温州医科大学学报
 
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2014 Vol. 44, No. 7
Published: 2014-07-25
 
 
476 The effect of ulinastatin on kidney injury caused by deep hypothermic low-flow cardiopulmonary bypass surgery in piglets
WANG Xiaocou1, XUE Qinghua2, YAN Fuxia2, LI Lihuan2, LIU Jinping3, LI Shoujun4, HU Shengshou4
Objective: To evaluate the effect of ulinastatin on kidney injury caused by deep hypothermic low-flow cardiopulmonary bypass surgery in piglets. Methods: Fifteen Beijing Landrace piglets were divided into ulinastatin group (Group U, n=5), control group (Group C, n=5) and sham operation group (Group S, n=5), randomly. Routine CPB was established after anesthetized and median thoracotomy in group U and C. When the temperature of piglets dropped to 25 ℃, low-flow CPB (50 mL · kg-1 · min-1) began. After 120 min of aortic cross-clamping, the circulation was reopened and adjusted, finally ceased CPB. Kidney tissue was harvested 120 min after CPB ceased. 12 000 IU · kg-1 of ulinastatin was given instantly when CPB began and circulation reopened respectively in group U, and group C received normal saline equivalently. Kidney tissue was harvested after anesthesia and median thoracotomy in group S. Venous blood samples were taken immediately after anesthesia induction (T1) in all groups, 5min (T2) and 120 min (T3) after the CPB shutdown merely in both Group U and C, for the test of Cystatin C (CysC), Serum SCratinine (SCr), blood urea nitrogen (BUN), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). When the experiment was terminated, test of the urine N-acetyl-β-D-glucosaminidase (NAG) and pathological examination of kidney tissues were performed in all three groups. Results: All 15 piglets completed experiment end. There were no statistics differences of CysC, SCr, BUN, IL-6, and TNF-α in all three groups (P>0.05) in T1 timepoints. Compared with Group C, CysC, SCr, BUN, IL-6, and TNF-α were significantly decreased respectively 12.50% (P>0.05), 2.97% (P>0.05), 0.37% (P>0.05), 26.28% (P<0.05), 10.81% (P<0.05) in T2 timepoints and 24.37% (P<0.05), 17.20% (P<0.05), 16.82% (P<0.05), 18.12% (P<0.05), 8.57% (P>0.05) in T3 timepoints in Group U. Compared with Group C, urine N-acetyl-β-D-glucosaminidase was significantly decreased 51.17% (P<0.05) in Group U. Kidney injury was observed in both Group U and C, and was lighter in group U, but not with Group S. Conclusion: Deep hypothermic low-flow cardiopulmonary bypass surgery will result in kidney injury on piglets, and ulinastatin can inhibit against those injury by inhibiting the inflammatory response.
2014 Vol. 44 (7): 476- [Abstract] ( 691 ) HTML (1 KB)  PDF  (0 KB)  ( 491 )
480 Expressions and methylation analysis of apoptosis-related genes Survivin and Bcl2L13 in mice subchronic exposure to inhaled benzene
LIN Chong1, LIU Zheng1, YU Xiuyuan1, PENG Chunhua1, ZHANG Yaya1, QIN Qiongyu1, ZHU Hua2, YANG Xinjun1, YAN Hongtao1
Objective: To explore the expression level and the CpG islands methylation status of apoptosis-related genes Survivin and Bcl2L13 in mice submitted to subchronic inhalation of benzene. Methods: C57BL/6J mice were randomly divided into 3 groups: high concentration (100 ppm), low concentration (1 ppm) and control group. A subchronic benzene exposure test was carried out using the dynamic inhibition control equipment. At the end of exposure tests, bone marrow cells were collected. Cell cycle and apoptosis were detected by flow cytometry. DNA methylation status of promoter of Survivin and Bcl2L13 were determined using the Matrix-assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) and mRNA expressions were quantitatively analyzed using real-time PCR. Results: Compared with the control group, the percentages of apoptosis cells in both exposure groups were obviously higher (P<0.01). Cell cycle arrest at S phase was observed in  low concentration group. The cell percentages at S phase and G2/M phase were significantly lower in high concentration group. Survivin mRNA expression was significantly reduced in low concentration group. Both Survivin and Bcl2L13 mRNA expressions were significantly suppressed in high concentration group. The low methylation levels of CpG islands of Survivin and Bcl2L13 promoters were observed in all groups. Moreover, the methylation levels were not impacted by benzene exposure. Conclusion: Subchronic exposure to benzene induced apoptosis, change the cell cycle, and decrease the mRNA expression of apoptosis-related genes Survivin and Bcl2L13 in mice bone marrow cell; but it don’t impact the methylation status of CpG islands in promoter regions of Survivin or Bcl2L13 genes.
