Nrf2,a key transcriptional factor in regulating endog-enous antioxidant signaling pathway,maintains the redox bal-ance by controlling the expression of a battery of antioxidant en-zymes,phase-Ⅱ detoxification enzymes and phase-Ⅲ transport-ers.Furthermore,Nrf2 regulates inflammation.Recent resear-ches have confirmed that Nrf2 provides a vital physiological role in kidney diseases,activation of Nrf2 enhances the antioxidant and anti-inflammatory ability in cellular and tissue levels,thusalleviates renal injury.Here,this article aims to summarize the protective effect of Nrf2 on various models of kidney impairment and explore the potential of Nrf2 as a therapeutic target to pre-vent kidney diseases.

BACKGROUND: How to effectively harvest bone marrow mesenchymal stem cells with homogeneity is crucial for cartilage tissue engineering research. OBJECTIVE: To isolate and culture rat bone marrow mesenchymal stem cells and to observe biological characteristics of the cells. METHODS: Bone marrow mesenchymal stem cells were isolated from the femur and tibia of 30 Sprague-Dawley rats using the whole bone marrow adhesion method. Cell surface markers were identified using flow cytometry, cell proliferation ability was observed through cell counting, and cell survival rate was determined by MTT assay. RESULTS AND CONCLUSION: The harvested cells were mostly round and oval, which partially showed a triangular shape. Cell fusion appeared after 12-15 days of inoculation. The proliferation of passaged cells was accelerated. Two hours after passage, the cells evenly covered the bottom of the culture dish. With the increasing of cell generations, the cell proliferation ability was gradually decreased. The survival rates of cells at passages 1-5 were over 95%, significantly higher than those at passages 6 and 7 (P < 0.05). The harvested cells were negative for CD34, but positive for CD44. To conclude, the whole bone marrow adhesion method is effective to isolate rat bone marrow mesenchymal stem cells with stable growth and strong proliferation ability. Passage 5 cells can be selected as seed cells for cartilage tissue engineering.

Objective To investigate the safety and effectiveness of using low-profile visualized intraluminal support (LVIS) stents for the treatment of aneurysms in the small intracranial vessels (diameter <2.5 mm).Methods Between October 2014 and April 2016,the clinical data of all 30 patients with intracranial saccular aneurysm treated with LVIS stents with the small parent arteries <2.5 mm in diameter in Changhai Hospital,the Second Military Medical University were analyzed retrospectively,including 7 ruptured aneurysms and 23 unruptured aneurysms.The anterior circulation aneurysm accounted for 93.3% (n=28),and the diameters of the parent arteries were 1.6-2.4 mm.The complications associated with surgery,angiography,clinical outcomes,and mid-term follow-up data were analyzed.Results The success rate of stent implantation was 100%.Immediate embolization results:Raymond grade Ⅰ in 12 cases (40.0%),Raymond grade Ⅱ in 11 cases (36.7%),and Raymond grade Ⅲ in 7 cases (23.3%).Complications occurred in 2 cases,including one perforating artery occlusion and one intraoperative rupture.Twenty-five patients accepted the angiographic follow-up (Raymond grade Ⅰ in 21 cases,grade Ⅱ in 3 cases,and grade Ⅲ in 1 case).The follow-up time ranged from 4 to 14 months,with an average of 8.1± 2.6 months.One patient had asymptomatic intracranial artery stenosis in the distal end of the stent.No new neurological dysfunction or death occurred.Conclusion The deployment of LVIS stents in small vessels is safe and feasible,the effect of mid-term follow-up is better.However,a larger sample study and long-term follow-up results are needed.

Objective To carry out health education nursing intervention mode for patients with hemodialy-sis,and to study and analyze the clinical nursing effect.Methods 112 cases of hemodialysis patients were randomlydivided into the observation group and the control group according to random number table,56 cases in each group. The patients of the control group were given conventional nursing model,and the patients of the observation group were given nursing intervention model on the basis of health education.The blood pressure,the internal fistula blockage, indwelling catheter caused by the incidence of infection and blood phosphorus level of compliance rate were compared in the two groups.Results After nursing intervention,diastolic blood pressure(76.17 ±7.02)mmHg and systolic blood pressure (131.17 ±8.77)mmHg of the observation group were significantly better than the control group [(90.91 ±8.44)mmHg,(141.29 ±7.08)mmHg],there were statistically significant differences(t =10.49,13.75, all P <0.05).The incidence rate of fistula obstruction (1.79%)and the catheter infection incidence rate(1.79%) of the observation group were significantly lower than the control group (28.57%,26.79%),there were statistically significant differences(χ2 =8.22,9.17,all P <0.05).The blood phosphorus level standard rate(60.71%)of the observation group was significantly higher than the control group(33.93%),there was statistically significant differ-ence (χ2 =11.45,P <0.05).Conclusion The incidence of complications is significantly decreased after nursing intervention of health education in patients with hemodialysis,and the indexes are improved significantly,and there is no obvious conflict of interest.

