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As a type of extracellular vesicles, exosomes are released by living cells and contain diverse bioactive molecules, including nucleic acids, proteins, lipids and metabolites. They play an important role in various physiological and pathological processes by a special intercellular communication medium. As endogenous vesicles, exosomes also have the advantages of systemic circulation stability, good biocompatibility and specific targeting of tissues and cells, as well as they are promising candidates for drug delivery system. The production mechanism of exosomes describe was summarized, the methods of extraction and separation the application and mechanism of exosomes in immune and inflammation-related diseases, cardiovascular system diseases, nervous system diseases, tumors, etc. were reviewed. The engineering modifications of exosomes in high targeting properties based on the drug delivery were overviewed. Exosomes support the diagnosis and prognostic assessment of multiple diseases, which have broad application prospects as a very potential safe and specific endogenous nano-drug carrier.
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Chinese medicinal resources are the cornerstone of the sustainable development of traditional Chinese medicine industry. However, due to the fecundity of species, over-exploitation, and limitations of artificial cultivation, some medicinal plants are depleted and even endangered. Tissue culture, a breakthrough technology in the breeding of traditional Chinese medicinal materials, is not limited by time and space, and can allow the production on an annual basis, which plays an important role in the protection of Chinese medicinal resources. The present study reviewed the applications of tissue culture of medicinal plants in the field of Chinese medicinal resources, including rapid propagation of medicinal plant seedlings, breeding of novel high-yield and high-quality cultivars, construction of a genetic transformation system, and production of secondary metabolites. Meanwhile, the current challenges and suggestions for the future development of this field were also proposed.
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Sustainable Development , Plants, Medicinal/genetics , Plant Breeding , Medicine, Chinese Traditional , TechnologyABSTRACT
Nanocarriers prepared from organic or inorganic materials are widely used in drug targeting system and diagnosis and treatment of disease. However, there are some problems, such as poor targeting, short circulation time in vivo and improvement in the biocompatibility. Biomimetic nanocarriers has carried out research on the issues, which based on different kinds of cell membrane for the nanocarriers modification, endogenous biofilm improving the biocompatibility of carriers in vivo, more accurate targeting, and even producing immunotherapeutic effect. The principle, method, targeting mechanism and therapeutic effect of biomimetic nano carrier technology of cell membrane have been reviewed in this paper, which provide a new direction for the research of new drug delivery system.
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Objective To prepare a biomimetic nano carrier macrophage membrane hybrid liposome by heterozygous macrophage membrane and liposome, which could be used for the clearance and toxicity inhibition of Vibrio vulnificus hemolysin A (VvhA). Methods Macrophage membrane was extracted and hybridized with liposome by thin-film evaporation combined extrusion method. The hybridized liposome of macrophage membrane was constructed and characterized. The in vitro detoxification ability of the hybridized vector was evaluated by hemolysis test and cytotoxicity test. The detoxification ability of the vector was evaluated by mouse skin infection model. Results Anti toxoid studies in vivo and in vitro showed that the anti-hemolysis rate of macrophage membrane heterozygous liposomes in vitro reached 97.03%, which could effectively inhibit the skin ulceration in subcutaneous infected mice and make the survival rate of abdominal infected mice reach 80%. Conclusion The constructed macrophage membrane hybrid liposome had high detoxification ability, which could provide a potential solution and research basis for the prevention and treatment of Vibrio vulnificus infection.
