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INTRODUCTION: This study aimed to evaluate whether the addition of a hemoadsorption (HA) cartridge, HA-380, in the cardiopulmonary bypass (CPB) circuit in acute type A aortic dissection (ATAAD) surgery reduced inflammatory cytokine levels and decreased postoperative complications. METHODS: A retrospective observational cohort study was conducted between March 1, 2021, and February 28, 2022. Patients with ATAAD undergoing emergent total arch replacement surgery were divided into the control (CON) and HA groups on the basis of the addition of the HA-380 cartridge in the CPB circuit. RESULTS: Overall, 121 patients met the eligibility criteria; 2 patients in each group who died within the first postoperative week were excluded. Further, 57 and 60 patients in the CON and HA groups, respectively, were included in the pooled analysis. The major perioperative data, baseline values of interleukin-6 (IL-6) and C-reactive protein, and therapeutic interventions were similar in the two groups (all, p > 0.05). The serum IL-6 levels increased more rapidly in the CON group than those in the HA group postoperatively (205.73 ± 174.72 vs. 146.13 ± 64.15 pg/mL, p = 0.020). The HA group had a lower incidence of postoperative acute kidney injury (AKI) and severe acute respiratory distress syndrome than the CON group (25.4 vs. 44.6%, p = 0.032 and 18.3 vs. 35.1%, p = 0.040, respectively). Logistic regression analyses showed that HA may be a protective factor against postoperative AKI. The incidence of bleeding, delirium, and stroke as well as the lengths of intensive care unit and hospital stay in both groups were similar (all, p > 0.05). CONCLUSIONS: The use of HA-380 in the CPB circuit may attenuate inflammatory response and reduce major complications following ATAAD surgery. HA may be associated with lower rate of postoperative AKI.
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Injúria Renal Aguda , Dissecção Aórtica , Humanos , Estudos Retrospectivos , Interleucina-6 , Dissecção Aórtica/cirurgia , Citocinas , Complicações Pós-Operatórias/terapia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Fatores de RiscoRESUMO
Linear dielectric polymers are potential candidates for electrostatic capacitors due to their high breakdown strength, high efficiency, and low dielectric loss. In this work, a novel poly (vinylidene fluoride) (PVDF) tailored linear PMMA-co-GMA (MG) copolymer-based all-organic dielectric film with high breakdown strength and discharge energy density was prepared by the solution blending method. Compared with the PMMA homopolymer, the MG copolymer behaved with a higher energy density (5.6 J/cm3) since the GMA component bestowed higher polarity and yielded deep traps for the copolymer. On the other hand, the introduction of PVDF into MG further improved the dielectric constant and overcame the brittleness of MG films. When the concentration of PVDF was 30 wt %, the MG/PVDF film exhibited a high discharged energy density of 10.8 J/cm3 at 600 MV/m with a 78.7% discharge efficiency, which was 2.5 times that of pure PVDF (4.3 J/cm3 at 320 MV/m) and 1.9 times that of pure MG (5.6 J/cm3 at 460 MV/m). The improvement in energy storage performance might be ascribed to the excellent thermodynamic miscibility and hydrogen bond interaction between the linear MG copolymer and the ferroelectric PVDF. This research provides a new and feasible strategy for designing all-organic dielectric films with high energy density for energy storage applications.
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In the present work, self-cleaning membranes of ionic liquid-grafted poly(vinylidene fluoride) (PVDF) polydopamine-coated TiO2 were prepared through a nonsolvent-induced phase separation method. PDA facilitates the uniform dispersion of TiO2 nanoparticles in PVDF substrates; meanwhile, TiO2@PDA core-shell particles and the hydrophilic IL improve the hydrophilicity of PVDF membranes and contribute to the increased average pore size and porosity, significantly improving the pure water permeation flux and dye wastewater flux (the water flux increased to 385.9 Lm-2 h-1). In addition, the combined effect of the positively charged IL and the strongly viscous PDA shell layer enhanced the retention and adsorption of dyes so that the retention and adsorption rates of both anionic and cationic dyes were close to 100%. Notably, the hydrophilic PDA allowed more TiO2 to migrate to the membrane surface during the phase transition; on the other hand, dopamine could promote photodegradation. Therefore, the combined two factors for TiO2@PDA were beneficial to the ultraviolet-catalytic (UV-catalytic) degradation of dyes on the surface of the membrane, leading to >80% degradation rates of various dyes. Thus, the high-efficiency and easy-to-operate wastewater treatment technology provides attractive potential for dye removal and resolution of membrane contamination.
