Background Researches showed that stem cells can rescue damaged cells through mitochondrial transfer.This mode has been used to regenerative cell-based therapy.Retinal pigment degeneration is an eye disease of retinal pigment epithelial (RPE) cell apoptosis as pathogenetic mechanism.Whether stem cells can repair the target cells by above mechanism has not been clarified.Objective This study was to investigate the influence of mitochondrial transfer on the function of RPE cells.Methods The RPE cells of Long-Evans rats were isolated and cultured and the third generation of cells were used in sequential experiment.The cells were identified by detecting the expressions of RPE65 and Bestrophin proteins with immunofluorescence stain.Mouse neural stem cells (NSCs) (C17.2 strain) with green fluorescence protein (GFP) and without GFP were cultured.Mitotracker-green and Mitotracker-red staining were separately used to labeled the mitochondria of RPE cells and NSCs.RPE cells were cocultured with NSCs,and wheat germ agglutinin (WGA) was used to mark the tunneling nanotubes (TNT) between the two kinds of cells,and then the mitochondrial migration in TNT was exhibited by the laser scanning confocal microscope.The proportion of RPE cells in different cycles was assayed after marked with propidium iodide (PI) by flow cytometry.The contents of ATP,ADP and AMP in RPE cells were detected by high performance liquid chromatography (HPLC).Results The third-generation of RPE cells grew well with the RPE65-and Bestrophinpositive rate ＞85％.The Mitotracker-red-labeled rates of NSCs and RPE cells were no less than 95％.TNT structure was seen to appear the blue fluorescence between RPE cells and NSCs 24 hours after co-cultured and the red dye mitochondria from NSCs migrated toward red dye mitochondria from RPEs with the lapse of time.The RPE cell proportion reduced in G1 phase and increased by 5％ and 2％ in the S phase and G2/M phase respectively after mitochondrial transfer than before (P=0.016,0.114,0.189).The contents of ATP,ADP and AMP in the RPE cells were (8.77 ±3.68),(2.76±0.92) and (1.07 ±0.65) μg/mg after cell co-culture,and those before co-culture were (11.29±2.29),(3.12±0.95) and (1.59± 1.22) μg/mg,without significant differences between them (P =0.370,0.668,0.553).Conclusions NSCs can transfer normal mitochondria to co-cultured RPEs via TNT structure.Mitochondrial exchange might be one of therapeutic mechanisms of NSCs recuing damaged RPE cells.

Objective To evaluate the effect of mild hypothermia combined with hydrogen-rich saline on cerebral injury after cardiac arrest and resuscitation in rats.Methods Healthy male Sprague-Dawley rats,aged 7-8 weeks,weighing 280-320 g,were divided into 5 groups (n=33 each) using a random number table method:sham operation group (group S),cardiac arrest and resuscitation group (group CAR),hydrogen-rich saline group (group H2),mild hypothermia group (group MH),and mild hypothermia plus hydrogen-rich saline group (group MH+H2).Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the cerebral injury model.Hydrogen-rich saline 5 ml/kg was intraperitoneally injected immediately after return of spontaneous circulation (ROSC) in H2 and MH+H2 groups,while the equal volume of normal saline was given instead in the other groups.The body temperature of rats was cooled down to 32-34℃ within 15 min starting from the time point immediately after ROSC and maintained for 4 h in MH and MH+H2 groups.Fifteen rats were selected at 24 h after ROSC to assess the neurological function score (NDS).Eighteen rats in each group were sacrificed at 24 h after ROSC,and brains were removed for microscopic examination of the pathological changes in hippocampal CA1 region after hematoxylin and eosin staining and for determination of pyramidal cell count and expression of glucose-regulated protein 78 (GRP78),C/EBP-homologous protein (CHOP),caspase-12,caspase-3,Bcl-2 and Bax in hippocampal CA1 region (by Western blot).Results Compared with group S,the NDS was significantly decreased,the pyramidal cell count was reduced,the expression of GRP78,CHOP,caspase-12,caspase-3 and Bax was up-regulated,and the expression of Bcl-2 was down-regulated in the other four groups (P＜0.05).Compared with group CA-R,the NDS and pyramidal cell count were significantly increased,the expression of GRP78 and Bcl-2 was up-regulated,and the expression of CHOP,caspase-12,caspase-3 and Bax was down-regulated in H2,MH and MH+H2 groups (P＜0.05).Compared with group H2 or group MH,the NDS and pyramidal cell count were significantly increased,the expression of caspase-3 and Bax was down-regulated,the expression of Bcl-2 was up-regulated (P＜0.05),and no significant change was found in the expression of GRP78,CHOP and caspase-12 in group MH+H2 (P＞ 0.05).Conclusion Combination of mild hypothermia and hydrogen-rich saline offers enhanced efficacy in reducing cerebral injury after cardiac arrest and resuscitation over mild hypothermia or hydrogen-rich saline alone in rats.

