Objective To investigate the changes of 4 histamine receptors (H1R, H2R, H2R and H4 R)in interstitial cystitis on animal experimental models. Methods Thirty female SD rats (250-300 g) were randomly divided into 2 groups as follows: 20 in experimental group and 10 in control group. The experimental group was filled with protamine sulfate+ potassium chloride to create interstitial cystitis model, the control group was sacrificed directly. At the end of the experiment, the bladders of all these SD rats were studied by the immunohistochemistry staining and the value of their mean absorbance (-A) was calculated by IPP4.5 image analysis software. The SPSS 11.5 was used to analyze the differences between the groups. Results Four kinds of histamine receptors mainly expressed in the bladder epithelium. In the experimental group, the (-A) of H1 R was 0. 054±0.031, the of H2R was 0.032±0.021, the (-A) of H3R was 0.047±0.033 and the (-A) of H4R was 0. 149±0. 191,respectively. In the control group, the A of H1R was 0. 017±0. 011, the (-A) of H2R was 0. 018±0. 015, the (-A) of H3R was 0. 014±0. 011, the (-A) of H4R was 0. 060±0.039, respectively. In contrast,the A of H1 R, H2 R and H3R in experimental group was increased significantly(P＜0.05); there was no significant change in (-A) of H4R expression(P＞0.05). Conclusions H1, H2 and H3 receptors in rat model interstitial cystitis bladder epithelium have increased and it indicates H1 R, H2R and H3R may be related to interstitial cystitis. H3 R may be a new treatment target of interstitial cystitis.

Objective To study a new stuff-block therapy method to promote closure of external gastrointestinal fistula. Methods Twenty-eight patients with different type of external gastrointestinal fistulae in different sites were treated with fibrin glue stuff-blocking technique. The fibrin glue dispensary system designed by the authors has a double-lumen catheter in different size.When the catheter inserted via the fistula to about 1cm from the intestinal fistula,the glue was relased through the catheter to seal the whole fistula. Results The insertion of dispensary catheter into the fistulae was successful in all the cases. No side-effect was observed in all the patients. In 17 patients the fistulae healed about one week after one time treatment, 11 patients′ fistulae healed in about two weeks after 2-3 time treatment. Twenty-five patents were followed up for 3-6 months . The fistula sustained healing and normal deal was restored.Conclusions Stuff-blocking of the fistula with fibrin glue by means of the dispensary system designed by the authors has satisfy results. It provided a new method for the treatment of external gastrointestinal fistula .

An analysis is made according to policy documents of localities on capitation payment, and by means of literature review and the analysis framework of the World Bank,this paper reviewed studied the following:definition of service package,per capita rate,designated institutions,design of financial regulations,and service supervision.Given the attempts made at localities,most of the schemes are incomplete in design,and defective in capitation measurement methods and dynamic adjustment mechanisms.The authors recommend a systematic design of the capitation payment scheme for better outcomes.

