BACKGROUND:At present,application revascularization and drug treatment may arrest aggravation of heart function and arrhythmic development,but effectiveness is limited.Infarcted myocardial cells are still impossible to regenerate.How to make necrotic myocardial cell regeneration and diastolic myocardial function is the problem to solve.OBJECTIVE:To analyze the study progress of bone marrow stem cells in treatment of myocardial infarction.RETRIEVAL STRATEGY:A computerized online database of Pubmed was searched to identify articles published from May 2000 to July 2006 with the key words of "the marrow stem-cell,cell transplant,myocardial infarction" in English.Simultaneously,articles published between October 1997 and December 2006 were identified in China Journal Full-text Database with the same key word in Chinese.Sixty-seven articles were retrieved and data were selected primarily.Inclusive criteria:①articles related to the transplantation of bone marrow stem cells for the treatment of myocardial infarction,②in the same field,articles recently published or in authoritative journals.Exclusive criteria:①articles of repetitive study,and ②Meta analysis.LITERATURE EVALUATION:Articles mainly analyzes the transplantation of stem cells for the treatment of myocardial infarction.Of the 30 included articles,10 were reviews and the rest was clinical or basic studies.DATA SYNTHESIS:①Bone marrow stem cells are composed of bone marrow mononuclear cells,hematopoietic stem cells,bone marrow mesenchymal stem cells,endothelial stem/progenitor cells,multipotent adult progenitor cells and so on.②After the transplantation,bone marrow stem cells can differentiate into myocardiocytes,and do effectively electromechanical coupling with receptors.Bone marrow stem cells can promote the angiogenesis in ischemic region,avoid ethical dispute and immunological rejection,and these cells are easy to collect.Bone marrow stem cells are adult stem cells,and its transdifferentiation deserves further study.Many clinical studies showed that autogeneic bone marrow stem cell transplantation for the treatment of acute myocardial infarction and heart failure could be achieved.③Matrix metalloproteinase,stem cell factor and stromal cell chemokine from bone marrow stem cells play important roles in stem cell mobilization,homing and myocardial repair.Tissue injury and high-level multipotential stem cells are two key factors of the differentiation of bone marrow stem cells in myocardial microenvironment.④ Problems in bone marrow stem cell transplantation included cell type,regulatory mechanism of transdifferentiation,optimal time,manner and safety of transplantation,etc.CONCLUSION:Through establishing complete animal model,the possibility of each technique in clinical procedures is explored.Bone marrow stem cells in treatment of acute myocardial infarction may become a new method,which has different from traditional drug treatment,interventional therapy of cardiovascular disease and surgical intervention.

Objective To analyze the characteristics of ocular symptoms of Sjgren syndrome and to examine the relation between signs and symptoms.Design Prospective case series.Participants 36 patients with Sjgren syndrome diagnosed by rheumatisms.Methods A self-designed questionnaire was used to investigate 4 symptoms of patients including dryness,grittiness,soreness or irritation,burning or watering.A series of clinic tests were completed as follows:break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.The positive rate of such symptoms was calculated.The consistency of the symptoms and signs were compared.Main Outcome Measures Break-up time,fluorescein corneal staining,lissamine green conjunctival staining,Schirmer I test.Results Patients with Sjgren syndrome were marked by ocular symptoms.There were efficient statistically significant correlations between grittiness and fluorescein corneal staining,lissamine green conjunctival staining,break-up time(P

Objective To explore the key points of perioperative nursing patients with planted soft tissue expander after breast cancer surgery.Method The clinical data of 55 patients with planted soft tissue expander after breast cancer surgery were reviewed to summarize the nursing measures.Result Operative process in 55 pattents were succesful,surgery time ranged from 3 to 5 hours.16 of 55 patients developed with complications and all of them were recovered and discharged.Conclusions Perioperative nursing intervention for the patients with planted soft tissue expander after breast cancer surgery can reduce the incidence of complications,improve the life quality and help them build up their confidence in social and family life.

Objective To study the delayed gastric emptying for patients underwent pylorus-preserving pancreaticoduodenectomy and standard Whipple procedure.Methods Clinical data of 401 consecutive patients who underwent standard Whipple procedure/pylorus-preserving pancreaticoduodenectomy between January 2012 and July 2016 in the First Affiliated Hospital of Harbin Medical University were retrospectively collected and analyzed.Using the independent-samples t test,x2 test or Fisher's exact test,Mann-Whitney test and other statistical methods to compare the postoperative complications between pylorus-preserving pancreaticoduodenectomy and standard Whipple procedure group.Results Compare with standard Whipple procedure group,delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy occurred in 8 of 35 patients (22.9％),obviously higher than it after standard Whipple procedure occurred in 40 of 366 patients (10.9％) (P =0.038).Other postoperative complications were not significantly different (P ≥ 0.05).Each level of delayed gastric emptying after pyloruspreserving pancreaticoduodenectomy and standard Whipple procedure were not significantly different (P ≥ 0.05),but the average recovery time of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy (12.13 ± 3.09) d was obviously shorter than it after standard Whipple procedure (17.28 ± 9.63) d (P =0.009).Conclusions Pylorus-preserving pancreaticoduodenectomy increases the risk of delayed gastric emptying,but it does not increase severity delayed gastric emnptying by each level.The recovery time of delayed gastric after pyloruspreserving pancreaticoduodenectomy is shorter.

