BACKGROUND:A large number of experiments have shown that bone marrow mesenchymal stem cels (BMSCs) have good effects on the treatment of lung disease or improvement of lung injury, and its therapeutic effect is mainly oriented to reduce the inflammatory response. OBJECTIVE: To study the effects of BMSCs combined with reduced glutathione in murine models of bleomycin-induced lung injury. METHODS:BMSCs were isolated from a male NOD/SCID mouse and cel morphology and phenotype were observed. Sixty-four female NOD/SCID mice were randomly divided into a control group, a model group, a BMSCs group and a BMSCs+reduced glutathione group (combined group). The control group received intratracheal injection of normal saline, the model group received intratracheal injection of bleomycin, and the BMSC group received BMSCs injectionvia the tail vein at 2 hours after intratracheal injection of bleomycin, and combined group received BMSCs+reduced glutathione injection via the tail vein at 2 hours after intratracheal injection of bleomycin. Al mice were kiled after 7 days, and levels of tumor necrosis factor-α, interleukin-β, malondialdehyde in lung tissue were detected and lung tissue specimens were obtained for pathological examination. RESULTS AND CONCLUSION:BMSCs were fibroblast-like cels, Positive for CD10, CD13 and CD44, but negative for CD34 and CD45. Compared with the control group, the levels of tumor necrosis factor-α, interleukin-β and malondialdehyde were increased in the model group, while decreased significantly in the BMSCs group and combined group (P < 0.05), especialy in the combined group (P < 0.05). Pathological examination showed that more serious lung injury was observed in the model group and BMSCs group than the combined group. These findings indicate that BMSCs combined with reduced glutathione can more effectively protect against bleomycin-induced lung injury.

Abstract?AlM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.? METHODS: Twenty - eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.?RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery (P<0. 05), the ocular function score was significantly higher than the healthy control group ( P<0. 05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery ( P<0. 05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery (P<0. 05). After 1mo, ocular function scores were significantly higher than the preoperative ( P< 0. 05 ), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative (P<0. 05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually. ?CONCLUSlON:To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Objective To investigate the epiderniology of fungemia and provide evidence for clinical therapy.Methods A retro- spective survey was done with the 31 cases of fungemia in our hospital from August 2004 to November 2005.Results More than 80% of the patients suffered from two and more underlying diseases.Over a half of infections developed following placement of catheters.And 83.9% of the patients had a history of antimicrobial agents use before blood culture.The pathogens of 24 (77.4%) cases were associated with Candida spp.Only 3 strains were C.albicans.The mortality rate of candidemia was 45.8%.Different Candida species had different resistance rates to antifungal agents.Conclusions Fungemia patients often have serious underlying diseases.Most fungemia cases were candidemia caused by non-C.albicans.Some fungal pathogens are re- sistant to fluconazole and itraconazole.

Fifty-six patients with Graves' ophthalmopathy(GO)were treated with antithyroid drug and oral prednisone for three months,TSH receptor antibody(TRAb)level was reduced,GO activity and severity of some patients were ameliorated but still positively associated with TRAb.It suggests that TRAb not only triggers off GO but also plays a possible role in the maintenance of the autoimmune process in GO.

INTRODUCTIONBicuspid aortic valve (BAV) is the most common form of adult congenital heart disease. When compared to patients with a normal trileaflet aortic valve, dilatation of the aortic root and the ascending aorta (Asc Ao) are the common findings in patients with BAV, with consequent higher risk of developing aortic aneurysm, aortic dissection and rupture. We aim to determine the site of the Asc Ao where maximum dilatation occurs in Asian adult patients with BAV.

MATERIALS AND METHODSAll subjects underwent full echocardiography examination. The diameter of the Asc Ao was measured at 3 cm, 4 cm, 5 cm, 6 cm and 7 cm from the level of aortic annulus to the Asc Ao in 2D from the parasternal long-axis view.

RESULTSA total of 80 patients (male/female: 45/35; mean age: 45.3 ± 16.2 years) with congenital BAV and 30 normal control group (male/female: 16/14; mean age: 45.9 ± 15.1 years) were enrolled. The indexed diameters of the Asc Ao were significantly larger than the control group. In patients with BAV, maximum dilatation of Asc Ao occurred around 6 cm distal to the aortic annulus.

CONCLUSIONIn patients with BAV, dilatation of Asc Ao is maximal at the mid Asc Ao region around 6 cm distal to the aorta annulus.

Adult ; Aneurysm, Dissecting ; epidemiology ; Aorta ; diagnostic imaging ; Aortic Aneurysm ; epidemiology ; Aortic Diseases ; diagnostic imaging ; epidemiology ; Aortic Rupture ; epidemiology ; Aortic Valve ; abnormalities ; diagnostic imaging ; Case-Control Studies ; Comorbidity ; Dilatation, Pathologic ; diagnostic imaging ; epidemiology ; Echocardiography ; Female ; Heart Valve Diseases ; diagnostic imaging ; epidemiology ; Humans ; Male ; Middle Aged ; Risk Factors ; Singapore ; epidemiology

