It is possible for bone marrow cells,peripheral blood cells,myocardial cells,muscle cells and embryonic stem cells differentiating into smooth muscle progenitor cells(SPCs),which can express special marks of myosin heavy chain.SPCs remained quiescent,until mobilized in response to injury or disease.With various growth factors,cytokines,SPCs are mobilized following physiological stress and subsequently home to site of vascular damage,where they contribute to the remodeling process.Recently,various studies have found that SPCs from different sources contributed to the remodeling process of vessels and development in atherosclerosis.It is generally accepted that SPCs contribute to pathological changes,leads to restenosis.But several recent papers reported findings that injection of SPCs increased collagen and SMC content and reduced macrophage content,consistent with a more stable plaque.SPCs may secrete cytokines and growth factors both locally and systemically that enhance plaque stability.It remains to be determined whether smooth progenitor cells,which are less well studied than their endothelial counterparts,can likewise be manipulated to achieve therapeutic genes benefit.This review has elucidated the origin and distribution of SPCs,mobilization and recruitment,and their roles in cardiac vascular diseases.

BACKGROUND:Bone marrow derived mesenchymal stem cells (BMSCs) will be homing to the lesions after balloon injury in the inflammatory reaction process.However,the molecular mechanism of transforming growth factor-β1 (TGF-β1) to promote BMSC into smooth muscle-like cell remains unclear.OBJECTIVE:To investigate the BMSC differentiation rate under different TGF-β1 levels after acute vascular injury.DESIGN,TIME AND SETTING:A randomized controlled animal experiment and in vitro induced cell observation were performed at the SPF Laboratory Animal Center and Laboratory of Tissue Engineering,Ninth People's Hospital of Shanghai Jiao Tong University Medical School between January 2008 and May 2009.MATERIALS:A total of 24 male SD rats were randomly divided into normal control and model groups with 12 animals in each group.In addition,6 4-weak-old male SD rats were used to prepare BMSCs.METHODS:Model of acute carotid artery injury was established in model group.Serum of normal control group and model group after 1,3,7 days of injury to detect TGF-β1 level after the vascular injury by ABC-ELISA.The BMSCs after one passage were cultured at a density of (1.0-3.0)×10~5 cells/100 mm in culture dish,and divided into two groups:in routine culture group,cells were cultured in high-glucose DMEM containing 20% fetal bovine serum;in TGF-β1 group,cells were induced by different concentrations of TGF-β1 (1,3,5 and 10 μg/L) based on routine culture for 1 week.MAIN OUTCOME MEASURES:Serum TGF-β1 level after the vascular injury;,cell morphological changes by inverted phase contrast microscopy;smooth muscle α-actin expression.RESULTS:The normal serum TGF-β1 level in rat was low,but increased rapidly after 1 day of injury,reached its peak at 3 days,and declined gradually but did not return to the basic level till day 7.After 1 week of induction,BMSCs were confluent,forming peak valley appearance.Immunocytochemistry showed that compared with routine culture,the rate differentiation of smooth muscle-like cell was significantly increased in cells stimulated by TGF-β1,especially 5 and 10 μg/L TGF-β1 (P ＜ 0.01).Real-time quantitative PCR results were similar to immunocytochemistry.CONCLUSION:Serum TGF-β1 level increased after acute vascular injury and peaked at day 3.In vitro,a similar concentration of TGF-β1 could induce cultured BMSC to differentiate into smooth muscle-like cells.

Recently,the incidence of Alzheimer's disease has been significantly increasing.However,the pathogenesis of Alzheimer's disease remains unknown.It is presumed that insulin and insulin receptor may be involved in the pathogenesis of Alzheimer's disease.The relationship between insulin and cerebral glucose metabolism,the relationship between insulin,insulin receptor,insulin resistance and pathogenesis of Alzheimer's disease as well as the possible mechanism are reviewed in this paper,and the progress of treatment of AD is also described.