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Polymer-based dielectric materials have been used in film capacitors due to their rapid charge-discharge rate, lightness, and low cost. Nevertheless, the energy storage properties of these dielectric films were limited by their weak polarization ability and low discharge energy density. Herein, the solution casting method was used to prepare all-organic crosslinked composite films using linear methyl methacrylate-co-glycidyl methacrylate (MG) as the matrix and ferroelectric poly(vinylidene fluoride) (PVDF) as the organic filler. The crosslinked MG networks can enhance the breakdown strength, restrain dielectric loss, and keep high discharge efficiency. What's more, the presence of PVDF can compensate for the low electrical displacement, improve the permittivity, and overcome the brittleness of the crosslinked films. The optimal all-organic crosslinked dielectric film exhibited an ultrahigh breakdown strength of 800 MV m-1 and a high efficiency of 77.4%. The maximum energy density of the composite film reached up to 12.1 J cm-3, which was nearly 120% higher than the energy density of 5.6 J cm-3 of the pure MG film. The enhancement in energy storage properties is ascribed to the synergistic effects of chemical crosslinking and hydrogen bonding. This study offers a feasible method for all-organic polymer films to fabricate energy storage equipment.
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All-organic polymer dielectric films have been widely used for different electrical devices in recent years. However, their development is impeded by low Ue and large device volume. In the present paper, polyvinylidene fluoride (PVDF) composite dielectric materials, with high energy density (Ue) and energy efficiency (η), were prepared through the synergistic effect of a new MMA-co-GMA (MG) copolymer and cyanoethylated cellulose. MG was miscible with PVDF, which reduced the dielectric loss (tan δ) and improved the η of PVDF due to the linear structure and the hydrogen bonding interaction with the epoxy groups for MG. To further enhance the Ue of the dielectric films, cyanoethylated cellulose (CR-C) was added as a third component into the PVDF composite matrix to improve the Ue. The deep trap effect of hydrogen bonds between PVDF/MG and CR-C improved the electric breakdown strength (Eb) of the three-phase composite films from 440 MV m-1 to 640 MV m-1. Moreover, the high polarization of cyanoethylated cellulose can significantly improve the Ue (24.43 J cm-3) of the three-phase composite dielectric film, and the efficiency can be maintained above 75% at 640 MV m-1. This research provides a new idea for the manufacturing of homogeneous and stable all-organic PVDF dielectric composite films based on the hydrogen bonding construction strategy.
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Recent years have witnessed an increasing interest in deploying state-of-the-art augmented reality (AR) head-mounted displays (HMDs) for agri-food applications. The benefits of AR HMDs to agri-food industry stakeholders (e.g., food suppliers, retail/food service) have received growing attention and recognition. AR HMDs enable users to make healthier dietary choices, experience novel changes in their perception of taste, enhance the cooking and food shopping experience, improve productivity at work and enhance the implementation of precision farming. Therefore, although development costs are still high, the case for integration of AR in food chains appears to be compelling. This review will present the most recent developments of AR HMDs for agri-food relevant applications. The summarized applications can be clustered into different themes: (1) dietary and food nutrition assessment; (2) food sensory science; (3) changing the eating environment; (4) retail food chain applications; (5) enhancing the cooking experience; (6) food-related training and learning; and (7) food production and precision farming. Limitations of current practices will be highlighted, along with some proposed applications.
