Objective:To observe the changes of blood glucose,insulin and dipeptidyl peptidase-Ⅳ(DPP-Ⅳ/CD26)on type 2 diabetes mellitus in rabbits after HUCBSC( human umbilical cord blood stem cells) transplantation. Methods:18 rabbits were randomly divided into normal control group (6 rats,Group C) and diabetic model group (12 rats). After preparation model of type 2 diabetes,and 6 rats of them were treated with HUCBSC ( CD45+,CD34-) transplantation by ear vein transfusion ( Group A) ,and 6 rats were treated with PBS(Group B). All three groups of rabbits were fed for 4 weeks,and the blood glucose was monitored every day,and the level of blood insulin and DPP-IV/CD26 were measured every week. Results:The negative expression rate of CD34 in HUCBSC was 96. 5%. The positive expression rate of CD45 in HUCBSC was 100%. Compared with non transplantation group,the blood glucose and DPP-IV/CD26 in the umbilical cord blood stem cell transplantation group were gradually decreased,and insulin level was gradually increased, the difference was statistically significant (P<0. 01). Conclusion:HUCBSC were round or oval,with adherent growth,HUCBSC trans-plantation can significantly reduce blood glucose, increase insulin secretion, reduce the level of DPP-IV/CD26, the immunological phenotype of HUCBSC was CD45+,CD34-,thus providing a new theoretical basis for the clinical treatment of diabetes and its complica-tions.

Objective To explore the effect of the transcutaneous tracheostomy tube in patients with pneumothorax and its clinical value. Methods A prospective randomized controlled trial was conducted. Thirty-two patients with pneumothorax admitted to Department of Critical Care Medicine of Harrison International Peace Hospital of Hebei Medical University from June 2010 to June 2014 were enrolled. The patients were divided into control group and observation group,with 16 cases in each group. Beside the treatment for primary disease,the patients in control group received thoracic close drainage with traditional silica gel tube as performed by thoracic surgeons,and those in observation group received thoracic close drainage with transcutaneous tracheostomy tube by intensive care doctors. The curative effect and complications of the two groups were observed. Results Compared with control group,the time from diagnosis to operation(minutes:8.00±1.36 vs. 23.06±3.83,t=14.790,P=0.000)and the operation time were significantly shortened(days:5.37±1.02 vs. 7.31±1.70,t=7.286,P=0.000),the frequency of drainage tube replacement(times:0.18±0.40 vs. 3.87±1.14,t=12.128,P=0.000)and the times of repeated chest radiography(times:1.12±0.34 vs. 2.93±0.77,t=8.589,P=0.000)in observation group were significantly reduced,the length of hospital day was significantly shortened(days:8.30±1.37 vs. 24.56±5.62,t=17.289, P=0.000),the rates of dislocation of drainage tube(0 vs. 3 cases),obstruction of the tube(0 vs. 5 cases),and subcutaneous emphysema(3 vs. 16 cases)were reduced obviously,but there was no difference in incidence of incision infection(1 vs. 3 cases)and infection of thoracic cavity(0 vs. 2 cases). Conclusions The usage of transcutaneous tracheostomy tube in patients with pneumothorax is safe and simple. Doctors in ICU can independently do this procedure,and its effect is positive.

Objective To learn the investigators′ satisfaction with CRCs and to identify the shortcomings with the CRC industry or institutional management for improvement. Methods A questionnaire survey was conducted among 120 clinical trial investigators at three tertiary general hospitals in January 2018. The questionnaire covered the basics, satisfaction with CRC, and comments of the investigator on other works of the CRC. The data acquired were subject to descriptive analysis, and the count data comparison method was Fisher precise test. Results The investigators were satisfied with CRCs in general. Specifically, their satisfaction with the " sense of responsibility" , " work hours" , and " command of GCP protocols"ranged 72.6% to 83.2% . That with " initiative" , " work stability" , and " rich clinical trial experience" fell below 60.0%. Affiliation of CRCs was correlated to "initiative"(P=0.007), and "command of clinical trial schemes and trial procedures" ( P =0.043), while investigators′ satisfaction with CRCs of uncertain affiliation fell significantly. Investigators′ experience was correlated to the " command of GCP protocols" of CRCs(P=0.035 ), as the more experienced the investigator, the less their satisfaction with the CRC. Conclusions Hospitals are expected to build a CRC standardized training system and hierarchical certification system; to standardize their CRC recruitment mechanism for overall management; to enhance their budgeting capability for sufficient CRC expenses, higher investigator efficiency and assured clinical trial quality.