Objective To explore biological characteristics of chondrogenic differentiation of human periosteum-derived cells and the role of BMP4 in chondrogenic differentiation of these cells.Methods From October 2009 to September 2012,periosteum was obtained from tibia of patients undergoing leg amputation surgery,and isolated periosteum-derived cells by tissue culture method.Cells were cultured in DMEM/F12 containing 10％ fetal bovine serum,and morphology of cells were observed under inverted microscope.Periosteum-derived cells growth and the effect of BMP4 on cells growth examined by cell count using trypan blue,and cells growth curve was made.Experiment was divided into control group,chondrogenic differentiation group and BMP4 group,cells were expanded and differentiated in the presence or absence of BMP4 and complete medium.Then toluidine and immunohistochemical staining analyzed proteoglycan and collagenⅡ expression of these cells after 14 and 21 days.The expression of aggrecan,collagen Ⅱ and SOX9 mRNA of these cells using real-time PCR.Results (1) Periosteumderived cells adhered to growth in vitro,the shape of cell presented fibroblast-like morphology changing into polygonal after 1 week and round cell formation after 2 weeks chondrrogenic differemtiation.Growth curve showed that the passage 3 and 9 cells had similar reproductive activity.The passage 3 cells were positive for CD90 (21.07％) and CD105 (25.84％).(2)Toluidine bule staining and type Ⅱ collagen immunohistochemical staining showed BMP4 group (40.29 ± 4.29,56.74 ± 5.12) and chondrogenic differentiated group (19.27 ± 3.71,38.31 ± 4.25) ccould secrete proteoglycan and collagen Ⅱ,control group were negative (10.24 ± 1.21,15.28 ± 2.23),BMP4 group were significantly than chondrogenic differentiated group.(3) The expression of aggrecan,collagen Ⅱ and SOX9 mRNA of BMP4 group(25.76 ±0.57,6.48 ±0.48,2.91 ±0.18)were significantly higher than that of control group(2.37 ±0.24,1.12 ± 0.31,1.07 ± 0.22)and chondrogenic differentiated group(11.12 ± 0.38,2.24 ± 0.41,1.54 ± 0.35)using real-time PCR.Conclusion Periosteum-derived cells have strong proliferative,and have good potentials of differentiating into chondroblasts like mesenchymal stem cells.BMP4 can promote chondrogenic differentiation of periosteum-derived cells in vitro cultures.

Objective To investigate the relationship of serum adiponectin (APN) gene promoter region single nucleotide polymorphism (SNP) frequency and type 2 diabetes mellitus (T2DM).Methods 120 cases of T2DM were divided into Yin Deficiency Syndromes(n=42), Yin hot (n=38), yin and yang (n=40) and 50 cases of normal volunteers were select as the control group. The diponectin gene (aPM1) promoter polymorphisms of each group were detected with polymerase chain reaction amplification (PCR).Results Serum APN Yin hot levels in patients with T2DM (6.98 ± 1.23 μg/ml) were lower than Qi and yin (2.55 ± 0.78 μg/ml) and yang group (3.48 ± 0.22 μg/ml) (P<0.05), and TG, LDL-C, TC (4.48 ± 0.87 mmol/L, 4.98 ± 0.42 mmol/L, 5.36 ± 0.79 mmol/L) were higher than Qi and yin (3.25 ± 0.75 mmol/L, 4.02 ± 0.69 mmol/L, 3.12 ± 0.52 mmol/L) and yang group (3.18 ± 0.69 mmol/L, 4.09 ± 0.71 mmol/L, 3.22 ± 0.78 mmol/L)(P<0.05). Yin hot type aPM1-11377G/C genotype of the GG genotype was significantly higher than the proportion of Qi and yin and yang group (P<0.05), while the yin and yang and yin and yang group aPM1-11377G/C genotype the proportion was higher in GG genotype (P<0.05). GG genotype was significantly lower than serum APN type CG and CC genotype (P<0.05), whereas no significantdifference in other indexes (P>0.05).Conclusion T2DM patients Yin hot type inherent relationship with aPM1-11377G/C polymorphism, aPM1-11377G/C polymorphism may reflect R2DM Disease Syndromes typing a certain extent, and by influence insulin resistance in patients with arterial plaque and serum APN levels, thereby affecting T2DM disease occurrence and progression.

