Exosome-based regenerative rehabilitation: A novel ice breaker for neurological disorders.

Neurological disorders affect a large population, often leading to different levels of disability and resulting in decreased quality of life. Due to the limited recovery obtained from surgical procedures and other medical approaches, a large number of patients with prolonged dysfunction receive neurorehabilitation protocols to improve their neural plasticity and regeneration. However, the poor neural regeneration ability cannot effectively rebuild the tissue integrity and neural functional networks; consequently, the prognoses of neurorehabilitation remain undetermined. To increase the chances of neural regeneration and functional recovery for patients with neurological disorders, regenerative rehabilitation was introduced with combined regenerative medicine and neurorehabilitation protocols to repair neural tissue damage and create an optimized biophysical microenvironment for neural regeneration potential. With the deepening of exosome research, an increasing number of studies have found that the systemic therapeutic effects of neurorehabilitation approaches are mediated by exosomes released by physically stimulated cells, which provides new insight into rehabilitative mechanisms. Meanwhile, exosome therapy also serves as an alternative cell-free therapy of regenerative medicine that is applied in partnership with neurorehabilitation approaches and formulates exosome-based neurological regenerative rehabilitation. In this study, we review the current state of exosome-associated neurorehabilitation. On the one hand, we focus on presenting the varied mediating effects of exosomes in neurorehabilitation protocols of specific neurological pathologies; on the other hand, we discuss the diverse combinations of exosome therapies and neurorehabilitation approaches in the field of neurological regenerative rehabilitation, aiming to increase the awareness of exosome research and applications in the rehabilitation of neurological disorders.

A global bibliometric and visualized analysis in the status and trends of corneal tissue engineering research from 1991 to 2021.

Corneal tissue engineering has developed rapidly in recent years, with a large number of publications emerging worldwide. This study focused on exploring the global status and research trends in this field. Publications related to corneal tissue engineering from 1991 to 2021 were acquired from the Science Citation Index-Expanded (SCI-Expanded) of Web of Science (WoS). Firstly, the VOS viewer software was chosen for visualizing bibliometric networks, including bibliographic coupling analysis, co-citation analysis, co-authorship analysis, and co-occurrence analysis, and the CiteSpace software was used to detect burst keywords. Subsequently, the publication trends in corneal tissue engineering research were also predicted. In present study, 953 publications were selected and analyzed. The number of annual publications was increasing globally and was predicted to continue the current trend. While Japan ranked top 1 in terms of average citation, the USA contributed the most to the corneal tissue engineering research with highest number of citations and highest H-index. The journal of Biomaterials contributed the largest publication number. The top-ranked institutions were National University of Singapore and Singapore National Eye Center. Additionally, researches could be manually divided into four clusters: "biomaterial related research," "cell related research," "transplantation therapy," and "mechanism research on biomaterials." Specifically, the research topic "hydrogel" was predicted to be hotspots which may help researchers to explore new directions for future research.

Puerarin prevents calcium oxalate crystal-induced renal epithelial cell autophagy by activating the SIRT1-mediated signaling pathway.

Calcium oxalate (CaOx) crystals can activate autophagy, causing damage to renal tubular epithelial cells (TECs). Puerarin has been shown to have protective and therapeutic effects against a variety of diseases by inhibiting autophagy activation. However, the protective effect of puerarin against CaOx crystals and the underlying molecular mechanisms are unclear. Cell Counting Kit-8 (CCK-8) assays were used to evaluate the effects of puerarin on cell viability. Intracellular reactive oxygen species (ROS) levels were measured by the cell-permeable fluorogenic probe 2,7-dichlorofluorescein diacetate (DCFH-DA). Immunofluorescence, immunohistochemistry, and western blotting were used to examine the expression of SIRT1, Beclin1, p62, and LC3, and explore the underlying molecular mechanisms in vivo and in vitro. Puerarin treatment significantly attenuated CaOx crystal-induced autophagy of TECs and CaOx cytotoxicity to TECs by altering SIRT1 expression in vitro and in vivo, whereas the SIRT1-specific inhibitor EX527 exerted contrasting effects. In addition, we found that the protective effect of puerarin was related to the SIRT1/AKT/p38 signaling pathway. The findings suggest that puerarin regulates CaOx crystal-induced autophagy by activating the SIRT1-mediated signaling pathway, and they suggest a series of potential therapeutic targets and strategies for treating nephrolithiasis.

