Microwave Ablation for Inoperable Stage I Non-Small Cell Lung Cancer in Patients Aged ≥70 Years: A Prospective, Single-Center Study.

PURPOSE: To evaluate the safety and survival outcomes of computed tomography-guided microwave ablation (MWA) for medically inoperable Stage I non-small cell lung cancer (NSCLC) in patients aged ≥70 years. MATERIALS AND METHODS: This study was a prospective, single-arm, single-center clinical trial. The MWA clinical trial enrolled patients aged ≥70 years with medically inoperable Stage I NSCLC from January 2021 to October 2021. All patients received biopsy and MWA synchronously with the coaxial technique. The primary endpoints were 1-year overall survival (OS) and progression-free survival (PFS). The secondary endpoint was adverse events. RESULTS: A total of 103 patients were enrolled. Ninety-seven patients were eligible and analyzed. The median age was 75 years (range, 70-91 years). The median diameter of tumors was 16 mm (range, 6-33 mm). Adenocarcinoma (87.6%) was the most common histologic finding. With a median follow-up of 16.0 months, the 1-year OS and PFS rates were 99.0% and 93.7%, respectively. There were no procedure-related deaths in any patient within 30 days after MWA. Most of the adverse events were minor. CONCLUSION: MWA is an effective and safe treatment for patients aged ≥70 years with medically inoperable Stage I NSCLC.

Synchronous percutaneous core-needle biopsy and microwave ablation for stage I non-small cell lung cancer in patients with Idiopathic pulmonary fibrosis: initial experience.

PURPOSE: This study aimed to retrospectively evaluate the safety and feasibility of computed tomography (CT)-guided synchronous percutaneous core-needle biopsy (CNB) and microwave ablation (MWA) for stage I non-small cell lung cancer (NSCLC) in patients with idiopathic pulmonary fibrosis (IPF). METHODS: From January 2019 to January 2023, nineteen stage I NSCLC patients with IPF underwent CT-guided synchronous percutaneous CNB and MWA in this study. The technical success rate, complications, local tumor progression (LTP) and overall survival (OS) were observed, and the effect of synchronous percutaneous CNB and MWA were evaluated. RESULTS: The technical success rate of synchronous percutaneous CNB and MWA was 100%. With a median follow-up time of 20.36 months, the median OS was 25 months (95% CI: 21.79, 28.20). The six-, twelve- and eighteen-month OS rates were 94.73%, 89.47% and 57.89%, respectively. The six-, twelve- and eighteen-month LTP rates were 0%, 10.52% and 31.57%, respectively. Major complications including pneumothorax, bronchopleural fistula and pneumonia occurred in 26.32% (5/19) patients. None of the patients died during the procedure. CONCLUSIONS: According to the results of the current study, CT-guided synchronous percutaneous CNB and MWA appears to be a safe and effective for stage I NSCLC in patients with IPF and providing an alternative therapeutic option for local control of pulmonary malignancy in high-risk patients.

Microwave ablation of lung malignancies with coexisting severe emphysema: a retrospective analysis of safety and efficacy in 26 patients.

PURPOSE: This retrospective study aimed to evaluate the safety and efficacy of microwave ablation (MWA) for lung malignancies in patients with severe emphysema. MATERIALS AND METHODS: The clinical records of 1075 consecutive patients treated for malignant lung tumors in our department were retrospectively reviewed. Emphysema was assessed based on standard-dose computed tomography (CT) and was considered severe when it occupied ≥25% of the lung. Overall, 26 patients (24 men and 2 women; mean age ± standard deviation [SD]: 71.23 ± 8.18 years, range: 59-88 years) with severe emphysema underwent CT-guided percutaneous MWA for treating 26 tumors (24: non-small cell lung cancer and 2: metastases). The mean tumor size was 3.0 cm (SD: 1.5, range: 1.2-6.5 cm). Follow-up was performed with CT at 1, 3, 6, 12 months after ablation, and every 6 months thereafter. Complications and efficacy were evaluated. RESULTS: The median follow-up duration in all patients was 17.5 months (range: 5-37 months, interquartile range: 15.8). The mortality rate was 0% within 30 days after ablation. Major complications including pneumonia, lung abscess and refractory pneumothorax occurred in 19.2% (5/26) patients. The technical success and efficacy rates were 88.5% (23/26) and 87.0% (20/23), respectively, and the local tumor progression rate was 30.0% (6/20). CONCLUSION: MWA appears to be a safe and effective therapeutic option for treating lung malignancies in patients with severe emphysema.

