BACKGROUND:Stem cel transplantation has incomparable superiorities in the treatment of cardiovascular diseases. But stem cel s have a very low efficiency to differentiate into myocardial cel s spontaneously, and there are many factors influencing stem cel differentiation. OBJECTIVE:To clarify the pros and cons of different sources of stem cel s in the treatment of myocardial infarction, to investigate the methods for improving the differentiation efficiency of myocardial cel s, optimal differentiation conditions and mechanism underlying exercise-induced stem cel mobilization and endogenous myocardial cel regeneration. METHODS:A computer-based search of CNKI and PubMed databases was performed by the first author for articles related to stem cel therapy for myocardial infarction and stem cel differentiation into myocardial cel s, exercise effect on stem cel proliferation and myocardial cel regeneration published from 1985 to 2015. The key words were“stem cel s, myocardial infarction, myocardial regeneration, cardiac cel , exercise”in Chinese and English, respectively. Final y, 54 articles were included in result analysis. RESULTS AND CONCLUSION:In recent years, a variety of chemical inducers and biological components have been used in the myocardial differentiation of stem cel s. Simulation of myocardial microenvironment and vascular cel growth factors are the main methods of inducing myocardial differentiation. Aerobic exercise-induced stem cel mobilization can induce ischemic cardiac angiogenesis and upregulate a variety of vascular endothelial growth factors so as to promote myocardial proliferation and repair. However, in-depth exploration is stil needed in the harvesting of stem cel s, transplant rejection, and regulatory mechanisms underlying the directed differentiation of stem cel s into cardiomyocytes.

Objective: To evaluate the effect of Twin-block function al appliance in the treatment of transmissible obstructive sleep apnea syndrome (O SAS). Methods: 7 cases of OSAS, aged 8.6～13.2 years, with sk e letal Angle II malocclusion were treated with Twin-block fuctional appliance fo r 13 months on an average. The position of the mandible, tongue, soft palate,hyo id bone and the radius vector of the upper airway was measured by lateral cepha lometric radiographs, the indexes of sleep condition, breath function and cardio vascular system were measured by polysomnography before and after treatment. Results: At the end of the treatment, the average increase in the radius of upper airway was 4.84 mm (P

A variety of extra-cellular signals could activate the target molecules and induce the associated biological effects depended on different signal pathways. Apoptosis, or programmed cell death, is a conservation process essential for normal development and homeostasis of biologist. It's known that a number of factors and pathways can lead to apoptosis. Specific phosphorlipids and proteins of biomembrane could activate the signal cascades of apoptosis. The interaction of caspases, bcl-2 family and mitochondria play an essential role in regulation of apoptosis.

Objective To investigate the influence of acupuncture on learning and memorial function and the expression of BDNF in prefrontal cortex of rats with sleep deprivation (SD), for providing theoretical evidence for treating sleep deprivation with acupuncture.Method Sixty Wistar rats were randomly divided into a control group, a model group, and an acupuncture group, 20 rats in each group. SD models were established by the modified multiple platform methods; the acupuncture group was intervened by acupuncture at Shenmen (HT 7); while the control group was left intact. Respectively after SD for 24 h and 72 h, the learning and memorial function was tested by using Morris water maze. Ten the rats were sacrificed to collect brain for detecting the expression of BDNF in prefrontal cortex via immunohistochemical method.Result The body weight, learning and memorial function, and the expression of BDNF in prefrontal cortex of the acupuncture group and model group were significantly different from those of the control group after SD for 24 h and 72 h (P<0.05). The learning and memorial function of the acupuncture group was significantly different from that of the model group after SD for 24 h and 72 h (P<0.05). The body weight and expression of BDNF in prefrontal cortex of the acupuncture group were significantly different from those of the model group after SD for 72 h (P<0.05).Conclusion Acupuncture can obviously improve the decline of the function of learning and memory of the SD rats, and also up-regulate the declined expression of BDNF in prefrontal cortex caused by SD.

Objective To investigate the changes of trace elements score in hairs in patients with hyperthyroidism and its relationship with thyroid function. Methods The trace elements(Mg,Ca,Cr,Mn,Fe,Cu,Zn,Sr,Mo,Ba)in hairs and serum thyroid hormones(FT_3 and FT_4)were measured in control group (60 cases) and hyperthyroidism group (67 cases). Results The levels of trace elements Zn,Cu,Mg,Cr were significantly lower (P

