BacKground:The mechanism of diabetic gastrointestinaI dysmotiIity is stiII uncIear. More and more studies showed that gastrointestinaI smooth muscIe derived factors pIay an important roIe in gastrointestinaI dysmotiIity. RecentIy,the roIe of RhoA/ROCK signaIing pathway in diabetic compIications become a research hotspot. Aims:To investigate the possibIe roIe of RhoA/ROCK signaIing pathway in diabetic coIon dysmotiIity by examining the expressions of major signaIing moIecuIes in diabetic coIon muscIe. Methods:NormaI coIon tissue sampIes taken from patients undergoing radicaI surgery for coIonic cancer from Sept. 2012 to Dec. 2013 at the First AffiIiated HospitaI of Nanjing MedicaI University were coIIected. According to gIycated hemogIobin IeveI,the patients were divided into diabetes meIIitus( DM)group and controI group. The expressions of major signaIing moIecuIes in RhoA/ROCK1 signaIing pathway incIuding RhoA,ROCK1,MYPT1 and p-MYPT1 were determined by immunohistochemistry or Western bIotting. Results:Immunohistochemistry showed that expression of RhoA protein in DM group was significantIy Iower than that in controI group(P<0. 05). Western bIotting showed that expression IeveIs of RhoA,ROCK1 and p-MYPT1 proteins were significantIy Iower in DM group than in controI group(0. 62 ± 0. 42 vs. 1. 15 ± 0. 69,0. 54 ± 0. 09 vs. 0. 75 ± 0. 05,0. 70 ± 0. 28 vs. 1. 04 ± 0. 47;P<0. 05),whereas no significant difference in expression IeveI of MYPT1 protein was found between DM group and controI group(0. 94 ± 0. 50 vs. 1. 21 ± 0. 80,P>0. 05). Conclusions:The inhibition of RhoA/ROCK signaIing pathway in diabetic coIon muscIe may have some correIation with diabetic coIon dysmotiIity.

BACKGROUND: In a series of recent studies it was demonstrated thatpolysaccharides play important roles in many physiologic and pathologicprocessions, such as infection, inflammation, inter-cell adherence and sig nal conduction, immune identification, cell proliferation and differentiation, as well as maintenance of cell structure and function. But the protectiveeffect of plant polysaccharides on gastrointestinal mucosa needs further re search. OBJECTIVE: To observe the effect of the total polysaccharides of SijunziDecoction (SJZD) (TPSJ) in different concentrations on the proliferation ofrat intestinal epithelial cell line IEC-6. DESIGN: Observational controlled trial. SETTING: Central Laboratory, Guangdong Hospital of Traditional ChineseMedicine. MATERIALS: ①Cell line: The IEC-6 of normal rats (Catalog No. RL 1592) was purchased from American Type Culture Collection (ATCC). IEC6 cells were originated mainly from intestinal crypt cells. ②Reagents anddrugs: DMEM medium, bovine insulin, gentamicin, fetal bovine serum (FBS) and DPBS were purchased from GIBCO Ltd. Cell proliferation kit(MTT) was purchased from Roche Ltd. Indomethacin was purchased fromSigma Company. SJZD was composed of Dangshen (Codonopsis pilosula),Baizhu (Atractylodes macrocephala), Fuling (Poria cocos) and Gancao (Glycyrrhizae uralensis), and these four drugs were in same ratio as Pharmacopoeia. The four herbs were boiled in water, extracted twice for 8 hours.Extract was combined, decompressed, concentrated, centrifugated with high speed to take out insoluble substance, put in glass paper to receive reverse lotic water dialysis for 2 hours. The final decoction was concentrated by heating followed by extraction with 80% ethanol. After overnight precipitation at room temperature and combination of sedimen, the total polysaccharide was obtained by deproteinating with the Sevag method.METHODS: ①The IEC-6 cell line was maintained in T-150 flasks with DMEM culture solution, and then put in CO2 incubator at 37 ℃, at saturated humidity, cultured at 0.05 volume fraction CO2, after being taken out from dry ice and defrosted rapidly in water-bath at 37 ℃. Flasks were incubated at 37 ℃ in 5% CO2· Stock cells were subcultured at a dilution of1:7 every 5-7 days and the medium was changed once every 2 days. The cells in passage 15-20 were used for testing. ②IEC-6 cells were inoculated at a density of 1×l04 cells/well in 96-well plates. Cultured were supplemented with TPSJ in a final concentrations ranging from 50, 100 and 200 mg/L after 6 hours, which was 3 TPSJ groups. One plate would be taken out for the examination of cell proliferation using MTT assay everyday. The cells that not administrated by any intervention were used as normal control group and cell proliferation was assayed using MTF at corresponding time points. ③IEC-6 cells were inoculated at a density of1×104 cells/well in 96-well plates, and then cultured in the DMEM supplemented with no serum from the following day for 24 hours. For the examiation of mucosal restitution, indomethacin at concentration of 40 mmol/L was employed to induce IEC-6 cells injured, which was indomethacin group. The three concentration of TPSJ was 50, 100 and 200 mg/L, respectively, which was 50,100,200 mg/L TPSJ groups. After drug action for 20 hours, the proliferation of cells was measured using MTT according to the manufacturer's instructions. IEC-cells without any intervention were used in the normal control group. Cell proliferation was determined with TT method at corresponding time points.MAIN OUTCOME MEASURES: MTT assay was used to examine the effects of TPSJ on IEC-6 cell proliferation in different times. MTT assay was used to detect the effect of TPSJ on IEC-6 cell proliferation inhibited by indomethacin.RESULTS: TPSJ could accelerate IEC-6 cells growth at different doses and in different time. After the cells were treated by 40 mmol/L indomethacin for 24 hours, the absorbance (A) of IEC-6 cells apparently declined compared with that in the normal control group (0.17±0.02,0.31±0.03; P ＜ 0.01). The A of IEC-6 cells treated by TPSJ in 100 mg/L group was apparently higher compared with indomechacin group (0.25±0.04, 0.17±0.02; P ＜ 0.01). The A of IEC-6 cells treated by TPSJ did not restored to the normal level, but there was no insignificant difference compared with normal group (P ＞ 0.05).CONCLUSION: TPSJ can accelerate the proliferation of IEC-6 cells. TPSJ can exert regulatory function both in intestinal mucosa absorption and immunity by affecting intestinal epithelial cells.

