Objective To exploring the effect of human amniotic mesenchymal stem cells(hAMSCs)on the re-pair of rat uterine scars.Methods The hAMSCs were isolated and cultured,Female SPF grade SD rats were selected for full-thickness incision of uterine wall and then implanted with hAMSCs.On the 30th day after op-eration,the uterine incision was examined histologically.ImageJ image analysis software was used to analyze and to compare the thickness of uterine myometrium and the percentage of fibrotic area in each group.Immuno-histochemical method was used for detecting the percentage of positive areas of α-SMA,TGF-β1,and Ki-67.Results Compared with the PBS group,the hAMSCs group showed significant thickening of the uterine mus-cle layer and fibrotic area was decreased,The positive expression of α-SMA,and Ki-67 significantly increased(P＜0.05),while the expression of TGF-β1 was significantly reduced(P＜0.05).Conclusions The hAMSCs may promote the repair of uterine incision scars by reducing the formation of scar fibrosis and promoting the proliferation of smooth muscle cells in uterine scars.

Objective:This study aimed to analyze differential metabolites in patients using a dual metabolic platform and to orientate early nutritional intervention in patients with cirrhosis.Methods:The skeletal muscle index (SMI) was calculated based on computed tomography (CT) measurements of skeletal muscle cross-sectional area at the third lumbar vertebra level. Pre-sarcopenia was diagnosed for males with SMI < 46.96 and for females with SMI < 32.46. Fifteen HBV-related liver cirrhosis patients with pre-sarcopenia were included as Group S while fourteen liver cirrhosis without pre-sarcopenia were Group NS. Liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) analyses were used to detect differential metabolites and disturbed pathways in the two groups.Results:Five pathways and twenty-eight pathways were defined as disturbed pathways in the plasma of liver cirrhosis patients with pre-sarcopenia by LC-MS and GC-MS, respectively. Most of these pathways are related to amino acid metabolism. Forty-two differential metabolites were imported into the disturbed pathways. Moreover, 3-hydroxypropanal, hydrocinnamic acid, betaine aldehyde, phosphohydroxypyruvic acid, (r)-3-hydroxybutyric acid, and creatinine were identified as potential biomarkers for pre-sarcopenia in HBV-related liver cirrhosis.Conclusions:The study identified a total of 33 pathways and related differential metabolites that were disturbed in HBV-related liver cirrhosis with pre-sarcopenia. The amino acid metabolism, urea cycle, and glyoxylate and dicarboxylate metabolism pathways may be associated with pre-sarcopenia in patients with HBV-related liver cirrhosis. These results provide a direction for nutritional supplementation in liver cirrhosis.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

OBJECTIVE： To conduct bibliometric analysis of off-label use in domestic and foreign. METHODS： Retrieved from CNKI， Wanfang database， VIP， PubMed， Embase and Web of Science during Jan. 1991 （in foreign） or Jan. 2007 （in domestic） to Dec. 2018， related literatures of off-label use were collected. General information （publication numbers distribution， journals distribution）， article cooperation （core researchers， research content） and keywords of domestic and foreign literatures were analyzed and summarized. RESULTS： A total of 1 647 domestic and 4 418 foreign literatures were retrieved， including 1 570 domestic and 4 238 foreign valid literatures. Publications increased over the past decade， with the largest number of domestic and foreign publication numbers in 2017 （355 in domestic and 465 in foreign）. The most published domestic and foreign journals were China Pharmacy （105 literatures） and European Journal of Clinical Pharmacology （51 literatures）. The core researchers in domestic and foreign were Li Youping and de la Torre JC. The contents of domestic researches included off-label use policy， current situation of off-label use in children， off-label use in ophthalmology， off-label use of Chinese patent medicine， etc. The contents of foreign researches included off-label use in antiviral drugs， off-label use in special population （children， alcoholic dependence patients， etc.）. Off-label use， rational drug use and drug instructions as well as human， off-label use and article were the top 3 keywords in domestic and foreign literatures， respectively. CONCLUSIONS： Off-label use research at home and abroad is increasing year by year. Research teams carry out co-operations actively. Bibliometric methods can help researchers broaden research directions， track research hotspots and select contributing journals.