Objective:To analysis the impact of public health emergencies on mood fluctuations of depression and the related factors in the elderly in Shanghai, in order to provide a new evidence for early psychological intervention.Methods:A cross-sectional survey was conducted among 983 elderly in the Department of Geriatrics of Xinhua Hospital Affiliated to Shanghai Jiaotong University and two communities in Changning and Hongkou Districts of Shanghai by using a self-compiled social life questionnaire and Geriatric Depression Scale(GDS-30)during corona virus disease(COVID)-19 outbreak from 1 February to 15 February 2020.The mood fluctuations of depression and the related influencing factors were analyzed by comparing the current GDS-30 scores with the scores within previous six months.Results:Of 983 questionnaires, 867 were valid.The incidence of mild fluctuations of depression was increased from 20.9%(181/867)to 27.2%(235/867)during the public health emergencies( P<0.05), with 3 cases of newly emerged severe depression.The GDS-30 scores were higher during the public health emergencies than before the emergencies(9.88±3.85 vs.7.67±3.54, P<0.05). The four risk factors inducing fluctuations of depression in the elderly were the number of coexisted chronic diseases ≥2( P=0.036), the lack of visits or communication from families( P=0.015), the family members exposing a risk to COVID-19( P<0.01), and the daily viewing of epidemic news more than 4 h( P=0.023). Linear regression analysis showed that cough, sore throat, dizziness, sleep disturbance and dyspnea were significantly related to the aggravation of depression(based on the increase of GDS-30 score)( P<0.05). Conclusions:Public health emergencies may exacerbate depression in the elderly.They are more likely to experience the aggravation of depression when they suffer from multiple chronic diseases, lack the child visits or communications, have the family members exposing a risk to COVID-19 and pay excessive attention to the epidemic.

Objective To detect the disinfectant-resistant geneqacA/B in the strains ofStaphylococcous aureus isolated from January 2014 to December 2014.Methods Fifty-one isolates were collected. PCR assay was used to detectmecA gene andqacA/B gene in the isolates followed byStaphylococcus protein A (spa) typing. Antimicrobial-resistant phenotypic typing was conducted to analyze the homology of theseqacA/B positive strains. The clinical information of the patients from whom the strains were isolated was collected to further understand the clinical background ofqacA/B-carryingS. aureus.Results The prevalence ofmecA and qacA/B genes was 21.6% (11/51) and 13.7% (7/51), respectively in the strains. The prevalence ofqacA/B gene in the methicillin-resistantS. aureus strains (54.5%, 6/11) was signiifcantly higher than that in the methicillin-sensitiveS. aureus strains (2.50%, 1/40). The prevalence ofmecA gene inqacA/B gene positive strains (6/7) was signiifcantly higher than that inqacA/B gene negative strains (1/7). TheseqacA/B positive strains were classiifed into 4 spa types (t037, t091, t932 and t895). The main type was t037 (4/7), which was from the pediatric ward.Conclusions The prevalence ofqacA/B gene is low in theS. aureus strains. However, the prevalence of this gene in methicillin-resistantS. aureus strains is far higher than that in methicillin-sensitiveS. aureus. spa type t037 may be a prevalent clone in pediatric ward.

Objective:To observe the distribution of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in different brain regions in aged rats and determine the role of VEGF and MVD in the aging process of the nervous system. Methods:We observed the expression of VEGF and MVD in different parts of rat brain in the 3- month group and 30-month group with immunohistochemical technique. Results:Compared with the 3-month group, the 30-month group showed fewer VEGF-positive cells and MVD in the brain (P<0.01), and the number varied signiifcantly in different brain regions(P<0.01). The motor cortex region contained more VEGF-positive cells and MVD than the hippocampus and cerebellum. Conclusion:VEGF-positive cells and MVD are decreased in every brain region of aged rats, and the motor cortex region contains more positive cells, suggesting exogenous VEGF may enhance the formation of microvessels and delay the aging of the nervous system.

