Mesenchymal stem cells (MSC) are multipotent, self-renewing cells that can be found mainly in the bone marrow, and other post-natal organs and tissues. The ease of isolation and expansion, together with the immunomodulatory properties and their capability to migrate to sites of infl ammation and tumours make them a suitable candidate for therapeutic use in the clinical settings. We review here the cellular mechanisms underlying the emerging applications of MSC in various fi elds.

Objective To observe the effect of Chaihushugansan combined with fluoxetine on interleukin -6 ( IL-6 ) , interleukin -1β( IL-1β) , tumor necrosis factor ( TNF-α) in the treatment of patients with postpartum depression.Methods 83 patients from November 2013 to July 2015 in Jiaxing Maternity and Child Health Care Hospital were randomly divided into 41 patients of observation group and 42 patients of control group.The control group were treated with fluoxetine treatment, the obsercation group received Chaihushugansan on the basis of control group.The Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA),IL-6, IL-1β, TNF-α, high-sensitivity C-reactive protein (hs-CRP) and adverse reactions were followed up and recorded.Results The HAMD and HAMA score in observation group post-treatment were (8.31 ±2.05,9.03 ±2.08)points, which were lower than (13.96 ±2.16, 13.61 ±2.14) points in control group (P<0.05).The serum IL-6 and IL-1βlevels in observation group post-treatment were (6.59 ±3.20,5.01 ±2.83)pg/mL, which were lower than (10.64 ±3.86,9.31 ±3.42)pg/mL in control group (P<0.05).The serum TNF-αand hs-CRP levels in observation group post-treatment were ( 9.16 ±2.01 ) pg/mL, ( 3.62 ±1.06 ) mg/L, which were lower than ( 12.30 ±2.37 ) pg/mL, (5.29 ±1.14)mg/L in control group (P<0.05).The total adverse reaction rate in observation group was 7.32%, significantly lower than 23.81% in control group ( P <0.05 ) .Conclusion Chaihushugansan combined with fluoxetine has a good therapeutic effect in the treatment of postpartum depression, could significantly reduce the IL-6, IL-1β, TNF-α levels, with fewer side effects, it is better than fluoxetine alone.

Objective To analyze the clinical characters,treatment and prognosis of primary malignant tumor in vagina.Methods A retrospective analysis of 42 patients diagnosed with primary malignant tumor in vagina in Peking Union Medical College Hospital(PUMCH)between Jan 1984 and Aug 2006 was performed.Results Primary malignant tumor accounted for 0.98%(42/4286)in the total gynecological malignant tumors during that period in PUMCH.According to the International Federation of Gynecology and Obstetrics(FIGO)staging system,19 cases were at stage Ⅰ,12 cases at stage Ⅱ,5 cases at stageⅢ,and 6 cases at stage Ⅵ.Thairteen cases were squamous carcinoma,13 cases were malignant melanoma,8 cases were adenocarcinoma.3 case8 were yolk sac tumor and 5 cases were other types.The majority of patients were treated with surgery combined with radiotherapy and chemotherapy.Up to August 2007,19 cases survived.18 cases were dead and 5 casefl were lost.The longest follow up was 10 years,with the median time of 2 years.The overall 2-year SUrvival rate was 60.6%.For stage Ⅰ,stage Ⅱ, and stage Ⅲ-Ⅵ,the 2-year survival rates were 71.3%.58.3%and 29.6%respectively.The 2-year survival rate of patients with squamous carcinoma Was 46.8%,malignant melanoma 72.9%,adenocarcinoma 20.0%and patients with yolk sac tumor were all alive tumor-free after 6-10 years'follow up.Conclusions The prognosis of primary malignant tumor in vagina is affected by clinical stage and histological type.A8 to malignant melanoma,radical surgery combined with chemotherapy and immunotherapy produce good effects.Patients with yolk sac tumor can be cured only with chemotherapy.As to other types,more treatment experiences are needed.

Animals ; Calcium ; metabolism ; Cell Line ; Cricetinae ; Cricetulus ; Dose-Response Relationship, Drug ; Fibroblasts ; drug effects ; metabolism ; Vehicle Emissions

In this study, we evaluated the biological properties of human mesenchymal stem cells transfected (hMSC) with a plasmid vector expressing human cytokine interleukin-12 (IL-12). Surface markers were analysed by immunophenotyping using flow cytometry. Differentiation capability was evaluated towards adipogenesis and osteogenesis. We demonstrated that successfully transfected hMSC retained their surface immunophenotypes and differentiation potential into adipocytes and osteocytes. These results indicate that hMSC may be a suitable vehicle for gene transduction.
Antigens, Surface/metabolism ; Biological Markers/metabolism ; Bone Marrow Cells/cytology ; Bone Marrow Cells/metabolism ; Cell Differentiation/physiology ; Cells, Cultured ; Flow Cytometry ; Immunophenotyping ; Interleukin-12/genetics ; Interleukin-12/metabolism ; Mesenchymal Stem Cells/*cytology ; Mesenchymal Stem Cells/metabolism ; Transfection

OBJECTIVETo evaluate the impact of lymphadenectomy on the relapse and survival of malignant ovarian germ cell tumor (OGCT).

