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Chronic graft-versus-host disease (cGVHD) is the main complication after allogeneic hematopoietic stem cell transplantation, which is also the major cause of non-relapse -related death. Due to its complex pathophysiological process, the response rate of conventional glucocorticoids combined with immunosuppressants is less than 50%. Second-line therapy should be given for patients with glucocorticoid-resistant cGVHD. Nevertheless, no consensus has been reached on current second-line therapy and the therapeutic effect is relatively poor. Mesenchymal stem cell (MSC) is one of the most common adult stem cells. Due to multi-dimensional and multi-target immune regulating function, MSC has been widely applied in the prevention and treatment of cGVHD. In addition, accumulated studies have confirmed the safety and efficacy of MSC in the treatment of cGVHD, which is expected to become a novel strategy for the prevention and management of cGVHD. In this article, research progress, mechanism and existing problems of prevention and treatment of cGVHD by MSC were reviewed, aiming to provide novel ideas for optimizing therapeutic regimens of MSC and enhancing the prevention and treatment effect of cGVHD in subsequent research.
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This study aims to explore the impact of Rehmannioside D (RD) on ovarian functions of rats with diminished ovarian reserve (DOR) and its underlying mechanisms of action. A single injection of cyclophosphamide was performed to establish a DOR rat model, and fourteen days after the injection, the rats were intragastrically administrated with RD for two weeks. Rat estrus cycles were tested using vaginal smears. Ovarian tissues were histologically evaluated, the number of primordial, mature, and atretic follicles was calculated, and the apoptotic rate of granulosa cells. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2 ) levels were determined by ELISA assays. Protein levels of Forkhead Box O1 (FOXO1), KLOTHO, Bcl-2, and Bax were investigated in ovarian tissues of DOR rats. The binding between FOXO1 and KLOTHO was verified by ChIP assay. High-dose administration of RD into DOR rats improved their estrus cycles, increased ovarian index, enhanced the number of primordial and mature follicles, reduced the number of atretic follicle number, and ovarian granulosa cell apoptosis in addition to inhibiting FSH and LH levels and upregulating E2 expression. FOXO1 and KLOTHO were significantly suppressed in DOR rats. FOXO1 knockdown partially suppressed the protective effects of RD on DOR rats, and KLOTHO overexpression could restore RD-induced blockade of DOR development despite knocking down FOXO1. FOXO1 antibody enriched KLOTHO promoter, and the binding between them was reduced in DOR group compared to that in sham group. RD improved ovarian functions in DOR rats and diminished granulosa cell apoptosis via the FOXO1/KLOTHO axis.
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@#Objective To study the feasibility and safety of CT-guided preoperative Hookwire localization of pulmonary nodules in clinical application. Methods Clinical data of 102 patients who were scheduled to undergo surgical treatment for pulmonary nodules from June 2015 to April 2020 in the North Ward of Thoracic Surgery Department of Ruijin Hospital were retrospectively analyzed. There were 38 males and 64 females, aged 23-82 (53.2±12.8) years. Results All 102 patients with pulmonary nodules underwent CT-guided preoperative Hookwire localization successfully, with a localization success rate of 100.0%. The localization time was 27.0 (11-67) min; the number of times to adjust the angle during the positioning process was 6.9 (3-14); the needle depth of the positioning needle was 41.5 (16.3-69.1) mm. A total of 48 (47.1%) patients had a small amount of bleeding in the lung tissue in the positioning area after positioning; 53 (51.9%) patients had a small amount of pneumothorax after positioning; 16 (15.7%) patients were found that the positioning needle completely shedded from the lung tissue in the subsequent surgery. One patient was transferred to open thoracotomy because of extensive dense adhesion in the thorax, and the remaining 101 patients were operated on under thoracoscopy. Postoperative pathology showed that 5 (4.9%) patients were adenocarcinoma in situ, 28 (27.5%) were microinvasive adenocarcinoma, 36 (35.3%) patients were invasive carcinoma and 32 (31.3%) patients were benign lesions. No patients had complications or adverse events related to preoperative positioning. Conclusion Pre-operative CT-guided localization of Hookwire intrapulmonary nodules is safe and effective, and can meet the intraoperative localization needs of thoracic surgeons in most clinical situations, and is not inferior to other preoperative localization methods currently used in clinics.
