Baekground:Obstetric hemorrhage is a major cause of maternal death during cesarean delivery.The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section.Methods:We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018.In this study,196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group).Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group.Patients in the IOCS group were matched 1:1 to patients in the ABT group.Results:After propensity score matching,137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group.Patients in the IOCS group were associated with significantly shorter length of hospital stay,compared with ABT group (8.9 ±4.1 days vs.10.3 ± 5.2 days,t=-2.506,P =0.013).The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t =-4.056,P ＜ 0.001).The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6g/L,respectively,which were significantly different (t=2.615,P=0.009).Allogeneic red blood cell transfusion was significantly lower at 0 unit (range:0-11.5 units) in the IOCS group when compared with 2 units (range:1-20 units) in the ABT group (P ＜ 0.001).Condusions:This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.

BACKGROUND: A tooth can be led to lose viability, split easily and miss immune defensive response by pulpitis and pulp necrosis. Determining how to achieve dental pulp regeneration has become a research focus in dentistry. The physicochemical properties and biocompatibility of scaffold materials are crucial for proliferation and differentiation of stem cells. OBJECTIVE: To study whether a gelatin scaffold can induce dental pulp stem cells to differentiate into fibroblasts.METHODS: Gelatin scaffolds at different concentrations were prepared by electrospinning method. The surface morphology and physical properties of gelatin scaffolds were tested by using scanning electron microscope and tensile tests. The human dental pulp stem cells (hDPSCs) were seeded on the scaffolds and the cell proliferation and fibrogenic differentiation were tested using MTT and RT-PCR. RESULTS AND CONCLUSION: The fiber diameter of the 7.5% gelatin scaffold was (2.02±0.36) μm, and it was increased to (3.15±0.52) μm after cross-linking. In the 15% gelatin scaffold, fiber bonding was detected and strengthened until the emergence of flat structures after cross-linking. Both 7.5% and 15% gelatin scaffolds could promote the adhesion and growth of hDPSCs. On day 7, the cell number on the 7.5% gelatin scaffold was significantly higher than that on the 15% gelatin scaffold (P < 0.05). The levels of Collagen I, α-SMA, Periostin and Fibronectin were also higher in the 7.5% gelatin scaffold than in the 15% gelatin scaffold (P < 0.05). In conclusion, 7.5% gelatin scaffold is more beneficial to the proliferation and fibrogenic differentiation of hDPSCs.

The combination of Danggui and Honghua (GH) is a popular herb pair commonly used in clinic for the treatment of blood stasis syndrome in China. To evaluate the activating blood circulation and dissipating blood stasis effects of the combination of different proportions of Danggui and Honghua on acute blood stasis rats, and optimize the proportion of GH to have the best activating blood circulation and dissipating blood stasis effect. Acute blood stasis rat model was induced by subcutaneous injection of adrenaline and ice water bath. The blood stasis rats were administrated intragastrically with GH (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1: 2, 1 : 4 and 0 : 1) extracts. The whole blood viscosity (WBV), plasma viscosity (PV), and high shear whole blood relative index (HSWBRI), low shear whole blood relative index (LSWBRI), and erythrocyte aggregation index (EAI) were tested to observe the effects of GH on hemorheology of blood stasis rats. And the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of GH on platelet aggregation index of blood stasis rats. In addition, the prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and plasma fibrinogen (FIB) were tested to observe the effects of GH on blood coagulation function of blood stasis rats. Then principal component analysis and multi-attribute comprehensive index methods were both used to comprehensively evaluate the total activating blood circulation and dissipating blood stasis effects of GH. The results showed that the hemorheological indexes and coagulation parameters of model group both had significant differences with normal group. Compared with model group, GH (1 : 0, 4 : 1, 2: 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1) could improve all the blood hemorheology indexes and regulate part indexes of blood coagulation function and platelet aggregation in acute blood stasis rats. Based on principal component analysis and multi-attribute comprehensive index methods, GH 1 : 1 and GH 3 : 2 both had the best effect of blood circulation and dissipating blood stasis, and the effect of GH 1 : 1 was slightly better than GH 3 : 2. These results suggest that GH could obviously ameliorate the abnormality of hemorheology and blood coagulation function in acute blood stasis rats. The optimized proportion of GH was consistent with regulations of medicine usage that GH 1 : 1 had the highest frequency used in traditional Chinese formulae. It could provide scientific basis for more effective application of the compatibility between Danggui and Honghua in modern clinic medicine.
Animals ; Blood Coagulation ; Blood Viscosity ; Carthamus tinctorius ; China ; Drugs, Chinese Herbal ; pharmacology ; Erythrocyte Aggregation ; Hemorheology ; Partial Thromboplastin Time ; Platelet Aggregation ; Principal Component Analysis ; Prothrombin Time ; Rats ; Rats, Sprague-Dawley ; Thrombin Time

