Objective To explore the effects of intramuscular injection human umbilical cord mesenchymal stem cells(hUCMSC)intramuscular injection on the cardiac function and myocardial ultrastructure in rats with Adria-mycin -induced dilated cardiomyopathy (DCM)rats.Methods One hundred and sixty rats were randomly divided in-to a normal group (20 cases)and DCMgroups (1 40 cases),rats in DCMgroups receiving Adriamycin (2 mg/kg)in-traperitoneally once a week for 8 weeks to establish DCM models.The DCM rats were randomly divided into a model control group (served as model group),the supernatant of hUCMSC group (served as supernatant group),the low -dose hUCMSC group(served as low -dose group),the medial -dose hUCMSC group(served as medial -dose group), and the high -dose hUCMSC group(served as high -dose group).Echocardiography was performed to evaluate the car-diac function,plasma brain natriuretic peptide (BNP)level and serum cardiac troponin I (cTnI)level were detected by enzyme -linked immunosorbent assay kit;light microscope and transmission electron microscopy (TEM)were used to observe the ultrastructure of myocardium.Results Rats in the DCM group showed low spirit,declining food intake, progressive emaciation,slow growth,hair loss and ascites.After the intramuscular injection of hUCMSC,the above symp-toms of rats in the low -dose and the medial -dose hUCMSC groups were improved significantly.Before the administra-tion of hUCMSC,the left ventricular ejection fraction (LVEF)[(64.53 ±2.61 )%]and the left ventricular fractional shortening (LVFS)[(30.80 ±2.1 1 )%]were significantly decreased in the DCMgroup compared to those of the con-trol group[(79.67 ±3.02 )%,(43.08 ±3.1 5 )%,all P <0.01 ].After the administration of hUCMSC,LVEF [(75.5 ±7.4)%,(74.0 ±6.1 )%]and LVFS[(40.8 ±3.8)%,(40.2 ±5.0)%]were significantly increased in the low -dose and the medial -dose group compared with those of the model group [(65.8 ±4.5)%,(30.2 ± 2.9)%,all P <0.01 ].The concentration of plasma BNP level [(438.3 ±82.2)ng/L,(341 .7 ±68.9)ng/L]and serum cTnI level [(375.9 ±1 1 0.9)ng/L,(355.9 ±55.6)ng/L]were significantly decreased compared with those of the model group [(449.9 ±91 .8)ng/L,(425.9 ±42.6)ng/L,all P <0.05].The findings of HE staining showed that cardiomyocytes were orderly arranged,edema decreased and cell nucleus homogeneously stained in the low -dose and the medial -dose group.The outcomes of TEM revealed that the ultrastructure of cardiomyocytes was improved in the low -dose and the medial -dose group compared with that of model group,and the cardiomyocyte sarcolemma re-mained intact,and the swelling of mitochondria ameliorated and the cristae of mitochondria remained clear.Conclusions Intramuscular injection of hUCMSC could significantly increase LVEF and LVFS in the Adriamycin -induced DCM rats,and decrease the plasma BNP levels and the serum cTnI levels,attenuate the myocardial pathological damage and improve myocardial ultrastructure.

Objective To investigate the expression levels of Interleukin(IL)?6 and matrix metalloproteinases(MMP)?13 in synovial fluid by in?vigorating kidney and activating blood formulae in treating rabbit knee osteoarthritis model. Methods A total of 30 New Zealand rabbit were ran?domly divided into blank group,model group,invigorating kidney group,activating blood group and invigorating kidney and activating blood group. Rabbits model with knee osteoarthritis were established by improved Hulth method. To give corresponding respectively the medicinal broth,model group was given saline,knee joint synovial fluid was collected after 4,8 and 12 weeks. Enzyme linked immunosorbent assay(ELISA)was used to measure the levels of IL?6 and MMP?13. Results The levels of IL?6 in rabbit knee osteoarthritis were obviously higher than that of normal control group at both 4 weeks and 8 weeks(P<0.001). But there was no statistical difference on the levels of IL?6 compared with controls in 12 weeks. In addition,the level of MMP?13 at 4 weeks,8 weeks and 12 weeks were significantly higher than the blank control group(P<0.001). After 8 weeks of Chinese medicine administration,the levels of IL?6 in synovial fluid were significantly decreased in invigorating kidney group,activating blood group and invigorating kidney and activating blood group(P<0.001),but there was no statistical difference among groups in 12 weeks. The MMP?13 levels of synovial fluid was significantly lower than the model group(P<0.001). Conclusion Our results indicate that IL?6 and MMP?13 par?ticipate in the pathological development of the rabbit knee osteoarthritis. Invigorating kidney and activating blood formulae could reduce the expres?sion of IL?6 and MMP?13 and alleviate osteoarthritis progression,and which is superior to the pure invigorating kidney formulae and activating blood formulae.

