristics. Results The depression level of patients with advanced lung cancer was negatively correlated with the psychological resilience of the patients (r=-0.50, P＜0.01). The hope level of the patients was positively correlated with the psychological resilience (r=0.62, P＜0.01). The depression level of the patients was negatively correlated with the hope level(r=-0.44, P＜0.01).The level of hope of patients with advanced lung cancer has a partial mediating effect in depression and mental resilience. The mediating effect value is -16.51 (95% CI=-0.20~-0.03), the ratio is 19.83%. Conclusions Patients with advanced lung cancer who receive regular treatment have a higher degree of depression, and the hope level play a role of the mediating effect between depression and mental toughness. Medical staff should improve the confidence and hope of patients with advanced lung cancer through intervention, and improve pessimism.

Causes for cancellation of inpatients elective operations on the day of surgical operation

CHEN Wen, ZHANG Sheng-jie, ZHANG Yue-lun, SHEN Le

2022, 42(2):  296-300.  doi:10.16352/j.issn.1001-6325.2022.02.023

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Objective To explore the rate and causes for cancellation of inpatients elective operations on the day of surgical operation in order to develop strategy for optimization of resource utilization. Methods This study retrospectively investigated inpatient elective operation cases in Peking Union Medical College Hospital from January 1 2019 to July 31 2020 from the hospital electronic information system and analyzed the rate and causes for cancellation of elective operations on the day of surgery. Results Totally 343 cases (0.52%) cancelled operation on the day of surgery among 66 090 inpatient elective operations. Reasons for cancellation involved medical(21.3%), surgical(39.7%), patients(29.2%)and anesthesia(9.9%)factors. Conclusions Most cancellation events can be prevented by improving specific measures like dedicated preoperative anesthesia assessment and the rate of operation cancellation is expected to be reduced significantly.

Detection rates of mental disorders in pregnant women with subjective depressive symptoms

ZHAO Ming-zhe, WEI Jing, DUAN Yan-ping, ZHAO Yue, MA Liang-kun

2022, 42(2):  301-305.  doi:10.16352/j.issn.1001-6325.2022.02.010

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Objective To analyze the detection rates of mental disorders in women with subjective depressive symptoms during pregnancy and the postnatal period. Methods From March 1st 2020 to February 28th 2021, Patient Health Questionnaire-9 items (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) were used to screen pregnant women and mothers who were established in a third-grade hospital. The women with PHQ-9≥5 or EPDS≥9 were followed up. Mini-International Neuropsychiatric Interview (MINI) was used to confirm the detection rates of mental disorders. Results Of the 342 women who were followed up, 24 (7.0%) were diagnosed with depressive episodes. There were 17 cases had depression in the past. Among them 3 women had a history of depression before pregnancy, and 14 had the first episode after pregnancy. The detection rate of depression in the second trimester is higher than that in the first and third trimester; 9 (2.6%)with (hypo)manic episodes; 6 (1.8%) with panic disorder; 13(3.8%) with agoraphobia; 3(0.9%) with social phobia; 15(4.4%) with generalized anxiety disorder; 6 (1.8%)with obsessive-compulsive disorder. Eighteen women suffered from two or more mental disorders, accounting for 29.0% of the total number of diagnosed mental disorders. Conclusions A variety of mental disorders occur in women with subjective depressive symptoms during pregnancy and the postnatal period, and comorbidity is a common finding. Pregnant women with depression may have several episodes during this period. So it is necessary to evaluate their mental status professionally.

Mini Reviews

Research progress on the role of NAD⁺ metabolism in cell function and related-diseases

HE Sheng-mei, ZHAO Hou-yu

2022, 42(2):  306-310.  doi:10.16352/j.issn.1001-6325.2022.02.014

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Nicotinamide adenine dinucleotide (NAD⁺) is an important coregulatory factor in cells. The metabolic disorder of NAD⁺ is closely related to the damage of cell function, physiological changes and the occurrence and development of diseases. The decrease of NAD⁺ level is accompanied by the occurrence of metabolic and age-related diseases such as aging, hearing impairment and cardiac damage.Therefore, it provides a new idea for the treatment of these diseases by supplementing and restoring the level of NAD⁺.

Advances in research on blood pressure regulation by clock gene PER

JI Hui-fang, FU Yang, DONG Yi-fei

2022, 42(2):  311-315.  doi:10.16352/j.issn.1001-6325.2022.02.018

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The abnormal expression of clock genes is closely related to the circadian rhythm of blood pressure and to the occurrence and development of hypertension. This article summarizes the relationship between the clock gene period (PER) and the circadian rhythm of blood pressure, the influence of abnormal expression of PER in peripheral tissues and organs related to blood pressure regulation on blood pressure, and the research progress in the field of hypertension chronotherapy. The author hopes to provide new ideas for the clinical diagnosis, treatment and prognosis of hypertension.

