Volume 92  ·   Issue 01  ·  2012

non-communicable diseases (NCD), mainly including cardiovascular and cerebrovascular diseases, malignant tumors, diabetes and chronic obstructive pulmonary disease, have become serious public health and social problems that endanger people's health and hinder social and economic development.According to the statistics of the World Health Organization (WHO) in 2008 [1], about 36 million of the 57 million deaths in the world die of NCD every year, accounting for more than 60% of all deaths, and 80% of these deaths occur in developing countries, which obviously lack enough understanding of the challenges of NCD at present.

Objective To explore the correlations between chemokines stromal cell-derived factor-1(CXCL12),monocyte chemotactic protein-1 (CCL2),regulated upon activation normal T cell expressed and secreted (RANTES) and early abortion. Methods The villus and decidua tissues of recurrent spontaneous abortion group ( n =26 ),medical abortion group ( n =30) and normal early pregnancy women ( control group,n =30) were collected at our hospital from 2008 to 2009.And their expressions of CXCL12,CCL2,RANTES mRNA were determined by real-time fluorescence quantitative PCR (polymerase chain reaction).Results The CXCL12,CCL2 and RANTES mRNA gene expressions were detected in firsttrimester placental villus and decidua tissues.And the gene expressions of CXCL12 mRNA in villus and decidua tissues in spontaneous abortion and medical abortion groups were significantly lower than that in the control group (P ＜ 0.01 ).But the gene expressions of CCL2 and RANTES mRNA in villus and decidua tissues were significantly higher than that in the control group (P ＜ 0.01 ).Conclusion CXCL12,CCL2 and RANTES are co-expressed in human villus and decidua tissues.The lower CXCL12 mRNA expression and the higher expressions of CCL2 and RANTES mRNA play important roles in the pathogenesis of early abortion.

Objective To compare the effectiveness of ultrasound plus radiography versus computed tomography(CT) in the diagnosis of ectopic intrauterine device (IUD) and analyze the ratio of cost and effectiveness (C/E) so as to provide scientific rationales for the selection of appropriate diagnostic methods.Methods A total of 70 cases were recruited from two major Chinese hospitals in 2009.They were examined with ultrasound plus radiography and CT respectively. The gold diagnostic criterion was postoperative diagnosis to compare the sensitivity,specificity,diagnostic index ( DI ),accuracy and C/E for different diagnostic methods.The SPSS 13.0 statistical analysis software was employed for data analysis.Results The data of 65 subjects were collected and analyzed. For ultrasound plus radiography,the sensitivity,specificity,DI,accuracy and C/E were 82.1％,88.9％,171.0％,83.1％ and 137.3 respectively.As for CT,the above indices were 96.4％,55.6％,152.0％,90.8％ and 170.7 respectively. Conclusion Considering the higher levels of specificity and DI and a lower C/E,ultrasound plus radiography is superior to CT so that the former modality shall become a first-choice in the diagnosis of ectopic IUD,especially at the grass-root family planning service stations.

Objective To evaluate the efficacy and safety of treating abortive remnants of induced abortion with different doses of mifepristone.Methods A total of 101 women undergoing post-abortion treatment at our family planning clinic from October 2009 to February 2011 were recruited and divided randomly into 4 groups.They were diagnosed as abortive remnants by ultrasound and blood level of β-HCG (human chorionic gonadotrophin).Three test groups received different doses of mifepristone and one group as control. The efficacy and safety of four groups were evaluated by clinical observations,ultrasonic examinations and blood level of β-HCG.Results The effective rates of mifepristone test and control groups were 61.60％ and 21.40％ respectively.And there were statistical significances between two groups ( P ＜ 0.01 ).After a 2-week treatment,the changes of blood level of β-HCG and reduction of residual size tested by ultrasound were better than those of the control group.And there were significant statistical differences (P ＜0.01 ). The group with high dose in short term achieved the best outcomes. After four weeks of treatment,blood level of β-HCG of test groups had no statistical significance ( P ＞ 0.05 ).There was statistical significance in pairwise comparison on reduction of residual size tested by ultrasound among test groups ( P ＜ 0.05 ). The high-dose group with achieved the largest short-term reduction. Statistical significances existed in the hemostatic time of vaginal hemorrhage and menstrual recovery between three test groups and the control group ( P ＜ 0.05 ). No statistical significance was found in healing time and the occurrence of adverse events among these 3 test groups ( both P ＞ 0.05 ).Conclusion Mifepristone is effective in the treatment of induced incomplete abortion.And a short-term large dose offers a better efficacy.

