Therapeutic effect of transplantation of bone marrow mesenchymal stem cells co-cultured with bone marrow M2 macrophages on a rat model of liver cirrhosis / 临床肝胆病杂志

ObjectiveTo investigate the effect of transplantation of bone marrow mesenchymal stem cells （BMSCs） co-cultured with bone marrow-derived M2 macrophages （M2-BMDMs）， named as BMSCM2， on a rat model of liver cirrhosis induced by carbon tetrachloride （CCl4）/2-acetaminofluorene （2-AAF）. MethodsRat BMDMs were isolated and polarized into M2 phenotype， and rat BMSCs were isolated and co-cultured with M2-BMDMs at the third generation to obtain BMSCM2. The rats were given subcutaneous injection of CCl4 for 6 weeks to establish a model of liver cirrhosis， and then they were randomly divided into model group （M group）， BMSC group， and BMSCM2 group， with 6 rats in each group. A normal group （N group） with 6 rats was also established. Since week 7， the model rats were given 2-AAF by gavage in addition to the subcutaneous injection of CCl4. Samples were collected at the end of week 10 to observe liver function， liver histopathology， and hydroxyproline （Hyp） content in liver tissue， as well as changes in the markers for hepatic stellate cells， hepatic progenitor cells， cholangiocytes， and hepatocytes. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the N group， the M group had significant increases in the activities of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） （P<0.01）； compared with the M group， the BMSC and BMSCM2 groups had significant reductions in ALT and AST （P<0.01）， and the BMSCM2 group had significantly better activities than the BMSC group （P<0.05）. Compared with the N group， the M group had significant increases in Hyp content and the mRNA and protein expression levels of alpha-smooth muscle actin （α-SMA） in the liver （P<0.01）； compared with the M group， the BMSC and BMSCM2 groups had significant reductions in Hyp content and the expression of α-SMA （P<0.05）， and the BMSCM2 group had a significantly lower level of α-SMA than the BMSC group （P<0.01）. Compared with the N group， the M group had significant increases in the mRNA expression levels of the hepatic progenitor cell markers EpCam and Sox9 and the cholangiocyte markers CK7 and CK19 （P<0.01） and significant reductions in the expression levels of the hepatocyte markers HNF-4α and Alb （P<0.01）； compared with the M group， the BMSC and BMSCM2 groups had significant reductions in the mRNA expression levels of EpCam， Sox9， CK7， and CK19 （P<0.05） and significant increases in the mRNA expression levels of HNF-4α and Alb （P<0.05）， and compared with the BMSC group， the BMSCM2 group had significant reductions in the mRNA expression levels of EpCam and CK19 （P<0.05） and significant increase in the expression level of HNF-4α （P<0.05）. ConclusionM2-BMDMs can enhance the therapeutic effect of BMSCs on CCl4/2-AAF-induced liver cirrhosis in rats， which provides new ideas for further improving the therapeutic effect of BMSCs on liver cirrhosis.

Construction and operation of the multi-level medical security system of the West China Women and Children Alliance / 中华医院管理杂志

Medical mutual aid is an important component of multi-level medical security system. West China Second University Hospital of Sichuan University led the establishment of the pediatric specialty alliance " West China Women and Children Alliance". Based on customized and inclusive mutual insurance product " Family Doctor Mutual Aid Plan", the alliance implemented key links such as mutual aid product forms, patient risk protection, institutional financing and hematopoiesis, and distribution of benefits to all parties, explored innovative mutual aid funding, payment, and incentive mechanisms, forming a closed-loop pediatric tiered diagnosis and treatment service system with the Mutual Aid Plan as the core. This system operated continuously under the " Four-in-One" framework, stimulating the integration of medical insurance and service supply systems while enhancing the synergistic effect between mutual insurance and social security. It has formed a distinctive health-centered multi-level medical security system within the alliance, and could provide reference for the construction and exploration of hierarchical diagnosis and treatment system.