Objective To investigate the correlation between 28-day prognosis and red cell distribution width (RDW) in sepsis patients.Methods This was a prospective observational study.Two hundred and thirteen sepsis patients were consecutively selected,and the patients were divided into 2 groups according to RDW:normal RDW group (RDW ＜ 0.15,160 cases) and high RDW group (RDW≥0.15,53 cases).The general conditions,acute physiology and chronic health evaluation (APACHE) 1Ⅱ score,sequential organ failure assessment (SOFA),hypersensitive C reactive protein (hs-CRP),procalcitonin (PCT),arterial blood lactic acid,liver function injury,renal function injury and 28-day mortality were compared between 2 groups.The independent risk factors of 28-day prognosis were analyzed by multifactor Logistic regression analysis.Kaplan-Meier survival analysis was used to draw the 28-day survival curve,and the survival rate was compared between 2 groups by log-rank test.Results The 28-day mortality in high RDW group (35.8％,19/53) was significantly higher than that in normal RDW group (17.5％,28/160),and there was statistical difference (P =0.007).RDW ≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.634,95％ CI 1.316-5.273,P =0.006).After adjusted by gender,age and other relative factors,RDW≥0.15 was the independent risk factor of 28-day death in sepsis patients (OR =2.895,95％ CI 1.155-7.252,P =0.023).The 28-day accumulative survival rate in high RDW group was significantly lower than that in normal RDW group (50.5％ vs.63.0％),and there was statistical difference (P =0.014).Conclusion The high RDW in sepsis patients is the independent risk factor of 28-day death,and RDW ≥0.15 shows an important predictive value in the prognosis of sepsis patients.

Objective To analyze the risk factors for the outcomes of recipients after orthotopic liver transplantation using donation after cardiac death (DCD) donors.Method A retrospective study was performed to observe the available clinical data of 60 patients who had receiced hepatic allografts of DCD donors from July 2007 to December 2012 in our hospital and a 3-year follow-up was conducted to investigate outcome.In the patients whose ALT and/or AST levels were more than 1500 U/L within 72 h following surgery,early allograft dysfunction (EAD) was defined.Potential risk fators right before surgery included donor and recipient age,donor ALT AST,TBIL and WIT,and recipient creatine,TBIL,INR,albumin,MELD,BMI and recipient CIT.Kaplan-meier method was used to calculate the cumulative survival rate.Log-rank test and Cox regression model were performed to analyze donors and recipients related risk factors by univariate and multivariate analysis respectively.All statistical data were analyzed by using SPSS 19.0.Results The overall cumulative survival rate of 1 and 3 years was 76％ and 62％ respectively.Donor ALT,AST and WIT,and recipient Cre,MELD,CIT and EAD were significant risk fators in univariate analysis.However,the multivariate analysis revealed that donor WIT was the only independent risk factor affecting survival in our study.Conclusion By identifying and controlling certain characteristics,the outcomes of DCD liver transplant recipients could be dramaticly improved.

Objective To investigate the status quo and influencing factors of self-management ability in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods Totally 339 CAPD patients with clinical follow-up regularly were investigated for the situation of self-management with general information questionnaire and Self-management Scale for CAPD.Results The total score of patients' self-management ability was (66.03±15.57).Multiple linear regression analysis showed that education level,marital status,occupation and duration of dialysis were influencing factors of patients' self-management ability.Conclusions Patients undergoing CAPD have certain degree of self-management ability.Nurses should promote their self-management ability according to different education level,marital status,occupation and duration of dialysis.

Objective To discuss methods of decoration reconstruction for finger defect in emergency and to observe the elinical effects.Methods Of the 41 cases of finger injuries of different degrees,15 were repaired with part of the skin flaps of the big toenails or skin flaps of the second toenalis,8 were repaired with part of the skin flaps of the big toenails,7 were reeonstructed with the second tiptoes,11 were repaired with the abdominal skin flaps of the big toes or lateral flaps of the second toes.Results All the 41 fingers sur- vived.One skin flap of the big toe was somewhat swelling and a decorating operation was performed.The 4～18 months of follow-up visitation of the rest cases revealed good function and shapes.No obvious functional ab- norality was found in the donating feet.Conclusion Various kinds of decoration reeonstruetion for finger defects are available to recover the hand shape and function as much as possible.

Objective Toinvestigatethecorrelationbetweentheredbloodcelldistributionwidth (RDW)and in-hospital prognosis in elderly patients with cerebral infarction and severe hemiplegia. Methods Atotalof209consecutiveelderlypatientswithcerebralinfarctionandhemiplegiadiagnosedat the Emergency Department,Central Hospital of Jiading District in Shanghai from January 2012 to December 2013 were enrolled retrospectively. All patients were divided into an L-RDW group (n=73 ),an M-RDW group (n=56),and an H-RDW group (n=80)according to the RDW trisection level. A single factor analysis of variance was used to compare the differences of clinical data,laboratory indexes,and mortality during hospitalization among the three groups. The patients were redivided into either a survival group (n=170)or a death group (n=39)according to their clinical outcomes. Its differences of RDW levels in the acute phase were compared. Logistic regression analysis was used to analyze the independence risk factors for the death of patients,and the risk ratio (OR)was calculated. Spearman correlation analysis was used to analyzeRDWandtheNationalInstitutesofHealthStrokeScale(NIHSS)scores.Results Themortality of the M-RDW group was significantly lower than that of the L-RDW and the H-RDW groups (1. 8%[n=1] vs. 12. 3%[n=9]and 36. 2%[n=29],all P<0. 01). the RDW level of the death group was significantly higher than that of the survival group (14.2 [13.3,15.1]vs.12.5 [11. 9,13. 5];P =0. 002). The H-RDW level (OR,12. 164,95%CI 2.544-58.181,P=0.002)and the NIHSS score (OR,1. 136, 95%CI 1. 056-1. 221,P=0. 001)were the independence risk factors for the death of the elderly patients with severe hemiplegia cerebral infarction;the RDW level was positively correlated with the NIHSSscore(r=0.167,P=0.016).Conclusion ThemortalityofdifferentRDWlevelsinelderly patients with cerebral infarction and severe hemiplegia showed aU shape. The mortality of the H-RDW is the highest. The RDW level has an important reference value for identifying the prognosis in elderly patients with cerebral infarction and severe hemiplegia.