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OBJECTIVE@#To observe the effects of the Xingnao Kaiqiao (regaining consciousness and opening orifices) acupuncture on hemorrhagic transformation and limb motor function after intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) in stroke patients.@*METHODS@#A total of 130 stroke patients after rt-PA thrombolytic were divided into an acupuncture group (58 cases, 1 case dropped off) and a non-acupuncture group (72 cases, 7 cases dropped off) according to whether they received acupuncture treatment. Propensity score matching (PSM) was used to match each group, with 38 patients in each group. The patients in the non-acupuncture group received rt-PA thrombolytic therapy and western medical basic treatment. In addition to the basic treatment, the patients in the acupuncture group received Xingnao Kaiqiao acupuncture at Shuigou (GV 26), bilateral Neiguan (PC 6), and ipsilateral Sanyinjiao (SP 6), Chize (LU 5), once a day for 14 days. The incidence of hemorrhagic transformation within 30 days after onset was compared between the two groups. The Fugl-Meyer assessment (FMA) score and activities of daily living (ADL) score were observed at baseline and 30 days, 6 months, 1 year after onset in the two groups. The disability rate at 6 months and 1 year after onset was recorded, and safety was evaluated in both groups.@*RESULTS@#The incidence of hemorrhagic transformation in the acupuncture group was 5.3% (2/38), which was lower than 21.1% (8/38) in the non-acupuncture group (P<0.05). At 30 days, 6 month, and 1 year after onset, the FMA and ADL scores of both groups were higher than those at baseline (P<0.01), and the scores in the acupuncture group were higher than those in the non-acupuncture group (P<0.01). The disability rate in the acupuncture group at 1 year after onset was 10.5% (4/38), which was lower than 28.9% (11/38) in the non-acupuncture group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05).@*CONCLUSION@#The Xingnao Kaiqiao acupuncture method could reduce the incidence of hemorrhagic transformation in stroke patients after intravenous thrombolysis with rt-PA, improve their motor function and daily living ability, and reduce the long-term disability rate.
Subject(s)
Humans , Tissue Plasminogen Activator/adverse effects , Activities of Daily Living , Prospective Studies , Stroke , Acupuncture Therapy , Thrombolytic Therapy/adverse effectsABSTRACT
OBJECTIVES@#To summarize our experience with the sural neurofasciocutaneous flap for reconstructing the soft tissue defects over the forefoot distal to the connecting line of midpoints in the metatarsal bones, and to compare the outcomes between the flap for resurfacing the defects distal and proximal to the connecting line.@*METHODS@#The clinical data of 425 sural neurofasciocutaneous flaps for repairing the soft tissue defects in the middle and lower leg, ankle, and foot between Apr. 2002 and Apr. 2020 were reviewed. Based on the connecting line of midpoints of the metatarsals, the sural neurofasciocutaneous flaps were divided into a forefoot group (flaps with furthest edges distal to the connecting line) and a peri-ankle group (flaps with the furthest edges proximal to the connecting line).@*RESULTS@#The partial necrosis rate in the forefoot group (14.5%, 10/69) was significantly higher than that in the peri-ankle group (7.0%, 25/356), with significant difference (P<0.05). Using the flap alone or in combination with a simple salvage treatment, the ratio of successful coverages of the defects was 98.6% (68/69) in the forefoot group, and 97.8% (348/356) in the peri-ankle group, respectively, with no statistical difference (P>0.05).@*CONCLUSIONS@#The sural neurofasciocutaneous flap is a better choice for covering the soft tissue defects over the forefoot distal to the connecting line of midpoints of the metatarsal bones. The survival reliability of the sural neurofasciocutaneous flap reconstructing the soft tissue defect proximal to the connecting line is superior to that of the flap reconstructing the defect distal to the connecting line.
