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2016 Vol. 46, No. 8 Published: 2016-08-25   547 The protective effect of transcutaneous electrical stimulation on vital organ function in neurosurgery doing controlled hypotension MO Yunchang, CHEN Linbi, Wang Xixi, PAN Yuanyuan, LUO Shan, HUANG Luping, Objective: To study the protective effect of transcutaneous electrical acupoint stimulation (TEAS) combined with controlled hypotension on brain, liver and kidney in neurosurgery. Methods: Fifty elective surgery patients with brain tumor were randomly divided into control group and treatment group, each was 25 cases. The treatment group (TEAS group) with TEAS plus controlled hypotension, stimulation frenquecy was 2/ 100 Hz, density wave, the intensity of 8-12 mA, electrical stimulation of bilateral Hegu, Sanyinjiao, Qu Chi and Zusanli, and reduced the mean arterial pressure (MAP) to the target and maintained 40-50 minutes. In the control group (Sham group): only electrodes attached to the same points, no stimulation, as other treatments with the TEAS group. Then we extracted internal jugular vein in these time points, including 5 minutes before lowering blood pressure (T1), to maintain blood pressure 60 minutes (T2), after elevated blood pressure 60 minutes (T3), 24 hours and 48 hours after surgery (T4 and T5), detected cerebral protection factor and damage factor: SOD, CGRP, ET, MDA, IL-6 and S100β protein; the function indicators of heart: LDH, cTnI, MYO, CK and CK-MB; indexes of liver function: prealbumin, glutathione, ALT, AST, ALP, γ-transglutaminase; renal function parameters: Cystatin C, BUN, Cr, uric acid. Results: ①The cerebral protection factor and damage factor: Compared with T1, the level of SOD decreased obviously in the patients of control group at T2, T3 and T5 time points (P<0.05), however the level of CGRP, ET, MDA, IL-6 increased in T3, T4 and T5 (P<0.05). Compared with the control group, the TEAS group respectively reduced IL-6 and S100β in T2, reducing the level of ET in T3, increasing the SOD in T4, and lowering the MDA in T5 (P<0.05). ②The function indicators of cardiac: there was no difference between these two groups in the function indicators of cardiac (P>0.05). ③The indexes of renal function: the level of cystatin C of sham group was significantly higher in the T2 and T3 compared with the T1 time point (P<0.05). Compared with the control group, the treatment group could reduce the level of cystatin C in the T2 and T3 (P<0.05). ④The indicators of liver function: compared with T1, the level of AST, ALT and α-GST respectively increased in the T2, T3, T4 and T5 (P<0.05), while the prealbumin level significantly decreased in two points, including T2 and T3 (P<0.05). The patients of TEAS group was observed the level of α-GST could be reduced in T2 and T3 and the level of AST and ALT also reduced in the T4 and T5 in these two points (P<0.05). Conclusion: The neurosurgery combines with controlled hypotension can cause a certain impact on the function of brain, liver and renal. However the transcutaneous electrical acupoint stimulation (TEAS) can play a role in organ protection. 2016 Vol. 46 (8): 547-553 [Abstract] ( 768 ) HTML (1 KB)  PDF (1275 KB)  ( 950 ) 554 Identification of dengue virus-derived highly conserved HLA-A*1101-restricted T-cell epitopes and study on their in vivo immune responses CHEN Xinyu, DUAN Zhiliang, JIANG Minghua, JIA Qingjun, XU Juanjuan, CHEN Bokun, WEN Jinsheng. Objective: To identify dengue virus serotype 2 (DENV-2)-derived HLA-A*1101-restricted T-cell epitopes and explore the characteristics of induced T cells. Methods: Based on the complete amino acid sequence of DENV-2, T-cell epitope prediction software was utilized to predict putative HLA-A*1101-restricted T-cell epitope. Based on HLA-A*1101 transgenic mice, the HLA-A*1101 restriction of epitope candidates and the characteristics of induced T cells were determined using ELISPOT assay, ELISA assay and CTL cytotoxicity assay. Results: Among 14 epitope candidated, each of 9 peptide (NS1161-170, NS1263-272, NS36-15, NS4b44-53, NS333-42, C58-67, E30-38, NS3576-584, and NS4a72-80) could induce IFN-γ-secreting T cell response in HLA-A*1101 transgenic mice. Except for IFN-γ, C58-67 - and NS3576-584 -specific T cells also could secret TNF-α while E30-38-specific T cells could secret TNF-α and IL-6 simultaneously. High levels of IFN-γ-secreting T cells were detected in DENV-2-infected HLA-A*1101 transgenic mice and directed to 6 peptides (NS4b44-53, NS333-42, C58-67, E30-38, NS3576-584, and NS4a72-80). The effector cells from HLA-A*1101 transgenic mice immunized with the mixture of 6 above-mentioned peptides efficiently lysed DENV-2-infected splenic monocytes. Conclusion: Nine DENV-2-derived peptides are identified as HLA-A*1101-restricted T-cell epitopes. 