Clinical phenotypic and genotypic analysis of 5 pediatric patients with β-ketothiolase deficiency / 中华儿科杂志

Objective: To summarize the clinical and genetic characteristics of children with β-ketothiolase deficiency (BKTD). Methods: The clinical characteristics, biochemical, markers detected by tandem mass spectrometry (MS/MS) and gas chromatography-mass spectrometry (GC/MS), as well as the variants in ACAT1 gene among 5 children with BKTD in Children's Hospital of Chongqing Medical University between October 2018 and December 2022 were retrospectively analyzed. Results: The onset age of the disease in 5 patients (4 males and 1 female) ranged from 9.7 to 28.0 months. During the acute phase, severe metabolic acidosis was observed with a pH of 6.9-7.1, as well as hypoglycaemia (2.3-3.4 mmol/L) and positive urinary ketone bodies (+-++++). Blood levels of methylcrotonyl carnitine, methylmalonyl carnitine and malonyl carnitine were 0.03-0.42, 0.34-1.43 and 0.83-3.53 μmol/L respectively and were significantly elevated. Urinary 2-methyl-3-hydroxybutyric acid was 22-202 and 3-hydroxybutyric acid was 4-6 066, both were higher than the normal levels. Methylcrotonylglycine was mild elevated (0-29). The metabolites detected by MS/MS and GC/MS were significantly reduced after treatment. Analysis of ACAT1 gene mutation was performed in 5 children. Most variants were missense (8/9). Four previously unreported variants were identified: c.678G>T (p.Trp226Cys), c.302A>G (p.Gln101Arg), c.627_629dupTGA (p.Asn209_Glu210insAsp) and c.316C>T (p.Gln106Ter), the first 2 variants were predicted to be damaging by SIFT, PolyPhen-2 and Mutation Taster software. c.316C>T (p.Gln106Ter) is a nonsense variant. Conclusions: β-ketothiolase deficiency is relatively rare, lacks specific clinical manifestations, however severe metabolic acidosis, hypoglycemia, and ketosis during the acute onset were consistent findings. Missense mutations in the ACAT1 gene are common genetic causes of β-ketothiolase deficiency.

BCS1Neonatal growth retardation and lactic acidosis initiated by novel mutation sites in L gene / 中华预防医学杂志

This study aims to analyze the clinical characteristics and genetic variations of two cases with developmental delay and lactic acidosis in a family, and to explore the relationship between genetic variations and clinical features. A retrospective analysis was conducted on the clinical characteristics of two siblings with developmental delay and lactic acidosis who were treated at the Neonatal Department of Children's Hospital of Chongqing Medical University in May 2019 and December 2021, respectively. Whole-exome sequencing was used to detect genetic variations in the affected children. Homology modeling of the BCS1L protein was performed to analyze the structural and functional changes of the protein. The correlation between genetic variations and clinical phenotypes was analyzed. The results showed that the main clinical features of the two affected children in this family were manifestations of mitochondrial respiratory chain complex Ⅲ deficiency, including prematurity, developmental delay, respiratory failure, lactic acidosis, cholestasis, liver dysfunction, renal tubular lesions, coagulation dysfunction, anemia, hypoglycemia, hypotonia, and early death. Whole-exome sequencing revealed a novel deletion mutation c.486_488delGGA (p.E163del) and a novel missense mutation c.992C>T (p.T331I) in the BCS1L gene. Structural analysis of the homology modeling showed that the compound heterozygous mutation had a significant impact on protein function. In conclusion, the novel mutation site c.992C>T (p.T331I) in the BCS1L gene is a "likely pathogenic" mutation, and the compound heterozygous mutation is closely related to the phenotype of mitochondrial respiratory chain complex Ⅲ deficiency.

