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In recent years, basic scientific research and clinical studies on mesenchymal stem cell-derived exosome (MSC-Exo) have developed rapidly. MSC-Exo has shown good anti-tumor effects in preclinical and clinical studies. However, due to its diverse sources and functions, MSC-Exo therapy still faces many ethical issues in clinical conversion and application, including the unclear tumor types and mechanisms of action applicable to MSC-Exo, the risk/benefit issues in the process of clinical research, the lack of safety/effectiveness evaluation standards, lax access standards, and the incomplete regulatory systems. The technical guidelines and regulatory policies related to the clinical transformation and application of stem cell therapy are constantly improving. Therefore, to effectively avoid ethical risks, regulate the research and treatment related to the clinical transformation and application of MSC-Exo therapy, and improve the safety and efficacy of MSC-Exo therapy in tumor therapy, it is proposed to deepen clinical research on the relationship between MSC-Exo and tumor regulation, strengthen the risk/benefit analysis, supervise and improve the professional quality of researcher, deeply root in the principle of subjects not to be harmed, construct and perfect the relevant regulatory system, and improve the reviewing ability of the ethics committee, so as to promote the rapid clinical transformation of MSC-Exo and bring good news to cancer patients.
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Objective:To analyze the clinicopathological characteristics, treatment responses and kidney outcomes of patients with atypical membranous nephropathy (MN), and to provide information for the clinical practice.Methods:The clinical data of patients with atypical MN and synchronous primary MN who were diagnosed, treated and followed up in Peking University First Hospital from January 2008 to June 2020 were retrospectively collected and analyzed. Clinicopathological features, treatment responses and kidney prognosis were compared between the two groups. The expression of phospholipase A2 receptor (PLA2R) in kidney tissues was detected by immunofluorescence. Serum anti-PLA2R antibody was detected by enzyme-linked immunosorbent assay. Clinicopathological indexes were compared between PLA2R-related MN group and non-PLA2R-related MN group. Kaplan-Meier (Log-rank test) survival curve and multivariate Cox regression analysis methods were used to analyze the influencing factors of kidney prognosis in patients with atypical MN. The primary endpoint of renal adverse outcome was renal insufficiency, defined as end-stage renal disease or estimated glomerular filtration rate (eGFR) decline>30% baseline and<60 ml·min -1·(1.73 m 2) -1. Results:A total of 65 atypical MN patients were enrolled in this study. Compared with primary MN ( n=324), patients with atypical MN had younger age ( Z=-4.229, P<0.001), higher proportion of hematuria ( χ2=5.555, P=0.018), higher level of urinary protein ( Z=2.228, P=0.026) and lower level of eGFR ( t=-5.108, P<0.001); the proportion of IgG4 deposition in kidneys was lower ( χ2=8.081, P=0.004), and the proportions of IgA ( χ2=16.969, P<0.001) and IgM ( χ2=9.281, P=0.002) deposition were higher. There was no significant difference on gender, serum albumin, positive proportion of anti-PLA2R antibody, anti-PLA2R antibody level and kidney C3/C1q deposition between the two groups (all P>0.05). The proportions of atypical MN patients receiving renin-angiotensin aldosterone system inhibitors (49.3% vs 57.1%), calcineurin inhibitors (27.7% vs 19.1%) and cyclophosphamide (21.5% vs 23.8%) were comparable to those of primary MN patients (all P>0.05). The rates of clinical remission (80.0% vs 77.2%), partial remission (44.6% vs 44.1%), complete remission (35.4% vs 33.1%), spontaneous remission (36.9% vs 42.6%), response to cyclophosphamide (85.7% vs 81.8%), response to calcineurin inhibitor (88.9% vs 79.0%), and relapse (30.8% vs 26.8%) in atypical MN patients were comparable to those in primary MN patients (all P>0.05). During the follow-up 30.0(21.5, 61.5) months, 15 atypical MN patients (23.1%) had eGFR reduction>30%, among whom 7 patients (10.8%) had eGFR reduction>50% and 3 patients (4.6%) had end-stage kidney disease. There was no significant difference on poor kidney prognosis between the two groups (all P>0.05). Kaplan-Meier survival curve showed that patients with age>39 years old ( χ2=10.092, P=0.001), eGFR≤100 ml·min -1·(1.73 m 2) -1( χ2=5.491, P=0.019), tubular interstitial lesion ( χ2=6.999, P=0.008) and no nephropathy remission ( χ2=22.952, P<0.001) had earlier poor renal prognosis. Multivariate Cox regression analysis showed that no nephropathy remission ( HR=12.604, 95% CI 2.691-59.037, P=0.001) was an independent influencing factor for poor renal prognosis in atypical MN patients. Conclusion:No significant difference is found between atypical MN and primary MN on treatment responses and kidney prognosis, which implies that clinical practice of atypical MN can be performed by referring to the guidelines and experience of primary MN.