2016 Vol. 46 (8): 554-560 [Abstract] ( 793 ) HTML (1 KB)  PDF (1862 KB)  ( 894 ) 561 Construction of recombinant eukaryotic expression vector of human intestinal trefoil factor and its expression in CHO/dhfr- cells ZHU Ronghe, CHEN Huiyao, ZHUANG Qiang, JIANG Songfu Objective: To construct eukaryotic expressing vector of human intestinal trefoil factor and express hITF protein in dihydrofolate reductase-deficient Chineses hamster ovary cells (CHO/dhfr-). Methods: The full length cDNA fragment was amplified by overlap extension PCR, then inserted into eukaryotic expression vector pIRES/dhfr. The recombinant vector was transfected into CHO/dhfr- cells by LipofectamineTM2000. The stable transfected CHO/dhfr- cell line was then established by screening cultures with G418. RT-PCR and ELISA were used to detect the expression of the protein. Results: The eukaryotic expression vector was constructed successfully, stable transfected CHO cell line was established, and hITF protein was expressed successfully. Conclusion: The recombinant plasmid pIRES/hITF/dhfr is successfully constructed and it expresses the protein in the supernatant of the CHO/dhfr- cells, which is the basis for pre-clinical study. 2016 Vol. 46 (8): 561-565 [Abstract] ( 623 ) HTML (1 KB)  PDF (1712 KB)  ( 803 ) 566 Prediction of subacute infarct lesion volume in hyperacute cerebral artery stroke: comparison of perfusion-weighted imaging and apparent diffusion coefficient maps SHAO Xiaotong, GUO Xianzhong, CHEN Weijian, WANG Hao, LIN Boli, XIA Nengzhi, YANG Yunjun. Objective: To compare perfusion-weighted imaging (PWI) and apparent diffusion coefficient (ADC) maps in prediction of infarct lesion volumes and growth in patient with hyperacute cerebral artery infarct. Methods: Twenty hyperacute cerebral artery stroke patients who underwent multimodal magnetic resonance imaging (MRI) in hyperacute (<6 h) phase and the follow-up MRI in the subacute (days 5-7) phase were retrospectively reviewed. Diffusion- and perfusion-weighted imaging lesion volumes were semi-automatically measured by a post-processing software of GE Healthcare 3.0 T MR scanner (Signa Twin Speed, GE Medical System, Milwaukee, Wisconsin, USA). Finally, to compare the two methods in infarct growth prediction, correlation and regression analysis and receiver operating characteristic curves were used. Results: The lesion volume of follow-up FLAIR was highly correlated with volumes predicted with ADC-, CBF-, CBV-, MTT-, and TTP-maps (all P<0.05). The correlation was higher for ADC-predicted volume (r=0.954, 95%CI: 0.804-1.000) than that for PWI- predicted volume (P<0.05). Besides, The infarct growth was correlated with ADC-DWI mismatch (r=0.744, P=0.001), but we didn’t find any correlation among infarct growth and CBF-DWI, CBV-DWI, MTT-DWI, TTP-DWI mismatches (all P>0.05). Conclusion: Data showed that by using the post-processing software provided by MR equipment, the ADC-based method is more feasible than PWI-based method for evaluating infarct growth and volume in the subacute phase, which makes early estimation of prognosis possible. 2016 Vol. 46 (8): 566-570 [Abstract] ( 712 ) HTML (1 KB)  PDF (1839 KB)  ( 728 ) 571 Clinical application of ultrasonography in monitoring gastric insufflation in children during induction of general anesthesia HU Qiong, ZHOU Bihua, YAN Haiya, LI Jun. Objective: To investigate the clinical value of ultrasonography in monitoring gastric insufflation related to facemask ventilation in pediatric patients during induction of general anesthesia. Methods: Fifty-four 2-4 years old male children received elective surgery under general anesthesia were randomized to 3 groups (P8, P12, and P16) defined by the PIP applied during PCV mode: 8, 12, and 16 cmH2O. Anesthesia was induced using fentanil, propofol and