Further exploration of the classification and clinical value of head-shaking nystagmus / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the classification of head shaking nystagmus（HSN） and its clinical value in vestibular peripheral diseases. Methods:Clinical data of 198 patients with peripheral vestibular disorders presenting with HSN were retrospectively analyzed. Video Nystagmograph（VNG） was applied to detect spontaneous nystagmus（SN）, HSN, and Caloric Test（CT）. The intensity and direction of SN and HSN as well as the unilateral weakness（UW） and direction preponderance（DP） values in caloric test was analyzed in patients. Results:Among the 198 patients with vestibular peripheral disease, there were 105 males and 93 females, with an average age of（49.1±14.4） years （range: 14-87 years）. One hundred and thirty seven patients were diagnosed as Vestibular Neuritis（VN）, 12 as Meniere's Disease（MD）, 41 as sudden deafness（SD） and 8 as Hunt's syndrome accompanied by vertigo. Among them, there were 116 patients in the acute phase, including 68 cases（58.6%） with decreased HSN, 4 cases（3.4%） with increased HSN, 5 cases（4.3%） with biphasic HSN, 38 cases（32.8%） with unchanged HSN, and 1 case（0.9%） with perverted HSN. There were 82 cases in the non-acute phase, 51 cases（62.2%） with decreased HSN, 3 cases（3.6%） with increased HSN, 9 cases（11.0%） with biphasic HSN, and 19 cases（23.2%） with unchanged HSN. In biphasic HSN, the intensity of phase I nystagmus was usually greater than that of phase II, and the difference was statistically significant（P<0.01）. There was no correlation between HSN type and course of disease or DP value. The intensity of HSN was negatively correlated with the course of disease（r=-0.320, P<0.001） and positively correlated with DP value（r=0.364, P<0.001）, respectively. The intensity of unchanged nystagmus and spontaneous nystagmus were（8.0±5.7） °/s and（8.5±6.4）°/s, respectively. There was no statistically significant difference in the intensity of nystagmus before and after shaking the head. Conclusion:HSN can be classified into five types and could be regarded as a potential SN within a specific frequency range （mid-frequency）. Similarly, SN could also be considered as a common sign of unilateral vestibular impairment at different frequencies. HSN intensity can reflect the dynamic process of vestibular compensation, and is valuable for assessing the frequency of damage in peripheral vestibular diseases and monitoring the progress of vestibular rehabilitation.

Biometry of width between labial transitional line angles in anterior teeth:an observational study

PURPOSE@#The maximum width between the mesial and distal labial transitional line angles, described as “esthetic width” herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. @*MATERIALS AND METHODS@#A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. @*RESULTS@#The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. @*CONCLUSION@#Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth.

Maternal hemoglobin levels in the third trimester and its correlation with pregnancy outcomes among rural residents in Tibetan Plateau / 中华围产医学杂志

Objective:To study the relationship between maternal hemoglobin concentration, anemia rate in the third trimester and the altitudes, pregnancy outcomes among pregnant women in Tibet rural areas.Methods:This prospective study collected clinical and laboratory data of 390 Tibetan pregnant women who delivered after 28 gestational weeks at Chaya People's Hospital, Changdu city, Tibet autonomous region, from May 2020 to March 2021. Blood routine examination was performed at admission and 24-72 h postpartum using an automatic hematologic analyzer. According to the hemoglobin standard adjusted for altitude by World Health Organization (WHO), the association between pregnancy outcomes and maternal hemoglobin levels and anemia rate before and after adjustment were analyzed using Mann-Whitney U one-way analysis of variance, Chi-square, Pearson correlation, and Spearman correlation tests. Results:(1) In these women, the mean actual hemoglobin concentration in the third trimester was (121±16) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 23.8% (93/390) and 20.3% (79/390), respectively. (2) After adjustment, the mean hemoglobin concentration was (93±17) g/L, and the prevalence of anemia and microcytic hypochromic anemia was 84.4% (329/390) and 30.5% (119/390), respectively. (3) Actual hemoglobin levels showed an increasing tendency as the altitude rose. At the altitude of 3 000-3 500 m, >3 500-4 000 m, and >4 000 m, the mean hemoglobin levels were (118±15) g/L, (119±17) g/L, and (124±16) g/L, respectively ( Ftrend=7.38, P=0.007). However, the prevalence of anemia and microcytic hypochromic anemia did not differ significantly between different altitude ( P>0.05). (4) Corrected hemoglobin levels were negatively associated with the altitude ( r=－0.31, P<0.001). At the altitude of 3 000~3 500 m, 3 500~4 000 m and >4 000 m, the mean corrected hemoglobin levels were (100±15) g/L, (92±17) g/L, and (87±18) g/L, respectively ( Ftrend=30.36, P<0.001). The prevalence of anemia increased with altitude ( χ2trend=15.44, P<0.001), but no association was observed between microcytic hypochromic anemia and altitudes ( P>0.05). (5) No association was found between actual or corrected anemia in the third trimester and adverse pregnancy outcomes, nor the hemoglobin level before or after adjustment and neonatal birth weight. Conclusions:In Tibet rural areas, the mean actual hemoglobin level in pregnant women tends to increase with the altitude. However, the prevalence of anemia and microcytic hypochromic anemia remains high and more attention should be paid to iron supplementary during pregnancy. After adjusting hemoglobin concentration based on WHO standard, more women were diagnosed as having anemia during pregnancy in this area, and the applicability of the diagnostic criteria for Tibetan residents requires further investigations.

