It is considered that the central nervous system (CNS) is an immunologically privileged organ, but its immunological privilege is not complete, and immunological rejection may also occurred after tissue transplantation. Neural stem cell (NSC) transplantation has developed a brand-new approach for the treatment of various CNS diseases. Despite the low immunogenicity of NSC, there are also troubles of immunological rejection. This article reviews the immunological characteristics of CNS, the mechanisms of immunological response and immunological rejection in CNS, as well as the problems of immunological rejection of NSC transplantation.

AIM To evaluate the changes of serum and brain tissue endoxin in model of bilateral cerebral hemisphere ischemic reperfusion injury, and effect of anti digoxin antiserum (an antagonist of endoxin). METHODS The bilateral cerebral hemisphere ischemic model was prepared by ligating three vascular by Kameyama's manner. SD rats were randomly divided into 7 groups and each group had 8 rats. Sham group, ischemic reperfusion group, negative control group, nimodipine group, low concentration anti digoxin antiserum group, middle concentration anti digoxin antiserum group, high concentration anti digoxin antiserum group. The blood was collected at the end of reperfusion, meanwhile rats were killed, and the bilateral cerebral hemisphere were took out and used to prepare encephlon homogenate and made into samples of light microscope. RESULTS Compared with sham group, the serum CK content increased; Brain tissue SOD activity reduced and MDA content increased importantly in ischemia reperfusion group; The levels of serum and brain tissue endoxin in ischemia reperfusion group were significantly higher, while ATPase activity in brain tissue decreased; Mitochondrial Ca 2+ content in brain tissue increased significantly and Mg 2+ content decreased significantly. In brain tissue,there was some inflammatory change and local necrosis;The rank order and structure of cell wasn't clear;The morphology of pyramidal cell was abnormal. Compared with ischemic reperfusion group, Anti digoxin antiserum reduced serum CK content; It antagonized lowering of SOD activity and increase of MDA content in brain tissue; It remarkably reduced the level of brain tissue endoxin; It reduced abnormal ion content of brain tissue mitochondrion induced by cerebral ischemic reperfusion injury; The high and middle concentration anti digoxin antiserum had a significant effect on raising brain tissue ATPase activity. It reduced neuron denaturation. CONCLUSION Cerebral ischemic reperfusion can increase the level of brain tissue and serum endoxin and higher endoxin can promote brain injury. Endoxin is a major factor involved in cerebral ischemic reperfusion injury. Anti digoxin antiserum can reduce brain tissue injury and had a protective and treatment effect on cerebral ischemic reperfusion injury by antagonizing the effect of endoxin.

