The expression of cyclooxygenase-2 (COX-2) mRNA and protein was significantly increased in rat glomerular mesangial cells (RCMC) treated separately with high glucose, high insulin, H2 O2 and advanced glycosylation end products. The expressions of COX-2 mRNA and protein in RCMC induced by above 4 factors were distinctly inhibited by sodium selenite, suggesting that sodium selenite might play a significant role in the prevention of diabetic nephropathy via this mechanism.

Objective To investigate the relationship among p38 mitogen-activated protein kinase (p38MAPK), NF-KB and monocyte chemoattractant protein-1 (MCP-1), and to study the role of p38MAPK, NF-κB and MCP-1 in diabetic nephropathy. Methods Protein expressions of p38MAPK and NF-κB, and mRNA expression of MCP-1 were initially investigated in rat mesangial cell line HBZY-1, which were incubated separately with 25mmol/L glucose, 100nmol/L insulin, 100 μmol/L H2 O2 and 100mg/L advanced glycosylation end products (AGEs). The relationship among p38MAPK, NF-κB and MCP-1 expression Was observed by usingSB203580, a specific inhibitor of p38MAPK. Results The expressions of p38MAPK, NF-κB and MCP-1 were increased in HBZY-1 cells incubated separately with 25mmol/L glucose, 100nmol/L insulin, 100μmol/L H2 O2and 100 mg/L AGEs. Expressions of NF-κB and MCP-1 were significantly reduced when p38MAPK was inhibited by SB203580. Conclusion p38MAPK, NF-κB and MCP-1 are involved in development of diabetic nephropathy, and p38MAPK stimulation is essential for the expressions of NF-κB and MCP-1.

Objective To determine the effect of Vibrio vulnificus cytolysin (VVC) inducing ap-optosis in human umbilical vein endothelial cell(HUVEC) and its possible mechanism. Methods The en-tire vvhA gene that encoding VVC from V. vulnificus strain GTC333 was amplified by PCR and sequenced af-ter T-A cloning. E. coli BL21DE3pET-42a-vvhA, a prokaryotic expression system of the vvhA gene, was then con-structed. Ni-NTA affinity chromatography was applied to purify the target recombinant protein rVVC, and SDS-PAGE plus Bio-Rad Agarose Image Analyzor were used to measure the output of rVVC and to determine the purity of rVVC extract. The activity of rVVC dissolving rabbit erythrocytes was detected by hemolysis test. DPNH chromotometry and TphBNa chromotometry were performed to examine the contents of LDH and K+ in the supernatants of rVVC-treated HUVEC cultures, respectively. The effect of rVVC inducing apepto-sis of HUVEC was detected by flow cytometry, rVVC was labeled with FITC and the location of FITC-labe-ling rVVC in HUVEC was observed by laser canfocal microscopy. Results The cloned whA gene had 96.09% and 98.26% similarities of nucleotide and amino acid sequences compared to the corresponding se-quences in GenBank. rVVC, with a dosage of 1 μg/ml, could dissolve rabbit erythrocytes (P<0.01). 10 μg/ml rVVC was able to promote the increases of K+ content (P<0.01) but no change of LDH content could be found in the cell supernatants. HUVEC was apoptotic after the cell was treated with 1～100 μg/ml of rVVC for 2 h. In the 5～240 min duration of co-incubation of FITC-labeling rVVC and HUVEC, the rV-VC gradually moved from surface to inner side of the membrane and then entered the cytoplasms. When FITC-labeling rVVC treated HUVEC for 30 min, most of the rVVC was found to be intracellular location. Conclusion rVVC has cytolytic activity. VVC has an ability to enter HUVEC and causes injury of HUVEC via inducing apoptosis, which may be the major pathogenic mechanism of VVC.