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OBJ ECTIVE To study the effect a nd mechanism of modified Yijing decoction on the decrease of ovarian reserve function（DOR）in rats. METHODS A total of 140 SPF female SD rats were randomly divided into control group ，model group ， positive control group （Estradiol valerate tablets 0.09 mg/kg），inhibitor group [modified Yijing decoction 23.6 g/kg+transcriptional inhibitor for hypoxia inducible factor- 1α（HIF-1α）YC-1 2 mg/kg] and modified Yijing decoction low-dose ，medium-dose and high-dose groups （5.9，11.8，23.6 g/kg）. Except for control group ，rats in other groups were given cyclophosphamide via femoral vein to induce DOR model ；after successful modeling for 2 h，rats in each group were given normal saline or relevant medicine intragastrically，once a day ，for 8 consecutive weeks.The estrous cycle of rats in each group was recorded ，and the ovarian index was calculated to observe the histopathological changes and autophagy in the ovary ；serum levels of follicle stimulating hormone （FSH），luteinizing hormone （LH），anti-Müllerian hormone （AMH）and estrogen （E2）were measured ；protein and mRNA levels of HIF-1α，B lymphoblastoma 2 gene/adenovirus E 1B interacting protein 3 recombinant protein （Bnip3）and yeast Atg 6 homolog of autophagy key molecule （Beclin1）in ovarian tissues of rats were all detected. RESULTS Compared with control group ，the ovarian indexes of model group and administration groups were decreased significantly （P＜0.05）. Model group possessed disturbed estrous cycle and the ovary tissues showed pathological morphology ，the autophagolysosomes appeared in ovary cells ，AMH and E 2 levels were significantly decreased （P＜0.05）；FSH and LH levels ，protein and mRNA expressions of HIF- 1α，Bnip3 and Beclin 1 were significantly increased （P＜0.05）. Compared with model group ，the estrous cycle of rats in positive control group and modified Yijing decoction groups gradually returned to normal ，the pat hological morphology of ovarian tissue and the autophagy of ovarian cells were improved ；the ovarian index ，AMH and E 2 levels were significantly increased （P＜0.05）；the levels of FSH and LH ，protein and mRNA expressions of HIF- 1 α ， Bnip3 and Beclin 1（except for protein of HIF- 1α，protein and wanyunhui188@163.com mRNA of Bnip 3 in modified Yijing decoction low-dose group ） were decreased significantly （P＜0.05）. The protein expressions of H IF-1α，Bnip3 and Beclin 1，mRNA expressions of HIF- 1α and Beclin 1 were decreased significantly in the inhibitor group （P＜0.05）. CONCLUSIONS Modified Yijing decoction can improve ovarian function ，regulate the secretion of sex hormone ，and protect ovarian tissue in DOR model rats ，and the mechanism of which may be related to the inhibition of HIF- 1α/ Bnip3/Beclin1 pathway.
