Impact of different anastomosis methods on post-recurrence after intestinal resection for Crohn's disease: A meta-analysis.

BACKGROUND: Crohn's disease (CD) is a chronic inflammatory disease of the gastrointestinal tract, often requiring intestinal resection as a common treatment. However, recurrence after surgery is common. The anastomotic configuration after bowel resection appears to be associated with the recurrence of CD. Previous studies have suggested that the Kono-S anastomosis may help to reduce the recurrence rate. However, the results remain controversial. Therefore, evidence-based evidence is needed to prove the advantages of Kono-S anastomosis. AIM: To measure the influence of anastomosis techniques on the long-term relapse rate of CD by conducting a meta-analysis. METHODS: PubMed, Scopus, and Cochrane Library were searched until October 8, 2023. Patients who underwent intestinal resection due to CD were included. The intervention measures included Kono-S anastomosis, whereas the control group received traditional anastomosis such as end-to-end, end-to-side, and side-to-side anastomosis. Only randomized clinical trials and observational studies were included. The primary outcome measures were hospital stay post-surgery, overall postoperative complication incidence, the proportion of Clavien-Dindo grade IIIa or higher, overall postoperative recurrence rate, and Rutgeerts score. RESULTS: From 2011 to 2023, six articles met the inclusion and exclusion criteria. The results indicated that Kono-S anastomosis can reduce the hospital stay post-surgery of patients with CD [MD = -0.26, 95%CI: -0.42 to -0.10, P = 0.002] than other traditional anastomosis methods. Compared to other traditional anastomosis methods, Kono-S anastomosis can significantly reduce the total recurrence rate [MD = 0.40, 95%CI: 0.17 to 0.98, P = 0.05] and postoperative Rutgeerts score [MD = -0.81, 95%CI: -0.96 to -0.66, P < 0.001] in patients with CD. However, there is no significant disparity in the overall occurrence of postoperative complications and the proportion of Clavien-Dindo ≥ IIIa. CONCLUSION: Kono-S anastomosis has the potential to expedite the recuperation of CD and diminish relapse hazards; however, additional larger trials are necessary to authenticate its effectiveness.

Development of Cost-Effective Fatty Liver Disease Prediction Models in a Chinese Population: Statistical and Machine Learning Approaches.

BACKGROUND: The increasing prevalence of nonalcoholic fatty liver disease (NAFLD) in China presents a significant public health concern. Traditional ultrasound, commonly used for fatty liver screening, often lacks the ability to accurately quantify steatosis, leading to insufficient follow-up for patients with moderate-to-severe steatosis. Transient elastography (TE) provides a more quantitative diagnosis of steatosis and fibrosis, closely aligning with biopsy results. Moreover, machine learning (ML) technology holds promise for developing more precise diagnostic models for NAFLD using a variety of laboratory indicators. OBJECTIVE: This study aims to develop a novel ML-based diagnostic model leveraging TE results for staging hepatic steatosis. The objective was to streamline the model's input features, creating a cost-effective and user-friendly tool to distinguish patients with NAFLD requiring follow-up. This innovative approach merges TE and ML to enhance diagnostic accuracy and efficiency in NAFLD assessment. METHODS: The study involved a comprehensive analysis of health examination records from Suzhou Municipal Hospital, spanning from March to May 2023. Patient data and questionnaire responses were meticulously inputted into Microsoft Excel 2019, followed by thorough data cleaning and model development using Python 3.7, with libraries scikit-learn and numpy to ensure data accuracy. A cohort comprising 978 residents with complete medical records and TE results was included for analysis. Various classification models, including logistic regression (LR), k-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), light gradient boosting machine (LightGBM), and extreme gradient boosting (XGBoost), were constructed and evaluated based on the area under the receiver operating characteristic curve (AUROC). RESULTS: Among the 916 patients included in the study, 273 were diagnosed with moderate-to-severe NAFLD. The concordance rate between traditional ultrasound and TE for detecting moderate-to-severe NAFLD was 84.6% (231/273). The AUROC values for the RF, LightGBM, XGBoost, SVM, KNN, and LR models were 0.91, 0.86, 0.83, 0.88, 0.77, and 0.81, respectively. These models achieved accuracy rates of 84%, 81%, 78%, 81%, 76%, and 77%, respectively. Notably, the RF model exhibited the best performance. A simplified RF model was developed with an AUROC of 0.88, featuring 62% sensitivity and 90% specificity. This simplified model used 6 key features: waist circumference, BMI, fasting plasma glucose, uric acid, total bilirubin, and high-sensitivity C-reactive protein. This approach offers a cost-effective and user-friendly tool while streamlining feature acquisition for training purposes. CONCLUSIONS: The study introduces a groundbreaking, cost-effective ML algorithm that leverages health examination data for identifying moderate-to-severe NAFLD. This model has the potential to significantly impact public health by enabling targeted investigations and interventions for NAFLD. By integrating TE and ML technologies, the study showcases innovative approaches to advancing NAFLD diagnostics.

