BACKGROUND:Urine-derived stem cels are most likely to come from the kidney tissue, and therefore, these cels are more adaptable to kidney microenvironment, providing a new option for the treatment of kidney diseases.
OBJECTIVE: To explore the therapeutic efficacy of human urine-derived stem cels on chronic nephropathy rats.
METHODS:The fresh urine samples of healthy people were colected, and then human urine-derived stem cels were extracted and cultured in vitro. Twenty Sprague-Dawley rats were used to prepare chronic nephropathy models, and given injection of human urine-derived stem cel suspension (experimental) or normal saline (control) into the renal cortex, respectively. Another 10 healthy rats were used as controls. Therapeutic effects on renal function were assessed by detection of serum creatinine level and glomerular filtration rate in the three groups. The kidney tissues of rats were taken and observed histomorphologicaly in each group.
RESULTS AND CONCLUSION: Human urine-derived stem cels were found to remarkable improve rat’s renal function as wel as reduce the histomorphological changes in the kidney tissues of rats. Compared with the control group, the serum creatinine level was decreased while the glomerular filtration rate was increased significantly in the experimental group; CD68 expression and infiltration of interstitial inflammatory cels were also markedly reduced in the experimental group. To conclude, human urine-derived stem cels can improve the renal function of chronic nephropathy rats.

Objective To investigate the clinical,imaging,pathological and molecular biological features of mitochondrial encephalomyopathy with lactic acidosis and stroke -like episodes(MELAS)in children.Methods The clinical,imaging,pathological and molecular biological features of 1 2 children with MELAS diagnosed through muscle biopsy or gene sequencing in the Fifth Affiliated Hospital of Zhengzhou University from January 201 1 to December 201 5 were retrospectively analyzed.Results (1 )Clinical features:the main manifestations included headache and vomiting in 1 1 cases,epileptic seizures in 9 cases,short stature in 8 cases,hairy in 7 cases,intolerance fatigue in 7 cases,cogni-tive decline in 7 cases,visual disturbance in 6 cases,hearing disturbance in 6 cases,and 5 cases had positive family history.In addition,7 cases had the serum lactic acid level increase in a rest for 1 0 min after exercise.(2)Imaging fea-tures:4 cases showed bilateral basal ganglia calcification symmetry in 8 patients who underwent head CT scan.The most frequently involved parts of the lesion were occipital in 1 0 cases,temporal in 9 cases and parietal lobe in 7 cases in stroke -like episodes.The lesions were lamellar necrosis.The abnormal areas by MRI showed low signal intensity on T1 weighted imaging,high signal intensity on T2 weighted imaging and fluid attenuated inversion recovery,high or equal signal intensity on diffusion weighted imaging,high or low signal intensity on apparent diffusion coefficient;the lactate peak significantly increased on magnetic resonance spectroscopy.The distribution was not in accordance with the control region of the cerebral vessels.Dynamic observation revealed that the lesions were reversible and migratory.(3)Myo-pathological features:muscle biopsy was performed in all children,and ragged -red fibers were found in 1 0 cases by im-proved Gomori staining,strongly succinate dehydrogenase -reactive were found in 9 cases,and the lipid droplets slight-ly increased in 8 cases by oil red O staining.Besides,the crystalline inclusion bodies in mitochondria were arranged in a parking lotpattern in 9 cases by electromicroscope.(4)Molecular biological characteristics:the mitochondrial gene mutations were analyzed in peripheral blood of 9 children and their parents,including 8 cases with A3243G muta-tion and 1 case with G13513A mutation.Five mothers had the same A3243G mutation site in 8 cases.Conclusions Children with MELAS have complex and varied clinical manifestations and certain characteristic of neuroimaging.More-over,muscle pathology and gene sequencing have important diagnostic value.Fully understanding the clinical,muscle pathology,imaging and molecular biological characteristics of children with MELAS can be helpful to the early diagnosis and treatment,also reduce misdiagnosis.

