Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor(rhG-CSF)in treatment of different leukopenia.Methods A total of 50 patients were divided into 4 groups:aplastic anemia(AA)group(n=10),myelodysplastic syndromes(MDS)group(n=10),drug-induced leukopenia group(n=20)(subdivided into hyperplasia group and hypoplasia group by the degree of cellularity)and iron deficiency anemia group(control group,n=10).The concentrations of G-CSF of peripheral blood were measured by ELISA method.The ratio of CD34+ cells and G-CSFR expression in blood marrow mononuclear cells(BMMNC)were measured by flow cytometry.Granulocyte colony-forming units(CFU-G)of MNC were cultured.Clinical efficacy of rhG-CSF to all patients were determined.Results The concentrations of G-CSF were higher in AA and drug-induced leukopenia groups than those of MDS and control groups(P0.05).Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups(P0.05).The ratio of CD34+ cells was lower in AA group than that of other groups(P0.05).Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups(P0.05).The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group,and superior in MDS group than in AA group(P

The epidemic tendency of dental caries of school students over the past 15 years in China was analyzed in order to provide bases for prevention of dental caries. Data sets of boys and girls at the age of 7, 9, 12 years (deciduous caries) and 7, 9, 12, 14, 17 years (permanent caries) were collected from the series of Chinese National Surveillance on Students' Constitution and Health (CNSSCH) between 1991 to 2005, a survey that covers 30 provinces of and autonomous regions of China, with Tibet Autonomous Region and Taiwan Province excluded owing to unavailability of related data. According to their socioeconomic status, three urban regions and three rural regions (province capital must be included) were selected in each province, where its socioeconomic status and sports exercise can represent the general level of the locality. All subjects were Han students. Prevalence of deciduous and permanent caries was measured. In 2005, the prevalence of deciduous caries at 7, 9, 12 years was 52.87%, 52.04% and 9.80% in urban boys, 59.37%, 58.68% and 12.18% in rural boys, and that of permanent caries in boys at 7, 9, 12, 14, and 17 years was 2.35%, 5.63%, 13.94%, 19.05% and 21.29% in urban boys, 3.42%, 7.26%, 13.35%, 16.16%, 18.55% in rural boys, while in girls at the same age groups, the prevalence of deciduous caries was 53.53%, 49.48%, 7.92% in urban girls, 59.95%, 56.13%, 8.85% in rural girls; the prevalence of permanent caries was 3.61%, 8.99%, 19.32%, 24.75%, 28.62% in urban girls, and 3.47%, 10.65%, 17.66%, 22.52%, 24.27% in rural girls. The epidemic manifested a gradient distribution in age groups, which was closely related to region of the study population. A dramatic decreasing trend was witnessed among all sex-age subgroups in the rural groups between 1990 and 2005, and such a trend was stronger in deciduous caries than in permanent caries, however, this kind of decreasing trend was not steady, because there was bounce during some year. Although the morbidity of dental caries in China is lower than the standard set by the World Health Organization, and the prevalence of dental caries decreased from 1991 to 2005, the prospect of epidemic dental caries in China is in no way optimistic. The total population with dental caries is still very large and the prevalence decreased unstably. Therefore, financial support on school oral health care should be increased, and a national school oral health service network should be set up.

Objective To observe the effect of case-based learning (CBL) applied in ward-round on residents training. Methods A total of 33 residents trained with routine ward-round and CBL ward-round in the neurological department were investigated with questionnaire. Results 30 effective answers were recalled. More of them reported that CBL ward-round was very significant in improving clinical thinking, mastering the specialized knowledge, developing autonomous learning and improving the communication with patients and their family members (P<0.05). Conclusion CBL ward-round is effective on improving the comprehensive professional abilities of residents.

