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Journal of Jiangsu University(Medicine Edition)

	2023 Vol.33 Issue.02 Published 2023-03-22

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		2023 Vol. 33 (02): 1- [Abstract] ( 17 ) [HTML 1KB] [ PDF 384KB] ( 494 )

	93	Evaluation of left ventricular function in uremic patients undergoing long-term peritoneal dialysis by myocardium layerspecific strain and myocardial work
		SHI Fei1, PAN Chun2, WU Yanni1, TANG Chao1, FENG Sheng3, ZHU Jing1
		［Abstract］Objective： To describe the left ventricular function of uremia patients with longterm peritoneal dialysis by application of myocardial layerspecific strain analysis and myocardial work techniques, and to evaluate the changes of myocardial function under longterm peritoneal dialysis. Methods： A total of 14 patients with uremia who underwent peritoneal dialysis regularly and whose left ventricular ejection fraction (LVEF) was normal by routine echocardiography were enrolled in the study. Routine two-dimensional echocardiographic parameters were measured. Left ventricular global longitudinal peak systolic strain (GLS) and the longitudinal peak systolic strain (LS) of the endocardium (LSendo), myocardium (LSmyo) and epicardium (LSepi) were measured by twodimensional speckle tracking imaging (2DSTI) and myocardial layerspecific strain analysis. Combined with blood pressure, the overall work parameters of the left ventricular myocardium were obtained to jointly evaluate the myocardial function of the left ventricle. The patients were followed up for 5 years and compared before and after 5 years of peritoneal dialysis. Results： After 5 years of regular peritoneal dialysis, there was no statistical difference in the change of LVEF in uremia patients, GLS significantly decreased in the four-chamber plane of the heart (P=0.018), and decreased from endocardium to epicardium (LSendoP=0.029, LSmyoP=0.017, LSepiP=0.004); global work parameters were mainly increased in global wasted work (GWW, P=0.048), but there were no significant differences in global constructive work (GCW), global work index (GWI) and global work efficiency (GWE). Conclusion： In uremia patients with longterm regular peritoneal dialysis for 5 years, the overall myocardial function of the left ventricle remained stable, but the local myocardial systolic function was further impaired, mainly evidenced by decrease of the myocardium of the posterior septum and lateral wall, and the myocardial work was dominated by elevated GWW.
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		2023 Vol. 33 (02): 93-98 [Abstract] ( 32 ) [HTML 1KB] [ PDF 3319KB] ( 585 )

