A qualitative study on inner experience of self-management behavior among elderly patients with type 2 diabetes in rural areas.

BACKGROUND: As a chronic metabolic disease, diabetes poses a serious threat to human health and has become a major public health problem in China and worldwide. In 2020, 30% of Chinese people (aged ≥ 60 years) reported having diabetes mellitus. Moreover, individuals with diabetes living in rural areas face a significantly higher mortality risk compared to those in urban areas. In this study, we explored the inner experience of self-management behaviors in elderly patients with type 2 diabetes in rural areas to inform targeted interventions. METHODS: A phenomenological research design was used to explore the inner experience of self-management in rural elderly diabetes. Ten elderly diabetic patients were sampled from December 2022 to March 2023 in rural areas of Yangcheng County, Jincheng City, ShanXi Province, China. The seven-step Colaizzi phenomenological was used to analyze the interview data and generate themes. RESULTS: Four themes emerged: "Insufficient self-management cognition", "Negative self-management attitude", "Slack self-management behavior", and "No time for self-management". CONCLUSION: The level of self-management among elderly patients with type 2 diabetes in rural areas is low. Healthcare professionals should develop targeted interventions aimed at enhancing their cognitive levels, modifying their coping styles, and improving their self-management abilities to improve their quality of life.

A behavioural driving model of adherence to home-based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed-methods study.

AIMS AND OBJECTIVES: To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence. BACKGROUND: Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored. DESIGN: An exploratory sequential mixed-methods study was conducted in this study. METHODS: A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1). RESULTS: Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence. CONCLUSIONS: This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence. RELEVANCE TO CLINICAL PRACTICE: To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear. PATIENT OR PUBLIC CONTRIBUTION: None.

Predictors of home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure: a theory-driven cross-sectional study.

BACKGROUND: The factors influencing home-based cardiac rehabilitation exercise adherence among patients with chronic heart failure remain unclear. This study aimed to explore predictors of home-based cardiac rehabilitation exercise adherence in these patients, based on the theory of planned behavior. METHODS: This theory-driven, cross-sectional study used convenience sampling to recruit patients with chronic heart failure undergoing home-based cardiac rehabilitation. Instruments used included the Home-Based Cardiac Rehabilitation Exercise Adherence Scale, the Multidimensional Self-Efficacy for Exercise Scale, the Perceived Social Support Scale, and the Tampa Scale for Kinesiophobia Heart. Multivariate linear hierarchical regression analysis was employed to examine the factors influencing exercise adherence. RESULTS: A total of 215 patients with chronic heart failure undergoing home-based cardiac rehabilitation participated in the study. The overall score for home cardiac rehabilitation exercise adherence was (48.73 ± 3.92). Multivariate linear hierarchical regression analysis revealed that age (ß=-0.087, p = 0.012), education level (ß = 0.080, p = 0.020), fear of movement (ß=-0.254, p < 0.001), perceived social support (ß = 0.451, p < 0.001), and exercise self-efficacy (ß = 0.289, p < 0.001) influenced home-based cardiac rehabilitation exercise adherence. In the second model, fear of exercise explained 23.60% of the total variance, while perceived social support and exercise self-efficacy explained 26.60% of the total variance in the third model. CONCLUSION: This study found that home-based cardiac rehabilitation exercise adherence in patients with chronic heart failure was suboptimal, and identified its influencing factors. Targeted interventions addressing these factors, such as tailored education, support, and addressing fear of exercise, may help improve exercise adherence.

Factors associated with patient delay for older adults with benign prostatic hyperplasia: A descriptive qualitative study.

Based on the theory of planned behavior, the aim of this study was to describe the influencing factors of patient delay intentions and behaviors in benign prostatic hyperplasia (BPH) patients and to provide a reference for the development of a patient delay intention scale. This study was carried out over 4 months in 2021 in Daqing, Heilongjiang, China. The participants were 20 patients with BPH who were aged 60 to 82 years and experienced patient delay; participants were selected through a purposive sampling method. The data were collected via face-to-face semistructured interviews. Five main themes emerged from the interviews, including an insufficient understanding of symptoms, experiences of coping instead of seeking health care, negative attitudes toward care-seeking, the influence of others on decision-making for care-seeking, and obstacles to seeking health care. In conclusion, the patient delay intentions and behaviors of BPH patients are the result of a combination of many factors.

