Objective To study the therapeutic effect of exosome derived from lipopolysaccharides (LPS) priming mesenchymal stem cells (MSCs) for diabetic wound healing. Methods Human umbilical cord MSCs were treated with LPS (100ng/ml) for 2 days, the supernatant were then collected, and exosomes were harvested by density gradient centrifugation and identified. Diabetic cutaneous wounds were prepared and the animals were divided into the following three groups: control group, untreated MSCs derived exosome (un-exosome) treatment group and LPS primed MSCs derived exosome (LPS-exosome) treatment group. Exosomes (60μg) were injected dispersively into the wound edge daily for 10 days. After treatment, the therapeutic results were evaluated by gross observation of the wounds, the expression levels of inflammation related factors and macrophage subtype markers in the injured sites were detected by qRT-PCR at day 3, 7 and 14 after treatment. Results Compared with control group, the diabetic wound healing was obviously improved in LPS-exosome treatment group after treatment for 7 and 14 days, with faster wound close, depressed expression of pro-inflammatory factors IL-1, IL-12 and M1 macrophage surface marker iNOS, and upregulation of anti-inflammatory factors IL-10, TGF-β and M2 macrophage surface marker CD163, the differences were significant (P<0.05). Conclusions LPS-exosome may balance macrophage plasticity, restrain chronic inflammation and accelerate diabetic cutaneous wound healing.

Objective To evaluate diagnostic accuracy based on patient history and physical examinations in medical outpatients.Methods Totally, 145 consecutive patients visiting general internal medicine clinic at a university-affiliated teaching hospital during October 10 to 17, 2008 were recruited into the study and followed-up for 12 months.Results Eighteen of 145 patients ( 12.4% ) were lost to followup.Diagnosis was confirmed by follow-up for 45 ( 35.4% ) of those with medically unexplained symptoms (MUS).Sensitivity of physical diagnosis for those with MUS was 82.2 percent, with specificity of 95.1 percent, likelihood ratios of positive and negative results of 16.9 percent and 0.19 percent, its positive and negative prediction values of 90.2 percent and 90.7 percent, and overall accuracy of 90.6 percent,respectively.Conclusions MUS was common in medical clinical practice.Preliminary diagnosis for MUS based on patient history and physical examinations has been proved remarkably reliable.Carefully selected auxiliary laboratory evaluation combined with physical diagnosis is important for management of MUS.

ObjectiveTo evaluate the surgical outcomes and prognosis of patients after liver resection for noncolorectal liver metastases.Methods72 patients with liver metastases who underwent liver resection at Tianjin Medical University Cancer Hospital were retrospectively studied.There were 32 males and 42 females,aged between 35～78 years.After liver resection,68 patients had a R0 resection (negative histological margin),and 4 patients had a R1 resection (positive histological margin).The primary tumours were breast,(n =16,22.2 ％),lung (n =14,19.4 ％),gastrointestinal (n=12,16.7％),gynecological (n =8,11.1％),pancreatobiliary (n =8,11.1％),melanoma (n=4,5.6％),sarcoma (n=4,5.6％),and genitourinary (n=2,2.8％).The mean diameter of the main tumour was 4.8 cm (range,1.5- 11.0 cm).The mean number of liver metastases was 1.2 (range,1-5).Liver metastases were synchronous in 6 patients (8.3％) and metachronous in the remaining 66 patients (91.7％).ResultsThe operative mortality was 0％.The mean hospital stay was 14.4 days (range 6-67 days).The median overall survival was 31 months (range,6-127 months).The 1-,3- and 5-year survival rates were 81.9％,37.5％ and 23.6％,respectively.Univariate analysis revealed primary tumour sites (breast vs.others),histological type (adenocarcinoma vs.others),postoperative chemotherapy,number of liver metastases (solitary vs.multiple) and time to liver metastases from diagnosis of primary tumours (≤ 12 months vs.＞ 12 months) were associated with overall survival (all,P＜0.05).In multivariate analysis,factors independently associated with poor survival were nonbreast origin (P =0.012),time to liver metastases from diagnosis of primary tumours ＜12 months (P=0.027) and multiple liver metastases (P=0.008).ConclusionsIn selected patients,liver resection is an effective and safe treatment for noncolorectal liver metastases.The time to liver metastases from diagnosis of primary tumours was independently associated with overall survival.For solitary or liver metastasis of breast origin,surgical resection significantly improved survival.