rocuronium in sequence. Once loss of eyelash reflex occurred, facemask pressure-controlled ventilation was started for a 120 s period while gastric insufflation was detected by real-time ultrasonographic monitoring. The antral cross-sectional area (CSA) was measured using ultrasonography before and after facemask ventilation. The noninvasive respiratory parameters were recorded at time 30, 60, 90, and 120 s during facemask ventilation. Results: After facemask ventilation for 120 s, gastric insufflation was detected in 24 children (45.3%) by ultrasonographic monitoring, and the antral CSA was significantly increased in groups P12 and P16. The Vt (mL/kg) of group P8 was significantly lower than the other two groups, and the probability of hypoventilation (Vt<6 mL/kg) was high which was 66.6%. After 120 s facemask ventilation, group P8 showed a certain CO2 accumulation for PETCO2 at (40.6±4.0) mmHg. Contrarily, group P16 showed excessive ventilation for PETCO2 at (23.6±1.4) mmHg. At the same time, the ETO2 of group P8 was lower than in groups P12 and P16 which had no significant difference. Conclusion: Ultrasonography can be well used in monitoring gastric insufflation related to facemask ventilation during induction of anesthesia. When PIP value is set as 12 mmHg, there was low incidence of gastric insufflation with adequate pulmonary ventilation in 2-4 years children. 2016 Vol. 46 (8): 571-574 [Abstract] ( 686 ) HTML (1 KB)  PDF (1297 KB)  ( 1038 ) 575 The analysis of cerebral vasospasm risk factor after aneurysms subarachnoid hemorrhage LIN Zhongxiao,JIN Qianqian, YOU Chaoguo, CAI Ming, SHENG Hansong, YIN Bo, ZHANG Nu. Objective: To analyze the occurrence and risk factor of cerebral vasospasm (CVS) after aneurysms subarachnoid hemorrhage (aSAH). It was useful to provid theoretical basis for the treatment and preventation of the CVS. Methods: The clinical data of 115 patients were retrospectively analyzed. The Chi-squared test and logistic multivariate analysis were used to analyze and assess cerebral vasospasm rate and high-risk factors. Results: The Chi-squared test showed that 52 patients appeared the CVS, and the occurrence rate of the CVS was 45.21% in 115 patients. Hunt grades, improved modified FISH grades, therapy methods and nimodpine were related to the CVS (P<0.05). But age, gender, history of hypertension, history of smoking, serous potassium, blood glucose and white blood cell were irrelated to the CVS (P>0.05). Multivariate logistic analysis revealed that therapy methods were irrelated to the CVS (P>0.05). However, Hunt grades, improved modified FISH grades (b>0, OR>1) were independent risk factor of the CVS (P<0.05), and nimodpine was a protective factor (b<0, OR<1) of the CVS (P<0.05). Conclusion: aSAH patients are vulnerable to the CVS. Nimodipine is a protective factor of the CVS, however, Hunt grades and improved modified FISH grades are high risk factors of the CVS. 2016 Vol. 46 (8): 575-577,581 [Abstract] ( 547 ) HTML (1 KB)  PDF (1259 KB)  ( 568 ) 578 IL-17 and IL-23 serum levels in patients undergoing colorectal cancer surgery: effects of different anesthetic techniques YANG Fen, YAN Fang, WEI Lei, WANG Xingshuang, ZHAO Jianhua. Objective: To compare the effects of continuous epidural block combined with intravenous anesthesia, total intravenous anesthesia and total inhalational anesthesia on pro-inflammatory cytokines IL-17 and IL-23 serum levels in patients undergoing colorectal cancer surgery. Methods: All patients were randomly divided into three trials groups (n=20): continuous epidural block combined intravenous anesthesia group (A group): patients received continuous epidural anesthesia of bupivacaine, and received intravenous anesthesia with propofol; total intravenous anesthesia group (B group): patients received total intravenous anesthesia with propofol and fentanil; total inhalational anesthesia group (C group): patients received total inhalational anesthesia with sevoflurane in O2 and Nitrous Oxide. Control group was composed of healthy subjects. Serum levels of IL-17 and IL-23 were quantified. Results: In three trials groups, levels of IL-17 and IL-23 were high prior to control group at induction of anesthesia (T0), and there was no difference between three groups (P>0.05). Compared with T0, levels of IL-17 and