Induced pluripotent stem cells can differentiate into a variety of cell types,which promote the development of human disease model,drug toxicity screening and sources of autologous cells.However,there have been many problems in the induced pluripotent stem cells reprogramming,such as safety and low efficiency.Small molecules are considered as a promising method to improve the reprogramming processes of induced pluripotent stem cell,and more and more small molecules have been identified to maintain stem cell self-renewal,providing a new approach to produce the desired reprogramming cells.

Acupuncture Therapy ; Humans ; Meridians ; Sensation

[ABSTRACT]OBJECTIVETo evaluate the effectiveness of low temperature radiofrequency ablation on tongue cancer in early stage (<2 cm T1 stage) .METHODS High differentiated tongue squamous cell carcinoma(<2 cm T1 stage) were removed with radiofrequency ablation in 11 patients and with high-frequency electrotome in 20 patients from 2009 to 2014 in our hospital. All the patients underwent elective neck dissection(I,Ⅱ,Ⅲ regions). Intraoperative blood loss, VAS ratings of post-operative pain, post-operative bleeding rate and the recurrence rate of tongue cancer or lymph node metastasis were compared between the two groups.RESULTSIn the radiofrequency ablation group, the mean intraoperative blood loss was 13.82±7.40ml, the VAS ratings of post-operative pain were 3.8±1.3 (day 1), 2.5±0.7 (day 3) and 1.8±0.6(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in one case at 6 month after operation. In the high-frequency electrotome group, the mean intraoperative blood loss was 40.55±12.03ml, the VAS ratings of post-operative pain were 6.8±1.3(day 1), 4.4±1.1(day 3) and 2.3±0.7(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in 3 cases at 6 month to one year after operation. The intraoperative blood loss and post-operative pain in radiofrequency ablation group were significantly lower and less than that in the high-frequency electrotome group.CONCLUSIONRadiofrequency ablation is a promising method for early stage tongue cancer with less blood loss, invasiveness and complications.

Objective:To evaluate the nasal safety of gastrodin nasal temperature-sensitive in situ gel through the studies on cilia toxicity in toads and mucosal irritation in rats. Methods:The toads were randomly divided into four groups, saline group, gastrodin in situ gel group, blank gel matrix group and sodium deoxycholate group, and the cilia toxicity was observed in vivo by a toad palate meth-od. The rats were randomly divided into three groups, saline group, gastrodin in situ gel group and blank gel matrix group, and the mucosal irritation was studied in rats through the observation of nasal mucosal pathological changes and behavioral indices. Results:Compared with the saline group, gastrodin in situ and blank gel matrix showed no notable effect on the cilia movement function in toads, and the effect on cilia movement of sodium deoxycholate showed statistically significant difference when compared with that of sa-line, gastrodin in situ gel and blank gel matrix (P<0. 01). During and after the treatment, no sneezing appeared in the rats. Com-pared with that in the saline group, the number of scratching nose in the gastrodin in situ gel group and blank gel matrix group in-creased (P<0. 05) without difference between the groups (P>0. 05), and after the 2-day withdrawal, that in the gastrodin in situ gel group and blank gel matrix group decreased significantly when compared with that at the last administration (P<0. 05) and showed no notable difference when compared with that in the saline group (P>0. 05). The number of inflammatory cells in the nasal mucosa in the gastrodin in situ gel group and blank gel matrix group increased complicated with congestion and cilia falling off, and after the with-drawal, the mucosal morphology in the three groups showed no significant difference. Conclusion:The local application of gastrodin in situ gel has high security, which is valuable to be studied further.

Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.