Effects of vestibular spontaneous nystagmus on visual smooth pursuit function / 中华耳鼻咽喉头颈外科杂志

Objective: The aim of the study is to analyze the effects of vestibular spontaneous nystagmus(SN) on the smooth pursuit function of visual ocularmotor system. Methods: A total of 46 patients with acute unilateral peripheral vestibular syndrome with SN (26 cases of vestibular neuritis, 6 cases of Ramsay Hunt Syndrome (RHS) with vertigo, 14 cases of sudden deafness with vertigo) were included in this work. In the study group, the results of SPT and SN test with videonystagmography(VNG) were also reviewed. Taking SPT parameters, the influence of SN intensity on SPT gain, asymmetry and waveform and their correlation were analyzed.SPSS19.0 software was used for statistical analysis. Results: Among the 46 patients, there were 36 cases of SN pointing to the healthy side(SN intensity range of 2.68°/s-32.53°/s), and 10 cases of SN pointing to the affected side (SN intensity range of 2.66°/s-16.54°/s). SN intensity was divided into 3 groups, including light(0.50°/s-5.00°/s), medium(5.01°/s-10.00°/s) and strong(>10.01°/s), accounting for 14 cases(30.4%), 18 cases(39.1%) and 14 cases(30.4%), respectively. The differences of the gain of SPT to the fast phase and slow phase direction in the overall groups and light, medium and strong groups of SN intensity respectively were statistically significant(ttotal=13.338, tlight=6.184, tmedium=8.436, tstrong=8.477, all of P<0.001). The difference of SPT gain in SN fast phase direction between groups with different SN intensity was statistically significant(F=9.639, P<0.001),there was no statistically significant difference in SPT gain between the groups on the SN slow phase direction(F=1.137, P=0.330).The SN intensity significantly negatively correlated with the SPT gain of the fast phase direction of SN (r=-0.433, P=0.003), that was, the SPT gain on the fast phase direction of SN decreased with the increase of SN intensity. There was no significant correlation between SN intensity and the gain of SPT on the slow phase direction of SN (r=-0.061, P=0.687). SPT waveform analysis showed that type I, type II and type III accounted for 8 cases(17.4%), 21 cases(45.6%) and 17 cases(37.0%), respectively. The corresponding mean values of SN intensity were (3.71±0.69)°/s, (7.44±1.88)°/s, (20.04±5.53)°/s, respectively, without type IV wave. The intensity of SN was positively correlated with the asymmetric value of the gain of SPT left and right(r=0.450,P=0.002). That was, with the increase of SN strength, the asymmetric value also increased, and the worse the asymmetry of the gain of SPT left and right pursuit was, the worse the SPT waveform was. Conclusion: SPT gain, asymmetry and SPT waveforms are all affected by SN, and the greater the intensity of SN, the greater the influence on the three. When SN is strong, type III waves may occur, suggesting that acute peripheral vestibular syndrome can also affect the visual ocularmotor systems.

Analysis of ecological recycling modes for Gastrodia elata cultivation / 中国中药杂志

Gastrodia elata is a kind of precious traditional Chinese medicine. In artificial cultivation, it has not got rid of its dependence on forest resources. In order to maintain the balance of the ecological system and reduce the waste of resources as much as possible, based on the information from field investigation at many places, this paper introduced the new ecological circulation planting patterns of G. elata, such as "forest-G. elata" supporting planting, G. elata-edible mushroom rotation, forest-G. elata-edible mushroom three-dimensional planting, fungus material classification planting technology, and so on. In this paper, we expounded the ecological problems solved by several planting patterns in G. elata production and analyzed their shortcomings. Finally, based on the exis-ting models, a complete ecological planting system of G. elata was summarized. This planting system emphasizes: ① The follow-up forests should be started before the planting of G. elata. And the economic forests were used to cultivation of G. elata. ② The classified utilization of fungus-growing materials. The leaves were used to cultivate germination bacteria of G. elata, the small branches were used to cultivate protocorm and juvenile tuber, the large branches were used to cultivate immature tuber, and the tree trunk was used to cultivate mature tuber. ③ Recycle utilization G. elata fungus material. The old fungus materials were used to produce strains or cultivate edible fungus. This design project not only solves the problems of the source of G. elata fungus material, the efficient utilization of fungus material and land resources, but also enriches the industrial structure. Using limited time and land resources to obtain greater economic benefits. It has certain guiding significance for poverty alleviation and ecological improvement.