	99	Accuracy of noninvasive blood pressure measurement in critically ill patients and and its impact on clinical decision-making
		YAN Ming, XU Ying, GU Qin
		［Abstract］Objective： To investigate the accuracy of noninvasive blood pressure measurement and the impact on clinical decisionmaking in critically ill patients. Methods： Using a prospective observational study, a total of 133 critically ill patients with established invasive blood pressure monitoring in the ICU of Nanjing Drum tower Hospital from March to December 2021 were included. Non-invasive and invasive blood pressure were measured and recorded simultaneously within 1 h after admission. The patients were divided into shock group with vasoactive drugs and non-shock group without vasoactive drugs. Spearman, Bland-Altman correlation analysis and interclass correlation coefficient (ICC) were applied to verify the consistency of the two monitoring methods, and the error grid method was used to analyze the effect of noninvasive blood pressure on guiding clinical decision-making. Results： ① Spearman correlation results showed that in nonshock patients, there were significant positive correlation between invasive and the non-invasive blood pressure (r of SBP, DBP, MAP were 0.69, 0.72, 0.70, all P<0.001). In shock patients, there was a significant positive correlation between SBPinvasive-SBPnoninvasive (r=0.34, P<0.05), while DBPinvasive-DBPnoninvasive, MAPinvasiveMAPnoninvasive without significant correlation (both P>0.05). ② Simple linear regression analysis revealed that in non-shock patients, there was a significant positive correlation between invasive and non-invasive blood pressure (R2 of SBP, DBP, MAP were 0.56, 0.58, 0.43, all P<0.05). In shock patients, invasive and noninvasive SBP and MAP were significantly positively correlated (R2 of SBP, MAP were 0.20, 0.10, P<005). DBPinvasive and DBPnoninvasive linear regression equation was not statistically significant (P>0.05). ③ The Bland-Altman analysis results showed that patients in the non-shock and shock groups, the proportion of data points between invasive and noninvasive blood pressure in the mean difference interval ±10 mmHg did not meet the non-invasive blood pressure measurement criteria of AAMI. Poor consistency (SBPinvasive-SBPnoninvasive, DBPinvasive-DBPnoninvasive, MAPinvasive-MAPnoninvasive data points in the average difference range of 10 mmHg: 63%, 73% and 76% of patients in non-shock group, and 35%, 50% and 52% in the shock group, respectively, all P<0.05). ④ The ICCs showed that in nonshock group patients, there was a significant positive correlation between SBPinvasive and SBPnoninvasive (the absolute consistency was 0.76＞0.75, P<0.001). In shock group patients, there were bad consistency coefficients between SBPinvasive and SBPnoninvasive, MAPinvasive and MAPnoninvasive (the absolute consistencies were 0.33, 0.31<0.4, both P<0.001), and the noncorrelation between DBPinvasive and DBPnoninvasive (P>0.05). ⑤ Error grid analysis results showed that in the shock group patients, the proportions of SBP measurements in the A to E hazard areas were 88.7%, 6.5%, 4.8%, 0%, and 0%. The proportions of the MAP measurements were 61.3%, 38.7%, 0%, 0%, and 0%. In the nonshock group .atients, the proportions of SBP measurements in the A to E hazard zone were 95.8%, 4.2%, 0%, 0%, and 0%. The proportions of MAP measurements were 97.2%, 1.4%, 1.4%, 0%, and 0%. ⑥ The multivariate Logistic regression showed that shock was a risk factor for the difference between non-invasive and invasive SBP, DBP and MAP greater than 10 mmHg (P<0.05), age was a risk factor for the difference between noninvasive and invasive SBP and MAP greater than 10 mmHg (P<0.05); heart rate was a risk factor for the difference between non-invasive and invasive SBP greater than 10 mmHg (P<0.05), and was a protective factor for the difference between noninvasive and invasive DBP and MAP greater than 10 mmHg (P<0.05). Conclusion： For critically ill patients with nonshock, the accuracy of non-invasive blood pressure measurement is better, and is more reliable to guide clinical decisionmaking with non-invasive MAP. It should be cautious when using non-invasive blood pressure instead of invasive blood pressure measurement in critically ill patients with shock.
		2023 Vol. 33 (02): 99-106,111 [Abstract] ( 20 ) [HTML 1KB] [ PDF 5119KB] ( 518 )

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		2023 Vol. 33 (02): 107-111 [Abstract] ( 30 ) [HTML 1KB] [ PDF 759KB] ( 605 )

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		2023 Vol. 33 (02): 112-117 [Abstract] ( 30 ) [HTML 1KB] [ PDF 770KB] ( 785 )

	118	Kaixuan-Jiedu decoction ameliorates imiquimod-induced psoriasis-like skin lesions in mice by regulating S1P
		QIN Yeping, DAI Dan, XIAO Xue, SONG Ping
		Objective： To investigate the effects of Kaixuan-Jiedu decoction (KXJD) on psoriasis-like mice model and its regulation of S1P. Methods： Twenty-five BALB/c mice were randomly and equally divided into normal group, model group, methotrexate group, KXJD-M and KXJD-H group. In addition to the normal group, the psoriasislike mice model were established by external application of imiquimod in other groups, and samples were taken after 7 days of continuous intervention. During the period, the skin lesions were photographed and the psoriasis area and severity index (PASI) score was calculated; HE staining was used to observe the pathological changes of skin lesions and measure the thickness of epidermis; the spleen and thymus were photographed and weighed; the expression of Ki67 and S1P in epidermis was detected by immunohistochemistry; Western blotting assay was used to detect the expression of KRT17, Claudin and Occludin in skin lesions; the mRNA levels of IL-17, IL-23 and S1PRs were detected by qRT-PCR. Results： Compared with the model group, KXJD could alleviate the psoriatic skin lesions, reduce the PASI score and epidermal hyperplasia (both P<0.01), improve the index of thymus and spleen and vascular proliferation (P<0.01 or P<0.05), reduce the mRNA expression of inflammatory factors IL-17 and IL-23 (P<0.01), and repair the skin barrier (P<0.05). Meanwhile, KXJD could downregulate the expression of S1P and S1PRs mRNA in epidermis (P<0.05). Conclusion： KXJD could alleviate the symptoms of local skin lesions in psoriasis, and its possible mechanism may be related with the regulation of S1P.
		2023 Vol. 33 (02): 118-125 [Abstract] ( 25 ) [HTML 1KB] [ PDF 57788KB] ( 500 )

