Regulation mechanism of macrophage transition in renal fibrosis / 器官移植

Renal fibrosis is a common pathological change from development to end-stage renal diseases in all progressive chronic kidney diseases. Renal fibrosis after kidney transplantation will severely affect the renal graft function. Macrophages are characterized with high heterogeneity and plasticity. During the process of kidney injury, macrophages are recruited, activated and polarized by local microenvironment, and participate in the process of renal tissue injury, repair and fibrosis through multiple mechanisms. Recent studies have shown that macrophages may transit into myofibroblasts and directly participate in the formation of renal fibrosis. This process is known as macrophage-myofibroblast transition. Nevertheless, the regulatory mechanism remains elusive. In this article, the role of macrophages in renal fibrosis, the characteristics of macrophage-myofibroblast transition and the possible regulatory mechanism were reviewed, aiming to provide reference for relevant research of renal fibrosis.

2022 Country Report on Medical Rehabilitation Services, Quality and Safety in Health Care System / 中国康复理论与实践

ObjectiveTo analyze the medical services, quality and safety of rehabilitation medicine departments in general hospitals and rehabilitation hospitals in 2021 in perspectives of structure, segment and outcome quality. MethodsWe analyzed the data from National Clinical Improvement System of the National Health Commission, involving 9 328 hospitals, including all secondary and above general hospitals and rehabilitation hospitals, as well as traditional Chinese Medicine hospitals and integrated traditional Chinese and Western medicine hospitals in 2021. A total of 2 513 sampling hospitals that equipped with rehabilitation wards were included. ResultsAmong the 9 328 general hospitals surveyed this year, only 2 713 had rehabilitation wards. In general hospitals, the average number of physicians per bed in 56.77% hospitals, the average number of rehabilitation therapists per bed in 80.36% hospitals, and the average number of nurses per bed in 53.53% hospitals did not meet the national requirements, and the average number of rehabilitation medical personnel per bed in rehabilitation medicine departments in different regions was significantly different. The rates of early rehabilitation intervention were 13.45%, 20.67% and 29.74% respectively in department of orthopedics, department of neurology and intensive care units in general hospitals. The average improvement rate of activities of daily living of discharged patients was 77.87% in rehabilitation department of general hospitals, and 69.01% in rehabilitation hospitals. ConclusionIn 2021, professional medical services, quality and safety of rehabilitation medicine in China have improved steadily. However, most general hospitals in China still have not configured the rehabilitation wards, and there are problems such as the total number of rehabilitation medical personnel in the country does not meet the requirements, early rehabilitation intervention is significantly insufficient, and the implementation of important evaluation and therapies is deficient. The effect of rehabilitation still needs to improve. It is necessary to continuously promote capacity building of the medical rehabilitation to improve the quality of medical rehabilitation services.

Progress in extension lag after knee surgery / 中华骨科杂志

Most literature defines knee extension lag as the failure of the knee joint to achieve the passive extension angle, and some literature defines the inability of the knee to complete the last 15° extension as knee extension lag. Extension lag is one of the common complications after knee surgery, which seriously affects the postoperative knee joint function of patients. Disuse atrophy due to prolonged postoperative bed rest, arthrogenic muscle inhibition due to pain and (or) swelling, direct injury to the knee extensor mechanism during surgery and nerve dysfunction of the quadriceps muscle can all contribute to extension lag. While rehabilitation exercises, physical therapy and medication can significantly improve the patient's symptoms, extension lag due to the knee extension device injury requires surgery if necessary to regain normal knee function. As surgical techniques continue to be refined and rehabilitation interventions advance, the prevention of extension lag and the minimization of angle of knee extension lag need to be given adequate attention by patients, physicians, and researchers. This article reviews clinical studies related to extension lag after knee surgery, focusing on etiology, treatment, prevention and prognosis, with the aim of providing a basis and guidance for the current clinical management.

Survey of rehabilitation competency of Chinese rehabilitation physicians using WHO rehabilitation competency framework / 中国康复理论与实践

ObjectiveTo investigate rehabilitation competence among trainers and trainees whom participated in the training program entitled National Training Program of Shortage Rehabilitation Physicians (NTPSRP) using World Health Organization rehabilitation competency framework (RCF). MethodsBased on RCF, a questionnaire was developed and administrated through network using Questionnaire Star. All the trainers and trainees who participated in NTPSRP were investigated in September, 2023. ResultsA total of 911 subjects were collected from 27 provinces, including 426 trainers (teachers) and 485 trainees (students). The average age of the teachers was older, with more years of work experience and professional experience in rehabilitation medicine. The degree and professional title of the teachers was also higher. The overall internal consistency reliability of the questionnaire was good (Cronbach's α = 0.988), and all the internal consistency reliability in five fields was good (Cronbach's α > 0.9). The five dimensional structure of RCF in the results was consistent with the prior model established by RCF theory. The self-ratings of all physicians in the five fields were higher than the median level, and was higher in the teachers than in the students [(3.42±0.68) vs. (2.73±0.80), P < 0.001]. Gender and years of experience in rehabilitation medicine were independent factors for the total score of the questionnaire. The total self-rating of female students was 9.65 points lower than that of the male (95%CI 4.386 to 14.914); and one more year in rehabilitation medicine would increase 1.78 points in self-rating (95%CI 1.140 to 2.419). ConclusionThe structure and content of RCF can be used to evaluate the competence of rehabilitation physicians. The teachers and students of NTPSRP are eligible to RCF. RCF-based evaluation can be used to guide the development of continuing education courses for rehabilitation professionals.