Objective characteristics of nystagmus in patients with posterior semicircular canal benign paroxysmal positional vertigo / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze and discuss the parameters and clinical significance of nystagmus in patients with benign positional paroxysmal vertigo (BPPV) of posterior semicircular canal.@*Methods@#The subjects of the study were 564 BPPV patients diagnosed with posterior semicircular canal canalithis (PSC-can) from January 2016 to July 2017 in Tianjin No.1 Central Hospital, including 186 males and 378 females, with a median age of 57 years. The induced nystagmus in Dix-Hallpike test was recorded by video nystagmuo graph(VNG), and the direction, latency, duration time and intensity characteristics of nystagmus were compared with the position of hanging and sitting.SPSS17.0 software was used for statistical analysis.@*Results@#Vertical torsional nystagmus was both induced with the position of hanging and sitting during Dix-Hallpike test. The vertical direction of the induced nystagmus was upward and downward respectively. The latency, duration time and intensity of lesion side were L(2.65±1.92; 1.44±1.24), D(14.90±10.46; 15.28±8.06), and P(29.75±21.26; 14.08±9.48). The latency and intensity in hanging position were higher than those of sitting. The intensity rate was about 2∶1, with statistically significant difference (t=13.831, and 17.296, P all<0.01). The direction of the induced nystagmus was opposite to turning in HSC-Can BPPV. The intensity turning to normal side was larger than lesion side obviously. The intensity rate was about 2∶1, the difference was statistically significant (t=17.296, P<0.01). There was no statistical difference of nystagmus during time between the two positions(t=-0.735, P>0.05).@*Conclusions@#The nystagmus intensity rate in Dix-Hallpike test between hanging and sitting position of lesion side in PSC-Can is 2∶1, which conforms to the Ewald′s law. The direction, latency and intensity of nystagmus can be used as a reference index for the localization diagnosis of PSC-Canotolith.

Efflect of miR-34a-Tangeted Regulation of HDACI on Apoptosis of AML Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the regulation of miR-34a on HDAC1 expression and its effect on the apoptosis of acute myeloid leukemia (AML) cells.@*METHODS@#miR-34a mimics, miR-34a inhibitor and miR-34a scramble were transfected into HL-60 cells. The effects of miR-34a expression levels on proliferation and apoptosis of HL-60 cell were detected by CCK8 assay and flow cytometry respectively. The expression of HDAC1 protein was assessed by Western blot after regulating miR-34a expression, the 3'UTR of HDAC1 was cloned and ligated to construct a dual luciferase reporter vector, and then the dual luciferase reporter assay was applied to verify the target of miR-34a, the expression vector pcDNA3.1-HDAC1 was constructed, the interaction of miR-34a and HDAC1 was analyzed by reversion test.@*RESULTS@#miR-34a over-expression could inhibit the proliferation of HL-60 cells and induce their apoptosis. Bioinformatics analysis indicated that the HDAC1 was a target gene of miR-34a. Western blot indicated that miR-34a overexpression down-regulated the expression of HDAC1. Dual luciferase reporter assay and reversion test showed that miR-34a could act at the 3-UTR of HDAC1 gene to regulate its expression.@*CONCLUSION@#miR-34a promotes the apoptosis of HL-60 cells via regulating HDAC1 expression.

A pilot study of the unilateral centrifugation subjective visual vertical in healthy young people / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the data of unilateral centrifugation subjective visual vertical (UC-SVV) in healthy young people.To study the function of utricle.@*Methods@#Between Decem ber 2017 and May 2018, thirty-two healthy young volunteers were tested by static subjective visual vertical(SVV) and low velocity UC-SVV with Neuro Kinetics Inc I-portal 6.0 Video nystagmus recording system and NOTC rotating chair system.The static SVV preset angle were -15.00°, 15.00°, -20.00°, 20.00°, -12.00° and 12.00° respectively.UC-SVV test parameters: rotating chair′s peak speed was 60°/s.The shift time from the middle to the lateral position was 30 s and the displacement was 3.85 cm.The chair rotated at 60 s at left, right and middle positions.Subjects underwent SVV during this period.SPSS 17.0 software was used to analyze the data.@*Results@#The mean and standard deviation of static SVV deviation in 32 volunteers was 0.21°±0.17°, 95%CI (-0.14°, 0.55°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the clockwise was 0.24°±0.25°, -0.10°±0.27°, -0.63°±0.26°, 95%CI(-0.26°, 0.74°), (-0.65°, 0.44°), (-1.16°, -0.10°). The mean and standard deviation of UC-SVV in the left, middle and right positions of the counter clockwise was 0.03°±0.27°, -0.11°±0.26°, -0.23°±0.26°, 95%CI(-0.52°, 0.59°), (-0.65°, 0.42°), (-0.76°, 0.30°). There was significant difference in the deviation between the left and the right side of counter clockwise rotation of UC-SVV(t=2.432, P<0.05), however, there was no significant difference in the angle of deviation between the left and right sides and the median position(t value was 0.951, -1.400, both P>0.05). There was no significant difference among each position in clockwise rotation of UC-SVV(F=0.253, P>0.05).@*Conclusion@#UC-SVV test with peak speed of 60°/s can cause vertical line deviation in the left and right lateral position, but the angle is small and the value of clinical application is limited.