A qualitative study of the cognitive behavioral intention of patients with diabetes in rural China who have experienced delayed diagnosis and treatment.

BACKGROUND: Great changes have taken place in terms of people's lifestyles and behavioral habits. Diabetes has become a threat to human health and is the most important noncommunicable disease. More than 60% of rural diabetic patients experience delayed diagnosis and treatment. In this study, we explore the inner experience of the delayed diagnosis and treatment of patients with diabetes in rural areas and provide a reference for targeted intervention. METHODS: A qualitative research design was used to examine the cognitive behavioral intention of patients in rural areas with delayed diagnosis and treatment of diabetes. Thirteen diabetes patients with delayed diagnosis and treatment were sampled with maximum variation in rural Daqing City and Tangshan City in China. The data analysis involved several levels of analysis consistent with qualitative research. RESULTS: The following themes were relevant to diabetes patients in rural areas with delayed diagnosis and treatment delay: "Lacked knowledge of diabetes", "Negative coping style", "Dissatisfaction with the existing medical service" and "Influence of social support". CONCLUSIONS: The respondents' delayed diagnosis and treatment represent a common phenomenon. Medical personnel should provide interventions for patients and encourage them to go to the hospital on time.

[The risk factors of chronic obstructive pulmonary disease in Heilongjiang province].

OBJECTIVE: To study the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) in Heilongjiang province. METHODS: This was a population-based and cross-sectional survey on prevalence of COPD in Heilongjiang province from September 2013 to March 2014. The stratified-cluster-random sampling method was performed to collect the data from 4 478 people in 5 cities (Jixi, Daqing, Suihua, Yichun and Jiagedaqi). The subjects were interviewed with questionnaires and tested with spirometry. A post-bronchodilator FEV1/FVC<70% was defined as diagnostic of COPD. RESULTS: Completed and qualified data were obtained from 4 059 participants. The average prevalence of COPD was 7.3% (urban 6.0%; rural 8.8%; men 8.6%; women 6.5%). When using SPSS18.0 for the single factors logistic regression analysis, results indicated that sex (OR = 0.700, 95%CI:0.540-0.907), age ≥ 50 (OR = 1.236, 95%CI:0.758-2.017), lower education level (OR = 1.551, 95%CI:0.929-2.590), biomass for cooking (compared with electricity, OR = 2.744, 95%CI:1.429-5.271), biomass (compared with centralized heat supply, OR = 1.229, 95%CI:0.120-12.546)and coal (compared with centralized heat supply, OR = 4.661, 95%CI:0.474-45.840) for heating, respiratory diseases (OR = 3.594, 95%CI:2.738-4.716), combined with cardiovascular disease (OR = 1.370, 95%CI:1.058-1.776) were the risk factors of COPD in Heilongjiang province. CONCLUSION: Higher risk for COPD was related with sex, age, education level, cooking fuel, heating methods, respiratory diseases and combined with cardiovascular disease.

How health seeking behavior develops in patients with type 2 diabetes: a qualitative study based on health belief model in China.

Background: Type 2 diabetes(T2DM) is a global health problem which is accompanied with multi-systemic complications, and associated with long-term health burden and economic burden. Effective health seeking behavior (HSB) refers to reasonably utilize health resources, effectively prevent and treat diseases, and maintain health. Effective health seeking behavior (HSB) is vital to mitigate the risk of T2DM complications. However, health seeking behavior for T2DM patients remains sub-optimal worldwide. Objective: The study aimed to explore the internal logic of how health seeking behavior of T2DM patients develops and the influencing factors of health seeking behavior. With a view to provide a reference basis for improving the health seeking behavior situation of T2DM patients. Methods: This study was conducted at an integrated tertiary hospital in China. People who were diagnosed with T2DM, capable of expressing clearly and had no mental illness, were approached based on a purposive sampling. The experience of T2DM and health seeking behavior were collected via in-depth interviews. A theory-driven thematic analysis based on Health Belief Model (HBM) was applied for data analysis. Inductive reasoning was used to identify emerging themes which were not included in HBM. Results: 26 patients with T2DM were included in the current study. Seven themes were identified, including: (1) T2DM diagnosis and severity; (2) T2DM treatment and management; (3) Perceived susceptibility of diabetes progression; (4) Perceived severity of diabetes progression; (5) Perceived benefits of health seeking behavior; (6) Perceived barriers of health seeking behavior; (7) Perception of behavioral cues. Generally, patients with T2DM lacked reliable sources of information, considered T2DM to be slow-progressing and without posing an immediate threat to life. Consequently, they did not fully grasp the long-term risks associated with T2DM or the protective effects of health seeking behavior. Conclusion: This study highlighted the challenges in health seeking behavior for patients with T2DM. It suggested that future interventions and strategies should involve multi-faceted approaches, targeting healthcare providers (HCPs), patients with T2DM, and their support networks. This comprehensive strategy can help patients better understand their condition and the importance of effective health seeking behavior. Ultimately, enhancing their capacity for adopting appropriate health-seeking practices.