Objective To explore the effect of the full-time rehabilitation nursing on the functional recovery after the noncemented total hip replacement .Methods One hundred and fourteen patients with noncemented total hip replacement were chosen and randomly divided into the control group ( n=51 ) and the observation group (n=63).The control group received the random rehabilitation nursing through the executive nurses, and the observation group received the full-time rehabilitation nursing through the full-time rehabilitation nurses.Results The scores of Harris at 1 d before discharge , 6 weeks after the operation and 3 months after the surgery were respectively (64.9 ±6.4), (78.5 ±5.1), (90.0 ±4.2) in the observation group, and were higher than those in the control group , and the differences were statistically significant ( t =5.377,3.059, 4.288, respectively;P<0.01).The scores of pain degree , living ability, walk ability at 1 d before discharge, 6 weeks after the operation and 3 moths after the operation between two groups had statistical significances ( P<0.01);when two groups of patients discharged hip X-ray showed good prosthesis , no exception.Experimental group patients with complications of 0.0%, the control group in the incidence of complications was 11.8%, the difference was statistically significant (χ2 =6.981,P <0.01).Conclusions The full-time rehabilitation nursing promotes the functional recovery after the noncemented total hip replacement .

Objective To explore the variation in the gene mutation patterns and risk factors of HBV polymerase region (P) in chronic viral hepatitis (CHB) patients with nucleoside analogues therapy.Methods A total of 108 chronic hepatitis B patients with viral breakthrough after the treatment of nucleoside analogues were selected as the study subjects.The PCR product direct sequencing method was used to analyze the genetic variation of HBV P region.Results Among 108 cases,69 cases were detected by gene drug resistance,and the mutation type amount to 12,among which rtM204I was the most common (30.4％),and the second was rtL180M/rtM204I combined mutation (13％).The proportion of the major nucleoside analogues resistance highest proportion of lamivudine was 62.3％,followed by adefovir dipivoxil (21.7％) and telbivudine (15.9％).There were 33 cases with a single site mutation,29 cases with two sites mutation and 7 cases with three and above sites mutation.In the 7 cases,1 case was treated with lamivudine,1 case with entecavir,and the remaining 5 cases with irregular combined or sequential use of lamivudine,adefovir dipivoxil and entecavir.Conclusion The amino acid of HBV P gene resistant mutation is complex and varied,and rtM204V/I mutation is the most common type.Three and above sites mutation is associated with irregular combined or sequential use of lamivudine,adefovir dipivoxil and entecavir.

Objective To explore the variation in the gene mutation patterns and risk factors of HBV polymerase region (P) in chronic viral hepatitis (CHB) patients with nucleoside analogues therapy.Methods A total of 108 chronic hepatitis B patients with viral breakthrough after the treatment of nucleoside analogues were selected as the study subjects.The PCR product direct sequencing method was used to analyze the genetic variation of HBV P region.Results Among 108 cases,69 cases were detected by gene drug resistance,and the mutation type amount to 12,among which rtM204I was the most common (30.4％),and the second was rtL180M/rtM204I combined mutation (13％).The proportion of the major nucleoside analogues resistance highest proportion of lamivudine was 62.3％,followed by adefovir dipivoxil (21.7％) and telbivudine (15.9％).There were 33 cases with a single site mutation,29 cases with two sites mutation and 7 cases with three and above sites mutation.In the 7 cases,1 case was treated with lamivudine,1 case with entecavir,and the remaining 5 cases with irregular combined or sequential use of lamivudine,adefovir dipivoxil and entecavir.Conclusion The amino acid of HBV P gene resistant mutation is complex and varied,and rtM204V/I mutation is the most common type.Three and above sites mutation is associated with irregular combined or sequential use of lamivudine,adefovir dipivoxil and entecavir.

