Objective We aimed to evaluate the role of CD4 + CD25 + T regulatory cells in predicting the prognoses of patients with sepsis.Methods Patients with sepsis in Shanghai Changzheng Hospital from December 2013 to April 2014 were identified and grouped into survival group (SG,n =19) and death group (DG,n =9) in accordance with their clinical outcomes.CD4 + CD25 +T regulatory cell ratio,C-replication protein,bilirubin,procalcitonin,and coagulation function were tested on the 1st day and 7th day,and APACHE Ⅱ and SOFA were analyzed to assess the predictability of this group of cells.Results Twentyeight patients were identified,with a mean age of (60.36 ± 15.30) years,a mean APACHE Ⅱ score of (16.68±7.00),and a mean SOFA score of (7.18 ±3.78).Twelve (42.9％) of the individuals were accompanied with severe multiple trauma,and 10 (35.7％) were in septic shock,and 9 (32.2％) died of severe sepsis.The first day CD4 + CD25 + T regulatory cell ratios on the first day were 2.10％ (0.80,3.10)％ (SG) vs.1.80％ (1.15,3.65)％ (DG) (Z=-0.148,P=0.883),andonday7 were 0.90％ (0.30,2.80)％ (SG) vs.5.70％ (2.60,8.30)％ (DG) (Z=-2.905,P=0.004) presented significant predictability.Conclusions Dynamic monitoring of CD4 + CD25 + T regulatory cells could predict the prognoses of patients with sepsis and should be generalized in clinical emergency practice.

Aim To investigate the role of COX-2 in BMP9 induced osteogenic differentiation,and the pos-sible mechanism underlying this function of COX-2. Methods We introduced real-time PCR, Western blot, and immunocytochemical staing to detect the effect of BMP9 on COX-2 expression.We employed chemiluminescence technique to assay ALP activities, RT-PCR to detect the expression of Smad6 and Smad7 , and Western blot to measure the expression of Runx2, Dlx-5,total Smad1/5/8,and phosphorylated Smad1/5/8.Finally,BMPR-Smad luciferase reporter assay was applied to measure the activation of BMPs/Smads signaling.Results BMP9 could induce the expression of COX-2 in C3H10T1/2 cells.Either inhibiting enzy-matic activity of COX-2 or knockdown of the expression of COX-2 reduced the BMP9 induced ALP activities in C3H10T1/2 cells,and COX-2 knockdown also inhibited the ectopic bone formation induced by BMP9 in C3H10T1/2 cells.Moreover,COX-2 knockdown inhibi-ted BMPR-Smad reporter activities and the phosphoryl-ation of Smad1/5/8,so did the expression of Smad6 and Smad7 .Conclusion COX-2 may play an impor-tant role in BMP9 induced osteogenic differentiation in MSCs by regulating the BMPs/Smads signaling trans-duction.

Objective To investigate the effects of different doses of gingko flavonoid on the expression of nuclear factor-κBp65 (NF-κBp65) and tumor necrosis factor-α(TNF-α) in mice with non-alcoholic fatty liver disease(NAFLD) .Methods The mice mod-el of NAFLD was constructed by the high fat diet for 4 weeks .The mice were randomly divided into the control group ,high fat model group ,high ,middle and low doses of gingko flavonoid groups .High ,middle and low doses of gingko flavonoid groups were respectively gavaged with the different doses of gingko flavonoid .The normal control group and the high fat model group were ga-vaged with normal saline .After 12 weeks ,the mice were killed for taking liver tissue and detecting NF-κBp65 expressions ,and ser-um TNF-αand triacylglycerol(TG) levels were detected .Results Compared with the normal control group ,the levels of NF-κBp65 ,TNF-αand TG in the high fat model group were increased(P<0 .05) .Compared with the high fat model group ,the levels of NF-κBp65 ,TNF-αand TG in the high ,middle and low doses of gingko flavonoid groups were decreased (P<0 .05) ,moreover the higher the dose ,the more obvious the decrease .Conclusion Gingko flavonoid may play certain role in the treatment of NAFLD by reducing the generation of NF-κBp65 ,TNF-αand TG .

BACKGROUND:Skin transplantation is regarded as the most effective therapy for large-area skin defects, which is limited by donor sources and immune rejection. Therefore, it is extremely accelerate the construction of the dermis in skin tissue engineering.
OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane on the repair of ful-thickness skin defects.
METHODS:Bone marrow mesenchymal stem cels were isolated from 15 New Zealand rabbits, and then cultured, amplified, subcultured and purified. Three ful-thickness skin defects were made on the back of every rabbit, and randomly treated with bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane as experimental group, bone marrow mesenchymal stem cels/calcium alginate gel as control 1 group, and calcium alginate gel as control 2 group. The wounds were al covered with amniotic membrane. After 7, 14, 21 days, new wound tissues were taken for hematoxylin-eosin staining, immunohistochemistry staining and image analysis.
RESULTS AND CONCLUSION: Dermis tissues in the experimental group were obviously thicker than those in control 1 and control 2 groups; there were more fibroblasts, vessels and colagen fibers in the experimental group. Especialy at 14 and 21 days after operation, epidermal hyperplasia was faster with a larger coverage area in the experimental group, and at 21 days, the new epidermal tissues mainly exhibited multi-layered structure, which was superior to the control 1 and 2 groups. It folows that the combination of bone marrow mesenchymal stem cels/calcium alginate gel, basic fibroblast growth factor and degradation membrane for skin defects can accelerate the repair and regeneration of the dermis, and thus promote the epidermis regeneration and reconstruction.

