Objective To observe the effect of Danzhi Jiangtang Capsules(DJC) on serum interleukin-18 (IL-18),cystatin C (CysC) and relative biochemical indexes in patients with early diabetic kidney disease(DKD),and to explore its protective action on the kidney.Methods Sixty-two hospitalized patients with early diabetic nephropathy (period 11-Ⅲ) in Endocrinology Department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine were divided into western medicine group and DJC group,31 cases in each group.The patients in western medicine group received conventional hypoglycemic drugs,and DJC group received DJC based on the treatment for the western medicine group.Before and after treatment,we observed the levels of serum IL-18,CysC,fasting plasma glucose (FPG),2-hour postprandial glucose (2hPG),glycosylated hemoglobin (HbA1c),serum creatinine (SCr),blood urea nitrogen (BUN),microalbumin (mAlb),urinary albumin /creatinine ratio (UACR),and estimated glomerular filtration rate (eGFR).Results The total effective rate was 90.0％ in DJC group and 76.7％ in the western medicine group,there being significant difference between the two groups(P ＜ 0.05).After treatment,the main traditional Chinese medical syndrome scores of DJC group were significantly lower than those before treatment,and the improvement was better than that of the western medicine group (P ＜ 0.05 or P ＜ 0.01).After treatment,the serum levels of IL-18,CysC,2hPG,SCr,BUN,mAlb,UACR in the two groups were significantly lower than those before treatment (P ＜ 0.05 or P ＜ 0.01),while eGFR level was higher than that before treatment (P ＜ 0.05 or P ＜ 0.01),and the improvement effect (except for BUN) in the DJC group was superior to that in the western medicine group(P ＜ 0.01).DJC had an effect on lowering the FPG and HbA1c (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the western medicine had no obvious effect on the two indexes (P ＞ 0.05).The results of Spearman correlation analysis showed that IL-18 was correlated with CysC,IL-18 and CysC were correlated with HbA1c,mALB and uACR.Conclusion DJC can protect renal function of patients with early diabetic nephropathy.

Objective To explore the value of abnormal imaging findings on susceptibility weighted imaging (SWI) in delayed graft function (DGF). Methods The conventional MRI and SWI images of 26 cases with DGF and 20 cases with normal renal function of transplanted kidneys were retrospectively analyzed. Patients with cysts and angiomyolipomas were excluded. Normal structures of transplanted kidney were identified. If lesions of abnormal signal intensity were found in the transplanted kidney, the location, border and signal intensity compared to renal cortex would be analyzed. The differences in signal intensity between the abnormal signal lesions and normal renal cortex in the same SWI layer of DGF were compared by using independent-sample t test. The differences in positive detection rate of discovering the abnormal signal lesions in DGF between conventional MRI and SWI were compared by using McNemar test. Results Of the 26 cases with DGF, one case was found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on both conventional MRI and SWI images. Ten cases were found to exhibit abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images only. Fifteen cases exhibited no abnormal signal lesions on both conventional MRI and SWI images. Twenty cases with normal renal function of transplanted kidney, no abnormal signal lesions were found on both conventional MRI and SWI images. The differences in signal intensity between the abnormally low signal lesions (130±20) and normal renal cortex (177±25) in the same SWI layer of 11 cases with DGF were statistically significant (t=-4.582,P<0.01). The differences in positive detection rate of discovering the abnormally low signal lesions in DGF between conventional MRI [3.8%(1/26)] and SWI [42.3% (11/26)] were statistically significant (χ2=8.100,P=0.002). Conclusions Abnormally low signal lesions with fuzzy boundary located at junctional zone between cortex and medulla on SWI images suggest the presence of DGF. Compared with conventional MRI, SWI appears to be superior in detecting the abnormally low signal lesions.

OBJECTIVETo investigate the potential of synovial mesenchymal stem cells (SMSC) in osteogenic differentiation.

METHODSSMSC were obtained by limited dilution method and expanded to culture in 25-milliliter flasks. The attached cells were treated with inductive medium containing dexamethasone, glycerophosphate and vitamin C at 3rd passage SMSC. The mineralized nodule was stained by Von Kossa method. The expression of ALP and osteopontin were detected by histochemical, immunohistological staining technique, respectively, while the expression of cbfa1 mRNA by RT-PCR.

RESULTSPure SMSC which were of spindle shape and star shape, uniform in size, could be induced to pleomorphism osteoblast in vitro, which were intensive positive in ALP and osteopontin. The expression of cbfa1 mRNA were also verified by RT-PCR and the polygonal cells formed nodular structure at 4 weeks. All these were coincident with the characters of osteoblast.

CONCLUSIONSMSC can be purified and induced into osteoblast in vitro.

Ascorbic Acid ; Cell Differentiation ; Dexamethasone ; Glycerophosphates ; Humans ; Mesenchymal Stromal Cells ; Osteoblasts ; Osteogenesis ; Osteopontin ; metabolism ; RNA, Messenger ; metabolism

Objective:This paper mainly discusses the health policy of early life of pregnant women and infants in Beijing as an example,and to provide the basis for policy formulation and optimization.Methods:By using the content analysis method,149 policy texts are divided into two dimensions:policy objectives and policy instruments.The results are described by manual coding,cross analysis and trend analysis.Results:In regard to Policy Objectives,improvement of maternal and child health service levels accounts for the biggest proportion(61.7%),whereas improvement of research level accounts for the least(8.1%).In the four dimensions of policy instruments,mandatory,spontaneous,capacity-building,and incentive tools account for 90%,55%,48%and 42%respectively.According to the trend analysis,integrity of policy system has been continuously improved and the proportion of infant and child care has also increased.Both cross-analysis and trend analysis have showed the strong use of coercive and incentive tools by relevant policies;The use of spontaneous and capacity-building tools is low and decreases over time.Conclusion:Improving the level of maternal and child health services is the core concern of Beijing's early life health policy.However,relatively little attention is paid to the family,infant and child care,and scientific research construction.As for Policy Instruments,mandatory tools are widely used;Incentive Tools and Spontaneous Tools are mainly applied in well-being and soft guidance;insufficient use of Capacity-building Tools.Suggestions:In the future,the policy system should be further improved,which should be targeted and deficiency-mending.It is suggested that more resources should be increased for the family system,more attention should be paid to vulnerable groups early in life,and more financial support should be applied to scientific research on maternal and child health.

Objective To comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP).Methods Literatures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3. Results Twenty-one studies were included with 2222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77％ (362/827) vs. 55.26％ (604/1093), odds ratio (OR) =0.68, 95％ confidential interval (95％CI) = 0.56-0.82,P = 0.0001], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95％CI = 2.60-6.66,P < 0.00001], incidence of MODS [25.93％ (70/270) vs. 55.36％ (155/280),OR = 0.26, 95％CI = 0.14-0.49,P< 0.0001], and incidence of ARDS [30.37％ (82/270) vs. 51.07％(143/280),OR = 0.42, 95％CI = 0.30-0.61,P < 0.00001], and inefficiency rate [8.72％ (13/149) vs. 34.64％ (53/153),OR=0.17, 95％CI = 0.09-0.34, P < 0.00001] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies.Conclusion HP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.

OBJECTIVETo validate the efficiency of 27-plex single nucleotide polymorphism (SNP) multiplex system for ancestry inference.

METHODSThe 27-plex SNP system was validated for its sensitivity and species specificity. A total of 533 samples were collected from African, Southern Chinese Han, China's ethic minorities (Yi, Hui, Miao, Tibet, and Uygur), European, Central Asian, Western Asian, Southern Asian, Southeast Asian and South American populations for clustering analysis of the genotypes by citing 3 representative continental ancestral groups [East Asia (CHB), Europe (CEU), and Africa (YRI)] from HapMap database.

RESULTSThe system sensitivity is 0.125 ng. Twenty and six genotypes were detected in chimpanzee and monkeys, respectively. Except in rs10496971, no more products were found in other animals. The system was capable of differentiating intercontinental populations but not of distinguishing between East Asian and Southeast Asian population or between Southern Chinese Han population and Chinese Ethnic populations (Hui, Miao, Yi and Tibet). This system achieved a 100% accuracy for intercontinental population source inference for 46 blind test samples.

CONCLUSION27-plex SNPs multiplex system has a high sensitivity and species specificity and can correctly differentiate the ancestry origins of individuals from African, European and East Asian for criminal case investigation. But this system is not capable of distinguishing subpopulation groups and more specific ancestry-informative markers are needed to improve its recognition of Southeast Asian and Chinese ethnic populations.

Animals ; Asian Continental Ancestry Group ; genetics ; China ; Ethnic Groups ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Polymorphism, Single Nucleotide ; Primates ; genetics

OBJECTIVETo evaluate the possibility of hepatitis B virus (HBV) as a vector in liver-targeting gene therapy.