Research progress on the role of endoplasmic reticulum stress in pathogenesis of hepatitis C virus infection

LI Ming-hao, FAN Liang-liang, XIANG Rong

2022, 42(2):  316-320.  doi:10.16352/j.issn.1001-6325.2022.02.013

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The infection caused by hepatitis C virus(HCV) often disturbs the momeostasis of endoplasmic reticulum. Accumulation of replication intermediates can lead to endoplasmic reticulum stress(ERS), which is closely related to the occurrence of many diseases. In order to prevent the harmful effects of endoplasmic reticulum stress, cells activate unfolded protein response(UPR) and apoptosis pathway. In early stage of virus infection, unfolded protein reaction is a main function to remove the proteins and other intermediates produced by the virus and when the infection deepens and the homeostasis is no longer to be maintained, the cell activates the apoptosis pathway. However, these pathways can also be manipulated by viral proteins to deepen infection and inhitit antiviral mechanism.

Origin and survival pathways of cancer stem cells in thyroid cancers

XIE Li-jun, ZHU Gao-hong, ZHAO Ji-hua, ZHANG Hai-bo, WANG Jiao

2022, 42(2):  321-324.  doi:10.16352/j.issn.1001-6325.2022.02.017

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More and more attentions were being paid to the study of tumor stem cells. It has been demonstrated that tumor stem cells were present in both differentiated thyroid cancer with a good prognosis as papillary or follicular cancer and undifferentiated ones with poor prognosis. Thyroid cancer stem cells (TCSCs) play a major role in tumor genesis, progression and metastasis, and may even be the root of recurrence and drug resistance in thyroid cancers. Therefore, the study of TCSCs is great importance to thyroid cancer treatment. In this paper, the authors reviewed the latest researches progress on the origin and survival pathways of TCSCs.

Research progress on drug targets for anti-retinal and choroidal neovascular diseases

LIU Chen, FANG Si-yin, GU Cao, WU Jin-hui

2022, 42(2):  325-329.  doi:10.16352/j.issn.1001-6325.2022.02.011

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The appearance of new blood vessels in the neovascular age-related macular degeneration (nAMD), diabetic retinopathy (DR),and other ocular diseases is one of the important reasons for blindness. Anti-vascular endothelial growth factor (VEGF) drugs are the current mainstream. However, some patients have poor efficacy and other adverse reactions. There is still a need to develop new drugs.

Association between discontinuation of aspirin and perioperative bleeding or ischemic events before neurosurgery

WANG Xin-yan, WANG Xin-xin, YU Yun, HAN Ru-quan

2022, 42(2):  330-334.  doi:10.16352/j.issn.1001-6325.2022.02.015

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The problem with discontinuation of aspirin during the perioperative period is that the patient is in a hypercoagulable state, which increases the occurrence of embolism event. However, continued use during the perioperative period may increase the risk of bleeding. This article reviews the bleeding and ischemic risks of stop use aspirin before neurosurgery, in order to guide the clinical practice.

Research progress of single nucleotide polymorphisms and immune cells in diabetic kidney disease

GUO Meng-ran, MIN Hang, YE Yue, XU Xiao-shuang, ZHEN Dong-hu

2022, 42(2):  335-339.  doi:10.16352/j.issn.1001-6325.2022.02.019

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Diabetic kidney disease has obvious family aggregation and ethnic differences, some single nucleotide polymorphisms (SNPs) related to the susceptibility of diabetic kidney disease have been identified, especially engulfment and cell motility 1 (ELMO1) and solute carrier family 12 member 3(SLC12A3), which are related to the development of diabetic kidney disease in Chinese population. Meanwhile, inflammation plays a key role in the occurrence and development of diabetic kidney disease, including T cell and type-2 innate lymphoid cell(ILC2) promote chronic inflammatory response and fibrosis of kidney by secreting inflammatory factors.