Effects of overexpression of AT2R on LPS-induced inflammatory responses in AML12 cells / 安徽医科大学学报

Objective @# Angiotensin Ⅱ Type 2 receptor (AT2R) is a major receptor of angiotensin Ⅱ , which has a protective effect on damage to various tissues and organs．In this study，an overexpression plasmid of AT2R was con- structed to explore the effect of overexpression of AT2R on lipopolysaccharide ( LPS ) -induced inflammatory re- sponse in mouse hepatocytes (AML12 cells) ．@*Methods @#Mice tissues and organs were used as samples to amplify the gene of interest (AT2R) fragments containing EcoR Ⅰ and Hind Ⅲ restriction sites，and then the final product was obtained by digestion and ligation．The final positive clones were sequenced and identified．The pCMV-Flag-N- AT2R plasmid was transfected into HEK 293T cells，and the expression of Flag protein was detected by the Western blot method after 24 h．AT2R expression on AML12 cells was observed by Western blot and laser confocal microsco- py．AML12 cells were treated differently and divided into control group，LPS treatment group，pCMV-Flag-N-AT2R group and pCMV-Flag-N-AT2R + LPS group，and cell viability was detected by CCK8．Western blot detected PCNA proteins and observed cell proliferation ; Cytoinflammatory factor levels were detected by qPCR ; Western blot detec- ted the expression level of nuclear transcription factor NF-кB (p65) in cells. @*Results @#The identification and se- quencing results of EcoR I and Hind III double restriction showed that pCMV-Flag-N-AT2R plasmid was successful- ly constructed，and the detection results of the Western blot method showed successful expression of AT2R protein. Laser confocal observed that there were AT2R receptors on AML12 cells，and AT2R recombinant plasmids could be expressed on AML12; Compared with the control group，the viability and proliferation ability of LPS-treated AML12 cells were weakened，while the levels of IL-6 and TNF-α increased，and the expression level of nuclear transcription factor NF-кB (p65) increased．Compared with the LPS group，the viability and proliferation of cells in AML12 cells treated with pCMV-Flag-N-AT2R and LPS were enhanced，while the levels of IL-6 and TNF-α decreased．The ex- pression of the nuclear transcription factor NF-кB ( p65 ) decreased．@*Conclusion @# AT2R overexpression plasmids were successfully constructed and successfully expressed on AML12 cells，and AT2R could inhibit the inflammatory response of LPS-induced AML12 cells.

Analysis on the resistance of Aedes albopictus to insecticides in Putuo District， Shanghai / 上海预防医学

Objective To investigate the type and consumption of sanitary insecticides used in Putuo District of Shanghai， determine the current resistance of Aedes albopictus to the insecticides， and explore the causes of regional variations in insecticide resistance spectrum. Methods Public and private institutions of pest control operation were investigated on the use of sanitary insecticides. Dipping method and tube method were used to measure the insecticide resistance of Aedes albopictus， including larvae and adults. Results The main insecticides used in residential areas and governmental units was β-cypermethrin， while that in markets and public environment was propoxur. In addition， and the insecticides in dengue control program was λ-cyhalothrin. Aedes albopictus larvae had medium resistance to parathion， and were sensitive to propoxur， with insignificant change within three years. Their resistance to permethrin and deltamethrin was medium and high， respectively. Moreover， resistance to β-cypermethrin increased over years. In contrast， resistance of adult Aedes albopictus differed by area， except consistently being sensitive to fenitrothion. Conclusion Multiple sanitary insecticides have been used in Putuo District. In addition， Aedes albopictus has different resistance to these insecticides by area. It suggests that resistance surveillance should be promoted， which may be crucial for scientific application of insecticides and impede the development of potential resistance.

IgG4 related disease involving the adrenal glands: a case report / 中华泌尿外科杂志

IgG4-related diseases have a low incidence and are easily misdiagnosed as tumors in clinical treatments. A 26-year-old male patient was admitted to the hospital because of a left adrenal tumor found in health examination for more than 5 months. The tumor in the left adrenal region could be seen from abdominal CT, and the retroperitoneal laparoscopic resection of the left adrenal tumor was performed. Postoperative pathology was consistent with IgG4-related diseases, and serum IgG4 was abnormally high. After 2 months’ follow-up, serum IgG4 returned to normal, and no special discomfort.

Gold nanoparticle-directed autophagy intervention for antitumor immunotherapy via inhibiting tumor-associated macrophage M2 polarization

Tumor-associated macrophages (TAMs), one of the dominating constituents of tumor microenvironment, are important contributors to cancer progression and treatment resistance. Therefore, regulation of TAMs polarization from M2 phenotype towards M1 phenotype has emerged as a new strategy for tumor immunotherapy. Herein, we successfully initiated antitumor immunotherapy by inhibiting TAMs M2 polarization via autophagy intervention with polyethylene glycol-conjugated gold nanoparticles (PEG-AuNPs). PEG-AuNPs suppressed TAMs M2 polarization in both in vitro and in vivo models, elicited antitumor immunotherapy and inhibited subcutaneous tumor growth in mice. As demonstrated by the mRFP-GFP-LC3 assay and analyzing the autophagy-related proteins (LC3, beclin1 and P62), PEG-AuNPs induced autophagic flux inhibition in TAMs, which is attributed to the PEG-AuNPs induced lysosome alkalization and membrane permeabilization. Besides, TAMs were prone to polarize towards M2 phenotype following autophagy activation, whereas inhibition of autophagic flux could reduce the M2 polarization of TAMs. Our results revealed a mechanism underlying PEG-AuNPs induced antitumor immunotherapy, where PEG-AuNPs reduce TAMs M2 polarization via induction of lysosome dysfunction and autophagic flux inhibition. This study elucidated the biological effects of nanomaterials on TAMs polarization and provided insight into harnessing the intrinsic immunomodulation capacity of nanomaterials for effective cancer treatment.

