Psychoanalysis of 300 patients with chronic gastritis / 中华消化杂志

Objective:To analyze the difference of psychosocial characteristics in patients with chronic gastritis.Methods:From June to December 2018, a total of 300 patients with chronic gastritis visited Xijing Hospital were consecutively enrolled. The patients were divided into chronic non-atrophic gastritis (CNAG) group, chronic atrophic gastritis (CAG) group and CAG with intestinal metaplasia group, with 100 cases in each group. Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), living events scale (LES) and Eysenck personality questionnaire (EPQ) were used for evaluation and analysis. Chi square test, analysis of variance, nonparametric rank sum test and Kruskal Wallis H test were used for statistical analysis. Results:The incidences of anxiety of the CAG group and the CAG with intestinal metaplasia group were both significantly higher than that of the CNAG group (64.0%, 64/100; 53.0%, 53/100; and 34.0%, 34/100; respectively), and the differences were statistically significant ( χ2=0.007 and 0.001, both P<0.05). The incidence of depression of the CAG with intestinal metaplasia group was significantly higher than those of CNAG group and the CAG group (24.0%, 24/100; 15.0%, 15/100 and 13.0%, 13/100; respectively), and the differences were statistically significant ( χ2=0.108 and 0.045, both P<0.05). The negative event score of LES of CAG with intestinal metaplasia group was higher than those of CNAG group and CAG group (0 (0, 6.75), 0 (0, 1.00), 0 (0, 0.75) respectively), and the differences were statistically significant ( Z=-2.619 and -3.022, both P<0.05). The proportion of patients with LES score ≥20 points (high mental stress) of CNAG group, CAG group and CAG with intestinal metaplasia group gradually increased (8.0%, 8/100; 9.0%, 9/100 and 18.0%, 18/100; respectively), and the difference was statistically significant ( χ2=0.036, P<0.05). In male patients and patients under 50 years old, the incidence of depression and the proportions of patients with LES score ≥20 points of CAG with intestinal metaplasia group were higher than those of CNAG group (22.5%, 9/40 vs. 9.6%, 5/52; 47.5%, 19/40 vs. 16.2%, 11/68; 22.5%, 9/40 vs. 7.7%, 4/52; and 20.0%, 8/40 vs. 4.4%, 3/68), and the differences were statistically significant ( χ2=0.015, 0.001, 0.043 and 0.013, all P<0.05). The results of EPQ showed that the psychoticism, extraversion or introversion, stability and concealment of CNAG group and CAG with intestinal metaplasia group, were mostly normal (43.3 to 56.7), accounting for 62.0% (62/100) and 45.0% (45/100), 56.0% (56/100) and 44.0% (44/100), 54.0% (54/100) and 44.0% (44/100), 59.0% (59/100) and 45.0% (45/100), respectively. The percentage of patients with high score (>56.7) of etraversion or introversion and concealment in CAG group and the CAG with intestinal metaplasia group were higher than those in the CNAG group (48.0%, 48/100; 23.0%, 23/100; 4.0%, 4/100 and 46.0%, 46/100; 21.0%, 21/100 and 7.0%, 7/100, respectively), and the differences were statistically significant ( χ2=0.001, 0.001, 0.001 and 0.004, all P<0.01). Conclusions:Anxiety is associated with CAG and intestinal metaplasia, while depression is associated with intestinal metaplasia. In male patients and patients under 50 years old, depression, negative event and high psychiatric stress are more significantly related to intestinal metaplasia. The mental characteristics of extroversion, emotional instability, psychoticism and concealment are closely associated with CAG.

Current research on liver regeneration: Pathogenesis and serum markers / 临床肝胆病杂志

Liver regeneration is an important response after liver injury and necrosis to maintain liver volume and function, with the involvement of various factors and signaling pathways. This process has three main stages, i.e., the initial stage of mitosis triggered by certain factors, the proliferation stage of promoting hepatocytes to enter the cell cycle, and the termination stage of promoting liver cells to reach a certain number and the recovery of liver mass. This article introduces various factors and multiple cellular signaling pathways that promote the differentiation of liver stem cells into liver cells to restore liver volume and function and summarizes the previous research findings of our group that alpha-fetoprotein is an important serum marker for liver regeneration after liver failure. The analysis shows that in-depth studies of the occurrence and clinical application of liver regeneration will help to improve the understanding of liver regeneration, better predict the prognosis of acute and chronic liver diseases, and provide new ideas and methods for the clinical diagnosis and treatment of various advanced liver diseases.

