Objective To repair the experimental femoral head necrosis with the implantation of tricalcium phosphate (TCP) loaded with human bone morphogenetic protein-2(hBMP-2) gene transfected bone marrow derived mesenchymal stem cells(BMSCs). Methods Established the animal models of femoral head necrosis in 22 goats by the ligation of the lateral and medial circumflex femoral arteries and delivery of liquid nitrogen into femoral head. 4 goats served as the control group without any treatment. 3 weeks after surgery, necrotic bone in the other 18 goats were removed and TCP loaded gene transfer cells were implanted into the femoral head with BMP-2 gene transfected BMSCs in right side and ?-gal gene transfected BMSCs in left side. BMP-2 concentrations in femoral head were tested by the ELISA at 1st, 2nd, 3rd week after implantation. Histological observation was done before and at 6th, 10th, 16th week after implantation. New bone volumes (NBV) were measured at 16th week after implantation by the histomorphometry method. X-ray was taken at 16th week after operation in untreated group and after treatment in BMP-2 group and ?-gal group. Results The concentration of BMP-2 in femoral head of BMP-2 group was higher than that of ?-gal group at different time point. Empty lacunae and fibrotic marrow were demonstrated before implantation. New bone was evident in the implantation field of BMP-2 group while fibrous tissues were evident in that of ?-gal group at 6th, 10th and 16th week after treatment. Histomorphology analysis indicated that the NBV in BMP-2 group was significantly higher than that in ?-gal group. Articular surface collapse were observed in the X-ray photograph of untreated group. Regular shape and normal density of femoral head in BMP-2 group compared with the irregular shape and low density of femoral head in ?-gal group could be demonstrated in the X-ray photograph 16 weeks after treatment. Conclusion Implantation of the TCP loaded with human BMP-2 gene transfected BMSCs could repair early-stage experimental femoral head necrosis.

Urid acid is one of the terminal metabolites of human body.More and more attention was paid to its metabolic mechanisms in intestinal tract;however, few studies were seen so far.This study aims to illuminate the metabolic mechanism of uric acid in intestinal tract by two ways:one is the transporters associated with intestinal epithelium, including ABCG2 and SLC2A9, the other is decomposition of uric acid by intestinal flora.We hope this review can provide new insights to decrease blood uric acid and treat urate-related diseases, and also provide a new way to alleviate drug-induced kidney damage.

Objective To establish a new T staging system for nasopharyngeal carcinoma ( NPC) based on magnetic resonances imaging ( MRI) and intensity?modulated radiotherapy ( IMRT) . Methods A retrospective analysis was performed on the clinical data of 608 patients who were newly diagnosed with non?metastatic NPC by MRI and treated with IMRT in our hospital from 2008 to 2010. All patients were staged according to the 7th edition of the UICC/AJCC staging system for NPC. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The Cox regression model was used for multivariate analyses. To deal with the deficiency in the current UICC/AJCC staging system, a new T staging system for NPC was established and systematically evaluated. Results The 5?year follow?up rate was 94?5%. The 5?year overall survival (OS), disease?free survival, local relapse?free survival (LRFS), and distant metastasis?free survival rates were 81?5%, 80?1%, 86?0%, and 81?1%, respectively. The univariate and multivariate analyses showed that the anatomic structures of nasopharynx, parapharyngeal space, and skull base were influencing factors for the OS rate (P=0?000?0?045). New T staging criteria were proposed based on the risk differences and survival curves:stage T1:invasion of the nasopharynx, parapharyngeal space, oropharynx, nasal cavity, skull base, and internal pterygoid muscle;stage T2:invasion of the external pterygoid muscle, paranasal sinus, intracalvarium, infratemporal fossa, and cranial nerves. The proposed T staging system achieved a good separation in both OS and LRFS curves. Conclusions The proposed new T staging system gives an objective prognostic prediction in patients with NPC, which provides an exploratory attempt toward a new clinical staging system for NPC.

