BACKGROUND:The mechanism and effect of glycogen synthase kinase 3β(GSK-3β) in the differentiation of cardiac stem cel s into cardiomyocytes are stil unclear, although GSK-3βis closely related to the life activities of cel s.
OBJECTIVE:To investigate the changes of GSK-3βexpression in the treatment of myocardial infarction in rats undergoing cardiac stem cel transplantation.
METHODS:The isolation and culture of cardiac stem cel s were performed in 10 neonatal rats. Lentivirus overexpressing GSK-3βor LacZ (control) was constructed and transferred into cardiac stem cel s. Animal model of myocardial infarction was made in 30 Sprague-Dawley rats. Six weeks after model preparation, rat models were assigned into GSK-3β, LacZ or PBS group. GSK-3βor LacZ overexpressing cardiac stem cel solution or PBS in equal volume was injected into the rat myocardium, respectively. Four weeks after transplantation, the cardiac function and myocardial col agen production in rats were detected and compared.
RESULTS AND CONCLUSION:Compared with the other two groups, the left ventricular ejection fraction was significantly higher, and the left ventricular end diastolic diameter was significantly lower in the GSK-3βgroup (P<0.05). Hydroxyproline content, type I col agen mRNA, and type III col agen mRNA expression were significantly lower in the GSK-3βgroup than the other two groups (P<0.05). Findings from Masson staining showed that the content of blue-stained col agen was significantly lower in the GSK-3βgroup than the LacZ group. Moreover, lowest myocardial infarction size was found in the GSK-3βgroup (P<0.05). Al these experimental findings show that GSK-3 overexpression plays a positive role in promoting the therapeutic effect of cardiac stem cel transplantation.

Objective: To investigate the efifcacy and safety of low dose erythropoietin (EPO) for treating the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention procedure.
Methods: A total of 80 patients of acute STEMI with successful PCI were randomized into 2 groups. EPO group, the patients received intravenous EPO 6000 IU in 100 ml of normal saline at immediately and 2, 4 days after PCI. Control group, the patients received 100 ml of normal saline at the same time points. n=40 in each group. The patients were followed-up for 6 months for routine blood test, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), the size of infarction, and plasma levels of BNP, hemoglobin. The major adverse cardiovascular events (MACE) and EPO related side effects were compared between 2 groups.
Results: The baseline condition was similar between 2 groups. With 6 months of treatment, EPO group showed obviously improved LVEF at 4 days after PCI, and decreased size of infarction, all P<0.05, while those indexes were similar in Control group, all P>0.05. In EPO group, with 6 months of treatment, LVESVI decreased from (49.76±32.65 ) ml/m2 to (34.78±19.98)
ml/m2, LVEDVI decreased from (92.23±27.65) ml/m2 to (84.52±25.76) ml/m2, all P>0.05, and in Control group, LVEDVI increased from (91.78±41.67) ml/m2 to (93.71±31.25) ml/m2, P>0.05. The incidence of MACE and EPO related side effects were similar between 2 groups, P>0.05.
Conclusion: Low dose EPO administration was effective and safe for treating AMI patients after PCI procedure.

Objective? To construct a multidisciplinary nutrition management model of stroke patients with nasal feeding based on Omaha system and to evaluate its effects. Methods? With the core of nutrition management of stroke patients with nasal feeding and based on patients' needs in hospitals, communities and families, we constructed a comprehensive assessment scale which included Omaha nursing problems of patients, intervention and outcome evaluation. And then, we carried out standardized intervention under the guide of the scale. From December 2017 to February 2018, we selected 65 stroke patients with nasal feeding from Taiyuan City Centre Hospital in control group (routine intervention) by convenience sampling. From March to May 2018, we selected 65 patients from Taiyuan City Centre Hospital in intervention group (nutrition management model intervention based on Omaha system). We compared the nutrition condition two weeks after catheterization and incidence of nasal feeding related complications one month after catheterization of patients between two groups respectively. We also evaluated the scores of Omaha cognition, behavior and condition of patients at catheterization, two weeks and one month after catheterization. Results? The serum albumin and nutritional status scores of the two groups of stroke patients were significantly different two weeks after intubation (P＜0.05). One month after intubation, the intervention group had diarrhea, aspiration pneumonia, constipation and accident. The incidence of extubation was significantly lower than that of the control group, and the difference was statistically significant (P＜0.05), but the improvement of vomiting and occlusion was not obvious, and the difference was not statistically significant (P＞0.05). In intervention group, patients' scores of Omaha cognition, behavior and condition of patients two weeks and one month after catheterization all increased with statistical differences (P＜0.05). Conclusions? Problems classification system of Omaha system can systematically and comprehensively evaluate the nursing problems among stroke patients with nasal feeding which helps assessors to find the neglected problems in traditional nursing and provides direction for formulating targeted intervention. Assessment for nursing outcomes promotes nurses to dynamically master patients' needs and improves patients' nutrition condition and incidence of complications. Therefore, nutrition management model of stroke patients with nasal feeding based on Omaha system is suitable for whole process management of stroke patients with nasal feeding which is worthy of being explored and popularized.

