BACKGROUND: As seed cells, human umbilical cord mesenchymal stem cells have many advantages, such as a broad array of sources, easy access, low immunogenicity, osteogenic differentiation potential, high proliferation and self-renewal ability. In recent years, there are more and more reports about their application for bone tissue engineering. OBJECTIVE: To summarize isolation, culture, osteogenic induction and scaffolds. METHODS: The first author searched CNKI and PubMed databases with key words of “human umbilical cord mesenchymal stem cells, isolation, culture, osteogenic differentiation, scaffold, bone tissue engineering” in both Chinese and English, so as to review the relevant literature from 2004 to 2020. Finally, 104 articles were included. RESULTS AND CONCLUSION: There are different methods of isolation and culture of umbilical cord mesenchymal stem cells. Serum-free or animal serum substitute culture system and co-culture technique have made great progress, and three-dimensional culture system will be the development direction in the future. The exact mechanisms of osteogenic differentiation of umbilical cord mesenchymal stem cells are unclear, which need further elucidation. To date, it is still the focus of researchers to develop composite scaffolds with better properties. Bio-printing technology has primarily solve the difficult problem of controlling precisely the complex inner structure of the scaffolds at the micron scale and fabricating individual scaffolds, bringing great hope for bone tissue engineering. The design and fabrication of scaffolds with multiple ideal compositions (including biocompatibility, high porosity at the micro and macro level, mechanical properties, related absorption and so on) and the less clinical side effects remain one of the key challenges in bone tissue engineering.

Objective To research the incidence and etiological factors of intraocular pressure(IOP)elevation in patients in early and late postop?erative stages after vitrectomy. Methods The clinical data of 235 cases(306 eyes)who underwent vitrectomy in our hospital were respectively ana?lyzed. IOP was measured before operation,in the early postoperative stage(within 2 weeks)and in the late postoperative stage(6 months after opera?tion or longer)by non?contact tonometer. Risk factors related with ocular hypertension happened in the early and late postoperative stages were statis?tically analyzed. Results The mean average IOP before operation was 15.3 ± 4.1 mmHg for the 306 eyes. Within the follow?up period of 6?20 months(mean,14.3 months),ocular hypertension occurred in 42 eyes[incidence,13.7%;mean,31.9 ± 6.0 mmHg]in the early postoperative stage and in 12 eyes[incidence,3.9%;mean,32.1 ± 5.7 mmHg]in the late postoperative stage. Logistic regression analysis revealed that lensecto?my,scleral buckling,cyclophotocoagulation,inert gas filling,silicone oil tamponade and diabetic retinopathy were the independent risk factors of oc?ular hypertension in early postoperative stage after vitrectomy,while lensectomy,scleral buckling,pan retinal photocoagulation,silicone oil tampon?ade,diabetic retinopathy and carotid artery stenosis were the independent risk factors of ocular hypertension in late postoperative stage after vitrecto?my. In addition,cyclophotocoagulation was a protective factor of IOP in the late postoperative stage. Conclusion The risk factors of ocular hyperten?sion after vitrectomy include the intraocular gapfiller,the mode of combined operation,disease type and carotid artery stenosis. IOP elevation that happens in the late postoperative stage is more harmful. Ocular hypertension in the late postoperative stage is not associated with that in the early stage.

