Diagnosis and treatment of emergency inguinal hernia / 中华消化外科杂志

Objective:To investigate the diagnosis and treatment of emergency inguinal hernia.Methods:The retrospective cross-sectional study was conducted. The clinical data of 236 patients with emergency inguinal hernia who were admitted to the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were collected. There were 194 males and 42 females, aged (69±30)years. Hospitalized patients received routine blood biochemistry test and imaging examinations for evaluation of characteristics of hernia contents and intestinal obstruction. Manual reduction and surgical treatment were selected according to the conditions of patients. Observation indicators: (1) treatment; (2) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect hernia recurrence and late-onset mesh infection up to August 2020. Measurement data were described as M (range) or M ( P25, P75), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were represented as absolute numbers, and comparison between groups was done using the chi-square test. Results:(1) Treatment: of the 236 patients, 106 cases had successful manual reduction, 124 cases underwent emergency operation, 6 cases refused surgery. ① For 106 cases with successful manual reduction (including 4 cases guided by B-ultrasonography), the manual reduction time was 5 minutes (2 minutes,7 minutes). Ninety-three of 106 patients underwent selective operation after manual reduction, including 89 cases with indirect hernia, 2 cases with direct hernia and 2 cases with compound hernia. The time to selective operation was 3 days(2 days,5 days) after manual reduction. Patients underwent mesh repair, of which the operation time, volume of intraoperative blood loss, time to postoperative first flatus, duration of postoperative hospital stay were 44 minutes (29 minutes, 66 minutes),10 mL(5 mL,20 mL), 1 day(1 day,2 days), 1 day(1 day,2 days), respectively. Eleven patients didn't undergo selective operation. Two patients with abdominal pain and fever after manual reduction were diagnosed with perforation of intestine by emergency surgical exploration, and then underwent partial intestinal resection combined with high ligation of hernial sac. ② There were 93 of 124 patients undergoing emergency operation with indirect hernia, 18 cases with femoral hernia, 6 cases with obturator hernia, 6 cases with compound hernia and 1 case with direct hernia. There were 54 of 124 patients undergoing open operation, including 21 cases with Bassini surgery, 18 cases with Lichtenstein surgery, 9 cases with Mc Vay surgery, 6 cases with high ligation of hernia sac. There were 70 patients undergoing laparoscopic operation, including 57 cases with laparoscopic transperitoneal preperitoneal hernia repair (TAPP), 10 cases with laparoscopic explora-tion + tissue repair and 3 cases with laparoscopic exploration + closure of inner inguinal ring. The operation time, volume of intraoperative blood loss, time to postoperative first flatus, cases with short-term postoperative complications were 60 minutes (50 minutes,76 minutes), 20 mL(14 mL,30 mL), 2 days(1 day,2 days), 15 cases for patients undergoing open surgery, respectively. The above indicators were 56 minutes (47 minutes,77 minutes), 20 mL(10 mL,25 mL), 2 days(1 day,2 days), 21 cases for patients under-going laparoscopic surgery. There was no significant difference in the above indicators between the two groups ( Z=?0.88, ?1.37, ?1.56, χ2=0.07, P>0.05). Cases with intraoperative placement of mesh and duration of hospital stay were 18 cases and 5 days(3 days,8 days) for patients undergoing open surgery, versus 57 cases and 3 days(2 days,5 days) for patients undergoing laparoscopic surgery, showing significant differences between the two groups ( χ2=29.50, Z=?4.32, P<0.05). (2) Follow-up: of 236 patients, 192 were followed up for 2?60 months, with a median follow-up time of 19 months. Seven patients had recurrence of hernia after emergency operation, including 3 with high ligation of the hernia sac, 2 with Bassini surgery, 1 with Lichtenstein surgery, and 1 with laparoscopic exploration + closure of inner inguinal ring. One patient with late-onset mesh infection after Lichtenstein surgery was improved after mesh removal. No long-term complications such as hernia recurrence or late-onset mesh infection occurred to the 184 patients. Conclusions:Emergency inguinal hernia had different state of illness, manual reduction is suitable for partial patients with incarceration. Surgery is the first choice, and the surgical procedure needs to be individually selected.

