A multicenter randomized controlled trial comparing short- and medium-term outcomes of novel biologics and lightweight synthetic mesh for laparoscopic inguinal hernia repair.

INTRODUCTION: The use of biological graft in laparoscopic inguinal hernia repair (LIHR) has been controversial, and there is a lack of high-level evidence to confirm the value of biological graft in LIHR. The purpose of this study is to evaluate the effectiveness of a novel composite biologics in LIHR. METHODS: A multicenter, single-blinded, randomized controlled clinical trial was designed. Fifty patients with unilateral primary inguinal hernia were randomly assigned to the experimental and control group (1:1). The experimental group was repaired with a non-crosslinked composite extracellular matrix from porcine urinary bladder matrix and small intestinal submucosa (UBM/SIS). The control group was repaired with a lightweight, large-pore, synthetic mesh. The primary endpoint was the effectiveness rate of hernia repair. RESULTS: The patients were followed up for four years. No significant difference was found between the experimental group and the control group in the effective rate of hernia repair (24/24[100%] vs 21/22[95.45%], RR, 0.4667; 95%CI, 0.3294-2.304; P = 0.4783). There was no fever, seroma, infection, groin pain, foreign body discomfort or recurrence in the experimental group during the follow-up. In the control group, there were 2 cases of seroma 14 days after operation, 1 case of groin discomfort 60 days after operation and one case of recurrence 410 days after surgery. CONCLUSION: Compared with the lightweight synthetic mesh, the novel UBM/SIS graft has comparable short-term and medium-term effectiveness in LIHR, and the incidence of postoperative complications such as seroma groin discomfort is lower. Trial registration Clinical Trials Registry: ChiCTR1800020173.

[Ameliorative effect of rare ginsenosides on reproductive injury induced by cyclophosphamide in female rats: based on metabonomics].

Objective: To investigate the effect of rare ginsenosides (RGS) on reproductive injury induced by cyclophosphamide (CP) in female rats. Methods: Twenty-four female rats were divided into four groups [normal control (NC), RGS, CP, and CP+RGS group] with 6 rats in each group. CP group (the model group) and CP+RGS group (the treatment group) were intraperitoneally injected with CP 30 mg/kg for 5 days for modeling, and CP+RGS group was given RGS intragastric intervention. General growth status of rats in each group was observed, the organ index was calculated, and the pathological changes of ovary, uterus, liver and kidney were observed by hematoxylin-eosin staining. Serum levels of estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH), pro-inflammatory factors interleukin (IL) 6, IL-1ß, tumor necrosis factor-α were detected. The urine samples were collected after RGS treatment for metabonomics analysis. Metabolomic profiling based on ultra performance liquid chromatography (UPLC) coupled with mass spectrometry (MS) was used to analyze and determine the urine metabolites of rats in each group. Results: Compared with NC group, the ovary index of CP group [(0.054±0.015) %] was significantly decreased (P<0.05), the uterus index [(0.293±0.036) %] and estradiol level [(62.9±6.4) pmol/L] were significantly decreased (all P<0.01), serum levels of FSH, LH, IL-6 and IL-1ß [(20.4±1.0) U/L, (29.0±3.0) U/L, (185.4±28.6) ng/L, (72.9±2.0) ng/L, respectively] were significantly increased (all P<0.01). Compared with CP group, the ovary index in CP+RGS group [(0.075±0.010) %] was significantly increased (P<0.05), serum estradiol level [(122.1±16.2) pmol/L] was significantly increased (P<0.01), serum FSH, IL-1ß and IL-6 levels [(16.7±1.0) U/L, (111.8±17.4) ng/L, (60.1±2.2) ng/L, respectively] were significantly decreased (all P<0.01). Metabonomics analysis results showed that, a total of 352 metabolites were detected in urine, of which 12 were found to be potential markers associated with reproductive injury according to the screening standard. After treatment with RGS, differential metabolites were improved in the direction of NC group. Pathway enrichment suggests that the therapeutic effect of RGS was related to multiple metabolic pathways, including purine metabolism and taurine and hypotaurine metabolism. Conclusion: RGS might reduce inflammation and thus ameliorate the damage caused by CP to the reproductive system of female rats by affecting purine metabolism and other pathways.

