1.Analysis of anorectal function in cervical cancer patients with chronic pelvic radiation disease
Yong CHEN ; Yuhua HUANG ; Jing WANG ; Danhua YAO ; Jian WANG ; Zhongliang CAI ; Qi MAO ; Yousheng LI
Journal of Medical Postgraduates 2016;29(4):388-391
[Abstract ] Objective Pelvic radiation disease(PRD) is multiple injuries in more than one organ resulted by pelvic radio-therapy.Patients have the symptoms of frequent feces and fecal incontinence after the resection of small bowel lesion .Sugeries on PRD patients were mainly distal ileum and ilieocecal valve resections , while the most susceptible part of pelvic radiation injury is rectum . However , little research has been done concerning PRD patients′anorectal functions .This study was mainly to evaluate the anorectal function of cervical cancer patients with PRD in order to provide evidence for the therapy and prognosis of PRD . Methods Cervical cancer patients with PRD in need of small bowel resection who hospitalized in our department from January 2014 to January 2015 were collected as patient group , while people from outpatient physical exam group were selected as control group according to the exclusion criteria of hypertension , diabetes, constipation and unrelaxed pelvic floor syndrome .PDR group and control group were matched according to age.All subjects underwent colonoscopy and anorectal manometry .Rectal radiation injury was estimated on the basis of colonoscopy results.Anorectal manometry results of PRD group and control group were analysised statistically . Results PRD group and control group both included 20 women without stenosis or obstruction in rectum .Significant difference was found between PRD group and con-trol group in anal resting pressure (47.23 ±9.08 mmHg vs 58.25 ±9.24 mmHg, P<0.05), anal maximum squeezing pressure (47.23 ±9.08 mmHg vs 58.25 ±9.24 mmHg, P<0.01), anal distension pressure (23.30 ±12.49 mmHg vs 39.10 ±9.99 mmHg, P<0.01), rectal defecation pressure(22.85 ±16,69 mmHg vs 50.90 ±9.14 mmHg, P<0.01) and maximum tolerated rectal volume (112.85 ±51.34 mL vs 173.50 ±48.15 mL, P<0.01).There was no significant difference between the two groups as to the lenghth of functional sphincters(P=0.313),rectum initial threshold(P=0.416) and rectal defecation threshold(P=0.161). Conclusion Ionization radiation that injures PRD patients′internal anal sphincters and external anal sphincters also reduces maximum tolerated rec -tal volumes preoperatively .It′s necessary to assess the muscles and nerve functions of anorectum before intestinal surgery in order to make a proper operation plan which will improve PRD patients′life quality.
2.Differentially expressed serum proteins in oral lichen planus patients before and after treated with Huashi Xingyu Qingre Decoction
Jian LIU ; Meijie ZHANG ; Tiejun LIU ; Yangyang ZHANG ; Yanzhi XU
Journal of Medical Postgraduates 2016;29(4):384-387
Objective Oral lichen planus ( OLP) is a common complaint in the oral mucosa , for which there is no definite therapy hitherto.This article aimed to investigate the possible effect of Huashi Xingyu Qingre Decoction (HXQD) on OLP. Methods This study included 30 randomly selected cases of OLP treated with HXQD .Fasting venous blood and total serum protein were obtained before and after medication for screening and identification of OLP-related differential proteins by two-dimensional fluorescence differ-ence gel electrophoresis (2D DIGE) and liquid chromatography-mass spectrometry (LC-MS), followed by Western blot validation . Results Haptoglobin , antithrombin Ⅲ, C1 complement , and vitamin D binding protein were differentially expressed in the serum of the OLP patients before and after treated with HXQD .Compared with the baseline , the expression of haptoglobin was significantly in-creased (103.086 ±27.536 vs 159.704 ±24.228, P<0.05) while that of antithrombin Ⅲ remarkably decreased after treatment (150.00 ±54.04 vs 98.00 ±28.04, P<0.05). Conclusion Haptoglobin, antithrombin Ⅲ, C1 complement, and vitamin D binding protein are differentially expressed in the serum of OLP patients before and after HXQD medication , which may be associated with the development and progression of OLP .
