BACKGROUND:Runx2 is considered to the main regulatory factor of osteogenic gene expression and be necessary for osteoblast differentiation, it plays an extremely important role in the osteoblast development, differentiation, regulation, bone calcification formation and bone repair.
OBJECTIVE:To observe the biological properties of mesenchymal stem cells from human exfoliated deciduous teeth, explore the osteogenic differentiation potential of deciduous teeth stem cells, and observe the dynamic expression of Runx2 gene at varying time points.
METHODS:The stem cells from human exfoliated deciduous teeth were isolated and cultured in vitro. The cellsurface antigen was detected with flow cytometry. The third passage cells were cultured in the adipogenic medium for 4 weeks, and oil red O staining was conducted to test lipid droplets formation. The third passage cells were cultured in the osteogenic medium for 21 days, and mineralized nodules were detected by alizarin red staining. Runx2 mRNA dynamic expression was detected with semi-quantitative RT-PCR at different time points.
RESULTS AND CONCLUSION:The stem cells from human exfoliated deciduous teeth were obtained by enzyme digestion and limited dilution methods. Flow cytometry results showed that, CD146 and STRO-1 were expressed to varying degrees. Oil red O staining revealed salmon pink positive particles. Alizarin red staining showed positive expression. RT-PCR results showed that, Runx2 expression was found at day 0, up-regulated from day 0 to day 6, and subsequently dropped with an expression bottom at day 12, after that a second expression peak occurred at day 18, fol owed by a stably regulation. The stem cells from human exfoliated deciduous teeth can be isolated and cultured in vitro, express surface antigen of mesenchymal stem cells, and have the potentials of differentiating into adipocytes and ostetoblasts. Runx2 gene profiles are dynamical y expressed during osteoblastic differentiation. Runx2 express throughout every stage of osteoblastic differentiation. The expression is up-regulated during early and later stages, and down-regulated in metaphase.

Objective To investigate the short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency.Methods One hundred and twenty patients with heart failure (NYHA Ⅲ-Ⅳ or Killip Ⅲ) were randomly divided into levosimendan group(n =60) and control group(n =60).The patients in levosimendan group were given intravenous levosimendan for 24 hours beside conventional heart failure medications.The patients in control group were given the conventional heart failure medications.The left ventricular ejection fraction (LVEF) was recorded and B-type natriuretic peptide (BNP) were measured before and after treatment.NYHA grade and mortality also were recorded.All patients were followed up for 3 months.Results The LVEF in the levosimendan group after the treatment was (35.6 ± 13.3)％,significantly higher than that in the control group ((31.4 ± 6.7) ％,F =8.952,P =0.002).The BNP in two groups after treatment were lower compared with before treatment(P ＜0.05).And it was more remarkable after treatment in levosimendan group compared with control group (441.0 (212.5,1050.0) ng/L vs.870.0 (435.0,1267.0) ng/L,P =0.014).The change of NYHA grade in levosimendan group was better than that in control group after 5 d.The recovery rate and ineffective or deterioration rate in levosimendan group were 45.0％ (27/60),26.7％ (16/30) and 43.3％ (26/60) respectively,higher than that of control group (28.3％ (17/60),20.0％ (12/60),36.7％ (22/60)) (OR =2.280,95％ CI 1.163-4.468,P =0.016).There was no significant difference in term of mortality between in hospital and 3 months follow-up in the levosimendan and the control group (20％ (12/60) vs.25％ (15/60),28.3％ (17/30) vs.41.7％ (25/60),x2 =1.543,P =0.214 and x2 =2.590,P =0.108).There was a decreasing trend regarding of readmission rate during 3 months in levosimendan group compared with that of the control group (21.7％ (13/60) vs.33.3％ (20/60),x2 =3.591,P =0.058),but mortality or readmission rate was lower than that in the control group (46.7 ％ (28/60)vs.66.7％ (40/60),x2 =4.835,P =0.028).Conclusion The short-term clinical efficacy of levosimendan on treating patients with decompensated cardiac insufficiency is remarkable better than the traditional treatment.