[Hypercapnia under controlled mechanical ventilation in patients with high-risk acute pulmonary thromboembolism].

Objective: To evaluate the variation of arterial partial pressure of carbon dioxide (PaCO2) in patients with high-risk pulmonary embolism under mechanical ventilation. Methods: We retrospectively analyzed the cases of high-risk pulmonary embolism who underwent intravenous thrombolysis in Peking Union Medical College Hospital from January 1, 2012, to May 1, 2022. The enrolled patients were divided into a mechanical-ventilated group and an active-breathing group according to whether they received invasive mechanical ventilation or not. The level of PaCO2 under active breathing between the two groups, the changes in PaCO2 before intubation, after intubation and after thrombolysis in the mechanical-ventilated group were compared. The 14-day all-cause mortality of the two groups was calculated and compared. Results: A total of 49 patients with high-risk pulmonary embolism were enrolled, including 22 patients in the mechanical-ventilated group and 27 patients in the active-breathing group. Before intubation, PaCO2 in both groups was lower than normal without statistically significant difference between the two groups. After effective thrombolysis therapy, PaCO2 in both groups recovered to the normal range. In the mechanical-ventilated group, PaCO2 significantly increased 11-147 min after intubation and returned to the normal range after thrombolysis therapy. The 14-day mortality in the mechanical-ventilated group was 54.5%, while all patients in the active-breathing group survived. Conclusions: Under mechanical controlled ventilation, patients with high-risk pulmonary embolism could represent hypercapnia which resolved after effective thrombolytic therapy. In mechanical ventilated patients with sudden-onset hypoxemia and hypercapnia, the possibility of high-risk pulmonary embolism should be considered.

[Effects of long working hours exposure on occupational stress and depression symptoms in couriers in Zhejiang Province].

Objective: To understand the current situation of long working hours exposure of couriers in Zhejiang Province, and to analyze the influence of long working hours exposure levels on their occupational stress and depression symptoms, and provide a basis for promoting the physical and mental health of couriers. Methods: From September to December 2021 , 1159 couriers from Zhejiang Express Transport Companies were selected as respondents by cluster sampling, and their basic information were collected. The occupational stress and depression symptoms of the couriers were assessed using the Core Occupational Stress Scale (COSS) and the Patient Health Questionnaire-9 (PHQ-9). The effects of long work hours (>48 h per week) on the occupational stress and depression symptoms of the couriers were analyzed. Results: The average age of 1159 courier in Zhejiang Province was (33.24±8.42) years, the average weekly working hours were (63.21±18.77) h, and 75.15% (871/1159) were long-term workers. The detection rates of occupational stress and depression symptoms in courier were 32.44% (376/1159) and 32.53% (377/1159), respectively. There were significant differences in the detection rates of occupational stress and depression symptoms among couriers with different ages, educational background, marital status, monthly average income, length of service, position or post, shift status, drinking status, and average weekly working hours (P <0.05). The adjusted logistic regression analysis showed that, after adjusting for the influence of confounding factors such as age, educational background, marital status, monthly average income, length of service, position or post, shift status and drinking status, compared with the weekly working hours ≤48 h, weekly working hours of 63-77 h, 78-92 h, ≥93 h were the risk factors for occupational stress (OR=1.547, 95%CI: 1.019-2.350; OR=1.886, 95%CI: 1.184-3.006; OR=2.338, 95%CI: 1.188-4.062) and depression symptoms (OR=1.897, 95%CI: 1.258-2.860; OR=2.041, 95%CI: 1.290-3.230; OR=4.978, 95%CI: 2.551-9.715) of couriers (P<0.05) . Conclusion: Long working hours could increase the risk of occupational stress and depression symptoms among couriers. It is necessary to arrange working hours reasonably to reduce the occurrence of occupational stress and depression symptoms of couriers.

