Objective To investigate the effect of construct the Notch1 (NICD) eukaryotic expression vector on the proliferation and differentiation of rat bone marrow mesenchymal stem cells (BMSCs) in vitro. Methods Rat BMSCs were experimented as the object. NICD eukaryotic expression vector was constructed. pEGFP-N1-NICD expressing plasmids were used to transfect BMSCs. The study included control group (CON group), empty vector group (VEC group) and the trans-fection group (TRA group). After 48-hour transfection, BMSCs were observed for general morphology. The protein expres-sions of NSE, GFAP and Notch1 were detected by real-time PCR and Western blotting assay respectively. The apoptosis, cy-cle distribution and cell proliferation were evaluated by flow cytometry and MTT assay. Results The DNA sequencing con-firmed that the pEGFP-N1-NICD recombinant plasmid was successfully constructed, and both VEC group and TRA group expressed green fluorescence after 48-hour transfection. The relative expression levels of Notch1 and GFAP mRNA and pro-tein were significantly higher in TRA group than those in VEC group and CON group (P<0.05), and there was no significant difference between VEC group and CON group. After 48-hour transfection, the ratio of living cells was significantly lower in TRA group than that of CON group and VEC group, and the early apoptotic rate and late apoptotic rate were significantly higher in TRA group than those of CON group and VEC group (P<0.05). The late apoptotic rate was significantly higher in VEC group than that of CON group. The proportion of G1/G0 cells was significantly higher in TRA group than that of CON group and VEC group, but S and G2/M cells were significantly lower (P<0.05). The value of growth curve was gradually de-creased in TRA group than that of CON group and VEC group (P<0.05). Conclusion The high expression of NICD gene might induce apoptosis of BMSCs, inhibit the proliferation in part, and induce into glial-like cell differentiation.

Objective Toinvestigate the effects of carbon dioxide pneumoperitoneum on cardiovascular system by making use of arterial pressure waveform analysis( FloTrac/Vigileo system) to observe the change of heart function of patients undergoing laparoscopy cholecystotomy. Methods Forty patients scheduled for elective laparoscopy cholecystotomy were divided into two groups with 20 cases each by random sampling.Ventilatory capacity was fixed (tidal volume was 10 ml/kg, frequency was 12 times/min) in group A and adjusted to keep arterial carbon dioxide tension (PaCO2) and end expiration carbon dioxide tension(PETCO2)in normal range in group B. The parameters, such as mean arterial pressure (MAP), cardiac output(CO),stroke volume (SV), stroke volume variability (SVV), heart rate(HR), pulse oxygen saturation (SpO2),PETCO2, PaCO2 were recorded and analyzed. Results In group A:HR,MAP,CI,SVV,PaCO2 and PETCO2 were increased at 10,30 min after pneumoperitoneum (P ＜0.05 or ＜0.01),there was no significant difference in SVV between the end of pneumoperitoneum and 5 min after intubation [(8 ±2)% vs. (9 ±3 )%](P＞ 0.05 ) ,but HR, MAP, CI,SVI,PaCO2 and PETCO2 increased significantly (P＜ 0.05 or ＜ 0.01 ). In group B: HR, MAP, CI, SVI, PaCO2 and PETCO2 at 10,30 min after pneumoperitoneum were no changes (P ＞0.05 ), SVV was higher than that at 5 min after intubation (P ＜ 0.01 ), there was no significant difference in SVV between the end of pneumoperitoneum and 5 ain after intubation [(9 ± 2)% vs. ( 10 ± 2)%] (P ＞0.05 ). HR, CI, SVI, PaCO2, PETCO2 at 30 min after pneumoperitoneum and the end of pneumoperitoneun were significantly higher in group A than those in group B (P ＜ 0.05 or ＜ 0.01 ). Conclusions During carbon dioxide pneumoperitoneum, hypercapnia can increase MAP, HR, CO,SV significantly, and intra abdominal pressure can decrease preload by hindering the reflow of inferior vena cava and abdominal viscera veins. Arterial pressure waveform analysis can promptly reflect the effects of carbon dioxide pneumoperitoneum on cardiovascular system and be in favour of adjusting the respiration parameters and managing transfusion in laparoscopic surgery.

BACKGROUND:In the development of nervous system, the main effect of sonic hedgehog signaling pathway is to induce the partition of dorsal and ventral sides in the central nervous system. When above signaling pathway is destroyed, ventral neurons in the central nervous system wil completely lose. OBJECTIVE: To establish adult rat models of acute compressive spinal cord injury, to detect the expression of development-related sonic hedgehog after acute compressive spinal cord injury, and to explore its effects on neural regeneration. METHODS:A total of 30 Sprague-Dawley rats at the same age were placed in a posterior compression device to establish models of acute compressive spinal cord injury. They were then randomly divided into lamina driling group (n=5) and acute spinal cord injury group (n=25). Sonic hedgehog mRNA was detected by in situ hybridization method at the injury site at 1, 3, 5, 7, and 14 days after spinal cord. RESULTS AND CONCLUSION:The expression levels of sonic hedgehog increased to the maximal expression levels in grey and white matters 10 mm distal to the lesion site at 7 days after injury. Sonic hedgehog expression was apparently less in ependymal cels than in grey and white matters and was restricted to 5 mm distal to the lesion site, being narrower in its distribution than its occurrence in grey and white matters. These data indicated that acute compressive spinal cord injury can induce the expression of sonic hedgehog. This expression maybe relates to adult neural cel regeneration.

