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2018 Vol. 48, No. 9 Published: 2018-09-25   0   Guide::    2018 Vol. 48 (9): 0-0 [Abstract] ( 564 ) HTML (1 KB)  PDF (985 KB)  ( 801 ) 625 The regulating effect of propofol on the expression of HMGB1 induced by TNF-α in microglia Zhang Mingxiao, Huang Luping, Jin Shenhui, Chen Sijia, Dai Qinxue. Objective: To investigate the effect of propofol on the expression of HMGB1 of microglia BV-2 cells induced by TNF-α. Methods: MTT was used to detect cell proliferation of microglia treated by propofol in different concentrations (5, 10, 20, 50, 100, 150 and 200 μmol/L). Control group, TNF-α (20 ng/mL) group, and TNF-α (20 ng/mL) + propofol (10, 20 and 50 μmol/L) group were set up. The expression of HMGB1 and the phosphorylation of p38 in microglia were detected by RT-qPCR and Western blot after microglia was pretreated with propofol (10, 20 and 50 μmol/L) and then stimulated with TNF-α. Utilizing siRNA to silence p38 before it was treated with propofol and the expression of HMGB1 was examined by RT-qPCR and Western blot. Results:High concentration of propofol (150 and 200 μmol/L) inhibited the proliferation of microglial cells. Compared with the control group, the expression of HMGB1 was increased after TNF-α stimulation. The expression of HMGB1 in TNF-α+propofol group was significantly reduced and presented dosage dependence compared with TNF-α group. Silencing p38 inhibited the TNF-α-induced expression of HMGB1 in microglia. There was no significant difference in HMGB1 expression between the group with silenced p38 alone and the propofol-treated group after silencing p38. Conclusion: Propofol can be used to regulate the expression of HMGB1 of microglial cells through activating p38 and thus affecting the advanced inflammatory response to brain injury. 2018 Vol. 48 (9): 625-629 [Abstract] ( 810 ) HTML (1 KB)  PDF (1675 KB)  ( 813 ) 630 Generation and evaluation of CCN1 gene knockout mice by Cre-LoxP technology Objective: To establish and identify the cysteine-rich 61 (CYR61/CCN1) gene knockout mice via Cre-LoxP conditional gene knockout technology, and to build animal model for researchers to explore the role and mechanism of CCN1 gene in lung inflammation. Methods: The introduced CCN1flox/flox mice and the mice that express pulmonary epithelial cell-specific Cre recombinase were bred and authenticated separately. After successful identification, two kinds of mice were hybridized. The off-spring mice with Cre+/-CCN1flox/flox genotyping were the objective mice. Results: Cre+/-CCN1flox/flox mice were successfully bred and identified. An intraperitoneal injection of tamoxifen was administered to stimulate the experiment group (Cre+/-CCN1flox/flox) and the control group (Cre-/-CCN1flox/flox). RT-PCR, immunofluorescence, immunohistochemical and Western-blot were applied to detect mRNA and protein expression of CCN1 in lung tissue. There was a significant decrease of CCN1 mRNA and protein expression in the lung tissues of experiment group compared with the control group. Conclusion: Based on the Cre-LoxP conditional gene knockout technology, we succeed in building a group of lung epithelial cell-specific CCN1 gene knockout mice which can stably go down to the future generation. This kind of mice would supply a technical basis for animal models in further researches of the regulation and mechanism of CCN1 gene in the inflammation of lung tissues. 2018 Vol. 48 (9): 630-635,640 [Abstract] ( 1064 ) HTML (1 KB)  PDF (1887 KB)  ( 1553 ) 636 The protective effect of Endocan on inflammation in endotoxin-induced acute lung injury in mice ZHANG Xiaolong, WU Haiya, CHEN Jie, WU Chengyun. Objective: To investigate the effect of Endocan on lipopolysaccharide (LPS) induced acute lung injury (ALI). Methods: LPS was used to construct C57BL/6 mice ALI model by aerosol inhalation for 30 min, and Endocan was injected intraperitoneally at 30 min prior to LPS exposure. Mice in control group were treated with normal saline at an equal volume. The mice were sacrificed 24 h after aerosol inhalation. The ratio of lung wet weight to dry weight (W/D) was measured to assess the extent of pulmonary edema. Myeloperoxidase (MPO) activity in lung