Periodontitis is a chronic infective disease characterized as the destruction of the supporting tissues of the teeth. Bone marrow mesenchymal stem cells, which are ideal adult stem cells for the regeneration of supporting tissues, may play important roles in restoring the structure and function of the periodontium and in promoting the treatment of periodontal disease. As a consequence, the characteristics, especially osteogenic differentiation mechanism, of these stem cells have been extensively investigated. The regulation of the physiological behavior of these stem cells is associated with BMAL1 gene. This gene is a potential treatment target for periodontal disease, although the specific mechanism remains inconclusive. This study aimed to describe the characteristics of BMAL1 gene and its ability to regulate the osteogenic differentiation of stem cells.
ARNTL Transcription Factors ; genetics ; Adult ; Adult Stem Cells ; Bone Marrow Cells ; physiology ; Cell Differentiation ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; physiology ; Osteogenesis ; physiology ; Periodontal Ligament ; Periodontitis ; Periodontium ; Regeneration ; Tooth

Objective To evaluate the application of embolic material, iron oxide nanoparticles?lipiodol?gelatin in the improvement of therapeutic effect of microwave ablation in vitrogelatin phantom model and in vivo VX2 renal tumors model. Methods After preparing new embolic material containing nano Fe2O3, in vitro model experiment was firstly conducted to verify the temperature distribution of the microwave ablation. Further verification was performed in bilateral renal VX2 tumors in rabbit model. A total of 10 (20 kidneys) New Zealand White rabbits bearing renal VX2 tumors were treated by renal artery embolization and CT guided microwave ablation, in which left kidneys were treated by material containing nano Fe2O3 in iodized oil and right kidneys were treated by renal embolization with super liquid iodized oil as a control. The same microwave ablation time and power were used for both kidneys. CT perfusion and histopathological examinations were performed to determine the renal perfusion parameters, tumor histopathology and tumor?related angiogenesis. Results In vitro experiments, when nano Fe2O3 was present in the local area at 1cm from the microwave needle at 20 and 60, the temperature reached(59.1 ± 1.7)° C, (95.5 ± 4.5)° C vs.(31.1 ± 2.5)and(45.6 ± 3.5)° C in the controls. Our present results strongly suggested that local nano Fe2O3 particles absorbed microwave and shielded microwave energy transferring to the surrounding tissue. Before and immediately after renal VX2 tumor embolization, blood flow significantly reduced from (31.4 ± 10.6) to (6.1 ± 9.9) ml · 100 ml-1 · min-1. Our pathology findings indicated nano Fe2O3?lipiodol-gelatin embolic agent stored in endovascular regions, while no penetration into the renal parenchyma happened. Conclusions This in vitro model and in vivo experiment suggest that the new embolic material containing nano Fe2O3 may help to improve heat efficiency of MWA microwave, and it is feasible to administer it through transcatheter arterial embolization approach for the microwave ablation therapy of kidney cancer.

Objective To observe the clinical effect of continuous intravenous pumping of octreotide in the treatment of intestinal endotoxemia.Methods Eighty patients with intestinal obstruction and non-surgical treatment were divided into group Ⅰ with 34 cases who received conventional-treatment and group Ⅱ with 46 cases who received conventional-treatment combined with octreotide 24 h continuous intravenous pumping.White blood cell count ( WBC ),diamine oxidase (DAO),D-lactic acid (D-LA) and endotoxin were detected before treatment and at 24 h,48 h,4 d after treatment.Results The content of WBC,DAO,D-LA and endotoxin in two groups all reached peak at 48 h after treatment.The difference of the content of WBC,DAO,D-LA and endotoxin between two groups had no statistical significance at 24 h after treatment (P ＞ 0.05).The content of WBC,DAO,D-LA and endotoxin of group Ⅱ at 48 h and 4 d after treatment were lower than those of group Ⅰ.And the difference at 48 h after treatment had statistical significance[(18.40 ±0.10)× 109/L vs.(20.60 ± 2.36) × 109/L,(6.12 ± 1.02) kU/L vs.(8.02 ± 1.54) kU/L,(2.14 ±0.21) mg/L vs.(3.34 ± 0.04) mg/L,(1.65 ±0.16) kEU/L w.(2.23 ±0.36) kEU/L] (P ＜ 0.01).While the difference at 4 d after treatment had no statistical significance(P＞ 0.05 ).Body temperature at 48 h after treatment,gastrointestinal decompression capacity,anus exhaust time of group Ⅱ were (37.60 + 3.01 )℃,(320.00 ± 76.14) ml/d,(54.00 ± 0.94) h respectively,and they all were superior to those of group Ⅰ[(38.50 ± 2.21 ) ℃,(500.00 ± 80.32) ml/d,(68.00 ± 1.02) h] (P ＜0.01).Conclusions Continuous intravenous pumping of octreotide can effectively protect the intestinal mucosal barrier function,improve intestinal permeability,reduce the trmslocation of intestinal flora,inhibit the incidence and development of enterogenous endotoxemia.And it provides new evidence to support the clinioal application of octreotide in patients with intestinal endotoxemia.