To observe the effects of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and postoperative cognitive dysfunction (POCD) of elderly patients, we collected 80 elderly patients undergoing selective coronary artery bypass graft under cardiopulmonary bypass. The Mini Mental State Examination (MMSE) was applied to test the cognitive function. The SjvO2, Da-jvO2 and CEO2 were used for the analysis of the cerebral oxygen metabolism. We found that POCD was related to disequilibrium of cerebral oxygen metabolism. Ultrasound-guided SGB before surgery reduced the incidence of POCD because of the improvement of cerebral oxygen metabolism.
Aged ; Autonomic Nerve Block ; Cardiopulmonary Bypass ; Cognition Disorders ; prevention & control ; Coronary Artery Bypass ; Humans ; Neuropsychological Tests ; Oxygen Consumption ; Postoperative Complications ; Stellate Ganglion ; diagnostic imaging ; Ultrasonography

Objective To investigate the factors influencing positive and negative affects ot orthodontic patients.Methods 145 orthodontic patients were selected and finished questionnaire survey.The questionnaires included demographic data,psychosocial impact of dental aesthetic questionnaire (PIDAQ),aesthetic content of index of orthodontic treatment need (IOTN-AC),perception of occlusion scale (POS),and positive affect and negative affect scale (PANAS).Mann-Whitney U-test,Kruskal-Walis H-test,and Spearman correlation analysis were used to analyze the relation between impact of dental aesthetics and positive and negative affects in orthodontic patients.Results The scores of adolescent patients were higher than adult patients in negative affect (U =1886.500,P＜0.05).The patients under orthodontic treatment scored higher than those before treatment (U=2228.000,P＜0.05).The subdomains of PIDAQ,such as social impact (x2=ll.794,P＜0.05),aesthetic attitude (x2 =45.853,P＜0.05),and dental confidence (x2 =33.551,P＜0.05) were related with negative affect.The scores of IOTN-AC,PIDAQ,POS demonstrated positive correlation with negative affect (P＜0.05).The scores of social impact showed negative correlation with positive affect (P＜0.05).Conclusions Adult orthodontic patients suffer more negative affect than adolescent patients.Orthodontic treatment could promote patients' positive affect.However,the negative psychosocial impact in dental aesthetics would strengthen the negative affect.

Objective To investigate the effect of splenectomy on infarct volume in middle cerebral artery occlusion in focal cerebral ischemia rats and its possible mechanisms.Methods Eighteen male Sprague-Dawley rats were randomly divided into spleneetomy,sham splenectomy,and control groups (n =6 in each group).A model of middle cerebral artery occlusion (MCAO) was induced by the intraluminal suture method 2 weeks after spleneetomy.The rats were decapitated and their brains were removed after 24 hours.The infarct volume was measured with Nissl body staining The number of macrophages in ischemic cortex was detected with immunofluorescence staining Results The infarct volume in the splenectomy group (34.93％ + 3.23％ )was significantly smaller than that in the sham splenectomy group (74.33％ + 2.36％ ; q =39.399,P ＜ 0.001 ) and the control group (77.30％ + 2.62％ ; q =42.369,P ＜ 0.001 ).However,there was no significant difference between the sham splenectomy group and the control group (q =2.970,P =0.082).The number of macrophages of the ischemic cortex in the splenectomy group (3.4 ± 1.07/per high power field) was significantly less than that in the sham splenectomy group (20.7±4.37/per high power field; q =17.300,P＜0.001) and the control group (18.87 ±4.17/per high power field; q =15.467,P ＜0.001).However,there was no significant difference between the sham splenectomy group and the control goup (q =1.833,P =0.384).Conclusions Splenectomy may reduce the infarct volume by reducing the number of macrophages in ischemic corticalregion.

