Ex vivo-expanded mesenchymal stem cells(MSCs)have been demonstrated to be a heterogeneous mixture of cells exhibiting varying proliferative,multipotential,and immunomodu-latory capacities.However,the exact characteristics of MSCs remain largely unknown.By single-cell RNA sequencing of 61,296 MSCs derived from bone marrow and Wharton's jelly,we revealed five distinct subpopulations.The developmental trajectory of these five MSC subpopulations was mapped,revealing a differentiation path from stem-like active proliferative cells(APCs)to multipotent progenitor cells,followed by branching into two paths:1)unipotent preadipocytes or 2)bipotent prechondro-osteoblasts that were subsequently differentiated into unipotent prechondro-cytes.The stem-like APCs,expressing the perivascular mesodermal progenitor markers CSPG4/MCAM/NES,uniquely exhibited strong proliferation and stemness signatures.Remarkably,the prechondrocyte subpopulation specifically expressed immunomodulatory genes and was able to sup-press activated CD3+T cell proliferation in vitro,supporting the role of this population in immunoregulation.In summary,our analysis mapped the heterogeneous subpopulations of MSCs and identified two subpopulations with potential functions in self-renewal and immunoregulation.Our findings advance the definition of MSCs by identifying the specific functions of their heteroge-neous cellular composition,allowing for more specific and effective MSC application through the purification of their functional subpopulations.

Objective:To observe the expression of molecular chaperone-mediated autophagy in hippocampal neurons and its relationship with brain injury after recurrent-status seizures.Methods:Seven-day-old SD rats were divided into two groups according to simple randomization: the control group (NS group, 6 rats) and the recurrent-seizure group (RS group, 39 rats). Rats in the RS group were subjected to recurrent seizures after repeated inhalation of flurothyl, with 30 minutes once each day for consecutive 7 days.A total of 30 convulsive models were successfully established (9 rats that failed to establish models were discarded), and they were further divided into 0 h, 1.5 h, 3 h, 12 h and 24 h after the last seizure according to simple randomization, with 6 rats in each group.Western blot and reverse transcription-polymerase chain reaction (RT-PCR) were adopted for the observation of the expression of molecular chaperone-mediated autophagy markers [heat shock cognate protein 70 (Hsc70), lysosome-associated membrane protein type 2a (LAMP-2a), heat shock protein 40(HSP40) and heat shock protein 90(HSP90)] in hip-pocampal neurons, and apoptosis was detected by TdT-mediated dUTP nick-end labeling (TUNEL).Results:(1) RT-PCR and Western blot showed that, compared with the NS group, the expression of Hsc70, as a molecular chape-rone, started to increase at 1.5 h and continued until 24 h after the last seizure in the RS group ( P<0.05). HSP90 increased immediately after the last seizure and lasted until 24 h after the seizure ( P<0.01); the expression of HSP40 and LAMP-2a also showed high expression after the last seizure episode ( P<0.05). (2) The TUNEL method showed that the number of apoptotic cells in the hippocampal CA1 region increased significantly at 3 h (36.33±5.16)/40 field, 12 h (44.83±4.83)/40 field and 24 h (54.83±7.16)/40 field after the last seizure compared with NS group(15.16±2.48)/40 field ( P<0.01). (3) Pearson correlation analysis showed that the level of apoptosis in hippocampal CA1 region of rats after recurrent seizures was positively correlated with the expression of molecular chaperone marker molecules (Hsc70: r=0.734, P=0.001; LAMP2a: r=0.790, P<0.001). Conclusions:After recurrent seizures in developmental rats, the presence of increased expression of multiple molecular chaperone-mediated autophagy, which may positively correlate with apoptosis, may be involved in the process of brain injury.

Objective:To evaluate the effects of rocuronium on limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.Methods:Ninety patients of both sexes, aged 50-80 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, with body mass index<30 kg/cm 2, scheduled for elective unilateral knee arthroplasty under general anesthesia combined with femoral nerve block from January 2019 to October 2019, were divided into 3 groups ( n=30 each) using a random number table method: normal saline group (group S), rocuronium 0.6 mg/kg group (group RL) and rocuronium 1.2 mg/kg group (group RH). Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and rocuronium 0.6 mg/kg (group RL) or 1.2 mg/kg (group RH) or equal volume of normal saline (group S). Mechanical ventilation was performed after placement of laryngeal mask to maintain P ETCO 2 35-45 mmHg.Femoral nerve block was performed under ultrasound guidance.Anesthesia was maintained by inhaling 1% sevoflurane and intravenous infusion of propofol and remifentanil to maintain entropy index at 40-60 during operation.Patient-controlled intravenous analgesia was performed with sufentanil after surgery to maintain visual analogue scale score ≤ 4 points.When visual analogue scale score was > 4, flurbiprofen axetil 100 mg was intravenously injected.The vastus medialis muscle at the edge of the incision was obtained at 60 min after inflation to determine the expression of dystrophin by immunohistochemistry.Arterial blood samples were collected immediately after inflation of the tourniquet, at 60 min after inflation, and at 5 and 30 min after deflation for determination of the serum malondialdehyde (MDA) concentrations by the thiobarbituric acid method.The effective pressing times of the analgesic pump and consumption of sufentanil and flurbiprofen axetil were recorded within 48 h after operation.The occurrence of responses to tourniquet and residual muscle relaxation during recovery from anesthesia, the first postoperative off-bed time and postoperative length of hospital stay were recorded.The thigh girth was measured before operation and at 24 and 48 h after operation, and the difference after and before operation was calculated.The range of motion of knees of the operated limb and tourniquet-related complications in the early postoperative period (3 days) and in the long-term postoperative period (3 months) were recorded. Results:Compared with group S, the expression of dystrophin in skeletal muscle was significantly up-regulated, the concentration of serum MDA was decreased at 30 min after deflation, and the difference in thigh girth at 24 and 48 h after operation was decreased in group RH, and the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH and group RL ( P<0.05). Compared with group RL, the range of motion of knees was significantly increased at 3 days and 3 months after operation, and the first postoperative off-bed time was shortened in group RH ( P<0.05). There was no significant difference in the incidence of responses to tourniquet, postoperative length of hospital stay, effective pressing times of the analgesic pump, postoperative consumption of sufentanil and flurbiprofen axetil, and the incidence of tourniquet-related complications in the early and long-term postoperative periods among the three groups ( P>0.05). No residual muscle relaxation was found during recovery from anesthesia in three groups. Conclusion:Rocuronium 1.2 mg/kg can reduce limb ischemia-reperfusion injury in the patients undergoing total knee arthroplasty.

Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.

Objective To investigate the the association between psychological behavior and self-awareness of obese children and family factors,in order to provide scientific basis for clinical intervention in obese children. Methods Fifty children with obesity ( obesity group) and fifty healthy children ( control group) were included in the study. All children were evaluated with the Achenbach Child Behavior Checklist (CBCL),Piers-Harris Child's self-concept Scale ( PHCSS), Family Environment Scale-Chinese Version ( FES-CV) and Egma Minnen av Bardndosnauppforstran(EMBU). Moreover,correlation analysis was applied in the study to explore family factors affecting behavioral problems and self-awareness of obese children. Re-sults Compared with control group,significant higher ratio of abnormal behaviors was found in children with obesity (P<0. 05). FES-CV showed that the degree of expressiveness((3. 16±1. 93),(4. 65±1. 02)),intel-lectual-cultural orientation((5. 31±1. 28),(6. 10±1. 83)) and active-recreational((2. 78±1. 36),(4. 84± 1. 72)) were lower than control group,and the degree of family conflict((4. 11±1. 45),(3. 32±1. 27)) and control((6. 42±1. 37),(5. 09±1. 65)) were higher in children with obesity (P<0. 05). Moreover,EMBU showed that emotional warmth score was significantly lower in obese group than that in control group (P<0. 01),and the scores of parent's rejection,father's severity,parent's over-interference,and mother's over-protection were significantly higher than the scores in control group(P<0. 05). In obese group,the correlation analyses showed a negative association between social withdrawal in children's behavioral problems and fami-ly expressiveness (r=-0. 62,P<0. 01),and a positive association between aggressivity and family conflict (r=0. 39,P<0. 05). There was a positive correlation between internalizing behavioral problems and mother's over-protection and over-interference(r=0. 60,P<0. 01). Low self-awareness was positive associated with parent's rejection and father's severity(r=0. 46,0. 51,0. 44 respectively,P<0. 05). Conclusion A signifi-cant higher risk of abnormal psychological behaviors and low self-concept can be found in children with obe-sity,which can closely related to family factors.

Objective:To compare the clinical utility of mammography with automated breast ultrasound system (ABUS) for detecting breast lesions. Methods:Data of 142 patients with 149 breast lesions who underwent both mammography and ABUS in Tianjin Medi-cal University Cancer Institute and Hospital were collected from Jnly 2016 to September 2016. The detection rates of the two methods were then determined. Results:The overall detection rate using ABUS was significantly higher than that of mammography (mammog-raphy: 87.2% vs. ABUS: 98.0%, P<0.05). However, no significant difference was observed in breast cancer detection rates between mammography and ABUS (mammography:91.1%vs. ABUS:97.0%, P<0.05). Moreover, the benign lesion detection rate was significant-ly higher in ABUS than in mammography (mammography:79.2%, vs. ABUS:100%, P<0.05). In dense breasts, the detection rates of overall lesions, breast cancers, and benign lesions for ABUS were 97.7%, 96.5%, and 100.0%, respectively;whereas those for mammog-raphy were 86.0%, 90.6%, and 77.3%, respectively (P<0.05). Owing to overlapping dense breast tissue and deep anatomic location, sev-eral lesions were missed on mammography. Conversely, most lesions missed on ABUS presented as calcifications. Conclusion:Com-pared with mammography, ABUS can detect more lesions especially in dense breasts. However, ABUS failed to detect calcifications, whereas mammography had distinct advantages in this regard. Overall, the two methods had potential supplementary value for breast cancer screening.

