Aim To investigate the treatment effect of Tongxinluo(TXL)combined peripheral blood derived mesenchymal stem cells(PB-MSCs)transplantation on angiogenesis of HIF-1 /VEGF pathway and miR-21 0 in diabetic foot(DF)rats.Methods Seventy male Spra-gue-Dawley rats were fed with high-fat diet and given
combined streptozotocin injection to build diabetic rat model.The femoral artery and vein of right lower ex-tremity of modeled rats were ligatured to induce DF model.The normal rats in the same batch copied is-chemia model served as control group.The modeled rats were divided into 6 groups :model group ,TXL
group,Cilostazol group,PB-MSCs group,TXL com-bined PB-MSCs(T-MSCs)group and Cilostazol com-bined PB-MSCs(C-MSCs)group.After the treatment for 28 days,animal gastrocnemius muscle and serum were taken for detection,in which serum was used to detect VEGF-A and HIF-1 α by ELISA,and muscle was used to detect VEGF-A and VEGF-R2 by Western blot,and VEGF-A by RT-PCR.Results Compared with the control group,the expressions of VEGF-A, HIF-1 α,VEGF-R2 and miR-21 0 in the model group were significantly reduced(P <0.01 ).Compared with the model group,the expressions of VEGF-A,VEGF-
R2 and miR-21 0 in each treatment group were signifi-cantly increased(P <0.01 ),where the expressions of VEGF-A,HIF-1 α,VEGF-R2 and miR-21 0 in the T-MSCs were higher than these in the TXL,cilostazol and PB-MSCs group(P <0.05,P <0.01 ).Conclusion TXL combined with PB-MSCs transplantation may be regulated by HIF-1 /VEGF pathway and miR-21 0,pro-moting endothelial cell proliferation,differentiation, and promoting the formation of new blood vessels.

Objective To observe the effect of auricular point sticking on the sleep quality of patients undergone liver transplantation.Method The sleep quality was assessed by using sleep quality scale. The patients undergone liver transplantation were randomized into two groups, both receiving auricular point sticking, while the insomnia zone was selected in the observation group and non-insomnia zone was selected in the control group, 4 weeks as a treatment course.Result In 4 weeks after the transplantation, there were significant inter-group differences in comparing the scores of unfreshing sleep, difficulty falling asleep, nightmairs, medications, post-insomnia reactivity, and the total score of the self-rating scale of sleep (SRSS) (P＜0.05); in 2 months after the transplantation, there were significant differences in comparing the scores of sleep latency, sleep efficiency, sleep disturbance, sleep medications, daytime dysfunction, and the global score of Pittsburgh Sleep Quality Index (PSQI) between the two groups (P＜0.05), indicating that the sleep quality in the observation group was markedly improved. Three months after transplantation, there were no significant differences in comparing the sleep indexes between the two groups (P>0.05).Conclusion Auricular point sticking at the insomnia zone can markedly improve the short-term sleep disorder in patients after liver transplantation, and can reduce the dose of sleep medications.

【Objective】 To study the location effect of the Mc Ab G9 to human esophageal carcinoma in tumor bearing nude mice. 【Methods】 125　I-G9 was prepared by Chloramine-T method. The distribution of 125 　 I-G9 was detected at different time (24, 48, and 72 h) after peritoneal injecti on. The percentage of the injected dose per gram of tissue(%ID/g) and the ratio of Tumor/non-Tumor were calculated. 【Results】 The distribution of 125　 I -G9 in tumor at the third day was showed by autoradiography obviously higher th an in other organ/tissue (except blood) and the highest is at the 48 h. The T/NT values are 2-7. The autoradiography indicated that radioactivity concentrated in tumor tissue. The concentration in tumor edge is more obvious than in the ce nter. 【Conclusion】 125　I-G9 has a considerable targeting activity and can well locate in esophageal carcinoma tissue in tumor bearing nude mice.

Objective To investigate the changes in the expression of mitochondrial transcription factor A (mtTFA) during one-lung ventilation (OLV)-induced lung injury in rabbits.Methods Sixty healthy male New Zealand white rabbits,weighing 2.5-3.0 kg,were randomized into 2 groups (n =8 each):two-lung ventilation (TLV) group and OLV group.The animals were anesthetized with iv 3％ pentobarbital sodium 30 mg/kg and tracheostomized.A self-made double lumen catheter was then intubated.Bilateral lungs were ventilated for 3 h in group TLN.In group OLV the left lung was ventilated for 2 h followed by 1 h TLV.Arterial blood samples were taken for blood gas analysis immediately after the beginning of ventilation,at 1 and 2 h of ventilation,and immediately after the end of ventilation.The oxygenation index was calculated.The animals were sacrificed after the end of ventilation and the apex of the left lung was removed and then cut and stained with HE for microscopic examination.The pathological changes of the lung were scored.The expression of mtTFA in lung tissues was measured by Western blot.Results Oxygenation index was significantly decreased,lung injury score was increased,the expression of mtTFA was down-regulated in group OLV compared with group TLV (P ＜ 0.05).The pathological changes of the lung were aggravated in group OLV.Conclusion OLV induces lung injury by down-regulation of mtTFA expression in rabbit lung tissues.