Objective To explore the effects of mifepristone on the expressions of HLA-G,HLA-E and HLA-F in extravillous cytotrophoblasts (EVCT).Methods Cultured EVCT during the first trimester were treated in vitro with progesterone and mifepristone.And the transcription levels of HLA-G,HLA-E and HLA-F genes were detected by RT-PCR (reverse transcription-polymerase chain reaction ).Results As compared with the controls,the levels of HLA-G,HLA-E and HLA-F mRNA significantly increased in EVCT after incubating with 0.1 ng/L progesterone ( P ＜ 0.05 ).These effects could be completely blocked by a co-incubation with mifepristone at the same concentrations.Conclusion Mifepristone can inhibit the effects of progesterone by down-regulating the expressions of HLA-G,HLA-E and HLA-F mRNA in trophoblasts during the first trimester.

Objective To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA).Methods A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA).The amount of hemorrhage and operative duration,degree of pain,rate of inducedabortion syndrome,rate of incomplete abortion,menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups.Results The average age,ratio of parous cases,ratio of the cases of first-pregnancy induced abortion were not different between 2 groups ( P ＞ 0.05 ).The amount of hemorrhage bleeding ( (4.9 ±3.2) ml),operative duration ( (90 ± 12) s),degree of pain,rate of induced-abortion syndrome,menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P ＜ 0.05).However,the rate of incomplete abortion (0.44％ ) in the EPIA group was significantly higher than that (0.21％) in the CIA group ( P ＜ 0.05 ).Conclusion EPIA has the advantages of lesser hemorrhage,less pain,shorter operative duration and fewer complications over CIA.Therefore the recovery of EPIA cases is earlier than that of CIA cases.While the risk of incomplete abortion stays high.

Objective To compare the clinical efficacies of two surgical methods in the treatment of medial tibil-femoral osteoarthritis.Methods Between October 2007 and June 2010,a total of 22 cases (25 knees) with severe osteoarthritis in medial tibial-femoral compartment underwent minimally invasive unicompartmental knee arthroplasty (UKA) with Sled prosthesis after arthroscopic procedure. And its clinical efficacy was compared with that of 22 cases ( 25 knees) undergoing total knee arthroplasty (TKA)with Gemini MK Ⅱ prosthesis almost simultaneously. Results There were no significant difference in general data between 2 groups( P ＞ 0.05 ).Compared with the TKA group,the UKA group had a smaller blood loss (( 148 ±26) vs (278 ±36) ml),a shorter operative duration ((68 ± 12) vs (86± 12) min),a faster progress of resuming 90 ° flexation ( (3.1 ± 1.8 ) vs (9.1 ± 2.2) d) and an earlier off-bed time ( P ＜0.05).All patients were followed up for 6 - 34 months.There was no significant difference in KSS ( Knee Society Score),function score or WOMAC (Western Ontario and McMaster Universities) score between 2 groups at the last follow-up( P ＞ 0.05 ).Conclusion The treatment of medial tibial-femoral osteoarthritis with minimally invasive UKA is superior to that with TKA in that it is less invasive,there is a faster recovery of joint functions and no significant difference exists in the mid-term clinical efficacies between them.

Objective To retrospectively analyze the etiological characteristics of infectious endophthalmitis so as to improve the positive detection rate of its pathogens in laboratory test. Methods The epidemiological features and laboratory findings of 319 inpatients (319 eyes) diagnosed with infectious endophthalmitis at our institute from January 2000 to December 2010 were retrospectively reviewed and analyzed. Results Ocular trauma (n =230,72.10％) was a major risk factor for infectious endophthalmitis.Bacteria and fungi were isolated from intraocualr specimens with the positive rates of 43.57％ ( 139/319) and 18.22％ (49/269)respectively.The positive rates of bacteria culture were 29.00％for nutrient broth medium and 50.23％ for blood enrichment medium respectively. And the difference was statistically significant ( x2 =12.58,P ＜ 0.01 ).The sensitivity of isolated bacteria to levofloxacin was 81.82％. The geometric mean of minimal inhibitory concentrations of amphotericin B, fluconazole,ketoconazole and itraconazole against fungi were 1.05, 5.07,3.00 and 2.42 μg/ml respectively.Conclusion The major cause of infectious endophthalmitis is ocular trauma and the dominant pathogen is bacteria. The use of blood enrichment medium may improve the positive rate of bacteria culture.Levofloxacin and amphotericin B are indicated for the treatment of bacterial and fungal endophthalmitis.

