Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

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Current progress on internal medicine in China—2006 Part I
YAO Dingkang, ZHU Liang, ZHAO Xue, MEI Changlin
Front. Med.. 2007, 1 (3): 235-247.  
https://doi.org/10.1007/s11684-007-0046-y

Abstract   PDF (301KB)
The growing interest has been placed in the current state of Chinaºs internal medicine from all over the world. Many data of internal medicine in China were collected by searching through some of the most prominent medical magazines published in China in 2006. Because there are many researches on the field of internal medicine, just some representative reports focusing on this topic were selected in this paper. In part I of this study, a summary of the advances made in cardiology, respiration diseases, and gastroenterology was presented.
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Involvement of p38 mitogen-activated protein kinase in the regulation of platelet-derived growth factor -induced cell migration
GONG Xiaowei, WEI Jie, LI Yusheng, CHENG Weiwei, DENG Peng, JIANG Yong
Front. Med.. 2007, 1 (3): 248-252.  
https://doi.org/10.1007/s11684-007-0047-x

Abstract   PDF (356KB)
The aim of this study was to investigate the role of p38 mitogen-activated protein kinase (MAPK) in cell migration induced by platelet-derived growth factor (PDGF). Western blot was performed to detect the phosphorylation of p38 in NIH3T3 cells treated with PDGF. A Transwell cell migration system was used to determine the effects of PDGF treatment on the migration of NIH3T3 cells and the influence of p38 deficiency on this process in a p38 gene knockout (p38-/-) mouse embryonic fibroblast cell line. On the stimulation of PDGF, the migration of NIH3T3 cells was significantly increased (P⟨0.001) compared to the control and p38 MAP kinase was simultaneously phosphorylated. Furthermore, the PDGF-induced cell migration was significantly blocked in p38 gene knockout (p38-/-) mouse embryonic fibroblasts (MEFs) (P⟨0.001) as compared with the wild type cells (p38+/+). p38 MAPK plays an important role in the regulation of cell migration induced by PDGF.
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Construction of Hsp90β gene specific silencing plasmid and its transfection efficiency
JI Yewei, NIE Bin, LI Ping, ZHOU Yuanguo, XU Xiaoyu
Front. Med.. 2007, 1 (3): 253-257.  
https://doi.org/10.1007/s11684-007-0048-9

Abstract   PDF (676KB)
The purpose of this work was to construct the plasmid that could direct the synthesis of siRNA-like transcripts and thus mediate strong and specific repression of human heat shock protein 90β (Hsp90β) gene expression and to compare the transfection efficiency of the plasmids in varying conditions of transfection. Three 64 nt oligos corresponding to different regions of the target gene were chemically synthesized and annealed and were then ligated with pSUPER EGFP1 plasmid and double-digested with HindIII and BglΠ. Recombinant plasmids were transformed into Escherichia coli, DH5a, and the colonies were picked and grown in the Amp-agarose. The presence of positive clones was checked by the means of endodigestion and sequencing. Three cell strains, HepG2, Human umbilicus vein endothelium cells (HUVEC) and HeK293, were cultured. Then the plasmids were transfected into the cells at different ratios of plasmid to Lipofectamine. The transfection efficiency was measured by detection of enhanced green fluorescence protein (EGFP). The presence of positive recombinant clones were verified by double-digestion and sequencing. The bases inserted into the plasmids were correct and the positive colonies were named pSuper-Hsp90β1, pSuper-Hsp90β2 and pSuper-Hsp90β3. After optimizing the ratio of plasmid to Lipofectamine, we achieved high transfection efficiency in HeK293 cells. Transfection efficiency was still low in the HepG2 cells. In conclusion, the si-RNA-synthesizing plasmids targeting Hsp90β were constructed and transfected into cells with different transfection efficiency.
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Observations on pathological and histochemical changes in piglet livers infected with Taenia saginata asiatica
LINGHU Yan, ZHU Wujun, BAO Huai′en, CHEN Yan
Front. Med.. 2007, 1 (3): 258-263.  
https://doi.org/10.1007/s11684-007-0049-8