RNA-Seq Based Transcriptome Analysis of Endothelial Differentiation of Bone Marrow Mesenchymal Stem Cells.

OBJECTIVE: The aim was to identify the change in gene expression between mesenchymal stem cells (MSCs) and induced endothelial cells (ECs) and to investigate the potential mechanism of endothelial differentiation based on ribonucleic acid sequencing (RNA-Seq) analysis. METHODS: MSCs were isolated from bone marrow and exposed to inducing medium. The dynamic transcription profiles of MSCs were identified and ECs were induced through RNA-seq. Differentially expressed genes (DEGs) were identified. Enrichment of functions and signalling pathways analysis were performed based on Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Quantitative real time polymerase chain reaction (qRT-PCR) was used to validate the genes selected from RNA-Seq. RESULTS: In total, 2769 DEGs were identified, of which 1117 genes were upregulated and 1652 genes were downregulated. GO and KEGG pathway analyses identified significantly enriched pathways in DEGs, including extracellular matrix organisation, blood vessel morphogenesis, angiogenesis, extracellular matrix binding, growth factor binding and glycosaminoglycan binding extracellular matrix-receptor interaction pathway, cytokine-receptor interaction pathway and transforming growth factor (TGF)-ß signalling pathway. All genes found to be associated with the TGF-ß pathway were significantly downregulated. Eleven novel genes were also identified that most likely are involved in endothelial differentiation and were upregulated with more than 10 fold change, which were further validated by qRT-PCR. CONCLUSION: The GO and KEGG analysis revealed that extracellular matrix, cytokines and the TGF-ß pathway play an important role in the process of endothelial differentiation. Furthermore, 11 genes were found that may be involved in the differentiation of MSCs into ECs and contribute to current understanding of the differentiation mechanism.

Efficient Differentiation of Bone Marrow Mesenchymal Stem Cells into Endothelial Cells in Vitro.

OBJECTIVE: Endothelial cells (ECs) play an important role in neovascularisation, but are too limited in number for adequate therapeutic applications. Mesenchymal stem cells (MSCs) have the potential to differentiate into endothelial lineage cells, which makes them attractive candidates for therapeutic angiogenesis. The aim of this study was to investigate efficient differentiation of MSCs into ECs by inducing medium in vitro. METHODS: MSCs were isolated from bone marrow by density gradient centrifugation. The characterisation of the MSCs was determined by their cluster of differentiation (CD) marker profile. Inducing medium containing vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), insulin like growth factor (IGF), epidermal growth factor (EGF), ascorbic acid, and heparin was applied to differentiate the MSCs into ECs. Endothelial differentiation was quantitatively evaluated using flow cytometry. Real time quantitative PCR (qRT-PCR) was used to analyse mRNA expression of endothelial markers. Tube formation assay was further performed to examine the functional status of the differentiated MSCs. RESULTS: Flow cytometry analysis demonstrated that CD31+ and CD34+ cells increased steadily from 12% at 3 days, to 40% at 7 days, and to 60% at 14 days. Immunofluorescence staining further confirmed the expression of CD31 and CD34. qRT-PCR showed that expression of von Willebrand factor (vWF), vascular endothelial cadherin (VE-cadherin) and vascular endothelial growth factor receptor-2 (VEGFR-2) were significantly higher in the induced MSCs group compared with the uninduced MSCs group. The functional behavior of the differentiated cells was tested by tube formation assay in vitro on matrigel. Induced MSCs were capable of developing capillary networks, and progressive formation of vessel like structures was associated with increased EC population. CONCLUSIONS: These results provide a method to efficiently promote differentiation of MSCs into ECs in vitro for potential application in the treatment of peripheral arterial disease.

Resonance light scattering method for detecting kanamycin in milk with enhanced sensitivity.

In this paper, a resonance light scattering (RLS) method was developed for detecting kanamycin with high sensitivity and selectivity. Here, aptamer specific to kanamycin was utilized for recognizing and competitively binding with kanamycin, and gold nanoparticles (GNPs) were used as probes. After adding kanamycin into solutions containing aptamer and GNPs, the GNPs would aggregate in the presence of NaCl, which resulted in the RLS signal intensities enhanced dramatically. Based on this phenomenon, kanamycin can be detected in the range of 10 to 600 nM with a limit of detection as 1 nM, which is more sensitive than many other instrumental methods, especially the commonly used UV-visible spectroscopic method. Furthermore, we demonstrated that this method can be used for detecting kanamycin in milk samples with satisfactory results, which is meaningful for solving food safety problems.