BACKGROUND:Studies have shown that intramuscular transplantation of xenogeneic umbilical cord mesenchymal stem cel s in a certain dose range is safe and reliable, and it also confirm that this approach is equal y safe and effective for heart failure in rats with dilated cardiomyopathy. OBJECTIVE:To explore the effect of human umbilical cord mesenchymal stem cel s through intramuscular injection on the cytokine expression in adriamycin-induced dilated cardiomyopathy (DCM) rats. METHODS:Total y 160 rats were randomly divided into control group (n=20) and DCM group (n=140). Rats in the DCM group were administered adriamycin intraperitoneal y to establish DCM model. The DCM rats were randomly subdivided into model control group (served as model group), cel supernatant group, the low-dose mesenchymal stem cel group (served as low-dose group), the middle-dose mesenchymal stem cel group (served as middle-dose group), and the high-dose mesenchymal stem cel s group (served as high-dose group). Secondary injection was performed at 4 weeks after first injection. RESULTS AND CONCLUSION:The ELISA test showed that the serum levels of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), leukemia inhibitor factor (LIF) and granulocyte macrophage colony stimulating factor (GM-CSF) were higher in the model group than the control group before and after intramuscular injection (P<0.05). After intramuscular injection, the levels of HGF, LIF, GM-CSF and VEGF in the low-dose group were increased significantly (P<0.05), which were significantly higher than those in the model group (P<0.05). The level of LIF in the middle-dose group was significantly elevated after injection (P<0.05), while there were no significant differences in HGF, VEGF and GM-CSF levels in the high-dose group before and after intramuscular injection (P>0.05). Both the immunohistochemical and RT-PCR results showed that the expressions of insulin-like growth factor-1, VEGF and HGF were increased in al the DCM rats as compared with the control group, which were increased most in the middle-dose group. These findings indicate that low-dose and middle-dose human umbilical cord mesenchymal stem cel s intramuscular injection can increase the serum levels of HGF, LIF, GM-CSF, VEGF and the expressions of IGF-1, HGF and VEGF in the myocardium of DCM rats.

Objective To analyze the characteristics of proximal deep vein thrombosis (DVT) after total joint arthroplasty.Methods 40 cases of proximal DVT were collected from May 2007 to October 2016 which were all diagnosed by lower limb venography or sonography.There were 9 males and 31 females aged from 38 to 86 years,average 67 years,and body mass index was from 16.94 to 31.25kg/m2,with an average of 24.3 kg/m2.29 cases of THA patients and 11 cases of TKA patients.The anatomical distribution,size,radiological performance,local physical findings were recorded and multivariable analysis was performed to evaluate the relationship between distribution of proximal DVT and related parameters including age,gender (male/female),side of leg(left/right),surgery type(knee and hip),preoperative diagnosis(femoral neck fracture/other disease),time of diagnosis with DVT (during hospitalization/after discharge).Results Among 40 proximal DVT cases,31 cases diagnosed by phlebography and 9 cases were diagnosed by ultrasound.2 cases were isolated proximal DVT while 38 cases connected with distal DVTs.9 cases of blood clots in the proximal and distal thrombosis connected discontinuously.There was no isolated proximal DVT in TKA group and 10 cases (90.9％) of blood clots in the proximal and distal thrombosis connected continuously while there were 2 cases (6.9％) isolated proximal DVTs in THA group and 21 (77.8％) of blood clots in the proximal and distal thrombosis connected discontinuously,and there was no statistic significant difference between the two groups.The average length of proximal was 8.85±9.3 1cm (range from 2-35cm) with 5.0±2.05 cm in TKA group and 10.31 ± 10.55 cmin THA group.A significant difference was found between the 2 groups (P=0.014).13 cases located in femoral veins and upper venous region which were all from THA group.There was a significant difference in the distribution between surgery type and preoperative diagnosis.However,there was no significant difference between other potential factors and distribution of proximal DVT.25 cases accepted the evaluation of symptom of DVT before scanning.However,no significant difference were found in edema,VAS score,Homans sign,Neuof sign between 9 TKA and 16 THA cases.Conclusion Proximal DVTs after knee and hip arthroplasty are more preferred to connect with distal DVT continuously.Surgery type and preoperative diagnosis have a significant effect on the distribution of proximal DVT.Proximal DVTs in THA and patients with preoperative femoral neck fracture could be more easily involving femoral veins and upper parts.