3.Bioinformatics analysis of the human MTERF1 gene promoter
Yongqin YANG ; Meitao SUN ; Yue LI ; Yun WANG ; Xiaojuan ZHANG ; Wei XIONG
Journal of Medical Postgraduates 2016;29(4):348-353
Objective The proteins encoded by mitochondrial transcription termination factor 1 ( MTERF1) plays important roles in regulating the mitochondrial gene expression and oxidative phosphorylation .This study was to investigate the characteristics and regulation mechanisms of the human MTERF1 gene with bioinformatics tools . Methods Using online bioinformatics software and phylogenetic foot-printing, we analyzed the promoter distribution , GpG island, transcription factors , and binding sites of the human MTERF1 gene. Results The human MTERF1 gene was located on 7q21.2, with a full length of 7845 bp, consisting of 4 exons and 3 introns.There were at least 2 promoters in the 5′region of the gene.The core promoter of the MTERF1 gene was located between 1878 and 2447 bp, which played a key role in its transcription .An 812 bp CpG island was observed in the gene promoter region .In addi-tion, 26 transcription factor binding sites were found in the conserved promoter region of human and mouse homologous MTERF1 genes. Conclusion Gene promoter-related online bioinformatics software can improve the efficiency of human MTERF1 gene promoter resear-ches and provide significant information for the prediction of gene pro-moter function.
4.Quantitative research and nursing effect of early ambulation in patients with gastrointestinal tumor after operation
Cancan XIA ; Zhiwei JIANG ; Gang WANG ; Xiaobo FENG ; Yang YANG ; Xianghong YE ; Yingchun HUANG ; Nanhai PENG
Journal of Medical Postgraduates 2016;29(4):411-415
Objective There is no quantization scheme for the early ambulation in patients with gastrointestinal tumor after operation of enhanced recovery .The aim of this study was to explore a suitable objective method of postoperative ambulation for gastro -intestinal tumor patients . Methods Sixty six gastrointestinal tumor postoperative patients were randomly assigned to two groups :ex-perimental group ( 33 cases ) and control group ( 33 cases ) .Enhanced recovery was adopted in the both groups afterthe operation . Wireless smart bracelets ( fitbit flex) were used in the experimental group , and the ambulation of patients was monitored by the hand of synchronous real time computer digital panel .At the same time, the patients was supervised for positive ambulation . Traditional quantitative methods of electronic pedometer were used in the control group.The postoperative ambulation , effect and compliance were compared between the two groups . Results Postoperative ambula-tion steps in the experimental group were increased compared with the control group on the days 1, 2, and 3postoperative, and the data were (208.70 ±45.76) vs (144.36 ±47.68), (560.73 ±148.67) vs (407.00 ±85.92), and (894.70 ±91.68) vs (674.00 ±73.06) steps (P<0.05).The first time of early ambulation, flatus, ca-tharsis, and compliance of ambulation showed significant difference in the two groups (P<0.05). Conclusion Wireless intelligent monitoring bracelet is objective and effective for monitoring and quantifying postoperative ambulation .It is superior to the traditional quantitative methods , and can improve the effect and compliance of the ambulation .Moreover , it can promote postoperative recovery in patient with enhanced recovery surgery .
