BACKGROUND:Umbilical cord mesenchymal stem cels are from the umbilical cord of newly born individuals and have no ethical issues, and therefore are promising candidates for seeded cels as a substitute for cel transplantation and regenerative medicine. OBJECTIVE:To investigate the effects of serum from liver injury rats on induced differentiation of human umbilical cord mesenchymal stem cels into hepatocyte-like cels and provide experimental evidence for use of human umbilical cord mesenchymal stem cels in the treatment of patients with end-stage liver disease in the clinic. METHODS: Rat models of acute liver injury were established by intraperitoneal injection of 10% carbon tetrachloride. Rats in the control group were intraperitonealy administered the same amount of soybean oil. Forty-eight hours after modeling, abdominal aorta blood was taken for serum preparation. Passage 3 human umbilical cord mesenchymal stem cels were cultured with 20% serum from liver injury rats and 20% fetal bovine serum. Morphology of human umbilical cord mesenchymal stem cels was observed before and after culture. Levels ofα-fetoprotein and albumin in the supernatant were detected. RESULTS AND CONCLUSION:Cels exhibited shuttle-shaped appearance and grew in whirlpool-like manner at 1 day after culture with serum from liver injury rats, exhibited short shuttle-shaped appearance at 2 days, were oval-shaped at 3 days, and were round and an extremely smal number of cels were floated at 4 days. At 4 days after culture with serum from liver injury rats, level of albumin in the cel supernatant was significantly increased than that before induction and that in the control group (P< 0.001), and there was no significant difference in level of α-fetoprotein in the cel supernatant. These results suggest that serum of liver injury rats can induce differentiation of umbilical cord mesenchymal stem cels into hepatocyte-like cels.

BACKGROUND:Umbilical cord blood transplantation can ameliorate hepatic and immunologic function,repair hepatic injury,and promote hepatic regeneration,however,the differentiation mechanism and biological characteristics remain poorly understood,and the long-term efficiency need to be explored.OBJECTIVE:To investigate the long-term therapeutic efficacy of infusing umbilical cord blood and blood plasma in treating chronic severe hepatitis B patients.METHODS:Totally 50 chronic severe hepatitis B patients received treatment at the Second Xiangya Hospital,Central South University from January 2003 to January 2004 were randomly divided into the treatment and control groups,with 25 cases in each group.All patient were accepted an ordinary synthetic treatment,and the differences between age,pathogenetic condition,medication had no significance.The umbilical cord blood was obtained from healthy full-term spontaneous delivery parturient,centrifugated,remained karyotes and cord plasma,and used within 24 hours.Patients in the treatment group were received umbilical cord blood infusion,200 mL once,1 2 times per week,totally,each patients infused 4-8 times(mean 5 times);those in the control group were infused with adult fresh blood plasma.The changes of hemogram and hepatic function were measured.RESULTS AND CONCLUSION:All the patients were followed-up for 1 year.The hemogram and hepatic function indexes were similar in the 2 groups before treatment(P ＞ 0.05).The hemogram index had no obviously difference at 1 year after treatment (P ＞ 0.05),but the alanine aminotransferase and total bilirubin levels were decreased in the treatment compared with the control group(P ＜ 0.05),but the albumin was significantly increased(P ＜ 0.05).Compared with before treatment,the platelet level had no significant changes at 1 year after treatment,but the alanine aminotransferase and total bilirubin levels were deeply decreased(P＜ 0.05),albumin was significantly increased(P ＜ 0.05);the platelet and albumin levels were dramatically decreased in the control group(P ＜ 0.05).It suggested that umbilical cord blood infusion can improve the hepatic function and hemogram;therefore,it can be served as supplementary therapeutic measure for severe hepatitis.

BACKGROUND: Studies of umbilical cord blood stem cells transplantation for liver function failure have demonstrated that Astragalus membranaceus preparation can stimulate hemopoietic stem/progenitor cell proliferation.OBJECTIVE: To explore the effect of Astragalus membranaceus injection on the differentiation of umbilical cord blood stem cell into hepatocyte in vitro and in vivo for the treatment of liver failure. METHODS: The third and fourth passage of human umbilical cord blood stem cells (HUCBSCs) were collected. In drug screening test, there were 4 groups: cells were separately cultured with 0, 40, 200, and 400 mg/L Astragalus membranaceus injection to screen the appropriate for cell growth. In cell differentiation test, there were 2 groups: HUCBSCs were respectively cultured with hepatocyte growth factor (HGF, 10 μg/L), and HGF (10 μg/L) plus 200 mg/L Astragalus membranaceus injection. D-aminogalactose was intraperitoneally injected to establish a model of acute liver failure. Surviving model rats (48 hours) were randomly divided into six groups: model control, Astragalus membranaceus injection, rat peripheral blood mononuclear cells, combination, combination+Cytoxan, and combination+dexamethasone groups. The alpha fetoprotein mRNA and albumin mRNA expression was determined by RT-PCR, and liver function indexes were observed. RESULTS AND CONCLUSION: Different mass concentration of Astragalus membranaceus injection displayed varied influence on HUCBSC proliferation: 200 mg/L was the best for HUCBSC proliferation. Compared with HUCBSC cultured with HGF alone, the number of albumen-positive cells in HUCBSCs cultured with 200 mg/L Astragalus membranaceus injection and HGF was greater (P < 0.05). Moreover, the expression of albumen mRNA in combination, combination+Cytoxan, and combination+dexamethasone groups was greater than rat peripheral blood mononuclear cells group, while alpha fetoprotein mRNA expression was only greater than rat peripheral blood mononuclear cells group in early stage. At 7 days of treatment, the values of alanine aminotransferase, aspartate amino transferase and total bilirubin were significantly greater in combination, combination+Cytoxan, and combination+dexamethasone groups compared with model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P < 0.05), but no differences were observed among model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P > 0.05). Results indicate that Astragalus membranaceus injection at 200 mg/L can promote the proliferation and differentiation of HUCBSCs into hepatocyte in vitro and in vivo, ameliorate liver function and improve treatment effect of HUCBSC transplantation for liver failure.

