Objective To evaluate the effect and safety of glibenclamide for gestational diabetes mellitus (GDM).Methods Cochrane Central Register of Controlled Trials (CENTRAL),Medline,EMBASE,Science Citation Index,CNKI,VIP,Wanfang Data,and CBM were searched for the randomized controlled trials (RCTs) of glibenclamide for gestational diabetes from the date of establishment of the databases to March 2013.The bibliographies of the included studies were searched,too.The included studies were evaluated by GRADE.The extracted data were analyzed by Rev-Man 5.1 and GRADEprofiler 3.2.2.Results Five RCTs were included.Effectiveness (such as maternal postprandial glucose,HbA1C) and adverse perinatal outcomes (such as the change of the pregnant women body weight,cesarean section rate,maternal hypoglycemia incidence,birth body length,incidence of hypoglycemia,jaundice,newborn being in the care unit,congenital malformations,stillbirth,and mortality neonatal) showed no differences between glibenclamide (alone or complemented with insulin) group and insulin group (P＞0.05).However,compared with insulin group,higher maternal fasting blood glucose,higher birth weight of newborn infants,and incidence of macrosomia were shown in glibenclamide group.Conclusion Glibenclamide can effectively control maternal blood sugar,and would be a promising alternative therapy for GDM,without adverse effect on fetal growth and development,but with the higher incidence of neonatal macrosomia.Due to the limitations of the included studies,more large-sample,high-quality RCTs are required.

The hallmarks of HIV infection include progressive CD4+T cell depletion and chronic immune activation.Effective antiretroviral therapy (ART) can restore CD4 +T cell counts and related immune responses to various opportunistic pathogens.On some occasions,improvement in the immune system leads to immune reconstitution inflammatory syndrome shortly after ART initiation.On the other hand,some patients fail to achieve a normal CD4 + T cell count despite long-term suppressive ART.Multiple studies have demonstrated that persistent immune activation and inflammation are closely associated with suboptimal immune recovery although the underlining mechanisms remain widely debated.

Abstract? AlM: To investigate the inhibition effect of bevacizumab on human Tenon capsule fibroblasts ( HTFs ) and discuss the countermeasures of bleb scarringscarring in glaucoma surgery countermeasures.? METHODS: Adopted cell recovery method and followed the aseptic principles, we performed the culture of HTFs which came from the Central Laboratory of Shaanxi People's Hospital cell library. Wound Healing assay:We scraped a cell-free zone on the cell surface when the cells reached confluence at 80%. The control group was added to serum-free DMEM medium. The HTFs of bevacizumab group were stimulated with 1mg/mL concentrations without DEME for 0, 24, 48, and 72h. The scratch width was observed and measured.? RESULTS: HTFs were long fusiform shape under microscope, the nucleus is in the center of the cell with larger nucleus, abundant cytoplasm, were arranged in a whorled growth out of shape, strong ability to proliferate, conform to general forms of fibroblast. The morphological and biological characteristics of cells after cryopreservation and resuscitation remain unchanged. Wound healing assay: 0h, equal to the initial width of the two groups, 24h when the migration distance of the two groups of cells are basically the same, 48h when the control group cell migration distance is greater than that in the bevacizumab processing group, 72h when the control group scratches basichealing, bevacizumab treated cells migrate closer than 48h no significant change, and a lot of cells died.?CONCLUSlON:Cell recovery method can successfully cultured HTFs, which was stability on morphology and biological properties, laying the cellular basis for experimental research. Fibroblast itself has a strong ability to migrate, outside - derived bevacizumab can inhibit HTFs migration evidently and it will cause excessive cell death when. Bevacizumab has certain extent inhibitory effect on HTFs migration, and it is likely to become one of the important drugs for creating bleb scarring after glaucoma surgery in the future.