Factors associated with sleep disorders among adolescent students in rural areas of China.

Background: This study aimed to determine sleep patterns and the prevalence and association factors of sleep disorders in a regionally representative sample in Mo Jiang, China. Methods: A total of 2,346 (participation rate 93.5%) Grade 7 students (aged 13-14 years) from 10 middle schools, including 1,213 (51.7%) boys and 1,133 (48.3%) girls, participated in the study. All the participants were invited to complete questionnaires that acquired information on sleep patterns, academic performance, academic stress, and sociodemographic factors. Sleep disorders were assessed using the Chinese version of the Children's Sleep Habits Questionnaire. Logistic regression models were used to investigate factors associated with sleep disorders. Results: The prevalence of sleep disorders among rural adolescents was 76.4%, which is higher than that among urban adolescents. Compared with previous findings in urban areas, our results indicate that sleep loss is much more severe in rural adolescents. Sleep disorders were positively associated with factors, such as watching TV [odds ratio (OR) = 1.22, p = 0.001], academic performance (OR = 1.80, p < 0.001), and academic stress (OR = 1.38, p = 0.04). In addition, girls were more likely to suffer from sleep disorders than boys (OR = 1.36, p = 0.01). Conclusion: Insufficient sleep and sleep disorders have become common health problems in rural Chinese adolescents.

Bullying victimization and suicide attempts among adolescents in 41 low- and middle-income countries: Roles of sleep deprivation and body mass.

Background: Suicide is the fourth leading cause of death for adolescents, and globally, over 75% of completed suicides occur in low- and middle-income countries (LMICs). Bullying has been proven to be closely related to suicide attempts. However, further understanding of the mechanisms underlying the relationship between bullying and adolescents' suicide attempts is urgently needed. Methods: We used data from the Global School-based Student Health Survey (GSHS) (2010-2017) from 41 LMICs or regions. This study was based on questions assessing bullying victimization, suicide attempts, sleep deprivation, and body mass. Chi-square tests were used to explore the correlations among the main variables. The mediating role of sleep deprivation and the moderating role of body mass index (BMI) were analyzed using PROCESS. Results: The results showed a positive association between bullying victimization and suicide attempts. Sleep deprivation partially mediated the relationship between the frequency of being bullied and suicide attempts. In addition, sleep deprivation played a full or partial mediating role in the relationship between different types of bullying and suicide attempts. BMI moderated the relationships between the frequency of being bullied and suicide attempts, between being made fun of about one's body and sleep deprivation, and between sleep deprivation and suicide attempts. Conclusion: Being bullied has a positive effect on suicide attempts, which is mediated by sleep deprivation and moderated by body mass. The results of this study are consistent with the stress-diathesis model of suicide, suggesting that being bullied is one of the stressors of suicide in adolescents, while sleep deprivation and body mass are susceptibility diatheses of suicide. The results are conducive to identifying adolescents at a high risk of suicide, suggesting that there is a need to pay more attention to bullied adolescents, especially their sleep quality and body mass, and design effective intervention measures to improve the current situation of adolescent suicide in LMICs.

Comparison of EQ-5D-5L and EORTC QLU-C10D utilities in gastric cancer patients.