AIM:To investigate the effect and mechanism of liver ischemia/reperfusion(I/R)injury on the changes of cardiac energy metabolism and structure.METHODS:48 healthy Wistar male rats were randomly divided into 6 groups as follows(n=8 in each group):control group(CTL),simply ischemia for 30 min without reperfusion(I group);reperfusion following ischemia for 30 min(I/R group);2 h reperfusion following ischemia for 30 min(I/R 2 h group);4 h reperfusion following ischemia for 30 min(I/R 4 h group)and 6 h reperfusion following ischemia for 30 min(I/R 6 h group).The level of serum endotoxin was measured.The levels of insulin and insulin antibody in heart were detected by radioimmunoassay.The contents of MDA,MPO and lactic acid in heart were also determined.RESULTS:During the process of liver I/R injury,the level of endotoxin increased in I group and I/R group and declined gradually for long time during reperfusion,but was still longer than that in CTL group(P0.05).CONCLUSION:During the process of liver I/R injury,endotoxin is absorbed from intestine and impairment of liver detoxication leads to endotoxemia,which might play a role in the changes of the energy metabolism and structure in heart.

Objective To approach the protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion. Methods A prospective randomly controlled trial was conducted. 70 mechanically ventilated patients with pulmonary contusion from January 2010 to December 2012 in the Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a control group and a therapy group by the difference in number odd or even,with 35 patients in each group. Based on the same principles of comprehensive treatment,the control group used midazolam,and the therapy group used dexmedetomidine for sedation. The measured parameters included oxygenation index(PaO2/FiO2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6), and extra-vacular lung water index(EVLWI)for both groups on the1st and 5th day. The incidence of delirium,the time of mechanical ventilation,and the incidence of hypotension were observed in both groups. Results Compared with those on the 1st day,TNF-α,IL-6 and EVLWI on the 5th day were decreased significantly in both groups〔the control group TNF-α(ng/L):1.29±0.38 vs. 2.21±0.37,IL-6(ng/L):97.97±28.77 vs. 131.03±41.52,EVLWI (mL/kg):8.25±2.03 vs. 11.96±3.36;the therapy group TNF-α:1.06±0.33 vs. 2.32±0.37,IL-6:82.07±23.35 vs. 134.98±64.25, EVLWI(mL/kg):6.74±1.33 vs. 11.23±2.78, all P<0.05〕, PaO2/FiO2 was increased obviously〔mmHg(1 mmHg=0.133 kPa),the control group:285.80±30.65 vs. 213.00±33.70,the therapy group:315.00±34.50 vs. 229.50±37.00,both P<0.05〕,TNF-αand IL-6 had no significant difference compared between the therapy group and control group(TNF-α:1.06±0.33 vs. 1.29±0.38,IL-6:82.07±23.35 vs. 97.97±28.77), while EVLWI and PaO2/FiO2 in the therapy group had remarkable differences compared with those of the control group〔EVLWI(mL/kg):6.74±1.33 vs. 8.25±2.03,PaO2/FiO2(mmHg):315.00±34.50 vs. 285.80±30.65,both P<0.05〕. The incidence of delirium(8.57% vs. 22.86%)and time of mechanical ventilation(day:4.10±1.09 vs. 6.88±1.66)in the therapy group were decreased markedly compared with those of the control group,and the incidence of hypotension had no significant difference between treatment or control groups(17.14% vs. 14.29%,P>0.05). Conclusion Dexmedetomidine has protective effect on mechanically ventilated patients with pulmonary contusion, and it is an relatively ideal sedative drug for these patients.