Abstract   PDF (809KB)
To study the pathological and histochemical characteristics of lesions in piglet livers infected with Taenia saginata asiatica (T. saginata asiatica) throughout the different stages, piglets were fed with eggs of T. saginata asiatica and raised in isolation in an animal center to establish the T. saginata asiatica infection model with normal piglets as control. The pathological changes in the piglet livers were observed after the infection using liver sections stained with hematoxylin and eosin. Histochemical methods were used to check the changes in lipid, glycogen and protein content in the liver. The data collected by image analysis were analyzed statistically with Statistical Package for the Social Science. The results show that T. saginata asiatica-exposed piglets were indeed infected. Inflammatory reactions began on the fourth day and progressed rapidly. Kupffer cell hyperplasia, hepatic hydropic degeneration and ballooning degeneration were found in the 10th 20th days after infection. Hepatic central veins and hepatic sinusoids were dilated and congested. Spotty necrosis occurred in some local liver tissues. In the 40th–60th days, granulomatous reactions and mild hepatocirrhosis were the main lesions. In the 70th–80th days, hepatocirrhosis and bile duct proliferation were observed in the liver. In the different stages, lipid drops were increased while glycogen and protein levels were decreased to some degree. There was a significant difference in metabolism between the infected group and the control group (P⟨0.01). It is concluded that pigs are the favorable intermediate host of T. saginata asiatica and its infection can result in serious pathological and histochemical lesions in host organs.
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Immunohistochemical characterization of hepatic stem cell-related cells in developing human liver
XU Jun, HU Yong, WANG Jian, ZHANG Taiping, ZHOU Ji, YU Hongyu
Front. Med.. 2007, 1 (3): 264-268.  
https://doi.org/10.1007/s11684-007-0050-2

Abstract   PDF (461KB)
Little is known about the expression characteristics of the various kinds of possible markers in hepatic stem cells (HSCs) and other HSC-related cells in human fetal liver in various developmental stages. It is significant to investigate the immunohistochemical expression for better understanding of the origin, differentiation and migration of HSCs in the developing human liver. H-E staining and immunohistochemical methods were used to observe the expression of hepatic/cholangiocellular differentiation markers (AFP, GST-π, CK7, CK19) and hematopoietic stem cell markers (CD34 and c-kit) in several kinds of HSC-related cells in thirty cases of fetal liver samples (4–35 weeks after pregnancy). AFP expression appears in fetal hepatocytes at four weeks’ gestation. It peaks at 16–24 weeks’ gestation and decreases gradually afterwards. Finally, weak signals were only found in some ductal plate cells and a few limiting plate cells. GST-π was detected in hepatic cord cells from the sixth week and in the ductal plate cells from the eighth week. Twenty-six weeks later, only some ductal plate cells and a few limiting plate cells show positive signals. CK19 expression peaks during the 6th–11th weeks in hepatic cord cells and decreases gradually afterwards, except for the ductal plates. CK7 expression was limited in the ductal plate cells and bile ducts cells from the 14th week. CD34 and c-kit were detected at the eighth week in some ductal plate cells and a few mononuclear cells in the hepatic cords/mesenchymal tissue of portal areas. After 21 weeks, CD34 and c-kit were found only in ductal plate cells and a few mononuclear cells in the hepatic mesenchymal tissue of portal areas. Fetal hepatocytes at 4–16 weeks’ gestation are mainly constituted by HSCs characterized with bi-potential differentiation capacity. At 16 weeks’ gestation, most hepatic cord cells begin to differentiate into hepatocytes and abundant HSCs remain in ductal plate (the origin site of Hering canals). It is also indicated that the hematopoietic stem cells may give rise to some HSCs in embryonic liver. These indirectly support the hypothesis about the location and origin of HSCs in liver valley hypothesis  reported previously.
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Influence and related mechanism of Retn gene expression on glucose uptake in 3T3-L1 cells
LI Yahui, DONG Shiyuan, YU Chao, JIANG Yu, LI Huaixing, SUN Shuhan
Front. Med.. 2007, 1 (3): 269-273.  
https://doi.org/10.1007/s11684-007-0051-1

