Volume 93  ·   Issue 47  ·  2013

To explore the prevalence of cataract and measure the outcomes after cataract surgery in patients aged≥50 years and to evaluate the validity of Rapid Assessment of Avoidable Blindness (RAAB).

A total of 76 clusters of 50 patients aged≥50 years were selected through probability proportionate to size sampling.The measurements of visual acuity (VA) were made with a tumbling-E chart and the diagnosis of the principal cause of visual impairment by an ophthalmologist.

A total of 3288 patients were examined with a response rate of 86.5%.There were 271 males (38.7%) and 2017 females (61.3%).Among 832 cataract patients, 175 (5.3%) had blindness due to cataract.The prevalence of cataract was 9.2%, 25.2%, 47.6%, 70.1% in 50,60,70,80 years old respectively.And 109 eyes underwent cataract surgery.Among 88 pseudophakic eyes (80.7%), 59 eyes achieved excellent outcomes (VA≥0.3) after surgery (54.1%).

The major cause of blindness in Anyue is due to cataract.Attention needs to be paid to improving outcomes after surgery.RAAB provides information about the magnitude and cause of avoidable blindness so that it may be used for planning and monitoring cataract.

To explore the cataract surgical rate (CSR) of Shanghai from 2006 to 2012 and examine its influencing factors.

As of 2003, a cataract surgery registration form had been filled by physicians after every cataract surgery in Shanghai.The local eye disease prevention team then entered the relevant information into the Shanghai Cataract Operations Database.Based upon this database, CSR of Shanghai was calculated.And the number of cataract surgeries was compared between Shanghai urban and suburban districts as well as among different medical institutions.

The overall CSR in Shanghai increased from 1741 in 2006 to 2313 in 2012.In 2012, CSR in urban districts reached 6013 while it stood at 460 and 584 in inner and outer suburb districts respectively.The number of hospitals performing cataract surgery in urban districts was much more than that in suburbs.And the average number of cataract surgeries per hospital per year in suburbs was only one third of that (748 cases) in urban areas.The number of cataract surgeries at in private hospitals increased rapidly during the past 7 years.The number of 1921 cases was nearly twice as many as that at tertiary hospitals in 2012.Phacoemulsification surgery was the most popular surgical choice for cataract removal, accounting for 98.40% of total cataract surgeries in 2012.

Until 2012, CSR in Shanghai dropped below the target of World Health Organization (WHO).A low level of CSR in suburbs is a major influencing factor for the overall level of CSR in Shanghai.

To survey the cataract surgery rate (CSR) according to the report data and its influencing factors of Jiangsu Province in 2012 so as to further improve CSR in China.

Through government websites in 2012, gross domestic product (GDP) and GDP per capital of 13 cities in Jiangsu Province and 7 counties of Nantong City reported to the Ministry of Health in China were collected to calculate CSR.The relationship between GDP and CSR of Jiangsu Province and Nantong City were analyzed with Spearman′s rank correlation,and the differences in the proportion of cataract surgery between government and private hospitals were analyzed by Chi-square test.

CSR in Jiangsu Province in 2012 was 939 cases per million population per year.Nantong City had the highest CSR (1362 cases per million population per year) and Suqian City the lowest (129 cases per million population per year).The GDP of 13 cities in Jiangsu Province had a positive correlation with CSR (spearman r=0.59, P=0.03), but there was no significant correlation with GDP per capital (spearman r=0.50,P=0.08).No significant correlation existed between GDP, GDP per capital and CSR of 7 counties of Nantong City (spearman r=-0.04, P=0.94; spearman r=-0.29, P=0.53).The proportion of private hospitals of Nantong was 33.3% and surgery cases were 4557 (45.9%).The CSR of Rugao County in 2012 was 3317 cases per million population per year.

Socioeconomic level may be related with CSR.Providing village cataract screening services and lowering surgical costs help to boost CSR in China.

To explore the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) in thrombolytic therapy of vena caval thromboembolism.

Ninety patients diagnosed of vena caval thromboembolism by ultrasound or angiography of infernal vena cava were randomly assigned into 2 groups.rt-PA and parental anticoagulant were given to the patients in the treatment group while those in the control group received only parental anticoagulation.D-dimer, fibrinogen and fibrinogen degradation product were analyzed after 2-week treatment.All subjects were closely monitored for the occurrence of severe complications.

