Allogeneic bone marrow-derived mesenchymal stromal cells for hepatitis B virus-related acute-on-chronic liver failure: A randomized controlled trial.

Mortality from hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) is high due to limited treatment options. Preclinical and clinical investigations have proved that treatment with mesenchymal stromal cells (MSCs) is beneficial for recovery from liver injury. We hypothesized that the outcome of HBV-related ACLF would be improved by MSC treatment. From 2010 to 2013, 110 patients with HBV-related ACLF were enrolled in this open-label, nonblinded randomized controlled study. The control group (n = 54) was treated with standard medical therapy (SMT) only. The experimental group (n = 56) was infused weekly for 4 weeks with 1.0 to 10 × 105 cells/kg allogeneic bone marrow-derived MSCs and then followed for 24 weeks. The cumulated survival rate of the MSC group was 73.2% (95% confidence interval 61.6%-84.8%) versus 55.6% (95% confidence interval 42.3%-68.9%) for the SMT group (P = 0.03). There were no infusion-related side effects, but fever was more frequent in MSC compared to SMT patients during weeks 5-24 of follow-up. No carcinoma occurred in any trial patient in either group. Compared with the control group, allogeneic bone marrow-derived MSC treatment markedly improved clinical laboratory measurements, including serum total bilirubin and Model for End-Stage Liver Disease scores. The incidence of severe infection in the MSC group was much lower than that in the SMT group (16.1% versus 33.3%, P = 0.04). Mortality from multiple organ failure and severe infection was higher in the SMT group than in the MSC group (37.0% versus 17.9%, P = 0.02). CONCLUSION: Peripheral infusion of allogeneic bone marrow-derived MSCs is safe and convenient for patients with HBV-related ACLF and significantly increases the 24-week survival rate by improving liver function and decreasing the incidence of severe infections. (Hepatology 2017;66:209-219).

[Study of lower extremity muscle function in stroke patients by velocity-encoded phase-contrast magnetic resonance imaging].

OBJECTIVE: To compare the difference of muscle dynamic characteristics for the ankle dorsiflexors and plantarflexors between stroke patients at the chronic stage and healthy controls so as to provide a new method of assessing the in vivo muscle function in patients with hemiplegia. METHODS: From May 2008 to May 2009, 26 stroke patients and 21 age-and gender-matched normal controls were recruited. All subjects were positioned on a scanner table and requested to perform the voluntary movement of ankle flexion-extension. The velocity encoded phase contrast magnetic resonance imaging (VE-PC MRI) provided the images of tibialis anterior muscle (TA), medial head of gastrocnemius muscle (MG) and soleus muscle (SOL) during a movement cycle. By measuring the calf muscle contraction velocity, the balance function was assessed by Berg balance scale (BBS). The correlation between scores of BBS and the mean maximum velocity were compared and analyzed. RESULTS: The peak velocity of TA (1 - 8 phase, 8.900 - 21.120 mm/s vs 12.99 - 34.50 mm/s), MG (12-19phase, 13.60 - 13.28 mm/s vs 25.85 - 18.38 mm/s) and SOL (12 - 16 phase, 18.63 - 33.62 mm/s vs 27.68 - 47.22 mm/s) was lower in the affected side than that in the controls during ankle extension (P < 0.05); During ankle dorsiflexion, the co-contraction index of SOL/TA (2 - 9 phase, 0.81 - 0.82 vs 0.27 - 0.44) and the co-contraction index of GM/TA (2 - 9 phase, 0.73 - 0.58 vs 0.10 - 0.11) was markedly higher in the affected side than the controls. The patient score of BBS was negatively correlated with the mean velocity of TA (r = -0.69, P = 0.001) and GM (r = -0.47, P = 0.01) in the affected side. There was correlation between TA (r = -0.60, P = 0.001) and GM (r = -0.49, P = 0.01) in the unaffected side. CONCLUSION: During the movement of active ankle flexion-extension, the velocities of TA, SOL and MG are lower in the affected side. The co-contraction index is markedly higher in the affected side during ankle dorsiflexion. This in turn leads to a decline of balance function in patients. VE-PC MRI can provide quantitative in vivo measurements of lower extremity muscle function in stroke patients.

