Diabetic retinopathy is a major cause of blindness all over the world, and it is one of the most serious and common microvascular complications of diabetes. Breakdown of the endothelial blood - retinal barrier ( BRB ) , as occurs in diabetic retinopathy, result in vasogenic edema and neural tissue damage, causing loss of vision. The inner BRB is created by complex tight juctions of retinal capillary endothelial cells, this barrier prevents the free diffusion of substances between the circulating blood and the neural retinal, the inner BRB efficiently supplies nutrients to the retinal and removes endobiotics and xenobiotics from the retina to maintain a constant milieu in the neural retina. The central mechanism of altered inner BRB function is a change in the permeability characteristics of retinal endothelial cells caused by elevated levels of cytokines, growth factors, advanced glycation end products, inflammation, hyperglycema and loss of pericytes. This article reviews the relationship between diabetes and the ultrastructure changes of BRB.

OBJECTIVETo assess the methodology and report quality of systematic evaluation and Meta-analysis of acupuncture and moxibustion in China.

METHODSRetrieve CBM, CNKI, WF and VIP database, collect data from the information system established by Epidata 2.1, assess the methodology and report quality by using the QQAQ and QUOROM, calculate the percentage of adequate rate.

RESULTSThirty-eight reviews, including twenty six systematic evaluation and twelve Meta-analyses, met the enrolled criteria. Twenty-two kinds of diseases and six diseases systems were included. The methodology quality scores were generally low (3.34 +/- 1.44). The causes of the problems were insufficient literature resource, bias in data collections and inaccurate merging methods. The report quality was relatively low in abstracts, methods, trial flow, introduction and data merging.

CONCLUSIONThe amount of literatures on systematic evaluation and Meta-analysis of acupuncture is gradually increasing from 2002. However, the quality control is not ideal. It is important to improve the methodology and report quality.

Objective To establish the method of combined hepatocyte growth factor (HGF) with epidermal growth factor (EGF) cultured human gallbladder epithelial cells(HGBECs) in vitro .Methods The epithelial layer was peeled away from human gallbladder ,epithelial layer were digested with collagenase Ⅳ and scraped repeatedly .HGBECs were isolated and seeded in cell cul-ture plates containing medium supplemented with or without 10 ng/mL EGF or with 10 ng/mL HGF and 10 ng/mL EGF respec-tively .Then the morphologic changes of the cells were observed and taken photos with inverted phase contrast microscope ,and counted number of cells ,MTT assay detected vigor of cells in different groups .Results The number of the HGBECs of the HGF+EGF group was obviously more than the EGF group ,the duration of the HGBECs of the HGF+ EGF group was obviously longer than the EGF group(19 .3 ± 2 .5)d vs .(14 .2 ± 2 .4)d ,P< 0 .05 .And the HGBECs of the group with HGF+ EGF had better cell vigor .Conclusion HGF combines with EGF added to medium can obviously promote the proliferation of HGBECs and prolong the duration and stabilize morphology of HGBECs in vitro .

Objective To analyse the distribution characteristics of major allergens initiating allergic diseases in children from rural Shanghai. Methods Eight hundred children with allergic diseases from rural Shanghai (rural ease group), 450 children with allergic diseases from urban Shanghai (urban ease group) and 100 healthy children from rural Shanghai (rural normal control group) underwent skin prick tests (SPT), and children of rural case group were subdivided into infant group, preschool age group and school age group according to age. The positive rates of allergens and SPT were compared among groups. Results The positive rate of SPT of rural case group was significantly higher than that of rural normal control group (73.38% vs 26.00%, P<0.05), and was significantly lower than that of urban ease group (73.38% vs 80.22%, P<0.05). Dermatophagoidesfarinae and Dermatophagoides pteronyssinus were the major allergens in rural ease group, with the positive rates of 57.88% and 59.13%, respectively. Except weed and rubber, there were significant differences in positive rates of the other allergens between rural ease group and the other two groups(P<0.05). There were significant differences in positive rates of SPT among different age groups of rural children with allergic diseases (P<0.05). Conclusion Dermatophagoides farinae and Dermatophagoides pteronyssinus are the major allergens in children with allergic diseases from rural Shanghai, whose positive rates of SPT are lower than those of children with allergic diseases from urban Shanghai. The positive rate of SPT is related to age to some extent.