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Realidade Aumentada , Óculos Inteligentes , Atenção , AprendizagemRESUMO
BACKGROUND: Chongqing reportedly has a large MSM population and a high STI prevalence in previous studies. However, most studies are attributed to independent cross-sectional studies, few studies have investigated trends in the prevalence of syphilis and HIV, as well as behavioural characteristics among MSM using serial surveillance surveys. METHODS: Data were collected in Chongqing through face-to-face questionnaire interview and laboratory testing in Chongqing. The respondents were recruited among MSM by snowball sampling from May 2013 to December 2017. The self-report questionnaire primarily included socio-demographics, HIV knowledge, and HIV-related behaviour characteristics over the year. Blood specimens were tested to diagnose HIV and syphilis infection by Chongqing CDC. Cochran-Armitage trend test and multivariate logistic regression were conducted to compare the changes in STI prevalence and independent behavioural factors among MSM. RESULTS: There were 6568 eligible participants (98.4%). The overall HIV prevalence was 20.5% among MSM in Chongqing, with a decrease from 23.0% in 2013 to 19.2% in 2017. The overall syphilis prevalence was 5.8%, with an increase from 3.2% in 2013 to 6.7% in 2017. The proportion of consistent condom use (CCU) during anal intercourse (46.3 to 57.7%, P<0.001),CCU with regular male partners(47.7 to 59.7%, P<0.001), CCU with casual male partners (51.5 to 62.3%, P<0.001) and drug use during anal intercourse (0.3 to 1.4%, P<0.05) were increasing. By contrast, a significant decrease was reported in the percentage of MSM with more than two regular male partners (66.0 to 21.4%, P<0.001) and more than two casual male partners (38.3 to 20.7%, P<0.001). A significant difference was observed in syphilis infection, testing for HIV antibodies and drug use during anal intercourse in the past years between the HIV-positive and HIV-negative respondents. CONCLUSION: A decreasing trend of HIV prevalence was showed during among MSM from 2013 to 2017 in Chongqing. While gradual reduction of high-risk behaviors along with HIV prevalence supported development of STI counselling and testing, increasing syphilis infection and drug use during anal intercourse warrants further understanding.
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Infecções por HIV/epidemiologia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Sífilis/epidemiologia , Adolescente , Adulto , Idoso , China/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Comportamento de Redução do Risco , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
In recent years, the field of microplastic (MP) research has evolved significantly; however, the lack of a standardized detection methodology has led to incomparability across studies. Addressing this gap, our current study innovates a reliable MP detection system that synergizes sample processing, machine learning, and optical photothermal infrared (O-PTIR) spectroscopy. This approach includes examining high-temperature filtration and alcohol treatment for reducing non-MP particles and utilizing a support vector machine (SVM) classifier focused on key wavenumbers that could discriminate between nylon MPs and non-nylon MPs (1077, 1541, 1635, 1711 cm-1 were selected based on the feature importance of SVM-Full wavenumber model) for enhanced MP identification. The SVM model built from key wavenumbers demonstrates a high accuracy rate of 91.33%. Results show that alcohol treatment is effective in minimizing non-MP particles, while filtration at 70 °C has limited impact. Additionally, this method was applied to assess MPs released from commercial nylon teabags, revealing an average release of 106 particles per teabag. This research integrates machine learning with O-PTIR spectroscopy, paving the way for potential standardization in MP detection methodologies and providing vital insights into their environmental and health implications.
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The escalating prominence of micro- and nanoplastics (MNPs) as emerging anthropogenic pollutants has sparked widespread scientific and public interest. These minuscule particles pervade the global environment, permeating drinking water and food sources, prompting concerns regarding their environmental impacts and potential risks to human health. In recent years, the field of MNP research has witnessed the development and application of cutting-edge infrared (IR) spectroscopic instruments. This review focuses on the recent application of advanced IR spectroscopic techniques and relevant instrumentation to analyse MNPs. A comprehensive literature search was conducted, encompassing articles published within the past three years. The findings revealed that Fourier transform infrared (FTIR) spectroscopy stands as the most used technique, with focal plane array FTIR (FPA-FTIR) representing the cutting edge in FTIR spectroscopy. The second most popular technique is quantum cascade laser infrared (QCL-IR) spectroscopy, which has facilitated rapid analysis of plastic particles. Following closely is optical photothermal infrared (O-PTIR) spectroscopy, which can furnish submicron spatial resolution. Subsequently, there is atomic force microscopy-based infrared (AFM-IR) spectroscopy, which has made it feasible to analyse MNPs at the nanoscale level. The most advanced IR instruments identified in articles covered in this review were compared. Comparison metrics encompass substrates/filters, data quality, spatial resolution, data acquisition speed, data processing and cost. The limitations of these IR instruments were identified, and recommendations to address these limitations were proposed. The findings of this review offer valuable guidance to MNP researchers in selecting suitable instrumentation for their research experiments, thereby facilitating advancements in research aimed at enhancing our understanding of the environmental and human health risks associated with MNPs.
