Background Marrow mesenchymal stem cells (MSCs) has been successful induced to differentiate into corneal cells,retinal ganglion cells (RGCs) and retinal neuron-like cells in recent years,but there are few studies about MSCs induced into photoreceptor cells and their microenvironment.Objective The aim of this study was to explore the induce and differentiation of bone marrow mesenchymal stem cells (BMSCs) into photoreceptor-like cells in vitro and microenvironment.Methods The second generation of human BMSCs strain and RPE cells strain were cultured and passaged,respectively,and the fourth generation of BMSCs and the third generation of RPE cells were used in the experiment.BMSCs were cocultured using the mesenchymal stem cells medium (MSCM) contained 20 μg/L basic fibroblast growth factor (bFGF),20 μg/L epithelial growth factor (EGF)and 20 μg/L brain derived neurotrophic factor (BDNF) with RPE cells to induce the differentiation of BMSCs in the induced group,and BMSCs were cultured in MSCM only in the control group.The morphology of induced and differentiated cells were observed under the inverted microscope.Inmmunocytochemistry was used in induced for 3-,5-,7-day cells to detect the expression rate of rhodopsin protein for the identification of phenotype of the differentiated cells.RT-PCR was used in induced for 5-,7-day cells to detect the expressions of rhodopsin mRNA and recoverin mRNA.Results Cultured BMSCs grew well with the spindle shape,and passaged RPE cells showed the uniform size and polygon shape with the abundant pigment in the cells.Some induced cells appeared to be the neuron-like cells with round shape and long prominence and the secondary reticular branches.The expression rates of rhodopsinin the cells were (5.83±0.29)％,(20.36±0.32)％ and (29.80±2.30)％ in the third,fifth and seventh day after induce,which were significantly higher than (0.71 ±0.35) ％,(2.56±0.24) ％ and (2.32±0.42) ％ of control cells (t3 d =41.510,t5d =107.290,t7 d =30.036,P＜0.01).The grey scales of rhodopsin mRNA and recoverin mRNA were significantly elevated in the induced and differentiated cells compared with control cells in the fifth and seventh day (rhodopsin mRNA:t5 d =103.506,t7 d =122.584,P＜0.01 ; recoverin mRNA:t5 d =106.674,t7 d =189.992,P＜0.01).Conclusions BMSCs can be successfully induced to differentiate into photoreceptor cells after cocultured by conditioned medium with RPE cells.

Objective:To analyze identify method of mild cognitive impairment. Methods:The Wechsler Adult Intelligence Scale-Chinese Revised (WAIS-RC) and Wechsler Memory Scale-Chinese Revised (WMS-RC) were examined in 150 patients with memory complaints. 63 individuals whose intelligence quotient (IQ) and memory quotient (MQ) over 85 were designated as normal elderly group;and 33 individuals whose IQ scores over 85 and MQ score between 70 and 84 as mild cognitive impairment(MCI-1) group; and 25 individuals whose IQ scores over 85 and MQ scores between 55 and 69 as MCI-2 group; 29 individuals whose IQ scores and MQ scores less than 85 and conformed with DSM-Ⅳ as Alzheimer disease group.Results: Picture short memory and mental control (B)showed the highest identification between the 2 MCI groups and normal elderly group. Besides, visual reproduction played an important role in mild memory decline (MCI-1) group. Tactile memory, logical memory and associated learning played an important role in moderate memory decline (MCI-2) group.Conclusion: Picture short memory and mental control (B) contribute to identify MCI speedily and effectively.

Objective:To assess clinical validity of the Chinese version of Mattis Dementia Rating Scale (DRS) in differentiating dementia of Alzheimer type (AD). Methods:Administered the DRS, mini-mental state examination (MMSE) and clinical dementia rating(CDR) to 61 outpatients with AD and 104 healthy elderly subjects in Shanghai.Results:There was significant correlation between DRS and the total score,and DRS and MMSE.DRS of the AD group had significant correlation with CDR.Its significant correlation with CDR suggested satisfactory concurrent validity of the scale. The optimal DRS cutoff score for AD according to education level revealed a sensitivity of 85%～94% and a specificity of 90%～94%.Conclusion:The DRS is a clinically valid test for the detection of AD and its severity of cognitive impairment.