Role of allograft inflammatory factor-1 in regulating the proliferation, migration and apoptosis of colorectal cancer cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of allograft inflammatory factor-1 (AIF-1) in colorectal cancer (CRC) progression and explore the possible mechanism.</p><p><b>METHODS</b>The expression levels of AIF-1 in 70 CRC tissues and paired adjacent tissues were detected using immunohistochemistry and Western blotting, and the correlation of AIF-1 expression with the clinicopathological features of the patients was analyzed. In the CRC cell line SW480, the functional role of AIF-1 in regulating tumor progression was investigated by transfecting the cells with an AIF-1-overexpressing plasmid (AIF-1) and a negative control plasmid (NC). EdU proliferation assay and flow cytometry were used to assess the cell proliferation and cell cycle changes; Transwell migration assay and Annexin V-APC/7-AAD apoptosis assay kit were used to analyze the cell migration and apoptosis. The changes in the biological behaviors of the cells were observed after application of SB203580 to block the p38 MAPK pathway. The expression levels of CDK4, cyclin D1, P21, P27, MMP2, MMP9, Bax, Bcl2, Bcl-xl, p38 and p-p38 were detected using Western blotting.</p><p><b>RESULTS</b>AIF-1 was down-regulated in CRC tissues compared with the adjacent normal tissues, and its expression level was positively correlated with lymph node metastasis (P=0.008), TNM stage (P=0.003) and tumor size (P=0.023). Overexpression of AIF-1 in SW480 cells significantly reduced EdU-positive cells and caused obvious cell cycle arrest in G1 phase (P<0.05). AIF-1 overexpression resulted in significantly lowered protein expressions of CDK4 and cyclin D1, enhanced expressions of P21 and P27, attenuated cell migration ability (P<0.001), and decreased protein levels of MMP2 and MMP9. AIF-1 overexpression also induced obvious apoptosis of SW480 cells (P<0.01), significantly increased the protein levels of Bax and p-p38, and decreased the protein levels of Bcl-2 and Bcl-xl; SB203580 significantly attenuated the apoptosis-inducing effect of AIF-1 overexpression.</p><p><b>CONCLUSION</b>AIF-1 plays the role of a tumor suppressor in CRC by inhibiting cell proliferation, suppressing cell migration and inducing cell apoptosis. AIF-1 overexpression promotes the apoptosis of CRC cells by activating the p38 MAPK pathway.</p>

Dynamic Change of Red Cell Distribution Width Levels in Prediction of Hospital Mortality in Chinese Elderly Patients with Septic Shock / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The normal range of red cell distribution width (RDW) level is <15%. Several studies have indicated that a high RDW level was associated with mortality in critically ill patients, and the patients with a high RDW level need increased focus in clinical practice. In view of the difficulty in defining the specific value of high RDW level, the key is to focus on the patient with the level beyond the normal upper limit. This study aimed to determine whether dynamic change of RDW levels, rather than the level itself, is predictive of death in elderly patients with septic shock when RDW level is beyond 15%.</p><p><b>METHODS</b>Between September 2013 and September 2015, the elderly septic shock patients with RDW level beyond 15% were enrolled in this study. The RDW levels were measured at enrollment (day 1), and days 4 and 7 after enrollment. Sequential Organ Failure Assessment (SOFA) scores were recorded simultaneously.</p><p><b>RESULTS</b>A total of 45 patients, including 32 males and 13 females, were included in the final analysis. Based on their hospital outcomes, these patients were divided into the survivor group (n = 26) and the nonsurvivor group (n = 19). There were no significant differences in age, gender, body mass index, initial level of RDW, Acute Physiology and Chronic Health Evaluation II scores, and SOFA scores between survivors and nonsurvivors. At days 4 and 7 measurement, both RDW level (median [interquartile range]: day 4: 15.8 [2.0]% vs. 16.7 [2.0]%, P= 0.011; and day 7: 15.6 [1.8]% vs. 17.7 [2.5]%, P= 0.001) and SOFA scores (day 4: 7.0 [4.0] vs. 16.0 [5.0], P< 0.001, day 7: 5.5 [4.0] vs. 17.0 [5.0], P< 0.001) were significantly lower in survivors than those in nonsurvivors. Dynamic changes of RDW and SOFA scores in survivor group were significantly different from those in nonsurvivor group (all P< 0.05). Continuous increase in RDW level was observed in 10 of the 13 nonsurvivors, but only in 3 of the 26 survivors. The level of RDW7 and dynamic changes significantly correlated with their counterparts of SOFA scores (all P< 0.05), whereas the levels of RDW1 and RDW4 had no significant correlation with their counterparts of SOFA scores (all P> 0.05).</p><p><b>CONCLUSIONS</b>Continuous increase in RDW level, rather than the level of RDW itself, was more useful in predicting hospital death in elderly patients with septic shock when the level of RDW was >15%. The dynamic changes of RDW were highly correlated with the SOFA score in the patients.</p>

