Trends in the biological functions and medical applications of extracellular vesicles and analogues

Natural extracellular vesicles (EVs) play important roles in many life processes such as in the intermolecular transfer of substances and genetic information exchanges. Investigating the origins and working mechanisms of natural EVs may provide an understanding of life activities, especially regarding the occurrence and development of diseases. Additionally, due to their vesicular structure, EVs (in small molecules, nucleic acids, proteins, etc.) could act as efficient drug-delivery carriers. Herein, we describe the sources and biological functions of various EVs, summarize the roles of EVs in disease diagnosis and treatment, and review the application of EVs as drug-delivery carriers. We also assess the challenges and perspectives of EVs in biomedical applications.

Correlation analysis of high risk human papillomavirus genotypes and cervical lesions in some areas of Beijing / 中国综合临床

Objective:To investigate the infection status and the infection rate of age stratification of human papillomavirus (HPV) subtypes in women at some areas of Beijing, who were diagnosed with no intraepithelial lesions and canceration, low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL), based on the diagnosis of women′s thinprep cytologic test(TCT).Methods:From January 2019 to December 2019, the cervical exfoliated cells of women who presented in Department of Gynaecology and Obstetrics of Beijing Anzhen Hospital Affiliated to Capital Medical University were collected, and the high-risk HPV typing nucleic acid test kit (fluorescence quantitative PCR) was used for genotyping.The results were retrospectively analyzed.Meanwhile, the patients who were tested by TCT at the same time were screened.According to the TCT pathological diagnosis, these patients were divided into three groups: no intraepithelial lesions and canceration (hereinafter referred to as the control group), low-grade squamous intraepithelial lesions (TCT-LSIL) and high-grade squamous intraepithelial lesions (TCT-HSIL). The chi square test was used for the statistical analysis.Results:In control group (561 cases), 68 cases were infected by at least one subtype of HPV, with a total positive rate of 12.12%.In TCT-LSIL group (385 cases), 288 cases were infected by at least one subtype of HPV, with a total positive rate of 74.81%.In TCT-HSIL group (170 cases), 128 cases were infected by at least one subtype of HPV, with a total positive rate of 75.29%.The highest positive rate was type 52 in the control group, while the highest positive rate was type 16 in the TCT-LSIL and TCT-HSIL groups.The infection rate of the three groups increased with the increase of cervical pathological grade.The infection rates of type 16, 18, 31, 33, 39, 45, 51, 52, 56, 58 and 68 were significantly different among the three groups (all P<0.05). The infection rate of HPV16 in the TCT-HSIL group was significantly higher than that in the control group and the TCT-LSIL group(P′<0.017). After all the subjects were stratified by age, only type 16 had statistical difference in infection rate among different age groups (all P<0.05). After age stratification of three groups, within the age<31 years old, the infection rates of 16, 18, 31, 33, 39, 45, 51, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age range of ≥31-<41 years old, the infection rates of 16, 18, 39, 51, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age range of ≥41-<51 years old, the infection rates of 16, 18, 35, 52, 56 and 58 types were statistically different among the three groups (all P<0.05). In the age≥51 years old, the infection rates of 16, 18, 31, 33, 51, 52 and 58 types were statistically different among the three groups (all P<0.05). After the age stratification of TCT-LSIL group, the infection rates of 16 and 45 types were statistically different among in the four groups of<31, ≥31-<41, ≥41-<51 and ≥51 years old (all P<0.05). However, there was no significant difference in the infection rate of each subtype in the control group and the TCT-HSIL group(all P>0.05). Conclusion:HPV subtypes 16, 18, 51, 52, and 58 are the main infection types in high grade squamous intraepithelial lesion patients, which are the main types of HPV caused cervical lesions.In addition, the infection rates of HPV in patients with cervical high-grade squamous intraepithelial lesionsare similar in different age groups.