Analysis of external exposure dose monitoring results of interventional radiology staff in a hospital from 2018 to 2020 / 中国辐射卫生

@#<b>Objective</b> To analyze the monitoring results of external exposure dose of interventional radiology staff in a tertiary general hospital in Beijing, China, 2018—2020, and to provide a basis for safe guarding staff health and hospital radiation protection management. <b>Methods</b> A total of 321 interventional radiology staff in a hospital in Beijing were selected to collect information on the types of interventional work, positions, and personal dose monitoring results in 2018—2020. The dose monitoring results were analyzed using SPSS 22.0. <b>Results</b> The effective monitoring rate for the three years was 78.82%, 81.65%, and 96.85%, respectively, showing an increasing trend (<i>χ</i>²_trend = 16.134, <i>P</i> < 0.001). The annual dose equivalent per capita was 0.142, 0.142, and 0.265 mSv, respectively. The annual dose equivalent per capita in 2020 was significantly higher than those in 2018 (<i>H</i> = 24.562, <i>P</i> < 0.001) and 2019 (<i>H</i> = 39.378, <i>P</i> < 0.001). The annual dose equivalent per capita in 2020 was in the order of interventional clinician > interventional nurse > technician (<i>H</i> = 10.699, 6.562, <i>P</i> < 0.01). The annual dose equivalent per capitain 2020 was higher in the cardiology interventional department than in the comprehensive interventional, neuro interventional, and vascular surgery departments (<i>H</i> = 35.530, 37.614, 35.496, <i>P</i> < 0.001). <b>Conclusion</b> The number of interventional radiology staff monitored from 2018 to 2020 increased year by year, so did the effective monitoring rate.The external exposure dose was at low levels, which generally meets the requirements of national occupational exposure limits. Training on radiation protection for interventional radiology staff should be further strengthened to raise awareness of radiation protection.

Effect and Molecular Mechanism of MFG-E8 on Sensitivity of Ovarian Cancer SKOV3 Cells to Cisplatin / 肿瘤防治研究

Objective To investigate the effect of silencing MFG-E8 gene on the sensitivity of SKOV3 cells to anticancer drugs and related mechanisms. Methods SKOV3 cells were transfected with MFG-E8 siRNA (Msi) and NC siRNA (Csi), respectively and the efficiency of transfection was confirmed by Western blot. The sensitivity of SKOV3 cells to cisplatin was observed by CCK-8 assay after transfection. The mRNA expression of ABCB1 and ABCC1 were detected by qRT-PCR. Effect of silencing MFG-E8 on the expression of ETM-related protein was detected by qRT-PCR and Western blot. Results MFG-E8 siRNA could effectively silence the expression of MFG-E8 protein. With the increasing drug concentration, the proliferation inhibition rate of each group also increased, and the cell proliferation inhibition rate of MFG-E8 siRNA group increased significantly (P < 0.01). Compared with NC siRNA group, downregulation of MFG-E8 expression led to decreased SKOV3 cell proliferation at 48h or 72h after 3 μg/ml cisplatin treat ment (P < 0.05). qRT-PCR results showed that the mRNA expression of ABCB1 and ABCC1 in Msi group were significantly lower than those in Csi group. qRT-PCR and Western blot results showed that silencing MFG-E8 gene down-regulated the mRNA and protein expression of N-Cadherin, Vimentin and Snail and up-regulated the expression of E-Cadherin. Conclusion Silencing the MFG-E8 gene can increase the sensitivity of SKOV3 cells against anti-tumor drugs and down-regulate the mRNA expression of ABCB1 and ABCC1, which may be related to the inhibition of EMT progression.