Absrtact: Osteoarthritis (OA) is a most common form of degenerative joint disease, primarily characterized by the degradation of articular cartilage, subchondral sclerosis and inflammation of the synovial membrane. Mesenchymal stem cells (MSCs), a multipotent adult stem cell population, can be isolated from many connective tissue lineages, including those of the diarthrodial joint. Joint-resident MSCs or MSC-like progenitor cells contribute to the maintenance of healthy microenvironment or to the response to trauma. The onset of degenerative changes in the joint related to abnormal condition or depletion of these endogenous MSCs and native host hyaline cartilage cells, leading to limited self-repair potential of the joint and advance of the degradation. To date, no acknowledged medical treatment strategies, including non-operative and classical surgical techniques, are efficient in restoring normal anatomy and function of hyaline cartilage in OA. This highlights an urgent need for better celled-based therapeutic strategies that supplement these functional cells exogenously to recover the tissue homeostasis and repair in joint cavity via chondrogenic and anti- in fl ammatory functions. In this review we focus on the role of native MSCs in healthy or OA joint and recent progress in cell-based researches utilizing culture-expanded chondrocytes, pluripotent stem cells, or MSCs from different sources for treating OA.

Objective To investigate the value of pathological examination in the diag-nosis of lethal cases due to acute poisoning.Methods The macroscopic and microscopic find-ings in 28 autopsy cases (10 cases of toxic gas,7 cases of pesticide,6 cases of drug,3 cases of alcohol and 2 cases of chinese herbal medicine) died of acute poisoning during the period from October,2001 to June,2012 were retrospectively reviewed.Results Gross Changes were found on gross examination in 22 of the 28 cases studied.Of them,7 cases died of acute carbon mono-xide poisoning had showed cherry red of Shiban,muscle,visceral organs and blood.In addition,11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively.Histologically,myocardial interstitial hemorrhage was observed in 9 cases,pulmonary hemorrhage in 18 cases,bronchospasm in 12 cases,cerebral hemorrhage in 4 cases,hepato-cyte necrosis in 11 cases,renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases.In 6 cases of oral pesticides poisoning,besides they had all gastric mucosa hemorrhage,the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases.In addition,acute inflammatory and necrosis of gastric wall in 6 cases of oral pesticides poisoning were observed under the light microscope.Drug addicts often suffered from chronic lesions in multiple organs,such as chronic liver disease,fatty infiltration of the myocardium with myocardial atrophy,interstitial lung disease and pulmonary foreign body granuloma.Conclusions Pathology examination is helpful in the diagnosis of some lethal cases due to acute ooisoning,and it can provide pathological basis to study on treatment of acute poisoning.

Objective To improve the accuracy of X-ray diagnosis of the deltoid ligament injury by evaluating the influence of plantar flexion on the diagnosis.Methods Twenty-four patients with ankle supination-extemal rotation fracture which was distal fibula fracture but no medial malleolus fracture were treated from February 2010 to December 2010.All the patients were taken Mortise radiograph with the ankle in four positions of plantar flexion(0°,15°,30° and 45°)applied with rotational stress and the deltoid ligament injury was identified with MRI.The medical clear space(MCS)and the superior clear space(SCS)on each radiograph were measured.The results were tested by a one-way analysis of variance model(ANOVA),based on the following criteria:(1)the MCS≥ 4 mm and MCS ＞ SCS,or when MCS≥5 mm and MCS ＞SCS.The MRI examination was taken as the gold standard to compare the influence of X-ray diagnosis of the deltoid ligament injury with different plantar flexions and different standards.Results The average MCS in four positions of plantar flexion(0°,15°,30°,and 45 °)with rotational stress were(4.10 ±0.79)mm,(4.55 ±0.72)mm,(4.99 ±0.56)mm and(5.71 ±0.86)ram,with statistical difference(P ＜0.05).The average SCS in four positions of plantar flexion(0°,15°,30°,and 45°)were(3.56 ±0.41)mm,(3.50 ±0.43)mm,(3.71 +0.44)mm and(3.93 ±0.51)mm,with no statistical difference in the four groups(P ＞0.05).With the MSC≥4 mm and MSC ＞ SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 50.0％,66.7％,88.9％ and 94.4％ respectively.With the MSC≥5 mm and MSC ＞SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 5.6％,11.1％,38.9％ and 77.8％ respectively.Condusions Different plantar flexion angle is an important factor for X-ray diagnosis of deltoid ligament injury of the ankle joint.The prevalence of false-positive findings of deltoid injury increases with the increase of plantar flexion.