tissues was measured to determine Neutrophil infiltration. The level of intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α) and interleukins-6 (IL-6) in bronchoalveolar lavage fluid (BALF) were detected by ELISA. The ultrastructural changes were visualized by electron microscope. Results: Compared with the control group, the lung W/D, MPO activity and the concentrations of TNF-α, IL-6 and ICAM-1 were dramatically increased in LPS group [W/D: 5.62±0.95 vs. 4.08±0.76, MPO (U/g): 2.71±0.59 vs. 1.39±0.28, TNF-α (pg/mL): 140.36±10.01 vs. 79.65±6.23, IL-6 (pg/mL): 156.54±17.82 vs. 50.11±6.02, ICAM-1 (pg/mL): 107.05±13.92 vs. 57.31±8.02, P<0.01] which could be relieved by Endocan treatment [W/D: 4.38±0.47 vs. 5.62±0.95, MPO (U/g): 1.84±0.42 vs. 2.71±0.59, TNF-α (pg/mL): 113.07±8.49 vs. 140.36±10.01, IL-6 (pg/mL): 123.22±12.80 vs. 156.54±17.82, ICAM-1 (pg/mL): 89.44±10.92 vs. 107.05±13.92, P<0.01]. Electron microscope data showed obvious ultrastructure injury induced by LPS, which was greatly attenuated in Endocan group. Conclusion: Endocan can suppress inflammatory response in endotoxin-induced acute lung injury, which suggests that Endcan may be a potential protective agent for ALI. 2018 Vol. 48 (9): 636-640 [Abstract] ( 686 ) HTML (1 KB)  PDF (2165 KB)  ( 865 ) 641 A comparison between neurotrophin-3 with retinoic acid and β-mercaptoethanol in the induction of bone marrow mesenchymal stem cells ZHANG Jie, QIN Huali, JIANG Ming. Objective: To explore the differences between two methods of inducing BMSCs into neuron-like cells in vitro. Methods: BMSCs were cultured and sub-cultured by the main method of whole bone marrow directly adherent to flasks, and the surface markers CD29, CD90 and CD45 of the third generation were then detected by flow cytometry. The third generation of BMSCs were pre-induced by basic fibroblast growth factor(bFGF), then neurotrophin-3 (NT-3)+retinoic acid (RA) and beta-mercaptoethanol (β-BME) were added respectively. Immunofluorescence was used to identify whether cells expressed neuron-specific enolase (NSE). Results: BMSCs with high quantity and purity could be obtained by the method of whole bone marrow directly adherent to flasks. We observed that the cells expressed CD29 and CD90 but not CD45 through flow cytometric detection, confirming that the cells were BMSCs. Both groups expressed NSE. The positive rate of 7 d in (NT-3+RA) group was higher than other time points (P<0.01), and the positive rate of 5 h in the β-BME group was higher than 1 h, and the positive rate of 1 h and 5 h in (NT-3+RA) group was lower than the β-BME group (P<0.01), but almost all cells in the β-BME group died in 24 h. Conclusion: The method of whole bone marrow directly adherent to flasks is suitable for extracting BMSCs. Both methods can be used to induce BMSCs differentiation into neuron-like cells. The survival time and later-stage positive rate of (NT-3+RA) group is better than β-BME group. 2018 Vol. 48 (9): 641-645 [Abstract] ( 710 ) HTML (1 KB)  PDF (1567 KB)  ( 836 ) 646 A study on the improvement of the immunofluorescence classification of membranoproliferative glomerul-onephritis like lesion LI Chang, ZHU Shuang, HUANG Zhaoxing. Objective: To explore the improvement of immunofluorescence (IF) classification of membranoproliferative glomerulonephritis (MPGN) like lesion, to understand the etiology of MPGN like lesions and the prevalence of idiopathic MPGN. Methods: MPGN like lesions were diagnosed by optical microscopic examination of renal biopsy tissues in 118 patients from January 1994 to April 2018 in the First Affiliated Hospital of Wenzhou Medical University. All these cases were studied by a modified method of IF classification based on IF classification which had been suggested by SETHI and FERVENZA, and combined with electron microscopic examination and clinical retrospective etiological analysis. Results: A total of 118 cases of MPGN like lesions, with an average age of 39.8±17.2 years old, including 12 cases of idiopathic MPGN and 9 738 cases of renal biopsy in the same period. Idiopathic MPGN accounted for 0.12% of the total cases of renal biopsy. According to the improved IF classification, immune-complex (IC) mediated MPGN accounted for 