The predictive value of dynamic changes of coagulation function for the occurrence and progression of isolated distal deep vein thrombosis of lower limbs in patients with acute brain injury / 中华危重病急救医学

Objective:To analyze risk factors for the occurrence and progression of isolated distal deep vein thrombosis (IDDVT) of lower limbs, and to explore the predictive value of dynamic changes of coagulation index D-dimer on the occurrence and progression of IDDVT in acute brain injury (ABI) patients during perioperative period.Methods:A retrospective case-control study was conducted. Perioperative ABI patients admitted to department of neurocritical care unit (NCCU) of the First Affiliated Hospital of University of Science and Technology of China from September 2019 to May 2020 were enrolled. Patients' baseline characteristics, disease characteristics, treatment approaches, outcomes and coagulation function index at 1, 2-4, 5-7 and > 7 days post operation were analyzed between patients with IDDVT and patients with progressive IDDVT. Risk factors for IDDVT occurrence and progression were identified by multivariate Logistic regression. Receiver operating characteristic curve (ROC curve) were drawn to assess the predictive value of coagulation indexes for IDDVT occurrence and progression.Results:A total of 164 ABI patients were enrolled. Most of the patients were elderly [age was 60 (51, 69) years], male [99 cases (60.4%)], and severe cases [Glasgow coma score (GCS) at admission was 6 (5, 8)]. The rates of IDDVT occurrence and progression were 61.6% (101 cases) and 16.8% (17 cases), respectively, the rate of proximal deep venous thrombosis (DVT) was 12.8% (21 cases). Compared with the IDDVT group (101 patients), patients without IDDVT group were younger (years: 55±13 vs. 62±13), length of intensive care unit (ICU) stay were shorter (days: 12±6 vs. 15±7), body mass index (BMI) and GCS at admission were higher [59 patients, BMI (kg/m 2): 23±5 vs. 19±8, GCS scores: 7±2 vs. 6±2], the differences were statistically significant (all P < 0.05). Compared with patients with IDDVT progression group, male patients were fewer [61.9% (52/84) vs. 88.2% (15/17)], the proportion of transfusion of red blood cell and anticoagulant therapy were lower [8.3% (7/84) vs. 29.4% (5/17) and 47.6% (40/84) vs. 94.1% (16/17)], the proportion of cerebral herniation was higher [42.9% (38/84) vs. 11.8% (2/17)] in patients without IDDVT progressive group. All of the differences were statistically significant (all P < 0.05). D-dimer were increased in two groups of whether IDDVT occurrence or not over time. D-dimer peaked on 5-7 days after surgery in IDDVT occurrence group, and then decreased. D-dimer peaked at > 7 days after surgery in patients without IDDVT. With time, D-dimer were increased in groups of whether IDDVT progression or not, both peaked at 5-7 days postoperation, and then decreased. Compared with non-IDDVTgroup, D-dimer was significantly increased in IDDVT group from 2-4 days after surgery [mg/L: 4.1 (2.3, 8.0) vs. 2.4 (1.7, 3.4), P < 0.05], and lasted until 5-7 days [mg/L: 5.5 (3.3, 11.4) vs. 3.9 (2.6, 5.8), P < 0.05]. Compared with IDDVT group, D-dimer was significantly increased in IDDVT progressive group from 2-4 days [mg/L: 11.2 (4.7, 20.0) vs. 3.7 (2.1, 6.8), P < 0.05], and lasted until 7 days [mg/L: 11.0 (3.0, 18.9) vs. 4.1 (2.6, 6.5), P < 0.05]. Multivariate Logistic regression analysis showed that age > 60 years [odds ratio ( OR) = 3.43, 95% confidence interval (95% CI) was 1.69-6.96, P = 0.001], GCS score at admission > 8 ( OR = 0.35, 95% CI was 0.17-0.76, P = 0.008), length of ICU stay > 13 days ( OR = 2.25, 95% CI was 1.08-4.70, P = 0.031) were risk factors for IDDVT. Gender ( OR = 0.19, 95% CI was 0.02-0.71, P = 0.019), transfusion of red blood cell ( OR = 6.50, 95% CI was 1.33-31.94, P = 0.021), cerebral herniation ( OR = 0.18, 95% CI was 0.37-0.90, P = 0.036) were risk factors for IDDVT profression. ROC curve analysis showed that age and D-dimer at 5-7 days were predicators of IDDVT [the area under curve ROC (AUC) were 0.68 and 0.72, 95% CI were 0.60-0.75 and 0.64-0.80, both P value were 0.000 1]. When the cut-off value of age was 60 years old and the D-dimer was 5.4 mg/L, the sensitivity were 60.6% and 54.4%, specificity were 71.2% and 80.9%, respectively, positive predictive value were 78.7%, 84.5%, negative predictive value were 51.2%, 48.1%, respectively. The elevation of D-dimer to 3.9 times at days 5-7 compared with day 1 of NCCU stay was a predicator of IDDVT progression (AUC = 0.81, 95% CI was 0.71-0.88, P = 0.000 1). The sensitivity, specificity, positive predictive value and negative predictive value were 76.5%, 74.6%, 41.9% and 93.0%, respectively. Conclusions:IDDVT occurrence and progressiveare common in severe ABI patients during perioperative period. The dynamic change of D-dimer, especially at days 5-7, is a valuable predictor of IDDVT progressionin ABI patients, which is helpful for guiding implementation of deep vein ultrasound of lower limb.

