Objective:To compare the differentiated endothelial cells from the embryonic stem cells in vitro with human umbilical vein endothelial cells (HUVECs).Methods:Induction of the stem cells HUES9 to endothelial cells follows 2 steps.Stem cells were treated with CHIR99021 (10 μmol/L) and bone morphogenetic protein 4 (25 ng/mL) for 3 days to keep mesoderm state,then subsequent exposure them to VEGF165 (200 ng/mL) and Forskolin (2 μmol/L) to differentiate into endothelial cells.The morphology of differentiated endothelial cells were compared with HUVECs.The surface marker CD144 on differentiated cells and HUVECs were detected.The capabilities of two types of endothelial ceils in migration and angiogenesis were examined.Results:The differentiated endothelial cells show the same morphology with HUVECs.After 6 days of differentiation,the efficiency reached 73.4％.The positive percentage of CD144 for the differentiated endothelial cells and HUVECs was 86.6％ and 94.4％,respectively.Both of them show capabilities of migration and angiogenesis,especially when they were treated with SB431542 to inhibit TGF-β signal pathway.Conclusion:The method for induction of stem cells to endothelial cells is productivity and it can be used for further study.

Objective:To explore bromodomain and extra-terminal (BET) inhibition in the regulation of vascular endothelial cells activation and early atherosclerosis formation and its potential molecular mechanisms.Methods:1.Human umbilical vein endothelial cells (HUVEC) and mouse heart endothelial cells (MHEC) were isolated,and tumor necrosis factor α (TNFα) was used to activate in flammatory genes transcription in the presence or absence of JQ1,a specific BET inhibitor.The groups are as follows:(1)Normal control group;(2) TNFα(25 ng/mL)group;(3) TNFα+JQ 1 group.The gene mRNA and protein expression of inflammatory cytokines were measured by both real-time PCR and flow cytometry (FCM).2.LDL receptor-deficient (LDLR-/-) mice were randomly divided into 2 groups:JQ1 group (n=8,JQlintraperitoneal,50 mg/kg,daily) and control group (n=8,DMSO,daily).After 8 weeks feeding with high cholesterol diet,vascular cell adhesion molecule-1 (VCAM-1) expression in aortic arch was measured by immunohistochemistry.The activity of nuclear factor kappa B (NF-κB) signaling was monitored by 5XκB luciferase reporter assay in HEK293.Results:TNFα dramatically induced the mRNA and protein expression of inflammatory genes and JQ 1 significantly downregulated the induction of them (E-selectin,P-selectin,VCAM-1,IL-8)(P＜0.01).Immunohistochemistry detection indicated that JQ1 significantly downregulated the expression of VCAM-1 in aortic arch induced by 8 weeks high cholesterol diet feeding comparing to control group.In addition,BET bromodomain inhibition downregulated TNFα upregulated NF-κB transcriptional activity (P＜0.01).Conclusions:Our study demonstrated that BET bromodomain was involved in NF-κB mediated inflammatory genes expression;inhibition of BET bromodomain suppressed vascular endothelial activation in vitro,and attenuated early atherogenesis in vivo.