Abstract   PDF (361KB)
The aim of this article was to investigate the influence and the related mechanism of the Retn gene on glucose uptake and insulin resistance in 3T3-L1 cells. Radioimmunoassay was used to determine glucose uptake in 3T3-L1 cells with different Retn gene expression levels, whether cells were stimulated by insulin or not. RT-PCR and real-time RT-PCR analysis were used to determine the mRNA levels of several glucose transport proteins in 3T3-L1 cells with different Retn gene expression levels, including insulin receptor substrate-1(IRS-1), phosphatidylinositol 3-kinase (PI-3K), AKT-2, glucose transporter-4 (GLUT-4), p38 mitogen-activated protein kinase (p38MAPK) and glycogen synthase kinase-3b (GSK-3β). The glucose uptake decreased with the increase in Retn gene expression in 3T3-L1 cells, which was independent of whether the cells were stimulated by insulin or not. The mRNA expression of two signal proteins PI-3K and AKT-2 decreased and the other two signal proteins, GSK-3β and p38MAPK, increased with Retn overexpression in 3T3-L1 cells. Resistin could induce insulin resistance in adipocytes, which might be related to the changes of some proteins in PI-3K and Ras pathways.
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Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic accumulative score
HUANG Jiuyi, WANG Guiqing, GUO Jiping, CAO Yifeng, WANG Yan, YANG Yongju, YU Xuehai
Front. Med.. 2007, 1 (3): 274-278.  
https://doi.org/10.1007/s11684-007-0052-0

Abstract   PDF (279KB)
The relative risk (RR) of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics. A total of 7,371 patients with hypertension with ages ≥40 years were selected from a population-based cohort study of the risk factors for stroke. The data on the baseline investigation of risk factors, the determination of cerebrovascular hemodynamic parameters (CVHP), and stroke follow-up were analyzed. The RR of stroke in patients with hypertension was evaluated by CVHP scores. Univariate analysis indicated that hypertension, complicated by other risk factors, had significant statistical association with the onset of stroke. RRs for stroke when hypertension complicated with decrease of hemodynamic scores, heart disease, cigarette smoking and alcohol consumption were 4.93 (95%CI, 3.26–7.45), 1.90 (95%CI, 1.36–2.66), 1.99 (95%CI, 1.42–2.79) and 1.73 (95%CI, 1.19–2.53) respectively. In multivariate analysis, hemodynamic score, age, sex, cigarette smoking, family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis. Among them, the RR of hemodynamic score was highest. The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points, the RR of stroke at 75, 60, 45, 30 and 15 points were 2.85, 4.43, 4.54, 5.40 and 9.88, respectively. The risk of stroke in patients with hypertension is closely asso ciated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.
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Partial portacaval shunt with H-grafts to treat portal hypertension
XU Geliang, HU Hejie, LI Jiansheng, YANG Shugao, CHAI Zhongpei, XU Rongnan
Front. Med.. 2007, 1 (3): 279-281.  
https://doi.org/10.1007/s11684-007-0053-z

Abstract   PDF (236KB)
Partial portosystemic shunts have been popularized because of a reported low rate of mortality and morbidity (especially encephalopathy, liver failure and occlusion). The results of partial portacaval shunts [small-diameter expanded polytetrafluoroethylene (ePTFE) H-graft portacaval shunt] were retrospectively reviewed to evaluate the clinical efficacy in the treatment of portal hypertension. Forty-three patients with portal hypertension were treated by small-diameter H-graft of ePTFE portacaval shunt from May 1995 to April 2006. Thirty-three had externally ringed grafts and ten had non-ringed ones. Ten had grafts of 10 mm in diameter and 33 had grafts of 8 mm. The left gastric artery and coronary vein were ligated in all the cases. Six had pericardial devascularization and splenectomy was performed in 42. An average decrease of free portal pressure (FPP) from (33.24 ± 4.78) cmH2O before shunting and (13.65 ± 5.65) cmH2O after shunting was observed. The portal blood flow was reduced by one-third of that before shunt. Thirty-eight patients survived and no upper gastro-intestinal rebleeding occurred in the follow-up period (50.5 months in average). Two were out of contact. Color Doppler ultrasonography and/or portography revealed the shunts were patent in 38 cases and were occluded in three cases (3/41, 7.3%). Encephalopathy developed in five cases (5/41, 12.2%). Partial (small-diameter ePTFE H-graft) portacaval shunting can reduce the portal pressure effectively. Majority of the hepatic flow from the portal vein can be maintained adequately. The shunts with reinforced grafts can keep a higher rate of patency. The morbidity of encephalopathy was lower than those with total shunt. The partial portacaval shunt is effective in preventing recurrent variceal bleeding.
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Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure
ZHANG Feng, WANG Xuehao, LI Xiangcheng, KONG Lianbao, SUN Beicheng, LI Guoqiang, QIAN Xiaofen, CHEN Feng, WANG Ke, LU Sheng, PU Liyong, LU Ling
Front. Med.. 2007, 1 (3): 282-286.  
https://doi.org/10.1007/s11684-007-0054-y

