AIM:To explore the effects of confluent endothelial progenitor cells (EPCs) derived from young and aged rats on the phenotype conversion, proliferation and migration of vascular smooth muscle cells ( SMCs) .METH-ODS:Mononuclear cells were obtained from the bone marrow of young (1~2 month old) and aged (19 to 26 month old) Sprague-Dawley rats and cultured with medium DMEM/F12 ( containing 15% fetal bovine serum, endothelial cell growth supplements (ECGs) 100 g/L, 1 ×105 units/L of penicillin and streptomycin, respectively).EPCs were characterized as double positive for DiI-Ac-LDL uptake and lectin binding.Abdominal aorta was obtained from 1 to 2 month old Sprague-Dawley rats.Vascular SMCs were cultured by tissue explant method and identified byα-SM-actin immunofluorescence.In transwell co-culture system, the confluent EPCs located in the upper chamber and SMCs were seeded on the lower cham-ber.The experiments were divided into passage 3 SMCs group (P3), passage 4 SMCs group (P4), passage 4 SMCs co-culture with EPCs derived from young rats group (P4YE) and passage 4 SMCs co-culture with EPCs derived from aged rats group (P4AE).The protein expression ofα-SM-actin and osteopontin was detected by Western blotting.[3H]-TdR incor-poration assay was used to determine the proliferation.SMC migration was analyzed by scratch wound healing assay.RE-SULTS:Compared with P3 group,α-SM-actin expression in P4 group significantly decreased and osteopontin protein ex-pression obviously increased, whereas no significant change was found in P4YE group.Compared with P4 group, confluent EPCs derived from young and aged rats both markedly increased α-SM-actin and decreased osteopontin expression in P4 SMCs.Compared with aged rat-derived EPCs, young rat-derived EPCs were more effectively to induce a delayed SMC phe-notype transition (from contractile phenotype to a synthetic phenotype), and to inhibit SMC proliferation and migration. CONCLUSION:Co-culture of confluent EPC induces a delayed vascular SMC phenotype transition and inhibits SMCs pro-liferation and migration.Young rat derived EPCs are more effective to induce a delayed vascular SMC phenotype transition and has stronger inhibitory effects on SMCs proliferation and migration compared with that derived from aged rats.

Objective:To investigate the effect of whole body vibration (WBV) on balance and walking ability after a stroke.Methods:Thirty stroke survivors were randomly divided into a control group ( n=15) and an experimental group ( n=15). Both groups received 30 minutes of routine rehabilitation training twice a day, 6 days a week for 2 weeks. The experimental group was additionally provided with 14 minutes of 10Hz WBV with an amplitude of 4mm every day during the 2 weeks. Before and after the intervention, balance was quantified using the front-behind inclination angle (F-BIA), the left-right inclination angle (L-RIA) and the single-leg stance time of the hemiplegic side (SSTHS). Walking efficiency was quantified using the 10 metre walk test (10MWT) and the 3 metre timed up-and-go test (3TUG). Results:There was a significant improvement in all of the measurements in both groups after the intervention, but the improvements in average L-RIA, SSTHS, 10 MWT and 3TUG results in the experimental group were significantly greater than those in the control group.Conclusions:Supplementing routine therapy with WBV can improve balance and walking ability after a stroke more effectively than routine therapy alone.