Application and evaluation of nursing-led multidisciplinary evidence-based intervention in anticoagulation management for inpatients with oral Warfarin / 中国实用护理杂志

Objective:To explore the effect of nursery-led multidisciplinary evidence-based intervention in the management of anticoagulation in inpatients with oral warfarin.Methods:In this study, Quasi-experimental research was adopted. 478 patients were selected as the baseline review group on August 1st, 2019 and December 31th, 2019, and 494 patients were selected as the after-effect evaluation group on February 1st, 2020 and May 31th, 2020 in cardiovascular surgery and cardiovascular medicine. Established a multidisciplinary team, according to theoretical framework basing on the evidence of continuous quality improvement model, combining with evidence and clinical practice to develop evidence-based solutions, the comparison of international normalized ratio (INR) before and after the intervention in the percentage of time in therapeutic range (TTR) and anticoagulant related the incidence of complications.Results:Before and after the multidisciplinary evidence-based intervention, the mean TTR of the patients were (51.67±31.04)% and (64.34±26.37)%, with statistically significant differences ( tvalue was 6.958, P<0.01); the incidence of bleeding and embolization was not statistically significant ( χ 2values were 0.294 and 0.268, P>0.05). Conclusion:Nursing-led multidisciplinary evidence-based interventions can improve the intensity and stability of oral warfarin anticoagulant therapy in inpatients.

Diethyl citrate inhibits vascular calcification in chronic kidney disease by CaSR/autophagy signaling axis / 西安交通大学学报(医学版)

Objective: To investigate the effects of calcium sensitive receptor (CaSR)/autophagy signaling axis on the inhibition of vascular calcification in chronic kidney disease (CKD) by diethyl citrate (Et2Cit). Methods: Rats and vascular smooth muscle cells (VSMCs) were divided into 5 groups: normal control group, model group, low-dose Et2Cit group, high-dose Et2Cit group and high-dose Et2Cit+NPS-2143 (CaSR inhibitor) group. After the intervention, the content of aorta calcium in each group was detected. Alizarin red staining was used to detect calcification in each cell group. mRNA expressions of calcification-related proteins, CaSR and autophagy-related proteins in the aorta of each group were detected by qRT-PCR. The expressions of the above proteins in each group were detected by Western blotting. Results: Compared with the control group, the calcification in model group was significantly increased, and Et2Cit intervention could reduce the calcification in a dose-dependent manner (P<0.05). Compared with high-dose Et2Cit group, high-dose Et2Cit+NPS-2143 group had significantly higher calcium content (P<0.05). Compared with those in the control group, the expressions of smooth muscle 22α (SM22α), CaSR and Beclin1 were decreased (P<0.05), while the expressions of runt related transcription factor 2 (RUNX2) and P62 were increased (P<0.05). Et2Cit intervention could reverse the above changes (P<0.05). Compared with the high-dose Et2Cit group, the high-dose Et2Cit + NPS-2143 group had significantly lower SM22α, CaSR and Beclin1, and significantly higher RUNX2 and P62 levels (P<0.05). Results: Et2Cit inhibits CKD vascular calcification partly via the CaSR and CaSR/autophagy signal axis.

Evaluation of iodine nutritional status of children and pregnant women in non-high iodine areas of Xuchang City / 中华地方病学杂志

Objective To evaluate the iodine nutritional status of children and pregnant women in non-high iodine areas with different water iodide levels that supplied with standard iodized salt. Methods In 2016 - 2018, after excluding high iodine towns, in each county 5 townships were selected according to the east, west, south, north, and middle orientation. If the township was concentrated in water supply, 1 sample of peripheral water was collected;If the water supply was dispersed, collected 10 water well samples in each village to test the water iodine content. And 40 children aged 8 - 10 years and 20 pregnant women were extracted to collect urine samples and household salt samples, and iodine of urine and salt samples were tested. Children's thyroid volume was examined by B-mode ultrasound. The differences of urinary iodine and child goiter rates among children and pregnant women in different water iodine content areas were analyzed. Results A total of 1282 water samples were collected from 30 townships in Xuchang City, and the median water iodine range of townships was 0.80 - 94.70 μg/L. A total of 1258 children aged 8 - 10 years were investigated, and the median salt iodine content of children homes was 26.8 mg/kg, ranging from 0 to 60.9 mg/kg; the median urinary iodine level of children was 211.5 μg/L, and the range was 8.3 - 833.6μg/L; 39 children with goiter were examined, and the children's goiter rate was 3.10％. A total of 616 pregnant women were investigated, and the median salt iodine content of pregnant women's homes was 26.9 mg/kg, ranging from 0 to 88.0 mg/kg; the median urinary iodine level of pregnant women was 182.2 μg/L, ranging from 9.7 to 609.6 μg/L. In the areas of the median water iodine 0 - < 10, 10 - < 50 and 50 - 100 μg/L, the median urinary iodine of 8 - 10 years old children were 202.6, 204.0, 320.5 μg/L, respectively, the difference between the three was statistically significant (H = 79.89, P < 0.01). And the area of 50 - 100 μg/L was significantly higher than 0 - <10.0, 10 - < 50 μg/L areas (P < 0.01); the children's goiter rate of the three areas was 1.58％ (10/634), 4.40％ (22/500) and 5.65％ (7/124), respectively; the median urinary iodine of pregnant women of the three areas respectively was 177.0, 180.9 and 238.0 μg/L, and the 50 - 100 μg/L areas was higher than 0 - < 10, 10 - < 50 μg/L areas(P <0.01). Conclusion The current standard iodized salt in non-high iodine areas in Xuchang City is basically suitable for most children and pregnant women with iodine nutrition, but the iodine nutrition of children with water iodine greater than 50 μg/L is excessive.