Pulmonary embolism (PE) refers to the endogenous or exogenous emboli blocking pulmonary trunk or branches, causing clinical and pathophysiological syndrome of pulmonary circulation disorder, the incidence rate is high. Sometimes PE patients were lack of specific symptoms and signs, or without any symptoms, which often result in misdiagnosis, un-timely diagnosis, and the delay of treatment. A PE case with syncope, vomiting and shock, which was proved to be pulmonary artery trunk and branch wide embolism later, was presented so as to improve the understanding of the disease.

Objective To study the relationship between the semen quality and age in infertile men in Qingyuan.Methods 727 cases of infertile men from Reproductive Medicine Center outpatient were enrolled and divided into 5 groups:≤ 25,> 25 - 30,>30-35,>35-40,>40 age groups.The semen characteristics were carried out by calculator assistance sperm analysis(CASA) technique and Diff-Quick staining method.Results The sperm density of >30 -35 age group was the highest,but there was no significantly difference from other groups(P >0.05).Semen analysis showed that the rates of PR,PR+NP and survival sperm were on downward trends with the increase of age,but not statistically significant(P >0.05).38.19% of >25 -30 age group reached WHO′s semen parameters standard,which was the highest proportion among 5 groups.And the proportion in >40 age group was the lowest,which counted for 27.42%.Conclusion The semen quality shows a down trend with the increase of age,however,the infertility could occur in the reproductive men at any stage.

Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.

Objective To investigate the epidemiological characteristics of traumatic cervical spinal cord injury (TCSCI) in ICU.Method The data of patients with TCSCI admitted from October 2010 to March 2016 in the intensive care unit were retrospectively studied.The general epidemiological data included:gender,age,marital status,occupation,cause of injury,injury severity,injured segment (ASIA grade),and complications were collected.Results There were 109 patients identified to have TCSCI with mean age of 53.72 ± 14.86 years (25.69％ patients in the range of 60-69 years old).The male to female ratio was 9:1,and the most were married.The majority of individuals were retired (30.27％),and the main causes of injury were traffic accidents and tumble.The C5 segment of the spine was the most vulnerable to be injured,and then the C4 segment was the nest in turn.There were up to 30.28％ patients suffered from multiple injuries,and 26.61％ patients also had a craniocerebral injury.Bedsore and respiratory system complications were the two leading complications,and 83 patients suffered from at least one system dysfunction with respiratory dysfunction accounted for 98.79％ and circulatory dysfunction accounted for 65.06％.Fifty-one patients presented more than two system dysfunctions (46.79％).Twenty patients (18.35％) died.Conclusion Patients with TCSCI in ICU presented specially characteristic features.Traffic accidents were the main cause of TCSCI,and fall accidents were one of the main causes in the elderly.The mortality of TCSCI was high,especially in males.The complication rate was relatively high and the most common complications were water and electrolyte disturbance and respiratory dysfunction.Multiple organ dysfunction incidences might be associated with the ASIA grades.

Humans ; HIV Infections/drug therapy* ; HIV-1/genetics* ; Tenofovir/therapeutic use* ; Anti-HIV Agents/therapeutic use* ; RNA ; Drug Combinations

Objective:To investigate the efficacy of the intelligent version of the Montreal Cognitive Assessment Scale(MoCA)in identifying mild cognitive impairment(MCI)in elderly inpatients.Methods:Seventy-five patients diagnosed with mild cognitive impairment(MCI group)from the Neurology and Geriatrics Departments of a tertiary hospital in Changsha City, along with 195 patients with normal cognitive function(normal control group), were selected between July 2020 and December 2022.Both groups underwent evaluations using the intelligent version of the Montreal Cognitive Assessment(MoCA)and the Mini Mental State Examination(MMSE), and the results were analyzed.Results:The MCI group showed significantly lower total MoCA scores and MMSE scores[(19.73±2.42) vs.(24.8±2.33)]compared to the normal control group[(24.47±2.02) vs.(26.50±1.65)], with a statistically significant difference( P<0.01).The optimal cut-off score for the MoCA was found to be 23.5 points in diagnosing MCI, showing higher sensitivity, specificity, and kappa value(96.0%, 82.1%, and 0.690)compared to the MMSE scale(90.0%, 62.6%, and 0.428). Conclusions:The intelligent MoCA has a high screening accuracy for identifying MCI in this population, demonstrating superior sensitivity and specificity compared to the MMSE.