Clinical efficacy of laparoscopic transabdominal preperitoneal hernia repair and risk analysis affecting postoperative complications / 中华消化外科杂志

Objective To explore the clinical efficacy of laparoscopic transabdominal preperitoneal (TAPP) hernia repair and risk factors affecting postoperative complications.Methods The retrospective casecontrol study was conducted.The clinical data of 595 patients who received laparoscopic TAPP hernia repair in the First Affiliated Hospital of Soochow University from February 2008 to August 2016 was collected.Operations were performed by the same doctors' team.Observation indicators:(1) surgical situations;(2) postoperative situations;(3) follow-up situations;(4) risk factors affecting complications after laparoscopic TAPP hernia repair.Follow-up using outpatient examination and telephone interview was performed to detect the recovery time of non-restricted activity,postoperative complications and hernia recurrence up to February 2017.Measurement data with normal distribution were represented as (x)±s.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model.Results (1) Surgical situations:595 patients underwent laparoscopic TAPP hernia repair using the heavy meshes.Overall operation time and overall volume of blood loss were (55±25) minutes and (7±5)mL,including operation time of (50±20)minutes in 502 unilateral hernias and operation time of (81 ± 29)minutes in 93 bilateral hernias.Of 595 patients,34 had incarcerated hernia,the contents of hernia:greater omentum,small intestine and sigmoid colon were detected in 21,11 and 2 patients,respectively,with an incarcerated time of 2-21 hours;4 with incarcerated hernia induced small intestinal necrosis received laparoscopy-assisted small intestinal resection ± anastomosis,1 with sigmoid colon necrosis received necrotic sigmoid canal resection ± sigmoidostomy and 29 received repair after the contents restoration of hernia.Operation time and volume of intraoperative blood loss in 34 patients with incarcerated hernia were (84 ± 39)minutes and (12±6) mL.Thirteen of 595 patients (10 with indirect hernia and 3 with direct hernia) had recurrent hernia,and operation time and volume of intraoperative blood loss were (75±-26)minutes and (10± 5)mL.(2) Postoperative situations:time to initial exsufflation of 595 patients was (19± 12)hours.Of 595 patients,590 took fluid diet at 6 hours postoperatively and 5 undergoing enterectomy took fluid diet at 24 hours postoperatively.The pain score at 1 day postoperatively and duration of hospital stay were respectively 2.5± 1.4 and (2.1± 1.9)days.(3) Follow-up situations:of 595 patients,593 recovered non-restricted activity at 2 weeks postoperatively and 2 didn't recover non-restricted activity at 2 weeks postoperatively.Of 595 patients,542 were followed up for 6-60 months,with a median time of 31 months.Fifty-seven,25,13 and 1 patients were respectively complicated with seroma,surgical pain,urinary retention and enteroparalysis,they were improved by symptomatic treatment,and the same patient can have multiple complications.There were no severe complications which needed surgical intervention,such as vascular injury,damnify of intestinal canal and poke hole hernia.Of 2 patients with recurrence of hernia,1 with right indirect hernia had recurrence of direct hernia and then received Lichtenstein tension-free hernia repair,and 1 received treatment in other hospital.(4) Risk factors affecting complications after laparoscopic TAPP hernia repair:results of univariate analysis showed that age,diameter of hernia sac,incarcerated hernia,recurrent hernia,operation time and volume of intraoperative blood loss were related factors affecting complications after laparoscopic TAPP hernia repair (x2 =6.657,55.296,44.305,5.253,117.461,100.722,P＜0.05).Results of multivariate analysis showed that diameter of hernia sac ≥ 4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL were independent risk factors affecting complications after laparoscopic TAPP hernia repair (OR =3.610,11.315,12.401,7.346,95％ confidence interval:2.009-6.486,3.579-35.772,5.408-28.437,3.739-14.434,P＜ 0.05).Conclusion Laparoscopic TAPP approach for inguinal hernia is safe and effective,and diameter of hernia sac ≥4 cm,incarcerated hernia,operation time ≥ 100 minutes and volume of intraoperative blood loss ≥ 10 mL are independent risk factors affecting complications after laparoscopic TAPP hernia repair.

