Mesenchymal stem cells in experimental autoimmune encephalomyelitis model of multiple sclerosis: A systematic review and meta-analysis.

BACKGROUND/AIMS: Mesenchymal stem cells (MSCs) transplantation has been considered a possible therapeutic method for Multiple Sclerosis (MS). However, no quantitative data synthesis of MSCs therapy for MS exists. We conducted a systematic review and meta-analysis to evaluate the effects of MSCs in experimental autoimmune encephalomyelitis (EAE) animal model of MS. METHODS: We identified eligible studies published from January 1980 to January 2017 by searching four electronic databases (PubMed, MEDLINE, Embase and Web of Science). The outcome was the effects of MSCs on clinical performance evaluated by the EAE clinical score. RESULTS: 36 preclinical studies including 675 animals in MSCs treatment group, and 693 animals in control group were included in this meta-analysis. We found that MSCs transplantation significantly ameliorated the symptoms and delayed the disease progression (SMD = -1.25, 95% CI: -1.45 to -1.05, P < 0.001). However, no significant differences in effect sizes were unveiled relative to clinical score standard (P = 0.35), type of MSCs (P = 0.35), source of MSCs (P = 0.06), MSCs dose (P = 0.44), delivery methods (P = 0.31) and follow up period (P = 0.73). CONCLUSIONS: The current study showed that MSCs transplantation could ameliorate clinical performance in EAE animal model of MS. These findings support the further studies translate MSCs to treat MS in humans.

Transformation of a Geriatric Department in China.

China has the world's largest elderly population, and the oldest-old population, with a current disability rate greater than 50%, will triple in the next 35 years. The field of geriatrics is young, because almost all geriatric departments were established after 2000, and so faces many challenges. Management of diseases and hospital care is the focus. Senior physicians were trained in other subspecialties, such as pulmonary or cardiology, and junior physicians entered geriatrics departments as masters or doctorate students after medical school. The inadequacy of post-acute and long-term care facilities has caused long hospital stays. There are no national systematic geriatric training programs, national board examinations, or qualifications in geriatrics. These challenges were used as a framework for guiding changes in the Department of Geriatrics at West China Hospital, Sichuan University. These changes have included international experiences and collaboration for physicians and nurses, revision of departmental conferences, and special training for a unique group of caregivers called hugong (untrained caregivers hired by families to be at the bedside of hospitalized individuals). The most significant yet challenging part of the transformation has been to develop and modify Western-based geriatric models of care (e.g., Acute Care of the Elderly unit, delirium prevention and management models, palliative care). Lastly, the department established Tianxia (in the sky) Doctors, an internet-based platform to connect the department's interdisciplinary team to other hospitals, nursing institutions, home-based care service stations, community health service centers, and pharmacies throughout the region.

Association of frailty syndrome with serum inflammatory biomarkers and geriatric parameters / 中华老年医学杂志

Objective To investigate the association of frailty with serum inflammatory biomarkers and geriatric parameters.Methods A total of 299 elderly people aged 60 and over were recruited,received frailty and comprehensive geriatric assessment,and were tested on serum levels of interleukin-10 (IL-10),interleukin-1β (IL-1β),monocyte chemoattractant protein-1 (MCP-1),monocyte chemoattractant protein-3 (MCP-3),macrophage inflammatory protein 1a (MIP-1α),macrophage inflammatory protein-1β (MIP-1β),tumor necrosis factor α (TNF-α),nuclear factor-κB (NF-κB) and sirtuin-1 (SIRT-1).Potential association of frailty with these biomarkers and several geriatric parameters was analyzed.Results Statistical differences in serum levels of MCP-1,MIP-1α and MIP-1β were detected between the frailty group and the non-frailty group (H=10.766,10.766 and 8.217,respectively;P =0.005,0.043 and 0.016,respectively).Logistic regression analyses showed that MCP-1 and MIP-1β were associated with frailty after adjustment for age,sex,body mass index (BMI),smoking,drinking,comorbidity and comprehensive geriatric assessment (OR=2.493,2.531,both F＜0.05).Conclusions MCP-1 and MIP-1β are risk factors for frailty.

Current research progress on mouse model of frailty / 中华老年医学杂志

Frailty is a common state or syndrome with a decline in physiological reserves and an increase in an individual's vulnerability for stress in the elderly.Frailty can increase the risk of disability,falls,hospitalization,delirium and mortality.However,the intervention of frailty is under the scarcity and its effectiveness is not satisfied.We need to find new targets to treat frailty according to the pathophysiology of frailty.Human physiology is very similar to that of mouse,thus,mouse can be an ideal animal model of human disease.Mouse models can provide insight into pathogenesis of frailty by reducing the influence of genetic and environment factors and provide more basic data for further studies of frailty.At present,the research on a mouse model of frailty is still in its infancy and still needs further study.This review will summarize the related studies and propose some new ideas for future studies on mouse model of frailty.

Evidence-based Prognosis for Patients with Postpartum HEELP Syndrome complicated with Acute Renal Failure / 沈阳医学院学报

Objective:To provide clinical evidence-based prognosis for patients with postpartum HEELP syndrome complicated with acute renal failure. Methods:The clinical question was proposed. Some database was searched to assess the evidence. Results:A total of 4 studies were included,however,the quality of the studies was low. The results of the studies was suitable for our patients. The death of patients with postpartum HEELP syndrome complicated with acute renal failure was attributed to multiple organ failure. The risk factors for poor prognosis was primipara, delivery after twin pregnancy, absence of typical symptoms, rapid clinical progression, high blood pressure, epigastric pain. Early assessment and diagnosis for maternal and infant, positive in intervention and be caution for the DIC and multiple organ failure, using plasmapheresis can improve the prognosis. Conclusion:Patients with postpartum HEELP syndrome complicated with acute renal failure have an acute process and poor prognosis, especially for patients without typical symptoms.