The changes from baseline in the above laboratory parameters in the treatment group were significantly greater than those of the control group (P<0.05).No severe complications occurred in either group.

rt-PA is both safe and effective for the thrombolytic therapy of vena caval thromboembolism.

The aim of the study was to analyze the nuclear magnetic resonance image (MRI) findings for invasion of paranasal sinuses in patients with nasopharyngeal carcinoma (NPC) and to improve the understanding of its MRI diagnosis.

The MRI data of 182 patients with nasopharyngeal carcinoma and paranasal sinus invasion were retrospectively analyzed.

One hundred and eigty-two patients developed paranasal sinus invasion, of which, the incidence of sphenoid sinus invasion was highest.The MRI findings of paranasal sinus invasion of patients with NPC were as follows: 100%, 95.6% and 56.6% patients revealed damage of sinus wall, uneven thickening of mucosa, masses of the sinus cavity connected with the primary tumor of nasopharynx, and all the lesions presented iso-or slightly hypo-intense signal on T₁WI and iso-or slightly hyper-intense signal on T₂WI and significantly heterogeneous enhancement after contrast administration, which were consistent with the primary tumor of the nasopharynx regarding to the signal intensity and reinforcement schedule.77.5% patients presented massive sinus cavity effusion.T₂-weighted images are excellent in differentiating high signal intensity thickened mucosa or retained secretions from relatively lower signal intensity tumor.In contrast-enhanced MRI, tumor with solid enhancement can be differentiated from thickened mucosa related to inflammation with a thin superficial enhancement.96.5% and 94.7% patients with maxillary sinus invasion and ethmoid sinus invasion were detected with the contrast enhanced axial T₁-weighted MR imaging respectively, which were higher than those with the non-enhanced axial T₁and T₂imaging (88.4% and 77.9% for maxillary sinus invasion; 65.8% and 73.7% for ethmoid sinus invasion), the differences were statistically significant (P<0.05 for all comparison).All patients with sphenoid sinus invasion were detected with the contrast enhanced sagittal T₁-weighted MR imaging.

Multiplanner MR scan and enhanced scan can improve the diagnosis of nvasion of paranasal sinuses in patients with NPC.The MRI findings of patients with NPC with paranasal sinus invasion include sinus wall damage; unevenly thickening mucous membrane of sinuses; tumors in sinus cavity connective with the primary tumor of nasopharynx,or with massive sinus cavity effusion.The T₂-weighted sequence and contrast enhanced sequence are conducive to differential diagnosis of inflammatory changes from neoplastic tissues.The enhanced axial T₁-weighted section and the enhanced sagittal T₁-weighted section are most helpful to detection of maxillary sinus, ethmoid sinus invasion and sphenoid sinus invasion, respectively.

To investigate the expression of UNC-112 protein in lung cancer and discuss its value.

The method of immunohistochemical SP was employed to detect the expression of UNC-112 protein in 210 cases of lung cancer, and evaluate its correlation with pathological classification.

UNC-112A and UNC-112B protein were highly expressed in non-small cell lung cancer, not expressed or expressed at very low levels in small cell lung cancer (P<0.05);the expression of UNC-112A protein in squamous cell carcinoma was significantly higher than those in adenocarcinoma (P<0.001) and large cell lung cancer (P<0.01),but there is no significant difference between adenocarcinoma and large cell lung cancer (P=0.18).UNC-112A protein expression level was positively correlated with the differentiation of squamous cell carcinoma (P=0.0024).The expression of UNC-112B protein was significantly higher in large cell lung cancer than those in adenocarcinoma (P=0.002) and squamous cell carcinoma (P<0.01),and it was significantly higher in adenocarcinoma than squamous cell carcinoma (P=0.005).

UNC-112 protein may be related to the heterogeneity of lung cancer, UNC-112A and UNC-112B protein play different roles in invasion and migration of lung cancer.

To explore the status of job burnout among Chinese physicians and identify the risk factors for hospital human resource management.

A total of 510 physicians from 10 areas of China participated in the survey from July to October 2012.

Among them, 84.9% reported medium or higher level of emotional exhaustion, 87.8% with moderate degree of depersonalization and 81.8% with at least moderate degree of diminished personal accomplishment.The degree of job burnout was higher among physicians who were unmarried (t=2.12,P=0.03;t=2.06, P=0.04), under 10-year seniority (P=0.03; P=0.01), working at tertiary hospitals (F=2.34, P=0.04) or emergency department (P<0.05).

