BACKGROUND:Most end-stage renal failure patients must undergo hemodialysis before and after kidney transplantation.Noncompliance is common in patients who undergo hemodialysis,and it correlated with mortality.The improvement in self-management behavior is beneficial to the improvement of survival rate and quailty of life of hemodialysis patients.OBJECTIVE:To investigate and analyze the effect of nursing intervention on self-management behavior and health-related quality of life in hemodialysis patients before and after kidney transplantation.DESIGN:A randomized and controlled analysis.SETTING:Department of Nursing and Hemodialysis Center,First Affiliated Hospital of China Medical University.PARTICIPANTS:Forty-eight renal failure patients who underwent hemodialysis in the Hemodialysis Center,First Affiliated Hospital of China Medical University between February and April 2006 were recruited in this study.The involved patients.including 29 males and 19 females,aged 22-77 years,able to read and write the questionnaires,voluntarily participated in this study.Written informed consents of treatments and investigation items were obtained from each patient.The study was approved by the Ethics Committee of the hospital.The involved patients were randomly assigned into 2 groups with 24 patients in each:intervention group and control group.METHODS:Patients in the intervention group were given 6 months of nursing(i.e.according to actual conditions,each patient was given health education by handing out health promoting stuffs,giving individual or centralized guidance as well as other modalities).Patients in the control group were given routine health education.MAIN OUTCOME MEASURES:Self-management behavior and health-related quality of life were assessed before,3 and 6 months after nursing intervention using self-management behavior questionnaire and short-form 36 health survey.RESULTS:Forty-eight patients who underwent hemodialysis participated in the final analysis.There were no significant differences in the total scores of self-management behavior questionnaire and short-form 36 health survey between intervention group and control group before and 3 months after nursing intervention(P＞0.05).Significant difference in the total scores of self-management behavior questionnaire and short-form 36 health survey existed in each group 6 months after nursing intervention in comparison with baseline(P＜0.01,0.05).The total scores of self-management behavior questionnaire of intervention group were significantly increased 6 months after nursing intervention in comparison with the baseline (P＜0.01).CONCLUSION:Nursing intervention markedly improve the self-management behavior and quailty of life of patients who undergo hemodialysis before and after kidney transplantation.

β-carotene has a wide range of application in food, pharmaceutical and cosmetic industries. For microbial production of β-carotene in Saccharomyces cerevisiae, the supply of geranylgeranyl diphosphate (GGPP) was firstly increased in S. cerevisiae BY4742 to obtain strain BY4742-T2 through over-expressing truncated 3-hydroxy-3-methylglutaryl-CoA reductase (tHMGR), which is the major rate-limiting enzyme in the mevalonate (MVA) pathway, and GGPP synthase (GGPS), which is a key enzyme in the diterpenoid synthetic pathway. The β-carotene synthetic genes of Pantoea agglomerans and Xanthophyllomyces dendrorhous were further integrated into strain BY4742-T2 for comparing β-carotene production. Over-expression of tHMGR and GGPS genes led to 26.0-fold increase of β-carotene production. In addition, genes from X. dendrorhous was more efficient than those from P. agglomerans for β-carotene production in S. cerevisiae. Strain BW02 was obtained which produced 1.56 mg/g (dry cell weight) β-carotene, which could be used further for constructing cell factories for β-carotene production.
Basidiomycota ; enzymology ; Farnesyltranstransferase ; genetics ; metabolism ; Hydroxymethylglutaryl CoA Reductases ; genetics ; metabolism ; Metabolic Engineering ; Polyisoprenyl Phosphates ; Saccharomyces cerevisiae ; metabolism ; beta Carotene ; biosynthesis

Objective To investigate the expression of SOX2 in gastric carcinoma and to analyze its relationship with clinicopathological features.Methods Immunohistochemistry method was used to detect the level of SOX2 in 67 cases of gastric carcinoma group and 30 cases of normal gastric mucosa group.Results The positive expression rate of SOX2 in gastric carcinoma group (52.24 ％) was obviously lower than that in normal gastric mucosa group (93.33 ％) (x2 =16.326,P ＜ 0.01).The SOX2 expression was significantly correlated with differentiation,the depth of invasion,lymph node metastasis and TNM stage of the tumor (all P ＜ 0.05).Conclusions The low expression of SOX2 may contribute to the early carcinogenesis of gastric carcinoma,and the expression level of SOX2 is closely related with lymph node metastasis and TNM stage.The expression level of SOX2 is a useful marker for predicting the prognosis of gastric carcinoma.