Purpose In order to find out a means that can both meet clinical requirements and reduce radiation dosage in the diagnosis of malignant biliary obstruction, the study aims to evaluate the image quality and the radiation dose of low tube voltage enhanced CT (100 kVp) in displaying malignant biliary obstruction in metal stents. Materials and Methods Between January 2012 and March 2014, 9 patients with highly suspected recurrent occlusion after biliary stent procedure were admitted in Peking Union Medical College Hospital and underwent high resolution three-phase dynamic enhanced CT scan. The CT images on portal veinal phase were reconstructed through the curved planar reformation and the CT values of 184 slices were evaluated along the pathway of the biliary stent. The reconstructed image quality was analyzed when the tube voltage was 140 kVp and 100 kVp respectively, and the different tumor-to-liver contrast-to-noise ratio (CNR) for each lesion, mean image noise, and figure of merit (FOM) between the two data sets were also compared. Results As the tube voltage decreased from 140 to 100 kVp, image noise increased from (19.88±3.62) HU to (24.22±4.24) HU (P<0.001), CNR increased by 15% and FOM improved by 50%. Conclusion A low tube voltage CT technique (100 kVp) improves tumor-to-liver CNR and significantly reduces radiation dose, therefore it is valuable in the manifestation of malignant obstruction in metal stents.

Objective To study the feasibility and effectiveness of liquid embolic agent HEMA-MMA in the arterial embolization therapy for the rabbit renal VX2 tumor models. Methods Renal VX2 tumor models were inoculated with the method of percutaneous CT-guided implantation of a small fragment of tumor into the inferior pole of the right kidney and were embolized when the max diameter was 1.5 cm. One model was embolized with the mixture of HEMA-MMA and carbonyl iron powder and was harvested immediately after embolization, the sample was fixed by paraformaldehyde for histopathological examination with methylene blue staining and HE staining to demonstrate the sizes of the vessels that the HEMA-MMA could reach. The remaining models were treated with pure HEMA-MMA by superselective or nonselective embolization (SSE or NSE). In SSE group, only the renal artery branch supplying the tumor was superselectively catheterized and embolized until the presence of“artery casting”change. In NSE group, the microcatheter was catheterized into the main renal artery then the whole renal artery branches and the renal capsular artery were embolized simultaneously until the presence of“artery casting”shape. Non-enhanced CT scans at immediate postoperation, on postoperative day 1 and day 3 were performed. The enhanced CT scans at the postoperative 1, 2 , 4 and 6 weeks were performed. Necrotic zone of the tumor was defined as non-enhancement in parenchyma phase, residual tumor was defined as delayed enhancement around the necrotic zone or obvious thickness and enhancement of the adjacent renal capsule. When detecting residual tumor, the model was followed up another 1 week and then harvested for histopathological examination. If there was no residual tumor and lung metastasis in 6 weeks follow-up after operation, we defined this as complete necrosis and then harvested the kidney for histopathological examination. Results Eleven of the 12 rabbits were successfully inoculated VX2 tumors. The mixture of HEMA-MMA and carbonyl iron powder deposited in the arterial vessels demonstrated mazarine in methylene blue staining and brownness in HE staining. The diameter of the tumor vessels which the agent could reach was 30—150 μm, there was no embolic agent detected in the venous blood vessels. 5 models were performed with superselective embolization and the other 5 were embolized with nonselective embolization. The embolic agent demonstrated high density and obviously deposited in the surrounding zone of the tumor on immediate postoperative CT images, density of the surrounding zone decreased accompanied by density increase in the central area of the tumor on the first day postoperative CT images. Density difference between the embolism zone and normal renal tissue disappeared on the third day postoperative CT images accompanied by swelling changes of the embolized area. Residual tumor was detected in all 5 superselectively treated cases (2 in 1 week, 3 in 2 weeks), which located in the area of junctional zone and subrenal capsule. The necrotic zone was demonstrated coagulative necrosis on histopathologic images, the boundary between the residual tumor and the necrotic zone was clearly showed both on histopathologic images and gross specimen. Renal capsular artery participating in the residual tumor blood supply was also shown on gross specimen. There was no residual tumor and lung metastasis detected in nonselective treated group during the period of 6 weeks follow-up. Atrophy of the whole tumor-burdened kidney was shown on gross specimen and complete coagulative necrosis of the total tumor and the renal capsule adjacent to the tumor was demonstrated on histopathologic images. Conclusions Liquid embolic agent HEMA-MMA can embolize tumor blood vessels with a diameter of 30—150 μm. The renal capsular artery participates in the blood supply of the VX2 kidney tumor, so only superselective embolization of the renal artery branch with this liquid embolic agent may not induce the whole necrosis of the tumor, but complete necrosis of the tumor can be obtained by embolizing of all the tumor vessels and the adjacent normal renal arteries with this liquid embolic agent.

