BACKGROUND: How dose sodium nitroprusside, as a vasodilatator, affect the potential of bone marrow-derived mesenchymal stem cells (MSCs) in hematopoietic differentiation?OBJECTIVE: To observe the changes during the differentiation of MSCs into hematopoietic cells after adding sodium nitroprusside, and compare the results with those of simple MSCs transplantation.DESIGN: A randomized grouping, controlled observation.SETTINGS: Department of Microbiology and Immunology; Department of Pathophysiology, Guangdong Medical College.MATERIALS: The experiments were carried out in Guangzhou Medical College in August 2006. Twenty-seven clean-degree balb/c mice of 7-8 weeks, were used as recipients, and were randomly divided into MSCs transplantation group (n =9), sodium nitroprusside+MSCs transplantation group (n =9) and blank control group (n =9). Another 4-week-old SD rat was selected as the MSCs donor. Sodium nitroprusside for injection (50 mg/piece) was provided by Beijing Double-Crane Modern Pharmaceutical Technology Co., Ltd (National drug approval: No. H11020907).METHODS: ① Under aseptic condition, the femur of SD rat was collected. MSCs in it were isolated for culture and amplifying in vitro. MSCs of passages 6-7 were digested and centrifugated, and the density was adjusted to 1×109 L-1.Monoclonal antibody with fluorescence labeled was added into cell suspension, and the phenotype was detected with flow cytometry. ② Sodium nitroprusside (50 mg/piece) was adjusted to the terminal concentration of 200 mg/L by adding with saline. It should be used within 4 hours. ③ Before transplantation, all the mice were exposed to 5.0 Gy. X-ray for 4 hours, and the absorbed dose was 1.45 Gy per minute. After irradiation, mice in the MSCs transplantation group were directly infused via caudal vein with 0.3 mL MSCs suspension (containing 1.5×106 cells); The mice in the sodium nitroprusside+MSCstransplantation group were firstly injected with the dispensed 200 mg/L sodium nitroprusside (0.15 mL), and immediately infused with 0.3 mL MSCs suspension (containing 1.5×106 cells) after 1 minute; The mice in the blank control group were infused with isovolume serum-free culture medium. ④ At 60 days after transplantation,peripheral blood was drawn from orbits of the survived mice in each group, single cell suspensions of bone marrow and spleen were prepared after the mice were killed, the levels of rat-derived hematopoietic cells CD11a and CD45 were detected with flow cytometry.MAIN OUTCOME MEASURES: ① MSCs culture and amplification; ② Levels of rat-derived hematopoietic cells in different tissues.RESULTS: All the 27 balb/c mice as recipients survived to the end of the experiment. ① MSCs isolation and amplification: The MSCs attached with uniform shapes of spindle and proliferated rapidly after culture for 3 days, and 90% of the cells were fused without overlapping at 6 days. The cells attached completely within 24 hours after passage,extended and became spindle again, rapidly proliferated and grew, and became fused completely at 3 days. ② Levels of rat-derived hematopoietic cells in different tissues: In the MSCs transplantation group and sodium nitroprusside+MSCs transplantation group, Iow expressions of rat-derived CD11a and CD45 hematopoietic cells could be detected in peripheral blood, bone marrow and spleen, and they were obviously higher in the sodium nitroprusside+MSCs transplantation group than in the MSCs transplantation group (t=2.619, P ＜ 0.05), while negative ones in the blank control group.CONCLUSION: MSCs have the ability to differentiate into hematopoietic stem cells, which can be promoted by sodium nitroprusside.

Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ～ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP＜0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P＜0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P＜0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P＜0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.