Day-case laparoscopic cholecystectomy: analysis of 59 consecutive patients / 国际外科学杂志

Objective To evaluate the feasibility and outcome of laparoscopic cholecystectomy as a overnight procedure in China.Methods The data of 59 consecutive patients who had undergone outpatient laparoscopic cholecystectomy between Januaiy 2013 and January 2015.All the patients were operated in the morning hours and discharged during 24 hours after operation.They were contacted by telephone 3 days subsequent to surgery and were seen in the outpatient unit 7 days after.Results Fifty-nine laparoscopic cholecystectomies were performed.No Conversion to open surgery case.The average operation time was 25 minutes,and restore semi-liquid diet 6 hours after the operation All the 59 patients were discharged during 24 hours after operations.None of the patients had an emergency readmission.None of the patients had complications 7 days after discharged.The average payment was 8 240 yuan.Conclusion These results suggest that laparoscopic cholecystectomy can be routinely performed as a overnight procedure.

Effect of 18-β Glycyrrhetinic Acid on the Endoplasmic Reticulum of Nasal Epithelial Cells in Allergic Rhinitis Model Rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of 18-β glycyrrhetinic acid (GA) on the endoplasmic reticulum of nasal epithelial cells in allergic rhinitis (AR) model rats.</p><p><b>METHODS</b>Totally 96 Wistar rats were randomly divided into the blank group, the AR model group, the loratadine group, the GA group, 24 in each group. AR models were established by peritoneally injecting ovalbumin (OVA). Morphological scoring was performed. GA at 21. 6 mg/kg was intragastrically administered to rats in the GA group. Nasal mucosal tissues were taken for electron microscopic examinations at the second, fourth, sixth, and tenth week after drug intervention.</p><p><b>RESULTS</b>The overlapping score was 2.10 ± 0.45 in the blank group, 5.10 ± 0.56 in the loratadine group, 5.10 ± 0.56 in the AR model group, 5.20 ± 0.78 in the GA group, showing statistical difference when compared with the blank group (P < 0.01). Results under transmission electron microscope showed that the number of the endoplasmic reticulum increased in the AR model group, with obvious cystic dilatation, a lot of vacuole formation, and degranulation. A large number of free ribosomes could be seen in cytoplasm. With persistent allergen exposure, changes mentioned above was progressively aggravated in the endoplasmic reticulum of nasal mucosal epithelium in the AR model group. But the dilation of endoplasmic reticulum, vacuole formation, and degranulation were relieved in the GA group, and got close to those of the blank group.</p><p><b>CONCLUSION</b>18-β GA could improve the expansion, vacuolization, and degranulation of the endoplasmic reticulum of nasal epithelial cells in AR model rats.</p>

Association between SIRT1 gene polymorphisms and longevity of populations from Yongfu region of Guangxi / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association between SIRT1 gene polymorphisms and the longevity phenomena in Yongfu region of Guangxi. In this case-control study, 500 individuals from Yongfu region of Guangxi were recruited. The subjects were divided into a longevity group (n=223, average age=93.17 U+00B1 3.08 yr) and a healthy control group (n=277, average age=46.92 U+00B1 17.12 yr). Polymerase chain reaction-high resolution melting curve (PCR-HRM) and DNA sequencing were used to determine the allelic and genotypic frequencies of rs3758391, rs3740051, rs2273773, rs4746720 and rs10997870 polymorphisms of SIRT1 gene in the two groups. The association between above polymorphisms and longevity was assessed.</p><p><b>RESULTS</b>In the longevity group, CT genotype of the rs4746720 locus was significantly more common than CC and TT genotypes (P=0.000, OR=2.098, 95%CI:1.412-4.117). However, no significant difference was found in the allelic and genotypic frequencies of rs3758391, rs3740051 and rs2273773 between the two groups.</p><p><b>CONCLUSION</b>There is an association between rs4746720 of SIRT1 gene and longevity in Yongfu region of Guangxi.</p>

