Objective To study the metabolic alteration in the brain of patients with cyanosed congenital heart disease (CCHD) by using 1H magnetic resonance spectroscopy ( 1H MRS) and discover the pathophysiology of chronic hypoxic brain, which will help to diagnose and treat this disease completely. Methods Twenty five patients with CCHD and 25 controls were performed PRESS 1H MRS and MRI, The areas under the resonance of metabolites were measured, the ratios of the other metabolites to Cr were calculated and compared. Results In patients with CCHD, the mean value of NAA/ Cr was significantly lower than that in controls ( P 0.05). Conclusion 1H MRS can detect brain metabolic changes in patients with cyanosed congenital heart disease in vivo noninvasively and can detect the metabolism disorder of the energy and amino acid, so the pathophysiology of this disease can be understood.

Objective:To study the inhibitory effect of bone marrow mesenchymal stem cells (MSC) on the proliferation of allogeneic T lymphocytes in patients with acute leukemia and its mechanism. Methods: 30 patients with acute myeloid leukemia ( AML) ,30 patients with acute lymphoblastic leukemia ( ALL) ,and 30 healthy subjects ( healthy group) were selected. MSC cells were isolated and cultured in three groups. The expression level of MSC cells in three groups were determined by MSC assay. The inhibitory effect of MSC on the proliferation of T cells was detected by Transwell assay. Results: AML group supernatant TGF-β1,HGF levels were significantly lower than the ALL group and the healthy group (P<0. 05),significantly higher than the levels of IL-11 ALL group of AML group,healthy group ( P<0. 05 ); three groups MSC supernatant IL-6 levels difference was not statistically significant ( P>0. 05). AML,ALL,MSC cells secrete cytokines healthy group of T lymphocyte proliferation still had a significant inhibitory effect, inhibition of differences in the case of contact and not in direct contact co-culture of T lymphocyte proliferation was not statistically sig-nificant (P> 0. 05); after joining the MSC,T cell proliferation in the three groups was significantly inhibited upon addition of anti-TGF-β1 antibody,anti-HGF antibody after T cell proliferation effective than a simple reversal join MSC (P<0. 05). Conclusion:MSC for acute leukemia patients inhibit allogeneic T lymphocyte proliferation,functioning principle may be related to the secretion of cyto-kines.

BACKGROUND:Type 1 diabetes mel itus is an autoimmune disease, which is characterized as the selective destruction of pancreatic beta cel s in the body, resulting in the lack of insulin secretion. Umbilical cord blood stem cel s have the potential to differentiate into islet cel s in vitro and in vivo, which play a certain hypoglycemic effect. OBJECTIVE:To explore the effects of umbilical cord blood stem cel s on blood glucose levels and PDX-1 and MafA levels in the pancreatic tissue of type 1 diabetic rats. METHODS:Thirty Sprague-Dawley rats were randomly divided into three groups, with 10 rats in each group. In treatment and model groups, type 1 diabetes mel itus modes were established. After modeling, the treatment group was given a single tail vein injection of umbilical cord blood stem cel s;the normal control group was given the same volume of normal saline;the model group was given the same volume of umbilical cord blood stem cel buffer solution. Oral glucose tolerance test was adopted to assess the islet function of rats;hematoxylin-eosin staining was used to observe the pancreatic morphology of rats;western blot and PCR methods were employed to detect expressions of PDX-1 and MafA in pancreatic tissues at protein and mRNA levels. RESULTS AND CONCLUSION:(1) Compared with the normal control group, the levels of blood glucose in the model and treatment groups were significantly higher at 0, 30, 60, 90 minutes (P<0.05). At 120 minutes, the blood glucose level in the model group was significantly higher than that in the normal control group (P<0.05), but there was no difference between the treatment and normal control groups (P>0.05). (2) The number of islets in the model group was decreased, and the boundary was unclear and irregular;in the treatment group, the number of islets was decreased, but the boundary was stil clear. (3) The expressions of PDX-1 and MafA in the treatment group were similar to those in the normal control group (P>0.05), but significantly higher than those in the model group (P<0.05). These findings suggest that the umbilical cord blood stem cel transplantation can significantly reduce the blood glucose levels in type 1 diabetic rats, improve the function of islet and morphology of pancreas, and up-reuglate the expressions of PDX-1 and MafA.