Breast reconstruction rate and profile in a Singapore patient population: a National University Hospital experience

<p><b>INTRODUCTION</b>Breast reconstruction is an integral part of breast cancer management with the aim of restoring a breast to its natural form. There is increasing awareness among women that it is a safe procedure and its benefits extend beyond aesthetics. Our aim was to establish the rate of breast reconstruction and provide an overview of the patients who underwent breast reconstruction at National University Hospital (NUH), Singapore.</p><p><b>METHODS</b>We evaluated factors that impact a patient's decision to proceed with breast reconstruction, such as ethnicity, age, time and type of implant. We retrospectively reviewed the medical records of women who had breast cancer and underwent breast surgery at NUH between 2001 and 2010.</p><p><b>RESULTS</b>The breast reconstruction rate in this study was 24.3%. There were 241 patients who underwent breast reconstruction surgeries (including delayed and immediate procedures) among 993 patients for whom mastectomies were done for breast cancer. Chinese patients were the largest ethnic group who underwent breast reconstruction after mastectomy (74.3%). Within a single ethnic patient group, Malay women had the largest proportion of women undergoing breast reconstruction (60.0%). The youngest woman in whom cancer was detected in our study was aged 20 years. Malay women showed the greatest preference for autologous tissue breast reconstruction (92.3%). The median age at cancer diagnosis of our cohort was 46 years.</p><p><b>CONCLUSION</b>We noted increases in the age of patients undergoing breast reconstruction and the proportion of breast reconstruction cases over the ten-year study period.</p>

Tension-free vaginal tape-Abbrevo procedure for female stress urinary incontinence: a prospective analysis over 22 months

<p><b>INTRODUCTION</b>We aimed to study the efficacy and safety of the tension-free vaginal tape (TVT)-Abbrevo procedure for female stress urinary incontinence (SUI).</p><p><b>METHODS</b>This was a prospective cohort study that aimed to determine the subjective and objective cure, improvement of SUI and incidence of complications among women who underwent TVT-Abbrevo for SUI during a period of 22 months from September 2011 to June 2013.</p><p><b>RESULTS</b>A total of 76 patients, with a mean age of 48.2 ± 8.1 years, underwent TVT-Abbrevo during the study period. Among them, 86.8% had vaginal delivery and 5.3% had instrumental delivery. Mean parity was 2.3 ± 0.8 and mean body mass index was 27.0 ± 5.0 kg/m. 11 (14.5%) patients had previously tried physiotherapy. Mean follow-up duration was 12.3 ± 5.6 months. The subjective cure rate for SUI at one-month, six-month and one-year follow-up was 95.7%, 90.8%, and 90.6%, respectively. Among the nine patients who completed the two-year follow-up, 88.9% reported either cure or improvement of SUI. At six months, the proportion of patients with objective cure was 86.8%, and the rates of postoperative groin pain and complications were low. In addition, overactive bladder symptoms disappeared in 76.3% of patients.</p><p><b>CONCLUSION</b>Our results are comparable with those of other studies, although long-term results remain to be seen.</p>

miR-211 inhibits the proliferation of human breast cancer cell lines through targeting TFAM / 基础医学与临床