Abstract   PDF (244KB)
Fulminant hepatitis is fatal in most cases and timely liver transplantation is the only effective treatment. This study evaluates the survival outcomes of patients who underwent living-donor liver transplantation (LDLT) using right lobe liver grafts for fulminant liver failure due to hepatitis B infection. Nine cases of adult right lobe LDLT were performed in our department from September 2002 to August 2005 and the clinical and following-up data were reviewed. According to the pre-transplant Child-Pugh-Turcotte classification, the nine patients were classified as grade C. The model for end-stage liver disease (MELD) score of these patients ranged from 16 to 42. The principal complications before transplantation included abnormal renal function, hepatic coma of different degrees and alimentary tract hemorrhage. The main complications after transplantation included pulmonary infection in two cases, acute renal failure in three cases and transplantation-related encephalopathy in one case. No primary failure of vascular or biliary complications occurred. The one-year survival rate was 55.6%. There were no serious complications or deaths in donors. In general, it is extremely difficult to treat fulminant hepatitis by conservative regimen, particularly, in cases with rapid progression. Emergency adult living-donor liver transplantation is an effective treatment for fulminant hepatitis patients and is relatively safe for donors.
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Effects of parenteral nutrition with and without GH on the GH/IGF-1 axis after hepatectomy in hepatocellular carcinoma with liver cirrhosis
CAO Jie, LUO Shimin, LIANG Lijian, LAI Jiaming, CHEN Shanming
Front. Med.. 2007, 1 (3): 287-293.  
https://doi.org/10.1007/s11684-007-0055-x

Abstract   PDF (296KB)
Postoperative hepatic insulin-like growth factor-1 (IGF-1) production may be severely disturbed in patients with liver cirrhosis. Complex alterations in the GH/IGF-1 axis are thought to play an important role in the protein catabolism that complicates major surgical procedures. The aim of this study was to explore the effects of parenteral nutrition (PN) with and without growth hormone (GH) on the GH/IGF-1 axis after hepatectomy for hepatocellular carcinoma (HCC) with cirrhosis and evaluate the potential roles of recombinant human GH (rhGH) therapy. Twenty-four patients with HCC with cirrhosis who underwent hepatectomy were randomly divided into two groups: a PN group (n = 12) and an rhGH+PN group (n = 12). Liver function, serum GH, IGF-1 and IGFBP-3 were measured before the operation and at postoperative days (POD) 1 and 6. Insulin-like growth factor-1 and IGFBP-3 mRNA in the liver tissue was detected by RT-PCR. The liver Ki67 immunohistochemistry staining was studied. At the same time, 12 patients with cholelithiasis or liver hemangioma who underwent operation served as normal control group. On POD 6, serum prealbumin, GH, IGF-1, IGFBP-3, hepatic IGF-1 mRNA, IGFBP-3 mRNA and liver Ki67 LI were higher in the rhGH+PN group than in the PN group. There was no significant difference in the 6- and 12-month tumor-free survival rate and the median tumor-free survival time between the PN group and the rhGH+PN group (P⟩0.05). These data indicate that rhGH+PN could ameliorate the changes in the GH/IGF-1 axis after hepatectomy for HCC in the setting of cirrhosis.
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Determination of telomerase activity in stem cells and non-stem cells of breast cancer
LI Zhi, HE Yanli, ZHANG Jiahua, ZHANG Jinghui, HUANG Tao
Front. Med.. 2007, 1 (3): 294-298.  
https://doi.org/10.1007/s11684-007-0056-9