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Humans , Ankle/surgery , Plastic Surgery Procedures , Reproducibility of Results , Soft Tissue Injuries/surgery , Surgical FlapsABSTRACT
ObjectiveTo investigate the effect and mechanism of Mori Folium extract on the glucose and lipid metabolism disorders in the liver of rats with type 2 diabetes mellitus （T2DM） through the phosphatidylinositol 3-kinase/protein kinase B/peroxisome proliferation-activated receptor α/carnitine palmitoyl transferase-1 （PI3K/Akt/PPARα/CPT-1） signaling pathway. MethodThe T2DM model was induced by the high-fat diet combined with the intraperitoneal injection of streptozotocin （STZ）. The model rats were randomly divided into a model group， a metformin （0.2 g·kg-1） group， and a Mori Folium water extract （4.0 g·kg-1） group according to blood glucose and body weight. In the 8-week administration， fasting blood glucose was measured at the same time every week. The histomorphological and fat changes in the rat liver were observed by hematoxylin-eosin （HE） staining and oil red O staining. The levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） in the serum were measured by biochemical methods. Western blot （WB） was used to quantitatively detect the protein expression of p-PI3K，PI3K，p-Akt，Akt，PPARα，and CPT-1 in the rat liver. ResultAfter 8-week administration， the blood glucose of rats was higher in the model group than that in the control group （P<0.01）， and lower in the Mori Folium water extract group than that in the model group （P<0.01）. The results of HE staining showed that the liver tissue structure of the control group was complete， and the hepatocytes were arranged radially around the central vein， while the hepatocyte injury in the model group was obvious. Compared with the model group， the Mori Folium water extract group showed improved vacuolar degeneration and no lesions such as small bile duct hyperplasia. Oil red O staining showed that there was no obvious steatosis and necrosis in the hepatocytes of rats in the control group， and no lipid droplets in the hepatocytes were observed， while the model group showed increased lipid droplets. Mori Folium significantly reduced the lipid droplets in the liver. Biochemical analysis showed that the levels of TC， TG， LDL-C， AST， and ALT in the model group were significantly higher than those in control group （P<0.01）. The levels of TC， TG， LDL-C， AST， and ALT in the Mori Folium water extract group were significantly lower than those in the model group （P<0.05，P<0.01）. WB showed that the protein expression of p-PI3K/PI3K， p-Akt/Akt， PPARα， and CPT-1 in the model group were lower than those in the control group （P<0.01）. Mori Folium water extract could increase the protein expression of p-PI3K/PI3K， p-Akt/Akt， PPARα， and CPT-1 （P<0.05 or P<0.01）. ConclusionThe hypoglycemic mechanism of Mori Folium water extract may be related to the regulation of the PI3K/Akt/PPARα/CPT-1 signaling pathway.
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Objective@#To explore the impairments of the left visual field (LVF) superiority among children with autism spectrum disorder (ASD), for further understanding of the attentional mechanism of social disturbance in ASD.@*Methods@#The mixed design for repeated measured data was used. The case group was consisted of 105 ASD children enrolled from the rehabilitation agencies in Tianjin from Sept. 2016 to Dec. 2019; and 105 typically developed children were enrolled from Tianjin as the control group by matching the chronological age and gender distribution. The preferential looking paradigm was used to explore the LVF superiority by eye tracking system. Fixation count (FC), total fixation duration (TFD) and the proportion of left hemiface were analyzed by the Mixed design ANOVA, in which the main effect of "group", visual field (left vs. right) and gender of the faces was evaluated in addition to the interactions.@*Results@#All the participants in both the ASD group and TD group completed the experiments. For the whole face in LVF or RVF, the main effect of group showed the statistical significance on both FC and TFD [FC： F (1，206) =26.27, P <0.01; TFD： F (1，206) =51.23, P <0.01]. The interaction of group×visual field on FC also was statistically significant [ F (1，206) =4.619， P =0.03], and the case group showed the difference between LVF and RVF (0.33±0.02，0.54±0.03， P < 0.01 ) by further simple effect analysis, none of the rest was statistically significant. Both the left hemiface of FC & TFD showed the main effect of group [FC： F (1，206) =13.77， P ＜0.01；TFD： F (1，206) =12.89， P ＜0.01] and interaction of group×visual field [FC： F (1，206) = 36.99， P ＜0.01；TFD： F (1，206) =38.62， P ＜0.01), similarly, there was higher left hemiface proportion of both FC & TFD in RVF than that in LVF (FC：0.36±0.03，0.56±0.03， P <0.01; TFD：0.36±0.03，0.57±0.03， P <0.01).@*Conclusion@#LVF superiority is not presented among children with ASD in this study, while the fixation in RVF remained relatively unaffected. The finding indicates the involvement of the fusiform face area of right hemisphere in the pathogenesis of ASD in addition to the weak central coherence account.