[Clinical and prognostic analysis of acute pulmonary thromboembolism in the elderly].

Objective: To analyse the clinical characteristics and to explore the prognostic factors of acute pulmonary thromboembolism in the elderly. Methods: The medical records of inpatients with acute pulmonary thromboembolism discharged from Peking Union Medical College Hospital from January 1, 2012, to February 1, 2019 were retrospectively reviewed. The eligible patients were divided into elderly group (≥ 60 years old) and non-elderly group (<60 years old). The clinical symptoms, complications, laboratory results, pulmonary embolism severity index (PESI) and mortality were compared between the two groups. Mortality was further compared among elderly patients of different age groups. Cox regression analysis was used to analyze the risk factors of 7-day and 30-day death in elderly patients with pulmonary embolism. Results: A total of 503 patients with acute pulmonary embolism were included, including 279 cases in the elderly group and 224 cases in the non-elderly group. The incidence of cardiac arrest was higher in the elderly group compared with non-elderly group, while the incidence of chest pain and hemoptysis was less common in the elderly group. The proportions of comorbidities, including diabetes, hypertension, and coronary heart disease were higher in the elderly group while the proportion of autoimmune diseases was higher in the non-elderly group. In terms of prognosis, the PESI score and 7-day and 30-day mortality in the elderly group were higher than those in the non-elderly group. The mortality of elderly patients increased with age. Cox univariate regression analysis showed that infection, hypoalbuminemia, hypocalcemia, elevated cardiac troponin(cTnI), elevated N-terminal prohormone of brain natriuretic pepride(NT-proBNP) and PESI grade were associated with 30-day death. Multivariate Cox regression analysis showed that PESI grade and decreased serum calcium concentration were independent risk factors for 7-day death of pulmonary embolism in elderly patients. PESI grade, decreased serum calcium concentration and infection were independent risk factors for 30-day death. Conclusions: The mortality of elderly patients with pulmonary embolism was higher than that of non-elderly patients, and the mortality increased gradually with age. PESI grade, decreased serum calcium concentration and infection were independent risk factors for 30-day death of pulmonary embolism in elderly patients.

[World Health Organization guidance Ethical and Governance of Artificial Intelligence for health and implications for China].

With the explosive growth of deep learning and big data technology, artificial intelligence has penetrated into various fields of medical and health care, bringing efficient and high-quality health services to patients, but also a series of ethical and social governance issues have emerged. In order to avoid and eliminate the foreseeable ethical risks and governance challenges in the development of medical artificial intelligence, the World Health Organization (WHO) first released the Ethical and Governance of Artificial Intelligence for Health guidance on June 28, 2021, aimed to provide a framework for ethical guidelines on the deployment of artificial intelligence in clinical practice. At present, there are still shortcomings and this paper takes Healthy China 2030 agenda and the WHO guidelines as strategic ideas, and proposes to shape a consensus on the ethics of medical artificial intelligence, establish rules for human subjects and ownership of responsibilities, improve the legal and regulatory system, and determine human decision-making and moral subject status, taking into account the cultivation of interdisciplinary talents' ethical literacy and other Chinese inspirations are expected to promote the development of medical artificial intelligence ethics governance.

[WHO global strategy on digital health and its implications to China].

The World Health Organization (WHO) released the global strategy report on digital health (2020-2025) in Geneva in 2019, which established the priority of the digital health strategy and formulated strategic objectives, guiding principles, action framework and implementation plans to promote the development of global digital health, and to achieve universal health coverage and the health-related sustainable development goals. Despite China's rapid development in the field of digital health, there is still a big gap between the realization of the goal of digital health. Therefore, it is urgent to grasp the major historical opportunity and step into a new era of digital health with the support of digital technology platform.

[Identification of serum biomarkers and evaluation of metabolism disorders in patients with oral squamous cell carcinoma].