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Objective:To preliminarily compile the words list of personality in southern China, and structurally analyse the words with natural personality traits.Methods:A semi-structured questionnaire was used to obtain 603 valid questionnaires in six provinces in southern China, and the lexical collation, consolidation, deletion, lexicographic analysis and structural analysis were conducted.Results:(1)After three rounds of collation and merging of 8 022 natural words describing personality traits, a personality trait word list containing 136 words was obtained.(2)Econometric analysis of words according to positivity, neutrality and negativity, showed that all negative words involving moral evaluations (ruthless, vicious, evil, cunning, narrow-minded and so on) were used to describe others, while negative words describing oneself were mainly non-virtuous words (capricious, stubborn, impatient, impetuous, pessimistic and so on). (3) The proportion of desirability and virtue dimensions in the words list was highest(23.20%, 16.80%); and the proportion of desirability and extroversion in total words frequency was highest(24.39%, 19.96%).Conclusion:A personality word list containing 136 personality traits in southern China is compiled from primary sources; and a 7-factor personality structure was latent in the word list.Subjects are richer in describing the content of the vocabulary of agreeable, virtuous, pioneering, and persevering personality traits, while agreeable and extroverted personality traits are most easily perceived in interpersonal interactions.
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<p><b>OBJECTIVE</b>To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS).</p><p><b>METHODS</b>A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan (AH), Shenmen (TF), Pizhixia (AT), Neifenmi (CO), Xin (CO), Shen (CO), Shenshangxian (TG), 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections.</p><p><b>RESULTS</b>The incidence of angiospasm was 4.9% (11/224) in the observation group, which was lower than 13.3% (34/256) in the control group (<0.01). The incidence of vagal reflex of the observation group was 7.1% (16/224), which was lower than 19.5% (50/256) of the control group (<0.01). The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6% (8/224), 7.1% (16/224), 6.3% (14/224) respectively in the observation group, which were lower than 14.8% (38/256), 15.6% (40/256), 15.2% (39/256) in the control group (all<0.01). .</p><p><b>CONCLUSION</b>Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.</p>
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Objective To investigate the correlation between oxidative stress and pain after laparoscopie myomectomy.Methods 84 patients with uterine myoma who were treated in Changsha Hospital of traditional Chinese Medicine from March 2014 to March 2017 were enrolled in the study.The patients were divided into the control group (n =42) and the observation group (n =42) according to the random number table method.The patients in the control group were treated with conventional laparotomy hysteromyoma expetion,and the patients in the observation group were treated by laparoscopic myomectomy.The levels of oxidative stress indexes [reactive oxygen species (ROS),malondialdehyde (MDA),advanced oxidation protein products (AOPP)] and pain indexes [interleukin-6 (IL-6),substance P (SP),prostaglandin E2 (PGE2) and visual analogue scale (VAS) score] were compared between two groups before operation,1 d after operation and 3 d after operation.Pearson correlation analysis was used to analyze the correlation between oxidative stress and pain.Results The levels of plasma ROS,MDA and AOPP in the two groups 1 d after operation and 3 d after operation were higher than those before operation (all P ＜ 0.05),the levels of plasma ROS,MDA and AOPP in observation group 1d after operation and 3 d after operation were significantly lower than in the control group (all P ＜ 0.05).The levels of serum IL-6,SP,PGE2 and VAS score in the two groups 1 d after operation and 3 d after operation were all higher than those before operation (all P ＜ 0.05),the levels of serum IL-6,SP,PGE2 and VAS score in observation group after 1 d and 3 d after operation were all lower than those in control group (all P ＜ 0.05).The results of Pearson correlation analysis showed that ROS,MDA and AOPP was positively correlated with PGE2 (P ＜ 0.05).Conclusions Laparoscopic myomectomy can effectively reduce the oxidative stress response to postoperative hysteromyoma and relieve postoperative pain,and oxidative stress is positively correlated with PGE2 after operation.