Exploration and practice of the two-way referral path of medical alliances based on telemedicine / 中华医院管理杂志

" Two-way referral, and synergy between the tertiary hospitals and primary institutions" is the core measure for promoting hierarchical diagnosis and treatment in the region. The authors introduced the exploration and practice of constructing a two-way referral path in the medical alliance based on telemedicine in West China Second University Hospital of Sichuan University. As of May 2021, the hospital had established a two-way referral path with 52 member hospitals of the medical alliance. By clarifying the functionality and positioning of these institutions, optimizing work processes and IT support, building the mechanism of referral and liaison, and that of appraisal as support, these efforts had achieved progresses in such fields as innovative medical service modes, lean management of referral processes, and promotion of hierarchical diagnosis and treatment system building.

C-arm hip fluoroscopy at primary position in the internal fixation of femoral neck fracture / 中华创伤骨科杂志

Objective:To evaluate the hip C-arm fluoroscopy at primary position in internal fixation of femoral neck fracture.Methods:A retrospective study was conducted of the 69 patients with femoral neck fracture who had been treated from August 2015 to August 2018.They were divided into a primary position group ( n=35) subjected to C-arm hip fluoroscopy at primary position under symmetry traction of bilateral lower limbs for reduction of femoral neck fracture and a control group ( n=34) subjected to C-arm hip fluoroscopy at frog’s position on the healthy side for traction and reduction of the injured hip. The 2 groups were compared in terms of fluoroscopy frequency, times of resetting guide pin, intraoperative blood loss and total operation time. Results:The 2 groups were comparable due to insignificant significances between them in the preoperative general data like gender, age, fracture type, injury cause, or interval from injury to operation ( P>0.05). Compared with the control group, the primary position group showed less intraoperative fluoroscopy (7.2 times ± 0.5 times versus 16.1 times ± 1.2 times), fewer times of resetting guide pin (2.1 times ± 0.31 times versus 4.7 times ± 0.8 times), less intraoperative blood loss (96.8 mL ± 18.6 mL versus 198.1 mL ± 13.2 mL), and shorter total operation time (1.2 h ± 0.2 h versus 1.6 h ± 0.3 h). All the differences were statistically significant ( P<0.05). Conclusions:C-arm hip fluoroscopy at primary position may protect the stability after fracture reduction because bilateral lower limbs are under symmetrical traction and the hip position needs no alteration. Operation of C-arm fluoroscopy is easy and convenient and produces clear images. Therefore, this new mode of fluoroscopy has advantages of less intraoperative fluoroscopy and guide pin resetting, leading to significantly reduced intraoperative blood loss, ineffective operation time and anesthesia time.

Study of chondrocyte on the layered scaffold under minic microgravity culture / 中国矫形外科杂志

[Objective]To evaluate the feasibility of the minic microgravity as a method and the layered cylindric collagen-chitosan-?-tricalcium phosphate composite as a scaffold for the cartilage tissue engineering after an observation of how it absorbs the chondrocytes and affects the cell behavior.[Method]The chondrocytes were isolated and multiplied in vitro,and then the chondrocytes were seeded onto the porous collagen-chitosan-?-tricalcium phosphate composite scaffold and were cultured in both minic microgravity and ordinary environment for 3 weeks.The effects of the composite scaffold on the cell adhesivity,proliferation,morphological changes and synthesis of the extracellularmatrix were observed by the growth curve,phase-contrast microscopy,histology,scanning electron microscopy and immunohistochemistry.[Result]The chondrocytes that adhered to the scaffold increased significantly and secreted extracellular matrix in the center of the porous scaffold around the chondrocytes under minic microgravity compared with ordinary environment.Immunohistochemistry of type Ⅱ collagen was positive.[Conclusion]The minic microgravity environment will be a good method for the cartilage tissue engineering.And the layered cylindric collagen-chitosan-?-tricalcium phosphate composite scaffold has a good cellular compatibility.It will be an ideal scaffold for the cartilage tissue engineering.