Objective Although vascular endothelial growth factor(VEGF)is a primary mediaor in diabetic retinopathy(DR).VEGF inhibition alone is insufficient for preventing retinal neovascularization.Some studies showed that erythropoietin(EPO)is a potent retinal angiogenic factor of independent of VEGF in DR.The present study is to investigate the effect of high glucose on the expression of mRNA and protein of the erythropoietin receptor(EPOR)in cultured human umbilical vein endothelial cells(UVECs)in vitro.MethodsHuman UVECs from the cell center of the hospital were cultured in vitro and passaged in DMEM containing 10% neonatal bovine serum with 22mmol/L of glucose for 12,24,48 and 72 hours in the experimental group.Cells cultured in 5.5mmol/L glucose were used as control group Ⅰ and mannitol + 22mmol/L of glucose(isotope)as control group Ⅱ.The expression of EPOR mRNA in Human UVECs were detected by semi-quantitative reverse transcriptase(RT)-polymerase chain reaction(PCR)and detected at A_(260mm)/A_(280mm).The PCR product was calculated as the A value of EPOR mRNA amplification/the A value of GAPDH mRNA amplification.The expression of EPOR protein in Human UVECs was detected by immunocytochemistry.ResultsThe A_(260mm)/A_(280mm) value of EPOR mRNA receptor expression was 0.32±0.02 in the 5.5mmol/L glucose group,and 0.34±0.02 in the mannitol+22mmol/L glucose group(P>0.05).In 12 hours,24 hours and 72 hours after the experiment,the A260mm/A280mm value of EPOR mRNA was 0.82±0.01,0.96±0.02 and 1.02±0.01,respectively,indicating a significant increase in comparison with the 5.5mmol/L glucose group.The expression of Human UVECs protein was gradually increased with passage in the experimental group.Expression of Human UVECs protein was stronger in various time points in the 22mmol/L glucose group than in the 5.5mmol/L glucose group.ConclusionHigh glucose elevates the expression of EPOR mRNA and protein in Human UVECs in a time-dependent manner.The effect of high glucose(22mmol/L glucose)on the expression of EPOR mRNA and protein in Human UVECs is not related to osmotic pressure.

Objective To regulate standardized ICD-10 case classification name and coding,and common clinical diagnosis name or expression of mapping rules,to systematically improve the quality of DRGs key data,and to assess the impact of medical diagnostic data quality on DRGs and the indicators based on the DRGs.Methods Extension of the glossaries of clinical diagnosis synonyms or near-synonyms,and establishment of a standardized maintenance procedure of ICD-10 dictionary.Adjustment of the impact extent of DRGs disease makeup on case classification,comparison of the consistency of principal diagnosis classification,and the consistency of DRGs grouping,as well as changes of such indicators as DRGs grouping reduction in variance (RIV) and case mix index (CMI).Results Data of the obstetrics,gynecology and pediatrics disciplines of a maternity and children hospital from 2012 to 2013 (72 005 cases)and 2014 to 2015 (77 705 cases) were chosen for prior-after comparison.The encoding consistency rate was 59.60％ before the improvement,with the improved standardized consistency rate rising to 66.38％afterwards;beforehand the DRGs grouping consistency rate was 69.30％,with the improved standardized consistency rate rising to 88.00％ afterwards;beforehand the cost RIV was 0.515,with the cost RIV rising to 0.576 afterwards;the CMI variations of individual campuses of healthcare institutions appear more reasonable.Conclusions Diagnostic quality control and improvement project can improve the data accuracy of coding.This empowers the RIV and CMI indexes calculated on such basis to better describe the complexity of clinical settings,conducive to establishing a value-oriented prepayment system which is more transparent,fair and reasonable.

BACKGROUND:Apoptosis of islet cel s is closely related to the long-term hyperglycemia-and hyperlipemia-induced injuries. OBJECTIVE:To observe the effect of Shizidaiping formula on the apoptosis and insulin secretion in MIN6 cel s under the high glucose and lipid environment, and to explore the protective effect of Shizidaiping formula and the related apoptosis mechanism. METHODS:MIN6 cel s were divided into normal, model, melbine, low-, medium-and high-dose Shizidaiping formula groups. The cel activity was examined by cel counting kit-8, the insulin secretion was measured by ELISA, the rate of apoptosis was measured by Annexin V-FITC&PI and the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 were examined by western blot assay. RESULTS AND CONCLUSION:Shizidaiping formula significantly improved MIN6 cel activity under high glucose and lipid condition (P<0.05), decreased early cel apoptosis, increased the level of insulin stimulated by low glucose in cel supernatant (P<0.05), and improved the expression levels of MEK1/2, ERK1/2 and p-ERK1/2 (P<0.05). These results suggest that Shizidaiping formula can protect islet cel s from hyperglycemia and hyperlipemia damage by improving the activity of MIN6 cel s, reducing the insulin secretion and inhibiting the apoptosis of pancreaticβcel s in MIN6 cel s.