Objective To study the outcomes and problems of comprehensive medical pricing reform in Jiangsu.Methods The business operations,drug proportion and patient′s expenses of 28 pilot hospitals in 1 5 counties of the province before and after the reform were compared,to learn the impacts of the pricing reform on both hospitals and patients.Results Medical revenue and medical service quantity of these hospitals during this period(January to June)of 2012—2014 maintain a fast growth,with lower drug proportions,and patients′expenditure unchanged.Compared with data of the same period in 2012, the total revenue growth rates of the hospitals in 2013 and 2014 were 13.4% and 1 1.1% respectively;and their drug proportions were 44.9% and 42.3%;and the expenditure growth rates for outpatient/emergency service were 5.9% and 3.1% respectively.Conclusions The reform has achieved an initial success.However the pricing system,needs to be further rationalized to build a better price formation mechanism,in line with relevant reforms.

Objective To realize real-time medical insurance settlement system of Xi'an based on Outpatient One Card Solution to reduce the errors due to artificial accounting.Methods The system was developed with C# language and Oracle 10g, based on interface function dynamic library calling rule and HIS data structure requirements provided by Xi'an municipal medical insurance center.Results The system realized real-time settlement of the patient with medical insurance card.Conclusion The system simplifies medical insurance outpatient treatment flow and implements data communication.

BACKGROUND:Whether transplanted bone marrow mesenchymal stem cells under hypoxic conditions can survive is crucial for the successful celltransplantation. Therefore, studies on the growth of bone marrow mesenchymal stem cells under hypoxic conditions in vitro can provide experimental evidence for in vivo celltransplantation. OBJECTIVE:To observe the expression of vascular endothelial growth factor in bone marrow mesenchymal stem cells under hypoxia. METHODS:Rat bone marrow mesenchymal stem cells were obtained and cultured, and observed under light microscopy. Passage 3 cells were cultured under normoxia (21%O2) and hypoxia (3%O2 hours. Then cellcounting kit-8 assay and flow cytometry were employed to detect cellproliferation in the two groups. Western blot assay was adopted to detect the expression of hypoxia-inducible factor-1αand vascular endothelial growth factor in the two groups. RESULTS AND CONCLUSION:(1)Rat bone marrow mesenchymal stem cells were obtained and cultured successful y, which were fusiform cells and had uniform shape under the light microscope. (2)The results of cellcounting kit-8 assay showed that the number of cells in the hypoxic group was higher than that in the normoxic group at each time point, and cellviability increased significantly at hours 36 and 48 (P<0.05). (3)The results of flow cytometry demonstrated that the proportion of cells in S phase and cellproliferation index in the hypoxic group were significantly increased, compared with the normoxic group (P<0.05). (4)Western blot results showed ), respectively, for 72 that there was a smal amount of the expression of hypoxia-inducible factor-1αand vascular endothelial growth factor in the normoxic group, but the expression of these two proteins in the hypoxic group was increased in a time-dependent manner (P<0.05). These findings suggest that hypoxia can induce proliferation of rat bone marrow mesenchymal stem cells cultured in vitro, and also raise hypoxia-inducible factor-1αand vascular endothelial growth factor expression in a time-dependent manner.