Background and purpose:Extranodal natural killer/T-cell lymphoma (ENKTL) is a form of non-Hodgkin’s lymphoma. The ENKTL incidence in China is much higher than that in the Western countries. The disease is highly malignant, not sensitive to chemotherapy, has short survival period and poor prognosis. Epstein-Barr virus (EBV) infection has close relationship with the development of the disease. However, there are still a few patients without EBV infection. This study aimed to discuss the clinical features and prognosis of EBV-encoded small RNA (EBER) in situ hybridization negative ENKTL.Methods:From Aug. 2011 to Oct. 2015, 326 cases were diagnosed with ENKTL from the First Affliated Hospital of Zhengzhou University. The expression of EBER was detected by in situ hy-bridization technique. The clinical pathological characteristics and prognosis of EBER-negative patients were analyzed. Results:In 326 patients with ENKTL, the negative rate of EBER was 2.45% (8/326). In 8 EBER-negative patients, the median survival time was 17 months. The log-rank test revealed that there was a signiifcant difference between EBER-negative and EBER-positive curves (χ2=6.407,P=0.011). Multivariate Cox proportional hazards regression analysis showed that in EBER-negative ENKTL, only lactate dehydrogenase (LDH) predicted survival time (P=0.008). EBV-DNA copy number in plasma was not signiifcantly correlated with survival time (P>0.05).Conclusion:The inci-dence of EBER-negative ENKTL is low. Patients with EBER-negative ENKTL have poorer prognosis than EBER-posi-tive patients. Elevated LDH may be a factor indicating poor prognosis.

Objective:To analyze clinical characteristics, treatment, and prognosis of B-cell lymphoma, unclassifiable, with features in-termediate between diffuse large B-cell lymphoma and Burkitt lymphoma (DLBCL/BL). Methods:The clinical and pathological data of 13 DLBCL/BL patients, who were treated in the First Affiliated Hospital of Zhengzhou University between January 2013 and December 2014, were collected. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Through the log-rank test, survival curves were compared among groups classified by clinical stage, age, serum lactate dehydrogenase (LDH) lev-el, international prognostic index (IPI) score, or first chemotherapy regimen. Results:Among the 13 patients with DLBCL/BL, 12 pa-tients showed extra-nodal involvement. The median OS and PFS were only 10 and 6 months, respectively. Univariate analysis showed that the LDH levels and IPI scores exerted statistically significant effects on prognosis. Some borderline differences in survival were not-ed among the CHOP, CHOP-like, and intensive chemotherapy groups. Conclusion:DLBCL/BL is an aggressive B-cell lymphoma with a short survival time. The majority of patients presented extra-nodal involvement. DLBCL/BL did not respond well to CHOP or CHOP-like regimen, and more intensive chemotherapy may improve survival. Elevated LDH levels and high IPI scores were predictors of poor sur-vival.

Objective To establish a comprehensive,simple,and effective scoring model for predicting the recurrence risk after endovascular embolization of intracranial aneurysms in order to assess the possibility of recurrence and to provide guidance for the selection of surgical protocols and postoperative management.Methods From May 2012 to May 2014,434 patients (441 aneurysms) with intracranial aneurysm treated with endovascular embolization at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled retrospectively,and they were used as a modeling group.After modeling,109 patients (109 aneurysms) were used as a validation group.In the modeling cohort,a predictive scoring model of recurrence risk was established according to the results of multivariate logistic regression analysis;the model was validated in the validation cohort.According to the scoring model of the modeling group,the scoring table of best cut-off value of the receiver operating characteristic (ROC) curves was divided into a low-risk and a high-risk of recurrence.The recurrence risk score model was compared with the North America aneurysm recanalization stratification scale (ARSS) model,and Raymond grade.Results Multivariate logistic regression analysis showed that the 3 factors included in the scores and finally,a established scoring model of recurrence risk prediction were non-stent assisted embolization (1 point),Raymond grade ≥Ⅱ (1 point),and the size of aneurysm (aneurysm >25 mm[3 points)],aneurysm 10-25 mm[1 point],and aneurysm <10 mm[0 point]).The validation indicated that the scoring system had higher predictive value (AUC=0.738,95%CI 0.641-0.834,P<0.05) and goodness of fit (Hosmer-Lemeshow χ2=2.109,P=0.146).The scoring table was further divided into the low-risk recurrence (0-1 point) and high-risk recurrence (2-5 points),its sensitivity was 72.73% (48/66) and specificity was 68.80% (258/375).The predictive ability of the aneurysm recurrence risk score model was similar to that of the ARSS score (χ2=0.54,P=0.462),and it was better than the Raymond grade (χ2=15.10,P<0.01).Conclusion The established simple aneurysm recurrence risk predicting score model in this study may accurately predict the recurrence of aneurysms,however,a multicenter,large sample prospective study is needed for further validation.