Purpose: Ischemic brain injury results in high mortality and serious neurologic morbidity. Here, we explored the role of SNHG15 in modulating neuronal damage and microglial inflammation after ischemia stroke. Materials and Methods: The hypoxia/ischemia models were induced by middle cerebral artery occlusion in mice and oxygenglucose deprivation/reoxygenation (OGD/R) in vitro. Quantitative real-time PCR (qRT-PCR) and Western blot were conducted to determine the levels of SNHG15, miR-302a-3p, and STAT1/NF-κB. Moreover, gain- or loss-of functional assays of SNHG15 and miR-302a-3p were conducted. MTT assay was used to evaluate the viability of HT22 cells, and the apoptotic level was determined by flow cytometry. Furthermore, enzyme-linked immunosorbent assay was performed to detect oxidative stress and inflammatory mediators in the ischemia cortex and OGD/R-treated BV2 microglia. Results: The SNHG15 and STAT1/NF-κB pathways were both distinctly up-regulated, while miR-302a-3p was notably down-regulated in the ischemia cortex. Additionally, overexpressing SNHG15 dramatically enhanced OGD/R-mediated neuronal apoptosis as well as the expression of oxidative stress and inflammation factors from microglia. In contrast, knocking down SNHG15 or overexpressing miR-302a-3p relieved OGD/R-mediated neuronal apoptosis and microglial activation. Moreover, the rescue experiment testified that overexpressing miR-302a-3p also attenuated SNHG15 up-regulation-induced effects. In terms of the mechanisms, SNHG15 sponged miR-302a-3p and activated STAT1/NF-κB as a competitive endogenous RNA, while miR-302a-3p targeted STAT1 and negatively regulated the STAT1/NF-κB pathway. Conclusion SNHG15 was up-regulated in the hypoxia/ischemia mouse or cell model. The inhibition of SNHG15 ameliorates ischemia/hypoxia-induced neuronal damage and microglial inflammation by regulating the miR-302a-3p/STAT1/NF-κB pathway.

Objective To identify the risk factors associated with recurrent urinary tract infection (RUTI) in children with neurogenic bladders (NB) who received clean intermittent catheterization (CIC) in order to provide recommendations for reducing the risk of RUTI.Methods Records of 184 children with NB managed by CIC at the Department of Urology Surgery,the First Affiliated Hospital of Zhengzhou University from July 2011 to September 2015 were reviewed and analyzed.According to UTI incidence,they were divided into 2 groups as occasional UTI group (0-1 time/year,OUTI group) and RUTI group (＞ 1 time/year).The clinical and urodynamic data were compared between 2 groups,and the risk factors were identified by regression analysis.Results Of the total patients,147 patients (79.9％) were diagnosed as OUTI and 37 cases (20.1％) as RUTI.Median follow-up lasted for average 27 months (12-39 months).The characteristics of RUTI group was indicated significantly in the study,which included increasing age(7.4 years old vs.5.9 years old),a higher level of spinal lesions,and more vesicoureteral reflux(VUR),and there were significant differences in bladder wall thickness(4.7 cm vs.3.6 cm) and lower bladder compliance compared with RUTI group (all P ＜ 0.05).But there was no statistical significance in gender,antibiotics,hydronephrosis,incontinence,bladder capacity,detrusor overactivity,detrusor sphincter dyssynergia and detrusor leakage point pressure between 2 groups (all P ＞ 0.05).Increasing age,increased bladder wall thickness,lower bladder com-pliance and the presence of VUR were independent risk factors associated with RUTI group (all P ＜ 0.05).Conclusions Increasing age,increasing bladder wall thickness,lower bladder compliance and VUR are the risk factors for RUTI in NB children managed with CIC.It is necessary to follow up video-urodynamic and ultrasound findings in order to identify the high-risk patients and provide the evidence for preventing RUTI.