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Infants suffering from angiostrongylus eosinophilic meningitis (AEM) is rare, while AEM can cause severe consequences.The diagnostic value of high-throughput sequencing for AEM was studied by analyzing 2 AEM children (< 2 years old) in the Department of Neurology, Shenzhen Children′s Hospital in 2019.Case 1 mainly pre-sented intermittent fever, vomiting, mental fatigue and bregma bulge.Case 2 mainly manifested intermittent fever, cough, vomiting and convulsion.Due to hypereosinophils in patients′ peripheral blood and cerebrospinal fluid (CSF), and abundant DNA sequences from a cantonensis in CSF and positive antibody test, the patients were diagnosed with AEM.The patients were treated with albendazole to deworm, and small doses of methylprednisolone to reduce inflammation.The clinical characteristics of AEM infant are not typical, and high-throughput sequencing technology can assist the diagnosis of AEM.
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This study investigated the correlation between periprostatic fat thickness (PPFT) measured on magnetic resonance imaging and lower urinary tract symptoms, erectile function, and benign prostatic hyperplasia (BPH) progression. A total of 286 treatment-naive men diagnosed with BPH in our department between March 2017 and February 2019 were included. Patients were divided into two groups according to the median value of PPFT: high (PPFT >4.35 mm) PPFT group and low (PPFT <4.35 mm) PPFT group. After the initial evaluation, all patients received a combination drug treatment of tamsulosin and finasteride for 12 months. Of the 286 enrolled patients, 244 completed the drug treatment course. Patients with high PPFT had larger prostate volume (PV; P = 0.013), higher International Prostate Symptom Score (IPSS; P = 0.008), and lower five-item version of the International Index of Erectile Function (IIEF-5) score (P = 0.002) than those with low PPFT. Both high and low PPFT groups showed significant improvements in PV, maximum flow rate, IPSS, and quality of life score and a decrease of IIEF-5 score after the combination drug treatment. The decrease of IIEF-5 score was more obvious in the high PPFT group than that in the low PPFT group. In addition, more patients in the high PPFT group underwent prostate surgery than those in the low PPFT group. Moreover, Pearson's correlation coefficient analysis indicated that PPFT was positively correlated with age, PV, and IPSS and negatively correlated with IIEF-5 score; however, body mass index was only negatively correlated with IIEF-5 score.
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OBJECTIVE@#To evaluate the clinical efficacy of acupuncture at different timings in acute stage for limb dysfunction in patients with cerebral infarction.@*METHODS@#A total of 101 patients with cerebral infarction limb dysfunction were divided into an early exposure group (@*RESULTS@#Compared before treatment, the mRS grade at 30 and 60 days after onset in the early exposure group was improved (@*CONCLUSION@#The timing of acupuncture is an independent factor affecting the disability status and limb motor dysfunction in patients with cerebral infarction, and the effect of early intervention may be better than late intervention.
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Humans , Acupuncture Points , Acupuncture Therapy , Cerebral Infarction/therapy , Pilot Projects , Prospective Studies , Stroke , Treatment OutcomeABSTRACT
Objective:To explore the status and influencing factors of optimistic coping among gynecologic tumor patients.Methods:A total of 401 cases of gynecologic tumor patients was selected by the convenient sampling method. They were investigated by the Jalowiec Coping Scale, The Eysenck Personality Questionnaire-Revised Short Scale for Chinese, General Self-Efficacy Scale, Social Support Rating Scale.Results:Optimistic coping in gynecologic tumor patients scored (1.61±0.36). The main influencing factors included residence place, education level, general self-efficacy score, personality trait score, they could explain 25.2% variation of optimistic coping of gynecological tumor patients.Conclusions:Optimistic coping in gynecologic tumor patients scored is at a low level. Residence and education level, general self-efficacy score and personality trait score are important factors that affect the level of optimistic coping in gynecologic tumor inpatients. Medical staff should develop targeted nursing intervention measures, pay attention to mining and shaping patients' positive and optimistic personality traits, in order to improve patients' optimistic coping level, to achieve the ultimate goal of improving patients' quality of life nursing.