ObjectiveTo investigate the treatment strategies and factors influencing the prognosis of patients with primary gallbladder carcinoma.MethodsThe clinical data of 135 patients with primary gallbladder cancer who were admitted to the Cancer Hospital of Tianjin Medical University from January 2000 to December 2009 were retrospectively analyzed.The survival curve was drawn by the Kaplan-Meier method,and the survival rates were analyzed by using the Log-rank test.Factors which may have influences on the prognosis were analyzed by univariate analysis and COX multivariate analysis.ResultsThe overall 1-,3-,5-year survival rates of the 135 patients were 46.7％,10.4％ and 5.2％,respectively.The 1-,3-,5-year survival rates of 74 patients who received radical resection of gallbladder cancer were 68.9％,18.9％ and 9.5％,respectively.The 1-,3-,5-year survival rates of 50 patients who received palliative treatment were 24.0％,0 and 0,respectively.The 1-,3-,5-year survival rates of 11 patients who received conservative treatment were 0,0 and 0,respectively.There was no significant difference in the survival rates among patients who received different treatment methods (x2 =5.642,P ＜ 0.05 ). Of the 9 patients with gallbladder cancer who received reoperation after laparoscopic choledochotomy,the survival time of 1 patient in stage Ⅰ and 1 of the 3 patients in stage Ⅱ who received radical surgery exceeded 5 years,while the survival time of 5 patients in stage Ⅱ who received palliative treatment was shorter than 5 years.There was a significant difference in the survival time among the 3 groups of patients ( x2 =5.642,P＜0.05).Under the condition of same TNM stages ( Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB),the survival rates of patients who received radical resection of gallbladder cancer were significantly higher than those who received palliative or conservative treatment ( x2 =8.971,21.250,44.153,6.696,21.722,P ＜ 0.05 ).The results of univariate analysis showed that age,CA19-9,TNM stages and treatment methods were risk factors influencing the median survival time ( x2 =8.466,3.977,9.837,5.642,P ＜ 0.05 ).The results of multivariate analysis showed that age,TNM stages and treatment methods were the independent risk factors influencing the median survival time ( Wald=5.779,14.724,11.640,P＜0.05).ConclusionThe prognosis of primary gallbladder cancer is poor.Age,TNM stages and treatment methods are the independent factors influencing the prognosis of patients with gallbladder cancer,and patients who receive radical resection have relatively good prognosis.

The human mitochondrial genome consists of approximate 1500 genes, among which 37 are encoded by the mitochondrial DNA (mtDNA) and the remainder encoded in the nuclear DNA (nDNA). The mitochondria produces large amount of the cellular reactive oxygen species (ROS). ROS induces the mutations of mtDNA and mtDNA, which are associated with a wide range of age-related diseases including neurodegenerative diseases, cardiomyopathy, diabetes and various cancers.
Aging ; DNA, Mitochondrial ; genetics ; Genetic Therapy ; Humans ; Mitochondria ; genetics ; metabolism ; Mutation ; Neurodegenerative Diseases ; genetics ; therapy ; Reactive Oxygen Species ; metabolism

Objective To explore the expressions ofhypoxia-inducible factor-1α(HIF-1α) and angiopoietin-2 (Ang-2) in children with nephroblastoma (NB) and its correlation with clinicopathology,prognosis and microvessel density(MVD).Methods Forty-five cases of NB treated by Pediatric Surgery Department of the First Affiliated Hospital of Guangxi Medical University,with NB resected from Jan.2008 to Jan.2012,were divided into groups according to histopathological type,clinical stage and National Wilm's Tumor Study-5 risk factors.The expressions of HIF-1α,Ang-2 and CD34/MVD in NB tissues and adjacent tissues were tested by immunohistochemical method,and the findings were analyzed with the combination of the clinical data and results of the follow-up.Results The ratio of HIF-1α and Ang-2 expressions in NB group was higher than that in the normal adjacent tissues(95.6％ vs 40％ and 86％ vs31.0％,respectively,P ＜ 0.05).HIF-1α and Ang-2 expressions were positively correlated with clinic stage and risk factors,and the postoperative cumulated survival rate was higher in low expression group of HIF-1α,Ang-2 compared with the higher expression group of HIF-1α,Ang-2 (P ＜ 0.05).MVD was higher in NB group than in normal adjacent tissue groups (58.22 ± 10.009 vs 49.43 ±-8.114,P＜0.05) and had a positive correlation with HIF-1α(r =0.442,P＜0.05) and Ang-2 (r =0.590,P ＜ 0.05).HIF-1α had a positive correlation with Ang-2 (r =0.442,P ＜ 0.05).Conclusion HIF-1α and Ang-2 could promote angiogenesis and proliferation in NB,which affects the prognosis.