Objective:To study the treatment outcomes of combining percutaneous transhepatic one-step biliary fistulation (PTOBF) followed by two stages cholangioscopic treatment for type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy, and in treatment of cholangiojejunostomy stenosis.Methods:The clinical data of 95 patients with type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy and were treated at Shandong Second Provincial General Hospital from September 2016 to December 2020 were analyzed retrospectively. There were 36 males and 59 females, with the age of (51.2±15.3) years (range 14 to 75 years). These patients initially underwent PTOBF rigid choledochoscopy, followed by electronic choledochoscopy via the fistula tract after 6-8 weeks. The hepatolithiasis removal, complications and hepatolithiasis recurrence rates, and the cholangio-intestinal anastomotic stenosis rate and treatments were recorded. The follow-up was performed to analyse prognosis.Results:All 95 patients successfully underwent PTOBF rigid choledochoscopy and electronic choledochoscopy via the fistula tract. In 92 patients (96.8%), stones were completely removed. In 3 patients, small amounts of peripheral bile duct stones were left behind. Of 49 patients had cholangio-intestinal anastomotic strictures. On cholangioscopic examination, the strictures were caused by anastomotic knots in the suture line in 25 patients and cicatricial stenosis in 24 patients. After biliary balloon dilation and removal of anastomotic suture line knots, the strictures were relieved in 49 patients. There were 2 patients who developed biliary bleeding and 2 patients pleural effusion after PTOBF rigid choledochoscopy. Hepatolithiasis recurred in 4 patients in 6 to 36 months later.Conclusion:PTOBF followed by two stages cholangioscopic treatment were safe and effective in treatment of type Ⅰ and Ⅱa hepatolithiasis after Roux-en-Y cholangiojejunostomy. A high hepatolithiasis removal rate was obtained. Balloon dilation and removal of biliary intestinal anastomotic suture knots effectively relieved biliary intestinal anastomotic stenosis. The long-term results needs to be further determined.

Objective: To learn the epidemiological characteristics of coronavirus disease 2019（COVID-19）in Huzhou,so as to provide reference for prevention and control of COVID-19. Methods: All the confirmed cases of COVID-19 in Huzhou,diagnosed according to the COVID-19 Diagnosis and Treatment Plan（Sixth Version Trial）and reported from January 25 to February 7,2020,were recruited. The process of diagnosis and treatment,clinical manifestation,exposure history and close contacts were collected to analyze the epidemiological characteristics. Results: On January 25,the first confirmed cases of COVID-19 in Huzhou was reported. By February 7,totally 10 confirmed cases were reported and no asymptomatic infection was found. They were all imported,including three Wuhan residents,two with a trip to Wuhan,three with a trip to Suizhou,one with a trip to Hangzhou and one with a trip to Thailand（two Wuhan passengers on the same flight）. The ratio of male to female cases was 1∶1. The median age was 32 years old. Seven cases were found when they went to a doctor by themselves,and three cases were found during the quarantine. The main clinical manifestations were fever,dry cough and fatigue. The median time from onset to diagnosis was 3 days. By March 3,all the cases were discharged,with median course of 24 days. There were 312 close contacts,and all of them were released after 14 days of quarantine. Conclusions To prevent imported cases from outside and stop spread inside taken by Huzhou government was proved to be effective. All the COVID-19 cases in Huzhou were imported,mostly from Wuhan. No local cases were reported.