Objecitve To evaluate the impact of adding methotrexate into DIA chemotherapy regimen (cisplatin,therarubicin and ifosfamide) on 3-year disease-free and overall survival of patients with ⅡB osteosarcoma in extremities.Methods Retrospectively analyzed 34 cases of ⅡB limb osteosarcoma according to the Musculoskeletal Tumor Society (MSTS) surgical staging system with pathologically diagnosed concurrent chemotherapy and comprehensive surgical treatment from May 2008 to April 2014.There were 20 males and 14 females,with an average age of 19.5±7.7 years (ranged from 9 to 44 years).28 patients underwent limb salvage surgery,and 6 patients received amputation.Tumor site included distal femur in 21 patients,proximal tibia in 9 patients,other sites in 4 patients.Seventeen patients underwent cisplatin,THP and ifosfamide (DIA) regimen of chemotherapy.The other 17 patients underwent cisplatin,THP,ifosfamide and methotrexate (MDIA) regimen.Patients charts were reviewed to get demographic data including age,gender,site,tumor size,surgery type,chemotherapy regimen,alkaline phosphatase,lactase dehydrogenase.The prognostic value of these factors on 3 years disease free survival and overall survival were calculated with KaplanMeier method and compared with Log-Rank test between different groups in univariate comparison and COX model for multivariate analysis was used to determine whether these demographic factors are independent prognostic factor for survival Results Two patients had local recurrence,7 patients had metastasis,and 2 patients had both local recurrence and metastasis..The 3-year survival of the whole group was 67.6％ (23/34).Seven patients died during follow-up.The overall survival was 79.4％ (27/34).The 3 -year disease-free survival in DIA group and MDIA group was 70.6％ (12/17) and 64.7％ (11/17),respectively.The 3-year overall survival was 82.4％ (14/17) and 76.5％ (13/17) in DIA group and MDIA group,respectively.Univariate analysis showed that there was no significant difference in either 3-year disease-free survival (x2=0.113,P=0.737) or overall survival (x2=0.197,P=0.657) between DIA and MDIA.Age was significantly correlated with prognostic in univariate analysis (x2=5.869,P=O.015),while gender,tumor site,tumor size,surgery type,ALP,LDH was not correlated with disease-free survival.Kaplan-meier analysis with LogRank test showed age (x2=6.134,P=O.013) and tumor size (x2=5.108,P=0.024) were statistically correlated with overall survival.Multivariate analysis with COX model showed that chemotherapy regimen was not an independent prognostic factor for 3-year disease-free survival or overall survival.Age was an independent prognostic factor for 3-year disease-free survival (HR=5.836,P=0.017).Conclusion The addition of MTX on the basis of DIA chemotherapy regimen did not significantly improve the 3-year disease-free survival and overall survival of stage ⅡB limb osteosarcoma.

Objective:To learn about the employment situation of community-dwelling spinal cord injury (SCI ) survivors in Jiangsu Province and the factors which influence it, aiming to put forward suggestions which can help them return to work.Methods:This cross-sectional observational study was based on a International Spinal Cord Injury (InSCI) community survey in Jiangsu Province using a questionnaire (InSCI questionnaire) devloped with the International Classification of Functioning, Disability and Health as the framework. Data were collected using the InSCI questionnaire. Data on sociodemographics, diseases, body functions, activities and participation, environmental factors, general health, well-being and so on were collected. Descriptive statistics were computed to analyze the respondents′ employment-related information. Correlation analysis and multiple linear regression were used to analyze factors influencing the employment of these community-dwelling SCI survivors.Results:From January to December of 2018, 726 completed questionnaires were collected-541 through telephone interviews, 152 via Internet links and 33 via face-to-face interviews. Logistic regression showed that residential patterns (odds ratio, OR=0.472), whether there was someone to take care of them at home or going out ( OR=0.405), age at the onset of injury ( OR=0.949), personal factors ( OR=1.068), activity and participation ( OR=1.034), and environmental factors ( OR=1.043) all influenced the respondents′ engaging in paid work. Conclusion:The employment rate of patients with spinal cord injury living in the community is low (22.8%). Comprehensive rehabilitation programs and adequate family and social support should be implemented to help them return to work.

Objective:To observe the effect of Risedronate on fracture healing in elderly patients with osteoporotic femoral intertrochanteric fracture.Methods:A retrospective case-control study was conducted on elderly patients with osteoporotic femoral intertrochanteric fractures in our hospital from June 2019 to June 2020.They were followed up regularly for 1 year after proximal femoral nail anti-rotation(PFNA)internal fixation.According to whether the patients took Risedronate during hospitalization, the patients were divided into two groups(PFNA internal fixation combined with Risedronate, 39 cases)and control group(PFNA internal fixation alone, 44 cases). The BMD values before and 1 year after operation were compared between the two groups.Harris score was used to evaluate hip function, Rush score was used to evaluate fracture healing, and the operation-related complications, adverse drug reactions and fractures in other parts were recorded.Results:The fractures of all patients healed 12 months after operation.There were no recurrent fractures in both groups during follow-up.The mean bone mineral density(BMD)T value in healthy side hip was(-2.83±0.46)in Risedronate group and(-3.16±0.42)in control group( t=-3.397, P=0.001). Among the total 83 patients, 39 patients in the Risedronate group had no obvious adverse reactions; 1 patient of 44 patients in the control group had obvious upper abdominal pain and discomfort, accompanied by nausea and lack of appetite.These symptoms improved after stopping the drug. Conclusions:Risedronate taken early after surgery does not affect fracture healing and can improve bone mineral density of healthy side hip.