Objective To evaluate the improvement effect of levosimendan by vein injection on short term cardiac function of patients with decompensated heart failure.Methods One hundred and sixty patients admitted due to heart failure were randomly divided into levosimendan group and control group (80 subjects for each group).Patients in control group were given a regular therapy including diuretics,vasodilators (including the recombinant human brain natriuretic peptide),angiotensin converting enzyme inhibitor(ACEI) or angiotensin Ⅱ receptorantagonists(ARB),β blockers,spironolactone and stain.Patients in levosimendan were administered levosimendan for 24 hours plus regular therapy.The improvements of dyspnoea in 9 days and cardiac function classification in 30 days after therapy were assessed.Mortality of 1 month and 3 month in two group were calculated and compared during follow-up.Results The dyspnoea improvement rate was superior than that of control group during 9 days (OR =1.956,95％ CI:1.156-3.310,P =0.013).The improvements in the levosimendan group were better than in the control group at 1 st day (OR =2.261,95 ％ CI:1.280-3.999,P =0.005),at 3rd (OR =2.002,95 ％ CI:1.111-3.607,P =0.021) and 5th day (OR =1.846,95 ％ CI:1.009 -3.377,P =0.047).However,there was no significant difference in term of improving dyspnoea between the levosimendan group and the control group at 9th day (P =0.126).Similarly,the improvement of cardiac function classification in the levosimendan group was superior than the control group during 30 days (OR =1.933,95％ CI:1.229-3.040,P =0.004).Although no significant difference was seen regarding of improving cardiac function classification between the two groups at 30th day after treatment (P =0.115),the improvements in the levosimendan group were better than in the control group at 3rd (OR =1.986,95％ CI:1.195-3.300,P =0.008),5th (OR =2.268,95 ％ CI:1.329-3.873,P =0.003),9th (OR =2.627,95 ％ CI:1.419-4.860,P =0.002) and 14th day(OR =2.212,95％ CI:1.189-4.112,P =0.012).Moreover,there was a nonsignificant reduction in terms of mortality in levosimendan group during 1-month and 3-month follow-up compared with control group (P ＞ 0.05).Condusion Levosimendan can effectively improve the short-term cardiac function in patients with decompensated heart failure.

Objective To learn about the incidence and epidemiological characteristics of breast cancer in parts of China by a survey of women's breast health. Methods Multi-stage stratified randomized cluster sampling of the cross-sectional study was applied in collecting data of women aged 25 to 70 in Shandong, Hebei, Jiangsu and Tianjin province. All subjects included in the investigation attended face-toface interviews and clinical breast examinations. Results 122 058 females aged 25-70 years old in three provinces and Tianjin metropolitan were included. 320 (58 incident cases) breast cancer cases were documented in this investigation, that is 262.2/105 in prevalence. There was a higher breast cancer prevalence in subjects aged 45 to 54 and aged 55 to 64 within one year. The standardized detection rate of 54.2/105 in rural areas was higher than urban areas' 45.3/105. Conclusion Carring out the screening of female breast cancer and popularizing the knowledge of breast cancer prevention consistently, which could improve the detected rate of breast cancer.