Objective To approach the clinical effect of cefoperazone sulbactam associated with tigecycline for treatment of patients with severe pulmonary infection caused by pan drug-resistant Acinetobacter baumannii in intensive care unit(ICU). Methods Retrospectively,the treatments of 88 patients with sepsis and pulmonary infection caused by pan drug-resistant Acinetobacter baumannii admitted in ICU from January,2011 to June,2013 were analyzed,among them antibiotics were used for 82 patients,and the rest 6 patients did not use antibiotics because of family refusal or abandonment of therapy. The patients having used antibiotics were divided into three groups:A group(27 patients)received cefoperazone sulbactam,B group(30 patients)received cefoperazone sulbactam associated with amikacin,and C group(25 patients)received cefoperazone sulbactam associated with tigecycline, antimicrobial treatment being for 7-15 days. The venous blood was collected to determine the changes in white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)before and after therapy. The rate of bacteriological efficiency,successful weaning of mechanical instrument,28-day mortality rate and clinical efficacy were observed after therapy in three groups. Results Before therapy,the comparisons of levels of WBC,CRP and PCT among three groups were of no statistically significant difference(all P>0.05),and they were decreased obviously after therapy in three groups among which they were decreased most significantly in C group〔WBC(×109/L):17.01±5.35 vs. 20.40±6.54,18.28±6.41;CRP(mg/L):64.6±8.4 vs. 68.3±12.7,70.0±13.4;PCT(μg/L):20.84±7.26 vs. 36.14±10.12,52.66±13.47,P<0.05〕. The rates of bacteriological efficiency and successful weaning in C group were increased more significantly than those in either A or B groups after therapy(bacteriological efficiency:76.00%vs. 44.44%,46.67%,χ2=9.750,P=0.006;rate of successful weaning:72.00%vs. 40.74%, 43.33%,χ2=12.083,P=0.009),and 28-day mortality rate in C group was much lower than those in A and B groups (24.00% vs. 48.15%,36.67%,χ2=11.510,P=0.030). The total clinical efficiency in C group was much higher than those in A and B groups(76.00%vs. 44.44%,46.67%,both P<0.05). Conclusion Cefoperazone sulbactam associated with tigecycline has significant clinical therapeutic effect in patients with pulmonary infection caused by pan drug-resistant Acinetobacter baumannii in ICU,as it can decrease inflammatory reaction,increase the rates of successful weaning and survival.

BACKGROUND: Embryonic stem cells can be induced to differentiate into neural precursors under certain conditions, and they can effectively integrate with host cells after transplanted into healthy or injured central nervous system, and then repair and rebuild the injured nerve tissue.OBJECTIVE: To observe the effects of transplantation of neural precursors induced by embryonic stem cells on the recovery of neurological function in mice with spinal cord injury.DESIGN: A randomized controlled animal trial.SETTING: Research Center of Developmental Biology, Shanghai Second Medical University.MATERIALS: Twenty-eight C57/BL6J mice of 6-8 weeks old, both sexes, were used. Mice embryonic stem cell strain S8 and carrier LacZ labeling genes were provided by Shanghai Research Center of Developmental Biology. High-glucose Dulbecco's modified Eagle media (DMEM), β-mercaptoethanol (BME), mice leukemia inhibitory factor (LIF) and mitocin-C were all from GIBCO attachment induction medium, which were provided by Shanghai Research Center of Developmental BiologyMETHODS: The experiment was carried out in the central laboratory of developmental biology of Shanghai Second Medical University from April 2003 to April 2004. The embryonic stem cells were cultured and induced to differentiate into neural precursors by means of attachment induction. The mice were anesthetized and made into models of spinal cord hemisection on the T9-T10 plan. The mice were randomly divided into three groups: sham operated group (n =9): Only T9-T10 spinous process and corresponding lamina of vertebra were removed, then the skin was sutured layer by layer;ransplantation group (n =10): After spinal cord hemisection, embryonic stem cells were injected into the vertebral canal about 1 cm away from the injured site; model group (n =9): DMEM was injected into the region around the injured site.The mice were evaluated with Basso, Beattie, Bresnahan (BBB) locomotor rating scale to observe the recovery of neurological function at 1, 2, 4, 6 and 8 weeks (the score ranged from 1 to 21 points, the higher the scores, the better the recovery of neurological function). At 8 weeks, the survival and differentiation of embryonic stem cells at the injured site of spinal cord were observed using X-Gal staining in each group. The positively stained sections with X-Gal at the injured site of spinal cord were detected with fluorescent immunohistochemical staining.MAIN OUTCOME MEASURES: ① Recovery of neurological function; ② Survival and differentiation of embryonic stem cells at the injured site of spinal cord; ③ Results of fluorescent immunohistochemical staining.RESULTS: ① The BBB scores in the transplantation group at 1, 2 and 4 weeks were higher than those in the model group (P ＜ 0.01). ② Survival and differentiation of embryonic stem cells at the injured site of spinal cord: In the transplantation group, there were X-Gal positively stained cells in the tissue sections of the injured spinal cord of mice,the cytoplasm was blue with nucleoli in it, i.e. the cells derived from embryonic stem cells, which were not observed in the sham-operated group and model group. In the transplantation group, the cells derived from embryonic stem cells, which were implanted to the injured spinal cord, distributed around the injured sites, and integrated with the surrounding tissue and had similar form with the surrounding cells. ③ At the injured site, X-Gal positively stained cells in the transplantation group aiso expressed neurofilaments (the specific marker of neurons), but did not express GFAP.CONCLUSION:The embryonic stem cells were cultured and induced to differentiate into neural progenitors, and they could survive, migrate and differentiate into neurons after transplantation, but there was no obvious improvement of neurological function.