In order to promote our country's research on transitional care for patients with chronic kidney disease (CKD),the article summarized research progress on transitional care for patients with CKD,analysed the problems existed including lack of evidence-based basis,insugiciency of Intervention staff,one-sided intervention content and effect evaluation,etc,and put forward the corresponding countermeasures.

Objective To explore the practice effect of problem-based learning(PBL) in teaching of pathogen biology and immunology at college level.Methods Three-year clinical majors of class 1 and 2 in Luohe Medical College were chose,class 1 as PBL experimental group(n=100) and class 2 as control group(n=100).Chapter of hepatitis virus was taught respectively using PBL and LBL teaching method.Teaching effect was evaluated by test and questionnaire.Teaching effects between PBL and LBL were compared.SPSS 13.0 was used to do statistical analysis and data were expressed as percentage.Chi-square test was performed and P＜0.05 shows statistically significant differences.Results Results of test showed that excellent and passing rates were higher in PBL group than in LBL group(P=0.000) ; flunked rate was lower in PBL group than in LBL group(P=0.000).Results of questionnaire showed that more than 80％ students thought that PBL can mobilize students' initiatives of learning,train cooperation consciousness and enhance language skills,etc.Conclusions PBL can be used in pathogen biology and immunology for 3-year clinical majors and deserves further application.

Objective: To investigate the level and timeliness of CD4+T lymphocyte cell (CD4 cell) counts at first measurement among newly reported HIV/AIDS cases in Taizhou City, Zhejiang Province from 2012 to 2021, so as to provide insights into improving the management of HIV/AIDS cases. Methods: Demographic data and first measurement of CD4 cell counts of newly reported HIV/AIDS cases in Taizhou City from 2012 to 2021 were collected from the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The level and time of CD4 cell counts at first measurement were descriptively analyzed, and factors affecting CD4 cell counts at first measurement were identified using a multivariable logistic regression model. Results: A total of 4 834 newly reported HIV/AIDS cases were recorded in Taizhou City from 2012 to 2021, including 3 889 men (80.45%), 2 005 cases at ages of 20 to 39 years (41.48%), and 2 130 farmers (44.06%). There were 1 664 cases (34.42%) with CD4 cell counts of <200/mm3 at first detection, 2 576 (53.29%) with CD4 cell counts of 200/mm3 to 499/mm3, and 594 (12.29%) with CD4 cell counts of ≥500/mm3. The proportion of CD4 cell counts of <200/mm3 showed a tendency towards a rise from 2012 to 2021 (χ2trend =4.250, P<0.001). There were 3 465 cases (71.68%) that had an interval of ≤14 days between the first detection of CD4 cell counts and confirmatory HIV test, 740 (15.31%) that had an interval of >14 to 30 days, 315 (6.52%) that had an interval of >30 to 90 days, 135 (2.79%) that had an interval of >90 to 180 days, and 179 (3.70%) that had an interval of >180 days. The proportion of an interval of ≤14 days appeared a tendency towards a rise from 2012 to 2021 (χ2trend=6.874, P<0.001). Multivariable logistic regression analysis identified women (OR=0.630, 95%CI: 0.529-0.751), age of ≥20 years (OR: 1.958 to 3.218, 95%CI: 1.216-5.412), other or unknown routes of HIV infection (OR=1.785, 95%CI: 1.100-2.896), and identification by medical institutions (OR=1.779, 95%CI: 1.497-2.114) as factors affecting CD4 cell counts of <200/mm3 at first measurement. Conclusions The timely detection of CD4 cell counts at first measurement gradually increased with year among newly reported HIV/AIDS cases in Taizhou City from 2012 to 2021; however, there were still 34.42% of cases with CD4 cell counts of <200/mm3. Gender, age, route of HIV infection, and sample source were factors affecting CD4 cell counts of <200/mm3 at first measurement.