Objective To discuss the education of exercise rehabilitation specialty in China using World Health Organization rehabil-itation competency framework(RCF). Methods With reference to World Health Organization Rehabilitation in Health Systems and RCF,this paper discussed the objectives,course contents and human resource management of exercise rehabilitation in China. Results Rehabilitation service was an important part of health service to achieve the goals of United Nations 2030 health coverage,well-being of all people and sustainable development.Sports rehabilitation would cultivate profession-als with knowledge of rehabilitation medicine and exercise rehabilitation.We should establish the concept of"people-oriented",improve the multi-disciplinary human resource management system,and improve the provi-sion of multi-dimensional rehabilitation services in communities and hospitals,to cultivate professionals with both theoretical and practical abilities.RCF played an important role in developing teaching objectives,which helped for competency oriented education,curriculum settings,and an education system centered on competency. Conclusion Under the context in Rehabilitation in Health Systems and RCF,we have clarified the competency character-istics required for the training of sports rehabilitation professionals,optimized the training mode of sports rehabil-itation professionals,and explored the path to achieve the goals of sports rehabilitation talent training.

According to the requirement of the national assessment for achieving the infection control criteria, 42 villages (among them,25 villages belonged to the first stratum, and 17 villages belonged to the second stratum) in 14 counties from 5 provinces, including Hunnan, Hubei, Jiangxi, Anhui and Yunnan, were selected as sampling villages for the assessment.The results from the field assessment showed that 154 out of 9 067 people were found infected with Sckistosoma japonicum, with an average infection rate of 1.7% ranged from 0.31 % to 4.10% , and only Yongping Village from Weishan County and Tenglong Village from Eryuan County were not found any case. A total of 46 out of 3 323 head of cattle were infected with S. japonicum, with an average infection rate of 1.38% ranged from 0.26% to 3.79% , and no any infected individual detected in Nanling County. No outbreak occurred in those sampling villages. Therefore, it is indicated that the five sampling provinces have reached the national criteria on infection control of schistosomiasis.

Objective To evaluate the feasibility of anticoagulant therapy for acute proximal deep vein thrombosis without inferior vena cava filter placement for femoral neck patients before hip arthroplasty.Methods From January 2013 to August 2017,9 femoral neck fractures patients with acute proximal deep vein thrombosis before hip arthroplasty were enrolled into this study.There were 3 men and 6 women.The average age was 76.44±5.39 years old (range,69 to 83 years old).The average injured time before admission was 4.00±4.06 days.All patients received anticoagulant therapy without placement of inferior vena cava filter before hip arthroplasty.Four patients received Rivaroxaban 10mg,two times per day,while two patients received Enoxaparin 0.4 ml,two times per day;3 cases received Batroxobin 0.5 ml,every other day combined with Rivaroxaban 10 mg one time per day or Enoxaparin 0.4 ml,one time per day.The size of thrombus before and after treatment,changes of coagulation markers,the outcome of thrombosis before surgery,during surgery,postoperatively and during follow-up,the related complications were recorded.Results The diagnosis time for proximal DVT was 3.89±3.01 days after admission.8 patients showed proximal DVT combined with distal thrombus and 1 patient showed isolated proximal DVT.The average length of proximal thrombus was 10.78±6.10 cm (range,4.0-20.0 cm).The mean duration of treatment was 14.22±7.03 days.The results showed 5 proximal DVTs have complete disappeared,3 cases significantly improved,and 1 case had no change but showed stable.After treatment,the length of the proximal thrombus was significantly decreased (10.77±6.10 cm vs.4.39±6.50 cm),there were statistically significant between two groups (t=3.429,P=0.009);D-dimer was significantly lower after treatment (10.47±4.87 μg/ml vs.2.59± 1.60 μg/ml) with statistical difference (t=4.970,P=O.O01).However,no statistical significance was found in other coagulation parameters such as plasma prothrombin time,the international normalized ratio,activated partial thromboplastin time,thrombin time,fibrinogen.Incision exudate occurred in one patient and anticoagulant therapy was paused,however,two days later,DVT recurred and then the patient received continuous therapy with drug anticoagulation.The average time for postoperative follow-up was 8.3±7.6 months.At the latest follow-up,4 cases had thoroughly recovered with the thrombi fully resolved;4 cases had significantly improved including three thrombi partly locating in the muscular veins and one partly locating in the infra-popliteal vein.One case became more severe after discharge and received continuous anticoagulant therapy.No death,symptomatic pulmonary embolism,bleeding and other adverse events occurred.Conclusion Inferior vena cava filter placement for femoral neck fracture patients with acute proximal venous thrombosis before hip arthroplasty may not be potent.Anticoagulant therapy which make the proximal thrombus completely dissolved or stabilized before surgery may be effective.

【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.