CircRNA is a new endogenous non-coding RNA(ncRNA ) and a member of the competitive endogenous RNA(ceRNA) family. Some researches have found that circRNA exists widely in organisms and interacts with miRNA, which has certain influence on the occurrence and development of liver diseases. This article reviews the research progress of circRNA and its biological functions, as well as the relationship between circRNA and liver disease, in order to expound the role of circRNA in liver diseases and guide clinical practice better.

Objective The primary aim of this study was to examine the proportion and natural history of Helicobacter pylori (Hp) negative bleeding peptic ulcers. Methods The study was designed as a multiple-center, case-control study conducted in 14 endoscopy centers in China from April 2006 to March 2007. Each center was expected to recruit 30 peptic ulcer patients with bleeding ( PUB group) and 30 without (PU group). All screened patients with upper gastrointestinal bleeding received endoscopy within 24 hours of admission. Biopsy specimens were taken from the antrum to determine Hp infection by rapid urease test and pathology. Patients with negative Hp infection at first examination were asked to receive urease breathe test (UBT) one month later. Results A total of 617 patients were enrolled with 263 in PUB group and 354 in PU group. There is no significant difference in demographic characters between 2 groups ( P ＞0. 05). The rate of Hp infection in PUB group ( 161/263, 61.2% ) was significantly lower than that in PUgroup (311/354, 87. 9%, P ＜0. 001 ). The incidence of complex ulcer in Hp positive PUB patients was 7.5% ( 12/161 ), which is significantly higher than that in Hp negative PUB patients ( 1/102, 1.0% , P =0. 018). In PUB group, no significant differences were found between Hp positive and negative patients in regarding of age, sex, rates of haematemesis, duodenal ulcer and gastric ulcer, and size of ulcer ( P ＞0. 05 ). Among 102 Hp negative cases in PUB, no positive case was found in UBT one month later. Conclusion We have demonstrated a rise in the incidence of Hp negative bleeding ulcers in China. The idiopathic ulcer was not rare, and might have a higher tendency to cause bleed.

Objective:To search for and summarize the best evidence on non-pharmacological interventions for orthostatic hypotension in patients with Parkinson disease.Methods:Based on the 6S model, the relevant guidelines, clinical decisions, evidence summaries, systematic reviews and expert consensus on non-pharmacological interventions for orthostatic hypotension in Parkinson disease patients were systematically retrieved from domestic and foreign databases. The search time was from the establishment of the database to December 2022. Two researchers independently screened the literature, evaluated the quality of the included literature, and extracted and summarized evidence that met the quality standards.Results:A total of 15 articles were included, including 4 guidelines, 2 clinical decision-making articles, 1 evidence summary article, 3 systematic evaluations and 5 expert consensus articles. A total of 24 pieces of best evidence were summarized from 7 aspects, including purpose, evaluation, capacity intervention, exercise intervention, posture intervention, physical intervention, health education and support.Conclusions:The best evidence on non-pharmacological intervention for orthostatic hypotension in patients with Parkinson disease can provide a reference for the practice of clinical medical staffs. It is suggested to apply the best evidence in combination with the patient's condition, preference and clinical environment, so as to reduce the incidence of orthostatic hypotension in patients with Parkinson disease and to ensure the safety of patients.

The Chinese Neonatal Network(CHNN) was established in 2018 with the mission of establishing a national collaboration platform, conducting high-quality and collaborative research, and ultimately improving the quality of neonatal-perinatal care and health in China.At present, 112 hospitals across the country have joined CHNN.CHNN has established a national standardized cohort of very premature infants/very low birth weight infants with >10 000 enrollments each year, has been leading data-driven collaborative quality improvement initiatives, conducting multicenter clinical studies, and performing multi-level training programs.Guided by the principles of collaboration and sharing, data-driven, continuous improvement, and international integration, CHNN has become an important platform for clinical and research collaboration in neonatal medicine in China.