Abstract   PDF (442KB)
Although all normal tissue cells, including stem cells, are genetically homologous, variation in gene expression patterns has already determined the distinct roles for individual cells in the physiological process due to the occurrence of epigenetic modification. This is of special importance for the existence of tissue stem cells because they are exclusively immortal within the body, capable of selfreplicating and differentiating by which tissues renew and repair itself and the total tissue cell population maintains a steady-state. Impairment of tissue stem cells is usually accompanied by a reduction in cell number, slows down the repair process and causes hypofunction. For instance, chemotherapy usually leads to depression of bone marrow and hair loss. Cellular aging is closely associated with the continuous erosion of the telomere while activation of telomerase repairs and maintains telomeres, thus slowing the aging process and prolonging cell life. In normal adults, telomerase activation mainly presents in tissue stem cells and progenitor cells giving them unlimited growth potential. Despite the extensive demonstration of telomerase activation in malignancy (>80%), scientists found that heterogeneity also exists among the tumor cells and only minorities of cells, designated as cancer stem cells, undergo processes analogous to the self-renewal and differentiation of normal stem cells while the rest have limited lifespans. In this study, telomerase activity was measured and compared in breast cancer stem cells and non-stem cells that were phenotypically sorted by examining surface marker expression. The results indicated that cancer stem cells show a higher level of enzyme activity than non-stem cells. In addition, associated with the repair of cancer tissue (or relapse) after chemotherapy, telomerase activity in stem cells was markedly increased.
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High risk factors for pulmonary fungous infection in intensive care units of neurosurgery
ZHU Wenyu, TAN Liping, CHEN Xiangfeng, HUANG Qiang, LAN Qing
Front. Med.. 2007, 1 (3): 299-303.  
https://doi.org/10.1007/s11684-007-0057-8

Abstract   PDF (265KB)
By analyzing the high risk factors for pulmonary fungous infection in intensive care units of neurosurgery, the strategy of early diagnosis and treatment was explored. According to the domestic diagnostic standard on pulmonary fungous infection, clinical data on 58 patients with the infection in our department were analyzed. One hundred and seventeen strains of fungi were separated from the 58 cases. Candidiasis was the most frequent type, accounting for 92.3% of the cases. Conditions such as the severity of primary diseases, long-time coma, long-term use of broad-spectrum antibiotic, abuse of glucocorticoid, the open airway, and some invasive intubations, may be regarded as high risk factors for pulmonary fungous infection. Fluconazole showed good clinical effects on the treatment of fungous infection. To eliminate these high risk factors, early diagnosis and the use of prophylactic antifungal agents can help reduce the incidence of pulmonary fungous infection.
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Influence of Survivin-targeted siRNA on the biological features of colorectal carcinoma cells
XIONG Ying, GUO Wen, LI Ting, LI Ke
Front. Med.. 2007, 1 (3): 304-307.  
https://doi.org/10.1007/s11684-007-0058-7

Abstract   PDF (278KB)
The transient transfection of survivin-targeted siRNA to Lovo cells and its influence on the biological features were studied. Two pairs of 19 base pairs (bp) siRNA-specific targeted survivin gene were designed and synthesized by in vitro transcription (Survivin-1, Survivin-2). After transient transfection of the two survivin-targeted siRNAs to Lovo cells by Lipofectamine™ 2000, the expression of survivin mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR). Apoptosis was detected by flow cytometry and cell proliferation was evaluated by MTT assay. We found that the expression levels of survivin mRNA of the two RNAi groups (Survivin-1 group and Survivin-2 group) respectively decreased by 70% and 39.1% compared with the control Lovo’s. Seventy-two hours after transfection, apoptosis rates of the two RNAi groups were 21.51% and 26.28%, both of which were higher than control Lovo’s (9.03%). The results at 72 h after transfection were that the optical density (OD) at 490 nm of the two RNAi groups was 0.581±0.070 and 0.681±0.104, both of which were much lower than the control Lovo’s (2.060±0.272). Based on the results, we can draw a conclusion that the two survivin-targeted siRNAs successfully suppressed the expression of survivin mRNA, inhibited cell growth and induce cell apoptosis. It provides a powerful evidence for colorectal carcinoma gene therapy.
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Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney disease
YU Xiaofang, XU Xialian, YE Zhibin
Front. Med.. 2007, 1 (3): 308-311.  
https://doi.org/10.1007/s11684-007-0059-6