78.8% (93/118), monoclonal immunoglobulin related MPGN accounted for 5.9% (7/118), C3 glomerulopathy and non immuno-mediated MPGN like lesions accounted for 8.5% (10/118) and 6.8% (8/118) respectively. Etiological classification: idiopathic MPGN accounted for 10.2% (12/118), the cases with secondary causes accounted for 89.8% (106/118), the most common secondary cause was systemic lupus erythematosus (SLE) which accounted for 34.7% (41/118), followed by hepatitis B virus (HBV) infection which accounted for 12.7% (15/118). Electron microscopy revealed 77 cases of MPGN like lesions, including 73 cases of MPGN and 4 cases of MPGN like lesions. The most frequent pathological type of MPGN was I type, accounting for 56.2% (41/73), followed by III type 41.1% (30/73). Secondary MPGN was 78.1% (32/41) and 90% (27/30) in type I and III respectively. Conclusion: The prevalence of idiopathic MPGN in Wenzhou is extremely low. Most of the cases with MPGN like lesions have secondary etiology which are common caused by SLE and HBV infection, and in which MPGN is the most common mediated by IC. The modified method of IF classification can lead to an improved understanding of the pathogenic mechanism in MPGN, and may be more helpful to the etiological identification of MPGN like lesions. 2018 Vol. 48 (9): 646-651,656 [Abstract] ( 650 ) HTML (1 KB)  PDF (1446 KB)  ( 780 ) 652 The effect of Xingnaojing injection on cognitive function of rats with traumatic brain injury CHEN Yihua, CHENG Zhenyu, SHAO Linhua, HE Zhongping, WANG Ruiquan, FU Bin. Objective: To investigate the effect of Xingnaojing injection on cognitive function of rats with traumatic brain injury and its related mechanisms. Methods: A total of 108 rats were randomly divided as sham-operation group, trauma group and treatment group, with 36 rats in each group. Rats were given an intraperitoneal injection of 1 mL normal saline in the sham-operation group and trauma group, while rats in treatment group were administered intraperitoneally with 5 mL/kg Xingnaojing injection once a day for 7 days. Escape latency was recorded using Morris water maze for 6 rats in each group. At 12, 24, 48, 72 and 168 h respectively after the model was established, 6 rats in each group were decapitated. Brain tissues surrounding traumatic lesion were obtained. Apoptotic neuronal cells were determined using TUNEL staining. Protein expressions of procaspase-3 were investigated using Western blot. Caspase-3 protein expressions were detected using immunohistochemical staining technique. Results: Percentage of apoptotic neuronal cells and protein expressions of procaspase-3 and caspase-3 in the rat brain tissues as well as escape latency of rats were significantly higher in the trauma group than in the sham-operation group (P<0.05). The preceding variables in rats were significantly lower in the treatment group than in the trauma group (P<0.05). Conclusion: Xingnaojing injection may improve cognitive function of rats with traumatic brain injury via inhibiting caspase-3 mediated neuronal cellular apoptosis. 2018 Vol. 48 (9): 652-656 [Abstract] ( 697 ) HTML (1 KB)  PDF (1738 KB)  ( 795 ) 657 Overexpression of Slug promotes invasiveness of oral squamous cell carcinoma Tca8113 cell line LIN Sisi, WANG Shuyi, SUN Wang, SHI Gengsheng. Objective: To investigate the effect of Slug overexpression on metastasis of oral squamous cell carcinoma (OSCC) cell line Tca8113. Methods: Tca8113 was cultured in RIPM1640 with 10% FBS. Plasmids encoding Slug mRNA and empty plasmid were transfected to Tca8113 respectively, the transfection efficiency was examined by observing fluorecene and detecting  the change of Slug expression by qPCR and Western blot assay, qPCR and Western blot assay detected changes in the expression of E-cadherin and Vimentin in three groups of cells. The scratch experiment detected the difference in cell metastasis. The Transwell experiment examined the changes in cell invasion ability. Results: Transfection efficiency was about 50%-60%, the mRNA and protein from Slug and Vimentin in GV141/slug group was obviously higher than the other two groups (P<0.05). While E-cadherin expression was significantly decreased (P<0.05). Wound healing and