Exosomes are a kind of endosomal vesicles that are secreted by most if not all living cells. Due to their capability of delivering a variety of cargos, such as tissue- or cell-specific proteins, lipids, and genetic materials, and their broad biological activities, exosomes have gained substantial attention as emerging therapeutics. Exosomes derived from mesenchymal stem cells (MSCs) and dendritic cells (DCs) are two types of exosomes that are widely studied. Many preclinical and clinical studies have shown that they have a satisfactory treatment effect in lung diseases, liver diseases, nervous system diseases, tumors, and other diseases. In addition, exosomes from macrophages, tumor cells, plant cells, and many other cells are getting more attention due to their therapeutic potential. Besides natural exosomes, research on engineered exosomes has also made plenty of progress. There have been several engineering methods of exosomes, such as targeting modification and loading of active ingredients. In this review, we summarize the research progress of therapeutic exosomes from different sources, and further discusses the application prospects of exosomes and possible challenges in the future.

BACKGROUNDAn increasing incidence of Crohn's disease has been found in China in recent years. Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn's disease in order to improve early diagnostic accuracy and therapeutic efficacy.

METHODSThirty patients with active Crohn's disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.

RESULTSMost patients were young adults with a higher proportion of females to males (ratio: 1.14:1). The disease affects any segment or a combination of segments along with the alimentary tract (from the mouth to the anus). In this study, the colon and small bowel were the major sites involved. Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30.8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host's nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported.

CONCLUSIONEndoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.

Adolescent ; Adult ; Aged ; Azathioprine ; therapeutic use ; Biopsy ; Child ; Crohn Disease ; diagnosis ; diagnostic imaging ; therapy ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Mesalamine ; administration & dosage ; Middle Aged ; Prednisone ; administration & dosage ; Sulfasalazine ; administration & dosage ; Ultrasonography

OBJECTIVE To study the differentiation of PC12 cells induced by total salvianolic acid (Tsa) and the mechanism. METHODS MTT assay was used to detect the effect of Tsa 0.01, 0.1 and 1.0 μg·L-1on proliferation of PC12 cells and on the cells damaged by oxygen and glucose deprivation (OGD).The number of projections of PC12 cells was statistically analyzed.Western blotting was applied to detect the levels of microtubule-associated protein2 (MAP-2), extracellular signal-regulated kinase1/2 (ERK1/2), phosphorylated ERK1/2(p-ERK1/2), mitogen-activated protein kinase kinase1/2(MEK1/2) and p-MEK1/2 proteins.MEK inhibitor U0126 was examined for its effect on expressions of p-ERK1/2 and ERK1/2 protein in PC12 cells induced by Tsa 1.0 μg·L-1.RESULTS Compared with normal control group, Tsa 1.0 μg·L-1could promote PC12 cell proliferation, and the survival rate was increased by 90%, but the survival rate of PC12 cells was not affected by Tsa 0.01 or 0.1 μg·L-1. Compared with OGD injured group,PC12 cells injured by OGD could be repaired by Tsa 0.1 or 1.0 μg·L-1,and the survival rate was increased to (47.7±1.8)% and (63.2±13.0)%, respectively (P<0.05, P<0.01). Compared with normal control group,Tsa 0.01,0.1 and 1.0 μg·L-1could promote the growth of PC12 cell projections (P<0.01). Western blotting results showed that Tsa could promote the expressions of MAP-2, p-ERK1/2 and p-MEK1/2 proteins, and this effect could be blocked by U0126 inhibitor (P<0.01). CONCLUSION Tsa can induce the proliferation and differentiation of PC12 cells, the mechanism of which is possibly the activation of p-MEK and p-ERK1/2.

