Objective To investigate the effects of pioglitazone on osteoblast proliferation and apoptosis.Methods MC3T3-E1 mouse osteoblastic cells were treated with 0, 5, 10, 20, 30, and 40 μmol/L pioglitazone for 24 h. Cell viability was measured by MTT, cell cycle and apoptosis were inspected with flow cytometry, the expressions of Bcl-2 and Bax proteins were examined via immuno-chemical staining. Results Survival of osteoblasts decreased in a dose-dependent manner. Compared with the control group, the cells in the G0/G1 and G2/M stages increased, while the cells in S stage decreased significantly. The percentage of apoptosis at 5 and 10 μmol/L were lower than that of the control group(P ＜ 0.05), While it was increased significantly at 30 and 40 μmol/L(P ＜0.01). Bax expression was attenuated at 10 μmol/L(P＜0. 01), returned to normal by 20 μmol/L, and was increased by 30 and 40 μmol/L(P ＜ 0. 01). Bcl-2 expression was enhanced at the dose ≤ 20 μmol/L(P ＜0.01). Positive correlation was found between the death rate and the expression intensity of Bax/Bcl-2(n = 15, r=0.796, P＜0.01). Conclusions Pioglitazone inhibits apoptosis of osteoblasts at low concentrations and protects the cells, but promotes their apoptosis at higher concentration, Bax/Bcl-2 may play an important role in mediating the piglitazone-induced apoptosis of osteoblasts. It inhibits DNA synthesis and cell proliferation.

ObjectiveTo investigate the best pattern of the discussion on nursing cases of severe cardiac patients and improve the quality of the clinical nursing activity.Methods90 nurses from six cardiac units were divided into the control group and the experimental group with 45 nurses in each group. The experimental group adopted PBL teaching method, the control group adopted conventional teaching method. The discussion of severe cardiac patients was proceeded twice every month for one year.Results The experimental group was better than the control group in master and application of the basic cardiac knowledge, nursing quality of serious patients and effectiveness of nurse-patient communication.ConclusionsDiscussion with PBL teaching method is superior to the conventional method. This method can widen the nurses'thread, improve the nurses' ability to solve problem, so it is worthy of wide application.

Objective To investigate the characteristic,diagnosis and treatment of the nipple discharge.Methods The clinical data of 174 cases who were diagnosed as nipple dlscharge from January 2001 to December2006 were collected and analyzed retrospectively.Results Among those 174 cases,136 cases were confirmed histopathologieally to be intraduetal papilloma.The confirmed diagnosis rate of intraduetal papilloma by galaetograghy was 85.00%.Carcinoma-charge rate of the intraduetal papilloma was 5.17%.Conclusion Nipple discharge was the most common symptom in the intraductal papillomatesis.The galaetography was a valuable method in the diagnosis of the intraduetal papilloma.There was carcinoma-charge possibility in the intraduetal papilloma.

Objective To study the relationship of the levels of serum interleukin-6 (IL-6) and C-reactive protein (CRP) with insulin resistance in normal glucose tolerant first-degree relatives (NGT) of type 2 diabetics.Methods A total of 218 normal glucose tolerance subjects , including 136 NGT of type 2 diabetes , and 82 normal control ( NC) without type 2 diabetes family history were enrolled.The levels of blood glucose, hemoglobin A1c (HbA1c), lipid, insulin, IL-6, and high-sensitivity C-reactive protein (hs-CRP) were measured.Results ⑴Compared with NC, the levels of homeostasis model assessment of insulin resistance (HOMA-IR), hs-CRP , and IL-6 in NGT were significantly increased [1.03~1.94 vs 0.42~0.95 , P <0.01;0.46~2.78 mg/L vs 0.39~1.56 mg/L, P <0.01;(13.6 ±8.99) pg/ml vs (8.08 ±3.67) pg/ml, P <0.01];⑵In NGT, hs-CRP was positively correlated with HOMA-IR and IL-6 ( r =0.326 , P <0.01;r =0.258 , P <0.05 );IL-6 was positively correlated with HOMA-IR ( r =0.350 , P <0.01).Conclusions IL-6 and CRP may correlate with the degree of insulin resistance in NGT of type 2 diabetics.

BACKGROUND:There are several routes for stem cel transplantation;however, it is stil unable to determine which one is the best. As for the different individuals with brain injury, the type of transplanted cel s, transplantation route and time wil affect the therapeutic effects.
OBJECTIVE:To investigate the effect of bone marrow mononuclear cel s transplanted via different approaches on neurological function of rats with traumatic brain injury.
METHODS:Bone marrow mononuclear cel s of rats were administered gradient centrifugation with Ficol lymphocyte separation medium, and were labeled with CFDA-SE in vitro as standby. Rat models of traumatic brain injury were established by the method of freefal . After successful establishment of rat models, bone marrow mononuclear cel s labeled with CFDA-SE were immediately transplanted into rats via injured area, lateral ventricle and internal carotid artery. One control group was designated for each transplantation route (bone marrow mononuclear cel s were replaced with the same volume of DMEM). The degree of neurological deficits was evaluated using mNSS scores at different time points after treatment. The brain tissue was harvested after the last neurobehavioral evaluation. The survival and migration of bone marrow mononuclear cel s in the injured area were observed under an inverted fluorescent microscope.
RESULTS AND CONCLUSION:At 7, 10, and 14 days after treatment, the mNSS scores of rats in al groups were al lower than those at 1 and 3 days (P<0.05). At 7 and 10 days, the mNSS scores of rats in the internal carotid artery transplantation group were significantly lower than those in the control group (P<0.05). At 14 days after treatment, the number of fluorescence-labeled cel s of rats in the internal carotid artery transplantation group was greater than that in the other groups (P<0.05) and these labeled cel s were widely distributed. The results demonstrate that the neurological function of rats can be improved by transplanting bone marrow mononuclear cel s via the internal carotid artery, and a large number of transplanted cel s can survive and migrate in the injured area.

Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.

Objective To explore the possible mechanism of Jianyi Recipe for improving the function of islet cells from the aspects of synthesis,secretion and inactivation of glucagon-like peptide-1 (GLP-1).Methods The diabetic rat model was established by feeding with high-lipid food combined with injection of streptozotocin (STZ).The rats were randomly divided into model group,Jianyi Recipe group,and normal group.The treatment for the rats lasted for 4 weeks.The blood glucose level was detected by the rapid blood glucose meter.The plasma levels of GLP-1 and insulin were detected by Luminex liquid phase protein chip technology.Pancreatic duodenal homeobox-1 (PDX-1) mRNA expression level was detected by quantitative real-time fluorescence polymerase chain reaction (PCR).The level of GLP-1 in ileum L cells was detected by immunohistochemistry,and dipeptidyl peptidase Ⅳ (DPP-Ⅳ)level was detected by enzyme-linked immunosorbent assay.Results Jianyi Recipe could decrease the levels of fasting blood glucose and postprandial glucose (P ＜ 0.05),promote the secretion of insulin (P ＜ 0.05),and increase PDX-1 mRNA expression level in the pancreas of the diabetic rats.Compared with the model group,plasma GLP-1 level,and ileal GLP-1 positive expression area and integrated optical density were increased (P ＜ 0.05) in Jianyi Recipe group,while the differences of serum DPP-Ⅳ levels were insignificant between the two groups (P＞ 0.05).Conclusion Jianyi Recipe maybe regulate the synthesis and secretion of GLP-1 to promote PDX-1 gene expression and insulin secretion,so as to reduce blood glucose in diabetic rats.

Objective To investigate a diabetic retinopathy ( DR ) detection algorithm based on transfer learning in small sample dataset. Methods Total of 4465 fundus color photographs taken by Gaoyao People ' s Hospital was used as the full dataset. The model training strategies using fixed pre-trained parameters and fine-tuning pre-trained parameters were used as the transfer learning group to compare with the non-transfer learning strategy that randomly initializes parameters. These three training strategies were applied to the training of three deep learning networks:ResNet50,Inception V3 and NASNet. In addition,a small dataset randomly extracted from the full dataset was used to study the impact of the reduction of training data on different strategies. The accuracy and training time of the diagnostic model were used to analyze the performance of different training strategies. Results The best results in different network architectures were chosen. The accuracy of the model obtained by fine-tuning pre-training parameters strategy was 90. 9％,which was higher than the strategy of fixed pre-training parameters (88. 1％) and the strategy of randomly initializing parameters ( 88. 4％) . The training time for fixed pre-training parameters was 10 minutes,less than the strategy of fine-tuning pre-training parameters ( 16 hours ) and the strategy of randomly initializing parameters (24 hours). After the training data was reduced,the accuracy of the model obtained by the strategy of randomly initializing parameters decreased by 8. 6％ on average,while the accuracy of the transfer learning group decreased by 2. 5％ on average. Conclusions The proposed automated and novel DR detection algorithm based on fine-tune and NASNet structure maintains high accuracy in small sample dataset,is found to be robust,and effective for the preliminary diagnosis of DR.

Objective:To investigate the relationship between serum matrix metalloproteinase-9 (MMP-9) level and the location and severity of bleeding in patients with cerebral microbleeds(CMBs).Methods:A total of 60 CMBs patients admitted to the Department of Neurology of the First Affiliated Hospital of the Xinxiang Medical University from January 2019 to August 2020 were selected as subjects as the CMBs group, and 60 healthy controls without nervous system diseases in outpatient physical examination during the same period were selected as the control group. The clinical data and biochemical indicators of the two groups were collected. Serum MMP-9 levels were measured by enzyme linked immunosorbent assay (ELISA). According to susceptibility weighted imaging (SWI), CMBs patients were divided into grade 1 group ( n=24), grade 2 group ( n=19) and grade 3 group ( n=17), and according to the micro analytical rating scale (MARS), the CMBs patients were divided into the lobar group ( n=19), the deep or infratentorial group ( n=17) and the mixed group ( n=24).The relationship between serum MMP-9 level and the location and severity of CMBs was analyzed. SPSS 19.0 software was used for data statistical analysis.One-way ANOVA, t-test and rank sum test were used for comparison. Logistic regression analysis was used to analyze the influencing factors. Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis. Results:The level of MMP-9 in CMBs group was significantly higher than that in control group (208.13(142.25, 285.88) μg/L, 149.50(93.40, 186.51)μg/L), and the difference was statistically significant ( P<0.05). Serum MMP-9 level was a risk factor of CMBs ( β=1.322, OR=3.750, 95% CI=2.038-7.997, P=0.002). The difference of level of MMP-9 in different severity of CMBs was statistically significant (147.55(109.25, 266.47)μg/L, 242.12(147.55, 288.80)μg/L, 270.42(203.43, 364.27)μg/L, P=0.017). Serum MMP-9 level was positively correlated with the number of CMBs ( r=0.371, P=0.003). The difference of MMP-9 level of CMBs in different locations were statistically significant (249.77(158.43, 338.46)μg/L, 188.83(138.52, 243.15)μg/L, 210.65(144.25, 255.78)μg/L, P=0.013). The increased serum MMP-9 level was a risk factor for CMBs( β=0.401, OR=1.122, 95% CI=1.004-1.204, P=0.036). Conclusion:The increased level of serum MMP-9 may be a risk factor of CMBs, especially for CMBs in cerebral lobesand, and the level of MMP-9 is positively correlated with the severity of CMBs.