The nystagmus characteristics of two positions of the horizontal semicircular canal cupulolithiasis / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the characteristics of nystagmus of horizontal semicircular canal cupulolithiasis(HSC-Cup) in Roll test and Dix-Hallpike test.@*Methods@#Between December 2016 and December 2017, a total of 164 patients with BPPV from Tianjin First Center Hospital, 124 HSC-Can BPPV and 40 HSC-Cup BPPV, were involved.The induced nystagmus in Roll test and Dix-Hallpike test were recorded by video-nystagmograph(VNG), whose direction and intensity characteristics were compared in various BPPV.@*Results@#HSC-Can patients were induced a horizontal nystagmus with Roll test, the nystagmus intensity of the disease and healthy side were (41.3±20.1)°/s (mean standard deviation)and(21.9±9.4)°/s respectively, the difference was statistically significant (t=6.709, P<0.05). HSC-Cup patients were induced a horizontal nystagmus that was opposite to the direction of the Roll test, the nystagmus intensity of the disease and the healthy side were (12.9±6.4)°/s and(29.1±9.3)°/s respectively, with significant difference (t=9.066, P<0.05). Among 124 cases of HSC-Can patients, 120 cases of horizontal nystagmus were recorded in the left and right sides of the Dix-Hallpike test in the same direction as the turning direction, the horizontal nystagmus intensity of the disease and the healthy sides were (15.1±10.0)°/s and(9.4±7.4)°/s respectively, the difference was statistically significant (t=2.365, P<0.05). And 40 cases of HSC-Cup patients were recorded at the head of the Dix-Hallpike test in the opposite direction to the horizontal eye earthquake.The horizontal nystagmus intensity of the disease and the healthy side were (5.3±2.8)°/s and(13.9±4.4)°/s respectively, the difference was statistically significant (t=10.579, P<0.05).@*Conclusions@#Characteristic horizontal nystagmus can be induced by HSC-Cup in both roll test and Dix-Hallpike test. Preliminary localization of Dix-Hallpike Test can also be used for HSC-Cup.

The characteristics and clinical significance of vestibular autorotation test in patients with vestibular migraine / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the characteristics and clinical utility of vestibular autorotation test (VAT) in patients with vestibular migraine(VM).@*Methods@#This study included two groups, a VM group (441 patients from Tianjin First Center Hospital between January 2015 and May 2016) and a control group (65 healthy subjects). Both groups undertook VAT; the parameters evaluated were horizontal gain/phase, vertical gain/phase and asymmetry. The differences in VAT results between the two groups were investigated.@*Results@#There were statistically significant differences in VAT results between the VM and the control group, namely elevated horizontal gain at frequency 2, 3, 4 and 5 Hz, delay horizontal phase at frequency 2, 4, 5 and 6 Hz, elevated vertical gain at frequency 2-6 Hz and delay vertical phase at frequency 4-6 Hz. There was no significant difference in asymmetric values between the VM group and the control group.@*Conclusions@#The results of this study indicate that VM patients have elevated horizontal gain and vertical gain, and delay horizontal phase and vertical phase. It is suggested that VAT represents a useful diagnostic tool which may provide objective evidence for the diagnosis and differential diagnosis of VM.

Effects of the Survivin shRNA-APC double-gene on the expressions of survivin,Cytc,Smac and Caspase-9 in the colon cancer mitochondrial apoptosis pathway / 医学研究生学报