BACKGROUND: To compare measurement properties of the utility scores derived from various country-specific value sets of EQ-5D-5L (5L) and EORTC QLU-C10D (10D) in gastric cancer patient. METHODS: The study used cross-sectional data of 243 Chinese gastric cancer patients who completed both 5L and EORTC QLQ-C30. Utility score of QLU-C10D is generated from all the available QLU-C10D value sets currently; the score of 5L is derived from the corresponding 5L value sets for the countries with both the 5L and QLU-C10D value sets and the Chinese 5L value set. Convergent validity was evaluated by testing their correlations with the VAS score. Known-group validity was assessed by comparing the utility scores the patients with different severities. Their relative efficiency (RE) was also compared. RESULTS: Correlation coefficient of 5L and QLU-C10D utility scores with VAS ranged from 0.54 to 0.59, and 0.55 to 0.63, respectively. Both the utility scores were in general able to discriminate the patients with different severities; and 5L utility score had higher RE in the majority of known-groups. CONCLUSION: EQ-5D-5L and QLU-C10D utility scores were different and, thus, non-swappable. They possess similar convergent validity and known-group validity; while EQ-5D-5L scores may have better discriminative power.

Evaluating health-related quality of life in gastric cancer patients in Suzhou, China.

BACKGROUND: Health-related quality of life (HRQOL) has become an important part of the evaluation of clinical efficacy and prognosis in gastric cancer. This study aimed to assess the HRQOL of patients with gastric cancer using the a five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and explore the factors influencing patients' perceived quality of life. For those significant factors, we can take appropriate measures to intervene to extend patient survival and improve the quality of life. METHODS: A cross-sectional questionnaire survey was administered to 243 patients with gastric cancer in the First Affiliated Hospital of Suzhou University from December 2018 to December 2020. HRQOL was measured by the Chinese version of the EQ-5D-5L. Nonparametric test analyses and a Tobit regression model were used to identify the independent variables associated with the EQ-5D-5L utility scores. RESULTS: In this research, the mean score was 0.810, and the median was 0.893. Approximately 25% of patients reported no problems at all in any of the five dimensions. Problems in pain and discomfort were the most frequently reported (64.2%). Nonparametric test analyses showed that patients who did not have health insurance, or who had a history of alcohol use, a family history of cancer, had received surgery only, or had an interval of less than 1 week between taking this survey and their last treatment, demonstrated lower EQ-5D-5L scores. The Tobit regression model confirmed that health insurance, family history, and treatment were significantly associated with EQ-5D-5L scores. CONCLUSIONS: The HRQOL of gastric cancer patients can be measured by EQ-5D-5L, and the results may provide a guide for choosing an appropriate individualized treatment plan.

Identification of breast cancer-related circRNAs by analysis of microarray and RNA-sequencing data: An observational study.

BACKGROUND: An increasing number of studies indicate that circular RNAs (circRNAs) participate in tumorigenesis. The aim of this study was to elucidate the regulatory mechanisms of circRNAs in breast cancer based on the construction of the circRNA-related ceRNA network. METHODS: The expression profiles of circRNAs, miRNAs, and mRNAs were obtained from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. A ceRNA network was constructed by Cytoscape. The interactions among proteins were analyzed using the STRING database, and hub genes were extracted using the cytoHubba application. The functions of the differentially expressed mRNAs (DEmRNAs) were analyzed by the Kyoto Encyclopedia of Gene and Genomes (KEGG) and the Gene Ontology (GO) database. RESULTS: In total, 7 differentially expressed circRNAs (DEcircRNAs), 27 differentially expressed miRNAs (DEmiRNAs), and 102 DEmRNAs were selected for the construction of the ceRNA network of breast cancer. We established a protein-protein interaction network and identified 6 hub genes. Then, a circRNA-miRNA-hub gene regulatory module was established based on 2 DEcircRNAs, 2 DEmiRNAs, and 2 DEmRNAs. GO and KEGG pathway analyses indicated the possible association of DEmRNAs with breast cancer onset and progression. CONCLUSIONS: The circRNA hsa_circ_0000519 is likely critical in the pathogenesis of breast cancer and may serve as a future therapeutic biomarker.

[Immunoregulatory Effect of Adipose Mesenchymal Stem Cells on Peripheral Blood Lymphocytes in Psoriasis Vulgaris Patients].