Tounongsan extract induces apoptosis in cultured Raji cells / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Tounongsan () extract (TNSE) on proliferation and apoptosis of the human lymphoma cell line Raji and its possible mechanism of action.</p><p><b>METHODS</b>The viability of TNSE-treated Raji cells was measured by a 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Cell apoptosis was determined by flow cytometry. The molecular mechanisms of TNSE-mediated apoptosis were further investigated by reverse transcription-polymerase chain reaction (RT-PCR) analysis of the mRNA expression of nuclear factor κB (NF-κB), Bcl-xL, Bcl-2-associated death promoter (Bad), caspase-9 and caspase-3. Western blotting was used to detect the protein expressions of NF-κB, Bad, cleaved caspase-9 and cleaved caspase-3.</p><p><b>RESULTS</b>TNSE inhibited Raji cell proliferation in dose- and time-dependent manners. After 48-h treatment with various concentrations of TNSE (125, 250 and 500 μg/mL), the apoptosis rates of Raji cell were 12.23%±1.98% (P<0.05), 20.97%±3.96% (P<0.01) and 30.4%±4.87% (P<0.01), respectively, compared with those of the control (6.02%±1.01%). RT-PCR demonstrated that NF-κB mRNA expression was significantly downregulated in Raji cells treated with 250 μg/mL TNSE for 48 h (P<0.05), while Bad, caspase-9 and caspase-3 mRNA levels were upregulated (P<0.05). Moreover, TNSE treatment resulted in downregulation of NF-κB protein expression and strikingly upregulated protein expressions of Bad, cleaved caspase-9, cleaved caspase-3 in a dose-dependent manner, as determined by Western blot.</p><p><b>CONCLUSION</b>TNSE exhibits significant anti-proliferative and apoptotic effects in Raji cells, which may be involved in regulation of NF-κB and Bad, and activation of caspase-9 and caspase-3.</p>

Effect of quercetin on neural stem cell proliferation in the subventricular zone of rats after focal cerebral ischemia-reperfusion injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of quercetin on the proliferation of neural stem cells in the subventricular zone (SVZ) of rats after focal cerebral ischemia.</p><p><b>METHODS</b>An adult rat model of middle cerebral artery occlusion (MCAO) model was established by placement of an intraluminal filament at the origin of the MCA. Quercetin was administered intraperitoneally in the rats at a dose of 50 mg/kg every 3 days starting at 6 h after MCAO, and BrdU (50 mg/kg daily) was also injected intraperitoneally starting at 4 h after MCAO. BrdU-positive cells in the SVZ were counted at 7, 14 and 21 days after MCAO.</p><p><b>RESULTS</b>Compared with the sham-operated group, the rats in the ischemic model group showed significantly increased BrdU-positive cells in the ipsilateral SVZ 7 days after MCAO, reaching the peak level on day 14 and beginning to decrease on day 21 (P<0.05). The number of ipsilateral BrdU-positive cells in quercetin group was significantly greater than that in the model group on days 7, 14 and 21 (P<0.05), and maintained the high level on day 21.</p><p><b>CONCLUSION</b>Quercetin can maintain a high level of neural stem cell proliferation in the SVZ after focal cerebral ischemia in adult rats.</p>