Objective To observe the effect of Allicin on renal tissue fibrosis in chronic renal failure (CRF) and to study the protective mechanism of Allicin on CRF rats. Methods The CRF rat models were established by intragastric administration of adenine solution (250 mg/kg) for 21 days. After successful modeling, 80 model rats were randomly divided into the normal control group, the model group and the allicin low, medium and high dose groups using a random number table method (n=20). Allicin low-, medium-, and high-dose groups were intragastrically administered with 2.5, 5, and 10 mg/ml of allicin respectively. The model group and normal control group were given an equal volume of normal saline, and were administered at 2 ml/kg body weight of the rats, with once a day continuous administration for 28 d. Two hours after the last dose, the kidney mass was measured and the kidney index was calculated. The pathological changes of renal tissue was observed by HE staining; the serum BUN, SCr, uric acid, and 24-hour urinary protein levels were measured by a biochemical analyzer; the levels of CRP, IL-6 and TNF-α in serum and the levels of ollagen type Ⅳ(CⅣ), type Ⅲ procollagen (PCⅢ), laminin (LN), Fibronectin (FN) in plasma were by ELISA; the expression of collagen type Ⅰ (Col Ⅰ), plasminogen activator inhibitor-1 (PAI-1) and MMP-1 were observed by mmunohistochemical staining. Results Compared with model group, the bodyweight of rats in allicin medium, high dose groups were increased and kidney index decreased (P＜0.05 or P＜0.01), kidney histopathology scores decreased (P＜0.01). Compared with model group, the level of BUN (14.51 ± 2.76 mmol/L, 11.48 ± 2.43 mmol/L vs. 24.07 ± 3.82 mmol/L), SCr (116.28 ± 27.35 μmol/L, 106.57 ± 24.18 μmol/L vs. 134.89 ± 35.02 μmol/L), Uric acid (83.34 ± 16.42 mmol/L, 77.86 ± 13.97 mmol/L vs. 114.76 ± 16.53 mmol/L), 24 h urinary protein (152.79 ± 48.43 mg, 137.03 ± 42.61 mg vs. 177.94 ± 96.47 mg), CRP (8.79 ± 1.84 mg/L, 7.51 ± 1.69 mg/L vs. 11.64 ± 1.95 mg/L), TNF-α (184.37 ± 24.15 ng/L, 126.82 ± 12.96 ng/L vs. 255.87 ± 31.93 ng/L) in the allicin medium and high dose groups were significantly decreased (P＜0.05 or P＜0.01); the levels of C-Ⅳ (40.26 ± 7.12 ng/ml, 23.79 ± 4.25 ng/ml vs. 67.53 ± 8.39 ng/ml), PC-Ⅲ (32.03 ± 5.89 ng/ml, 24.31 ± 5.84 ng/ml vs. 54.20 ± 7.08 ng/ml), LN (99.05 ± 38.17 ng/ml, 83.42 ± 28.83 ng/ml vs. 117.83 ± 35.76 ng/ml) in plasma in the allicin medium and high dose groups were significantly decreased and the level of FN (98.58 ± 21.43 mg/L, 125.96 ± 25.12 mg/L vs. 66.72 ± 13.09 mg/L) in plasma in the allicin medium and high dose groups were significantly increased (P＜0.05 or P＜0.01); the expression of Col Ⅰ (0.17 ± 0.03, 0.09 ± 0.03 vs. 0.27 ± 0.05), PAI-1 (0.20 ± 0.05, 0.16 ± 0.04 vs. 0.31 ± 0.08) were down-regulated and the expression of MMP-1 (0.10 ± 0.03, 0.22 ± 0.05 vs. 0.04 ± 0.02) were up-regulated (P＜0.05 or P＜0.01). Conclusion Allicin has protective effects on CRF rats by inhibiting the renal tissue fibrosis and alleviating inflammation.

Objective:To analyze the value of dual energy CT parameters combined with serum procollagen Ⅰ N-terminal propeptide (PⅠNP) and beta C-terminal cross-linked telopeptide of type Ⅰ collagen (β-CTX) in differential diagnosis of spinal bone metastasis from lung cancer and myeloma.Methods:The clinical data of 54 patients with spinal bone metastasis from lung cancer and 50 patients with myeloma in Jincheng People′s Hospital from October 2019 to March 2021 were analyzed retrospectively. All patients were examined by dual energy CT on the day of admission, and the CT values at the energy levels of 40 to 80 keV (energy interval of 10 keV) were recorded. The serum PⅠNP and β-CTX levels were detected by chemiluminescent assay before treatment. The pathological examination results were taken as gold standard, and the CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels were compared between 2 groups. Receiver operating characteristic (ROC) curve was used to analyze the differential diagnosis value of the CT values at the energy levels of 40 to 80 keV, serum PⅠNP and β-CTX levels alone and combination.Results:The CT values at the energy levels of 40 to 80 keV by dual energy CT and serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer were significantly higher than those in patients with myeloma: 79.86 (61.20, 116.32) HU vs. 58.29 (46.92, 64.03) HU, 64.48 (50.27, 90.08) HU vs. 45.78 (38.59, 56.75) HU, 57.35 (43.31, 78.04) HU vs. 43.62 (36.91, 54.06) HU, 52.05 (42.98, 75.79) HU vs. 41.26 (32.84, 51.76) HU, 45.52 (38.55, 63.59) HU vs. 36.68 (28.72, 49.83) HU, 66.35 (31.15, 81.97) μg/L vs. 31.38 (27.76, 34.50) μg/L and 0.61 (0.48, 0.67) μg/L vs. 0.49 (0.47, 0.52) μg/L, and there were statistical differences ( P<0.05 or <0.01). ROC curve analysis result showed that the sensitivity of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT was higher than those alone (83.33% vs. 59.26%, 61.11%, 62.96%, 64.81% and 66.67), the area under the curve (AUC) was also higher than those alone (0.882 vs. 0.798, 0.811, 0.817, 0.801 and 0.773), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of the combination of serum PⅠNP and β-CTX levels was higher than those alone (81.48% vs. 57.41% and 62.96%), the AUC was higher than those alone (0.829 vs. 0.753 and 0.729), and there were statistical differences ( P<0.01 or <0.05); the sensitivity of all indexes combined in the differential diagnosis of spinal bone metastasis from lung cancer and myeloma was higher than those of the combination of the CT values at the energy levels of 40 to 80 keV by dual energy CT, the combination of serum PⅠNP and β-CTX levels (98.15% vs. 83.33% and 81.48%), the same as AUC (0.976 vs. 0.882 and 0.829), and there were statistical differences ( P<0.01); there were no significant differences in the specificity of each index alone and combination ( P>0.05). Conclusions:Compared with myeloma, the CT values at the energy levels of 40 to 80 keV by dual energy CT, serum PⅠNP and β-CTX levels in patients with spinal bone metastasis from lung cancer are increased, and the combination of the above indexes has ideal value in differential diagnosis of the two diseases.