Fire effects on soil carbon cycling pools in forest ecosystems: A global meta-analysis.

Changes in soil carbon (C) pools driven by fire in forest ecosystems remain equivocal, especially at a global scale. In this study we analyzed data from 232 studies consisting of 1702 observations to investigate whether ecosystem type, climate zone, stand age, soil depth, slope, elevation, and the time since fire in influence of forest soil carbon pools to fire regime (fire type, fire season, fire intensity). Additionally, we explored the potential mechanisms of the relationships between multiple response variables to the fire using linear regression and random forest models. On aggregate, fires significantly increased the mean effect sizes of several key soil carbon cycling components-including microbial biomass carbon (MBC), dissolved organic carbon (DOC), total carbon (TC), pyrogenic carbon (PyC), soil organic matter (SOM), soil organic carbon (SOC) by 0.77, 0.89, 0.87, 1.22, 0.97 and 0.93, respectively, compared to unburned forests ecosystems. However, the fire effects on soil C pools vary widely between environmental factors and duration, and are mediated by factors such as tree species, fire type, and soil layer. A correlation analysis displayed the effects of fire on MBC and DOC were significantly and negatively correlated with elevation. Fire effects on the forest floor and mineral soil indicated significantly increased PyC. SOC and TC in coniferous tree species are the most sensitive to fires, thereby altering important feedback relationships with the fire-vegetatale-climate system. Interestingly, latitude has a stronger influence on SOC than mean annual precipitation or elevation, indicating that variations in latitude play a significant role in regulating the amount of SOC in forest ecosystems. Overall, the results illustrated geographic variation in fire effects on soil C cycling underscores the need for region-specific fire management plans, and help us understand the responses of soil C cycling to fire in forest ecosystems, and facilitate decision-making to forest fire management.

Understanding the taxonomic homogenization of road-influenced plant assemblages in the Qionglai mountain range: A functional and phylogenetic perspective.

As an increasingly prevalent form of human activity, roads drive the taxonomic homogenization of mountain plant assemblages, threatening global biodiversity. However, little is known about how mountain roads impact functional and phylogenetic beta diversity and how these effects are related to taxonomic homogenization. To understand the mechanism of taxonomic homogenization triggered by mountain roads, we used species absence/presence data from 76 plots (2 m*50 m) and values for 12 traits measured on 978 species from the interior and roadside communities in the Qionglai mountain range, one of the temperate regions with the highest plant species richness in the world. We used a structural equation modeling approach (SEM) to consider several surrogates of road disturbance (changes in soil physicochemical properties and the presence or absence of roads) and the causal relationship between three facets of beta diversity (taxonomic beta diversity, TBD; functional beta diversity, FBD and phylogenetic beta diversity, PBD). The results suggest that TBD, FBD and PBD respond inconsistently to mountain roads, despite strong positive correlations between the three facets of plant beta diversity in the study area. Compared with the interior community, the ßtotal.tax and ßtotal.func of the roadside community decreased by 2.54% and 2.22%, respectively, which were related to the reduction of species and trait richness differences and replacements; however, we did not find the same results when assessing the changes in ßtotal.phy, which represents tip-weighted PBD (twPBD). Furthermore, the largest effect of roads on beta diversity was reflected in basal-weighted PBD (bwPBD), which decreased by 9.97%, indicating that those species with fewer extant relatives and longer evolutionary histories are more sensitive to mountain roads. Therefore, it is necessary to take targeted protection measures for ancient species in roadside communities. In addition, we believe that it is still necessary to take measures to prevent the further dispersal of nonnative species, although the presence of non-native species in roadside plots has led to small changes in three facets of beta diversity. There were causal relationships between the three facets of beta diversity, but their intensity and sign different in the SEM of different components of beta diversity (i.e., richness difference and replacement). Our findings suggest that the homogenization of community species composition at the landscape scale arises by a combination of adaptive responses of the functional traits of organisms to environmental consistency (e.g., reduced the differences in soil variables) caused by roads and resorting or reassembly of community clades composition due to environmental filtering. These results contribute to our comprehensive understanding of the impact of mountain roads on plant diversity, which highlights the complex relationship between human pressure and biodiversity loss.