	126	Significance and detection of the mitochondrial DNA in peripheral blood from patients with psoriasis vulgaris
		CAO Yang1, SHEN Yuhong2, SONG Shishen2, QIAN Qing2
		Objective： To investigate the level of mitochondrial DNA (mtDNA) in peripheral blood of patients with psoriasis vulgaris and its mechanism in the disease. Methods： The peripheral blood of 28 patients with psoriasis vulgaris and 28 healthy controls were collected, and the plasma mtDNA level was detected by quantitative real-time PCR (qRT-PCR). The peripheral blood mononuclear cells (PBMCs) were isolated, and the mRNA expression levels of cyclic GMPAMP synthase (cGAS) and stimulator of interferon gene (STING) were detected by qRT-PCR. PBMCs were co-cultured with mtDNA, and the concentrations of interleukin (IL)-23, IL-17 and interferon (IFN)-γ in the supernatant were detected by enzyme-linked immunosorbent assay. Results： Compared with the healthy group, the mtDNA expression in the peripheral blood of the psoriasis group was significantly increased ［(2.34±0.81) vs (1.18±0.25), P<0.001］, and was positively correlated with the psoriasis area and severity index (PASI) score (r=0.693, P<0.001). Compared with the healthy group, the levels of cGAS and STING mRNA in PBMCs of the psoriasis group were significantly increased (both P<0.001). The concentrations of IL-23, IL-17 and IFN-γ in the supernatant of PBMCs cocultured with mtDNA were significantly higher than those in the blank control group (all P<0.001) and positively correlated with PASI score (r=0.647, 0.585, 0.492, all P<0.01). Conclusion： The mtDNA in peripheral blood of patients with psoriasis is abnormally elevated and may participate in the process of psoriasis by activating cGAS/STING signaling pathway in immune cells.
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		2023 Vol. 33 (02): 126-129,134 [Abstract] ( 19 ) [HTML 1KB] [ PDF 938KB] ( 595 )

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		2023 Vol. 33 (02): 130-134 [Abstract] ( 24 ) [HTML 1KB] [ PDF 764KB] ( 714 )

	135	Acrylonitrile-induced cytotoxicity in insulin resistance-Buffalo rat liver cells: protective effect of phenylethyl isothiocyanate
		ZHU Xueyu1, ZHOU Jie1, DONG Ying2, LU Rongzhu1, LI Fang1
		Objective： To investigate the susceptibility of insulin resistance-Buffalo rat liver (IR-BRL) cells to acrylonitrile toxicity and the attenuation effect of diet-based chemical phenethyl isothiocyanate (PEITC). Methods： Treat BRL cells with 50 nmol/L insulin for 24 h to construct the IRBRL cell model with considering glucose consumption, insulin receptor substrate-2 (IRS-2) protein and intracellular phosphatidylinositol-3 kinase (PI3K) protein expression as evaluation indicators. IR-BRL cells treated with 2.5-5.0 mmol/L acrylonitrile for 12 h, and the cell viability and cytotoxicity were assessed by MTT reduction and lactate dehydrogenase (LDH) leakage respectively to evaluate the susceptibility characteristics of IR-BRL cells to acrylonitrile and then the above acrylonitrile-exposed IR-BRL cells was pretreated with 1.25-5.0 μmol/L PEITC for 1 hour and repeat the above examination to evaluate its attenuation effect. Results： The glucose consumption and the expression of IRS2 and PI3K proteins of BRL cells treated with insulin has shown significantly reduced, indicating the successful establishment of insulin resistance model of BRL cells. Compared with normal BRL cells, the IR-BRL cells treated with 2.5 and 4.0 mmol/L acrylonitrile showed significantly lower cell viability and higher LDH leakage rate, indicating that IR-BRL cells were more sensitive to acrylonitrile. Compared with normal infected hepatocytes, the pretreatment of 1.25-5.0 μmol/L PEITC could significantly reverse the above indicators. Conclusion： IRBRL cells are more sensitive to acrylonitrile, and PEITC may decrease its susceptibility.
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		2023 Vol. 33 (02): 135-140 [Abstract] ( 21 ) [HTML 1KB] [ PDF 1061KB] ( 682 )