Objective: To explore the changes in serum metabolic profile in patients with oral squamous cell carcinoma (OSCC) and to identify the diagnostic biomarkers in order to provide new ideas for the early diagnosis of OSCC. Methods: In total, 76 OSCC patients who were diagnosed at the Department of Oral and Maxillofacial Surgery and 70 healthy individuals who at the Department of Medical Center of The First Affiliated Hospital of Zhengzhou University from August 2019 to January 2020 were recruited in The study. According to the random number table method, all subjects were divided into a test group (n=96) and a verification group (n=50). Subjects in the test group consisted of 51 OSCC patients and 45 healthy subjects and subjects in the verification group included 25 OSCC patients and 25 healthy individuals. Serum samples and clinical data of each of the subjects were collected. The serum samples were analyzed by ultra-high-performance liquid chromatography quadrupole-Orbitrap high resolution accurate mass spectrometry. Principal component analysis, orthogonal partial least square discrimination analysis and t-test were used to profile the differential metabolites in the test group. Pathway analysis of differential metabolites was performed. In addition, binary logistic regression analysis and receiver operating characteristic analysis were used in order to establish the potential diagnostic panel. Results: Twenty-one endogenous differential metabolites were identified showing significant association with OSCC. Results of pathway analysis suggested that OSCC associated with lipid metabolism and amino acid metabolism (P<0.05). A novel diagnostic panel consisting of lysophosphatidylcholine (LysoPC) (16∶0/0∶0), LysoPC[18∶1(9z)/0∶0], taurine and D-glutamic acid was defined. The panel performed a high area under the receiver operating characteristic curve (0.998, 95%CI: 0.994-0.999, P<0.05). Conclusions: There were obvious lipid and amino acid metabolism disorders in OSCC patients. It was an effective method to establish a diagnostic model by metabolomics.

[Clinical effects of follicle unit extraction transplantation combined with recombinant bovine basic fibroblast growth factor and minoxidil in the treatment of secondary cicatricial alopecia].

Objective: To explore the clinical effects of follicle unit extraction (FUE) transplantation combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel and minoxidil tincture in treating secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia). Methods: A retrospective observational study was conducted. According to the different treatment methods, 50 cicatricial alopecia patients who met the inclusion criteria and only underwent FUE transplantation in the First Affiliated Hospital of Air Force Medical University from March 2013 to April 2017 were recruited into FUE alone group (26 males and 24 females, aged (28±13) years), and 50 cicatricial alopecia patients who met the inclusion criteria and underwent FUE transplantation+rb-bFGF gel during 1 to 14 days after surgery+minoxidil tincture during 15 to 180 days after surgery in this hospital from May 2017 to April 2020 were recruited into FUE+rb-bFGF+minoxidil group (32 males and 18 females, aged (27±9) years). Hair loss rates in post surgery month (PSM) 3 and 6, hair survival rates and satisfaction rates of patients in PSM 12, and the adverse effect rates of patients in the 2 groups within PSM 12 were observed and calculated. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and independent sample t test. Results: In PSM 3 and 6, the hair loss rates of patients in FUE alone group were significantly higher than those in FUE+rb-bFGF+minoxidil group, respectively (t=70.850, 42.610, P<0.01). In PSM 12, the hair survival rate of patients in FUE+rb-bFGF+minoxidil group was (91.0±2.8)%, which was significantly higher than (80.9±6.9)% in FUE alone group (t=9.665, P<0.01). In PSM 12, 25 patients were very satisfied, 12 patients were fairly satisfied, 10 patients were slightly satisfied, 2 patients were not satisfied, and 1 patient was very unsatisfied in FUE alone group; 42 patients were very satisfied, 5 patients were fairly satisfied, and 3 patients were slightly satisfied in FUE+rb-bFGF+minoxidil group. The satisfaction rate of patients in FUE alone group was 74% (37/50), which was significantly lower than 94% (47/50) in FUE+rb-bFGF+minoxidil group (P<0.01). Within PSM 12, compared with those in FUE+rb-bFGF+minoxidil group, the incidence rates of folliculitis, abnormal growth direction, and skin necrosis in transplant site were not obviously changed in FUE alone group (P>0.05), while the incidence of scar in donor site was significantly higher (P<0.05). Conclusions: Compared with FUE transplantation alone, FUE transplantation combined with rb-bFGF and minoxidil can reduce the hair loss rate, improve the hair survival rate and the satisfaction rate of patients with cicatricial alopecia after FUE transplantation, with less adverse effects, thus are good for cicatricial alopecia treatment.