Abstract   PDF (269KB)
In patients with chronic renal failure, whether they have had hemodialysis or not, the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney function. The detection of tumor markers is extensively used for the diagnosis of corresponding tumors. It has been recently shown that some tumor markers are higher in patients with chronic kidney disease (CKD) than in the normal population. The effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA, CA199, CA125, AFP, CA153, CA724, CYFRA21-1, NSE, SCC-Ag, PSA, and fPSA. The 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this study. The 232 non-dialysis patients were divided into three groups according to their Ccr. In group 1, Ccr was ≤25 mL/min. In group 2, Ccr was between 25 and 50 mL/min. In group 3, Ccr was ≥50 mL/min. The male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three groups. Nine tumor markers in 37 uremic patients were tested. For comparison, 37 non-dialysis patients with similar Ccr of the same age and gender served as controls. There existed significant differences in serum levels of CEA, CA199, CYFRA21-1, NSE, and SCC-Ag among different Ccr groups and the markers bore a negative correlation with Ccr. There were no significant differences among the three groups in the serum concentrations of CA125, AFP, CA153, CA724, PSA and fPSA. The serum levels of CA125 and NSE were significantly higher (P199, CYFRA21-1, NSE, CA125 and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP, CA153, CA724, PSA and fPSA were as valuable as they were in patients with normal kidney function. Hemodialysis further increased the serum level of CA125 and NSE.
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Mutation analysis of KCNQ1, KCNH2, SCN5A, KCNE1 and KCNE2 genes in Chinese patients with long QT syndrome
DU Rong, TIAN Li, YUAN Guohui, LI Jin, REN Faxin, GUI Le, LI Wei, ZHANG Shouyan, KANG Cailian, YANG Junguo
Front. Med.. 2007, 1 (3): 312-315.  
https://doi.org/10.1007/s11684-007-0060-0

Abstract   PDF (457KB)
Long QT syndrome (LQTS) is the prototype of the cardiac ion channelopathies, which cause syncope and sudden death. Inherited LQTS is represented by the autosomal dominant Romano-ward syndrome (RWS), which is not accompanied by congenital deafness, and the autosomal recessive Jervell and Lange-Nielsen syndrome (JLNS), which is accompanied by congenital deafness. The LQTS-causing mutations have been reported in patients and families from Europe, North America and Japan. Few genetic studies have been carried out in families with JLNS from China. This study investigates the molecular pathology in four families with LQTS (including a family with JLNS) in the Chinese population. Polymerase chain reaction and DNA sequencing were used to screen for KCNQ1, KCNH2, KCNE1, KCNE2 and SCN5A mutation. A missense mutation G314S in an RWS family was identified, and a single nucleotide polymorphism (SNP) G643S was indentified in the KCNQ1 of the JLNS family. In this JLNS family, another heterozygous novel mutation in exon 2a was found in KCNQ1 of the patients. Our data provide useful information for the identification of polymorphisms and mutations related to LQTS and the Brugada Syndrome (BS) in Chinese populations.
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Abnormal glycosylated hemoglobin as a predictive factor for glucose metabolism disorders in antipsychotic treatment
XU Leping, JI Juying, DUAN Yiyang, SHI Hui, ZHANG Bin, SHAO Yaqin, SUN Jian
Front. Med.. 2007, 1 (3): 316-319.  
https://doi.org/10.1007/s11684-007-0061-z

