Objective To observe the effect ofmycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome.Methods From June 2009 to June 2010,67cases of old patients with refractory nephrotic syndrome were divided into two groups by random digits table,32 cases in control group were treated with cyclophosphamide combined with prednisone and 35 cases in observation group were treated with mycophenolate mofetil combined with predrisone.The clinical effect and the levels of urinary protein,serum creatinine and serum uric acid between two groups were compared.Results There was no significant difference in total effective rate between two groups [68.8％(22/32) vs.74.3％ (26/35)] (P ＞ 0.05 ).After treatment,the levels of urinary protein,serum creatinine and serum uric acid in two groups were decreased (P＜ 0.05 ),but there were no significant differences between two groups (P ＞ 0.05 ).The adverse reaction rate in observation group was significantly lower than that in control group (P ＜ 0.05).Conclusion Mycophenolate mofetil combined with prednisone in treatment of old patients with refractory nephrotic syndrome has good effect and low adverse reaction,and it can be applied in clinic.

BACKGROUND:Lumbar fusion is a conventional effective measure to treat spondylolisthesis, spinal stenosis or with deformity. Bilateral pedicle screw fixation is recognized as the standard treatment for various spinal disorders, and has biomechanical and clinical advantages. OBJECTIVE:To evaluate the effects of bilateral pedicle screw fixation in the repair of lumbar disc herniation to restore disc height from the angle of imaging. METHODS: Clinical data of 42 patients with lumbar disc herniation were retrospectively analyzed. They al received bilateral pedicle screw fixation. Pain was evaluated before implantation, immediately and 1 month after implantation using Japanese Orthopaedic Association score of lower back pain and visual analog scale score. X-ray including anteriorposterior and lateral films of lumbar spine and MRI were used. CT was utilized to verify screw placement conditions and complications. RESULTS AND CONCLUSION:A total of 42 patients were folowed up for 3-6 months. Compared with pre-implantation, Japanese Orthopaedic Association score and visual analog scale score were significantly improved immediately after implantation (P < 0.01). There was no significant difference in Japanese Orthopaedic Association score between 1 month and immediately after implantation (P > 0.05). The height of intervertebral discs was significantly higher immediately and 1 month after implantation than pre-implantation (P < 0.01). The symptoms were lessened after fixation in al cases, and their qualities of life elevated. At 1 month, X-ray films and CT images revealed that no screw loosening, breakage or displacement occurred. The height of intervertebral discs was perfectly restored. No adverse events appeared in patients. These data indicate that bilateral pedicle screw fixation for lumbar intervertebral disc herniation can effectively restore the height of intervertebral discs, improve clinical symptoms and have biological and clinical superiority.

Objective To compare and analyze the changes of CEA,CA19-9,CA72-4 in different pathologictypes of gastric cancer.Methods 93 patients with gastric cancer were divided into different groups according to the histological types,pathologic types and TNM staging.The levels of CEA,CA19-9,CA72-4 of the patients were measured,then the results were compared and analyzed.Results The level of serum tumor marker of the moderately differentiated group was obviously higher than that of well-differentiated group(P ＜ 0.05),while the level of serum tumor marker of the poorly differentiated group was obviously higher than that of moderately differentiated group (P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between the well-differentiated group,moderately differentiatedgroup and poorly differentiated group were statistically significant(F =61.433,57.882,125.547,all P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between patients of TMN Ⅰ stage,TMN Ⅱ stage,TMN Ⅲ stage,TMN Ⅳstage were statistically significant(F =189.624,95.236,80.342,all P ＜ 0.05).The difference of serum tumor marker between different histological groups was not statistically significant (all P ＞ 0.05).Conclusion The concentration of serum CEA,CA19-9,CA72-4 will be higher if the gastric tumor is poorly differentiated or invades deeply,but the concentration of serum tumor has nothing to do with the histological types of the tumor.