Medical Education

Evaluation of the simulation degree of 3D printed removable pituitary tumor resection model

GU Xiao, PAN Zhou-xian, CHEN Shi, SHEN Zhen, NIU Lu-lu, PAN Hui, YAO Yong

2022, 42(2):  340-344.  doi:10.16352/j.issn.1001-6325.2022.02.020

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Objective To explore the simulation degree of the 3D printed removable transnasal pituitary adenoma resection model, and to discuss the possibility of teaching operation with the model. Methods Using patient CT modeling, fine optimization and 3D printed technology, a removable pituitary adenoma resection model was constructed. Nineteen evaluators from Peking Union Medical College Hospital were selected, who were divided into “lower seniority group”(seniority ＜10 years) and “higher seniority group” (seniority ≥10 years). Each physician operated on the 3D printed pituitary adenoma resection model. They filled out questionnaires and evaluation scales before and after the operation. Results The higher seniority group have more operation experience than the lower seniority group. The scores of the simulation degree items are all around 4, and there is no significant difference found in different scoring items. The simulation degree score of “pituitary adenoma removal” is relatively low. The scores from the higher seniority group are generally lower than those of the lower seniority group. Before the operation, the scores in the lower seniority group were significantly lower than those of the higher seniority group, while the confidence scores of the two groups after the operation tended to be the same. The difference between scores before and after operation were significantly higher in lower seniority group (P＜0.05). Conclusions The model has high simulation degree and can be used in teaching experiments.

Construction and practice of an innovative general education course of “Medicine + Humanity” under the background of New Medicine

CUI Yan

2022, 42(2):  345-347.  doi:10.16352/j.issn.1001-6325.2022.02.016

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With the advance of the construction of “New Medicine”, the establishment of interdisciplinary and innovative courses has become an urgent work and challenge. This paper introduces the goals, methods, contents, practice and feedback of the innovative general education course of “Medicine + Humanity” in Tianjin Medical University. Our study paves the way for the crosstalk and integration of general education courses from different majors.

Application of learning curve of supervision practice in radial artery catheterization by ultrasound-guided dynamic needle tip positioning technique

TIAN Yuan, YU Chun-hua, RUAN Xia, BAI Bing, ZHANG Yue-lun, HUANG Yu-guang

2022, 42(2):  348-352.  doi:10.16352/j.issn.1001-6325.2022.02.021

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Objective To analyze and describe the learning curve of radial artery catheterization under ultrasound-guided dynamic needle tip positioning (DNTP) by anesthesia residents in Peking Union Medical College Hospital and to explore the learning intensity of supervision practice required to master this technique. Methods From January 2018 to June 2018, the learning records of two anesthesia residents in the Peking Union Medical College Hospital who perform radial artery catheterization under ultrasound-guided DNTP technique were used to describe the learning curve of cumulative sum analysis (CUSUM). The learning intensities were explored to improve the attempts and time needed for successful catheterization, first-attempt and overall success rates. The evaluation indexes before and after reaching the learning intensity were compared. Results Taking the attempts and time needed for successful catheterization, and the first and overall success rate as the evaluation indexes, the learning intensity required for the two trainees to master DNTP was 29/36, 29/29, 29/36 and 14/11 cases. After reaching this learning intensity, the number of operations required for successful puncture and catheterization decreased significantly (P＜ 0.05), and the time required, the first time and the overall success rate improved. Conclusions Considering the attempts and time needed for successful catheterization, first-attempt and overall success rates the learning intensity of the supervision practice needs to reach 36 cases.

Application of simulation teaching in transthoracic echocardiographic training

GUO Xiao-xiao, GUO Li-lin, WEI Tong-hui, FANG Li-gang

2022, 42(2):  353-356.  doi:10.16352/j.issn.1001-6325.2022.02.022

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Objective To compare the effect of simulation training and tradition training methods in the teaching of acquisition skills of transthoracic echocardiography (TTE). Methods From July 1, 2020 to April 30, 2021, 30 doctors receiving TTE training in the department of cardiology of Peking Union Medical College Hospital were recruited and randomly divided into two groups: the tradition training group and the simulation group. After training, the view-specific transthoracic echocardiographic examination scores and the total operation time were compared between the two groups. Results The duration of the examinations on TTE acquisition in the simulation group was significantly shorter than that in the tradition training group [(471±66)s vs (530±60)s](P＜0.05). The total score of the view-specific transthoracic echocardiographic examination in the simulation group was significantly higher than that in the tradition training group (42.7±2.5 vs 38.7±3.0, P＜0.01), especially in the parasternal aortic short axis view (3.9±0.9 vs 3.2±0.4, P＜0.05), apical two chamber view (4.0±0.8 vs 3.2±0.9, P＜0.05) and superior sternal fossa view (3.8±0.8 vs 2.6±1.1, P＜0.01). The satisfaction of the simulation group was significantly higher than that of the tradition training group (P＜0.05). Conclusions The application of simulation teaching in TTE training is feasible and useful with acquired better skills in TTE image acquisition and improved student satisfaction.