Objective To explore the characteristics of endocardiac and extracardiac haemodynamics parameters in fetus with thickened nuchal translucency (NT) and analyze the relationship between hemodynamic changes and fetal prognosis.Methods The fetal appearance was observed during the first trimester. And the thickness of NT or soft tissue of neck was quantified. The endocardiac and extracardiac haemodynamic parameters were measured by ultrasound Doppler.The parameters were compared between fetus with thickened NT and normal fetus.Echocardiography was performed individually in both 2nd trimester and newborn stage. Results Eight cases with greater NT thickness were found. Four cases terminated pregnancy during the first or second trimester: one was diagnosed as persistent arterial trunk during a 13-week gestation,one with congenital cystic adenomatoid malformation during second trimester.Both were confirmed by autopsy; one with pleural fluid and ascites while another aborted at the expectant mother's will.Four cases were delivered full-term.Among them,one had congenital anal atresia while the other 3 cases were normal.Endocardiac haemodynamic parameters were normal in all cases with thickened NT and no heart malformaiton.Higher pulsatility index ( PI),resistive index (RI) and ratio of velocity of systole and diastole (S/D) in venous duct were observed in 5 cases.The endocardiac and extracardiac haemodynamics parameters of the cases with thickened NT and complicated with heart malformation were different from normal cases.Conclusion Greater NT thickness is closely correlated with chromosomal abnormalities,congenital cardic defects,other structure abnormalities and a poor prognosis. Ultrasound Doppler can evaluate the fetal heart functions accurately. If abnormal endocardiac and extracardiac parameters are found in fetus with thickened NT,the existence of heart malformation should be considered.When abnormal extracardiac Doppler waveshape or greater blood flow resistance is found with normal endocardiac parameters,prognostic follow-ups should be conducted with chromosomal examinations.

Objective To explore the practicability of resecting small lesions in deep brain by intraoperative magnetic resonance imaging (iMRI) and neuronavigator-assisted microsurgery and its clinical efficacies.Methods A total of 42 cases with small lesions in deep brain underwent intraoperative MRI and neuronavigator-assisted microsurgery.The drifting of neuronavigation was corrected by images acquired from intraoperative MR rescanning.Results All lesions were successfully identified and 40 cases totally removed without mortality.Only 3 cases developed new neurological deficits post-operatively while 2 of them returned to normal neurological functions after a follow-up duration of 3 months to 2 years.Conclusion The application of intraoperative MRI can effectively correct the drifting of neuronavigation and enhance the accuracy of microsurgical neuronavigation for small lesions in deep brain.

Objective To investigate the independent risk factors of influencing short-term survival and prognosis of patients with HBV-related acute-on-chronic liver failure ( HBV-ACLF).Methods The clinical data of 338 HBV-ACLF patients hospitalized from January 2007 to December 2010 were collected and analyzed by a Cox regression model.Results The Cox regression analysis showed than gastrointestinal hemorrhage,hepatorenal syndrome,electrolyte imbalance and hepatic encephalopathy could significantly increase their recent mortality risks.And the values of relative risk (RR) were 2.526,2.356,2.068 and 1.896 respectively.Prothrombin activity ( Exp (β):0.821 ) and opportunity of antiviral therapy (Exp(β) of early stage: 0.526; Exp (β) of medium stage: 0.601 ) were protective factors of reduced mortality.Conclusion Gastrointestinal hemorrhage,hepatorenal syndrome,electrolyte imbalance,hepatic encephalopathy,prothrombin activity and opportunity of antiviral therapy are independent risk factors of influencing short-term survival and prognosis of HBV-ACLF patients.The combination of MELD score and multivariate analysis is a more scientific method of determining the prognosis of HBV-related ACLF.

In China, because most women have weak awareness of contraception or misunderstanding of contraception, or even use condoms, safe period, extracorporeal semen and other methods with low efficiency, and can't adhere to the correct use, the rate of induced abortion and repeated abortion are very high.