Alzheimer's disease(AD),the most common form of dementia,it is lack of effective cure or preventive treatment.Dementias in the elder are an increasing medical,social and economic problems and current treatments are only mildly effective.Recently,amyloid-beta protein(A?) has become a major therapeutic target.A? vaccine treatment can improve cognition in the patients with AD,but adverse events,such as meningencephalitis were observed in clinical study.The passive A? immunotherapy in humans is effective with possible safety.However,patients need to be monitored carefully.

Objective To investigate the expression and significance of Peripheral blood of Toll-like receptor-4 and cytotoxic T lymphocyte-associated antigen-4 in patients with essential hypertension. Methods We selected 35 patients with hypertension and 20 healthy people.We used flow cytometry to investigate TLR4 expression levels, and ELISA to detect the expression of CTLA-4. Results TLR4 expression in peripheral blood of patients with hypertension was (8.63 ±1.16)%, significantly higher (5.27 ± 1.25)%.The difference was statistically significant (t = 6.16,P < 0.05); CTLA-4 expression in peripheral blood of patients with hypertension was significantly higher (P<0.05); Hypertensive patients with CTLA-4 positive rate and TC, LDL-C was positively correlated (P<0.05); TLR4 and CTLA-4 was positive correlation (r = 0.886,P < 0.05). Conclusions TLR4 and CTLA-4 were high expression in hypertensive patients with hypertension,and related to hypertension.

Objective To investigate the clinical effect of early use of enteral nutrition therapy in elderly diabetic patients suffering from severe lower respiratory tract infection.Methods A prospective,randomized,open,controlled trial was conducted.Patients aged ≥ 60 years old with diabetes mellitus complicated by severe lower respiratory tract infection admitted to Department of Geriatrics of the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from July 2013 to June 2015 were enrolled,and they were divided into the observation group (nasogastric tube infusion of fresubin) and control group (ordinary liquid diet) according to the random number table method,with 60 patients in each group.Nutritional status,inflammation state and immunological indexes before treatment (0 day) and 4,7,14 days after treatment,the outcome of the disease and the nutrition related complications were compared between two groups.Results After treatment,serum albumin (ALB),pro-albumin (PA),immunoglobulin A and G (IgA,IgG) were significantly increased compared with those before treatment in both groups [at 7 days,ALB (g/L):28.37 ± 0.40 vs.26.72 ± 0.37 in control group,29.12 ± 0.25 vs.26.86 ± 0.26 in observation group;PA (mg/L):53.80 ± 6.28 vs.43.76 ± 6.93 in control group,58.46 ± 8.70 vs.44.68 ± 7.33 in observation group;IgG (g/L):11.62±4.72 vs.9.98±3.71 in control group,13.36±4.58 vs.9.88±3.27 in observation group;IgA (g/L):2.31 ±0.35 vs.1.50±0.39 in control group,3.07±0.48 vs.1.37±0.29 in observation group;all P ＜ 0.05].Compared with the control group,the level of PA in observation group was significantly increased from 7 days on (mg/L:58.46 ± 8.70 vs.53.80 ± 6.28,P ＜ 0.05),while ALB,IgG,IgA levels in observation group increased at 14 days [ALB (g/L):33.24 ± 0.45 vs.30.76±0.79,IgG (g/L):15.03 ±3.73 vs.11.45 ±2.83,IgA (g/L):3.56±0.32 vs.2.50±0.16,all P ＜ 0.05].The levels of C-reactive protein (CRP) and procalcitonin (PCT) in both groups gradually lowered,but they were significantly lower in observation group than those in the control group from 4 days on [CRP (mg/L):17.72±4.23 vs.20.96±5.83,PCT (ng/L):123±37 vs.257±88,both P ＜ 0.05],up to 14 days.The hospital mortality rate of the observation group was lowered compared with that of the control group (6.67％ vs.8.89％),and the duration of mechanical ventilation was significantly shortened (hours:145.00±19.39 vs.193.00± 18.97,P ＜ 0.05),insulin dosage was also significantly decreased (U:33.52 ± 5.74 vs.49.71 ± 6.99,P ＜ 0.05).There was no significant difference in the incidence of abdominal distension,diarrhea and reflux of gastric contents between the two groups,and they were relieved after treatment and had no influence on further enteral nutrition therapy.Conclusion Early administration of the complicated enteral nutrition in elderly diabetic patients with severe lower respiratory tract infection cannot only decrease the levels of pro-inflammatory factors in patients,but also shorten the duration of mechanical ventilation,enhance immunity,improve the curative effect with little influence on the blood glucose level.