Objective To evaluate the short-term clinical efficacy and safety of administration of levosimendan or milrinone added to conventional therapy in patients with decompensated heart failure.Methods A total of 180 patients admitted due to heart failure [NYHA (New York Heart Association) class Ⅲ or Ⅳ] were randomly (random number) divided into control group,milrinone group and levosimendan group (n =60,each group).A continuous infusion of milrinone added to conventional therapy was administered for 72 hours in milrinone group,while administration of levosimendan for 24 hours in levosimendan group.The changes in left ventricular ejection fraction (LVEF),left ventricle end-diastolic diameter (LVDD) and B-type natriuretic peptide (BNP) plasma level were compared between before and after treatment,respectively,and comparisons of improvement in cardiac function (NYHA class) and hospital mortality were carried out among three groups.Patients were further followed up at 3 months after treatment.Results The LVEF in levosimendan group after treatment had significantly more increased than that in control group [(32.0±6.3)％ vs.(30.6 ±5.5)％,P =0.007].Compared BNP before treatment,the sums of BNP deducted were 444.0 (-74.0,1068.0) pg/mL,469.0 (141.5,1151.5) pg/mL and 936.5 (437.8,1566.8) pg/mL in control group,milrinone group and levosimendan group,respectively after treatment (all P ＜ 0.01).Moreover,the deduction in BNP was more dramatic in levosimendan group compared with control or milrinone group (t =3.256 or 2.665,P =0.004 or 0.026).After treatment for 5 days,the probability at least of achieving more effectively better improvement in NYHA class (cardiac function) in levosimendan group was 2.036 times that of control group (95％ CI:1.030-4.028,P =0.041).The incidence of combined end point events (death or readmission) in levosimendan group was significantly lower than that in milrinone group (50％ vs.70％,HR =0.573,95％ CI:0.358-0.917,P=0.020),while in hospital mortality,readmission or 3-month mortality incidence was similar among 3 groups (P ＞ 0.05).Conclusions The short-term clinical efficacy of levosimendan is superior to that of milrinone or conventional therapy in patients with decompensated heart failure.

Objective:To discuss the necessity of upgrade and verification laboratory information management system( LIMS) in drug control institutes. Methods:LIMS was upgraded and validated in a laboratory. Results:The upgrade and verification of LIMS en-sured the primitiveness and accuracy of laboratory date, and improved the work efficiency. Conclusion:The application of LIMS sys-tem ensures the reliability of the date and is of great significance to the development of drug testing organizations.

Objective: To explore the risk stratification of pulse oxygen saturation (SpO₂) in patients with emergency hypoxemia patients, and to provide evidence for the identification of critical illness. Methods: Self-designed clinical data registration form for patients with emergency hypoxemia, and prospective collection of 344 hypoxemia patients in the emergency department of Peking Union Medical College Hospital from March to April in 2018, including baseline data (name, gender, age, ID number, date, registration time), hospitalization method, past history, patient complaint and diagnosis, triage level, SpO₂, whether to enter the rescue room, etc. Results: All of 344 emergency hypoxemia patients, there were 163 cases (21.2%) of ambulances, and 107 cases (31.1%) of patients requiring immediate rescue. There were 54 cases (25.7%) and 53 cases (39.6%) in need of immediate rescue in day shift (8:00-20:00) and night shift (20:00-8:00 next day), with 9:00-10:00, 14:00-15:00, 20:00-24:00 in the majority. There was a statistical difference in the way of hospitalization, triage, and SpO₂ (χ²=29.537, 25.780, t=4.722, all P<0.05) . SpO₂ risk stratification was 0.905 in patients without pulmonary disease, and SpO₂ risk stratification in patients with lung disease was 0.765. Conclusions Patients with hypoxemia account for a certain proportion in the emergency department and are in critical condition. The degree of critical condition of patients can be evaluated based on whether they have lung diseases, and the risk stratification of patients can be accurately determined with the help of SpO₂, so as to further guide the hierarchical treatment measures for patients with emergency hypoxemia and rationally optimize the allocation of emergency resources.