Objective: To explore the application value on combined examination of blood levels of growth differentiation factor-15 (GDF-15) and NT-pro B-type natriuretic peptide (NT-proBNP) in patients after successful cardiopulmonary resuscitation (CPR) for their recent prognosis.
Methods: A total of 102 patients with sudden cardiac arrest and successful CPR in our hospital were enrolled. Blood levels of GDF-15 were examined at immediately, 12 h and 24-48 h after CPR respectively. According to GDF-15 levels, the patients were divided into 3 groups: Group A, the patients with GDF-15<1200 ng/L at all-time points,n=31; Group B, GDF-15 level consistently increasing and GDF-15>1200 ng/L at all-time points,n=35; Group C, GDF-15 level consistently increasing at 12 h and 24-48 h after CPR, while it was lower at 24-48 h than 12 h after CPR,n=36. Blood levels of NT-proBNP and left ventricular ejection fraction (LVEF) were also examined. The patients were followed-up for 6 months for post-CPR death.
Results: Blood levels of GDF-15 and NT-proBNP were related, NT-proBNP level was changing with GDF-15 varying. GDF-15 and NT-proBNP level was negatively related to LVEF (r=-0.530,P<0.001), the patients with GDF-15>1800 ng/L and NT-proBNP>400 pg/ml had the higher mortality than those had the lower levels of GDF-15 and NT-proBNP,P<0.05. Survival analysis presented that 6 months survival rate in Group B was lower than Group A and Group C,P<0.05; survival rate was similar between Group A and Group C,P>0.05.
Conclusion: Combined examination for blood levels of GDF-15 and NT-proBNP may better predict the recent prognosis in patients who received CPR.

BACKGROUND:Thrombospondin-1 is an important endogenous activator of transforming growth factor beta 1 in this experimental inflammatory kidney disease model. Transforming growth factor beta 1 is considered the major cytokine that causes tissue fibrosis in many different inflammatory disease processes, in particular in renal disease.
OBJECTIVE:To investigate the expression of thrombospondin-1 on renal fibrosis in rats.
METHODS:Healthy male Sprague-Dawley rats were randomly divided into sham surgery group and model group. In themodel group, right ureters of rats were ligated to construct models of renal fibrosis. 3 weeks after surgery, blood and urine were obtained weekly. Enzyme linked immunosorbent assay and Bradford method were used to detect the contents of serum creatinine,blood urea nitrogen and urinary protein. After rats were sacrificed, kidneys were fixed. Western blot assay was utilized to identify the expression of vascular endothelial growth factor, transforming growth factor beta 1 and thrombospondin-1 protein. Hematoxylin-eosin staining was applied to detect the changes in pathological structure of the kidney after surgery.
RESULTS AND CONCLUSION:(1) One week after model induction, urinary protein, serum creatinine and urea nitrogen levels were significantly higher in the model group than in the sham surgery group (P< 0.05). Three weeks later, the difference in each index was significant (P< 0.01), which showed that the injury of the kidney was aggravated. (2) Transforming growth factor beta 1 protein and thrombospondin-1 expression was significantly higher in the model group than in the sham surgery group, but vascular endothelial growth factor protein expression was significantly lower in the model group than in the sham surgery group. (3) Hematoxylin-eosin staining results demonstrated that severe pathological changes of renal tissue in rats were detected after ligation of renal tubule. (4) These results confirmed that thrombospondin-1 expression increased in renal tissue, and its expression was strongly associated with vascular endothelial growth factor protein and transforming growth factor beta 1, which may play an important role in the renal fibrosis.