[Clinical effects of fine follicular unit extraction and transplantation in repairing cicatricial eyebrow defects].

Objective: To observe the clinical effects of fine follicular unit extraction (FUE) and transplantation in repairing cicatricial eyebrow defects. Methods: The retrospective observational study was conducted. From September 2013 to January 2020, 58 patients (36 males and 22 females, aged 12-40 years) underwent fine FUE and transplantation to treat cicatricial eyebrow defects in the First Affiliated Hospital of Air Force Medical University. The hair survival rate in 10 months post operation was observed and calculated, and the curative effect was graded. Visual Analogue Scale was used to evaluate patients' satisfaction in one year post operation. The adverse reactions during operation and within one year post operation were recorded, and the adverse reaction incidence was calculated. Results: The hair survival rate of 58 patients in 10 months post operation was (84±5)%. Four patients (6.9%) had good curative effect, 54 patients (93.1%) had excellent curative effect in effect evaluation. Four patients (6.90%) were moderately satisfied, 5 patients (8.62%) were fairly satisfied, and 49 patients (84.48%) were very satisfied in satisfaction evaluation. Twelve patients had 14 adverse reactions, with an incidence of 24.14%. Conclusions: Fine FUE and transplantation can provide good cosmetic results for patients with cicatricial eyebrow defects, with high satisfaction of patient and few adverse reactions.

Downregulation of HOXA11 enhances endometrial cancer malignancy and cisplatin resistance via activating PTEN/AKT signaling pathway.

PURPOSE: Endometrial cancer is the most common malignant tumor of female genital system worldwide. Homeobox A11 (HOXA11) is an evolutionarily conserved Homeobox gene closely implicated in carcinogenesis. However, the mechanisms of HOXA11 in the progression and cisplatin resistance of endometrial cancer remain unclear. METHODS: The expression of HOXA11 was analyzed based on 548 endometrial cancer and 35 control tissues from The Cancer Genome Atlas (TCGA) database. Transwell assay was performed to investigate the effect of HOXA11 on endometrial cell migration and invasion. TUNEL staining was carried out to assay the role of HOXA11 in endometrial cell apoptosis. Western blot was employed to detect the protein levels of B cell lymphoma-2 (Bcl-2), Bcl-2 associated X (Bax), cleaved caspase-3, matrix metalloproteinase-2/9 (MMP/9), phosphatase and tensin homolog (PTEN), protein kinase B (AKT) and p-AKT. RESULTS: TCGA data showed that HOXA11 expression was significantly down-regulated in endometrial cancer tissue samples. The overexpression of HOXA11 promoted the apoptosis, but inhibited the proliferation, migration and invasion of endometrial cancer cells. HOXA11 knockdown with small interfering RNA (siRNA) considerably repressed cell apoptosis, while promoted cell proliferation, migration, and invasion through PTEN/AKT signaling pathway. Interestingly, HOXA11 was lowly expressed in Ishikawa cells treated with cisplatin. In addition, HOXA11 knockdown increased the resistance of endometrial cancer to cisplatin through activating PTEN/AKT signaling pathway. CONCLUSION: Low HOXA11 expression may promote the proliferation, migration, invasion of endometrial cancer cells, and increase their resistance to cisplatin through activating PTEN/AKT pathway.