Abstract   PDF (304KB)
The aim of this study was to observe the changes in glucose metabolism after antipsychotic (APS) therapy, to note the influencing factors, as well as to discuss the relationship between the occurrence of glucose metabolism disorders of APS origin and abnormal glycosylated hemoglobin (HbA1c) levels. One hundred and fifty-two patients with schizophrenia, whose fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) in the oral glucose tolerance test (2HPG) were normal, were grouped according to the HbA1c levels, one normal and the other abnormal, and were randomly enrolled into risperidone, clozapine and chlorpromazine treatment for six weeks. The FPG and 2hPG were measured at the baseline and at the end of the study. In the group with abnormal HbA1c and clozapine therapy, 2HPG was higher after the study [(9.5±1.8) mmol/L] than that before the study [(7.2±1.4) mmol/L] and the difference was statistically significant (P⟨0.01). FPG had no statistically significant difference before and after the study in any group (P⟩0.05). HbA1c levels and drugs contributing to 2HPG at the end of study had statistical cross-action (P⟨0.01). In the abnormal HbA1c group, 2HPG after the study was higher in the clozapine treatment group [(9.5±1.8) mmol/L] than in the risperidone treatment group [(7.4±1.7) mmol/L] and the chlorpromazine treatment group [(7.3±1.6) mmol/L]. The differences were statistically significant (P⟨0.01). In the normal HbA1c group there was no statistically significant difference before and after the study in any group (P⟩0.05). 2HPG before [(7.1±1.6) mmol/L] and after the study [(8.1±1.9) mmol/L] was higher in the abnormal HbA1c group than in the normal HbA1c group [(6.2±1.4) mmol/L vs (6.5±1.4) mmol/L] with the difference being statistically significant (P⟨0.01 vs P⟨0.001). As compared with normal HbA1c group, the relative risk (RR) of glucose metabolism disease occurrence was 4.7 in the abnormal HbA1c group with the difference being statistically significant (P⟨0.001). Patients with abnormal HbA1c are more likely to have a higher risk of having glucose metabolism disorders after APS treatment.
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Association of the genetic polymorphism of EPHX1 and EPHX2 with the susceptibility to chronic benzene poisoning
SUN Pin, ZHANG Zhongbin, WU Fen, WAN Junxiang, JIN Xibeng, XIA Zhaolin
Front. Med.. 2007, 1 (3): 320-326.  
https://doi.org/10.1007/s11684-007-0062-y

Abstract   PDF (339KB)
The aim of this study was to explore the association of the genetic polymorphism of EPHX1 and EPHX2 with the susceptibility to chronic benzene poisoning (CBP). A case-control study of 268 patients with CBP and 268 healthy workers matched by age and sex, all of whom were occupationally exposed to benzene, was conducted. The single nucleotide polymorphisms (SNPs, rs2854451, rs3738047, rs2234922 and rs1051741) of EPHX1 gene and the SNP (rs751141) of EPHX2 gene were tested by the TaqMan PCR method. In the subjects carrying the genotype of EPHX1 rs3738047 GG, the risk of CBP was decreased in the individuals simultaneously carrying EPHX1 rs2234922 G (P = 0.02). Alternatively, in the subjects carrying the genotype of EPHX1 rs2234922 AA, the risk of CBP was increased in the individuals simultaneously carrying the allele of EPHX2 rs751141A (P = 0.03). It was also found that there were potential interactions between alcohol consumption and the polymorphism of EPHX1 rs1051741 (χH2 = 5.28, P = 0.02) or rs2234922 (χH2= 6.71, P = 0.01). Compared to individuals with EPHX1 rs1051741 CC or rs2234922 AA genotype in the drinkers, the risk of CBP in those carrying genotypes of EPHX1 rs1051741 CT+TT or rs2234922 AG+GG was decreased, respectively (P = 0.04, P⟨0.01). Haplotype analysis of polymorphisms in EPHX1 showed that the risk of CBP was increased in the subjects with haplotype 2 (rs2854451-A, rs3738047-G, rs2234922-A, rs1051741-C) or haplotype 4 (rs2854451-G, rs3738047-A, rs2234922-G, rs1051741-T), but decreased in those with haplotype 6 (rs2854451-G, rs3738047-G, rs2234922-G, rs1051741-T) or haplotype 10 (rs2854451-A, rs3738047-A, rs2234922-G, rs1051741-T), respectively. Logistic regression analysis revealed that smoking might play a role in modifying the risk of CBP (OR = 0.313, 95% CI: 0.123 0.794, p= 0.015). The genetic polymorphism in EPHX1 may be associated with the risk of CBP in the Chinese occupational population and further research is needed for the association between the genetic polymorphism in EPHX2 and the susceptibility to CBP.
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Relationship between reactive oxygen species and sodium-selenite-induced DNA damage in HepG2 cells
ZOU Yunfeng, NIU Piye, GONG Zhiyong, YANG Jin, YUAN Jing, WU Tangchun, CHEN Xuemin
Front. Med.. 2007, 1 (3): 327-332.  
https://doi.org/10.1007/s11684-007-0063-x