ObjectiveTo evaluate the safety and efficacy of 30 mg pioglitazone hydrochloride combined with sulphonyurea in the treatment of type 2 diabetic patients.MethodsA randomized, double blind, placebo-controlled, parallel group, multicenter study was performed.A total of 236 patients, who had fasting plasma glucose(FPG) 7.5-13.0 mmol/L and glycosylated hemoglobin A1c(HbA1 c) 7.0％ -12.0％,treated with stable dosage of a sulphonyurea for at least 30 days previously, were randomized to receive placebo or pioglitazone 30 mg once daily for 16 weeks.The sulphonyurea and dosage remained unchanged.ResultsThe patients who had been treated with pioglitazone 30 mg showed significant decrease than that in the placebo group on the average from baseline in FPG [(1.48 ±2.08) mmol/L vs (-0.17 ± 1.92)mmol/L, P＜0.05], and in HbAlc [(0.92 ±0.10)％ vs (0.28 ±0.11)％, P＜0.05].Since fasting plasma insulin (Flns) levels decreased (0.24 ±0.04) mU/L and (0.09 ±0.04) mU/L in the two groups.The homeostatic model assessment insulin resistant (HOMA-IR) decreased 1.42 ± 2.90 and 0.46 ± 3.53 in two groups.The triglyceride level was decreased 0.36 mmol/L and 0.14 mmol/L, and the HDL-C level increased 0.17 mmol/L and 0.05 mmol/L in two groups.There were significant differences in two groups (all P ＜ 0.05).ConclusionsThe 16-week clinical study demonstrated that pioglitazone hydrochloride with a dosage of 30mg daily, could significantly improve the blood glucose control and enhance the insulin sensitivity, lower triglyceride and raise HDL-C level as an additional therapy to a stable-dose sulphonyurea in Chinese type 2 diabetic patients previously poorly controlled by single sulphonyurea therapy, and furthermore had good safety and compliance.

Objective To explore the value of predictive nursing of elderly patients with se-vere myocardial infarction.Methods A total of 56 patients with severe myocardial infarction ran-domized into study group and control group with 28 cases in each group.The control group used conventional nursing,including symptomatic in nursing after adverse psychology,complications and constipation,and study group applied predictive nursing including closely monitoring and pre-vention of adverse psychology and various complications on admission.Results The incidence of complications,constipation and mortality in the study group was significantly lower than that in the control group ,the differences between the two groups were statistically significant (P <0.05).The depression scores and anxiety scores were significantly lower than that in the control group,which indicated that the psychological state in the study group was better than that in the control group,the difference was statistically significant (P <0.01).Conclusion It is of great value for the elderly patients with severe myocardial infarction applied predictive nursing and it can reduce the incidence of complications,constipation and mortality,and help patients to maintain good metal status.

Objective To explore the value of predictive nursing of elderly patients with se-vere myocardial infarction.Methods A total of 56 patients with severe myocardial infarction ran-domized into study group and control group with 28 cases in each group.The control group used conventional nursing,including symptomatic in nursing after adverse psychology,complications and constipation,and study group applied predictive nursing including closely monitoring and pre-vention of adverse psychology and various complications on admission.Results The incidence of complications,constipation and mortality in the study group was significantly lower than that in the control group ,the differences between the two groups were statistically significant (P <0.05).The depression scores and anxiety scores were significantly lower than that in the control group,which indicated that the psychological state in the study group was better than that in the control group,the difference was statistically significant (P <0.01).Conclusion It is of great value for the elderly patients with severe myocardial infarction applied predictive nursing and it can reduce the incidence of complications,constipation and mortality,and help patients to maintain good metal status.