Assessing the effect of roads on mountain plant diversity beyond species richness.

A comprehensive understanding of the effects of mountain roads on plant diversity is critical to finding the most effective solutions for managing this particular driver. Little is known, however, about the simultaneous effects that road have on the multiple facets of biodiversity, although roads are considered to be one of the major disturbances in the Qionglai mountain range. In this study, we analyzed the impact of roads on the multiple facets of plant diversity (taxonomic, functional and phylogenetic diversity) in the study area using Hill numbers by comparing plant diversity between roadside and interior plots at the landscape scale, then, we used linear mixed models to analyze the effect of mountain roads on the multiple facets of plant diversity along an elevational gradient. The results showed that the roadside plots lacked 29.45% of the total number of species with particular functional traits (such as a relatively high specific leaf area (SLA), a relatively low leaf dry matter content (LDMC) and relatively old clades) and exclusively contained 14.62% of the total number of species. Compared with the interior community, the taxonomic, functional and phylogenetic diversity of roadside community decreased by no more than 26.78%, 24.90% and 16.62%, respectively. Taxonomic and functional diversity of dominant and common species showed greater changes to road disturbances, while rare species showed the greatest change in phylogenetic diversity. Taxonomic homogenization of roadside communities was accompanied by functional and phylogenetic homogenization. Additionally, the impact of roads on these three facets of plant diversity showed the characteristics of peak clipping along the elevation gradient. Our findings highlight the negative impact of roads on the taxonomic, functional and phylogenetic diversity of the Qionglai mountain range, as roads promote communities that are more similar in taxonomic, functional, and phylogenetic composition, and to a greater extent contributed to compositional evenness. These effects tend to be functionally and phylogenetically non-random, and species in some clades or with some functional traits are at higher risk of loss. Our results are important for the conservation and management of nature reserves, especially for local governments aiming to create new infrastructure to connect natural mountainous areas.

The illness perception and health promotion behaviour of young and middle-aged patients with hyperuricaemia: A qualitative study.

AIM: The purpose of this qualitative study was to describe the health-promoting behaviours of patients with hyperuricaemia and influencing factors. DESIGN: A descriptive qualitative design was used to gain insight into the personal experience of health promotion behaviour in patients with hyperuricaemia. METHODS: Sixteen patients were sampled in face-to-face interviews with maximum variation, and the data were transcribed verbatim. The data analysis was based on the phrases of thematic analysis outlined by Braun and Clarke (2006). RESULTS: Four main themes were identified in the data: (a) Perception of disease; (b) Motivation to change health-promoting behaviour; (c) Strategies for health-promoting behaviour; and (d) Encounter obstacles to change health-promoting behaviour.

Off-the-shelf GMP-grade UC-MSCs as therapeutic drugs for the amelioration of CCl4-induced acute-on-chronic liver failure in NOD-SCID mice.

BACKGROUND AND PURPOSE: Umbilical cord-derived mesenchymal stem/stromal cells (UC-MSCs) are advanced therapy medicinal products (ATMPs) and thus act as an alternative to liver transplantation for acute-on-chronic liver failure (ACLF). Therewith, we are aiming to evaluate the pharmacologyandpharmacokinetics of GMP-grade UC-MSCs products on carbon tetrachloride (CCl4)-induced ACLF mouse model and the concomitant therapeutic dose for intravenous administration. METHODS: For the purpose, the GMP-grade UC-MSCs products were transplanted intravenously into the aforementioned CCl4-induced ACLF NOD-SCID mouse model, and the therapeutic effect was evaluated with the aid of serological, biochemical and histological assessments. Meanwhile, the correlationshipbetween the treatment groups and other characteristics were determined by conducting principal component analysis (PCA). To further verify the spatio-temporal pharmacokinetics of UC-MSCs products on ACLF treatment, we took advantage of the bioluminescence imaging (BLI) technology with the dual-color fluorescence reporter construct (pLV-Fluc-eGFP). RESULTS: The biological characteristics of UC-MSCs products were in conformity with the International Society of Cell Therapy (ISCT) criteriaand the GMP requirements. ACLF mice with high dose of UC-MSCs treatment revealed significantly alleviated pathological manifestations with a dramatically improved survival rate, the alleviation of liver injury with reduced hepatic enzyme, inflammatory infiltration and inflammatory cytokines. Notably, UC-MSCs in ACLF mice displayed preferable homing and delayed attenuation in the damaged liver tissue. CONCLUSION: Collectively, our data indicated the feasibility of UC-MSC-based cytotherapy for ACLF model administration. Our findings have provided new references for pharmacologyandpharmacokinetics assessments, which will provide overwhelming evidence for pre-clinical study in vivo.