Background As a main cellular component of retinal microvascular,retinal vascular endothelial cells (RVECs) play critical roles in the occurrence and development of diabetic retinopathy (DR) by proliferating,migrating and angiogenesis.Apolipoprotein A-Ⅰ (ApoA-Ⅰ) is the major apolipoprotein of high density lipoprotein.ApoA-Ⅰ is overexpressed in the retina of diabetic patients and plays different effects on RVECs upon different microenvironments,but its relationship with RVECs in high glucose environment is still not elucidated.Objective This study was to investigate the effects of ApoA-Ⅰ on proliferation,migration,tubulogenesis and vascular endothelial growth factor (VEGF) expression in human RVECs (hRVECs) in high glucose environment.Methods hRVECs were cultured with DMEM containing 10％ fetal bovine serum and passaged,and the cells at generation 3 to 6 were used in the study.The cells were divided into low-glucose group,low-glucose+ApoA-Ⅰ group,high-glucose group and high-glucose+ApoA-Ⅰ group,and the low concentration glucose (5 mmol/L),high contration glucose (25 mmol/L)and ApoA-Ⅰ (30 μg/ml) was added separately according to grouping.The proliferation and migration rate of the cells were evaluated by cell counting kit-8 (CCK-8) assay and scratch wound test respectively.The tubulogenesis of the cells was examined by tube formation test.The mRNA and protein expression of VEGF in the cells was detected by using real-time fluorescence quantitative PCR and Western blot.Results The prolifative value (absorbancy) and migration rate of the cells in the high-glucose group were significantly higher than those in the low-glucose group,and those in the high-glucose+ApoA-Ⅰ group were significantly reduced in comparion with the high-glucose group (A value:P =0.001,0.033;migration rate:P =0.001,0.010).The number of tubes in the low-glucose group,low-glucose+ ApoA-Ⅰ group,high-glucose group and high-glucose+ApoA-Ⅰ group was 7.250±2.217,9.250±2.630,19.000± 3.916 and 11.500±3.697,showing a significant difference among the groups (F=10.335,P=0.001).The number of tubes in the high-glucose group was more than that in the low-glucose group,and the number of tubes in the highglucose+ApoA-Ⅰ group was less that that in the high-glucose group (P=0.001,0.037).The relative expression levels of VEGF mRNA were 0.944 ± 0.083,1.117 ± 0.204,1.768 ± 0.164 and 1.301 ± 0.077,and those of V EGF protein were 1.000±0.130,1.217±0.152,1.871 ±0.101 and 1.609±0.087 in the low-glucose group,low-glucose+ ApoA-Ⅰ group,high-glucose group and high-glucose+ApoA-Ⅰ group,respectively,with significant differences among the groups (mRNA:F =18.640,P =0.001;protein:F =10.335,P =0.001),and the expressions of VEGF mRNA and protein in the high-glucose group were significantly higher than those in the low-glucose group and high glucose+ ApoA-Ⅰ group (mRNA:P=0.000,0.004;protein:P=0.000,0.029).Conclusions ApoA-Ⅰ plays inhibitory effects on the proliferation,migration and tubulogenesis of hRVECs in high glucose environment,which may be associated with the downregulation of VEGF expression.

Objective To test whether the prophylactic small dose amitriptyline has any beneficial influence on the rate of poststroke depression (PSD) by clinical experiment. Methods All 123 patients with first stroke were divided into the intervention group and the control group according to the block randomization tables. The patients in the intervention group were treated with 12. 5 mg amitriptyline every night for more than 1 month and the control group was blank Before and at the end of the observation, the rate of PSD and activities of daily living (ADL), degree of neurological deficit (NIHSS) of all the subjects were assessed. Results At the end of the one-month treatment, the intervention group had lower rate of PSD (16. 4% ) than the control (51.6%);and they had lower score in NIHSS (2. 83 ± 1.74 vs 3. 64 ±1.93) and higher score in ADL (93.0 ± 16. 1 vs 87.0 ± 37. 1) than the control. Multivariate Logistic regression analysis showed: the change of ADL score was closely related to the rate of PSD (RR =3.01 ,P =0. 04); the change of NIHSS score was closely related to the rate of PSD ( RR = 2. 42, P = 0. 03 );prophylactic small dose amitriptyline was closely related to PSD ( RR = 3.11, P = 0. 01 ). Conclusions Prophylactic small dose amitriptyline can decrease the rat of PSD, reduce the neurologic impairment and improve the activity of daily living.

