BACKGROUND:Heart transplantation is an effective method for treatment of end-stage heart failure, but immune rejection that seriously impact therapeutic effacicy is easy to occur after transplantation. OBJECTIVE:To investigate the regulatory effect of bone marrow mesenchymal stem cel s on the immune function of rats undergoiong heart transplantation. METHODS:Twenty Lewis rats were enrol ed as donors, and 20 Wistar rats as recipients. Heart transplantation models were established in the Wistar rats. These 20 model rats were randomized into cel transplantation and control group with 10 rats in each group. Forty-eight hours after heart transplantation, rats in the cel transplantation group were given bone marrow mesenchymal stem cel suspension (1 mL, 2×108 cel s/L) via the tail vein, while rats in the control group were given normal saline in the same dose. Then, the expression levels of serum interleukin-2, interleukin-10 and percentage of CD4+, CD8+, CD4+/CD8+, CD4+CD25high, CD4+CD25high Foxp3+T cel s in the venous blood were detected in the two groups at 7 days after cel transplantation. Additional y, rat myocardial tissues were taken and observed pathological y. RESULTS AND CONCLUSION:The survival time of the cel transplantation group was significantly longer than that of the control group (P<0.05). The expression level of interleukin-2 showed no significant difference between the two groups (P>0.05), but the level of interleukin-10 in the cel transplantation group was significantly higher than that in the control group (P<0.05). Compared with the control group, the percentage of CD4+/CD8+, CD4+CD25high, CD4+CD25high Foxp3+and CD4+T cel s was significantly higher, and the percentage of CD8+T cel s was significantly lower in the cel transplantation group (P<0.05). Histopathological findings showed that there were a smal amount of infiltrated lymphocytes in the cel transplantation group with the presence of slight bleeding and edema, and these inflammatory reactions were milder than those in the control group. These findings indicate that bone marrow mesenchymal stem cel transplantation can effectively reduce the rejection in rats undergoing heart transplantation.

Objective To investigate the urinary iodine level and the thyroid function of early pregnant women in Qingdao,to explore the relationship between the iodine nutritional status and hypothyroidism.Methods 326 early pregnant women (<12 gestational weeks)were collected.The urinary iodine concentration and serum thyroid stimulating hormone (TSH),free thyroxine (FT4 ),thyroid peroxidase antibody (TPOAb)were detected. Results The median of urine iodine of pregnant women was 176.57μg/L,and the ratios of iodine deficient,iodine adequate,iodine more than adequate and iodine excessive groups were 3 8.65%,41.10%,15.95% and 4.30%.The total ratio of innormal urine iodine was 58.9%(192 /326).The differences between the ratios of the iodine deficient group,iodine excessive group and iodine adequate group both had statistically significant(χ2 =4.308,P <0.05;χ2 =4.826,P <0.05 ).There was no effect of iodine intake levels on serum thyroid peroxidase antibody.Conclusion There is no iodine deficiency among early pregnant women in Qingdao,but still individuals expose iodine deficiency.Iodine deficiency and iodine excessive are the risk factors of hypothyroidism during early pregnancy women,so we commend to detect the urinary iodine level.

AIM To observe the effect of phosphonoformic acid (PFA) in different concentration on vascular calcification induced by elevated phosphate. METHODS The cell culture of bovine aortic smooth muscle were performed. Calcium deposition in different phosphate and PFA concentrations were determined by O cresolphthalein complexone method, and osteocalcin expression by radioimmunity and RT PCR. RESULTS Compared to Pi 1 5 mmol?L -1 group,bovine smooth muscle cells (BSMC) cultured in medium containing Pi 2 0 mmol?L -1 phosphate level increased calcium deposition 〔On day 6, (77 187?11 692) mg?g -1 Pro versus (25 768?1 750) mg?g -1 Pro, P

Objective To investigate the mechanism of high phosphate - stimulated calcification in vascular smooth muscle cell. Methods The cell culture of bovine aortic smooth muscle was performed. Osteocalcin (OC) mRNA expression and calcium deposition in different phosphate concentrations [normal phosphate (Pi 1. 5mmol/L), high phosphate (2.0mmol/L)] were determined by radioimmunoassay, RT-PCR, and 0-cresolphthalein complexone method respectively. Results After 72 hours,high phosphate treatment of smooth muscle cells(SMC) enhanced the expression of osteocalcin protein [Pi 2. 0 mmol/L versus Pi 1. 5 mmol/L: (15. 03?2. 60) pg/u-g protein versus (2. 98 ?0.84) pg/ug protein, P

Objective To discuss the value of nursing work in 64-slice CT urography. Methods 240 patients participated in the 64-slice CT urography, inquiring medical history and iodine allergic history, paying attention to their psychological state and finishing iodine preliminary test before examination, ob-serving patients carefully, pre-judging any possible adverse effect and formulating corresponding measures during the examination, giving expectant treatment according to the various condition and nursing instruc-tion. Results 239 patients passed through the examination smoothly, agents exosmosis happened in one case and led to failure, but satisfactory image was obtained after rescanning. Conclusions Nursing oper-ation penetrates every step of 64-slice CT urography, which is a non-traumatic, low-expense and high-safety examination. Effect nursing directly influences the accuracy of the results, proficient nursing opera-tion and patient psychological nursing is the important part of it.