Crop plant genotyping by real-time PCR analysis of crude extracts of seeds.

Development of agricultural biotechnology requires rapid and convenient methods for crop plant genotyping. Real-time PCR is sensitive and reliable, and has been a routine technique in plant research. However, its application is limited by the cumbersome DNA template preparation procedures. We tested three PCR master mixes for direct amplification of crude seed DNA extracts without extensive purification. One mix had higher resistance to plant-derived PCR inhibitors and was shown to be applicable to various important crop plants. Furthermore, this method is capable of detecting single-copy genes from 2 mg pieces of seeds repetitively. Meanwhile, melting curve analysis could detect amplicons directly without electrophoresis manipulations. Taken together, this direct real-time PCR method provides a rapid and convenient tool for seed genotypic screening in crop plants.

[Efficacy of splenic artery trunk embolization with detachable balloon for portal hypertension and hypersplenism].

OBJECTIVE: To investigate the efficacy of detachable balloon for splenic artery trunk embolization in patients with cirrhotic portal hypertension and hypersplenism. METHODS: Eight patients with cirrhotic portal hypertension received splenic artery trunk disconnection using detachable balloons under the guidance of digital subtraction angiography. The diameter and blood flow of the portal vein, the superior mesenteric vein, the splenic vein and the hepatic artery were measured by color Doppler ultrasound. Markers of liver function and blood coagulation, and routine blood parameters were assessed. Gastroscopy was used to evaluate to the degree of gastroesophageal varices. All complications experienced during the perioperative period were recorded. RESULTS: The portal vein diameter decreased from 1.55±0.38 cm to 1.55±0.38 cm, and the splenic artery diameter decreased from 1.45±0.10 cm to 1.41±0.09 cm (P < 0.05). The portal vein blood flow was reduced from 971.52±174.77 ml/min to 785.86±100.17 ml/min, and the splenic vein blood flow decreased from 938.01±208.86 ml/min to 644.02±188.15 ml/min, while the hepatic artery blood flow increased from 261.25±65.47 ml/min to 449.32±84.05 ml/min (P < 0.05). The symptoms of splenism were improved effectively, with platelet counts rising from 37.75±10.61*109/L to 138.63±28.22*109/L after the procedure (P < 0.05). There were no episodes of severe complications or death in the perioperative period, and all patients showed remarkable improvement in markers of liver function and coagulation function, and improvement of esophagogastric varices. CONCLUSIONS: The interventional disconnection technique of the splenic artery trunk using detachable balloon for the treatment of portal hypertension and hypersplenism is safe and effective.

Marine-derived EGFR inhibitors: novel compounds targeting breast cancer growth and drug resistance.

Breast cancer (BC) continues to be a major health challenge globally, ranking as the fifth leading cause of cancer mortality among women, despite advancements in cancer detection and treatment. In this study, we identified four novel compounds from marine organisms that effectively target and inhibit the Epidermal Growth Factor Receptor (EGFR), crucial for BC cell growth and proliferation. These compounds not only induced early apoptosis through Caspase-3 activation but also showed significant inhibitory effects on EGFR mutations associated with drug resistance (T790M, L858R, and L858R/T790M), demonstrating high EGFR kinase selectivity. Cell Thermal Shift Assay (CETSA) experiments indicated that Tandyukisin stabilizes EGFR in a concentration-dependent manner. Furthermore, binding competition assays using surface plasmon resonance technology revealed that Tandyukisin and Trichoharzin bound to distinct sites on EGFR and that their combined use enhanced apoptosis in BC cells. This discovery may pave the way for developing new marine-derived EGFR inhibitors, offering a promising avenue for innovative cancer treatment strategies and addressing EGFR-mediated drug resistance.

Recent advances in drug delivery of celastrol for enhancing efficiency and reducing the toxicity.