Objectives To compare the efficiency and clearance of single dose low molecular weight heparin(LMWH) as anticoagulant in hemodiafiltration and hemodialysis.Methods Twenty-two patients were enrolled in the study.A single injection of LMWH(Nadroparin calcium 7500ICUAXa) was given before hemodiafiltration and hemodialysis respectively.The anti-factor-Xa activity and the activated partial thromboplastin time(APTT) in plasma were assayed during the treatment,and the dialyzer coagulation was observed.The changes of urea and serum creatinine were measured before and after the treatment.Results The anti-factor-Xa activity of LMWH during hemodiafiltration was lower than that during hemodialysis.However,there was no significant difference in APTT between the two groups.Conclusions A single bolus injection of Nadroparin provides a simple and effective anticoagulation regimen for hemodiafiltration lasting up to four hours.

Objective To evaluate and compare the clinical outcomes of concurrent chemoradiotherapy with different radiation doses for esophageal carcinoma. Methods 78 cases of esophageal carcinoma receiving primary definitive treatment in our department between May 1 , 2005 to June 31 2007 were analyzed retrospectively. The patients with esophageal carcinoma were divided into high- ( > 50 Gy, median dose of 64 Gy) and low-dose (50 Gy) groups according to their prescription doses (n = 35, 43, respectively). Chemotherapy regimen consisted of cisplatin (75 mg/m2, d1) and 5-FU (500 ~ 600 mg/m2, D2 ~ 5) starting at days 1, 28, 49 and 70 after the beginning of radiotherapy with 2 ~ 4 cycles. The two groups were compared in terms of the early treatment outcomes, the side effects and survival rates. Results The 1,3 and 5-year survival rates for the high and low dose groups were 71.4%, 34.3%, 25.7%and 76.7%, 41.9%, 30.2%, respectively. The median survival time was 19 and 22 months respectively without statistical difference. The high dose group was more likely to have higher incidence rate of grade Ⅲ to Ⅳ myelosuppression in spite of the statistical difference. The high dose group had significantly higher incidence of esophagitis than did the low dose group (P=0.040). Conclusion For esophageal carcinoma with only indications of concurrent chemoradiotherapy, te low dose radiation (50 Gy) has comparable outcomes and less side effects compared with the high dose radiation (>50 Gy).

Objective To explore relationship between imaging classification and pathological type,and the electron microscopic ultrastructure by observing the ultrastructural features of congenital cystic adenomatoid malformation (CCAM).Methods Children with CCAM in the Guangdong Women and Children Hospital from May 2014 to November 2014,were analyzed,imaging classification was performed according to enhanced Computed Tomography (CT) scanning,and the surgical specimens were stained by HE and scanning electron microscope was used to observe the tissue structures of various of CCAM.Results Eight cases were enrolled in this research (5 boys and 3 girls),and the mean age of surgery was (5.4 ± 1.1) month old.According to the features of enhanced CT scanning,there were 2 cases of the type-Ⅰ,and the other 3 cases of type-Ⅱ,and 3 cases of type-Ⅲ;According to the characteristics of the pathological types,there was 1 case of type-Ⅰ,4 cases of type-Ⅱ,and the other 3 cases of type-Ⅲ.There was 1 case which classified as type-Ⅰ by CT,however classified as type-Ⅱ by pathological typing.The findings of CT features were in complete correspondence with the pathological types in the rest cases.Electron microscopic findings showed the alveolar spaces were enlarged,the alveolar cells were reduced,the lamellar bodies were decreased and immature and microvilli were also decreased.There was no significant difference between Ⅰ and Ⅱ type under the viewpoint of electron microscope.The common features between type Ⅰ,and type Ⅱ included that the alveolar space was enlarged,the alveolar space had been pressed between enlarged alveolar space,the alveolar cell were decreased and immature,and fibrous hypertrophy was also found.Conclusions There are differences between ultrastructural analysis and clinical pathological typing which suggests the clinical importance of the electron microscopy ultrastructural analysis combined with pathology for typing.There need further clinical and laboratory studies,especially the combination of microscopy-electrical control microscope for typing with related predictive models for follow-up of CCAM.

Objective:To formulate the norm value of auditory verbal learning test(AVLT)in the normal aged in Chinese community.Methods:360 normal old people(55 to 85 years)in city proper of Shanghai were enrolled and evaluated by AVLT,MMSE test of words reading ability and executive ablity,memory self-evaluation and medical history related to cognitive impairment.Results:70% of the normal old people complained of hypomnesia;The age of 70 and 80 was the hinge points of auditory verbal memory decreasing.AVLT had a moderate relation to age,and a lower relation to educational level.Female did better in AVLT than Male.Furthermore,AVLT had a significant relation to MMSE score,a mild relation to memory self-evaluation,and only related to hypertension of all the medical history.The cut off score of short-term recall,long delayed term recall and total AVLT score(-1SD,-1.5SD and-2SD)was listed.Conclusion:Norm value of AVLT is an effective tool of testing memory impairment.

