Under the impact of medical and health system reform and focal events in China, the medical vio-lence policy change is characterized by partial discontinuous equilibrium. It gradually evolves from policymaker-based discontinuity to participatory one, from single decision-making field to the collaborative one, and from the ex-cessive protection of unilateral interest to the maintenance of public interest as a core. In the future, if we want to re-alize the effective minimization of medical violence by public policy, the participation of all parties in the policy deci-sion should be strengthened, the focal events should be analyzed as policy issues, and the policy should be clear in order to overcome the negative influence of the inactivity of old policies.

Objective To investigate the impact of human adipose-derived stem cells(hASCs) -plastelet-rich plasma(PRP) composite on the wound healing of radiation skin injury of nude mice.Methods ASCs were isolated from healthy adults after liposuction, conducted primary culture and subculture.PRP was prepared by two-step ultracentrifugation.The ASCs-PRP composite was prepared with ASCs (1 ×107cells/ml) at passage 6 and PRP.Twenty-four nude mice were randomly divided into 4 groups (n=6).A round shaped full-thickness skin defect (D=1cm) was made on the mice back after 20Gy (60Co) round shaped exposure (D=2cm).Right after radiation, wounds were treated as follows,in group A,there was ASCs+PRP, in group B, PRP,in group C, ASCs,in group D, sham group.The wounds were observed at postoperative 7 and 14 days.HE and CD31 stain were observed at 14th days after surgery.Results The wound healing of group A healed completely at 14th days.In group D,the wound healing were slowest and still filled with granulation tissue at 14th days.The wound healing of group B and group C were faster than that of group D, but they haven′t healed completely at 14th days.The inflammatory cells were significantly lower and the blood vessel density positive rate were significantly higher in ACSs+PRP group than in ACSs group,PRP group and sham group (P<0.05).Conclusion ASCs-PRP Composite can accelerate the wound healing of radiation skin injury by promoting wound angiogenesis.

BACKGROUND: Previous studies have found that nerve growth factors play an important role in the process of wound healing, but there is less research for the low-affinity nerve growth factor receptor p75 and sortilin in fibroblasts, and no reports on whether there are differences in expression of p75 and sortilin in the scar fibroblasts and normal skin fibroblasts. OBJECTIVE: To study the expression of low-affility nerve growth factor receptor p75 and sortilin in the normal human skin fibroblasts and the human keloid fibroblasts. METHODS: The keloid fibroblasts and normal hunman skin fibroblasts were cultured in vitro, and the immortalized epithelial cells HaCaT were used as the positive control. The real-time PCR was used to detect the mRNA expression of the p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts, and western blot and immunocytochemical staining were used to detect the protein expression of p75 and sortilin. RESULTS AND CONCLUSION: The real-time PCR and western blot results showed that in the protein and mRNA levels, p75 and sortilin showed positive expression in the keloid fibroblasts and normal human skin fibroblasts, and there was no significant difference in the expression of p75 between keloid fibroblasts and normal human skin fibroblasts, and the expressions of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were significantly lower than those in HaCaT. There was no significant difference of p75 expression between keloid fibroblasts and normal human skin fibroblasts, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts (P < 0.05). Immunocytochemical staining result showed that the expression of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were distributed in the membrane and cytoplasm. Precursor nerve growth factor combined with high-affinity p75 receptor could promote the apoptosis of the cells with the help of sortilin, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts, which may associated with the high proliferation of the keloid fibroblasts. The results provide a new target for the prevention and treatment of pathological scars.

Objective To evaluate the expression of MMP-2 and MMP-9 and their relation with tumor invasion and metastasis in transitional cell carcinoma of bladder (TCCB). Methods Immunohistochemistry of EliVision were respectively used to determine the MMP-2 and MMP-9 expression in tumor tissues of 46 patients with TCCB and 14 cases of control group which were screened quantitatively (3-5 cm of surrounding tumor) between August 2006 and August 2008. Results Expression of MMP-2 and MMP-9 in TCCB are obviously higher than the normal control group (P <0.01), expressions of MMP-2 and MMP-9 in level Ⅱ,Ⅲ are obviously higher than in level Ⅰ (P <0.01), but there was no significant relationship between high stage or level Ⅲ and low stage or level Ⅱ (P >0.05). Conclusion The positive expressions of MMP-2 and MMP-9 in tumor tissues correlated with the malignant degree, invasion and metastasis of TCCB, MMP-2, MMP-9 could be useful indicators for the assessment of prognosis of TCCB.