N,N-Dimethylformamide inhibits high glucose-induced osteoporosis via attenuating MAPK and NF-κB signalling.

AIMS: The role of N,N-dimethylformamide (DMF) in diabetes-induced osteoporosis (DM-OS) progression remains unclear. Here, we aimed to explore the effect of DMF on DM-OS development. METHODS: Diabetic models of mice, RAW 264.7 cells, and bone marrow macrophages (BMMs) were established by streptozotocin stimulation, high glucose treatment, and receptor activator of nuclear factor-κB ligand (RANKL) treatment, respectively. The effects of DMF on DM-OS development in these models were examined by micro-CT analysis, haematoxylin and eosin (H&E) staining, osteoclast differentiation of RAW 264.7 cells and BMMs, H&E and tartrate-resistant acid phosphatase (TRAP) staining, enzyme-linked immunosorbent assay (ELISA) of TRAP5b and c-terminal telopeptides of type 1 (CTX1) analyses, reactive oxygen species (ROS) analysis, quantitative reverse transcription polymerase chain reaction (qRT-PCR), Cell Counting Kit-8 (CCK-8) assay, and Western blot. RESULTS: The established diabetic mice were more sensitive to ovariectomy (OVX)-induced osteoporosis, and DMF treatment inhibited the sensitivity. OVX-treated diabetic mice exhibited higher TRAP5b and c-terminal telopeptides of type 1 (CTX1) levels, and DMF treatment inhibited the enhancement. DMF reduced RAW 264.7 cell viability. Glucose treatment enhanced the levels of TRAP5b, cathepsin K, Atp6v0d2, and H+-ATPase, ROS, while DMF reversed this phenotype. The glucose-increased protein levels were inhibited by DMF in cells treated with RANKL. The expression levels of antioxidant enzymes Gclc, Gclm, Ho-1, and Nqo1 were upregulated by DMF. DMF attenuated high glucose-caused osteoclast differentiation by targeting mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signalling in BMMs. CONCLUSION: DMF inhibits high glucose-induced osteoporosis by targeting MAPK and NF-κB signalling. Cite this article: Bone Joint Res 2022;11(4):200-209.

Controllable Preparation of Ag-Ce/ZnO Nanorods Photocatalyst and Its Growth on Modified Polyester Surface in Water Bath.

In this paper, a simple and effective method to prepare Ag-Ce/ZnO nanorods photocatalyst and grow them controllably on modified polyester fabrics was presented to fabricate multifunctional textiles. Analytical grade zinc acetate dihydrate and sodium hydroxide were used as the main raw materials to prepare Ag-Ce/ZnO nanorods. Morphological, structural and chemical characterization of the Ag-Ce/ZnO nanorods was performed by XRD, UV-vis and other spectroscopies. The results showed that the Ag-Ce/ZnO nanorods had a hexagonal wurtzite structure. After 60 minutes of irradiation under ultraviolet light, the Ag-Ce/ZnO nanorods showed a percentage photodegradation of 93.14% for a methylene blue (MB) solution. Modified polyester fabrics covered with the Ag-Ce/ZnO nanorods were then prepared in a water bath. By a series of tests, it was observed that the Ag-Ce/ZnO nanorods on the modified polyester surface were neatly arranged and had good photocatalytic properties. Moreover, the UPF of the modified polyester fabric after finishing increased from 30.4 to 877.2. The multifunctional properties of the finished fabric exhibited good durability.

Multidisciplinary treatment of primary intracranial yolk sac tumor: A case report and literature review.