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Objective:To investigate the clinical effects and influence factors of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs in the treatment of idiopathic choroidal neovascularization (ICNV).Methods:This retrospective study involved 27 patients (27 eyes) with ICNV from July 2012 to July 2015. Patients received intravitreal bevacizumab (1.25 mg), ranibizumab (0.05 mg), additional injection was provided if it was needed. The average follow-up time was 168 weeks. The recovery of best corrected visual acuity (BCVA) and central foveal retinal thickness (CRT) of the affected eye was observed. Follow up once a month after the initial treatment until the lesion was completely absorbed or scarred (the first follow-up period). Follow up every 12 weeks was performed to observe the recurrence of the lesions (the second stage of long-term follow-up). One month after the last injection of the first follow-up period, according to the regression of choroidal neovascularization (CNV), the affected eyes were divided into a significant improvement group (significant improvement group) and an insignificant improvement group (non-significant improvement group)), to analyze the effects of age, course of disease, type of drugs, number of injections, baseline BCVA and CRT on the regression of CNV lesions. According to the results of long-term follow-up, the eyes were divided into recurrence group and non-recurrence group, and the factors affecting the recurrence of CNV lesions were analyzed. Measurement data between groups was compared by using independent sample t test or non-parametric test; count data was compared by using χ2 test. Logistic regression analysis was used to analyze the factors affecting the regression and recurrence of the lesion. Results:At baseline and 1 month after the last injection in the first stage, the average BCVA of the eyes were 55.70±15.21 and 73.59±12.08 letters; CRT was 338.3±89.32 and 264.5±47.47 μm, respectively. The BCVA and CRT of the affected eyes were compared at the two time points, and the differences were statistically significant ( Z= -3.886, -4.061; P<0.001). The BCVA of the eyes in the significant improvement group and the insignificant improvement group were 65.38±17.27 and 51.63±12.61 letters, respectively; the difference between the two groups of BCVA was statistically significant ( t=-2.316, P=0.029). The results of long-term follow-up showed that of the 27 eyes, 6 eyes had recurrence; the average recurrence time was 90.83±49.02 weeks. After another intravitreal injection of anti-VEGF drugs, the CNV lesions was resolved. The average injection times of the relapsed group and the non-relapsed group were 3.67±0.816 and 2.24±0.768, respectively. The average injection times of the relapsed group was significantly higher than that of the non-relapsed group, and the difference was statistically significant ( Z=-3.253, P<0.001). There was no statistically significant difference between the two groups of eyes at baseline and CRT at the last follow-up ( Z=-1.342,-1.313; P=0.195, 0.195). Conclusion:Intravitreal injection of anti-VEGF drugs can effectively increase the regression rate of BCVA and CNV lesions in ICNV eyes; high baseline visual acuity indicates better CNV lesion regression after treatment. Relapsed patients can be effectively improved after re-treatment with anti-VEGF drugs, and CNV recurrence has no significant effect on the final prognosis.
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The development of Hainan traditional Chinese medicated diet therapy was surveyed and analyzed. The related suggestions are supplied for the development of traditional Chinese medicated diet therapy in Hainan. The designed questionnaires are set up for the surveys that include the respondents’ awareness of the medicated diet therapy and the current status of the medicated diet therapy markets. A total of 450 questionnaires have been sent and 363 respondents (80.67%) were reveiced and analyzed. The result showed that 49.59% (180/363) of the respondents knew the TCM diet therapy well, 43.80% (159/363) favored TCM diet. More than half of the respondents keep in the beauty maintain, the weight-loss and qi and blood maintain by TCM diet. The respondents showed their own favour when they consumed TCM diet. 44.63% (162/363) of the respondents regarded the effectiveness of the TCM diet as important, and 31.40% (114/363) regarded the flavour or taste of the diet as important. The highest consumption of TCM diet that can be accepted was 160 yuan per person. The reputation of a medicinal restaurant is the most important factor for consumers. To cultivate the professionals for the medicated diet’s services and management is an urgent undertaking. To utilize the specific medicines and foods of Hainan for developing the TCM diet is a positive motives. It is necessary to adopt international standards to strengthen the government’s control over the entirely industrial chain of the TCM diet therapy. It will be prosperous to utilize the characteristic culture to establish the medicinal restaurants in Hainan. They will become the new engines for improving economic, social and cultural development of Hainan free trade.
