Exosomes secreted by mesenchymal stem cells have shown great therapeutic potential in regenerative medicine .In this study, we performed meta-analysis to assess the clinical effectiveness of using exosomes in ischemia /reperfusion injury based on the reports pub-lished between January 2000 and September 2015 and indexed in the PubMed and Web of Science databases .The effect of exosomes on heart function was evaluated according to the following parameters:the area at risk as a percentage of the left ventricle , infarct size as a percentage of the area at risk , infarct size as a percentage of the left ventricle , left ventricular ejection fraction , left ventricular frac-tion shortening , end-diastolic volume , and end-systolic volume .Our analysis indicated that the currently available evidence confirmed the therapeutic potential of mesenchymal stem cell-secreted exosomes in the improvement of heart function .However , further mechanis-tic studies, therapeutic safety and clinical trials are required for optimization and validation of this approach to cardiac regeneration after ischemia/reperfusion injury .

Biomimetics ; Blood Cells ; metabolism ; CD55 Antigens ; blood ; CD59 Antigens ; blood ; Cell Membrane ; Humans ; Male ; Submarine Medicine

Although globally recommended standardized stratification treatment of acute myeloid leukemia (AML) effectively improves its therapeutic effects and prognosis,due to unknown personalized differences of tumorous biology,most of the patients eventually develop to therapy failure,relapse,and even death.Additionally,a number of patients are naturally resistant to current used combined chemotherapy and with extremely poor prognosis,This review presents definitions of refractory and relapsed AML,then describes their pathogenetic mechanism and lastly summarizes three aspects of therapeutic principle,clinical drugs and hematopoietic stem cell transplantation (HSCT).To review advances in relapsed and refractory AML diagnosis and treatment will be helpful to master disease characteristics and to guide clinical treatment.

Objective To investigate the clinical efficacy of uterine incision diverticulum type repair after cesarean section treated by laparoscopy and transvaginal combined with repair in.order to provide the reference for the clinical operation scheme selection.Methods Fifty-two patients who underwent uterine incision diverticulum type repair after cesarean section in the Second People's Hospital of Jingzhou were randomly divided into observation group and control group with 26 cases in each.Patients in the observation group were treated with laparoscopy combined with repair treatment,and patients in the control group were treated with transvaginal repair treatment.The operation periods,cut bleeding volume,postoperative anal exhaust time for the first time,postoperative highest temperature and length of hospital stay were recorded to evaluate the repair and uterine diverticula recovery at 3 months after operation.Results The operation periods in the observation group was (119.91 ± 35.73) min,longer than that in the control group ((62.32 ± 31.83) min ; t =3.514,P ＜0.05).There were on significant differences between two groups in terms of the amount of bleeding,anal discharge first time,the highest postoperative temperature and contrast after a few days in hospital (P＞ 0.05).After treatment,the observation group menstrual recovery rate was 84.62％ and 88.46％ in the control group.The differences were not statistically significant (x2 =1.14,1.76,P ＞ 0.05).Conclusion Laparoscopy hemiorrhaphy and transvaginal repair are effective treatment for uterine incision diverticulum after caesarean operation.The corresponding treatment plan can be made according to the patient's condition.

Objective To investigate the feasability of resorbable porcine-derived, xenogeneic aortas acelullar tissue matrix (ACTM) to be used as scaffold for cervical esophageal defect repair in a dog model. Methods Esophageal segmental defect measuring 5cm in length were created by surgical resection in 6 mature Chinese mongrel health dogs, then the defect were repaired with aorta acelullar tissue matrix (ACTM). The animals were kept alive for periods. The healing process was observed. Results There no death after perioperative period, one dog had anastomotic leakage. one dog was died of esophagus rupture as the result of esophageal dilation. Submucosal tissue regeneration and abundant neovascularization were found at 2 weeks. The squamous epithelium covered the most part of grafts surface in dogs killed after 4 weeks. 12 weeks later the squamous epithelium comprising 8 to 12 layers, both esophageal glands and muscle tissue were found. The graft material itself was mostly absorbed and could not be identified by naked eyes in the dogs killed after 12 weeks. Conclusion ACTM show promise as an ideal treatment option for esophageal repair.

The public ethics consciousness,with medical ethics included,fundamentally depends on the gradual improvement in the self-identity of human as objective itself.However,the improvement of humanistic consciousness is a long and painful process.Former recognition of historical culture,including the humanistic ideal in traditional Chinese ethical thoughts and systemic rational thoughts in modern western society,mainly employs transcendental test of abstract anthroposophy as its cultural premise,superficially enhancing certain individuals and their thoughts,motives,and objectives to historical ontology,but actually resulting in the absence of human individuals in realistic history.The self-conscious improvement of human-oriented public ethics can only be realized by the subjective humanistic consciousness which undergoes the regression from axiology,epistemology,to existence theory,making human realize that they themselves are the utmost purpose of all values and significances.

The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

Objective To study the expression of LRP16 and E-cadherin(E-cad),ER,PR in eutopic endometrium and ectopic endometrium of endometriosis(EM),as well as to study the relation one another and the possible clinical significance.Methods The expression of LRP16 and E-cadherin,ER,PR in endometrium was detected by immunohistochemical two step staining methods in 72 patients with endometriosis which was finally confirmed by laparoscopic operation.Results The expression of LRP16 in epithelioglandular endochylema in eutopic endometrium of EM was significantly higher than that in ectopic endometrium(P

Acute myeloid leukemia (AML) is a group of heterogeneous diseases with diverse genetic abnormalities,variable responsiveness to therapy and prognosis.In recent years,a lot of information has become available regarding chromosome and gene mutations that occur in AML and their influence on prognosis.Improvements in the understanding of molecular biology of AML are critical for accurate diagnosis.risk stratification,monitoring of minimal residual disease and provides opportunities to develop targeted therapies and improve the clinical outcome.This article reviewed chromosome abnormalities and characteristic gene mutations,and discussed their clinical signiflcances and presented new drugs in clinical trials presented in the 55th ASH annual meeting.

Objective To investigate the application value of real clinical case centered situation simulation examination model in clinical medicine. Methods Two classes were randomly selected from 2008 grade clinical medicine majors, respectively as test group(n=158) and control group(n=156). Final examination of test group includes usual performance, case-oriented situation simulation examination (COSSE) and final written examination. Traditional methods were used in control group. The same paper was used in final written examination of the two groups. Scores of written examination and question-naires were used to evaluate the COSSE model. Data were processed using SPSS 16.0 statistical software;t and chi-square tests were used to analyze the data;P<0.05 signifies that the difference is statistically sig-nificant. Results Scores of final examination in test group were higher than those in control group(P<0.001). Times of independent completion of history taking, physical examinations and medical record writing were more in test group than in control group(P=0.002,0.017,0.048). Conclusions Contents and methods of COSSE is conducive to improving student's professional comprehensive ability.