Objective To investigate the effect of 5-azacytidine(5-AZA) on apoptosis of bone marrow mesenchymal stem cells(BMSCs).Methods BMSCs were isolated from bone marrow of mouse tibia and femur; the expression of MSC specific markers CD44 and CD90 in BMSCs was measured by immunofluorescence staining;BMSCs were cultured in vitro in the medium supplemented with 0,10 and 20 μmol/L 5-AZA for 48 hours.Cell apoptosis was measured with fluorescent labeled inhibitor of caspases (FLICA) apoptosis kit and 4',6-diamidino-2-phenylindole (DAPI) staining ;the expression of apoptosis-related proteins Annexin V and Caspase-3 in the treated BMSCs was detected by Western blot.Results In this study,BMSCs positively expressed MSC specific markers CD44 and CD90.DAPI staining and Caspase-3 staining both showed that 10 and 20 μmol/L 5-AZA markedly increased apoptotic rate of BMSCs;the apoptosis-positive rate in DAPI staining was (21.086 ± 2.601) ％,(34.467 ± 3.724) ％ and (46.512 ± 3.864) ％,the apoptosis-positive rate in Caspase-3 staining was (5.354 ± 0.735)％,(15.462 ± 2.385)％ and (28.190 ± 4.190)％ in the controls,10 and 20 μmol/L 5-AZA groups,and there were significant differences among the control group and 5-AZA treated groups(all P ＜0.01).Western blot assay showed that Annexin V and Caspase-3 were both markedly upregulated in 5-AZA treated cells;the relative level of Annexin V expression was(26.612 ±2.184)％,(42.873 ±4.313)％ and (50.056 ± 4.457) ％,the relative level of Caspase-3 expression was (19.231 ± 2.683) ％,(38.618 ± 5.385) ％ and(91.235 ± 7.116)％ in the controls,10 and 20 μmol/L 5-AZA groups,and there were significant differences among the control group and 5-AZA treated groups (all P ＜ 0.01).Conclusion The commonly used doses of 5-AZA can induce apoptosis of BMSCs.

Background: The rate of death among people living with HIV/AIDS has decreased significantly as a result of treatment with highly active antiretroviral therapy (HAART). However, the issues of drug induced toxicities and complexity of current HAART regimens has remained of great concern. The aim of this study was to determine factors influencing antiretroviral regimen changes among people living with HIV/AIDS in China. Methods: This retrospective study collected data through face-to-face interviews with people living with HIV/AIDS who were receiving HAART, and gathered relevant information from infectious disease hospitals. The following information were collected: social-demographic characteristics, antiretroviral therapies, CD4 cell counts, virus loads, reasons for changing medication and other related data. Mean and percentages were used to describe the frequency of regimen change among patients, and binary logistic regression was employed to test the factors influencing regimen change. Results: 1,123 people who had experienced regimen change were included in the analysis. On average, patients remained on HAART for 10.2 months before changing regimen, and the average CD4 cell count and viral load (VL) were 383.1 cells/μl and 28,132.4 copies/mL respectively when changing regimen. The reasons for modification were determined as treatment failure (52.5％), adverse reactions (32.3％), and other reasons including pregnancy (15.2％). There are significant differences in regimen change among people with different genders (P<0.001), modes of transmission (P<0.001), duration of HAART (P<0.001) and initial CD4 cell counts (P=0.0024). Males, drug users, people taking long-term medication, and those with lower initial CD4 counts when starting HAART tend to change regimen. Conclusion: Treatment failure was the main reason for the change of HAART regimen. Males, drug users, people on long-term medication and those with lower initial CD4 cell counts when starting HAART were most likely to change regimen.

