BACKGROUND:The mechanisms of mesenchymal stem cells directional y homing to infarcted myocardium post myocardial infarction are stil unclear.
OBJECTIVE:To investigate the role of stromal cellderived factor-1 (SDF-1)/C-X-C chemokine receptor 4 (CXCR4) axis on mesenchymal stem cellmigration promoted by mononuclear cells after myocardial infarction.
METHODS:Cardiomyocytes and mesenchymal stem cells were respectively isolated from suckling and adult Sprague-Dawley rats. Twelve healthy Sprague-Dawley rats were selected (six rats for myocardial infarction models and six for sham models), then circulating mononuclear cells were isolated. 4,6-Diamino-2-phenyl indole-labeled mesenchymal stem cells, cardiomyocytes and mononuclear cells were cultured into the upper, middle and lower layers of the tri-chamber coculture system, respectively. In this experiment, there were four groups:myocardial infarction group, AMD3100 (CXCR4 inhibitor) group, sham group and blank control group. After 48 hours, the number of migrating mesenchymal stem cells with blue-lighting nucleus was calculated under fluoroscope. Immunocytochemistry and immunofluorescent staining was used to detect SDF-1 expression in cardiomyocytes and CXCR4 expression in mesenchymal stem cells, respectively.
RESULTS AND CONCLUSION:Migrating mesenchymal stem cells with positive expression of CXCR4 were observed in each group other than the blank control group. The number of migrating mesenchymal stem cells was higher in the myocardial infarction group than in the other groups. Tumor necrosis factor-αneutralizing antibody and CXCR4 inhibitor AMD3100 could obviously reduce the number of migrating mesenchymal stem cells (P<0.05). Cardiomyocytes in each group expressed SDF-1 positively. The gray values of SDF-1 expression in the myocardial infarction and AMD3100 groups were significantly higher than those in the sham and blank control groups (P<0.05). SDF-1/CXCR4 axis plays a certain role in mesenchymal stem cells migration promoted by mononuclear cells after myocardial infarction.

Objective To compare the curative effect between minimal invasive internal fixation with Mast Quadrant and tra -ditional open internal fixation for treating thoracolumbar fractures .Methods A total of 46 cases suffered thoracolumbar fractures were randomly divided into the minimally invasive group (MQ) and the traditional open group (TO) ,the patients in MQ group re-ceived minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive channel ;the patients in TO group received pedicle internal fixation under traditional open channel .Perioperative related indicators ,imaging indicators and improvements of low back pain were recorded and statistically compared respectively .Results The different of the volume of blood loss ,operation time and length of incision and postoperative volume of drainage between the two groups were statistically significant (P < 0 .05) ,the different of the volume of hospital duration ,postoperative VAS score between the two groups were statistically significant (P <0 .05) .The different of the volume of flange height in injured vertebral fanterior ,Cobb Angle between preoperative and postopera-tive were statistically significant (P< 0 .05) .And comparison between groups had no statistical significance (P> 0 .05) .Conclusion Compared with traditional open operation ,minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive chan-nel has the advantage of more simple operation ,less intraoperative bleeding and postoperative pain less invasive ,fast recovery and short hospitalization stay .

AIM: To investigate the distribution in mice and pharmacokinetics in rabbits of fraction Ⅲ isolated from Naja naja atra venom. METHODS: Fraction Ⅲ was labelled with [~(125)Ⅰ] by chloramine-T method. The drug concentration in blood was determined by a radionuclide tracing kinetic methods. The distribution of [~(125)Ⅰ]-fraction Ⅲ in mice was determined based on the ratio of the relative incorporation of radioactivity in tissues to that in blood. RESULTS: In two and four hours after intravenous injection of fraction Ⅲ in mice, the organs in which the ratio of the radioactivity incorporation was bigger than 1 were liver, kidney, lung, heart and muscle, whth the maximun in kidney. After intravenous injection of fraction Ⅲ, with dosages of 75, 150 and 300 ?g/kg, respectively, the T_(1/2)?, T_(1/2)? and T_(1/2)? were 39.6-42.5 min, 16.8-17.3 h and 21.7-22.1 h, respectively. There was no significant difference between the different dosages. CONCLUSION: Fraction Ⅲ was mostly found in kidney, followed by liver and lung after intravenous administration in mice. The pharmacokinetics is in accordance with the feature of three atrioventricular modle. The AUC is in direct proportion to the dosage. It suggests that the distribution and clearance of the drug is a grade 1 linear kinetic process. [

OBJECTIVEThe imbalance between extracellular matrix (ECM) synthesis and degradation induces the excessive ECM deposition and thus renal fibrosis. The decoction (A&A) which is a combination of two Chinese herbs, Astragalus membranaceus var. mongholicus and Angelica sinensis, has been shown to alleviate ECM production in animal models of chronic kidney diseases. In this paper, the effect of A&A on ECM degradation was investigated with interstitial fibrosis in rats.

METHODMale Wistar rats were randomly divided into sham, unilateral ureteral obstruction (UUO) and UAA (UUO plus A&A administration) groups. After administration of A&A (14 g x kg(-1) x d(-1)) by gavage for 3, 7 and 10 days, morphological changes were evaluated by HE, PAS and Sirius red staining technique. The expression of plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA), the activity of PAI-1 and t-PA were determined by ELISA. The activity of matrix metalloproteinases (MMP-9, MMP-2), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were evaluated by gelatin zymography or reverse gelatin zymography, respectively.

