25 May 2020, Volume 47 Issue 03

    

• Select all
  |

Papers
• Select
  Metabolomic analysis of cutaneous T-cell lymphoma(CTCL) xenograft mice plasma and skin tissue based on GC/MS

  CAO Yi-qing, SHEN Xiao-yan, CAO Han, KANG Hong-yan, LE Yun-chen, LIANG Dong, YU Yun-qiu

  jms. 2020, 47(03): 301-311. https://doi.org/10.3969/j.issn.1672-8467.2020.03.001

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To investigate the changes in plasma and skin tissue metabolomes in mice after cutaneous T-cell lymphoma (CTCL),and to find differential metabolites associated with them. Methods A total of 21 Balb/c female nude mice were randomly divided into control group and experimental group.CTCL model was induced by HH cell(T cell Lymphoma ATCC CRL-2105).Plasma and tumor tissue samples of cutaneous T-cell lymphoma mice were analyzed by untargeted metabolomics method based on GC/MS and principal component analysis was performed. Results A total of 62 differential metabolites were identified,13 of which were found in both plasma and tissue samples. Combined with our previous metabolomics studies on LC/MS-based CTCL tumor-bearing mice plasma and tumor tissue, 9 identical differential metabolisms were identified by GC/MS and LC/MS platforms. The branched-chain amino acids and glucose were increased in plasma, glycerol-3-phosphate was increased in plasma and tumor tissues,and o-phosphoethanolamine degraded by sphingosine-1-phosphate was increased in plasma. Conclusion Sixty-two differential metabolites have improved the understanding of CTCL metabolites and related pathways,which is helpful for the clinical diagnosis of CTCL.
• Select
  Bioinformatics analysis of Bach1 in mouse embryo development

  LYU Xiao-yu, WANG Xin-hong, MENG Dan

  jms. 2020, 47(03): 312-319. https://doi.org/10.3969/j.issn.1672-8467.2020.03.002

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To study the expression of transcription factor Bach1 during mouse embryonic development and to analyze its expression and regulation mechanism by bioinformatics.Methods Weighted gene co-expression network analysis (WGCNA) was used to analyze the transcription group data of different periods of mouse embryo development obtained from Gene Expression Omnibus (GEO) database (GSE92634).Seventeen co-expression modules were constructed from 8 933 genes in 10 mouse embryo samples,and were carried out Gene Ontology (GO) function enrichment analysis for specific co-expression genes in specific modules containing Bach1 gene.Results The study showed that transcription factor Bach1 was identified as an important space-time regulatory central gene.The genes co-expressed with Bach1 in mouse embryos were closely related to embryonic development and vascular development,including Vegfb,Tcf15,Znf622 and Fam105b,suggesting that Bach1 may play an important role in mouse embryonic development and vascular development.The expression trend of Bach1 and Vegfb genes during mouse embryonic development was basically the same from E5.5 to E7.5 days.Analysis of another transcriptome database of mouse embryonic development (GSE120963) indicated the similar expression trend of Bach1 and Vegfb genes.Bach1 was highly enriched in the promoter or enhancer regions of Tcf15,Znf622 and Fam105b genes,indicating that Bach1 may directly regulate the transcription of these genes.Furthermore,the GO enrichment analysis showed that the genes co-expressed with Bach1 were closely related to Wnt signaling pathway, protein modification and translation, chromatin remodeling,DNA damage response,cell cycle regulation and ubiquitin modification.Conclusions The bioinformatics analysis suggested that Bach1 might play an important role in mouse embryo development and was closely related to vascular development.
• Select
  Comparison of algorithm-derived cardiorespiratory fitness(CRF)and 6 minutes walking distance(6MWD)in predicting postoperative pulmonary complications(PPCs)in patients undergoing major upper abdominal surgery

  YIN Xin, XU Zhi-bo, QIAN Fu-yong, ZHANG Xi-xue, LIU Song-bin, GU Wei-dong

  jms. 2020, 47(03): 320-326. https://doi.org/10.3969/j.issn.1672-8467.2020.03.003

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objectives To compare the predicting performance on postoperative pulmonary complications (PPCs) between 6-minute walking distance (6MWD) and algorithm-derived cardiorespiratory fitness (CRF) in patients undergoing major upper abdominal surgery. Methods Patients scheduled for major upper abdominal surgery from Aug 2018 to Jul 2019 were consecutively enrolled.6MWD was performed and clinical characteristics were recorded before surgery.CRF was estimated using a formula consisting of 6MWD,age,body weight,and resting heart rate.The occurrence of PPCs after surgery was recorded.Patents were divided into PPCs group and non-PPCs group according to whether clinically significant PPCs occurred.The independent risk factors of PPCs were analyzed using multiple Logistic regression.The sensitivity,specificity and cut-off point of 6MWD and algorithm-derived CRF to predict PPCs were analyzed.Area under receiver operating characteristic curve (AUC) between 6MWD and algorithm-derived CRF was compared using Z test. Results One hundred and sixty one patients undergoing major upper abdominal surgery were enrolled. PPCs occurred in 35 patients (21.7%). 6MWD in PPCs patients was (346.7±109.0) m,which was significantly lower than that in non-PPCs patients of (439.9±68.3) m (P<0.001).CRF in PPCs group was (8.0±1.3) MET,which was significantly lower than that in non-PPCs group of (10.1±1.2) MET (P<0.001).Multivariate logistic regression analysis showed that 6MWD,age,resting heart rate and body mass index (BMI) were independent risk factors for PPCs. 6MWD ≤ 389 m was cut-off point for predicting PPCs with sensitivity of 68.6% and specificity of 81.0%.CRF ≤ 9.27 MET was cut-off point for predicting PPCs with sensitivity of 91.4% and specificity of 76.2%.The AUC of CRF to predict PPCs was significantly bigger than that of 6MWD (Z=2.624,P=0.009). Conclusion Algorithm-derived CRF is better than 6MWD alone in predicting PPCs in patients undergoing major upper abdominal surgery.Algorithm-derived CRF is an effective tool to screen patients with high risk for PPCs after major upper abdominal surgery.
• Select
  Correlation between current situation of self-injury and suicide behaviors and relevant health behaviors among adolescents

  LI Yi-xuan, LU Yi-han, WEN Xiao-sa, CHEN Di-di, TAO Shi-ji, XU Xiao-li, TANG Hong-mei, TIAN Xiu-hong, HE Dan-dan

  jms. 2020, 47(03): 327-333. https://doi.org/10.3969/j.issn.1672-8467.2020.03.004

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To study the incidence and influencing factors of self-injury and suicide behaviors,and to provide evidence for the further health education and intervention measures. Methods A total of 11, 661 students from primary school, junior high school, senior high school and vocational high school in Minhang district of Shanghai were randomly selected by stratified cluster random sampling method,and interviewed with anonymous questionnaires. Chi-square test was used to analyze the distribution characteristics of related factors, and multi-factor unconditional Logistic regression was used to analyze the risk factors of suicide behaviors. Results The reported suicide behaviors rate was 14.2%, including 11.3% in the early adolescence,17.1% in the middle adolescence and 18.4% in the late adolescence.The results of the Logistic analysis showed that the risk factors of suicide behaviors contains:adolescence(middle OR=1.40, late OR=1.23), unhealthy diet(OR=1.22), overweight(OR=1.20), school bullying(OR=1.93), feel lonely(OR=2.84), unhappy due to learning pressure(OR=1.85), insomnia(OR=1.88), running away from home(OR=8.67). The protective factors of suicide behaviors contains:living with parents(OR=0.82), grades described as good and moderate(OR=0.80 and 0.82). Conclusions The proportion of teenagers with suicide behaviors in Minhang district is low. Factors affecting suicidal behaviors of adolescents mainly focus on running away from home and feeling lonely.Relevant departments should carry out corresponding mental health education for teenagers and take comprehensive intervention measures to improve their overall health.
• Select
  Clinical feasibility of combined videolaryngoscopy and disposcope endoscope in patients with pharyngeal neoplasm

  XU Rui, JIA Ji-e, QIAO Hui, WANG Sheng-yu, CHEN Jing, LU Yi

  jms. 2020, 47(03): 334-338. https://doi.org/10.3969/j.issn.1672-8467.2020.03.005

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To investigate the clinical feasibility of combined videolaryngoscopy and Disposcope endoscope in patients with pharyngeal neoplasm. Methods One hundred and twenty patients with pharyngeal neoplasm admitted to Department of Head and Neck Surgery,Eye,Ear,Nose and Throat Hospital of Fudan University between Dec 2018 and Mar 2019 were randomly divided into videolaryngoscopy group (group A,n=40),disposcope endoscope group (group B,n=40) and disposcope endoscope+videolaryngoscopy group (group C,n=40).Heart rate (HR),mean arterial pressure (MAP) at T₀(before anesthesia),T₁(after drug administration),T₂(after tracheal intubation),T₃ (3 minute after tracheal intubation),the first-attempt success rate of tracheal intubation,total success rate of tracheal intubation intubation time and intubation-related complications were recorded. Results The intubation time of group C was significant short[(28.9±9.9)s vs. (38.5±12.4)s,P<0.05],and the first-attempt success rate was significant high in group C compared to group B (100% vs. 82.5%, P<0.05).The MAP at T₂ is significant lower in group B compared to group A[(79±6)mmHg vs. (101.5±13.3)mmHg,P<0.05],and the HR at T₂ was significant higher in group C compared to group A[(102.6±9.3)bpm vs. (94.2±12.7) bpm,P<0.05].No significant difference in HR and MAP at other time points.Two patients with mild teeth bleeding and 1 patient with mild bleeding of the epiglottis neoplasm were in group A,and the complication rate was 7.5%.No complication was found in group B.In gourp C,1 patient with mild teeth bleeding was recorded,and the complication rate was 2.5%. Conclusion Disposcope endoscope and videolaryngoscopy used in combination to make a personalized intubation may synergistic effectively improve the success rate of intubation in patients of patients with pharyngeal neoplasm, provide more stable hemodynamics,shorter intubation time and fewer complications.
• Select
  Efficacy and safety of oral hypoglycemic agents for gestational diabetes mellitus(GDM): an overview of systematic reviews