Objective Rapamycin can improve characteristic pathology of AD by improving the level of autophagy.But, its internal mechanism still needs further study.This study was aimed to observe the protective effect of Rapamycin (RAPA) on the injury of rat pheochromocytoma (PC12) cells induced by β-amyloid protein25-35 (Aβ25-35).Methods PC12 cells in the logarithmic phase were randomly divided into 5 groups: control group(similar free-serum DMEM), model group, 10μmol/L RAPA treated group, 40μmol/L RAPA treated group and 160μmol/L RAPA treated group(add 10μmol/L, 40μmol/L RAPA, 160μmol/L respectively).Except the control group, each group was cultured with 20μmol/L Aβ25-35 to established the cell injury model.Results ①Compared with the survival rate of cells[(51.47±2.59)%] and the apoptosis rate of cells[(52.22±2.33)%] of the model group,the survival rate of cells in 10、40、160μmol/L RAPA treated groups and control group[(54.64±2.42)%, (64.79±2.91)% ,(56.50±2.55)% and (99.98±0.73)%] significantly increased, but the apoptosis rate of cells [(45.33±2.83)%, (36.89±2.85)%, (48.00±2.83)% and (3.33±2.45)%] significantly decreased(All P<0.05).②In model group,the expressions of p-PKB is 0.33±0.01, p-mTOR is 1.97±0.05, p-tau is 2.09±0.19.Compared with model group, in 10、40、160μmol/L RAPA treated groups and control group,these expressions of p-PKB (0.37±0.01, 0.42±0.01, 0.40±0.01 and 0.44±0.02) were significantly increased, however p-mTOR (1.64±0.05, 0.66±0.04, 0.35±0.01 and 0.62±0.01) and p-tau (2.02±0.15, 1.79±0.05, 1.86±0.06 and1.53±0.04) were decreased(All, P<0.05).ConclusionRAPA can increase Aβ25-35-induced PC12 cells viability, decrease cells apoptosis rates, and have a protective effect on Aβ25-35-induced PC12 cells death.The mechanism of its protective effect may be related to the inhibition of mTOR regulating PI3K/PKB/mTOR signal transduction pathway by negative feedback and the reduction of tau protein hyperphosphorylation.

The serum TSH levels of 107 infants with subclinical hypothyroidism (SH) were > 20 mIU/L after 1-8 check-up, along with FT4, TT4, within low normal range. After given small dosage L-T4, for 4 weeks, blood TSH level obviously descended while FT4, TT4, ascended (all P <0.01). Seven cases of thyroid hypogenesis and 7 strumas were found by ultrasonography. It seems appropriate to use dosage of 3-4 μg·kg·-1·d-1 L-T4 in treating SH.

Positive linear correlation was found between TSH level and detection rate of congenital hypothyroidism (CH). When measured with a cut-off point at 9, 10, 15 and 20 mU/L of TSH, the sensitivity of positive detection rate for CH was 99.77%, 96.80%, 81.25% and 71.88%, respectively. TSH > 9 mU/L seems to be a reasonable cut-off value.

OBJECTIVETo evaluate the prevalence of avian influenza virus in various environment and the influence factors for subtype H7 prevalence in live poultry markets.

METHODSWe collected environmental samples from various environments across 11 cities of Zhejiang province between October 2014 and March 2015. Cage surface swabs, chopping board surface swabs, feces, water for cleaning, drinking water and swabs of other surfaces were collected. A total of 6 457 samples were collected, including 4 487 samples from poultry markets, 820 samples from poultry farms, 715 samples from backyard poultry pens, 118 samples from poultry processing factories, 118 samples from wild bird habitats and 86 samples from other sites. The chi-squared test was used to compare virus prevalence among sample types, sites types, and poultry markets types. Binary logistic regression was used to analyze factors on H7 subtype prevalence in poultry markets.

RESULTSOf 6 457 samples, 32.54% (2 101) samples were positive for avian influenza, with 3.67% (237) positive for H5 subtype, 12.02%(776) positive for H7 subtype, 11.77%(760) positive for H9 subtype. Of 237 live poultry markets, 33.8% (80) were positive for H7 subtype. The prevalence of influenza A in poultry processing factories was the highest at 43.72% (101/231) (χ(2)=737.80, P<0.001). Poultry markets were contaminated most seriously by subtype H5/H7/H9 with the prevalence of 27.55% (1 236/4 487) (χ(2)=436.37, P<0.001). Compared with markets with 1 type of poultry, OR was 4.58 (95%CI: 1.63-12.87) for markets with ≥2 types of poultry.

CONCLUSIONLive poultry markets and poultry processing factories were contaminated most seriously by avian influenza. The types of poultry might be the factor which influenced the subtype H7 prevalence in poultry markets.

Animals ; Birds ; Environment ; Feces ; Food-Processing Industry ; Influenza A virus ; isolation & purification ; Influenza in Birds ; epidemiology ; Poultry ; virology ; Risk Factors ; Seasons

Objective:To investigate the outcomes of the regimen with docetaxel, cisplatin, and 5-fluorouracil (TPF regimen) in chrono-chemotherapy, and evaluate the feasibility of reducing the toxicity and immunological damage in nasopharyngeal carcinoma (NPC) patients with distant metastasis at preliminary diagnosis, then to compare the advantages and disadvantages between chrono-che-motherapy and traditional chemotherapy. Methods:A total of 46 NPC patients with distant metastasis at preliminary diagnosis (UICC 2010 stage IVc) were enrolled in this study. These NPC patients were randomly divided into chrono-chemotherapy and conventional chemotherapy groups, with 23 cases for each group. TPF neo-adjuvant chemotherapy was conducted in both groups for two cycles, with 21 days to 28 days for each cycle. The following regimen was used for the chrono-chemotherapy group:docetaxel 75 mg/m2, infu-sion, d1;cisplatin 75 mg/m2, 10:00 a.m.-10:00 p.m., continuous infusion, d1-d5;and fluorouracil 750 mg/(m2 · d), 10:00 p.m.-10:00 a. m., continuous intravenous infusion, d1-d5. The following regimen was used for the conventional chemotherapy group:docetaxel 75 mg/m2, infusion, d1;cisplatin 75 mg/m2, infusion, d1;and fluorouracil 750 mg/(m2· d), continuous infusion, d1-d5, 120 h. Patients who obtained therapeutic efficacy via induction chemotherapy were provided with intensity-modulated radiotherapy as a concurrent radio-therapy and chemotherapy (DDP 100 mg/m2, infusion, d1-d2, with 21 days each cycle and a total of two courses). One month after con-current chemoradiation, an adjuvant chemotherapy with the same regimen as the induction chemotherapy was employed for a total of two courses. Acute and late toxicities were graded in accordance with the Common Terminology Criteria for Adverse Events v3.0 scor-ing. Tumor response was evaluated using the 2000 Response Evaluation Criteria in Solid Tumors. The effective rates included complete and partial responses. Relevant data were analyzed by SPSS16.0 statistical software. Results:More emesis was observed at Grade 2 or above in the conventional chemotherapy group than in the chrono-chemotherapy group, with statistical significance between the two groups (P=0.035). After chemotherapy, the value of CD4/CD8 increased in the chrono-chemotherapy group and decreased in the con-ventional chemotherapy group, with statistical significance between the two groups (P=0.033). Conclusion:The proposed chrono-che-motherapy outperforms conventional chemotherapy in reducing the occurrence of severe vomiting. This chrono-chemotherapy may be advantageous in reducing severe bone marrow depression and may play a positive role in the immune function of NPC patients.

Objective To monitor the quality of intravenous infusions in a constructed closed-loop tracking system,and to discuss its application effect.Methods The information program is reinvested in a team for the closed-loop tracking system of the intravenous infusion.There are modules of processing medical orders,pharmacy preparations,execution procedures with the doctor's orders,as well as the computing module.The system was put into clinical trial operation in November 2021 and officially applied in January 2022.Specifically,the number of infusion-related adverse events/red-light alert is recorded and compared before(January to December 2021)and after(January to December 2022)the application of the system.Random sampling method has been performed in a ward to investigate the amount of abnormal infusion for the comparison.Results It is shown that it occurred 3 times for the infusion-related adverse events before the operation of the system,and a time after that.In the neurological inpatients,we observe the amount of red-light alert as 5,120.25±775.82 before the system operation,and 1,518.25±74.77 after that.It is shown to decline by 70.35％on average with statistical significance on the total difference(P＜0.001).Monthly amount of infusion in the ward is 5,184 with 155 times of overfast(2.99％)for 775 minutes in total,and with 207 times of slow(3.99％)for 1,035 minutes in total.The average handling time per contact is 5 minutes.Conclusion The closed-loop tracking system for intravenous infusion quality monitoring can track and record the whole process of intravenous infusions.It is expected to provide accurate and objective data for closed-loop quality inspection on clinical nursing practice,which is conducive to nursing managers for any potential problems during infusion processing timely,to promote standardized nursing operations,and to further improve the safety of inpatients with intravenous infusion and medication.