Background Scarring of filtration channel following glaucoma filtering surgery is a main cause of the failure of the surgery.The proliferation,epithelial-mesenchymal transition and extracellular matrix remodeling of fibroblasts are thought to be the primary pathological mechanism of scarring.Connective tissue growth factor (CTGF) plays a promoting role in the formation of scar.Whether CTGF participates in mesenchymal-epithelial transition of human Tenon capsule fibroblasts (HTFs) is not clear yet.Objective This study attempted to investigate the effect of CTGF on the mesenchymal-epithelial transition of HTFs in vitro.Methods HTFs were cultured and passaged in high glucose DMEM medium with 10％ fetal bovine serum,and the cells of generation 3-6 were used in this experiment.The cells were divided into the blank control group and CTGF-treated group and were routinely cultured in the blank control group.CTGF was added in the medium in the CTGF-treated group,with the final concentration 50 ng/ml CTGF.Immunofluorescence staining was used to identify and locate the expression of E-cadherin protein in the cells,and Western blot assay was employed to quantitatively analyze the expression level of E-cadherin protein in 48 hours after culture.Results The HTFs grew well with the spindle-like shape and vortex-like arrangement.The red fluorescence (E-cadherin protein) in the cytoplasm and blue fluorescence in the cellular nucleus were seen in the CTGF-treated group,but only nucleus with blue fluorescence were obtained in the blank control group.Western blot assay showed that the E-cadherin protein expression was absent in the blank control group,however,the relative expression level of E-cadherin protein in the cells was 0.63± 0.08.Conclusions E-cadherin protein is not expressed in fibroblast derived from mesenchymal tissue.However,CTGF can induce the expression of E-cadherin in HTFs.This study suggests that CTGF promotes the mesenchymal-epithelial transition of HTFs in vitro.

Objective To investigate the impact of bone marrow mesenchymal stem cell transplantation on a rat model of experimental autoimmune uveitis (EAU) and analyze its immune regulatory mechanisms in vivo. Methods Eighteen Lewis rats were randomly divided into three groups: model control group, intervention group and normal control group, six animals in each group. Human retinal S-antigen peptide (HS-AgP35, 1 mg/ml) was mixed and emulsified with complete Freund's adjuvant and injected into hind foot pad of rats on the first and eighth day to establish the animal model of EAU. For bone marrow mesenchymal stem cell transplantation, 1 ml of cell suspension (2 × 106 cells/ml) was injected into tail vein of the intervention group rats on the first day when the emulsified S-antigen was injected. EAU manifestation, pathological change and IFN-γ level were evaluated and compared among those three groups after two weeks. Results No abnormal signs were found in the eyes of rats in normal control group. The manifestation grading of the intervention group (two rats at grade 0, three rats at grade 0.5, one rat at grade one) was significantly different from the model control group (one rat at grade one, one rat at grade two, three rats at grade three, one rat at grade four) (P=0. 015). The retina of rats in normal control group was ordinary under light microscope. The histopathological grading of the intervention group (one rat at grade 0, four rats at grade 0.5, one rat at grade one) and the model control group (four rats at grade three, two rats at grade four) was also statistically different (P＜0. 01). Furthermore, the IFN-γ level in peripheral blood of the intervention group rats declined significantly compared to the model control group (t=9. 057 4, P=0. 01). Conclusions Bone marrow mesenchymal stem cells can inhibit EAU significantly,possibly by lowering the level of IFN-γ, thereby reduce the severity of uveitis and improve the condition of uveitis in rats.

Objective To study the effect of cell wall polysaccharide (CWP) of Thallus Laminariae (TL) on thrombosis and blood coagulation.Methods Thrombosis was induced by arteriovenous shunt,ligation of inferior vena cava and electric stimulation of common carotid artery,after intraperitoneal injection of CWP or nomal saline for 3 days.The weight of thrombus and the occlusion time were examined in the normal saline group and high-dose (100 mg/kg) and low-dose (20 mg/kg) groups of CWP of TL.Blood coagulation time (CT),plasma prothrombin time (PT) and partial thromboplastin time (APTT) were measured to observe the effect of CWP on blood coagulation.Results Compared with the control group,both high-dose CWP of TL and low-dose CWP can obviously decrease the weight of thrombus and prolong the occlusion time,CT and APTT.High-dose CWP could also prolong PT obviously,the differences being significant.Low-dosa CWP also prolong PT,but the difference was not significant statistically.Conclusion CWP of TL can inhibit the thrombus formation and blood coagulation in rats.