  ZHANG Meng-xing, ZHOU Ying-feng, ZHONG Jie, LI Li, DING Yan

  jms. 2020, 47(03): 339-351. https://doi.org/10.3969/j.issn.1672-8467.2020.03.006

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To overview the systematic review(SR) of efficacy and safety of oral hypoglycemic agents (OHA) for gestational diabetes mellitus (GDM). Methods The Cochrane Library,The Joanna Briggs Institute Library,EMBASE,PubMed,CBM,CNKI,WANFANG,VIP database were electronically searched to collect SR and meta-analysis on OHA of GDM from inception to Nov 2018. Two reviewers independently screened literature, then AMSTAR tool was used to assess the methodological quality of included studies. Data extracted were used to perform meta-analysis through RevMan 5 software. The GRADE tool was used to grade the evidence quality of outcome measures included in the SRs. Results A total of 13 relevant SRs were included,involving 31 RCTs. The assessment results of AMSTAR toolsuggested that:the quality of systematic reviews included need to be improved. Main outcome of meta-analysis:Metformin is better than insulin in postprandial blood glucose control and the incidence of Pregnancy-induced hypertension (PIH),weight gain after randomization, gestational age was lower in the metformin group. At the same time,the neonatal birth weight in the metformin group was lower. It can also significantly reduce several adverse neonatal outcomes including incidence of large for gestational age (LGA),hypoglycemia and neonatal intensive care admission. Glyburide is comparable with insulin in glycemic control and maternal outcomes.However, it may increase birth weight,and increase incidence of macrosomia and hypoglycemia.GRADE results showed:among 38 outcomes,2 outcomes were of high quality, 13 outcomes were of moderate quality, 14 outcomes were of low quality and 9 outcomes were of very low quality.And the main downgrading factors were the limitations and imprecision of the study. Conclusion The current overview shows that OHAs (metformin or glyburide) is comparable with insulin in general glycemic control, furthermore, metformin is even more effective than insulin in postprandial glucose control.There is barely data on the long-term effects of OHAs (metformin or glyburide)on maternal outcomes and neonatal outcomes.
• Select
  Expression and clinical significance of G3BP1 in cervical cancer

  ZHAO Jun-da, GUO Chun-feng, WU Xin

  jms. 2020, 47(03): 352-360. https://doi.org/10.3969/j.issn.1672-8467.2020.03.007

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To study the expression pattern of G3BP1 (Ras-GTPase-activating protein SH3 domain binding protein 1) in cervical cancer tissues and explore its clinical significance. Methods We analyzed the difference in G3BP1 mRNA expression between cervical cancer and adjacent non-tumor tissues using public GEO datasets.We also constructed tissue microarray (TMA) containing 306 cervical cancer tissues,and detected the expression of G3BP1 protein with immunohistochemistry (IHC).Statistical analysis was employed to compare the expression of G3BP1 between cervical cancer and normal as well as cervical intraepithelial neoplasia,and to analyze the correlation of G3BP1 expression with clinicopathological characteristics and prognosis of patients. Results In GSE6791,GSE7803 and GSE7410 datasets,we found that the G3BP1 mRNA expression was higher in cervical cancer than that in adjacent non-tumor tissues.IHC assay indicated that G3BP1 protein expression was gradually increased along with cervical intraepithelial neoplasia and tumorigenesis.Chi-square test analysis revealed that high G3BP1 expression was associated with elder age,larger tumor size,poorer differentiation,myometrial infiltration,vaginal infiltration,pelvic lymph node metastasis,and late FIGO stage,and predicted poor outcome of cervical cancer patients. Multivariate analysis identified G3BP1 as an independent prognostic factor,which could improve the predictive accuracy for the overall survival when incorporated into FIGO staging system. Conclusion G3BP1 was proposed as a novel independent prognostic factor,and might be involved in the carcinogenesis and development of cervical cancer.
• Select
  CT-guided radiofrequency ablation(RFA)for advanced pancreatic cancer

  YU Tian-zhu, CHEN Yi, GONG Gao-quan, LIU Ling-xiao, WANG Cheng-gang, LI Guo-ping, WANG Liang-wen, LI Chang-yu, GAO Shan-shan, WANG Xiao-lin

  jms. 2020, 47(03): 361-366. https://doi.org/10.3969/j.issn.1672-8467.2020.03.008

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To assess the technical feasibility and safety of CT-guided radiofrequency ablation(RFA)for advanced pancreatic cancer. Methods From May 2016 to Jan.2019, the patients with unresectable advanced pancreatic adenocarcinoma who received CT-guided RFA treatment in Zhongshan Hospital, Fudan University were enrolled.The Habib EUS RFA probe of 1 Fr in diameter was used for the procedure.The main outcome measures were to assess the feasibility and safety of CT-guided RFA, and the secondary outcome measures were to determine the effects of this procedure on primary tumour growth. Results Six patients were enrolled and CT-guided RFA was feasible in all patients.No severe complication(such as acute pancreatitis, haemorrhage, pancreatic fistulas, etc)occurred during or after the procedure. Two patients experienced self-limiting abdominal pain and one patient had transient increased amylase level.One month after RFA,the Habib EUS RFA formed a low-density necrotic area in advanced pancreatic cancer lesions. Conclusions CT-guided Habib EUS RFA is available treatment for advanced pancreatic cancer.
• Select
  Application of surface anesthesia guided by fiberoptic bronchoscopy in awake intubation of laryngeal carcinoma patients with difficult intubation

  LI Jie, WANG Ding-ding, LI Wei-xing

  jms. 2020, 47(03): 367-370,391. https://doi.org/10.3969/j.issn.1672-8467.2020.03.009