Objective: To evaluate the efficacy of ultrasound-guided caudal epidural block for postoperative analgesia in the infants undergoing lobectomy under general anesthesia. Methods: Sixty American Society of Anesthesiology physical status Ⅱ or Ⅲ pediatric patients of both sexes, aged 1-3 yr, weighing 10-16 kg, scheduled for elective lobectomy under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: control group (group C) and epidural block group (group E). Caudal epidural block was performed under ultrasound guidance after induction of general anesthesia and at 15 min before surgery in group E. An epidural catheter was inserted at T_{6, 7} interspace, 0.1% ropivacaine 1 mg/kg was injected at 5 min after injecting 1% lidocaine 3 ml, the diffusion of epidural fluid was controlled at T_3-10, and the epidural catheter was then removed.An analgesia pump was connected at the end of the surgery in two groups.Pain was evaluated using Face Legs Activity Cry Consolability scale.When Face Legs Activity Cry Consolability scale score>3, the pump was pressed.When pain was still unrelieved 5 min later, sufentanil 0.1-0.2 μg/kg was intravenously injected.The patients were followed up for 48 h after operation, and the requirement for additional remifentanil and sufentanil, and the occurrence of postoperative nausea and vomiting, respiratory depression, hypoxemia and over-sedation was recorded.The number of pressing times, extubation time and duration of intensive care unit stay were also recorded.Pain at 1 and 2 days after operation was evaluated using the Postoperative Pain Measure for Parents. Results: Compared with group C, the consumption of remifentanil, the number of pressing times and requirement for additional sufentanil were significantly decreased, the incidence of each index of the Postoperative Pain Masure for Patients was decreased at 1 day after surgery, the extubation time and duration of intensive care unit stay were shortened, and the incidence of nausea and vomiting and over-sedation was decreased in group E (P<0.05). Conclusion Ultrasound-guided caudal epidural block provides better efficacy and fewer side effects for postoperative analgesia in the infants undergoing lobectomy under general anesthesia.

Objective To investigate the roles of long noncoding RNA-myocardial infarction-associated transcript (MIAT) on lens epithelial cells (LECs) fibrosis induced by transforming growth factor-β2(TGF-β2).Methods LECs line (SRA01/04) was cultured in conventional DMEM (normal control group) and DMEM containing 10 ng/ml TGF-β2(TGF-β2 induced group) for 48 hours.The morphology of the cells was observed under the optical microscope,and the relative expression levels of M IAT,E-cadherin (E-cad),α-smooth muscle action (α-SMA),collagen Ⅰ (Coll Ⅰ) in protein level and mRNA level were detected by real-time fluorescence quantitative PCR and Western blot,respectively.The cells cultured in DMEM or DMEM containing 10 ng/ml TGF-β2 were transfected by siNRA empty carrier (siNRA group,siNRA+TGF-β2 group) and siRNA-MIAT (siRNA-MIAT group,siNRA-MIAT+ TGF-β2 group) for 48 hours,and the morphology of the cells was observed under the optical microscope,and the relative expression levels of MIAT,E-cadherin (E-cad),α-smooth muscle action (α-SMA),collagen Ⅰ (Coll Ⅰ) in protein level and mRNA level were detected by real-time fluorescence quantitative PCR and Western blot.Results The cells in the normal control group showed the round and polygon in shape,and those in the TGF-β2 induced group showed the spindle-like.Compared with the normal control group,the relative expression levels of MIAT mRNA,α-SMA mRNA and Coll Ⅰ mRNA were significantly elevated (2.497 ± 0.644 vs.0.827 ± 0.062;2.951 ±0.146 vs.1.085±0.517;2.115 ±0.090 vs.1.002 ± 0.088),and the expression of E-Cad mRNA was significantly reduced (0.102±0.027 vs.1.020±0.262) in the TGF-β2 induced group (P =0.045,0.004,0.000,0.025).The expressions of MIAT,α-SMA,Coll Ⅰ and E-Cad showed a similar trend between two groups.The relative expressions of MIAT protein and mRNA were evidently reduced in the SiRNA-MIAT group compared with the siRNA empty vector group (all at P＜0.05).Compared with the siRNA+TGF-β2 group,the relative expressions of α-SMA and Coll Ⅰ in protein and mRNA levels were significantly reduced,and the expressions of E-cad protwin and mRNA were elevated in the siRNA-MIAT+TGF-β2 group (all at P＜0.01).Conclusions MIAT might participate in TGF-β2-induced LECs-EMT.The down-regulation of MIAT in the LECs inhibits the fibrosis of LECs.

Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.