METHODSThe clinical data of 102 OGCT cases treated in Peking Union Medical College Hospital from June 1980 to June 2003 were analyzed retrospectively. All the data about lymphadenectomy during primary and secondary surgery were collected, and other factors related to prognosis were also collected at the same time. Chi-squared test was applied in the univariate analysis related to relapse of disease. Cox model was applied in multivariate analysis related to relapse and survival of disease.

RESULTSPelvic and paraaortic lymph node metastasis was not significantly related to prognosis in primary and secondary treated patients. Lymphadenectomy showed no significant impact on disease relapse and survival. In the primary treatment, International Federation of Gynecology and Obstetrics (FIGO) staging, chemotherapy regimen, residual tumor and lymphadenectomy were the significant factors related to the relapse. After being stratified for the chemotherapy regimen, lymphadenectomy was not significantly related to the relapse in bleomycin +etoposide +cisplatin or cisplatin +vincristine +bleomycin regimen group, and lymphadenectomy could prevent relapse in no chemotherapy or other chemotherapy regimen group. In relapsed patients, only residual tumor was significantly related to survival time after relapse.

CONCLUSIONSPelvic lymph node metastasis is not the significant risk factor related to prognosis. Lymphadenectomy may have a beneficial effect on survival, although such effect is not significant. Although lymphadenectomy provides important information for prognosis, they provide little benefit to those patients already requiring chemotherapy based on the original operative findings. Lymphadenectomy should be performed to primary or relapsed patients by an expert surgical team.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Combined Modality Therapy ; Female ; Germinoma ; mortality ; pathology ; surgery ; therapy ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; mortality ; pathology ; surgery ; therapy ; Neoplasm Staging ; Ovarian Neoplasms ; mortality ; pathology ; surgery ; therapy ; Prognosis ; Retroperitoneal Space ; Retrospective Studies

OBJECTIVETo evaluate clinical characteristics, prognosis, prognostic factors, and the ideal treatment of the young patients with cervical malignant tumor.

METHODSWe analyzed retrospectively 52 cervical malignant tumor patients younger than 35 years (study group) and 45 cervical carcinoma patients older than 50 years (control group) who were admitted in Peking Union Medical College Hospital from 1985 to 2002. The data were analyzed statistically by SPSS10.0. The ovarian functions were evaluated by the questionnaire and the serum sex hormone assay.

RESULTSIn study group, the median age was (31.0 +/- 0.6) years old. The most common clinical symptoms were contact bleeding and irregular bleeding; 55.8% of patients had more than one symptom. HPV positive rate was 20.5%, which was higher than control group significantly (P < 0.05). The percentage of advanced stage (stage II b-stage IV b) of disease in study group and control group were 30.8% and 22.2%, respectively, the difference was significant (P < 0.05). The most common histological type was squamous cell carcinoma (71.2%) in study group, while the percentage of non-squamous cell carcinoma (43.8%) in patients younger than 30 years was much higher than control group (P < 0.05). All the histological type was non-squamous cell carcinoma in the patients younger than 25 years. Histological grade showed that G1, G2, and G3 were 21.2%, 54.5%, and 24.2% respectively in study group. The percentage of bulky cervix (tumor diameter > 4 cm) in study group and control group was 27.9% and 2.7% respectively (P < 0.005). The overall 5-year survival rates were 75.7% in study group, lower than control group (P < 0.05). The COX hazards regression model showed histological type (P = 0.003) and bulky cervix (P = 0.001) were of significant prognostic values.

CONCLUSIONSThere are more advanced stage carcinoma and non-squamous cell carcinoma patients with poor prognosis in study group. The treatment to younger patients should be concerned individually, as well as preservation of reproductive and female endocrine function should be considered.

Adenocarcinoma ; diagnosis ; surgery ; virology ; Adult ; Age Factors ; Carcinoma, Squamous Cell ; diagnosis ; surgery ; virology ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Function Tests ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; Prognosis ; Regression Analysis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; diagnosis ; surgery ; virology

BACKGROUNDThe primary ovarian sarcoma is a very rare malignancy. The objective of this study was to further investigate the clinicopathologic features and outcome in patients with primary sarcoma of the ovary.

METHODSBetween 1988 and 2007, 24 patients with primary ovarian sarcoma who underwent treatment at Peking Union Medical Hospital were reviewed retrospectively. Response to treatment, progression and overall survival were analyzed.