BACKGROUND: It is conceivable that bone marrow stem cells can differentiate into smooth muscle cells (SMCs) and contribute to neointimal formation in atherogenesis. However, the mechanism remains unknown. The "milieu-induced-differentiation" hypothesis focuses on the key role of cell-to-cell contact and cytokine on the differentiation of stem cells. Bone marrow mesenchymal stem cells (MSCs) have the potential to differentiate into SMCs.OBJECTIVE: To induce MSCs into SMCs in vitro, and investigate the influence of the differentiated SMCs or cell factors on MSCs differentiation.DESIGN: Controlled experiment in vitro with repeated observation and measurement based on cells.SETTING: Department of Cardiology, First Hospital of Xi'an Jiaotong University.MATERIALS: The experiment was accomplished in the Laboratory of Cardiology, First Hospital of Xi'an Jiaotong University between May 2003 and May 2004. SD rats of either gender were provided by the Animal Center of Xi'an Jiao Tong University, 60-80 g, 90-110 g. The following antibodies were used: Mouse anti human SM-α-actin (NeoMarkers),Mouse anti human Calponin (NeoMarkers), TRITC-coupled goat anti mouse IgG antibody (SBA). Mouse anti rat CD34 conjugated FITC (Santa Cruz), Mouse anti rat CD71 conjugated FITC (Oxford Biotechnology), Mouse anti rat anti-CD90 conjugated PE (Oxford Biotechnology). Lipofectamine 2000 (Invitrogen). PEGFP-N3 (the laboratory).METHODS: Bone marrow mesenchymal stem cells were obtained from rat bone marrow by using percoll density gradient centrifugation. SMCs were isolated by using tissue explantation method. Flow cytometer was used to detect the immunofluorescence stain. Then MSCs and SMCs were identified. MSCs were transfected with pEGFP-N3 by Lipofectamine 2000, while untransfected MSCs were taken as controls. Conditioned culture of MSCs and SMCs: ①MSCs at passage 3 were seeded on chamber slides in a 12-well culture plate. The medium was DMEM containing 0%, 5%,7.5% fetal bovine serum (FBS) and SMCs conditioned medium containing 0%, 5%, 7.5% FBS, respectively. The cells were cultured for 10-14 days and immunofluorescence analysis was performed by using monoclonal antibodies against SM-α-actin, calponin.②Indirect co-culture of MSCs with SMCs were established using a semi-permeable membrane cell culture insert. The inserts were plated into culture well. SMCs were cultured on the inside of inserts while MSCs were added to the outside of inserts, respectively. MSCs were culture alone in medium containing 3%, 7.5% FBS and immunofluorescence analysis was performed by using monoclonal antibodies against SM-α-actin, calponin.③MSCs were transfected with pEGFP-N3. After 24 hours, the MSCs were cocultivated with SMCs at an equal density for 7-14 days.As a control, MSCs were cultured alone. MSCs co-cultured were stained with antibodies against calponin, SM-α-actin. MAIN OUTCOME MEASURES: ①Identification of MSCs by floe cytometer.②cytoplasmic antigen expression of SMCs. RESULTS: ①Immunofluorescence analysis showed that MSCs expressed SM-α-actin, but did not express calponin. As a control, SMCs expressed both SM-α-actin and calponin.②Flow cytometry showed that MSCs expressed CD71 of low level, CD90 of high level and no expression of CD34. ③The MSCs transfected with green fluorescence protein continued to express for 2-3 weeks. ④MSCs grew well in SMCs conditioned medium or different concentrations of FBS. Cell growth was FBS concentration dependent in indirect co-culture system of MSCs and SMCs. Several double-positive cells in direct co-culture system were detected enhanced green fluorescence protein and antibodies against calponin, SM-α-actin. CONCLUSION: ①SMCs conditioned medium and cell factor only promote MSCs growth and cytoplasmic granules increase. But these do not induce MSCs differentiate into SMCs. ②The cell-to-cell contact is essential for MSCs differentiation to SMCs.

Objective To observe the somatic embryogenesis in in-vitro cultured Dendrobium candidum wall.Ex Lindl.(DCWL),and to supply evidence for its rapid propagation and germplasm preservation.Methods Protocorm-like bodies and callus of DCWL subcultured for 30 days was used as the explants,N6 was used as the basic culture with phytohormone added,and fungal extracts as the elicitor.Protocorm-like bodies and callus of DCWL were used for induction culture.Results Somatic embryogenesis in in-vitro cultured DCWL derived from the epithelial cells or inner cells of callus of DCWL.Conclusion A large amount of buds can be obtained by the induction and culture of protocorm-like bodies and callus of DCWL.

Objective To examine the change of body weight (BW) and blood pressure (BP) in obese rats, clarify relationships between BP and BW and other factors. Methods Male Spraque-Dawley rats were fed either with normal diet (ND) or high calorie diet (HC) for 20 weeks. BW and BP of tail artery were observed biweekly and tetraweekly respectively; serum leptin and fasting insulin (FINS) were detected by enzyme-linked immunoadsordent assay (ELISA) and radioimmunoassay (RIA) respectively. Fasting plasma glucose (FPG) and free fatty acid(FFA) were measured by conventional means. Results BW, abdominal fat weight (AFW), ratio of abdominal fat weight to body weight (RF/W), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum levels of leptin and FINS, FPG, FFA increased in the HD group after 20 weeks diet intervention (P＜0.05 or P＜0.01). SBP was strongly correlated with BW, leptin, FINS and FFA (P＜0.05), DBP was correlated with FFA (r=0.47, P＜0.05). In addition, leptin was positively correlated with BW, AFW, RF/W, FINS and FFA (P＜0.05 or P＜0.01). Conclusion In this study of high calorie-diet induced rats, the gain of BW is accompanied by increased BP. The obese rats have hyperleptinemia, hyperinsulinemia, hyperglycemia and dyslipidemia which may have important effects on the development of obesity-related hypertension. RF/W is the key factor in which affect serum leptin level.