Transwell assays indicated that the ability of invation in GV141/slug cells was stronger than that of the other two groups (P<0.05). Conclusion: In this study, we found Slug expression could increased the ability of invation of Tca8113 cells by regulating EMT. 2018 Vol. 48 (9): 657-661,666 [Abstract] ( 789 ) HTML (1 KB)  PDF (1910 KB)  ( 868 ) 662 The assessment of morphological changes of the trigeminal nerves in primary trigeminal neuralgia and its correlation with the extent of pain by the contrast-enhanced 3D FLASH and 3D CISS sequences YANG Dengfa, WANG Linyou, YANG Tiejun, LI Junmiao, SHEN Jianmin, WU Liang, JIN Yong, ZHOU Kaiyu, LI Youcheng. Guide::  Objective: To assess the morphologic changes in the primary trigeminal neuralgia with the high-resolution MR imaging, and to evaluate the correlation between the degrees of neurovascular compression and the extent of pain. Methods: Forty-eight patients with trigeminal neuralgia undergoing the enhanced three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) sequence were retrospectively analyzed. The length and area of the cisternal segment of the trigeminal nerve, the trigeminal-pontine angle and the cross-sectional area of cerebellopontine angle cistern were measured. The vascular compression was classified into three degrees: degree I, no contact; degree II, contact or suspicious; degree III, compression. The extent of pain was measured by visual analog score. Results: There were 8 cases in degree I, 28 cases in degree II, and 12 cases in degree III. The length of the cisternal segment of the affected side and the healthy side was (9.17±3.30) mm and (9.53±2.50) mm respectively, showing no statistical difference (P>0.05). The area of the cisternal segment of the affected side and the healthy side was (19.78±6.95) mm2 and (26.37±13.20) mm2 respectively, showing significant difference (P<0.05). The trigeminal-pontine angle of the affected side and the healthy side was 40.02°±14.43° and 52.57°±16.10° respectively, showing statistical difference (P<0.05). The cross-sectional area of cerebellopontine angle cistern of the affected side and the healthy side was (191.75±68.75) mm2 and (236.74±64.79) mm2 respectively, showing statistical difference (P<0.05). Positive correlation could be found between the degrees of NVC and the extent of pain in the patients with TN (P=0.033, r=0.309). Conclusion: The morphologic changes can be diagnosed qualitatively and quantitatively with the high-resolution MR imaging. Sharp trigeminal-pontine angle, narrow area of the cerebellopontine angle cistern increase the chance of neurovascular contact, and cause TN easily. There is correlation between the degrees of NVC and the extent of pain in the patients with TN. 2018 Vol. 48 (9): 662-666 [Abstract] ( 854 ) HTML (1 KB)  PDF (1385 KB)  ( 960 ) 667 The clinical value of low tube voltage CTA in the diagnosis of acute lower extremity trauma with vascular injury CHEN Yonghua, FU Gangze, CHEN Cong, LI Na, WU Enfu. Objective: To explore the feasibility of 100 kV low tube voltage CTA (L-CTA) in the diagnosis of acute lower limb trauma with vascular injury. Methods: Thirty patients of suspected lower limb trauma with acute vascular injury were examined by L-CTA. Objective parameter, subjective scoring of image quality and radiation dose were analyzed. Compared with the results of emergency surgery, the sensitivity and accuracy of L-CTA in  the diagnosis of vascular injury were evaluated. Results: The subjective image quality was good and the scores were all above 3 in the L-CTA group. Compared with conventional CTA of lower extremity, the L-CTA group had an increase in vessel density (VD) and noise (P<0.05). There was no significant difference in signal noise ratio (SNR) and contrast noise ratio (CNR) between two groups (P>0.05). Volume CT dose index (CTDIvol) and dose length product (DLP) in the L-CTA group were lower than those in the conventional group (P<0.05), with the radiation dose decreased by 32%. L-CTA was used to diagnose 18 cases of arterial occlusion, including 2 cases of arterial wall rupture, 5 cases of arterial stenosis, 4 cases of pseudoaneurysm, and 3 cases of arteriovenous fistula. The sensitivity of diagnosis was 100% and the diagnostic coincidence rate was 90%, comparing with the results of emergency surgery. Conclusion: 100 kV L-CTA examination for patients with acute lower limb trauma combined with vascular injury could meet the diagnostic needs and effectively reduce the radiation dose. 2018 Vol. 48 (9): 667-671 [Abstract] ( 785 ) HTML (1 KB)  PDF (1581 KB)  ( 738 ) 672 A comparison between benign and malignant appendiceal mucocele in CT based on multiple factors analysis MI Yucheng, LI Qianyun, ZHU Nina, YING Xuyan, YIN Liling, PAN Weixing, WANG Dongnv.  