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Growing attention is being directed towards exploring the potential harmful effects of microplastic (MP) particles on human health. Previous reports on human exposure to MPs have primarily focused on inhalation, ingestion, transdermal routes, and, potentially, transplacental transfer. The intravenous transfer of MP particles in routine healthcare settings has received limited exploration in existing literature. Standard hospital IV system set up with 0.9 % NaCl in a laminar flow hood with MP contamination precautions. Various volumes of 0.9 % NaCl passed through the system, some with a volumetric pump. Fluid filtered with Anodisc filters washed with isopropyl alcohol. The IV cannula was immersed in Mili-Q water for 72 h to simulate vein conditions. Subsequently, the water was filtered and washed. Optical photothermal infrared (O-PTIR) microspectroscopy is used to examine filters for MP particles. All filters examined from the IV infusion system contained MP particles, including MPs from the polymer materials used in the manufacture of the IV delivery systems (polydimethylsiloxane, polypropylene, polystyrene, and polyvinyl chloride) and MP particles arising from plastic resin additives (epoxy resin, polyamide resin, and polysiloxane-containing MPs). The geometric mean from the extrapolated result data indicated that approximately 0.90 MP particles per mL of 0.9 % NaCl solution can be administered through a conventional IV infusion system in the absence of a volumetric pump. However, with the implementation of a pump, this value may increase to 1.57 particles per mL. Notably, over 72 h, a single cannula was found to release approximately 558 MP particles including polydimethylsiloxane, polysiloxane-containing MPs, polyamide resin, and epoxy resin. Routine IV infusion systems release microplastics. MP particles are also released around IV cannulas, suggesting transfer into the circulatory system during standard IV procedures.
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Microplásticos , Microplásticos/análise , Espectrofotometria Infravermelho , Monitoramento Ambiental/métodos , Infusões Intravenosas , Humanos , Plásticos/análiseRESUMO
The compelling integration of superhydrophobic coatings with light-to-heat conversion capabilities has garnered substantial interest due to their dual functionality encompassing passive anti-icing and deicing attributes. However, the insufficient mechanical stability and the environmental and human health concerns stemming from the extensive use of organic solvents limit their practical application. In this study, an all-waterborne superhydrophobic photothermal coating (PCPAS) was prepared through the synergy of composite micro-nanoparticles derived from carbon nanotubes (CNT), polydopamine (PDA), and Ag particles with fluorine-containing polyacrylic emulsion (PFA). The PDA provided active sites for Ag+ reduction reaction and enhanced the interfacial interaction between CNT and Ag particles. The interfacial enhancement enabled the coating to maintain stable superhydrophobicity after 260 times sandpaper abrasion and 240 times tape peeling. Simultaneously, the composite micro-nanoparticle's light-to-heat conversion ability gave the coating excellent anti-icing/deicing capabilities. Under the condition of -20 °C, the freezing time of 30 µL of water droplets was extended to 392 s, and 2 × 2 × 2 cm ice cubes placed on the surface of the coating could completely melt after only 1142 s under simulated sunlight irradiation with a 1 kW/m2 intensity. In addition, the coating also had suitable self-cleaning properties and substrate applicability. The comprehensive attributes of this all-waterborne photothermal superhydrophobic coating render it a promising contender for anti-icing and deicing applications in challenging outdoor environments.