Objective To analyze the incidence,mortality and survival rates of pancreatic cancer in Pudong New Area of Shanghai from 2002 to 2010.Methods The residents in Pudong New Area of Shanghai were recruited in this study during the period 2002 ～ 2010,the incidence,mortality were calculated according to different age groups and genders.The standardized morbidity and mortality of pancreatic cancer were calculated by world standard population.Logarithmic linear regression was used to calculate the annual percentage change (APC) of incidence and mortality.The 1 ～ 5 year survival of pancreatic cancer patients was analyzed by Kaplan-Meier method and COX regression analysis,and the survival of patients with different TNM staging,with or without operation was determined.Results Among 3089 newly occurred pancreatic cancer cases during 2002 ～ 2010,1707 and 1382 cases were males and females,respectively,with an average age of (69 ± 12) and (73 ± 12) years old,the crude incidence for both genders was 13.32/100 000,and it was 14.71/100 000 for males,which was higher than that in females (11.93/100 000).The ratio of male and female for incidence of age standardize was 1.57:1.There were 2963 death in total,including 1627 males and 1336 females,with a crude mortality rate of 12.78/100 000.The crude mortality rate for males was 14.02/100 000,which was higher than that in females (11.53/100 000).The ratio of male and female ASR for mortality was 1.55:1.Both incidence and mortality significantly increased for males aged over 35 and females aged over 40.The peak of morbidity and mortality appeared in male over 80 years old,and in female over 85 years old.The 1 ～ 5 year survival rates of pancreatic cancer patients were 16.59％,7.31％,5.23％,4.33％ and 3.87％,respectively.The differences in 1 ～5 year survival rates between surgical and non-surgical management groups were statistically significant (P ＜ 0.05).The median survival time of TNM 0 ～ Ⅱ,Ⅲ and Ⅳ staging was (250.00 ± 33.37),(224.00 ± 15.82),(86.00 ± 4.52) d.There was a statistically significant difference among the survival of TNM-Ⅳ and TNM 0 ～ Ⅰ,TNM Ⅲ (P ＜ 0.001).Conclusions The incidence and mortality of pancreatic cancer in males are higher than those in females in Pudong New Area of Shanghai.The survival is associated with TNM staging at diagnosis and whether surgical operation is performed.

Objective: To design the proficiency testing (PT) project (No. NIFDC-PT-183) for assays of bismuth potassium citrate capsules and organize to assess the proficiency of complexometric titration in laboratories, and provide some technical analyses and advices.
Methods: Two groups of samples with different concentration were prepared. The uniformity was evaluated with one-way analysis of variance and the stability was confirmed with t-test, whose results all conformed the requirements. The samples with three combinations were randomly distributed to 279 laboratories. The determination was performed according to the assays of bismuth potassium citrate capsules in Volume Ⅱ of the Chinese Pharmacopoeia 2015. The median value and normalized interquartile range (NIQR) of robust statistical analysis was adopted and Z-scores were used to evaluate the results from each of laboratories.
Results: Among 279 laboratories, 240 laboratories results were satisfactory, 23 were questionable, and the other 16 were unsatisfied. The satisfaction rate was 86.0%.
Conclusion: The overall capacity of national laboratories for assays of bismuth potassium citrate capsules is good while a portion of participants require further improvement.

Objective To evaluate the clinical and histological outcomes in a cohort of chronic hepatitis B (CHB) patients who had histologically confirmed severe liver fibrosis and received lamivudine (LAM) therapy for up to 10 years. Methods Thirty-nine CHB patients with severe liver fibrosis (Ishak fibrosis score≥4) were treated with LAM for up to 10 years. Disease progression liver histological improvement, virological and biochemical responses were evaluated during follow-up. Data were analyzed using paired t test, Fisher exact test and Willcoxon test. Results Twenty-eight patients completed the 10-year follow-up. There were 5 (17.9% ) patients with disease progression.At the end of follow up, 16 patients received a second liver biopsy, which showed significant improvement of histological activity index (1.1 ± 1.4 vs 7. 1 ± 3.2, t =- 0.82, P＜0.01 ) and Ishak fibrosis score (3.6±2.2 vs 5.3±0.7, t= -2.89, P＜0.05) compared to baseline. There were 3 cases with Ishak fibrosis score improved from F5 to F0. Among 27 patients, 3(11% ) cases achieved hepatitis B surface antigen (HBsAg) loss and 2 (7 % ) achieved HBsAg seroconversion. At the end of follow-up, 19 out of 23 (83% ) hepatitis B e antigen (HBeAg) positive patients obtained HBeAg loss and 9 (39 % ) obtained HBeAg seroconversion. During LAM treatment, 11 patients experienced virological breakthrough or detected documented LAM-related resistance mutation. The viral loads of all patients were below 1 ×103 copy/mL at the end of follow-up after rescued by add-on or switch to another nucleotide analog.Conclusions Long-term LAM therapy can delay the disease progression in CHB patients with severe liver fibrosis, increase HBsAg and HBeAg loss rates, sustain suppression of HBV replication at a low level and even totally reverse the liver fibrosis in some patients. The effect of LAM resistance mutation on disease outcomes would be reduced by rescue therapy.