Objective:To investigate the effect of S100A10 macrophage-mediated inflammation and migration.Methods:C57BL/6J mouse model of S100A10-KO,and RAW264.7 cell line of S100A10-KO were established.Taking mice's peritoneal macro-phages(PMs)and bone marrow macrophages(BMDMs),resuscitating RAW264.7 cell lines,and collecting cells.qRT-PCR was used to detect the effect of S100A10 knockout on the secretion of inflammatory factors in macrophages;wound healing assay and Transwell assay were used to detect the effect of S100A10 knockout on macrophage migration;CCK8 kit was used to detect the effect of S100A10 knockout on the proliferation of RAW264.7 cells;qRT-PCR and Western blot were used to detect the expressions of matrix metallopro-teinase 9(MMP9)and non-muscle myosin heavy chain 9(MYH9).Results:After S100A10 knockout,the inflammatory factors IL-6,IL-1β and MCP-1 levels(P<0.05)secreted by RAW264.7,PMs and BMDMs were excreted decreased;cell scratches and Transwell showed that S100A10 knockout inhibited macrophage migration;CCK8 experiments showed that the proliferation capacity of macro-phages weakened after S100A10 knockout;qRT-PCR and Western blot experiments showed that the migration-related proteins MMP9 and MYH9 decreased after S100A10 knockout.Conclusion:S100A10 knockout decreases the secretion of inflammatory factors by macrophages and attenuated the migration and proliferation of macrophages.

Objective:To explore the role of activated CD4 + T cells in cardiac remodeling after myocardial infarction (MI). Methods:① Experiment in vitro: naive CD4 + T cells were isolated in mouse spleen, and then stimulated with plate-bound anti-CD3 and anti-CD28 for 48 hours. Exosomes isolated from the supernatant of activated CD4 + T cells were incubated with cardiac fibroblasts (CFs) for 48 hours, and then the ability of CFs proliferation, migration and differentiation were detected by cell counting kit-8 (CCK-8) assay, Transwell assay, and immunofluorescence assay. ② Experiment in vivo: 40 male C57 mice were divided into 4 groups according to random number table method, including control group (Ctrl group), sham operation group (Sham group), MI group, and exosome treatment group (MI+Exo group), with 10 in each group. The mice model of MI was established by ligating the left anterior descending coronary artery. In MI+Exo group, 40 μg/d exosomes were injected intravenously into the tail after modeling. Cardiac function and cardiac fibrosis post-MI were assessed by echocardiography and quantitative polymerase chain reaction (qPCR) at 4th week. Results:① In vitro: exosomes derived from activated CD4 + T cells significantly promote CFs proliferation, migration and differentiation [proliferation ability ( A value): 0.31±0.01 vs. 0.21±0.01, migration capability (cells/MP): 79.20±3.34 vs. 48.80±2.13, differentiation ability (α-smooth muscle actin, α-SMA; fluorescence intensity): 1.56±0.03 vs. 1.00±0.02, all P < 0.05]. ② In vivo: echocardiographic analysis showed that exosomes derived from activated CD4 + T cells aggravated the deterioration of cardiac dysfunction post-MI than MI group, as indicated by left ventricular ejection fraction (LVEF) and fractional shortening (FS) decreased significantly [LVEF: 0.185±0.008 vs. 0.257±0.022, FS: (9.72±1.72)% vs. (14.08±1.08)%, both P < 0.05], left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) increased significantly [LVEDD (mm): 5.43±0.29 vs. 4.62±0.35, LVESD (mm): 4.94±0.12 vs. 3.69±0.29, both P < 0.05]. Additionally, qPCR showed that exosomes derived from activated CD4 + T cells remarkably promoted myocardial fibrosis post-MI than MI group, as indicated by the mRNA expression of α-SMA, collagens (Col1a1, Col3a1) in MI+Exo group was significantly higher than that in MI group [α-SMA (2 -ΔΔCT): 4.72±0.89 vs. 3.58±0.78, Col1a1 (2 -ΔΔCT): 6.59±0.56 vs. 4.23±0.42, Col3a1 (2 -ΔΔCT): 13.40±1.03 vs.4.96±0.36, all P < 0.05]. Conclusion:Activated CD4 + T cells promote cardiac remodeling following MI through transferring exosomes to CFs.