Study on the longevity related mitochondrial genome variation in Bama elderly population in Guangxi province / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the human mitochondrial DNA (mtDNA) variations associated with longevity in Bama elderly population from Guangxi.</p><p><b>METHODS</b>Mitochondrial genome of 20 individuals over 96 years of age was sequenced, and seven target single nucleotide polymorphism (SNPs) were observed by comparing with the standard rCRS sequence, and two were tested by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in a larger population including 208 individuals of 90-113 years old, and 586 unrelated control individuals from Guangxi.</p><p><b>RESULTS</b>The 4824G frequency of the mtDNA4824A/G locus increased with age both in the long-lived elderly and in controls. And it was significantly higher in controls than that in long-lived population (P<0.05).</p><p><b>CONCLUSION</b>The mtDNA4824 A/G is not only an age-related locus, its mutation is also negatively correlated with longevity.</p>

Effect of Lianggesan on the expression of signal transducer and activator of transcription 1 in a rat model of lipopolysaccharide-induced acute lung injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of Lianggesan on the expression of signal transducer and activator of transcription 1 (STAT1) in rats with lipopolysaccharide (LPS)-induced acute lung injury and explore the possible mechanisms of the therapeutic effects.</p><p><b>METHODS</b>Endotoxemia was induced in Wistar rats by intravenous injection of LPS (5 mg/kg). The rats were randomly divided into 6 groups, namely the control group, acute lung injury group (LPS group), 3 Lianggesan groups treated at different doses, and LPS+DEX treatment group. Each group, except for the control group, was further divided into 5 subgroups and examined at 1, 2, 4, 8 and 16 h after LPS injection. Western blotting was used to detect the protein expression of STAT1 and p-STAT1 in the lung tissue.</p><p><b>RESULTS</b>In LPS group, the expression of STAT1 began to increase at 1 h following LPS injection, reaching the peak level at 4 h; the peak expression of p-STAT1 occurred at 2 h after LPS administration (P<0.01). Compared with LPS group, the 3 Lianggesan groups and DEX group showed significantly decreased expressions of STAT1 and p-STAT1 at 2, 4 and 8 h after LPS injection (P<0.05 or 0.01).</p><p><b>CONCLUSION</b>Abnormal expression of STAT1 occurs in the lung tissue in the event of ALI. Lianggesan can relieve LPS-induced acute lung injury in rats by decreasing the expression of STAT1 and p-STAT1.</p>

Protective effect of mild hypothermia on astrocytes with traumatic or ischemic injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the protective effect of mild hypothermia on rat astrocytes with traumatic or ischemic injury.</p><p><b>METHODS</b>Rat astrocytes in primary culture were subjected to scratching or hypoxic injury and exposed to normothermia (37 degrees celsius;) or hypothermia (34 or 32 degrees celsius;) for 24 h. The morphology of the astrocytes was evaluated by live/dead staining, and the cell injury was measured by lactate dehydrogenase (LDH) release assay.</p><p><b>RESULTS</b>As the temperature reduced the LDH release rate from the cells in hypoxic group decreased significantly, to (11.48 - or + 1.53)% at 34 degrees celsius; and (3.79 - or + 0.45)% at 32 degrees celsius; as compared to that in normothermia [(33.02 - or + 3.58)%] in the absence of rat white blood cells (WBC) (P<0.001). LDH release rate of the hypoxic cells further decreased in the presence of rat WBC to (51.14 - or + 2.17 )% at 37 degrees celsius;, (19.53 - or + 4.37)% at 34 degrees celsius; and (16.68 - or + 1.47)% at 32 degrees celsius; (P<0.001). In the scratched cells, with or without WBC, LDH release rate showed no significant variation between the 3 temperatures (P>0.05).</p><p><b>CONCLUSION</b>Mild hypothermia offers obvious protective effects on rat astrocytes against ischemic damage but not against mechanical injury.</p>