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To study the effect of surface anesthesia guided by fiberoptic bronchoscope on awake orotracheal fiberoptic intubation. Methods Sixty patients with elective laryngeal surgery under general anesthesia and with tracheal intubation difficulties,were randomly divided into two groups:group A received pharyngeal surface anesthesia and surface anesthesia guided by fiberoptic bronchoscope,and group B received pharyngeal surface anesthesia and airway surface anesthesia by cricothyroid membrane puncture.The patient was then intubated through the mouth guided by fiberoptic bronchoscope. Intubation time,cough score of patients during surface anesthesia,nausea,cough score of patients during intubation,comfort score during intubation,and tolerance score and patient comfort score after intubation were recorded.Oxygen saturation(SpO₂),average arterial pressure (MAP) and heart rate (HR) were recorded after enter the operating room (T₀),after surface anesthesia (T₁),after tracheal tube entry into glottis (T₂),and after intubation and before injection of general anesthesia (T₃). Results The cough score of patients during local anesthesia, nausea score during intubation, cough score of patients during intubation,comfort score during intubation, and tolerance score after intubation in group A were all lower than those in group B (P<0.05).At T₀ and T₁,there was no significant difference in HR and MAP between the two groups.At T₂ and T₃,HR and MAP in group A were lower than those in group B (P<0.05).There was no significant difference in SpO₂ between the two groups at all time points. Conclusion Surface anesthesia guided by fiberoptic bronchoscope can provide better intubation conditions and higher patient satisfaction for patients with laryngeal cancer,compared with traditional endotracheal surface anesthesia by cricothyroid membrane puncture.
• Select
  The expression of gonadotropin releasing hormone receptor(GnRH-R) in breast cancer and the analysis of its clinical significance

  CHEN Hong-liang, CHENG Qian, SUN Yi-hua, WANG Chao, BAI Fang, ZHANG Peng, ZHANG Ming-di, LIN Qing, WU Ke-jin

  jms. 2020, 47(03): 371-377. https://doi.org/10.3969/j.issn.1672-8467.2020.03.010

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To evaluate the expression of gonadotropin releasing hormone receptor (GnRH-R) in breast cancer and to analyze its significance with clinical-pathological characteristics and survival outcomes. Methods Tissue microarrays were comprised of 656 cases of early invasive breast cancer tissue diagnosed between 2013 and 2018 together with 131 cases of paracancerous tissue. The expression of GnRH-R was evaluated by immunohistochemistry. The independent related factor with high expression of GnRH-R was evaluated by multiple Logistic regressions. The disease-free survival (DFS) outcomes between patients with high or low expression of GnRH-R were compared by means of Kaplan-Meier methods and Log-Rank test. Results The high expression rate of GnRH-R was significantly higher in tumor tissue than in paracancerous tissue (54.0% vs. 28.2%,P<0.001),and was also significantly higher in estrogen receptor (ER) negative breast cancer than in ER positive breast cancer (65.3% vs. 48.0%,P<0.001). According to multiple Logistic regressions,lower N stage,negative lymphovascular invasion (LVI) and higher Ki-67 level were independent related factors with high expression of GnRH-R. Although there was no significant difference in DFS between patients with high and low expression of GnRH-R (Log Rank P=0.132) as a whole,cases with high expression of GnRH-R had significantly improved DFS compared with those with low expression of GnRH-R (Log Rank P=0.023) among ER negative patients. Conclusion GnRH-R might be a potential treating target for breast cancer,especially for hormone receptor negative breast cancer.
• Select
  Factors associated with medication adherence in community patients with coronary artery disease based on health belief model(HBM): a cross-sectional study

  FANG Jia-lie, CHEN Wan-li, WANG Jing-ya, ZHAO Jie, WANG Ji-wei, SHAO Chun-hai

  jms. 2020, 47(03): 378-384,391. https://doi.org/10.3969/j.issn.1672-8467.2020.03.011

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To explore factors affecting medication adherence in patients with coronary artery disease (CAD) based on Health Belief Model (HBM). Methods This community register-based,cross-sectional study consisted of individuals diagnosed with CAD in Jing'an District of Shanghai (n=189).The data were obtained through face-to-face interviews using a questionnaire covering sociodemographic characteristics,CAD status,HBM variables,Health-Promoting Lifestyle Profile Ⅱ (HPLP-Ⅱ),and the 8-item Morisky Medication Adherence Scales (MMAS-8).The independent two-sample t-test and F-test were used to analyze the influence of demographic characteristics on health-promoting lifestyle and medication adherence.Pearson's correlations were used to analyze associations among variables.Multiple linear regression models were used to evaluate effects of HBM variables on adherence to medication behavior,and health-promoting lifestyles. Results Among the 189 patients,38.6% were males and 61.4% were females, 137 cases were over 60 years old. There were significant positive correlations between the HBM variables, adherence to health promoting lifestyles and medication behavior. The value of the correlation coefficient varies from 0.173 to 0.734. Multiple linear regression analysis suggested that the perceived barriers (β=0.190,P=0.021) on health responsibility (R²=0.073,P=0.016),the perceived susceptibility (β=0.134,P=0.008) on physical activity (R²=0.274,P<0.001),the perceived severity (β=0.221,P=0.005) and the perceived benefits (β=0.100,P=0.008) on mental growth (R²=0.423,P<0.001),the perceived benefit (β=0.181,P=0.026) on stress management (R²=0.302,P<0.001),were significant impact factors,respectively.Additionally,the perceived susceptibility (β=0.689,P=0.027),perceived severity (β=0.580,P=0.003),perceived impairment (β=0.689,P=0.002),and self-efficacy (β=0.417,P=0.023) had a statistically significant effects on medication behavior (R²=0.645,P<0.001). Conclusion The HBM provides a useful framework for investigating predictors of medication adherence in patients with CAD.Future intervention to improve medication adherence should focus on changing the health beliefs among patients with CAD.
• Select
  Public anxiety and its influencing factors in the initial outbreak of COVID-19