Objective To explore the efficiency of prophylactic intravesical chemotherapy after nephroureterectomy for primary upper tract urothelial carcinoma.Methods Forty-seven patients with primary upper tract urothelial carcinoma who underwent nephroureterectomy were retrospectively analyzed.There were 25 male and 22 female patients with mean age of 68 years.Patients were divided into intravesical chemotherapy group (n =32) and non-intravesical chemotherapy group (n =15).In the intravesical chemotherapy group, there were 14 male and 18 female patients with mean age of 70.3 years;20 cases located at left side while 12 at the right side.In non-intravesical chemotherapy group, There were 11 male and 4 female patients with mean age of 65.0 years;10 cases located at left side while 5 at the right side.The age, gender, side of the two groups were not statistical different.The two groups were followed up, and the tumor stage, grade, recurrence rate, cancer-free survival time were compared.Results The pathology results of all cases were urothelial carcinoma.In the intravesical chemotherapy group, 23 cases were high grade tumors with 9 low grade tumors.There were 15 cases of Ta-T1 stage, 8 cases of T2 stage and 9 cases of T3 stage;the tumor of 19 cases located at pelvis, 12 located at ureter, 1 located at pelvis and ureter;the mean size of the tumors was (2.75 ± 1.49) cm;8 cases were multiple while 24 were single.In the non-intravesical chemotherapy group, 12 cases were high grade tumors with 3 low grade tumors, there were 6 cases of Ta-T1 stage, 4 cases of T2 stage and 5 cases of T3 stage;the tumor of 11 cases located at pelvis, 3 located at ureter, 1 located at pelvis and ureter;the mean size of the tumors was (3.11 ± 1.48) cm;6 cases were multiple while 9 were single.The items mentioned above did not reach statistical difference between the two groups(P ＞0.05).6 patients relapsed in intravesical chemotherapy group while 7 in non-intravesical chemotherapy group.The recurrence rate of bladder cancer of intravesical chemotherapy group was lower than that of non-intravesical chemotherapy group (18.75％ vs.46.67％, χ2 =3.978, P =0.046).Compared with non-intravesical chemotherapy group, intravesical chemotherapy group had longer cancer-free survival, but it did not reach statistical difference (36.5months vs.29.6months, t =1.079, P =0.286).The age and tumor grade were risk factors of bladder cancer recurrence, meanwhile the gender, tumor side, tumor stage, voided urine cytology, tumor size, and location were not.Conclusion Prophylactic intravesical chemotherapy after nephroureterectomy for primary upper tract urothelial carcinoma could reduce the recurrence rate of bladder cancer.

Objective To study the role of bone morphogenetic protein-7 in the osteogenic differentiation of periosteal cellsin vitro. Methods Periosteal cells, obtained from adult tibial periosteum, were cultured by routine method in vitro, and divided into two groups. One group cultured with BMP7 and the supplements of 100 nmol dexametasone, 10 mmol b-glycerophosphate and 50 mg/mL L-ascorbic acid (BMP7 group), the other cultured with the supplements alone as the control (control group). Ultrastructure and morphological changes of periosteal cells were observed by contrast phase microscope and electron microscope. In order to test the expression of markers of osteoblastic differantiation in periosteal cells, involved mineralized node and alkaline phosphatase. Each group was tested at the time of 5 d, 10 d, 15 d, 20 d, respectively, using ALP kit stain and Von Kossa stain with 3 samples at each time. Results The periosteal cells cultured by routine method and induced into osteoblast differentiation with BMP7 were both growing well, in vitro. Microscope observations showed that the periosteal cells were spindle-shaped, well-stacked, transparent and three-dimensional in the early stage, and cube-shaped or puncheon shaped in the mitotic phase, gradually became wide shuttle and irregular shape with a lot secretion in telophase. The positive cells were visible by the ALP kit staining and Von Kossa staining of calcium nodules at 5 d, 10 d, 15 d and 20 d in both groups.A difference of positive rate at each time point was found between BMP7 group and control group at 5 d, 10 d, 15 d, 20 d, and the difference was statistically significant (P ＜ 0.01). Conclusion It displayed well regeneration and osteogenesis ability in the periosteal cell. BMP7 has definite osteo-inductive activity, which can obviously enhance the proliferation and ossifyng differentiation of periosteal cells.

Objective To investigate the clinical value of CT spectral imaging parameters in evaluating the liver function in patients with different types of Budd-Chiari syndrome (BCS),by comparing the normalized iodine concentration (NIC) and the slope of spectral curve in liver segment Ⅰ-Ⅷ,portal vein (PV),hepatic vein (HV),inferior vena cava (IVC) and spleen.Methods Eighty-one patients with BCS underwent spectral CT angiography.NIC,spectral decay curve and the slope of spectral curve of liver segment Ⅰ-Ⅷ in portal venous phase,PV,HV,IVC and spleen were measured and calculated.Clinical indicators of liver function including prothrombin time (PT),albumin (ALB),total bilirubin (TBIL),aspartate transaminase (AST),alanine transaminase (ALT) were recorded.Quantitative data were analyzed using One-way ANOVA.Pearson correlation analysis was used to evaluate the correlation of liver NIC and clinical liver function indexes.Results PT and TBIL were negatively correlated with liver NIC and there was a positive correlation between ALB and liver NIC (P＜0.05).The differences of NIC among the three types of BCS in liver segment Ⅱ-Ⅵ,HV,IVC and spleen were statistically significant (P＜0.05) and the difference of slopes of the spectral curves among three types of BCS in liver segment Ⅱ-V and spleen was statistically significant (P＜0.05).Conclusion Combined use of spectral CT multi-site and multi-parameter imaging may be useful in the evaluation of liver function in patients with BCS.