As a common phenomenon in China, job burnout among physicians should raise great concerns.Individual′s marriage status, length of service, degree of education, hospital class and affiliated department should be considered when identification and intervention of physicians′job burnout are implemented.

To determine the association of single-nucleotide polymorphisms (SNPs) +45T/G of adiponectin gene with gestational diabetes mellitus (GDM) and neonate birth weight.

A total of 264 GDM and 272 pregnant women with normal glucose (NG) were enrolled.DNA was successfully extracted from peripheral blood leucocyte samples.And SNPs+45T/G of adiponectin gene were examined.We also analyzed differences in the genotypic distribution and allelic frequencies in SNP+45T/G of adiponectin gene among GDM group with different neonate birth weights.

There was no significant difference between two groups with respects to SNP+45T/G polymorphisms of adiponectin gene (P>0.05).But significant genotypic difference existed in SNP+45T/G among three GDM groups with different birth weights.Frequencies of T allele were significantly higher in the GDM group with higher birth weight, 68.75% in GDM group with macrosomia and 72.86% in GDM group with 3000-4000 g birth weight (both P<0.01).And there was no significant difference in SNP+45T/G polymorphisms of adiponectin gene between GDM women and NG group with macrosomia.

SNP+45T/G polymorphisms of adiponectin gene are not associated with GDM.However, SNP+45T/G polymorphisms of adiponectin gene of GDM women are closely associated with neonate birth weigh.The G/T polymorphisms of SNP+45 of adiponectin are not obviously associated with a higher occurrence of macrosomia in GDM women.

To explore the application of Femoston in hormone replacement treatment-frozen embryo transfer (HRT-FET) versus endometrial preparation with Progynova and examine the effects of different endometrial thickness and estradiol levels on clinical outcomes.

Retrospective analysis was conducted for a total of 1072 HRT-FET cycles at our center during January-June 2012.According to the type of medication, the patients were divided into 2 groups: Group A:Progynova only (798 cycles).Group B: non-satisfactory endometrial thickness or E2 level only by Progynova or repeated implantation failure, Progynova plus Femoston for preparing endometrium (274 cycles).Then the inter-group differences of basic profiles and clinical outcomes were compared.Comparison of clinical outcomes was performed based on different estradiol (E2) levels and endometrial thickness on the day of using progesterone.And then, the patients whose endometrial double thickness was thinner than 7 mm in Progynova+ Femoston group were compared with the group of similar endometrial thickness in 2011.The data were analyzed with SPSS 16.0.

In Group A, the percentage of first transfer, average endometrial thickness on the day of using progesterone in FET cycles were all significantly higher than Group B.And the ratio of<7 mm was significantly higher in Group B (8.8% vs 2.4%).However, no significant differences existed in clinical pregnancy rate (54.8% vs 52.9%) or embryo implantation rate (38.1% vs 35.8%).With endometrial thickening, both clinical pregnancy and embryo implantation rates increased.There was no significant difference in maximum E2 level.Clinical pregnancy rate, embryo implantation rate and live birth rate of the patients whose endometrial double thickness was thinner than 7 mm in Group B were all higher than those of similar endometrial thickness (all Progynova only) in 2011.

For patients with thin endometrium, vaginal Femoston may be added if ideal endometrial thickness or E2 level is not achieved by Progynova alone.It improves endometrial receptivity and clinical outcomes are more satisfactory.

To evaluate the value of preventive tracheotomy in patients with acute cervical spinal cord injury.

A retrospective analysis was performed on 54 cases of severe C₄-C₈ cervical spinal cord injury patients undergoing anterior fixation.They were classified as A and B according to the criteria of American Spinal Injury Association.And no tracheotomy was performed preoperatively.The patients with a high risk of dyspnea and with an indication for preventive tracheotomy received a preventive tracheotomy right after anterior fixation.11 cases were classified into tracheotomy group and 43 cases were in non-tracheotomy group.The preoperative and hospital stays,incidence of hyoxemia and pulmonary infection, incidence of surgical incision site infection and mortality were analyzed between two groups.

The preoperative and hospital stays of tracheotomy group were shorter than those of non-tracheotomy group (2.9±1.2 vs 5.7±4.4 days, 10.3±4.0 vs 16.5±9.2 days).The incidence of hyoxemia was lower in tracheotomy group (9.1% vs 44.2%).There was difference existed between two groups.44.2% patients in the non-tracheotomy group underwent tracheotomy or endotracheal intubation for dyspnea and hyoxemia.There was no significant difference between two groups in the incidence of pulmonary infection (9.1% vs 7.0%) or surgical incision site infection (0 vs 2.3%).The mortality of non-tracheotomy group was 3.07 folds of that of tracheotomy group (9.1% vs 27.9%).But there was no significant statistical difference.