5.Orbital blowout fracture reconstruction using titanium mesh pre-bent with computer-aided rapid prototy-ping technology
Xiang ZHANG ; Wei CHEN ; Gang CAO ; Zhen DONG ; Jinke XU ; Binyao LIU ; Tingyuan LUO ; Juan MA ; Senlin ZHANG
Journal of Medical Postgraduates 2016;29(4):407-410
Objective This study was to evaluate the clinical outcomes of orbital blowout fracture repair using the individual titanium mesh bent by computer-aided rapid prototyping . Methods The CT imaging data of 11 cases of orbital blowout fracture were analyzed.The subciliary approach was used for the exposure of the fractures .An appropriate 3D-printed titanium mesh pre-bent by computer-aided rapid prototyping was selected and implanted according to the characteristics of a given defect .The surgical results were analyzed by evaluating diplopia , eyeball movement , enophthalmos , and the position of the titanium mesh and comparing the orbital vol-ume before and after surgery . Results All the operations were successfully accomplished .No remolding or trimming was needed for the pre-bent titanium mesh and implanted titanium mesh was tightly fixed to the orbital wall .The patients were followed up for 3 -12 months, which revealed no symptoms of diplopia in any of the patients . Volumetric analysis showed a significantly reduced orbital volume difference from (2.60 ±0.43) mL preoperatively to (-0.07 ±0.62) mL postoperatively (P<0.01).Enophthalmos was desirably correc-ted, with the enophthalmos difference decreased from (2.35 ±0.81)mm preoperatively to (-0.10 ±0.52) mm postoperatively (P<0.01).No extra-ocular muscle limitation was observed . Conclusion The individual titanium mesh bent with computer-aided rapid prototyping technology can be applied to orbital blowout fracture repair , which may achieve a high success rate of anatomic restoration of the orbital volume and effective prevention of enophthalmos .
6.Histopathology of the temporal artery in young ischemic stroke patients with elevated serum immunoglobu-lin E
Shizhan LI ; Haibo LIU ; Ruibing GUO ; Nan WU ; Shuhong YU ; Lingling ZHAO ; Ruifeng SHI ; Wanhong CHEN ; Renliang ZHANG
Journal of Medical Postgraduates 2016;29(4):401-406
Objective Ischemic stroke with elevated serum immunoglobulin E ( IgE) in some young patients is regarded as cerebral vasculitis clinically though without sufficient pathological evidence .This study was to investigate the characteristics of vascular lesions in these patients by temporal artery biopsy . Methods We performed histopathologic examinations on the temporal arteries of 32 young ischemic stroke patients with unknown etiology , 16 with normal and the other 16 with elevated serum IgE .We observed inflammatory cells infiltration and mast cells by HE staining and toluidine blue stai-ning respectively and determined the expressions of matrix metalloproteinase -9 (MMP-9), monocyte chemotaxis protein -1 (MCP-1) and serum IgE by immunohistochemistry . Results Compared with the patients with normal IgE , those of the elevated IgE group showed a significantly higher rate of inflammatory cells infiltration (12.5%vs 62.5%, P<0.01), with 1 case of focal necrosis and fi-brinous exudation in the adventitia in the latter group .The average optical density ( OD) of monocyte chemotaxis protein-1 ( MCP-1) in the temporal artery was also dramatically higher in the elevated IgE group than in the normal controls ([9.25 ±5.79] ×10 -5 vs [4.41 ±2.87] ×10 -5, P<0.01).The average OD of matrix metalloproteinase 9 (MMP-9) and intima-media thickness were both increased in the elevated IgE group ([32.79 ±21.38] ×10 -4 and [0.25 ±0.06] mm) but showed no statistically significant differ-ence from those in the normal IgE group ([25.23 ±12.78] ×10 -4 and [0.22 ±0.06] mm) (both P>0.05).Nor was any signifi-cant difference observed in the number of the mast cells between the normal and elevated IgE groups (2.8 ±1.5 vs 3.6 ±2.3, P>0.05). Conclusion The infiltration and necrosis of inflammatory cells and fibrin exudation in the temporal artery of the young pa-tient with elevated serum IgE are likely to be the manifestations of vasculitis , and MCP-1 may play a role in the pathogenesis of the disease.
