Exhaustive drainage versus fixed-time drainage for chronic subdural hematoma after one-burr hole craniostomy (ECHO): study protocol for a multicenter randomized controlled trial.

BACKGROUND: Chronic subdural hematomas (CSDHs) are one of the most common neurosurgical conditions. The standard surgical technique includes burr-hole craniostomy, followed by intraoperative irrigation and placement of subdural closed-system drainage. The drainage is generally removed after 48 h, which can be described as fixed-time drainage strategy. According to literature, the recurrence rate is 5-33% with this strategy. In our retrospective study, postoperative hematoma volume was found to significantly increase the risk of recurrence. Based on these results, an exhaustive drainage strategy is conducted to minimize postoperative hematoma volume and achieve a low recurrence rate and good outcomes. METHODS: This is a prospective, multicenter, open-label, blinded endpoint randomized controlled trial designed to include 304 participants over the age of 18-90 years presenting with a symptomatic CSDH verified on cranial computed tomography or magnetic resonance imaging. Participants will be randomly allocated to perform exhaustive drainage (treatment group) or fixed-time drainage (control group) after a one-burr hole craniostomy. The primary endpoint will be recurrence indicating a reoperation within 6 months. DISCUSSION: This study will validate the effect and safety of exhaustive drainage after one-burr hole craniostomy in reducing recurrence rates and provide critical information to improve CSDH surgical management. TRIAL REGISTRATION: Clinicaltrials.gov, NCT04573387. Registered on October 5, 2020.

Ectopic Acsl6 Overexpression Partially Improves Isoproterenol-Induced Cardiac Hypertrophy In Vivo and Cardiomyocyte Hypertrophy In Vitro.

ABSTRACT: The increase in cardiac myocyte size is a critical issue in cardiac hypertrophy development. In this study, 61 differentially expressed genes between hypertrophic rats and normal controls were enriched in the positive modulation of fatty acid uptake, fatty acid metabolism and degradation, cardiac conduction, and the oxidation of carbohydrates and other processes. Acsl6 was significantly downregulated in hypertrophic rat and mouse hearts according to online data. Based on the experimental data, Acsl6 was underexpressed in ISO-induced cardiac hypertrophy mouse model and isoproterenol (ISO)-induced cardiomyocyte hypertrophy cell model. In vivo, Acsl6 overexpression partially attenuated ISO-induced increases in the cross-sectional area and cardiac hypertrophy, elevated hypertrophic markers, and caused impairment of cardiac function. In vitro, Acsl6 overexpression partially attenuated ISO-induced cardiomyocyte hypertrophy and increased hypertrophic markers. Conclusively, Ascl6 is downregulated in ISO-induced cardiac hypertrophy mouse model and ISO-induced cardiomyocyte hypertrophy cell model. Acsl6 overexpression could partially improve cardiac hypertrophy in vivo and cardiomyocyte hypertrophy in vitro, possibly through the regulation of HIF-1α/Hippo pathway.

Star-Shaped ROMP Polymers Coated with Oligothiophenes That Exhibit Unique Emission.

A series of oligo(thiophene)-modified "soluble" star-shaped ring-opening metathesis polymerization (ROMP) polymers were prepared by sequential living ROMP of norbornene and a cross-linking agent using a molybdenum-alkylidene catalyst, followed by Wittig-type coupling for termination with oligo(thiophene) carboxaldehydes. The resultant star-shaped ROMP polymers displayed unique emission properties affected by the core size and arm repeat units as well as the kind of oligothiophene coated. The effects of the thiophene groups on photophysical properties of star-shaped/linear polymers were studied via time-resolved fluorescence spectroscopy. Fluorescence lifetimes were determined in THF as 400, 640, 730, and 820 ps for Star 3TPh, Linear 3TPh, Star 4T, and Linear 4T, respectively. A significant enhancement of the nonradiative rate constants k nr in the star-shaped polymers results in relatively lower fluorescence quantum yields and shorter fluorescence lifetimes compared to the corresponding linear polymers.

Effect of the Linking Group on the Thermoelectric Properties of Poly(Schiff Base)s and Their Metallopolymers.