The components of metabolic syndrome that influencing the prevalence of cardiovascular disease in a follow-up study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate metabolic syndrome components that influencing the prevalence of cardiovascular disease (CVD).</p><p><b>METHODS</b>Five hundred persons were selected from a unit in Nanning city, Guangxi, based on the cross-sectional study on a distribution of population with metabolic syndrome in 2004 and followed them up for 3.5 more years. Physical examination would include detection on blood pressure, glucose, serum cholesterol and body index etc. When someone suffered from cardiovascular disease would be viewed as an 'end-point event'. Criteria of diagnosis were under the basis of CVD from the WHO-MONICA.</p><p><b>RESULTS</b>(1) The mean value of physical and biochemical index as BMI, waist circumstance, systolic pressure, diastolic pressure. Fast serum glucose, triglyceride in the population with more MS components were higher than the ones with less components. (2) The prevalence rates of CVD in the four groups were 2.97%, 4.19%, 7.97%, 11.88% respectively with significant differences between the groups (P = 0.0008). (3) Data from the logistic analysis manifested that when compared to the 0 group, the risk rate of CVD for groups having 1, 2, 3 components were 1.41, 2.68, 4.00 respectively. After adjusted age and sex, time of occurrences, results from the Cox model showed that the risk rate of CVD for groups with 1, 2, 3 components were 1.29, 2.47, 3.67 (RR 95%CI: 1.02 - 13.14) respectively. (4) Kaplan-Meier analysis showed that the cum hazard of CVD in the 3rd group was higher than in the 0, 1 group, and at the end of follow-up, the cum hazard of CVD was 12.7% in the 3rd group among population with metabolic syndrome.</p><p><b>CONCLUSION</b>When increasing the number of components of metabolic syndrome, the higher risk ratio for population to suffer from CVD was seen. With the natural process of disease, the more components of metabolic syndrome in population, the higher cum hazard would influence the occurrence of CVD in the future.</p>

Construction of delta-pIRES2-EGFP plasmid and its expression in HEK293 cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct the delta-pIRES2-EGFP plasmid and investigate its expression in HEK293 cells.</p><p><b>METHODS</b>Full length cDNA of rat delta opioid receptor gene amplified from rat brain tissues using reverse transcription and nested PCR was cloned into pMD20 T vector. The delta cDNA was inserted into pIRES2-EGFP plasmid to construct the recombinant eukaryotic plasmid delta-pIRES2-EGFP, which was transfected into HEK293 cells via Lipofectamine2000. The expression of delta was examined under fluorescence microscope.</p><p><b>RESULTS</b>The recombinant delta-pIRES2-EGFP plasmid was successfully constructed, and high expression of delta was detected in HEK293 cells transfected by the plasmid.</p><p><b>CONCLUSION</b>delta-pIRES2-EGFP has been successfully cloned, which shows high expression of delta in HEK293 cells.</p>

Association of haplotype formed on HLA-DRB1 and HLA-DQA1 alleles with outcomes of hepatitis B virus infection / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of haplotype of HLA-DRB1 and HLA-DQA1 alleles with outcomes of hepatitis B virus infection in Han population of north China.</p><p><b>METHODS</b>Two hundred and seven chronic hepatitis B (HB) patients, two hundred and twelve chronic asymptomatic hepatitis B virus (HBV) carriers (HBV carrier) and one hundred and forty-eight self-limited HBV infection were investigated for HLA-DRB1 and HLA-DQA1 alleles by sequence specific-polymerase chain reaction (PCR-SSP).</p><p><b>RESULTS</b>The frequency of DRB1*04-DQA1*0301 haplotype was 10.03% in self-limited HBV infection subjects, significantly higher than that in chronic HB patients (3.66%) (P=0.0005)ûthe frequency of DRB1*15/*16-DQA1*0102 haplotype was 6.80% in self-limited HBV infection subjects, significantly higher than 1.94% in chronic HB patients (P=0.0012) and 1.65% in asymptomatic HBV carriers (P=0.0004)ûwhile the frequency of DRB1*04-DQA1*0302 haplotype was 3.10% in chronic HB patients, higher than that in self-limited HBV infection subjects (0.39%) (P=0.0077).</p><p><b>CONCLUSION</b>Individuals with different haplotypes composed of HLA-DRB1 and HLA-DQA1 might have different outcomes of HBV infection.</p>

