BACKGROUND:Several studies have demonstrated that bone marrow mesenchymal stem cells (BMSCs) inhibit the proliferation and activation of T lymphocytes, exerting a role of negative immunological regulation. OBJECTIVE: To induce rat BMSCs to differentiate into neuron-like cells in vitro using all-trans retinoic acid and to investigate the effects of differentiated cells on T lymphocyte proliferation.DESIGN, TIME AND SETTING: A cytological in vitro observation was performed in Guangdong Medical College in March 2008.MATERIALS: Two male 4-week-old Sprague Dawley rats were provided by the Laboratory Animal Center of Guangdong Medical College. Fresh healthy human blood was provided by the Department of Clinical Laboratory, Guangdong Medical College. METHODS: Rat BMSCs were isolated by adherent method and were passaged in vitro. Cells of passage 5 were pre-induced with Low glucose-dulbecco's modified eagle's medium (LG-DMEM) containing 0.3 mg/L all-trans retinoic acid and 10% fetal bovine serum. Twenty-four hours later, aforementioned LG-DMEM was discarded and LG-DMEM containing 0.6 mg/L all-trans retinoic acid was added to induce cells differentiation into neuron-like cells. Fresh healthy human blood was taken to prepare responding cells. Rat BMSCs, as stimulator cells, were included for one-way mixed lymphocyte reaction. Four groups were designated. Control group: 100 μL of responding cells at a concentration of 1×109/L; Experimental group 1:1×104 neuron-like cells + 100 μL of responding cells; Experimental group 2:1×105 neuron-like cells + 100 μL of responding cells; Experimental group 3:1×106 neuron-like cells + 100 μL of responding cells.MAIN OUTCOME MEASURES: Morphological observation of induce-differentiated cells, identification of nerve cells, and one-way mixed lymphocyte reaction results.RESULTS: Fifty minutes after addition of inducing medium, under the optical microscope, BMSCs exhibited a typical morphology of perikaryon. Three hours later, most of cells became into bipolar or multipolar neuron-like cell appearance with cell bodies and processes. Immunocytochemical staining results showed that majority of cells exhibited neuron specific enolase- and nestin-positive expression and glial fibrillary acidic protein-negative expression. Compared with the control group, radionuclide counts per minute were significantly reduced in each experimental group (P<0.05). There was significant difference in radionuclide counts per minute between experimental groups (P<0.05). With increasing BMSCs amount, the inhibitory effects on T lymphocyte proliferation were more evident.CONCLUSION: AII-trans retinoic acid can induce neuron-like cell differentiation of rat BMSCs in vitro. The neuron-like cells can inhibit human T lymphocyte proliferation in a dose-dependent manner.

Objective To explore clinical characteristics and pathogenic gene of lisencephaly. Methods The clinical manifestation, laboratory examination and gene detection results of lisencephaly in two children were analyzed retrospectively, and relevant literature were reviewed. Results Two male children with lisencephaly are at ages of 7 months, and 3 years and 4 months respectively. Both of them were admitted to hospital due to epilepsy and loss of consciousness at the time of attack. There was no obvious abnormality in laboratory examination. Both of their EEG indicated epileptic wave. Cranial MRI showed lissencelphaly. Gene analysis showed that there was a heterozygous mutation of IVS3-1G>A in PAFAH1B1 gene in a child, which resulted in the deletion of exon 4 in mRNA level by functional analysis. No mutations were found in the parents of the child. The other one had c.274A>G mutation (p.K92E) in PAFAH1B1 gene, which has not been reported before, and his parents were normal. Conclusion Patients with lissencelphaly may combine with epilepsy, and the PAFAH1B1 gene mutation is the common cause.