Objective To study the application of carcinoembryonic antigen (CEA),carbohydrate antigens19-9 (CA19-9) and carbohydrate antigens72-4 (CA72-4) in the diagnosis of gastric cancer.Methods A total of 78 patients with gastric cancer underwent treatment in our hospital from August,2007 to June,2011 were enrolled as the case group.A total of 78 patients with benign gastric diseases and 78 healthy residents of the same period and district were randomly selected as the benign group and healthy control group,respectively.Measurements of serum CA72-4,CA19-9,CEA of all the cases and control group were performed.And the measurements of the three groups were statistically compared.Results The Serum concentration of CA72-4,CA19-9,CEA were significantly higher than the other two groups [CEA:(27.56 ± 18.36) μg/L vs (2.44 ±0.97) μg/L vs (2.37 ± 1.25) μg/L,F =145.346,P ＜0.0001 ; CA19-9:(99.87 ±80.53) kU/L vs (18.21 ±10.36) kU/Lvs (17.48 ±9.66) kU/L,F=78.503,P＜0.0001; CA72-4:(56.13 ±39.26)kU/L vs (5.77 ±2.95) kU/L vs (3.62 ±2.18) kU/L,F =133.892,P ＜0.0001].And the positive rate of the gastric cancer group were significantly higher than those of the other two groups [CEA:69.23％,10.26％and 7.69％; CA19-9:57.69％,23.07％ and 20.51％; CA72-4:83.33％,10.26％ and 8.97％].The combination of the 3 measurements obtained the highest accuracy of diagnosis,while for single measurement,CA72-4 had the highest accuracy.Conclusion CEA,CA19-9 and CA72-4 have a significant meaning in the early diagnosis of gastric cancer,which has high sensitivity and specificity.The detection rate of the gastric cancer will be improved if the test of CEA,CA19-9 and CA72-4 are combined.

Objective To reveal inpatient service utilization and medical burden in disease-caused poor rural families,for policy references.Methods By means of convenience sampling method,face-toface interview was made to inpatients from such families in Miyi County of Sichuan Province,Binhai County of Jiangsu Province and Xingtai County of Hebei Province.Results Totally 453 effective questionnaires were collected,with an effective rate of 96.7％.Respondents feature low income and fund raising capability,while 75.3％ of them pay their inpatient costs out-of-pocket,17.7％ pay with loans from others and 7.1％ pay by financial assistance from relatives;but they tend to go to higher level hospitals and have higher financial burdens for diseases.Conclusions Rural hospitalization resources should be optimized and integrated,levels of the New Rural Cooperative Medical System be improved,the catastrophic health care system be perfected and the health insurance coverage be gradually expanded for the low-income and marginalized population.