Objective: To assess by multiple-factor analysis the feasibility of using CT in differentiating malignant from benign lesions in patients with pathologically confirmed appendiceal mucoceles. Methods: CT scans of 27 patients with pathologically confirmed appendiceal mucoceles were reviewed retrospectively. The pathologic results were simple mucocele (n=4), mucosal hyperplasia (n=2), mucinous cystadenoma (n=13), which were formed into a benign group, and mucinous cystadenocarcinoma (n=8), which constituted the malignant group. The clinical characteristics and the CT results were analyzed respectively. The sensitivity and specificity of the significant CT results in diagnosis of malignant appendiceal mucoceles were calculated. Results: There was statistical difference in age between malignant and benign group (P<0.05). CT showed significant differences in wall thickness (OR=3.023, 95%CI=1.106-5.468) and contour (OR=14.486, 95%CI=2.011-96.268) between malignant and benign cases (P<0.05). The sensitivity of wall thickness and contour in diagnosis of malignant appendiceal mucoceles was 62.5% and 75% respectively. The specificity of wall thickness and contour was 100% and 84% respectively. Conclusion: Differentiation of malignant from benign mucoceles can be difficult with CT. Age, wall thickness and contour are the factors most likely to be associated with malignancy. 2018 Vol. 48 (9): 672-675 [Abstract] ( 832 ) HTML (1 KB)  PDF (1437 KB)  ( 960 ) 676 The effects of long-term prophylactic dose of Staphylococcus and Neisseria Tablets on immune function and life quality in patients with moderately severe COPD patients LIU Xianbing, LI Fang, ZHENG Xiaoyan Objective: To explore the effects of long-term prophylactic dose of Staphylococcus and Neisseria Tablets on immune function and life quality in patients with moderately severe COPD patients. Methods: Sixty patients with moderately severe COPD admitted to People’s Hospital of Quzhou between January 2016 to January 2017 were randomly divided into treatment group (n=30) and basic group (n=30). The treatment group was prescribed with Staphylococcus and Neisseria Tablets (two tablets twice daily, oral) for 3 months on the basis of routine treatment, while the basic group was given routine treatment only. After 3 months of treatment, analysis was made to compare the immune function and the life quality of these groups. The number of exacerbations was counted before and after treatment for 1 year. Meanwhile, 30 healthy people who came to our hospital for physical checkup in the same period were selected as healthy controls. Results: Compared with the control group, both the treatment group and the basic group had decreased levels of COPD CD3+, CD4+, CD4+/CD8+, NK cells, B cells, IgG, lgA, lgM, and increased levels of CD8+, HAD (P<0.05). The immune indices of the treatment group and the basic group did not show any significant difference (P>0.05). Patients in the treatment group did not report any obvious discomfort during the course of treatment. After the treatment, CD3+, CD4+, CD4+/CD8+, NK cells, B cells, IgG, lgA, FEV1 had increased, while CD8+, CAT, mMRC, HAD and the number of exacerbationshad decreased significantly (P<0.05). There was no significant difference in the level of IgM before and after treatment (P>0.05). Compared with the basic group, the frequency of upper respiratory tract infection and duration of the symptoms were significantly less in the treatment group (P<0.05). No obvious changes had been found in the indices of the basic group before and after treatment (P>0.05). Conclusion: The body’s immune function had declined in patients with moderately severe COPD. Long-term prophylactic dose of Staphylococcus and Neisseria Tablets was safe and effective, which can enhance the body’s immune function, reduce respiratory symptoms and improve life quality of the patients with moderately severe COPD. 2018 Vol. 48 (9): 676-679,683 [Abstract] ( 752 ) HTML (1 KB)  PDF (1320 KB)  ( 1052 ) 680 Observation of the fluorescent signals in the organs of mice HUANG Zhaoshuai, LIN Wu, CHEN Xiaoming.  