Celastrol is a quinone methyl triterpenoid monomeric ingredient extracted from the root of Tripterygium wilfordii. Celastrol shows potential pharmacological activities in various diseases, which include inflammatory, obesity, cancer, and bacterial diseases. However, the application prospect of celastrol is largely limited by its low bioavailability, poor water solubility, and undesired off-target cytotoxicity. To address these problems, a number of drug delivery methods and technologies have been reported to enhance the efficiency and reduce the toxicity of celastrol. We classified the current drug delivery technologies into two parts. The direct chemical modification includes nucleic acid aptamer-celastrol conjugate, nucleic acid aptamer-dendrimer-celastrol conjugate, and glucolipid-celastrol conjugate. The indirect modification includes dendrimers, polymers, albumins, and vesicular carriers. The current technologies can covalently bond or encapsulate celastrol, which improves its selectivity. Here, we present a review that focalizes the recent advances of drug delivery strategies in enhancing the efficiency and reducing the toxicity of celastrol.

Diagnostic performance and safety of percutaneous fine-needle aspiration immediately before microwave ablation for pulmonary ground-glass nodules.

Background: This study sought to evaluate the safety and diagnostic performance of computed tomography (CT)-guided fine-needle aspiration (FNA) immediately before microwave ablation (MWA) for pulmonary ground-glass nodules (GGNs). Methods: This retrospective study analyzed the synchronous CT-guided biopsy and MWA data of 92 GGNs (male to female ratio 37:55; age 60.4±12.5 years; size 1.4±0.6 cm). FNA was performed in all patients, and sequential core-needle biopsy (CNB) was performed in 62 patients. The positive diagnosis rate was determined. The diagnostic yield was compared on the basis of the biopsy methods (FNA, CNB, or both), the nodule diameter (<1.5 and ≥1.5 cm), and the lesion component (pure GGN or part-solid GGN). The procedure-related complications were recorded. Results: The technical success rate was 100%. The positive rates of FNA and CNB were 70.7% and 72.6% respectively, but did not differ significantly (P=0.8). Sequential FNA and CNB showed better diagnostic performance (88.7%) than did either alone (P=0.008 and P=0.023, respectively). The diagnostic yield of CNB for pure GGNs was significantly lower than that for part-solid GGNs (P=0.016). The diagnostic yield was lower for smaller nodules (78.3% vs. 87.5%; P=0.28), but the differences were not significant. Grade 1 pulmonary hemorrhages were observed in 10 (10.9%) sessions after FNA, including 8 cases of hemorrhage along the needle track and 2 cases of perilesional hemorrhage, but these hemorrhages did not hamper the accuracy of the antenna placement. Conclusions: FNA immediately before MWA is a reliable technique for the diagnosis of GGNs that does not alter the accuracy of the antenna placement. Sequential FNA and CNB improves the diagnostic ability of GGNs compared to either method used alone.

Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma.

BACKGROUND: Hilar cholangiocarcinoma (HC) is a good adaptation certificate of hepatic arterectomy, and hepatic arterectomy is conductive to the radical resection of cholangiocarcinoma, which simplifies the operation and helps with a combined resection of the peripheral portal tissue. With continuous development of surgical techniques, especially microsurgical technique, vascular invasion is no longer a contraindication to surgery in the past 10 years. However, hepatic artery reconstruction after hepatic arterectomy has been performed to treat liver tumor in many centers with better results, but it is rarely applied in advanced HC. AIM: To determine the prognosis of patients with advanced HC after hepatic artery resection and reconstruction. METHODS: A total of 98 patients with HC who underwent radical operation in our hospital were selected for this retrospective analysis. According to whether the patients underwent hepatic artery resection and reconstruction or not, they were divided into reconstruction (n = 40) and control (n = 58) groups. The traumatic indices, surgical resection margin, liver function tests before and after the operation, and surgical complications were compared between the two groups. RESULTS: Operation time, blood loss, hospital stay, and gastrointestinal function recovery time were higher in the reconstruction group than in the control group (P < 0.05); The R0 resection rates were 90.00% and 72.41% in the reconstruction and control groups, respectively (P < 0.05). Serum alanine aminotransferase was lower in the reconstruction group on day one and three postoperatively, whereas serum aspartate aminotransferase was lower on the third day (P < 0.05). Preoperatively, the Karnofsky performance status scores were similar between the groups (P > 0.05), but was higher in the reconstruction group (P < 0.05) two weeks postoperatively. There was no difference in the complication rate between the two groups (27.50% vs 32.67%, P > 0.05). Two-year survival rate (42.50% vs 39.66%) and two-year survival time (22.0 mo vs 23.0 mo) were similar between the groups (P > 0.05). CONCLUSION: Radical surgery combined with reconstruction after hepatic artery resection improves R0 resection rate and reduces postoperative liver injury in advanced HC. However, the operation is difficult and the effect on survival time is not clear.