BACKGROUND: Embryonic stem cell (ESC) is a kind of highly undifferentiated totipotent cell. It can proliferate and maintain its totipotency in the system cultured in vitro. It is one of most promising stem cells in thetreatment of central nerve injury.OBJECTIVE: To observe the survival and migration of induced transplanted ESC in mice with spinal injury and hypoxic-ischemic encephalopathy.DESIGN: A completely randomized grouping design, controlled animal experiment.SETTING: Laboratory of Developmental Biology Research Center of Shanghai Second Medical University.MATERIALS: Sixty C57/BL6J mice, of clean grade and either gender, aged 6 to 8 weeks (n =30) and 7 days (n =30)were provided by the Shanghai Experimental Animal Center, Chinese Academy of Sciences [Permission No, SCXK (hu)2003-0003]. This animal experiment was approved by Animal Ethics Committee. Mouse ESC strain S8, labeled LacZ marker gene (Provided by Shanghai Developmental Biology Research Center). X-gal dyeing reagent (Sigma Company).METHODS: This experiment was carried out in the laboratory of Shanghai Developmental Biology Research Center (Shanghai Key Laboratory) from October 2002 to December 2003. ① Experimental grouping of spinal injury: Sixteen C57/BL6J successful mice models, aged 6-8 weeks, were randomized into 2 groups: experimental group (n =8), in which, following right spinal semi-sectioning, derivated cell suspension for inducing the in vitro differentiation of ESC was injected at 1 cm away from injury through vertebral canal, and control group (n =8), in which, following right spinal semi-sectioning, phosphate buffer solution (PBS) was injected at the peripheral region of injury. ② Hypoxic-ischemic encephalopathy experimental grouping: Sixteen successful C57/BL6J mice models, aged 7 days, were randomized into 2 groups: experimental group (n =8), following ligation of right common carotid artery, mice were placed in the closed container containing 0.08 volume fraction of oxygen and 0.92 volume fraction of Nitrogen gas, and taken out 1.5 hours later; 3 μL ESCs were injected into the right cerebral ventricle at about 1 week, and control group (n =8), in which, the same amount of PBS was injected into the right cerebral ventricle. ③ At 12 weeks after transplantation, the survival and migration of induced ESCs labeled by Lac-Z in the spinal cord and brain were observed by zymologic method.MATN OUTCOME MEASURES: Survival and migration of ESCs in the central nervous system.RESULTS: ①After being induced in vitro and transplanted to spinal injured region, ESCs differentiated into neural precursor cells. Neural precursor cells could survive in the injured region and migrate to 5 mm away from injured region.Immunohistochemistry proved that the neural precursor cells of transplanted ESCs could differentiate into neurons.Morphologically, it was proved that neural precursor cells-derived from ESCs could well integrate peripheral tissue. ② The induced ESCs were injected into the lateral cerebral ventricle of mice. Derived ESCs widely distributed in the injured hippocampal region, cerebral cortex ventricle choroid plexus, vascular endothelium and other regions, and integrated peripheral tissue, which were similar to adjacent cells in morphology, suggesting that induced ESCs also could survive for long time and far migrate.CONCLUSION:The induced ESC can survive and migrate in the host injured brain and spinal cord, and the migration of ESCs is more obvious in the brain than in the spinal cord.