Objective To explore clinical characteristics of alveolar soft part sarcoma(ASPS) and prognosis factors related to surgical treatment.Methods This study retrospectively analyzed 29 ASPS consecutive cases between Sep.1982 to Sep.2010,including 18 males and 11 females,with average 24.4 and median 21 years old (ranging 9 to 58).26 patients with surgery were enrolled in this study,with 23 cases primarily ocurred in soft tissue and 3 cases in bone.There were 17 cases with painless mass (65.4％,17/26) and 9 cases with pain (36.4％,9/26).Demographics,tumor size,stage,surgical margin,adjuvant chemotherapy provided,local recurrence,metastatic rate and overall survival probability were evaluated.We used multivariate analysis of logistic regression and Cox regression for local recurrence and survival rate respectively,and univariate analysis for tumor size,surgical margin,adjuvant chemotherapy and local recurrence.Results According to the Enneking classification,we distinguished stage Ⅱ 14 cases and stage Ⅲ 12 cases.Marginal excision was obtained in 9 cases as well as wide resection in 17 patients.The average and median follow-up time was 45.9 and 31 months (ranging 5 to 226) respectively,12 cases eventually survived (46.2％).The 5-year survival rates for stage Ⅱ and Ⅲ cases were 79.5％ and 23.4％ respectively.We found significant difference for local recurrence with surgical margin.However,there was no significant difference for prevention of metastatic progression with or without adjuvant chemotherapy.For tumor size,5-year survival rate of ＞ 5 cm and ＜ 5 cm group were 40.7％ and 80.0％ respectively.Multivariate analysis of logistic regression showed the surgical marginal was the only significant risk factor for local recurrence,while Cox regression showed both stage and tumor size were independent prognostic indicators for survival.Conclusion Although presenting as a slowly growing and painless mass,ASPS is an aggressive tumor with high risk of metastasis.Prognosis of ASPS is basically related to the characteristics of tumor size,surgical stage and quality of surgery.With limited improvement of adjuvant chemotherapy for metastasis control and survival,new agents are eagerly needed to complement surgery to eradicate this disease.

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

Objective To study the effect of dialysis adcquacy,microinflammation and residual renal function on nutritional status of hemodialysis patients.Methods One hundred and fourteen patients were enrolled in this study.Kt/V,?_2-MG and serum iPTH were measured as markers of hemodialysis adequacy.Nutritional evaluation included MQSGA,Alb,Hb,TF,IGF-1,IGFBP-3 and anthropometrics such as HGS,BSF,TSF,MAC,MAMC and AMA.Serum IL-6,TNF-?and CRP were detected to assess microinflammation.Urinary volume of 24 hours was measured to investigate the residual renal function (RRF).Results (1)There were different correlations and regressive associations of Kt/V,iPTH and?_2-MG with HGS,MAMC,AMA,Alb,Hb,nPCR,IGF-1 and MQSGA respectively.(2) There were significant correlations and regressive associations of RRF to HGS,TSF,MAMC,Alb,nPCR and IGF-1 within the first year of hemodialysis.(3) There were different correlations and regression relationships of IL-6,TNF-?and CRP with HGS、MAMC、AMA、Alb、TSF、Hb、nPCR、IGF-1 respectively.(4) Multivariate analysis showed that Kt/V,iPTH,IL-6, TNF-?,?_2-MG and RRF were influencing factors,among them,Kt/V,iPTH,IL-6 and TNF-?were independent predictors of nutritional status.Conclusions Hemodialysis adequacy and micruinflammation may impact on nutritional status.Residual renal function may be involved in nutritional status in the first year of hemodialysis.Kt/V,iPTH,IL-6 and TNF-?are independent factors affecting nutritional status.

The rapid development of the globalization process has brought global health problems and made global health a hotspot in the world. China’s “One Belt and One Road” initiative has strengthened economic and trade exchanges between China and Asia, Africa, Europe, and has also increased health risks such as the spread of infectious diseases, disease spectrum, and lifestyle changes, posing challenges to the development of global health in China. Based on the history of global health, this paper made a brief review of the current status and future development of global health research. It pointed out that China’s global health research started late and had many shortcomings. In the context of the One Belt And One Road initiative, We should seize opportunities and meet challenges to contribute to the construction of "Healthy China" and the promotion to global health.