Prevalence and related factors of depression and anxiety in a cohort of Chinese elderly caregivers in the nursing home.

BACKGROUND: The heavy care burden, the long-term dependence of the disabled elderly, and the changing social roles can put elderly caregivers at high risk for mental disorders. This study aimed to explore the prevalence and related factors of depression and anxiety among elderly caregivers and examine the role of resilience in depression and anxiety. METHODS: A multicentre cross-sectional survey was designed. A total of 953 elderly caregivers in nursing homes were recruited in three provinces in China using convenience sampling. Depression and anxiety were measured by self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Multivariate logistic regression analysis was used to explore the key factors associated with depression and anxiety. RESULTS: The median SDS score was 40 (interquartile interval 34-48), and the median SAS score was 48 (interquartile interval 38-56). In this cohort, 19.4% reported depression and 44.0% anxiety. Working hours, sensitive personality and health status were related factors for depression symptom. In terms of anxiety symptoms, its related factors included working hours, health status and higher monthly income. Furthermore, resilience was associated with depression and anxiety among caregivers. LIMITATIONS: A selection bias may be caused by convenience sampling and voluntary participation. CONCLUSION: Depression and anxiety symptoms were common in the cohort of Chinese elderly caregivers in the nursing home. The factors explored in this study may contribute to the development of individualized interventions for depression and anxiety symptoms.

A Brief Analysis of Mesenchymal Stem Cells as Biological Drugs for the Treatment of Acute-on-Chronic Liver Failure (ACLF): Safety and Potency.

Acute-on-Chronic Liver Failure (ACLF) is characterized by acute exacerbation of chronic hepatitis, organ failure, high mortality, and poor prognosis. At present, the clinical methods of treatment include comprehensive treatment with medicines, artificial liver system, and Orthotopic Liver Transplantation (OLT), and of these, OLT is considered the most effective treatment for ACLF. However, it is difficult for ACLF patients to benefit from OLT due to the shortage of liver donors, high cost, unpredictable postoperative complications, and long-term use of immunosuppressive drugs; therefore, it is important to explore a new treatment option. With the development of stem cell transplantation technology in recent years, several studies have shown that treatment of ACLF with Mesenchymal Stem Cells (MSCs) leads to higher survival rates, and has good tolerance and safety rates, thereby improving the liver function and quality of life of patients; it has also become one of the popular research topics in clinical trials. This paper summarizes the current clinical interventions and treatments of ACLF, including the clinical trials, therapeutic mechanisms, and research progress on MSC application in the treatment of ACLF. The problems and challenges of the development of MSC-based therapy in the future are also discussed.

Application of mesenchymal stem cell therapy for the treatment of osteoarthritis of the knee: A concise review.

Osteoarthritis (OA) refers to a chronic joint disease characterized by degenerative changes of articular cartilage and secondary bone hyperplasia. Since articular cartilage has a special structure, namely the absence of blood vessels as well as the low conversion rate of chondrocytes in the cartilage matrix, the treatment faces numerous clinical challenges. Traditional OA treatment (e.g., arthroscopic debridement, microfracture, autologous or allogeneic cartilage transplantation, chondrocyte transplantation) is primarily symptomatic treatment and pain management, which cannot contribute to regenerating degenerated cartilage or reducing joint inflammation. Also, the generated mixed fibrous cartilage tissue is not the same as natural hyaline cartilage. Mesenchymal stem cells (MSCs) have turned into the most extensively explored new therapeutic drugs in cell-based OA treatment as a result of their ability to differentiate into chondrocytes and their immunomodulatory properties. In this study, the preliminary results of preclinical (OA animal model)/clinical trials regarding the effects of MSCs on cartilage repair of knee joints are briefly summarized, which lay a solid application basis for more and deeper clinical studies on cell-based OA treatment.

