Objective:To investigate the mechanism of Smad7 gene modified bone marrow mesenchymal stem cells ( Smad7-BMSCs) to prevent hepatic fibrosis in vitro. Methods:Smad7-EGFP-BMSCs were established by isolating and purifying BMSCs of rats, and transfecting Ad-Smad7-EGFP. HSC-T6 were divided into Group A, Group B, Group C and Group D, which were respectively incubated with Smad7-EGFP-BMSCs, BMSCs, Smad7 plasmid and PBS for 72 hours. The level of Smad7and TGF-β1protein in the culture solution was determined by ELISA. The expression of mRNA and protein of Smad7,TGF-β1,Col Ⅰ and α-SMA in the hepatic stellate cells were respectively determined by Western blot and RT-PCR. Cellular apoptosis was determined by flow cytometry. Results:(1)The results of ELISA showed that the level of TGF-β1 protein decreased(P<0. 01) but the level of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the level of TGF-β1 protein decreased(P<0. 01) but the level of Smad7 protein increased (P<0. 01) in Group D compared with Group B and Group C. (2)The results of Western blot and RT-PCR showed that the level of mRNA and protein of Smad7,TGF-β1,Col Ⅰ and α-SMA decreased(P<0. 01) but the level of mRNA and protein of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the level of mRNA and protein of Smad7,TGF-β1,ColⅠandα-SMA decreased(P<0. 01) but the level of mRNA and protein of Smad7 protein increased (P<0. 01) in Group D compared with Group B and Group C. (3)The results of flow cytometry showed that the rate of cellular apoptosis de-creased(P<0. 01),but the level of Smad7 protein increased (P<0. 01) in Group B,Group C and Group D compared with Group A;the rate of cellular apoptosis decreased(P<0. 01)in Group D compared with Group B and Group C. Conclusion:Smad7-BMSCs can have the effect of anti-hepatic fibrosis by affecting TGF-β1 signal pathway and promoting cellular apoptosis in hepatic stellate cells.

Objective To explore the Influence of different health education approaches to standard anticoagulation of non-valvular atrial fibrillation. Methods 400 patients with NVAF were randomly divided into the research group (n=200) and the control group (n=200). Baseline clinical information was recorded. Both groups were given regular education and treatment. The control group was randomly divided into two subgroups. One subgroup (patients or/and family members) was given knowledge lectures of atrial fibrillation, atrial fibrillation anticoagulant, and application of warfarin. The other was given the knowledge through booklets. Standard anticoagulation fulfillment rate, ischemic stroke, other events of artery embolism, major bleeding, minor bleeding and death in the two groups were observed after 1 year. The cost for different education approaches was also compared between the 2 subgroups. Results (1)In the research group, standard anticoagulation fullfillment rate (40.53%) was higher than that of the control group(15.96%) (P<0.01). The rate of ischemic stroke (2.63%) was also lower than the control group (4.49%) (χ2=4.49, P<0.05). The death rate was lower in the research group than those in the control group, but minor bleeding rate was higher, without statistically significance (P>0.05).Other artery embolism rate , major bleeding, minor bleeding, death rate had no statistical difference. (2)Knowledge lecture group (10.8±1.0 min) spend more time than the booklet group (1.0±0.5 min) (P<0.01). The booklet group (5.1±1.1 yuan) costed more in terms of money than the knowledge lecture group (1.8±0.5 yuan) (P<0.01). (3)The knowledge lecture group showed higher standard anticoagulation fulfillment rate (47.96%) than that of booklet group (32.60%) (χ2=7.33, P<0.01). There was no statistical difference in ischemic stroke rate, other artery embolism rate, major bleeding rate, minor bleeding rate and the death rate. Conclusions Detailed, correct anticoagulant education and guidance can improve NVAF patients with standard anticoagulation, and reduce the risk of ischemic stroke. Knowledge lecture consumes more time but can improve the standard anticoagulation fulfillment rate.

Objective To investigate the diagnostic value of serum Cystatin C and 24 h urine microalbumin quantitative exami-nation in the early gestational diabetes kidney.Methods Chose 110 cases of patients from 37 to 40 weeks during pregnancy with gestational diabetes.According to the GFR,patients were divided into GFR moderate decline group A (30 ml/min/1.73m2 ≤GFR<60ml/min/1.73m2 ,n=30),GFR mild decline group B (60 ml/min/1.73m2 ≤GFR<89 ml/min/1.73m2 ,n=42)and GFR normal group C (GFR≥90 ml/min/1.73 m2 ,n=38).Choose the same gestational weeks 40 healthy preg-nants cases as control group D.Statistics of four groups of serum Cys C,24 h urine microalbumin quantitative,serum urea and creatinine,then analize.Results The levels of serum cystatin C and urine microalbumin compared between each group respectively,the differences were statistically significant (F=31.209,34.698,P <0.01,respectively).The levels of blood u-rea and creatinine in group A when compared with the other groups,found that the difference was statistically significant (F=5.845,4.575,P <0.01,respectively).When comparing the levels of blood urea and creatinine among the groups B,C and D,there was no statistical difference of significance (P >0.05).There was positive correlation between levels serum Cys C and urine microalbumin in group A and B (r=0.756,0.725,t=5.209,4.835,P <0.01,respectively).The sensitivity of Cys C and urine microalbumin were 95.2% and 90.5%,sensitivity of the combination of Cys C and urine microalbumin was 100% (χ2 =8.24,7.08,P <0.05,respectively).Conclusion As sensitive indicators of gestational diabetes in the early renal damage stage,joint detection of Cys C and urine microalbumin is of great significance for diagnosis and monitoring of diabe-tes in the early renal damage stage.