Objective To explore effects of heroin and ephedrine on the histological structure and ChAT activity of hypothalamus and hippocampus of filial mice. Expression of Bcl-2 associated X protein(Bax protein) and keratinocyte growth factor(KGF) of hypothalamus and hippocampus were measured. Methods One hundred and eight filial mice were given intraperitoneal injection of heroin and ephedrine by gradually increase of doses, apoptosis and expression of Bax protein and KGF of hypothalamus and hippocampus were observed by Giemsa staining and immunohistochemistry, and the ChAT activity was detected by colorimetry. Results After administration of heroin and ephedrine at 5,10,15,20 days, the number of apoptotic cells and expression of Bax protein and KGF of hypothalamus and hippocampus were significantly increased and ChAT activity was lower than those of the control group(P<0.05 or P<0.01). There were differences between heroin group and the ephedrine group in the above-mentioned four indexes (P<0.05 or P<0.01). The number of apoptotic cells and Bax protein and KGF immunopositive neurons of hypothalamus and hippocampus increased by the increase in dose of heroin and ephedrine. Conclusions Heroin and ephedrine had great effect on the histological structure and ChAT activity of hypothalamus and hippocampus of filial mice, and this effects would be related to the cell apoptosis of hypothalamus and hippocampus.

Objective Through conducting the project of quality improvement for intrahospital transport of critically ill patients from ward to ICU,to establish graded management under early warning to improve transport efficiency and quality.Methods Through setting up project team,setting goals of quality improvement,measuring and analyzing transport status,the graded management under early warning was established from three aspects:condition,equipment and transport personnel.The graded management under early warning was applied to clinical nursing practice to evaluate the effects.Results There was no statistical difference before and after the implementation of graded management under early warning in gender,age and condition of critical ill patients between two groups,but the time of transport was significantly reduced after the implementation,while there was no equipment failure,and the incidence of adverse events associated with devices decreased effectively.Conclusion The establishment and application of graded management under early warning has effectively reduced the risks of transport,improved efficiency and quality of transport.

Objective To explore the effects of tilted seat surface on front protraction of upper limb and postural adjustment while sitting in children with spastic cerebral palsy. Methods From 2010 to 2014, 15 children with spastic cerebral palsy (patients group) and 15 healthy children (control group) were recruited. They were asked to reach forward sitting on the tilted seat surface with different degrees (-15°, 0°, 15° ) to test the reaction time and movement time. The contraction times of rectus abdominis and back extensors were recorded and ana-lyzed. Results The reaction time and movement time were shorter, and the contraction rates of rectus abdominis and back extensors were lower in the degree with-15° than with 0° and 15° (P<0.001). There was no difference in reaction time between two groups (P>0.05), and the movement time was longer in the patients group than in the control group (P<0.001). The contraction rates were higher in the patients group than in the control group. Conclusion Anterior tilted seat surface may improve the front protraction function of upper limb and the postural adjustment in children with cerebral palsy.

Objective To investigate the effect of β-catenin on the osteogenic differentiation of human periodontal ligament stem cells (PDLSCs) under mechanical tension.Methods PDLSCs were seperately cultured in vitro from the periodontium attached at freshly extracted teeth.β-catenin-targeting agonist or inhibitor was applied to the PDLSCs to upregulate or downregulate the expression of activity of β-catenin protein.The expression of β-catenin protein and the osteogenetic related markers(ALP,BMP2,Runx 2) under the mechanical tension with different period(0,6,12,24 h) were assessed with Western blot in the PDLSCs irritated with agonist or inhibitor.Results Compared with the PDLSCs without mechanical tension,the expression of osteogenesis related marker proteins,ALP and Runx 2,in PDLSCs were enhanced under the circular mechanial tensile stress (P ＜ 0.05).In the PDLSCs irritated with WAY-262611,the β-catenin-targeting agonist,the expression of osteogenetic related markers ALP in the PDLSCs was improved during the first 12 h period of mechnical tensile load,which was significantly higher than that in the DMSO group.Conclusion Wnt/β-catenin signaling pathway plays an important role in the early osteogenesis differentiation of PDLSCs under cyclic tension.The β-catenin promotes osteogenic differentiation of PDLSCs under mechanical tension.