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@#Objective To explore the association between total cholesterol and type 2 diabetes ( T2DM) ． Methods Non－diabetic people who aged 20 to 90 years at the baseline and who had physical examination more than 2 times were screened． Comparisons of the baseline characteristics were conducted with Student－t test or Pearson chi－square test． Generalized estimating equation ( GEE) was used to analyze the effect of total cholesterol of quantiles groups ( 2．10－ mmol /L，4．16－ mmol /L，4．76－ mmol /L and 5．42 －13．29 mmol /L) to type 2 diabetes． Results The cohort with an average age of 3．53 years per person in- cluded 12 928 subjects and 45 626 person－years． During the follow－up，447 cases of new－onset diabetes occurred and the incidence density was 9. 80‰． The high incidence of type 2 diabetes increased with the increase of total cholesterol． After adjusting the factors including age，high density lipoprotein，hypertension and obesity，based on the 2. 10－ mmol /L group，the relative risk ( RR) of the 4. 16－ mmol /L，4. 76－ mmol/L and 5. 42－13. 29 mmol /L group were 1. 24( 95% CI: 0. 83－1. 86) ，1. 75 ( 95% CI: 1. 19－2. 56) and 3. 60( 95% CI: 2. 51－5. 17) ，respectively． Conclusions Total cholesterol is associated with type 2 diabetes，and as the total cholesterol increases，the risk of developing type 2 diabetes increases．
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This paper summarized the operation cooperation and management of the first case of bilateral lung transplantation assisted with double extracorporeal membrane oxygenation (ECMO) for the recipient with novel coronavirus pneumonia (COVID-19) in the world. The bilateral lung transplantation assisted by double ECMO had been accomplished successfully on a recipient with COVID-19, who was supported by ventilator and ECMO, with other organs function basically normal. The operation took 405 min and went smoothly. The cooperation and management guidelines of the operation room included the following: setting up of COVID-19 emergency operation group quickly; listing and preparing of the detailed operation supplies; transferring of the whole system of lung transplantation operating room in Wuxi People's Hospital to the Wuxi No.5 People's Hospital (isolation hospital); reconstruction of a negative pressure operating room for lung transplantation; formulating and strictly implementing the guidelines and management process for the operation of patient with COVID-19.
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The envelope glycoprotein subunit gp120 and the transmembrane subunit gp41 of human immunodeficiency virus type 1(HIV-1)play important roles in the process of viral entry into target cells, and serve as key targets for developing HIV-1 entry inhibitors. Peptide HIV entry inhibitors, such as T20, are limited in clinical application due to the lack of oral properties. However, because of the possible oral administration and high bioavailability, small molecule compounds become more and more important in the research for HIV entry inhibitors. In this review, we summarize the recent advances in the development of small molecule HIV-1 entry inhibitors, including the NBD and BMS series of small-molecule inhibitors targeting gp120 as well as the NB-206 and ADS-J1 se- ries of small-molecule inhibitors targeting gp41. These small molecule inhibitors are promising compounds with research value, which lay a foundation for the design of more efficient and more reasonable small-molecule HIV-1 entry inhibitors.
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Radial styloid stenosing tenosynovitis is a kind of common chronic motor system injuries, and could lead to joint pain and aggravates with activity, in further makes a great impact on people's daily life. At present, therapeutic methods for this disease could divid into conservative treatment and surgical treatment. What we pay attention to is cure. Conservative treatment could effectively relieve pain and improve wrist motion in acute phase, however, it make little difference on long--term effect and usually cause to reappear. Surgical treatment, as a kind of invasive therapies, is chosen only when facing recalcitrant radial styloid stenosing tenosynovitis with many complications for its high cure rate. The author thought that patient education should play an important role in the therapy of radial styloid stenosing tenosynovitis, comprehensive treatment could be applied according to the different conditions of disease development, and could increase cure disease.
