Objective To explore the effects of early growth response gene-1 (Egr-1) on bone marrow mesenchymal stem cells (BMSC) proliferation and osteogenic differentiation,which is aimed at providing new molecular targets for the treatment of osteoporosis.Methods Bone marrow was collected from adult men and the BMSCs were cultured primarily and observed by microscope.Meanwhile,flow cytometry was used for BMSCs phenotypic identification;After transfection of pcDNA3.1/Egr-1 into BM SCs,the level of BMSCs proliferation was determined by MTT respectively on the 2 d,4 d and 6 d;On the 7 d after transfection,the ALP activity assay was used for testing the ALP activity in BMSCs.And then,alizarin red S-calcium kit was used for measuring the calcified knots respectively on the 7 d,14 d and 21 d;On the 21 d after transfection,real-time qPCR and Western blotting were used respectively for measuring the expression of mRNA and protein of Egr-1,Runx2 and NDRG1;Further,BMSCs were transfected with Egr-1 siRNA,and the content of calcium nodules,ALP activity,the expression of Egr-1,Runx2 and NDRG1 were detected as above methods.Results The cells cultured in vitro showed high level of CD90 and CD29 and very low level of CD34 and CD45,which is accorded with the characteristic of BMSCs.The pcDNA3.1/Egr-1 transfection for BMSCs had no effect on cells prolifera tion.However,the calcified knots,ALP activity and the expression of Egr 1,Runx2 and NDRG1 were increased after transfection of pcDNA3.1/Egr-1 for BMSCs.In addition,Egr-1 siRNA showed the opposite effect with pcDNA3.1/Egr-1 transfection for BMSCs.Conclusion Egr-1 induces osteogenic differentiation of BMSCs by promoting NDRG1 but has no effects on proliferation of BMSCs.

Objective To assess the changes in heart geometry and function during off-pump coronary artery bypass grafting(CABG).Methods Thirty ASAⅡorⅢpatients(24 males,6 females)aged 50-78 undergoing elective off-pump CABG were studied.After induction of anesthesia and tracheal intubation a catheter which was connected to the monitor measuring continuous cardiac output(CCO),mixed venous blood oxygen saturation(S(?)O_2)and CEDV was placed via right internal jugular vein and the probe of multi-phase transesophageal echocardiograph(TEE)(Sonos HP 2500)was inserted in the esophagus.The distance between the probe and the incisors was between 34-45 cm.The hemodynamic variables and TEE parameters were recorded when epicardium was opened(T_1,baseline)when the octopus tissue stabilizer was placed during anastomosis between the graft vessel and left anterior descending artery(LAD)(T_2)left circumflex artery(LCX)(T_3)and right coronary artery(RCA)(T_4)and when the anastomoses between the vessel grafts and aorta was completed (T_5).Results At T_2 the mitral valve deceleration time(DT_1)and the blood flow through the mitral valve(Q_1) were decreased significantly as compared with the baseline(T_1);MAP was significantly decreased while HR and CVP were increased(P＜0.05).At T_3 the left and right ventricular end-diastolic diameter(LVEDD,RVEDD), tricuspid valve diameter(TVD)and the blood flow through Q_1 and tricuspid valve(Q_2)were significantly decreased as compared to the baseline values at T_1.The mitral valve E/A ratio was increased while the tricuspid valve E/A ratio was decreased(P＜0.05).The MAP,S(?)O_2,right ventricular end-systolic and end-diastolic volume(RVESV,RVEDV)and right ventricular ejection fraction were significantly decreased while HR and CVP were increased at T_3 as compared to the baseline at T_1.At T_4 LVESD,LVEDD,MVD,tricuspid valve E/A ratio and Q_1 were significantly decreased as compared to the baseline at T_1(P＜0.05).MAP,MPAP,SV,S(?)O_2, RVEF,RVESV and RVEDV were significantly decreased while HR and CVP were increased(P＜0.05).At T_5 all the TEE and hemodynamic parameters returned to the baseline valves at T_1.Conclusion During anastomoses between graft vessels and LAD,LCX and RCA,both left and right ventricles are compared to some extent and the heart function is impaired temporarily but returns to the baseline after the anastomoses are completed.

Objective:To observe the influence of parenteral nutrition support on nutritional status and immune function in patients with neoadjuvant chemotherapy for gastric cancer.Methods:60 patients with locally advanced gastric cancer were randomly divided into PN group and control group,30 cases in each group.The nutritional status and immune function were compared.Results:Adverse reaction of chemotherapy in PN group was less than in control group (P ＜ 0.05).ALB,TF.PA and IgA,IgG,IgM,CD4+ and CD4+/CD8+ were all higher in PN group than in control group 7 days after surgery (P ＜ 0.05).Conclusion:Parenteral nutrition support is helpful to improve patients' nutritional state during chemotherapy and operation.