Objective To investigate the role of miR-211/TFAM in the regulation of proliferation of breast cancer cells .Methods In the present study , we transfected breast cancer cells with miR-211 mimics or miR-211 inhibitor to achieve miR-211 and detected the expression of miR-211 and the expression level of TFAM proteins in response to miR-211 overexpression or miR-211 silencing;luciferase reporter gene plasmid with or without a six base pairs mutation in the 3′UTR of TFAM ( mut-TFAM/wt-TFAM) were conducted and co-transfected with miR-211 mimics or miR-211 inhibitor, then the change of the luciferase activity was detected;then pcDNA3.1/TFAM plasmid was constructed and co-transfected with miR-211 mimics or miR-211 inhibitor, TFAM protein expression level changes were determined in response to miR-211 overexpression or miR-211 silencing; lastly the cell proliferation was determined in response to mimics NC/miR-211 mimics and pcDNA3.1/TFAM co-transfection.Results Overex-pression of miR-211 inhibits the expression of TFAM protein , miR-211 silencing promote TFAM protein expression;miR-211 can regulate the expression of TFAM by direct targeting;TFAM over expression was achieved by pcDNA3.1/TFAM transfection , and TFAM overe xpression can restore the inhibitory effect of miR-211 on TFAM;miR-211 inhibited the growth and proliferation of breast cancer cells , TFAM can promote the growth and proliferation of breast cancer cells;TFAM restored the inhibitory effect of miR-211 on growth and proliferation of breast cancer cells .Conclusions miR-211 regulates the growth of breast cancer cell with targeting of HMGB .

Creation of Consistent Burn Wounds: A Rat Model

BACKGROUND: Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. METHODS: Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to 100degrees C in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. RESULTS: Average wound size was 0.9957 cm2 (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. CONCLUSIONS: This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.

Incidence of hydronephrosis in severe uterovaginal or vault prolapse

<p><b>INTRODUCTION</b>We aimed to evaluate the local incidences of hydronephrosis and renal impairment in the presence of severe uterovaginal or vault prolapse, and determine whether treatment by surgery or ring pessary resulted in the resolution of hydronephrosis in these patients.</p><p><b>METHODS</b>This was a retrospective case study of 121 patients who presented with severe uterovaginal or vault prolapse. All patients who had fourth degree uterovaginal or vault prolapse, and underwent renal ultrasonography and renal function blood tests were included in the study. Follow-up imaging for hydronephrosis was performed to determine the outcome after patients received treatment.</p><p><b>RESULTS</b>The mean age of the study population was 66.1 years. The overall incidence of hydronephrosis was 20.6%. The incidence of hydronephrosis in patients with severe vault prolapse was 7.1%, while that in patients with severe uterovaginal prolapse was 22.4%. Of the 25 patients with hydronephrosis, 16 (64.0%) had complete resolution of hydronephrosis after treatment, 5 (20.0%) had residual but smaller degrees of hydronephrosis, and 4 (16.0%) were lost to follow-up. The incidence of renal impairment was 3.3%.</p><p><b>CONCLUSION</b>The local incidence of hydronephrosis in patients with severe uterovaginal or vault prolapse was 20.6% in our study. We established that 3.3% of women with severe uterovaginal or vault prolapse had mild renal impairment. Treatment by vaginal surgery for severe uterovaginal or vault prolapse appears to result in either complete resolution or improvement of hydronephrosis in the majority of patients.</p>

Retrospective study of transobturator polypropylene mesh kit for the management of pelvic organ prolapse

<p><b>INTRODUCTION</b>This retrospective study assessed the surgical outcomes of patients for whom the transobturator polypropylene mesh kit was used for the management of pelvic organ prolapse (Gynecare Prolift) in a tertiary urogynaecological centre in Singapore from January 1, 2006 to December 31, 2007.</p><p><b>METHODS</b>169 patients (2006 n = 95; 2007 n = 74) with total (n = 76), anterior (n = 82) and posterior (n = 11) Prolifts were followed up for two years post-surgery.</p><p><b>RESULTS</b>Intraoperatively, the incidence of haematoma, blood loss > 1,000 mL and blood transfusion was lower in 2007 than in 2006, although the difference was not statistically significant. One (1.4%) patient had rectal perforation in 2007. The mesh erosion rates were similar for all Prolift types (total 17.2%; posterior 14.5%; anterior 18.2%). Two patients, who had total Prolift in 2006, required mesh excision under anaesthesia for mesh extrusion. 138 (81.7%) patients were available for review at two years - nine (6.5%) patients had recurrent cystourethrocoeles and two (1.4%) had recurrent vault prolapse. Of the nine patients who had total Prolift with uterine conservation, two (1.4%) had recurrent uterine descent. The subjective cure rates two years after Prolift surgery were 98.7% for patients from 2006 and 100% for patients from 2007. The objective cure rates were 89.6% for patients from 2006 and 91.8% for patients from 2007.</p><p><b>CONCLUSION</b>Prolift mesh surgery appears to have a very high success rate for pelvic reconstructive surgery. The learning curve of the surgeon may, however, be a factor determining surgical outcome in these patients.</p>

