Induced pluripotent stem cells(iPS)are derived from the differentiated somatic cells that regain the differentiation capabilities by the direct nuclear reprogramming with the exogenous factors.The methods for iPS induction evolved from transcription factors to RNA binding proteins,small molecules,and extracellular signals with the efforts in improving biosafty.The cellular and epigenetic characterization for iPS generation is a progressive and time-dependent process,which is tightly associated with the cellular differentiation status.However,epigenetics of iPS is not same as the embryonic stem cells.In combination with gene therapy and cellular transplantation therapy,the achievements of iPS had been applied in animal disease model treatment.

Objective:To evaluate the predictive value of 3 methods, namely plasma paraquat concentration, severity index of paraquat poisoning (SIPP), and acute physiology and chronic health evaluation (APACHE II) in severity evaluation and prognosis of acute paraquat poisoning. Methods:A total of 73 acute paraquat poisoning patients with oral administration were collected. Paraquat concentration in the plasma and other parameters on admission for SIPP and APACHE II were taken from medical records. According to the clinical outcome in the hospital or 7 days atfer the discharge, discrimination and calibration test were performed to evaluate the prognosis of the 3 methods. Results:Discrimination of the 3 methods was greater than 0.8, and the area under the receiver operator curve for SIPP (0.938) was greater than paraquat concentration in the plasma (0.857) and APACHE II (0.801) with statistical signiifcance (z=2.429, 2.021;P=0.015, 0.043). Difference in plasma paraquat concentration (0.857) and APACHE II (0.801) had no statistical signiifcance (z=0.755, P=0.450). Hosmer-Lemeshow good fit test suggested better calibration value with statistical signiifcance for the 3 methods (P>0.05). Conclusion:hTe 3 methods are valid in the severity evaluation and prognosis of acute paraquat poisoning. SIPP is the most preferred method, followed by paraquat concentration on admission. When there is no facility to measure paraqut concentration, APACHE II can be used as a reference for the death risk in acute paraquat poisoning.

Objective To discuss the correlations between hemoperfusion(HP) times and therapeutic effects/prognosis in patients with severe acute organophosphorus poisoning(AOPP). Methods According to the frequency of HP,82 patients with severe AOPP were divided into three groups:non HP(25 cases),HP1(27 cases) and HP2(30 cases)groups. The non HP group received only routine treatment,on the basis of routine treatment,the HP1 group accepted once HP within 12 hours after poisoning and the HP2 group underwent twice or more times of HP,the interval between each time being 24 hours. The comparisions of clinical indexes,incidences of complications and rates of mortality among the three groups were performed. Results With the increase of HP times,the dosages of atropine and pralidoxime chloride were significantly reduced,the times of serum cholinesterase(ChE)activity recovery,consciousness recovery,hospitalization and mechanical ventilation were significantly shortened,the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in 48 hours after admission,incidence of complications and mortality were evidently decreased(all P<0.05). Compared with those in HP1 group,the dosages of atropine(mg:164.57±68.82 vs. 256.81±97.06)and pralidoxime chloride(mg:6.95±1.40 vs. 8.76±1.64) in HP2 group were significantly reduced,the times of ChE activity recovery(day:9.03±2.46 vs. 10.96±3.44), consciousness recovery(hour:23.83±6.29 vs. 39.93±8.24),hospitalization(hour:9.57±2.39 vs. 11.52±3.02) and mechanical ventilation(hour:40.50±16.55 vs. 65.74±18.88)in HP2 group were significantly shortened;APACHEⅡscore during 48 hours after admission(11.97±3.47 vs. 14.26±2.88)was obviously decreased,and the incidences of complications,such as intermediate syndrome(10.0% vs. 18.5%),rebound phenomenon(3.3% vs. 25.9%),arrhythmia(13.3%vs. 44.4%),multiple organ dysfunction syndrome(MODS,6.7%vs. 29.6%)and mortality rate(6.7% vs. 18.5%)in HP2 group were markedly decreased(all P<0.05). Conclusion It is recommendable that combined with routine treatment,early and multiple HP application would enhance the therapeutic effect and decrease the mortality in patients with severe AOPP.

Adolescent ; Alkanes ; poisoning ; Alkenes ; poisoning ; Daphne ; chemistry ; Humans ; Male

Administration, Oral ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Peracetic Acid ; administration & dosage ; poisoning ; Poisoning ; diagnosis ; therapy

Objective To study the protective effects of aldioxa tablets on aspirin-induced gastric mucosal lesions in rat model. Methods Sixty healthy male Wistar rats were randomly divided into five groups: Ⅰ (injury group), Ⅱ (control group), Ⅲ (sucralfate protective group), Ⅳ (aluminium hydroxide protective group), and Ⅴ (aldioxa protective group). The three protective groups were treated with sucralfate, aluminium hydroxide and aldioxa tablets respectively before gastric mucosal injury was induced. Then the ulcer index (UI), epithelial damage scoring (EDS) were measured, and the pathological changes on histological sections and ultrastructural sections of gastric mucosa were assessed under microscope or electron microscope. Results The data of group Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ obtained were as follow: ulcer index: 42.13±6.22, 3.13±1.46, 8.63±3.48, 18.00±6.16, 8.00±3.17, respectively; epithelial damage scoring: 3.67±0.49, 1.25±0.45, 1.41±0.51, 2.42±0.79, 1.50±0.52, respectively. In comparison with injury group, the ulcer index and epithelial damage scoring of gastric mucosa in aldioxa protective group were significantly decreased. Conclusions The results revealed that aldioxa tablets had a significant protection effect on rats with acute gastric mucosal injury induced by aspirin.

