BACKGROUND: Bone marrow mesenchymal stem cells (MSCs) have multi-differentiation potential. In the acute wound, MSCs have been demonstrated to have the potential for differentiating into skin cells. However, there are few reports regarding its differentiation in diabetic wound.OBJECTIVE: To observe the feasibility of differentiation of MSCs into the cells of skin appendages under the microenvironment of diabetic wound.METHODS: MSCs were isolated from the bone marrow of rats, purified and cultured. Third or fourth passage MSCs were selected and labeled with 5-bromodeoxyuridine (5-BrdU). The rats were injected intraperitoneally with single administration of streptozocin to establish diabetes model. After 2 weeks, a round skin wound was made on the dorsal back of rats. BrdU-labeled MSCs at a density of 1×10~9/L were injected into the wound of the rats. The specimens were harvested from the wound tissues to prepare sections at 2 and 3 weeks after transplantation, followed by immunohistochemical staining with BrdU or keratin. RESULTS AND CONCLUSION: BrdU positive cells aggregated in the epidermis, dermis and hypodermia. Some positive cells appeared in the sebaceous glands and sebaceous duct cells and expressed keratin simultaneously in serial sections. During diabetic wound healing, MSCs have the potential to differentiate into the cells of the skin appendages.

Objective To establish the GFR reference range of solitary kidney by 99 Tcm?DTPA SPECT imaging and explore factors influencing renal compensation. Methods A total of 108 patients ( 62 males, 46 females, age range:5-83 (47±19) years) with only one functional kidney who underwent 99Tcm?DTPA dynamic imaging from January 2011 to September 2015 were retrospectively analyzed. The GFR was measured to establish the reference range. Meanwhile, the potential influence factors were analyzed, inclu?ding age, gender, location of the functional kidney, removal and causes of the non?functional kidney. Two?sample t test, one?way analysis of variance and Bonferroni test were used. Results The GFR were (71.81± 23.23) ml/min in the 108 patients. There were no significant differences of GFR between male and female patients ( t=0.496) , between patients with left functional kidney and those with right functional kidney( t=0.999), between patients with and without removed non?function kidney(t=-1.966), and among patients with different causes of the non?function kidney( F=1.894;all P>0.05) . The GFR was significant different in different groups based on age( F=13.924, P<0.001) . There was a negative correlation between the GFR and age( r=-0.570, P<0.001) . The GFR CV in different age groups (≤20 years, 20 years60 years) were 37.6%,26.7%,21.3%,30.1%, respectively. Conclusions It is objective and efficient to assess the renal compensation by establishing the reference values for GFR of the solitary kidney. There is a negative correlation between age and renal compensation, and the variation of renal compensation is larger in younger patients.

Objective To offer decision support for reasonable allocation of medical resources by analysis of the present resources allocated.Methods Lorenz curve and Gini coefficient method were called into play.This paper studied such medical resources as the practicing doctors,registered nurses,medical institutions and hospital beds,from both the population distribution and geographical distribution aspects.The purpose is to compare the allocation in these municipalities (Beijing,Tianjin,Shanghai and Chongqing).Results If the Lorenz curve is drawn based on the total population served with such resources,the Gini coefficients indieate relatively balanced allocation of medical institutions,practicing physicians,and registered nurses in the municipalities,and highly balanced allocation of hospital beds.If the curve is drawn based on geographical distribution,the Gini Coefficient indicates relatively balanced allocation of medical institutions allocation in these municipalities,yet considerable difference in the allocation of practicing physicians,registered nurses,and hospital beds.Conclusion The study shows that medical resources allocation in China in these municipalities mirrors the condition of Priority to population density,and neglect of geographical distribution.It also reveals poor equity in the geographical distribution of medical resources,which plagues accessibility of medical resources.

