Objective To investigate the influence of acupuncture therapy on neural stem cell (NCS) proliferation and differentiation in the hippocampus of the senescence-accelerated prone-8 (SAP8) mouse. Methods Twenty-four SAP8 mice were randomly and equally divided into a model group and an acupuncture group. Twelve senescence-accelerated resistant ( SAR1 ) mice served as the control group. Acupuncture was administered at the Baihui (DU20) point to mice in the acupuncture group once daily for 21 consecutive days. Bromodeoxyuridine (BrdU) was used to detect the proliferation and differentiation of NCSs in the hippocampus through double-labeled immunofluoresSAR1 group, the positive cells in the SAP8 group were significantly fewer Compared to the SAP8 group, positive cells markers of neuron or glia cell positive cells appeared. Compared to the SAR1 group, the expression of BrdU/GFAP increased in the SAP8 group, and decreased after acupuncture but not significantly. BrdU/S-100 β cells decreased significantly in the SAP8 group, and increased after acupuncture, but again not significantly. Compared to the SAR1 group BrdU/GalC positive cells increased significantly in the SAP8 group and decreased significantly after acupuncture.Conclusions After acupuncture treatment for 21 days, the differentiation of hippocampal NSCs into oligodendrocytes was inhibited, but there was little effect on their differentiating into neurons and immature astrocytes.

The authors summarize Professor SHI Qi's clinical experience in diagnosing and treating chronic tendon and bone disease.The specific diagnosing and treating thinking and methods could be summarized as follows:1)Three stages,which means chronic tendon and bone disease could be treated according to early,medium and late stages.2) Three differentiations,which include differentiating disease,type and syndrome.3) Three examining,which include seeing patient clearly,reading the disease and getting the key point.In addition,Prof.SHI emphasizes threepoint syndrome differentiation which means the combination of the lesion's target,peri-target and whole syndrome characteristics differentiation.In the process of treatment,Prof.SHI emphasizes three methods combination of herb,technique and breathing technique.Both internal and external treatments should be used.Prof.SHI advocates that the control strategy should be the prevention,treatment and recuperation integration concept,including preventing disease,early treatment to prevent deterioration and preventing reoccurrence after cure.

BACKGROUND:Human umbilical cord mesenchymal stem cells (hUC-MSCs) may be mutated duringin vitro culture based on the spontaneous malignant transformation of adult stem cells and tumor stem cell theory, and there may be a risk of tumorigenesis after in vivo transplantation. Therefore, to establish and perfect the in vitro safety testing procedures will actively promote the clinical application of stem cells. OBJECTIVE:To investigate the tumorigenic mechanism of hUC-MSCs and the expression level of DNA methyltransferase (DNMTs) in hUC-MSCs. METHODS:Primary hUC-MSCs were isolated and expanded by tissue adherent culture. 3-Methycholanthrene was used to cause the malignant transformation in hUC-MSCs (experimental group), followed by morphological observation and tumorigenesis experiment in nude mice. Then, the tumor tissues were obtained and identified by pathological examination and primary cell culture, and the levels of DNMTs mRNA in hUC-MSCs treated with 3-methycholanthrene and dimethyl sulfoxide (control group) were detected by real-time RT-PCR and compared. RESULTS AND CONCLUSION:hUC-MSCs treated with 3-methycholanthrene led to malignant transformation, which showed malignant growth and non-integer ploidy changes in the cell nuclei, and formed a malignant tumor in immune-deficient mice after injection. Compared with the control group, the cells in the experimental group showed higher expression of DNMTs mRNA as detected by real-time RT-PCR. To conclude, hUC-MSCs can trigger malignant transformation in the morphology and the epigenetics under certain conditions. DNMTs can be a candidate for prevention against malignant transformation of transplanted stem cells.

Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma (PHC) patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group (48 cases) and the experimental group (43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions (including services and techniques, concern and care, services and techniques and overall satisfaction) were (132.75 ± 13.71), (48.30 ± 6.53), (42.60 ± 4.62), (35.98 ± 3.85), (5.88 ± 0.94), while they were (122.89 ± 16.62), (44.53 ± 7.74), (39.49 ± 5.67), (33.53±4.40), (5.33±1.13) in the control group. And the scores of the experimental group were significantly higher than that of the control group (t=-2.961, t=-2.409, t=-2.753, t=-2.709, t=-2.389, P<0.05). Furthermore,after implementing the fast-track clinical nursing pathway,the total score of nurse job satisfaction and the scores of six factors were (143.23 ± 9.40), (28.45 ± 2.72), (24.82 ± 2.28), (23.05 ± 1.33), (13.91 ± 1.95), (15.05 ± 1.43), (16.64 ± 1.65) while they were (127.36 ± 13.14), (25.68 ± 4.16), (19.64 ± 2.75), (20.23 ± 2.35), (13.23 ± 2.22), (13.68 ± 2.01), (14.50 ± 1.95) before the implementation. The former was significantly better than the latter (t =-12.462,-7.743,-12.670,-6.560,-2.417,-1.483,-6.587,P<0.05). However, no differences were observed in the other two dimensions of wages and benefits andwork-family balance(t =-1.945,-1.312,P>0.05) since the scores after implementation were (13.86 ± 2.12), (7.45 ± 1.57), while that of (13.18 ± 2.30)、(7.23 ± 1.41) were obtained before performance. Conclusions Application of fast- track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients.

Trajectories refer to the motion paths followed by objects in space. Disease trajectories, which depict the evolution of disease processes over time, are significantly important for assessing diseases, formulating treatment strategies, and predicting prognosis. Critical illness is one of the leading causes of death. With advances in critical care medicine, there is increasing focus on the occurrence and development of critical illnesses. Understanding the development trajectory of critical illness is helpful to promote the early identification, intervention, and treatment of high-risk patients, avoid prolongation of the course of disease, reduce the risk of multiple organ failure, and provide important reference for the development of targeted prevention and intervention strategies, thereby reducing the incidence and mortality of critical illness. In recent years, various trajectory modeling methods have been applied to the study of critical illness. These include, but are not limited to, latent growth curve modeling (LGCM), growth mixture modeling (GMM), group-based trajectory modeling (GBTM), latent transition analysis (LTA), and latent class analysis (LCA). The aim of this article is to review the definition of disease trajectories, the methods used in trajectory modeling, and their applications and future prospects in critical illness research.

Objective To evaluate the efficacy and safety of nasal continuous positive airway pres-sure (NCPAP) in treatment of severe pneumonia in children. Methods A series of 150 children with severe pneumonia were prospectively included from January 2016 to June 2017. The 150 children all still had short-ness of breath after 1 hours of nasal oxygen delivery,and then switched to NCPAP. We collected related clini-cal parameters (the basic vital signs,blood gas analysis index,shortness of breath,wheezing,groaning,nasal incitement,three depressions sign and NCPAP parameters) at three time points,including 0 h,1 h,4 h after using NCPAP. We compared the clinical parameters among the three time points before and after NCPAP with the purpose to assess the efficacy and safety of NCPAP. Results The proportion of shortness of breath (χ2=272. 218,P=0. 01),fast heart rate(χ2=31. 625,P=0. 01),wheezing(χ2=7. 624,P=0. 02),moaning (χ2=7. 203,P=0. 025),nasal flaring(χ2=74. 032,P＜0. 01),three depressions sign(χ2=117. 030,P＜0. 01) gradually decreased with statistically different among 0 h,1 h and 4 h after using NCPAP. PaO2/FiO2 (F=7. 32,P＜0. 01) gradually increased with statistically different among 0 h,1 h and 4 h after using NCPAP. Twenty-seven patients required intubations. PaO2and PaO2/FiO2in patiens received intubations were lower than those in patients only received NCPAP before treatment. Conclusion NCPAP is an effective and safe way for severe pneumonia children who remained abnormal breathing after conventional oxygen inhalation.

Objective To study the clinical data of patients treated with nasal continuous positive airway pressure (NCPAP) in PICU,and to explore the application time and range of NCPAP in critically ill children. Methods A prospective study was conducted to collect clinical data of 192 severe patients admitted to PICU from January 2016 to June 2017 who had shortness of breath after giving oxygen through nasal cath-eter for 1 hour and then switched to NCPAP. According to using NCPAP oxygen partial pressure,children were divided into three groups:group A[ shortness of breath ( PaO2≥70 mmHg,1 mmHg＝0. 133 kPa) ], group B[shortness of breath combined,reduced oxygen partial pressure(50mmHg

