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25 December 2019, Volume 18 Issue 06 Previous Issue    Next Issue

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Serum level of 25-vitamin D3 in pregnant women and its correlation with gestational diabetes mellitus and predictive value for occurrence of GDM YAO Xiaoyan, CHEN Jun 2019, 18 (06):  634-639.  DOI: 10.16150/j.1671-2870.2019.06.006 Abstract ( 255 )   HTML ( 3 )   PDF (680KB) ( 73 )   Objective: To investigate the correlation between serum level of 25-vitamin D3 [25(OH)D3] and gestational diabetes mellitus (GDM), and to analyze whether 25(OH)D3 can predict the occurrence of GDM. Methods: The pregnant women registered in our hospital in 2018 were tested for fast blood glucose (FBG) and glycated hemoglobin (HbA1c) in first trimester (8-12 week), serum 25(OH)D3 in second trimester (13-15 week), and oral glucose tolerance test (OGTT) in second and third trimester (24-28 week). The pregnant women were categorized into gestational diabetes mellitus group (GDM) (1 130 cases) and normal pregnant group (control group) (1 102 cases). Compared the related indices between the two groups, analyzed the correlation between 25(OH)D3 and each index and the predictive value of 25(OH)D3 for GDM. Results: There were no significant differences in BMI and age between the two groups (P>0.05). The serum 25(OH)D3 level in GDM group was lower than that in control group [(45.10±15.84) nmol/L vs (46.77±16.61) nmol/L, P<0.05]. Vitamin D level in pregnant women was generally low: 25(OH)D3 was inadequate in 95%, and deficient in up to 60%. There was a negative correlation between 25(OH)D3 and FBG in early pregnancy (r=-0.063, P=0.035). At the fasting time point of OGTT, there was a significant difference in level of 25(OH)D3 [（45.61±16.74） nmol/L vs （43.73±14.12） nmol/L (P<0.05)] between the two groups having or not having normal FBG, and there was no significant difference in other time points of GOTT between the two groups. The area under ROC curve for serum 25(OH)D3 to predict GDM was less than 0.5. Conclusions: Vitamin D level in pregnant women is generally low in Shanghai. Level of 25(OH)D3 is negatively correlated with FBG level, however, serum 25(OH)D3 in second trimester is not suitable for predicting GDM. Figures and Tables | References | Related Articles | Metrics

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Diagnostic value of nerve electrophysiological studies for Bortezomib-induced peripheral neuropathy in multiple myeloma patients LU Hongyu, CAO Yafeng, GU Jun, WANG Jing, CHEN Mei, SONG Luxi 2019, 18 (06):  640-644.  DOI: 10.16150/j.1671-2870.2019.06.007 Abstract ( 274 )   HTML ( 4 )   PDF (554KB) ( 68 )   Objective: To study the diagnostic value of nerve electrophysiological studies (NES) for Bortezomib-induced peripheral neuropathy (BiPN) in patients with multiple myeloma(MM). Methods: A total of 79 patients with MM treated with bortezomib based induction chemotherapy were enrolled. The baseline and post-treatment perpheral neuropathy（PN） was assessed by clinical adverse effects and NES, and the results between these two assessing methods were compared. Results: Thirty-one of 79 (39.2%) MM patients had baseline NES abnormalities before treated with bortezomib, of them 20 (64.5%) patients developed BiPN at last, and early and grade 2 or higher BiPN also concentrated in patients with abnormal baseline NES. Compared with bone marrow plasma cells, serum LDH, β2 microglobulin and other prognostic related clinical and laboratory indices, abnormal baseline NES was the only index that had significant difference between groups having or not having BiPN ( χ2=6.410, P=0.011). After 4 courses of treatment, 33 patients were diagnosed as having BiPN, among them 25(75.8%) patients were diagnosed by clinical adverse effects and 17 (51.5%) patients by subsequent NES. There was no significant difference in positive rate between the two assessment methods ( χ2=3.803, P=0.051). Of the 33 patients diagnosed as having BiPN, the diagnostic results of clinical adverse effects and of subsequent NES were consistent in 9 patients (27.3%) and inconsistent in 24 cases (72.7%), the consistency between the two assessment methods was poor (rn=0.220, P=0.051). Conclusions: Abnormal baseline NES has some value for the prediction of BiPN, however, clinical assessment is still important for BiPN, and subsequent NES can be served as a supplement for clinical assessment of BiPN. Figures and Tables | References | Related Articles | Metrics