Objective To investigate the effect of adipose mesenchymal stem cells(AMSCs) on the peripheral blood lymphocyte(PBL) in psoriasis vulgaris(PV) patients and the expression and secretion profiles of related inflammatory cytokines in the PBL.Methods AMSCs from three PV patients were co-cultured with PBL. Peripheral blood regulatory cells(Treg) and T helper cell 17(Th17)ratio was measured by flow cytometry. The anti- and pro-inflammatory cytokines expressed and secreted by PBL were detected by quantitative real-time polymerase chain reaction(qRT-PCR) and enzyme-linked immunosorbent assay(ELISA).Results The Treg/total lymphocyte ratio was significantly higher in the healthy people AMSCs+PBL co-culture group[(3.2±0.5)%;P=0.001],but AMSCs in patients had a tendency to promote the proliferation of Treg cells [(1.3±0.2)%],with no significant difference(P=0.485) when compared with the PBL culture alone group[(1.0±0.1)%]. qRT-PCR showed that the ability of PBL in expressing Treg transcription factor forkhead box p3 and transforming growth factor(TGF)-Β mRNA was significantly lower in psoriasis AMSCs+PBL co-culture group than in the healthy people AMSCs+PBL co-culture group(P=0.00,P=0.03),AMSCs had a tendency to promote the expression of interlukin(IL)-10 in peripheral blood lymphocytes,but there was no significant difference(P=0.09).ELISA showed the PBL in healthy people AMSCs+PBL co-culture group secreted the anti-inflammatory cytokine IL-10[(156.9±41.8) ng/Μl] and TGF-Β[(2774.1 ± 526.4) ng/Μl];in contrast,the abilities of PBL in PV patient AMSCs+PBL co-culture group in secreting the anti-inflammatory cytokines has a downward trend:IL-10[(90.4±28.8) ng/Μl] and TGF-Β[(1597.9±55.7) ng/Μl],although the differences were not statistically significant. After the co-culture,the proportion of Th17 cells in the psoriasis AMSCs+PBL co-culture group[(0.8±0.3)%] showed a decreasing trend when compared with the PBL culture alone group[(1.1±0.1)%],although the results were not statistically significant. Also,the proportion of Th17 cells showed no significant difference between PV patient AMSCs+PBL co-culture group and healthy people AMSCs+PBL co-culture group. Finally,both the psoriasis AMSCs+PBL co-culture group and the healthy people AMSCs+PBL co-culture group showed no obvious inhibitory effect on the expression and secretion of Th17 transcription factor retinoid-related orphan nuclear receptor Γt and pro-inflammatory cytokines IL-17 and IL-23 in PBL,and there was no significant difference between these two groups.Conclusions AMSCs in PV patients have decreased ability in regulating the anti-inflammatory function of peripheral blood Treg lymphocytes. However,they have no effect on the proinflammatory effect of peripheral blood Th17 lymphocytes.

Utilization of a Wheat660K SNP array-derived high-density genetic map for high-resolution mapping of a major QTL for kernel number.

In crop plants, a high-density genetic linkage map is essential for both genetic and genomic researches. The complexity and the large size of wheat genome have hampered the acquisition of a high-resolution genetic map. In this study, we report a high-density genetic map based on an individual mapping population using the Affymetrix Wheat660K single-nucleotide polymorphism (SNP) array as a probe in hexaploid wheat. The resultant genetic map consisted of 119 566 loci spanning 4424.4 cM, and 119 001 of those loci were SNP markers. This genetic map showed good collinearity with the 90 K and 820 K consensus genetic maps and was also in accordance with the recently released wheat whole genome assembly. The high-density wheat genetic map will provide a major resource for future genetic and genomic research in wheat. Moreover, a comparative genomics analysis among gramineous plant genomes was conducted based on the high-density wheat genetic map, providing an overview of the structural relationships among theses gramineous plant genomes. A major stable quantitative trait locus (QTL) for kernel number per spike was characterized, providing a solid foundation for the future high-resolution mapping and map-based cloning of the targeted QTL.

Prevalence, types and awareness of glaucoma in a multi-ethnic population in rural China: the Yunnan Minority Eye Study.