Objective: To understand emotional and behavioral problems of children aged 3-6 years, and to explore the role of parenting style in the development of those problems. Methods: A total of 2 278 children from 11 public kindergartens in Tongling City from April to June 2018 were selected by cluster sampling method. The questionnaire was made up by parents. The questionnaire mainly included: children, basic information of parents and children, children’s psychology and behavior, and parents’ education style, etc. Results: Among 2 278 children, 192(8.43%) had abnormal emotional symptoms, 214 (9.39%) had conduct problems, 376(16.50%) had hyperactivity problems, 537(23.57%) had peer problems, 233(10.2%) had abnormal total difficulty scores and 254(11.15%) had prosocial behaviors. Gender, age, health status of the child, second-hand smoke exposure of the baby, parents’ education level, family economic conditions, and parents’ education mode are all the influencing factors of children’s emotion and behavior(P<0.05). Logistic analysis showed that father’s support participation(OR=0.96, 95%CI=0.95-0.98), mother’s support participation (OR=0.94, 95%CI=0.92-0.95), mother’s hostility compulsion (OR=1.08, 95%CI=1.06-1.10) and 3-6-year-old children’s abnormal mood and behavior were correlated(P<0.01). Conclusion Parental support and maternal hostile are related to emotional and behavioral problems of 3-6-year-old children.

Primary angle-closure glaucoma (PACG) is a common subtype of glaucoma and one of the leading causes of blindness in Asia.Trabeculectomy has been recognized as an effective filtering surgery for PACG and is widely used in clinical practice, but its high risk of postoperative complications, especially bleb scarring over time can not be ignored.Nowadays, non-bleb-based minimally invasive glaucoma surgeries (MIGS) have attracted much attention.Surgeries opening, restoring, or expanding Schlemm canal to reconstruct aqueous humor outflow pathway is one of the MIGS and able to achieve moderate intraocular pressure (IOP) reduction, which has been widely used in the treatment of primary open-angle glaucoma (POAG) for a long time.However, based on the pathogenesis of PACG and its similar pathological changes in Schlemm canal to POAG, some retrospective studies and prospective single-arm studies discovered that Schlemm canal surgery combined with phacoemulsification and/or goniosynechialysis appears to lower IOP well and safe in PACG eyes in recent years.Whether Schlemm canal surgery is also suitable or effective for PACG is getting some attention and is still controversial up to now, mostly due to some differences in pathogenesis between PACG and POAG, it is necessary to perform randomized controlled trials to confirm the efficacy of Schlemm canal surgery for PACG and upgrade the therapeutic strategy of PACG.

OBJECTIVETo assess the performance of pediatric risk of mortality (PRISM), pediatric index of mortality 2 (PIM2) in predicting mortality in critically ill pediatric patients via a prospective study.

METHODThe outcome and the variables required to calculate PRISM and PIM2 were collected. The efficiency of PRISM and PIM2 in differentiation between death and survival by calculating the area under the receiver operating characteristic curve (ROC). Calibration across deciles of risk was evaluated using the Hosmer-Lemeshow goodness-of-fit χ(2) test.

RESULTA total of 412 critically ill pediatric patients transferred to Hunan Children's Hospital during August 1, 2012 and May 31, 2013 were enrolled in the study, and more than two-thirds of the children were suffering from respiratory and miscellaneous diseases; 45 (10.9%) inter-hospital transport of critically ill pediatric patients died at the time of hospitalization. The expected number of deaths were 45.01 by PRISM, and the expected number of deaths were 44.99 by PIM2. The expected mortality rate was 10.9% for PRISM or PIM2. The standardized mortality rate was 1.000 (0.710-1.290) for PRISM and 1.000 (0.710-1.290) for PIM2. The Hosmer-Lemeshow test gave a chi-square of 8.75 (P=0.364) for PRISM and 22.75 (P<0.05) for PIM2, PRISM had better fitting with the actual mortality than PIM2. The area under the receiver-operating characteristics (ROC) curve (95% confidence intervals, CI) were 0.829 (0.768-0.890) for PRISM and 0.758 (0.667-0.849) for PIM2.

CONCLUSIONAlthough the PIM2 test is less well calibrated overall, both PRISM and PIM2 can offer a good capacity for discriminating between survivors and moribund patients. The good performance of PRISM and PIM2 are demonstrated in predicting mortality probability in critically ill pediatric patients.