Background Permethrin is a commonly used pyrethroid insecticide and has been found to be potentially neurotoxic. Microglia are innate immune cells in the central nervous system and are involved in the development of a range of neurodegenerative diseases. Objective To observe possible toxic effects of permethrin on human microglia clone 3 (HMC3) in vitro and explore associated mechanism. Methods HMC3 were treated with 0, 10, 25, and 55 μmol·L⁻¹ permethrin for 72 h. Cell cycle and apoptosis were measured using flow cytometry. Cyclin-dependent kinase 1 (CDK1), cyclin-dependent kinase inhibitor 1A (CDKN1A), cyclin B2 (CCNB2), cellular tumor antigen p53 (p53), factor-related apoptosis (FAS), caspase 3 (CASP3), and H2A histone family member X (H2AX) were detected by quantitative real-time PCR (qPCR). The differential genes and enrichment pathways of HMC3 after 0 and 25 μmol·L⁻¹ permethrin treatment was analyzed by RNA sequencing. HMC3 was treated by 0, 10, 25, and 55 μmol· L⁻¹ permethrin for 72 h. The content of nitric oxide (NO) in the supernatant was detected using Griess reagent. The secretion level of interleukin-6 (IL-6) was detected by enzyme linked immunosorbent assay (ELISA). The mRNA expression levels of mitogen-activated protein kinase (MAPK) pathway (including MAPK1, MAPK8, and MAPK14), interleukin-1β (IL-1β), IL-6, and matrix metalloproteinase (MMP) families (including MMP1, MMP2, MMP3, and MMP9) were detected by qPCR. The protein expressions of phosphorylated p38 mitogen-activated protein kinase (p-p38), phosphorylated extracellular signal-regulated kinase (p-ERK), IL-1β, IL-6, and MMP1 were detected by Western blot. Results HMC3 was arrested in G2/M phase after 0, 10, 25, and 55 μmol·L⁻¹ permethrin treatment for 72 h, of which there was a statistically significant difference between the 55 μmol·L⁻¹ permethrin treatment group and the control group (P<0.01), and the mRNA expression of CDKN1A was up-regulated according to the qPCR (P<0.05). There was no statistically significant difference in the proportions of apoptosis between the groups (P＞0.05). The RNA sequencing showed that the differential genes were enriched in the MAPK pathway, and the mRNA expressions of MAPK1, MAPK8, and MAPK14 were up-regulated after the permethrin treatment at 55 μmol·L⁻¹ compared to the control group by qPCR (P<0.05). The Western blot revealed that, compared to the control group, the levels of p-p38 and p-ERK were increased after the 10 μmol·L⁻¹ permetrin treatment (P<0.05), the p-ERK level was increased after the 25 μmol·L⁻¹ permetrin treatment (P<0.05), and the p-p38 level was up-regulated after the 55 μmol·L⁻¹ permetrin treatment (P<0.05). The secretion of NO in the supernatant of HMC3 increased after permetrin treatment compared to the control group (P<0.05), the mRNA and protein expressions and the secretion of IL-6 showed an upward trend, the mRNA and protein expressions of IL-1β were up-regulated (P<0.05), and the mRNA and protein expressions of MMP1 were up-regulated in the 25 and 55 μmol·L⁻¹ permethrin groups (P<0.05). Conclusion Permethrin inhibits HMC3 cell proliferation in vitro, induces cell cycle arrest, activates MAPK pathway, and promotes the expression of inflammatory factors IL-1β and MMP1, which may be one of the mechanism of neurotoxicity induced by permethrin.

The paper aims to explore the studying method for the pharmacokinetics of drugs in target organs, the pharmacokinetic process of tramadol hydrochloride in the extracellular fluid of frontal cortex (FrCx) of mice was investigated. Six male mice (Kunming strain) were anaesthetized (urethane, 1.8 g x kg(-1), ip) and secured on a stereotaxic frame. A microdialysis probe was implanted into the FrCx and perfused with artificial cerebrospinal fluid at a flow rate of 2 microL x min(-1). One hour later, mice were administrated (ip) with tramadol hydrochloride (50 mg x kg(-1)) and dialysates were collected continuously at 12-min intervals (24 microL each) for 6 h. The tramadol concentration in dialysates was determined by HPLC-Ultraviolet detection method, and the concentration-time curve and pharmacokinetic parameters of tramadol were calculated with DAS software. The results showed that the pharmacokinetic process of tramadol in the FrCx extracellular fluid of mice was fitted to a two-compartment open model, and the main pharmacokinetic parameters t1/2alpha, t1/2beta, t(max), C(max) and AUC(0-infinity) were (0.27 +/- 0.05) h, (2.72 +/- 0.24) h, (0.50 +/- 0.10) h, (2 110.37 +/- 291.22) microg x L(-1) and (4 474.51 +/- 441.79) microg x L(-1) x h, respectively. In conclusion, a studying method for pharmacokinetics of drugs in the target organ is established, which is simple and feasible. Tramadol hydrochloride shows a two-compartment model in the extracellular fluid of the mouse FrCx, and the distribution- and elimination half-life are 0.5 h and 2.7 h, respectively.
Animals ; Area Under Curve ; Chromatography, High Pressure Liquid ; Extracellular Fluid ; metabolism ; Frontal Lobe ; metabolism ; Half-Life ; Male ; Mice ; Microdialysis ; Tramadol ; pharmacokinetics ; Ultraviolet Rays