Objective To investigate the correlation between the angle and distribution of non-calcified plaque of left main coronary bifurcation and its hydrodynamic theory. Methods Retrospective analysis of 55 patients suspected of coronary heart disease who had undergone coronary computed tomographic angiography from January 2014 to June 2016.Angle,quadrant distribution,distance from bifurcation reference plane,minimal lumen area and extravascular elastic membrane cross section area of left main coronary bifurcation were measured. Then we calculated the plaque burden. The left main coronary bifurcation lesions were divided into plaque group and non-plaque group.Student's t test was used to compare the two groups.The left main coronary bifurcation lesions were divided into≥70°group and<70° group, Chi-square test and Fisher exact test were used to compared the two groups. Pearson correlation analysis was used to analyse the bifurcation angle and plaque distance. The data of non-plaque group was imported into the MIMICS,3-MATIC and abaqus CFD software to establish the hydrodynamic model,which was used to analyze the changes of pressure and velocity at different angles.Results Plaque group has 25 patients whose average value of the bifurcation angle was(55.95±14.77)°;non-plaque group has 30 patients whose average value of the bifurcation angle was(55.95±14.77)°.Angle difference was statistically significant between plaque and non-plaque group(t=2.893,P=0.006);Plaque difference was statistically significant between≥70°and<70°groups.The distance was negatively correlated with bifurcation angle(r=-0.773,P<0.001). Following the increase of bifurcation angle, the vascular wall area of high pressure and low speed region growed The green region of low-wall pressure with irregular distribution appeared in the lateral wall of the vessel that opposite to the red region of the bifurcation,and this region had lager gradient variability of wall pressure. Conclusion With the increase of coronary bifurcation angle, the possibility of plaque formation increases, the distance from plaque to bifurcation increases,the plaques tend to appear in the lateral wall of the blood vessels.

Objective:To analyze the incidence and risk factors of non-acute symptomatic portal vein thrombosis (PVT) after endoscopic gastric variceal injection (GVI) in the treatment of liver cirrhosis with gastric variceal bleeding (GVB).Methods:66 patients with GVB who were treated with GVI for the first time from July 2017 to October 2019 in Minhang Hospital Affiliated to Fudan University were retrospectively analyzed. The data of gender, age, preoperative Child-Pugh grade, preoperative platelet count, preoperative plasma D-dimer concentration, preoperative splenic length, preoperative portal vein velocity, preoperative splenic vein velocity, preoperative portal vein diameter, preoperative splenic vein diameter, treatment times, total number of injection points, total dose of sclerosing agent and tissue adhesive agent were collected. The patients were divided into PVT group and non-PVT group according to the occurrence of non-acute symptomatic PVT within one year after GVI. Univariate analysis was performed first, and then the factors with P<0.2 were included in the binary logistic regression model to screen the risk factors of PVT after GVI. Results:There were 25 cases (37.88%) in PVT group and 41 cases (62.12%) in non-PVT group. There were significant differences in D-dimer concentration, spleen length, Child-Pugh grade and total dose of sclerosing agent between the two groups ( P<0.05). The D-dimer concentration ( OR=2.319, 95% CI:1.359-3.956), spleen length ( OR=1.044, 95% CI:1.007-1.081) and total dose of sclerosing agent ( OR=1.075, 95% CI:1.004-1.152) were independent risk factors for PVT ( P<0.05). Conclusions:Preoperative D-dimer concentration, spleen length and total dose of sclerosing agent can predict the risk of PVT after GVI. In order to reduce the risk of PVT after GVI, the dose of sclerosing agent should be reduced as much as possible.

Objective To investigate the effect and safety of recombinant human brain natriuretic peptide (rhBNP) on heart failure in acute severe viral myocarditis patients(ASVMC).Methods 27 patients from Jan 2010 to Dec 2013 admitted to the Third Affiliated Hospital of Sun Yat-Sen University were divided into two group,rhBNP group 14 patients,control group 13 patients,rhBNP group received rhBNP on the treatment of cedilanid,diuresis,vascular dilation,BNP,cTnI,CK-MB and echocardiography were observed,therapeutic effect of two group were also observed.Results rhBNP decreased BNP [(203.1 ± 39.8) vs.(1185.5 ±48.3) pg/ml],cTnT [(13.5 ±9.8)vs.(24.8 ±13.2) μg/L],CK-MB[(32.9 ±10.7)vs.(195.3 ± 48.2) U/L],improved LVEF [(59.2 ± 9.2) ％ vs.(38.1 ± 8.8) ％] significantly,P ＜ 0.05.Furthermore,the therapeutic effect of rhBNP group were better than control group(P ＜ 0.05),and we didn' t observe obvious side effects in rhBNP group.Conclusion rhBNP is an effective and safe therapeutic measures for heart failure in ASVMC.