Objective To explore the relation of matrix metalloproteinase-2(MMP-2) expressed in liver tissue of biliary atresia(BA) and liver fibrosis,jaundice free,cholangitis onset and survival time with native liver after Kasai hepatoenterostomy (KH).Methods Clinical and pathological data were collected in 65 cases of BA,with a completely 2 years' follow-up after KH(BA group) from Jan.2009 to Dec.2010 and 15 cases of children without hepatobiliary disease (control group) were compared at the same time,while expression of MMP-2 in liver tissue was measured by adopting immunohistochemistry.Results Ohkuma's score of liver fibrosis was higher in BA group than that in control group(Z =-4.02,P ＜ 0.001).The staining positive rate and the expression of MMP-2 were higher in BA group than those in control group(x2 =33.88,P ＜ 0.001 ;Z =-5.14,P ＜ 0.001,respectively).With the increase of Ohkuma's score and the age at KH,the expression of MMP-2 was higher(r =0.686,0.465,P ＜ 0.001,respectively).With the higher expression of MMP-2,the rate of jaundice free was lower(r =-0.687,P ＜ 0.001) and the incidence of cholangitis was increased (r =0.361,P =0.003).Those with lower expression of MMP-2 increased 2 year's survival time of native liver 2 years after operation (x2 =64.000,P ＜ 0.001).Conclusions In BA,the expression of M MP-2 in liver is related to the development of liver fibrosis,jaundice clearawe,cholangitis occurrence and survival time of native liver and it can be used as an index to evaluate therapeutic effect and prognosis after KH.

OBJECTIVETo study the temporal trend and spatial distribution of premature mortality burden due to chronic obstructive pulmonary disease (COPD) in terms of years of life lost (YLL) in an urban region of Kunming for the years 1998-2003.

METHODSPan Long district was selected as the study region. YLL was used to measure premature mortality burden due to COPD. The tate of YLL per 1000 residents was calculated without age-weighting but with 3% discounting rate and broken down by year. Geographic information system (GIS) technique was used to display the spatial distribution of premature mortality burden due to COPD during the six years of study.

RESULTSDuring the years from 1998 to 2003, the premature mortality burden due to COPD decreased by years while males seemed to have a higher YLL rate of COPD than females. Central areas remained to have higher YLL/1000 population values of COPD for the six years, whereas remote areas tended to have a decreasing trend of YLL/1000 population values of COPD in the same period.

CONCLUSIONCentral areas of the city should be emphasized in further control of COPD in the urban region of Kunming.

Cause of Death ; trends ; China ; epidemiology ; Female ; Geographic Information Systems ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive ; epidemiology ; mortality

AIMTo investigate the effects of melatonin (MT) on histology and behavioral tests during global cerebral ischemia-reperfusion in gerbils.

METHODSGlobal cerebral ischemia was induced by occluding the bilateral common carotid arteries for 10 min in gerbils. Three doses of MT were administrated intraperitoneally 30 min prior to the onset of ischemia. Locomotor activity was measured by using the open field method 3 and 7 days after the ischemic episode. T maze test was carried out 4, 5 and 6 days after ischemia to assess the working memory of gerbils. Neuronal damage was assessed in CA1 pyramidal layer of gerbil hippocampus and evaluated 7 days after ischemia.

RESULTSMT significantly reversed the locomotor activity increases, ameliorated learning and working memory deficit, and reduced the extent of CA1 hippocampal pyramidal cells injury after transient global cerebral ischemia in the Mongolian gerbil.

CONCLUSIONMT provides significantly protective effect against both histological and behavioral consequences of global cerebral ischemia-reperfusion injury in gerbils.

Animals ; Brain Ischemia ; complications ; Female ; Gerbillinae ; Hippocampus ; drug effects ; pathology ; Learning ; drug effects ; Male ; Melatonin ; pharmacology ; therapeutic use ; Memory ; drug effects ; Motor Activity ; drug effects ; Neurons ; pathology ; Neuroprotective Agents ; pharmacology ; therapeutic use ; Random Allocation ; Reperfusion Injury ; etiology ; physiopathology ; prevention & control

OBJECTIVETo observe the effect of Qingyi Decoction (QYD) in treating severe acute pancreatitis (SAP) and its impacts on blood levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 6 and 8 (IL-6 and IL-8).

METHODSOne hundred and ten patients of SAP were equally randomized into the treated group and the control group, they were treated with the same therapeutic program excepting that QYD was given only to the treated group. The post-treatment incidence of severe complication, mortality and operation transferring rate, as well as the changes of APACHE II scores and blood levels of TNF-alpha, IL-6 and IL-8 in patients of both groups were observed.

RESULTSThe incidences of the two severe complications, acute respiratory distress syndrome and intestinal paralysis, in the treated group was 3.6% and 5.4% respectively, while in the control group, 12.7% and 18.2%, showing statistical significance between groups (P < 0.05). The APACHE II score in the treated group decreased significantly on the 7th day, which was better than that in the control group (8.14 +/- 2.30 scores vs 3.35 +/- 2.20 scores, P < 0. 05). In addition, the efficacy in the treated group was also superior to that in the control group in terms of reducing mortality, operation transferring rate, and blood levels of TNF-alpha, IL-6 and IL-8 on the 7th and 9th day (P < 0. 05).

CONCLUSIONQYD could markedly improve the prognosis of SAP patients by way of lowering the blood levels of TNF-alpha, IL-6 and IL-8.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Male ; Middle Aged ; Pancreatitis, Acute Necrotizing ; blood ; drug therapy ; Phytotherapy ; Tumor Necrosis Factor-alpha ; blood ; Young Adult