This review focuses on the fetal origins of adult disease hypothesis put forward by David Barker and his colleagues,recent advances in epidemiological studies and experimental research in this field.Barker Hypothesis states that environmental factors,particularly intrauterine nutrition,as indicated by birth weight,operate in early life to program the risks for adverse health outcomes in adult life.A large growing body of reports described the association between the early development and adult diseases,such as diabetes,hypertension,coronary heart disease,abnormal lipids metabolism,obesity and cancer,etc.Experimental studies show that the changes of some key genes' expression,caused by epigenetic modifications,lead to a permanent alteration of cellular proliferation and differentiation and finally the genesis in key tissues and organs.These results bring about the impairment in structures and functions and the increased susceptibility to chronic diseases in adult life.The hypothesis provides a new perspective for the prevention and therapy of chronic diseases.

Objective To observe the correlation between platelet parameters , platelet activation marker and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus. Methods One hundred and ninety-five type 2 diabetic patients were enrolled in this study. The patients were divided into the normal control group, the CIMT increased group and the clot group according to the carotid intima-media thickness. Levels of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit(PCT), urinary 11-dehydro-thromboxane B2 (11-DH-TXB2) and other clinical, biochemical characteristics were measured. Results (1) Levels of serum LDL-C, MPV, PDW, urinary 11-DH-TXB2 and clinical course in the clot group were higher than those in the CIMT increased group and the normal control group (P < 0.05). (2) Compared with the normal control group, the clinical course, serum LDL-C, MPV, PDW and urinary 11-DH-TXB2 were higher in the CIMT increased group (P < 0.05). (3) By using with spearman rank correlation test, carotid intima-media thickness was positively associated with age , course , BMI , GLU , GHbA1C , LDL-C , MPV , PDW and urinary 11-DH-TXB2, whereas carotid intima-media thickness was negative associated with HDL-C, PLT (both P < 0.05). (4) MPV, PDW and urinary11-DH-TXB2 were shown as the independent risk factors for CIMT. Conclusions Platelet activation marker and platelet parameters are associated with carotid intima-media thickness in patients with type 2 diabetes mellitus.

Objectives To explore if the rat bone marrow mesenchymal stem cells (BMSCs) modified by human heme oxygenase 1 (hHO-1) gene combined with GATA-4 gene may promote the ability of anti-apoptosis and myocardial transdifferentiation in vitro in hypoxia ischemic environment.Methods The rat BMSCs were isolated and cultured by whole bone marrow adherence and identified in vitro,and then were transfected with recombinant adenovirus;Western blotting was used to determinate the optimal time of gene expression;the genetically modified BMSCs were taken to hypoxia serum-free conditions simulating ischemia hypoxia microenvironment in vivo;CCK-8 kit and trypan blue staining were performed to detect the 12,24,48 and 72h survival rates in hypoxia ischemia respectively;flow cytometry was used to detect the apoptosis of BMSCs in hypoxia ischemia for 24h.The cardiomyocyte-specific cardiac troponin Ⅰ (cTnI) was detected by Western blotting and cellular immunofluorescence.Results The 12,24,48 and 72h survival rates were higher in hHO-1+GATA-4 group cultured in ischemia and hypoxia condition than in hHO-1 group (P＜0.05) and GATA-4 group (P＜0.05).After 24h cultivation in ischemia hypoxia condition,the apoptotic rates were lower in hHO-1+GATA-4 group than in hHO-1 group (P＜0.05) and GATA-4 group (P＜0.05).No significant difference existed in cTnI expressions between GATA-4 group and hHO-1+GATA-4 group.Conclusion Compared with transfection of hHO-1 or GATA-4 single gene,hHO-1 combined with GATA-4 transduction can significantly increase the survival rate of BMSCs in hypoxia ischemic condition,but myocardial transdifferentiation does not increase significantly.

OBJECTIVE:To study the inhibitory effects of propolis on growth of transplantation tumor in mice.METHO_ DS:Using different concentrations of propolis to feed the mice for two months,the tumor cells(S 180 )were transplanted into subaxillary tissue of the mice.After8days,the tumor mass was takent off the body of the mice,and weighted,then paraffin sections were observed and the number of karyokinesis of tumor cells was counted under the microscops.RESULTS:The weight of tumor mass were lighter in the propolis group than in the control group(P