Intravenous injection of allogeneic umbilical cord-derived multipotent mesenchymal stromal cells reduces the infarct area and ameliorates cardiac function in a porcine model of acute myocardial infarction.

BACKGROUND: Multipotent mesenchymal stromal cell (MSC) therapy has been widely recognized as a feasible strategy for regenerating injured myocardial tissue. However, little is known about the efficacy of intravenous injection of allogeneic umbilical cord (UC) MSCs in preclinical models of porcine myocardial infarction. METHODS: Different dosages of allogeneic UC-MSCs or the vehicle [phosphate-buffered saline (PBS)] were delivered intravenously into an acute myocardial infarction (AMI) porcine model twice after coronary ligation. Echocardiography was performed to examine the cardiac function and single photon emission computed tomography (SPECT) and positron emission tomography (PET)/computed tomography (CT) was performed to detect cardiac perfusion and nonviable myocardium. At the end of the experiment, 2,3,5-triphenyl-tetrazolium chloride (TTC) staining and Masson T staining were performed to determine the infarct area. The protein and gene expression levels associated with cardiac function, inflammation, and angiogenesis were examined by Western blot and real time polymerase chain reaction (PCR). In vivo trafficking of intravenous injection of allogeneic UC-MSCs enhanced green fluorescent protein (eGFP) was detected by real time PCR and immunofluorescence. RESULTS: After systemic delivery, allogeneic UC-MSCs were largely distributed in the lungs and some in the infracted myocardium. At week 8 following AMI, echocardiography demonstrated significantly improved fractional shortening in the high-dose (1.5 × 106 cells/kg) group. SPECT-PET/CT showed that UC-MSC treatment in both high and low doses markedly ameliorated the left ventricle (LV) infarct area but did not significantly improve the myocardial perfusion defect. LV remodeling was inhibited by UC-MSC therapy, as reflected by a marked reduction in rthe fibrosis area at basal, middle, and apical levels and reduced extracellular matrix deposition in the total myocardial area. Inflammatory biomarkers (tumor necrosis factor alpha and interleukin-6) were reduced and pro-angiogenesis factors (vascular endothelial growth factor and platelet/endothelial cell adhesion molecule 1) were augmented in the myocardial infarct and border area. High-dose UC-MSCs increased the connexin 43 (Cx43) (myocardium preservation) expression in remote area of the LV myocardium after AMI. CONCLUSIONS: Intravenous injection of UC-MSCs is a feasible and effective way to preserve LV function and ameliorate myocardial remodeling in porcine AMI. The cardioprotective effects of UC-MSCs were attributed to paracrine factors that appear to augment angiogenesis, limit inflammation, and preserve Cx43 gap junction.

Transplantation of Human Placenta-Derived Mesenchymal Stem Cells Alleviates Critical Limb Ischemia in Diabetic Nude Rats.

Neovasculogenesis induced by stem cell therapy is an innovative approach to improve critical limb ischemia (CLI) in diabetes. Mesenchymal stem cells (MSCs) are ideal candidates due to their angiogenic and immunomodulatory features. The aim of this study is to determine the therapeutic effects of human placenta-derived MSCs (P-MSCs) on diabetic CLI, with or without exogenous insulin administration, and the underlying mechanism of any effect. A series of in vitro experiments were performed to assess the stemness and vasculogenic activity of P-MSCs. P-MSCs were intramuscularly injected at two different doses with and without the administration of insulin. The efficacy of P-MSC transplantation was evaluated by ischemia damage score, ambulatory score, laser Doppler perfusion image (LDPI), capillary, and vascular density. In vivo imaging was applied to track the implanted P-MSCs. In vivo differentiation and in situ secretion of angiogenic cytokines were determined. In vitro experimental outcomes showed the differentiation potential and potent paracrine effect of P-MSCs. P-MSCs survived in vivo for at least 3 weeks and led to the acceleration of ischemia recovery, due to newly formed capillaries, increased arterioles, and secretion of various proangiogenic factors. P-MSCs participate in angiogenesis and vascularization directly through differentiation and cytokine expression.