[Relationship between the changes of surface electromyographic signal of thigh muscle and balance function in stroke patients].

OBJECTIVE: To explore the relationship between the changes of surface electromyography (sEMG) signal of thigh muscles and balance function in stroke patients during maximum isometric voluntary contraction (MIVC) of knee extension and flexion so as to provide rationales for rehabilitation. METHODS: Twenty-one stroke patients and 18 age- and sex-matched normal controls were recruited for this study. The surface electromyographic signals of of vastus medialis (VM), rectus femoris (RF), vastus lateralis (RL) and biceps femoris (BF) were recorded during MIVC of knee extension and flexion. Root mean square (RMS) and co-contraction ratio (CR) of both groups were compared and analyzed. The balance function was assessed by Berg balance scale (BBS). RESULTS: There were significant differences in RMS of VM, RF, VL and BF of ipsilateral [(136 +/- 63) microV, (107 +/- 24) microV, (154 +/- 19) microV, (91 +/- 63) microV], thigh during knee extension and flexion (P < 0.05). There were significant differences in CR on ipsilateral thigh muscles than the unaffected (43% +/- 13% vs 37% +/- 20%) and controls (43% +/- 13% vs 32% +/- 10%) during knee flexion (P < 0.05). The RMS of RF and BF on ipsilateral thigh was significantly positively correlated with the score of BBS (rRF = 0.53, P = 0.01 vs rBF = 0.51, P = 0.02); The CR of knee extension and flexion on ipsilateral thigh had a significantly negative correlation (CRE = -0.59, P = 0.005 vs. CRF = -0.41, P = 0.046). CONCLUSION: The strength of bilateral thigh muscles decreases in stroke patients. The spasticity of thigh extensor still exists. Besides reducing the spasticity of hemiplegic limb extensor, rehabilitation should also focus upon bilateral thigh muscles, particularly ipsilateral RF and BF strength training to improve the knee joint stability and improve the balance function.

[Effects of cultivation patterns on wheat yield and soil fertility in dryland]. / æ ½åŸ¹æ¨¡å¼å¯¹æ—±åœ°å°éº¦äº§é‡å’ŒåœŸå£¤è‚¥åŠ›çš„å½±å“.

A field experiment was conducted to examine the effects of plastic film mulching (PM), straw retention (SR), and planting green manure (GM) on winter wheat grain yield and soil fertility. The results showed that PM did not have consistently positive effect on the grain yield, when compared to the traditional patterns (TP). No difference of average grain yield was observed between them over three years. Soil total nitrogen (N), available phosphorus (P), potassium (K), sulfur (S), zinc (Zn) and manganese (Mn) were decreased in 20-40 cm layer in PM than those in TP, while no difference was observed for soil organic matter, nitrate (NO3--N), available iron (Fe) and copper (Cu). The mean grain yield of three years decreased by 12.1% in SR than that in TP treatment. At maturity stage of winter wheat, soil total N and available Cu was increased by 5.8% in 0-20 cm and 6.2% in 20-40 cm layer, respectively, while soil available P and Mn were decreased by 36.1% and 10.2%, respectively. No difference was observed between SR and TP treatments for soil organic matter, NO3--N, available K, S, Zn and Fe at anthesis and maturity stages. Compared to the TP treatment, the mean grain yield was decreased by 12.1% in GM treatment. Soil pH, available P and S were decreased, while the soil organic matter, total N, NO3--N, and available Zn and Mn were increased. No difference was observed for soil available K, Fe and Cu. In conclusion, the PM and SR were not beneficial for the improvement of soil fertility, and thus inhibited the grain yield increase in dryland with low soil fertility level. The GM has greater potential to increase soil nutrients, but it should be paid more attention to the risk of grain yield reduction due to insufficient annual precipitation.

[Effects of cultivation patterns on wheat yield and grain nutrient concentration in dryland]. / æ ½åŸ¹æ¨¡å¼å¯¹æ—±åœ°å°éº¦äº§é‡å’Œç±½ç²’å »åˆ†å«é‡çš„å½±å“.