	141	Hyperuricemia accelerate Aβ deposition in rat hippocampus and the related mechanisms#br#
		ZHOU Meng1, CHEN Zhihan1, ZHENG Weiping2, DAI Yijun1, GAO Fei1, YAN Qing1
		Objective： To investigate the effects of serum uric acid levels on cognitive function and Aβ expression in hippocampus of rats, and to explore the related mechanisms. Methods： Twentyfour Wistar male rats were randomly divided into control group, lowdose model group, middledose model group and highdose model group, with 6 rats in each group. The hyperuricemia animal model was established by using yeast extract feed combined with different concentrations of potassium oxonate intraperitoneal injection for 4 weeks. The learning and memory ability of the rats in each group was tested by Morris water maze. The expression levels of Aβ and key proteins in Aβ production and clearance pathways in the hippocampus of rats in each group were detected by ELLISA and Western blotting assays. Results： Compared with the control group, the level of uric acid in each model group was significantly increased (P<0.01). And there was no significant difference in the number of times of crossing the platform and the time spent in the quadrant of the platform in each group. Compared with control group, the expression levels of Aβ142, amyloid precursor protein (APP), βsite APP cleaving enzyme 1 (BACE1), neprilysin (NEP) and insulin degrading enzyme (IDE) were increased in model groups, and the expression levels increased with the raise of serum uric acid level. However, the expression of ABCG2 was decreased in model group, and gradually decreased with the increase of serum uric acid level. Conclusion： Hyperuricemia can aggravate Aβ deposition in rat hippocampus, possibly through the APPBACE1 pathway to increase the production of Aβ or/and the ABCG2 pathway to reduce the clearance of Aβ, rather than through NEP, IDE degradation pathways. Hyperuricemia had no significant effect on cognitive function.
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		2023 Vol. 33 (02): 141-145 [Abstract] ( 25 ) [HTML 1KB] [ PDF 1078KB] ( 483 )

	146	Plasticizer DEHP inhibits the growth of mouse spermatogonia GC-1 spg through the ferroptosis pathway#br#
		LIN Bohan1, LIU Wei1, WANG Zixuan1, WANG Chao1, LI Tao1, YANG Qin2, YU Qiwen1, SUN Xiaochun1
		Objective： To investigate the mechanism of DEHP-induced damage on mouse spermatogonial cell GC-1 spg function. Methods： GC1 spg were treated with various concentrations of DEHP (0, 30, 60, 90, 120 μmol/L). The effects of DEHP on the proliferation and migration of GC-1 spg were observed by CCK8 test, colony formation test and Transwell assay, and the relative contents of iron ion (Fe3+) and malondialdehyde (MDA) in GC-1 spg cells were determined by chemical spectrophotometry. The expression of cystine glutamate reverse transporter (xCT) and glutathione peroxidase 4 (GPX4) in GC1 spg was detected by Western blotting assay. The expression of intracellular reactive oxygen species （ROS） and the changes of mitochondrial membrane potential were detected by cellular immunofluorescence. The proliferation ability of GC-1 spg was detected by CCK8 assay after ferroptosis inhibitor Ferrostatin1 (1 μmol/L) was cotreated with DEHP (90 μmol/L) 24 h. Results： Compared with the control group (0 μmol/L), the proliferation, cloning and migration ability of cells in 30, 60, 90, 120 μmol/L DEHP groups were significantly decreased, while the contents of MDA,ROS and Fe3+ (90, 120 μmol/L DEHP group) were significantly increased. The mitochondrial membrane potential (60, 90, 120 μmol/L DEHP group) and the expression of GPX4 (60, 90, 120 μmol/L DEHP group), xCT protein were significantly decreased. The ability of cell proliferation after co-treatment of DEHP and Ferrostatin-1 was significantly higher than that of DEHP alone. Conclusion： DEHP can inhibit proliferation and migration capacity of GC-1 spg and reduce the expression of GPX4 and xCT proteins in GC-1 spg, possibly causing ferroptosis.
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		2023 Vol. 33 (02): 146-151 [Abstract] ( 22 ) [HTML 1KB] [ PDF 7768KB] ( 625 )