Objective: To investigate the efficacy of alternative donor (AD) in the treatment of aplastic anemia (AA) in children. Methods: The clinical data of AA children who received AD HSCT in our center from Apr. 2010 to Dec. 2016 were retrospectively analyzed. The overall survival (OS) rate, implant success rate, incidence of acute and chronic graft-versus-host disease (GVHD) were statistically analyzed. Results: A total of 109 children with acquired AA, including 64 severe AA (SAA) , 32 very severe AA (VSAA) and 13 transfusion dependent non-severe AA (NSAA) , were recruited in this retrospective AD HSCT study, the median age was 6 (0.8-18) years old. Of them, 44 patients with 10/10 matched unrelated donor (MUD) , 44 patients with mismatched unrelated donor (MMUD) and 21 patients with mismatched related donor (MMRD) . All patients did not receive ATG before HSCT and the active infection was excluded. Except 3 patients suffered from a second graft failure (2 of them rescued by second HSCT) , 106/109 (97.2%) were engrafted with neutrophil and platelet recovery occurring at a median of 13 days (range, 9-19) and 16 days (range, 10-81) post-transplant. Until day 100 post transplantation, the incidence was 74.3% (81/109) for acute GVHD (aGVHD) and 39.4% (43/109) for grade Ⅱ-Ⅳ aGVHD, 30.7% (31/101) and 9.9% (10/101) for overall chronic GVHD (cGVHD) and moderate cGVHD, respectively, and nobody developed an extend cGVHD. After median follow up of 39 (0.7-103) months for all patients, 13 of 109 patients died. The estimated 5-year overall survival (OS) of the entire cohort was 88.1% (95%CI 81.1%-91.4%) with no difference among the MUD, MMUD and MMRD cohort (93.2%, 84.1% and 85.7%, respectively, P=0.361) . Conclusion These excellent outcomes suggest that unmanipulated AD PBSC is a good HSCT source for children with SAA. It’s reasonable to consider AD HSCT as first line therapy for SAA children without matched sibling donor. Better strategies are required to prevent GVHD.

Objective To evaluate efficacy and safety of acarbose compared with metformin as add-on therapy in patients with type 2 diabetes mellitus inadequately controlled with insulin. Methods This was a randomized, open-labeled, and parallel group study. Ninety-one type 2 diabetic patients ( HbA1C7.5%-11.0%) who were suboptimally controlled despite receiving twice daily injection of insulin (30-60 U/d for at least 8 weeks) were enrolled. They were randomly assigned 1 ∶ 1 ∶ 1 to continuation of insulin, insulin with acarbose (Ins+Aca), and insulin with metformin (Ins+Met) groups to insulin treatment. The levels of HbA1C, oral glucose tolerance test, blood lipids etc were measured at baseline and 12 weeks, and adverse events were recorded. Results The mean HbA1C levelsdecreasedfrom(7.9±0.4)%atbaselineto(7.0±0.3)%atweek12(P＜0.01)intheIns+Acagroupand(7.8 ±0.2)%to(7.0±0.3)%in the Ins+Met group(P＜0.01), while no significant change in HbA1Cin the insulin alone group. Adding acarbose to insulin resulted in similar reductions in HbA1Crelative to metformin (P＝0.431). The achievement rate of HbA1Cbelow 7.0%at week 12 was the same(both 70%) between the Ins+Aca group and the Ins+Met group. Insulin combined with acarbose in improving blood glucose fluctuation effect was more significant than that incombinationwithmetformin(P＜0.01),withstandarddeviation(SD)ofbloodglucose[(1.1±0.5vs2.7±0.6) mmol/L, P＜0.01], postprandial blood glucose fluctuations [(0.5 ± 0.7 vs 2.8 ± 0.4) mmol/L, P＜0.01], the maximumbloodglucosefluctuations[(2.8±0.7vs4.6±0.6)mmol/L,P＜0.01].Theweightlossoccurredinboththe Ins+AcaandtheIns+Metgroups[-(0.5±0.8vs1.0±0.4)kg].Therewasnosignificantchangesinbloodpressure and lipid profile. Hypoglycemic episodes were comparable in all groups. No serious adverse event was noted in any group. Conclusions Adding acarbose or metformin to insulin therapy could achieve improvements in glycemic control with similar reductions in HbA1Clevels and weight, when comparing with insulin treatment alone. Add-on acarbose to insulin therapy may exist more effectively on glucose fluctuation than that of add-on metformin, which may have important clinical implications in those patients with postprandial hyperglycemia, large blood glucose fluctuation, and intolerance to metformin.