ABSTRACT:Objective To investigate the bone marrow stem cell mobilization and homing changes of peripheral blood due to diabetic myocardial ischemia in rats and the change of expression of the vascular endothelial growth factor (VEGF)and the tumor necrosis factorα(TNFα)in ischemic myocardial tissue.Methods The diabetic model of male Sprague-Dawley rats was created by intraperitoneal injection of streptozotocin first.Then the diabetic myocardial ischemia model was established through ligation of the left anterior descending coronary artery. The rats were divided into ischemic day-1,day-3,day-7,and day-28 groups.And their time-matching diabetic sham operation control group and normal sham operation control group were also established,with 6 rats in each group. Flow cytometry was used to measure the percentage of CD34+ cells in peripheral blood mononuclear cells for each group.Immunohistochemistry was used to observe the homing of CD34+ cells and the expression of VEGF and TNFαin the ischemic myocardium.Results The mobilization of bone marrow stem cells was initiated after the surgery in the rat models of myocardial ischemia in diabetes and it peaked within 1 week and decreased with the passage of time.Accordingly the homing of CD34+ cells and the expressions of VEGF and TNFαin the ischemic myocardium were significantly increased.Conclusion During the early stage,the diabetic ischemic myocardium can mobilize bone marrow stem cells into the peripheral blood and start homing to the ischemic myocardium by increasing VEGF and TNFαin the ischemic myocardium,thereby initiating the self-protection mechanisms.

Objective:To investigate the changes of ultrastructure of myocardial cells and the expression levels of tumor necrosis factor α(TNF-α) in myocardium tissue of the diabetic rabbits during early myocardial ischemia and their mechanisms,and to provide the theoretical basis for studying the pathogenesis of diabetic myocardial ischemia injury.Methods:A total of 42 healthy male New Zealand white rabbits were chosen.The method of intravenous injection of alloxan in ear vein was used to establish the diabetic models in 26 rabbits among 42 rabbits;the method of partial ligation of left anterior descending coronary artery by thoracotomy was used to establish the diabetic myocardial ischemia models in 22 model rabbits with diabetes.A total of 16 (modeling succesfully) were divided into diabetic myocardial ischemia 7 d group and 28 d group;other 16 rabbits were used as sham operation groups at the relevant time points(7 and 28 d),and there were 8 rabbits in each group.The ultrastructure of myocardial cells was observed by transmission electron microscope;the apoptosis index (AI) of myocardial cells in ischemic myocardium tissue of the rabbits was detected by TUNEL method;the expression levels of TNF-α in ischemic myocardium tissue of the rabbits were detected by real-time RT-PCR method.Results:In sham operation groups,the nuclei of myocardial cells was bigger,the nuclear chromatin was in uniform distribution,the myofibril ordered arrangement,the sarcomere was neat;the mitochondria between myofibril were rich,and their structures were clear.For the rabbits in diabetic myocardial ischemia group,their early-stage cardiocyte nuclei were irregular in shape,myofibrils was loose in structure,the part of myofibril was broken,and the mitochondrial hyperplasia between the myocardial cells was obvious.Compared with sham operation groups,the AI of myocardial cells and the expression levels of TNF-α in the ischemic myocardial cells of the rabbits in diabetic myocardial ischemia 7 d and 28 d groups were significantly increased(P<0.05),and the indexes mentioned above in diabetic myocardial ischemia 7 d group was higher than those in diabetic myocardial ischemia 28 d group(P<0.05).Conclusion:The destruction of ultrasturctue and obvious apoptosis of the myocardial cells of the rabbits occur in the early stage of diabetic myocardial ischemia.The increasing of expression level of TNF-α may involve in the myocardial ischemic injury.

Objective To investigate the protective effects and mechanisms of granulocyte-colony-stimulating factor (G-CSF)on a rabbit model of chronic myocardial ischemia.Methods Myocardial ischemia models were created by partial ligation of the left anterior descending coronary artery in Japanese white male rabbits.Rabbits were subcutaneously injected with G-CSF (G-CSF group)or saline (control group)for 6 days after myocardial ischemia.The percentage of CD34-positive cells in the peripheral blood was evaluated by flow cytometry,and CD34-positive cells homing and vWF expression in the ischemic myocardium were determined by immunohistochemistry.Results Rabbits in G-CSF group had a higher survival rate than those in control group (P <0.05).Immunohistochemistry of the ischemic myocardium showed that compared with control group,G-CSF group had increased homing of CD34-positive cells on day 7 post-surgery,and more vessels on day 28 post-surgery by anti-von Willebrand factor staining.In addition,we observed an increase in the percentage of CD34-positive cells in the peripheral blood in G-CSF group.Conclusion G-CSF produces an obvious protective effect against chronic myocardial ischemia in rabbits by increasing stem cell mobilization,homing to ischemic myocardium and accelerating neovascularization.