2014 Vol. 44 (7): 480- [Abstract] ( 664 ) HTML (1 KB)  PDF  (0 KB)  ( 516 )
485 Establishment of a direct competitive ELISA for recombinant human EGF-IL-18 fusion protein
HONG Defang1, AI Dongdong1, Ding Linchao1, LV Jianxin1, ZHONG Lianjin1, LI Baoqiu2, GAO Lichang2, JIN Liqin1.
Objective: To establish a direct competitive ELISA for determining recombinant human EGF-IL-18 (rhEGF-IL-18) fusion protein levels in serum samples of macaca fascicularis and perform a validation for the assay which would be used in pharmacokinetics. Methods: The optimal concentrations of coating antibody and enzyme-labelled antigen were determined by chessboard titration crossing test. The direct competitive ELISA for determining rhEGF-IL-18 was established and the methodology performance was evaluated. Results: The optimal concentrations of coating antibody and enzyme-labelled antigen were 4 μg/mL and 1:1 000, respectively. The range of the standard curve was 100~900 ng/mL (R2=0.9898). The RSD of intra-day and inter-day were lower than 2.42% and 2.20%, respectively. The recovery was 95.3%~103.0%. The RSD of the samples standing at room temperature 1 h, freezing and thawing twice, cryopreserved for 20 days were less than 15%. The lower limit of quantification was 20.0 ng/mL. Conclusion: ELISA established in this study is stable and feasible.
2014 Vol. 44 (7): 485- [Abstract] ( 611 ) HTML (1 KB)  PDF  (0 KB)  ( 457 )
489 Expressions and significance of p40, TTF-1, p63 and CK5/6 in lung adenocarcinoma and squamous carcinoma
JIAO Lizhuo, CHEN Hanbin, ZHAO Lingling, WANG Ling, LIN Zhongmin, CHEN Lin, CHEN Guorong, CAI Guoping.
Objective: To explore the expression and differential significance of p40, TTF-1, p63 and CK5/6 in adenocarcinama and squamous carcinoma of lung. Methods: Using the technology of tissue microarray and immunohistochemical method, the expression of p40, TTF-1, p63 and CK5/6 was detect in 108 cases specimens of lung adenocarcinoma and 66 cases specimens of lung squamous carcinoma and the difference and clinical pathological significance were analyzed. Results: ①The positive expression rates of p40, p63, CK5/6, TTF-1 in lung squamous cell carcinoma were 93.9% (62/66), 86.4% (57/66), 89.4% (59/66) and 6.1% (4/62), respectively. ②The positive expression rates of p40, p63, CK5/6, TTF-1 in lung adenocarcinoma were 3.7 (4/108), 22.2% (24/108), 24.1% (26/108) and 95.4% (103/108). ③The specificity of p40, p63, CK5/6 for lung squamous carcinoma was 96.3%, 77.8% and 75.9%, the specificity of p40 was higher than that of p63 and CK5/6 (P<0.05). ④p40, p63 and TTF-1 had relevant with gender, pathological type, tumor size, history of smoking (P< 0.05), and had no relevant with age, the degree of differentiation, lymph node metastasis and TNM stages (P> 0.05). ⑤The expression rate of p40 (89.3%) was higher than that of p63 (78.6%) and CK5/6 (82.1%) in poorly differentiated lung squamous carcinoma. Conclusion: p40, p63, CK5/6 and TTF-1 have a important value in the diagnosis and identify of lung cancer. p40 is obviously better than p63 and CK5/6 in the identification of lung squamous carcinomas, and has higher expression rate in poorly differentiated squamous carcinoma of lung. Gender, pathological type, tumor size, history of smoking are relevant with the expression of p40, p63, TTF-1 and CK5/6.