Evaluation of iodine nutritional status of children and pregnant women in non-high iodine areas of Xuchang City / 中华地方病学杂志

Objective@#To evaluate the iodine nutritional status of children and pregnant women in non-high iodine areas with different water iodide levels that supplied with standard iodized salt.@*Methods@#In 2016-2018, after excluding high iodine towns, in each county 5 townships were selected according to the east, west, south, north, and middle orientation. If the township was concentrated in water supply, 1 sample of peripheral water was collected; If the water supply was dispersed, collected 10 water well samples in each village to test the water iodine content. And 40 children aged 8-10 years and 20 pregnant women were extracted to collect urine samples and household salt samples, and iodine of urine and salt samples were tested. Children's thyroid volume was examined by B-mode ultrasound. The differences of urinary iodine and child goiter rates among children and pregnant women in different water iodine content areas were analyzed.@*Results@#A total of 1 282 water samples were collected from 30 townships in Xuchang City, and the median water iodine range of townships was 0.80-94.70 μg/L. A total of 1 258 children aged 8-10 years were investigated, and the median salt iodine content of children homes was 26.8 mg/kg, ranging from 0 to 60.9 mg/kg; the median urinary iodine level of children was 211.5 μg/L, and the range was 8.3-833.6 μg/L; 39 children with goiter were examined, and the children's goiter rate was 3.10%. A total of 616 pregnant women were investigated, and the median salt iodine content of pregnant women's homes was 26.9 mg/kg, ranging from 0 to 88.0 mg/kg; the median urinary iodine level of pregnant women was 182.2 μg/L, ranging from 9.7 to 609.6 μg/L. In the areas of the median water iodine 0-< 10, 10-< 50 and 50-100 μg/L, the median urinary iodine of 8-10 years old children were 202.6, 204.0, 320.5 μg/L, respectively, the difference between the three was statistically significant (H=79.89, P < 0.01). And the area of 50-100 μg/L was significantly higher than 0-< 10.0, 10-< 50 μg/L areas (P < 0.01); the children's goiter rate of the three areas was 1.58% (10/634), 4.40% (22/500) and 5.65% (7/124), respectively; the median urinary iodine of pregnant women of the three areas respectively was 177.0, 180.9 and 238.0 μg/L, and the 50-100 μg/L areas was higher than 0-< 10, 10- < 50 μg/L areas(P < 0.01).@*Conclusion@#The current standard iodized salt in non-high iodine areas in Xuchang City is basically suitable for most children and pregnant women with iodine nutrition, but the iodine nutrition of children with water iodine greater than 50 μg/L is excessive.

Development of an immunochromatographic strip for detection of antibodies against porcine reproductive and respiratory syndrome virus

A simple and rapid immunochromatographic test strip incorporating a colloidal gold-labeled recombinant Nsp7 antigen probe was successfully developed for the detection of anti-porcine reproductive and respiratory syndrome virus (PRRSV) antibodies in swine. Recombinant Nsp7 protein of PRRSV labeled with colloidal gold was dispensed on a conjugate pad for use as the detector. Staphylococcal protein A and purified porcine anti-Nsp7 antibodies were blotted on a nitrocellulose membrane to form test and control lines, respectively. A comparison of the strip with standard diagnostic tests, enzyme-linked immunosorbent assays and immunoperoxidase monolayer assay, was also performed. The immunochromatographic test strip was shown to be of high specificity and sensitivity. Furthermore, the strip assay is rapid and easy to perform with no requirement for professional-level skills or equipment. It is suggested that the immunochromatographic test strip can be used to quickly and accurately detect PRRSV antibody and to be suitable for diagnostic purposes in the field.

