Background Normal ultrastructure is the anatomical basis of retinal pigment epithelial(RPE) cells to perform normal physiological function.At present the precipitation method is often used to detect the ultrastructure of RPE cells with transmission electron microscopy(TEM).Objective The aim of this study was to explore a simple and feasible approach to examine the ultrastructure of human embryonic stem cell-derived retinal pigment epithelial (hESC-RPE) cells.Methods hESCs were induced and differentiated into RPE cells by the spontaneous differentiation method,and the expressions of microphthalmia associated transcription factor MITF and paired-box gene 6 (PAX6),specific protein of RPE cells,in the cells were detected by immunofluorescence assay.hESC-RPE cells were inoculated into Transwell filter,and the ultrastructure of the cell sheet was examined under the TEM.Then the ultrastructure of the cell sheet specimens was compared with those of hESC-RPE cells from cell precipitation and RPE cell specimens of 90-day-old Long Evans rats.Results MITF and PAX6 were positively expressed in hESC-RPE cells.The normal ultrastructure were visible in the RPE cells of rats under the TEM,including apical microvilli,polarized melanin granules,cellular nucleus,basement membrane and intercellular junctions,and the ultrastructure of hESC-RPE cell sheet on Transwell was similar to the RPE cells in rats.However,only scatter melanin granules,nonpolar nucleus and scanty microvilli were observed under the TEM in the hESC-RPE cells by cell precipitation method.Conclusions Without digestion process,hESC-RPE cell sheet on Transwell can retain the normal ultrastructure of hESC-RPE cells under the TEM,with a more simple and reliable advantage.

Abstract: Objective　To analyze the epidemiological characteristics of public health emergencies in Xishuangbanna Dai Autonomous Prefecture from 2012 to 2021, and to provide reference for formulating relevant prevention and control measures. Methods　The data of public health emergencies reported in Xishuangbanna from 2012 to 2021 were collected and analyzed through the China Disease Prevention and Control Information System. Results A total of 78 public health emergencies (including "Unrated" events) were reported in Xishuangbanna from 2012 to 2021. The highest 21 cases and the lowest 3 cases were reported every year. A total of 1 0374 cases were reported in 78 public health emergencies, involving a population of 1 703 049, with a morbidity of 609.14/100 000, 24 deaths, mortality of 1.41/100 000 and fatality rate of 231.35/100 000. The event level was mainly "general (level Ⅳ)" with 52 incidents, accounting for 66.67%, and 17 incidents of "major (level Ⅲ)", accounting for 21.79%. 51 cases were mainly infectious diseases, accounting for 65.39%. The peak periods for incidents were May-July and November-February of the next year; there were 39 incidents in schools, accounting for 50%, followed by 20 incidents in families, accounting for 25.64%. The top three reported cases were food poisoning (32.05%), chicken pox 17 (21.79%) and dengue fever 10 (12.82%). Among the 24 deaths in public health emergencies, 22 were caused by food poisoning. Wild bacteria poisoning and alcohol poisoning were the main causes of food poisoning, accounting for 45.83% and 37.5% of the total deaths, respectively. Conclusion Infectious diseases, especially respiratory diseases and food poisoning are the focus of the prevention and control of public health emergencies in Xishuangbanna Dai Autonomous Prefecture, of which Schools and families should be pay close attention. Plague, a Class A infectious disease, caused by the bacterium Yersinia pestis has occurred in two inter-animal outbreaks in 10 years and spread to the population, which should be of great concern.

Objective To explore the safety of the mobilization of peripheral blood stem cells(PBSC)by granulocyte colony-stimulating factor(G-CSF)in elderly donors.Methods 28 peripheral arteriosclerotic occlusive disease(PAOD)elderly patients(aged≥60 years),and 29 healthy sibling young/adult donors(aged＜60 years)for peripheral allogenic stem cell transplantation were included.Blood samples were collected immediately before starting G-CSF and prior to PBSC collection to analyze the following parameters:the WBC counts,fibrinogen(FIB),D-dimer (D-D),thrombin antithrombin complex(TAT),antithrombin(AT)and yon Willebrand factor antigen(vWF:Ag). Results It had a very significant increase in D-D and vWF:Ag and a very significant decrease of AT(P＜0.01),af- ter mobilization by G-CSF,and a increase in FIB and TAT were also observed(P＜0.05,P＜0.01)in elderly group.In the young/aduh group,the increase in FIB was significant(P＜0.05).The elevating extent of D-D and TAT after G-CSF administration was significantly higher in elderly group than that in young/adult group(P＜0.05).Compared to young/adult group,there was a significant increase in thrombotic events and cerebrovascular ac- cident(P＜0.05).Conclusion In PBCS donorsreceiving G-CSF it reveals activation of both coagulation and en- dothelial cells and inhibition of anticoagulant system that can favor the developing of thrombotic events,which is more remarkable in elderly donors.Therefore a careful monitoring for coagulation system should be considered in those elderly cases.