	152	Correlation between CT value of thoracic vertebrae cancellous bone and coronary artery calcification in type 2 diabetes mellitus patients#br#
		LIU Wen, LU Zukun, WANG Dongqing, ZHU Haitao, SONG Lian, CAO Xiongfeng
		Objective： To explore the correlation between CT values of thoracic cancellous bone and coronary artery calcification parameters in patients with type 2 diabetes mellitus (T2DM) during single coronary spiral CT scan. Methods： Seventytwo patients with T2DM who underwent 256row Revolution spiral CT scanning from July 2018 to November 2019 were recruited as the study subjects and divided into negative and positive coronary calcification groups. The differences in clinical data and CT measurements of thoracic cancellous bone between the two groups were analyzed. Spearman rank correlation analysis was conducted to analyze the correlation between CT values of cancellous bone of thoracic vertebral body and the degree of coronary artery calcification (number of involved branches and severity). Results： Onetime coronary spiral CT scan can synchronously obtain coronary calcification data and thoracic cancellous bone CT measurements in patients with T2DM, and complete onestop targeted analysis. There were significant differences in age, gender, history of hypertension, duration of diabetes and CT values of thoracic cancellous bone between negative and positive groups (P<0.05 or P＜0.001). CT values of thoracic cancellous bone in T2DM patients were significantly negatively correlated with the number of branches involved in coronary artery calcification (rs=-0.748, P<0.001) and severity (rs=-0.846, P<0.001). Conclusion： In the assessment of the relationship between the severity of coronary artery calcification and bone density in T2DM patients, coronary spiral CT scan can be used to reflect the bone density of patients by simultaneously detecting the CT value of thoracic cancellous bone, which further helps T2DM patients avoid multiple radiation examinations and save time and money.
		2023 Vol. 33 (02): 152-155,161 [Abstract] ( 32 ) [HTML 1KB] [ PDF 2141KB] ( 482 )

	156	Clinical characteristics of 26 cases with endocrine gland diseases related to programmed death receptor-1 (PD1) inhibitors in cancer patients
		WANG Qun1, JIANG Jinjin2, LU Zhiqiang2, ZHAO Lin2
		Objective： To explore the clinical characteristics of endocrine gland diseases related to programmed death receptor1 (PD1) inhibitors in cancer patients. Methods： From January 2020 to December 2020, 26 patients admitted by the Department of Endocrinology, Zhongshan Hospital affiliated to Fudan University were retrospected. All patients showed immune-related adverse events (irAEs) in endocrine system after the administration of PD-1 inhibitors due to cancers. The relationship and clinical features of PD-1 inhibitor induced endocrine gland damages were analyzed. Results： Of 26 patients, 19 were male (73.08%) and 7 were female (26.92%). The average age was (61.62±9.77) years. PD-1 inhibitorassociated hypophysitis was found in 18 cases (69.23%), among whom, the pituitary adrenal axis involvement was found in all cases, adrenal axis and thyroid axis involvement was found in 4 cases, and posterior pituitary lobe involvement was not found. PD-1 inhibitors associated primary thyroid dysfunction was found in 9 patients (34.62%). Related type 1 diabetes was found in 5 cases (19.23%). Autoimmune polyendocrine syndrome (APS) was found in 7 cases (26.92%), including 6 cases involving pituitary and thyroid gland, and 1 case involving pituitary and pancreas. PD-1-related primary adrenal hypofunction was not observed. Conclusion： The endocrine gland related indicators should be evaluated before and during the administration of immune checkpoint inhibitors (ICPis) in cancer patients to reduce misdiagnosis and missed diagnosis, improve safety during the immunotherapy, and enhance the patients′ quality of life.
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		2023 Vol. 33 (02): 156-161 [Abstract] ( 22 ) [HTML 1KB] [ PDF 772KB] ( 476 )

