Establishment and validation of a model for brain injury state evaluation and prognosis prediction.

PURPOSE: Traumatic brain injury (TBI) is one of the leading causes of disability and death in modern times, whose evaluation and prognosis prediction have been one of the most critical issues in TBI management. However, the existed models for the abovementioned purposes were defective to varying degrees. This study aims to establish an ideal brain injury state clinical prediction model (BISCPM). METHODS: This study was a retrospective design. The six-month outcomes of patients were selected as the end point event. BISCPM was established by using the split-sample technology, and externally validated via different tests of comparison between the observed and predicted six-month mortality in validating group. TBI patients admitted from July 2006 to June 2012 were recruited and randomly divided into establishing model group and validating model group. Twenty-one scoring indicators were included in BISCPM and divided into three parts, A, B, and C. Part A included movement, pupillary reflex and diameter, CT parameters, and secondary brain insult factors, etc. Part B was age and part C was medical history of the patients. The total score of part A, B and C was final score of BISCPM. RESULTS: Altogether 1156 TBI patients were included with 578 cases in each group. The score of BISCPM from validating group ranged from 2.75 to 31.94, averaging 13.64 ± 5.59. There was not statistical difference between observed and predicted mortality for validating group. The discrimination validation showed that the BISCPM is superior to international mission for prognosis and analysis of clinical trials (IMPACT) lab model. CONCLUSION: BISCPM is an effective model for state evaluation and prognosis prediction of TBI patients. The use of BISCPM could be of great significance for decision-making in management of TBI.

[Differentiation of ectomesenchymal stem cells into dendritic cells in vitro induced by cytokines].

AIM: To induce the differentiation of ectomesenchymal stem cells (EMSCs) into dentritic cells (DCs) in vitro. METHODS: The EMSCs were cultured for 17 days continuously in RPMI1640 medium containing 100 ng/mL rat recombinant GM-CSF and 200 U/mL rat recombinant IL-3. On the 19th day, they were induced by rat recombinant TNF-α. The characteristics of the induced EMSCs were observed in aspects of morphology, ultrastructure, surface marker, mixed lymphocyte reaction and secretion of IL-12. The bone marrow-derived mesenchymal stem cells (BMSCs) of Sprague Dawley rat were used as controls. RESULTS: The induced EMSCs exhibited slender pseudopodia, burr and partial adherent growth. Scanning electron microscopy showed that the cells displayed processes and pseudopodia. The expressions of surface markers of induced EMSCs were similar to those of BMSCs-induced DCs. The mixed lymphocyte reaction assay revealed that the EMSCs stimulated the proliferation of lymphocytes. The induced EMSCs displayed the ability of IL-12 secretion. CONCLUSION: EMSCs can be differentiated into DCs by induction in vitro.