Research on polymer impurities has always been important in the quality control of cephalosporins. Research on polymers in cephalosporins that lack active amino groups on the C-7 side chain has not been reported. Therefore, our study used cefazolin sodium, which is widely used in the clinic, as an example. The polymer in cefazolin sodium and its product "cefazolin sodium pentahydrate for injection" was analyzed by column switching liquid chromatography-high resolution mass spectrometry. Two polymer impurity peaks were detected and the possible structures of these polymers were suggested. Through two-dimensional liquid chromatography, the chromatographic peaks following Sephadex gel chromatography and high-performance gel chromatography were compared to those obtained by reverse high-performance liquid chromatography (HPLC) for cefazolin sodium as reported in the Chinese Pharmacopoeia. The HPLC method proves more suitable for polymer detection than Sephadex gel chromatography and high-performance gel chromatography. The method of polymer detection for cefazolin sodium was established using the method of related substances HPLC as described in the Chinese Pharmacopoeia.

OBJECTIVETo investigate the effects of endothelial microvesicles (EMVs) induced by calcium ionophore A23187 on H9c2 cardiomyocytes.

METHODSHuman umbilical vein endothelial cells (HUVECs) were treated with 10 micromol/L A23187 for 30 min. EMVs from HUVECs were isolated by ultracentrifugation from the conditioned culture medium. EMVs were characterized using 1 and 2 microm latex beads and anti-PE-CD144 antibody by flow cytometry. For functional research, EMVs at different concentrations were cocultured with H9c2 cardiomyocytes for 6 h. Cell viability of H9c2 cells and the activity of LDH leaked from H9c2 cells were tested by colorimetry. Moreover, apoptosis of H9c2 cells was observed through Hoechst 33258 staining and tested by FITC-Annexin V/PI double staining.

RESULTSEMVs were induced by A23187 on HUVECs, and isolated by ultracentrifugation. We identified the membrane vesicles (< 1 microm) induced by A23187 were CD144 positive. In addition, the EMVs could significantly reduce the viability of H9c2 cells, and increase LDH leakage from H9c2 cells in a dose dependent manner (P < 0.05). Condensed nuclei could be observed with the increasing concentrations of EMVs through Hoechst 33258 staining. Furthermore, increased apoptosis rates of H9c2 cells could be assessed through FITC-Annexin V/PI double staining by flow cytometry.

CONCLUSIONMicrovesicles could be released from HUVECs after induced by A23187 through calcium influx, and these EMVs exerted a pro-apoptotic effect on H9c2 cells by induction of apoptosis.

Annexin A5 ; Apoptosis ; Calcimycin ; pharmacology ; Calcium ; metabolism ; Cell Line ; Cell Membrane ; drug effects ; Coculture Techniques ; Flow Cytometry ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; Human Umbilical Vein Endothelial Cells ; Humans ; Myocytes, Cardiac ; drug effects ; Staining and Labeling

Along with progress of modern science and technology, human is utilizing natural resources and their inherent law more effectively and more efficiently according to their own purposes. Chinese medicine pair (CMP) is relatively fixed combination of two TCMs which was proven to be effective in clinical application. CMP has its inner specification, and it is an intermediate point between single herb and many TCM formulae. With the aid of modern science and technology, and by means of choosing appropriate strategies and approaches, the compatibility rules of CMP might be revealed, which will be significant to develop the compatibility theory of TCM formulae and create modern TCM new drugs.
Animals ; Clinical Trials as Topic ; Drug Interactions ; Humans ; Medicine, Chinese Traditional ; methods ; Research Design ; Systems Biology

The diagnosis, treatment, operation and diagnosis of two cases of occupational frostbite diagnosed in Shandong Academy of Occupational Healthy Occupational Medicine were analyzed retrospectively. In these two patients working in a low temperature environment, the finger frostbite did not arouse enough attention, one patient did not receive timely diagnosis and treatment, and one patient received timely medical treatment, but did not receive proper treatment, which ultimately led to the adverse consequences of finger amputation. The staff under the low temperature environment should strictly carry out the low temperature operation protection standard and improve their self-protection consciousness. If frostbite occurs, they should seek medical treatment in time, which can effectively reduce the disability rate.