Objective To investigate the anti-HBs level in 15 years after vaccination in adults and newborns in Beijing and provide the suggestion for the adult hepatitis B (HB) immunization plan.Methods A serological survey was conducted in 6 705 subjects aged > 1 year old by multistage randomized cluster sampling in Beijing during August 2013 to February 2014.The subjects who had received a 3-dose recombination HB vaccine when they were newborns or adults aged ≥15 years old and did not undergo revaccination were selected.Antibody to hepatitis B surface antigen (anti-HBs) titers and positive rates in 15 years after vaccination were evaluated.Results A total of 129 and 463 subjects who were vaccinated in adults and newborns were enrolled in the study.Based on the self-limited rate(30%) of HBV infection among the general population aged 15 to 59 years, anti-HBs positive rates for the subjects vaccinated in adults were estimated to be 58.6%,62.5 % and 48.4% during 0-4, 5-9 and 10-15years after vaccination respectively.The corresponding median of anti-HBs titers were 288.8, 120.6 and 62.6 mIU/mL.The anti-HBs positive rates for the subjects vaccinated in newborns during 0-4, 5-9 and 10-15 years after vaccination were 83.3%, 47.3% and 43.5%, respectively.The corresponding anti-HBs titers were 71.8, 8.9 and 6.7 mIU/mL.Conclusions The protection afforded by primary immunization with recombination vaccine in adults and newborns lasts at least 15 years.

Objective To evaluate the effectiveness and influencing factors of 131I treatment for cervical lymph node metastases of papillary thyroid carcinoma (PTC).Methods Eighty-nine post-operative PTC patients (24 males,65 females,11-72 years) with cervical lymph nodes as the only site of metastasis (negative serum TgAb,1-4 times of 131I treatment) on 131I planar Rx-WBS or SPECT/CT were retrospectively reviewed.Results of 131I Rx-WBS or SPECT/CT,serum Tg levels under both TSH-suppressed and TSH-stimulated conditions were measured and recorded.CR and PR were recognized as effective therapy.x2 test and logistic regression analysis were used to analyze the data.Results The effective rate of 1-4 times of 131I treatment was 57.30％(51/89),73.03％(65/89),80.90％(72/89),83.15％(74/89),respectively (x2=18.792,P＜0.01).Logistic regression analysis suggested that therapeutic effectiveness was related to the size of metastatic lymph nodes and whether metastatic lymph nodes could be visualized on the post-ablative 131I Rx-WBS or SPECT/CT.Conclusions 131I treatment is an effective modality for PTC patients with cervical lymph nodes as the only site of metastasis.The cumulative effective rate increased within a limited times of treatment.The size of metastatic lymph nodes and whether metastatic lymph nodes could be visualized on the first post-ablative 131I Rx-WBS or SPECT/CT are the key factors for the therapeutic effectiveness.

Objective The aim of this retrospective study was to analyze the role of surgery in the management of limited-stage-Ⅱ small cell lung cancer.Methods A retrospective review of 82 patients with limited-stage Ⅱ small cell lung cancer between January 2001 and December 2009 was performed.The prognostic impact of different therapy and the clinicopathologic factors were analyzed.Using SPSS 16.0 statistical software for data analysis.Log-rank test for the difference of survivale rate.Using the Cox model for muliti-factor survival analysis.Chi-square test for local recurrence and distant metastasis rate.Results The overall median survival time and the 1-,3-,and 5-year overall survival rates were 27.0 months,62.1％,35.9％,and 21.0％,respectively.Median survival was 34.0 months in surgical patients vs 16.0 months in nonsurgical patients (P =0.000).Median survival after lobectomy or pneumonectomy was significantly longer than after wedge resection (P =0.048).However,survival after wedge resection was still significantly longer than survival in nonsurgical patients(P =0.024).Survival analysis confirmed that the operation,chemotherapy and radiotherapy were showed to be independent prognostic factors.The local-regional recurrencer rates of lobectomy or pneumonectomy group was lower than wedge resection group(P =0.030).The distant metastasis rates of lobectomy or pneumonectomy group was lower than nonsurgical grou (P =0.021).Conclusion This study suggests that lobectomy or pneumonectomy combined with adjuvant radio-chemotherapy should be recommended for patients with limited-stage Ⅱ small cell lung cancer.

