Effect of exosomes derived from bone mesenchymal stem cells on postoperative cognitive function and SIRT1/NF-κB signaling pathway in aged mice / 中华麻醉学杂志

Objective:To evaluate the effect of exosomes derived from bone mesenchymal stem cells (BMSCs-EXO) on the postoperative cognitive function and silent infomation regulator 1 (SIRT1)/ nuclear factor kappa B (NF-κB) signaling pathway in aged mice.Methods:BMSCs-EXO were isolated by differential centrifugation method and then identified. Twenty healthy male C57BL/6 aged mice, aged 18 months, weighing 35-40 g, were divided into 4 groups ( n=5 each) using a random number table method: sham operation group (Sham group), operation group (O group), BMSCs-EXO group and EX527 (SIRT1 inhibitor)group. The abdomen regions were shaved for sterilization without exploratory laparotomy in Sham group. Exploratory laparotomy was performed in O group. BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in BMSCs-EXO group. EX527 5 mg/kg was intraperitoneally injected daily at 1-3 days before surgery, and BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in EX527 group. Morris water maze test was used to evaluate the learning and memory ability for 5 consecutive days staring from the 1st day after surgery. Mice were sacrificed at 1 h after the end of Morris water maze test on day 5 after surgery, and the hippocampal tissues were collected for observation of the pathological changes of hippocampal CA1 region and for determination of the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA (quantitative real-time polymerase chain reaction) and SIRT1 and NF-κB p65 (by Western blot). Results:Compared with Sham group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were found in O group. Compared with O group, the escape latency was significantly shortened, the times of original platform crossing were increased, the swimming time spent in the original platform quadrant was prolonged, the expression of TNF-α, IL-6 and IL-1β mRNA was down-regulated, the expression of SIRT1 was up-regulated, the expression of NF-κB p65 was down-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were significantly attenuated in BMSCs-EXO group ( P<0.05). Compared with BMSCs-EXO group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of TNF-α, IL-6 and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were accentuated in EX527 group. Conclusions:BMSCs-EXO can improve the postoperative cognitive function in aged mice, and the mechanism may be associated with the activation of SIRT1/NF-κB signaling pathway.

Construction of a neuroinflammation model: a microglia-neuron co-culture system / 中华麻醉学杂志

Objective:To develop an in vitro neuroinflammation model by establishing a microglia-neuron co-culture system. Methods:Mouse microglia (BV-2), motor neurons (NSC34) and hippocampal neurons (HT-22) were selected.This experiment was performed in two parts.Experiment Ⅰ BV-2 microglia were stimulated with different concentrations of lipopolysaccharide (LPS, 10, 100, 500 and 1 000 ng/ml). Microglia culture supernatant(Conditioned Medium) was extracted and two types of neurons were cultured separately.The concentration of LPS that resulted in a significant 50% decrease in neuronal viability was selected using the CCK-8 method for establishment of the Transwell co-culture system.Experiment Ⅱ Microglia were cultured in the upper chamber of Transwell, and neurons were seeded in the lower chamber.Microglia were divided into 2 groups ( n=12 each) using the random number table method: control group and LPS group.In control group and LPS group, microglia were cultured for 6 h with cell culture medium and LPS, respectively, then the medium was replaced with fresh medium, microglia were continuously incubated for 12 h, and then the cells in the upper and lower chambers were combined.The cells were incubated using the BV-2-NSC34 Transwell co-culture system for 12 h and using the BV-2-HT-22 Transwell co-culture system for 24 h. The concentrations of interleukin-1beta (IL-1β) and IL-18 in neuronal culture supernatant were measured by enzyme-linked immunosorbent assay, the apoptotic rate of neurons was determined by flow cytometry, the expression of Bcl-2 and Bax mRNA in neurons was detected by quantitative real-time polymerase chain reaction, and the expression of cleaved caspase-3, Bcl-2 and Bax in neurons was detected by Western blot. Results:Experiment Ⅰ LPS concentration for stimulation was 10 ng/ml in BV-2-NSC34 Transwell co-culture system and 1, 000 ng/ml in BV-2-HT-22 Transwell co-culture system.Experiment Ⅱ Compared with control group, the concentrations of IL-1β and IL-18 and apoptotic rate of neurons were significantly increased, Bax protein and mRNA expression was up-regulated, Bcl-2 protein and mRNA expression was down-regulated, and cleaved caspase-3 expression was up-regulated in LPS group ( P<0.05 or 0.01). Conclusions:The microglia-neuron co-culture system is successfully established by the conditioned medium technique and Transwell co-culture system, which provides an experimental protocol for establishment of neuroinflammation models associated with postoperative cognitive dysfunction.