We studied the effect of surfactin on cell proliferation, apoptosis and the cytoskeleton in human breast cancer cell line MCF-7 in vitro. The result of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) showed that the surfactin inhibited proliferation of MCF-7 cells in a dose- and time-dependent manner, with IC50 at 48 h of 27.3 micromol/L. Surfactin-induced cell death was considered to be apoptotic by observing the typical apoptotic morphological changes by AO/EB staining. Flow cytometric analysis also demonstrated that surfactin caused time-dependent apoptosis of MCF-7 cells through cell arrest at G2/M phase. Immunofluorescence and Western blotting showed that surfactin significantly suppressed the expression of vimentin, induced the alpha-tubulin depolymerization and rearrangement and then the skeleton system of the cells changed dramatically. Based on our findings, surfactin can significantly inhibit the growth of MCF-7 cells and induce apoptosis.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytoskeleton ; drug effects ; Female ; Humans ; Lipopeptides ; pharmacology ; Peptides, Cyclic ; pharmacology

Objective To compare the effects of general anesthesia and spinal anesthesia on prognosis of cesarean section in parturients with medium and severe pulmonary arterial hypertension (PAH).Methods Parturients with medium and severe PAH,at ≥ 24 weeks of gestation,aged 20-45 yr,undergoing elective cesarean section under general or epidural anesthesia from November 1,2011 to December 31,2017 in our hospital,were divided into general anesthesia group and epidural anesthesia group according to the anesthetic method.General anesthesia was combined intravenous-inhalational anesthesia.The highest temperature within 5 days after surgery,the lowest SpO2 (inhaling oxygen 2-4 L/min via a nasal tube) within 3 days after surgery,duration of intensive care unit stay,time of postoperative use of antibiotics,requirement for targeted drugs for pulmonary hypertension,results of laboratory tests (blood biochemistry,coagulation function),postoperative mechanical ventilation,length of hospital stay,and hospitalization costs were recorded.The Apgar score and weight of the newborn,postoperative complications and death of the newborn and parturients in hospital were recorded.Cox regression analysis was used to identify the risk factors after cesarean section in parturients with medium and severe PAH.Results Fifty-seven parturients were enrolled in this study,with 21 cases in general anesthesia group and 36 cases in epidural anesthesia group.Compared with general anesthesia group,the rate of postoperative mechanical ventilation was significantly decreased,the incidence of adverse events of parturients in hospital and mortality rate were decreased,the postoperative level of albumin was increased,activated partial thromboplastin time was shortened (P＜0.05),and no significant change was found in the other parameters in epidural anesthesia group (P＞ 0.05).The results of Cox regression analysis showed that anesthetic method and preoperative SpO2difference were independent risk factors for cesarean section-related adverse events and death of parturients with medium and severe PAH.The risk of adverse events and death of parturients was significantly higher in general anesthesia group than in epidural anesthesia group (P＜0.05).Conclusion Epidural anesthesia produces better prognosis than general anesthesia when used for cesarean section in parturients with moderate and severe PAH.

Attaining higher peak bone mass and strength in early life stage is critical for reducing risk of osteoporosis or lower bone mass later in life. Genetic factors such as race and gender are mostly responsible for the variability and timing of reaching peak bone mass. In general, Asians have lower areal bone mineral density and would reach peak bone mass earlier when they are compared to Caucasians. Among different lifestyle factors, strong evidence is only available for positive effects of dietary calcium and physical exercise on bone accretion. Studies showed that the calcium intake of Chinese population at all ages is well below the recommended intake levels. To develop peak bone mass and strength to reach their genetic potentials, achieving adequate calcium and vitamin D intake through promoting dietary intake and/or supplementation, are strongly recommended, especially in Chinese adolescents.