Objective To study the clinical significance of chromosome karyotyping in pregnant women with a history of abnormal pregnancy. Methods The fetal chromosome karyotypes of 1 193 pregnant women with a history of abnormal pregnancy in Peking University First Hospital from January 4, 2005 to December 31, 2013 were analyzed. According to the etiology of their previous abnormal pregnancy, these women were divided into four groups: 273 women had children with inherited metabolic disorders or single-gene genetic diseases (group A), 81 women had children or fetuses with chromosome abnormalities (group B), eight cases had an abnormal chromosomal karyotype in either husband or wife (group C), and 833 women had abnormal pregnancy of unknown causes(group D). Results Forty-eight [4.0%(48/1 193)] and fetuses were found to have abnormal chromosomal karyotypes, including 26 cases of chromosome polymorphism variations and 22 cases of numerical and structural abnormalities (four cases of trisomy 21, four cases of numerical sex chromosome abnormalities, three cases of trisomy 18, three cases of extra small chromosome mosaicism, three cases of reciprocal translocation, one case of Robertsonian translocation, one case of chromosome six inversion between the arms, one case of chromosome three inversion between the arms, one case of mosaicism of trisomy 14 and one case of structural abnormality of chromosome 14). In group A, four cases (1.5%) of chromosomal abnormalities of clinical significance and four cases of chromosome polymorphism variations were detected. Meanwhile, 61 fetuses with inherited metabolic disorders or single-gene genetic diseases and two cases of gene mutation carriers were detected in group A, but among whom, there were no abnormal chromosome karyotype cases. In group B, two cases (2.5%) of chromosomal abnormalities were found. In group C, two cases (2/8) of reciprocal translocation were found, whose karyotypes were the same as the parents. In group D, three cases of trisomy 21, three cases of trisomy 18, two cases of extra small chromosome mosaicism and two cases of numerical sex chromosome abnormalities were found. All the mothers in this group were of advanced age. Four cases of structural abnormalities and 22 cases of chromosome polymorphism variations were also found in this group, chromosomal analysis was subsequently performed in those couples, and found that the abnormal chromosomal karyotypes in the fetuses were the same as those in the parents. Conclusions Appropriate prenatal cell genetic diagnostic methods should be chosen according to the causes of abnormal pregnancy history.

Objective Based on animal model of left ventricular pressure overload induced cardiac fibrosis,to investigate the specific role and molecular mechanism of KLF15 gene in this process.Methods To establish rat animal model of pressure overload induced cardiac hypertrophy by aortic coarctation under non artificial ventilation conditions,and then release the constriction,to observe the rat heart color Doppler images,myocardial interstitial fibrosis features and protein expression level changes of KLF15、Transforming growth factor-β (TGF-β) 、Connective tissue growth factor (CTGF)、Myocardin-related transcription factor A(MRTF-A) in overload-unload corresponding time points.Results We successfully completed aortic banding and debanding operations by use of SD rats without artificial ventilation.Through color Doppler echocardiography detection,from images to know:the effect of constriction and loosening is definite.The expression of collagen type Ⅰ,collagen type Ⅲ,TGF-β,CTGF,MRTF-A were significantly higher and myocardial hypertrophy was aggravated but the KLF15 protein expression level was significantly lower in pressure overloaded rats than in Sham rats(all P ＜ 0.05).All values were in an increasing tendency with the constrictive time prolonged (P ＜ 0.05).The response to unloading was opposite,the sooner to loose the better to the recovery to normal.The differences of indicators are very notable (P ＜ 0.05).Conclusion By feedback regulation TGF-β,KLF15 inhibited the effect of CTGF and MRTF-A,reducing myocardial interstitial fibrosis.