Objective To explore the construct validity of the competency assessment questionnaire for junior registered nurses and offer evidence for further tool developments. Methods A total of 603 junior registered nurses from eight level three class A hospitals in Beijing were included and investigated by the competency assessment questionnaire. Exploratory factor analysis was used to analyze the data. According to the results and the experts panel discussion, the items were selected and adjusted. Results The final questionnaire consisted of 4 factors with 23 items and the accumulating explanatory rate of the 4 factors was 61. 785%. The Cronbach′s α coefficient was 0. 787. Conclusions The competency assessment questionnaire for junior registered nurses can evaluate the competency of nurses from 4 aspects, and can also help to guide the improvement of following standardized training.

Objective To discuss the application effects of nurse-leading care program in patients with type 2 diabetes. Methods A total of 68 cases of diabetic patients in our hospital were selected as observation group (implementation of nurse-led care programs) from January to May 2014, while 66 cases of diabetic patients in our hospital were selected as control group ( given conventional nursing care) from August 2013 to December 2013. The comparison of the two groups were carried out about nursing treatment compliance, self-care ability and life quality. Results The patients in the observation group after interventions, the score of compliance about blood sugar monitoring, medication taking, regular exercise, reasonable control of healthy eating, pathoglycemia handling, foot care, smoking cessation, complication prevention scores were significantly higher than those of the control group (t= -3. 659,-3. 524,-3. 869,-4. 569,-2. 568,-4. 023,-3. 759,-3. 214; P < 0. 01 ). The patients′ healthy education level, self-nursing care, self conception, self-responsibility and quality of life in the observation group improved. Conclusions Nurse-leading care program can improve the patients′treatment compliance, self-care ability and life quality of patients.

Objective To explore the influence of pithy formula of diet and exercise on patients with metabolic syndrome.Methods A total of 240 patients with metabolic syndrome from March 2010 to March 2014 were randomly divided into pithy formula group (n=120) and control group (n=120).Patients in the control group were given conventional education of diet and exercise of metabolic syndrome,while patients in the pithy formula group were given pithy formula of diet and exercise, exercise training and food model and doing interactive education.Before and after the intervention, fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, free fatty acid, triglyceride, diet and exercise score, life mode intervention compliance score of two groups in sixth month were observed and compared.Results Compared with patients before intervention, fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, free fatty acid, triglyceride of patients in the two groups were reduced 6 months after intervention, while the degree of reduce was statistically in pithy formula group (P<0.05).No significant difference was found in the scores of diet and exercise, life mode intervention compliance between two groups ( P >0.05 ).Six months after intervention, diet and exercise scores of metabolic syndrome ( 86.5 ±9.7 vs 67.2 ±9.2 ) , intervention compliance scores of mode of life ( 26.6 ±5.2 vs 24.6 ±5.1 ) of patients in pithy formula group were significantly increased than that before the intervention and control group [(86.5 ±9.7 vs 79.4 ±8.5), (26.6 ±5.2 vs 24.9 ±5.0)](t=15.814,3.008,6.030,2.581,respectively;P<0.01).Conclusions Pithy formula of diet and exercise has positive influence on patients with metabolic syndrome which can improve the patients’ condition and compliance with diet and exercise.

Objective To discuss the application of discharge planning services for patients with metabolic syndrome .Methods Totals of 168 cases clearly diagnosed as Metabolic Syndrome ( MS ) from October 2012 to October 2013 in our hospital were chosen and all cases were randomly divided into experimental group and control group .The control group was underwent routine nursing education , while experimental group was given discharge planning services based on routine .Self-behavior management , blood pressure , fasting plasma glucose , body mass index ( BMI ) , total cholesterol index and other general indicators between two groups were compared after nursing intervention .Results After intervention , the division score of disease monitor, complication management, operation skill, medication compliance, diet, water and salt restricted and self-management were (9.20 ±1.36), (2.32 ±0.21), (8.06 ±1.85), (5.86 ±0.12), (5.61 ±1.03) and (30.28 ±3.26), which were higher than those in the control group (t=5.365,2.363,3.657,2.115,6.644, 3.215;P<0.05).Except of self-behavior management in the experimental group and medication compliance and complication management in the control group enhanced after intervention (P <0.05), the other four dimensions had no statistical significance (P>0.05).The BMI, systolic pressure, diastolic pressure, total cholesterol and fasting plasma glucose were ( 24.98 ±3.55 ) kg/m2 , ( 132.6 ±12.3 ) mmHg, ( 89.6 ± 11.2)mmHg,(4.56 ±1.20)mmol/L and (7.62 ±2.65)mmol/L respectively (t =3.265, 2.986, 2.856, 3.021, 5.962, respectively; P <0.01).Conclusions Discharge planning services can improve the self-behavior management ability of patients with the metabolic syndrome , and can effectively control the patient ’ s BMI, blood pressure, total cholesterol and fasting glucose .