Objective:To examine the expression pattern of DSP,DMP1,CBFA1,BMP2 in rat dental pulp stem cells(RDPSCs).Methods:Immunohistochemical staining was carried out using antibodies against DSP,DMP1, CBFA1 ,BMP2 in rat dental pulp stem cells. Mineralization was induced in the RDPSCs and expression of DSP and DMP1 was measured after induction.Results:CBFA1 and BMP2 were positive in RDPSCs. Only a few RDPSCs were stained positive for DMP1. DSP expression was observed in the minority of these cells. However, the majority of the RDPSCs were found strongly positive for DSP and DMP1 after mineralization induction.Conclusion:Positive expression of CBFA1 and BMP2 indicates the premature nature of RDPSCs. The dentin-specific expression of DSP demonstrates that the RDPSCs can differentiate along odontoblastic lineage.

Objective To provide useful information for the diagnosis and differentiation through exploring the tumor with polyserositis as the initial symptom.Methods There was a case present with fever,poor spirit,abdominal distention and edema in Children's Hospital of Hebei Province.The characteristics and results of physical examination were summarized and discussed according to the condition evolution phases.The possible etiological factors were analyzed.The treatment was adjusted.Further physical examination was improved.The final diagnosis was tracked.Results After getting admitted to hospital,the patient received CT scan and ultrasound examination for many times.The results suggested the pericardial effusion,pleural effusion,peritoneal effusion and cardiac insufficiency.The child had made a slight improvement through treatment.However,he had hemiparesis.Cerebral infarction was demonstrated through magnetic resonance imaging(MRI),magnetic resonance angiography (MRA),magnetic resonance venography (MRV).Ultrasound showed that there was more pericardial effusion,aortic root solid low echo mass,pulmonary arterial wall stiffness,left and right pulmonary artery blood flow speed increased.Neck and chest enhanced CT showed mediastinal lesions.Pathology examination results suggested myeloid sarcoma after referral to superior hospital.Conclusions When children had an unexplained polyserositis,more comprehensive analysis were needed.The illness condition should be explained with Monism as far as possible.Repeated inspections would be necessary when the pathogenesis was not clear.Careful watch for the tumor should be kept.

Objective To explore the effectiveness and safety of high frequency oscillatory ventilation(HFOV) in children with measles complicated with severe pneumonia and the acute respiratory distress syndrome(ARDS).Methods A total of 63 children with measles complicated with severe pneumonia and the ARDS were divided into conventional mechanical ventilation(CMV) group and HFOV group.The PaO2/ FiO2,oxygenation index (OI),HR and mean arterial pressure (MAP) before treatment and 12 h,24 h,48 h after treatment were detected.The rate of air leak and the motality in two groups were compared.The efficacy and safety of HFOV treatment were evaluated in children with measles complicated with pneumonia and severe ARDS.Results In HFOV group,the PaO2/FiO2 ratio was elevated and OI was decreased significantly after 12 h and maintained for at least 48 h.Compared with CMV group,OI of HFOV group improved more significantly,and the difference was statistically significant.The ventilation time in HFOV group was shorten than that in CMV group[(7.97 ±3.06) d vs.(11.03 ±3.60) d],but there was no statistical difference between two groups (P ＞ 0.05).The heart rate after treatment 48 h was gradually returned to normal,and there was no statistical difference between the two groups.There were no significant changes in the MAP of two groups after treatment.There were no significant differences in the incidence of air leak between the CMV group and the HFOV group(24.2％ vs.16.7％).The mortality rate of CMV group and HFOV group was respectively 45.5 ％ and 33.3 ％,and there was no statistically significant difference.Conclusion HFOV was effective in oxygenation and seems to be safe for pediatric patients with measles complicated with severe pneumonia and the ARDS.Also it didn't influence the occurrence of complications.It has no adverse influence on hemodynamic parameters.Early intervention of HFOV is safe and effective for the children with measles complicated with severe pneumonia and ARDS.