Objective To evaluate the feasibility of interventional catheterization via saphenous artery route in treating hepatic and renal lesions, to compare its advantages and disadvantages with trans-femoral approach catheterization, and to discuss the feasibility of using saphenous artery route to replace femoral artery approach.Methods A total of 24 rabbits bearing VX2 liver and kidney tumor were randomly divided into via femoral artery catheterization group (control group,n=8) and via saphenous artery catheterization group (study group,n=16). Surface distribution and variation of saphenous artery were recorded. After the saphenous artery was isolated, blood vessel was punctured with a 22 G needle, through which a 0.018 inch micro guide wire together with a 5-F micro catheter sheath was inserted into the artery, then, a Y-valve was connected to the sheath. DSA was performed to determine the diameters of the saphenous artery, femoral artery and iliac artery. The used time for isolating the artery and indwelling the sheath, the depth of sheath insertion, the success rate of catheterization, the incision infection rate and the occurrence of claudication in both groups were recorded, and the results were compared. Results Saphenous artery could be clearly observed on body surface in 91.67%of rabbits (22/24). Successful insertion of catheter sheath was achieved in all rabbits of both groups. The used time of isolating artery, the depth of sheath insertion, the incision infection rate and the occurrence of claudication at 7 and 14 days after the treatment in the study group were(367.30±37.30) seconds, (20.20±2.60) mm, 0%, 6.25%and 0%respectively, while those in the control group were (978.20±156.30) seconds,(58.60±9.50) mm, 37.50%, 62.50% and 25% respectively. The differences in above mentioned measurement items between the two groups were statistically significant (P<0.05). The used time of indwelling the sheath and the occurrence of claudication at one day after the treatment in the study group and in the control group were (42.80 ±9.90) seconds, 70% and (43.60 ±7.0) seconds, 100%respectively, and no statistically significant differences existed between the two groups (P>0.05). The diameters of the saphenous artery, superficial femoral artery, common femoral artery, external iliac artery and common iliac artery were (1.29±0.12) mm,(1.91±0.27) mm, (2.18±0.15) mm, (2.22±0.13) mm and(2.39± 0.15) mm respectively. Conclusion In rabbits, the saphenous artery is usually superficially located, its anatomical variation rate is very low, and its internal diameter can match 5- F micro catheter sheath. Catheterization via saphenous artery is convenient, time-saving with less damage and fewer complications. Therefore, in treating hepatic and renal lesions in rabbits the catheterization via saphenous artery can be used as the technique of first choice to replace the femoral approach catheterization.

Objective To introduce the method and experience of the setting of psychological care nurses,to discuss its effect on high-quality nursing and on amelioration of the patients' negative moods.Methods Psychological care nurses were set up in all the clinical departments,after systemic training of psychological knowledge and became qualified psychological consultant via national certification examination.We took psychological care nurses as the leading role,assisted with other nursing modes.By the means of mental status scale in non-psychiatric settings (MSSNS) and the satisfaction questionnaire of psychological care to evaluate the patients' mental status and satisfaction degrees before and after the intervention in 297 cases.Results Patients'scores of anxiety scale,depression,anger,loneliness factor and the total score of the MSSNS after the psychological nursing intervention were significant differences than those before the psychological nursing intervention,[(39.66±4.70)vs (45.59±6.45),(23.31±2.28)vs (26.59±3.35),(13.91 ±3.01) vs (15.12±2.58),(17.58±3.74)vs (20.29 ±4.67),(92.09±6.85)vs (106.66±8.58),t values was 14.376,15.213,23.992,13.974,13.641 respectively,P＜0.05].The satisfaction rate of patients for psychological nursing intervention after the intervention was 96.97％(288/297),which was significant higher than that before the intervention,69.70％(207/297),x2=79.53,P＜0.05.Conclusions Psychological care demands professional qualities.Only through systemic training,can grasp the nurses master professional psychological knowledge and skill,so as to apply scientific psychological care to the patients and help them to solve their psychological perplexities and maintain physical and psychological well-beings.