BACKGROUND:The mechanism and effect of glycogen synthase kinase 3β(GSK-3β) in the differentiation of cardiac stem cel s into cardiomyocytes are stil unclear, although GSK-3βis closely related to the life activities of cel s.
OBJECTIVE:To investigate the changes of GSK-3βexpression in the treatment of myocardial infarction in rats undergoing cardiac stem cel transplantation.
METHODS:The isolation and culture of cardiac stem cel s were performed in 10 neonatal rats. Lentivirus overexpressing GSK-3βor LacZ (control) was constructed and transferred into cardiac stem cel s. Animal model of myocardial infarction was made in 30 Sprague-Dawley rats. Six weeks after model preparation, rat models were assigned into GSK-3β, LacZ or PBS group. GSK-3βor LacZ overexpressing cardiac stem cel solution or PBS in equal volume was injected into the rat myocardium, respectively. Four weeks after transplantation, the cardiac function and myocardial col agen production in rats were detected and compared.
RESULTS AND CONCLUSION:Compared with the other two groups, the left ventricular ejection fraction was significantly higher, and the left ventricular end diastolic diameter was significantly lower in the GSK-3βgroup (P<0.05). Hydroxyproline content, type I col agen mRNA, and type III col agen mRNA expression were significantly lower in the GSK-3βgroup than the other two groups (P<0.05). Findings from Masson staining showed that the content of blue-stained col agen was significantly lower in the GSK-3βgroup than the LacZ group. Moreover, lowest myocardial infarction size was found in the GSK-3βgroup (P<0.05). Al these experimental findings show that GSK-3 overexpression plays a positive role in promoting the therapeutic effect of cardiac stem cel transplantation.

Objective To investigate the effects of VCAM-1 on migration and invasion of glioma cell lines . Methods The techniques of lentivirus pSGU6/GFP/Neo-based VCAM-1 shRNA and EF1 a-GFP/puro-based VCAM-1 expression vector, the scratch wound healing migration and transwell invasion assays , and the Western blot and cell staining were applied to observe the effects of VCAM-1 expression levels on migration and invasion of glioma cell line cells.There are four groups in T98G cells including control, vector, scramble and shRNA-VCAM-1 groups and three groups in U251 cells covering control, vector and VCAM-1 overexpressed groups ( n=6 per group) .Results The stabled glioma cell lines of T98 G cells with down-regulated VCAM-1 and U251 cells with VCAM-1 overexpression were established by using lentivirus-based VCAM-1 shRNA and expression vector.The ability of scratch wound healing (migration activity) decreased significantly (P<0.01) in T98G cells with lower VCAM-1 expression levels, while the migration activity was obviously improved in U251 cells with overexpressed VCAM-1 ( P <0.05 ) .Similarly, the invasion ability was significantly inhibited ( P <0.05) in T98G cells with silenced VCAM-1, as well as VCAM-1 overexpression could enhance the invasion ability of U251 cells ( P<0.01 ) .Conclusions VCAM-1 improves the migration activity and invasion ability of human glioma cell line cells.

Objective To compare and analyze clinical and pathological data of autopsyconfirmed invasive fungal disease (IFD) in elderly patients in order to achieve a better understanding of the clinical and pathological characteristics of IFD.Methods A total of 18 cases of IFD were diagnosed by autopsy from 1984 to 2014 at Beijing Hospital.Clinical and pathological data of IFD,including risk factors,clinical manifestation,X-ray and pathological characteristics,were analyzed retrospectively.Results The 18 cases were all male wvith an average age of (83.7±7.2) years and each patient had at least one risk factor for IFD.Of them,14 patients (77.8％) suffered malignancies of various origins.With respect to the pathogens,Mucor (6 cases) was the most common one,followed by Aspergilla (4 cases),Mycotoruloides (4 cases) and Cryptococci (2 cases).The lung was the most frequently implicated organ wvith 13 cases (72.2％),followed by the gastrointestinal tract.Vascular erosion was an important pathological characteristic of fungal infection,whose presentations included vasculitis,hemorrhage and embolism in tissues and organs.14 patients died from fungal infection-related causes,of which.massive hemorrhage as a result of vascular erosion by fungal infection was responsible for four patients' deaths.Conclusions Malignancies are an important risk factor for invasive fungal disease in elderly patients.Vascular erosion is a significant character of fungal infection.