As polymer-based thermoelectric (TE) materials possess attractive features such as light weight, flexibility, low toxicity and ease of processibility, an increasing number of conducting polymers and their composites with high TE performances have been developed in recent years. Up to date, however, the research focusing on the structure-performance relationship remains rare. In this paper, two series of poly(Schiff base)s with either C=C or C≡C linker and their metallopolymers were synthesized and doped with single-walled carbon nanotubes to evaluate how the linking groups affected the TE properties of the resulting composites. Apart from the effect exerted by the morphology, experimental results suggested that the linkers played a key role in determining the band gaps, preferred molecular conformation and extent of conjugation of the polymers, which became key factors that influenced the TE properties of the resulting materials. Additionally, upon coordination with transition metal ions, the TE properties could be tuned readily.

Bioinformatics Analysis of the Expression of ATP Binding Cassette Subfamily C Member 3 (ABCC3) in Human Glioma.

OBJECTIVE: To investigate the expression of the ABCC3 gene in human glioma and its correlation with the patient's prognosis. METHODS: The cancer genome atlas (TCGA) database was used to analyze the differential expression of the ABCC3 gene in human glioma. The STRING database was used to construct the protein-protein interaction (PPI) network of the ABCC3 gene coding protein. The co-expression genes relevant to the ABCC3 gene were analyzed by the Pearson correlation test. A log-rank test was used to analyze the difference of overall survival (OS) and disease-free survival (DFS) between the high and low ABCC3 gene expression groups. RESULTS: The expression level of the ABCC3 gene in glioma tissues was lower than that of corresponding normal brain tissues. The PPI network contains 51 nodes with the average node degree of 13.3 and the local clustering coefficient of 0.72 which indicated that the PPI enrichment was significant (p<0.001). Ten hub genes (ABCC3,NR1I2,NR1H4,-CYP7A1,SLC10A1,CYP3A4,UGT1A1,UGT1A8,UGT1A6 and ALB) were identified by the cytoscape software. The KEGG analysis was enriched in drug metabolism - cytochrome P450 and PPAR signaling pathway. CFI gene expression level was positive correlated with the ABCC3 expression level (r=0.71, p<0.05). And the CNRIP1 gene expressed was negative correlated with ABCC3 expression (r=-0.43, p<0.05). The overall survival (HR=2.8, P<0.05) and disease-free survival rates (HR=2.0, P<0.05) of patients with ABCC3 low expression glioma were significantly higher than those of patients with high expression of ABCC3. Conclusion The expression level of the ABCC3 gene in glioma was decreased compared to normal brain tissue. The overall survival and disease-free survival of in the ABCC3 low-expression group was significant decreased.

One-pot synthesis of end-functionalised soluble star-shaped polymers by living ring-opening metathesis polymerisation using a molybdenum-alkylidene catalyst.

Precise synthesis of soluble star-shaped polymers has been achieved by adopting living ring-opening metathesis polymerisation (ROMP) using a molybdenum-alkylidene catalyst with sequential addition of norbornene and cross-linking agent; the method provides efficient one-pot synthesis of high molecular weight end-functionalised star-shaped polymers (M n = >1.37 × 105) with more arms (branching) with rather low PDI values (M w/M n = 1.17-1.37) under the optimised conditions.

Inhibition of BET bromodomain attenuates angiotensin II induced abdominal aortic aneurysm in ApoE-/- mice.

BACKGROUND: Excessive degradation of extracellular matrix by matrix metalloproteinases (MMP) is the major pathological feature of abdominal aortic aneurysm (AAA). Suppression of extracellular matrix degradation attenuates AAA initiation and progression in preclinical models. In the present study, we wanted to test the effect of JQ1, a small chemical molecule that selectively targets bromodomain and extra-terminal domain (BET), on AngII induced AAA formation in ApoE-/- mice. METHODS AND RESULTS: To study the role of BET bromodomain in AAA pathogenesis, male ApoE-/- mice were infused with angiotensin II (AngII, 1000ng/kg/min) for 21days and cotreated with JQ1 (50mg/kg daily) or vehicle control (DMSO). In the in vitro study, we determined the mRNA expression of MMP genes by qPCR and their activity both by the kit and gelatin zymography assay. BET bromodomain inhibition resulted in decreased abdominal aortic diameter (P<0.05) measured by in vivo vascular ultrasound and ex vivo pathologic assessment of aortas. In pursuit of mechanisms for this effect on AAA, we observed that JQ1 treatment led to a downregulation of metalloproteinase gene expression and enzymatic activity both in vitro and in vivo. CONCLUSIONS: BET bromodomain inhibition improved AAA pathological sequelae, and this effect might be achieved though suppression of MMP genes expression and their activity.