ObjectiveTo assess the blood-saving effect of acute plateletpheresis (APP) and back-transfusion in patients undergoing open.heart surgery with CPB.MethodsThirty ASA Ⅱ or Ⅲ patients aged 41-63 yr weighing 52-72 kg undergoing open heart surgery with CPB were randomly divided into 2 groups (n =15 each):control group (group C) and APP group.In APP group,platelet-rich plasma was harvested immediately after induction of anesthesia and transfused back to the patient after termination of CPB and neutralization of heparin with protamine.In group C plateletpheresis was not performed.Hb,Plt,PT,APTT and Fib were measured before induction and at 1,24 and 48 h after operation.CPB time,aortic crossclamping time,postoperative chest tube drainage and blood product transfusion requirements were recorded.ResultsIn APP group the volume of the whole blood processed for plateletpheresis was (1285 ± 185) ml and ( 192 ± 38) ml of platelet-rich plasma was sequestered.The platelet count of the sequestered plasma was(817 ± 282) × 109/L,accounting for (21 ± 3) ％ of the total number of Pit in the whole blood volume.The plateletpheresis took (35 ± 10) min.The platelet count at 1 h after operation was significantly higher in APP group than in group C.The volume of postoperative chest tube drainage at 24 h after operation was significantly lower in APP group than in group C.Less allogeneic RBC and Plt were transfused in APP group than in group C.There was no significant difference in other variables between the 2 groups.ConclusionAPP has blood-saving effect in patients undergoing open heart surgery with CPB.

Objective To evaluate the effects of sevoflurane on right ventricular systolic function after cardiopulmonary bypass in patients undergoing coronary artery bypass grafting(CABG). Methods Eighteen patients with coronary heart disease,13 males,5 females,ASA Ⅱ or Ⅲ,aged 50-80 years,measuring 1 50-182 cm in height,weighing 5 1-96 kg,scheduled for CABG under CPB were enrolled in this study.Anesthesia was maintained with intravenous anesthesia, and 1 MAC sevoflurane inhalation lasted for 60 min after CPB.Hemodynamic indicators such as HR,MAP, CVP,cardiac output (CO),Systemic vascular resistance (SVR)and right ventricular parameters in-cluding tricuspid annular plane systolic excursion (TAPSE)and velocity (TAPSV)were recorded be-fore sternotomy (T2 ),30 min after CPB (T3 ),60 min after CPB (T4 ).Results Compared with T1 , CO was increased at T2 (P <0.05);compared with T2 ,CO was decreased at T3 and T4 (P <0.05 or P <0.01),with a statistical significance;compared with T1 ,TAPSE and TAPSV were increased at T2 (P <0.05 or P <0.01);compared with T2 ,TAPSE and TAPSV were decreased at T3 and T4 (P<0.05);with a statistical significance in TAPSE and TAPSV.Conclusion For the patients undergo-ing CABG under CPB,1 MAC sevoflurane inhalation after CPB can reduce right ventricular systolic function,which,however,is within the normal ranges.

Objective To explore the impact of waist-to-hip ratio (WHR) in type 2 diabetic probands on the phenotype of insulin resistance and β-cell function in normoglycemic first-degree relatives. Methods One hundred and eighty-six type 2 diabetic probands and 489 normoglycemic first-degree relatives were selected from 186 type 2 diabetes core families. 115 first-degree relatives (FDR1 group) of probands with low WHR (1st quartile: <0.86 for males and <0.84 for females) and 106 first-degree relatives (FDR2 group) of probands with high WHR (4th quartile: >0.92 for males and >0.89 for females) were identified to intensively study from 489 normoglycemic first-degree relatives. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to estimate insulin sensitivity, and β-cell function was quantified as the ratio of the incremental insulin to glucose responses over the first 30 min (△I30/△G30) during the oral glucose tolerance test. The latter measure was also adjusted for the assay of insulin sensitivity as it modulated β-cell function (△I,,30>·△G-1,30·HOMA-IR-1). Results The body mass index, the waist circumference and waist-to-height ratio in female first-degree relatives, systolic blood pressure, triglyceride and HOMA-1R were significantly higher in FDR2 group than those in FDR1 group andhigh density lipoprotein cholesterol,△I30/△G30, △I-130·HOMA-IR-1were significantly lower in FDR2 group than those in FDRI group (P < 0.05 or P < 0.O1). The waist circumference and waist-to-height ratio in relatives of probands with low and high WHR were positively correlated with the HOMA-IR. However, the least square regression analysis showed that the slope from regression in FDR2 group were significantly steeper than thatin FDR1 group(both P <0.01). Conclusion The normoglycemic first-degree relatives of the type 2 diabetic probands with high WHR had much more evident phenotype of insulin resistance and decreased β-cell function, and a slight increase in abdominal obesity had a greater impact on insulin resistance.

The knowledge of endocrine metabolic diseases represented by type 2 diabetes mellitus is highly specialized, complicated, and has many clinical guidelines. In this context, team based learning teaching combined with case teaching based on evidence-based medicine was applied in the actual class teaching. The class was divided into several groups and the students were encouraged to discuss and study from each other with the guidance of teachers. Consequently, students' learning interests and spirit of team-work were greatly enhanced, the way of thinking using evidence-based medicine and their ability to solve the practical clinical problems were also improved.