Objective To discuss the effeet of nursing intervention in the prevention of psychiatric disorder in patients after coronary artery bypass grafting (CABG). Methods Patients with CABG(202 cases) were divided into the control group (100 cases) and the intervention group (102 cases).The control group received routine treatment and nursing while the intervention group was given systemic nursing intervention.The mental status was evaluated by mini-mental status examination (MMSE). Results The incidence of psychiatric disorder in the intervention group was 4 cases (3.92%),which was statistically lower than those in the control group(16 cases,16.00%). Conclusions Effective nursing intervention combined with effective treatment could prevent and control the psychiatric disorder of patients after CABG.

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .

Objective To investigate the effect of hyperphosphatemia on type Ⅱa sodium dependent phosphate cotransporter (NaPi-2)mRNA expression in the kidneys of 5/6 nephrectomized (STNx)rats and evaluate the interference of Renagel. Methods Forty-two male Sprague-Dawley rats underwent 5/6 nephrectomy or sham operation. The animals were then divided into seven groups: (1)STNx+high-Pi diet(HP) group (1.2%P); (2)STNx+low-Pi diet(LP) group(0.2%P); (3)STNx+ normal-Pi diet (NP) group; (4)STNx+HP+Renagel-treated (Ren)group; (5)sham+HP group; (6) sham+LP group; (7)sham+NP group. Serum ionized calcium (iCa) , phosphorus, and iPTH levels were detected at day 2,7,14.The kidneys were removed after the rats were sacrificed on day 14 and serum 1,25-(OH)2D3 and FEp were measured. RT-PCR was applied to examine NaPi-2 mRNA. Results Serum P and iPTH levels in STNx+HP group were significantly higher than those in STNx+ LP and 3 sham groups (P0.05)among these five groups mentioned above. Serum P and iPTH levels in Renagel-treated group were much lower than those in STNx+HP group (P

Objective To explore the characteristic of intelligence, personality and mentality of patients with intractable epilepsy and analyzethe related factors on intelligence. Methods 68 patients with intractable epilepsy and 60 healthy persons were assessed with Raven'sstandard progressive matrices (SPM), Eysenck personality questionnaire (EPQ) and 90 symptoms checklist (SCL-90). The related factors onintelligence were analyzed. Results Compared with controls, the total score and IQ of SPM of the patients decreased significantly (P<0.05).There were 51.4% of intellectual deficiency in patients with intractable epilepsy, which was higher than that of controls (1.7%) (P<0.05).There was no significant difference in score of EPQ and the proportion of personality type between 2 groups (P>0.05). The total score ofSCL-90 and the factor score, such as somatization, interpersonal sensitivity, depression, anxiety and hostility in patients were higher thanthose in controls(P<0.05). Various factors, including the onset age, course of disease, seizure types, frequency, duration, number of drug, thescores of SCL-90 were correlated with the intelligence of epileptic patients (P<0.05). Conclusion The intelligence of many patients with intractableepilepsy were damaged, and many patients were with various psychological barriers. The onset age, course of disease, seizuretypes, frequency, duration and number of drug were important factors related with intellectual disorders in patients with intractable epilepsy.

Objective:To evaluate the value of combined measurement of urinary insulin-like growth factor-binding protein 7 (IGFBP7) and urinary metalloproteinase inhibitor-2 (TIMP-2) in the early diagnosis and prognosis of cardiac surgery-associated acute kidney injury (CSA-AKI).Methods:From March 2018 to June 2018, cardiac surgery patients admitted to the cardiac macrovascular surgery department of the First Affiliated Hospital of Nanjing Medical University were prospectively included, and the blood creatinine was monitored to observe the presence of acute kidney injury (AKI). The prognostic information of the patients was collected, including in-hospital dialysis, in-hospital death, complete recovery of kidney function at discharge, death in one year after surgery, and progression to chronic kidney disease. The levels of urine IGFBP7 and TIMP-2 at 6 h, 24 h and 48 h after cardiac surgery were detected by enzyme linked immunosorbent assay (ELISA), and the urine creatinine (Cr) was also measured. Moreover, receiver operating characteristic curves (ROC) were plotted and the areas under the curves ( AUC) were calculated to evaluate the predictive value and prognostic value of urinary [TIMP-2]·[IGFBP7] (T*I for short) and urine T*I/urine Cr 2 in CSA-AKI. Results:A total of 74 patients with age of (58.43±10.91) years old and 47 males, were enrolled in this study, of which 24 cases (32.4%) had AKI and 10 cases (13.5%) had stage 2-3 AKI. Compared with the non-AKI group, the AKI group had significantly higher levels of urine T*I levels at 6 h and 24 h (both P<0.05). The AUC of T*I at 24 h predicting for AKI was 0.71(95% CI 0.59-0.81, P=0.001, cutoff value 0.020, sensitivity 79.2%, specificity 56.0%), while the AUC for stage 2-3 AKI was 0.85 (95% CI 0.75-0.92, P<0.001, cutoff value 0.083, sensitivity 70.0%, specificity 90.6%). Urinary T*I normalized for urinary creatinine excretion did not show better predictive value. In addition, of T*I at 24 h predicting for poor hospitalization outcome, renal recovery, and one year postoperative death, the AUC was 0.82(95% CI 0.71-0.90, P=0.001), 0.80(95% CI 0.66-0.86, P<0.001), and 0.81(95% CI 0.70-0.89, P=0.047), respectively. Conclusion:The combined detection of TIMP-2 and IGFBP7 in urine is expected to be a biomarker for early diagnosis of CSA-AKI and has certain clinical value in predicting the prognosis of CSA-AKI.