Subgroup characteristics of insular low-grade glioma based on clinical and molecular analysis of 42 cases.

Although the classification of insular glioma has been established based on the anatomical location in order to facilitate personalized surgical resection, the diagnosis based on anatomical and functional characteristics becomes more complex when insular tumors extend into either the frontobasal brain region and/or the temporal lobe, as part of the limbic system. Moreover, prognosis of insular tumor resection is still controversial. Further analysis of subgroup characteristics of insular grade II gliomas based on clinical and molecular analysis is required to reliably determine patients' survival rates. In this retrospective study 20 purely insular grade II gliomas patients and 22 paralimbic grade II gliomas that involved frontal and/or temporal lobes were compared with regard to epidemiological and clinical characteristics. The molecular profiles including Isocitrate dehydrogenase 1 (IDH1), telomerase reverse transcriptase (TERT) promoter, and P53 mutations, 1p19q co-deletion were analyzed, and microRNA profiles were assessed by microarray and bioinformatics analysis. Purely insular grade II gliomas displayed a high frequency of IDH1 mutations with favorable outcome. IDH1 mutated paralimbic glioma shared many parameters with the purely insular glioma in respect to growth patterns, survival, and microRNA profile, but differed significantly from the IDH1 wild type paralimbic gliomas. Our findings suggest that IDH1 mutations can define subpopulations of insular gliomas with distinct disease entities regardless of tumor extension patterns. These findings could be useful to develop a customized treatment strategy for insular glioma patients.

Meta-analysis Identifies Serum C-Reactive Protein as an Indicator of Atrial Fibrillation Risk After Coronary Artery Bypass Graft.

A meta-analysis-based study was conducted to examine the clinical value of serum C-reactive protein (CRP) levels in predicting postoperative atrial fibrillation (POAF) in patients with coronary artery disease (CAD) who underwent coronary artery bypass graft. Computer-based search of scientific literature databases was performed to identify relevant studies in strict accordance with our inclusion and exclusion criteria. Data extracted from the selected studies were used to perform meta-analysis using the STATA 12.0 statistical software. Standardized mean differences (SMDs) with their 95% confidence interval (95% CI) were calculated. The database search strategy initially identified 62 articles (Chinese = 17, English = 45). After multiple levels of screening and validation, 15 case-control studies (Chinese = 1, English = 14), containing of a total of 3110 atrial fibrillation patients (POAF = 925, non-POAF = 2185), were selected for our meta-analysis. The meta-analysis results confirmed that serum CRP level was remarkably higher in patients with POAF compared with non-POAF (SMD = 1.36; 95% CI, 0.44-2.28; P = 0.004). Ethnicity-stratified analysis revealed that elevated serum CRP levels were associated with an increased risk of POAF in white patients with CAD (SMD = 0.85; 95% CI, 0.12-1.58; P = 0.022), but not Asian patients with CAD (SMD = 3.31, 95% CI, -0.04 to 6.66; P = 0.053). Elevated CRP levels, indicating profound inflammation, may be associated with significantly increased risk of POAF in patients with CAD who underwent coronary artery bypass graft. Thus, serum CRP levels are important for early diagnosis and monitoring of POAF in high-risk patients.

TERT promoter mutated WHO grades II and III gliomas are located preferentially in the frontal lobe and avoid the midline.