Comparison of laparoscopic-assisted anorectoplasty and posterior sagittal anorectoplasty for high and intermediate anorectal malformations / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the efficacy of laparoscopic-assisted anorectoplasty (LAARP) and posterior sagittal anorectoplasty (PSARP) for high and intermediate anorectal malformation (ARM).</p><p><b>METHODS</b>Clinical data 60 children with high and intermediate ARM who underwent LAARP (40 cases of three-port laparoscopy, 20 cases of transumbilical single incision laparoscopy ) between January 2010 to December 2014 were retrospectively analyzed. Clinical data of 36 children with high and intermediate ARM who underwent PSARP between January 1992 to December 2002 were used as control. The duration of operation, blood loss, hospital stay, postoperative complications and long-term anal function were compared between two groups. Krickenbeck classification was applied to assess the anorectal function.</p><p><b>RESULTS</b>Baseline data, such as gender, age at operation, sacral index and proctatresia site, were not significantly different between two groups. As compared to PSARP group, LAARP group presented shorter operative time [(113±13) min vs. (132±10) min, P=0.01], less operative blood loss [(11.5±1.6) ml vs. (14.3±1.7) ml, P=0.03], shorter postoperative hospital stay [(6.9±0.7) d vs. (8.2±0.8) d, P=0.02] and lower morbidity of postoperative complication [11.7% (7/60) vs. 27.8% (10/36), P=0.02]. Postoperative defecation evaluation showed that LAPPR group had lower percentage of 2-3 grade constipation than PSARP group [0% vs. 22.2%(8/36), P=0.00]. While percentage of 2-3 grade voluntary bowel movement [5.9% (3/51) vs. 16.7% (6/36), P=0.20] and percentage of 2-3 grade soiling [5.9%(3/51) vs. 16.7%(6/36), P=0.20] were not significantly different between two groups.</p><p><b>CONCLUSIONS</b>LAARP is safe and effective in the treatment of high and intermediate ARM. Compared with PSARP, LAARP has some advantages, such as better cosmetic results and faster recovery.</p>

Association between abnormalities of the distal rectal pouch and postoperative bowel function in high or intermediate anal atresia / 中华普通外科杂志

Objective To evaluate wall histological abnormalities 2 to 3 cm to the end in high or intermediate anal atresia in order to identify features that explain postoperative bowel dysfunctions.Methods Sixty anal atresia patients treated in the Capital Pediatric Institution between January 2008 and December 2012 were recruited in our study.36 patients were resected the terminal anal segment (3 cm).Compared with those 24 cases who were not.Resected samples were fixed for HE and immuno-histochemical stainings.Clinical data including sacral ratio (SR),age at operation,gender,bowel function were evaluated.Results There was no significant difference in patients' SR value,gender and age at operation between resected group and control group.The median follow-up period was 4.5 years.The rates of voluntary bowel movement,soiling (grade 1,2,3) were similar in both groups,however,the rates of severe constipation in resection group was significantly lower that in control group (3 ％ vs.21％,P ＜ 0.05) In the bowel wall of distal 2 cm anrectal canal,the connective tissue was found to be irregular and abnormally represented.Muscle coat was abnormal in all cases,showing the dysplasia circular and longitudinal layers.The number of enteric nervous system was significant fewer in distal 2cm anrectal canal than that in distal 3 cm(1.6 ±0.9 vs.5.6 ±1.8,t=11.715,P＜0.01).Conclusions Resection of terminal 3 cm at least of the atresia anal canal benefits postoperative bowel defecation function.