2014 Vol. 44 (7): 489- [Abstract] ( 1950 ) HTML (1 KB)  PDF  (0 KB)  ( 354 )
494 Effect of IL-11 on Th1, Th2 cells and T-bet, GATA-3 mRNA in patients with ITP
YAO Rongxin1, LI Qianqian1, LIN Ying1, ZHOU Xiemin1, BAO Yunhua2.

Objective: To study the effect of IL-11 on Th1, Th2 cells and the expression of modulatory gene T-bet mRNA and GATA-3 mRNA in patients with ITP. Methods: Extracting PBMNC from peripheral blood of ten patients with ITP and using different concentration of IL-11 (0, 25, 50, 100, 200 ng/mL) to cultivate PBMNC for 4 days. Detecting the proportion of Th1, Th2 cells and the quantity of T-bet mRNA, GATA-3 mRNA by flow cytometry and quamtiy RT-PCR. Results: In different concentrations of IL-11, the differences of Th1, Th2 and the ratio of Th1/Th2 were the most significant between 0 ng/mL group and 100 ng/mL group, it showed that the level of Th1 and the ratio of Th1/Th2 decreased, the level of Th2 increased in the 100 ng/mL group. The differences of T-bet mRNA, GATA-3 mRNA, and the ratio of T-bet/GATA-3 mRNA were the most significant between 0 ng/mL group and 100 ng/mL group. Its shows that the expression of T-bet mRNA and the raatio of T-bet/GATA-3 decreased, the expression of GATA-3 mRNA increased in the 100 ng/mL group. Conclusion: IL-11 in vitro can promote Th1 cell convert to Th2 cell in patients with ITP, and can increase the expression of GATA-3 mRNA and decrease the expression T-bet mRNA.
2014 Vol. 44 (7): 494- [Abstract] ( 607 ) HTML (1 KB)  PDF  (0 KB)  ( 411 )
503 Analysis on indexes of lipid metabolism and status indicators before blood clots in patients with obstructive sleep apnea hypoventilation syndrome accompanied chronic obstructive pulmonary disease
YE Huan, XU Bin, SHI Xiaohong, WU Lifeng, SHAO Meiqin, JIN Xiaosheng
 Objective: To observe the changes of indexes of lipid metabolism and status indicators before blood clots in patients with OSAHS (obstructive sleep apnea hypoventilation syndrome) accompanied COPD (chronic obstructive pulmonary disease), and whether lipid metabolism disorder and hypercoagulable state exist in them is discussed. Methods: Patients with OSAHS accompanied COPD were brought into OS (overlap syndrome) group. There were 30 cases in OS group, 41 cases in OSAHS group, 48 cases in COPD group and 45 cases in control group separately. Pulmonary function test and blood specimen detection were carried in all individuals. Blood specimen detection included triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), non-high density lipoprotein-cholesterol (non-HDL-C), lipoprotein (α) (Lpα), apolipoprotein A1 (apoA1), apolipoprotein B (apoB), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), plasma D-dimmer (D-Dimmer) and homocysteine (Hcy). Statistic analysis was carried with SPSS l8.0. Results: apoA1 and HDL-C in OS group and 0SAHS group were less than those in control group and COPD group significantly (P<0.05). apoA1 and HDL-C in OS group were less than those in 0SAHS group significantly (P<0.05). LPα, apoB, TG, TC, LDL-C and N-HDL-C in OS group and 0SAHS group were more than those in control group and COPD group significantly (P<0.05). LPα, apoB, TG, TC, LDL-C and non-HDL-C of OS group were more than those in 0SAHS group significantly (P<0.05). There was no significant difference between control group and COPD group in apoA1, HDL-C, LPα, apoB, TG, TC, LDL-C and non-HDL-C (P>0.05). PT, APTT and TT in OS group, 0SAHS group and COPD group were less than those in control group significantly (P<0.05). PT, APTT and TT in 0S group were less than those in 0SAHS group and COPD group significantly (P<0.05). FIB, D-Dimmer and Hcy in OS group, 0SAHS group and COPD group were more than those in control group significantly (P<0.05). FIB, D-Dimmer and Hcy in OS group were more than those in 0SAHS group and COPD group significantly (P<0.05). There was no significant difference between 0SAHS group and COPD group in PT, APTT, TT, FIB, D-Dimmer, Hcy (P>0.05). Conclusion: OSAHS and OS can induce plasma lipid metabolism disorder, and hypercoagulable state exist in patients with COPD or 0SAHS or OS, and patients with OS is obvious relatively.