Objective To explore the puberty and height development in childern with congenital adrenal hyperplasia(CAH) due to 21-hydroxylase deficiency(21-OHD) with the simple virilizing(SV) form.Methods Patients of SV 21-OHD,diagnosed and treated in Tianjin Children's Hospital from Jan.1970 to Jan.2008,were treated with cortisone acetate or hydrocortisone after diagnosed,and blood investigations were performed as part of monitoring,and dosages were adjusted accordingly to obtain normal growth velocity and slow bone age(BA) development.Gonadotropin-releasing hormone agonist(Gn-RHa) was given after the appearance of central precocious puberty(CPP).Forty-one patients(18 females,23 males) had achieved final height before Dec.31st 2008,and their puberty and height development were analyzed in this longitudinal study by contrast the ages and statures of obtaining final height(FH),chronological age(CA) and BA of G2/B2 stage,duration from G2/B2 stage to obtain FH and stature development of different gender during this period and the influences of compliancy on the ages and statures of obtaining FH were contrasted.Results With regarding to the age of testicular volume ≥4 mL,78.26% boys were before 9 years old.As far as the age of breast development was concerned,38.89% girls were before 8 year old and 66.67% menarche occurred before 10 year old.The differences between the duration and stature development of the period from the state of G2/B2 to skeletal maturation of different gender were significant (Pa

Objective To analyze rate of and reasons for not undertaking insulin pump therapy in children with type 1 diabetes(T1DM) and explore potential countermeasures.Methods Two hundred and seventy-eight persons of T1DM,diagnosed in Tianjin Children′s Hospital from Jan.2000 to Dec.2008,were assigned to fill in a questionnaire on T1DM and insulin pump therapy.Reasons for different compliances were analyzed and strategies were explored.Results Eighty-five point twenty-five percent of the children(237 persons) undertook the therapy and 14.75%(41 persons) refused.In the group of younger than 3 years,58.33%(21 persons)accepted the therapy,while in the group of older than 3 years,89.26%(216 persons) undertook it,consequently there was statistically significant difference(?2=23.83,P

Objective To observe the effects of 7,8-dihydroxyflavone (7,8-DHF) on hypoxia induced endoplasmic reticulum stress (ERS) in human proximal tubular epithelial cells (HK-2).Methods The mRNA level of ERS associated biomarkers was evaluated by RT-PCR assay in cell hypoxia damaged model.And HK-2 cells were pretreated with different concentrations of 7,8-DHF through CCK-8 assay;meanwhile CCAAT/enhancer-binding protein homologous protein (CHOP),Cyr61,Akt and p-Akt were determined by western blotting assay.Moreover,HK-2 cells were pretreated by LY294002,a kind of PI3K/Akt inhibitor,to inhibit the PI3K/Akt signaling,and its effects on protein level induced by 7,8-DHF was detected.HK-2 cells was then over-expressed Cyr61 and exposed to hypoxia Apoptosis rate and CHOP expression were determined.Results Compared to hypoxia group (P ＜ 0.01),Hypoxia for 12h was effective in inducing ERS (P ＜ 0.01),while pretreatment with 7,8-DHF (100 μmol/L) increased cell proliferation significantly.The protein expressions of Cyr61 and p-Akt in H+7,8-DHF group were higher,but the level of CHOP was decreased (P ＜ 0.05).With LY294002 pretreated,the expression of Cyr61,p-Akt was down-regulated (all P ＜ 0.05) while the expression of CHOP was up-regulated (P ＜ 0.05).In comparison to empty plasmid group,when cells were transfected with over-expression of Cyr61 plasmid and exposed to hypoxia,the number of apoptotic tubular cells was decreased (P ＜ 0.01).And over-expression of Cyr61 significantly reducedCHOP expression compared with the empty plasmid group (P ＜ 0.01).Conclusion Pretreatment of 7,8-DHF could protect cells from hypoxia injury and inhibit ERS,which may involve the Akt-Cyr61 signaling pathway.

Following the blood pressure, pulse, breathing and body temperature, pain was identified as the fifth vital signs.Postoperative pain of the spine and spinal cord surgery was a neuropathic pain, it was severe and may affect multiple systems of the patients.Therefore, postoperative analgesia of spine and spinal cord surgery is very important.

Objective To compare the effect of TNF-α preconditioning and ischemic preconditioning on hepatic ischemia-reperfusion injury ( IRI) and investigate the underlying mechanisms of TNF-αpreconditioning. Methods Fourty healthy male Wistar rats were random-ly divided into four groups which were Sham-operated group ( SO) ,ischemia-reperfusion group ( IR group:produced by total inflow occlusion for 30 min) ,ischemic preconditioning group ( IPC group:induce with 10 min hepatic ischemic and open 10 min before IR) and TNF-αpre-conditioning group ( TPC group:intraperitoneal injection with 1 μg/kg TNF-a 30 min prior to IR) . The sample of blood and hepatic tissue of all groups were taken after experiment. The protein levels of NF-κBp65 and Bcl-2 in the hepatic tissue were detected by immunohistochemis-try. Results There was significant difference (P<0. 05) between IR group and IPC group,TPC group on the level of ALT,AST and the expression of NF-κBp65 and Bcl-2,apoptosis index in hepatic tissue. There was no significance difference (P>0. 05) between IPC group and TPC group. Conclusion TNF-α preconditioning decreased the intensity of hepatic IRI,just as ischemic preconditioning,by induces an de-crease in the NF-κBp65 expression and an increase in the Bcl-2 expression.

Objectives To understand essential basis data availability for implementation of cost accounting in TCM hospitals. Methods Costs of a total of 1588 TCM hospitals were investigated by conducting the baseline survey via questionnaires in 2013. Results Departmental basic data (including ratio of office staff and entire staff, ratio of outpatient and inpatient departments in clinical department), and construction data for housing were well accessible, while utility fee and internal service data were not. Conclusion ①Public TCM hospitals need to improve and specify the basic cost data. ②Differences exit among different types and levels of hospitals in the availability of data. ③There are still difficulties in carrying out cost accounting in public TCM hospitals, which needs strong supports from all relevant departments.

ATP binding cassette C4(ABCC4,MRP4)plays an important role in transshipment physio-logic,endogenous or exogenous substances. The over expression of ABCC4 gene has been found in many kinds of solid tumors and hematological malignancies. The target gene also influences metastasis and recurrence process. ABCC4 can reduce the intracellular concentration and the sensitivity of various chemotherapy drugs, which is bad for prognosis.