Objective To evaluate the murine model of dry eye induced by hyperosmolar saline. Methods Sixty female BALB/c mice at the age of 6 -8 weeks were randomly divided into blank group,control group and experimental group,20 in each group. Mice in control and experimental groups were treated with 308 mOsmol/L and 500 mOsmol/L sodium chloride solution,respectively,5 times a day. Mice in blank group were not treated with sodium chloride solution. Schirmer test,fluorescein staining,corneal scoring,rose bengal staining,tear ferns experiment,corneal epithelial HE staining and thickness measurement,conjunctival epithelial PAS staining and Goblet cell counting were conducted on days 0,7,14,28,and 42,respectively. Corneal surface was observed by scanning electron microscopy on day 42. Results No significant difference was found in the above parameters on day 0 between the two groups. On day 7,the volume of tears was significantly smaller in experimental group ( 2. 3 ? 0. 4 mm) than in blank group ( 3. 0 ? 0. 5mm) and control group ( 3. 1 ?0. 5 mm) ( P

Objective To investigate the experience and needs of caregivers of patients with hematopoietic stem cell transplantion (HSCT) , in order to provide the basis for targeted intervention. Methods Using qualitative phenomenological research methods, semi- structured interviews of 10 caregivers of HSCT patients were conducted, then the data were summarized and analyzed. Results Four themes were extracted: heavy caregiving burden, adaptation to the caregiving role, professional support needs, humanistic care needs. Conclusions The medical staff should strengthen the health education on HSCT caregivers to improve their ability and their own health concerns, alleviate their psychological pressure, and mobilize social forces to reduce the burden of care.

Abstract: Objective　To analyze the drug resistance of Staphylococcus aureus in blood samples of children and adults from 50 hospitals in Shandong Province, and to understand the drug sensitivity characteristics of Staphylococcus aureus bloodstream infection (BSI), so as to provide reference for clinical experience. Methods　The distribution and drug resistance of Staphylococcus aureus isolated from blood samples from 50 hospitals in Shandong province from 2017 to 2020 were analyzed based on the Cooperative Research Network of Pediatric Bacterial and Fungal Resistance Monitoring in Shandong Province. Meanwhile, the drug sensitivity characteristics of Staphylococcus aureus were divided into children group (<14 years old) and adult group (≥14 years old). The data were analyzed by Whonet 5.6 and SPSS 22.0 with reference to CLSI 2021 M100 document standard judgment results. Results　A total of 3 661 Staphylococcus aureus strains were collected from 50 medical institutions in Shandong Province, including 675 in 2017, 870 in 2018, 1 080 in 2019, and 1 036 in 2020. The drug resistance rates of multiple antibiotics in blood culture methicillin-resistant Staphylococcus aureus (MRSA) group and methicillin-sensitive Staphylococcus aureus (MSSA) group were significantly different (P<0.05). There were significant differences in antibiotic resistance rates between adult group and children group (P<0.05). The overall detection rate of MRSA was 27.5%, and no staphylococcus aureus strains resistant to vancomycin, linezolid and tigecycline were found. Conclusion　The detection rate of MRSA strains decreased continuously and increased by 2020. The detection rate of MRSA in adult group was lower than that in children group, suggesting that we should pay attention to the monitoring of bacterial resistance in children group, to the management of multiple resistant bacteria and rational use of antibacterial drugs.

objective To investigate the ability of insulin sensitivity index HOMA2-%S and secretion function index HOMA2-%B calculated by HOMA2,the new homeostasis model assessment,in clinical application. Methods Eighty female volunteers with polycystic ovary syndrome in Chongqing area [50 subjects with normal glucose tolerance(NGT group)and 30 subjects with impaired glucose regulation(IGR group)]were involved in this study.Thev underwent a 75 g oral glucose tolerance test(OGTF)and the Botnia clamp test. From the data of faming blood samples in OGTF,insulin sensitivity index HOMAI-ISI,secretion function index HOMAl-β and disposal index DI-HOMA1 were calculated by the old homeostasis model assessment(HOMA I),meanwhile insulin sensitivity index HOMA2-%S,secretion function index HOMA2-%B and disposal index(DI-HOMA2) were caleulated by the new homeostasis model assessment (HOMA2).Correlation coefficients between insulin sensitivity index and GIR (the glucose infusion rate at steady state of Botnia clamp test),and between insulin secretion function index and AIR(the acute insulin response in Botnia clamp test),were studied.Results The Pearson's linear correlation coefficient between HOMA2-%S and GIR(r=0.503),HOMA1-ISI and HOMA2-%S (r= 0.990).HOMA2-%B and AIR(r=0.382),HOMA1-B and HOMA2-%B(r=0.976) were all statistically significant(a11 P<0.01).The glucose disposal indexes calculated from the HOMA2 and HOMA1 of 1GR group were significantly lower than those from the NGT group(t=2.825,P<0.Ol;t=2.222,P<0.05). Conclusion The HOMA2 is a better model in evaluating the insulin sensitivity and secretion function and is recommended to be widely used in clinical evaluation.