Humans ; Laparoscopy ; methods ; trends ; Pancreaticoduodenectomy ; methods

Objective To investigate toe-brachial index ( TBI) in the diagnosis of peripheral artery disease ( PAD) and its risk factors in the patients with type 2 diabetes.Methods TBI was examined in the 238 patients with type 2 diabetes.The patients were divided into the group with low TBI ( TBI≤0.7 ) and the group with normal ABI ( TBI>0.7 ) .The two groups were compared for clinical parameters.Results Thirty two patients (13.4%)with abnormal ABI (TBI≤0.7) showed older age [(63.8 ±9.9) yrs vs (54.9 ±10.8) yrs, P =0.000] , lower diastolic blood pressure [(70.5 ±6.9) mmHg vs (74.9 ±9.1) mmHg, P =0.003], more frequency of hypertension (56.3%vs 38.3%, P =0.043), coronary artery heart disease (28.7%vs 10.7%, P =0.020) and cere-bral vascular disease (15.6%vs 4.4%, P =0.025).Step-wise analysis screened that age and diastolic blood pressure were the inde-pendent risk factors for TBI .Conclusions Aging and hypertension were the risk factors in the patients with abnormal TBI in type 2 di-abetes.TBI was an easy and economical method for diagnosing PAD in patients with type 2 diabetes.

Objective To explore curriculum and faculty qualification of Chongqing operating room (OR) specialty certified nurse theoretical tralning program by feedback of students, and to im-prove the quality of tralning. Method Relying on the national key project of the First Affiliated Hos-pital of Chongqing Medical University, Chongqing Health administration OR nurse specialist tralning program set additional courses related to research, teaching, patient safety and first ald tralning based on operation room specialist nurse tralning outline. 81 participants were given questionnalres issued by college of nursing after the 7th OR specialist nurse theoretical tralning, and statistics analysis was made of it. Result Effective questionnalres was100%. The overall judgment on theory tralning was high, with 92.60%of the students giving overall score above 150 points (out of 170);93.84%of students sat-isfied on teaching staff ratio while 95.06% students satisfied on course content. For the 17 items, the majority scores given by the students were ≥ 9 points (a 10-points scale), on the top of the list were item “Theoretical tralning helps to enhance professional theoretical level and guide clinical practice”“Teaching content meet needs of OR specialist nurses” “Teaching content is helpful to improve the core competence of specialist nurses” (all 96.30%, 78 out of 81), while the bottom was “Instructor create an environment which fosters student participation”(85.19%, 69 out of 81). Conclusion Chong-qing OR specialist theoretical tralning has good practical and guidance property, the content meet OR nurses needs, instructor ratio is reasonable, and students are highly satisfied with it. Instructors need to encourage students' participation in class interaction, and pay attention to improving their research capabilities.

OBJECTIVETo evaluate the functional outcomes of modified limited "L" incision beside the Achilles tendon with distraction bone block arthrodesis in treatment of subtalar osteoarthritis.

METHODSFrom March 2009 to September 2012, a total of 22 cases of old calcaneus fractures with subtalar osteoarthritis were treated with modified limited "L" incision and distraction bone block arthrodesis including 13 males and 9 females with a mean age of 35.3 years old (ranged 22 to 49). The mean time from calcaneal fracture was 21 months (ranged 11 to 32). According to the Stephens-Sanders classification, 16 cases were type II and 6 were type III. The modified-AOFAS ankle-hindfoot score was used for functional outcomes evaluation.

RESULTSThere was one incision necrosis and no infection, implant failure, bone-graft absorbed or talus necrosis was note at the follow-up time. A total of 21 cases were followed up for a mean time of 29 months (ranged from 18 to 46 months). All of the cases reached a bony union within 4 months postoperation. The mean modified-AOFAS ankle-hindfoot score was 82.6 points (ranged from 66 to 92 points),reached a significantly improvement in comparing with the mean preoperative score (50.8 points,ranged from 32 to 65 points, P < 0.01).

CONCLUSIONThe modified limited"L" incision beside the Achilles tendon with distraction bone block arthrodesis is an acceptable and alternative treatment method for subtalar osteoarthritis. This method is easy to use and with less complication. It can correct the main pathological changes and reach good functional outcomes.

Adult ; Arthrodesis ; methods ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis ; surgery ; Subtalar Joint ; surgery