PURPOSE: To determine the prevalence, types and awareness of glaucoma in a rural community in China and to examine possible ethnic variations. METHODS: The Yunnan Minority Eye Study was a multi-ethnic community-based eye survey using random cluster sampling strategies. 2133 Bai, 2205 Han and 2208 Yi Chinese aged 50 years or older participated in this study. Glaucoma including primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG) and secondary glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. RESULTS: The overall age-standardized prevalence of all glaucoma was 2.6% (95% confidence interval [CI]: 2.2-3.1%) in this population. It was 1.8% (95% CI: 1.1-1.9%) for POAG and 0.5% (95% CI: 0.9-1.6%) for PACG, respectively. Among 29 people with secondary glaucoma, 27 (93%) were blind in at least one eye. The presence of primary open-angle glaucoma was associated with male gender (odds ratio [OR] = 2.94; comparing men with women), Yi ethnicity (OR = 2.27; comparing Yi with Han people), higher IOP (OR = 1.09 per mmHg increase), and the presence of myopia (OR = 1.84). Of the 212 participants with glaucoma, only 38 (18%) were aware of the disease and had been diagnosed previously as having glaucoma or suspected glaucoma. Patients who were better educated tended to be aware of the disease. CONCLUSIONS: Significant ethnic difference in the prevalence of POAG was observed in this study. The low awareness of glaucoma highlights the pressing need to increase public awareness of this potentially blinding condition in rural China.

Population-based assessment of visual impairment among ethnic Dai adults in a rural community in China.

Dai ethnicity is one of the major Chinese ethnic minorities with a population of about 1.2 million. We aimed to determine the prevalence and potential causes of visual impairment (VI) among ethnic Dai adults aged 50 years or older in a rural community in China. A population-based survey including 2163 ethnic Dai people (80.5%) was undertaken using a random cluster sampling strategy. The detailed eye examination was performed after pupil dilation by trained study ophthalmologists and optometrists. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) was measured using the Early Treatment Diabetic Retinopathy Study logMAR chart and VI was defined as a VA of less than 20/63 in the better-seeing eye. The overall prevalence of presenting blindness and low vision was 3.0% (95% CI, 2.3-3.7) and 13.3% (95% CI, 11.9-14.8), respectively. The prevalence estimates were reduced to 2.1% (95% CI, 1.5-2.8) and 6.7% (95% CI, 5.7-7.8) when BCVA was considered. Men were more likely to be affected by low vision but less likely to be blind compared with women. Cataract accounted for 62.7% of presenting low vision and 68.8% of presenting blindness, respectively. In conclusion, VI was a significant health concern in Dai Chinese in China.

Protection of Nerve Injury with Exosome Extracted from Mesenchymal Stem Cell.

OBJECTIVE: To investigate the protective effect of Exosomes from human adipose-derived mesenchymal stem cells (hAMSCs) in neural injury induced by glutamate and its possible mechanism. METHODS: Characteristics of Exosomes from hAMSCs were identified by electron microscopy and Western blot analysis. Cytokines that might play a major role in the protective effect were tested by enzyme-linked immunosorbent assay (ELISA). The protective action of Exosome and its possible signaling pathway were researched by the in vitro neural injury induced by glutamate, including control group (without Glu), Glu group (dealing with Glu), Glu+Exo group (dealing with Glu +100 ng/ml Exo), Glu+Exo+Akt group (dealing with Glu+100 ng/ml Exo+10 µmol/L Akt), Glu+Exo+Erk group (dealing with 100 ng/ml Glu+100 ng/ml Exo+10 µmol/L Erk), and Glu+Exo+TrkB group (dealing with Glu+100 ng/ml Exo +10 µmol/L TrkB). RESULTS: Exosomes from hAMSCs had similar sizes to those isolated from other kinds of cells, and expressed the characteristic proteins such as CD63, CD81, HSP70, and HSP90. Cytokines that had neurotrophic effects on Exosomes were mainly insulin-like growth factor and hepatocyte growth factor, with the concentration being 9336.49±258.63 and 58,645.50±16,014.62, respectively; brain derived neurotrophic factor, nerve growth factor,and vascular endothelial growth factor had lower levels, with the concentration being 1928.25±385.47, 1136.94±5.99, and 33.34±9.43, respectively. MTS assay showed that the PC12 cell survival rates were 0.842±0.047, 0.306±0.024, 0.566±0.026, 0.461±0.016, 0.497±0.003, and 0.515±0.034 in the control group, Glu group, Glu+Exo group, Glu+Exo+Akt group, Glu+Exo+Erk group, and Glu+Exo+TrkB group; obviously, it was significantly lower in Glu group than in control group (P=0.02), significantly higher in Glu+Exo group than in Glu group (P=0.01), and significantly lower in Glu+Exo+Akt group than in Glu+Exo group (P=0.01). CONCLUSION: Exosomes secreted from hAMSCs have protective effect against neuron damage induced by glutamate, which may be mediated through activating the PI3/K-Akt signalling pathway.