Abstract   PDF (356KB)
Selenium compounds, as an effective chemopreventive agent, can induce apoptosis in tumor cells. Reactive oxygen species (ROS) are important mediators in apoptosis induced by various stimuli, which include chemopreventive agents. In this study, we investigated the relationship between ROS and the levels of DNA damage induced by selenite in HepG2 cells. After HepG2 cells were treated with selenite, there was a dose-dependent decrease in cell viability. The levels of ROS induced by selenite were measured by 2′, 7′-dichlorofluorescein diacetate (DCFH-DA) fluorescence, which shows a dose- and time-dependent increase in HepG2 cells. The levels of DNA damage in HepG2 increased in all cells treated with an increasing dose of selenite at 0, 2.5, 5, 10, and 20 μmol/L. N-acetylcysteine (NAC), a known antioxidant, increased cell viability and decreased ROS generation. Moreover, NAC effectively blocked DNA damage induced by selenite. These results revealed that ROS might play an important role in selenite-induced DNA damage that can be reduced by NAC treatment.
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Synchronous rectal adenocarcinoma and anal canal adenocarcinoma
GU Jin, YAO Yunfeng, LI Jiyou, LU Aiping, WANG Hongyi
Front. Med.. 2007, 1 (3): 333-337.  
https://doi.org/10.1007/s11684-007-0064-9

Abstract   PDF (972KB)
It is difficult to distinguish a rectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas. The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified. Here, we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma. Five months after resection, he developed an adenocarcinoma in the anal canal. The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins (CKs) 7 and 20 were performed. The index tumor demonstrated CK 7 /CK 20+ and the second showed CK7+/CK20+. For this reason, we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately. It is very important to differentiate the anorectal lesions pathologically because of the impact on the therapeutic options available, especially for the lesion arising in the anal canal.
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Sudden death due to arrhythmogenic right ventricular cardiomyopathy: Two case reports
CHEN Xinshan, ZHANG Yigu, RAO Guangxun, HUANG Guangzhao
Front. Med.. 2007, 1 (3): 338-342.  
https://doi.org/10.1007/s11684-007-0065-8

Abstract   PDF (542KB)
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of primary myocardial disease characterized by the regional or global replacement of right ventricular myocardium by fatty and fibrolipomatous tissues. The ARVC, usually presenting with different clinical manifestations and pathological changes, were mainly seen in young men and is one of the main causes of sudden death in the young. Here two autopsied cases of Chinese men aged 30 and 23 years old who appeared healthy but died suddenly while at work are reported respectively. One of the victims had extensive and severe pathological changes in his heart involving the left ventricular wall as well as the ventricular septum and the right atrium. Not only was there a global fatty and fibrolipomatous tissue replacement of the right ventricular myocardia, but also mild sarcoplasmic coagulation in the myocardium and focal lymphocytic infiltration in the myocardial interstitium of the right ventricular wall. In addition, slight atherosclerosis of the coronary artery and intimal thickening of the sino-atrial node were observed. It is believed that there are no marked differences in the pathological changes of ARVC between Chinese patients and patients from western countries. The etiology and pathogenesis of ARVC could not be explained by a single cause or factor and they are probably related to various congenital and acquired causes or factors.
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