  CHEN Su-hong, DAI Jun-ming, HU Qiao, CHEN Hao, WANG Yi, GAO Jun-ling, ZHENG Pin-pin, FU Hua

  jms. 2020, 47(03): 385-391. https://doi.org/10.3969/j.issn.1672-8467.2020.03.012

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To explore the psychological status and influencing factors of the public during the initial outbreak of the coronavirus disease 2019 (COVID-19),and provide the basis for mental health intervention. Methods A cross-sectional study was conducted using an online questionnaire from Jan 31 to Feb 2,2020.The questionnaire included demographic information,anxiety,resilience and self-designed stressors scale,and was conducted among adults affected by the COVID-19 epidemic in China.Chi-square test and Logistic regression analysis were used for statistical analysis. Results A total of 4 827 valid questionnaires were obtained,with the average age of 32.3±10.0 years old,and females accounting for 67.7%.Only 7.9% of the objects had exposure history of Hubei province,while 14.8% had suspected or confirmed cases in the community.The average score of GAD-7 was 6.29±5.48,and the prevalence of moderate or severe anxiety was 22.6%.With moderate or severe anxiety as the dependent variable,Logistic regression analysis found that medium to high understanding of COVID-19 (OR:2.74-7.97,P<0.001) and strong perception of infection risk (OR=1.74,95%CI:1.37-2.20) significantly increased the risk of anxiety.In addition,ages between 35 and 44 years old,retired or non-professional technicians,exposure history of Hubei province and confirmed or suspected cases in the community were also risk factors for anxiety (P<0.05),while bachelor's degree or above and psychological resilience were protective factors for anxiety (P<0.05). Conclusion Under the outbreak,information of COVID-19 and perception of the risk of transmission will increase the risk of anxiety.There is widesprend anxiety in the public,and mental intervention should be strengthened to increase social support and psychological resilience.
• Select
  Effect of different degrees of neuromuscular blockade(NMB)on surgical conditions, perioperative pulmonary oxygenation function and postoperative pulmonary complications in laparoscopic colorectal surgery

  LIU Yi, JIANG Hui, WU Xin, MIAO Chang-hong, SUN Zhi-rong, WANG Fei, ZHONG Jing

  jms. 2020, 47(03): 392-399. https://doi.org/10.3969/j.issn.1672-8467.2020.03.013

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To investigate the effect of different neuromuscular blockade depth on surgical conditions,perioperative lung oxygenation function and perioperative lung injury. Methods Seventy-six patients undergoing laparoscopic surgery for colorectal cancer were randomly distributed into deep (A) or moderate neuromuscular block group (B) by a computer software,with 38 patients for each group. Neuromuscular function was measured with an acceleromyograph method and quantitative neuromuscular transmission monitored with a TOF-Watch SX system.Neuromuscular situation of patients in group A (1-2 post-tetanic count) and group B (1-2 train-of-four response) were maintained by a 0.6 mg/kg titration dose of rocuronium followed by routine laparoscopic surgery. Propofol target control (Ce 2.5 μg/mL) compounding with remifentanil (0.2 μg·kg^-1·min^-1),sufentanil (0.3-0.4 μg/kg) and rocuronium (0.6 mg/kg) infusion was employed for general anesthesia.The intraoperative narcotrend index was 27-46.At the end of the operation,patients of the two groups were intravenously injected with sugammadex.Outcomes such as surgical condition,adjusted mean intra-abdominal pressure (IAP),parameters of cardiovascular system,oxygenation index (OI),dynamic lung compliance (Cdyn),pain score,gas passing time,postoperative pulmonary complications (PPCs) and 30-day unplanned readmission were recorded and compared between the two groups. Results Compared with group B combined with sugammadex,group A combined with sugammadex showed a better surgical condition (P<0.01),a lower intra-abdominal pressure (P<0.01),shorter postoperative gas passing time (P<0.05),lower postoperative abdominal pain scores (P<0.05),increased perioperative OI (P<0.05) and intraoperative Cdyn (P<0.05) as well as decreased incidence rate of PPCs (P<0.05).Outcomes of PACU time,postoperative hospital stay,30-day unplanned readmission showed no statistical meaning between the two groups (P>0.05). Conclusions This study provided a clinical evidence for worth considering of deep NMB for patients undergoing laparoscopic colorectal surgery,and showing outcomes including better surgical condition and pulmonary oxygenation function,lower PPCs as well as lower IAP,less severe postoperative pain and faster bowel function recovery.
Medical Experience Communications
• Select
  The depletion of connexins(Cx)in stable coronary artery disease: a cross-sectional study