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Study on motion characteristics of gastric cancer cells using glassy dynamics analysis JIANG Jiang, ZENG Zhikun, SHI Bowen, PAN Zhaocheng, YAN Ling, WANG Yujie, ZHANG Huan 2019, 18 (06):  645-648.  DOI: 10.16150/j.1671-2870.2019.06.008 Abstract ( 333 )   HTML ( 2 )   PDF (697KB) ( 85 )   Objective: To study the motion characteristics of gastric cancer cells in liquid culture environment using glassy dynamics analysis. Methods: Lentiviral vector carrying green fluorescent protein (GFP) was transfected into gastric cancer cells. Trajectories of gastric cancer cells along X, Y, and Z axis in the liquid environment were recorded at real time under the laser scanning confocal microscope. Glassy dynamics analysis was used to analyze the velocity distribution, mean square displacements (MSD) of gastric cells, and function χ4 (Δt) of self-overlap function Q on four-point susceptibi-lity was established. Results: Observation under inverted fluorescence microscope showed that cell transfection efficiency was 100%. Laser con-focal microscopy showed that cell velocity distribution presented the Gaussian distribution. With the increase of cell density, self-diffusion constant D in XY plane by MSD calculation decreased and glassy dynamics of cells aggravated by function χ4. Conclusions: The motion of gastric cancer cells is influenced by cell density in the liquid environment and presenting the characteristics of glassy dynamics. Figures and Tables | References | Related Articles | Metrics

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Pulmonary colloid adenocarcinoma: Clinical pathological analysis of 4 cases and review of literature XU Haimin, CHEN Xiaoyan, ZHANG Jing, WANG Chaofu 2019, 18 (06):  649-654.  DOI: 10.16150/j.1671-2870.2019.06.009 Abstract ( 675 )   HTML ( 2 )   PDF (975KB) ( 100 )   Objective: To investigate the clinicopathological features, immunophenotype, molecular characteristics and differential diagnosis of colloid adenocarcinoma. Methods: The clinical and pathological data of 4 cases of pulmonary adenocarcinoma were retrospectively analyzed, and associated literature was reviewed. Results: All 4 patients were elderly men, aged 61-67 years, with a median age of 64 years. Three of them had a history of smoking. The clinical manifestations were non-specific symptoms such as fatigue and cough, or without symptoms. The tumors were located in right upper lobe in 3 cases and right lower lobe in 1 case; 3 cases were peripheral located and 1 case almost occupied the entire lobe. The maximum diameter was 1.6-12.0 cm. The cut surface was grayish white, jelly-like and shiny. Microscopically, the tumor showed abundant mucin pools which destroyed the walls of alveolar spaces. The tumor cells showed goblet or signet-ring morphology, with moderate nuclear atypia and low mitotic rate, presenting singly, in small clusters or micropapillary clusters. Tumor cells floated in the mucin pool and a small number of tumor cells might line the alveolar space. Psammoma bodies could be seen in 2 cases. Immunophenotyping showed that 4 cases expressed CK7 and MUC-1, 1 case expressed CK20, 3 cases expressed TTF-1 and NapsinA（1 diffuse and 2 focal）, 2 cases expressed CDX-2, MUC-2 and Villin, 3 cases expressed MUC5AC. Molecular detection showed KRAS mutation in one case. Conclusions: Pulmonary adenocarcinoma is rarely seen. The pathological diagnosis depends on histopathological examination and immunohistochemical staining. The differential diagnosis includes primary mucinous tumor of lung and metastatic mucinous adenocarcinoma. Most cases of pulmonary adenocarcinoma have a good prognosis, but the presence of non-colloid component, interstitial infiltration and micropapillary structure suggests a worse prognosis. Figures and Tables | References | Related Articles | Metrics