Efficacy evaluation of laparoscopic surgery for children with persistent cloaca / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and efficacy of laparoscopic surgery in the treatment of children with persistent cloaca.</p><p><b>METHODS</b>Clinical data of 26 female children with high type persistent cloaca undergoing operation in the Capital Pediatric Institution between November 2005 and February 2015 were retrospectively analyzed. Mean age of these children was (1.4±1.6) years old. Distal end of rectum locating in the superior border of pubis was the standard of diagnosis. Laparoscopy-assisted anorectoplasty (LAARP), vaginoplasty and urethroplasty were performed in 17 cases (LAARP group), including 3-port laparoscopy in 12 cases and single-port laparoscopy in 5 cases. Abdominoperineal pull through (APPT), vaginoplasty and urethroplasty were performed in the other 9 cases (APPT group). Sacral ratio (SR), length of common channel, intraoperative blood loss, operation time, postoperative hospital stay, postoperative complications and bowel function were compared between two groups. Postoperative defecation was evaluated by the Krickenbeck standard.</p><p><b>RESULTS</b>Operations were successfully performed in all patients and no case in LAARP group was transferred to open abdominal operation. There were no significant differences in SR value, length of common channel and age at operation between the two groups. As compared to APPT group, the mean operative time was shorter [(124.1±4.9) minutes vs. (131.8±3.2) minutes, P=0.000], the intraoperative blood loss was less [(10.5±2.1) ml vs. (16.2±2.7) ml, P=0.000], and the postoperative hospital stay was shorter [(5.7±0.5) days vs. (9.2±0.4) days, P=0.000] in LAARP group. In LAARP group, there were no significant differences in operation time, intraoperative blood loss and postoperative hospital stay between 3-port and single-port laparoscopic surgery (all P>0.05). The mean follow-up period was (4.0±2.8) months in LAARP group and (6.0±2.3) months of APPT group. There is one case have wound infection in ARRT patients. The rates of voluntary bowel movement, soiling, constipation (grade 1, 2, 3) were similar in both groups, however, the overall bowel function after LAARP was better than that of ARRT according to the Krickenbeck classification (10.7±0.2 vs. 9.7±1.2, P=0.047). Postoperative rectal mucosa prolapse was found in 2 cases of LAARP group and 1 case in APPT group. One case of APPT group developed wound infection. No urethrovaginal fistula relapse, anal stenosis or urethral stricture was found in all the cases.</p><p><b>CONCLUSIONS</b>The LAARP is safe and feasible in the treatment of persistent cloaca.</p>

Application of laparoscopy in the diagnosis and treatment of neonates and infants with congenital intestinal atresia and stenosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and efficacy of laparoscopic procedure in the diagnosis and treatment of congenital intestinal atresia and stenosis in neonates and infants.</p><p><b>METHODS</b>Between September 2009 and September 2013, 55 cases with intestinal atresia and stenosis underwent laparoscope-assisted procedures in our department. There were, 32 males and 23 females, Twelve cases were diagnosed as duodenal atresia and stenosis and 43 as intestinal atresia and stenosis. The age at hospitalization was 7 minutes to 7 months(mean 9.88 d). After the diagnosis by multiport or transumbilical single-site laparoscopic exploration, cases with duodenal atresia and stenosis and part of the cases with proximal jejunum were treated by laparoscopic operations to remove the septum and restore intestinal continuity. In other cases with intestinal atresia and stenosis, laparoscopic inspection was performed to make diagnosis and then the proximal and distal ends of the atresia were exteriorized through the umbilical port site for end-to-oblique anastomosis.</p><p><b>RESULTS</b>All the 55 cases underwent this minimally invasive approach, and no case was converted to open surgery. The operative time of laparoscopic procedure for duodenal atresia and stenosis (n=12) ranged from 80 to 145 min(mean, 110 min). During the follow-up of 3-34 months, one case had recurrent postoperative vomiting induced by giant duodenal expansion above anastomotic stoma and died the second day after operation. The operative time of laparoscopic surgery for intestinal atresia and stenosis (n=43) ranged from 35 to 70 min (mean 46 min). During the follow-up of 3-36 months, 3 cases complicated with meconium peritonitis had postoperative short bowel syndrome and died. One case died of intestinal perforation at 3 month postoperatively. One case died of intestinal adhesion at 7 month postoperatively. The rest of cases had favorable outcomes.</p><p><b>CONCLUSION</b>Laparoscopic surgery for the diagnosis and treatment of intestinal atresia and stenosis has advantages of small incision, less trauma, and rapid recovery.</p>

Prenatal diagnosis and perinatal management of 30 cases of meconium peritonitis / 中华围产医学杂志

Objective To investigate the efficacy of standardized protocol,including prenatal diagnosis,perinatal management and treatment,on babies with meconium peritonitis.Methods A standardized protocol with prenatal diagnosis,perinatal management,treatment and follow-up on congenital anomaly was founded by Capital Institute of Pediatrics and several other obstetric hospitals.Thirty neonates diagnosed as meconium peritonitis prenatally from March 15,2006 to August 27,2012 were intervened according to this protoccl.The data of diagnosis,treatment after birth and prognosis were analyzed.Results (1) Prenatal diagnosis:Abnormal meconium peritonitis relative signs were found by ultrasound in all of these 30 cases.Among them,23 cases presented with intestine dilation,15 with polyhydromnios,nine with ascites,four with abdominal cystic mass and four calcification.(2)Diagnosis after birth (n=27):The most common imaging findings in abdominal X-ray were distention (27 cases),dilated intestine with air-fluid levels (22 cases) and calcification (11 cases).The most common imaging findings in ultrasound were obvious intestinal dilation (19 cases),cystic mass (7 cases) and calcification (7 cases).(3) Operation:Except for three cases without symptoms,the other 27 infants received operation at averagely 42 hours after birth (12 h-5 d).Besides the basic treatment as removal of the fuci and dissection of adhesion,peritoneal drainage was performed in one infant,two-stoma enterostomy in seven infants,inverted T-shape enterostomy in eight infants and primary intestinal anastomosis in 11 infants.Among these 27 cases,24 cases were cured,2 cases refused following treatment after surgery and one case was lost to follow up.Conclusions Standardized protocol with prenatal diagnosis,perinatal management and earlier intervention might improve the prognosis of meconium peritonitis.