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Marine fouling on concrete has become one of the severest problems that damage the surface and even cause internal corrosion of marine concrete. Dissimilarly to the previous abuse of toxic antifoulants, developing hydrophobic waterborne antifouling materials could be regarded as one of the most environment-friendly and potential directions to protect marine concrete. However, the insufficient hydrophobicity, antifouling, and mechanical properties limit their application. Herein, we reported a series of hybrid coatings combining hyperbranched polyglycerol (HPG) decorated waterborne fluoro silicone polyurethane (H) and HPG-grafted graphene oxide (G-HPG) that improve the hydrophobicity, antifouling, and mechanical properties. The hybrid materials were modified by the hyperbranched polyglycerol synthesized based on the anionic-ring-opening reaction between glycerol and ethylene glycol or polyethylene glycol. Remarkably, the hydrophobicity (115.19°) and antifouling properties (BSA absorption of 2.33 µg/cm2 and P. tricornutum attachment of 1.289 × 104 CFU/cm2) of the materials could be developed by the modification of HPG with higher generation numbers and backbone molecular weights. Moreover, the mechanical properties negligibly decreased (tensile strength decreased from 11.29 MPa to 10.49 MPa, same pencil hardness and adhesion grade as H of 2H and grade 2). The results revealed that the HPG of higher generation numbers and backbone molecular weights could benefit materials with enhanced antifouling properties and hydrophobicity. The method of hyperbranched modification can be regarded as potentially effective in developing the durability and antifouling properties of marine antifouling materials.
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OBJECTIVE: This retrospective study explored the association between calcium oxalate (CaOx) stones and metabolic syndrome. It also developed and validated a nomogram to aid in the prediction of CaOx stones. METHODS: This case-control study enrolled 150 patients with CaOx stones and 635 individuals without urolithiasis from October 2016 to October 2018. Student's t-test, the chi-squared test, and logistic univariate and multivariate regression analyses were used. A nomogram for prediction of CaOx stones was established based on independent associated factors. The concordance index and calibration curves were plotted to determine nomogram accuracy. RESULTS: Female sex, age ≥66 years, blood pressure (systolic pressure ≥130 mmHg and/or diastolic pressure ≥85 mmHg), and blood uric acid level independently influenced the risk of CaOx stones, according to multivariate logistic regression analysis; these factors were included in the nomogram. The concordance index was 0.701 (95% confidence interval: 0.658-0.737). The standard curve showed a robust fit with the calibrated predictive curve. CONCLUSIONS: Female sex, age ≥66 years, elevated blood pressure, and blood uric acid level independently influenced the risk of CaOx stones. Our nomogram for the prediction of CaOx stones may provide a clinical basis for the assessment of CaOx stone and facilitate early prevention efforts.
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Oxalato de Cálcio , Síndrome Metabólica , Idoso , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Síndrome Metabólica/diagnóstico , Nomogramas , Estudos RetrospectivosRESUMO
ABSTRACT: Pancreatic cancer (PC) is a malignant tumor which ranks fourth in cancer-related death. However, the specificity and sensitivity of traditional biomarkers such as carbohydrate antigen 19-9 no longer meet the clinical requirements.Tools as ONCOMINE and Gene Expression Profiling Interactive Analysis (GEPIA) were used to analyze the differential expression of matrix metalloproteinases (MMPs) in PC and adjacent tissues. For further analysis, we adopted database for annotation, visualization and integrated discovery (DAVID 6.8), transcriptional regulatory relationships unraveled by sentence-based text (TRRUST) and other tools. We also identified drugs targeted the selected MMPs.Eight MMPs (MMP1, MMP2, MMP7, MMP9, MMP11, MMP12, MMP14, and MMP28) were differentially expressed in PC and adjacent tissue. MMP1 (Pâ=â.0189), MMP7 (Pâ=â.000216), MMP11 (Pâ=â.0209), MMP14 (Pâ=â.00611) were correlated with the pathological stages of PC. Patients with higher expression of MMP1 (Pâ=â.0011), MMP2 (Pâ=â.011), MMP7 (Pâ=â.0081), MMP9 (Pâ=â.046), MMP11 (Pâ=â.0019), MMP12 (Pâ=â.0011), MMP14 (Pâ=â.0011), and MMP28 (Pâ=â6.3e-06) showed poor prognosis. Ten transcription factors were associated with the up-regulation of selected MMPs. Marimastat (DB00786) was found to target selected MMPs.Our research revealed that selected MMPs played an important role in the early diagnosis and prognosis of PC.