IL-23 significantly decreased at 60 min after the start of surgery (T1), 30 min post-surgery (T2) and 24 h post-surgery (T3); Levels of IL-17 and IL-23 were significantly lower at T1 than T2 and T3, and they were significantly lower at T2 than T3 (P<0.05). At T1 and T2, levels of IL-17 and IL-23 were significantly lower in A group than that in B group, and they were significantly lower in B group than C group (P<0.05); there was no difference between three trials  groups at 24 h post-surgery (P>0.05). Conclusion: Three anesthetic techniques significantly decreases IL-17 and IL-23 levels, so they has inhibiting effect on colorectal cancer. In this respect, continuous epidural block combined with intravenous anesthesia is better than the other two, total intravenous anesthesia is better than total inhalational anesthesia. 2016 Vol. 46 (8): 578-581 [Abstract] ( 644 ) HTML (1 KB)  PDF (1272 KB)  ( 812 ) 582 Clinical significance of HPV L1 capsid protein detection in cervical exfoliated cell in cervical intraepithelial neoplasm ZHANG Aimu, SHEN Qi, ZHAO Jing, LIAO Hongli, ZHU Xueqiong. Objective: To explore the clinical significance of HPV L1 capsid protein detection in cervical exfoliated cell in cervical intraepithelial neoplasm in diagnosis and follow up. Methods: Select 276 patients with high-risk human papilloma virus who used to be in Wenzhou Centrol Hospital between January 2013 and June 2013 and the cytological diagnosis was atypical squamous epithelial cell without certain diagnosis significance. All patients accept HPV L1 capsid protein detection in cervical exfoliated cell and colposcope cervical biopsy. Results: ①The expression rate of HPV L1 capsid protein in cytological diagnosis LSIL was up to 70.09% (75/107), followed by ASCUS with the expression rate of 55.46% (66/119), and the expression rate in ASC-H, HSIL, SCC was 10% (5/50) with the significant difference (P<0.05). ②The positive expression rate of HPV L1 capsid protein in CC, CIN I, CIN II-III and SCC was 63.55% (68/107), 75.32% (58/77), 21.59% (19/88), and 0 (0/4) respectively, and there was significant statistical difference (P>0.05). The expression of HPV L1 in CC and CIN I was significantly higher than that in CIN II-III and SCC. ③In high-risk HPV positive women, sensitivity of single TCT inspection and TCT combined with HPV L1 detection on histopathology≥CIN II screening was 46.73% and 88.89%; specificity was 96.20% and 88.65%; positive predictive values were 86% and 71.43%; negative predictive values were 78.32% and 96.15%, respectively. ④In follow-up 31 women with CIN I for 1 year, our fiangdings showed that these two HPV L1 immunostaining results exhibited clearly opposite progression and regression trends that were statistically significant (P<0.05). The sensitivity, specificity, positive predictive values, negative predictive values were 91.67%, 57.89%, 57.89% and 91.67%, respectively. Conclusion: ①The expression rate of HPV L1 capsid protein decreases with the increase of cervical lesions degree; ②In high-risk HPV positive women, TCT combining with HPV L1 detection has higher sensitivity (88.89% vs 46.73%) and negative predictive (96.15% vs 78.32%) than single TCT inspection on histopathology≥CIN II screening; ③It is predicted that there are higher value of sensitivity and negative predictive to predict the spontaneous regression of CIN I of HPV L1 positive ones, which is worth promoting. 2016 Vol. 46 (8): 582-585,589 [Abstract] ( 863 ) HTML (1 KB)  PDF (1298 KB)  ( 1227 ) 586 Evaluation the anxiety behavior in different dosage of MPTP-induced Parkinson’s mice YE Suzhen, SHI Jian, XIA Yu, ZHANG Shuping, HUANG Hanjin. Objective: To study the anxiety behavior in different dosage of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) -induced Parkinson’s mice. Methods: Forty C57BL/6J were randomly divided into 4 groups: Low-dose group (LG), moderate-dose group (DG), high-dose group (HG) and control group (CG). The anxiety behavior in mice was tested with the elevated plus-maze test and the light/dark box. Results: The time of stayed in the dark box of model groups mice were longer than those of the control group (P<0.05), but the time and transition among model groups mice had no difference (P>0.05). The OE, OT and OT% in mode groups mic were significant lower than that in the control group (P<0.05) in the elevated plus-maze test, but there was no significant difference among the three model groups (P>0.05). The OE% in LG and DG was lower than that in control group (P<0.05) in the elevated plus-maze test. Conclusion: Anxious behavior appears in the model groups of early PD mice. But there is no difference among those model groups. The anxiety behavior is not dose-dependent. 2016 Vol. 46 (8): 586-589 [Abstract] ( 694 ) HTML (1 KB)  PDF (1317 KB)  ( 874 ) 590 Comparison of different methods for mouse pulmonary microvascular endothelial cells culture ZHOU Lingping, FENG Cheng, TANG Xuebin, XU Honglei. Objective: To explore an efficient and stable method for the mouse pulmonary microvascular endothelial cells (PMVECs) culture. Methods: Forty-five 1 week old Balb/c mice were randomly divided into three groups. Mouse PMVECs were isolated and cultured respectively by enzyme digestion method, explants method and immunimagnetic beads method. Cells were identified by morphological observation and VIII factor related antigen immunofluorescence staining. The success rate of primary culture and the time required from primary culture to the beginning of the first passage was calculated, the cell purity was determinated, growth curves were drew by MTT method. Results: Short spindle and polygonal microvascular endothelial cells were observed in all of the three methods. Those cells were positive to the VIII factor related antigen. The success rate and cell activity in immunomagnetic beads method group increased significantly compared with the other two groups (P<0.01). As for the time required from primary cultured to the beginning of the first passage, it decreased in immunomagnetic beads method group compared with the explant method group (P<0.05). And the purity increased significantly in immunomagnetic beads method group compared with the enzyme digestion method group (P<0.01). Conclusion: Immunomagnetic beads method is of higher repeatability, rapider separation, and obtains much higher purity and better activity mice PMVECs. 2016 Vol. 46 (8): 590-593 [Abstract] ( 771 ) HTML (1 KB)  PDF (1429 KB)  ( 1046 ) 594 Expression and clinical roles of Survivin and EGFR in endometrial carcinoma LIN Feng, WANG Fang, ZHOU Kai. Objective: To investigate the expression of Survivin and EGFR in endometrial cancer tissues and to explore their relationship with histopathological grade, tumor stages, lymph node metastasis, etc. At last, the clinical roles of Survivin and EGFR in endometrial cancer were explored. Methods: The expressions of Survivin and EGFR were detected by immunohistochemical methods in the paraffin embedded sections of 71 endometrial cancer patients and the clinical data had been reviewed. Twenty normal endometrial tissues and 20 atypical hyperplasia endometrial tissues were chosen as control group. Results: Survivin and EGFR were over-expressed in 80.2% and 52.1% endometrial cancer specimens. The expression of Survivin was correlated to the histological grade and the expression of EGFR was correlated to the histological grade and overall survival. Over expression of Survivin and EGFR were correlated to each other. Conclusion: Both Survivin and EGFR were over-expressed in endometrial cancer specimens. Survivin and EGFR may play key roles in the development of endometrial cancer. Detection of the expression of Survivin and EGFR can be proposed in the evaluation of malignant degree and prognosis of endometrial cancer. 2016 Vol. 46 (8): 594-596 [Abstract] ( 598 ) HTML (1 KB)  PDF (1234 KB)  ( 905 ) 597 Effects of diabetes on oxidative stress in burn wounds GONG Xiaohua, WU Wenjun, CHEN Xiong, ZHOU Qi, SHEN Feixia, CHEN Rujun Objective: To observe the metabolite level of oxidative stress in burned patients with or without type 2 diabetes mellitus, and to explore the relationship between oxidative stress and diabetic burned wounds. Methods: The patients were divided into 3 groups, including burned patients without DM (Burn group), burned patients with DM (DM-B group) and DM without burns. And another 21 healthy subjects were enrolled as control group. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in plasma and wounds were detected. Results: The plasma levels of SOD in the DM-B group, Burn group and DM group were lower than that of the control group (P<0.05). The plasma concentrations of MDA were statistically significantly higher in the groups of DM-B, Burn and DM in comparison with the control group. The levels of SOD in the burn wounds were lower in DM-B group compared to Burn group on the 1st day following injury (P<0.05), which maintained until the 21st day. In DM-B group a statistically significant increase of the MDA was observed from the 1st day until the 21st day. Conclusion: These data show evidence of a marked,long-lasting oxidative stress in burned patients with DM compared to the burned patients without DM. For this reason, burned patients with DM are recommended to receive exogenous antioxidants. 2016 Vol. 46 (8): 597-599 [Abstract] ( 627 ) HTML (1 KB)  PDF (1264 KB)  ( 789 ) 600 Imaging quality optimization of CT cerebral angiography by using single source spectral CT Wang Aimin, Tang Kun, Li Rui, Cao Guoquan, Pan Kehua, Wang Zhenzhang, Lin Jie Objective: To determinate the optimal keV levels of single source spectral CT by evaluating imaging qualities of CT cerebral angiography. Methods: A total of 53 cases underwent spectral CT were enrolled in this study. All images of cerebral angiography were reconstructed by software of spectral CT from 40 to 140 keV in 10 keV increments. The mean vessel attenuation and the contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR) of the following arteries: basilar artery, internal carotid artery, anterior cerebral artery, middle cerebral artery and posterior cerebral artery were measured and calculated respectively. Subjective assessment on imaging quality was performed by using a 5-point scoring system. The results of objective image quality among different keV levels were compared using one-way analysis of variance. For subjective assessment, the Nonparametric Wilcoxon test was used to analyze the differences in subjective scores. Results: The image noise at 70-140 keV levels was statistically lower than that at 40, 50 and 60 keV levels. The image CNR and SNR between 60 keV and 70 keV levels showed on statistically differences, but markedly higher than other keV levels (P<0.05). The scores of subjective image quality at 70 keV level were all higher than other keV levels including 60 keV level (P<0.05). Conclusion: The 70 keV level can be commended as an optimal keV setting for spectral CT cerebral angiography by improving image CNR, SNR and reducing image noise. 2016 Vol. 46 (8): 600-603 [Abstract] ( 608 ) HTML (1 KB)  PDF (1777 KB)  ( 1014 ) 610 Drug versus surgery treatment for patients with microprolactinoma in China: a Meta-analysis LU Jianglong, CAI Lin, WU Jinsen, ZHENG Weiming, ZHUGE Qichuan, SU Zhipeng. Objective: To evaluate the efficacy and safety of drug versus surgery treatment for patients with microprolactinoma in China. Methods: Case-control trials of drug versus surgery treatment for patients with microprolactinoma in China were collected from PubMed, Embase, Wanfang, VIP and CNKI databases, then systematic review and meta-analysis was conducted. Results: A total of 12 case-control trials involving 1 671 patients were included, and the average follow-up time was more than 6 months. As for the total effective rate, including normalization of prolactin levels, normalization of the menstrual cycle and disappearance of galactorrhea, no significant differences were found between drug treatment group and surgery treatment group. The incidence of side effects was higher in drug treatment group than that in surgery treatment group (OR=3.27, 95%CI: 2.191～4.90, P<0.001). In patients with prolactin levels less than 200 ng/mL before treatment, the rate of normoprolactinemia was lower in drug treatment group than that in surgery treatment group (OR=0.34, 95%CI: 0.17～0.68, P=0.002). Conclusion: Observational evidence supports that the surgical options should at least be discussed for microprolactinomas, especially with prolactin levels less than 200 ng/mL, provids that an experienced pituitary neurosurgeon is available. Patients should be explained that medical therapy may need to be continued for many years and surgery has about 70 % chance of solving the problem permanently. 2016 Vol. 46 (8): 610-614 [Abstract] ( 649 ) HTML (1 KB)  PDF (1523 KB)  ( 1037 )

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