Objective:To investigate the clinical characteristics of pregnant women with leukemia, the condition of leukemia and the influence of clinical treatment on maternal and infant outcomes, and to explore the best clinical management method of leukemia in pregnancy.Methods:Among 79 890 pregnant and lying-in women in Qilu Hospital of Shandong University from January 2004 to December 2015, 22 cases (0.028%) were with leukemia, including 5 cases of leukemia diagnosed before pregnancy [all acute myeloid leukemia (AML)] and 17 cases of leukemia diagnosed for the first time after pregnancy [9 cases of AML, 5 cases of chronic myeloid leukemia (CML), 2 cases of acute lymphoblastic leukemia (ALL), and 1 case of chronic lymphocytic leukemia (CLL)]. According to the gestational weeks of admission and confirmed gestational weeks of leukemia, the 22 patients were divided into early-stage group (initial gestational week < 14 weeks, 5 cases), mid-stage group (newly diagnosed gestational week ≥ 14 weeks and < 28 weeks, 11 cases), and late-stage group (newly diagnosed gestational week ≥ 28 weeks, 6 cases, including 2 cases with previous diagnosis of leukemia). The final pregnancy outcomes included abortion, induced labor, premature delivery, full-term delivery and maternal and infant death. The effects of clinical treatment and obstetric treatment of leukemia on the final maternal and infant outcomes, follow-up to understand the progress of primary disease and fertility of pregnant women, and the impact of leukemia and pregnancy treatment on long-term health status of infants were analyzed.Results:Among 22 patients with leukemia in pregnancy, 14 cases (63.6%) (5 cases in early-stage group and 9 cases in mid-stage group) choosed to give up pregnancy, including 4 cases of early pregnancy abortion and 10 cases of mid pregnancy induced abortion; 12 cases of 14 cases were induced abortion or induced labor after leukemia remission induced by advanced chemotherapy. The remaining 8 patients (2 cases in mid-stage group and 6 cases in late-stage group) continued pregnancy and gave birth to live infants, of which 3 cases received chemotherapy before delivery.Conclusions:Gestational leukemia is a high-risk obstetric case, but it is still expected to achieve good pregnancy outcome under good management and treatment. On the basis of following the principles of leukemia treatment, according to the gestational weeks and patients' wishes, the individualized clinical management plan is formulated, and the accurate chemotherapy timing is conducive to the prognosis of mother and infant.

Objective Designed a method that can automaticaly distinguish the X-ray radiological positions based on image information.Methods For any selected input clinical X-ray digital images, we extract the image outline in the edge detection method using optimal threshold selection, then process binarization. After compared with the whole body phantom X-ray images, then process gray level similarity traverse detection.Results By optimizing the decision, the best matching region of the same inputfi lm was obtained, and the imaging part of the patient is determined based on prior knowledge.Conclusion The algorithm is fast and has a high degree of robust.