OBJECTIVETo classify the whistling deformities of the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair.

METHODSAccording to exposure degrees of the gum and the crown of the anterior upper incisors, 136 patients with whistling deformities after primary repair of bilateral cleft lip at the Department of Oral and Maxillofacial Surgery of Xiang Ya Hospital, Central South University were examined and the whistling deformities were classified into four grades. Grade I: the crowns of the left and the right upper incisors were exposed about one-second. Grade II: the whole crowns of the upper incisors were exposed or plus the exposure of the crowns of medial sagittal portion of the left and the right upper lateral incisors. Grade III: the whole crowns of two upper incisors and one-second of the attached gum of two upper incisors or the crowns and one-second of attached gum of the two upper incisors with over two-third of transverse crowns of the lateral incisors were exposed. Grade IV: the crowns and corresponding attached gum of the upper incisors and over two-third of medial sagittal crowns of the upper lateral incisors were exposed. The relation between the degrees of the whistling deformities and the primary procedures of the bilateral cleft lip or the bilateral cleft lip and cleft palate was analyzed.

RESULTSSixty patients (44.2 percent) had grade I whistling deformities; forty-seven patients (34.5 percent) were Grade II; 16 patients (11.8 percent) were Grade III; 13 cases (9.5 percent) were Grade IV. The results showed that grade I and grade II whistling deformities were obviously more (about 3.7 times) than grade IlI and grade IV whistling deformities.

CONCLUSIONSClassification of whistling deformities provided the objective basis for the selection of operation techniques of cleft lip.

Adolescent ; Adult ; Child ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Lip ; abnormalities ; Male ; Postoperative Complications ; surgery ; Reconstructive Surgical Procedures ; methods ; Young Adult

Chronic obstructive pulmonary disease (COPD), a common preventable and treatable disease, is characterized by airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways. Its main pathological manifestations include airway inflammation, mucus hypersecretion, oxidative stress and apoptotic epithelial cells. Recent research suggests that MAP kinases and Keap1-Nrf2-ARE signaling pathway are involved in the pathological process of inflammation and oxidative stress. This review explores the potential role of the cross talk of these signaling pathways in airway inflammation, mucus hypersecretion, oxidative stress and apoptotic epithelial cells. To clarify the roles of cross talk between MAP kinases and Keap1-Nrf2-ARE signaling pathway, we also focus on the drugs related to that in the treatment of COPD, and it provides ideas for more drug research in the treatment of COPD.
Apoptosis ; Epithelial Cells ; cytology ; Humans ; Inflammation ; Intracellular Signaling Peptides and Proteins ; Kelch-Like ECH-Associated Protein 1 ; Mitogen-Activated Protein Kinases ; NF-E2-Related Factor 2 ; Oxidative Stress ; Pulmonary Disease, Chronic Obstructive ; metabolism ; Respiratory System ; Signal Transduction

Aged ; Humans ; Male ; Urinary Diversion ; adverse effects ; Urinary Fistula ; diagnosis ; etiology

OBJECTIVETo explore an innovative technique that is aided by multi-disciplinary hybrid approach in identification and treatment of tracheoesophageal fistula (TEF) in children intraoperatively.

METHODFrom April 2008 to October 2011, 4 patients with isolated TEF were presented with 2 H-type fistulas and 2 recurrent TEF. For all the four cases, with the cooperation of the gastroenterologists, respiratory physician and surgeon, methylene blue was first injected into the trachea for detecting the dye in the esophagus by the gastroscopy. Bronchoscopy was performed where the fistula tract was shown by the methylene blue and a guide wire was passed through the fistula. The patients underwent rigid gastroscopy and the guide wire was identified and brought out through the mouth by biopsy pliers. This created a wire loop through the fistula. X-ray was then used to identify the level of the fistula. According to the level of the fistula it was determined whether surgical incision and approach should be used. The fistula was then repaired successfully by surgery.