Objective To understand clinical distribution and antimicrobial resistance of clinically isolated Serratia marcescens(S .marcescens ),and provide basis for rational use of antimicrobial agents,as well as prevention and control of infection.Methods 427 S .marcescens strains isolated between January 1 ,2012 and December 31 ,2015 were analyzed,antimicrobial susceptibility testing were performed by disk diffusion method.Results 427 S . marcescens strains were mainly from respiratory tract (70.26%),among which the majority were from sputum (64.87%).S .marcescens were primarily from intensive care unit(ICU,19.44%),department of integrated tradi-tional Chinese and Western medicine(15.46%)as well as rehabilitation department (13.58%).The resistance rates of S .marcescens to cefoperazone/sulbactam,ertapenem,cefepime,ceftazidime,amikacin,imipenem,levofloxacin, and piperacillin/tazobactam were all<10%;resistance rates to ciprofloxacin,gentamicin,tobramycin,ceftriaxone, sulfamethoxazole/trimethoprim (SMZ/TMP),and aztreonam were 10%-30%.Difference in the resistance rates of S .marcescens to cefoperazone/sulbactam,ciprofloxacin,ceftriaxone,amikacin,aztreonam,and SMZ/TMP dur-ing 4 years were statistically significant (P <0.05).In 2012-2013,resistance rates of S .marcescens to cefopera-zone/sulbactam,ciprofloxacin,ceftriaxone,aztreonam,and SMZ/TMP increased obviously,then resistance rates tend to be stable,while resistance rates to cefoperazone/sulbactam decreased.Conclusion Susceptibility of S.marcescens to most antimicrobial agents are high,but resistance had increasing tendency;susceptible rates of S .marcescens to ertapenem,ceftazidime,levofloxacin,and piperacillin/tazobactam are all high,and can be used as the empirical medication for the treatment of related infection.

Objective A preliminary study on the etiology , the gene typing , the PCR-ribotyping and the clinical features of Clostridium difficile from clinical isolates at Xiangya Hospital could improve the isolation rate and provide the basis for effectively prevention of C.difficile.Methods A prospective observational study was performed.A total of 452 stool samples were collected during June to December 2012 at Xiangya Hospital.All stools were anaerobic cultured by selective medium and identified by API 20A for C.difficile.The positive isolates were detected the toxin genes ( tcdA, tcdB, cdtA, cdtB ) and ribotyping (16S-23S internal spacer region ) by PCR.The clinical data of all patients were collected and analyzed through Logistic regression to discover the risk factors for the development of C.difficile infection ( CDI ) . Results The rate of CDI occurrence was 13.94%(63/452), among them, 42.86%(36/63) were A-B+strains and only 14.29%(9/63) were obtained from community acquired-CDI.No binary toxin was detected in any of the isolates.Eleven different PCR ribotypes were identified , the dominant ribotype CD017 accounted for 22.22%(14/63).Logistic regression analysis showed that the risk factors for CDI included age>55(P=0.016;OR=4.45;95%CI:1.33-14.91), diarrhea frequency(P=0.007, OR=0.03;95%CI:0.002 -0.38 ) and the duration of diarrhea ( P =0.015; OR =7.86; 95%CI: 1.50 -41.16 ) . Conclusions C.difficile is the main pathogens of diarrhea patients and is mainly from hospital infections with higher detection rate of A -B+ in Xiangya Hospital.Ribotyping exist comparative advantages type CD017.No evidence suggests outbreak of C.difficile infection.

Objective To investigate the diagnostic value of the T-SPOT.TB in connective tissue disease(CTD) combined with tuberculosis.Methods This is a case-control study.Forty-four patients with CTD combined with tuberculosis were enrolled from Xiangya Hospital of Central South University from September 2011 to July 2012.Another forty-four CTD patients without tuberculosis were evaluated as a control group.The diagnostic value of T-SPOT.TB and risk factors of the false negative results by T-SPOT.TB were analyzed.Results The sensitivity of T-SPOT.TB (70.5％,31/44) was significantly higher than that of TST(27.3％,12/44) for CTD combined with tuberculosis patients (x2 =16.42,P ＜ 0.001).The specificity of T-SPOT.TB and TST were 93.2％ (41/44) and 88.6％ (39/44),respectively.There was no significant difference between the specificity (x2 =0.14,P =0.711).The positive predictive value of T-SPOT.TB was 91.2％ (31/34).The negative predictive value was 75.9％ (41/54).Youden's index was 0.64,and the positive likelihood ratio was 10.3.All the index were higher than that of TST (0.16 and 2.4).While the negative likelihood ratio which was 0.32 was lower than that of TST (0.82).When spot forming cell frequencies of T-SPOT.TB of PBMC was set to 38SFCs/106 PBMC,it had the best cut-off value.Age,use of glucocorticoids or immunosuppressant therapy,lymphocytopenia and hypoalbuminemia were not associated with false negative T-SPOT.TB assay.Conclusion The T-SPOT.TB assay is much more useful than TST for diagnosing CTD combined with tuberculosis.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; China ; DNA Methylation ; Female ; Humans ; Male ; Muscular Dystrophy, Facioscapulohumeral ; genetics ; Pedigree ; Young Adult