	162	Effect of advanced modeled iterative reconstruction on bronchial artery CT imaging in people with different body mass index#br#
		XU Junfeng, ZHANG Yanan, YIN Jianbing, LIU Jia, MING Jialei, CUI Lei
		Objective： To explore the effect of advanced iterative reconstruction algorithm (ADMIRE) on CT imaging of bronchial artery (BA) in people with different body mass index (BMI), and the best iterative reconstruction intensity was screened out. Methods： Fiftyone patients underwent BA CT imaging based on ADMIRE (intensity 1~5). According to BMI, they were divided into underweight group (BMI＜18.5 kg/m2)， normal weight group(18.5 kg/m2≤BMI＜24.0 kg/m2)， overweight group (BMI≥24.0 kg/m2). The BA diameter of the 3 groups and the subjective and objective scores of BA imaging quality under different ADMIRE intensities were compared to screen the optimal iterative reconstruction intensity. Results： There were no significant differences in the diameter of BA and the subjective and objective scores under the same ADMIRE intensity among the 3 groups (P>0.05). The image noise of each group decreased significantly with the increase of ADMIRE intensity, and the signal-to-noise ratio (SNR) and contrast to noise ratio (CNR) of normal weight group and overweight group increased significantly with the increase of ADMIRE intensity. Pair comparison of the same group showed that the SNR of the normal weight group under ADMIRE 5 intensity was statistically different from other iterative intensities and the SNR and CNR of the overweight group under ADMIRE 5 intensity were significantly different from other iterative intensities (P＜0.05). The subjective score of ADMIRE 4 in the overweight group was significantly higher than the iterative intensity of 1-3 (P＜0.05); the subjective scores of ADMIRE 4 and ADMIRE 5 in the normal weight group were similar (P>0 05), but the readability of ADMIRE 4 (96.3%) is higher than that of ADMIRE 5 (92.6%). Conclusion： The diameter of BA was not affected by BMI. ADMIRE 4 and ADMIRE 5 were recommended as the optimal iterative intensity level for displaying BA in the normal weight group and overweight group during BA CT imaging.
		2023 Vol. 33 (02): 162-166,173 [Abstract] ( 27 ) [HTML 1KB] [ PDF 1621KB] ( 534 )

	167	Authenticity identification of famous and precious animal medicine tortoiseshell by terahertz time-domain spectroscopy#br#
		JIANG Jun1,2, ZENG Yichen2, CHEN Zhiying2, PEI Dan3, HE Jinjin2, TANG Haifa4, CAO Yunfei3, CAI Hui1
		Objective： To establish a new method for identification of true and false tortoiseshells by terahertz timedomain spectroscopy and stoichiometry. Methods： The samples of authentic tortoiseshell and fake tortoiseshell from the redeared slider were selected for further experiments. The typical characteristics of the two samples were compared by classical character identification and microscope identification methods, and then the spectral information of the samples was measured by terahertz timedomain spectrometer. The sample spectra were smoothprocessed and baseline calibrated, and the data were analyzed by stoichiometric method to distinguish the authentic tortoiseshells from the fake tortoiseshells. Results： The results of character identification showed that there were only slight differences between intact and fake tortoiseshell samples, and little differences in fragments or powder. Microscopic identification of the two samples did not find obvious characteristic difference structure. After fast Fourier transform filter and orthogonal partial least square discriminant analysis, the terahertz timedomain spectral curves of the two samples showed significant differences. Conclusion： Terahertz timedomain spectroscopy combined with orthogonal partial least square discriminant analysis could achieve accurate identification of true and false tortoiseshells.
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		2023 Vol. 33 (02): 167-173 [Abstract] ( 29 ) [HTML 1KB] [ PDF 8985KB] ( 518 )

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		2023 Vol. 33 (02): 174-179,184 [Abstract] ( 23 ) [HTML 1KB] [ PDF 802KB] ( 543 )

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		2023 Vol. 33 (02): 180-184 [Abstract] ( 26 ) [HTML 1KB] [ PDF 762KB] ( 710 )

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