Objective To investigate the carotid atherosclerosis(AS) in hemodialysis(HD) patients.Methods Clinical index was measured and intma-media thickness(IMT) of extracranial common carotid artery and presence of atherosclerotic plaques were determined by high-resolution B-mode ultrasonography.Results The age,disease duration,HD duration,triglyceride(TG),low density lipoprotein(LDL),serum C-reactive protein(CRP),mean carotid artery IMT in HD with atherosclerotic plaque were significantly higher than HD without atherosclerotic plaque patients,however,the serum albumin(Alb) was significantly decreased.Mean carotid artery IMT is related to the disease duration,Alb,TG,LDL,CRP in HD patients.Conclusion The CRP,mean carotid artery IMT were increased in HD with atherosclerotic plaque.Mean carotid artery IMT is related to the disease duration,Alb,TG,LDL,CRP in HD patients.To improve malnutrition and decrease micro-inflammation,serum lipid might reduce the rate of AS in HD.

Objective To evaluate the role of mammalian target of rapamycin (mTOR ) in reduction of oxygen-glucose deprivation and restoration (OGD/R )-induced injury to isolated cardiomyocytes by hypoxic preconditioning (HPC) in neonatal rats .Methods Primary cardiomyocytes were obtained from neonatal Sprague-Dawley rats (1-3 days after birth ) ,and seeded in 96-well plates at the density of 1 × 105 cells/ml (200μl/well ) . The cells were randomly divided into 6 groups ( n=6 each ) using a random number table:control group (group C) ,rapamycin group (group R) ,group OGD/R ,rapamycin+OGD/R group (group R+OGD/R);group HPC+OGD/R ,and rapamycin+HPC+OGD/R group (group R+HPC+OGD/R) .Rapamycin (final concentration 20 nmol/L) was added to the culture media and the cells were then incubated for 1 h in group R .In R+OGD/R group ,rapamycin (final concentration 20 nmol/L ) was added to the culture media ,the cells were then incubated for 1 h ,and then OGD/R was performed .In HPC+OGD/R group ,OGD/R was performed immediately after HPC was completed .In R+HPC+OGD/R group ,rapamycin (final concentration 20 nmol/L) was added to the culture media ,the cells were then incubated for 1 h , and then HPC and OGD/R were performed . All the cells were subjected to OGD for 2 h followed by restoration of O2-glucose supply for 3 h to induce OGD/R .HPC was induced by 3 cycles of 10 min hypoxia followed by 30 min reoxygenation .The cell viability (using MTT assay ) and lactic dehydrogenase (LDH) activity in the culture medium were determined .Results Compared with group C ,the cell viability was significantly decreased , and LDH activities in the culture medium were increased in OGD/R , R+OGD/R ,HPC+OGD/R and R+ HPC+OGD/R groups ( P<0.05 ) ,while no significant change was found in the cell viability and LDH activities in R group ( P>0.05) .The cell viability was significantly higher ,and LDH activity in the culture medium were lower in HPC+OGD/R group than in OGD/R group ,and in R+HPC+OGD/R group than in HPC + OGD/R group ( P< 0.05 ) .Conclusion mTOR is involved in HPC-induced attenuation of OGD/R injury to isolated cardiomyocytes in neonatal rats .

Objective To study the characteristics of bone mineral density and bone metabolism in elderly men.Methods 220 male elderly hospitalized patients were selected and divided into three groups according to age:65-74 years group,75-84 years group and 85-94 years group.Bone mineral density and bone metabolic biochemical makers including serum parathyroid hormone (PTH),bone gla-protein (BGP) and 25-dihydroxy vitamin D (25-OH VD) were detected.Results The prevalence of osteoporosis was increased along with ageing in three groups (6.8％,12.0％ vs.22.9％,respectively,F=4.986,P＜0.05).The characteristics of bone metabolism showed that serum PTH level was increased and serum levels of BGP,25-OH VD were decreased along with ageing (F =4.986,3.245,5.997,all P＜0.05),and the levels of BGP,25-OH VD were generally decreased in elderly men.Conclusions The prevalence of osteoporosis is high in elderly men.Bone metabolism can be used as the auxiliary index for osteoporosis risk assessment,which is helpful for the early diagnosis of primary osteoporosis.