Objective Little is known about the effect of RNAi on mitochondrial apoptotic pathways. This study aims to explore the effects of the Survivin shRNA-APC double-gene on colon cancer mitochondrial apoptosis pathway-related factors survivin,cytochrome C (Cytc),second mitochondria-derived activator of caspases (Smac),and cysteine aspartic acid specific protease 9 (Caspase-9) as well as on the apoptosis of colon cancer transplanted tumor (CCTT) cells. Methods Thirty nude mice were randomly divided into five groups of equal number,Survivin shRNA-APC double-gene,survivin shRNA,APC,empty vector and blank transfection. The CCTT model was established in the nude mice by subcutaneous injection of the colon cancer cell strains stably transfected with the Survivin shRNA-APC double-gene,survivin shRNA,APC,an empty vector and HT-29,respectively,into the mid-posterior part of the left armpit of the nude mice. The rate of tumor growth inhibition was calculated by measuring the volume and weight of the CCTTs in the nude mice. The mRNA and protein expressions of survivin,Cytc,Smac and Caspase-9 in the tumor tissue were detected by real time PCR and immunohistochemistry,respectively,and the apoptosis rate of the CCTT cells was detected by TUNEL. Results The model of CCTT was successfully established in the nude mice. Com-pared with the empty vector and blank transfection groups,the mice in the double-gene,survivin shRNA and APC groups showed sig-nificantly decreased average volume and weight of the tumor tissue (P<0.05) but increased inhibition rate of its volume and weight (P<0.05). In comparison with the survivin shRNA and APC groups,the double-gene group exhibited remarkably decreased average volume and weight of the tumor tissue (P<0.05) but increased inhibition rate of its volume and weight (P<0.05). The mRNA and pro-tein expressions of survivin were significantly lower while those of Cytc,Smac and Caspase-9 markedly higher in the double-gene,sur-vivin shRNA and APC groups than in the empty vector and blank transfection groups (P<0.05),the former even lower (P<0.05) and the latter even higher in the double-gene than in the survivin shRNA and APC groups (P<0.05). The apoptosis rate of the CCTT cells was significantly increased in the double-gene ([56.78±3.04]%),survivin shRNA ([33.61±2.02]%) and APC groups ([30.16± 1.72]%) as compared with the empty vector ([10.05±0.42]%) and blank transfection groups ([9.87±0.30])% (P<0.05),even higher in the double-gene group than in the survivin shRNA and APC groups (P<0.05). Conclusion The Survivin shRNA-APC double-gene may induce apoptosis of colon cancer transplanted tumor cells by down-regulating the expression of the apoptosis inhibitor survivin,upregulating the expressions of Cytc,Smac and Caspase-9,and suppressing the growth of the colon transplanted tumor,with more significant abilities than a single gene in regulating apoptosis-related factors,inducing cell apoptosis and inhibiting the growth of the transplanted tumor.

Effects of survivin shRNA-APC double gene co-expression stably transfected cell lines on the angiogenesis of HT-29 colon cancer cells subcutaneous xenografts in nude mice / 中国综合临床

Objective To investigate the effects of survivin shRNA-APC double gene co-expression stably transfected cell lines on the VEGF、COX-2 expressions and angiogenesis of subcutaneous exnotransplanted tumor tissues cell of HT-29 colon cancer in nude mice.Methods Forty nude mice were randomly divided into five groups,the negative control group,empty vector group,Survivin shRNA group,APC group,double-gene group.The stably transfected cell lines and HT-29 colon cancer cells were cultured,PBS suspension resulted in cell density of 2× 107/ml,injected with respective stably transfected cell lines to establish an SXT model.All the mice were sacrificed after six weeks in order to separate the subcutaneous tumor,the expressions of the VEGF,COX-2mRNA and protein were detected by Real time PCR and immunohistochemistry,CD34 antibody was used to mark the vascular endothelial cells,and the MVD values were detected by immunohistochemistry.Results Tumors were formed in the nude mice of each group.The expressions of VEGF,COX-2 mRNA in Survivin shRNA group ((50.84±3.64)％,(50.11±3.91)％),APC group((74.28±6.87)％,(72.39±6.55)％) and Survivin shRNA-APC double-gene group ((21.78±4.00) ％,(20.74±5.12) ％) were significantly lower than those in the empty vector groups((100.00±0.00) ％,(100.00±0.00) ％) or negative control group ((98.22±0.38) ％,(97.61 + 0.77)),the differences were statistically significant (P ＜ 0.05);the expressions of VEGF,COX-2 mRNA in Survivin shRNA-APC double-gene group were significantly lower than those in APC groups,Survivin shRNA group,the differences were statistically significant (P＜0.05).The expressions of VEGF,COX-2 protein in Survivin shRNA group (5.15 ± 1.02,5.26 ± 0.91),APC group (4.96 ± 1.12,4.93 ± 1.18),and Survivin shRNA-APC double-gene groups (1.81 ± 0.84,1.80± 0.81)were significantli lower than those in the negative control group (8.95± 0.55,8.77± 0.60) and empty vector group (9.17± 0.49,9.01 ± 0.80),the differences were statistically significant(P＜0.05),the expressions of VEGF,COX-2 protein in the Survivin shRNA-APC double-gene group were significantly lower than those than in APC group,Survivin shRNA group(P＜0.05);the expressions of MVD in APC group (12.14± 3.45),Survivin shRNA group (11.39 ± 2.94) and Survivin shRNA-APC double-gene group (3.96 ± 2.20) were lower than those in the negative control group (25.09 ± 5.59) and empty vector group (27.87 ± 7.36),the differences were statistically significant (P ＜ 0.05),the MVD in the Survivin shRNA-APC double-gene group was even lower than that in APC group,Survivin shRNA group,the differences were statistically significant (P ＜ 0.05).Conclusion Survivin shRNA-APC double gene coexpression stably transfected cell lines can significantly reduce the expression of the VEGF,COX-2 mRNA and protein and then inhibit the angiogenesis of transplanted tumor tissue,and its inhibitory effect is more effective than that og Survivin shRNA and APC single gene stable strain.