OBJECTIVE: To evaluate the use of Xingnaojing Injection in medical insurance inpatients in Beijing city so as to provide reference for rational drug use and medical insurance billing.METHODS: Inpatient cases using Xingnaojing Injection in 5 Beijing hospitals of different levels were randomly sampled from the 2004 Beijing Medical Insurance Database,and analyzed in terms of indication, dosage, treatment course and ADR.RESULTS: A total of 676 cases were sampled with more than 25 kinds of indications,and among the top 10 indications, 18.0% were inconsistent with the instruction,and 17.5% were in lack of evidence support such as randomized controlled trials.Individual dose of Xingnaojing Injection was(27.9?9.0)mL, which was higher than the usual dose described by the instructions and clinical trials.The mean treatment course of Xingnaojing Injeciton was 14.6 days,with 20.9% exceeding 20 days.Drugs used in combination with Xingnaojing Injection included anti - thrombosis agents( 13.3% ) and traditional Chinese medicines with the action of promoting blood circulation and removing blood stasis (12.7%) .CONCLUSION: The use of Xingnaojing injection in medical insurance patients was not consistant with the instruction or evidence supported by clinical trials.

?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

Objective:Marrow mesenchymal stem cells differentiates into neuron-like cells when induced by Gastrodia,which verifies the multipotentiality of the stem cells.Here to detect the immunogenic properties of the neuron-like cells after differentiation.Methods:Human mesenchymal stem cells were isolated from bone marrow by wall sticking method,amplified by in vitro culture,and differentiated into neuron-like cells by oriented induction with Gastrodia.The morphology of cells was observed under light microscopy.Neuron-specific enolase (NSE),nestin and glial fibrillary acidic protein (GFAP) were detected by imnunocytochemistry.The expression of HLA-DR protein after induction was tested by flow cytometry(FCM).The immunogenic properties of the neuron-like cells induced from hMSCs were detected by one-way mixed lymphocyte reaction(MLR).Results:Human mesenchymal stem cells could be separated and amplified in vitro.After being induced by Gastrodia for 3 hours,most of the cells would be differentiated into neuron-like cells,revealing cytodendrite.By immunochemical staining,the cells showed positive of NSE,nestin,and negative of GFAP.HLA-DR was not detectable on differentiated hMSCs by FCM.MLR assays demonstrate that differentiated hMSCs fail to stimulate proliferative response of hPBLs.Conclusion:Human mesenchymal stem cells could be induced to differentiate into neuron-like cells by Gastrodia.MLR assays demonstrate that differentiated hMSCs fail to stimulate proliferative response of hPBLs.They are low immunogenic.

Objective To explore the relationship between platelet to lymphocyte ratio (PLR) and microangiopathyin type 2 diabetes mellitus. Methods In this case-control study, the clinical data on 428 adult patients with type 2 diabetic microangiopathy in our hospital from January 2009 to December 2015 were retrospectively analyzed. PLR, age, sex, fasting blood glucose, glycosylated hemoglobin, total cholesterol and triglyceride were tested to investigate their relationship with type 2 diabetic microangiopathy. Results Logistic regression analysis showed that PLR was a risk factor of type 2 diabetic microangiopathy (OR = 3.162, 95%CI:1.556 ~ 7.421, P < 0.05). Conclusions Greater PLR is closely related to type 2 diabetic microangiopathy, and we should pay attention to type 2 diabetic microangiopathy with a greater PLR in clinical practice.

Objective To investigate the clinical efficacy of white mustard seed moxibustion on four flower points [bilateral points Geshu(BL 17) and Danshu(BL 19)] in treating night sweat.Method One hundred and twenty patients with night sweat were randomly allocated to groups A, B and C, 40 cases each. Group A received white mustard seed moxibustion on four flower points; group B, oral administration of zuogui pills; group C, application of millet paste to four flower points. After 22 days of treatment, pre-treatment and post-treatment TCM symptoms and signs of hyperhidrosis scores were compared in the three groups and the clinical therapeutic effects were compared between the three groups.ResultThere was a statistically significant pre-/post-treatment difference in the TCM symptoms and signs of hyperhidrosis score in the three groups (P<0.05). The cure rate and the total efficacy rate were 50.0% and 92.5%, respectively, in group A; 27.5% and 75.0%, respectively, in group B; 12.5% and 50.0%, respectively, in group C. There were statistically significant differences in the cure rate and the total efficacy rate, and the TCM symptoms and signs of hyperhidrosis score between group A and group B or C (P<0.05) and between groups B and C (P<0.05).Conclusion White mustard seed moxibustion on four flower points is an effective way to treat night sweat and can markedly improve its symptoms in the patients.