Objective To analyze the changes of insulin-like growth factor-1(IGF-1) serum level in diabetic lower extremity angiopathy,explore the role of IGF-1 in the pathogenesis of diabetic vascular complications,and provide basis for prevention and treatment of diabetic angiopathy.Methods We selected 74 type 2 diabetes mellitus(T2DM) patients as case group and 15 normal people as control group.All of the research subjects were measured in height,weight,blood pressure,blood glucose,blood lipid,fast insulin,and urinary albumin excretion rate(UAER).The serum IGF-1 level was measured with ELISA.Arteries of both lower extremities were measured with color Doppler flow image.Results ① The serum IGF-1 level was significantly higher in DM patients than in control group.② The serum IGF-1 level was significantly higher in diabetic patients with lower extremities arterial vasculopathy than diabetic patients without.The results showed a positive correlation between the serum IGF-1 level and severity of lower extremity arterial vasculopathy.③ There was a positive correlation between diabetic duration,UAER,total cholesterol(TC),lower density lipoprotein(LDL) in blood and lower extremity arterial vasculopathy in diabetic patients.Conclusion The serum IGF-1 level can reflect the severity of lower extremity arterial vasculopathy.The serum IGF-1 level may be a reference valuable in diagnosis of diabetic macroangiopathy and a new cure point for diabetic macroangiopathy.

Objective To investigate the relationship between the coagulation system status and the pulmonary hemorrhage in children with severe hand,foot and mouth disease(HFMD)and approach the clinical significance of early detection of coagulation function. Methods By prospective case design method,89 cases with HFMD admitted to Department of Critical Care Medicine of Hebei Provincial Children Hospital from July 2010 to July 2012 were enrolled. The children were divided into severe group(46 cases)and critical group(43 cases)according to the severity of disease,and the children in critical group were subdivided into survivor group(26 cases)and non-survivor group (17 cases). Forty-four healthy children with the same age and in the same period were served as healthy control group. The blood of children was collected immediately after admission for determination of blood routine, prothrombin time(PT),thrombin time(TT),activated partial thrombin time(APTT),fibrinogen(Fg),and D-dimer (DD). Results There were no significant differences in PT,TT,APTT and Fg among severe group,critical group and health control group(all P>0.05). The blood platelets count(PLT)in severe group and critical group was significantly lower than that in health control group(×109/L:245±130,237±156 vs. 389±120),while the DD was significantly higher than that in healthy control group(mg/L:0.34±0.67,0.41±0.08 vs. 0.24±0.13),and the DD in critical group was obviously higher than that in severe group(all P<0.05). The mortality rate in critical group was 39.5%,and there were no significant differences in PT,APTT,Fg,TT and PLT between survivor group and non-survivor group(all P>0.05),but the DD in non-survivor group was significantly lower than that in survivor group(mg/L:0.60±0.09 vs. 0.12±0.09,P<0.05). Conclusions In children with severe or critical HFMD, the coagulation factor and blood platelet were in a state of mobilization,mild consumption state with the existence of fibrinolytic inhibition,but without systemic bleeding tendency,therefore it is in a compensatory stage of disseminated intravascular coagulation(DIC),not the mechanism of pulmonary hemorrhage. The monitor of DD has its clinical significance in evaluations of the disease situation and its prognosis.

Aim To investigate the anti-angiogenesis and anti-xenograftes of UA in zebrafish larvaes. Meth-ods 24 hour post-fertilization ( hpf ) TG zebrafish was treated with different concentration of UA for 24h, and the number of intersegmental vessels( IVS) were detec-ted under fluorescent microscope respectively;then the models of AB/TG zebrafish xenografts were established by be micro-injected with SMMC-7721 or HT-29 cell at 48hpf respectively, and after cocultured with UA for 48h, optical density (OD) of the SMMC-7721 cell and subintestinal veins ( SIVs) induced by HT-29 were e-valuated under confocal microscope. Results ISV as-say showed that UA could cause IVS missing or disap-perance, inhibition ratio reaching 20. 25% and 26. 65%. UA blocked the spread of SMMC-7721 cells in zebrafish and OD value,and inhibition ratios at three concentrations were 38. 01%, 54. 69%, 61. 88%, re-spectively; in another SIVs assay induced by xeno-grafts, UA at concentration 10 and 15mg·L-1 showed that SIVs were inhibited (P<0. 01) obviously. Con-clusion UA could inhibit the angiogenesis and the growth of SMMC-7721/HT-29 xenografts,and the anti-tumor mechanism may be related with VEGFR2 expres-sion.

BACKGROUND AND OBJECTIVERadiation sensitivity is closely related to tissue oxygen, and rh-endostatin can induce the high level of oxygen content in tumor by "normalizing" tumor angiogenesis which is associated with radiotherapy sensitivity. The aim of this study is to observe the effect of combination of radiotherapy with rh-endostatin in the rats with lung cancer.