Liraglutide regulates proliferation, differentiation, and apoptosis of preosteoblasts through a signaling network of Notch/Wnt/Hedgehog signaling pathways.

OBJECTIVE: This study aims to investigate whether liraglutide can affect proliferation, osteogenic differentiation and serum deprivation-induced apoptosis of preosteoblast cell line MC3T3-E1 through the Notch, Wnt/ß-catenin, and Hedgehog (Hh) signaling pathways. MATERIALS AND METHODS: MC3T3-E1 cells were exposed to different treatments (via Notch inhibitor DAPT, an Hh inhibitor cyclopamine, or serum deprivation) or transfections of different siRNAs (targeting glucagon-like peptide-1 receptor (GLP-1R), ß-catenin, or Gli1) in the presence or absence of 100 nM liraglutide. Cell proliferation, mRNA levels of osteogenic differentiation-related genes, mRNA and protein levels of the Notch and Hh signaling pathway proteins, and apoptosis-related proteins were assessed. RESULTS: Liraglutide significantly increased proliferation of MC3T3-E1 cells, expression levels of the Notch and Hh signaling pathway proteins and ß-catenin, and mRNA levels of osteogenic differentiation-related genes and TCF7L2. Moreover, liraglutide promoted a translocation of ß-catenin, increased a ratio of Bcl-2/Bax proteins, reduced serum deprivation-induced apoptosis of MC3T3-E1 cells, and a ratio of caspase-3/procaspase-3. However, a cotreatment with liraglutide and DAPT reversed the alterations. A cyclopamine treatment and knockdowns of GLP-1R, Gli1, and ß-catenin significantly reduced the expression of Notch proteins. Furthermore, the knockdown of GLP-1R, ß-catenin, or Gli1 significantly increased apoptosis, which could be inhibited by liraglutide. CONCLUSIONS: In summary, liraglutide can promote proliferation and differentiation of MC3T3-E1 cells, and inhibit their serum deprivation-induced apoptosis by activating both the Notch and Hh signaling pathways involving ß-catenin and Gli1. These results provide a therapeutic foundation that patients with diabetes and osteoporosis may be cured with treatments of liraglutide.

Response of broiler chickens in the starter and finisher phases to 3 sources of microbial phytase.

A broiler chicken study was conducted for 42 D to evaluate their responses to 3 commercially available microbial phytases. Growth performance, nutrient digestibility, and bone mineralization at days 21 and 42 posthatching were used as parameters of evaluation. The study was a randomized complete block design with 12 treatments, 8 replicate pens, and 25 birds per pen. Treatments included a positive control (PC), a negative control (NC) with crude protein (CP), nonphytate phosphorus (P), and calcium (Ca) reduced by 18, 1.5, and 1.8 g/kg, respectively; the NC + 4 levels of phytase A (250, 500, 750, 1,000 FTU/kg), 3 levels of phytase B (250, 500, 750 FTU/kg), and 3 levels of phytase C (500, 750, 1,000 FTU/kg). Broilers fed the NC diet had reduced (P < 0.05) performance and digestibility measures at days 21 and 42 relative to the PC. All phytase enzymes improved (P < 0.05) BW, gain, feed efficiency, and tibia ash weight and percent. Inclusion of phytase at the highest levels improved (P < 0.05) tibia ash weight by an average of 18.5 and 22% at days 21 and 42, respectively, over the NC. Phytase A linearly improved (P < 0.05) the apparent ileal digestibility (AID) of DM, Ca, P, copper, and sodium at day 21, and the AID of energy, nitrogen, and all amino acid (AA) digestibility at day 42 posthatching. Phytase B linearly (P < 0.05) improved BW gain and feed efficiency of birds at day 21 and quadratically improved (P < 0.05) the AID of nitrogen and all AA in birds at day 42. Supplementation of birds fed the NC with phytase C linearly improved (P < 0.05) the BW gain, feed intake, feed efficiency, and AID of DM, energy, nitrogen, all AA, and all minerals except manganese at day 42. In conclusion, all 3 phytase products improved the growth performance, nutrient and mineral digestibility, and bone mineralization of birds fed diets deficient in nitrogen, Ca, and P similar to or more than birds fed diet adequate in P and CP.