Objective:On the basis of introducing and piloting long-term care insurance services and providing home care for older adults with disabilities in Suzhou, this paper aims to explore the working experience of home caregivers in the caring environment, understand their difficulties and issues, explore their true feelings and the relevant causes, and to draw lessons from their experience, providing constructive suggestions for the establishment of caregivers as well as policy recommendations for the government.Methods:The qualitative research method was used to collect the field experience data of 9 home caregivers in the caring environemnt through observation and semi-structured interview. Colaizzi phenomenological analysis was used to process and analyze the data.Result:1. Heavy workload and lack of incentive mechanism; 2. Care experience is diverse, with a sense of achievement and happiness, but lack of family′s trust and identification; 3. Professional trainings and peer support are needed.Conclusion:1. Improving the working environment of caregivers and reducing the burden of care; 2.Improve the employment treatment of home care workers, and actively improve the relevant incentive mechanism;3. Paying attention to the emotional experience of caregivers and helping them adapt to their role; 4.Standardize professional knowledge and skills training, provide risk assessment tools, and improve the quality of care.

Objective To evaluation the effect of high flow humidification oxygen (HFHO) therapy for two elderly cases with respiratory rhythm abnormalities and multiple organ dysfunction weaning from mechanical ventilation.Methods Clinical features and weaning processes of two elderly cases with respiratory rhythm abnormalities and multiple organ dysfunction were analyzed and the related literature was reviewed.Results Two elderly patients had multiple organ dysfunction,respiratory rhythm abnormalities and other difficult weaning factors.After a variety of unsuccessfully weaning patterns,HFHO was successfully used in helping patients wean from mechanical ventilation,with gradually increasing the time of HFHO and restoring respiratory muscle function.Conclusions For elderly patients with artificial airways,respiratory muscle dysfunction(long-term mechanical ventilation)and/or respiratory rhythm abnormalities,HFHO is a promising weaning method.

Objective To compare the synergies between the transcutaneous needle electrodes and the ETT surface electrodes used for neurological surveillance in thyroidology,and explore how to identify and protect recurrent laryngeal nerve and vagus nerve when the patient is not suitable for oral plug or surface electrodes are failure.Methods To collect and analyze the clinical data of 32 patients undergoing surgical treatment for thyroid disease,a total of 40 neurons of the recurrent laryngeal nerves and vagus nerves were monitored,and the amplitude and latency were recorded using ETT surface electrodes and transcutaneous needle electrodes for nerve monitoring,respectively.SPSS 26.0 software was used for statistical analysis,paired t-tests were used to analyze and compare the latency periods,and the rank sum test was used to analyze whether there is a difference in the amplitude obtained from stimulation of transcutaneous needle electrodes and ETT surface electrodes.Results When the transcutaneous needle electrodes were used in thyroid surgery,we identified all the nerves,obtained two-phase electrical signals similar to the latency and amplitude of the ETT surface electrodes,and could effectively identify the recurrent laryngeal nerve and vagus nerve[(3.22±0.50)ms vs.(3.85±1.00)ms,P＜0.05]through the incapacity period,with no obvious difference in the monitoring effect from the ETT surface electrodes[(3.04±0.58)ms vs.(3.89±1.07)ms,P＜0.05].At the same time,the visualization and safety of transcutaneous needle electrodes were higher,with great advantages.Conclusion Transcutaneous needle electrodes can effectively assist in identifying and protecting the recurrent laryngeal nerve and vagus nerve,and thus are an important supplement to ETT surface electrodes.