Objective To explore the influence of nutrition status on cognitive function in patients with Alzheimer disease(AD)so as to provide theoretical support for clinical intervention. Methods A total of 182 patients with AD(over 60 years old)treated in Neurology Departments and Geriatrics Department from three class Ⅲ grade A general hospitals in Taiyuan City were selected as study subjects by purposive sampling from June to December 2016. The cognitive function and nutrition status were evaluated with the mini-mental state examination(MMSE)and the short-form mini-nutritional assessment(MNA-SF)respectively. The relation between them was analyzed with variance analysis,correlation analysis and regression analysis. Results The average score of MMSE and the total score of MNA-SF were(18.13±5.44)and(9.66±2.40). There were statistically significant differences in the dimension scores(weight loss during the last 3 months, having suffered psychological stress or acute disease in the past 3 months,mobility,neuropsychological problems,having food intake declined over the past 3 months due to loss of appetite,digestive problem, chewing or swallowing difficulties)and the total score of nutrition status among groups of mild,moderate and severe cognitive impairment(F=4.600,5.046,12.265,12.962,64.361,12.767;P<0.05). Pearson correlation analysis showed that the dimension scores(weight loss during the last 3 months,mobility,neuropsychological problems,having food intake declined over the past 3 months due to loss of appetite,digestive problem,chewing or swallowing difficulties)and the total score of nutrition status had positive correlations with the score of MMSE with significant differences(r=0.033,0.510,0.324,0.550,0.386;P<0.05). The score of dimension on having suffered psychological stress or acute disease in the past 3 months had a significantly negative correlation with the score of MMSE(r=-0.166,P<0.05). Regression analysis revealed that there was still a positive correlation between the total score of nutrition status and the score of MMSE after adjusting ages,days for reading books and newspapers one week,being with brain diseases or medical histories(β′=0.365,P<0.05). Conclusions Medical staff should strengthen evaluation on early nutrition status in AD patients and take effective interventions so as to delay the progression of cognitive impairment and improve the quality of life of patients.

Objective:To analyze the genetic etiology and prognosis in fetuses with increased nuchal translucency (NT) in order to assist in the clinical prenatal genetic counseling and diagnosis.Methods:This study retrospectively enrolled 1 658 cases of singleton pregnancy (<35 years old) receiving invasive prenatal diagnosis, including karyotype analysis and/or chromosome microarray analysis or copy number variation (CNV) sequencing, due to NT value ≥2.5 mm in the first trimester in Henan Provincial People's Hospital from August 2014 to December 2021. They were divided into different groups according to the thickness of NT (≥2.5-<3.0, ≥3.0-<3.5, ≥3.5-<4.5, ≥4.5-<5.5, ≥5.5-<6.5 and ≥6.5 mm groups) and abnormal ultrasound findings (isolated increased NT group, increased NT complicated by soft markers/non-severe structural abnormality group and increased NT complicated by severe structural abnormality group). The results of invasive prenatal diagnosis and pregnancy outcomes were compared between different groups using Chi-square test and trend Chi-square test. Results:The detection rates of numerical abnormalities of chromosomes were 15.8% (262/1 658) and 17.6% (252/1 431) when the NT thickness cut-off value were 2.5 mm or 3.0 mm, respectively. Overall, the detection rate of numerical abnormalities of chromosomes increased with thickness of NT ( χ2trend=180.75, P<0.001), ranging from 6.6% (44/671) in the NT≥2.5-<3.5 mm group to 45.6% (113/248) in the NT≥5.5 mm group. The incidence of pathogenic/likely pathogenic CNV(P/LP CNV) did not increased with NT thickness ( χ2trend=3.26, P=0.071), and the highest detection rate was observed in the NT≥4.5-<5.5 mm group (9.0%, 19/211). The detection rate of numerical abnormalities of chromosomes plus P/LP CNV in the isolated NT≥2.5-<3.0 mm group and NT≥3.0-<3.5 mm group were 5.3% (10/188) and 9.6% (36/375), respectively, however, the difference was not statistically significant ( χ2=3.06, P=0.080). The detection rates of numerical abnormalities of chromosomes plus P/LP CNV in the isolated NT≥3.5-<4.5 mm group and NT≥2.5-<3.0 mm complicated by soft markers/ non-severe structural abnormality group were 12.7% (52/410) and 24.1% (7/29), respectively, and the risk were 2.6 times (95% CI: 1.3-5.2) and 5.7 times (95% CI: 2.0-16.4) of the isolated NT≥2.5-<3.0 mm group, respectively. The pregnancy termination rate increased with the NT thickness ( χ2trend=304.42, P<0.001), ranging from 10.8% (23/212) in the NT≥2.5-<3.0 mm group to 90.7% (117/129) in the NT≥6.5 mm group. After exclusion of the pregnancies terminated due to numerical abnormalities of chromosomes and P/LP CNV, 87.6% (862/984) of the fetus with increased NT were born alive. Conclusions:The detection rate of numerical abnormalities of chromosomes increases with the thickness of NT. Invasive prenatal diagnosis is required for non-advance aged singleton pregnant women when fetuses present with isolated NT≥2.5 mm with or without soft markers/structural abnormalities.