Objective To evaluate the efficacy and safety of urinary diversion in patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS).Methods Clinical data of 15 female patients who underwent urinary diversion treatment for IC/BPS in our hospital from January 2008 to July 2018 were retrospectively analyzed.The mean age of the subjects was 64 years old (range 29-79),and the mean disease history of IC/BPS was 5 years (range 2-15).Behavior therapy,oral medicine therapy,intravesical instillation,bladder submucosal injection of botulinum toxin type A and sacral neuromodulation showed unsatisfied outcomes in these patients.Before the surgical intervention,the average urinary frequency was (30.7 ± 11.6) per day,the median visual analogue scale (VAS) was 95 (range 50-100),the O'Leary-Sant Index was 35 (range 31-36) [all the interstitial cystitis problem index (ICPI) was 16],the pelvic pain and urgency/frequency patient symptom scale (PUF) was 35 (range 32-36) [the bother score was 12 (range 11-12)],all the quality of life (QOL) was 6,and the average serum creatinine was (81.1 ± 13.5) μmol/L.Two patients underwent cutaneous ureterostomy without cystectomy,1 patient underwent ileal conduit urinary diversion without cystectomy,and the other 12 patients underwent laparoscopic ileal conduit urinary diversion with cystectomy.The differences of the Global Response Assessment (GRA),complications,VAS,ICPI,PUF,QOL and the serum creatinine before and after the operation were compared.Results The mean postoperative follow-up period was 24 months (range 6-110).The last follow-up showed that all the GRA was 7,the median VAS was 0 (range 0-30),all the ICPI was 0,all the PUF(bother score)was 0,and the median QOL was 2 (1-4),which were significantly different with those before the surgery (all P ＜ 0.01).The last follow-up showed that the average serum creatinine was (83.8 ± 12.5)μ mol/L,which were not significantly different with that before the surgery (P =0.22).Postoperative adhesive intestinal obstruction occurred in 3 subjects.Conclusions Urinary diversion might be an effective and adequate treatment for refractory IC/BPS to eliminate pain or lower urinary tract symptom and improve quality of life of the patients.

OBJECTIVE: To detect pathogenic variant in a juvenile with severe type Cornelia de Lange syndrome (CdLS). METHODS: A 12-year-old female presented with comprehensive developmental retardation and deformity of lower limbs. Genomic DNA was extracted from peripheral blood sample of the patient. Whole exome sequencing was performed to identify pathogenic variants. Putative variant was verified by Sanger sequencing. The impact of variants was predicted and validated by bioinformatic analysis. RESULTS: A de novo missense variant, c.1507A>G (p. Lys503Glu), was found in the NIPBL gene of the proband. The variant was unreported previously and predicted to be pathogenic by PolyPhen-2, MutationTaster and SIFT. Using HomoloGene system, the 503 loci in the NIPBL protein are highly conserved. The change of amino acid (Glu), locating in 503 locus, was found to cause the Neuromodulin_N superfamily domain destroyed, resulting in severe damage to the function of NIPBL protein. CONCLUSION The de novo missense variant c.1507A>G (p. Lys503Glu) of the NIPBL gene probably underlies the disease in this patient.
Cell Cycle Proteins ; genetics ; Child ; De Lange Syndrome ; genetics ; Developmental Disabilities ; genetics ; Female ; Humans ; Mutation, Missense ; Phenotype