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Study on carbapenem resistance genes within isolated carbapenem-resistant Escherichia coli strains DIAO Wenjing, HUANGFU Yuchan, ZHU Weinan, LIU Jingxian, LIU Ying, SHEN Lisong 2019, 18 (06):  655-661.  DOI: 10.16150/j.1671-2870.2019.06.010 Abstract ( 509 )   HTML ( 3 )   PDF (712KB) ( 73 )   Objective: To study the carbapenem resistance genes of clinically isolated carbapenem-resistant Escherichia coli strains. Methods: Non-repetitive carbapenem-resistant Escherichia coli strains isolated from clinical specimens of inpatients in our hospital from March 2009 to October 2017 were collected. The strains were firstly confirmed by MicroflexTM MALDI-TOF MS, then drug sensitivity of isolates was tested by K-B method combined with Vitek-2 Compact Automatic Microbiological Analyzer. Rapid screening of carbapenemase-producing Escherichia coli was performed using the modified carbapenem inactivation method (mCIM). Commonly seen carbapenemase was detected by regular PCR and DNA sequencing. The clinical data of patients were analyzed. Result: From March 2009 to December 2017, a total of 84 non-repetitive carbapenem-resistant Escherichia coli strains were isolated. Drug resistance test showed that carbapenem-resistant Escherichia coli had a very high resistance rate (up to 80%-100%) for most of the commonly used drugs except amikacin, whose drug resistance rate was less than 50%. A total of 71 carbapenemase-producing strains were identified by mCIM. The PCR and DNA sequencing results for drug resistance genes showed that there were 65 strains carrying blaNDM, with blaNDM-5 (64.6%, 42/65) and blaNDM-1(24.6%, 16/65) as the main types, and of them 2 strains carried both blaNDM-1 and blaMCR-1; 6s trains carriedblakpc-2; while no blaGES, blaIMP, blaVIM, blaOXA were detected. Altogether 17 types of clinical specimens and 23 departments were concerned, urine samples accounted for 30.95% (26/84) and sputum samples accounted for 21.43% (18/84). Carbapenemase-producing strains were mainly isolated from pediatric patients (66.7%, 56/84). Most of the strains isolated from children and infants were enzyme-producing (96.4%, 54/56), of which blaNDM-5 accounted for 63.0%(34/54). Most of the strains isolated from elderly patients were non-enzyme-producing (62.5%, 10/16). Besides, 54% (45/84) of these patients underwent surgery, while 33% (28/84) of them were treated with indwelling deep vein catheter and invasive medical procedures. Conclusions: The carbapenem-resistant Escherichia coli strains isolated from patients in our hospital mostly are multi-drug resistant. NDM and KPC are the main carbapenemase, and NDM-5 is the major type with a detection rate as high as 50%(42/84). The isolated rate of carbapenem-resistant Escherichia coli in pediatric wards is high, especially in critical care wards. Figures and Tables | References | Related Articles | Metrics

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Clinical value of ultrasonography in diagnosis of cervical lymph node metastasis of thyroid cancer GU Yaoyao, NI Xuejun 2019, 18 (06):  662-667.  DOI: 10.16150/j.1671-2870.2019.06.011 Abstract ( 384 )   HTML ( 1 )   PDF (695KB) ( 167 )   Objective: To study the clinical value of ultrasonography in diagnosis of cervical lymph node metastasis of thyroid cancer. Methods: The data of 70 cervical lymph nodes of 52 pathologically confirmed thyroid cancer patients (papillary carcinoma 43 cases, follicular carcinoma 4 cases, medullary carcinoma 4 cases, undifferentiated carcinoma 1 case) were retrospectively analyzed. All patients had ultrasonographic examination taken before operation. Gray-scale ultrasound was used to observe the morphology of lymph nodes, the internal echo, and the existence of lymph node hilum. Color doppler ultrasonography was used to detect blood flow distribution of lymph node. Lymph node length to diameter ratio <2, disappearance of lymph node hilum, calcification, cystic change, rich blood supply, and high echo were considered as suspicious character. The distribution of lymph nodes was recorded according to cervical lymph node area, and the lymph node metastasis in neck was assessed. Postoperative pathological diagnosis was taken as gold standard for evaluating the value of ultrasonography in diagnosis of lymph node metastasis of thyroid cancer in neck. Results: Seventy cervical lymph nodes were confirmed by pathology, among which 36 were thyroid cancer metastasis. The sensitivity and specificity of ultrasonography for diagnosis of cervical lymph node metastasis of thyroid cancer were 86.11% and 100%,respectively; the positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 87.17%. The sensitivity of ultrasonography for diagnosing lymph node metastasis in central cervical region was 78.95%, NPV was 85.19%, lower than that of lymph node metastasis in lateral region (sensitivity 94.12%, NPV 91.67%). Cervical metastatic lymph nodes of different pathological types of thyroid carcinoma had different ultrasonographic features. Most of the metastatic lymph nodes had a length to diameter ratio <2 (28/31), disappearance of lymph node hilum (26/31), and rich blood supply (18/31). The feature of papillary carcinoma metastatic lymph nodes was diverse; calcification, cystic change and high echo were not seen in follicular carcinoma metastatic lymph nodes(0/3); medullary carcinoma metastatic lymph nodes were often calcified (3/4) and rich in blood supply (4/4), and cystic change was not seen (0/4); anaplastic carcinoma metastatic lymph nodes was rich in blood supply (1/1), and no calcification, cystic change and high echo(0/1). Conclusions: Ultrasonography is of practical value in the clinical diagnosis of cervical lymph node metastasis of thyroid cancer, which can make an accurate diagnosis and guide the establishing of appropriate treatment program. The diagnostic accuracy for metastatic lymph nodes in cervical lateral region is higher than that in central region. Figures and Tables | References | Related Articles | Metrics