Analysis on the construction and application of telemedicine system in Tibet Autonomous Region / 中华医院管理杂志

Objective:To investigate the construction and application of telemedicine system in Tibet Autonomous Region.Methods:From June to July 2020, medical institutions at all levels in Tibet Autonomous Region were visited. Relevant information was collected through discussion, questionnaires and field visits, and the data of effective questionnaires were statistically analyzed.Results:A total of 125 medical institutions were visited, covering 7 regions of Tibet Autonomous Region, of which 74 medical institutions were able to realize audio-video two-way communication with the telemedicine platform of the PLA General Hospital. Seventy-three valid questionnaires were collected, and 64(88%)hospitals had software or hardware audio and video terminals. Twenty-five hospitals had never carried out remote consultation, accounting for 34%. The annual remote consultation amount of 35 hospitals was less than 10 cases, and that of 11 hospitals was 11-100 cases. Only 2 hospitals had carried out remote ECG and remote ultrasound diagnosis, with an annual consultation volume of more than 100 cases.Conclusions:The hospitals at or above the county level in Tibet Autonomous Region have established telemedicine system, but there are few remote services, the system idle rate is high, and the distance education resources are not matched.

Preliminary Study of CT Three-dimensional Reconstruction Combined with Ground Glass Nodules of Natural Lung Collapse in Thoracoscopic Pulmonary Segmental Resection / 中国肺癌杂志

BACKGROUND@#Computed tomography (CT) three-dimensional reconstruction technology is increasingly used in preoperative planning of patients with ground glass nodule (GGN), but how to accurately locate the nodule and ensure the safe resection edge is still a difficult problem for clinicians. The purpose of this study was to investigate the accuracy, convenience and safety of CT three-dimensional reconstruction combined with intraoperative natural collapse localization in total thoracoscopic segmental pneumonectomy.@*METHODS@#A total of 45 patients with radiographic findings of pulmonary GGN admitted from July 2019 to December 2019 were selected as the study group. All patients received thin-slice CT scan and underwent preoperative three-dimensional reconstruction. After anesthesia, the small thoracic operation opening and the airway of the patients were quickly opened, and the lung was rapidly and naturally collapsed by pressure difference. GGN were positioned according to the natural marker line, and marked with 3-0 prolene line. After specimen removal, the distance between the GGN and the suture mark, the distance between the GGN and the incision margin were measured, and the incision margin was routinely examined. The general clinical data, pathological data and postoperative complications were counted and compared with 45 consecutive patients who were located with hookwire positioning needle in the same period.@*RESULTS@#The average localization time of non-invasive GGN with natural lung collapse during operation was 6.9 min, and the localization accuracy was 90.6%. There were 2 cases of extensive pleural adhesion and 1 case of emphysema. Postoperative pathology was confirmed as lung adenocarcinoma, and the examination of incision margin was negative. No GGNs were scanned again after surgery, and the precise resection rate of lung segment was 100.0%.@*CONCLUSIONS@#CT three-dimensional reconstruction combined with GGN localization of natural lung collapse during operation can shorten the time of searching for GGN during operation and guarantee the safety of the incision margin. It is a more economical and convenient localization method and makes pulmonary segment resection more accurate.

Drug resistance in HIV-1-infected patients after failed antiretroviral therapy in Suqian, Jiangsu Province / 中华微生物学和免疫学杂志

Objective:To evaluate the emergence and prevalence of drug-resistant strains among HIV-1-infected individuals who had failed antiretroviral therapy (ART) in Suqian.Methods:A total of 561 HIV-1-infected patients who had received ART for six months and above in Suqian in 2019 were recruited. Whole blood samples were collected from them with EDTA anticoagulation tubes. Viral loads (VLs) were tested for evaluating the outcomes of ART. HIV-1 subtypes and drug-resistant genotypes were detected if VL in blood samples was ≥1 000 IU/ml for further analyzing the emergence and prevalence of resistant strains.Results:ART successfully suppressed the replication of HIV-1 in 91.1% of the 561 patients (VLs≤1 000 IU/ml). Forty-six HIV-1 pol gene sequences were obtained through RT-PCR from 50 patients experiencing failed ART. Phylogenetic analysis showed that the predominant subtype was CRF07_BC (32.6%), and some new recombinant subtypes (CRF67_01B, CRF79_0107 and CRF87_cpx) were also detected. Drug-resistant strains mainly caused by K65R (30.8%), M184V/I (30.8%), K103N (19.2%), Y181C (23.1%) and G190A/S (23.1%) mutations were isolated form 56.5% of the patients failed to respond to ART. ART failure in the cases (43.5%) negative for drug-resistant strains might result from non-adherence. Conclusions:CRF07_BC was the predominant subtype of HIV-1 circulating in Suqian and various new recombinant subtypes were emerged. Drug resistance might be the main cause of ART failure. It was very necessary to enhance the adherence education during the course of ART for suppressing the replication of HIV-1 and preventing from the emergence of drug-resistant strains.

