BACKGROUND:Currently, transplantation of bone marrow mesenchymal stem cel s into the spinal cord is very limited to the recovery of animals fol owing spinal cord injury. Methylcobalamin is a common drug for the treatment of neurological diseases and injuries, but its effects on bone marrow mesenchymal stem cel s are unclear. OBJECTIVE:To study the feasibility of bone marrow mesenchymal stem cel s differentiating into neuron-like cel s induced by methylcobalamin in vitro and to observe the cel viability and proliferation of differentiated cel s. Methods:Rat bone marrow mesenchymal stem cel s were isolated, cultured and purified by density gradient centrifugation and adherent culture. The fourth to fifth generation of bone marrow mesenchymal stem cel s were treated for 24, 48 and 72 hours with different concentrations (25, 50 and 100 mg/L) of methylcobalamin. The morphological changes and cel growth were continuously observed under an inverted phase constract microscope. The viability of induced cel s was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expressions of Nestin and neuron-specific enolase were identified by reverse transcription PCR and western blot. RESULTS AND CONCLUSION:Most of bone marrow mesenchymal stem cel s could differentiate into neuron-like cel s after induction with methylcobalamin. The expressions of Nestin and neuron-specific enolase were up-regulated after 48 hours of methylcobalamin treatment at different concentrations, especial y after treatment with 100 mg/L methylcobalamin. Similarly, the expressions of Nestin and neuron-specific enolase could be increased significantly after 100 mg/L methylcobalamin treatment for 24, 48 and 72 hours, especial y for 72 hours. It is indicated that methylcobalamin can induce bone marrow mesenchymal stem cel s differentiating into neuron-like cel s, and the optimal concentration of methylcobalamin is 100 mg/L.

Objective To conduct a meta-analysis of the curative effect and safety of the drug-coated balloon (DCB) and uncoated balloon (UCB) in treating femoropopliteal artery ischemic disease in order to provide more credible conclusion to guide clinical practice.Methods By retrieving relevant documents contained in Medline,EMbase,Cochrane library,EBSCO,Springer Link,Scopus,Web and other data pools,the research articles of clinical trials that met the inclusion and exclusion criteria were collected.According to the risk assessment standard of Cochrane collaboration network,the academic qualities of included articles were evaluated,the relevant data were extracted,then,the meta-analysis was conducted with RevMan5.3 software.Results A total of 8 papers were collected,which were originated from 6 clinical trials (from 2008 to 2015) and included 1188 patients in total.DCB group had 722 patients,and UCB group had 466 patients.Meta analysis showed that the target lesion revascularization (TLR) rates at 6,12 and 24 months after angioplasty in DCB group were significantly lower than those in UCB group.The late lumen loss (LLL) amount and re-stenosis rate at 6 month after angioplasty in DCB group were lower than those in UCB group.No statistically significant differences in amputation rate and mortality at 6,12 and 24 months after angioplasty existed between the two groups.Conclusion In treating femoropopliteal artery ischemic disease,the use of DCB is superior to the use of UCB in aspects of TLR rate,LLL amount and re-stenosis rate,besides,no significant difference in safety exists between DCB and UCB.Therefore,priority should be given to the use of DCB when the patient's economic conditions permit.

In recent years,the humanistic quality education in vast number of medical colleges and universities shows a low level of wandering state.This in not only related with the poor condition of current humanistic quality course,but also related with the diametrically opposed humanistic quality education and medical professional education and lack of organic integration.To improve the medical colleges' educational level is urgent to establish the concept of holographic education of great medicine,great education and great culture,improve the teaching quality of current humanistic quality education,actively explore the deep integration of humanistic quality education and medical professional education,improve the humanistic quality and nurturing ability of teachers staff in medical universities and colleges,and so on.

Objective To investigate the clinical efficacy of one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach the medial edge of rectus abdominis in treating severe lumbosa-cral tuberculosis .Methods 17 cases with L4-S1 tuberculosis were treated by internal fixation with pedicle screw ,anterior debride-ment through the extraperitoneal approach the medial edge of rectus abdominis ,and application of allogenic bone from January 2008 to December 2011 .All patients performed X-ray ,CT and MRI examinations before surgery .L5-S1 were involved in 8 cases ,L4-5 were involved in 6 cases ,and L4-S1 were involved in 3 cases;unilateral psoas abscess was found in 6 cases ,while bilateral psoas ab-scess was found in 3 cases ;Among the 17 cases ,8 cases had intraspinal invasion ,and 5 cases were combined with neurological dys-functions ,however ,according to Frankel grade ,4 cases were grade D ,and 1 case was grade C .Regular anti-tuberculosis treatment was given for more than 2 weeks before surgery ,and regular supportive treatment and anti-tuberculosis treatment were given for 9-12 months after surgery .As for regular follow-up(3 ,6 ,9 ,and 12 months after surgery ,and every 6 months later on) ,patients had examinations including ESR and X-ray to evaluate the tuberculosis activity and the condition of bone graft fusion ;while accord-ing to Frankel grade of nerves function ,changes in nerve function before and after surgery were evaluated in patients ,and changes of lumbosacral angle were also comparatively studied before and after surgery .Results There were no great vessel injuries and no nerve injuries except one case who had intraoperative ureteral injury which was repaired in time .The 17 patients were all followed up for 10-36 months(18 months average) ,and all reached clinical healing without complications such as tuberculous peritonitis ,e-rectile dysfunction and retrograde ejaculation .During the follow-up period ,there were no tuberculosis recurrence ,no loosening of in-ternal fixation ,and no break of rod and nail ;the grafted bones were fused in all patients with an average time of 7 .5 months ;accord-ing to Frankel grade of nerves function ,only one patient was grade D ,while the other four cases recovered to grade E .The lumbosa-cral angle of patients was corrected from 23 .8° ± 4 .0°(19 .8°-27 .8°) before surgery to 29 .1° ± 3 .6°(25 .5°-32 .7°) after surgery , and the change was statistical significance(P<0 .05) .Conclusion The one-stage posterior internal fixation with pedicle screw and anterior debridement of bone grafting through the extraperitoneal approach inside of rectus abdominis is a safe and effective meth-od ,which can thoroughly remove the focus ,reconstruct the lumbosacral stability ,and prevent the loosening of bone grafting .

An EPA and DHA enriched fish oil ( containing EPA 0.24 g/L, DHA 0.47g/L ) was administered by gastric intubation at the dose of O.2ml/100g wt for a period of one month in the hyperlipoprotein-emia rats caused by high lipid and cholesterol feeding. The administration of fish oil resulted in reduction in TG ( Triglyceride ) ; TC ( Total Cholesterol ) and VLDL-C + LDL-C levels in serum. Levels of HDL2-C and ratio of HDL2/HDL3 were elevated although there was no significant change in level of HDL-C. The study suggests that oral administration of EPA and DHA enriched fish oil might reduce the developoment of atherosclerosis.

OB J ECT I V E To explore the adjacentpatterns between adenoid and Eustachian cushion in hypertrophic adenoid children and to study its relationship with otitis media with effusion(OME). METHODS A retrospective analysis was conducted in 144 cases of pediatric adenoidal hypertrophy(or concurrenttonsil hypertrophy) admitted for adenoid ablation under the 700 nasal endoscope. Children were divided into 3 groups(TypeⅠ, Ⅱ and Ⅲ) according to adjacentpatterns between adenoid and Eustachian cushion.The incidence of OME, severe hypertrophy of adenoid(A/N>0.7) in differentgroup were analyzed. RESULTS There were 34 children (23.6%) with OME, 3 (9.1%) in type Ⅰ, 10(16.9%) in type Ⅱ and 21(40.4%) in type Ⅲ. No significantdifference was existed between the incidence of OME in type Ⅰ and Ⅱ. In contrast, significantdifference were found in the incidence of OME between the type Ⅲ and type Ⅰ, Ⅱ. The incidence of severe adenoid hypertrophy was 34.9% in typeⅠandⅡ children and 82.2% in type Ⅲ children(P<0.05). CONCLUSION Adjacentpatterns between adenoid and Eustachian cushion, the degree of adenoid hypertrophy play an importantrole in the incidence of OME.