RATIONALE: Intracranial yolk sac tumors (YSTs) are rare malignancies with limited treatment options and a dismal prognosis. They are usually managed with surgical resection and chemoradiotherapy. PATIENT CONCERNS: Here, we report a patient with primary YST in the pineal region who achieved long term survival. Despite undergoing treatment, he experienced several recurrences over a 15-year period. DIAGNOSIS: Brain magnetic resonance imaging (MRI) demonstrated the presence of space-occupying lesions in the pineal region and the medial tail of the left lateral ventricle. The tumors were excised, and the histological diagnosis suggested an intracranial YST. INTERVENTIONS: The patient achieved long term survival after combined modality therapy including surgery, stereotactic radiosurgery (SRS)/intensity modulated radiation therapy (IMRT), chemotherapy, and targeted therapy. OUTCOMES: The disease remained stable. However, the patient gave up treatment and passed away in October 2020, with a total survival of about 15 years. LESSONS: To the best of our knowledge, this patient with intracranial YST had received a longer survival compared with other published reports. We summarize previously published reports of intracranial YST and discuss the importance of multidisciplinary treatment. SRS may have a role, as a focal boost to residual tumor after resection or in case of recurrence after conventional radiotherapy, in the multimodality management of intracranial YSTs.

Rosiglitazone Suppresses Calcium Oxalate Crystal Binding and Oxalate-Induced Oxidative Stress in Renal Epithelial Cells by Promoting PPAR-γ Activation and Subsequent Regulation of TGF-ß1 and HGF Expression.

Peroxisome proliferator-activated receptor- (PPAR-) γ is a ligand-dependent transcription factor, and it has become evident that PPAR-γ agonists have renoprotective effects, but their influence and mechanism during the development of calcium oxalate (CaOx) nephrolithiasis remain unknown. Rosiglitazone (RSG) was used as a representative PPAR-γ agonist in our experiments. The expression of transforming growth factor-ß1 (TGF-ß1), hepatocyte growth factor (HGF), c-Met, p-Met, PPAR-γ, p-PPAR-γ (Ser112), Smad2, Smad3, pSmad2/3, and Smad7 was examined in oxalate-treated Madin-Darby canine kidney (MDCK) cells and a stone-forming rat model. A CCK-8 assay was used to evaluate the effects of RSG on cell viability. In addition, intracellular reactive oxygen species (ROS) levels were monitored, and lipid peroxidation in renal tissue was detected according to superoxide dismutase and malondialdehyde levels. Moreover, the location and extent of CaOx crystal deposition were evaluated by Pizzolato staining. Our results showed that, both in vitro and in vivo, oxalate impaired PPAR-γ expression and phosphorylation, and then accumulative ROS production was observed, accompanied by enhanced TGF-ß1 and reduced HGF. These phenomena could be reversed by the addition of RSG. RSG also promoted cell viability and proliferation and decreased oxidative stress damage and CaOx crystal deposition. However, these protective effects of RSG were abrogated by the PPAR-γ-specific inhibitor GW9662. Our results revealed that the reduction of PPAR-γ activity played a critical role in oxalate-induced ROS damage and CaOx stone formation. RSG can regulate TGF-ß1 and HGF/c-Met through PPAR-γ to exert antioxidant effects against hyperoxaluria and alleviate crystal deposition. Therefore, PPAR-γ agonists may be expected to be a novel therapy for nephrolithiasis, and this effect is related to PPAR-γ-dependent suppression of oxidative stress.

Caffeine improves bladder function in streptozotocin-induced diabetic rats.

AIMS: To examine the protective effects of caffeine in rats with diabetes mellitus (DM) by using urodynamics. METHODS: Female Sprague-Dawley rats (n = 24) were divided into four groups: control group, DM group, DM + caffeine (5 mg/kg/day), and DM + caffeine (10 mg/kg/day). DM was induced by streptozotocin (STZ). Cystometric studies were conducted on all rats. After 8 weeks of treatment with caffeine, the urodynamic parameters, including bladder capacity, residual urine volume, voiding time, and peak voiding pressure, were measured. RESULTS: DM rats had a higher bladder capacity and post-void residual urine volume (PVR), an increased voiding time and peak voiding pressure, and a markedly lower voiding efficiency than the control group rats. After treatment with caffeine, bladder capacity, post-void residual urine volume, and peak voiding pressure were significant lower than those in the DM group, but voiding efficiency was markedly higher. CONCLUSION: The results suggested that caffeine (5 or 10 mg/kg/day) may improve the bladder function at 8 weeks after STZ induction. Thus, this may represent a potential strategy to increase voiding efficiency in diabetes.