Physicochemical property, bacterial diversity, and volatile profile during ripening of naturally fermented dry mutton sausage produced from Jianzhou big-eared goat.

Physicochemical properties, bacterial communities, and volatile compounds of mutton sausage produced from Jianzhou Big-Eared goat meat during natural ripening were investigated. Firmicutes and Bacteroidetes accounted for over 66% of all operational taxonomic units (OTUs) throughout the whole process, with Lachnospiraceae_NK4A136_group and Staphylococcus as the predominant genus during the early and later ripening periods, respectively. The evolution of microbial composition became less rich and diverse. The uncultured bacterium, the Lachnospiraceae_NK4A136_group, and Staphylococcus were marker bacteria on days 0, 7, and 26, respectively, with none on day 16. The bacteria distribution seemed to influence the volatile profile of mutton sausage throughout processing, with the bacterial composition on day 0 and day 7 clustered separately from day 16 and day 26, and the same pattern for the volatile profile. Meanwhile, the concentration of total volatile fraction significantly increased, and the majority of the volatile compounds were generated during late ripening. Non-anal, hexanal, decanal, heptanal, dodecyl aldehyde, benzaldehyde, 3-methylbutanal, γ-dodecalactone, 2-pentylfuran, and 1-octen-3-ol were key volatile compounds, contributing to the overall mutton sausage flavors. Based on Spearman's correlation analysis, Staphylococcus as well as Psychrobacter were positively correlated with the production of the key volatile compounds, and other bacteria such as Lachnospiraceae_NK4A136_group, Bacteroides, Lactobacillus, Prevotella_1, Odoribacter, and so on were associated with the production of most alcohols and esters.

Advances in study of the sequence of lung tumor biopsy and thermal ablation.

Percutaneous thermal ablation is an important treatment for lung cancer and is widely used in hospitals. Puncture biopsy is generally required for pathological diagnosis before or after thermal ablation. Pathological diagnosis provides both evidence of benign and malignant lesions for ablation therapy and is of important significance for the next step in disease management. Furthermore, the sequence of ablation and biopsy affects the accuracy of pathological diagnosis, the complete ablation rate of thermal ablation, and incidence of surgery-related complications. Ultimately, it may affect the patient's benefit from local treatment. This article reviews the research progress of traditional asynchronous biopsy followed by ablation, the emerging methods of synchronous biopsy followed by ablation, and synchronous ablation followed by biopsy in the last decade. KEY POINTS: The sequence of ablation and biopsy affects the accuracy of pathological diagnosis, the complete ablation rate of thermal ablation, and the incidence of surgical-related complications. This article reviewed the recent 10 years' literature on the surgical sequence of biopsy and ablation for lung tumors, the advantages, disadvantages and indications of different orders were analyzed.

Enhanced Electromagnetic Wave Absorption for Y2O3-Doped SiBCN Ceramics.

Polymer-derived SiBCN ceramics (PDCs-SiBCN) are promising ultrahigh-temperature ceramics owing to their excellent high-temperature oxidation resistance and electromagnetic wave (EMW)-absorbing capability. In this paper, the microstructure evolutions, the dielectric properties, and EMW absorption properties of Y2O3-doped SiBCN ceramics were investigated. The results reveal that Y2O3 acting as a catalyst promotes the formation of SiC, BN(C), and graphite crystalline phases in the SiBCN ceramics, and these crystalline phases are constructed as conduction phases and polarization phases to enhance the EMW-adsorbing properties. The minimum reflection loss (RLmin) reaches -42.22 dB at 15.28 GHz, and the effective absorption bandwidth is 4.72 GHz (13.28-18.00 GHz). In addition, there is only 0.56 wt % mass loss for the Y2O3-doped SiBCN ceramics when they are heated from ambient temperature to 1500 °C in air, indicating that the Y2O3-doped SiBCN ceramics obtain excellent oxidation resistance at high temperature. We believe that rare metal oxidation is beneficial for the growth of crystalline phases in the PDCs, resulting in high EMW-absorbing properties and oxidation resistance. Thus, the research extends a novel method and design strategy for microstructure regulation and property enhancement of PDCs.