Association of polymorphisms of human leucocyte antigen -DRB1 and -DQA1 allele with outcomes of hepatitis B virus infection in Han population of north China / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the association of polymorphisms of human leucocyte antigen (HLA) -DRB1 and -DQA1 region allele with outcomes of hepatitis B virus (HBV) infection in Han population of north China.</p><p><b>METHODS</b>A total of 207 chronic hepatitis B (HB) patients, 212 chronic asymptomatic HBV carriers (HBV carrier), and 148 self-limited HBV infection were recruited to examine the association between gene polymorphisms and outcomes of HBV infection. Polymerase chain reaction-sequence specific primers (PCR-SSP) technique was used to genotype HLA-DRB1 and HLA-DQA1 loci.</p><p><b>RESULTS</b>The frequency of HLA-DQA1 * 0301 in chronic HB patients (14.81%) was significantly lower than those in HBV carriers (25.24%) and self-limited HBV infection subjects (25.00%) (Pc = 0.002; Pc = 0.007). The frequency of HLA-DQA1 * 0102 in self-limited HBV infection subjects (8.78%) was significantly higher than those in chronic HB patients (2.18%) and HBV carriers (1.89%) (Pc = 0.000; P = 0.000). In addition, the frequency of HLA-DQA1 * 0302 in self-limited HBV infection subjects (4.05%) was significantly lower than that in chronic HB patients (11.41%) (Pc = 0.005). HLA-DQA1 * 0302 was demonstrated to be risk factors of chronic HBV (OR = 3.913, P = 0.0006), while HLA-DQA1* 0102 and HLA-DQA1 * 0301 to be protective factors against chronic HBV (OR = 0.200, P = 0.0004; OR = 0.258, P = 0.0000) after age, sex, smoking and drinking were adjusted by logistic regression analysis. There were positive interactions between drinking and HLA-DQA1 * 0102 [interaction index (II) = 1.49] or HLA-DQA1 * 0302 (II = 12.12). There were negative interactions between drinking and HLA-DQA1 * 0301 (II = 0.78)</p><p><b>CONCLUSIONS</b>The subjects with HLA-DQA1 * 0302 allele have an increased risk to chronic HB infection compared with other subjects without this allele, while HLA-DQA1 * 0301 and HLA-DQA1 * 0102 are associated with HBV clearness. Gene-environment interaction can affect the outcomes of HBV infection.</p>

Clinical features and correlative factors of senile coronary heart disease accompanied with depression / 中国康复理论与实践

@#ObjectiveTo investigate clinical features, correlative factors and prognosis of senile coronary heart disease accompanied with depression.MethodsFifty two senile patients of coronary hart disease with depression were selected for the observation group, sixty cases without depression as control group. Clinical features, family conditions, society factors and Holter report (supervision) of two groups were analyzed.ResultsClinical features such as severe dyssomnia, anxiety agitation, emotion depressing, loss of interest, feeling waste and sense of guilty in patients of observation group were significant different with those in control group. The rate of family harmoniousness and society supporting between patients of two groups were significantly different. The incidence of ventricular arrhythmias, atrial arrhythmia and myocardial ischemia changes on ST-T in the Holter reports of patients in observation group were higher than those in control group (P<0.05 or P<0.01). The incidence of cardiac sudden death of patients in observation group was also higher than patients in control group (P<0.05).ConclusionClinical symptoms such as severs dyssomnia, anxiety agitation, emotion depressing are easily occurred in senile coronary heart disease patients with depression. Patients with depression have higher incidence of cardiac sudden death, having better relationship and society support are advantageous to prevent and reduce the depression in senile coronary heart disease patients.

Cognitive Ability and Apolipoprotein E Genotypes in Long Lived Elderly in Bama area of Guangxi / 中国心理卫生杂志

Objective:To study the relation between the distribution ofapolipoprotein E(apoE)genotypes and cognitive impairment onset in long lived elderly in Bama area in Guangxi in china.Methods:A total of 112 long lived elderly aged 90 years old and over were collected and tested with MMSE to inspect their cognitive function,and they were classified into cognition impaired group and non-impaired group according to MMSE scores.We determined the AopE genotypes by way of PCR-RFLP technique,and compared the differences of AopE allele and genotype of the two groups.Result:The cognitive disfunction was found to be 14.29% in long lived elderly in Bama area.The ApoE ? 3/? 3 genotypes have highest frequency in long-lived elderly,next is ?2/3,and ?4/4 is lowest frequency.There were significant differences of ? 4 allele frequencies between cognition impaired group and non-impaired group(P