The promoter region of telomerase reverse transcriptase (TERTp) and isocitrate dehydrogenase (IDH) have been regarded as biomarkers with distinct clinical and phenotypic features. Investigated the possible correlations between tumor location and genetic alterations would enhance our understanding of gliomagenesis and heterogeneity of glioma. We examined mutations of TERTp and IDH by direct sequencing and fluorescence in-situ hybridization in a cohort of 225 grades II and III diffuse gliomas. Correlation analysis between molecular markers and tumor locations was performed by Chi-square tests/Fisher's exact test and multivariate logistic regression analysis. We found gliomas in frontal lobe showed higher frequency of TERTp mutation (P=0.0337) and simultaneously mutations of IDH and TERTp (IDH (mut)-TERTp(mut)) (P=0.0281) than frequency of biomarkers mutation of tumors in no-Frontal lobes, while lower frequency of TERTp mutation (P<0.0001) and simultaneously wild type of IDH and TERTp (IDH (wt)-TERTp(wt)) (P<0.0001) in midline than no-midline lobes. Logistic regression analysis indicated that locations of tumors associated with TERTp mutation (OR=0.540, 95% CI 0.324-0.900, P=0.018) and status of combinations of IDH and TERTp (IDH (mut)-TERTp (mut) vs. IDH (wt)-TERTp (wt) OR=0.162, 95% CI 0.075-0.350, P<0.001). In conclusion, grades II and III gliomas harboring TERTp mutation were located preferentially in the frontal lobe and rarely in midline. Association of IDH-TERTp status and tumor location suggests their potential values in molecular classification of grades II and III gliomas.

IL-8 up-regulates proliferative angiogenesis in ischemic myocardium in rabbits through phosphorylation of Akt/GSK-3ß(ser9) dependent pathways.

BACKGROUND: Therapeutic myocardial angiogenesis is an important compensatory mechanism in severely coronary stenosis. Previous studies demonstrated that interleukin-8 (IL-8) not only plays an important role in inflammation, but also a potent angiogenic factor through p38 mitogen-activated protein kinase (p38MAPK), nuclear factor-kappaB (NK-κB)-dependent pathway in carcinoma. Our study sought to investigate the effects of IL-8 on the angiogenesis and the underlying mechanism in the ischemic myocardium. METHODS: Acute myocardial infarction animal model was established with male rabbits by directly suturing the left anterior descending branch, then lentivirus-mediated IL-8 was quarterly injected into the borderline of infarction area immediately. We employed CoCl2 induced hypoxic HUVECs for in vitro ischemia study. Left ventricular end-diastolic diameter (LVEDd) and ejection fraction (EF) were measured by echocardiography in pre-operation and at 6(th) week after operation. CD34 was detected with immunohistochemisty to analyse angiogenesis. Western blot was performed with regard to IL-8, protein kinase B (PKB/Akt) and Glycogen synthase kinase-3ß(ser9) (GSK-3ß(ser9)). For the HUVECs' proliferation and apoptosis, multiscan spectrum reader at A570 nm and annexin V-FITC/PI staining method were used respectively. RESULTS: The levels of IL-8, phosphorylated Akt and GSK-3ß(ser9) in focal myocardium significantly increased, and the over expression of IL-8 led to an increasing in angiogenesis in rabbits. Hypoxia inhibited cell proliferation and promoted apoptosis. IL-8 induced cell proliferation, phosphorylation of Akt and GSK-3ß(ser9), inhibited apoptosis and Caspase3 expression in HUVECs, which were attenuated by anti-IL-8 or the Akt inhibitor LY294002. CONCLUSIONS: The present results indicate that IL-8 can increase angiogenesis in myocardial infarction, which maybe through enhancing Akt and GSK-3ß(ser9) expression, and inhibiting myocardial apoptosis.

[Five-case report for transvenous epicardial pacemaker implantation via coronary sinus in patients after prosthetic tricuspid valve replacement].

Five patients after prosthetic tricuspid valve, who received pacemaker implantation via coronary sinus during Oct, 2011 and Jul, 2014, were enrolled. Pacemakers were implanted via coronary vein in 5 patients without complications. The stimulation thresholds keep stable and symptoms (such as short breath and fatigue) were disappeared during the follow-up. For patients after tricuspid valve replacement, implantation of pacemaker via coronary sinus provides a safe and invasive approach and avoids opening the chest again.

Ring-tension adjusted ethylene polymerization by aryliminocycloheptapyridyl nickel complexes.

