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Objective To investigate the effects of exosomes derived from human dental pulp mes-enchymal stem cells ( hDPSC-exosomes) on the maturation and function of dendritic cells ( DC) stimulated by lipopolysaccharide ( LPS ) , and to evaluate their regulatory effects on the immune system. Methods Adult permanent teeth-derived dental pulp mesenchymal stem cells were cultured in vitro to extract exosomes in the cell culture medium. The morphology and sizes of the exosomes were observed under transmission electron microscopy. Expression of CD9 and CD63 on the surface of the exosomes was detected by Western blot. PBS, LPS and LPS+hDPSC-exosomes were respectively used to stimulate mouse bone marrow-derived dendritic cells (DC2. 4) for 24 h. A blank control group was set up accordingly. Expression of co-stimulato-ry molecules and cytokine secretion were detected by flow cytometry and ELISA, respectively. Expression of TLR2, TLR4 and NF-κB at mRNA level was detected by RT-PCR. Changes in the functions of DC were evaluated by mixed lymphocyte reaction ( MLR) . Results Adult permanent teeth-derived dental pulp mes-enchymal stem cells were successfully isolated. Up-regulated CD73 and CD90, and down-regulated CD45 were detected on the surface of the cells. Under electron microscopy ( SEM ) , hDPSC-exosomes showed round or oval microcapsule bodies about 50-80 nm in diameter with positive surface markers of CD9 and CD63. hDPSCs-exosomes could significantly reduce the LPS-induced expression of co-stimulatory molecules CD11c and CD86 on DC surface. Moreover, hDPSCs-exosomes increased TGF-β expression and decreased IL-4. They could also significantly inhibit the proliferation of splenic lymphocytes that was induced by DC af-ter LPS stimulation. Compared with the blank control group, hDPSC-exosomes could promote the expression of TLR2 and TLR4 on DC surface and up-regulate the expression of NF-κB. Conclusions This study showed that hDPSC-exosomes could inhibit the activation and functional maturation of DC, promote the de-velopment towards tolerant DC through TLR-NF-κB signaling pathway, and induce immune tolerance to regu-late immune balance.
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Objective To investigate the mechanism and prevention of syncope on patients with hypertrophic cardiomyopathy (HCM). Methods Seventy-six cases of HOCM (obstruction group) were successfully operated by PTSMA and oral ACEI/ARB. After six months , they were treated with β-receptor blocker. Another 29 patients (control group) with LVOTPG < 50 mmHg or < 70 mmHg after pharmacologic stress test (PST), have being treated with β-receptor blocker. The results was observed as follow: (1) the difference of between syncope incidence and positive incidence induced by PST in control group; (2) the difference of syncope incidence at half year, a year and admission in control group; (3) the difference of syncope incidence in obstruction group before and after operation; (4) the difference of syncope incidence after six months between two groups at same period; (5) the difference of syncope incidence one year between two groups. Results In control group, the syncope positive incidence induced PST was 55.5%. Treating with medications for half a year , syncope incidence significantly dropped than that on admission (P < 0.05); Obstruction group syncope incidence in the history obviously lower than the control group syncope positive induced PST (P < 0.05), and half a year after takingβ-receptor blocker syncope incidence was significantly dropped than before (P < 0.01). Conclusions The mechanism of syncope with HOCM is not only obstruction but also neuronal reflex. PST is an very useful inspection item for screening the ablation indication, analysis syncope mechanism, and guiding clinical medication.β-receptor blocker is an effective drug on treating and preventing syncope with HCM.
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Objective To explore the method and efficiency of percutaneous transluminal septal tunnet myocardial ablation(PTSTMA) in treatment of 26 cases hypertrophic obstructive cardiomyopathy (HOCM) who were not suitable for conventional technology.Methods Firstly,we used a monorail Balloon which was slightly bigger than the interventricular septal branch of coronary artery and dilated it until posterior septal.After that,an OTW Balloon with larger size than the monorail was used to dilate again until made aventricular septum tunnel.Then,some alcohol was injected and PTSTMA was performed.Finally,we did the other and/or another interventricular septal branch by above method until the left ventricular outflow tract pressure gradient (LVOTPG) reduced ≥50％.The clinical indexes of the 26 cases HOCM immediately pest-operation of PTSTMA were observed and the follow up data during short term and metaphase were analyzed.Results The LVOTPG reduced ≥50％ in the26 cases HOCM,immediately after PTSTMA,the LVOTPG reduced from (75.6 ±22.4)mm Hg to (21.4 ± 5.8) mm Hg (t =11.94,P ＜ 0.01).At three months after ablation,the thickness of septal myocardium reduced from (22.8 ± 5.8) ram before ablation to (16.8 ± 4.2) mm(t =4.27,P ＜ 0.01),left atrium dimension reduced from(48.0 ±7.0) mm to (42.0 ±8.6) mm (t =2.76,P ＜0.01).Followed up 6.0to 60.0 months,the patients suffering from chest pain reduced from 14 cases before to 4 cases after the procedure(53.8％ (14/26) vs 15.4％ (4/26),x2 =8.49,P ＜ 0.01),the patients with expiratory dyspnea reduced from 26 cases to 5 cases(100％ (26/26) vs 19.2％ (5/26),x2 =35.22,P ＜ 0.01),NYHA functional class improved from (2.4 ± 0.6) to (1.4 ± 0.7) (t =5.53,P ＜ 0.01).Conclusion The PTSTMA was a supplemental method of PTSMA on treating HOCM,which was safe and useful during the short term and metaphase.