BACKGROUND:Currently, there is no effective treatment for keloids that often recur. Its pathogenesis is stil entirely unclear, and fibroblast proliferation and apoptosis have become a research hotspot.
OBJECTIVE:To investigate the expression of Livin, Smac and Caspase-3 in keloids and to analyze their relationship so as to preliminarily explore the significance of Livin, Smac and Caspase-3 in the pathogenesis of keloids.
METHODS:RT-PCR and immunohistochemical methods were used to detect the mRNA and protein expressions of Livin, Smac and Caspase-3 in keloids (n=20) and normal skin tissues (n=20).
RESULTS AND CONCLUSION:Compared with the normal skin tissue, the mRNA and protein positive expressions of Livin were significantly higher in keloids (P < 0.05), while the mRNA and protein positive expressions of Smac and Caspase-3 were lower in keloids (P < 0.05). There was a negative association between Livin and Smac, Caspase-3 protein expression in keloids. These findings indicate that the high mRNA expression of Livin may cause the imbalance between proliferation and apoptosis of fibroblasts by inhibiting the mRNA expression of Smac and Caspase-3, and eventualy lead to the formation of keloid.

Objective To study the effects of berberine (BBR) on the gene mRNA expression of fat-specific protein 27 (FSP27) and PR domain containing 16 (PRDM16) signal pathway in visceral white adipose tissues (VWAT) from type 2 dia? betic (T2DM) Chinese hamsters, and explore the related mechanisms. Methods The obese insulin-resistant (OIR) hamster model was induced by high-fat diet, and T2DM hamster model was created by OIR hamster model injected with low-dose streptozotocin. The control group was fed with standard laboratory chow. After the induction, the hamsters were randomly di?vided into control, OIR, obese T2DM and BBR-treated T2DM groups. After nine-week BBR treatment, real-time quantita?tive PCR was used to measure the gene mRNA expression changes of VWAT FSP27 and PRDM16 signal pathway and their target genes from different groups. Results Compared with control group, the gene mRNA expressions of PRDM16, CtBP-1, CtBP-2, C/EBPβ, PPARγ, PGC1α, PGC-1β and brown adipose tissue-specific genes such as UCP-1, Cidea, Elovl3, PPARα, and Acox, Cpt1 and Acadm were decreased and that of FSP27 and white adipose tissue-specific genes including Resistin, MEST and Serpina3k were increased in VWAT in OIR and obese T2DM groups. BBR treatment down-regulated FSP27 expression, enhanced PRDM16 signal pathway, and induced the gene mRNA expression of brown adipose tissue-spe?cific genes in VWAT of obese T2DM group to develop browning gene phenotype of VWAT, and then improved fat-induced insulin resistance. Conclusion The decreased FSP27 expression and increased PRDM16 expression are involved in the molecular mechanisms of browning of visceral white adipose tissues induced by BBR, and which contributes to improve ab?normal lipids metabolism and fat-induced insulin resistance in VWAT by enhancing consumption of energy as heat to re?store VWAT function.