In 2002, a research report about toxic warfare launched by the United States Air Force attracted the attentionof the U.S.military and civilian disaster emergency rescue organizations .By reviewing historical events related to the malicioususe of toxic industrial chemicals in the war , this report proposed the concept of Toxic Warfare , and discussed itsimpact on the United States military and homeland security .In this paper, the concept and history of toxic warfare and itsinfluence on American military and homeland security are reviewed , the threats of toxic warfare facing China and counter -measures against toxic warfare are analyzed.

Objective To investigate the efficacy of preemptive analgesia with parecoxib sodium combined with local infiltration anesthesia with ropivacaine for postoperative pain after laparoscopic cholecystectomy.Methods One hundred and fifty ASA Ⅰ or Ⅱ patients,aged 41-63 yr,weighing 55-87 kg,scheduled for laparoscopic cholecystectomy under the general anesthesia,were randomly divided into 3 groups (n=50 each): parecoxib sodium+0.9％ normal saline (group A),parecoxib sodium + 0.5％ ropivacaine (group B) and parecoxib sodium + 0.75 ％ ropivacaine (group C).Parecoxib sodium 40 mg was injected intravenously 30 min before induction of anesthesia.Anesthesia was induced and maintained with remifentanil and propofol given by TCI.Immediately before skin closure,0.9％ normal saline 12 ml was given in group A,and 0.5％ and 0.75％ ropivacaine 12 ml were injected for local infiltration anesthesia in groups B and C,respectively.VAS scores were maintained ≤ 3after operation.When VAS scores ＞ 3,pethidine 75 mg was injected intramuscularly.Ramsay sedation scores were recorded at the end of operation and 2,4,8,12 and 24 h after operation.The side effects (nausea and vomiting,allergy,respiratory depression,etc.),requirement for pethidine,algesic sites (incisional pain,upper abdominal pain,referred pain in right shoulder),and condition of the wound healing were all recorded within 24 h after opcration.Results Compared with group A,Ramsay sedation scores,the incidence of nausea and vomiting,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in groups B and C (P ＜ 0.05 or 0.01).Compared with group B,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in group C (P ＜ 0.05 or 0.01).There was no significant difference in Ramsay sedation scores between groups B and C (P ＞ 0.05).There was no significant difference in the condition of the wound healing,upper abdominal pain and referred pain in right shoulder between groups A,B and C (P ＞ 0.05).Conclusion For the patients scheduled for laparoscopic cholecystectomy,local infiltration anesthesia with ropivacaine can improve the efficacy of preemptive analgesia with parecoxib sodium,and it provides better postoperative analgesia when 0.75 ％ ropivacaine is used.

OBJECTIVE:To promote rational use of Xingnaojing (XNJ) injection in medical insurance patients.METHODS:Clinical trials on indications of XNJ were searched systematically,and clinical evidence that XNJ was applied for different indications were collected and classified.A questionnaire survey was carried out in 20 medical institutions to find out the doctors' attitude and prescribing practice relating to indications,application indications,usage and dosage,timing of application and drug combination of XNJ.The results of above 2 kinds of studies were provided to a group of experts to reach consensus about guideline of XNJ.RESULTS:Guidelines of XNJ,which contained the application indications,timing of medication,dosage,treatment course and drug combination,were developed.The strength and degree of evidence were labeled for each items of recommendation.CONCLUSION:For drugs with low-quality clinical evidence,guideline should be developed according to experts' consensus which is based on evidence-based medicine.