Objective To explore the effect of quality nursing service implemented in the neonatal intensive care units (NICU).Methods According to the characteristics of NICU,we implemented the quality nursing service by means of perfecting rules,regulations and work process,strengthening the nurses' training,changing the way of scheduling nurses' roster and refining the basic nursing care,etc.Then the satisfaction of patients with nursing job,the improvement of nursing quality and the number of nursing malpractices was recorded before (n =1 578) and after (n =1 507) quality nursing service implementation.Results Basic nursing passing rate was 96.7％,writing passing rate was 98.0％ after quality nursing service implementation,and those before implementation were 91.1％ and 91.0％,respectively,and the differences between the two groups was significant (x2 =6.827,11.368;P ＜0.01).Other measurements index of nursing after and before quality nursing service implementation were also different (P ＜0.05).Score of environmental device was (4.71 ±0.31 ),the score of humanistic care was (4.56 ± 0.34),were higher than those before quality nursing implementation,( 3.72 ±0.69) and (3.95 ± 0.46),respectively,and the difference was significant (t =51.01,41.74; P ＜ 0.01 ).Other satisfactory scores were also different between the two group ( P ＜ 0.01 ).Number of nursing malpractices after implementation was less than that before high quality nursing implementation ( x2 =7.007,8.993,6.563 ; P ＜0.05).Conclusions The implementation of quality nursing service in NICU can improve the quality of nursing,raise the relative's satisfaction with nursing job and reduce the number of nursing malpractices.Therefore,It's feasible to implement quality nursing service in NICU.

Objective To investigate the capabilities of neonatal nurses in the military hospitals,so as to provide a reference for training neonatal specialized nurses.Methods Totals of 217 neonatal nurses were investigated with" neonatal wards and/or NICU nurses status questionnaire in military hospital in 2013" designed by Nursing Council affiliated to Military Pediatrics Association.Results The mean score of the dimensions of basic skills was (1.98 ± 0.01),while specialized skills was (1.52 ± 0.07),arranged in ascending order as follows:nursing of ECMO,CRRT,peritoneal dialysis,reflux enema,Invasive parameters monitoring,NO inhalation,stoma care,PICC placement and maintenance,Invasive mechanical ventilation,TPN preparation.Conclusions The basic skills of neonatal nurses is at the upper-middle level,but specialized skills of neonatal nurses should be improved.It is necessary to establish a training centre for systematic specialized neonatal nurse training as soon as possible,in order to improve neonatal nurses' overall core capabilities in the military hospitals.

OBJECTIVETo investigate the effects of microvesicles (MVs) derived from hypoxia/reoxygenation (H/R)-treated human umbilical vein endothelial cells (HUVECs) on endothelium-dependent relaxation of rat thoracic aortic rings.

METHODSH/R injury model was established to induce HUVECs to release H/R-EMVs. H/R-EMVs from HUVECs were isolated by ultracentrifugation from the conditioned culture medium. H/R-EMVs were characterized using 1 μm latex beads and anti-PE-CD144 by flow cytometry. Thoracic aortic rings of rats were incubated with 2.5, 5, 10, 20 μg/ml H/R-EMVs derived from H/R-treated HUVECs for 4 hours, and their endothelium-dependent relaxation in response to acetylcholine (ACh) or endothelium-independent relaxation in response to sodium nitroprusside (SNP) was recorded in vitro. The nitric oxide (NO) production of ACh-treated thoracic aortic rings of rats was measured using Griess reagent. The expression of endothelial NO synthase (eNOS) and phosphorylated eNOS (p-eNOS, Ser-1177) in the thoracic aortic rings of rats was detected by Western blotting. Furthermore, the levels of SOD and MDA in H/R-EMVs-treated thoracic aortic rings of rats were measured using SOD and MDA kit.

RESULTSH/R-EMVs were induced by H/R-treated HUVECs and isolated by ultracentrifugation. The membrane vesicles (< 1 μm) induced by H/R were CD144 positive. ACh-induced relaxation and NO production of rat thoracic aortic rings were impaired by H/R-EMVs treatment in a concentration-dependent manner (P < 0.05, P < 0.01). The expression of total eNOS (t-eNOS) was not affected by H/R-EMVs. However, the expression of p-eNOS decreased after treated with H/R-EMVs. The activity of SOD decreased and the level of MDA increased in H/R-EMVs treated rat thoracic aortic rings (P < 0.01).

CONCLUSIONACh induced endothelium-dependent relaxation of thoracic aortic rings of rats was impaired by H/R-EMVs in a concentration-dependent manner. The mechanisms included a decrease in NO production, p-eNOS expression and an increase in oxidative stress.

Acetylcholine ; pharmacology ; Animals ; Aorta, Thoracic ; physiology ; Cell Hypoxia ; Endothelium, Vascular ; physiology ; Human Umbilical Vein Endothelial Cells ; cytology ; Humans ; In Vitro Techniques ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Nitroprusside ; pharmacology ; Oxidative Stress ; Rats