Mesaconitine was incubated with rat liver microsomes in vitro. The metabolites of mesaconitine in rat liver microsomes were identified by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method with high resolution power. A typical reaction mixture of 100 mol L-1 Tris-HCI buffer (pH 7.4) containing 0.5 gL-1 microsomal protein and 50 micro molL-1 mesaconitine was prepared. The above reaction mixture was divided into six groups, and the volume of each group was 200 micro L. The incubation mixture was pre-incubated at 37 degrees C for 2 min and the reactions were initiated by adding NADPH generating system. After 90 min incubation at 37 degrees C, 200 micro L of acetonitrile was added to each group to stop the reaction. The metabolites of mesaconitine were investigated by UPLC-MS/MS method. Mesaconitine and 6 metabolites M1-M6 were found in the incubation system. The structures were characterized according to the data from MS/MS spectra and literatures. The metabolic reactions of mesaconitine in rat liver microsomes included the demethylation, deacetylation, dehydrogenation and hydroxylation. The major metabolic pathways of mesaconitine in rat liver microsomes were determined by UPLC-MS/MS on multiple reaction monitoring (MRM) mode combined with specific inhibitors of cytochrome P450 (CYP) isoforms, including alpha-naphthoflavone (CYP1A2), quinine (CYP2D), diethyldithiocarbamate (CYP2E1), ketoconazole (CYP3A) and sulfaphenazole (CYP2C), separately. Mesaconitine was mainly metabolized by CYP3A. CYP2C and CYP2D were also more important CYP isoforms for the metabolism reactions of mesaconitine, but CYP1A2 and CYP2E1 haven't any contribution to MA metabolism in rat liver microsomes.
Aconitine ; analogs & derivatives ; metabolism ; Animals ; Chromatography, High Pressure Liquid ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Cytochrome P-450 Enzyme Inhibitors ; Cytochrome P-450 Enzyme System ; metabolism ; Enzyme Inhibitors ; pharmacology ; Ketoconazole ; pharmacology ; Male ; Metabolic Networks and Pathways ; Microsomes, Liver ; enzymology ; metabolism ; Quinine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Sulfaphenazole ; pharmacology ; Tandem Mass Spectrometry

BACKGROUND: Nitric oxide in the central nervous system is involved in controlling the sympathetic outflow. The authors' recent data show that the reduction of nitric oxide in the rostral ventrolateral medulla (RVLM)enhanced the cardiac sympathetic afferent reflex (CSAR) evoked by stimulating the cardiac sympathetic afferent nerves in rats with chronic heart failure (CHF).OBJECTIVE: To further investigate the effect of nitric oxide in the RVLM on modulating the CSAR evoked by epicardial chemical stimulation in rats with CHF.DESIGN: Randomized controlled experiment.SETTING: Department of Physiology, Nanjing Medical University, and Department of Cellular and Integrative Physiology, University of Nebraska College of Medicine.MATERIALS: This study was carried out in the Department of Physiology, Nanjing Medical University from July 2003 to May 2004. A total of 52male Sprague-Dawley rats weighing 360-420 g were used, and were randomly divided into chronic heart failure group and control group with 23 in each group.METHODS: The rats were carried out either sham surgery or the left coronary artery ligation. Six to eight weeks later, all rats were anesthetized with α-chloralose and urethane and baroreceptor denervated and vagotomized. The CSAR was evoked by epicardial application of bradykinin (BK, 0.04 μg and 0.4 μg in 2.0 μL) to mimic the effect of chemical stimulation on the heart in the CHF state. The renal sympathetic nerve activity (RSNA), mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and during elicitation of the CSAR. Cannulae were inserted into the RVLM for microinjections.croinjection of MeTC, a nitric oxide synthase inhibitor, into the RVLM on Effects of epicardial pretreatment with lidocaine on the CSAR in CHF rats.infarction of (30.6±2.0) % of the left ventricular (LV) surface. The systolic arterial pressure, pulse pressure, left ventricle peak systolic pressure and maximum of the first differentiation of left ventricular pressure were decreased and the left ventricular end-diastolic pressure was significantly ininto the RVLM had no significant effects on the CSAR in rats with CHF,of SNAP (50 nmol) into the RVLM inhibited the CSAR in both sham rats ventricle abolished the CSAR evoked by epicardial application ofBK on the same area.CONCLUSION: Nitric oxide in the RVLM inhibits the CSAR evoked by epicardial application of BK in normal rats and CHF rats, and the reduction of nitric oxide in the RVLM led to the augmentation of the CSAR in CHF rats.