RESULTMorphological analysis showed severe interstitial mononuclear cells infiltration, tubular atrophy, renal fibrosis and collagen expression in kidneys of UUO group, which was reduced by A&A administration (P < 0.05, UAA vs UUO group). Compared with the sham group, the expression of PAI-1 was significantly increased in UUO group by 63%, 91% and 112% at day 3, 7 and 10 respectively; and there were a remarkable decrease in UAA group by 44%, 43% and 52% at day 3, 7 and 10. The expression of active PAI-1 was strikingly increased in UUO group at day 3 [(30.5 +/- 23.8) ng x g(-1) vs. (0.0 +/- 0.0) ng x g(-1), P < 0.05)], day 7 [(36.5 +/- 11.2) ng x g(-1) vs. (0.0 +/- 0.0) ng x g(-1), P < 0.05)], and day 10 [(54.5 +/- 14.2) ng x g(-1) vs. (0.5 +/- 0.5) ng x g(-1), P < 0.05)]. The active PAI-1 was decreased in UAA group at day 7 [(14.9 +/- 0.5) ng x g(-1) vs. (36.5 +/- 11.2) ng x g(-1), P < 0.05] and day 10 [(15.4 +/- 4.8) ng x g(-1) vs. (54.5 +/- 14.2) ng x g(-1), P < 0.05]. The expression of t-PA was increased in UUO group only at day 3 [(58.1 +/- 16.5) microg x g(-1) vs. (30.1 +/- 17.3) microg x g(-1)], P < 0.05), meanwhile decreased in UAA group [(26.3 +/- 8.7) microg x g(-1) vs. (58.1 +/- 16.5) microg x g(-1), P < 0.05)]. But the expression of active t-PA was shown no significantly difference among the three groups. For MMP-2 and MMP-9 activity, they were significantly higher compared with the sham group in UUO group, but no significantly change after A&A treatment. The TIMP-1 activity was significantly increased in UUO group by 28% and 63% at day 7 and 10 respectively, significantly decreased in UAA group by 40% and 39% at the same time point.

CONCLUSIONThe anti-fibrosis effects of A&A might be associated with modulating the imbalance of PAs/PAIs system as well as MMPs/TIMPs system, thereby alleviate ECM accumulation and interstitial fibrosis.

Angelica sinensis ; chemistry ; Animals ; Astragalus Plant ; chemistry ; Drugs, Chinese Herbal ; administration & dosage ; Extracellular Matrix ; metabolism ; Fibrosis ; Humans ; Kidney ; enzymology ; metabolism ; pathology ; Kidney Diseases ; drug therapy ; enzymology ; metabolism ; pathology ; Male ; Matrix Metalloproteinase 1 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Plasminogen Activator Inhibitor 1 ; metabolism ; Rats ; Rats, Wistar ; Tissue Plasminogen Activator ; metabolism

Objective To investigate the blood pressure variability(BPV) and circadian rhythms in young and middle-aged people with H-type hypertension.Methods The ambulatory blood pressure monitoring data from 89 young and middle-aged patients with mild-to-moderate hypertension were retrospectively analyzed.All cases were divided into the H-type hypertension group (n=56) and non-H-type hypertension group(n=33) according to plasma homocysteine(Hcy) level.Blood pressure in different time periods(including 24hSBP/24hDBP,dSBP/dDBP,nSBP/nDBP,mSBP/mDBP,mnSBP/mnDBP),variability(including 24hSBPV/24hDBPV,dSBPV/dDBPV,nSBPV/nDBPV,mSBPV/mDBPV,mnSBPV/mnDBPV),day and night average heart rate,dipper ratio of SBP/DBP and morning blood pressure surge were compared between the two group.Results 24hSBP,dSBP,nSBP and mSBP in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group,while 24hDBP,dDBP,nDBP and mDBP were significantly lower than those in the non-H-type group,the differences were statistically significant(P＜0.01).24hSBPV,24hDBPV,dSBPV,nDBPV and mSBPV had statistically significantly difference between the H-type hypertension group and non-H-type hypertension group(P＜0.05).The dipper ratio of SBP and mean MBPS in the H-type hypertension group were significantly higher than those in the non-H-type hypertension group(P＜0.01).Conclusion Blood pressure variability is increased within a certain range in young and middle-aged patients with H-type hypertension,which is correlated to circadian rhythm changes.

Objective To explore the risk factors of acute renal failure (ARF)in patients with ECMO.Methods Retrospective analysis the patients with ECMO.There were 91 males and 79 fe-males.The age was 18-73 years old.Data of patients'preoperative basic situation(gender,age, history of related diseases,including hypertension,diabetes,heart history),related clinical situations during ECMO period,complications were collected.Patients were divided into two groups according to the ARF occurring.We selected the risk factors which may affect the ARF through the single factor analysis,and then determined the independent risk factors that affected the ECMO ARF by lo-gistic regression analysi.Results This study included 170 cases,91 cases occurred ARF (53.5%). Single factor analysis:the patient with CPR before ECMO,high lactic acid levels pre-ECMO,high inotropic equivalents,large amounts of red blood cells,plasma and platelet transfusion,high C-reac-tive protein levels and high BNP levels during ECMO,long time of ECMO support were associated with patients with ARF.Multiple factors analysis showed that high lactic acid levels pre-ECMO (OR 2.96,95% CI 1.38-6.34),P=0.005),high inotropic equivalents (OR 3.17,95% CI 1.52-6.61, P=0.002)were independent risk factors of ARF in patients with ECMO.Conclusion The patients with ECMO have a high incidence of acute renal failure,large doses of positive inotropic drug and high lactic acid levels are independent risk factors of acute renal failure in patients with ECMO.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone