Hepatic stellate cells(HSCs),the pluripotent cells,exist between liver sinusoidal endothelial cells and hepatic epithelial cells. Activated HSCs transform to myofibroblast-like cells,start to proliferate,and de novo express some proinflammatory and profibrogenic genes,which promote hepatic fibrogenesis. Previous studies mainly focused on the relationship between HSCs and liver fibrosis,however,recent studies indicate that HSCs are essential for proliferation, differentiation and maturation of various liver cells in the process of liver development and regeneration. This review systematically summarized the source,developmental regulation and function of HSCs,and focused on progress of recent studies on the role of HSCs in liver development and regeneration. The novel knowledge of HSCs may provide clues for treatment of liver diseases.

The plants of the genus Ehretia Linn. composed of about 50 species mainly distributed in tropical Asia and Africa.They have been used as folk medicines or traditional tea to treat various ailments in China for a long time. This contribution reviews the chemical constituents isolated from the plants of the genus Ehretia Linn. and related biological activities of these species in the past few decades. The compounds in the genus mainly belong to the classes of phenolic acids, flavonoids, benzoquinones, cyanogenetic glycosides, and fatty acids. The main biological activities include antioxidant, anti-inflammatory, antisnake venom, and anti-allergic activities.

Objective To investigate the antiviral effects of antisense phosphorothioate oligodeoxynucleotide (ASODN)in 9HTEO infected with influenza A virus (IFAV) in vitro. Methods The ASODN which complemented to genomic PB1, M2, NS, PB2, HA mRNA of IFAV was used to investigate antiviral effection in vitro. The cytopathic effect (CPE) was observed, and the cell survival rates were measured by MTF assay, plaque assay, RT-PCR, Western blot and Immunofluorescence were performed to test anti-viral efficiency of PB1, M2, NS in cells mRNA and protein level. Results 9HTEO cells infected with IFAV almost all died when the multipicity of infection (MOI) is aboved after 5 days cell culture. The ASODN could increase the cell survival rates. The IFAV PB1, M2, NS significantly reduced CPE of IFAV infected 9HTEO cells, reduced the viral replication of IFAV in the cells (P <0.05). Conclusion The ASODN which targeted the mRNA of IFAV gene showed a significant and specific anti-IFAV effect both in mRNA and protein level in cells culture system. The study indicates that the PB1, M2 and NS mRNA may play an important role in regulating IFAV replication, and ASODN may have inhibitory activity on IFAV replication. The results established the basis for further study on new drugs against IFAV infection include the highly pathogenic H5N1 influenza virus.

ObjectiveTo investigate the difference of pathogenicity between the two genotypes of human metapneumovirus(hMPV) for the further research.MethodsAt various time after hMPV infection in BALB/c mice,viral titers of lung tissue were measured by real-time RT-PCR,pathology was assessed by a histopathological scoring system,airway responsiveness was assayed by animal lung function monitoring equipment.Pathogenicity was then measured by detailed evaluation through the results above.Results There is no significant difference in weight of mice between control group and experimental group through dynamic monitoring ; though the difference was exists in airway responsiveness and pathological changes of mice between control group and experimental group,the differences were not statistically in airway reaction,pathological changes and virus drops among the three groups of experimental group.ConclusionThere is no difference in pathogenicity between the two subtypes of hMPV in infection of BALB/c mice,viral genotype do not appear to be associated with pathogenicity.

Objective? To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA), and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods? Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale(MFS)and the Barthel Index(BI)for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results? A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95), of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P＜ 0.05). There were significant differences in the risk of falls between elderly KOA patients in "whether taking drugs", "whether using walking aids", "status of self-care ability", and "age" (P＜ 0.05). Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P＜ 0.05). Conclusions? In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life.

Objective:To propose the application of recognizing bone species by touching blindly (ARBTB) and verify its application effect in human anatomy experimental courses.Methods:The study included experiment 1 and experiment 2, and the research objects were 60 students majoring in clinical medicine in Batch 2019 and 60 students majoring in preventive medicine in Batch 2018, respectively. The research objects in each experiment were randomized into mainstream teaching method group and ARBTB group, with 30 students in each group. In experiment 1, after students studying for the same hours, both of two groups carried out the same test, and then the average scores of the two groups were compared. In experiment 2, the average time spent by the two groups of students in osteology learning was compared.Results:In experiment 1, ARBTB group's average score of the test was significantly higher than that of the mainstream teaching group ( P<0.001). In experiment 2, the ARBTB group took much less time in osteology learning than the mainstream teaching group ( P<0.001). Conclusion:Compared with the mainstream teaching method, ARBTB is more effective in osteology learning, which is worth popularizing.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