It is very important to assess the role of suitable social medical support level in operation and adjustment of social medical insurance system.The social medical support level in Shandong Province was measured and analyzed,the coordination of social medical support level and economic development was emphasized with suggestions put forward for the development of system and optimization of policies.

ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.

The distribution of authors, institutions that published papers, and key words in CNKI-covered papers on library information service model was analyzed, which showed that there are a number of high production authors in China engaged in studies on library information service model but the number of cooperative studies is few, aca-demic libraries are active in performing related studies but public libraries seldom participate in such studies, the related studies are focused on the application of information technologies and the personal demands of users.

The key words, social network and author cooperation network in papers ( published in 2003-2014 ) on reform in domestic public hospitals were analyzed using Ucinet and CiteSpace visual softwares with CNKI as the data source.The current situation in reform in domestic public hospitals was revealed by mining its research hotspots, progress and author cooperation .Some suggestions were put forward for strengthening the reform in domestic public hospitals .

BACKGROUNDSIRT3 is an important regulator in cell metabolism, and recent studies have shown that it may be involved in the pharmacological effects of metformin. However, the molecular mechanisms underlying this process are unclear.

METHODSThe effects of SIRT3 on the regulation of oxidative stress and insulin resistance in skeletal muscle were evaluated in vitro. Differentiated L6 skeletal muscle cells were treated with 750 µmol/L palmitic acid to induce insulin resistance. SIRT3 was knocked down and overexpressed in L6 cells. SIRT3, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) p65, c-Jun N-terminal kinase 1 (JNK1), and superoxide dismutase 2 (SOD2) were evaluated by Western blotting.

RESULTSOver expression of SIRT3 increased glucose uptake and decreased ROS production in L6-IR cells as well as in L6 cells. Knock-down of SIRT3 induced increased production of ROS while decreased glucose uptake in both L6 and L6-IR cells, and these effects were reversed by N-acetyl-L-cysteine (NAC). Metformin increased the expression of SIRT3 (1.5-fold) and SOD2 (2-fold) while down regulating NF-κB p65 (1.5-fold) and JNK1 (1.5-fold). Knockdown of SIRT3 (P < 0.05) reversed the metformin-induced decreases in NF-κB p65 and JNK1 and the metformin-induced increase in SOD2 (P < 0.05).

CONCLUSIONSUpregulated SIRT3 is involved in the pharmacological mechanism by which metformin promotes glucose uptake. Additionally, SIRT3 may function as an important regulator of oxidative stress and a new alternative approach for targeting insulin resistance-related diseases.

Animals ; Cell Line ; Insulin Resistance ; physiology ; Metformin ; pharmacology ; Muscle Fibers, Skeletal ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Rats ; Sirtuin 3 ; metabolism ; Transcription Factor RelA ; metabolism

BACKGROUND:The umbilical cord mesenchymal stem cells possess multipotent differentiation capacity, but less research focus on its differentiation into fibroblasts.
OBJECTIVE:To investigate the capacity of human umbilical cord mesenchymal stem cells differentiating into fibroblasts.
METHODS:Using adherent method, human umbilical cord mesenchymal stem cells were isolated, and flow cytometric analysis of the surface antigen was performed. Passage 3 cells were selected for osteogenic and
adipogenic differentiation, and cells differentiated into fibroblasts under the induction of basic fibroblast growth factor. RESULTS AND CONCLUSION:Adherent stem cells were stably isolated from the umbilical cord. Human umbilical cord mesenchymal stem cells lowly expressed CD31, CD45, CD40, HLA-DR, but strongly expressed CD29, CD90, CD44, CD105. Oil red O staining showed red droplets were ful of the cytoplasm after adipogenic induction;alizarin red staining showed red calcium nodules after osteogenic induction. After induced by basic fibroblast growth factor, the type I col agen expression was significantly higher than that in the control group. These findings indicate that the adherent human umbilical cord mesenchymal stem cells are reliably isolated with high purity;basic fibroblast growth factor can induce differentiation of umbilical cord mesenchymal stem cells into fibroblasts.