Pyrroloquinoline quinone promotes chondrocyte proliferation and inhibits interleukin-1beta-induced chondrocyte apoptosis / 中国组织工程研究

BACKGROUND:Pyrroloquinoline quinone is found to accelerate Schwann cel proliferation and growth factor secretion, but there is no report addressing its role in articular cartilage and chondrocytes. OBJECTIVE: To investigate the role of pyrroloquinoline quinone in chondrocyte proliferation and interleukin-1β-induced chondrocyte apoptosis in the articular cartilage of knee joints and to verify the protective mechanism involved. METHODS: Chondrocytes were isolated from New Zealand white rabbits (1 month of age), digested under aseptic conditions, and cultured in DMEM/F12 in the presence of 10% fetal bovine serum to alow for proliferation until passage 2. Adherent chondrocytes were cultured in serum-free DMEM/F12 medium with 0, 6.25, 12.5, 25.0, 50.0 and 100.0 μmol/L pyrroloquinoline quinone, separately. Proliferation activity was determined by MTT at 48 hours of pyrroloquinoline quinone administration. Cel cycle was determined by flow cytometry at 30 hours after pyrroloquinoline quinone administration. Apoptosis was determined by flow cytometry folowing 24 hours of pyrroloquinoline quinone pretreatment and 15 hours of interleukin-1β induction. RESULTS AND CONCLUSION: Pyrroloquinoline quinone enhanced chondrocyte proliferation activity, increased percentage of S phase and G2/M phase in a dose dependent manner and reached the peak when the concentration of pyrroloquinoline quinone was 12.5-25.0 μmol/L (P< 0.05). Pyrroloquinoline quinone also inhibited interleukin-1β-induced chondrocyte apoptosis in early and late stage, and 25.0 μmol/L pyrroloquinoline quinone had the best effects (P < 0.05). These findings suggest pyrroloquinoline quinone can promote chondrocyte division and proliferation, and protect the cels from interleukin-1β-induced apoptosis.

Research on multi-agent based modeling and simulation of hospital system / 生物医学工程学杂志

In this paper, the theory of complex adaptive system (CAS) and its modeling method are introduced. The complex characters of the hospital system is analyzed. The agile manufacturing and cell reconstruction technologies are used to reconstruct the hospital system. Then we set forth a research for simulation of hospital system based on the methodology of Multi-Agent technology and high level architecture (HLA). Finally, a simulation framework based on HLA for hospital system is presented.

Problems of network and information security in hospital and solutions / 医疗卫生装备

With the development of network and information in hospital,the issue of security has been raised and got more and more important.This article describes the factors that might threaten the network and information security,such as the reliability of network equipments,computer viruses,invalid intrusion,the security of inner-network,the thunder,users' actions and so on.Then some solutions to the problems are proposed.This could be an instruction to design or update the hospital's network and information system.

Research of Solutions to IP Conflict Events in Large-Scale Hospital / 医疗卫生装备

Objective To rapidly locate the'illegal' host so as to solve IP conflict events.Methods In combination with the characteristics of large-scale hospital network,SNMP was utilized in network management to rapidly locate the 'illegal' hosts' address when IP conflict occurred.Results The'illegal' IP occupier could be rapidly and effectivly located.Conclusion The IP conflict can be solved efficiently.[Chinese Medical Equipment Journal,2008,29(2):42-44]

Research of Data Center Based on Regional Collaborative Healthcare Platform / 医疗卫生装备

Objective To research the functions and design methods of data center for regional collaborative healthcare.Methods Combined with the informatization of regional collaborative healthcare,the necessary for constructing the regional medical data center was analyzed,with its task and implementation discussed.Results A set of solution to data storage,service and coding in the data center for regional collaborative healthcare was put forward.Conclusion The data center promotes the informatization of regional collaborative healthcare.