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Objective:To observe the effect of functional electrical stimulation (FES) combined with an ankle-foot orthosis (AFO) and gait training on lower limb motor function, gait parameters and the joint angles of hemiplegic stroke survivors.Methods:Thirty-two stroke survivors who met the inclusion criteria were selected and randomly divided into a control group ( n=10), an orthosis group ( n=10), and a combination therapy group ( n=12). In addition to routine medication and rehabilitation, the control group received only gait training, the orthosis group received gait training and an AFO and the combination therapy group was given FES, an AFO and gait training. All three groups were treated for four weeks. Then, the Fugl-Meyer lower extremity assessment (FMA-LE), the Brunnstrom lower extremity assessment (BRL), and Functional Ambulation Categories (FACs) were used to evaluate the lower limb motor function and walking ability of the three groups. The gait parameters of the three groups were quantified using a three-dimensional gait analyzer, and the changes in the hemiplegic gait before and after treatment were compared among the three groups. Results:After the treatment the average FMA-LE, FAC and BRL scores, time-space parameters, and joint angle parameters of all three groups had all improved significantly. After the intervention the average indicators in the combined therapy group (including stride frequency, stride length and walking speed) were all significantly better than in the other two groups.Conclusions:Adding FES to gait training with an AFO can effectively improve lower limb motor function and the walking ability of hemiplegic stroke survivors.
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Objective@#To explore the application value of combined detection of serum macrophage inhibitory cytokine-1(MIC-1), carcinoembryonic antigen(CEA)and carbohydrate antigens in the diagnosis and prognosis of elderly patients with colorectal cancer.172 elderly patients with colorectal cancer were selected retrospectively as the observation group, 175 elderly patients with benign colorectal lesions were enrolled as the benign lesion group and 166 healthy elderly subjects as the control group.@*Methods@#The levels of MIC-1, CEA, carbohydrate antigens of 199(CA199), 724(CA724), 242(CA242), 125(CA125), and 50(CA50)were compared among the three groups, and the diagnostic efficacy was calculated.The difference in the above-mentioned indicators between patients with different stages and prognosis in the observation group were compared.@*Results@#Levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 were higher in the observation group than in the benign lesion group and the control group, and the above indexes were higher in the benign lesion group than in the control group.The sensitivity, positive predictive value and negative predictive value of MIC-1 were the highest in single index test(68.6%, 72.8% and 84.6%, respectively). The specificity of CA199 was the highest(91.2%). The combined detections greatly improved sensitivity, positive predictive value and negative predictive value(89.0%, 79.3% and 94.1%, respectively). In the observation group, levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in the elderly colorectal cancer patients were higher in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ.The levels of MIC-1, CEA, CA199, CA242, CA724, CA125 and CA50 in elderly patients with recurrence and metastasis of colorectal cancer were higher than those in patients without recurrence and metastasis.@*Conclusions@#Combined detection of multiple indicators can improve the sensitivity of diagnosis, and is more conducive to the early diagnosis of elderly patients with colorectal cancer.
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Objective To explore the application value of combined detection of serum macrophage inhibitory cytokine-1 (MIC-1),carcinoembryonic antigen (CEA) and carbohydrate antigens in the diagnosis and prognosis of elderly patients with colorectal cancer.172 elderly patients with colorectal cancer were selected retrospectively as the observation group,175 elderly patients with benign colorectal lesions were enrolled as the benign lesion group and 166 healthy elderly subjects as the control group.Methods The levels of MIC-1,CEA,carbohydrate antigens of 199(CA199),724 (CA724),242 (CA242),125 (CA125),and 50 (CA50) were compared among the three groups,and the diagnostic efficacy was calculated.The difference in the above-mentioned indicators between patients with different stages and prognosis in the observation group were compared.Results Levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 were higher in the observation group than in the benign lesion group and the control group,and the above indexes were higher in the benign lesion group than in the control group.The sensitivity,positive predictive value and negative predictive value of MIC-1 were the highest in single index test (68.6 ％,72.8％ and 84.6 ％,respectively).The specificity of CA199 was the highest(91.2 ％).The combined detections greatly improved sensitivity,positive predictive value and negative predictive value(89.0％,79.3％ and 94.1 ％,respectively).In the observation group,levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 in the elderly colorectal cancer patients were higher in stage Ⅲ and Ⅳ than in stage Ⅰ and Ⅱ.The levels of MIC-1,CEA,CA199,CA242,CA724,CA125 and CA50 in elderly patients with recurrence and metastasis of colorectal cancer were higher than those in patients without recurrence and metastasis.Conclusions Combined detection of multiple indicators can improve the sensitivity of diagnosis,and is more conducive to the early diagnosis of elderly patients with colorectal cancer.