RESULTIn the 4 patients, with the aid of gastroscopy and bronchoscopy, identification of the fistula intraoperatively was then facilitated by traction on the loop. The fistula was identified and repaired. There were no fistula recurrences.

CONCLUSIONMulti-disciplinary hybrid therapy for tracheoesophageal fistula in children is beneficial for the precise localization of the fistula. This new technique is an effective and definitive method in identification and treatment of TEF in children.

Bronchoscopy ; methods ; Child, Preschool ; Female ; Gastroscopy ; methods ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Patient Care Team ; Retrospective Studies ; Suture Techniques ; Tracheoesophageal Fistula ; diagnosis ; surgery ; Treatment Outcome

Objective To learn the awareness and influencing factors of mental health knowledge in Yinzhou District. Methods The multi-stage cluster sampling was used to investigate 1239 residents by using the questionnaire of the residents' mental health awareness. Results The total awareness rate was 61.3％, and the awareness rate that was relatively low was mainly concentrated on "World Suicide Prevention Day" (29.9％),"mental illness was a problem in mind" (32.1％),"mental illness was due to the stimulation" (44.0％) . Multiple linear regression analysis found that the residents who were older (β=0.039, P<0.05), lived in city (β=2.073, P<0.05), worked as administrators, technicians, and waiters compared with self-employed, retired and unemployed (β: -2.350 - -1.591, P <0.05) scored higher. Conclusion The residents' awareness of mental health knowledge is low. The urban residents, self-employed, workers, farmers, are the key populations to be educated with mental health system.

Objective:To discuss the management principles and skills for treatment of intractable ureterostenosis under ureteroscope.Methods:Our management experience on 19 patients with intractable ureteral stenosis was retrospectively analyzed.The 19 cases included urological TB-caused multiple ureteral stenosis,oncothlipsis to ureters from intestinal tract or gynecology,restenosis 3 months to 12 years after pelviureteric junction plasty,operative site stenosis after ureterolithotomy. double ureter back flow accompanied by stenosis,ureter imperforation after renal parenchyma lithotomy without placing double"J",ureter imperforation 3 months after extracorporeal shock-wave lithotripsy due to ureterolith,tubal bladder stoma stenosis after renal transplantation,restenosis after tubal bladder stoma due to distal ureterostenosis,and so on.All the patients were treated under ureteroscope.The management methods included:the Wolf 8/9.8 CH12?and Wolf 6/7.6 CH5?ureteroscope was used as a dilator to dilate the stenoses:balloon expanding under ureteroscope was used to dilate the stenoses;the ureter pliers was used to expand the stenoses to different directions;the cold knife was used to open the stenoses;if the diameter of stenoses were smaller than the that of the ureteroscopes,F4.5 or F3 double"J"tubes were inserted guided by a wire under ureteroscope; and 2 or 3 weeks later,a larger tube or two tubes were introduced into the stenoses already dilated partly by the former tube. Results:Ureteroscopic method failed in treating 2 patients in our group and succeeded in treating all the other patients.The outcomes of patient were fine during 9 months to 3 years'follow-up.Conclusion:It is difficult to treat patients with intractable ureterostenoses.With good experience in manipulation of ureteroscope,the flexible application of several techniques according to the different conditions of different patients can guarantee successful treatment in most patients.

Objective To evaluate the impact of Emotional Freedom Techniques on anxiety,depression and selfefficacy of elderly patients with type 2 diabetes mellitus.Methods Totally 120 elderly patients with type 2 diabetes mellitus complicated with anxiety and depression were randomly divided into the experimental group(n=60) and the control group(n=60).All patients received routine drug therapy and diabetic education,and patients in the experimental group performed Emotional Freedom Techniques for 4 weeks,10～15 min per time,3 times per day.Two groups were evaluated by Self-Rating Anxiety Scale,Self-Rating Depression Scale and Diabetes Self-Efficacy Scale before and after the intervention.Results The total scores of SAS and SDS in the experimental group after intervention were significantly lower than those before intervention and in the control group(P＜0.01).The total scores of DSES in the experimental group were significantly higher than those before intervention and in the control group (P＜0.01).Conclusion Emotional Freedom Techniques can effectively reduce anxiety,depression and improve self-efficacy of elderly patients with type 2 diabetes mellitus.