Melatonin for the treatment of spinal cord injury.

Spinal cord injury (SCI) from trauma or disease severely impairs sensory and motor function. Neurorehabilitation after SCI is a complex medical process that focuses on improving neurologic function and repairing damaged connections in the central nervous system. An increasing number of preclinical studies suggest that melatonin may be useful for the treatment of SCI. Melatonin is an indolamine that is primarily secreted by the pineal gland and known to be regulated by photoperiodicity. However, it is also a versatile hormone with antioxidative, antiapoptotic, neuroprotective, and anti-inflammatory properties. Here, we review the neuroprotective properties of melatonin and the potential mechanisms by which it might be beneficial in the treatment of SCI. We also describe therapies that combine melatonin with exercise, oxytetracycline, and dexamethasone to attenuate the secondary injury after SCI and limit potential side effects. Finally, we discuss how injury at different spinal levels may differentially affect the secretion of melatonin.

A rare anomalous origin of right vertebral artery with double branch: First case report.

Vertebral artery origin anomalies are typically incidental findings during angiography. We present an extremely rare variant in which the right vertebral artery has a double origin from the right subclavian artery and right common carotid artery in association with an aberrant right subclavian artery, which has never been reported before.

Ultrasonic versus electrosurgical device for laparoscopic cholecystectomy: A systematic review with meta-analysis and trial sequential analysis.

BACKGROUND: Ultrasonic and electrosurgical energy dissectors are main dissecting devices widely used for the laparoscopic cholecystectomy. Trial sequential analyses can establish whether firm evidence favoring a specific device has been reached from accumulated literature. To explore this, we performed a meta-analysis and trial sequential analyses. METHODS: PubMed, Embase, and the Cochrane Library were searched from inception to October 2016. The primary outcome was operative time. The secondary outcomes included adverse events during operation, postoperative complications, intra-abdominal collection, hospital stay, hospital costs, and sick leave or time to full recovery. Relative risks (RRs) were calculated for dichotomous outcomes and mean differences (MDs) for continuous outcomes. Finally, we calculated numbers needed to treat to examine benefits of the ultrasonic device. RESULTS: We identified 19 studies. Compared with the electrosurgical device, the ultrasonic device led to shorter operative time (MD, -14.86; 95% confidence interval (CI), -21.45 to -8.27; P < 0.00001), less blood loss (MD, -47.24; 95% CI, -79.57 to -14.90; P = 0.004), fewer gallbladder perforations (RR, 0.45; 95% CI, 0.35 to 0.57; P < 0.00001), shorter hospital stay (MD, -0.37; 95% CI, -0.61 to -0.14; P = 0.002), and fewer abdominal pains (MD, -0.95; 95% CI, -1.40 to -0.50; P < 0.0001). The trial sequential analysis demonstrated that the cumulative z-curve crossed the trial sequential monitoring and reached the required information size of the operative time. The numbers needed to treat to avoid one gallbladder perforation and postoperative nausea, respectively, were 7 and 15. CONCLUSIONS: Compared with the electrosurgery device, the ultrasonic device could be superior with more clinical effectiveness. The trial sequential analysis demonstrated that further studies about the operative time were not needed.

[Estimation of Winter Wheat Leaf Nitrogen Accumulation using Machine Learning Algorithm and Visible Spectral].