ObjectiveTo observe the effect of early rehabilitation on patients with closed traumatic brain injury (TBI).Methods80 TBI patients were divided into rehabilitation group and control group with 40 cases in each group. The control group was treated with routine surgical and other treatments. The rehabilitation group was treated with limb exercise and daily living training, besides treatments mentioned above. The scores of degrees of neural damage, Fugl-Meyer Assessment (FMA), modified Barthel index (MBI) and disability rating scale, and complications within 3 months of two groups were compared.ResultsThe scores of degree of neural damage, FMA, MBI and disability rating scale, and rate of complication of the rehabilitation group were significantly different from that of the control group (P<0.05～0.01).ConclusionEarly rehabilitation can improve brain function and reduce complication incidence of TBI patients.

Objective To investigate the potential role of disc repositioning and condyle restoration in the treatment of type Ⅲ traumatogenic temporomandibular joint (TMJ) ankylosis. Methods Eight patients including four females and four males at age range of 7-22 years (mean 13.6 years) were enrolled in this study. The patients suffered from traumatogenic TMJ ankylosis for 1-12 years. The preoperative interincisal opening distances ranged from 2 mm to 10 mm. During surgery, the traumatogenic callus of the lateral condyle process was removed, the condyle process was formed, and then the dislocated disc was sutured to the articular capsule or soft tissues around. Results All patients were followed up for 6-38 months and the last follow-up examination showed that the average interincisal opening distance was 30 mm. No recurrence or TMJ symptoms were found during the period of follow-up. Conclusions Disc repositioning and condyle restoration has the advantages of simple procedures, minor trauma and little recurrence and proves to be a feasible and effective method for the treatment of type Ⅲ traumatogenic TMJ ankylosis.

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus (HIV) patients in whom antiretroviral therapy (ART) was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004-2016 were included and divided into two treatment groups-Group 1 (treatment time ≤ 3 years,n1 =5,218) and Group 2 (treatment time ＞ 3 years,n2 =4,200).Patient follow-up data,including age,cluster of differentiation 4 (CD4) count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl (interquartile range,77.0-282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2 (P ＜ 0.05).A significant interaction between group and time effects was observed (P ＜ 0.05) in total cholesterol (TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time (P =0.001).The initial CD4 count (odds ratio [OR] =0.756),female sex (OR =0.713),Zerit (d4T) (OR =1.443),TC (OR =1.285),and aspartate aminotransferase level (OR =1.002) were significantly associated with the survival time of dead patients with HIV (P ＜ 0.05).Additionally,the initial CD4 count (OR =1.456),age (OR =1.022),time interval (OR =0.903),patient's living status (OR =0.597),d4T (OR =2.256),and triglyceride (OR =0.930) and hemoglobin levels (OR =0.997) were significantly associated with the treatment time of HIV patients with drug withdrawal (P ＜ 0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

Objective:To explore the relationship between thyroid parenchymal echogenicity abnormalities and thyroid function evolution in health examination population.Methods:It was a cohort study. According to the inclusion and exclusion criteria, participants were selected from individuals who underwent thyroid color ultrasound and thyroid function tests at the Health Management Center of Tianjin Medical University General Hospital from January to December 2017. Data including age, gender, smoking history, alcohol consumption history, personal medical history, and thyroid function re-examination information were collected. Follow-up was conducted until the occurrence of thyroid function abnormalities or until the end of the follow-up period. The cumulative incidence rate and incidence density of thyroid function abnormalities were evaluated. Cox regression analysis was used to analyze the relationship between thyroid parenchymal echogenicity abnormalities and thyroid function evolution.Results:A total of 6 754 participants were included in this study, with an average age of (45.80±12.12) years, and females accounted for 42.7%. The mean follow-up time was 1.82 years, with a cumulative follow-up duration of 12 263 person-years. During the follow-up period, 154 new cases of thyroid function abnormalities occurred, with a cumulative incidence rate of 2.28% (95% CI: 1.94%-2.66%) and an incidence density of 12.56/1 000 person-years (95% CI: 10.66/1 000-14.69/1 000 person-years). The multivariate adjusted Cox regression analysis showed that individuals with thyroid parenchymal echogenicity abnormalities had a significantly increased risk of developing isolated thyroid stimulating hormone abnormalities and thyroid function abnormalities, with HR(95% CI) of 3.09 (2.02-4.73) and 2.92(1.96-4.33), respectively, both P<0.001. Stratified analysis showed that, except for body mass index <18.5 kg/m 2, current smoking, and current alcohol consumption, all other stratified factors showed a significant increase in the risk of thyroid function abnormalities in individuals with thyroid parenchymal echogenicity abnormalities. Conclusion:Thyroid parenchymal echogenicity abnormalities are important risk factors for the evolution of thyroid function abnormalities. Continuous monitoring of thyroid function should be given due attention.