Objective:To evaluate early left ventricular myocardial work in patients with metabolic syndrome (MS) by pressure-strain loops (PSL).Methods:From September 2020 to April 2021, 70 MS patients in the First Hospital of Qinhuangdao Affiliated to Hebei Medical University without left ventricular remodeling were selected as MS group and 65 normal controls as control group, PSL was used to obtain the myocardial power parameters, including global work index (GWI), global work efficiency (GWE), global constructive work (GCW) and global wasted work (GWW). The changes of the parameters were compared between the two groups and their correlations with biochemical parameters were performed in MS group.Results:The left ventricular global longitudinal strain (GLS), GWI, GCW and GWE in MS group were lower than those in normal group, while GWW was higher than that in normal group ( P<0.05). Pearson correlation analysis showed that GWI was positively correlated with high-density lipoprotein cholesterol (HDL-C) ( r=0.194, P<0.05), and negatively correlated with diastolic blood pressure (DBP), waist circumference (WC), fasting blood glucose (Glu), triglyceride (TG) and GLS ( r=-0.257, -0.452, -0.239, -0.193, -0.758, all P<0.05). GWE was negatively correlated with SBP, DBP, WC, Glu, TG and GLS ( r=-0.360, -0.269, -0.326, -0.352, -0.265, -0.663, all P<0.01), and positively correlated with HDL-C ( r=0.201, P<0.05). GCW was negatively correlated with WC and GLS ( r=-0.299, -0.737; all P<0.001). GWW was positively correlated with SBP, DBP, WC, Glu, TG and GLS ( r=0.435, 0.308, 0.413, 0.547, 0.272, 0.400, all P<0.01), and negatively correlated with HDL-C ( r=-0.336, P<0.001). Conclusions:PSL can quantitatively evaluate the changes of early myocardial work in MS patients with good repeatability and has certain clinical value.

BACKGROUNDLowering intraocular pressure (IOP) is currently the only therapeutic approach in primary open-angle glaucoma. and the fixed-combination medications are needed to achieve sufficiently low target IOP. A multicenter prospective study in the Chinese population was needed to confirm the safety and efficacy of Bimatoprost/Timolol Fixed Combination Eye Drop in China. In this study, we evaluated the safety and efficacy of Bimatoprost/Timolol Fixed Combination with concurrent administration of its components in Chinese patients with open-angle glaucoma or ocular hypertension.

METHODSIn this multicenter, randomized, double-masked, parallel controlled study, patients with open-angle glaucoma or ocular hypertension who were insufficiently responsive to monotherapy with either topical β-blockers or prostaglandin analogues were randomized to one of two active treatment groups in a 1:1 ratio at 11 Chinese ophthalmic departments. Bimatoprost/timolol fixed combination treatment was a fixed combination of 0.03% bimatoprost and 0.5% timolol (followed by vehicle for masking) once daily at 19:00 P.M. and concurrent treatment was 0.03% bimatoprost followed by 0.5% timolol once daily at 19:00 P.M. The primary efficacy variable was change from baseline in mean diurnal intraocular pressure (IOP) at week 4 visit in the intent-to-treat (ITT) population. Primary analysis evaluated the non-inferiority of bimatoprost/ timolol fixed combination to concurrent with respect to the primary variable using a confidence interval (CI) approach. Bimatoprost/timolol fixed combination was to be considered non-inferior to concurrent if the upper limit of the 95% CI for the between-treatment (bimatoprost/timolol fixed combination minus concurrent) difference was ≤ 1.5 mmHg. Adverse events were collected and slit-lamp examinations were performed to assess safety. Between-group comparisons of the incidence of adverse events were performed using the Pearson chi-square test or Fisher's exact test.

RESULTSOf the enrolled 235 patients, 121 patients were randomized to receive bimatoprost/timolol fixed combination and, 114 patients were randomized to receive concurrent treatment. At baseline the mean value of mean diurnal IOP was (25.20 ± 3.06) mmHg in the bimatoprost/timolol fixed combination group and (24.87 ± 3.88) mmHg in the concurrent group. The difference between the treatment groups was not statistically significant. The mean change from baseline in mean diurnal IOP (± standard deviation) in the bimatoprost/timolol fixed combination group was (-9.38 ± 4.66) mmHg and it was (-8.93 ± 4.25) mmHg in the concurrent group (P < 0.01). The difference between the two treatment groups (bimatoprost/timolol fixed combination minus concurrent) in the change from baseline of mean diurnal IOP was -0.556 mmHg (95% CI: -1.68, 0.57, P = 0.330). The upper limit of the 95% CI was less than 1.5 mmHg, the predefined margin of non-inferiority. Adverse events occurred in 26.4% (32/121) of the bimatoprost/timolol fixed combination patients and 30.7% (35/114) of the concurrent patients. The most frequent adverse event was conjunctival hyperemia, which was reported as treatment related in 16.5% (20/121) in the bimatoprost/timolol fixed combination group and 18.4% (21/114) in the concurrent group (P > 0.05).

CONCLUSIONSBimatoprost/Timolol Fixed Combination administered in Chinese patients with open-angle glaucoma or ocular hypertension was not inferior to concurrent dosing with the individual components. Safety profiles were similar between the treatment groups.

Adolescent ; Adult ; Aged ; Amides ; administration & dosage ; adverse effects ; therapeutic use ; Bimatoprost ; Cloprostenol ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Female ; Glaucoma, Open-Angle ; drug therapy ; Humans ; Male ; Middle Aged ; Ocular Hypertension ; drug therapy ; Timolol ; administration & dosage ; adverse effects ; therapeutic use ; Young Adult