Type I diabetes mellitus (T_1DM) is a chronic metabolic disease liable to teenagers all over the world. Its mechanism is due to the attack of auto-immune system on the body's own islet cells leading to hyperglycemia with great damages to the body. The implantation of islet cells is an effective way of curing T_1DM. The authors reviewed in detail the research advancement of islet cell source from stem cells of the bone marrow interstitial substance.

Objective To investigate the possibility of bone marrow mesenchymal stem cells to transdifferentiate into insulinf-secreting cells or islet progenitors,and to demonstrate whether these islet-like cells can generate insulin and glucagon. Methods BMSCs were isolated from tibia or thighbone of 6-8 weeks normal SD rat,purified on the basis of their ability to adhere to matrix,and expanded through their self-renewal.Two-step strategy was adopted,BMSCs were induced to generate nestin-positive cells under diffferentiation culture medium 1(added 20??g/L bFGF,10??g/L EGF and 2% B-(27) in DMDM/F-(12) medium) in step one;Nestin-positive cells were differentiated and developed into islet-like cells or islet progenitors under complexed culture medium 2(added 10??g/L Betacellulin,10??g/L HCF,10??g/L Activin A,10?mmol/L nicotide and 2% B27 serum-free in HG-DMEM medium) in step two.The differentiated cells were tested by Dithiazone staining;Immunocytochemistry was carried out using standard protocols in which the cells were incubated with Rb-Rat insulin monoclone antibody,mouse-human glucogan polyclone antibody and Rb-Rat nestin monoclone antibody and assessed by examining the cells under a Zeiss microscope.Insulin secretion in response to insulin secretagogues(glucose) was assayed by radioimmunoassay(RIA). Results After 5 days,BMSCs were expressing nestin,a marker shared with neural stem cells and pancreatic stem cells.Dithiazone staining was positive(bright orange).The differentiated cell masses were containing insulin and glycagon as indicated by immunocytochemistry.RIA demonstrated that these cell mass could generate insulin,the responsibility to glucose was weak.Conclusion BMSCs can be induced to differentiate into insulin-secreting cells or islet progenitors by adding various different cell growth factors and the strategy is repeatable.This study may present a potential approach for the treatment of insulin-depended diabetes by interventional therapy.

Objective Identify the arsenic and fluorin contents in coal from major producing coal mines in south of Shaanxi,providing a scientific foundation for the formulation of the prevention strategy.Methods In the 6 major coal mine areas governed by Ankang and Hanzhong city,the 62 mines with comparatively large production scales and sales locally,which may have some effective forces on the causing of the local arsenic and fluorin poisoning,were inveatigated,on-the-spot sampling are carried out,the fluorine in coal was determined by the combustion-hydrolysis/fluoride-ion selective electrode method and the arsenic in coal was determined by the atomic fluorescence.Results The maximum of the fluoride content in coal from the 62 investigated coal mines was 3 053.04 mg/kg,and the minimum was 6.58 mg/kg;the arithmetic mean was 1 034.30 mg/kg;the geometric mean was 656.85 mg/kg;The maximum of arsenic content in coal was 484.71mg/kg,and the minimum was 29.64 mg/kg;the arithmetic mean was 197.64 mg/kg,the geometric mean was 174.29 mg/kg.Conclusion The contents of fluoride and arsenic are seriously exceeded the standard limits in the 62 investigated coal mines,especially in stone coal mines.

Objective To study the dynamic changes and clinical significance of vascular endothelial grouth factor(VEGF) and Interleukin 1?(IL 1?) in patients with ischemic cerebral vascular disease.Methods Serum VEGF and IL 1? levels were determined by ELISA and balanced radioimmunoassay respectively in 16 patients with TIA and 38 patients with cerebral infarction during different phase (in 24 h,at 3 d,7d and 14 d after the onset of disease),and 30 healthy controls were included.Results It was found that the levels of VEGF in patients with infarction were much higher than those with TIA( P 0.05 ).Conclusion VEGF and IL 1? may take part in the pathological process of ischemic brain damage VEGF may serve as a sensitive monitor to estimate the cerebral ischemic degree and clinical prognosis.