The preventive tracheotomy is an effective solution for the patients with respiratory compromises, a high risk of dyspnea and with an indication for preventive tracheotomy.The preventive tracheotomy for severe cervical spinal cord can improve respiratory function effectively and fixation may be performed earlier.And there are lower rates of mortality and infection.

To detect the functional networks of the red nucleus and substantia nigra duing the resting state in normal subjects with functional magnetic resonance imaging (f MRI).

Sixteen normal subjects were performed resting state f MRI scanning and susceptibility weighted imaging.The function connectivity networks base on seed regions of the red nucleus and substantia nigra were extracted from low frequency fluctuation signal in f MRI data by using a temporal correlation method.Individual functional maps were entered two-tailed one-sample t test to determine brain regions with significant positive correlation to the seeds.The statistic threshold was set at P<0.001, cluster size>42 (336 mm³), cluster connectivity criterion 5 rmm with Alphasim correction.

Brain regions involved in the functional connectivity network of the red nucleus include: dorsal anterior cingutate, supramarginal gyrus, the ventrolateral and the ventromedial nucleus of the thalamus, globus pallidus, dorsal thalamus, hippocampus, substantia nigra, red nucleus, pons, dentate nucleus, vermis; Brain regions involved in the functional connectivity network of the substantia nigra include: anterior cingutate, supramarginal gyrus, globus pallidus, dorsal thalamus, hippocampus, lobus insularis, substantia nigra, red nucleus, pons, dentate nucleus.The distribution of thhe networks of the red nucleus and substantia nigra presented symmetrical.Although the functional networks of the red nucleus and substantia nigra overlaped largely with each other, the rubral network was slightly different with the nigral network, witch showed strong correlations with more wide-spread striatum and thalamus areas.

The functional networks of the red nucleus and substantia nigra reflected strong interplay within the extrapyramidal subcortical system, as well as correlations between some limited cerebral cortices; Functional magnetic resonance imaging is a potential powerful tool to explore the extrapyramidal system.

To employ trans-esophageal echocardiography (TEE) to observe the tourniquet′s influence on cardiac function in total knee arthroplasty (TKA).

Twenty ASA Ⅰ-Ⅱ patients undergoing TKA under general anesthesia from September 2011 to February 2012 at Department of Orthopedics, Beijing Jishuitan Hospital were selected.Tourniquet was loosened at 30 minutes after the start of TKA.And TEE was employed to observe the occurrence rate and degree of intra-cardiac embolus and the changes of cardiac function at 5, 10 and 15 min post-loosening respectively.

Different degrees of "meteor-shaped" microemboli images appeared in right atriums of all patients.The "meteor shape" image was the most obvious after loosening for 5 min.It started to decrease after 10 min, persisted generally and declined further after 15 min.The left ventricular areas at end diastole (LVAd) after loosening tourniquet for 5, 10 and 15 min were (7.62±0.54), (7.86±0.46) and (8.55±0.56) cm² respectively.And there were remarkable changes compared with the area (9.80±0.48) cm² pre-loosening (P<0.01).The fractional area change (FAC) showed obvious decrease since loosening for 5 min (P<0.01).

Massive meteor-shaped microembolis appear on TEE with weakened cardiac function.

To explore the safety and immediate efficacy of endovascular treatment for superior mesenteric artery embolism.

From November 2007 to October 2012, 18 cases of superior mesenteric artery embolism were treated by thrombus extraction and/or catheter-directed thrombolysis.There were 13 males and 5 females with an age range of 44-91 years.The concurrent conditions included atrial fibrillation (n=8) and rheumatic valve disease (n=3).All diagnoses were made with abdominal enhanced computed tomography (CT) examination.Embolism was predominantly located at 3 to 10 cm away from opening.The procedures included thrombus extraction plus system thrombosis (n=3), thrombus extraction and catheter-directed thrombolysis (n=6), catheter-directed thrombolysis (n=5) and thrombus extraction, catheter-directed thrombolysis and PTA (n=2).