The aneurysms at the initial segment of splenic artery are rare. This paper aimed to investigate the methods to treat the true aneurysm at the initial segment of splenic artery by aneurysmectomy plus vascular reconstruction. Retrospectively reviewed were 11 cases of true aneurysm at the initial segment of splenic artery who were treated in our hospital from January 2000 to June 2013. All cases were diagnosed by color ultrasonography, computer tomography (CT) and angiography. Upon resection of the aneurysm, the auto-vein transplantation was performed in situ between the hepatic artery and the distal part of the splenic artery in 1 case; the artificial vessel bypass was done between the infra-renal aorta and distal portion of the splenic artery in 7 cases; the splenectomy was done in 2 cases; the splenectomy in combination with ligation of multiple small aneurysms were performed in 1 case. All cases were cured and discharged from the hospital 10-14 days after operation. A 1-14 year follow-up showed that 9 cases survived, and 2 cases died, including 1 case who died of acute myocardial infarction 2 years after aorta-splenic artery bypass operation and 1 case who died of acute cerebral hemorrhage 5 years after aneurysm resection and the splenectomy. Among 6 cases receiving aorta-splenic artery bypass, 1 gradually developed stenosis at anatomosed site, which eventually progressed to complete occlusion 2 years to 6 years after operation, without suffering from splenic infarction because the spleen was supplied by the short gastric vessel and its collaterals. The other 5 cases receiving aorta-splenic artery bypass and 1 case undergoing autologous vascular transplantation did not develop stricture or pseudoaneurysm at the stoma. Our study showed that the aneurysmectomy plus vascular reconstruction is a better treatment for aneurysm at the initial segment of splenic artery.
Aneurysm ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Splenic Artery ; surgery ; Survival Analysis ; Treatment Outcome ; Veins ; transplantation

By the time of primary 21st century, water hyacinth had become a serious environmental problem in China. Water hyacinth contributes to the major part of ecological hazards from the invasion of foreign plant species, which is estimated about USD 7 billion a year in values. In the past 10 years, herbicides glyphosate, 2,4-D and paraquat have been used in controlling water hyacinth in China. Although the herbicides provided effective control on the weed in some areas, they could not provide the sustainable inhibition on the weed population, while would lead to pollution of water at various levels. At present, the herbicide application on water hyacinth is forbidden in many areas of China such as Shanghai. In this situation, the asexual reproduction inhibitor, KWH02, was invented for controlling water hyacinth and it provided about 70% of growth inhibition without any risk of dead plant pollution. It has been about 10 years for bio-control of water hyacinth in China. Works focused on mainly the efficacy and safety of the utilization of foreign insects. Researches on microorganism herbicides to control water hyacinth were started and obtained primary achievements in recent years. Although there are different opinion on how to face the water hyacinth problem in China, it is accepted widely that the control methods should be high efficient and safe with low cost. Some practical measures for integrated management of water hyacinth are suggested.
Animals ; China ; Ecology ; Eichhornia ; growth & development ; Female ; Herbicides ; pharmacology ; Male ; Pest Control, Biological ; Rats ; Weevils

king condition before pregnancy were associated with the development of polydactyly and syndactyly.

Objective To determine the awareness, treatment and control of hypertension and its determinants in the elderly hypertensive patients of Dean nationality so as to explore the associated determinants. Methods This was a cross-sectional, population-based survey. A total of 939 persons aged 60 years and older sampled by stratified sampling method from the elderly population of Dean nationality were examined from July to September 2016. Meanwhile, the data of medical history and examination were collected. Results There were 353 elderly patients with hypertension in the 939 subjects. The awareness, treatment and control of hypertension in the elderly hypertensive patients (EHP), which was 47.3％, 36.5％and 22.1％respectively, were higher than the results of previous national study and had the upward trends with the increasing age (<0.05) . In comparison with the reference group, EHP living in middle economic level area had the higher awareness, treatment and control of hypertension (<0.05) . The results of covariate-adjusted multilevel logistic regression model indicated that there was a cross-level interaction effect between middle economic level area and dyslipidemia on the awareness and treatment of hypertension respectively, and a cross-level interaction effect between middle economic level area and low fat diet on the control of hypertension ( <0.05) . The individual level covariates, age (OR=1.3412, 1.3144, 95％ CI 1.0217-1.7609, 1.0030-1.7225) and diabetes ( OR=2.6735, 2.3078, 95％ CI 1.0721-6.6672, 1.0240-5.2007), had the positive association with the awareness and treatment of hypertension;age (OR=1.4740, 95％CI 1.0034-2.1654), non-drinking (OR=3.2056, 95％CI 1.5554-6.6066) and low salt diet (OR=3.6969, 95％CI 1.7996-7.5946) had the positive association with the control of hypertension. Conclusion The awareness, treatment and control of hypertension in the EHP of Dean nationality were higher than those of the national level, and the dominant factors were economic level, age, dyslipidemia, diabetes, non-drinking, low fat diet and low salt diet, etc.

