BACKGROUND: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord can induce differentiation into islet-like cells.OBJECTIVE: To verify the possibility of human umbilical cord derived mesenchymal stem cells co-cultured with rat pancreatic cells differentiate into islet-like cells, and to observe the effects of transplantation of islet-like cells on blood glucose of diabetic rats.METHODS: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord was separated, induced, passaged, and co-cultured with pancreatic cells to induce differentiation into islet-like clusters. Rats were divided into the normal control, model and experimental groups. Rats in the model group were prepared for diabetic models, and those in the experimental group were transplanted islet-like cells after model preparation. RESULTS AND CONCLUSION: There were cells crawled out of cultured Wharton's Jelly of the human umbilical cord, and morphology of adhered cells turned into fusiform shape at 7 days. The isolated cells are characterized by expressing specific surface markers of mesenchymal stem cells, such as CD44, CD29, CD105, but not expressing CD34, CD45 or CD14. The cells were strongly stained by PDX-1 and human insulin at 7 and 10 days. Compared with the simple culture group, the expression of human insulin and concentration of C-peptide were obviously increased; PDX-1 and human insulin mRNA expressions were highly expressed at 7 and 10 days after induction. Compared with the model group, the streptozotocin test of rats in the experimental group was obvious decreased (P < 0.01), but extremely higher than that of the normal control group at 1 week after transplantation (P < 0.01). Brdu positive nuclei and insulin positive kytoplasms could be seen in the experimental group at 8 weeks after transplantation. The results demonstrated that, umbilical cord derived mesenchymal stem cells existed in Wharton's Jelly. The co-cultured cells promote mesenchymal stem cells differentiating into islet-like cells, which can dramatically decrease blood glucose in diabetic rats.

[摘 要] 目的：探究益气活血汤对恶性肿瘤患者癌痛及癌因性疲乏（CRF）的疗效。方法: 选取2020年1月至2022年12月间安徽省中医药大学第二附属医院收治的82例确诊发生CRF的恶性肿瘤患者（气血亏虚证），采用随机数字表余数分组法将其分为对照组与观察组，每组各41例。对照组患者采用常规止痛、止吐、化痰等对症治疗及健康、心理指导，观察组患者在对照组干预的基础上联合益气活血汤治疗，4周为1个疗程。治疗前及治疗4周后，对两组患者进行中医证候积分评估，以积分变化评估中医临床疗效；采用修订版Piper疲乏量表（RPFS）评估CRF的改善情况；采用数字疼痛分级法（NRS）评分比较癌痛情况；检测患者外周血纤维蛋白原（FIB）、D-二聚体（D-D）评价凝血功能差异，检测患者肝、肾功能指标以评估益气活血汤治疗的安全性。结果：治疗前，两组患者在中医证候积分、RPFS评分、NRS评分及外周血FIB、D-D方面的差异均无显著统计学意义（均P>0.05）。治疗4周后，两组患者在神疲乏力、面色淡白或萎黄、自汗、失眠健忘、手足麻木的证候评分及总积分均较治疗前明显降低（均P<0.05），且观察组各项评分均低于对照组（均P<0.05），中医临床疗效明显高于对照组（P<0.05）；两组患者RPFS各维度评分及总分均较治疗前降低（均P<0.05），观察组行为、情感、感觉维度RPFS评分及总分均低于对照组（均P<0.05），观察组CRF的改善明显优于对照组（P<0.05）；两组患者NRS评分及外周血FIB、D-D指标均较治疗前降低（均P<0.05），且观察组均低于对照组（均P<0.05）。两组患者治疗期间均未发生肝功能、肾功能等明显异常，说明益气活血汤安全性良好。结论：益气活血汤可纠正气血亏虚之证，改善机体凝血功能，促进恶性肿瘤患者CRF及癌痛的减轻，临床应用价值较高。