BACKGROUND:Compared with traditional autogenous bone graft, composite, as the carrier of seed cells, possesses advantages of fewer traumas and no limitation of donor site in repairing bone defect.OBJECTIVE: To observe the ability of the composite of β-tricalcium phosphate artificial bone-hyaluronic acid-type I collagen (β-TCP/HA/COL-I), as induced bone marrow stromal cell (MSC) carrier, to repair rabbit radial defect, and the feasibility with the composite as bone substitute material.DESIGN: A randomized and controlled trial.SETTING: Department of Orthopaedics, Renmin HospitaL, Wuhan University.MATERIALS; The study was conducted in the Department of Orthopaedics Renmin Hospital, Wuhan University between September 2003 and July 2004. Thirty-one New Zealand big white rabbits, aged 6 months, with body mass of 1.5 to 2.0 kg were enrolled in this study. The rabbits were randomized into control group (n =4) and experimental group (n =27).METHODS : ①In vitro induction and culture of MSCs was performed on 31 white rabbits, and the alkaline phosphatase (ALP) positive ratio of induced MSCs was observed. The structure of β-TCP/HA/COL-I was observed under scanning electron microscope. ② A 2 cm radial defect was created through operation. Eight weeks later, composites of β-TCP/HA/COL-I/MSCs were implanted into one side of rabbits in the experimental group, and autogenous bone was implanted into the other side. Rabbits in the control group were untouched. ③All the animals in the experimental group were randomly sacrificed at postoperative 4,8 and 12 weeks, 6 rabbits at 4 and 8 weeks, 15 at 12 weeks; Animals in the control group were sacrificed at 12 weeks. Gross observation, X-ray photographing, haematoxylin-eosin (HE) dyeing, and assessment of inorganic ingredient were performed. Osteogenic area and biomechanical tests were performed at 12weeks. Repairing effects on bone defect in each group were compared.MAIN OUTCOME MEASURES: The ALP positive ratio of induced MSCs; The structure of composite ofβ-TCP/HA/COL-I;Gross observation; X-ray photographing; HE dyeing and assessment of inorganic ingredient; Osteogenic area and biomechanical tests.RESULTS: All the 31 rabbits entered the stage of result analysis. ① The ALP positive ratio of cells reached 75% after induction and culture. ② Scanning electron microscope observation showed that 3 kinds of materials with abundant cellular structure distributed evenly. ③ The osteogenic area at 12 weeks was (72.5±3.6)% and (76.7±6.2)% in the experimental group and autogenous group, respectively (P ＞ 0.05). ④The maximum bending moment was (521.0±61.1) and (554.3±53.3)N·mm in the experimental group and control group, respectively; The maximum displacement at point of application of force was (0.816±0.071)and (0.870±0.103)respectively, without significant difference (P ＞ 0.05). ⑤Inorganic ingredient in the composite was 75%, 57% and 42% at 4,8 and 12 weeks respectively, suggesting that the inorganic component in the material was gradually decomposed with the elongation of time. ⑥Results of gross observation,X-ray photographing, histopathological examination, biomechanical test showed that with the elongation of time, composite of β-TCP/HA/COL-I/MSCs could repair bone defect in the experimental group, while bone defect in the control group had not been repaired.CONCLUSTON: Composite of β-TCP/HA/COL-I /MSCs possesses the same effect on repairing bone defect as autogenous bone, so it may be used as autogenous bone graft substitute.

BACKGROUND:Stem cels are induced to differentiate into endothelial-like cels that can be used for the treatment of diabetic lower extremity vascular disease. However, it is unclear whether these endothelial-like cels can completely replace endothelial cels to improve vascular disease and what are the differences between endothelial-like cels and endothelial cels. OBJECTIVE:To explore the differences and similarities between endothelial-like cels and human umbilical vein endothelial cels in the aspects of morphology, function, and viability. METHODS:Umbilical cord mesenchymal stem cels and umbilical vein endothelial cels were isolated, cultured and identified using flow cytometry and immunohistochemical method. Isolated umbilical cord mesenchymal stem cels were induced in DMEM-LG/F12 containing 10 μg/L vascular endothelial growth factor, 10 μg/L basic
fibroblast growth factor and 2% fetal bovine serum to differentiate into endothelial-like cels folowed by immunohistochemical identification. To compare endothelial-like cels with human umbilical vein endothelial cels, cel migration detection, active substance measurement and three-dimensional angiogenesis test were performed. RESULTS AND CONCLUSION:Isolated umbilical cord mesenchymal stem cels strongly expressed the surface markers of mesenchymal stem cels, and human umbilical vein endothelial cels strongly expressed CD31 and VWF. After induction, the umbilical cord mesenchymal stem cels were identified to highly express CD31 and VWF. Through cel migration, active substance and three-dimensional angiogenesis tests, endothelial-like cels were similar to endothelial cels in the function and activity, and superior to endothelial cels. Cite this article:Hao XJ, Hao HY, Zhu MJ, Yuan Z, Li WW, Chen J, Zhu LY. Endothelial-like cels versus human umbilical vein endothelial cels. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):83-88.