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Objective Four different methods were examined to identify a safer and more reliable method for tail vein punctures in C57BL/6 mice. Methods In total,320 mice were randomly divided into four groups: a blank group, incandescent lamp baking method group,three-line method group,and combined method group. Blood samples were taken from the left or right peripheral vein of puncture mice. Puncture success rate of each group was recorded. SPSS 13.0 software was used to compare statistical difference among groups. Results Compared with the blank group,success rates of the other three methods were significantly higher(P < 0.001). Further, the three-line method was better than the incandescent lamp baking method(P< 0.001). The success rate of the combined method was significantly higher than the three-line and incandescent lamp baking methods(P< 0.001). Conclusions The combined method greatly improved the success rate of tail vein punctures in C57BL/6 mice. This method is more reliable and should be more widely used in the future.
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A female infant presented with skin defects and blisters for 2 hours after birth.Physical examination showed asymmetric skin defects on both lower extremities and left wrist,a thin-walled blister on the dorsal side of the right hand,and partial loss of the oral mucosa.No other abnormal signs were found.Genetic testing showed a heterozygous pathogenic mutation c.481C ＞ T (p.Gln161*) in exon 4 of the COL7A1 (NM-000094) gene and a heterozygous pathogenic mutation c.1837C ＞ T (p.Arg613*) in exon 14 of the COL7A1 (NM-000094) gene,which were also identified in the patient's father and mother respectively.The infant was diagnosed with congenital skin defects.The patient received protective isolation,focal washing with 0.9％ sodium chloride physiological solution,topical epidermal growth factor and comprehensive treatment for infection prevention.After 6-day treatment,the patient was discharged with dry and non-exudative skin lesions.This case prompted that abnormal heterozygosis mutation at C.481 and C.1837 sites on the COL7A1 (NM-000094) gene could form compound heterozygote,acting as pathogenic mutation.
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Objective To investigate the correlation of PICC tip position and weight gaining in very low birth weight infants.Methods We performed a retrospective study using chest X-ray films of very low birth weight infants in NICU who had PICCs inserted in a tertiary hospital.We recorded the tip positions on plain radiographs and calculated the position change,and calculated weight gaining ratio.Spearman regression model was used to analyze the relationship between tip position migration and weight gaining ratio.Results A total of 57 cases of very low birth weight infants were included,containing 246 X-ray films.On the first day of taking X-ray,weight was 0.6-1.46 (1.06±0.25) kg,the median and interquartile spacing are 5(3,7)d.The last time of taking X-ray was(24.0±9.1) dafter PICC placement;weight gaining ratio was 11.8％～114.8％,the median and interquartile spacing are 41.5％ (27.1％,65.3％).All PICCs tip position changed,75％ of which migrated more than 2 vertebrae,50％ of which migrated 3 vertebrae,and the median and interquartile spacing are 3 (1.8,3.5) vertebrae.The distances of tip migration were correlated with weight gaining ratio.With an approximate 2,3 and 4 vertebrae of PICC tip migration,the corresponding weight gaining ratio was about 40％,70％ and 100％.The correlation coefficient between PICC tip position migration and weight gaining ratio was-0.7(P＜0.01),but there was difference in different insertion sites.Conclusion PICC tip position is greatly influenced by weight gaining among very low birth weight infants.By considering the initial placement position,the crucial moment to assess catheter location is at 40％ and 70％ weight gaining ratio.After 100％ weight gaining,PICCs should be removed or replaced.PICCs can easily be affected by bone growth and limb movement,require higher frequency of catheter localization.