BACKGROUND:Common strategies for preventing diabetic nephropathy include effective control of blood sugar and blood pressure, inhibition of the rennin-angiotensin system and lipid-lowering therapy, but it is often difficult to get the desired results. OBJECTIVE:To investigate the effect of transplantation of bone marrow mesenchymal stem cels on levels of blood glucose and urinary total protein in diabetic nephropathy rats. METHODS: Forty-five Sprague-Dawley rats were randomly divided into three groups (n=15 per group): normal control group, diabetic nephropathy group and stem cel transplantation group. Rats in the diabetic nephropathy and stem cel transplantation groups were given single use of 60 mg/kg streptozotocin to make diabetic nephropathy models. The same dose of citric acid-sodium citrate buffer was injected in the normal control group. After modeling, 200μL of bone marrow mesenchymal stem cel solution (2×106) was injected into the left ventricle of rats in the stem cel transplantation group, and then at 7 days after the first transplantation, the cel transplantation was conducted again. The same dose of serum-free L-DMEM was injected intracardialy into the rats in the normal control and diabetic nephropathy groups. Levels of urinary total protein and blood glucose were detected. RESULTS AND CONCLUSION:At 1, 4, 8 weeks after treatment, the urinary total protein and blood glucose levels were significantly higher in the stem cel transplantation group and diabetic nephropathy group than the normal control group (P < 0.05). At 1 week after treatment, the urinary total protein and blood glucose levels were significantly lower in the stem cel transplantation group than the diabetic nephropathy group (P < 0.05). At 4 and 8 weeks after treatment, the total urinary protein and blood glucose levels were slightly higher in the diabetic nephropathy group than the stem cel transplantation group, but there was no significant difference (P > 0.05). These findings indicate that bone marrow mesenchymal stem cel transplantation in diabetic nephropathy rats can get good results in a short period, significantly improve the blood glucose and urinary total protein levels, but the long-term treatment effect is poor.

Objective:To observe the protective effect of Zhicao Tea Mixture on Müller cells and the expression of inflammatory factors in mice with diabetic retinopathy.Methods:Seventy-five C57BL/6J mice were randomly divided into the normal control group, diabetes mellitus (DM) group, low concentrations group, medium concentrations group and high concentrations group, with 16 mice in each group. The diabetes model of mice in all groups except the normal control group were established by intraperitoneal injection of STZ (60 mg/kg). Four weeks after the successful modeling, the Zhicao Tea Mixture with low (30 ml/kg), medium (60 ml/kg) and high concentrations (120 ml/kg) were respectively administered by gavage. Weight and blood glucose of mice in each group were measured every two weeks. After 8 weeks, Western blot method was used to detect the mice retina Müller cells activation marker gelatinous fibrous acidic protein (GFAP). Immunofluorescence was performed to detect the expression GFAP and glutamine synthetase (GS). Real-time quantitative PCR (RT- qPCR) and ELISA were used to determine the mRNA and protein expression levels of mouse retinal VEGF, TNF-α, IL-1β and IL-6 respectively.Results:The weight of mice in the DM group was lower than that of the normal control group, and the blood glucose was increased. Zhicao Tea Mixture had no effect on the weight of DM mice, but had a significant hypoglycemic effect. The GFAP expression ( t=38.318, P<0.001) in the retina of mice in the DM group was increased and GS expression ( t=29.737, P<0.001) was decreased compared with the control group. The GFAP expression ( t=13.677, 19.387, 16.305; P<0.05) in the retina of mice in the low, medium and high concentrations group were decreased and GS expression ( t=5.170, 19.399, 6.705; P<0.05) were increased compared with the DM group. The expressions of retinal inflammatory factors VEGF, TNF-α, IL-1β and IL-6 in DM group all increased, while the expressions of the above-mentioned inflammatory factors in the retina of mice decreased in the low, medium and high concentrations group. Conclusion:Zhicao Tea Mixture can decrease the blood glucose of DM mice and reduces the diabetic retinal inflammatory response.