In order to study the feasibility of using digital image analysis and machine learning algorithm to estimate leaf nitrogen accumulation (LNA) of winter wheat at canopy level, digital images of winter wheat canopies grown under six levels of nitrogen application rate were taken for four times during the elongation stage. Meanwhile, wheat plants were sampled to measure LNA. The random forest method using CIEL*a*b* components was used to segment wheat plant from soil background and then extract canopy cover, RGB components of sRGB color space and compute five color indices derived from RGB components. Correlation analysis was carried out to identify the relationship between LNA and canopy cover (CC), RGB components, and five color indices. Two kinds of nonlinear least squares regression models (NLS) with different independent variables of color components and color indices, and three machine learning algorithmic of artificial neural network (ANN), support vector regression (SVR), and random forests method (RF) were used to estimate winter wheat leaf nitrogen accumulation. All three machine learning algorithm had four input variables of CC, R, G, and B. The results showed that, CC, R and G component of sRGB color space, and five color indices derived from RGB components showed significant correlations with LNA during the elongation stage. CC revealed the highest correlation with LNA. The lowest accuracy in estimation LNA was achieved by using nonlinear least square model with CC and color indices, and RF had showed the problem of overfitting. The other three methods of LNA with CC and RGB components, ANN, and SVR had showed good performance with higher R2 (0.851, 0.845, and 0.862) and lower RMSE (19.440, 19.820, and 18.698) for model calibration and validation, revealing good generalization ability.

[Estimation of Winter Wheat Biomass Using Visible Spectral and BP Based Artificial Neural Networks].

The objective of this study was to evaluate the feasibility of using color digital image analysis and back propagation (BP) based artificial neural networks (ANN) method to estimate above ground biomass at the canopy level of winter wheat field. Digital color images of winter wheat canopies grown under six levels of nitrogen treatments were taken with a digital camera for four times during the elongation stage and at the same time wheat plants were sampled to measure above ground biomass. Canopy cover (CC) and 10 color indices were calculated from winter wheat canopy images by using image analysis program (developed in Microsoft Visual Basic). Correlation analysis was carried out to identify the relationship between CC, 10 color indices and winter wheat above ground biomass. Stepwise multiple linear regression and BP based ANN methods were used to establish the models to estimate winter wheat above ground biomass. The results showed that CC, and two color indices had a significant cor- relation with above ground biomass. CC revealed the highest correlation with winter wheat above ground biomass. Stepwise multiple linear regression model constituting CC and color indices of NDI and b, and BP based ANN model with four variables (CC, g, b and NDI) for input was constructed to estimate winter wheat above ground biomass. The validation results indicate that the model using BP based ANN method has a better performance with higher R2 (0.903) and lower RMSE (61.706) and RRMSE (18.876) in comparation with the stepwise regression model.

[Segmentation of Winter Wheat Canopy Image Based on Visual Spectral and Random Forest Algorithm].

Digital image analysis has been widely used in non-destructive monitoring of crop growth and nitrogen nutrition status due to its simplicity and efficiency. It is necessary to segment winter wheat plant from soil background for accessing canopy cover, intensity level of visible spectrum (R, G, and B) and other color indices derived from RGB. In present study, according to the variation in R, G, and B components of sRGB color space and L*, a*, and b* components of CIEL* a* b* color space between wheat plant and soil background, the segmentation of wheat plant from soil background were conducted by the Otsu's method based on a* component of CIEL* a* b* color space, and RGB based random forest method, and CIEL* a* b* based random forest method, respectively. Also the ability to segment wheat plant from soil background was evaluated with the value of segmentation accuracy. The results showed that all three methods had revealed good ability to segment wheat plant from soil background. The Otsu's method had lowest segmentation accuracy in comparison with the other two methods. There were only little difference in segmentation error between the two random forest methods. In conclusion, the random forest method had revealed its capacity to segment wheat plant from soil background with only the visual spectral information of canopy image without any color components combinations or any color space transformation.

Growth responses of in vitro Fusarium oxysporum f. sp. niveum to external supply of tannic acid.

Allelochemicals released from root exudates or decaying residues of plants play diversified roles in ecological interactions of plant-pathogen. The objective of this work was to evaluate the allelopathic effect of an externally supplied tannic acid on soil-borne in vitro Fusarium oxysporum f. sp. niveum. Results showed that the tannic acid decreased the growth of the fungus up to 9.5% at 800 mg l(-1). Conidial germination was reduced by 52.3% in comparison with the control. However, sporulation and mycotoxin production by the fungus were stimulated. The activity of pectinase and proteinase were initially increased and finally decreased with increase in concentrations of tannic acid. Tannic acid served as an ecological allelochemical, repressing the growth of the pathogen.