AIM: To evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from Cirrus optical coherence tomography (OCT) instrument.METHODS: In this prospective cross-sectional study,retinal thickness images at 6mm×6mm around fovea were obtained from 86 eyes of 43 normal subjects with Cirrus HD-OCT instrument.The retinal images from patients were analysis by Cirrus automated algorithm GCA software,including ganglion cell layer and inner plexiform layer(GCIPL).During this study,operator A would make 2 times measurements to all patients,after that operator B would make another 2 times measurements by Repeat scan model.All the data,including GCL average thickness,min thickness,12 clock average thickness,2 clock average thickness,4 clock average thickness,6 clock average thickness,8 clock average thickness and 10 clock average thickness were measured by SPSS 15.0 software.Standard deviation (SD),coefficient of variation (CV) and interclass correlation coefficient (ICC) were calculated from the results of three-times tests by different examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.RESULTS: The average GCIPL thickness of OD was 85.12±3.95μm;the minimum average GCIPL thickness was 83.21±4.41μm;the standard deviation of OD in clock map was from 3.79μm to 4.84μm;CV(95%CI) was between 0.26 and 0.93;ICC was from 0.939 to 0.989.The average GCL+IPL thickness of OS was 84.65±8.73μm;the minimum average GCPL thickness was 81±13.08μm;the standard deviation of OS in clock map was from 8.24μm to 10.56μm;CV(95%CI) was between 0.92 and 4.94;ICC was from 0.264 to 0.968.CONCLUSION: Cirrus HD-OCT GCA software with automated algorithm can offer accurate and repeatable thickness profile of OCT retinal image.GCA is a useful and reliable approach to the measurement of intra-retinal layer thickness,which may improve the diagnosis and monitoring of retinal diseases.

Background Proliferative vitreoretinopathy (PVR) is one of the major causes of retinal detachment surgery failure.Based on proteomic studies of PVR vitreous,the insulin-like growth factor binding protein-6 (IGFBP-6) protein was specifically expressed in the vitreous and serum of PVR patients.Furthermore,its expression level is higher in the vitreous and serum in severe PVR patients than that in mild PVR patients.Objective This experiment was to detect the expression of IGFBP-6 in a PVR rat model.Methods Seventy 7-week old male SPF Wistar rats were included and were randomized into the PVR model group and control group.A mixture of RPE-J cell suspension(5 μl) and platelet-rich plasma (5 μl) was intravitreally injected in the left eyes of adult Wistar rats to establish the PVR model,and normal saline solution was administered in the same way in the control group.The rat eyes were clinically examined 1 week,2,3 and 4 weeks after injection,and PVR was graded based on the criteria of Francine.The animals were sacrificed after 1 week,2,4 or 8 weeks for the preparation of retinal sections and liver extraction.Expression levels of IGFBP-6 mRNA in the rat retina and liver were assayed by real-time Q-PCR.The expression of IGFBP-6 protein in the rat serum and vitreous was detected by ELISA.The use of animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Purified IGFBP-6 RNA was extracted from the liver and retina of Wistar rat and quantified by real-time Q-PCR.The expression level of IGFBP-6 mRNA in retina was (3.79± 1.33) × 10-4 in the PVR model rats,showing a significant decline in comparison with the control rats with a level of(8.32±2.96) × 10 4,4 weeks after injection (t =3.42,P＜0.01).The expression of IGFBP-6 mRNA in the 4th week was significantly lower than that of 1 week,2 or 8 weeks after the establishment of the PVR model(P＜0.05).No significant difference was found in the IGFBP-6 mRNA level in the liver between the PVR group and control group(27.60± 14.01 × 10 4 vs.25.01 ± 12.04 ×10-4,respectively),as well as among the different time points(P＞0.05).IGFBP-6 mRNA content in the retina was significantly reduced in grades 1,2 or 3 of the PVR groups compared with the control group(P＞0.05),but there was no significant difference among the different grades of PVR groups (P＞0.05).Concentrations of IGFBP-6 protein in grades 1,2 and 3 of the PVR model group were (221.00 ± 19.32),(229.63 ± 18.89) and (225.70 ± 26.71) μg/L,with a significant elevation in comparison with (173.25 ±21.11) μg/L of the control group (t =2.14,P＜0.05).However,there was no significant change among the different grades of PVR groups(t=1.24,1.46,P＞0.05).The concentrations of IGFBP-6 protein in the vitreous and serum were higher in PVR rat samples (vitreous:225.44±19.36 μg/L;serum:108.48 ± 15.78 μg/L) than in control rats (vitreous:173.25 ± 21.11 μg/L,serum:95.96 ±17.40 μg/L)(P＜0.05).Conclusions The concentrations of IGFBP-6 protein in the vitreous and serum increase in PVR rats.The results indicate that the increased IGFBP-6 in the vitreous might be a localized autocrine secretion of the eye.