OBJECTIVE: The prepare decellularized extracellular matrix (ECM) scaffold materials derived from human cervical carcinoma tissues for 3D culture of cervical carcinoma cells. METHODS: Fresh human cervical carcinoma tissues were treated with sodium lauryl ether sulfate (SLES) solution to prepare decellularized ECM scaffolds. The scaffolds were examined for ECM microstructure and residual contents of key ECM components (collagen, glycosaminoglycan, and elastin) and genetic materials by pathological staining and biochemical content analysis. In vitro 3D culture models were established by injecting cultured cervical cancer cells into the prepared ECM scaffolds. The cells in the recellularized scaffolds were compared with those in a conventional 2D culture system for cell behaviors including migration, proliferation and epithelial-mesenchymal transition (EMT) wsing HE staining, immunohistochemical staining and molecular biological technology analysis. Resistance to 5-fluorouracil (5-Fu) of the cells in the two culture systems was tested by analyzing the cell apoptosis rates via flow cytometry. RESULTS: SLES treatment effectively removed cells and genetic materials from human cervical carcinoma tissues but well preserved the microenvironment structure and biological activity of ECM. Compared with the 2D culture system, the 3D culture models significantly promoted proliferation, migration, EMT and 5-Fu resistance of human cervical cancer cells. CONCLUSION The decellularized ECM scaffolds prepared using human cervical carcinoma tissues provide the basis for construction of in vitro 3D culture models for human cervical cancer cells.
Female ; Humans ; Decellularized Extracellular Matrix ; Extracellular Matrix ; Uterine Cervical Neoplasms ; Tissue Scaffolds/chemistry* ; Carcinoma ; Fluorouracil/pharmacology* ; Tissue Engineering ; Tumor Microenvironment

ObjectiveTo explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019（COVID-19） based on the differences of syndromes and traditional Chinese medicine（TCM） treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. MethodDemographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system （HIS） of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. ResultA total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai，dominated by young and middle-aged males，had clinical symptoms of fever， abnormal sweating，and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat， with manifest cold， dampness， and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness， accompanied by draining depressed heat. The core Chinese medicines used are Poria，Armeniacae Semen Amarum，Gypsum Fibrosum，Citri Reticulatae Pericarpium，and Pogostemonis Herba. By contrast，the 105 patients in Ruili， dominated by young females， had atypical clinical symptoms， and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach， with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen， resolving dampness， and dispersing Qi with light drugs. The core Chinese medicines used are Poria，Atractylodis Macrocephalae Rhizoma，Glycyrrhizae Radix et Rhizoma，Coicis Semen，Platycodonis Radix，Lonicerae Japonicae Flos， and Pogostemonis Herba. ConclusionThe differences in clinical characteristics， TCM syndromes， and medication of COVID-19 patients from the two places may result from different regions，population characteristics， and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments.

OBJECTIVETo examine the proportion and reasons of drop-out from antiretroviral therapy (ART) among 8 367 adult HIV-infected individuals in Dehong prefecture, Yunnan province.

METHODSAll adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART.

RESULTSThe proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4% (1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as: living area, gender, age, marital status, HIV transmission route, baseline CD4⁺ T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model, drop-out from ART was significantly correlated with residential area, marital status, HIV transmission route, baseline CD4⁺ T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city, Lianghe county or Yingjiang County, being married or living with partner, HIV infection through sexual contact, with baseline CD4⁺ T cell counts ≤ 200 cells/mm³, and ART included in the initial treatment regimen etc., were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART, 704 (58.6%) were lost to follow-up, 303 (25.2%) did not adhere to treatment, 74 (6.2%) moved out the region, 64 (5.3%) were Burmese that had returned to Burma, 29 (2.4%) stopped the treatment according to doctors' advice, 18 (1.5%) were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied, according to the situation of patients.

CONCLUSIONThe proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.