Objective To investigate the current situation of coal-burning-borne endemic arsenism in the disease affected areas,the usage of anti-arsenism stove and the formation of related behavior;,to evaluate the control effect,so as to provide a basis for development of control strategies.Methods Surveillances were carried out according to the provisions and requirements of The Surveillance Project for Shaanxi Institute Coal-Burning-Borne Endemic Arsenicosis (Trial.).Four villages in two counties of Ankang city and Hanzhong city in Shaanxi Province were monitored in 2010-2014.Using simple random sampling method,10 families in each village were randomly selected to survey the situation of the stove used and related behavior changes.Five households in each village were randomly selected; arsenic level in coal was determined; high arsenic exposed population was investigated according to Endemic Arsenism Diagnostic Criteria (WS/T 211-2001).Urine samples of 30 patients with arsenism were randomly selected to determine the arsenic content.Results The proper utilization rate and the qualified households of improved stoves and iron stoves were all low; the correct drying rate and the correct storage rate of peppers and corns were higher than 95％.The washing rate of corns and peppers before eating were all 100％.A total of 100 copies of coal samples were tested and the arsenism content was between 12.295-455.827 mg/kg,and the geometric mean value of the arsenism content was (91.819 ± 80.989)mg/kg.Seventeen thousand eight hundred and fifty-five individuals were investigated and 1 232 cases of arsenism were diagnosed in the 4 villages; the prevalence rate was 6.90％ (1 232/17 855); urinary arsenism content was between not detected-0.287 mg/L; and the geometric mean value of the arsenic content was 0.033 mg/L.Conclusions The coal-burning-borne endemic arsenism in Shaanxi is in a prevalent state; many anti-arsenism stoves are out of order; and the proper utilization rate is low.To strengthen the disease surveillance,health education and management of anti-arsenism stoves are key measures in control of coal-burning borne endemic arsenism in the future.

Objective To investigate the influence of fluoride and arsenic exposure on children's intelligence and growth development.Methods The illness seriously and lightly affected areas in the coal-burning-borne arsenism and fluorosis areas in the south part of Shaanxi were selected as survey sites from 2011 to 2012,while the illness non-affected areas as controls.Children's IQ was tested,dental fluorosis and growth level of 8-12-year-old students in the school were investigated by random sampling,and the differences of children's IQ and the level of their growth among different groups were analyzed.Urine samples of the children were collected to determine the fluoride and the arsenic content.Results In the illness seriously affected,lightly affected and nonaffected areas,the medians of urinary fluoride of children were 1.96,0.81 and 0.54 mg/L,respectively; and the medians of their urinary arsenic were 0.023,0.019 and 0.018 mg/L,respectively.The average IQ levels were 101.22 + 15.97,104.83 ± 12.78 and 107,92 + 13.62,respectively.In illness seriously affected,lightly affected and non-affected areas,the differences of their height,weight,chest circumference and lung capacity between groups(x2 =36.549,25.859,28.021 and 45.627,all P ＜ 0.01) were significantly different.The height,weight,chest circumference and lung capacity of the children in illness seriously affected(136 cm,31 kg,64 cm,1 432 ml) and lightly affected areas (137 cm,30 kg,65 cm,1 433 ml) were all less than those of the illness non-affected areas (141 cm,34 kg,67 cm,1 660 ml,Z =-5.858,-4.151,-4.196,-4.500,-5.189,-3.240,-6.698 and -4.008,all P ＜ 0.01) ; lung capacity of children in illness seriously affected areas was less than that of the illness lightly affected areas (Z =-2.395,P ＜ 0.05).Their urinary fluoride and arsenic levels were negatively correlated with their IQ(r =-0.560,-0.353,all P ＜ 0.05).Conclusions Fluorine and arsenic exposure is not conducive to children's intellectual development and growth.We propose to strengthen the measure of changing stove furnace in order to provide a healthy growth environment for children.

Copeptin is a part of the C-terminal pro-arginine vasopressin. It is correlated with the prognosis of various diseases. Recent studies have found that copeptin is a novel,independent prognostic marker for stroke, and it may improve the existing risk stratification scheme of stroke.