A field experiment was conducted to examine the effects of plastic film mulching (PM), straw retention (SR) and planting green manure (GM) on grain yield and nutrient concentrations of winter wheat. Compared to the traditional pattern (TP), plastic film mulching showed no significant effect on the average yield over the three years but increased the average phosphorus (P) uptake and concentration in grain by 8.4% and 13.0%, respectively. The average uptake of nitrogen (N), sulfur (S) and iron (Fe) was decreased by 12.6%, 15.0% and 11.1%, and the corresponding concentration was decreased by 12.1%, 12.9% and 10.1%, respectively. There was no significant effect on grain zinc (Zn) concentration. Straw retention decreased grain yield by 12.1%, reduced the average uptake of N, S and Fe decreased by 22.5%, 21.0% and 19.8%, and their corresponding concentration by 10.1%, 9.4% and 3.8%, respectively. The average uptake of P in grain was decreased by 9.8% with straw retention, while the P concentration was increased by 5.0%. There was no significant effect of straw retention on Zn concentration in grain. Planting green manure decreased the grain yield by 12.1%. It had no significant effect on the average uptake of N and Zn, but increased the grain N and Zn concentration by 12.1% and 12.6%, respectively. It showed no impact on P, S and Fe concentration in grain. The discordance between variation of grain yield and its nutrient uptake under different cultivations was the key reason for the changes of their nutrient concentration. Considering the potential adverse effects of plastic film mulching and straw retention on the quantity and quality of grain yield, suitable N fertilization should be applied to ensure the nutrient requirement for grain yield and regulate the uptake and utilization of N, S and Fe for improving the grain quality. Planting green manure could improve soil fertility and increase grain N and Zn concentration, but the yield reduction deserves more attention.

Evidence of cortical reorganization of language networks after stroke with subacute Broca's aphasia: a blood oxygenation level dependent-functional magnetic resonance imaging study.

Aphasia is an acquired language disorder that is a common consequence of stroke. The pathogenesis of the disease is not fully understood, and as a result, current treatment options are not satisfactory. Here, we used blood oxygenation level-dependent functional magnetic resonance imaging to evaluate the activation of bilateral cortices in patients with Broca's aphasia 1 to 3 months after stroke. Our results showed that language expression was associated with multiple brain regions in which the right hemisphere participated in the generation of language. The activation areas in the left hemisphere of aphasia patients were significantly smaller compared with those in healthy adults. The activation frequency, volumes, and intensity in the regions related to language, such as the left inferior frontal gyrus (Broca's area), the left superior temporal gyrus, and the right inferior frontal gyrus (the mirror region of Broca's area), were lower in patients compared with healthy adults. In contrast, activation in the right superior temporal gyrus, the bilateral superior parietal lobule, and the left inferior temporal gyrus was stronger in patients compared with healthy controls. These results suggest that the right inferior frontal gyrus plays a role in the recovery of language function in the subacute stage of stroke-related aphasia by increasing the engagement of related brain areas.

[Mitigation of nitrous oxide emissions in vegetable system by treating soil with dicyandiamide, a nitrification inhibitor].

Undisturbed soil monolith lysimeter was used to investigate the effectiveness of DCD (dicyandiamide) in reducing N2O emissions in vegetable (Chinese cabbage and pepper) field. Results showed that DCD significantly reduced total N2O emission in vegetable field. Total N2O emissions from the urea treatment without DCD reached 0.215 kg x hm(-2) for Chinese cabbage, and it reduced to 0.109 kg x hm(-2), equivalent to a 49.3% reduction. The total N2O emissions for pepper were much higher compared with those for Chinese cabbage. The total N2O emitted from the urea treatment was 2.32 kg x hm(-2) (without DCD) and it was reduced to 1.14 kg x hm(-2) with DCD application, representing a 50.9% reduction. In the control treatments where no urea was applied, the daily N2O flux was very low and it never exceeded 9 microg x (m2 x h) (-1) for Chinese cabbage and 22 microg x (m2 x h) (-1) for pepper, respectively, but DCD also reduced N2O emissions (33.5% for Chinese cabbage and 33.4% for pepper). In addition, the urea-N emission factor (EF) was 0.15%, 0.99% for Chinese cabbage and pepper without DCD, respectively, and it was reduced to 0.07%, 0.52% when DCD was applied. These results demonstrated the potential of using nitrification inhibitors (DCD) to mitigate N2O emissions in vegetable system.