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Perfilação da Expressão Gênica/métodos , Ácidos Hidroxâmicos/farmacologia , Metaloproteinases da Matriz , Neoplasias Pancreáticas , Biomarcadores/metabolismo , Biologia Computacional , Regulação Neoplásica da Expressão Gênica , Humanos , Inibidores de Metaloproteinases de Matriz/farmacologia , Metaloproteinases da Matriz/classificação , Metaloproteinases da Matriz/genética , Metaloproteinases da Matriz/metabolismo , Metaloendopeptidases , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/metabolismo , PrognósticoRESUMO
OBJECTIVES: Mesenchymal stem cells (MSCs) are potentially ideal for type 2 diabetes treatment, owing to their multidirectional differentiation ability and immunomodulatory properties. Here we investigated whether the stem cells from human exfoliated deciduous teeth (SHED) in combination with hyperbaric oxygen (HBO) could treat type 2 diabetic rats, and explored the underlying mechanism. METHODS: SD rats were used to generate a type 2 diabetes model, which received stem cell therapy, HBO therapy, or both together. Before and after treatment, body weight, blood glucose, and serum insulin, blood lipid, pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6), and urinary proteins were measured and compared. After 6 weeks, rats were sacrificed and their organs were subjected to hematoxylin and eosin staining and immunofluorescence staining for insulin and glucagon; apoptosis and proliferation were analyzed in islet cells. Structural changes in islets were observed under an electron microscope. Expression levels of Pdx1, Ngn3, and Pax4 mRNAs in the pancreas were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS: In comparison with diabetic mice, those treated with the combination or SHE therapy showed decreased blood glucose, insulin resistance, serum lipids, and pro-inflammatory cytokines and increased body weight and serum insulin. The morphology and structure of pancreatic islets improved, as evident from an increase in insulin-positive cells and a decrease in glucagon-positive cells. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining of islet cells revealed the decreased apoptosis index, while Ki67 and proliferating cell nuclear antigen staining showed increased proliferation index. Pancreatic expression of Pdx1, Ngn3, and Pax4 was upregulated. CONCLUSION: SHED combined with HBO therapy was effective for treating type 2 diabetic rats. The underlying mechanism may involve SHED-mediated increase in the proliferation and trans-differentiation of islet ß-cells and decrease in pro-inflammatory cytokines and apoptosis of islets.
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Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Oxigenoterapia Hiperbárica/métodos , Células Secretoras de Insulina , Transplante de Células-Tronco Mesenquimais , Animais , China , Diabetes Mellitus Tipo 2/induzido quimicamente , Humanos , Insulina , Masculino , Células-Tronco Mesenquimais , Camundongos , Ratos , Ratos Sprague-Dawley , Células-Tronco , Dente DecíduoRESUMO
OBJECTIVES: Mesenchymal stem cells (MSCs) are potentially ideal for type 2 diabetes treatment, owing to their multidirectional differentiation ability and immunomodulatory properties. Here we investigated whether the stem cells from human exfoliated deciduous teeth (SHED) in combination with hyperbaric oxygen (HBO) could treat type 2 diabetic rats, and explored the underlying mechanism. METHODS: SD rats were used to generate a type 2 diabetes model, which received stem cell therapy, HBO therapy, or both together. Before and after treatment, body weight, blood glucose, and serum insulin, blood lipid, pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6), and urinary proteins were measured and compared. After 6 weeks, rats were sacrificed and their organs were subjected to hematoxylin and eosin staining and immunofluorescence staining for insulin and glucagon; apoptosis and proliferation were analyzed in islet cells. Structural changes in islets were observed under an electron microscope. Expression levels of Pdx1, Ngn3, and Pax4 mRNAs in the pancreas were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS: In comparison with diabetic mice, those treated with the combination or SHE therapy showed decreased blood glucose, insulin resistance, serum lipids, and pro-inflammatory cytokines and increased body weight and serum insulin. The morphology and structure of pancreatic islets improved, as evident from an increase in insulin-positive cells and a decrease in glucagon-positive cells. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining of islet cells revealed the decreased apoptosis index, while Ki67 and proliferating cell nuclear antigen staining showed increased proliferation index. Pancreatic expression of Pdx1, Ngn3, and Pax4 was upregulated. CONCLUSION: SHED combined with HBO therapy was effective for treating type 2 diabetic rats. The underlying mechanism may involve SHED-mediated increase in the proliferation and trans-differentiation of islet β-cells and decrease in pro-inflammatory cytokines and apoptosis of islets.