Effects of hypoxia-inducible factor -2α on the expression of tight junction proteins and permeability in rat glomerular endothelial cells under hypoxia condition / 中华肾脏病杂志

Objective To investigate the role of hypoxia?inducible factor?2α(HIF?2α) in the expression of tight junction proteins and permeability alterations in rat glomerular endothelial cells (rGENCs) under hypoxia condition. Methods The expressions of the HIF?2α and tight junction proteins such as occludin and ZO?1 of rGENCs were examined after exposed to 5%oxygen at different treatment time periods (0 h, 12 h, 24 h and 48 h). Then lentiviral transfection was used to knock down HIF?2α expression in rGENCs. The cells were split into four groups, including i) control group where rGENCs were cultured under normal oxygen conditions, ii) hypoxia group, iii) negative control group where rGENCs were infected with a negative vector, iv) HIF?2α lentivirus transfection group. Group ii, iii and iv were kept in hypoxic chamber (5% O2, 5% CO2 and 90% N2) for 24 h. The expressions of occludin, ZO?1 and HIF?2α were assessed by Western blotting. The permeability of rGENCs was measured using trans?epithelium electrical resistant (TEER) by Millicell? ERS voltohmmeter. Results With the elongation of hypoxia time, the expression of HIF?2α was increased gradually, while the occludin expression was decreased, there was statistically significance difference in each group (all P0.05). And a dramatic decrease in TEER of hypoxia cells was detected as compare with control cells (P0.05). Conclusion Hypoxia may promote HIF?2α expression, which could increase the permeability of rGENCs by reducing the expression of occludin and ZO?1.

Effect of bone-marrow mesenchymal stem cell transplantation on behavioral changes in mice after ischemic brain injury / 中华行为医学与脑科学杂志

Objective To study the effect of bone-marrow mesenchymal stem cell (BMSC) via artery transplantation on behavior changes after ischemic brain injury in mice.Methods 60 mice (C57BL/6) were divided randomly into sham group,brain ischemia group (MCAO group) and stem cell therapy group (BMSC group).The latter two groups were injected respectively with 200 μl PBS or BMSC suspension into common carotid arteries namely when removal suture after middle cerebral artery occlusion model,while sham group was only isolated carotid artery.Infarct size of brain tissue was measured by TTC staining.Focal deficit score,Morris water maze test,the rotating beam test and Rotarod test were resepectively made to evaluate the animal behavior after injury.Results Adequate amounts of BMSCs were harvested by adherence screening method and subculture.Ischemic area of BMSC group ((34.98±12.49) ％) was significantly smaller than that of MCAO group ((42.36±9.41)％) at 2nd day after injury (P＜0.05).Compared with MCAO group,focal deficit score of BMSC group reduced significantly at 3rd day after injury,and got to the most significant differences at 5th day after injury (P＜0.01);escape latency of BMSC group was significantly shortened at 7th day and 14th day after injury in Morris water maze test (P＜ 0.05),meanwhile time percentage,distance percentage in the target quadrant and the times corssing the platform were increased gradually after injury,and reached significant differences at 14th day after injury(P＜0.05);exercise time in Rotarod runner increased at every time point after injury,and reached most significant differences at 14th day after injury(P＜0.01);walking speed in the rotating beam test increased most significantly at 14th day after injury,meanwhile walking distance at 5th and 10th day after injury(P＜0.01).Conclusion BMSC transplantation via carotid artery can significantly improve neural function,learning,balance and motor function after brain injury,which will be a new way of TBI therapy.

Effect of early screening and intervention on congenital hypothyroidism / 中国基层医药

Objective To investigate the effect of early screening and intervention on congenital hypothyroid-ism.Methods Thyroid stimulating hormone (TSH),three thyroid stimulating hormone (T3 )and thyroid hormone (T4 )were screened in 72h after birth,and thyroid ultrasound examination.All the patients were treated with the treat-ment of the left -to -thyroid hormone,0 -6 months medication dose 25 -50g/d,6 -12months medication dose 50 -100g/d,1 -3months medication dose 75 -100g/d.Serum TSH was reviewed every three months in the age of 1 years, 2 -3 years old every six months to review the serum TSH.Results The mean value of TSH in children with congeni-tal hypothyroidism was (68.7 ±15.3)mU /L.The mean value of T4 was (42.4 ±13.1)nmol/L.100 cases of chil-dren,including 38 cases of primary congenital hypothyroidism,transient congenital hypothyroidism in 62 cases.Ultra-sound examination showed primary congenital hypothyroidism were developmental abnormalities,and abnormal absence of a total of 18 cases (47.4%),Abnormal blood flow in 15 cases (39.5%);No abnormalities were found in the ultrasound examination of the transient congenital hypothyroidism.Before treatment,TSH in children with congenital hypothyroidism was significantly higher than that in the control group[(68.7 ±15.3)mU /L vs (4.6 ±1.1)mU /L], T4 was significantly lower than the control group[(42.4 ±13.1)nmol/L vs (124.4 ±45.5)nmol/L],the differences were statistically significant (t =22.867,16.058,all P 0.05).After 1 -3 years follow -up observation,children with Gesell development scale test showed that children with adaptability,large movements,fine movements,language and social skills to reach the normal level.Conclusion Early screening and treatment of the patients with congenital hypothyroidism is beneficial to the rehabilitation of the patients with congenital hypothyroidism.