Objective To explore the protective effect of human 14-3-3 γ gene transfer on dopaminergic cells against rotenone-induced injury.Methods Adenovirus vector carrying the gene of 14-3-3 γ (Ad/14-3-3 γ) was employed to transfect PC12 cells.Then the cells were exposed to rotenone as a model of Parkinson's disease.Methyl thiazolyl tetrazolium (MTT) was used to assay the viability of PC12 cells.The 4',6-diamidino-2-phenylindole (DAPI) staining was used to analyze the apoptotic ratio of PC12 cells among the groups of control,Ad/14-3-3 γ,Ad-null and Rotenone. And high performance liquid chromatography ( HPLC ) was performed to detect the secreting functions of PC12 cells.The aggregates of α-Synuclein protein were detected under confocal microscopy.Results MTT showed that the cell absorbance A570 of Ad/14-3-3 γ group ( 0.46 ± 0.09 ) was higher than that of Ad-null group (0.19 ± 0.08 ) and rotenone group (0.16 ± 0.07 ),but lower than that of normal control ( 0.63 ± 0.11 ),( all P ＜ 0.01 ) ;HPLC-ECD showed that the levels of dopamine (189 ± 11 ) ng/ml and noradrenalin (55 ±8) ng/ml in the culture fluid of Ad/14-3-3 γ group were higher than those of Ad-null group(79 ± 12,38 ± 7 )ng/ml and rotenone group(81 ± 13,39 ± 7) ng/ml ( all P ＜ 0.01 ).DAPI staining showed that cell apoptosis ratio of group Ad/14-3-3 γ (27％ ±64％ ) was lower than that of group Ad-null (53％ ± 10％ ) and rotenone group (56％ ± 12％,P ＜ 0.01 ),but higher than that of control group ( 10％ ±5％,P ＜ 0.01 ).Under confocal microscopy,the aggregates of o-synuclein protein in PC12 cells were detected more in Ad-null group and rotenone group than that in Ad/14-3-3 γ group.Conclusion Gene transfer of Ad/14-3-3 γ has a protective effect on dopaminergic cells against rotenone-induced injury.

Objective To construct TRX-ABAD-DP-TRX (T-A-T) fusion gene of a novel ABAD-DP aptamer through the insertion of ABAD-DP into the modified human thioredoxin (hTRX) and exploit the possibility of further applications for the gene therapy of Alzheimer's disease.Methods According to the designed sequence,the target fragments of TRX1,TRX2 and ABAD-DP were created by PCR ( polymerase chain reaction) and then inserted into the multiple clone site of adeno-associated virus shuttle plasmid pSSHG-CMV with gene cloning technique.The corresponding fusion gene TRX1-ABAD-DP-TRX2 was identified by restriction enzymes digestion with EcoR Ⅰ and BamH Ⅰ.The recombinant adeno-associated virus (AAV/T-A-T) was produced in HeLa cells with linear polyethylenimine.The expression of T-A-T fusion gene and co-localization between T-A-T and Aβ peptide in NIH 3T3 cells were examined by fluorescent immunohistochemistry.Results The size of fusogenic fragment TRX1-ABAD-DP-TRX2 was approximately 435 bp.And it was consistent with our design.T-A-T fusion gene was expressed in NIH 3T3 cells.Through co-expression,T-A-T aptamer and intracellular A3 peptide were co-localized.It indicated that T-A-T aptamer could bind Aβ within NIH 3T3 cells.Conclusion The TRX1-ABAD-DP-TRX2 fusion gene is successfully cloned and expressed.And it may provide rationales for further applications in the gene therapy of Alzheimer's disease.

Objective To explore the molecular mechanisms of Aurora kinase inhibitor PHA739358 in inhibited proliferation and in vitro induced apoptosis of breast cancer cells. Methods The in vitro cultured T47D cells in logarithmic growth phase were used.The effects of PHA739358 on cell proliferation were examined by MTT (methyl thiazolyl tetrazolium ) assay. The variety of nuclear and spindle morphologies was examined by immunofluorescence.And G2/M arrest was determined by flow cytometry.The morphological changes of apoptotic cells were observed by fluorescent microscope.The levels of Aurora kinase relative protein expression phosphorate-AuroraA (p-AuroraA),AuroraA,phosphorate-histone H3 (p-histone H3 ),histone H3,cell cycle-specific protein expression CyclinBl,cell cycle regulative protein expression Cdc2,Cdc25c,phosphorate-Cdc2 (p-Cdc2),phosphorate-Cdc25c (p-Cdc25c) and apoptosis relative protein expression PARP,Bcl-2 and Bax were detected by Western blot.The apoptotic rate was examined by flow cytometer.Results PHA739358 obviously inhibited the proliferation of T47D cells after a 24 h or 48 h treatment in a dose-dependent and time-dependent manner.Their IC50 values were (3.44:0.54) and ( 0.21 ± 0.67 ) μmol/L respectively. Flow cytometry showed that G2/M arrested in a dosedependent manner.PHA739358 dose-dependently and time-dependently promoted the dissection of PARP (poly (ADP-ribose) polymerase); down-regulated the expressions of Bcl-2,p-AuroraA,p-histone H3,CyclinB1 and up-regulated the levels of Bax,p-Cdc25c,p-Cdc2,P21 and P53 protein.PHA739358 had no significant effects on the expressions of AuroraA and histone H3. Flow cytometry and fluorescence microscope showed that PHA739358 significantly induced apoptosis. Flow cytometry showed the rate of apoptosis significantly increased from 0.31％ ± 0.03％ to 40.6％ ± 0.81％. Conclusion The proliferation-inhibiting and apoptosis-inducing effects of PHA739358 may provide new therapeutic approaches of breast cancer.