2014 Vol. 44 (7): 503- [Abstract] ( 718 ) HTML (1 KB)  PDF  (0 KB)  ( 567 )
508 Dexmedetomidine enhances the efficacy of local anesthetics on sciatic nerve block
HU Xiawei1, ZHOU Riyong2, WANG Quanguang2, WU Yanqin1, XU Xuzhong2
Objective: A randomized and double-blinded observation anesthesia efficacy of dexmedetomidine on local anesthetics for popliteal sciatic nerve block. Methods: Sixty patients who undergone unilateral great saphenouse vein surgery were randomly divided into two groups: Group DL and Group SL (n=30). Ultrasound-guided sciatic nerve block proximal to the neural bifurcation at the popliteal fossa combined with femoral and obturator nerve block were performed in all patients. The sciatic nerve was blocked with 2% lidocaine 9.5 mL and 0.75% ropivacaine 10 mL combined with 0.5 mL (50 μg) dexmedetomidine or 0.5 mL saline in Group DL and Group SL respectively, totally 20 mL. The sensory onset time of lateral sural cutaneous nerve (CN), sural nerve (SN), superficial peroneal nerve (SPN), profundum peroneal nerve (PPN), lateral plantar nerve (LPN) and medial plantar nerve (MPN) were recorded; the motor onset time of tibial nerve and common peroneal nerve were recorded; furthermore,the duration of sensory and motor block were recorded. Results: The sensory onset time of SN, SPN, LPN and MPN in Group DL were significantly faster than those in Group SL (P<0.05), whereas the sensory time of CN and SPN were not different between the two groups (P>0.05); the motor onset time of tibial nerve and common peroneal nerve in Group DL were significantly faster than those in Group SL (P<0.05); the duration of sensory and motor block were significantly faster in Group DL than those in Group SL (P<0.05). Conclusion: Dexmedetomidine enhances the anesthesia efficacy of local anesthetics on sciatic nerve block.
2014 Vol. 44 (7): 508- [Abstract] ( 809 ) HTML (1 KB)  PDF  (0 KB)  ( 443 )
517 Effect of allicin on the cardiac function of ischemic myocardium in rabbits
LIN Jingran, CHEN Ziwei, LU Zuyan, WANG Zhitao, FENG Wenhui, PAN Jianchun, ZHU Xinbo.
Objective: To explore the effect of allicin on the cardiac function of ischemic myocardium in rabbits. Methods: Models of the acute rabbits’ myocardial ischemia were established by giving injections with pituitrin (1.5 U/kg) on ear vein with the method of self-controlled study, then observed the ECG and hemodynamic parameters. When these parameters returned to normal levels, injected with allicin (15 mg/kg) on the ear vein to pre-protect the myocardium, then injected with pituitrin (1.5 U/kg) after 15 minutes, and compared the differences between the ischemic models about the ECG and hemodynamic parameters after 30 s, 1 min, 2  min, 5 min, 10 min and 15 min. Results: Compared with ischemic models, allicin could speed up the heart rate and significantly inhibited the decrease of LVSP, ±dp/dtmax and the increase of LVDP. Conclusion: Allicin has a good effect on improving and protecting the function of ischemic myocardium.