Effects of Individual Prehabilitation on Functional Outcome Six Weeks after Total Knee Arthroplasty / 中国康复理论与实践

Objective To observe the effects of individual prehabilitation on the functional outcome six weeks after total knee arthroplas-ty (TKA). Methods The patients undergoing TKA from March, 2013 to August, 2015 were randomly divided into prehabilitation group (n=30) and control group (n=29). The prehabilitation group received individual rehabilitation since enrolled in the study. The control group re-ceived no prehabilitation. All the patients received regular pre-surgical education, surgery and post-surgical rehabilitation. Both groups were evaluated with Numerical Rating Scale (NRS) of pain, active range of motion (AROM), Manual Muscle Test (MMT), fall index, TimedUp and Go(TUG), and Hospital for Special Surgery-Knee Scale (HSS-KS). Results The scores of NRS reduced six weeks after TKA (t>2.342, P2.827, P0.05), and it increased in the control group six weeks after TKA (t>3.555, P0.05);the AROM of knee extension increased before TKA in the control group (Z=-2.257, P=0.024), and no increasement was found in the prehabilitation group (Z=0, P=1.000), and it decreased six weeks after TKA in both groups (Z>2.247, P2.387, P0.05). The muscle strength of trunk extensor and the upside of rectus abdominis showed no statistical difference between two groups six weeks after TKA (t0.05), the muscle strength of the downside of rectus abdominis and external oblique was more in the prehabilitation group than in the control group (t=2.585, P=0.013). There was no significant difference in the fall index be-fore TKA (t0.05), and it was lower in the prehabilitation group than in the control group six weeks after TKA (t=-2.837, P=0.007). The time of TUG shortened before TKA in the prehabilitation group (t=3.554, P=0.002), and it prolonged in the control group (t=-4.507, P2.092, P<0.05). Conclusion Individual prehabilitation could reduce pain, and improve the trunk muscles, the ability of walking and the function of the knee before and six weeks after TKA.

Morphological and Immunohistochemical Identification of Villous M Cells in the Small Intestine of Newborn Piglets / Identificación Morfológica e Inmunohistoquímica de los Epiteliocitos Microplegados de las Vellosidades en el Intestino Delgado de Lechones Recién Nacidos

Microfold (M) cells act as antigen-sampling sites for initiating antigen specific mucosal immune responses, but they may also provide a gateway for enteropathogen entry. In this study we demonstrated villous M cells by morphological and immunohistochemical methods to be present in the three regions of the small intestine from newborn piglets. Immunohistochemical analysis, using anti- cytokeratin 18 (CK18) primary antibodies, showed a gradually decreased density of M cells from the lower crypt epithelium to the upper villous epithelium. The proportion of villous M cells was greater in the ileum than in the duodenum or the mid-jejunum. Ultrastructural observation revealed that villous M cells were mainly columnar in shape in the duodenum and the mid-jejunum, and appeared as more pocket-like structure in the ileum. These villous M cells exhibited short and irregular microvilli, rich vesicles and reduced glycocalyx, but lacked the lymphocyte-containing basolateral invagination. Our results support evidence that M cells can develop in the small intestinal villous epithelium of newborn piglets, implying that villous M cells may begin developing in the pig's small intestine during fetal stages, which depends neither on the influence of the mucosal lymphoid tissue nor the antigen from the intestinal lumen stimulation. In addition, the variable morphology and heterogeneity distribution of villous M cells in the three regions of the small intestine may be indicative of its different functional properties. This information extent our understanding of the diversity of M cells and provides important basic knowledge for further research on the actual role of villous M cells in neonate.