Objective: To investigate the disability status and its epidemiological characteristics in the elderly in urban and rural communities in China. Methods: The participants were from the project of Prevention and Intervention on Neurodegenerative Disease for Elderly in China conducted in 2015. A total of 23 803 urban and rural residents aged over 60 years were selected through stratified multi-stage cluster sampling in 6 provinces for a set of standardized questionnaire interview and physical examinations. Activities of daily living (ADL) scale was used to assess the disability status of the elderly. χ² test was used to analyze the difference in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) disabilities in different elderly populations. Multivariate logistic regression model was used to analyze the influence factors for disability. Results: Taking bath had the highest impairment rate (1.7%) while eating had the lowest impairment rate (0.6%) in BADL. Making phone call had the highest impairment rate (16.6%), followed by taking bus (5.5%) and taking medicine (1.8%) in IADL. The BADL and IADL disability rates in community seniors were 2.1% and 19.1%, respectively. BADL disability rate was higher in females, the widowed, illiterate, the elderly with low body weight or obesity (P<0.05). IADL disability rate was higher in females, rural residents, the widowed, the elderly with lower educational level or lower body weight (P<0.05). Multivariate analysis showed that risk for BADL disability increased with age and abnormal BMI, and decreased with the increase of education level. The risk factors for IADL disability included being female, age, rural residence, being widowed and low BMI. The risk for IADL disability was lower in those with higher education level and overweight or obesity. Conclusion The present study showed that the disability rate was high in the elderly in China, which was influenced by the aging and multi demographic characteristics of the elderly. It is important to strengthen the prevention of BADL and IADL disabilities and intervention in the elderly.

Objective:To explore the clinicalfactors related to allograft fibrosis after pediatric liver transplantation.Methods:The clinical data were respectively analyzed for 94 pediatric recipients from January 2013 to December 2016 at Tianjin First Central Hospital.The Patients were assigned into fibrotic and non-fibrotic groups based upon the results of protocol liver biopsies. Univariate and multivariate Logistic regression analyses were performed for examining the risk factors of fibrosis after pediatric livertransplantation. Then Logistic regression model was established to obtain the predicted value of combined predictive factors.Thereceiver operating characteristic curve (ROC) was conducted to evaluate the predictive value of combined predictive factors.Results:A total number of 54(57.5%) patients occurred fibrosis among the 94 patients. There weresignificant differences in cold ischemia time (Z=2.094), warm ischemia time (Z=2.421), biliary stricture( χ2=4.560), drug-induced liver injury ( χ2=7.389), hepatic artery thrombosis and rejection ( χ2=6.955)between two groups ( P<0.05). Logistic regression analysis showed that cold ischemia time (OR=1.003, 95%CI: 1.000~1.007, P=0.044), biliary stricture(OR=6.451, 95%CI: 1.205~33.295), rejection(OR=2.735, 95%CI: 1.057~7.077)and drug-induced liver injury (OR=4.977, 95%CI: 1.207~20.522, P=0.026) were independent risk factors for fibrosis 5 years after liver transplantation. The area under the ROC curve was 0.786(95%CI: 0.691~0.881), for predicting patient outcome.If using 0.311as a cutoff Value, the sensitivity was 90.70%, and the specificity was 60.00%. However, through the ROC curve comparison, there was statistical significance between combined predictive factors and the other independent risk factors ( P>0.05). Conclusions:The incidence of fibrosis 5 years after pediatricliver transplantation is 57.5%. Prolonged cold ischemia time, biliarystricture, rejectionand drug-induced liver injury after liver transplantation are independent risk factors for fibrosis 5 years after pediatric liver transplantation.And the combined predictive factors have a high predictive value forallograftfibrosis.

Amid ongoing reforms in the healthcare system and the pursuit of high-quality development in public hospi-tals,the significance of party building in leading the standardization of hospital party branches has become increasingly promi-nent.Taking a university's affiliated hospital as an example,this study comprehensively analyzes the current situation of Party building on the standardized construction of party branches within university-affiliated public hospitals using the SWOT method.Meanwhile,this paper proposes targeted strategies by assessing the strengths,weaknesses,opportunities,and challenges of party building leadership.These strategies are intended to refine the framework for the role of Party building in advancing the standard-ized construction of Party branches in university-affiliated public hospitals.