METHODSA fragment containing the small envelope gene of HBV was replaced with the reporter gene green fluorescent protein (GFP) to construct the recombinant HBV vector, which was transfected into HepG2 cells with liposome. The expression of GFP was observed with fluorescence microscope. The HBV cccDNA was testified using semi-nest PCR. The viral particles of the recombinant HBV in culture medium were detected by PCR as well as Southern blot.

RESULTSThe HBV vector carrying the interesting gene of GFP could express the functional protein in the transfected hepatocytes. However, the recombinant HBV vector was replication-deficient, which could not be packed and replicated in the hepatocytes to secrete mature recombinant HBV particles carrying the interesting gene of GFP when transfected solely but could when cotransfected with the recombinant and helper construct which lacked part of 5'-proximal HBV RNA packaging signal epsilon.

CONCLUSIONIt is possible that HBV is reconstructed as a liver-targeting vector for gene therapy.

Cell Transformation, Viral ; Cells, Cultured ; Gene Transfer Techniques ; Genes, Reporter ; Genetic Therapy ; methods ; Genetic Vectors ; genetics ; physiology ; Hepatitis B virus ; genetics ; physiology ; Hepatocytes ; cytology ; virology ; Humans ; Liver ; cytology ; virology ; Recombinant Proteins ; genetics ; Transfection ; Virus Replication

BACKGROUNDThe optimal stenting strategy for the treatment of coronary bifurcation lesions (CBLs) remains uncertain. The present study observed technical feasibility and reliability, 9-month clinical and angiographic outcomes of the modified culotte stenting (MCS) in the treatment of CBLs with drug-eluting stents.

METHODSA total of 34 consecutive patients with CBLs that required stenting the parent vessel (PV), the main branch (MB) and the side branch (SB) were included. All patients were first assigned to receive MCS for CBL interventions (per MCS), and might be switched to receive the double-kissing-crush stenting (DKS) in case of temporally acute branch occlusion (per protocol).

RESULTSThe immediate angiographic or procedural success was achieved in 33/34 (97%) lesions (patients) per MCS, 34/34 (100%) lesions (patients) per protocol with 100% successful final balloon kissing. The long-term clinical success at 9 months was 94% per MCS and 94% per protocol, only 2 patients had reoccurrence of angina but none of them needed target lesion revascularization. There were no procedure-related biomarker elevation, no in-stent thrombosis peri-procedurally and at 9-month follow-up. Quantitative coronary angiography data at 9 months showed that in-stent (6%) or in-segment (6%) binary stenosis was infrequent, and minimal lumen diameter was significantly reduced but late lumen loss was acceptable with only (0.10 ± 0.14) mm for PV, (0.21 ± 0.23) mm for MB and (0.27 ± 0.32) mm for SB.

CONCLUSIONSMCS for treatment of CBLs that required dual-stent implantation was technically easier and safer, readily to complete final balloon kissing, and was associated with high immediate success and optimal 9-month outcomes.

Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies

Objective To compare the long-term effect between minimally invasive (MIS) and open approaches in one-level posterior lumbar interbody fusion (O-PLIF) after more than 10 years follow up. Methods All 131 patients (lumbar spine le-sions) in our hospital were randomized into MIS-PLIF group and O-PLIF group from March 2006 to March 2008. In MIS-PLIF group, there are 66 patients, 34 males and 32 females, with the average of 52.3 ± 6.7 years old (range from 40 to 63). In O-PLIF group, there are 65 patients, 29 males and 36 females, with the average of 51.1 ± 6.9 years old (range from 46 to 63). Regarding March 2018 as last follow-up, differences in intervertebral disc height and segmental lordosis restoration of the operation segment , lumbar lordosis restoration, multifidus cross section area (CSA), multifidus atrophy rate, fusion rate, visual analogue scale (VAS) for back and leg pain, Oswestry Disability Index(ODI), Japanese Orthopaedic Association cores (JOA) and postoperative long-term compli-cations were evaluated between the two groups. The related risk factors of postoperative long-term complications were evaluated in further analysis. Results Complete follow-up data were available on 37 patients in MIS-PLIF group and 35 patients in O-PLIF group, with the follow-up rate of 56.1％and 53.8％respectively,and with the mean follow-up time of 134.5 ±8.4 and 137.1±5.8 months respectively. At three time nodes of one year after operation, five years after operation and last follow-up after operation, there were significant differences in lumbar lordosis restoration (one year after operation and last follow-up after operation)( 5.0°± 2.3° vs. 3.9°±1.4°;4.7°±2.4° vs. 3.7°±1.5°), multifidus CSA (965.4±164.9 mm2 vs. 884.9±168.2 mm2;891.1±155.9 mm2 vs. 783.2± 163.0 mm2; 764.8 ± 148.3 mm2 vs. 643.5 ± 150.0 mm2), multifidus atrophy rate (8.5％± 2.5％ vs. 16.6％± 5.8％; 15.6％± 3.5％ vs. 26.2％±7.4％;27.6％±6.5％vs. 39.3％±9.3％), postoperative VAS for back pain (2.2±1.0 vs. 2.9±1.2;1.7±0.9 vs. 2.2±1.0;1.4±1.0 vs. 2.2±1.2), JOA score (22.3±3.8 vs. 19.9±4.2;23.1±4.3 vs. 19.3±3.9;22.4±4.2 vs. 19.6±4.0) and ODI (11.6％±4.8％vs. 22.0％± 7.7％;9.4％±3.9％vs. 12.3％±4.9％;8.6％±4.0％vs. 11.0％±4.6％) between the two groups (P<0.05). However, there were no sig-nificant differences in segmental lordosis, intervertebral height restoration, lumbar lordosis restoration (one year after operation), fusion rate or postoperative VAS for leg pain between MIS-PLIF and O-PLIF(P>0.05). Intractable back pain and adjacent segment disease were the major postoperative long-term complications for MIS-PLIF group (3 cases and 2 cases) and O-PLIF group (10 cas-es and 7 cases), and the difference was statistically significant in the intractable back pain incidence rate ( 8.5％vs. 28.6％,χ2=5.090, P=0.024), but not in the adjacent segment disease(5.4％vs. 20％,χ2=0.002, P=0.061). What's more, patients with intracta-ble back pain suffered more obviously multifidus atrophy than patients without intractable back pain at three time nodes of one year after operation (19.4±4.4％vs. 10.9±5.1％, P<0.05), five years after operation (30.2±5.4％vs. 18.7±6.7％, P<0.05) and last fol-low-up after operation (44.5±5.7％vs. 30.8±8.9％, P<0.05) . Conclusion In the long-term follow up, compared with O-PLIF, MIS-PLIF had advantages in better maintenance of lumbar lordosis, protection of the multifidus muscle, reduced lower back pain, JOA score, ODI score and intractable back pain incidence rate. Multifidus atrophy may be a related risk factor of intractable back pain.

OBJECTIVETo investigate the frequency of JAK2V617F mutation in Chinese patients with chronic myeloproliferative neoplasms (MPN) and to study the relationship between JAK2V617F mutation and clinical characteristics.

METHODSJAK2V617F mutation was screened by allele-specific polymerase chain reaction (AS-PCR).

RESULTSJAK2V617F mutation was detected in 277 of the 412 patients with MPN. The frequency of JAK2V617F mutation was similar among essential thrombocythemia (ET), idiopathic myelofibrosis (IMF) and chronic myeloproliferative disorders-unclassified (MPD-U) (P > 0.05), but it was significantly lower than that in polycythemia vera (PV) (P < 0.05). The presence of JAK2V617F was found to be significantly correlative with advanced age at diagnosis (P < 0.01) and with higher hemoglobin levels and higher leukocyte counts (P < 0.05). Significant difference was found in complication of vascular events between JAK2V617 positive and negative patients (P < 0.05). JAK2V617F positive MPD-U patients were more prone to progress into typical MPN compared with JAK2V617F negative MPD-U patients. The association between abnormal karyotype and JAK2V617F was not found in cytogenetical analysis of 301 patients.

CONCLUSIONThe presence of JAK2V617F in MPD-U is associated with the disease development. There is a correlation between JAK2V617F mutation in MPN and advanced age, higher leukocyte counts, hemoglobin level and vascular events.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hemoglobins ; metabolism ; Humans ; Janus Kinase 2 ; genetics ; Leukocyte Count ; Male ; Middle Aged ; Mutation ; Myeloproliferative Disorders ; blood ; complications ; genetics ; Polycythemia Vera ; blood ; complications ; genetics ; Primary Myelofibrosis ; blood ; complications ; genetics ; Thrombocythemia, Essential ; blood ; complications ; genetics ; Thrombosis ; etiology ; Young Adult