BACKGROUND:Establishing a stable and reliable animal model of acute pancreatitis is of great significance for understanding its pathogenesis,pathophysiological characteristics,and clinical medication.Domestic and foreign studies have shown that cerulein,L-arginine,and sodium taurocholate can induce acute pancreatitis,but their pathophysiological characteristics and model characteristics are still unclear. OBJECTIVE:To establish an acute pancreatitis rat model using cerulein,L-arginine,and sodium taurocholate and to observe the changing patterns of model features at different time points. METHODS:Ninety-six healthy male Sprague-Dawley rats were randomly divided into normal group,cerulein group,L-arginine group,and sodium taurocholate group,with 24 rats in each group.Within each group,there were three subgroups(n=8 per group):12-,24-,and 48-hour subgroups.Cerulein was administered via intraperitoneal injection six times with a 1-hour interval.L-arginine was administered through two intraperitoneal injections with a 1-hour interval.Sodium taurocholate was injected for inducing acute pancreatitis models through retrograde injection into the bile-pancreatic duct.By examining the rat survival rate,gross morphology of the pancreas,calculating the pancreatic organ index,and measuring levels of amylase,lipase,alanine transaminase,aspartate transaminase,blood urea nitrogen,and creatinine,as well as observing pancreatic tissue pathological features through hematoxylin-eosin staining and conducting a pancreatic injury scoring,we evaluated the changing patterns of model features at different time points. RESULTS AND CONCLUSION:Compared with the normal group,the overall survival rate of rats was 100%in the cerulein group,88%in the L-arginine group,and 96%in the sodium taurocholate group.The pancreatic organ index was increased in all groups.Gross observation indicated that,In the cerulein group,pancreatic edema,blurred lobes,and looseness were visible.In the L-arginine group,the pancreatic glands were enlarged and thickened with patchy bleeding.In the sodium taurocholate group,pancreatic tissue showed varying degrees of congestion and edema accompanied by scattered flakes of hemorrhage and necrosis.The levels of serum alanine transaminase,aspartate transaminase,blood urea nitrogen,creatinine,amylase,and lipase in rats exhibited consistent changes.In the cerulein group,these parameters possibly peaked at 12 hours(P<0.05)and then showed a declining trend.In the L-arginine group,they reached the highest levels at 24 hours(P<0.05)and significantly decreased at 48 hours.In the sodium taurocholate group,serum amylase and lipase remained at higher levels at 12 hours with a slow decline trend(P<0.05).Compared with the normal group,microscopic examination revealed mild acinar edema and widened interlobular spaces in the cerulein group,with a higher presence of inflammatory cells.In the L-arginine group,there was widening of interlobular spaces,extensive infiltration of inflammatory cells,and patchy necrotic areas.In the sodium taurocholate group,significant pancreatic edema,structural disarray,extensive necrotic foci,and inflammatory cell infiltration were observed.Compared with the normal group,the pathological scores of induced acute pancreatitis in all three models were significantly different at each time point(P<0.05).Moreover,the pathological scores in each group increased over time,indicating a gradual worsening of pancreatic tissue damage.When comparing different models at the same time,there were differences in pathological scores,with the sodium taurocholate group having the highest scores,followed by the L-arginine group,and the cerulein group having the lowest scores.Analyzing the three models at the same time point,the most severe condition was in the sodium taurocholate group,which was characterized by pancreatic hemorrhage and necrosis,followed by the L-arginine group,which was characterized by necrosis,and the least severe condition was in the cerulein group,mainly characterized by edema.The serum biochemical index levels of the cerulein and L-arginine groups decreased at 48 hours,indicating that these two models may have a tendency to self-heal and belong to a self-limiting disease course.The serum biochemical index levels of the sodium taurocholate group decreased slowly after 12 hours.Therefore,pancreatic injury in the sodium taurocholate group might not be relieved after 48 hours or longer.

Objective:To explore the carrier status of carbapenems-resistant Klebsiella pneumoniae (CRKP) plasmids in burn patients and analyze the correlation of these plasmids with the transmission of CRKP. Methods:A retrospective observational study was conducted. A total of 26 CRKP strains, which were isolated from the clinic-related samples of 22 burn patients (with 20 males and 2 females, aged (42±16) years) admitted to the First Affiliated Hospital of Army Medical University (the Third Military Medical University) from January to December 2017, were collected and individually numbered. The plasmids of the strains were extracted by alkali lysis. After determination of the plasmid concentration by a nucleic acid concentration detector, the agarose gel electrophoresis was used to visualize the bands, and rough plasmids typing was performed. The plasmid of the smallest numbered CRKP in each plasmid type was transformed into competent Escherichia coli ( E. coli) strain Top10 (hereinafter referred to as TOP10 strain). The growth of each transformed strains and a Top10 strain cultivated in ampicillin containing Luria-Bertani (LB) agar medium overnight was observed, and the proportion of successful transformation was calculated. The plasmids from the smallest numbered plasmid carrying CRKP strain of successfully transformed Top10 strains (hereinafter referred to as the smallest successfully transformed strain) and correspondingly numbered CRKP were extracted, and then, the agarose gel electrophoresis was used to visualize the bands. Aforementioned successfully transformed strains and a TOP10 strain were used for the antimicrobial susceptibility testing with 17 antibiotics commonly used in clinic. The plasmid from the smallest successfully transformed strain was sequenced using the next-generation sequencing technology. Bioinformatics analyses such as protein-coding gene prediction and protein sequence alignment were performed successively. The sequence was subsequently named pKP03-NDM1 according to the carrying of drug resistance gene. According to the whole genome sequence of the plasmid carried by the smallest successfully transformed strain, the polymerase chain reaction, agarose gel electrophoresis, and gene sequencing were used to detect the New Delhi metallo-beta lactamase-1 ( blaNDM-1) of plasmids in the remaining 25 strains of CRKP. The ST typing in multilocus sequence typing of 26 strains of CRKP was analyzed based on the literature. Results:Plasmids were successfully extracted from 26 CRKP, with mass concentrations ranging from 19.3 to 189.8 ng/μL. Each of the 26 CRKP carrying plasmids showed at least one band longer than 2 500 bp in the agarose gel electrophoresis, which were roughly divided into 6 patterns of A, B, C, D, E, and F. After overnight cultivation, no growth of strains was observed in LB agar medium containing ampicillin inoculated with the TOP10 strain or TOP10 strains transformed by the plasmid of CRKP patterning A, B, D, or E. In contrast, TOP10 strains transformed by the pattern C plasmid from NO.3 CRKP and the pattern F plasmid from NO.15 CRKP resulted in numerous colony growths, and those transformed strains were named as TOP10-pKP03 and TOP10-pKP15, respectively. The proportion of successful transformation was 1/3. The plasmid carried by TOP10-pKP03 showed a single band in the agarose gel electrophoresis, which was the same size as the largest band of the plasmid from NO.3 CRKP. The TOP10 strain was sensitive to the 17 antibiotics commonly used in clinic. TOP10-pKP03 and TOP10-pKP15 were resistant to penicillins, cephalosporins, and carbapenems but remained sensitive to monocyclic β-lactam, aminoglycosides, quinolones and tigecycline. The full length of the plasmid carried by TOP10-pKP03 was 41 190 bp. In addition to blaNDM-1, this plasmid carried bleMBL, T4SS, bleomycin resistance gene, conjugation transfer elements, and relaxase, etc. The plasmid showed 99% nucleotide identity similarity and the same length to the plasmid pJN24NDM1 extracted from an E. coli isolate JN24. Totally 16 (61.5%) CRKP were confirmed to carrying blaNDM-1 gene, among the ST typing of the 16 strains, 11 strains were ST11, while ST215, ST260, ST395, ST2230, and new ST had 1 strain each. Among the ST typing of 10 blaNDM-1-negative CRKP, 8 strains were ST11, while ST395 and ST2230 had 1 strain each. Conclusions:A blaNDM-1 gene carrying plasmid pKP03-NDM1 was extracted and sequenced from CRKP isolated from burn patients, with a high plasmid carrying rate. Meanwhile, this plasmid may mediate inter-CRKP and CRKP- E. coli horizontal transfer of blaNDM-1, leading to transmission of antimicrobial resistance.

Objective:To evaluate the safety and efficacy of the treatment for oppressive spinal by microwave ablation combined with percutaneous fixation and open decompression.Methods:From January 2015 to September 2018, 20 patients with 26 spinal metastatic were treated with microwave ablation combined with percutaneous fixation and open decompression, including 13 males and 7 females with an average age of 43.85±18.67 years (range, 16-79 years). The locations of the lesions included: 9 in the thoracic, 11 in the lumbar. The tumors' type: myeloma 2 cases, leukemia 1 case, liver cancer 4 cases, osteosarcoma 2 cases, lung cancer 5 cases, kidney cancer 1 case, esophagus cancer 1case, cervical cancer 1 case, intestinal cancer 1 case, prostate cancer 1 case, adenoid cystic cancer 1case. Preoperatively all the patients suffered with the local pain and the spinal cord or nerve root compression symptoms. All 20 cases were examined with CT or MRI to determine the lesions and the sizes of metastasis, as well as to evaluate the ablation zone. The entry of the pedicle screws were performed by Wiltse method through paravertebral muscles. After that the lesions were treated with partial resection for decompression of spinal cord or nerve root, and followed with microwave ablation at the metastasis site. Thermometer was used to monitor the temperature at the central and posterior edges of the vertebral body. The surrounding important tissue were cooled by ice saline. 13 patients were performed with vertebroplasty for enhancement the intensity of the vertebral body. The visual analogue scale (VAS) score was used to evaluate the effect of pain relief after surgery. The postoperative neurological function and performance status were evaluated using Frankel grading and Eastern Cooperative Oncology Group (ECOG).Results:Each lesion was heated for 5.43±2.07 min (range, 3-10 min). The power of microwave ablation was 40-60 W. The mean blood loss during operation was 852.50±514.40 ml (range, 100-1 700 ml). The mean operating time was 4.11±0.99 h (range, 2.5-6.0 h). The temperature inside the lesion was 70-85 ℃. The temperature of the surrounding tissue was maintained at<43 ℃ by repeated frozen saline flush. All cases were followed up for 8.45±2.01 months (range, 6-14 months) without any recurrence. The VAS score of the 20 patients at 48 h, 1 month, 3 months and 6 months after operation were 1.55±1.23, 2.70±0.87, 2.40±1.14 and 3.05±1.00 points, which were all statistically lowerthan the preoperative score 5.95±1.18 ( P<0.05). The Frankel grading of 14 patients had at least one grade improvement 6 months after operation. There were 8 patients shown markedly improved ECOG score 6 months after surgery. Only one case suffered from reduced myodynamiaof lower limb and covered in one month after system treatment. Conclusion:The microwave ablation combined with percutaneous fixation and open decompression could resolve the spinal and nerve compression, relieve the pain in metastatic spinal oppression, reconstruct the stability, and improve the quality of lives, which is a safe and effective palliative surgical method.