[Design and clinical application of goal-oriented retroperitoneoscopic adrenalectomy].

Objective: To investigate the goal-oriented retroperitoneoscopic adrenalectomy and report the initial experiment. Methods: A total of 102 patients were selected to our clinic experiment, and performed retroperitoneoscopic adrenalectomy with the new method. including adrenal cortex adenoma 76 cases, phaochromocytoma 12 cases, adrenal cyst 6 cases, myelolipoma 4 cases, gangliocytoma 1 case and corticohyperplassia 3 cases. The mean diameter of the tumors was 2.8 cm (0.5-5.8 cm). The operative procedure was briefly described as such, with ultrasound guiding, a needle was punched percutaneously up to the adrenal mass or the renal upper pole from lateral to posterior axillary line just below the inferior border of the 12th rib. labeled the pathway of the needle with methylene blue. Along the way of the needle, a 12 mm port was introduced into the retroperitoneal space with closed method, and the laparoscope with a working tunnel was introduced to make a tunnel along the label up to the adrenal for finally removing it. Additional port should be used when it was needed in the procedure. Results: The procedures of all patients were successful, and 10 patients were performed with only one port, 81 patients with two ports, 11 patients with three ports. The operative duration was 49 (31-115) min, the average blood loss was 38 (0-260) ml. There was no transition to open surgery and no perioperative complications. The length of postoperative hospital stay was 4.1 d (2-7 d). 98 patients were available for follow-up of 16.5 months (1-38 months), no complication was found. Conclusions: The new method of retroperitoneoscopic adrenalectomy is feasible and safe for renal masses, and compared to the conventional method, it may be less trauma to the abdominal wall and retropertoneal tissue, and it was also better on cosmetics.

Correction of Hyperglycemia in Diabetic Rats With the Use of Microencapsulated Young Market Pig Islets.

OBJECTIVE: The aim of this work was to investigate the transplantation efficacy of microencapsulated young market pig islets in a diabetic rat model. METHODS: Islets were isolated and purified from young market pigs obtained from a local slaughterhouse. The islets were encapsulated in barium alginate and subjected to a glucose-induced insulin release functional assay in culture. Microencapsulated islets were transplanted into diabetic Sprague-Dawley rats and removed after 30 days for histologic examination. RESULTS: The mean islet equivalent (IEQ) yield per gram of digested tissue was 3,125 ± 617 IEQ/g after isolation and 2,618 ± 917 IEQ/g after purification, respectively. Host rats' blood glucose concentrations normalized (from 22.3 ± 2.7 mmol/L to 5.1 ± 0.67 mmol/L) following encapsulated islet transplantation. After graft removal, hyperglycemia recurred in the rats, indicating that the grafts were responsible for maintaining euglycemia. Histology revealed viable islets in the capsules 30 days after graft removal. Immunolabeling of insulin verified that ß-cells within the capsules remained well granulated. No fibrosis or immune cells were found in histopathology. CONCLUSIONS: Barium alginate encapsulation of young market pig islets can normalize glucose regulation in diabetic rats without fibrosis or an immunologic response.

A method for characterising human intervertebral disc glycosaminoglycan disaccharides using liquid chromatography-mass spectrometry with multiple reaction monitoring.