Objective:To test the validity and reliability of the General Alienation Scale (GAS)in college students sample.Methods:Totally 1200 college students were surveyed,using classical test theory (CTT)and i-tem response theory (IRT)to test the psychometric properties of GAS.Under the framework of CTT,item selec-tion was performed with all data.Then,the sample was divided into two groups based on the input order to exam-ine the construct validity.Exploratory factor analysis (EFA)and parallel analysis (PA)were performed with odd group,while confirmatory factor analysis (CFA)was performed with even group.Criterion validity was examined with the short-form of the University of California Los Angeles Loneliness Scale (ULS-8),General Self-Efficacy Scale (GSES),Rosenberg Self-Esteem Scale (RSES).Under the framework of IRT,all data was fitted the rat-ing scale model (RSM),including the principal component analysis of residuals (PCAR),the item fit indexes (Infit and Outfit),measurement reliability (item separation index,item reliability,person separation index and person reliability)and the Wright map.Results:Under the framework of CTT,the GAS was retained 13 items except item 2 and 5.The results of both EFA and PA showed that 13 items of GAS was one-dimensional,and there was a good fit of CFA (χ2 /df=2.689,P <0.001,CFI =0.897,TLI =0.877,RMSEA =0.055,SRMR =0.046).The correlation coefficients were 0.57, -0.60 and -0.40 with the GAS,ULS-8,GSES,RSES
scores respectively (Ps <0.001 ).The Cronbach 's αcoefficient and confidence interval were 0.81 (0.80, 0.83).Under the framework of IRT,the ratio of first-paired eigenvalue was 1.6 in PCAR.The infit and outfit of retaining 13 items in CTT were from 0.6 to 1.4 excluding item 4.The item separation index,item reliability,per-son separation index and person reliability of the 12-item GAS were10.91,0.99,2.14 and 0.82 respectively.The item difficulty can matched with person ability,and they were closed to the normal distribution.Conclusion:It suggests that the General Alienation Scale (GAS)is of good validity and reliability,and it could be used as an ef-fective tool for measuring the alienation of college students.

Objective To evaluate the incidence and imaging features of tibial plateau fracture combined with dislocation.Methods A total of 298 patients with intact imaging data treated for tibial plateau fracture from December 2012 to June 2014 were analyzed retrospcctively.Tilt angle of medial fragment fracture line,ratio of width of medial fragment to total plateau,surface area percentage,fragment height,and major displacement were measured on CT images using picture archiving and communication system (PACS).Results Eighteen patients (6.0％) had tibial plateau fractures combined with dislocation,with tilt angle of medial or posteromedial fragment fracture line of (62.1 ± 14.1)°.Eleven patients (61％) had split of the medial tibial plateau with surface area percentage of (46.3 ± 2.5) ％,fragment height of (43.9 ± 6.2) mm,and major displacement of (5.3 ± 2.1) mm.Seven patients (39％) had posteromedial fragment fracture with surface area percentage of (25.1 ± 5.7) ％,fragment height of (40.0 ± 10.1) mm,and major displacement of (4.8 ± 6.45) mm.Conclusions Fracture line of fracture-dislocation tibial plateau fracture is much often through the eminence or located at the lateral eminence with large medial or posteromedial fragments.Surgical approaches and directions of nailing should be considered properly according to the morphological characteristics.

Objective To investigate mortality risk factors in patients with severe cardiorenal syndrome treated with continuous hemofiltration therapy. So we can optimally select patients who may benefit more from this therapy. Methods The clinical data of 68 severe cardiorenal syndrome patients admitted to the ICU of Beijing Shijitan Hospital from May 2012 to May 2015 were retrospectievly analyzed and evaluated. These patients were divided into two groups based on survival or death during hospitalization. Logistic regression analysis was employed to identify independent risk factors for death of patients with severe cardiorenal syndrome during ICU stay. Results There were 36 cases in the death group and 32 cases in the survival group. In the death group, the age,mechanical ventilation rates, vasoactive drug application rates, leukocytes, neutrophils, C-reactive protein,left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly higher than those in the survival group,while hemoglobin, serum creatinine, left ventricular ejection fraction, average single amount of dehydration in continuous hemofiltration process were significantly lower than those in the survival group. Logistic regression analysis showed that age, vasoactive drug application rates, APACHEⅡscore and leukocytes were independent risk factors of mortality. Conclusions Cardiac function, mechanical ventilation therapy, average single amount of dehydration in continuous hemofiltration, hemoglobin, C-reactive protein were closely related to the prognosis of severe cardiorenal syndrome patients. The patient′s age,infection, vasoactive drug application, APACHEⅡ score were important risk factors of mortality during hospitalization.

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431