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Objective:To study the stability of safflower yellow for injection respectively mixed with fructose injection,invert sugar injection,invert sugar electrolyte injection,glucose and sodium chloride injection,5% glucose injection,10% glucose injection and 0.9% sodium chloride injection. Methods:The physical appearance,number of particles and pH value were observed at room temper-ature after mixing safflower yellow respectively with above injections for 8 hours at the same concentration as that in clinical use. The content of safflower yellow was determined by high performance liquid chromatography (HPLC). Results: There was no significant difference in appearance,pH or safflower yellow content after the mixing,and the number of insolubility particles met the requirement in Chinese Pharmacopeia (2015 edition).Conclusion:Safflower yellow for injection is stable after dissolved in the 7 varieties of infu-sions in 8h.
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Objective To evaluate effects of steep meridian clear corneal incisions on corneal anterior surface and total astigmatism in phacoemulsification surgery . Methods Clinical data of 56 cases of phacoemulsification surgery with steep meridian clear corneal incisions from August to December 2015 were analyzed in this retrospective study .Corneal anterior surface and total astigmatism were measured with the Pentacam 3D anterior segment measurement and analysis system at the time before surgery and 1 month and 3 months after surgery .The polar coordinate analysis was used to evaluate effects of steep meridian incisions on corneal astigmatism . Results All the operations were accomplished successfully with smooth recovery .The corneal anterior surface and total astigmatism reduced significantly after 1 month and 3 months in astigmatic polar value AKP ( +0) (P0.05).No significant differences were detected between both corneal anterior surface and total astigmatism in AKP(+0) or AKP(+45) between 1 month and 3 months after surgery. Conclusion Steep meridian incision performed on the preoperative steeper meridian of keratometric astigmatism may reduce corneal total astigmatism .
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Objective To study the immune system regulatory effects of CD8+CD28-regulatory T lymphocytes in an experimental bone marrow mesenchymal stem cell treatment of autoimmune encephalomyelitis.Methods A model of autoimmune encephalomyelitis (EAE) was established in twenty-eight C57BL/6 female mice,6 to 8 weeks old weighing 16 to 20 g using myelinoligodendrocyte glycoprotein 35-55 amino acid peptide (MOG35-55).The mice were randomly divided into a phosphate-buffered solution (PBS) group (n =7),an MSCs-Low group [n =7 which received an injection of 2× 105 mesenchymal stem cells (MSCs)],an MSCs-Med group (n=7,1× 106 MSCs),and an MSCs-High group (n=7,5×106 MSCs).Their clinical condition was then evaluated daily.On the 15th day after the MOG35-55 immunization,the different MSC doses were administered intravenously via the tail.On the 30th day the mice were sacrificed to observe any neuropathology of the spinal cord.At the same time,FACS flow cytometry was used to assay CD8+CD28-T cells in the spleen.Results Compared with the PBS control group,the MSC treatment effectively alleviated illness among the mice by the 15th day after the immunization.The maximum and average disease scores and clinical illness scores had all improved significantly.The medium dosage worked best.Neuropathological analysis showed that the MSC treatment could significantly reduce the invasion of inflammatory cells and minimize demyelination in the spinal cord.Furthermore,the CD8+ CD28-regulatory T cells in the spleens of the MSCtreated animals increased compared with the PBS control group,though the secreted levels of IL-10 showed no obvious difference.Conclusions Treatment with MCSs can promote the recovery of neural function in autoimmune encephalomyelitis,at least in mice.CD8+CD28-regulatory T cells may not be the main effector cells,playing only a synergistic therapeutic role.