Intervertebral disc (IVD) degeneration results in the depletion of proteoglycans and glycosaminoglycans (GAGs), which can lead to structural and mechanical loss of IVD function, ingrowth of nociceptive nerve fibres and eventually discogenic pain. Specific GAG types as well as their disaccharide patterns can be predictive of disease and degeneration in several tissues but have not been comprehensively studied within the IVD. A highly sensitive mass spectrometry based technique with multiple reaction monitoring (MRM) was used to provide characterisation of chondroitin sulphate (CS), hyaluronic acid (HA), heparan sulphate (HS) and their disaccharide sulphation patterns across different anatomical regions of human IVDs. Principal component analysis further distinguished important regional variations and proposed potential ageing variations in GAG profiles. CS was the GAG in greatest abundance in the IVD followed by HA and HS. Principal component analysis identified clear separation of GAG profiles between nucleus pulposus and annulus fibrosus in young and old specimens. Distinct patterns of predominantly expressed disaccharides of CS and HS between young and old IVD samples, provided preliminary evidence that important alterations in disaccharides occur within IVDs during ageing. This technique offered a novel approach to identify and quantify specific GAG disaccharides in human IVDs and the data presented were the first to offer insight into the spatial distribution as well as association with ageing of GAGs and GAG disaccharide sulphation patterns across the human IVD.

Autophagy promotes MSC-mediated vascularization in cutaneous wound healing via regulation of VEGF secretion.

Vascularization deficiency caused a lot of diseases, such as diabetes ulcer and myocardial infarction. Mesenchymal stem cells (MSCs), with the self-renewal and multipotent differentiation capacities, have been used for many diseases treatment through regulation microenvironment. Numerous studies reported that MSCs transplantation could largely improve cutaneous wound healing via paracrine secretion of growth factors. However, whether MSCs take part in the angiogenesis process directly remains elusive. Previous study proved that autophagy inhibited immunosuppressive function of MSCs and prevented the degradation of MSCs function in inflammatory and senescent microenvironment. Here, we proved that autophagy determines the therapeutic effect of MSCs in cutaneous wound healing through promoting endothelial cells angiogenesis and demonstrated that the paracrine of vascular endothelial growth factor (VEGF) in MSCs was required in wound site. We further revealed that autophagy enhanced the VEGF secretion from MSCs through ERK phosphorylation directly. Collectively, we put forward that autophagy mediated paracrine of VEGF plays a central role in MSCs cured cutaneous wound healing and may provide a new therapeutic method for angiogenesis-related diseases.

[Application of artificial intelligence in diagnosis of medical endoscope].

Through a brief overview of the origin and development of artificial intelligence, the research progress of artificial intelligence in digestive endoscopy, ophthalmoscopy and electronic colposcopy was summarized, and the importance of its application was clarified. This article induced the main problems and suggestions of artificial intelligence in the development of medical endoscopes, and prospected the future application of artificial intelligence in medical endoscopy diagnosis.

Effects of dl-3-n-butylphthalide on serum VEGF and bFGF levels in acute cerebral infarction.

OBJECTIVE: To observe the curative effect of dl-3-n-Butylphthalide (NBP) on patients with acute cerebral infarction (ACI) and its effects on levels of serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). PATIENTS AND METHODS: A total of 160 ACI patients treated in our hospital who met the criteria were selected and randomly divided into treatment group (n=80, including 42 males and 38 females) and control group (n=80, including 40 males and 40 females). The control group was treated with routine drug therapy, while the treatment group was treated with butylphthalide on this basis. The curative effect was evaluated using the National Institute of Health Stroke Scale (NIHSS) and the Activity of Daily Life Scale (ADL Scale). The levels of the two factors in serum were measured using enzyme-linked immunosorbent assay (ELISA), and the changes in the levels of the two factors in serum at different time points before and after treatment were compared between the two groups. RESULTS: After treatment, the levels of the two factors in serum in both groups were significantly increased compared with those before treatment (p<0.05), and the increase in treatment group was more significant than that in control group (p<0.05). The scores of ADL scale in both groups were significantly increased after treatment compared with those before treatment, and the increase in treatment group was more significant than that in control group (p<0.05). The scores of NIHSS in both groups were significantly decreased compared with those before treatment, and the decrease in treatment group was more significant than that in control group (p<0.05). CONCLUSIONS: NBP can improve the expressions of VEGF and bFGF in serum of ACI patients, and its effect is superior to that of conventional drugs.