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 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.

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 changes in peripheral blood 25-hydroxyvitamin D3 [25-(OH)D3],CD4+ regulatory T (Treg) cells,and Th17 cells in patients with primary biliary cirrhosis (PBC) and their mechanism of action in PBC.Methods A total of 22 patients with PBC were enrolled and the male/female ratio was 1∶21,with a mean age of 61± 12 years.There were 7 healthy volunteers matched for age in the normal control group.Electrochemiluminescence immunoassay was used to measure the peripheral blood 25-(OH)D3 level in the PBC group and normal control group,and flow cytometry was used to analyze the changes in Th1 7 cells and CD4+ Treg cells.The t-test,rank sum test,Pearson correlation analysis,or Spearman's rank correlation analysis was used for statistical analysis according to the type of the data.Results The PBC group had a significantly lower serum 25-(OH)D3 levcl than the normal control group (9.49±3.65 vs 27.35±2.35 ng/ml,P ＜ 0.01).Compared with the normal control group,the PBC group had a significantly higher percentage of Th1 7 cells (2.05％±1.17％ vs 0.99％±0.12％,P ＜ 0.01) and a significantly lower percentage of CD4+ Treg cells (2.54％± 1.14％ vs 3.78％±0.51％,P ＜ 0.05);there was a significant difference in Th17/Treg ratio between the PBC group and the normal control group (1.00±0.63 vs 0.26±0.02,P ＜ 0.01).In the PBC group,peripheral blood 25-(OH)D3 was not correlated with Th17 cells or Th17/Treg ratio (r =-0.062 and-0.328,P ＞ 0.05),while it was positively correlated with the percentage ofCD4+ Treg cells (r =0.468,P ＜ 0.05).Conclusion Patients with PBC have significant reductions in peripheral blood 25-(OH)D3 and percentage of CD4+ Treg cells,a significant increase in the percentage ofTh17 cells,and immune unbalance of Th17 cells and CD4+ Treg cells.25-(OH)D3 can upregulate the percentage of CD4+ Treg cells and thus affect the development and progression of PBC,and exogenous vitamin D may improve immune function in PBC patients.

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 explore the causal relationship between abdominal subcutaneous adipose tissue volume(ASAT)measured by MRI and cardiovascular disease risk with Mendelian randomization(MR).Methods Genome-wide association study(GWAS)data for ASAT measured by MRI were provided by the IEU OpenGWAS project,while GW AS data for cardiovascular disease came from the Finngen database.The primary analysis method employed was the inverse variance weighted(I VW)method.Additional MR analysis methods,included MR-Egger regression,weighted median(WME),simple mode method,and weighted model method.Heterogeneity,horizontal pleiotropy and leave-one-out sensitivity analysis were conducted to verify the robustness of the results and funnel plots were used to verify the evaluation.Scatter plots were used to visualize the causal relationship between ASAT and cardiovascular disease.Results There was a causal relationship between ASAT and the risk of ischemic heart disease(IHD)[odds ratio(OR)1.126,95％confidence interval(CI)1.042-1.217,P=0.003)],heart failure(HF)(OR 1.145,95％CI 1.024-1.281,P=0.017),and hypertension(OR 1.096,95％CI 1.014-1.184,P=0.021),but there was no significant causal relationship with cardiac arrest(CA)(P＞0.05).Heterogeneity was observed in the analysis of ASAT with IHD(Cochran's Q=53.467,P=0.018),HF(Cochran's Q=54.761,P=0.013),and hypertension(Cochran's Q=55.321,P=0.002).Further horizontal pleiotropy MR-Egger intercept tests and funnel plots indicated no horizontal pleiotropy in MR analysis(P＞0.05).Leave-one-out sensitivity analysis results demonstrated the robustness of the study findings.Conclusion There is a causal relationship between ASAT measured by MRI and the risk of IHD,HF,and hypertension.This highlights the need for clinical practitioners to pay attention to the cardiovascular disease risk in obese patients,especially those with abdominal obesity.