Objective:To investigate the feasibility, safety and reasonable operation of nasointestinal canal indwelling guided by miniature system in severe neurosurgery patients, and compare its advantages and disadvantages with traditional blind insertion.Methods:A prospective randomized controlled trial design was used to select 128 critically ill patients in need of enteral nutrition support at the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from March 2022 to October 2023 by convenient sampling method. They were divided into blind insertion group and visualization group by random number table method, with 64 cases in each group. Nasointestinal canal indwelling was performed in the blind insertion group by traditional blind insertion method, and in the visualization group, nasointestinal canal indwelling was performed by indentations guided by the miniature visualization system. The success rate of initial catheterization, the time of catheterization, complications, changes of vital signs during catheterization and changes of nutritional indexes after catheterization were evaluated in 2 groups.Results:In the blind insertion group, there were 35 males and 29 females, aged (59.44 ± 13.84) years old. In the visualization group, there were 41 males and 23 females, aged (58.28 ± 12.08) years old. The success rate of the first catheter placement in the visual group was 96.8% (62/64), higher than that in the blind group 82.8% (53/64), and the difference was statistically significant ( χ2=6.94, P<0.05). The catheter placement time of the visualization group was (20.08 ± 2.69) min, which was shorter than that of the blind insertion group (38.19 ± 3.79) min, and the difference between the two groups was statistically significant ( t=29.99, P<0.05). There was no significant difference in the incidence of complications, changes of vital signs during catheterization and the changes of nutritional indexes after catheterization between two groups (all P>0.05). Conclusions:Compared with traditional blind nasointestinal canal indwelling, nasointestinal canal indwelling guided by the miniature visualization system can improve the success rate of the first catheterization and shorten the catheterization time. Although there is no difference in the complication rate, changes in vital signs during catheterization and changes in nutritional indexes after catheterization, it is believed that with the continuous development and upgrading of this technology, it will further reflect the advantages of this technology, which is worthy of further clinical trials and application.

ObjectiveTo explore the effect of early individualized rehabilitation on patients with severe mechanical ventilation. MethodsA total of 36 patients on mechanical ventilation admitted to the ICU of the Second Affiliated Hospital of Anhui Medical University from March, 2019 to February, 2020 were randomly divided into control group (n = 18) and rehabilitation group (n = 18). All the patients completed a rehabilitation assessment within 24 hours of admission, including clinical assessment, state of consciousness and muscle strength assessment. The control group was treated with intensive care routine treatment, including symptomatic treatment of primary disease, nutritional support, placement of normal limbs, active and passive movement of limbs. The rehabilitation group received early individualized rehabilitation in addition., including active and passive limb movements, transfer training, physical factor therapy, and respiratory muscle training after the specific evaluation. The mechanical ventilation duration and ICU length of stay, the hospitalization cost, Richmond Agitation and Sedation Scale (RASS), acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ), and the content of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 were compared. ResultsThere was no significant difference in the weaning rate and hospitalization cost between two groups (P > 0.05). The mechanical ventilation duration and ICU length of stay were less in the rehabilitation group than in the control group (t > 2.067, P < 0.05). After treatment, the score of APACHEⅡ and the content of TNF-α and IL-6 decreased in the control group (t > 2.040, P < 0.05); the score of APACHEⅡ and the content of TNF-α, IL-6 and IL-8 decreased in the rehabilitation group (t > 4.141, P < 0.001); the content of TNF-α, IL-6 and IL-8 was less in the rehabilitation group than in the control group (t > 2.217, P < 0.05). The improvement of all the indexes was better in the rehabilitation group than in the control group (|Z| > 2.104, P < 0.05). ConclusionFor patients on mechanical ventilation, early individualized rehabilitation could improve the sedation, relieve the inflammatory reaction, accelerate the process of weaning, and reduce the length of stay with no extra cost.