Objective: To investigate the feasibility of cine three-dimensional (3D) balanced steady-state free precession (b-SSFP) imaging combined with a non-local means (NLM) algorithm for image denoising in evaluating cardiac function in children with repaired tetralogy of Fallot (rTOF). Materials and Methods: Thirty-five patients with rTOF (mean age, 12 years; range, 7–18 years) were enrolled to undergo cardiac cine image acquisition, including two-dimensional (2D) b-SSFP, 3D b-SSFP, and 3D b-SSFP combined with NLM. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) of the two ventricles were measured and indexed by body surface index. Acquisition time and image quality were recorded and compared among the three imaging sequences. Results: 3D b-SSFP with denoising vs. 2D b-SSFP had high correlation coefficients for EDV, ESV, SV, and EF of the left (0.959– 0.991; p < 0.001) as well as right (0.755–0.965; p < 0.001) ventricular metrics. The image acquisition time ± standard deviation (SD) was 25.1 ± 2.4 seconds for 3D b-SSFP compared with 277.6 ± 0.7 seconds for 2D b-SSFP, indicating a significantly shorter time with the 3D than the 2D sequence (p < 0.001). Image quality score was better with 3D b-SSFP combined with denoising than with 3D b-SSFP (mean ± SD, 3.8 ± 0.6 vs. 3.5 ± 0.6; p = 0.005). Signal-to-noise ratios for blood and myocardium as well as contrast between blood and myocardium were higher for 3D b-SSFP combined with denoising than for 3D b-SSFP (p < 0.05 for all but septal myocardium). Conclusion The 3D b-SSFP sequence can significantly reduce acquisition time compared to the 2D b-SSFP sequence for cine imaging in the evaluation of ventricular function in children with rTOF, and its quality can be further improved by combining it with an NLM denoising method.

Bilateral inferior petrosal sinus sampling(BIPSS), with or without desmopressin stimulation, is the gold standard in the diagnosis of Cushing′s disease. A few of patients with Cushing′s disease present a false negative result in BIPSS. These patients are often misdiagnosed as ectopic adrenocorticotropin(ACTH) syndrome(EAS). Here we report a case of Cushing′s disease with a false negative BIPSS, in the hope to aid clinical physicians in the differential diagnosis and treatment of ACTH-dependent Cushing′s syndrome.

Objective:To explore the effects of external diaphragm electrical stimulation on the diaphragm thickness and function in mechanically ventilated children.Methods:A randomized controlled trial was conducted in children who were admitted to PICU at Children′s Hospital of Fudan University and received mechanical ventilation between June 2021 and April 2022.The control group was given the routine treatment of mechanical ventilation, and the intervention group was given external diaphragm electrical stimulation in the early stage of mechanical ventilation in addition to routine treatment.Diaphragm thickness was continuously measured by bedside ultrasound every day for one week after mechanical ventilation, and the changing trend of diaphragm thickness was observed, and the diaphragmatic thickening fraction (DTf) and the incidence of ventilator-induced diaphragmtic dysfunction(VIDD) were calculated at the same time.Results:A total of 32 valid samples were included, including 15 cases in intervention group (10 males) and 17 cases in control group (11 males). The median age of the patients was 33 (10, 77) months, and the median duration of mechanical ventilation was 12 (8, 21) days.The reasons for mechanical ventilation in children included respiratory insufficiency in ten cases, brain dysfunction in ten cases, heart failure in eight cases, and postoperative surgery in four cases.The diaphragm end-expiratory thickness (DTe) in intervention group and the control group showed a gradually decreasing trend from the 1st day to the 7th day.The left thickness was reduced by 11% on the 7th day compared to 1st day in intervention group, which was reduced by 18% in control group; the average daily DTe was reduced by 2% per day in intervention group and by 3% per day in control group.The trends on the right and left were similar.The DTe thickness in the intervention group was greater than that in control group, among which, the mean DTe thickness in the left side of the intervention group on the 7th day was (0.110 7±0.023 7)cm, which was greater than that in control group (0.093 5±0.016 9)cm, and the difference was statistically significant ( t=-2.372, P<0.05); On the second day, the mean DTe thickness on the right side in the intervention group was (0.1267±0.0277) cm, which was greater than that in control group (0.104 7±0.018 1)cm, and the difference was statistically significant ( t=-2.688, P<0.05). DTf in the intervention group was lower than that in control group at 7th day, but the difference was not statistically significant(left DTf: adjusted mean difference was -0.117, P=0.088; right DTf: adjusted mean difference was -0.065, P=0.277). The incidence of VIDD in the intervention group was lower than that in control group(33.3% vs.41.2%), but the difference was not statistically significant ( χ2=0.005, P=0.946). Conclusion:External diaphragmatic electrical stimulation may be helpful for alleviating diaphragmatic atrophy in mechanically ventilated children.However, whether the improvement of diaphragm atrophy is beneficial to clinical outcome still needs further study.