Laparoscope diagnosis and treatment for annular pancreas in neonates: report of 9 cases / 中华胰腺病杂志

Objective To summarize our preliminary experience and evaluate the clinical value of laparoscope diagnosis and treatment for annular pancreas in neonates.Methods A retrospective review of laparoscope diagnosis and treatment for annular pancreas in 9 children from September 2009 to January 2013 was performed.Among them,5 were male,4 were female.The age was ranging from 1 to 13 d.A lowerpressure pneumoperitoneum of 5 ～ 8 mm Hg (1 mm Hg =0.133 kPa) was used.Eight cases of diamond duodenal anastomosis were performed under laparoscope after the diagnosis was established,and 1 case underwent procedure through slightly enlarged umbilical port site.Results Eight cases of diamond duodenal anastomosis were performed under laparoscope,and the operation time was 80 ～ 140 min (mean 105 min),in 1 case it was performed through umbilical port incision,the operation time was 64 min,and the length of incision was about 2.5 cm.Feedings were started at postoperative day 4 to 7 (mean 5 d),and patients were discharged at postoperative day 8 to 14 (mean 10 d).The cases were followed-up for 3 ～ 20 months (mean 6.7 months),and I case complicated with anal atresia died of pneumonia 6 months later.Other cases were uneventfully recovered and symptoms were alleviated with normal gastroenterological function,no preoperative symptoms recurred,and the nutrition and growth status was excellent.Conclusions Annular pancreas can be diagnosed through laparoscopy.Laparoscope diagnosis and treatment for annular pancreas has the advantages of small incision,micro-invasion and faster recovery,can be safely performed in neonatal period.

Loss of β-catenin inhibits Stat-5α phosphorylation in bcr-abl induced leukemia cells / 白血病·淋巴瘤

Objective To investigate the influence of β-catenin gene deletion on Stat-5α phosphorylation in bcr-abl induced leukemia cells. Methods The established conditonal hematopoitic β-catenin knockout mice were used to isolate bone marrow cells. Exogenous bcr-abl fusion gene was transduced to these bone marrow cells by retroviral infection with intent to transfom them to leukemia cells.Immunofluorescence was performed to detect the phosphorylation status of Stat-5α in both β-catenin deletion cells and control cells. bcr-abl transcription and protein levels were evaluated with real-time PCR and western blotting. Results Phosphorylation of Stat-5α was reduced significantly in β-catenin deletion leukemia cells on comparison with control cells despite that total Stat-5α protein showed no obvious changes. Total tyrosine phosphorylation and bcr-abl protein expression were reduced in bcr-abl induced β-catenin deletion CML cells,on the contrary, both of the reduction were not seen in bcr-abl induced β-catenin deletion ALL cells.Conclusion Loss of β-catenin inhibits both Stat-5α phosphorylationin and bcr-abl expression in bcr-abl induced leukemia cells.