Members of genus Acanthamoeba are widely distributed in the environment. Some are pathogenic and cause keratitis and fatal granulomatous amoebic encephalitis. In this study, we isolated an Acanthamoeba CJW/W1 strain from tap water in Wuxi, Jiangsu Province, China. Its 18S rDNA was sequenced and a phylogenetic tree was constructed. The isolated cysts belonged to morphologic group II. Comparison of 18S rDNA sequences of CJW/W1 strain and other isolates showed high similarity (99.7%) to a clinical isolate Asp, KA/E28. A phylogeny analysis confirmed this isolate belonged to the pathogenic genotype T4, the most common strain associated with Acanthamoeba-related diseases. This is the first report of an Acanthamoeba strain isolated from tap water in Wuxi, China. Acanthamoeba could be a public health threat to the contact lens wearers and, therefore, its prevalence should be monitored.
Acanthamoeba ; China ; DNA, Ribosomal ; Encephalitis ; Genotype ; Keratitis ; Phylogeny ; Prevalence ; Public Health ; Trees ; Viperidae ; Water

Objective To investigate serum vitamin D levels in tuberculosis (TB) patients with different blood glucose status.Methods Two hundred and forty seven TB patients were recruited from tuberculosis clinics in Jilin province and 80 normal subjects who underwent health check up in Beijing Hospital served as controls.Blood samples were collected,fasting blood glucose (FBG) and serum vitamin D [25 (OH)D] levels were measured.Results FBG results showed that there were 95 patients with normal FBG,69 with pre-diabetes (pre-DM) and 83 with diabetes mellitus (DM).Vitamin D measurement showed that 25(OH) D level in TB patients with normal FBG,pre-DM and DM was 16.1 (10.7,26.2) μg/L,12.9 (9.6,20.1) μg/L and 12.4 (10.4,16.9) μg/L,respectively,(x2 =19.608,P ＜ 0.001) and were much lower than that in the normal controls (20.5 μg/L) (x2 =21.701,P ＜ 0.001).Proportion of TB patients with 25 (OH)D sever deficiency(＜ 10.0 μg/L)in patients with normal FBG,pre-DM and DM was 20.0％ (19/95),31.9％ (22/69),and 24.1％ (20/83) respectively (x2 =6.376,P ＜ 0.05);proportion of 25 (OH) D deficiency (10.0-19.9 ng/ml) in three groups was 41.1％ (39/95),40.6％ (28/69),and 57.8 ％ (48/83),respectively (x2 =15.141,P ＜ 0.05);sufficient 25 (OH) D (≥ 30.0 μg/L) was 14.7％ (14/95),7.2％ (5/69),and 1.2％ (1/83),respectively (x2 =19.118;P ＜0.05).While the proportion of TB patient with 25 (OH) D insufficiency (20.0-29.9 ng/ml) was 24.2％ (23/95),20.3％ (14/69),and 16.9％ (14/48) respectively (x2 =0.933,P =0.627).In TB patients with normal FBG,risk factors for 25 (OH) D deficiency were smoking (OR =5.619,95％ CI:1.293-24.424,P =0.021),cold season (OR =14.402,95％CI:4.070-50.965,P ＜ 0.001) and smear negative TB (OR =6.194,95 ％ CI:1.873-20.481,P =0.003).Living in rural area (OR =3.429,95％ CI:1.040-11.299,P =0.043) was the risk factor for 25 (OH) D deficiency in TB patients with pre-DM and age ≥ 60 years (OR =2.474,95％CI:1.086-5.623,P =0.031) was risk factor for 25 (OH) D deficiency in those with DM.Conclusions Vitamin D level is lower in TB patients than that in normal controls.The diabetic TB patients have the lowest 25 (OH) D level and have highest proportion of vitamin D deficiency and sever deficiency,particularly for elderly patients.