Prognostic value of plasma ghrelin in predicting the outcome of patients with chronic heart failure.

BACKGROUND AND AIMS: Ghrelin is an endogenous ligand of the growth hormone (GH) secretagogue receptor and is closely associated with chronic heart failure (CHF). We undertook this study to investigate the relevance of ghrelin in CHF prognosis. METHODS: A total of 145 in-patients with CHF in NYHA class II, III or IV despite optimized therapy were prospectively included in the study, grouped according to NYHA class and compared with 55 healthy control subjects. Ghrelin and N-terminal pro-B-type natriuretic peptide (Nt pro-BNP) were measured in plasma by ELISA. Echocardiographic information was also measured, including left atrial dimension, left ventricular end-diastolic diameter, LV volume and left ventricular ejection fraction (LVEF). Patients were followed for 2 years or until major adverse cardiac events. RESULTS: Plasma ghrelin levels were significantly lower in patients with CHF than in control subjects (p = 0.014). In addition, plasma ghrelin levels differed significantly with the severity of CHF. Notably, survival analysis showed that high ghrelin levels were an indicator of a favorable prognosis for CHF. Our results also showed that ghrelin correlated inversely with plasma Nt pro-BNP levels (r = -0.562, p <0.001) and positively with LVEF (r = 0.620, p <0.001) in patients with CHF. Furthermore, multivariate analysis showed that ghrelin levels were independently associated with adverse cardiac events (hazard ratio: 0.72; 95% CI: 0.64-0.81, p = 0.03). CONCLUSIONS: Ghrelin is a new biomarker of CHF severity as well as a new prognostic predictor for patients with CHF. Future experimental and clinical studies are warranted to evaluate ghrelin as a novel prognostic tool and for its therapeutic potential in patients with CHF.

[Concept of mesenchymal stem cells: bring more insights into functional research of MSC].

Mesenchymal stem cells have generated great interest among researchers and physicians due to their unique biological characteristics and potential clinical applications. Here, I propose for the first time the concept of a hierarchical system which is composed of all mesenchymal stem cells from post-embryonic subtotipotent stem cells to MSC progenitors. Post-embryonic subtotipotent stem cells are left-over cells during embryonic development and are on the top of the hierarchy. MSC system is a combination of cells that are derived from different stages of embryonic development, possess different differentiation potential and ultimately give rise to cells that share a similar set of phenotypic markers. The concept of MSC system has important implications: (1) it entirely explains the three important biological characteristics of MSC: stem cell properties of MSC, MSC as components of tissue microenvironment and immunomodulatory functions of MSC. (2) It balances immune responses and tissue metabolism. (3) It could provide tissue-specific stem cells for clinical application with high efficiency and safety. In a word, this concept constitutes an important part of the biological properties of MSC and will help researchers gain better insight into MSC.

[Study on inducing differentiation of human amniotic epithelial cells into insulin secreting cells in vitro].

OBJECTIVE: To investigate the differentiation of human amniotic epithelial cells (hAECs) into insulin secreting cells (ISCs) in vitro. METHODS: The hAECs were isolated from human amnion by trypsin digestion, and the phenotype of the isolated cells were identified by flow cytometry and immunocytochemical staining. The hAECs at passage 3 were treated with nicotinamide and N2 supplement to investigate their differentiation into ISCs. At different times after differentiation, the expression of insulin and beta2 microglobulin (beta2-MG) was determined by immunocytochemical staining, while the content of insulin in supernatant from cultured hAECs was detected by radioimmunoassay and the expressions of insulin, pancreatic and duodenal homeobox factor-1 (PDX-1) mRNA were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: (1) hAECs expressed high percent of CD29, CD73, CD166 and CK19. (2) At 7, 14 and 21 days, the percentages of insulin-positive cells in induced groups were 74.00% +/- 1.73%, 75.33% +/- 1.15% (see symbol) 75.67% +/- 0.58% respectively, which were negative in control groups. (3) At 7, 14 and 21 days, contents of insulin in supernatant from induced groups were (328.47 +/- 3.22) microIU/ml, (332.26 +/- 1.22) microIU/ml and (329.68 +/- 2.57) microIU/ml respectively, they were significantly higher than those in control groups (All P < 0.01). (4) PDX-1 mRNA and beta2-MG were expressed before and after the induction of hAECs, but insulin mRNA was expressed only in the induced groups. CONCLUSION: hAECs can differentiate into ISCs, having the potential application for therapy of type I diabetes.