Objective To investigate the relationship between levels of arsenic and selenium in hair and urine of patients with arsenic poisoning caused by coal-burning.Methods Based on the Standard of Diagnosis for Endemic Arsenism (WS/T 211-2001),about fifty arsenism or suspicious patients over 40 years old were separately selected from Haoping Town and Shuang'an Town of Ziyang County,and the high-arsenic stone coal of Haoping Town was consumed in these two towns,all patients were divided into suspicious,light,moderate,and severe groups.Five coal samples were collected from homes of patients with arsenic poisoning,which were crushed to pieces and sufficiently mixed,0.5 kg of the crushed coal was collected by quartering method to determine arsenic and selenium content;at the same time,5 water samples were collected in homes of patients with arsenic poisoning to determine arsenic and selenium content;in each investigation site,5 ploughs were selected according to the five directions as east,west,south,north and centre,to collect 15-30 cm soil of plough layer,after blending with four points method of shrinkage,1.0 kg was collected to determine arsenic and selenium content in the soil;the urine of all patients instantly and 0.5 g hair sample within 20 mm from the scalp on occiput were collected to determine arsenic and selenium content.Dual channel atomic fluorescence spectrophotometer was used to measure the arsenic and selenium content in the coal,water,soil,urine and hair samples.The contents of arsenic and selenium in coal,water and soil were expressed as （x） ± s;the contents of arsenic and selenium in urine and hair were expressed as medium (M) and quartile range (QR).Results The patients with arseniasis in moderate and severe groups from Shuang'an Town accounted for 9.8％ (5/51) of the total number of patients;the patients in moderate and severe groups from Haoping Town accounted for 39.2％ (20/51).Compared between the two towns of the proportion of arsenic poisoning clinical index,the difference was statistically significant (x2 =31.224,P ＜ 0.01).Compared between Haoping Town and Shuang'an Town,the arsenic contents of soil [(150.71 ± 127.10),(71.10 ± 22.75) mg/kg],water [(0.004 1 ± 0.000 2),(0.006 3 ± 0.000 4) mg/L],urine [0.025 2 (0.023 2),0.026 7 (0.025 6) mg/L] and hair [2.54 (3.52),2.81 (5.98) mg/kg] were not significantly different (Z =-0.913,-1.776,-0.079,-0.544,all P ＞ 0.05).The selenium contents of soil [(5.93 ± 5.76) mg/kg],water [(0.036 9 ± 0.001 8) mg/L],urine [0.056 3 (0.152 2) mg/L] and hair [3.65 (5.43) mg/kg] in Shuang'an Town were higher than those of Haoping Town [(2.41 ± 1.03) mg/kg,(0.006 1 ± 0.000 6) mg/L,0.015 6 (0.013 4) mg/L and 1.52 (2.05) mg/kg],the differences were statistically significant (Z =-2.619,-2.611,-4.765,-2.485,all P ＜ 0.01).There was a positive correlation between hair arsenic and arsenic in clinical grading (r =0.874,P ＜ 0.01);there was a negative correlation between hair selenium and arsenic in clinical grading (r =-0.400,P ＜ 0.01).Conclusions High selenium environment affects the severity of patients with arsenic poisoning,indicating that selenium may promote arsenic metabolism and reduce arsenic accumulation in vivo.Selenium may have an antagonist effect on arsenic.