Objective To establish a three-dimensional (3D) finite element model of a swine mandible, simulate the dynamic procedure of bullet damaging the swine mandible and explore a finite ele-ment analysis method on maxiilofacial gunshot wound. Methods The digital imaging and communica-tions in medicine (DICOM) data obtained from CT scanning of a swine mandible were remerged into a 3D finite element model of the original specimen through Mimics and ANSA software, then a simulation of 3D finite element model penetrated by a 7.62 mm bullet was carried out through LS-DYNA software. The simulation data were compared with those from animal experiment in laboratory to test the feasibility of 3D finite element model and the simulation method. Results A 3D finite element model of a swine mandi-ble was established, with highly identical geometric size with the specimen. In the meantime, the dynam-ic process of a 7.62 mm bullet damage to the model was successfully simulated. Data from the simulation and those from animal experiment showed a high level of consistency. Conclusion 3D finite element method is prosperous in application in basic research on maxillofacial gunshot wound.

Objective To study the expression of HER4 in renal cell carcinoma and elucidate therelationship between HER4 expression and the clinical features of renal cell carcinoma. Methods Seventy-five cases of paraffin-embedded tissues from renal eell carcinoma were tested for the expres-sion of HER4 by immunohistochemistry.Forty-six cases were male,29 cases were female,the median age was 49 years old.All of these cases were diagnosed as renal cell carcinoma(51 cases of clear cell carcinoma,1 5 cases of granular cell carcinoma,and 9 cases of papillary adenocarcinoma).The control group was 20 cases of normal renal tissue 5 am away from the tumor.Descriptive analysis was applied to compare the differences used the x2.test.Statistical analysis was done by SPSS 10.0. Results HER4 was overexpressed in 78.7%RCC(9 cases with weak positive,18 cases moderate positive,41 caseS intensive positive and 7 cases negative)cases.The expression of HER4 was negative in all nor-mal tissue.The overexpression of HER4 was correlated with the lymph node metastasis and TNM staging(P<0.05). Conclusions HER4 overexpressionis correlated with Stage of RCC.

Objective To identify risk factors of lymph node metastasis in superficial esophageal squamous cell carcinoma (ESCC),and to provide evidence for treatment choice under endoscope.Methods From January 2007 to December 2011,285 patients with pathologically diagnosed ESCC who received surgery and had clear record of lymph nodes resection were enrolled.The clinical pathological data of these patients were analyzed,including age,gender,smoking and drinking history,history of cancer,family history of cancer,location,tumor size,presence of esophageal,depth of infiltration,differentiation,and vascular cancer embolus.Univariate analysis (chi square test or Fisher exact probability method) and multivariate Logistic regression analysis were performed for risk factors of lymph node metastasis assessment.According to the rates of lymph node metastasis,patients were divided into three groups as follows:low risk,high risk and extremely high risk of lymph node metastasis.KaplanMeier method was used to calculate the average survival time and cumulative five years survival rate.Results Among the 285 patients with ESCC,40 (14.0 ％) patients with lymph node metastasis.The results of univariate analysis showed that location (x2 =9.333),tumor length (Fisher exact probability method),depth of infiltration (x2 =9.327),differentiation degree (Fisher exact probability method) vascular cancer embolus (Fisher exact probability method) were significantly associated with lymph node metastasis (all P＜0.05).The results of multivariate analysis indicated that tumor length over 5 cm,invasion to submucosal layer and vascular cancer embolus were independent risk factors of lymph node metastasis,and the odd ratio was 17.408(95％ confidence interval (CI) 1.557 to 194.686),3.471(95％CI 1.440 to 8.365) and 6.256(95％CI 1.787 to 21.910),respectively.The lymph node metastasis rates of patients in low risk,high risk and extremely high risk group were 5.2％(6/115),15.8％ (24/152) and 10/18,respectively;the average survival times were (69.9 ± 2.4),(63.8 ± 2.1) and (51.7 ± 1.7) months,respectively.The cumulative five years survival rates were 59 ％,51 ％ and 31％,respectively,and the difference was statistically significant (x2 6.816,P=0.033).Conclusions The risk of lymph node metastasis is high in ESCC patients with tumor length over 5 cm,invasion to submucosal layer and vascular cancer embolus,and the prognosis is poor.Lymph node metastasis should be considered when endoscopic therapy is chosen.