Objective:To investigate the effect of pioglitazone on blood pressure,blood glucose and beta cell function and the mecha- nism of oxidative stress in hypertensive patients with impaired glucose tolerance(IGT). Methods:One hundred and sixty patients were divided into two groups:pioglitazone group and control group.The levels of fasting plasma glucose(FPC),2 hours postprandial glucose(2hPG),blood pressure,Homa I3,Homa IR,blood malondiahtehyde (MDA)and superoxide dismutase before and after pioglitazone treatment were compared. Results:After pioglitazone treatment for 8 weeks,FPG,2hPG,FInS,2hPInS,GHbAlc,mean systolic and diastolic blood pressure,Homa IR and blood MDA were significantly decreased(P

Chest contusion is the soft-tissue injury disorders that the external violence directly destroys the chest wall and the soft tissues, causing chest pain, fullness, and symptoms aggravate when the chest moves. Chinese medicine showed many treatments with clinical efficacy. Therefore, Chinese medicine has been widely used in clinics. This paper was to review the research progress of Chinese medicine treatment for chest contusion.

Objective To investigate the clinical effects of Alprostadil combined with Shuxuetong treatment on patients with diabetic peripheral neuropathy,and its influence on malondialdehyde(MDA),superoxide dismutase(SOD) and total antioxidative capability(TAOC).Methods Totally 160 patients with DPN were divided into two groups: treatment group(100 cases) and control group(60 cases).The levels of blood SOD activity,serum MDA and serum TAOC were determined before and after treatment.Results The symptoms in both groups were significantly improved,but the total effective rate in treatment group was significantly better than that in control group(80.0% vs.41.7%,P

Objective To evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2～6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.

AIM To investigate the preventive effects of Shangke Huangshui Gauze (Scutellariae Radix,Coptidis Rhizoma,Phellodendri chinensis Cortex,etc.) on vascular crisis after digital replantation.METHODS Sixty-eight cases of patients with amputated digits meeting the inclusion criteria were randomly divided into observation group (36 cases with 57 fingers) and control group (32 cases with 54 fingers),the former was wet-dressed with Shangke Huangshui Gauze,the latter was bandaged with sterile dry gauze.The observation and comparison were made between the two groups on four coagulation indexes,visual analog scores (VAS),improvement of swelling degrees,the occurrence rates and survival rates of vascular crisis after operation,together with the evaluation of efficacy and adverse reaction.RESULTS In the observation group,the 7th day after operation,the prothrombin time,activated partial thromboplastin time,international normalized ratio,thrombin time and swelling improvement rate were higher than those in the control group;but the fibrinogen and postoperative 4 days' VAS pain score were lower than those in the control group.The incidence rates of vascular crisis and adverse reaction in the observation group were lower than those in the control group,and the survival rate of replanted fingers was higher than that in the control group.CONCLUSION Shangke Huangshui Gauze can prevent the occurrence of vascular crisis after digital replantation to a certain extent without obvious adverse reaction.

AIM To investigate the effects of Sanqi Huayu Oral Liquid (Notoginseng Radix et Rhizoma,Corydalis Rhizoma) on femoral shaft comminuted fracture caused by trauma in perioperative period of high-risk groups.METHODS One hundred and twenty patients meeting the inclusion criteria were randomly and equally divided into treatment group and control group.The control group was treated by low molecular weight heparin calcium injection,while the treatment group was additionally given Sanqi Huayu Oral Liquid.Two groups' levels of serum IL-6,TNF-α and D-D were detected on pre-operation and the 1 st,3rd,7th after operation,respectively.Additionally,the adverse drug reactions were also observed.RESULTS There were no statistically significant differences in the levels of serum IL-6,TNF-α and D-D between the two groups before operation.The first day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups showed increasing trends,which had similar elevated levels without statistically significant differences.The third day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups presented downward trends,but those in the treatment group were decreased more markedly with statistically significant differences.Furthermore,the seventh day after operation,the levels of serum IL-6,TNF-α and D-D between the two groups were lower than those before the operation,and these indices in the treatment group were lower than those in the control group with statistically significant differences.CONCLUSION Sanqi Huayu Oral Liquid can not only effectively reduce the levels of serum IL-6,TNF-α and D-D in perioperative period of high-risk groups,but also prevent the formation of deep vein thrombosis.

Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P<0.05).The average diagnosis week of NTDs was 24.0 and those of anencephalus,spina bifida and encephalocele were 21.2,27.1 and 24.7 respectively (P<0.05).The detection rates of NTDs before 16 weeks,16-20 weeks,20-24 weeks,24-28 weeks and after 28 weeks were 14.1%,49.4%,46.3%,49.2% and 52.1% respectively (P<0.05).The detection rates of NTDs in hospitals,maternal and child care service centers and family planning centers were 46.4%,52.0% and 28.1% respectively (P<0.05).The detection rate of NTDs by two-dimensional ultrasound equipment was 41.3% and 83.3% by three-dimensional ultrasound equipment (P>0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.