Objective:To observe any effect of combining motor imagery therapy (MIT) with repeated transcranial magnetic stimulation (rTMS) for improving upper limb motor functioning after a stroke.Methods:Ninety stroke survivors were randomly divided into a control group, an MIT group and a combination group, each of 30. All received conventional rehabilitation therapy, while the MIT group additionally received MIT and the combination group received the MIT along with 1Hz rTMS applied over the M1 region of the contralateral cortex. Before and after 4 weeks of treatment, everyone′s upper limb functioning was quantified using the Fugl-Meyer assessment scale (FMA) and the Hong Kong version of the hemiplegia upper limb function test (FTHUE-HK). Motor evoked potentials (MEPs), cortical latency (CL) and central motor conduction time (CMCT) were also recorded.Results:After the treatment the average FMA and FTHUE-HK scores of all three groups had improved significantly. The average CL and CMCT were significantly shortened. Compared with the control group, the average upper limb FMA score and FTHUE-HK scores of the treatment group were significantly higher. The combination group showed a significant improvement in its average MEP cortical latency and CMCT values.Conclusions:MIT therapy alone can improve the upper limb motor functioning of stroke survivors, but it is more effective in combination with rTMS.

ObjectiveTo investigate the effect of galvanic vestibular stimulation on stroke patients with lateropulsion. MethodsFrom February to October, 2023, 30 stroke patients with lateropulsion in the First Affiliated Hospital of Nanjing Medical University were divided into control group (n = 15) and experimental group (n = 15) randomly. The control group received routine rehabilitation and sham galvanic vestibular stimulation, and the experimental group received routine rehabilitation and true galvanic vestibular stimulation, for two weeks. They were assessed with Scale for Contraversive Pushing (SCP), subjective visual vertical (SVV), Line Cancellation Test (LCT), Star Cancellation Test (SCT), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC) and Barthel Index (BI) before and after treatment. ResultsAll the indexes improved in both groups after intervention (|t| > 2.461, Z > 3.000, P < 0.05), except the SVV orientation, SVV certainty and SCT in the control group; while the SCP, SVV certainty, LCT and FAC were better in the experimental group than in the control group (|t| > 2.189, Z = -2.862, P < 0.05), and the differences before and after intervention were better in the experimental group than in the control group (|t| > 2.382, P < 0.05), except LCT. SCP was correlated with SVV orientation, SVV certainty, SCT, BBS, BI and FAC (|r| > 0.381, P < 0.05). ConclusionGalvanic vestibular stimulation can improve the lateropulsion, balance, walking function and activities of daily living in stroke patients, which may be related to improvement for spatial cognitive function, especially vertical perception.

Objective To explore the role and potential mechanisms of all-trans retinoic acid （ATRA） on activation and oxidative stress of hepatic stellate cell （HSC）. Methods Platelet-derived growth factor （PDGF-bb, 10 ng/ml） was applied to induce the activation of HSCs, which was then treated with ATRA at a dosage of 5 μmol/L for 48 h. The effects of ATRA on HSC activation were evaluated by detecting changes in cell growth viability and phenotypic marker expression. The effects of ATRA on HSC oxidative stress were evaluated by detecting changes in intracellular reactive oxygen species （ROS）, reduced glutathione （GSH） and malondialdehyde （MDA）, and the expression of antioxidant genes. The effects of ATRA on HSC autophagic activity were evaluated by detecting changes in autophagy marker expression and autophagic flow. Results Compared with the PDGF-bb group, the cell viability was significantly reduced in ATRA-treated HSCs （P<0.01）, as well as the expression of α-SMA and Collagen I. The intracellular levels of ROS and MDA were significantly reduced in ATRA-treated HSCs （P<0.01）, whereas the GSH level was significantly increased （P<0.01）. The expression levels of antioxidant genes （NRF2, HO-1, and ATF4）, were significantly higher in ATRA-treated HSCs than those in the normal ones under PDGF-bb condition （P<0.01）. Meanwhile, the expression of autophagy markers Beclin 1 and LC3 Ⅱ/I, and signal of autophagy flow in ATRA-treated HSCs were found to be significantly reduced （P<0.01）. Conclusion ATRA significantly inhibited PDGF-bb-induced HSC activation and reduced the level of oxidative stress and autophagic activity of HSCs, which had potential applications in the prevention and treatment of liver fibrosis.