Thrombelastography in evaluating effect of antiplatelet drugs for patients undergoing peripheral endovascular treatment and relationship with ischemic-events-free duration / 中华普通外科杂志

Objective To evaluate the effect of antiplatelet drugs and ischemic-events-free duration by thromboelastography (TEG) in patients undergoing peripheral endovascular treatment.Methods From Mar 2015 to Oct 2016,38 patients undergoing initial successful peripheral stenting and then coming back for recurrent ischemic events.TEG was used to evaluate the platelet inhibition rate induced by arachidonic acid (AA％) approach,the platelet inhibition rate induced by adenosine diphosphate (ADP％) approach,and the ADP-induced platelet-fibrin clot strength (MAADP).Clinical feature differences between patients with MAADP ＞ 47 mm and MAADP ≤ 47 mm were compared.Results AA％ less than 50％ was found in 9 patients(23.9％),and ADP％ less than 30％ in 14 patients(36.8％).5 patients met the two conditions.Patients with MAADp ＞ 47 mm had a significantly lower ADP％ (x2 =10.755,P ＜ 0.001),compared to patients with MAADP ≤47 mm.Univariate survival analysis showed ADP％ ＜ 30％ and MAADP ＞47 mm were risk factors for getting shorter ischemic-events-free duration,compared to patients with ADP％ ≥ 30 (P ＜ 0.001),with MAADP ≤47 mm (x2 =4.408,P =0.036).Conclusions TEG may detect those patients who has a low response to antiplatelet drugs,and some TEG parameters may have a ischemic predictive value.

The anticoagulation status:a cross-sectional survey of 1 000 cases single center study of patients with atrial fibrillation / 复旦学报（医学版）

Objective To investigate the epidemiological status and the anticoagulation treatment of atrial fibrillation (AF) patients,and to provide evidence for improving anticoagulation therapeutic effect in AF patients.Methods We performed a cross-sectional epidemiological investigation of 1 000 patients and out-patients with AF in Huashan Hospital.The clinical data including clinical feature,coexistent diseases,auxiliary examination,and treatment regimen of these patients were collected.The clinical features and anticoagulation status of AF patients were analyzed based on the stroke history,stroke risk evaluation and CHA2DS2-VASc score stratification.Results The mean age of these AF patients was (72.1 ± 11.1) years old.The most common coexistent diseases were hypertension (65％),coronary heart disease (32％) and diabetes (27％).About 6％ of the AF patients were diagosed with non-valvularatrial fibrillation (NVAF),and 22％ had stroke history.Patients were divided into two groups according to their stroke history.Compared with the non-stroke group,the stroke group was found to be older,with longer course of AF and poorer hypertension control.The overall anticoagulation rate was 32 ％ and antiplatelet rate was 46 ％.The anticoagulation rate of stroke group was 44％,higher than the non-stroke group (P＜0.001) but 78％ of these patients began anticoagulation therapy after the occurrence of stroke.When CHA2 DS2-VASc scores of NVAF patients were 2 to 5,the anticoagulation proportion increased gradually.When the scores were 2 to 6,the antiplatelet ratio increased gradually.But when the scores were 7-8 points,both anticoagulation and antiplatelet rates were in decline.Conclusions The anticoagulation rate in AF patients was still low at present,while relatively higher in patients with stroke.Anticoagulation could prevent stroke,AF patients still could benefit from anticoagulation after stroke,but anticoagulation before stroke could get more benefits.

Effect of Intravenous Dexmedetomidine Injection(1 μg/kg)on the Intubating Conditions without Muscle Relaxants in Children after Inhalation Induction with Sevoflurane / 中国医学科学院学报