Effect of genetic variants in KCNJ11, ABCC8, PPARG and HNF4A loci on the susceptibility of type 2 diabetes in Chinese Han population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>KCNJ11, ABCC8, PPARG, and HNF4A have been found to be associated with type 2 diabetes in populations with different genetic backgrounds. The aim of this study was to test, in a Chinese Han population from Beijing, whether the genetic variants in these four genes were associated with genetic predisposition to type 2 diabetes.</p><p><b>METHODS</b>We studied the association of four representative SNPs in KCNJ11, ABCC8, PPARG, and HNF4A by genotyping them using ABI SNaPshot Multiplex System in 400 unrelated type 2 diabetic patients and 400 unrelated normoglycaemic subjects.</p><p><b>RESULTS</b>rs5219 (E23K) in KCNJ11 was associated with genetic susceptibility to type 2 diabetes (OR = 1.400 with 95% CI 1.117 1.755, P = 0.004 under an additive model, OR = 1.652 with 95% CI 1.086 2.513, P = 0.019 under a recessive model, and OR = 1.521 with 95% CI 1.089 2.123, P = 0.014 under a dominant model) after adjusting for sex and body mass index (BMI). We did not find evidence of association for ABCC8 rs1799854, PPARG rs1801282 (Pro12Ala) and HNF4A rs2144908. Genotype-phenotype correlation analysis revealed that rs1799854 in ABCC8 was associated with 2-hour postprandial insulin secretion (P = 0.005) after adjusting for sex, age and BMI. Although no interactions between the four variants on the risk of type 2 diabetes were detected, the multiplicative interaction between PPARG Pro12Ala and HNF4A rs2144908 was found to be associated with 2-hour postprandial insulin (P = 0.004 under an additive model for rs2144908; and P = 0.001 under a dominant model for rs2144908) after adjusting for age, sex and BMI, assuming a dominant model for PPARG Pro12Ala.</p><p><b>CONCLUSIONS</b>Our study replicated the association of rs5219 in KCNJ11 with type 2 diabetes in Chinese Han population in Beijing. And we also observed that ABCC8 as well as the interaction between PPARG and HNF4A may contribute to post-challenge insulin secretion.</p>

Molecular scanning of candidate mtDNA gene fragment in diabetic pedigrees / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To explore novel pathogenic mutation in the mitochondrial DNA gene in diabetic pedigree.</p><p><b>METHODS</b>Twenty-eight suspected mitochondrial DNA diabetic families were recruited. The gene fragment was produced by PCR, and mutation was detected by direct sequencing.</p><p><b>RESULTS</b>In one pedigree, the proband and her mother were found carrying the most common nt3243 A --> G mutation and another 16S rRNA 3205C --> T mutation. But only 3205C --> T was found in her affected brother. All the two patients were deaf and developed diabetes in early age, characterized by impaired beta cell function and low body mass index (BMI). The proband had relatively higher lactic acid concentration than normal individuals. A novel ND1 gene 3434 A --> G(TAT --> TGT) mutation was explored in another proband with deafness and her affected family members.</p><p><b>CONCLUSION</b>16SrRNA 3205C --> T mutation was found in a mitochondrial diabetes mellitus pedigree, implying its potential pathogenic role in diabetes. Another novel ND1 3434 A --> G mutation was found in another diabetic pedigree. Because this mutation causes amino acid change (Tyr --> Cys) and is co-segregated with diabetes, it may be diabetogenic.</p>