  BAO Li-wen, LIN Yang-yi, ZHANG Jin-jin, CHEN Hua, SHI Hai-ming, LI Jian, YAN Ping-ping

  jms. 2020, 47(03): 400-403,420. https://doi.org/10.3969/j.issn.1672-8467.2020.03.014

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective We sought to assess the association between the expression of connexins (Cx) in monocyte of coronary artery and stable coronary artery disease (CAD). Methods This is a cross-sectional study.After assigned consent form,patients were divided into CAD group and non-coronary artery disease (non-CAD) group according to coronary angiography.During coronary angiography procedure,coronary blood samples were collected and monocytes were separated by high-speed centrifugation.The qRT-PCR methods were performed to test the expression of connexins (Cx37,Cx40,Cx43,Cx46) of monocytes by single-blind experimenter. The data were analyzed using multivariate Logistic regression. Results Eighty-one patients were enrolled in this study, with an average age of (66.1±10.2) years and 63.5% were males.There were 35 patients in CAD group and 46 patients in non-CAD group.The qRT-PCR indicated that the expressions of Cx37,Cx40,Cx43 and Cx46 in CHD group were lower than those in the non-CHD group.Multivariate Logistic regression analysis indicated that only Cx43 showed significant statistical difference (OR=0.63,P=0.043,95%CI:0.41-0.98). Conclusion The depletion of Cx43 may be a key factor of CAD progression.
• Select
  Clinical observation after ICL implantation following posterior scleral reinforcement(PSR)for high myopia of adult

  CHEN Xun, WANG Xiao-ying, ZHOU Xing-tao, CHU Ren-yuan

  jms. 2020, 47(03): 404-410. https://doi.org/10.3969/j.issn.1672-8467.2020.03.015

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To compare the safety,efficacy and the changes of axial length between posterior chamber implantable collamer lens (ICL) implantation after posterior scleral reinforcement (PSR) and ICL implantation only for high myopia in adults. Methods This study evaluated 20 eyes of 10 patients who underwent PSR+ICL surgery and 22 eyes of 11 patients who underwent ICL surgery only.The examinations included uncorrected distance visualacuity and corrected distance visual acuity,refraction,axial length,K value and fundoscopic examinations. Results The mean follow-ups were (3.37±1.35) years in the PSR+ICL group and (3.58±2.33) years in the ICL group.The safety indices of 1 week and the last visit after PSR+ICL surgery were 1.69±0.52 and 1.80±0.69,respectively,the efficacy indices were 1.34±0.47 and 1.22±0.54,respectively.At 1 week and the last visit after ICL surgery,the safety indices were 1.39±0.32 and 1.45±0.36,respectively,and the efficacy indices were 1.05±0.33 and 0.95±0.36,respectively.Spherical equivalent refractive error changed from (-17.11±2.91) D preoperatively to (-0.91±1.24) D 1 week after PSR+ICL surgery and (-1.53±1.29) D on the last visit, with (-0.191±0.41) D myopia progressing annually;and changed from (-17.38±4.6)8 D preoperatively to (-1.15±2.57) D 1 week after ICL surgery and (-1.91±2.53) D on the last visit, with (-0.261±0.27) D myopia progressing annually.The annual axial elongations were (0.045±0.11) mm (P=0.021) in the PSR+ICL group and (0.103±0.06) mm (P<0.001) in the ICL group, respectively,and a statistical difference (P=0.039) was seen between the PSR+ICL group and the ICL group. Macular hemorrhage was observed in 2 eyes of 2 patients in ICL group. Conclusion ICL implantation following PSR for high myopia is relatively safe,effective and stable,PSR may slow the axial elongation of high myopia.
• Select
  The value of ultrasound in the diagnosis and differential diagnosis of primary renal lymphoma(PRL)

  ZHANG Hui, LU Qing, CAO Jia-ying, JI Zheng-biao, HUANG Bei-jian, WANG Wen-ping

  jms. 2020, 47(03): 411-414. https://doi.org/10.3969/j.issn.1672-8467.2020.03.016

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To analyze the value of ultrasound in the diagnosis of primary renal lymphoma (PRL). Methods Ultrasound findings,classifications and diagnosis of 16 PRL in 15 patients were retrospectively summarized.All cases confirmed with pathology after surgery or ultrasound-guided biopsy. Results Fifteen patients were 13 males and 2 females, with age ranged from 35 to 81(62.1±14.2)years old. Fourteen patients were unilateral,and one was bilateral. The ultrasonographic appearance of PRL included 7 cases of intrarenal type, 1 case of diffuse type, 4 cases of perirenal type and 4 cases of mixed type, respectively.The maximum diameters of PRL lesions ranged from 41-164 mm.The diagnosis of ultrasound was as follows:10 cases of malignant tumors (7 lesions in 6 cases with diagnosis of lymphoma),3 undetermined cases, 1 case of perirenal hemorrhage, and 1 case of hamartoma hemorrhage.The diagnosis and misdiagnosis rate were 43.8%(7/16)and 12.5%(2/16),respectively. The pathology was derived from surgery and biopsy in 5 and 12 cases,respectively. The final diagnosis was 9 diffuse large B-cell lymphoma(DLBCL), 1 peripheral T-cell lymphoma, 1 mucosa-associated lymphoma, 1 non-Hodgkin's lymphoma NKT cell type, and 1 Burkitt's lymphoma.The other 2 cases were only diagnosed as lymphoma without further classification. Conclusions The ultrasound manifestations of PRL included intrarenal type, perirenal type, diffuse type and mixed type.The perirenal and diffuse types are specific for PRL.The intrarenal type should be distinguished from other renal solid lesions with ultrasound-guided biopsy preferred for preoperative diagnosis.
Method and Technique
• Select
  Impact of continuous non-invasive arterial pressure(CNAP)and non-invasive arterial pressure(NIAP)monitoring on hemodynamic fluctuation during spinal anaesthesia for cesarean section