The stoichiometric reactions of 5,6,7,8-tetrahydrocycloheptapyridin-9-one (cycloheptapyridin-9-one) with various anilines lead to corresponding mixtures of 9-aryliminocycloheptapyridine and the isomeric 9-arylamino-5,6,7-trihydrocycloheptapyridine derivatives; these compounds further reacted with nickel dichloride to form 9-aryliminocycloheptapyridyl nickel chlorides, respectively. The new organic compounds were analyzed by the NMR measurements, and all the organic and complex compounds were characterized by the FT-IR spectroscopy and elemental analysis. In addition, the molecular structures of representative nickel complexes and , determined by means of single-crystal X-ray diffraction, were found to be binuclear dimers with distorted square-pyramidal geometry around the nickel centers. On activation with either ethylaluminium sesquichloride (Et3Al2Cl3) or methylaluminoxane (MAO), all nickel complex pre-catalysts exhibited high activities of up to 7.80 × 10(6) g PE mol(-1) (Ni) h(-1) toward ethylene polymerization and produced highly branched polyethylenes in narrow polydispersity. The title nickel complexes showed comparable activities with 8-arylimino-5,6,7-trihydroquinolyl nickel analogues; whilst both exhibited higher activities than did the 2-iminopyridyl nickel analogues due to the enhancement of the ring-tension of cyclic-fused pyridine derivatives.

Protective effect of microRNA-30b on hypoxia/reoxygenation-induced apoptosis in H9C2 cardiomyocytes.

We examined the protective role of microRNA-30b (miR-30b) in ischemia-reperfusion (I/R)-induced injury in rat H9C2 cardiomyocytes. H9C2 cells were subjected to hypoxia-reoxygenation (H/R) treatment to simulate ischemia-reperfusion (I/R) injury. H9C2 cells were divided into: vehicle control (VC) group; scrambled inhibitors (INC) group; scrambled mimics (MNC) group; H/R+VC group; H/R+INC group; H/R+mimics group. H/R induced apoptosis was detected by flow cytometry and the pathways involved in miR-30b-mediated protection were examined by analyzing the expression of miR-30b, Bcl-2, Bax, Caspase-3, KRAS, p-AKT and total AKT in H9C2 cells. Overexpression of miR-30b mimic (H/R+mimics group) significantly increased Bcl-2 and Bcl-2/Bax levels and decreased Bax and Caspase-3 levels, compared with the H/R+VC group (all P<0.05). Consistent with this, the apoptosis rate was significantly decreased in the H/R+mimics group (P<0.05) compared with the H/R+VC group. Western blot analysis revealed that overexpression of miR-30b mimic resulted in significantly increase in AKT activation and decreased KRAS, compared to the H/R+VC group (both P<0.05). In conclusion, the H/R induced apoptosis decreased miR-30b expression, but over-expression of miR-30b inhibited H/R induced apoptosis. The observed miR-30b-mediated protection against H/R induced apoptosis involved the upregulation of Ras-PI3K-Akt pathway.

Serum fetuin-A levels in patients with cardiovascular disease: a meta-analysis.

BACKGROUND: Fetuin-A (FA) suppresses arterial calcification, promotes insulin resistance, and appears to be elevated in patients with cardiovascular diseases (CVD), but the data is still inconsistent. To clarify the correlation between serum FA levels and the presence and severity of CVDs, we performed this meta-analysis. METHOD: Potential relevant studies were identified covering the following databases: PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine (CBM), and China National Knowledge Infrastructure (CNKI) databases. Data from eligible studies were extracted and included in the meta-analysis using a random-effects model. RESULTS: Ten case-control studies, including 1,281 patients with CVDs and 2,663 healthy controls, were included. The results showed significant differences in serum levels of FA between the CVDs patients and the healthy controls (SMD=1.36, 95%CI: 0.37-2.36, P=0.007). Ethnicity-subgroup analysis implied that low serum FA levels are related to CVDs in Caucasians (SMD=1.73, 95%CI: 0.20-3.26, P=0.026), but not in Asians (SMD=1.04, 95%CI: -0.33-2.40, P=0.138). CONCLUSION: The data indicated that decreased serum FA level is correlated with the development of CVDs. FA might be clinically valuable for reflecting the progression of CVDs.

Cyclotrimerization of terminal alkynes catalyzed by the system of NiCl2/Zn and (benzimidazolyl)-6-(1-(arylimino)ethyl)pyridines.

An effective regioselective cyclotrimerization of terminal alkynes is achieved by the direct utilization of NiCl2·6H2O, Zn, and 2-(benzimidazolyl)-6-(1-(arylimino)ethyl)pyridine in one step under ambient temperature.

CuCl-catalyzed ortho trifluoromethylation of arenes and heteroarenes with a pivalamido directing group.

The CuCl catalyzed direct trifluoromethylation of sp(2) C-H bonds has been realized, using the Togni reagent as the CF3 source. This reaction achieves the goal of regio-selectively converting C-H into C-CF3 with ecological and readily available starting materials.