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BACKGROUND:A large number of studies have shown that bone marrow mesenchymal stem cels (BMSCs) with differentiation ability can be used to treat kidney injury. Epimedium has good anti-inflammatory and immune restoration ability. OBJECTIVE:To observe the effect of epimedium with BMSC transplantation on rat’s kidney disease caused by adriamycin nephrosis. METHODS:Fifty rats were equivalently randomized to receive no treatment in control group, tail vein injection of normal saline plus intragastric injection of normal saline in model group, tail vein injection of BMSCs plus intragastric injection of epimedium decoction in combined group, tail vein injection of BMSCs in BMSCs group, and intragastric injection of epimedium decoction in epimedium group. Rat models of adriamycin nephrosis were made in the latter four groups through tail vein injection of doxorubicin hydrochloride, while rats in the control group were only given the same volume of normal saline. Twenty-four hours after modeling, rats in the latter four groups began to be given the corresponding treatments. Epimedium decoction was given in the combined and epimedium groups at a dose of 1 mL/d, for consecutive 1 week. RESULTS AND CONCLUSION:Compared with the model group, mitigated kidney injury and reduced urinary protein level were found in rats undergoing BMSCs and/or epimedium decoction treatment; the levels of plasma albumin and catalase were significantly increased in the combined group and epimedium group, while the levels of serum cholesterol, triglycerides and malondialdehyde decreased; the mRNA expression of transforming growth factor β1 in the kidney tissues was dramaticaly declined in the combined group and BMSC group. To conclude, the combined use of epimedium and BMSCs is superior to their use alone in the treatment of kidney disease.
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Objective:To analyze and evaluate the quality control of Radix Aucklandiae in Xianglian preparation and develop a new quality control method for the preparation through standard testing and exploration study on 127 batches of samples .Methods:Ac-cording to the mandatory method , Radix Aucklandiae was identified by TLC .In the exploratory research , the volatile compounds in Xianglian preparation was analyzed by SPME/GC-MS, and the GC-MS fingerprints of volatile compounds in Xianglian preparation with different dosage forms were established .The contents of costunolide and dehydrocostuslactone in Xianglian preparation were determined by UPLC.Results:According to the current quality standard , all the batches of samples met the standard with the qualified rate of 100%.The composition of volatile compounds in different dosage forms was similar , while the relative contents were quite different . The contents of costunolide and dehydrocostuslactone in Xianglian preparation were different .Conclusion: The exploratory research provides reference for the further revision of drug standard and monitoring quality of the preparation .
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Objective To evaluate the expression of endothelial Per-ARNT-Sim domain protein-1(EPAS-1)/hypoxia-inducible factor-2?(HIF-2?) and its relationship with vascular endothelial growth factor (VEGF) in bladder transitional cell carcinoma (BTCC). Methods The expression of EPAS-1/HIF-2? and VEGF by immunohistochemical staining was examined in 60 cases of BTCC (Grade Ⅰ in 28 cases,Grade Ⅱ in 12,Grade Ⅲ in 20) and 8 subjects with normal urothelium. Of the 60 cases 29 had superficial (≤pT 1) bladder cancer and 31 had invasive (≥pT 2 bladder cancer).?2 test was used to assess the relationship between EPAS-1/HIF-2? and VEGF expression versus tumor grade and stage. Results The expressions of EPAS-1/HIF-2? and VEGF were negative in all normal bladder tissue but high in BTCC.Of the 60 cases,34 (56.6%) were positive and 26 ( 43.4%) were negative for EPAS1/HIF-2?.Four cases (14.3%) of Grade Ⅰ,11 (91.7%) of Grade Ⅱ and 19 (95.0%) of Grade Ⅲ were positive for EPAS-1/HIF-2?. Positive staining was seen in 5 (17.2%) of the superficial and 29 (93.5%) of the invasive cancer cases.EPAS-1/HIF-2? positivity was correlated with high histological grade (r=0.862,P