Objective To evaluate the efficacy and safety of 125I seed implantation combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (PHC).Methods 156 patients who had unresectable PHC seen from January 2012 to December 2015 in our unit were randomly assigned into the study group (76 patients) and the control group (80 patients).The study group of patients were treated with intra-hepatic implantation of 125I seed + TACE,and the control group of patients were treated with three dimensional conformal radiotherapy (3DCRT) + TACE.After ra diotherapy the two groups of patients underwent 2 to 3 times TACE treatment.The biomarker levels were compared between the two groups before and after treatment,and the short-term efficacy,clinical safety and 1 year survival rates were assessed.Results The success rates of the treatment for the two groups were both 100％.Patients in the study group were implanted with 1 016 125I seeds,with an average of (13.7 ± 2.5) seeds per patient.The two groups had no significant difference on short-term efficacy (P ＞ 0.05).The DCR,ORR and 1 year survival rates in the study group were 63.2％,92.1％,55.5％,and they were 61.3％,90.0％,58.1％ in the control group,respectively.There were no significant differences between these 2 groups (P ＞ 0.05).At 1 month after treatment,the two groups had no significant differences onAFP,IGF-Ⅱ and IGFBP-2 [(5.08±0.85) μg/L vs.(5.12 ±0.79) μg/L,(4.77 ±0.58) μg/L vs.(4.86 ±0.53) μg/L,(4.98 ±0.67) μg/L vs.(5.04 ±0.71) μg/L] (P＞0.05).There were no signif-icant differences on chemotherapy drug toxicities between the two groups (P ＞ 0.05).The incidence of radi-ation hepatitis in the study group was 1.3％,while the incidences of radiation dermatitis,hepatitis,gastriculcer in the control group were 5.0％,8.8％,2.5％,respectively.The radiation dermatitis incidence inthe study group was significantly lower than that of the control group (P ＜ 0.05).In the study group,2 pa-tients (2.6％) had their 125I seed slightly moved.Conclusion The short-term efficacy of 125I seed implan-tation plus TACE in the treatment of PHC is no less than the 3DCRT + TACE regimen,but with less radia-tion side effects.

BACKGROUND:Nanocomposite hydrogel has great research prospects and application potential in the treatment of osteoarthritis. OBJECTIVE:To review the research progress of nanocomposite hydrogel in osteoarthritis and cartilage repair. METHODS:Databases such as CNKI and PubMed were searched.The English key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,electrostatic interaction,covalent crosslinking",and the Chinese key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,physical encapsulation,electrostatic effect,covalent cross-linking".After an initial screening of all articles based on inclusion and exclusion criteria,71 articles with high correlation were retained for review. RESULTS AND CONCLUSION:In cell or animal experiments,nanocomposite hydrogel has the effect of improving osteoarthritis.Nanocomposite hydrogel can promote cartilage repair,improve the internal environment of osteoarthritis,and achieve the therapeutic purpose of osteoarthritis by improving the mechanical environment between joints,carrying targeted drugs,and promoting the chondrogenesis of seed cells.At present,the research of nanocomposite hydrogel in osteoarthritis disease still has a huge space to play.It is expected to open up a new way for the clinical treatment of osteoarthritis by continuing to deepen the research of material preparation and actively carrying out cell and animal experiments.

Danggui Buxuetang， derived from Clarifying Doubts about Damage from Internal and External Causes （Volume 2）： Treatise on Heat Injury to Stomach Qi（《内外伤辨惑论卷中·暑伤胃气论》） by LI Dongyuan in the Jin and Yuan dynasties， is a classic and famous formula for tonifying qi and generating blood that has been inherited and promoted by successive generations of medical practitioners and has been included in the "Catalogue of Ancient Classical Prescriptions （First Batch）" published by the National Administration of Traditional Chinese Medicine in 2018. The paper analyzed the historical origin， composition， dosage， processing， preparation， decocting， and taking methods， efficacy， and application of the classic formula Danggui Buxuetang by consulting ancient and modern literature and combining the key information examination principles of ancient classic prescriptions. A total of 604 pieces of information on relevant ancient literature were collected， including 186 ancient Chinese medical books， of which 40 （five in the Jin and Yuan dynasties， 19 in the Ming Dynasty， and 16 in the Qing Dynasty） had detailed records of composition， processing， and dosage. Danggui Buxuetang is mainly comprised of Astragali Radix and Angelicae Sinensis Radix. According to the ancient and modern dose conversion， there are 37.3-38.1 g of Astragali Radix and 7.5-7.6 g of Angelicae Sinensis Radix in the formula. Astragali Radix is preferably fried with honey and Angelicae Sinensis Radix with wine. Astragali Radix and Angelicae Sinensis Radix are decocted with 600 mL of water to 300 mL， and taken warm before meals. The main effect of this formula are described in ancient books as blood deficiency and fever， with symptoms of muscle fever， dryness and heat， irritability and thirst， red eyes and face， sleeplessness in daytime and night， and surging and feeble pulse which is weak under hard pressing， and it is a famous formula for replenishing qi and generating blood. Modern research shows that Danggui Buxuetang is commonly used in the treatment of various kinds of anemia， diabetic nephropathy， tumors， and cardiovascular and cerebrovascular diseases. The above research results can provide a reference for the subsequent development and research on the classic formula Danggui Buxuetang.