2014 Vol. 44 (7): 517- [Abstract] ( 654 ) HTML (1 KB)  PDF  (0 KB)  ( 359 )
521 Clinical analysis of tracheobronchial tuberculosis with bronchoscopic performance looked like lung cancer
LI Ping, YAN Sunshun, WU Liqin, DAI Yuanrong
Objective: To improve the diagnosis and avoid misdiagnosis of tracheobronchial tuberculosis which bronchoscopic performance looked like lung cancer. Methods: The clinical data of 10 cases tracheobronchial tuberculosis which bronchoscopic performance looked like lung cancer from the Second Affiliated Hospital of Wenzhou Medical University during October 2011 to October 2012 were collected, and the possible causes of misdiagnosis of lung cancer were analysed. Results: Tracheobronchial tuberculosis often occured in middle-aged (90%, 9/10). Main clinical symptoms were cough, sputum and haemoptysis. Sputum-positive rate was low. Lesions locus of TBTB was mostly common on left upper lobar bronchus and right upper lobar bronchus (50%, 7/14). The rate of missed diagnosis and misdiagnosis were 50%. Bronchoscopy performance was neoplasm, which surface had some necrosis. Neoplasm could look like cauliflower, nodular or circular. Bronchus near the neoplasm often had stenosis, and was similar to bronchoscopic performance of primary lung cancer. So it made difficult to identify TBTB and primary lung cancer. There were 7 patients whose brush biopsy for acid-fast bacilli was positive (7/10). There were 7 patients whose brush pathology was positive (7/10). There were 4 patients whose biopsy pathology was positive (4/7). Three patients were positive in pathology of brush and biopsy. Three patients were positive in brush biopsy for acid-fast bacilli and biopsy pathology. Two patients were positive in pathology of brush and biopsy, and brush biopsy for acid-fast bacilli. Conclusion: Tracheobronchial tuberculosis is lack of specific clinical manifestations. When bronchoscopic performance can not be made a diagnosis of tracheobronchial tuberculosis or lung cancer, diagnose relys on bacteriology and biopsy pathology.
2014 Vol. 44 (7): 521- [Abstract] ( 694 ) HTML (1 KB)  PDF  (0 KB)  ( 391 )
524 Clinical characteristics about immunosuppressant related pneumocystis carinii pneumonia in kidney disease
LIN Haixia, SU Zhen, HE Limei, SHU Danhua, HUANG Peipei, ZHANG Huidi.
Objective: To analyze etiology and clinical characteristics of pneumocystis carinii pneumonia in kidney disease patients who accepted immunosuppressive therapy. Methods: Retrospective analyse clinical datas and immunosuppressive schemes of 49 cases kidney disease patients, accompanied with lung infection during June, 2006 to August, 2013 from the First Affiliated Hospital of Wenzhou Medical University. Results: Kidney transplant patients were 20 cases, non-kidney transplant patients were 29 cases. Membranous nephropathy patients were 8 cases, vasculitis associated nephropathy patients were 3 cases, IgA nephropathy patients were 4 cases, lupus nephritis patients were 7 cases, purpura nephritis was 1 case, the other chronic glomerulonephritis patients were 26 cases. Interstitial pneumonia was the main clinical feature in patients, who mainly represent with breathing trouble, cough and fever. 12 cases of pneumocystis carinii pneumonia (PCP), including 9 cases of kidney transplant patients, 3 cases of non-kidney transplant patients. Conclusion: The high incidence of lung infection is observed in kidney disease patients who accepted immunosuppressive therapy in the first year (53.0%), especially in patients of renal transplantation in 6 months. The patients of PCP have no specific clinical manifestations, and are prone to respiratory failure, and hypoalbuminemia is one of the independent risk factors for PCP, we should pay attention to PCP, give a sufficient amount of sulfamethoxazole, use plasma and albumin if necessary, and adjust the dosage of immunosuppressant in time.