7.Reduced field-of-view diffusion weighted imaging in diagnosis of prostate cancer
Yi WANG ; Yuankai LIN ; Changsheng ZHOU ; Jun ZHANG ; Zongjun ZHANG
Journal of Medical Postgraduates 2016;29(4):395-400
Objective With the improvement of technology and strategy , reduced field-of-view diffusion weighted imaging ( rFOV DWI) has provided more robust imaging .This article was intended to compare the clinical utility between rFOV DWI and con-ventional DWI in the diagnosis of prostate cancer . Methods Retrospective analysis was made on 58 prostate cancer patients under-going verification of biopsy or surgery after 3.0 T MRI rFOV DWI and regular DWI examinations in Nanjing General Hospital of Nan-jing Military Command from August 2014 to September 2015 , among whom prostate cancer and benign prostatic hyperplasia were 31 cases and 27 cases respectively .Independent grading was made by 2 radiol-ogists who were unaware of any clinical data and sequences in the as-pects of distortion on DW images , lesion conspicuity on DWI ( b=1000 ) and ADC images according to a 4-point Likert scale .rFOV and conventional DWI sequences were acquired using b =400,1000,0s/mm2.The IVIM double exponential model software was applied to generate ACD value, slow dispersive coefficient(D value) and parameterized image of volume fraction of fast dispersion (f value).Se-quence analysis was made in suspected peripheral tumor regions of prostate cancer patients and and healthy peripheral zones of patients with benign prostatic hyperplasia respectively to get ACD , D and f values .The ratio values rADC , rD and rf were attained compared with obturator internus .ROC analysis was made on the efficacy of different parameters of two sequences in prostate cancer . Results Image qualities of rFOV DWI were rated superior to conventional DWI (P<0.001,Wilcoxon Signed-Rank Test).Compared with con-ventional DWI, ADC value (0.728 ±0.094 vs 0.789 ±0.116, P<0.05)and D value(0.622 ±0.077 vs 0.651 ±0.099, P<0.05)of peripheral tumor regions in rFOV DWI were lower and the difference was statistically significant , whereas no significant difference was found in f value(P=0.932).No difference was found in area under ROC curve of f value between rFOV DWI and traditional DWI (0.853 vs 0.767, P=0.283). Conclusion The rFOV DWI sequence yielded can efficiently improve image quality , which is of important value to the clinical diagnosis of prostate cancer .
8.Clinical effects on patients with hypertension under follow-up intervention
Yong ZHONG ; Yongping PENG ; Yunpeng YOU ; Jun WANG ; Ying WANG ; Dadong ZHENG ; Shiyong PAN
Journal of Medical Postgraduates 2016;29(4):392-394
Objective The control rate of blood pressure in hypertension patients is very low in our country , while follow-up intervention can significantly improve the situation .This study aimed to evaluate the clinical effects of anti-hypertension under follow-up intervention . Methods From October 2013 to October 2014 , 125 patients with hypertension were chose as the study objectives after first clinical anti-hypertension and were divided into intervention group (follow-up,n=65) and control group(no follow-up,n=60). Comparative analysis was made in blood pressure control , compliance with therapy and cardiovascular event incidence between the two groups after 12 weeks'intervention. Results After 12 weeks, diastolic and systolic blood pressure in intervention group was signifi-cantly lower than that in control group (P<0.05).Significant difference was also found in the compliance with drug-taking between in-tervention group and control group (73.8%vs 43.3%, P<0.01).During the follow-up period, 1 case in the control group suffered stroke and unstable angina pectoris hospitalized for treatment . Conclusion Follow-up intervention after clinical service can improve the efficacy of blood pressure control and encourage the patients to live healthy lifestyle .