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The study aims to investigate the embryo-fetus development toxicity of the novel PPAR-δ agonist HS060098 on SD rats. The pregnant rats that were randomly divided into the solvent control group (1% hydroxypropyl methyl cellulose water solution) and HS060098 suspension groups (10, 30 and 100 mg x kg(-1) xd(-1)) were orally administered with HS060098 suspension or vehicle during the gestation of 6 -15 days (GD6-15). At termination (GD20), female rats were sacrificed. The pregnant females were evaluated by corpora lutea count, implantation sites, existence and death of embryos. Fetal sex, weight, externals, variations and malformations of viscus and skeleton were observed. The results show that there were no significant abnormality in maternal general conditions and fetal appearance as well as viscera, but in the 100 mg x kg(-1) x d(-1) group, the maternal weight gain decreased greatly (P < 0.01) and the skeletal ossification delayed remarkably (P < 0.01); in the 30 mg x kg(-1) xd(-1) group, the fatal and litter number of incompletely ossified sternebrae II was higher than those of the control group (P < 0.05); the skeletal malformations occurred in all dose groups, which indicate that the novel PPAR-δ agonist HS060098 had maternal toxicity and adversely effected fetal skeletal development under the experimental conditions.
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This article introduces the experience of CHEN Ying-yi, chief physician and one of the teacher of the fourth group of inheriting academic experience of veteran TCM experts of China, in treating perimenopausal women’s dysfunctional uterine bleeding. Chen holds that the basic pathogenesis of perimenopausal dysfunctional uterine bleeding is kidney deficiency with fever or stagnation. Treatment should focus on replenishing kidney and using the traditional Chinese drug by stages. The methods of stopping bleeding, clearing origin and reinstating the status quo are used flexibly. In clinic, it should grasp the key points of syndrome differentiation, and modify the therapy in accordance with the symptoms. Validated by clinical application, Chen’s experience has satisfactory curative effect and reference values for the treatment of perimenopausal women’s dysfunctional uterine bleeding.
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This article presents the experience ofPhysician-in-charge CHEN Ying-yi in treating maternal-fetal ABO incompatibility from four aspects:cause and pathogenesis ofthe disease, treatment thought, special prescription for the disease alone, and treatment experience.Mrs.CHEN Ying-yi considers the damp, heat and stasis pathogen as key factors ofthe disease, and the deficiency ofthe spleen and the kidney as the fundamental reasons.The principle oftreatment is eliminating pathogenic factors and supporting healthy energy, and treating the disease and preventing abortion.Her empirical prescription of‘lianhuang tang(decoction oflotus receptacle and prepared rhubarb )', modified in accordance with the symptoms, has obtained very good curative effect for the treatment ofthis disease.
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The polar sports tester made in Finland as one of the most widespread instruments in physical training is of importance for sports training. In this paper, we have developed a set of system for analysis of physical training workload using the measured data of the Polar Sports Tester, and have established a set of analysis indices and reports of the physical training workload, including five categories and 127 quantitative indices. It can reflect the distribution of physical workload and provide a series of parameters for coaches to direct scientific training and raise sport level.
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Humans , Adaptation, Physiological , Physiology , Gymnastics , Models, Biological , Physical Endurance , Physiology , Software , Sports , PhysiologyABSTRACT
Using computer technique, artificial neural network and fuzzy control theory, we have explored a real-time control method for the athlete's physical workload intensity in order that the goal of physical training can be reached effectively in accordance to the exercise plan. The technique could be useful for improving the efficiency of scientific physical training.