Objective To explore the changes and its significance of the expression of vascular endothelial growth factor (VEGF) protein and messenger RNA in the Beagle dogs femoral head during the repairing process of the osteonecrosis of femoral head ( ONFH ) under different stress force stimulations.Methods Twenty-four Beagle dogs were selected to establish the model of ONFH through the method of liquid nitrogen cryopreservation.In the mean time,the necrotic femoral heads stimulated by different stress forces were enrolled into 3 groups: group B (low stress force stimulation group),group C (high stress force stimulation group) and group D (average stress force stimulation group).Group A was control group.The beagle dogs were sacrificed at Weeks 4 and 8 post-operation.The changes of femoral head were evaluated by histological observation,immunohistochemical staining and quantitative reverse transcription-polymerase chain reaction (RT-PCR).Results Histological observation showed that articular cartilage,morphology and structure of trabecular bone in group D was better than those of groups B and C.Immunohistochemistry revealed that the VEGF protein positive staining in group D was significantly higher than that in groups A,B and C at Weeks 4 and 8 post-operation.The expression of VEGF mRNA in group D was much more than that in groups A,B and C by RT-PCR.And the expression was higher at Week 8 post-operation.Conclusion Proper stress force stimulation can effectively promote the expression of VEGF protein and messenger RNA in necrotic femoral head of Beagle dogs and boost angiogenesis to improve the blood supply of necrotic femoral head so as to accelerate the repairing process of ONFH.

C5b-9, also known as membrane attack complex, is a common terminal effector product formed by the activation of the complement system through classical, bypass and lectin pathways. In recent years, many studies at home and abroad have found that C5b-9 deposited on the cell surface can stimulate various biological activities of many kinds of cells, including the production of inflammatory mediators, cytokines, and induce the expression of membrane proteins. This cell stimulation effect of C5b-9 plays a role in the pathogenesis and progression of many diseases, especially sublytic C5b-9, which has multiple pathogenic roles in inflammation, nervous system diseases, kidney diseases and atherosclerosis.

According to the data recently released by the International Agency for Research on Cancer, there are more than 800,000 new head and neck and primary central nervous system tumors in the world every year [1]. Although typical radionecrosis is rare at present, cognitive impairment after radiotherapy and chemotherapy is still common [2]. The latest research holds that the once recognized brain radiation tolerance of 60 Gy under conventional segmentation conditions is too conservative, and the probability of radionecrosis after 5 years of brain irradiation is ≤5% (TD5/5). The tolerance should be 72Gy; However, cognitive impairment without radionecrosis may occur at lower doses [3]. Cognitive impairment caused by ionizing radiation is often manifested as hippocampal-dependent cognitive function decline [4], while non-hippocampal-dependent cognitive function impairment is not obvious [5].

There has been no major breakthrough in contraceptive technology since the advent of the pill for 50 years. Steroidal hormone contraceptives cannot meet the needs worldwide, especially in developing countries. It is estimated that more than 200 million women worldwide do not have access to modern contraceptives; About 460 million abortions occur every year, most of them in developing countries [1]. Contraception is an important part of family planning, which can improve maternal and child health and reduce population growth. In 2007, the World Health Organization clearly put forward the urgent need to develop non-hormonal anti-fertility drugs. With the continuous discovery of regulating embryo implantation factors, they will provide new targets for the research and development of new anti-fertility drugs.