Priming of the Cells: Hypoxic Preconditioning for Stem Cell Therapy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>Stem cell-based therapies are promising in regenerative medicine for protecting and repairing damaged brain tissues after injury or in the context of chronic diseases. Hypoxia can induce physiological and pathological responses. A hypoxic insult might act as a double-edged sword, it induces cell death and brain damage, but on the other hand, sublethal hypoxia can trigger an adaptation response called hypoxic preconditioning or hypoxic tolerance that is of immense importance for the survival of cells and tissues.</p><p><b>DATA SOURCES</b>This review was based on articles published in PubMed databases up to August 16, 2017, with the following keywords: "stem cells," "hypoxic preconditioning," "ischemic preconditioning," and "cell transplantation."</p><p><b>STUDY SELECTION</b>Original articles and critical reviews on the topics were selected.</p><p><b>RESULTS</b>Hypoxic preconditioning has been investigated as a primary endogenous protective mechanism and possible treatment against ischemic injuries. Many cellular and molecular mechanisms underlying the protective effects of hypoxic preconditioning have been identified.</p><p><b>CONCLUSIONS</b>In cell transplantation therapy, hypoxic pretreatment of stem cells and neural progenitors markedly increases the survival and regenerative capabilities of these cells in the host environment, leading to enhanced therapeutic effects in various disease models. Regenerative treatments can mobilize endogenous stem cells for neurogenesis and angiogenesis in the adult brain. Furthermore, transplantation of stem cells/neural progenitors achieves therapeutic benefits via cell replacement and/or increased trophic support. Combinatorial approaches of cell-based therapy with additional strategies such as neuroprotective protocols, anti-inflammatory treatment, and rehabilitation therapy can significantly improve therapeutic benefits. In this review, we will discuss the recent progress regarding cell types and applications in regenerative medicine as well as future applications.</p>

Coronary artery calcification across ethnic groups in Singapore

<p><b>INTRODUCTION</b>In Singapore, the age-standardised event rates of myocardial infarction (MI) are 2- and 3-fold higher for Malays and Indians respectively compared to the Chinese. The objectives of this study were to determine the prevalence and quantity of coronary artery calcification (CAC) and non-calcified plaques across these 3 ethnic groups.</p><p><b>MATERIALS AND METHODS</b>This was a retrospective descriptive study. We identified 1041 patients (810 Chinese, 139 Malays, 92 Indians) without previous history of cardiovascular disease who underwent cardiac computed tomography for atypical chest pain evaluation. A cardiologist, who was blinded to the patients' clinical demographics, reviewed all scans. We retrospectively analysed all their case records.</p><p><b>RESULTS</b>Overall, Malays were most likely to be active smokers (P = 0.02), Indians had the highest prevalence of diabetes mellitus (P = 0.01) and Chinese had the highest mean age (P <0.0001). The overall prevalence of patients with non-calcified plaques as the only manifestation of sub-clinical coronary artery disease was 2.1%. There was no significant difference in the prevalence of CAC, mean CAC score or prevalence of non-calcified plaques among the 3 ethnic groups. Active smoking, age and hypertension were independent predictors of CAC. Non-calcified plaques were positively associated with male gender, age, dyslipidaemia and diabetes mellitus.</p><p><b>CONCLUSION</b>The higher MI rates in Malays and Indians in Singapore cannot be explained by any difference in CAC or non-calcified plaque. More research with prospective follow-up of larger patient populations is necessary to establish if ethnic-specific calibration of CAC measures is needed to adjust for differences among ethnic groups.</p>

New Endoscopic Hemostasis Methods

Endoscopic treatment for non-variceal upper gastrointestinal bleeding has evolved over decades. Injection with diluted epinephrine is considered as a less than adequate treatment, and the current standard therapy should include second modality if epinephrine injection is used initially. Definitive hemostasis rate following mono-therapy with either thermo-coagulation or hemo-clipping compares favorably with dual therapies. The use of adsorptive powder (Hemo-spray) is a promising treatment although it needs comparative studies between hemospray and other modalities. Stronger hemo-clips with better torque control and wider span are now available. Over-the-scope clips capture a large amount of tissue and may prove useful in refractory bleeding. Experimental treatments include an endoscopic stitch device to over-sew the bleeding lesion and targeted therapy to the sub-serosal bleeding artery as guided by echo-endoscopy. Angiographic embolization of bleeding artery should be considered in chronic ulcers that fail endoscopic treatment especially in elderly patients with a major bleed manifested in hypotension.

Le traitement des gangrènes périnéales et de la sphère genitale par le miel

Les gangrenes du perinee et des parties molles se rencontrent sous les tropiques avec une frequence non negligeable. Leur prise en charge therapeutique se heurte souvent au cout des produits pharmaceutiques utilises. Depuis deux ans ces lesions sont traitees avec du miel en raison de ses proprietes antibiotiques et cicatrisantes(3;7)

L'antibioprophylaxie a l'Augmentin en chirurgie digestive au CHU de Lome : a propos de 125 observations

L'utilisation d'antibiotiques en chirurgie pour la prevention des infections des plaies post-operatoires chez les malades exposes a ce risque est maintenant de pratique courante. La pertinence d'un tel traitement a ete cependant le sujet de nombreuses controverses. L'une des difficultes majeures qu'il convient de surmonter en vue d'effectuer une comparaison solide entre les agents anti-infectieux est la variabilite liee a la diversite des malades traites. L'ideal serait d'assurer la comparabilite des deux groupes mais ceci est difficile en raison de la diversite des infections et de leur gravite entre les malades. Cet essai; limite a la chirurgie abdominale chez des patients dont le profil clinique a ete soigneusement enregistre avant l'intervention devait permettre de tirer des conclusions valides. Le but principal de cette etude est donc de mettre en evidence l'efficacite de l'Augmentin dans le traitement et la prevention de l'etat septique abdominal post-operatoire; et de la comparer a celle d'une antibiotherapie standard