Objective To study the change of the structural and biological properties of the cardiovascular tissue after cell extracting. Methods The native and treated pulmonary cusp and pulmonary artery wall were evaluated by HE stain, ETVG stain, immunochemistry stain and scan electron microscopy. The contents of the main macro-molecules were measured. The content and position of calcium was investigated by subcutaneous implantation in a rat model. Results The acellularization procedure resulted in an almost complete removal of the original cells while the construction of the matrix remained. The contents of colleagen and elastin increased while soluble GAG reduced. The content of calcium in acellular tissue by xenogenic implantation was less obviously than that in fresh one. Conclusion A suitable acellularization procedure can remove all cells and most soluble proteins, and matrix remains nearly intact, so as to alleviate obviously calcification via xenogenic implantation in vivo.

Objective To investigate the effect of estrogen replacement therapy applied in different periods to ovariectomized rats and to evaluate the cognitive function of the rats.Methods Totally 40 rats were ovariectomized to be postmenopausal models.They were divided into early hormone replacement therapy group (n =10,managed by estradiol valerate at day 3 after surgery),early control group (n =10,managed by saline at day 3 after surgery),late hormone replacement therapy (n =10,managed by estradiol valerate at day 90 after surgery for 30 days) and late control group (n =10,managed by saline at day 90 after surgery for 30 days).The behavior indicators of the rats were evaluated by Morris watermaze and hippocampal metabolite was detected by proton magnetic resonance spectroscopy,including N-acetylaspartate (NAA),choline containing compounds (Cho),creatine(Cr),myoinositol (mI),NAA/Cr,Cho/Cr and mI/Cr.Results (1) Navigation test: escape latency were (43 ± 13) s at the early control group,(28 ± 9) s at the early HRT group,(82 ±26) s at the late control group and (48 ± 18) s at late HRT group.Swimming distance were (1 404 ± 238) cm at the early control group,(878 ± 354) cm at the early HRT group,(2411 ±818) cm at the late control group and (1 310 ±434) cm at the late HRT group.The escape latency and swimming distance of the early and late HRT groups were significantly shorter than those at the control groups (P ＜ 0.05).(2) Spatial probe test: the swimming time in the target quadrant of rats in the early HRT group (34.0 ± 3.0) s were longer than those in other groups (P ＜ 0.05).(3) Proton magnetic resonance spectroscopy: NAA/Cr were 1.12 ±0.17 at the early control group,1.26 ±0.12 at the early HRT group,1.57 ±0.21 at the late control group and 1.38 ±0.28 at the late HRT group.The late HRT group and the late control group were higher than their early groups (F =6.05,P =0.040).There was no significant difference between the HRT groups and the control groups (F =0.04,P =0.860).mI/Cr were 0.69 ±0.04 at the early control group,0.46 ±0.12 at the early HRT group,0.70 ±0.03 at the late control group and 0.75 ± 0.08 at the late HRT group.There were statistically significant differences of the experimental time between the early and late groups(F =16.45,P =0.004).The differences between the early HRT group and the early control group,and the late HRT group and the late control group were significant(F =6.01,P =0.040).And there was an interaction with the experimental time and HRT measures (F =13.79,P =0.006) ; early HRT can reduce the average level of mI/Cr.Cho/Cr were 0.95 ± 0.09 at the early control group,0.80 ±0.12 at the early HRT group,0.87 ±0.09 at the late control group and 0.85 ± 0.12 at the late HRT group.There was no significant difference among those groups (P ＞0.05).NAA/mI: there was an interaction with the experimental time and HRT measures (F =12.95,P =0.007).Early HRT can elevated levels of NAA/mI,while the late results were reversed.Conclusion Earlier estrogen replacement therapy may play a positive role in improving cognitive function of the ovariectomized rats.

Since Shaw et al,first reported the first case successfully treated by veno-venous bypass (VVB),there has been great controversy on the routine application of VVB during conventional liver transplantation and piggyback liver transplantation in recent decades.With the improvements on the surgical skills,surgical techniques and anesthesiology,only a small portion of patients have the indications for VVB in liver transplantation routinely.This article reviews the current publications in this topic,which may provide new insight into the liver transplantation in clinical practice.

Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

Objective: To explore the influence of awareness on the behaviors of Chinese adults with diabetes mellitus, so as to provide scientific evidence for developing relevant policies and strategies in the prevention and control of diabetes.Methods: Data from the 2013 China Chronic Disease Risk Factor Surveillance were used, covering 297 surveillance counties (districts).The variables involved in this cross-sectional study included: the prevalence of diabetes, the awareness situation, demographic characteristics, behaviors, and other information.The study used descriptive analysis to analyze diabetes status and chi-square test to determine the difference in the distribution of behaviors between patients who were aware of their disease and those who were not.Logistic analysis was performed to examine the influence of diabetes awareness on patients' behaviors with adjustment for potential confounders.Results: A total of 175 670 subjects were involved.The prevalence of self-reported diabetes in China in 2013 was 3.9%, while the awareness rate was 38.6%.The percentage of current smokers or current drinkers among the patients who were aware of their disease (20.2%, 25.0%) was less than that among the patients who were not aware (25.8%, 35.0%).The proportion of those who often exercised among the patients who were aware of their disease (83.4%) was higher than that among the patients who were not aware (79.0%).There was slightly higher proportion of the subjects who had insufficient intake of vegetables and fruits or over intake of red meat among the patients who were aware of their disease (49.4%, 28.0%) than that among the patients who were not aware (48.4%, 26.1%).After controlling urban and rural areas, regions, age, gender, nationality, marital status, educational level, occupation, and income factors, the possibility of current smoking (OR=0.79) or drinking (OR=0.58) among the patients who were aware of their disease was lower than among those who were not;the possibility of more than 150-minute physical activity per week (OR=1.30) among the patients who were aware of their disease was higher than among those who were not.Conclusion: The awareness rate of diabetes in China still remains low.Kno-wing whether they have diabetes or not has an effect on individual choice of behaviors, including smoking, drinking and physical activities.Therefore, health education and health examination for diabetes should be further expanded with wide cooperation from all relevant departments, thus forming an integrated environment involving individuals, health systems and socioeconomic policies to prevent and control diabetes.