Objective To detect Mycobacterium tuberculosis (MTB)and its resistance against rifampin (RIF ) by applying Xpert MTB/RIF assay in the clinical samples from patients with extrapulmonary tuberculosis,and to discuss the value of this assay in extrapulmonary tuberculosis. Methods Totally 300 clinical samples from the patients who were highly suspected with extrapulmonary tuberculosis and hospitalized in Department of Tuberculosis Section,Shanghai Public Health Clinical Center of Fudan University from May 2014 to May 2015 were collected.Smear and fluorescence staining microscopy,MGIT 960 BACTEC liquid culture,Xpert MTB/RIF assay were applied to detect MTB in these samples.Meanwhile,all the patients received the peripheral blood T-cell spot of tuberculosis test (T-SPOT.TB).The sensitivity and specificity of Xpert MTB/RIF assay for MTB and its resistance against rifampin (RIF)in extrapulmonary tuberculosis samples were evaluated.The measurement data of two independent samples were analyzed by using t test and enumeration data were analyzed by usingχ2 test.Results Totally 282 out of 300 clinical samples from patients with extrapulmonary tuberculosis were included in this study,and 62.7% were male with average age of (32.1 ±24.6 )years and 37.3%were female with average age of (37.8 ±21 .0)years.When MGIT 960 BACTEC liquid culture results were considered as standard diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of Xpert MTB/RIF assay were 53.8% (95 %CI :37.4%—69.6%),100.0% (95 %CI :86.3%—100.0%),100.0% (95 %CI :80.8%—100.0%)and 63.3% (95 %CI :48.3%—76.2%), respectively.The sensitivity of Xpert MTB/RIF assay in smear-positive/culture-positive samples was 92.3% (95 %CI :62.1 %— 99.6%),while that in smear-negative/culture-positive samples was only 34.6% (95 %CI :17.9%— 55 .6%).Xpert MTB/RIF assay had advantage for detecting MTB in fine needle aspirates,pus,stool and urine,but not in serous effusion and cerebrospinal fluid.However,the sensitivities of MGIT BACTEC 960 liquid culture,fluorescence smear and T-SPOT.TB were 25 .8%, 21 .8% and 70.2%,respectively,and the specificities were 95 .5 %,90.3% and 51 .6%,respectively. The diagnostic value of Xpert MTB/RIF assay was not significantly different from those of MGIT BACTEC 960 liquid culture and fluorescence smear (χ2 =0.61 and 3.45 ,respectively;both P >0.05 ), while it was significantly different from T-SPOT.TB (χ2 =50.58,P <0.05).The sensitivity of T-SPOT. TB was significantly superior to Xpert MTB/RIF assay,but the specificity was relatively low.The sensitivity and specificity of Xpert MTB/RIF assay in RIF resistance detection were 71 .4% (95 %CI :30.3%—94.9%)and 100.0% (95 %CI :86.7%—100.0%),respectively.Conclusions The sensitivity and specificity of Xpert MTB/RIF assay in detecting MTB in fine needle aspirates,pus,stool and urine are relatively high,but not in serous effusion and cerebrospinal fluid.However,the pros of rapid detection and the ability of detecting RIF resistance are useful for the diagnose of extrapulmonary tuberculosis in clinical settings.

Objective To investigate the effects of cisplatin on the expression of calpain in mouse cochlear hair cells in vitro ,and to explore the mechanism of cisplatin-induced apoptosis in mouse cochlear hair cells .Meth‐ods A total of 600 cochlear basilar membranes isolated from Kunming mice at postnatal day 3 were cultured for 24 hours ,then randomly divided into control group and 3 cisplatin groups (4 μg/ml ,8 μg/ml and 16 μg/ml) .Each group contained 150 basilar membranes .Four groups were continually cultured for another 24 hours .Hoechst 33258 staining was used to detect the apoptosis of cochlear hair cell .Immunofluorescent staining and Western blot were carried out for detecting the expressions of calpain 1 (μ-calpain) and calpain 2 (m-calpain) in mouse cochlear hair cells .Results The percent of apoptotic hair cells in the three cisplatin groups (15 .63% ± 0 .20% ,38 .40% ± 2 .64% and 64 .24% ± 0 .05% ,respectively) was greater than that of in the control group (5 .55% ± 0 .12% ) , showing a clear dose-response relationship (P<0 .01) .Furthermore ,the expressions of μ -calpain and m -cal‐pain in different cisplatin groups were increased ,and m -calpain expression was great remarkably with increased concentration of cisplatin (P<0 .01) .Conclusion Our results suggest that cisplatin can induce the apoptosis in mouse cochlear hair cells by regulating calpain pathway .This may play a role in the cisplatin-induced ototoxicity .