RESULTSPatients with ovarian sarcoma had a mean age of (54.3 ± 10.3) years, and 16 of them were postmenopausal. The most common symptom was abdominal pain, present in 14 patients. Of the 24 patients, 16 patients were pathologically diagnosed as carcinosarcoma (known as malignant mixed mesodermal tumor (MMMT)), 2 as ovarian leiomyosarcoma (LS) and 6 patients as ovarian endometrial stromal sarcoma (ESS). The patients in optimal debulking group had a median survival period of 28 months and 1-year survival rate of 71%. The patients in suboptimal debulking group had a significantly lower median survival of 6 months (P = 0.02) and 1-year survival rate of 29%. Among the patients, 23 patients received chemotherapy and most of regimens were based on platinum, 3 patients received chemoradiation. The mean number of courses of combined chemotherapy was 6.6 ± 5.0, and the response was unsatisfactory. The median survival for the entire group was 18.7 months. The one-year survival rate was 58%, and two-year survival rate only 29%.

CONCLUSIONSOvarian primary sarcoma has a poor overall prognosis. Optimal debulking surgery appears to be of prognostic significance. There is a clear need for further study to explore the role and the regimen of platinum-based chemotherapy in primary ovarian sarcoma.

Adult ; Aged ; Female ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Ovarian Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Retrospective Studies ; Sarcoma ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Survival Rate

OBJECTIVETo compare the clinical characteristics of three subcategories of laparoscopic hysterectomy: total laparoscopic hysterectomy (TLH) and two subcategories of laparoscopic-assisted vaginal hysterectomy (LAVH): LAVHs and LAVHb.

METHODSWe retrospectively analyzed the clinical data of 393 patients underwent laparoscopic hysterectomy, including TLH (n=178), LAVHa (n=177), and LAVHb (n=38), in our hospital from September 2002 to September 2005.

RESULTSMyoma and adenomyosis of uterus were the most common diseases in this study, accounting for 66.9%, 38.4%, and 52.6% in TLH group, LAVHa group, and LAVHb group, respectively. The mean surgery duration and blood loss were not significantly different between TLH group and LAVHa group (P > 0.05), but were significantly less in TLH group than in LAVHb group (P < 0.05). The bulk of uterus in TLH group was significantly bigger than in other two groups (P < 0.05). The incidence of major complications in the TLH group (9. 0%) was lower than in LAVHa group (14.1%) and in LAVHb group (18.4%), but without statistical significance. Conclusion Compared with LAVH, TLH is feasible to deal with bigger uterus with less blood loss and shorter surgery duration and without more frequent complications.

Endometriosis ; surgery ; Female ; Humans ; Hysterectomy ; adverse effects ; methods ; Hysterectomy, Vaginal ; adverse effects ; methods ; Laparoscopy ; adverse effects ; methods ; Myoma ; surgery ; Retrospective Studies ; Uterine Neoplasms ; surgery

This study was purposed to investigate the short-term effects of citrate administration on bone metabolism in the healthy blood donor volunteers. A crossover, placebo-controlled trial were conducted on 22 healthy blood donor volunteers. The volunteers received either a standardized infusion of citrate at 1.5 mg/(kg.min) or the equal volume of placebo normal saline, were washout for 2-3 weeks. During washout serial blood samples were collected and analyzed for bone biochemical markers and electrolytes, such as bone formation marker osteocalcin (OC), bone resorption marker carboxyterminal telopeptide of type I collagen (CTX), intact parathyroid hormone ((i)PTH), ionized calcium ((i)Ca(2+)) and phosphorus (P(i)). Serial urine samples were collected and analyzed for Ca(2+), P(i) and creatinine concentration. The results showed that compared with placebo group, infusion of citrate increased serum levels of OC and CTX (p < 0.0001). The greatest increase of OC and CTX levels occurred at the completion of the intervention. The increment of CTX was higher than OC (p = 0.02), and the OC/CTX ratio decreased (p < 0.01). Infusion of citrate also induced profound increase in serum (i)PTH level (p < 0.0001) and urinary calcium excretion (p < 0.0001), and decrease in serum (i)Ca(2+) (p < 0.0001) and P(i) (p < 0.01) levels. The decrease of (i)Ca(2+) level in female was higher than that in male (p = 0.007), but the changes of (i)PTH, OC, and CTX levels showed no differences between female and male. Changes of OC and CTX levels were closely related to each other (r = 0.56, p < 0.0001) and changes of both markers were negatively correlated with the change of serum (i)Ca(2+) concentration during the citrate intervention(r(OC) = -0.44, r(CTX) = -0.44, p < 0.0001). Increased levels of (i)PTH showed positively correlation with OC (r = 0.34, p = 0.02) and borderline correlation with CTX (r = 0.29, p = 0.06) in male. No such relationship was observed in female. All bone markers and electrolyte levels returned to baseline within 24 hours. It is concluded that the citrate load at the dose as a single platelet apheresis results in profound increase of bone turnover, which is characterized by a short-term increase of bone resorption and excretion of calcium. The possible effect of citrate on bone mass of long-term frequent platelet apheresis donor is worth concerning.
Adult ; Blood Donors ; Bone Remodeling ; drug effects ; Bone and Bones ; drug effects ; metabolism ; Citric Acid ; pharmacology ; Cross-Over Studies ; Female ; Humans ; Male ; Osteocalcin ; blood