[Association between differentiation potential of immortalized human mesenchymal stem cells and cluster of differentiation antigens].

OBJECTIVE: To explore the relationship between multi-differentiation potential of monoclonal immortalized human mesenchymal stem cells (hMSC-TERT) in vivo and their cluster of differentiation antigens (CD). METHODS: Monoclonal hMSC-TERT were isolated using limiting dilution. Direct immunofluorescence staining flow cytometry was used to detect the cluster of differentiation antigens (CD44, CD45, CD105) of these cell lines. Their adipocytic, osteogenic, neuronal differentiation potential in vitro were determined by Oil Red O staining, Von Kossa staining and immunocytochemistry for tubulin-ß III antibody. Then hMSC-TERTs were transplanted subcutaneously into severe combined immunodeficiency (SCID) mice. The cell grafts were removed and analyzed by immunohistochemistry for pathologic tissue markers for multi-differentiation potential of hMSC-TERT cells in vivo. RESULTS: CD105+ cell was 84.68% positive in hMSC-TERT-C19 while <5% in other monoclonal cell lines. The positive rate of cytokeratin in grafts formed by hMSC-TERT-C19 cell line in SCID mice was much higher than the others (P < 0.01). CONCLUSION: The positive CD105 of monoclonal hMSC-TERTs may be directly correlated with its epithelial differentiation potential.

[Effects of high plating densities on in vitro and in vivo differentiation capability of immortalized human mesenchymal stem cells].

OBJECTIVE: To determine whether different cell plating densities could influence the potential differentiation of immortalized human mesenchymal stem cells (hMSC-TERT). METHODS: Extensive characterization was performed for two independent cell lines derived from parental hMSC-TERT cell line based on different plating densities during expansion in culture: 1: 2 (hMSC-TERT2) and 1: 20 (hMSC-TERT20). Their adipocytic, osteogenic, neuronal differentiation potential in vitro and multidirectional differentiation potential in vivo were analyzed by immunohistochemistry for pathologic tissue markers. RESULTS: hMSC-TERT2 formed cellular adipose foci and mineralized tuberculum after in vitro induction while hMSC-TERT20 showed adipocytes but no adipose foci or mineralized tuberculum. The positive rate of hMSC-TERT2 formed tissues on VIM, GFAP and LCA (89.17% ± 5.97%, 72.5% ± 10.11% and 76.67% ± 11.15%) under SCID murine skin were more than that of hMSC-TERT20 formed tissues (0.33% ± 0.65%, 9.58% ± 4.29% and 22.08% ± 6.95%). CONCLUSION: The cell lines derived at high plating density may have more powerful differentiation potential in vitro and in vivo than those derived at low cell plating density.

[Associativity between differentiation potential and VEGF secretory capability of immortalized human mesenchymal stem cells].

OBJECTIVE: To investigate the multi-differentiation potential and VEGF secretory volume of monoclonal immortalized human mesenchymal stem cells (hMSC-TERT) and to determine the relationship between them. METHODS: Monoclonal hMSC-TERT were isolated using limiting dilution. The growth curves of them were detected by method of MTT. ELISA was used to detect the concentration of VEGF in the supernatant of those monoclonal hMSC-TERT. Their adipocytic, osteogenic, neuronal differentiation potential in vitro were determined by Oil Red O staining, Von Kossa staining and immunocytochemistry for Tubulin-ßIII antibody. Those Monoclonal hMSC-TERT were transplanted into the subcutaneously of severe combined immunodeficiency (SCID) mice. The grafts of those cells were removed and analyzed by immunohistochemistry for pathologic tissue markers to discover the multi-differentiation potential of those monoclonal hMSC-TERT in vivo. RESULTS: There was statistically significant difference between different monoclonal hMSC-TERT in mult differentiation potential and the decreased concentration of VEGF in the supernatant of those monoclonal hMSC-TERT from the 3(rd) day to the 5(th) day. The positive rates of CK in grafts formed by those monoclonal hMSC-TERT in SCID mice were direct correlation with the decreased concentration of VEGF in the supernatant of those cells. CONCLUSION: The secretory capability of VEGF of those monoclonal hMSC-TERT may direct correlation with the epithelial differentiation potential of those cells.