Objective To establish a comprehensive evaluation system for the patient monitor clinical application based on real world data(RWD)to provide references for levels of medical institutions to purchase patient monitors.Methods RWD method was used to collect clinical application data of the monitors from 14 medical institutions in Guangxi Zhuang Autonomous Region,and a Chinese brand X(including X1 series for mid-end products and X2 series for high-end products)and a foreign brand Y(including Y1 series for mid-end products and Y2 series for high-end products)with the highest market share were selected to construct a monitor clinical application evaluation system involving in five indicators such as clinical efficacy,applicability,reliability,instrument function and service system.Data processing was carried out with Mantel-Haenszel analysis,propensity score analysis and pairwise comparison method to calculate the clinical application evaluation scores of X and Y brands of monitors.Results In the mid-end products,X series gained advantages over Y series in clinical efficacy,reliability and applicability(P＜0.05),while the differences between the service systems were not statistically signifi-cantly(P＞0.05);in the high-end products,there were no significant differences between the clinical efficacy,applicability,reliability and service systems(P＞0.05).Brand X and Y monitors were equipped with similar basic and advanced functions.Conchision The evaluation system established based on real-world data can be able to effectively evaluate the clinical appli-cation of the monitor,which provides references for clinical application evaluation of medical devices in China.[Chinese Medical Equipment Journal,2023,44(11):71-78]

Objective To analyze the results of application on China Infectious Diseases Automated-alert and Response System(CIDARS)and for further improving the system. Methods Amount of signal, proportion of signal responded, time to signal response, manner of signal verification and the outcome of each signal in CIDARS were descriptively analyzed from July 1,2008to June 30, 2010. Results A total of 533 829 signals were generated nationwide on 28 kinds of infectious diseases in the system. 97.13% of the signals had been responded and the median time to response was 1.1 hours. Among them, 2472 signals were generated by the fixed-value detection method which involved 9 kinds of diseases after the preliminary verification, field investigation and laboratory tests. 2202 signals were excluded, and finally 246 cholera cases, 15 plague cases and 9H5N1 cases as well as 39 outbreaks of cholera were confirmed. 531 357 signals were generated by the other method - the 'moving percentile method' which involved 19 kinds of diseases. The average amount of signal per county per week was 1.65, with 6603 signals(1.24%)preliminarily verified as suspected outbreaks and 1594 outbreaks were finally confirmed by further field investigation. For diseases in CIDARS, the proportion of signals related to suspected outbreaks to all triggered signals showed a positive correlation with the proportion of cases related to outbreaks of all the reported cases (r=0.963, P＜0.01). Conclusion The signals of CIDARS were responded timely, and the signal could act as a clue for potential outbreaks, which helped enhancing the ability on outbreaks detection for local public health departments.

Objective To analyze the pilot results of both temporal and temporal-spatial models in outbreaks detection in China Infectious Diseases Automated-alert and Response System (CIDARS)to further improve the system. Methods The amount of signal, sensitivity, false alarm rate and time to detection regarding these two models of CIDARS, were analyzed from December 6,2009 to December 5,2010 in 221 pilot counties of 20 provinces. Results The sensitivity of these two models was equal(both 98.15%). However, when comparing to the temporal model, the temporal-spatial model had a 59.86% reduction on the signals(15 702)while the false alarm rate of the temporal-spatial model(0.73%)was lower than the temporal model(1.79%), and the time to detection of the temporal-spatial model(0 day)was also 1 day shorter than the temporal model.Conclusion Comparing to the temporal model, the temporal-spatial model of CIDARS seemed to be better performed on outbreak detection.