9.Serum-free culture of the MKN-45 gastric cancer cell line and preparation of stem cells
Yiqian JIANG ; Xiaoxiang GUAN ; Qingmin GUO ; Xiaoping XU ; Suhong AN ; Yiyang HE ; Juncai LIANG ; Lijuan HAN
Journal of Medical Postgraduates 2016;29(4):380-383
[Abstract ] Objective Difficulties with the preparation of gastric cancer stem cells (CSCs) have been a main obstacle to the studies of gastric cancer .This article addresses the technology of the serum-free medium suspension cultivation of the MKN-45 gastric cancer cell line and screening of stem cells from the cell line based on the biomarkers of gastric CSCs . Methods MKN-45 cells were cultured in serum-free medium for 8 weeks and those in the logarithmic phase cultivated with hoechst 33342 followed by detection of the side cells by flow cytometry .When the side population cells reached 25%, all the cell microspheres were collected , hatched with CD133 and CD44, and subjected to fluorescence-activated cell sorting.The CDl33 +and CD44 +cells were selected as gastric CSCs . Results About 40%of the MKN-45 gastric CSCs were alive , prolif-erated, and formed floating cell balls .Side population cells constitu-ted 3.4% of the MKN-45 cells and 26.9% of the cell balls.The CDl33 +and CD44 +cells made up 11.2% of the MKN-45 cells and 90.3%of the cell balls. Conclusion Cell balls rich in CSCs can be successfully obtained by serum-free medium suspension culti-vation and CSCs can be screened out with hoechst 33342 and surface markers , which may serve as an experimental ground for the stud-ies of gastric CSCs .
10.Effects of simvastatin versus alendronate on bone loss and biomechanical property deterioration in ovariec-tomized rats
Yan ZHANG ; Hao LIU ; Lei XING ; Guobin ZHANG ; Zhongbao JIA ; Faming TIAN
Journal of Medical Postgraduates 2016;29(4):375-379
Objective Alendronate is widely used as an anti-osteoporosis agent , while simvastatin , as a lipid-lowering drug , is being considered beneficial for bone formation .The present study aims to compare the effects of simvastatin and alendronate on bone loss in ovariectomized ( OVX) rats. Methods Thirty-two female SD rats were equally randomized into a sham operation , an OVX mod-el, a simvastatin ( OVX +S), and an alendronate ( OVX +A) group.All the rats but those in the sham operation group underwent dual ovariectomy .The animals of the OVX model and OVX +S groups were treated intragastrically with vehicle and simvastatin at 5 mg per kg of the body weight per day , respectively , while those of the OVX+A group injected subcutaneously with alendronate at 70μg per kg of the body weight per week .After 12 weeks of intervention , all the rats were sacrificed for detection of the serum concentrations of PINP and ICTP by ELISA, analysis of bone mineral density and bone histo-morphometry parameters of L 4 vertebrae , determination of the maximum loading and elastic modulus of L 5 vertebrae by compression test. Results The serum concentrations of P1NP and ICTP were significantly lower in the sham operation than in the other three groups (P<0.05), and that of ICTP markedly lower in the OVX +A than in the OVX model and OVX +S groups (P<0.05).Bone mineral density was remarkably lower in the OVX model ([0.238 ±0.007] g/cm2 ) than in the sham operation ([0.276 ±0.015] g/cm2), OVX+S ([0.250 ±0.014] g/cm2) and OVX+A groups ([0.269 ±0.014] g/cm2) (P<0.05), lower in the OVX+S than in the sham operation and OVX +A groups (P<0.05), but with no statistically significant difference between the latter two (P>0.05).Bone histomorphometry showed significantly lower BV /TV in the OVX model than in the sham operation and OVX +A groups ([19.9 ±1.69]%vs [29.03 ±2.59]%and [27.05 ±1.91]%, P<0.05), but markedly higher Tb.Sp in the former than in the latter two groups ([357.33 ±26.55] μm vs [211.17 ±16.56] μm and [252.50 ±19.35] μm, P<0.05).The maximum load and elastic modulus of L5 vertebrae were significantly lower in the OVX model rats than in the other three groups (P <0.05). Conclusion Both simvastatin and alendronate can inhibit bone loss in OVX rats , with comparable effects of preventing the deteriora-tion of biomechanical properties , but the latter is evidently more effective in maintaining bone mineral density .