The technical success rate was 100%.Two cases had new embolism in popliteal artery.Another case with peritoneal irritation syndrome died after automatic discharge.The other 17 patients obtained satisfactory results and were followed up after 6 months by color Doppler ultrasound or abdominal enhanced CT.It showed that superior mesenteric arteries were unobstructed, but local stenosis occurred in 2 cases.

Endovascular interventional therapy is both safe and efficacious in the treatment of superior mesenteric artery embolization.And its immediate effect is satisfactory.

To explore the role of Syk and VEGF-C in the development of NSCLC.

Transfered these genes (eukaryotic expression vector pcDNA3.1-VEGF-C and p LNCX-syk) into A549 cells with the liposomes.Tested the expression of VEGF-C mRNA and Syk mRNA with RT-PCR.Investigated the cell invasion assay with transwell chamber in vitro.Analysised the expression of VEGF-C proteins in A549 cells and detect Syk and VEGF-C proteins of 81 NSCLC tissue samples with immunohistochemical staining.

Higher expression of VEGF-C was revealed in VEGF-C-construct-transfected A549 cell than that in controls through RT-PCR (P<0.05) and immunohistochemistry (P<0.01).RT-PCR also revealed that Syk expression was higher in Sykconstruct-transfected cells than in controls (P<0.05).The cell invading experiments showed that there was more invaded cells in both transfected terms than in controls (P<0.05).The expression of Syk protein in NSCLC tissue were significantly lower than that in the normal lung tissue (P<0.05), while the expression of VEGF-C protein in NSCLC tissue were significantly higher than that in the normal lung tissue (P<0.05).The expression of Syk and VEGF-C has a negative correlationship (r=-1.000, P=0.019).

The expression of Syk and VEGF-C has a negative correlationship in NSCLC tissue, VEGF-C-construct-transfected A549 cells are more aggressive than Syk-constructtransfected cells.And they may cooperated with each other in the development of NSCLC.

To investigate whether protective effect of tacrolimus postconditioning on rats′spinal cord ischemia-reperfusion injury is mediated by up-regulation of activity of endogenous antioxidant enzymes and down-regulation of production of oxygen free radicals.

Ninety male Sprague-Dawley rats were randomly divided into ischemia-reperfusion (IR) group, tacrolimus postconditioning (TP) group and sham operation (SO) group.The model of spinal cord ischemia was prepared by means of catheterization through femoral artery and balloon dilatation.IR group underwent reperfusion 20 min after spinal cord ischemia.TP group experienced a single injection of tacrolimus (0.5 mg/kg) through the left common carotid artery at the onset of reperfusion.SO group received femoral artery catheterization only.Fluorospectrophotometry was employed to detect the level of reactive oxygen species (ROS) in injured spinal cord segment at 15 minutes after reperfusion.The content of malondialdehyde (MDA) and activity of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-PX) were determined at 15 minutes, 1, 6, and 24 hours after reperfusion respectively.BBB scale was conducted to evaluate hindlimb motor function at 14 days after reperfusion.

The level of ROS in TP group was significantly lower than that in IR group at 15 minutes after reperfusion.The activity of SOD was significantly higher in TP group than in IR group at all observational time points, while the activities of CAT and GSH-PX were significantly higher in TP group than in IR group at 1 and 6 hours after reperfusion.The content of MDA in TP group was significantly less than that in IR group at all observational time points.The motor function score of TP group was significantly superior to that of IR group at 14 days after reperfusion.

Tacrolimus postconditioningcan improve activity of endogenous antioxidant enzymes, decrease production of oxygen free radicals, suppress lipid peroxidation,and thereby promote functional recovery after spinal cord ischemia-reperfusion injury in rats.

To explore the effects of aging on the levels of reproduction-related mRNA genes including Gnrh, KISS1/KISS1r, estrogen receptor-alpha (ERα), estrogen receptor-beta (ERβ) and progesterone receptor (PR) in hypothalamus.

Proestrus and metestrus in young (3-4 months) and middle-aged (10-11 months) female mice and diestrus in senile (18-19 months) female mice were observed.And the levels of related m RNA genes in preoptic area anterior hypothalamus (POA-AH) and medial basal hypothalamus (MBH) were determined by real-time polymerase chain reaction (RT-PCR).