Objective: To observe the fluorescent signals in the liver, spleen and lung of mice and the quenching effect of autofluorescence by copper sulfate. Methods: ①Cell experiments: RG2 (rat glioma cell line) cells were divided into the control and treatment groups. Following maturity and attachment, two groups were fixed by 4% PFA. The treatment group was treated with 1.0 mmol/L copper sulfate solution (ammonium acetate buffer) for 10 min while the control group was not treated by the solution mentioned above. After sealed with fluorescent gel, the fluorescent intensity of these two groups was observed. ②Animal experiments: C57/BL6 mice were divided randomly into normal group and tail vein injection group. In tail vein injection group, the mice were injected with 100 µL of RG2 cell suspension and were sacrificed on the fourth day. After cardiac perfusion, the lungs, livers, and spleens were collected for frozen sections. In normal group, after cardiac perfusion, the lungs, livers, and spleens of mice were collected directly. The fluorescent signals of each organ and the effect of copper sulfate solution were observed. Results: After the treatment of copper sulfate, the fluorescent signals of RG2 reduced. The fluorescence distribution in each organ in mice was different; there was almost no autofluorescence in the lung; no obvious autofluorescence in the liver; marked autofluorescence in the spleen, which could not be eliminated by the treatment of copper sulfate solution. In contrast, the green fluorescence signals in the lung and liver in the tail vein injection group could be observed obviously. Conclusion: Copper sulfate can reduce the fluorescent intensity of cells and remove the background signal of spleen to a certain extent; the lung and liver can serve as better organs for the observation of fluorescence signals. 2018 Vol. 48 (9): 680-683 [Abstract] ( 1027 ) HTML (1 KB)  PDF (1426 KB)  ( 1437 ) 684 Infliximab combined with enteral nutrition for the clinical value of moderate to severe ulcerative colitis SHAO Xiaoxiao, CAO Jiale, YU Lingmin, JIANG Yi. Objective: To observe the clinical value of infliximab combined with enteral nutrition (EN) in the treatment of moderate to severe ulcerative colitis (UC). Methods: A total of 20 patients with moderate to severe UC who showed no response to traditional therapies were selected in this study. These UC patients were treated with intravenous micropump of infliximab at a dose of 5 mg/kg for 6 times, combined EN treatment for 3 months and oral azathioprine for maintenance treatment. Results: After treatment, the body mass index (BMI), hemoglobin (Hb) and serum albumin (ALB) in UC patients were all significantly increased than those before treatment (all P<0.05), while the modified Mayo score, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC) in UC patients were all lower than those before treatment (all P<0.05). A total of 16 UC patients showed effective response to the treatment, of whom 15 UC patients achieved clinical remission and 12 UC patients achieved mucosal healing. Followed up for 6 to 24 months, 1 UC patient developed malignant lymphoma, 1 UC patient had a relapse after withdrawal of azathioprine, and the remaining patients had good disease control without recurrence. Conclusion: Infliximab combined with EN-induced clinical remission and maintenance therapy with azathioprine could have good clinical efficacy in the treatment of moderate to severe UC, and it also could improve the prognosis of UC patients. 