Objective To investigate the effect of low salt diet on vascular remodeling of rat induced by high fructose(HF).Methods Wistar male rats weighed 180-200 g were fed for 8 weeks and randomly divided into 6 groups:(1) control group was given the normal fodder and distilled water;(2) high fructose group(HF) was given normal fodder (0.5 ％ NaCl,w/w) and fructose water(10 ％,w/v);(3) high-salt group (HNa) was given high salt fodder (7 ％ NaCl,w/w) and distilled water;(4) high fructose combined with high salt diet group(HFNa) was simultaneously given high salt fodder and 10 ％ fructose water;(5)high fructose combined low salt group(HFLNa) was simultaneously given low salt fodder and 10％ fructose water;(6) high fructose combined with spirotaclone group(HFE) was given 10％ fructose water for 4 weeks and then added with spirotaelone(50 mg · kg-1 · d-1 by tube feeding) for continuous 4 weeks.The changes of arterial blood pressure,vascular wall histological evaluation and expression of α-SMA and fibronectin in vascular wall were detected in each group.Results (1) Compared with the blood pressure[(111.03 ±9.17) mm Hg] in the control group,the blood pressure in the HF and HNa groups were (133.94± 5.86) mm Hg and (128.09±7.56) mm Hg respectively,which were significantly increased(P＜0.05);(2) HF mainly caused the hyperplasia of vascular wall middle layer smooth muscle.The a-SMA expression results in the HF group was (0.006 3 ±0.000 21),which in the control group was (0.004 6 ± 0.000 31),the difference was statistically significant(P＜0.05),moreover which promoted the elastic fibers increase;while HNa mainly stimulated the elastic fibers to thicken and extracellular matrix deposition,the fibronectin expression was 0.002 6 ± 0.000 2 in the HNa group and (0.004 7±0.000 2)in the HF group,compared with(0.001 3±0.000 1)in the normal group,which were significantly increased(P＜0.001);(3) the blood pressure was (106.04±9.59) mm Hg in the HFLNa group,(103.99±7.12) mm Hg in the HFE group,compared with(133.94±5.86) mm Hg in the HF group,showing that the blood pressure in the HFLNa group and HFE group was significantly decreased compared with the HF group (P＜0.05);moreover the vascular remodeling in the HFLNa group(0.006 8±0.000 2) and HFE group (0.004 2±0.000 4) was improved,and compared with the HF group(0.006 3±0.000 2),α-SMA expression was significantly decreased (P＜0.05).Conclusion Low salt diet can effectively improve vascular remodeling induced by HEF.

Objective To evaluate the effects of dexmedetomidine combined with lidocaine on postopera-tive cytokine response after abdominal hysterectomy. Methods We enrolled 80 women with American Society of Anesthesiologists(ASA)physical statusⅠandⅡ,aged 35-68,and scheduled for elective abdominal hysterectomy under general anesthesia.The patients were randomly assigned into CON group,LIDO group,DEX group and LI-DO + DEX group(n=25 in each group). The four groups received an Ⅳ bolus infusion of normal saline,lido-caine,dexmedetomidine,and lidocaine combined with dexmedetomidine respectively,over 10 minutes before in-duction of anesthesia,followed by a continuous IV infusion of normal saline,lidocaine,dexmedetomidine,and li-docaine combined with dexmedetomidine until abdominal wound closure,respectively.Interleukin-6 and tumor ne-crosis factor-α levels in serum were measured before administration of drugs(T1),at the end of surgery(T2),post-operative 2 hour(T3)and postoperative 24 hour(T4). Results Interleukin-6 and tumor necrosis factor-α level in serum were higher at T2,T3and T4in the four groups. Compared to those in CON group,interleukin-6 and tumor necrosis factor-α levels in DEX and DEX+LIDO group were significantly decreased at T2,T3and T4(P<0.05). Interleukin-6 and tumor necrosis factor-α level in serum in LIDO group were also decreased at T2,T3and T4,but there was no significant difference between CON group and LIDO group(P > 0.05). Compared to that in LIDO group,tumor necrosis factor-α level in serum in DEX group was significantly decreased at T3and T4;interleukin-6 level in serum in DEX group was significantly decreased at T2,T3and T4(P<0.05).Interleukin-6 and tumor ne-crosis factor-α levels in serum in DEX+LIDO group were the lowest compared to those in other three groups at T2,T3and T4(P < 0.05). Recovery time and extubation time were significantly prolonged between DEX group and DEX + LIDO group(P < 0.05). Conclusions Dexmedetomidine combined with lidocaine infusion significantly decrease postoperative cytokine response and this may be attributed to the anti-inflammation effects of dexmedetomi-dine and lidocaine.

Background: Antibiotic resistance is a significant public health concern around the globe.Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. Objective: This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. Methods: Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. Results: The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). Conclusions Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

Post-stroke aphasia (PSA) is a common speech disorder after stroke, involving at least 1/3 of stroke patients, and causing serious adverse effects on their lives and work. The available intervention measures include speech and language rehabilitation therapy, drug therapy, and non-invasive brain stimulation technology. The latter mainly includes transcranial magnetic stimulation and transcranial direct current stimulation (tDCS). tDCS can have a positive impact on PSA by promoting its self-repair, regulating the level of neurotransmitters, and inhibiting inflammation. This article reviews the effect of tDCS on the self-recovery mechanism of PSA and its treatment.

In order to reveal the intestinal absorption mechanism of saikosaponin d (SSd) in vitro and in vivo, the current research investigated the effects of different experimental conditions (time, concentration, temperature, pH, intestinal segments), transporter inhibitors, paracellular pathway enhancer, metabolic enzyme inhibitors on the intestinal absorption of SSd, in Caco-2 monolayers and a single pass perfusion model in rats.The results showed that the apparent permeability coefficient (Papp) and effective permeability coefficient (Peff) of SSd were 4.75 × 10-7 - 6.38 × 10-7 cm/s and 0.19 × 10-4- 0.27 × 10-4 cm/s, respectively, indicating that it was a low permeability compound, and that the transmembrane transport of SSd was concentration-dependent (0.5-5 μmol/L) and time-dependent (0-180 min).Ileum was the main absorption site for SSd. Experimental results based on Caco-2 monolayers showed that the P-gp inhibitor and paracellular permeability enhancer significantly increased the absorption of SSd (P < 0.05), which was consistent with the results obtained in rats. Inhibitors of OATPs and OCTs showed different results in vitro and in vivo, which may be related to the lower expression of them in jejunum.In summary, the intestinal absorption of SSd occurs through a carrier-mediated and energy-dependent transport, as well as passive diffusion, and P-glycoprotein plays an important role in the active transport of SSd.

Objective:To investigate the correlation between total MRI burden and serum uric acid level in patients with cerebral small vessel disease(CSVD) and its gender differences.Methods:A total of 217 patients with CSVD were retrospectively included as the research objects, and the clinical data such as serum uric acid value were collected.The imaging findings of patients with CSVD were evaluated by MRI, and the total MRI burden score of CSVD was calculated.According to the total MRI burden score of CSVD, patients with CSVD were divided into mild-to-moderate burden group ( n=133) and severe burden group ( n=84). SPSS 20.0 software was used for data analysis and processing.Logistic regression was used to analyze the relationship between uric acid and the total MRI burden score of CSVD. Results:The serum uric acid of severe burden group was higher than that of mild-to-moderate burden group((326.94±70.95)μmol/L, (293.42±80.52)μmol/L, P=0.002). The multivariate logistic regression analysis showed that the elevated level of serum uric acid was an independent risk factors for total MRI burden of CSVD ( β=0.005, OR=1.005, 95% CI=1.001-1.009, P=0.019). The patients with CSVD were equally divided into four group based on the serum uric acid concentration.After controlling the confounding factors, with the increase of uric acid level, the risk of aggravating total MRI burden score of CSVD increased, and the difference was statistically significant( P=0.001). Serum uric acid(for each quartile increase)was an independent risk factor for total MRI burden in male patients with CSVD( β=0.482, OR=1.619, 95% CI=1.125-2.330, P=0.010), while there was no significant difference in female patients( P=0.070). Conclusion:Serum uric acid level is a risk factor for increasing the total MRI burden in male patients with CSVD, but this effect is not found in female patients with CSVD.

Acute respiratory distress syndrome (ARDS) refers to acute diffuse lung injury caused by a variety of intrapulmonary and/or extrapulmonary factors such as infection and trauma. Uncontrolled inflammatory response is the main pathological feature. Different functional states of alveolar macrophages have different effects on inflammatory response. Transcription activating factor 3 (ATF3) is a fast response gene in the early stage of stress. In recent years, it has been found that ATF3 plays an important role in regulating the inflammatory response of ARDS by regulating the function of macrophages. This paper reviews the regulatory effects of ATF3 on alveolar macrophage polarization, autophagy and endoplasmic reticulum stress and its effects on the inflammatory process of ARDS, aiming to provide a new research direction for the prevention and treatment of ARDS.