Objective To study the relationship between extracellular signal-regulated kinases（ERK）phosphorylation and indirect activa-tion of the epidermal growth factor receptor（EGFR）in cultured cerebellar granule neurons induced by homocysteine.Methods We pri-marily cultured 7-day-old CD-1 mouse cerebellar granule neurons for 7 days and treated with different agents（saline,AG1478,Hcy and AG1478＋Hcy）.The phosphorylation of ERK was analyzed by Western blot,and apoptotic rate by flow cytometry.Results Compared with saline and AG1478 groups,the phosphorylation of ERK was increased in Hcy group（P 〈 0.05）.When we pretreated the cells with tyr-phostin AG1478,an inhibitor of EGFR,there was no difference in the activation of ERK compared with the control group.We found obvious neuronal apoptosis when 7-day-old CD-1 mouse cerebellar granule neurons were cultured for 7 days and treated with Hcy for 6 hours,and the apoptosis induced by Hcy was aggravated when the neurons were pretreated with AG1478（P 〈 0.05）.No apoptosis was found in the saline and AG1478 groups.Conclusion The role of Hcy on ERK activation suggests the involvement of an indirect activation process of EGFR,which has neural potentially protective effect.

Objective According to the characteristics of skin defects in ankle and foot select the posterior lateral leg pedide skin flaps supplyed by different blood to repair,providing advice and reference.Methods Between January,2001 and December,2015,163 cases of soft tissue defects at the foot and ankle were treated in our department.①The sural neurovascular flap was used in 93 cases in ankle and foot defect.②The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery in 36 cases in ankle and foot defect.③The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery including sensory reconstruction in 16 cases in heel rejion defect.④Peroneal artery perforator flap in 10 cases in anterior ankle,lateral malleolus and posterior malleolus defect.⑤The use of the sural fasciocutaneous flap alonged with peroneal artery and perforators in 8 cases in dorsal foot defect.The donor site with skin graft.Results Of the 93 sural neurovascular flaps,8 had partial loss,which were cured after dressing.All the sural nerve nutritional vessel flaps pediele with the perforating branch of the peroneal artery survived.Sensory grading standard by UK Medical Research Council was used to evaluate the recovery of sensory function on the last follow-up.The sensory function recovery of heel region flaps with reconstruction of the sensory was between S0 and S1.All peroneal artery perforator flaps survived.One of the sural fasciocutaneous flap alonged with peroneal artery and perforators occurred distal epidermis,which were cured after dressing.All patients were followed up 6-50 months (mean 20 months).All patients had recoveryed walking function,and infection wound had no recurrence after surgery.Conclusion According to the location,size,severity and the injury of peripheral vascular,select the most simple,safe,minimal damage flap for the soft tissue defects at the foot and ankle.The right choice and the exact design can improve flap survival rate,and recieve good clinical results.

This study was aimed to establish the TLC identification method of Radix Mirab ilis himalaic a. The β-sitosterol and daucosterol were used as the reference substances. The single-factor test was used. A variety of factors which affected TLC were systematically investigated to filter out the best TLC conditions for identification of different batches of medicines. The results showed that the best TLC conditions were as follows: silica gel G plates, extraction solvent (methanol), reagent (5% sulfuric acid in ethanol), extraction method (ultrasonic extraction with methanol), ex-tracted time (30 min), the agent (petroleum ether-ethyl acetate-acetone (5:2:1)) and sample volume (6 μL). It was concluded that the method, which had high separation degree, was reproducible and simple. It can be used as the quality control of Radix Mirab ilis himalaic a.

Objective To compare differences and similarities of the content of trigonelline in Himalaica mirabilis of either wild or cultivated materials from different places. Methods An HPLC method was established to determine the content of trigonelline in Himalaica mirabilis. ZORBAX XDB-CN column (4.6 mm×250 mm, 5 μm) was used, with mobile phase of acetonitrile-0.03%acetic acid (85∶15), flow rate of 0.8 mL/min, detection wavelength of 265 nm, determination wavelength of 360 nm, and column temperature of 30 ℃. Results Regression calculation was made on peak area with the reference solution concentration, and then got the regression equation A=23.409C-26.398, r=0.999 8. Trigonelline showed good linear relation with peak area among the range of 2.004-200.400 μg/mL. The average recovery of trigonelline was 99.57%, RSD=1.11%. Conclusion There was no significant difference in the content of trigonelline of either wild or cultivated materials from different places. This study laid the foundation of application of the cultivated Himalaica mirabilis.

Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.