Objective To determine the utility of musculoskeletal ultrasound imaging to support physical findings in different stages of recovery and in recommending treatment regimens.Methods Forty-three hemiplegic stroke survivors with shoulder pain were enrolled.Physical examinations were performed 3 and 6 months after the stroke using a visual analogue scale (VAS),a modified Ashworth scale,measurements of passive range of motion and Brunnstrom staging.This was coupled with sonography of the long head of the biceps,the subscapularis tendon,the supraspinatus tendon,the infraspinatus tendon,the acromioclavicular joint and the subacromial-subdeltoid bursa.Results Three months after the stroke the average VAS score correlated negatively with the average Brunnstrom stage of the shoulders (r=-0.39,P≤0.01),with the range of passive abduction (r=-0.56,P≤ 0.01),the range of passive external rotation (r=-0.36,P≤ 0.02),and the range of passive flexion (r=-0.37,P≤ 0.02).It was positively correlated with abnormal sonographic findings of the long head tendon of the biceps (r=0.32,P≤ 0.04),the subscapularis tendons (r=0.31,P≤0.04) and the supraspinatus tendons (r=0.53,P≤0.01).However,3 months later the VAS results were negatively correlated with Brunnstrom stage (r=-0.45,P ≤ 0.01),range of passive shoulder abduction (r=-0.60,P≤0.01),range of passive external rotation (r=-0.41,P≤0.01),and passive range of flexion (r=-0.52,P≤ 0.01),but positively correlated with spasticity (r=0.34,P≤ 0.03),biceps tendinopathy (r=0.45,P≤0.01),subscapularis tendinopathy (r=0.33,P≤ 0.03) and supraspinatus tendinopathy (r=0.56,P≤ 0.01).Rotator cuff injury was significantly more severe 6 months after stroke than at 3 months.The incidence of pain in the hemiplegic shoulder and abnormal sonographic findings of the biceps tendon and subscapularis tendon were significantly higher at 6 months than at 3 months after the stroke.Supraspinatus tendon problems were notable both at 3 and 6 months.Conclusions Pain in a hemiplegic shoulder is positively correlated with abnormal sonographic findings but negatively correlated with Brunnstrom stages and passive range of motion 3 and 6 months after stroke.Six months after stroke,pain is positively correlated with muscle tone.The tendon at the long head of the biceps and the rotator cuff are vulnerable to injury,especially at 6 months after stroke.

Objective To investigate the change of plasma ghrelin level and explore the related factors of ghrelin alteration in elderly hypertensive patients with psychological distress. Methods A total of 300 elders, who were screened with Hamilton Anxiety Scale (HAMA), Hamilton Rating Scale for Depression (HAMD), and the Symptom Checklist-90 (SCL-90) for psychological stress and somato-psychological manifestations respectively, were divided into hypertension group (n=148) and non-hypertension group (n=152). Their blood samples were collected to measure the plasma level of ghrelin and total cortisol on the same day. Results The incidences of anxiety and depression were 27.7% and 11.7%, respectively, in all the enrolled elders. However, the rates of psychological distress, particularly anxiety, were significantly higher in the hypertensive elders than in the non-hypertensive ones (43.2% vs. 12.5%). Anxiety was positively related to the cortisol level but negatively related to the plasma ghrelin level, and the latter two were negatively correlated with each other. Conclusion Chronic increase of plasma cortisol induced by long-term anxiety can lead to the reduction of ghrelin level, which then adversely affects blood pressure in elders with psychological distress. Therefore, ghrelin might be a selective antihypertensive medicine for hypertensive elders with anxiety.