Objective Toinvestigatethevalueofimagingdiagnosisofthe lymphangioleiomyomatosis( LAM ).MethodsFifteen patients with LAM confirmed by pathological assessment were analyzed retrospectively for radiologic findings.They had chest radiograph, chest highresolution CT (HRCT),abdominal CT, direct lymphangiography(DLG), chest CT and abdominal CT after DLG.Results Chest radiograph findings included normal (1),increasing of lung markings (3),disseminated honeycomb or reticular pattern ( 11 ), pneumothorax ( 2 ), and pleural effusion ( 14 ). Chest conventional CT and HRCT showed typical imaging manifestation of PLAM in all cases, including sporadic or disseminated cysts in bilateral lungs. According to the grading standard of pulmonary disease made by Avila et at, there were 3 cases in grade Ⅰ , 5 cases in grade Ⅱ and 7 cases in grade Ⅲ . Fourteen of 15 patients with LAM had positive abdominal CT findings in retroperitoneum and pelvic cavity. Common abdominal CT findings included cystic lymphangioma in 9 of 14 patients, lymphangiomyoma in 13 and both coexisting in 7.One of the14patients alsohadhepaticlipomaandangiomyolipomas.Onepatienthadrenal angiomyolipomas; and one patient had hysteromyoma. All 15 cases underwent DLG, 1 cases had lymphatic obstruction in the lumbar 3 level, the remaining 14 cases had varying degrees of thoracic duct stenosis, or obstruction. Neck trunk, subclavian trunk and bronchial trunk showed lymphatic reflux. On post-DLG CT,thoracic duet outlet obstruction was not demonstrated in 3 cases, the remaining 12 cases showed thoracic outlet obstruction, consistent with the DLG findings.Conclusion HRCT is a useful diagnostic method showing characteristic findings of PLAM. MSCT can help to detect abdominal LAM. DLG and MSCT after DLG have value in displaying obstruction site of thoracic duct or lymphatic trunks and provide guidance for operative treatment.

Objective To investigate the regular,variant and parasitic arterial blood supply in liver cancer,so as to improve the effects of treatment on liver cancer by TACE.Methods 52 liver cancer focus confirmed by pathology and imaging were retrospectively analysed First,the routine DSA was performed,if following conditions including no tumor staining or no vessel area within tumor on arterial phase and filling defect within tumor on parenchyma phase were presented,then DSA via superior mesenteric artery,left gastric artery,inferior phrenic artery,right adrenal artery,internal thoracic artery and intercostal artery were perfomed again.Results 39 focus with regular arterial blood supply(75%),13 focus with variant (25%) and 11 focus with parasitic arterial blood supply (21%) are observed .Conclusion The liver cancer focuses are mainly fed by the regular arterial blood supply of liver artery ,but still 25% are by variant arterial blood supply.The chemoembolization for liver cancer through regular ,variant and parasitic arterial blood supply can improve the therapeutic effect.

Objective To investigate the clinical features and treatment ofBrucellosis disease in children in recent years.Methods The clinical data of 24 children withBrucellosis disease admitted during January 2011 to December 2015 were retrospectively analyzed.Results In 24 children, 18 was male and 6 was female and average age was 9.8±3.13 years (4-14 years). Twenty-four children were diagnosed withBrucellosis disease by positive tiger red plate agglutination tests and their antibody titer was 1:800-1:100. The children lived mainly in the pastoral areas; four cases (16.67%) had sick family members and cattle and sheep; three cases (12.5%) had histoty of contact only with sick family members; 12 cases (50.00%) had cattle and sheep exposure history; 3 cases (12.5%) had raised cattle or sheep at home in the past 2 years; 2 cases (8.33%) had not have clear transmission route. The onset of the disease occurred year round, with the highest incidence in June and July. The common clinical symptoms were fever, arthralgia, weak, sweat, and anorexia, combined with hepatomegaly and splenomegaly. Patients younger than 8 years old were treated with rifampin and sulfamethoxazole. Patients equal to or older than 8 years old were treated with doxycycline and rifampin. Twenty-three children had been cured after treatment. Only one child stopped taking the drugs 3 weeks after discharge, which resulted in recurrence.Conclusion For children living in pasturing area suffered with unexplained recurrent fever, brucellosis disease should be considered and ruled out.

Adult ; Asthma ; metabolism ; physiopathology ; Basic-Leucine Zipper Transcription Factors ; genetics ; physiology ; Fanconi Anemia Complementation Group Proteins ; genetics ; physiology ; Female ; Glutamate-Cysteine Ligase ; metabolism ; Humans ; Inflammation ; metabolism ; pathology ; Male ; NF-E2-Related Factor 2 ; genetics ; physiology ; RNA, Messenger ; genetics ; metabolism ; Sputum ; cytology