Objective To develop a prediction model for functional gain in the activities of daily living (ADL) after stroke rehabilitation. Methods Logistic regression was applied to 896 patient records from two hospitals. Functional gains in ADL were measured using a modified Barthel index (MBI). Results Five parameters were screened in the logistic regression model. The equation was: Logit( P/Y =1)=6.259+1.048 ( first onset to admission interval)+1.242(MBI score at admission)+0.300(number of comorbidities)+1.095(retired cadre dummy)+ 0.906(worker dummy) + 1.384 (professional dummy). This formulation accounted for about 78% of the variance in the data. Conclusions MBI score at admission, the interval between first onset and admission, comorbidities, job status and occupation are the main factors predicting functional ADL gains after stroke. The model can be used to predict outcomes for individual stroke patients at admission to rehabilitation.

AIM:This study was performed to investigate the feasibility and efficiency of exogenous mesenchymal stem cells(MSCs) transplantation on post-infarction ventricular remodeling and heart function in rats and compare the effects between adult rat MSCs and neonate rat MSCs transplantation.METHODS:1-2 hours after left coronary artery ligation,MSCs cultured in ex vivo,marked with BrdU,were injected directly into the border of infarcts in exogenous rats.6 weeks after transplantation,rat' heart function,ventricular remodeling and pathological results were measured.RESULTS:MSCs transplantation decreased LV end-diastolic diameter and end-systolic diameter,limited LV chamber dilatation and reduced collagen content significantly.The numbers of blood vessels and cardiomyocytes were increased.BrdU-labelled MSCs with oval nucleus were widely distributed.There were no significant difference between adult rat MSCs and neonate rat MSCs transplanted groups.CONCLUSION:MSCs can survive and home in exogenous host infarct hearts without addition of any immunosuppressant.MSCs transplantation has benificial effects on remodeling processes and contributes to improvement of cardiac function,which may be related with the reduction of the amount of the collagen,promotion of myogenesis and angiogenesis.