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Humans , Radius , Tendon Entrapment , Diagnosis , Therapeutics , Tenosynovitis , Therapeutics , Wrist , Wrist JointABSTRACT
Objective:To understand the current status and existing problems of medical students' cognition of new medical ethics view, and to provide reference for the innovation of medical ethics education mode. Methods:A self-designed questionnaire was used to investigate the medical students in a university in Changsha. A total of 450 questionnaires were distributed and 440 questionnaires were collected. Results:Medical students generally had a better understanding of the new medical ethics view and could establish a"patient centered" service concept. But the medical ethics cognition of some medical students was not consistent with the medical ethics behavior, and the medical value orientation was not clear. Conclusion:In order to improve the medical ethics cognition level of medical students, it needs to establish a new medical ethics education mode with the integration of school, society and family, make medical ethics education integrate with clinical practice effectively, strengthen medical students' legal education meanwhile, and effectively carry out the new medical ethics view for medical students.
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ST-segment elevation myocardial infarction (STEMI) is the most serious type of coronary heart disease, accounting for 25%to 40%of acute myocardial infarction (AMI). The key to treat STEMI is to restore myocardial perfusion in the infarct area, to rescue the ischemic myocardium, and to reduce the size of infarction. About 41%to 67%of patients with STEMI have multiple vascular disease (MVD). Compared with single vessel disease, the clinical outcome of MVD is worse. In these patients, it still remains a controversial topic in emergency interventions for STEMI patients, the infarct-related artery only revascularization or multi-vessel revascularization, and the timing of revascularization. The clinical studies of revascularization strategy for MVD in STEMI patients have been ongoing, and the results have also led to the continuous updating of guidelines and treatment strategies.
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In recent years, benefited from the progress of clinical studies of early diagnosis and early revascularization in acute myocardial infarction (AMI), the guidelines for Europe and the United States and the Chinese academic continue to be updated to guide our clinical practice. However, AMI still remains one of the major causes of death in the worldwide. Over the past 10 years, the incidence of AMI increased rapidly in China, and the mortality kept at a high level. There is still plenty of room to improve in the early diagnosis of cardiac troponin, revascularization strategy optimization of non-infarct-related vascular, optimized new antiplatelet therapy, development of regional synergies network and chest pain center. There is still a long way from the standardized treatment of AMI. It is very important to complete early diagnosis and optimum treatment of AMI.
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Objective To establish detection limit and clinical reportable range for detection of anti-HBs by chemiluminescence method and evaluate by clinical application.Methods Referring to the Clinical and Laboratory Standards Institute (CLSI) relevant documents,the programme of blank limit (LoB),detection limit (LoD),quantitative detection limit (LoQ),analytical range of measurement (AMR),clinical reportable range (CRR) for detection of anti-HBs by chemiluminescence method,were designed and measured.The established clinical reportable range and maximum dilution were used to predict the recovery stage of acute hepatitis B patients and to evaluate the effectiveness of different vaccines.Results LoB,LoD,LoQ,AMR and CRR for detection of anti-HBs by chemiluminescence method were 0.87,1.89,3.0,0～970.50 and 3.0 ～48 525 mIU/ml respectively,and the maximum dilution was 1 ∶ 50.The patient with acute hepatitis B showed elevated anti-HBs at fourth weeks after treatment (CRR).The anti-HBs mean was the highest in the B vaccine of the three vaccines.Conclusion The establishment of detection limit and clinical reportable range for detection of anti-HBs by chemiluminescence method was better meet the requirements of clinical laboratories,provide reliable results for clinical laboratories.