Objective To compare the analgesia effect of transversus abdominis plane(TAP) block and caudal block after radical surgery of Hirschsprung’s disease.Methods Sixty pediatric pa-tients,52 males,8 females,aged 1-3 yr,of ASA physical status Ⅰ or Ⅱ,scheduled for elective rad-ical surgery on Hirschsprung’s disease,were equally randomized into TAP block group(group TAP) and caudal block group (group CA).0.2% ropivacaine 1 ml/kg was used in both blocks.FLAAC scores were measured at 6,12,18 and 24 h after surgery.The requirement of sufentanil every 6 h, the first passage of flatus,the time of removing urine tube and the incidence of nausea and vomiting within 24 hours were recorded.Results Compared with group TAP,FLAAC scores and the require-ment of sufentanil were significantly decreased at 6 h after operation in group CA(P <0.05).FLAAC scores and the requirement of sufentanil were similar at 12,18 and 24 h in the two groups.The first passage of flatus,the time of removing urine tube in group TAP were significantly shorter than group CA(P < 0.05 ).The incidence of nausea and vomiting were not significantly different in the two groups.Conclusion Although both TAP block and caudal block can provide effective analgesia for the pediatric patients after radical surgery on Hirschsprung’s disease,caudal block provided superior anal-gesia at early stage after operation,however,TAP block is more beneficial for earlier recovery of bowl function.

BACKGROUND:Impaired balance between osteogenesis and adipogenesis of bone marrow mesenchymal stem cels is a crucial pathological mechanism of osteoporosis. Mechanical loads applied to bone tissue can increase bone formation and improve bone strength, and meanwhile lead to the release of extracelular nucleotides, such as adenosine triphosphate.
OBJECTIVE: To determine the effects of adenosine triphosphate on the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cels and to investigate the underlying mechanisms.
METHODS:The effect of adenosine triphosphate (10, 50, 250 μmol/L) on differentiation of bone marrow mesenchymal stem cels were measured by osteogenic and adipogenic related genes expression, alizarin red staining and oil red O staining. The activation of ERK1/2 signaling pathway by adenosine triphosphate was tested using western blot assay.
RESULTS AND CONCLUSION: Incubation of bone marrow mesenchymal stem cels with adenosine triphosphate resulted in the dose-dependent increase of osteogenic genes expression and calcium deposition, and inhibition of adipogenic genes expression and lipid droplet formation, but had no effects on cel proliferation. Adenosine triphosphate activated ERK1/2 signaling pathway, and U0126 as an ERK1/2 inhibitor restrained the effect of adenosine triphosphate on the differentiation of bone marrow mesenchymal stem cels.

Mounting evidence supports that a newly identified regulatory T cell (Treg), CD4(+)LAP(+) Treg, is associated with oral tolerance induction and following inhibition of atherosclerosis, but little is described about whether nasal tolerance to antigen likewise induces the novel Tregs production and the relevant antiatherosclerotic benefit. We investigated the effect of nasal administration of heat shock protein-60 (HSP60) on atherogenesis. HSP60 or phosphate buffer solution (PBS) was nasally administered to six-week-old male ApoE(-/-) mice. At the 10th week after the nasal administration, there was a significant decrease in atherosclerotic plaque areas of aortic roots in the HSP60-treated mice as compared with those in the PBS-treated mice. Atherosclerosis suppression was accompanied with a significant increase in CD4(+)LAP(+) and CD4(+)CD25(+)Foxp3(+) Tregs and a concurrently increased production of TGF-β in the HSP60-treated mice. The protective effect of HSP60 was offset by injection of anti-TGF-β antibody. It is concluded that nasal administration of HSP60 can inhibit atherosclerotic formation through immune tolerance which is established by Tregs depending on the induction of anti-inflammatory cytokine TGF-β. Immune tolerance induced by nasal administration of HSP60 may provide an alternative therapeutic method for atherosclerosis.

AIM: To observe the efficacy of hemoperfusion (HP) to treat one case suffering from overdose digoxin poisoning. METHODS: HA 330 ml and YT 160 hemoperfusion cartridges were used and blood vessel was femoral vein, single needle and two chamber catheter. Four HP were done. RESULTS: The blood digoxin level were 16 ?g?L -1 before and after the 1st HP, 9.22 ?g?L -1 at the 2nd, 12.4 ?g?L -1 before the 3th, 10.45 ?g?L -1 after the 3th, 3.22 ?g?L -1 before the 4th, and 2.84 ?g?L -1 after the 4th HP. CONCLUSION: This case demonstrats that multiple HP at different period may decrease the blood digoxin level step by step.