  HAN Chao, LU Yao-jun, HUANG Shao-qiang

  jms. 2020, 47(03): 415-420. https://doi.org/10.3969/j.issn.1672-8467.2020.03.017

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To assess the ability of a continuous non-invasive arterial pressure (CNAP) monitoring system to reduce intra-anesthetic hemodynamic fluctuation during caesarean section compared with non-invasive intermittent arterial pressure (NIAP) measurement. Methods Fourty healthy women scheduled for planned cesarean delivery under spinal anesthesia were recruited for this study.They were divided into two groups:continuous non-invasive arterial pressure device (Group CS,n=20) and intermittent oscillometric arterial pressure measurement (Group N,n=20),by using a computer-generated random number table.Blood pressure (BP) management was performed using the same protocol,with BP measured by intermittent BP cuff (i.e.,NIAP measurement) in Group N or by CNAP monitoring in Group CS.We assessed the accuracy and precision of the CNAP and NIAP measurement using Bland-Altman.Additionally,the time of hypotension after spinal anesthesia,the incidence of hypotension and the duration of hemodynamic stability were recorded. Results From 2 270 arterial pressure readings,biases (SD) for NIAP-CNAP for systolic blood pressure (SBP),diastolic blood pressure (DBP) and mean blood pressure(MBP) for all patients were(-4±14 mmHg),(-9±14 mmHg) and (-6±13 mmHg),respectively.Severe hypertension occurred less frequently in Group CS than in Group N after spinal anesthesia (11.1% vs.28.9%,P=0.035).The duration of hemodynamic stability (systolic BP 80%-110% of baseline) intraoperatively was longer in the Group CS than in the Group N (93.5% vs.83.7%,P=0.01). Conclusion CNAP monitoring may improve hemodynamic stability in the parturients during spinal anaesthesia compared with NIAP measurement.
• Select
  The value of estimated 24-hour urinary natriuresis(e24UNa)by morning urine in cardiovascular risk assessment

  YU Qian, SHI Mei-fang, ZHANG Wei-tao, SHEN Jun-fei, WANG Bei-li, PAN Bai-shen, GUO Wei, LI Gang

  jms. 2020, 47(03): 421-425,433. https://doi.org/10.3969/j.issn.1672-8467.2020.03.018

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To examine the value of estimated 24-hour urinary sodium natriuresis (e24UNa) by morning urine in cardiovascular risk assessment. Methods This study has enrolled 4 035 elderly volunteers from a local community in Shanghai.We collected morning urine and fasting serum samples from volunteers with basic epidemiological data for sodium analysis,and Kawasaki formula was used to calculate the e24UNa.The correlation between e24UNa and other cardiovascular disease related factors were analyzed.Meanwhile,10-year Framingham risk score was used for category and the e24UNa of different risk level has been studied. Results The mean e24UNa of subjects was 9879 mg/d. In the 3 groups with different e24Una values (high: ≤ 10 636 mg/d,medium:10 636~12 699 mg/d,low: ≥ 12 699 mg/d),there were statistically significant differences in the following indicators (P<0.05):male ratio of 31.74%, 47.87% and 59.78%; waist circumference of (85.66±10.07),(88.13±9.23) and (90.14±9.40) cm;hip circumference of (95.57±7.33),(97.41±7.09) and (98.72±6.69) cm, body mass index of (24.38±3.46),(25.25±3.34) and (25.73±3.30) kg/m²,smoking rate of 4.75%,8.09% and 8.31%;fasting blood glucose of (5.60±1.67),(5.62±1.50) and (5.78±1.68) mmol/L,cholesterol of (5.53±1.17),(5.37±1.22) and (5.34±1.18) mmol/L and sex hormone binding globulin of (71.06±34.98),(62.55±29.92) and (59.95±27.55) nmol/L.The e24UNa level increased[(9 239.87±2 140.720),(9 622.46±2 193.57),(9 878.15±2 217.14) and (10 322.30±2 365.33) mg/d] with the Framingham risk score (<10%,10-20%,20-30% and >30%)(P<0.001). Conclusion The e24UNa calculated by morning urine is more convinient as a laboratory biomarker for the guide of dietary sodium limit in preventing the cardiovascular disease events.
• Select
  UHPLC/MSⁿ multi-mode composite determination of 13 chemical components in extracts and preparations of Yupingfeng compound