Clinical value of capture of cancer cells in pleural fluid of patients with lung cancer by cytochip / 中国肺癌杂志

<p><b>BACKGROUND</b>Immunocytochemistry is valuabale in differentiating malignant fluids from benign ones. However, the diagnostic value of a single tumor marker is limited. The aim of this study is to evaluate the clinical value of capture of cancer cells in pleural fluids of patients with lung cancer by cytochip.</p><p><b>METHODS</b>A new pattern cytochip was developed to immunize hybridization of cells in pleural fluids of patients with 42 lung cancers and with 20 lung benign lesions. Ten antibodies were fixed on the cytochip, they were epithelial specific antigen (ESA), CD44V6, ND-1, T cell (CD3), CD45RO, B cell (CD20), CD79a, Hodgkin's cell (CD15), CD30 and macrophage (CD68).</p><p><b>RESULTS</b>The point of positive hybridization showed round distribution with clear border, and the shape of cell displayed well. The positive numbers of ESA, CD44V6, ND-1 were 35, 30, 38 respectively in pleural fluids of 42 patients with luog cancers; lymphocytes and neutrophils were found on the 1 ESA and 1 ND-1 respectively, and only lymphocytes were found on the 3 CD44V6 in 20 ones with lung benign lesions; the other 7 antibodies did not capture cancer cells except for lymphocytes, neutrophils and macrophages from two pleural fluids.</p><p><b>CONCLUSIONS</b>The cytochip could be an important practical foreground in clinic for diagnosing cancer cells in pleural fluids of patients with lung cancer.</p>

Observation of Curative Effects of Compound Glycyrrhizin Combining Desloratadine in the Treatment of Chronic Urticaria / 中国药房

OBJECTIVE:To observe the clinical efficacy of compound glycyrrhizin combining desloratadine in the treat?ment of chronic urticaria.METHODS:103patients with chronic urticaria were randomly divided into treatment group which were treated with compound glycyrrhizin plus desloratadine and controlled group which were treated with single desloratadine.The courses of treatment for both groups were2weeks.RESULTS:The total effective rates of the treatment group and the controlled group were96.15%and82.35%,respectively.There were significant differences between the2groups(P

Laparoscopically assisted anorectoplasty for intermediate imperforate anus: A report of 11 cases / 中国微创外科杂志

Objective To explore the feasibility of laparoscopically assisted one-stage anorectoplasty for the treatment of intermediate imperforate anus. Methods Under laparoscopic visualization, the rectum was mobilized. Then the rectourethral (or rectovaginal) fistula was repaired laparoscopically (6 cases) or through perineal approach (4 cases). Afterwards a tunnel was made through the center of pelvic floor musculature by combined use of laparoscopic and perineal approach. The rectum was pull-through the perineum and anastomosed with skin. At Last the colostomy was closed. Results Laparoscopically assisted anorectal pull-through was successfully performed in all cases. The mean duration of laparoscopic dissection was 32.8 minutes (range, 25~78 minutes). The mean blood loss was 5.3 ml (range, 2~10 ml). No blood transfusion was needed. The intraurethral catheter or cystostomy tube was removed on the 11th postoperative day. No intraoperative complication was encountered and all infants had uneventful postoperative recovery without wound infection. During a follow-up for 3~66 months (mean, 45 months), the fecal continence evaluation showed excellent in 8 cases and good in 3 cases. Conclusions Laparoscopically assisted anorectoplasty is an effective and minimally invasive technique for the treatment of intermediate imperforate anus. This technique has advantages of simple performance, accurate identification of the center of the pelvic floor musculature, and low infection rate.

The correlation between basic fibroblast growth factor and extracellular matrix in dental pulp during root development of permanent teeth / 实用口腔医学杂志

Objective: To detect the expression of basic fibroblast growth factor(bFGF), type Ⅲ collagen(Ⅲ-col)and fibronectin(FN) in human dental pulp at different root development stages of permanent teeth. Methods: 10 teeth at stage Ri～R 1/4 ,15 at R 1/3 ～R 3/ 4 and 12 at Rc～Ac were sectioned for following examination.bFGF, Ⅲ-col and F N were qualitatively and quantitatively analyzed by the use of immunohistologica l SP method and image analysis technique. Results: The ex pression of bFGF became gradually weaker and weaker with the development of too th root (P

EXPRESSION AND LOCALIZATION OF THROMBOMODULIN IN HUMAN FETAL LUNG / 解剖学报

Objective\ To detect thrombomodulin protein in 18 weeks human fetal lung. Methods\ SP method was used in the study. Results\ It showed that, in fetal lung tissues, thrombomodulin expressed in the endothelial cells of capillaries surrounding the primary alveoli, but it was absent in cuboid cells and ciliated\|columnary epithelium cells and cartilage. Conclusion\ Our results suggest that thrombomodulin does not exist in middle and late stage's human fetal lung.\;