Objective:To investigate the effect of the extract of Schisandra chinensis on the matrix metalloproteinases(MMPs) system in kidney tissue of the diabetic rats,and to explore its protective effect on the kidney tissue from the matrix degradation perspective.Methods:STZ was used to establish rat models of diabetes mellitus.A total of 45 diabetic rats were randomly divided into model group,extract of Schisandra chinensis group and Benazepril group,and there were 15 rats in each group.Another 15 rats were selected and used as normal control group.12 weeks after administration,the routine blood and urine biochemical indexes,the histological changes,blood glucose (BG),blood urea nitrogen(BUN),serum creatinine(Scr),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterin(LDL-C),total cholesterol(T-CHO),and triglyceride(TG) levels,excretion rates of albuminuria and proteinuria of the rats in various groups were detected;the expression amounts of fibronectin (FN),type Ⅳ collagen (Col Ⅳ),and matrix metalloproteinase inhibitor metalloproteinase-2 (TIMP-2) in kidney tissue of the rats were detected by immunohistochemical method;the activity of matrix metalloproteinase-2 (MMP-2) was detected by zymography.Results:Compared with model group,the glomeruli matrix accumulation of the rats in extract of Schisandra chinensis group was significantly improved,the excretion rate of albuminuria,LDL-C level and serum MDA level were decreased(P<0.05),the activities of CAT(P<0.01)and SOD(P<0.05)in kidney tissue were increased,and the level of MDA in kidney tissue was decreased(P<0.05).The immunohistochemistry results showed that compared with model group,the expression amounts of FN,Col Ⅳ,and TIMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group were significantly decreased.The zymography results showed that compared with model group,the activity of MMP-2 in kidney tissue of the rats in extract of Schisandra chinensis group was significantly increased(P<0.05).Conclusion:Extract of Schisandra chinensis has protective effect on the kidney tissue of the diabetic rats induced by STZ,and the mechanism may be related to the inhibition of oxidative stress and the improvement of MMP-2 activity as well as the inhibition of TIMP-2 expression which could improve the matrix degradation.

Objective: To evaluate the clinical effects of CGF membrane for repairing the oral mucosa defects. Methods: 39 patients were selected with oral mucosa defects after surgical resections. 19 defects were covered by autologous CGF membranes as the experimental group. 20 defects were not covered by membrane as the control group. Regular follow-up were performed at one week, two weeks, three weeks, one month, two months, three months after the operations. And wound healings were compared in the groups. Results: CGF membranes of the 19 patients in the experimental group survived completely. And no infection occurred. The wound healing rate of the experimental group was higher than that of the control group at two weeks, three weeks and one month after the operations. And the difference was statistically significant(P<0.05). The VAS score of the experimental group was lower than that of the control group at one week, two weeks, three weeks and one month(P<0.05). The mean score of VSS score in the experimental group was lower than that in the control group (P<0.05). Conclusions Repair of the oral mucosa defects with CGF membrane can shorten the period of wound healing, relieve the postoperative discomfort and reduce the scar. It was a safe and effective method worthy to be popularized.

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .

Objective To investigate the changes of regional homogeneity ( ReHo) in Parkinson's disease (PD) patients with depression and their relationship with major depressive disorder.Methods A total of 42 PD patients without depression , 20 PD patients with depression, 20 major depressive disorder patients and 47 well-matched healthy controls were scanned with resting-state functional magnetic resonance imaging for ReHo analysis.The Hamilton Depression Scale (HAMD), Unified Parkinson's Disease Rating Scale (UPDRS-Ⅲ) and Hoehn-Yahr stage were used to assess the clinical symptoms , then the correlations between abnormal brain regions and clinical data were explored.Results ( 1 ) The main effect of Parkinson's disease: PD group showed higher ReHo in left ventrolateral prefrontal cortex and right precuneus, but lower ReHo in bilateral supplementary motor area and left angular gyrus.(2) The main effect of depression: The depression group had increased ReHo in bilateral cerebellum , and decreased ReHo in bilateral precentral gyrus , postcentral gyrus , left inferior frontal gyrus, left posterior cingulate gyrus , left supplementary motor area , right dorsolateral prefrontal cortex , right inferior parietal gyrus and right calcarine.(3) Interactive effect of PD and depression : Interactive brain areas included bilateral middle frontal gyrus, left inferior frontal cortex and supramarginal gyrus.(4) The ReHo of the brain regions under main effect of depression including right dorsolateral prefrontal cortex (r＝-0.526, P＜0.01) and right inferior parietal gyrus ( r＝-0.456, P＜0.01) had significant negative correlation with HAMD scores. Conclusion PD patients with depression have abnormal brain function , and PD with depression is not simply an overlay of PD and major depressive disorder.