METHODSImmediate lewis cancerous ascetic injection method was used to make rats tumors bearing model, then the rats was divided into four groups randomly: group A was treated with saline; group B was treated with rh-endostatin; group C was treated with irradiation and group D was treated with rh-endostatin and irradiation. After all rats were treated, inhibition rates and the tumor growth curve were calculated. Immunohistochemisty was adopted to check the expressions of vascular endothelial growth factor (VEGF) and microvessel density (MVD).

RESULTSCompared with group A, the growth rates of the tumors in the other group were obviously slower, and the tumor weights were significantly different form group A (P < 0.05). Compared with the other groups, the tumor weights of group D were obviously reduced (P < 0.05). Compared with group A, VEGF and MVD of other three groups were reduced (P < 0.05), and group D were significantly cut down.

CONCLUSIONCombination with radiotherapy and rh-endostatin could inhibit the lung cancer significantly in rats. The possible mechanisms are to decrease the expression ofVEGF and inhibit the production of angiogenesis.

Animals ; Carcinoma, Lewis Lung ; drug therapy ; metabolism ; pathology ; radiotherapy ; Endostatins ; therapeutic use ; Female ; Immunohistochemistry ; Lung Neoplasms ; drug therapy ; metabolism ; radiotherapy ; Mice ; Mice, Inbred C57BL ; Microvessels ; pathology ; Random Allocation ; Vascular Endothelial Growth Factor A ; metabolism

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.

【Objective】 To investigate the clinical efficacy and safety of transurethral blue laser vaporescetion of the prostate in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 The clinical data of 100 BPH patients undergoing the surgery in our hospital during May and Sep.2022 were retrospectively analyzed. The observations included operation time, bladder irrigation duration, postoperative catheter indwelling time, hospital stay, complications, as well as changes in hemoglobin, International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), bladder residual urine volume (PVR), and other related indicators before and 3 months after surgery. 【Results】 All 100 procedures were successfully completed without turning to transurethral resection of the prostate and/or open surgery. No blood transfusion was needed. The operation time was (37.8±19.6) min, bladder irrigation time (1.3±0.5) d, catheter indwelling time (12.7±0.4) d, hospital stay (3.4±0.7) d, hemoglobin drop (4.1±7.1) g/L. The postoperative IPSS and QoL score were significantly lower than those before surgery (P<0.05); postoperative Qmax was higher than that before surgery (P<0.05); postoperative PVR was smaller than that before surgery (P<0.05). Urinary retention occurred in 4 cases (4%) after removal of the catheter; carnal hematuria and bladder clot formation occurred in 3 cases (3%); mixed urinary incontinence occurred in 2 cases (2%); stenosis of the external urethra occurred in 2 cases (2%). All complications were cured after symptomatic treatment. There were no serious perioperative complications, no intraoperative complications such as ureteral orifice injury or bladder perforation, and no serious postoperative complications such as transurethral resection syndrome (TURS), permanent urinary incontinence or bladder neck contracture. 【Conclusion】 The blue laser surgical system had satisfactory effects of vaporization and hemostasia. Transurethral blue laser vaporesection of the prostate is safe and effective in the treatment of BPH.

【Objective】 To investigate the effects of 450 nm diode blue laser on the morphological changes and thermal damage of renal pelvis under different conditions. 【Methods】 An ex vivo study was conducted on a fresh porcine pelvis model (7 cm×5 cm×3 cm). The laser fiber was fixed on the mechanical arm perpendicular to the renal pelvis tissue, and the distance between them was 1-2 mm. The renal pelvis tissue was incised at a speed of 1-2 mm/s and power of 5-30 W. After the incised tissue was fixed in formalin (4%), the morphology, depth, width and coagulation thickness were observed with naked eyes and a microscope. 【Results】 The different powers had different vaporization and incision effects. When the operating distance was 2 mm, the speed was 2 mm/s and power was 5 W, the vaporization depth, width and coagulation thickness were approximately 0 9 mm, 0.25 mm and 0.35 mm, respectively. With the increase of power, the vaporization width and depth increased, and the coagulation thickness was 0.35-0.50 mm. When the power was more than 10 W, the renal pelvis tissue was easily penetrated. When the laser power was 20 W, the section of the renal pelvis showed an irregular shape of vaporization. When the operating distance was 1 mm, the whole renal pelvis tissue was easily vaporized. When it was 2 mm, a wide and safe energy treatment window was produced. 【Conclusion】 The 450 nm diode blue laser can vaporize and incise renal pelvis tissue safely and effectively, with high precision and little thermal damage. It is expected to be a new surgical tool in the treatment of renal pelvis lesions.