Objective:To investigate the impacts of galangin(Gal)on the immune inflammatory response in preeclampsia(PE)rats by regulating the IL-6/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods:Pregnant rats were injected subcutaneously with L-arginine methyl ester(L-NAME 125 mg/kg)to establish a PE model.After successful modeling,they were randomly grouped into Model group,low,medium and high doses Gal groups(10,30,and 60 mg/kg)and activator group(60 mg/kg Gal+0.05 mg/kg IL-6/STAT3 pathway activator rIL-6).Twelve pregnant rats of the same period were randomly selected as the control group,and each group was given corresponding drugs by gavage and intraperitoneal injection,once a day for a continuous week.The levels of mean caudal artery pressure(MAP)and 24-hour urinary protein and blood urea nitrogen(BUN)in rats during the third trimester of pregnancy were measured using a blood pressure tester and a fully automated biochemical analyzer;the number and weight of the average offspring of pregnant mice in each group were calculated,and the pregnancy outcome was analyzed;HE staining was applied to observe the pathological damage of rat placenta;ELISA was applied to detect the levels of IL-6,IL-1β and TNF-α in the placenta of rats in each group;the proportion of T lymphocytes in rat peripheral blood was detected by flow cytometry;Western blot was applied to detect the expression of IL-6/STAT3 pathway protein in rat placenta.Results:Compared with control group,the lev-els of MAP,24-hour urinary protein,BUN,IL-6,IL-1β,TNF-α,the CD8+T cells,and the expression levels of IL-6 and p-STAT3/STAT3 proteins in Model group were obviously increased,the placenta tissue was severely damaged,the mean offspring number and mean offspring weight,the proportions of CD3+T,CD4+T,and CD4+/CD8+T cells were decreased(P<0.05);compared with Model group,the levels of MAP,24-hour urinary protein,BUN,IL-6,IL-1β,TNF-α,the CD8+T cells,and the expression levels of IL-6 and p-STAT3/STAT3 proteins in Gal low,medium and high doses groups were obviously decreased,the damage to placental tissue was reduced,the mean offspring number and mean offspring weight,the proportions of CD3+T,CD4+T,and CD4+/CD8+T cells were in-creased(P<0.05);compared with Gal high-dose group,the levels of MAP,24-hour urinary protein,BUN,IL-6,IL-1β,TNF-α,the CD8+T cells,and the expression levels of IL-6 and p-STAT3/STAT3 proteins in activator group were obviously increased,the placenta tissue was aggravated,the mean offspring number and mean offspring weight,the proportions of CD3+T,CD4+T and CD4+/CD8+T cells were decreased(P<0.05).Conclusion:Gal may play a role in alleviating PE symptoms and improving pregnancy outcomes by inhibit-ing the IL-6/STAT3 pathway,inhibiting inflammatory reactions,and regulating cellular immunity.

Objective:To explore application of mixed teaching platform in the clinical practice teaching of the laboratory medicine in Children's hospitals.Methods:We constructed a mixed online and offline teaching platform based on the Laboratory Quality Management System (LQMS) in the Children's Hospital of Chongqing Medical University. The undergraduates from Batch 2016 ( n=15) and Batch 2018 ( n=12) of College of Laboratory Medicine of Chongqing Medical University were taken as control group and experimental group respectively. Traditional teaching method was adopted by the control group, and the mixed teaching method was adopted by the experimental group. The results of two groups' clinical practice assessment, rate of outstanding students (total score ≥ 90) and rate of satisfaction (score ≥ 90) were compared to evaluate the teaching effect. SPSS 17.0 was used to conduct t-test and Chi-square test. Results:The database of teaching platform includes 68 teaching cases, 198 pieces of courseware, 305 clinical cases and 3 036 atlases. The test bank has accumulated 4 657 tests, covering clinical laboratory, immunology, biochemistry, microbiology and blood transfusion. The results of students in experimental group were significantly better than those of the control group [the score of clinical practice assessment: (85.90±5.04) vs. (78.90±6.75)( P<0.05); rate of outstanding students: 33.3% (4/12) vs. 6.7% (1/15), P>0.05; rate of satisfaction: 86.7% (13/15) vs. 100.0% (12/12) ( P>0.05). Conclusion:The mixed online and offline teaching platform based on the LQMS is highly recognized by students and can significantly improve the effect of clinical practice teaching, which can provide typical medical case teaching at any time and make up for limited case type in children's hospital.

Objective This study aimed to evaluate the prognostic value of regional lymph node spread in patients with stage Ⅱ nasal-type NK/T-cell lymphoma of the upper aerodigestive tract (UADT-NKTCL).Methods From 1987 to 2013,a total of 97 patients with newly-diagnosed stage Ⅱ UADT-NKTCL were retrospectively reviewed.Primary tumors were located in the nasal cavity (n=52) or extranasal UADT sites (n=45).The majority of patients were treated with primary radiotherapy.Sixty-five patients were treated with combined modality therapy (CMT),and 32 patients were treated with radiotherapy alone (n=27) or chemotherapy alone (n=5).The Kaplan-Meier method was used to calculate the survival rate,and the log-rank test was used for survival difference analysis and monovariate prognostic analysis.The Cox regression model was used to multivariate prognostic analysis.Results The 5-year overall survival (OS) and progression-free survival (PFS) rates for all stage Ⅱ patients were 57% and 49%,respectively.The presence of a lower neck lymph node (defined as extension below the caudal border of the cricoid cartilage) was significantly associated with poor outcomes on univariate analysis and maintained significance on multivariate analysis.The median survival for patients with lower neck lymph node was 19.3 months and the 2-,5-years OS rates were 28% and 11%(P=0.000).For stage Ⅱ patients,CMT significantly improved survival.The 5-year OS and PFS rates were 64% and 52% for CMT,compared with 40.4%(P=0.006) and 42% for single modality therapy (P=0.088).Conclusion The level of regional lymph node is a powerful prognostic factor for stage Ⅱ UADT-NKTCL.The involvement of low neck lymph node is significantly associated with poorer survival outcomes.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.