Objective To explore the association between inducible nitric oxide synthase (iNOS) gene polymorphisms and ischemic stroke in Uygur population of Xinjiang.Methods A case-control study was performed,included 316 patients with ischemic stroke,admitted to our hospital from June 2007 to December 2013,and 316 age-and gender-matched healthy subjects in Uygur population of Hami.The genotypes ofrs2779248(C/T) and rs1137933(C/T) were determined by Taqman probe fluorescent quantitative PCR.Results The distribution frequencies of rs2779248 (CC,CT and TT) were 51.9％,42.1％ and 6.0％ in the patient group,ands 61.7％,30.1％ and 8.2％ in the controls,respectively.As compared with those with rs2779248 CC genotype,individuals with CT+TT genotype and CT genotype had higher risk ofischemic stroke,the odds ratio was 1.49 (95％CI:1.09-2.05,P=0.013)and 1.66 (95％CI:1.19-2.32,P=0.003).The distribution frequencies ofrs1137933 (CC,CT and TT) were 66.8％,28.5％ and 4.7％ in the patient group,ands 66.8％,27.8％ and 5.4％ in the controls,respectively;no significant difference was noted between the patient group and controls in the distribution frequencies (P＞0.05).Multi-factor Logistic regression analysis indicated that mutation of genotype C＞T in rs2779248was the independent risk factor of ischemic stroke in Uygur population of Hami after adjusting related risk factors (OR=1.55,95％CI:1.00-2.40,P=0.049).Conclusion The polymorphisms ofrs2779248 in iNOS gene may modify the risk of ischemic stroke in Uygur population of Hami,but no association is found in rs1137933.

Objective:To explore the impact of graft recipient weight ratio(GRWR)on pediatric whole liver transplantation in infants aged under 1 year.Methods:From January 2014 to December 2019, clinical data were retrospectively reviewed for 140 children aged under 1 year with whole liver transplantation.They were divided into 3 groups of low GRWR(GRWR<2.5%, 48 cases), middle GRWR(2.5%≤GRWR<5%, 73 cases)and high GRWR(GRWR≥5%, 19 cases). Basic profiles, major postoperative complications and survival rate of graft/recipient were compared.Results:There were 62 males and 78 females with an average age of (7.34±1.81)months and an average weight of(6.81±1.09)kg.The median GRWR was 3.27%(1.33%~8.12%). The higher level of GRWR, the greater age, weight and graft weight of donor in three groups and there was statistical difference ( P<0.05); operative duration, postoperative ICU stay and hospital stay were longer in low GRWR group than those in middle GRWR group and there was statistical difference( P<0.05); The incidence of postoperative hepatic artery thrombosis was higher in low GRWR group than that in middle GRWR group(31.3%vs 8.2%)and there was statistical difference( P<0.05); 4 cases of small-for-size syndrome occurred in low GRWR group, it was significantly different from the other two groups and there was statistical difference( P<0.05); the median follow-up period was(50.7±23.4)months.The survival rates of grafts at 3-month and 1/5-year were 89.6%, 91.8%, 100%; 87.5%, 87.7%, 100%; 87.5%, 87.7%, 100%and there was no inter-group difference( P>0.05). The survival rates of recipients at 3 months, 1 year and 5 years post-operation were 93.8%, 91.8%, 100%; 91.7%, 87.7%, 100%; 91.7%, 87.7%, 100%and there was no inter-group difference( P>0.05). Conclusions:Different from pediatric living donor transplantation, GRWR≥5%does not affect the survival rate of recipient/graft during whole liver transplantation.And GRWR<2.5%may boost the postoperative incidence of hepatic artery thrombosis and small liver syndrome.

Objective:To survey the prevalence and comorbidity of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in Shanxi province from 2018 to 2021.Methods:The data of patients with CTEPH from 2018 to 2021 were extracted from the Health Statistics Direct Reporting System of Shanxi Provincial Health Commission; the population data of Shanxi Province was obtained from the Statistical Yearbook of Shanxi Province. The prevalence rate of CTEPH in Shanxi Province in 2018, 2019, 2020 and 2021 was calculated. The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) was used to identity the specific Charlson comorbidity from other diagnosis on the medical record. The severity of the comorbidity scale was classified as mild (aCCI≤2 points), moderate (aCCI=3-5 points), moderate-severe (aCCI=6-8 points), and severe (aCCI≥9 points).Result:A total of 300 patients with CTEPH were identified in the whole province during the period with the mean age of(65.5±11.5)years, there were 31, 65, 83 and 121 cases in 2018, 2019, 2020 and 2021, and the corresponding prevalence rates were 0.9/10 6, 1.9/10 6, 2.4/10 6 and 3.5/10 6, respectively showing an increasing trend. The patients with CTEPH in this study involved 14 Charlson comorbidities, among which the chronic lung disease was in the highest proportion (198/300, 66.0%), followed by peripheral vascular disease (126/300, 42.0%) and chronic congestive heart failure (121/300, 40.3%). There were 16.3% (49/300) of patients with mild comorbidity, 56.3% (169/300) with moderate comorbidity, 22.3% (67/300) with moderate-severity comorbidity, and 5.0% (15/300) with severity comorbidity. Conclusions:The prevalence of CTEPH in Shanxi province from 2018 to 2021 was 0.9-3.5/10 6 showing an upward trend. The chronic lung disease, peripheral vascular disease and chronic congestive heart failure are the main comorbidities of patients with CTEPH, and mostly with moderate comorbidity.