2014 Vol. 44 (7): 524- [Abstract] ( 584 ) HTML (1 KB)  PDF  (0 KB)  ( 436 )
528 observation on curative effect of mycophenolate mofetil on frequently relapse nephrotic syndrome in children
YE Xiaohua1, YANG Qing1, LIN Ruixia1, ZHUANG Jieqiu1, LI Changchong2.1.Department of Renal Medicine, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou,
Objective: To observe and evaluate the efficacy and safety of mycophenolate mofetil (MMF) on frequently relapse nephrotic syndrome (FRNS) in children. Methods: Thirty-five patients with FRNS were chosen for observation. Prednisolone was administered 2.0 mg/kg per day and reduced gradually after remission. MMF 20～40 mg/kg daily in two divided doses after relapse was therefore commenced and this treatment continued for at least 6 months. MMF was abandoned if proved ineffective or continued with a gradually reducing dose if not. Urinalysis, complete blood counts, biochemistry and adverse effects were supervised during the treatmeant. Results: Mean 6-monthly relapse  rates decreased significantly from 3.34 (2.49, 5.50) episodes before MMF therapy to 0.00 (0.00, 1.00) episodes in the first 6 months in 33 patients (P<0.001), from 3.14 (2.40, 5.00)episodes before MMF therapy to 0.00 (0.00, 1.00) episodes in the next 6 months in 30 patients (P<0.001), from 3.34 (2.57, 6.00) episodes before MMF therapy to 1.00 (0.00, 1.20) episodes in 13th-18th month in 23 patients (P<0.001), and from 3.34 (2.49, 6.00) episodes before MMF therapy to 0.60 (0.00, 1.05) episodes in 17 patients who followed-up for more than 18 months. Prednisolone dosage was tapering during the treatment (P<0.001). Adverse effects observed were as the following: one patient had transient abdominal pain, one had got acute appendicitis, two had more cold than usual, one got urinary tract infection and one had a muscle tremor phenomena. No patients were found suffering from hematological abnormalities, impaired renal or hepatic function. Conclusion: MMF is an effective and safe immunosuppressant for children with FRNS.
2014 Vol. 44 (7): 528- [Abstract] ( 771 ) HTML (1 KB)  PDF  (0 KB)  ( 461 )
532 Effect of self-ligating and conventional preadjusted brackets on root resorption in severe anterior crowding Class I patients
CHEN Weiting, ZHENG Minling, ZHOU Yu.
Objective: To investigate the effect of self-ligating and in the apical root conventional brackets on root resorption in severe anterior crowding Class I patients after orthodontic treatment. Methods: Seventy subjects who completed orthodontic treatment in Orthodontic of Hospital Stomatology, Wenzhou Medical University from 2006 to 2012 were divided into two group: self-ligating group (35 subjects treated with the Damon3 0.022” bracket) and conventional group (35 subjects with the 0.022” 3M bracket). Quantitative measurements of crown and root lengths for the maxillary and the mandibular central and lateral incisors in the same person were used with the same machine and similar set up. Means and standard deviations for the percentage root resorption per tooth group were calculated by SPSS11.0. Results: No statistically significant difference in root resorption between the two appliance systems was found. The less root resorption observed in self-ligating group was more than that in the conventional group. Conclusion: There is no significant difference in root resorption between self-ligating brackets and conventional brackets in severe crowding incisors subjects.
2014 Vol. 44 (7): 532- [Abstract] ( 618 ) HTML (1 KB)  PDF  (0 KB)  ( 400 )
536 Clinical study of ultrasound-guided nerve block around brachial artery in hand trauma patients
TANG Hongli, GENG Wujun, CHEN Hongfei, XU Xuzhong
Objective: To explore the clinical effect of ultrasound-guided nerve block around brachial artery on the hand trauma patients. Methods: Sixty patients treated with hand trauma surgery were divided into two groups randomly, named the group I (ultrasound-guided nerve block group) and the group II (blind block group). Mixture by lidocaine1% and ropivacaine 0.375% as local anesthesia was used for nevre block in two groups. The nerve block operation time, the onset time of anesthesia, the effectireness of nerve block and the complication of the two groups were observed. Results: There was no statistically significant difference of the onset time and the anesthesia effectreness between two groups of patients (P>0.05). The operation time of group I was obviously shorter than that of the group II (P<0.05). The difference of anesthesia effect of hand sensory innervation and motor innervation regional was no statistically significant. Conclusion: Ultrasound-guided nerve block around brachial artery on the hand trauma patients can shorten the anesthesia operation time, ensure the satistied anesthetic effect, and is effective and safe.
2014 Vol. 44 (7): 536- [Abstract] ( 702 ) HTML (1 KB)  PDF  (0 KB)  ( 382 )
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