  LIN Wen-wen, GUO Xiao-min, LIU Xiu-jie, ZHAO Yan, YANG Ping, MEI Qi-bing

  jms. 2020, 47(03): 426-433. https://doi.org/10.3969/j.issn.1672-8467.2020.03.019

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Objective To establish an effective UHPLC/MSⁿ method for the simultaneous determination of 13 active components and provide an efficient quality control method for yupingfeng extracts. Methods According to the analysis of the pharmacodynamics and pharmacokinetics of each single drug in Yupingfeng and its prescriptions by consulting the literature,prim-o-glucosylcimifugin, calycosin-7-O-β-D-glucoside,cimifugin,5-O-methylvisammioside,ononin,sec-o-glucosylhamaudol,formononetin,astragaloside Ⅳ,atractylenolide Ⅲ,astragaloside Ⅱ,astragaloside Ⅰ,atractylenolide Ⅱ and atractylenolide Ⅰ were used as quality control ingredients of Yupingfeng compound. ACQUITY UPLC^® HSS T3 column was used,with the mobile phase comprising of acetonitrile and 0.1% formic acid aqueous solution as mobile flowing at a flow rate of 0.5 mL/min. Results The 13 constituents showed good specificity and no interference peak.A good linearity was observed for all the 13 components with the recoveries of 95%-105% and all RSD<3%. Conclusion UHPLC/MSⁿ detection is a simple and accurate method to apply in the quality control of Yupingfeng compound.
• Select
  A survey on the reliability and validity of Parent Attitudes about Childhood Vaccines(PACV)

  HE Ying-xia, JIN Jie, ZHANG Ming-zhi

  jms. 2020, 47(03): 434-438. https://doi.org/10.3969/j.issn.1672-8467.2020.03.020

  Abstract ( ) Download PDF ( )   Knowledge map   Save

  Objective To translate Parent Attitudes about Childhood Vaccines (PACV) into Chinese,and measure its reliability and validity. Methods The PACV scale was translated according to the transcultural adaptation guidelines. After the pre-test was completed with the translated questionnaire,148 parents of children aged 6 years and younger were investigated. Results The content validity index of the 15-item scale was 1.0.Factor analysis showed that Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy was 0.702 (P<0.01).Three factors were extracted from the principal component analysis (PCA).The cumulative variance explained was 56.1%.The results were same with the original scale on general attitudes,faith in vaccine's safety and efficacy,and immunization behavior. The total Cronbach's α value of the scale was 0.701,and the reliability of the subscales of "General attitudes","Safety and efficacy" and "Behavior" were 0.810,0.704 and 0.604 respectively.After two weeks,the total retest reliability scale was 0.753, and the subscales were 0.798,0.714 and 0.701 respectively. Conclusion The Chinese version of PACV has good reliability and validity,which can be used to evaluate parents' attitude towards vaccination.However,multi-center and large sample studies are still needed to verify this version.
Reviews
• Select
  Progress in pharmacological strategies targeting KRAS gene mutated cancers

  BIAN Yun-yi, YANG Xiao-dong, ZHAN Cheng, YAO Guang-yu, BI Guo-shu, FAN Hong

  jms. 2020, 47(03): 439-447,455. https://doi.org/10.3969/j.issn.1672-8467.2020.03.021

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Kirsten rat sarcoma viral oncogene (KRAS) mutation is one of the most common carcinogenic factors in a variety of tumors,which leads to the continuous activation of KRAS,while it in turn promotes cell proliferation and drives tumorigenesis.Although the exploration of targeted drugs targeting KRAS gene mutations has been a hot research topic for decades,it has not yet been developed to discover clinically effective drugs for KRAS gene mutations.Currently,the mechanisms of targeted therapy for KRAS gene mutation are mainly inhibiting the mutated KRAS genes directly,changing the KRAS membrane localization,inhibiting KRAS signaling pathways,and inhibiting KRAS mutant synergistic lethal genes.Here,we briefly review the progress of pharmacological strategies targeting KRAS mutated cancers.
• Select
  The autonomic nervous regulation of stem cell homeostasis and mobilization

  CHEN Xiao-yan, LI Qing-mei, JI Shi-meng, CHENG Ting-ting, ZHOU Jian, CHEN Cui-cui, SU Xiao, SONG Yuan-lin

  jms. 2020, 47(03): 448-455. https://doi.org/10.3969/j.issn.1672-8467.2020.03.022

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  Stem cells possess self-renewal capacity and multi-directional differentiation potential. It participates in maintaining homeostasis and tissue repair process. The mobilization,homing,and tissueresident of stem cells are regulated by multiple factors,especially the autonomic nervous system. Autonomic nervous system is a complex and precisely tuned network, which include the sympathetic nerve and parasympathetic nerve.This review summarizes the effect of sympathetic, parasympathetic nerve, and neuropeptide on stem cells and its clinical value.
Case Report
• Select
  A re-appraised case of suspected pneumothorax(hemopneumothorax) caused by sharp instrument

  LI Bei-xu, JIANG Jie-qing, JI Ming, XUE Ai-min

  jms. 2020, 47(03): 456-458. https://doi.org/10.3969/j.issn.1672-8467.2020.03.023

  Abstract ( ) Download PDF ( ) HTML   Knowledge map   Save

  In the case of minor injury and minor injury criticality,since there is no sufficient evidence to prove that the injury is more serious, the principle of minor(no)injury until proved major injury is followed to appraise the degree of injury.This was a case of suspected pneumothorax(hemopneumothorax)caused by sharp instrument.Because there was no sufficient evidence to prove pneumothorax(hemopneumothorax)or penetrating wound in thoracic wall, or to deny the clinical history of no penetrating wound in thoracic wall. Due to the principle of minor injury until proved major injury and the mild injury consequences, this case was appraised as mildly minor injury.