Objective To investigate the neuroprotective effect of thyroid hormones T3 on cerebral ischemia-reperfusion injury in rats and its mechanism.Methods SD rats were divided into four groups:sham+saline group,sham+T3 group,MCAO+saline group,MCAO+T3 group.The cerebral ischemia-reperfusion injury rat models were established by right middle cerebral artery occlusion.Thyroid hormones(10 μg/100 g)or normal saline were given respectively by intraperitoneal injection twice at 1 h after the onset of ischemia and 6 h after reperfusion.Neurobehavioral score was evaluated at 24 h after reperfusion;TTC staining was used to label infarction area;RT-PCR was used to detect the mRNA level of nerve growth factor(NGF)and brain derived neurotrophic factor(BDNF)in brain tissue;Western blot was employed to determine alterations in protein levels of NGF and BDNF.Results Compared with MCAO+saline group,the neurological deficit and the volume of cerebral infarction of MCAO+T3 group was decreased,and the mRNA and protein expression of NGF and BDNF of MCAO+T3 group were increased(P<0.05).Conclusion Thyroid Hormones could promote the nerve repair,stimulate the nerve regeneration and improve the nervous behavioral function by up-regulating the expression of NGF and BDNF.

Objective To explore the clinical value of combined detection of human leucocyte antigen G (HLA-G) and interleu-kin10(IL-10) in children patients with cytomegalovirus(CMV) hepatitis .Methods 122 children patients with CMV hepatitis in our hospital from January 2013 to January 2017 were selected as the children patients group and contemporaneous 116 healthy children were selected as the control group .The levels of plasma HLA-G and IL-10 were detected by adopting ELISA .Then their correlation and diagnostic value were analyzed .Results The levels of plasma HLA-G and IL-10 in the children patients group were significant-ly higher than those in the control group ,and the difference was statistically significant (P<0 .05) .In grouping according to the age of the month ,the levels of plasma HLA-G and IL-10 in the 1-6 months old patients group were highest .HLA-G and IL-10 had a positive correlation(r=0 .445) .Moreover ,the receiver operating characteristic curve analysis results showed that the area under the curve of combined detection of plasma HLA-G and IL-10 was maximal and its diagnostic efficiency was highest .Conclusion The combined detection of plasma HLA-G and IL-10 can increase the accuracy of CMV infection diagnosis and has an important clinical significance .

Objective To evaluate the application of atherogenic index of plasma (AIP) and intima-media thickness of carotid artery (CA-IMT) in renal arteriolar sclerosis patients with chronic renal failure.Methods One hundred and twenty nine patients with chronic renal failure patients underwent ultrasound-guided percutaneous renal biopsy from October 2013 to June 2014,the biopsy results showed that renal arteriolar sclerosis was identified in 72 patients (atherosclerosis group) and no renal arterioles sclerosis was detected in 57 patients (non-atherosclerosis group);71 healthy adults were enrolled in the study as controls.The age,height,body weight,systolic and diastolic blood pressure,the indexes of blood lipid and renal function were documented and compared among three groups.The correlation of AIP and CBMmax of common carotid artery and carotid bifurcation with blood lipid level and renal function was analyzed.Results There was significant difference in body weight among patients with atherosclerosis [(70.77 ± 14.27) kg],without atherosclerosis [(60.63 ± 12.12) kg] and the controls [(64.20 ± 8.13) kg] (t =3.071,3.391,all P ＜ 0.05).The TG [(2.43 ± 1.61) mmol/L vs.(1.02 ± 0.37) mmol/L],TC [(7.40 ± 8.80) mmol/L vs.(4.53 ±0.67)mmol/L],LDL-C[(4.40 ±2.13) mmol/L vs.(2.85 ±0.70) mmol/L],AlP[(0.15 ± 0.351) vs.(-0.127 ± 0.184)] of the atherosclerosis group were higher than those of control group (t =5.975,2.252,2.614,-5.467,all P ＜ 0.05).The HDL-C of atherosclerosis group was lower than that of control group [(0.78 ±0.16) mmol/L vs.(1.29 ±0.21) mmol/L,t =4.750,P ＜0.05].The Scr[(117.24 ± 94.27) mmol/L vs.(64.16 ± 13.42) mmol/L],BUN [(6.73 ± 3.58) mmol/L vs.(4.66 ± 1.08) mmol/L] of the atherosclerosis group were higher,and the GFR was lower [(65.60 ±23.00)ml · min-1 · 1.73 m-2 vs.(124.78 ± 24.35)ml · min-1l.73 m-2,t =5.118] than those of control group (t =4.730,4.702).The Scr of the atherosclerosis group was higher,and the GFR was lower [(65.60 ± 23.00) ml · min-1 · 1.73 m-2 vs.(95.60±53.00)ml · min-1 · 1.73 m-2,t =3.514] than those of the non-atherosclerosis group [(117.24 ± 94.27) mmol/L vs.(71.35 ± 42.18) mmol/L,t =3.690].There were positive correlation between TG and LDL-C (r =0.828,0.323,P ＜ 0.05) and negative correlation between AIP and HDL-C (r =-0.489,P ＜0.05).There was positive correlation of CBMmax with Scr,BUN and AIP (r =0.394,0.289,0.528,all P ＜ 0.05),and negative correlation between CBMmax and GFR (r =-0.277,P ＜ 0.05).Conclusion Body weight,GFR,AIP and CBMmax are useful indicators in evaluation of renal arteriolar sclerosis in patients with chronic renal failure.AIP is a sensitive index for abnormal blood lipid level.AIP and CBMmax are important risk factors in chronic renal failure patients with renal arteriolar sclerosis.