In middle-aged mice on proestrus, the level of Gnrh mRNA in POA-AH (0.896±0.049) was significantly lower than that in young mice (1.228±0.147, P=0.049).The level of ERα mRNA in POA-AH decreased in young mice on proestrus whereas increased in middle-aged mice (0.432±0.063 vs 0.603±0.018, P=0.016).The level of ERα mRNA of POA-AH, both in middle-aged mice (0.432±0.063, P=0.014) and senile mice (0.403±0.145, P=0.020) on diestrus, were significantly lower than that in young mice.The PR mRNA expression in middle-aged mice on proestrus (1.037±0.037) was markedly lower than that in young mice (1.251±0.081, P=0.031).In senile mice, the levels of Gnrh mRNA (1.520±0.146, P=0.004) and ERβ mRNA (1.572±0.184, P=0.011) increased in POA-AH compared with that in young mice on metestrus.Aging had no effect upon KISS1 and KISS1r mRNA levels in POA-AH.In contrast, KISS1 mRNA level of MBH in middle-aged (1.663±0.398, P=0.037) and senile (2.622±0.454, P=0.014) mice obviously increased compared with the young mice group.

Higher levels of ERα mRNA and decreases of PR and Gnrh mRNA in POA-AH in middle-aged mice on proestrus may play an important role in declining reproductive function.

To explore the interaction mechanism and influence between fatty acids oxidation and p38MAPK signal transduction pathway in trophoblast cells stimulated by fatty acids of different chain lengths.

Serum-free trophoblast cells cultured in vitro were divided into 5 groups, i.e.incubation with DMEM/F12 medium without FFA (F-FFA), short-chain fatty acids (SC-FFA), medium-chain fatty acids (MC-FFA), long-chain fatty acids (LC-FFA) and very longchain fatty acids (VLC-FFA).Then cells in each group were stimulated by DMEM/F12 medium, NADPH oxidase inhibitor (Apocynin) and p38MAPK inhibitor (SB203580) and were subdivided into FFA plus-DMEM group, plus-NADPH-I and plus-p38MAPK-I groups.Expressions of mRNA and protein of LCHAD in trophoblast cells were detected by real-time polymerase chain reaction (PCR) and Western blot.

(1) mRNA expression of LCHAD: theΔct of mRNA of LCHAD in FFFA+DMED, SC-FFA+DMEM, MC-FFA+DMEM, LC-FFA+DMEM, LC-FFA+NADPH-I, LC-FFA+p38MAPK-I and VLC-FFA+DMEM, VLC-FFA+NADPH-I, VLC-FFA+p38MAPK-I groups were 4.57±0.12, 4.36±0.09, 4.55±0.10, 6.84±0.42, 4.45±0.24, 5.08±0.36, 2.23±0.15,3.90±0.32, 3.81±0.41.Compared with the F-FFA groups, the relative m RNA expressions of LCH AD significantly decreased in LC-FFA+DMEM/p38MAPK-I groups (P<0.05) while increased in VLC-FFA groups (P<0.05).Compared with the LC-FFA+DMEM groups, the relative mRNA expressions of LCHAD increased in LC-FFA+NADPH-I/p38MAPK-I groups (P<0.05).The relative m RNA expressions of LCHAD in VLC-FFA+NADPH-I/p38MAPK-I groups significantly decreased versus VLC-FFA+DMEM group (P<0.05). (2) Protein expression of LCH AD: The relative protein expressions of LCHAD in F-FFA+DMED, SC-FFA+DMEM, MCFFA+DMEM, LC-FFA+DMEM, LC-FFA+NADPH-I, LC-FFA+p38MAPK-I and VLC-FFA+DMEM, VLC-FFA+NADPH-I, VLC-FFA+p38MAPK-I groups were 23.6±13.0, 21.2±10.2, 19.7±1.9, 10.6±2.6,14.0±1.8,14.0±2.8,29.3±1.9,35.8±3.2 and 35.2±4.5 respectively.Compared with the F-FFA groups, the protein expressions of LCHAD significantly decreased in LCFFA groups (P<0.05) while increased in VLC-FFA+NADPH-I/p38MAPK-I groups (P<0.05).

Free fatty acids affect the gene and protein expressions of mitochondrialβ-oxidation enzyme of LCHAD in trophoblastic cells.Fatty acidβ-oxidation is impaired in trophoblast cells incubated with long-chain fatty acid.NADPH oxidase and p38MAPK inhibitors may alleviate such an effect.Thus p38MAPK signal transduction pathway may participate in this process.The correlation between very long chain fatty acids and fatty acidβ-oxidation is confirmed.But their interactions require further explorations.