Synchronous microwave ablation followed by core-needle biopsy via a coaxial cannula for highly suspected malignant lung ground-glass opacities: A single-center, single-arm retrospective study.

BACKGROUND: This study aimed to retrospectively explore the safety and feasibility of computed tomography (CT)-guided synchronous microwave ablation (MWA) followed by core-needle biopsy (CNB) via a coaxial cannula for highly suspected malignant lung ground-glass opacities (GGOs). METHODS: The clinical data of 66 patients (66 GGOs) treated with CT-guided synchronous MWA followed by CNB via a coaxial cannula from January 2019 to January 2021 were included in this study. The technical success rate, curative effect, and complications were evaluated. RESULTS: Technical success rates were 100%. The pneumothorax rate was 36.4% (24/66). 72.7% (48/66) patients had the bronchopulmonary hemorrhage, 81.3% of hemorrhage was attributable to CNB. 24.2% (16/66) patients had varying degrees of pleural effusion. The pathological results were adenocarcinomas (n = 44), atypical adenomatous hyperplasia (n = 2), chronic inflammation (n = 3) and indeterminate pathological diagnosis (n = 17) with a 69.7% (46/66) positive diagnosis rate. The therapeutic response rate was 100.0% (66/66). CONCLUSIONS: Synchronous MWA followed by CNB via a coaxial cannula has a satisfactory ablation effectiveness and an acceptable biopsy positive rate, which is an alternative treatment for highly suspected malignant GGOs.

A Novel Method for Accurate Quantification of Split Glomerular Filtration Rate Using Combination of Tc-99m-DTPA Renal Dynamic Imaging and Its Plasma Clearance.

PURPOSE: To precisely quantify split glomerular filtration rate by Tc-99m-DTPA renal dynamic imaging and plasma clearance in order to increase its consistency among doctors. METHODS: Tc-99m-DTPA renal dynamic imaging was performed according to the conventional radionuclide renal dynamic imaging by five double-blinded doctors independently and automatically calculated split GFR, namely, gGFR. Moreover, the conventional radionuclide renal dynamic imaging was assessed to only outline the kidney, blank background, and automatically calculated split GFR, gGFR'. The total GFR value of patients, tGFR, was obtained by the double-plasma method. According to the formula, Precise GFR (pGFR) = gGFR'/(gGFR' + gGFR') × tGFR. The precise GFR value of the divided kidney, pGFR, was calculated. The Kendall's W test was used to compare the consistency of gGFR and pGFR drawn by five physicians. RESULTS: According to Kendall's W consistency test, Kendall's coefficient of concordance was 0.834, p = 0.0001 using conventional method. The same five doctors used blank background again and the same standard Gates method to draw the kidneys, which automatically calculated gGFR'. Using input formula, the pGFR was calculated and Kendall's W consistency test (Kendall's coefficient of concordance = 0.956, p = 0.0001). CONCLUSION: The combination of Tc-99m-DTPA renal dynamic imaging combined with the double-plasma method could achieve accurate split GFR, and because of the omission of influence factors, the consistency of pGFR obtained by different doctors using this method was significantly higher than that of conventional Tc-99m-DTPA renal dynamic imaging.

Bone marrow mesenchymal stem cell-derived endothelial cells increase capillary density and accelerate angiogenesis in mouse hindlimb ischemia model.