Objective:To evaluate the clinical value of color Doppler ultrasound(CDUS) combined with vascular enhancement technology(VET) in diagnosis of iliac vein compression syndrome(IVCS).Methods:From Jan 2016 to Oct 2018, 252 patients with the lower extremities chronic venous diseases(CVD) were selected in the Second Hospital of Hebei Medical University. The ipsilateral iliac veins of the affected limbs were examined by CDUS, VET and the combined diagnosis of IVCS before X-Ray venography(XRV). Iliac vein diameter stenosis ratio(DSR)>50% in transverse section was the criterion of ultrasound diagnosis of IVCS. The stenosis site of iliac vein and indirect signs of IVCS, such as presence of collateral circulation and the retrograde flow of internal iliac vein were recorded. The cases, which had the same results in CDUS, VET and both and XRV, were divided into IVCS group and non-IVCS group. The results of XRV were taken as the gold standard, the diagnostic efficiency of the above 3 methods in diagnosis of IVCS was calculated. The cases identically diagnosed by the most effective ultrasonic method and XRV were divided into DVT group and non-DVT group according to the deep vein thrombosis in lower limbs. In the non-DVT group, there were five groups of C2-C6 on the basis of the CEAP clinical grades of CVD in lower extremity. The relationship between IVCS and different CEAP clinical grades were analyzed. The locations of common iliac vein stenosis and collateral circulation formation and internal iliac vein reverse flow were evaluated for the diagnosis of the IVCS.Results:①XRV diagnosis of IVCS was used as the gold standard. Compared with CDUS and VET alone, the sensitivity and specificity of CDUS combined with VET was the highest(all P<0.05). ②The distribution of DVT and non-DVT was significantly different in IVCS group and non-IVCS group diagnosed by the CDUS combined with VET(χ 2=145.0, P<0.001). ③In the non-DVT group, statistically significant differences of grades C3 and C5 were found between IVCS group and non-IVCS group(all P<0.05), while the differences of grades C2, C4 and C6 were non-significant(all P>0.05). ④For the proportion of the iliac vein stenosis sites, the prevalence of the primary section of left common iliac vein was much higher than those of the primary section of right common iliac vein and the middle-distal sections of bilateral common iliac veins(all P<0.05). There was no statistical difference between the middle-distal section of bilateral common iliac veins, and nor was bilateral junction area between external iliac vein and common femoral vein(all P>0.05). ⑤In IVCS group, which had the same results of CDUS combined with VET and XRV, there were statistical differences in the positive rate of collateral circulation and the retrograde flow of internal iliac vein(χ 2=6.717, P=0.010), and the former is higher than the latter. Conclusions:CDUS combined with VET has a higher diagnostic efficiency for IVCS than VET or CDUS alone. The presence of IVCS is closely related to DVT of lower extremities, but not related to clinical class of CEAP. The most common site of IVCS is the initial segment of the left common iliac vein. The presence of collateral circulation can be used as indirect indicators for the diagnosis of IVCS.

Objective:To explore the clinical value of point-of-care ultrasonography(PoCUS) in the diagnosis of acute pulmonary embolism(PE).Methods:Consecutive 196 patients suspected of acute PE were enrolled in East Branch, the Second Hospital of Hebei Medical University from January 2017 to November 2017. All the patients were categorized into no PE group( n=143) and PE group( n=53) based on CTPA results. PoCUS was performed and considered diagnostic for PE if one or more right ventricular dysfunction (right ventricular dilation, right ventricular free wall hypokinesia, increased tricuspid regurgitation velocity or decreased tricuspid annular plane systolic excursion), deep venous thrombosis(DVT) or subpleural infarcts were detected. Results:With CTPA as the gold standard for diagnosis, the sensitivity (94.34%), Youden index (0.531) and the area under the ROC curve(AUC) (0.765) of the combined diagnosis of PE by transthoracic echocardiography(TTE), lower limb vein compression ultrasonography(CUS) and lung ultrasonography (LUS) were the highest. The specificity (94.41%) and accuracy (81.63%) of LUS in the diagnosis of PE were the highest, and the misdiagnosis rate (5.59%) of LUS the lowest. The sensitivity of the combined triple PoCUS (TTE, CUS, and LUS) diagnosis of PE was higher than TTE and CUS combined diagnosis ( P=0.016), and the sensitivity and specificity were higher than TTE and CUS combined diagnosis as a whole ( P<0.005). Conclusions:The combined triple PoCUS (TTE, CUS, and LUS) has the highest accuracy in the diagnosis of PE, while LUS has a high specificity and a low misdiagnosis rate in the diagnosis of PE. Therefore, it is recommended to apply the combined triple PoCUS in clinical practice.

Objective:To observe the morphological and hemodynamics changes of aortic segments in mice with angiotensinogen Ⅱ(Ang II) combined with β-aminopropionitrile(BAPN) induced-aortic dissection by color Doppler ultrasound(CDUS).Methods:Twenty male mice of 6-8 weeks old C57BL/6 were randomly divided into two groups: the model group( n=10) was induced by intraperitoneal injection of Ang Ⅱ combined with BAPN to establish mice model with aortic dissection; the control group( n=10) was intraperitoneally injected with normal saline.The body weight, systolic and diastolic blood pressure of the mice were routinely recorded. On the 42th day, CDUS was used to measure the indexes of ascending aorta(AoA), descending thoracic aorta(DAo) and suprarenal aorta(SAo) in both groups, including the inner diameter of the cross section, peak systolic velocity(PSV), the end diastolic velocity(EDV), the resistance index(RI), the pulsatility index(PI), time average mean velocity(TAMV), the heart rate(HR) and the maximal shear rate(SR). Then, the aortas were harvested from the root to the bifurcation of the renal artery. The pathological changes of the aortic wall were observed using hematoxylin-eosin(HE) staining. Results:①There were statistically significant differences in body weight, systolic blood pressure, diastolic blood pressure and heart rate between the model group and the control group(all P<0.05). Compared with the control group(0/10), the incidence of the AoA dissection(8/10) in the model group was obviously higher, the difference was statistically significant( P<0.05); while the incidence of the DAo dissection(4/10) and the SAo dissection(3/10) in the model group was slightly higher, the differences were not statistically significant (all P>0.05). ②Compared with the ascending aorta of the control group, the inner diameter, PSV, EDV, TAMV, PI and SR in the model group were significantly higher(all P<0.05), while RI showed no significant difference between the two groups ( P>0.05). For the descending thoracic aorta, PSV, EDV, TAMV, PI and SR in model group were higher than those of the control group(all P<0.05), however the inner diameter and RI were not significantly different between the two groups (all P>0.05). And for the superior renal aorta, PSV, TAMV, RI, PI and SR in the model group were obviously higher than the control group(all P<0.05), whereas the inner diameter and EDV were not significantly different between the two groups (all P>0.05). ③The HE of the tissue section in the model group showed, the aortas were obviously dilated, irregular, with inhomogeneously thickening wall; the endothelial cell nuclei were slightly stained, and some intima and middle layer ruptured and protruded outward to form dissecting aneurysms. The adventitias were markedly infiltrated with inflammatory cells. Conclusions:Ultrasonography could primarily evaluate the hemodynamic changes of aorta in hypertension with aortic dissection, and the PSV, TAMV, PI and SR of aorta may be important indicators for early predicting the occurrence of aortic dissection in hypertension.