Objective To explore the prenatal care before pregnant for women having plan to get second child, and to provide references for the development and guidance of the nursing work for the second pregnant women.Methods From January to October 2015, 1028 pregnant ages women who had plan to have second child were randomly selected and divided into control group and experimental group according to the order of entry into Maternal and Child Health Care Center. The control group (n=514) received routine pre-pregnancy care, while the experimental group (n=514) were given combined nursing intervention. All the women were followed up for 18 to 24 months. The results of the two groups before and after the intervention were analyzed in preconception eugenic health examination related knowledge of the situation. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the mental state and the compliance of pre-pregnancy health examination were compared.Results Compared with the control group, the knowledge of prenatal health examination was significantly higher in the experimental group than that in the control group, as well as health examination, inherited diseases, risk assessment, and pregnant related health knowledge (P<0.05). After the intervention, the scores of the two groups were significantly lower than that before intervention in SDS and SAS, and the difference was statistically significant (P<0.05); after intervention, SDS, SAS and other psychological scores in the experimental group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). The compliance of the experimental group after intervention was significantly higher than that of the control group (P<0.05).Conclusions Nursing intervention can significantly improve the health knowledge of women having second child plan, and the awareness rate is improved after intervention. The effect of nursing intervention on improving the psychological status of pregnant women is satisfactory.

Patients with diabetic retinopathy often experience diabetes distress when facing the challenges of the disease, which has adverse effects on their health outcomes. This paper summarizes the current situation of diabetes distress in patients with diabetic retinopathy, and the assessment tools, influencing factors, and intervention measures, aiming to provide a reference for healthcare professionals to conduct intervention studies.

AIM: To evaluate the effect of TDF withdrawal time on changes of serum HBV-M, HBV DNA and ALT level in the mother-to-child blocking of the maternal population. METHODS: A prospective, randomized and controlled study was conducted. The 120 pregnant women with HBV who took TDF during 24 to 28 weeks of gestation were randomly divided into group A (withdrawal at delivery) and group B (withdrawal at 4 weeks postpartum), levels of HBV-M, HBV DNA, and ALT at different times were detected. The results were statistically analyzed by Wilcoxon Rank-sum test and χ

Objective:To explore the application effect and evaluation of virtual reality technology in oral implant therapy training.Methods:In November 2018, one adult patient (female, 36 years old) with missing right mandibular first molar was treated in the Department of Implantology, School and Hospital of Stomatology, Fujian Medical University. The three-dimensional virtual models of mandible and implant surgery tools were established, and the virtual reality software (Unity 3D 5.5.1) was imported. Combined with the virtual reality head mounted display, a virtual reality training system simulating the dental implant treatment process was independently developed. Ten refresher doctors and 20 graduate students in Department of Implantology, School and Hospital of Stomatology, Fujian Medical University from September 2018 to December 2019 were recruited as the experimental objects (no clinical experience was found). According to the level and seniority of doctors, they were randomly divided into virtual training group and conventional training control group, which made the two groups comparable, with 15 in each group. Subjective scores (including anatomical structure, surgical field of vision, cavity preparation, implant placement and process mastery) were given after the corresponding training in the two groups, and the virtual reality training system was used to test. The mesial and distal direction, buccolingual direction, depth and angle deviation of implants before and after the training were analyzed, and the differences between the two groups were compared.Results:The subjective scores of five dimensions in the virtual training group were significantly higher than those in the conventional training control group ( P<0.05). In the virtual training group, the mesial and distal, buccolingual, depth and angle deviation of implants were (0.73±0.33), (0.78±0.41), (0.61±0.32) mm and 6.66°±3.87°. All of them were significantly lower than those in the control group [(0.85±0.32), (1.12±0.38), (0.89±0.24) mm and 9.68°±3.74°] ( P<0.05). Conclusions:The self-developed virtual reality system of oral implant has good application effect, good operability and predictability. It can be effectively carried out in implant education and training, and it can strengthen skills of doctors, and is conducive to the practical operation.

Pediatric dentistry treats patients aged 0-18 years, encompassing the characteristics of general dentistry. The clinical techniques are closely related to restorative dentistry, endodontics, orthodontics, and maxillofacial surgery, while also possessing unique aspects. It particularly focuses on the growth and development patterns of children′s dentition and maxillofacial structures. Currently, digital technology has deeply integrated with various clinical disciplines of dentistry, and pediatric dentistry has made significant progress with pediatric-specific digital applications. On one hand, the introduction of mature digital technologies is enabling the digital transformation of pediatric dental treatment models; on the other hand, there is innovative development of new digital technologies tailored to the specific needs of pediatric dental care, filling gaps in the field. Based on years of research in digital technology for pediatric dentistry, our team details the current innovative applications and scientific explorations in this area from these two perspectives. Additionally, we anticipate the potential expansion of digital technologies not yet applied in pediatric dentistry, providing a reference for clinical scholars in the field to conduct exploratory research.