Aim: To preliminarily investigate the antioxidant activity of the acidic exopolysaccharide(EPS-A) from cultivated Cordyceps sisnensis in vitro and in vivo. Methods: PC12 cells were injured by H_2O_2 after the cells were treated with different doses of EPS-A for 6 h, and then the levels of malondialdelyde( MDA) and superoxide dis-mutase (SOD) in PC12 cells were determined. H22 cells were inoculated into the right oxter of each mouse after ICR mice were treated with EPS-A for 7 days, and tumor-bearing mice were treated with EPS-A for 7 days. MDA level and SOD activity in liver, brain and serum were assayed, and tumor weight of each mouse was measured as well. Results: EPS-A significantly decreased the production of MDA and increased SOD activity in H_2O_2-injured PC12 cells. Moreover, EPS-A inhibited H22 tumor growth in mice, in which the level of MDA in liver and brain was reduced, and SOD activity in liver, brain and serum was enhanced. Conclusion: EPS-A exhibited antioxidant activity in cell cultures and mice.

Objective To analyze the outcomes of renal transplantation from donation after citizen death (DCD) in our single center.Method We retrospectively investigated the recipient outcomes of renal allografts from DCD.Between November 2010 and 31st December 2014,our institution performed 242 renal transplants from DCD.Outcome variables (survival of recipients/allografts and adverse events) and characteristics of marginal donor transplants were analyzed.Result There were 139 males and 44 females in the enrolled 183 donors,and the range of age was from 2 days to 68 years.183 donors included 102 cases of donation after brain death (category Ⅰ),22 cases of donation after circulatory death (category Ⅱ) and 59 cases of donation after brain death followed by circulatory death (category Ⅲ).Utilizing these renal allografts,we performed 242 kidney transplantations including 237 single kidney transplants and 5 pediatric en bloc kidney transplants.The age of recipients ranged from 12 to 64 years.The data indicated that the 1-year recipient/allograft survival rate was 93.8％ and 90.5％,respectively.The rate of delayed graft function (DGF) was 33.1 ％,higher than that from executed prisoners allografts (23.6％,P＜0.05).However,the rate of 1-year acute rejection,interstitial pneumonia and the other adverse events (urinary fistula,ureteral obstruction and cardiac and cerebral vascular accident,etc.) was similar to that from executed prisoners allografts.In addition,good results from pediatric and elder donor renal transplantation were shown in our data,even though the discard rate of elder donor kidney was high.Conclusion By comprehensive evaluation,strictly screening donors and enhancing the rnanagenent of donors,the long-term survival of recipients may be prolonged and the incidence of DGF and primary graft non-function (PNF) may be decreased.The marginal donors from pediatric and elder DCD donors could be utilized in clinical transplantation safely and effectively as long as reasonable evaluation was carried out.