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Value of procalcitonin and C-reactive protein in early stage acute biliary pancreatitis ZHANG Shu, WANG Lulu, SUN Jing, JIANG Shihu 2019, 18 (06):  668-671.  DOI: 10.16150/j.1671-2870.2019.06.012 Abstract ( 425 )   HTML ( 7 )   PDF (440KB) ( 77 )   Objective: To compare the value of procalcitonin (PCT) and c-reactive protein (CRP) in early diagnosis and treatment of acute biliary pancreatitis. Methods: Data from a total of 195 patients diagnosed with acute pancreatitis (AP) from January 2014 to March 2018 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. According to the etiology, the patients were divided into acute biliary pancreatitis (ABP) and acute non-biliary pancreatitis (ANBP) groups. And the ABP group was further divided into mild ABP (MABP), moderately severe ABP (MSABP) and severe ABP (SABP) groups according to the severity of the disease. Differences of PCT and CRP levels within 48 hours after admission and the in-hospital death rate were compared between these groups. Results: In the early 48 hours after admission the level of PCT in patients with ABP was higher than that of ANBP（P<0.05), while there was no difference in CPR between 2 groups. Serum procalcitonin level within 48 hours after admission in SABP group was significantly higher than those in MABP and MSABP groups. Procalcitonin level within 48 hours after admission was significantly higher in the dead group than in the surviving group (P<0.001), and CRP levels within 48 hours after admission had little differences among these groups（P=0.769）. Conclusions: In the early 48 hours after admission, the detection of serum PCT level is superior to CRP level for evaluating the severity and prognosis of ABP. Figures and Tables | References | Related Articles | Metrics

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Application of microcolumn gel technique in safe blood transfusion JIN Yanping, JIANG Ming, JIA Fangming 2019, 18 (06):  672-675.  DOI: 10.16150/j.1671-2870.2019.06.013 Abstract ( 301 )   HTML ( 5 )   PDF (440KB) ( 82 )   Objective: To study the value of microcolumn gel technique in safe blood transfusion. Methods: Altogether 6 630 patients who needed blood transfusion from July 2014 to June 2019 were selected for irregular antibody screening and cross matching test by microcolumn gel method, and the results were compared with those of the polybrene method. Results: All 6 630 patients were screened by microcolumn gel method, and 35 cases had irregular antibody detected, the detection rate of irregular antibody was 0.53% (35/6 630); whereas the detection rate of irregular antibody by polybrene method was 0.39%(26/6 630), there was no significant difference between the two methods (P>0.05). All 6 630 patients were cross-matched by microcolumn gel method, the failure rate was 0.72% (48/6 630); when cross-matched by polybrene method, the failure rate was 0.45% (30/6 630); the difference between the two methods was statistically significant (P<0.05). Of the 49 cases with failure of cross-matching, the cross-test by microcolumn gel method showed failure in 48 cases; 1 case was showed by the polybrene method only, antibody identification had not revealed the specificity. The sensitivity of cross matching by microcolumn gel method was 97.96% ( 48/49), which was significantly higher than that by polybrene method (61.22%, 30/49). The difference was statistically significant (P<0.05). Conclusions: The microcolumn gel technology has high sensitivity, easy for standardization, with clear and accurate results, easy for interpretation, and has important application value for ensuring safety of blood transfusion. However, the polybrene method is rapid and simple, also has high sensitivity, and is suitable for emergency treatment. Appropriate method should be selected according to patient's condition on the premise of ensuring the safety of blood transfusion. Conditions allowing the two methods to verify each other would ensure the safety and effectiveness of blood transfusion. Figures and Tables | References | Related Articles | Metrics

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Experimental evaluation of efficacy of a HIV filter ZHANG Lin, ZHOU Ying, LI Haicong, SUN Meiyan, SUN Wenxiu, LU Lingqing, ZHU Zhaoqin, TANG Qi, ZHANG Renfang, SHEN Yinzhong, LU Hongzhou 2019, 18 (06):  676-679.  DOI: 10.16150/j.1671-2870.2019.06.014 Abstract ( 396 )   HTML ( 3 )   PDF (480KB) ( 41 )   Objective: To test the efficacy of a disposable membrane filter for the elimination of HIV. Methods: A total of 10 plasma samples were tested in this study. Plasma samples containing HIV were pressurizedly filtered through the filter. Copies of HIV RNA in the plasma before and after filtration were counted to calculate the efficacy of the filter. Results: The average HIV clearance rate of the filter was 96.62%. There was significant difference in number of HIV RNA copies before and after filtration (P=0.001). However, linear relationship was not seen between the clearance rate and the initial number of HIV RNA copies (P=0.924 2). Conclusions: The HIV clearance rate of this disposable membrane filter is high, and it might be feasible to eliminate the HIV virus by physical adsorption. Figures and Tables | References | Related Articles | Metrics