BACKGROUND: Mesenchymal stem cells (MSCs) can improve limb perfusion and increase vessel density in a murine model of hindlimb ischemia. But low engraftment rate of those cells limited their therapeutic effect. Endothelial cells (ECs) play an important role in neovascularization. And MSCs can differentiate into ECs in vitro. The aim of this study is to investigate if EC differentiation of MSCs in vitro before transplantation is effective in improving therapeutic outcomes in the treatment of ischemic disease in a murine ischemia animal model. METHODS: MSCs were isolated from the bone marrow of EGFP-transgenic mice by density gradient centrifugation. The identity of the MSCs was determined by their cluster of differentiation (CD) marker profile by flow cytometry. Inducing medium containing a few cytokines was applied to induce the MSCs to differentiate into ECs. Endothelial differentiation was quantitatively evaluated using flow cytometry, quantitative real-time PCR (qRT-PCR), immunofluorescence, Matrigel tube formation assay, and Dil-labeled acetylated low-density lipoprotein uptake assay. Mouse hindlimb ischemia model was made by excision of the femoral artery. Uninduced EGFP+ MSCs, induced EGFP+ MSCs, and PBS were intramuscularly injected into the gastrocnemius following ischemia no later than 24 h after operation. Restoration of blood flow and muscle function was evaluated by laser Doppler perfusion imaging. Immunofluorescence was conducted to evaluate the engraftment of transplanted MSCs. Histological analysis was performed to evaluate blood vessel formation. RESULTS: Induced EGFP+ MSCs expressed endothelial markers and exhibited tube formation capacity. Mice in the induced EGFP+ MSCs group had a better blood perfusion recovery, enhanced vessel densities, higher engraftment, and improved function of the ischemic limb than those in the uninduced EGFP+ MSCs or PBS groups. CONCLUSIONS: This study reveals that after short-term pre-treatment in the EC-inducing medium, induced MSCs acquire stronger vessel formation capability and enhanced angiogenic therapeutic effect in the murine hindlimb ischemia model.

Splenic artery embolization with detachable balloons for hypersplenism.

Objective This study was performed to investigate the efficacy of proximal splenic artery embolization using detachable balloons for patients with hypersplenism and portal hypertension. Methods Twelve patients diagnosed with hypersplenism with thrombocytopenia or leukocytopenia caused by portal hypertension were treated by proximal splenic artery embolization with detachable balloons and metallic fibered coils. All patients were followed for up to 6 months. Blood parameters, coagulation factors, and liver function indicators were measured. Enhanced computed tomography and abdominal ultrasonography examinations were also performed in advance to confirm the infarction area and evaluate the changes in spleen size. Results Postoperative angiography demonstrated complete embolization of the proximal splenic artery in all 12 patients. Thrombocyte and leukocyte counts rose significantly in all patients in 2 weeks and stayed significantly higher than those before embolization throughout the 6-month follow-up. The total bilirubin concentration and prothrombin activity recovered significantly and returned to normal levels 6 months later. Computed tomography revealed partial infarction and liquefaction of the splenic parenchyma in nine patients. Conclusions Proximal splenic artery embolization using detachable balloons could be considered a safe and effective therapeutic modality in alleviating hypersplenism secondary to portal hypertension.

Prophylactic selective arterial embolization for renal angiomyolipomas: efficacy and evaluation of predictive factors of significant shrinkage.

PURPOSE: To evaluate the efficacy of prophylactic selective arterial embolization (SAE) of angiomyolipomas (AMLs) and to find out predictive factors of significant shrinkage of AMLs after SAE. METHODS: Patients receiving prophylactic SAE for renal AMLs with complete medical records were included. The changes of the size, urine erythrocyte counts, and serum creatinine of all patients pre- and post-embolization were assessed. Demographic data, symptoms, the background of tuberous sclerosis complex (TSC), aneurysms, enhancement features, initial tumor sizes, and serum creatinine pre-embolization were estimated as predictive factors of significant shrinkage in size. RESULTS: Forty-five patients receiving prophylactic SAE for AMLs successfully in our center were included with median follow-up of 14.0 months (interquartile range 6.5-40.5). Mean size of AMLs decreased from 10.7 ± 6.2 to 8.3 ± 5.9 cm by 23.4% ± 20.6% at the latest follow-up (P < 0.001). Urine erythrocytes decreased significantly after SAE (11.1 [interquartile range 5.7-23.2] vs. 6.4 [interquartile range 2.7-13.4], P < 0.001). In addition, there was no significant change between the serum creatinine before and after embolization (81.8 ± 14.9 mmol/L vs. 83.6 ± 17.1 mmol/L, P = 0.224). Of the variables mentioned above, only the enhanced area of AMLs before SAE was statistically significant between the groups with and without significant shrinkage (P < 0.001). In multiv-ariate analysis, enhanced area < 25% (AOR = 0.015, 95% CI 0.001-0.367) and having the background of TSC (AOR = 0.056, 95% CI 0.004-0.799) were identified as predictive factors of significant shrinkage of the tumors. CONCLUSIONS: Prophylactic SAE is effective in reducing the size of renal AMLs and decreasing urine erythrocytes with preservation of renal function. Significant shrinkage of AMLs after SAE is modulated by the enhanced area and the background of TSC.