Los epiteliocitos microplegados (células M) actúan como receptores de antígeno para iniciar la respuesta inmune específica de las mucosas, pero también pueden proporcionar una puerta de entrada para enteropatógenos. En este estudio, se demostró por métodos morfológicos e inmunohistoquímicos que los epiteliocitos microplegados de las vellosidades están presentes en las tres regiones del intestino delgado de lechones recién nacidos. Se utilizaron anticuerpos primarios de citoqueratina 18 (CK18) para el análisis inmunohistoquímico, el cual mostró una disminución gradual de la densidad de los epiteliocitos microplegados desde el epitelio de las criptas inferiores hasta el epitelio de las vellosidades superiores. La proporción de los epiteliocitos microplegados, fue mayor en el íleon que el duodeno o yeyuno medio. La observación ultraestructural reveló que los epiteliocitos microplegados fueron principalmente de forma columnar en el duodeno y el yeyuno medio. Además, mostraron microvellosidades cortas e irregulares, muchas vesículas y glucocáliz reducidos, pero carecían de invaginaciones basolaterales contenedoras de linfocitos. Nuestros resultados apoyan la evidencia de que los epiteliocitos microplegados pueden desarrollarse en el epitelio de las vellosidades intestinales de los lechones recién nacidos, lo que implica que estas células pueden comenzar a desarrollarse en el intestino delgado del cerdo durante las etapas fetales, y no dependen ni de la influencia del tejido linfoide de las mucosas ni del antígeno para la estimulación del lumen intestinal. Además, la morfología y heterogeneidad de distribución de los epiteliocitos microplegados en las tres regiones del intestino delgado pueden ser indicativas de sus diferentes propiedades funcionales. Esta información mejora nuestra comprensión de la diversidad de los epiteliocitos microplegados y proporciona conocimientos básicos importantes para la investigación sobre el papel de los epiteliocitos microplegados en las vellosidades del neonato.

A Comparative Study of 2 different Teaching Modes Used in Rehabilitation Medicine Continuing Education: the Physicians and Therapists Teaching Together or Separately / 中国康复理论与实践

@# Objective To compare the acceptance of 2 different teaching modes－physicians and therapists teaching together and separately in continuing education students of rehabilitation medicine. Methods A questionnaire was filled by the students who attended the lectures of both Rehabilitation of Elbow Injury and Rehabilitation of Wrist Injury in the 9th National Orthopedic Class. The former lecture was taught by the rehabilitation physician and physical therapist together (together mode), and the latter lecture was taught by the rehabilitation physician and physical therapist separately (separate mode). The questionnaire included the choices and text questions. Results There were 45 copies of effective questionnaire all together. The satisfaction of both lectures were above 90%. As to teaching modes, 77.8% students liked together mode better, and 22.2% students preferd the separate mode. 93.9% students would or maybe use together mode in their future work, and 88.9% in separate mode. Conclusion The mode of physician and therapist giving lectures together is well accepted by students.

Isokinetic Strength of Knee Flexors and Extensors and Relationship with Functions in Patients with Knee Osteoarthritis / 中国康复理论与实践

Objective To investigate the isokinetic strength of knee extensors and flexors in patients with knee osteoarthritis (KOA), and to establish the correlation between the isokinetic strength and function in patients with KOA. Methods 23 patients with bilateral KOA and 14 matched normal controls finished the isokinetic test of knee extensors and flexors, the Five Times Sit-to-Stand Test (FTSST), Gait analy-sis, and Balance test. The KOA patients were evaluated with Visual Analog Scale (VAS) for pain and Western Ontario and McMaster Univer-sity Osteoarthritis Index (WOMAC). Results It was less of the peak torque, average peak torque, average power, max rep total work, total work of knee extensors and flexors in the mainly involved limbs than the contralateral limbs (P0.05). Conclusion It is weak of the isokinetic strength of knee extensors and flexors in patients with KOA in the mainly involved limb, as well as the isokinetic strength of knee extensors compared with the normal controls. The changes in the ex-tensors and flexors are not equivalent. The peak torque of knee extensors significantly correlated with the pain and functions of the knee.

Magnetic resonance spectroscopic study on regional cerebral metabolic changes of rabbits with explosive brain injury / 中华创伤杂志

Objective To evaluate the regional cerebral metabolic changes in different episodes by magnetic resonance spectroscopy (MRS) after explosive brain injury in rabbits. Methods Fortyfive New Zealand white rabbits were randomly divided into eight groups, ie, normal control group( 10 rabbits) and trauma group (35 rabbits). The explosive injury in trauma group was induced by explosion of 600 mg TNT equivalent of paper detonators at 6.5 cm above the rabbit brain. The rabbits in trauma group was divided into 1,6, 12, 24 hours, 3, 7, 14 days subgroups (6 rabbits per group). The survival rate was observed at different time points after explosive injury. The MRS was used to detect the regional cerebral metabolic changes including N-acetylaspartate (NAA)/creatine (Cr) ratio and choline(Cho)/Cr ratio as well as evolution of blast injuries over time. Results The rabbits survived for overseven days in the trauma groups, with typical brain contusion manifested by pathological and conventional MRI. Compared with the normal control group, the NAA/Cr ratio was markedly decreased at one hour after injury, slightly rose again at 24 hours and fell again after seven days. The Cho/Cr ratio was markedly increased at one hour after injury, slightly fell again at 12 hours and rose again at three days after injury.Conclusions MRS can manifest the regional cerebral metabolic changes of rabbits with explosive injury at different time points and hence provide a theoretical basis for understanding the local tissue changes and determining the type of tissue damage after blast injury.