2018 Vol. 48 (9): 684-687 [Abstract] ( 804 ) HTML (1 KB)  PDF (1360 KB)  ( 752 ) 688 The relationship between the shear wave velocities of gastric cancer tissues and clinical characteristics of gastric cancer patients WANG Xiaohua, HE Huiliao, JIANG Shuying, LIN Yiyi  Objective: To investigate the relationship between the shear wave velocities of gastric cancer tissues and clinical characteristics in gastric cancer patients. Methods: A total of 53 patients with gastric cancer confirmed by operative pathology underwent an ultrasound-based acoustic radiation force impulse (ARFI) technique before the surgery. The shear wave velocity was obtained using virtual tough tissues quantification (VTQ) of ARFI technique, and the relationship between the findings of VTQ in gastric cancer tissues and clinical characteristics in gastric cancer patients were analyzed, including their sex and age, size of lesions, the tumor location, invasive depth, lymph node metastases, and degree of tissue differentiation. Results: The preoperative shear wave velocities of gastric cancer tissues were not correlated with sex and age of the patients or size and location of the tumor (P>0.05). There was no significant difference in the degree of tissue differentiation (P>0.05). The shear wave velocities of gastric cancer tissues in patients with lymph node metastases were higher than those in patients without lymph node metastases (P<0.05), and they were positively correlated with the depth of tumor invasion (P<0.05). Multiple linear regression analysis revealed lymph node metastases were related with the shear wave velocities of gastric cancer tissues. Conclusion: The shear wave velocities of gastric cancer tissues were positively related with lymph node metastases. It may be considered a helpful index in assessing gastric cancer and provide basis for the formulation of the therapeutic regimen of the gastric cancer patients. 2018 Vol. 48 (9): 688-690,693 [Abstract] ( 793 ) HTML (1 KB)  PDF (1325 KB)  ( 985 ) 691 Clinical analysis of lumbar hernia in 29 cases WANG Chen, HUANG Hanzhang, DU Zhou, ZHOU Feng, RUAN Xiaojiao, HAN Shaoliang. Objective: To study the clinical manifestation, diagnosis and treatment of lumbar hernia. Methods: The clinical data of 29 patients with lumbar hernia who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January 1990 to December 2017 were analyzed retrospectively. Results: Among 13 males and 16 females, there wer 18 left, 10 right and 1 bilateral hernias. Reversible hernias were in 28 cases and incarcerated hernia in 1 cases. There were 27 lumbar hernias protruded from the upper lumbar triangle (Grynfelt’s triangle), 2 cases from the lower lumbar triangle (Petit’s triangle). The most common clinical manifestations were reversible mass of the back, which was observed in 28 cases, and 21 cases were associated with back pain, while 2 cases associated with incomplete intestinal obstruction such as abdominal distension, abdominal pain, nausea and vomiting. The correct rate of preoperative ultrasound diagnosis was 79.3% (23/29 cases), and the correct rate of CT scanning diagnosis before operation was 86.2% (25/29 cases). In this group, 4 cases were treated conservatively and 25 cases were treated surgically. The surgical procedures included simple suture in 1 case, mesh repair in 23 cases, and laparoscopic mash repair in 1 case. All the 25 patients well recovered after operation, with their clinical symptoms disappeared. During the follow-up period, 1 case recurred 2 months after operation, and was cured by mesh repair operation again. Conclusion: The diagnosis of lumbar hernia is based on its clinical manifestations, B ultrasound and CT findings, and the first choice of treatment is tension-free repair with mesh. 2018 Vol. 48 (9): 691-693 [Abstract] ( 750 ) HTML (1 KB)  PDF (1289 KB)  ( 941 ) 694 Nursing care for neonates with isovaleric acidemia: a case study ZHANG Shuanghong, LIU Jiaqi, LYU Junying, WU Yujie, ZHANG Liping. Guide::   To report the nursing care experience of one case of neonatal isovaleric acidemia. Nursing points included: emergency nursing; key points of condition observation; medical care; early assessment of the bleeding tendency and the nursing care; guidance for follow-up visits. After treatment and careful nursing, the patient was discharged from hospital with improved symptoms. 2018 Vol. 48 (9): 694-697 [Abstract] ( 716 ) HTML (1 KB)  PDF (1300 KB)  ( 832 )

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