Prevention of Biliary Duct Injury in Laparoscopic Cholecystectomy Using Optical Fiber Illumination in Common Bile Duct.

BACKGROUND: Biliary duct injury (BDI) is one of the most common complications in laparoscopic cholectecystomy (LC), in this study, we have tried to place an illuminating optical fiber via endoscopy in the CBD during LC, the biliary duct anatomy can be clearly delineated, thus CBD injury is avoided. METHODS: Sixteen patients with chronic cholecystitis or/and cholelithiasis from February 2007 to June 2008 were performed LC with placement of optical fiber in CBD, the fiber with cold light illuminates the whole extrahepatic biliary system. Three 6-mm titanium clips were applied to the soft tissue surrounding the hepatic duct, CBD and the cystic duct confluence with CBD, respectively; one titanium clip was applied to the surface of cystic duct near the infundibulum of gallbladder. The cytic duct, CBD and common hepatic duct were clearly identified and delineated in the operating field and LC was performed. RESULTS: All the 16 patients were performed LC using this procedure successfully, there were no LC-related complications, nor complications related to endoscopic retrograde cholangiopanceatography (ERCP). CONCLUSIONS: The endoscopically placed optical fiber in the CBD can clearly identify the CBD, Calot's triangle and the common hepatic duct, this can reduce the bile duct injury in LC and imporve the safety of LC.

[Diagnostic significance of cytokeratin 19 and 20 expression on micrometastasis of colorectal cancer].

OBJECTIVE: To inquire into the diagnostic significance of cytokeratin 19(CK19) and cytokeratin 20(CK20) expression on hematogenous micrometastasis of colorectal cancer. METHODS: Forty-four patients with colorectal cancer were collected as colorectal cancer groups, and another 18 patients treated with abdominal surgical operations because of benign diseases were collected as benign disease group. Blood of all the patients was harvested from their portal and peripheral veins, and CK19 and CK20 levels in the blood were determined by RT-PCR. RESULTS: There were no positive expression of CK19 and CK20 in the portal and peripheral blood of all the patients in benign disease group. Of the colorectal cancer group, 34 patients(77.3%) appeared positive expressions of CK19 and/or CK20 in portal and peripheral blood, and there was significant difference in the expressions of CK19 and CK20 between the two groups(P<0.05). Within the colorectal cancer group, the positive expression rates of CK19 and CK20 in peripheral blood were 36.4% and 52.3%, and the rates in portal blood were 59.1% and 72.7%. The rates of portal blood were significantly higher than those of peripheral blood(P<0.05). The positive expression rate in patients at stage III( was significantly higher than that in patients at stage I( orII( (P<0.05). The postoperative metastasis and recurrence rate of colorectal cancer in patients with positive expression of CK19 and CK20 in peripheral blood was 61.5%, which was significantly higher than that(25.0%) in patients with positive expression in portal blood only(P<0.05). CONCLUSIONS: In patients with colorectal cancer, the expressions of CK19 and CK20, which are determined by RT-PCR in blood from portal and peripheral veins, are the sensitive and specific indexes for diagnosing hematogenous micrometastasis of the cancer.

[Motor cortex by real-time imaging process functional MRI during finger movements].

OBJECTIVE: To explore the techniques of RTIP-fMRI scanning and the correspondence between structure and functional changes of motor cortex during self-paced finger movements by RTIP-fMRI in normal volunteers. METHODS: The 15 healthy volunteers were studied by RTIP-fMRI, and the activation tasks consisted of self-paced finger movements performed with the right and the left hands. Image postprocessing was done on the workstation by "correlation coefficient" algorithm analysis method, IAC and SPM software. RESULTS: There was a good correspondence between the anatomical landmarks of the somatotopical organization of primary motor areas in the 15 volunteers; during the finger tasks, the functional changes occurred in the contralateral primary motor-somatosensory cortex (M1/S1), the supplementary motor area (SMA), and the ipsilateral primary motor cortex. CONCLUSION: RTIP, a promising new technique, can localize the motor cortex accurately. It is superior to any other fMRI techniques, and may be used widely in the function research of the brain.