Objective To investigate the effect of intravenous dexmedetomidine injection(1 μg/kg)on the intubating conditions after inhalation induction with sevoflurane 8% and nitrous oxide(NO)50% in children. Methods Totally 122 patients aged 4-10 years with an American Society of Anesthesiologists physical statusⅠ undergoing elective plastic surgery under general anesthesia were randomly divided to dexmedetomidine group(intraveneously injected with dexmedetomidine 1μg/kg)and control group(injected with normal saline)by using the random sampling table.On arrival of the operating room,anesthesia was induced with sevoflurane 8% and NO 50% in oxygen 50%.When the patient became unconscious,the intravenous cannula 24was inserted on the dorsum of hand.One minute later,laryngoscopy and tracheal intubation were performed.The intubating conditions were assessed by the scoring system in the previous study. Results The rates of acceptable conditions were 97% and 90% in dexmedetomidine group and in control group(P=0.143),and the rates of excellent conditions were 82% and 67%(P=0.04),respectively.In dexmedetomidine group,there were no signifi-cant differences of mean arterial presser and heart rate between the time-point of before intubation and the time-point of immediately after intubation.Conclusion Intravenous bolus of dexmedetomidine(1 μg/kg)can effectively improve the intubating conditions after inhalation induction of sevoflurane 8% and NO 50% in children and make the hemodynamics more stable during tracheal intubation.

Frequency characteristics of the semicicular canals damage in patients with Meniere disease / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate semicircular canal damage and its frequency characteristics in Meniere disease patients.@*Methods@#Sixty-seven Meniere disease patients accepted the video-head impulse test(vHIT)which responses to semicircular canal function of high frequency area, head shaking test(HST) which responses to semicircular canal function of middle frequency area, and caloric test(CT) which responses to semicircular canal function of low frequency area.Preferences were recorded including the video head impulse test gain (vHIT-G), head shaking nystagmus (HSN) and parameters of the unilateral weakness (UW) as observation index, and results of all the three tests were analyzed according to Meniere disease patients. SPSS 17.0 software was used to analyzed the data.@*Results@#The positive rate of CT, HSN and vHIT were 70.1%(47/67), 41.8%(28/67) and 23.9%(16/67) respectively. Comparation of the positive rate among CT, HST and vHIT showed statistically significant difference (χ2=10.93, P=0.001; χ2=28.79, P=0.000). Comparation of the positive rate between HST and vHIT showed statistically significant difference(χ2=4.87, P=0.027).@*Conclusions@#Semicircular canal function damage in Meniere disease patients mainly presents in the low frequency area, which indicates a characteristic phenomenon that low-frequency function area (caloric test results) is more predisposed to be involved than that of middle-frequency function area (head shaking testing)and high-frequency function area (video head impulse testing) in Meniere disease patients.

The exploration on optimization of two alternatives between roll test and Dix-Hallpike test in benign paroxysmal positional vertigo / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the objective characteristics of roll test and Dix-Hallpike test in benign paroxysmal positional vertigo(BPPV)patients, discussing the premier solution of positional test.@*Methods@#A total of 230 patients with BPPV, whereas 170 posterior semicircular canal canalithiasis (PSC-Can) BPPV and 60 horizontal semicircular canal canalithiasis (HSC-Can) BPPV were involved respectively. The induced nystagmus in roll test and Dix-Hallpike test was recorded by video nystagmuo graph (VNG), and the direction, intensity and time characteristics of nystagmus were compared in various BPPV.SPSS19.0 software was used for statistical analysis.@*Results@#Vertically upward nystagmus was induced by hanging in 170 PSC-Can Dix-Hallpike test, and the nystagmus reversed and turned weaker when the subjects came to sit. The intensity of nystagmus at turning to lesion side by hanging and sitting were (30.3±14.1)°/s and (12.6±7.5)°/s respectively, the difference was statistically significant (t=20.153, P<0.05). However, no nystagmus was induced in PSC-Can roll test. Horizontal nystagmus in the same direction with turning was induced in 60 HSC-Can roll test. The intensity of nystagmus at turning to lesion side and normal side was (42.0±18.0)°/s and (20.3±8.7)°/s respectively, the difference was statistically significant (t=12.731, P<0.05). Furthermore, horizontal nystagmus in the same direction with turning was induced in 57 HSC-Can Dix-Hallpike. The coherence was 95% with the results of roll test.@*Conclusions@#Dix-Hallpike test can not only be used to diagnose PSC-Can, but also induce nystagmus in HSC-Can effectively. Whereas the roll test only show significance in diagnosing HSC-Can. To avoid uncomfortable stimulation to patients as much as possible, we suggest to use Dix-Hallpike test at first, and to judge whether using roll test based on the result of the horizontal nystagmus.

Advances in research on the role of T cell subsets in ventricular remodeling / 中国比较医学杂志

Ventricular remodeling is one of the main causes of heart failure. A large number of studies have shown that inflammation plays an important role in the occurrence and development of ventricular remodeling. Recent studies found that chronic inflammation mediated by T cells is closely related to the progression of ventricular remodeling. This review summarized the recent research progress of T lymphocyte subsets in ventricular remodeling.