Objective: To acquire the main result quality indicators status of tertiary maternal and child health(MCH) hospitals in China, supporting the decision making. Methods: The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the management operation, inpatient death, re-return, hospital-acquired infection, surgical complications and patient safety of these hospitals in China in 2017. Statistical descriptions were made using average, rate and composition comparison data. Results: The proportion of health technicians of tertiary MCH hospitals in China was 83.66%, the average hospitalization days were 5.96 days, with bed occupancy rate of 90.01%. The success rate of neonatal resuscitation was high. Meanwhile, the mortality rate of hospitalized maternal critical illness, the total hospitalization mortality rate of neonatal patients, the incidence of complications in surgical patients, the incidence of neonatal injury and the incidence of birth injury in vaginal delivery were higher in the institutions that had not participated in the MCH hospital accreditation. Conclusions The management of tertiary MCH hospitals in China was in good condition, and the relevant policies and projects have achieved remarkable results. Compared with general hospitals, hospital infection and re-return indicators were good. The quality and safety of tertiary MCH hospitals which have not participated in the MCH hospital assessment were poor. It is recommended to carry out MCH hospital accreditation to improve quality and safety.

Objective:To analyze the status of secondary maternal and child health hospital accreditation in China and the impact of such accreditation on their service improvement.Methods:The paper used the propensity score matching method to match the accreditation group and the non-accreditation group in 1∶1 ratio, and compared the related indicators of service capability of maternal and child health hospitals between the two groups by non-parametric test and Chi-square test.Results:A total of 842 maternal and child health care hospitals were matched. A comparison was made between the accreditation group and the non-accreditation group, and the differences of the following indicators of individual services within the hospital were statistically significant( P<0.01). These indicators were annual emergency attendance, the number of types of health services for women and children, the utilization rate of beds, the average daily hospital bed of each practicing physician; the following indicators of service management within their coverage were statistically significant: namely the proportion of institutions carrying out health education evaluation within their coverage, that of institutions producing uniform " Mother and Child Health Handbook", that of institutions carrying out information quality control, as well as analysis and utilization.These indicators of the accreditation group were higher than those in the non-accreditation group( P<0.01). Conclusions:Given the role played by maternal and child health institution accreditation in promoting secondary maternal and child health hospital regarding better service content, quantity, efficiency and the quality of business management within their coverage, there is still room for improvement.

Objective:To acquire the impact of COVID-19 pandemic on the operation of tertiary maternal and child health(MCH) hospitals in China, for decision making support of health administrative departments and hospital managers.Methods:The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the resource allocation, workload, treatment quality, work efficiency and asset operation of the tertiary MCH hospitals in China in 2019(pre pandemic) and 2020(during pandemic). Statistical descriptions were made using median.Results:In 2019 and 2020, the number of tertiary MCH hospitals in China was 236 and 258, respectively, and their relevant data were analyzed. In terms of resource allocation, the number of health technicians in 2019 and 2020 was 560 and 548, respectively, and the actual number of available beds was 308 and 305 respectively. In terms of workload, the annual outpatient visits in 2020 were 337 990, a decrease of 23.6%from that in 2019; The total number of emergency visits was 28 997, a decrease of 32.5%; The total number of discharged patients was 13 673, a decrease by 20.5%; A total of 4 723 training sessions on MCH were held for primary institutions, an increase of 1.2 percent. A total of 1 953 724 primary-level health technicians were trained, an increase of 175.2 percent. In terms of work efficiency, the average length of hospital stay of discharged patients decreased from 5.56 days in 2019 to 5.00 days in 2020. Bed utilization rate decreased from 88.90% to 69.15%; Bed turnover decreased from 53.69 to 44.22. In terms of treatment quality, the critical illness mortality rate of inpatients was 0.37% in 2020, 0.11% lower than that in 2019. The in-hospital mortality rate for neonatal patients was 0.04%, a 0.03% drop. In terms of asset operation, the total revenue in 2020 was 248.355 million yuan, an increase of 4.46% compared with 2019, in which the proportion of financial subsidies increased from 11.26% to 15.72%.Conclusions:The in-hospital services and institutional health care services of tertiary MCH hospitals in China were downsized by the COVID-19 pandemic, while the work efficiency was relatively stable, along with acceptable resource allocation, good treatment quality and asset operation.