Objectives Todynamicallyobservethechangesofhemodynamicparametersinpatients with severe stenosis of unilateral middle cerebral artery (MCA)by transcranial Doppler ultrasound (TCD) andtoevaluateandanalyzetherelatedfactorsforinfluencingthestenoticprocess.Methods Atotalof 113 consecutive patients with severe stenosis of unilateral MCA screened by TCD and confirmed by computed tomography angiography (CTA)and digital subtraction angiography (DSA)were enrolled retrospectively. They were divided into either a progressive group (n =43 )or a non-progressive group (n=90)according to the variation of MCA hemodynamic parameters. The effects of age,sex,major risk factors for cerebrovascular disease,clinical symptoms,clinical medication,and drug compliance on the stenotic process were documented and analyzed. Results (1)The comparison of detection rate of the risk factors for cerebrovascular disease:The patients with a history of smoking (72. 1%[n=31])in the progressive group was significantly higher than that (51. 1%[n=46])in the non-progressive group (P=0.022). The period of smoking of the patients in the progressive group were longer than that in the non-progressive group (28 ± 12 years vs. 21 ± 10 years,P=0. 011). (2)Comparison of MCA hemodynamic parameters:The distal pulsatility indexes of MCA stenosis at the first diagnosis in the progressive group were all lower than those in the non-progressive group (0. 66 ± 0. 10 vs. 0. 70 ± 0. 13;t= -2. 096,P=0. 038),and the distal pulsatility indexes of MCA stenosis at the end point in the patients of the progressive group were lower than those in the non-progressive group (0. 61 ± 0. 15 vs. 0. 74 ± 0. 15). There were significant differences (t=-2. 718,P= 0. 008). The peak systolic velocity (PSV)of the progressive MCA stenotic segments at the end point in 10 patients of the progressive group was higher than that in the non-progressive group (299 ± 23 cm/s vs. 244 ± 50 cm/s,t=3. 437;P=0. 001),while PSV of MCA in 33 patients with occlusion in the progressive group were significantly lower than those in the non-progressive group (56 ± 18 cm/s vs. 244 ± 50 cm/s,t= -20. 905;P=0. 000). (3)The regular medication:The patients using statins (atorvastatin calcium)were significantly lower than those of the non-progressive group (2. 3%[n=1] vs. 54. 4%[n=49],χ2 =33. 690;P<0. 01). (4)During the follow up period,the recurrence rates of transient ischemic attack and stroke of the progressive group were significantly higher than those of the non-progressive group (27. 9%[n=12]vs. 6. 7%[n=6],32. 6%[n=14]vs. 2. 2%[n=2];all P<0.01). (5)Multivariate Logistic regression analysis showed that smokers (OR,4. 403,95%CI 1. 094-14.017),cerebrovascular event recurrence (OR,10. 648,95%CI 2. 530 -41. 261),and irregularly taking statins (OR,5. 675,95%CI 1. 631-152. 740)were all closely associated with the progress of severeMCAstenosis.Conclusion EvaluationofthehemodynamicchangesofsevereMCAstenosiswith TCD follow up study can be used as an important basis for clinical assessment of the outcomes. Stop smoking and regularly taking statins may help to delay the progress of MCA stenosis.

Objective To evaluate the correlations of vascular structures,hemodynamic changes and recanalization before receiving carotid endarterectomy ( CEA) in patients with subtotal or complete occlusion of carotid artery using color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) ultrasonography. Methods A total of 107 patients were diagnosed as subtotal ( stenosis rate 95% to 99%) or complete occlusion of carotid artery with DSA and treated with CEA at Beijing Xuanwu Hospital, Capital Medical University from January 2005 to January 2014 were enrolled retrospectively. The mean age of patients was 61 ± 9 years. According to the findings of DSA,they were divided into either a carotid artery subtotal occlusion group (n=63) or a complete occlusion group (n=44). The vascular diameter,the locations of the lesions ( internal carotid artery or common carotid artery) ,the lumen echo characteristics,and whether internal-external artery collateral circulation patent or not at different stages in patients of both groups were documented. Results The lumen diameter of distal segment was significant wider in patients of the complete occlusion group compared with the subtotal occlusion group (4. 1 ± 1. 1 mm vs. 3. 2 ± 0. 8 mm). There was significant difference between the 2 groups (P <0. 01). There was no significant difference between the location of occlusion and the recanalization rate (P=0. 460). The recanalization rate of the lumen homogeneous echo ( hypoecho and echodense) filling patients (94. 1% vs. 86. 7%) was significantly higher than that of the patients of heterogeneity echo. In patients with complete occlusion of internal carotid artery,the recanalization of CEA would increase when the internal-external collateral arteries were patent. For general comparison,the recanalization rate of the subtotal occlusion group was significantly higher than that of the complete occlusion group (P<0. 01). Conclusion The carotid artery diameter normal or broadening ,the homogeneous echo in the occlusive lumen and the internal-external collateral arteries patency are closely associated with the recanalization rate. The preoperative ultrasonography has great value for the assessment of recanalization of carotid artery occlusive disease after CEA.