Objective To build demand scale for Post-hospital intestinal colostomy patients and test the reliability and validity. Methods Through the investigation of relevant literature at home and abroad,Based on the Maslow's Need Hierarchy Theory, in combination with intestinal colostomy patients psychological scale, using qualitative research, a semi-structured interview was conducted in 12 patients with colostomy A thorough understanding of colostomy patients Post-hospital care needs content (interview time as follows:September-October 2015), to analysis the interview recording data, the item pool of the scale for post-hospital care needs in patients with colostomy was constructed. Choosing 200 patients from the department of Proctology of third-grade class-A hospitals of Jilin province, and carries on the scale of clinical testing, after collecting the relative data , and make use of Critical Ration、the correlation coefficient method and the internal consistency coefficient method、further concludes that the scale items should be added or not, and picking up the internal consistency reliability 1/2 reliability retest reliability content validity and structure validity to analysis each item. Results The demand scale for Post-hospital intestinal colostomy patients included 6 dimensions and 24 items. The total content validity index (S-CVI) of the scale was 0.968, and the content validity index (I-CVI) of each item was 0.78-1.00. By exploratory factor analysis, 6 principal components were extracted, and the cumulative explanation variation of 6 principal components was 91.753％. This indicated that the scale had good validity. The total Cronbach a coefficient of the scale was 0.751, and the Cronbach a coefficient of each dimension was 0.968-0.974, all above 0.7, which indicated that the internal consistency was good. The half-fold reliability and retest reliability of the scale were 0.794 and 0.827 respectively. Conclusion The scale designed in this study has good reliability and validity, and can be used as an effective assessment tool for nursing needs of patients after discharge from enterotomy.

Objective To make a system evaluation regarding the effect and safety of the"Nourishing Kidney and Activating Blood"method in the treatment of diabetic cognitive impairment.Methods According to the requirements of evidence-based medicine,the domestic and foreign databases were searched comprehensively,and the time limit was from the establishment of databases to June 2022,so as to find out the clinical randomized controlled trials of"Nourishing Kidney and Activating Blood"method in treating diabetic cognitive impairment.Revman5.3 was used for meta-analysis and risk bias evaluation,TSA0.9 for sequential analysis,Stata15.0 for publication bias evaluation,and GRADE3.6 for evidence quality evaluation.Results Eventually,14 RCTs were included with a sample size of 1126 cases.Meta-analysis showed that compared with conventional western medicine treatment,the"Nourishing Kidney and Activating Blood"method could significantly improve the effective rate of treating cognitive dysfunction in diabetes[OR=5.06,95%CI(3.38,7.57),P<0.00001],and significantly improve the total MoCA score of patients[MD=2.11,95%CI(1.76,2.47),P<0.00001],MMSE score[MD=1.86,95%CI(1.13,2.59),P<0.00001],MQ score[MD=13.40,95%CI(11.23,15.57),P<0.00001]and HDS score[MD=-3.36,95%CI(2.61,4.11),P<0.00001].Meanwhile,the"Nourishing Kidney and Activating Blood"method could reduce the level of glycosylated hemoglobin in DCI patients[MD=-0.84,95%CI(-1.37,-0.32),P=0.002].However,since the drugs used in the control group have no hypoglycemic effect,this conclusion needs to be further verified.In addition,the ability of the"Nourishing Kidney and Activating Blood"method to improve CDR score[MD=-0.01,95%CI(-0.08,0.07),P=0.84],ADL score[MD=2.10,95%CI(-1.62,5.82),P=0.27],TCM syndrome score[MD=-4.46,95%CI(-10.94,2.02),P=0.18]and reduce adverse reactions[OR=0.36,95%CI(0.08,1.60),P=0.18]was equivalent to that of conventional western medicine.Begg's test and Egger's test suggested that there might be some publication bias in the research.Metaninf command chart and sequential analysis of experiments indicated that the stability of research results was relatively good.The quality evaluation of evidence showed that the evidence of effective rate,glycosylated hemoglobin,MoCA scale score,MMSE score and MQ score was medium quality,the evidence of fasting blood glucose,CDR score and HDS score was low quality,and the evidence of ADL score,TCM syndrome score and adverse reactions was extremely low quality.Conclusion The existing literature evidence showed that the"Nourishing Kidney and Activating Blood"method had a good clinical effect in treating diabetic cognitive impairment,and it could reduce the blood glucose level and improve the cognitive function of patients,with certain safety.However,the above conclusions still needed more large samples and multi-center RCT to be further verified due to the limitation of the quality and quantity of the included literature.