Objective To observe the influence of Fibronectin-Thrombopoietin(FN-TPO) gene modified human bone marrow mesenchymal stem cells(MSCs) on the engraftment of cord blood hematopoietic stem cells.Methods FN-TPO gene modified human bone marrow MSCs combined with cord blood mononuclear cells(CB-MNC) were transplanted to sublethal dose treated severe combined immunodeficiency disease(SCID) mice.After transplantation,these mice were observed for 4 weeks.Peripheral blood cell counts were performed at different time point to assay the hematopoietic system status of the mice.Four weeks after the transplantation,human-sourced cell integration was assayed by flow cytometry(FCM) and polymerase chain reaction(PCR).Results One week after the cell transplantation,every main index of the peripheral blood cell counts in the gene modified group was higher than that in the control groups(P

Objective:To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation (LIDH). Methods:A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps. In the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results:The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion: Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.

Objective To investigate the feasibility and clinical value of double-balloon endoscopy in subjects of failed conventional colonoseopy and gastro-intestinal tract modified surgery.Methods Doubleballoon endoscopy was performed in thirty-two subjects of failed conventional colonoscopy,three and nine patients of previous subtotal gastrectomy with BillrothⅡand gastro-intestinal modified surgery for various clinical manifestations.Suceessful intubation rates of terminal ileum or cecum in colonoscopic failure patients,afferent and efferent loop intubation in patients of BillrothⅡand alimentary tract modified surgery,were recorded and diagnostic yields in these patients were also observed.Results The endoscopy was successfully intubated into terminal ileum or cecum in 29 subjects,the intubated rate was 90.6%,the endoscopic diagnosis was obtained in 7 subjects,and endoscopic treatment was performed in 3 subjects.The endoscopy was successfully inserted in terminus of afferent loop and 150-180 cm of efferent below the anastomosis in all 3 patients of Billroth type Ⅱ gastrectomy,and the diagnosis was all clarified.And endoscopic retrograde cholangiopancreatography was performed in one patient.Five of nine patients with previous alimentary tract modified surgery had lesions detected after endoscopic procedure,and double-balloon endoscopy could have a thorough visualization on operated area and suspected region as needed.Abdominal pain and melaena were observed in 8 and 3 subjects respectively.Transient urine amylase elevation was found in one patient.The symptoms were alleviated and amylase was returned to normal after treatment.Conclusions Double-balloon endoscopy was a safe and feasible remediai endoscopic procedure with high diagnostic yields and endotherapeutic interventional capability,in patients of failed conventional colonoscopy and previous BillrothⅡgastrectomy and alimentary modified surgery.

Objective To explore the genetic mutation in neonates who failed to pass hearing screening.Methods A total of 111 cases of neonates who failed to pass hearing screening and were conifrmed sensorineural deafness by auditory brainstem evoked potential (ABR) were randomly selected. The heel blood was collected and DNA was extracted.GJB2, SLC26A4, and 11 mutation hotspots in mitochondria gene12SrRNA were tested. The relationship between degree of hearing loss and gene mutation was analyzed.Results In 111 neonates, mutation in deafness gene were found in 24 cases (21.6%) . Among them 14 cases (12.6%) hadGJB2 gene mutation including 5 cases of 235delC single heterozygous mutation, 5 cases of 235delC, and 1 case each of 299_300delAT compound heterozygous mutation, 235delC homozygous mutation, 299_300delAT single heterozygous mutation, 176_191del16 and 235delC compound heterozygous mutation, and 299_300delAT and 508_511dupAACG compound heterozygous mutation respectively. Ten cases (9.0%) hadSLC26A4 gene mutation including 2 cases of IVS7-2A>G single heterozygous mutation, 3 cases of 1226G>A single heterozygous mutation, 2 cases of 2168A>G single heterozygous mutation, and 3 cases of IVS7-2A>G and 2168A>G compound heterozygous mutation. Mitochondrial gene mutations were not detected. Conclusions Deafness gene mutation is detected in more than 1/5 neonates who failed to pass newborn hearing screening. GJB2 gene mutation is the most commons. The implementation of hotspots deafness gene detection can improve the diagnostic rate of deafness.

The phenomenon of recessive absence was initiated by many malpractices in current medical educational system.In this article we try to analyze this phenomenon,speculate the subjective and objective reasons,propose countermeasures such as improving teachers quality,reforming traditional teaching mode,strengthening medical ethics education,enriching teaching means and addressing student-centered lectures.

Objective To investigate whether cesarean section on pregnant women with chronic hepatitis B virus (HBV) infection may reduce mother-to-infant transmission risk of HBV.Methods Preserved serum samples of pregnant women at 15-20 weeks of gestation which were collected from July 2002 to August 2004 in 14 counties of Jiangsu Province were analyzed retrospectively.These samples were tested for HBV serologic markers with enzyme immunoassay,and 419 cases of positive hepatitis B surface antigen (HBsAg) were found.HBV DNA level of these HBsAg-positive women were further quantitatively measured with real-time polymerase chain reaction assay.Children of these 419 HBsAg-positive mothers were followed up during October 2009 to March 2010 and 298 of them were contactable (71.1％),among which 281 were enrolled in final analysis as they had complete information and had been vaccinated with three regular doses of HBV vaccine during infantile period.The 281 children were tested for serum HBV markers.The HBV infection rate in these children at age 5-7 was compared between those born by cesarean setion (CS group,n =136) and by vaginal delivery (VD group,n=145).T-test,x2 test or Fisher's exact test was used to analyze relevant parameters.Results(1) Maternal HBeAg-positive rates [25.7％ (35/136) vs 34.5％ (50/145)],HBV DNA levels in HBeAg-positive women [(2.30 × 106) IU/ml vs (2.09× 106) IU/ml],the percentages of HBIG injection after birth [38.2％ (52/136) vs 35.9％ (52/145)],breastfeeding ratios [82.4％ (112/136) vs 75.9％ (110/145)],and children' s ages at the follow-up [(5.9 ± 0.8) vs (6.0±0.6)] were comparable between CS group and VD group (all P＞0.05).(2) Among these 281 children,272 (96.8％) were HBsAg-negative,9 (3.2％) were HBsAg-positive and 163 (58.0％) were anti-HBs-positive.The prevalence of HBsAg-positive [(2.9％ (4/136) vs 3.4％ (5/145)],HBsAg negative and anti HBc positive [0.0％ (0/136) vs 1.4％ (2/145)] and anti-HBs positive [57.4％(78/136) vs 58.6％(85/145)] in CS group were similar to those in VD group.Conclusions Cesarean section does not reduce the risk of mother-to-infant transmission of HBV.In clinical practice,elective cesarean section should not be suggested in order to prevent HBV vertical infection.

Objective To investigate the interventional effect of multidimensional strategy to reduce the incidence of neonatal ventilator-associated pneumonia.Methods The patients who were admitted to the NICU department and received mechanical ventilation (MV) for more than 48 hours from October 2012 to September 2014 were recruited. The control group received the experienced interventions from October 2012 to September 2013, neonates from October 2013 to September 2014 were recruited as the intervention group receiving multidimensional controlling strategy, including bundle care, education, pro-cess and outcome surveillance and feedback on the practices. The compliance of before-after implementation of interventions were quantitatively evaluated,and the rate of VAP was compared between the two groups.Results The compliance rate of hand hygiene and the qualiifed rate of sputum suction, oral care, drain condensation from ventilator circuit, semi-recumbent posi-tion, and preventing of stress-ulcers were increased 17.0%, 11.4%, 14.7%, 18.2%, 37.5% and 56.3% respectively after implemen-tation of multidimensional strategy, and had statistical difference (χ2=36.47-294.36,P<0.01). But the qualiifed rate of antibiotic use only was 66.1% in the post-VAP bundle phases, and showed no statistical difference before and after(P>0.05). The VAP rate was 41.7 cases per 1000 MV-days during control group and 19.7 cases per 1000 MV-days during intervention group, had statis-tical signiifcance (P<0.05). But the rate of ventilator application showed no statistical difference between two group (P>0.05). ConclusionThe multidimensional strategy can effectively prevent the incidence of VAP.

Objective To investigate the dynamic alterations of parameters of platelet in newborns with pulmonary hemorrhage(PHN).Methods One hundred and forty-eight cases were selected into research group,within 48 hours after admission,every 3 hours at the time of pulmonary bleeding,peripheral arterial blood were collected and tint deal blood samples were examined with full-automatic blood cell analyzer in order to monitor dynamically changes of platelet and its parameters.Results The blood platelet count(BPC),thronbocytocrit and PDW were greatly changed at 6 hours before occuring pulmonary hemorrhage(all P

Objective: To explore the changes of right heart structure in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 194 T2DM patients were recruited in our research including those complicated with hypertension (HP). The patients were divided into 2 groups: T2DM+HP group and T2DM group,n=97 in each group. In addition, there was a Control group composed by 97 healthy subjects from regular physical examination at the same period of time. Right heart structure was assessed and compared by echocardiography in all participants. Results: The pulmonary artery diameter (PAD), right atrial short axis diameter (RA-D1), right atrial long axis diameter (RA-D2) and right atrial area (RAA) were different among 3 groups, allP<0.05. Right ventricular (RV) basal diameter (RV-D1) and RV out flow tract diameter (RVOT1) were similar among different groups,P=0.066 andP=0.059. Compare with Control group, T2DM+HP group had increased RA-D1, RA-D2, RAA and PAD, allP<0.05, while right ventricular free wall thickness was similar between 2 groups; T2DM group showed increased PAD,P<0.05, while RA-D2 was similar,P=0.061. Linear correlation analysis indicated that RV-D1, RVOT1, PA, RA-D1, RA-D2 and RAA were positively related to BMI (r=0.123-0.380) and waist-to-hip ratio (r=0.136-0.325), allP<0.05; RA-D2 and RAA were positively related to natural logarithm of urinary albumin excretion rate (lnUAER) (r=0.172 andr=0.130),P<0.05; PAD was positively related to diastolic blood pressure and E/E' (r=0.154 andr=0.172), negatively related E/A (r=-0.118),P<0.05. Multi regression analysis presented that gender and BMI were independently related to RV-D1, RVOT1, RA-D1, RA-D2 and RAA; BMI and diastolic blood pressure were independently related to PAD; lnUAER was independently related to RAA. Conclusion: T2DM+HP patients had broadened PA and RV basal part, increased RA-D and RAA; the changes of right heart structure were relatively mild in T2DM patients. Elevated blood pressure, BMI and UAER were closely related to the changes of right heart structure in T2DM patients.

Objective In order to investigate the relationship among reflux esophagitis,Barrett's e- sophagus and esophageal adenocarcinomas,the expressions of Cdx2 and MUC2 gene were studied.Methods Using immunohistochemistry,the expressions of the Cdx2 and MUC2 were detected in the esophageal mu- cosa of 30 patients with reflux esophagitis,18 patients with Barrett's esophagus and 25 patients with esopha- geal adenocareinoma.Results The positive rate and staining intensity of Cdx2 and MUC2 expressions in re- flux esophagitis,Barrett's esophagus and esophageal adenocarcinoma were significantly higher than those in normal esophageal mucosa(P