A new cerebral hemorrhage model in cynomolgus macaques created by injection of autologous anticoagulated blood into the brain.

The aim of this study was to establish and validate a clinically relevant model of intracerebral hemorrhage (ICH) via injection of autologous blood into the brains of cynomolgus macaques (Macaca fascicularis). Eight male cynomolgus macaques received 1.5 mL of fresh anticoagulated autologous femoral artery blood into the inner side of the claustrum near the right basal ganglia under stereotactic guidance. Animals were evaluated with MRI and positron emission tomography (PET) scanning before and 24 hours after surgery and once per week thereafter. A neurological deficit scale was used to assess the animals on days 1, 2, 3, 7, 14, 21, and 28 after surgery. Animals showed focal neurological signs corresponding to the MRI-located hematoma. The behavioral impairment progressively ameliorated over time, but never fully resolved. The hematoma was absorbed over time but was still present 4 weeks after surgery, with persistent metabolic deficit detected using PET scanning. Histological examinations confirmed the in vivo findings. This ICH model in a non-human primate mimics human ICH in the basal ganglia and may be useful for assessing the safety and efficacy of neuroprotective agents.

Mechanisms of the protective effects of BMSCs promoted by TMDR with heparinized bFGF-incorporated stent in pig model of acute myocardial ischemia.

This study investigates the mechanism by which transmyocardial drilling revascularization combined with heparinized basic fibroblast growth factor incorporated degradable stent implantation (TMDRSI) enhanced effects of bone marrow mesenchymal stem cells (BMSCs) transplantation against acute ischemic myocardial injury. After the mid-third of left anterior descending artery was ligated, miniswine were divided into none-treatment group (control, n = 6), BMSCs implantation group (C, n = 6), TMDRSI group (TS, n = 6) and TMDRSI and BMSCs implantation group (TSC, n = 6). Two channels of 3.5 mm diameter were established by a self-made drill in the ischemic region, into which a stent was implanted for the TS and TSC groups. Autologous BMSCs were transplanted into the ischemic region in C group or around the channels in TSC group. Expression of von Willebrand factor, vascular endothelial growth factor, interleukin-1ß, transforming growth factor-ß(3) , cell proliferation and apoptosis, histological and morphological analyses, myocardial remodelling and cardiac function were evaluated at different time-points. Six weeks after the operation, the above indices were significantly improved in TSC group compared with others (P < 0.05), though C and TS groups also showed better results than the control group (P < 0.05). The new method was shown to have activated paracrine pathway of transplanted BMSCs, increased survival and differentiation of such cells, and enhanced effects of BMSCs transplantation on myocardial remodelling, which may provide a new strategy for cell therapies against acute ischemic myocardial injury.

[Virus free induction of umbilical cord derived mesenchymal stem cells into islet-like cells].

OBJECTIVE: To explore the feasibility of using a virus-free system in the induction of umbilical cord derived mesenchymal stem cells (UC-MSCs) into insulin-secreting cells. METHODS: MSCs were isolated from human umbilical cord and induced into insulin-secreting cells with a three-stage method. The mRNA expression levels of foxa2, sox17, pdx1, ngn3, pax4, insulin, and glut-2 were compared between induced and non-induced groups by RT-PCR in each stage. The distribution pattern of insulin and c-peptide were detected by immunofluorescence staining and observed by fluorescence microscopy. Insulin and c-peptide secretion and glucose responsiveness were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: Transcription factors foxa2, sox17, pdx1, ngn3, pax4, insulin, and glut-2 were expressed in the induced cells. The mRNA expression levels of foxa2 and sox17 were significantly higher in the induced group than those in non-induced group in the first stage (all P < 0.05), pdx1, ngn3, and pax4 were significantly higher in the induced cells than those in non-induced cells in the second stage (all P < 0.05), and insulin and glut-2 expressions were significantly up-regulated in the induced group at last stage (all P < 0.05). Immunofluorescence staining showed that insulin and c-peptide were located in the cytoplasm of more than 90% of induced cells. ELISA showed that total intracellular insulin content of the induced cells contained up to (346.3 739 +/- 32.5 149) microU/ml, which was significantly higher than insulin in non-induced cells (17.69 +/- 1.46) microU/ml (P < 0.01). C-peptide content of the induced cells measured up to (195.10 +/- 8.88) pmol/L/h (P < 0.01), when exposed to 5.5 mmol/L glucose (P < 0.01). When stimulated with 22 mmol/L glucose, the c-peptide content of the induced cells increased to (340.99 +/- 7.91) pmol/L/h (P < 0.01 ). CONCLUSION: The umbilical cord derived MSCs can be efficiently induced into insulin-secreting cells via a virus-free system.