Objective To discuss the relationship between various T lymphocyte subsets apoptosis and disease progression in chronic antiretroviral-naive HIV/AIDS patients. Methods Thirty-six chronic antiretrovi-ral-naive HIV-infected individuals as well as 16 healthy HIV-negative controls were performed in this study. Ac-cording to the CD4~+ T cell counts, all the patients were divided three groups: < 200/μl, 200-350/μl and > 350/μl. After the peripheral blood mononuclear cells(PBMC) were isolated, T lymphocyte subpopulations were determined by the expression of CD45RO and CD27, and the apoptosis of different T cell subsets were measured by Annexin V staining, then analyzed by flow cytometry. To investigate whether the apoptosis of T cells varied with the culture time in vitro, 4 healthy controls and 4 patients were chosen as subjects, and the lev-els of cell apoptosis were analyzed at the culture time points of 0, 3, 6, 12, 24 h. Results (1)The percenta-ges of the AnnexinV expression on CD4~+ and CD8~+ T cells and all the subsets in HIV/AIDS patients were sig-nificantly higher than that in the healthy controls (P<0.05), but there were no significant differences among the three HIV-infected patient groups(P>0.05). (2) No significant correlations were observed between the levels of apoptosis of all the T cells and subsets and total CD4~+ T cell counts(P>0.05) ,nor with the HIV viral load (P>0.05). (3)As the culture time prolonged in vitro, the levels of apoptosis and necrosis of CD4~6 T cells in HIV/AIDS patients were significantly higher than those in the healthy conlrols, and the CD4~+ T cells were more susceptible to apoptosis and necrosis compared with CD8~+ T cells. Conclusion The levels of T cell apoptosis in HIV/AIDS patients was significantly higher than those in the healthy controls, at the same time, CD4~+ T cells were more susceptible to apoptosis and necrosis compared with CD8~+ T cells, but no correlation was found between the T cell apoptsis and disease progression.

AIM: To investigate the effects of Hua Yu Dao Zhi decoction (HYDZD) on renal interstitial fibrosis induced by gentamicin in rats. METHODS: 32 healthy male Wistar rats were randomly divided into 3 groups: control group (n=6), gentamicin group (n=13) and HYDZD+gentamicin group (n=13). The renal tubulointerstitial fibrosis in rats was induced by gentamicin for 9 d. All rats were sacrificed on 30 d after modeling and renal tissues were stained with HE. The renal indexes were calculated and the changes of serum creatinine, blood urea nitrogen, total urinary protein in 24 h, and the level of α-SMA, Smad2, Smad7 were detected. RESULTS: Compared to control group, it was observed that there was mainly necrosis and partly degeneration in the renal tubular epithelial cells, proliferation of fibroblasts and infiltration of the inflammatory cells in the interstitial substance in gentamicin group under the light microscope. The renal indexes, serum creatinine, blood urea nitrogen, total urinary protein in 24 h, and the level of α-SMA, Smad2 were significantly higher than those in control group (P<0.01) and the level of Smad7 was significantly lower than that in control group (P<0.01). Under the light microscope, the results of all mentioned above in HYDZD+gentamicin group were improved significantly (P<0.01), the level of α-SMA, Smad2 were significantly lower than those in gentamicin group (P<0.01). However, no significant difference of Smad7 protein expression between gentamicin group and HYDZD+gentamicin group was observed (P>0.05). CONCLUSION: HYDZD is very effective in preventing and treating renal interstitial fibrosis caused by gentamicin with the decreased level of Smad2.

BACKGROUND:No studies currently focus on the measurement of daily water loss under certain physical activity level continuously and precisely.
OBJECTIVE:To provide evidence for daily water requirement in Chinese young men based on the measurement of the daily water loss in Chinese young men under moderate physical activity.
METHODS:Twenty male subjects were enroled, and 23-hour whole-body sweat loss and urine output were measured using high-precision body weighting scale in whole-room indirect calorimeter. The results were converted to daily (24-hour) water requirement to determine the daily water requirement. Daily whole-body sweat loss per unit body weight, daily whole-body sweat loss per unit fat free mass and daily whole-body sweat loss per unit surface area were calculated.
RESULTS AND CONCLUSION:In Chinese young men, daily water loss was (3 339.7±509.9) g, daily urine output was (1 982.9±449.5) g and daily whole-body sweat loss was (1 356.7±215.6) g. There was a linear correlation between water intake and water loss (r=0.616,P < 0.05). Daily whole-body sweat loss per unit body weight was (21.0±3.6) g/kg, daily whole-body sweat loss per unit fat free mass was (25.8±3.9) g/kg and daily whole-body sweat loss per unit surface area was (799.4±129.4) g/m2. Daily water requirement of Chinese young men under moderate physical activity is approximately 3 340g, and moreover, water loss increases with the increase of water intake.