[Clinical observation on the effect of electroacupuncture of Sanyinjiao (SP 6) on labor].

OBJECTIVE: To observe the effect of electroacupuncture (EA) of Sanyinjiao (SP 6) on labor in parturients. METHODS: A total of 349 parturients were randomly divided into EA (n=117), sham-EA (n=117) and control (n=115) groups. The visual analog scale (VAS) was used to assess the pain intensity of puerperas with labor before and after acupuncture intervention. After excluding those puerperas with cesarean section, the time required for each stage of labor and the total duration of labor were observed in 286 cases of natural delivery women including 92 cases in the control group, 94 cases in the sham-EA group and 100 cases in the EA group. EA (2 Hz/100 Hz, 20 mA) was given to the puerperas for 30 min after the needle in a cannula was tapped into Sanyinjiao(SP 6) and when the dilatation of cervix was about 2-3 cm wide. For puerperas of sham-EA group, the operation was similar, but no real acupuncture needle and no real electric current were given. RESULTS: The VAS score for childbirth pain intensity was significantly lower in EA group than in control group (P < 0.05) and had no significant difference between sham-EA and control group (P > 0.05). The duration of the active phase of the first stage of labor was significantly lower in EA group than in sham-EA group (P < 0.05), but had no significant difference between sham-EA and control groups (P > 0.05). No significant differences were found among the 3 groups in the latency of the first stage of labor, in the duration of the 2nd and the 3rd stages of labor and in the total phase of labor (P > 0.05). CONCLUSION: EA of SP 6 can relieve the pain intensity of the labor and shorten the duration of the active period of first stage of labor in puerperas, suggesting an improvement of the quality of delivery after EA.

Mid-term effect of stem cells combined with transmyocardial degradable stent on swine model of acute myocardial infarction.

BACKGROUND: We aimed to confirm the mid-term results of the new method combined with bone marrow-derived mesenchymal stem cells (MSCs) transplantation and transmyocardial drilling revascularization (TMDR) with degradable stent incorporated with basic fibroblast growth factor and heparin. METHODS: The miniswine underwent acute myocardial infarction by ligation of the left anterior descending coronary artery. Transmyocardial channels with 3.5 mm diameter (TMDR) were made by mechanical drilling in the infarction territory and basic fibroblast growth factor stents were implanted into the channels. Animals were randomly divided into the following four groups (n=6 in each): control; II: MSCs implantation; III: TMDR+stent implantation; IV: TMDR+stent implantation+MSCs implantation. Three months postoperatively, ECG-gated single photon emission computed tomography, histopathological examination, and reverse transcription-polymerase chain reaction were carried out. RESULTS: Left ventricular ejection fraction and myocardial perfusion were significantly improved in group IV than that in other groups (P<0.05). Compared with other groups, vessel density was augmented and cell apoptosis was reduced in group IV (P<0.01). Reverse transcription-polymerase chain reaction results showed that the expression levels of von Willebrand factor, transforming growth factor-beta3, vascular endothelial growth factor, and interleukin-1beta were much higher in group IV than that in other groups (P<0.05). CONCLUSION: Three months after operation, MSCs transplantation combined with TMDR and degradable stent significantly improved cardiac function, enhanced neovascular density, reduced infarcted size, improved ventricular remodeling, and reduced cardiac myocyte apoptosis, and therefore provides strong information for clinical trial.