Objective　To study the effects of sFas in hepatocellular cancer (HCC) and chronic hepatitis (CH). Methods　The serum sFas was detected in 18 patients with HCC, 12 patients with CH and 6 cases of normal control by ELISA. Results　The serum sFas in HCC was obviously increased and had significant difference with the patients of CH and normal control (P<0.01). The serum sFas had positive correlation with the serum TBIL(P<0.01), but negative correlation with the ALB, PTA and the ratio of ALT/AST(P<0.01).Conclusions　sFas may resist the occurrence of HCC apoptosis. In CH, sFas has correlation with the severity of CH. The role of sFas in viral hepatitis is uncertain.

Objective To investigate the therapeutic effect of human umbilical cord blood nucleated cell therapy(HUCBNCT) in patients with chronic severe viral hepatitis,and the effect of HUCBNCT on ductular proliferation and hepatic oval cell proliferation.Methods A total of 90 patients with chronic severe viral hepatitis were divided into two groups randomly,and the two groups were treated with adult plasma transfusion(control group),and HUCBNCT(treatment group),respectively.The therapeutic effect in all patients was evaluated by determination of liver function.Some patients had liver biopsy and CK19,CD34,albumin and AFP of the biopsy tissues were detected.Results Liver necrosis in treatment group was milder than that of control group,and the positive rate of CK19 staining in treatment group was higher than that of control group.Co-expression of CK19 and albumin were observed in some atypical ductular proliferation cells,which were like the oval cells in shape and immunohistochemical characteristics.Conclusion HUCBNCT,which can promote liver ductular and oval cell proliferation,may have promising therapeutic effect on patients with chronic severe viral hepatitis.

Objective To investigate the protective effects of recombination rat augmenter of liver regeneration (rrALR) on tubular cell injury and renal dysfunction in rats with acute renal failure (ARF)induced by gentamicin. Methods One hundred fifty female Wistar rots were randomly divided into 5 groups: group A (control), group B (gentamincin 140 mg/kg+ saline 100 μg/kg), group C (gentarnincin 140 mg/kg +blank plasmid 100 μg/kg), group Dl (gentaminein 140 mg/kg+rrALR 80 μg/kg), group D2 (gentamincin 140 mg/kg +rrALR 160 μg/kg). Rats were sacrificed at day 4, 8, 12, 16 and 21 after gentamicin first injection. Blood urea nitrogen (BUN), serum creatinine (Scr) and urine N-aeetyl-β-D-glucosaminidase (UNAG) were measured. The histopathologic changes were observed by periodic aeid-Schiff (PAS) staining. Protein expression of ALR and PCNA in renal tissue was detected using immtmohistochemistry and Western blot. Results Compared with control rots, the levels of BUN, Scr and UNAG were significantly increased in ARF rats at day 4, 8, 12 and 16 (P<0.05), however, the renal dysfunction and the renal histopathologieal injury were significantly improved in ARF rats simultaneously administered with rrALR (group D) compared with ARF rats (group B and C). The protein level of ALR, the number of PCNA positive tubular ceils and the proliferation index (PI) in group D were significantly higher than those of group B and C (P<0.05). Conclusion rrALR can promote the regeneration of tubular cells in nephrotoxie ARF rats and ameliorate renal dysfunction.

Objective To determine the influencing factors of post-stroke depression by machine learning.Methods Stroke patients' medical records (688 cases eligible) were extracted from record system,including age,gender,pulse manifestation,complexion,tongue quality,fur,Chinese medicine intervention,body mass index (BMI),blood pressure,blood glucose,blood triglyceride,blood total cholesterol,smoking history,drinking history,depression family history,stroke lesion site in imaging,as well as the final depression judgment.Single rule algorithm (1R) was adopted to learn.The risk factors influencing post-stroke patients' depression in extracted information were determined.Then the cases collected were divided into the training dataset (500 cases) and the test dataset (188cases).Optimal discriminant results were obtained by random forest model.Results Single rule algorithm showed that the most important influencing factor of post-stroke depression was stroke lesion site.By computer speculation,stroke lesions in the frontal and temporal lobes were most prone to post-stroke depression.Basal ganglia,brain stem,cerebellum,medulla oblongata and occipital lobe lesions were less likely to cause depression.The accurate classification rate could amount to 88.95％ (612/688 cases).Random forest model determination was made in the former 500cases in the training dataset.The total correct rate of determining depression was 98.2％.The total correct rate of determination in 188 cases of the test dataset was 99.47％.Six hundred and eighty-eight patients' data were learnt by random forest model.The total correct rate was 98.84％.The importance measure results showed that top 3 important indexes of post-stroke depression were lesion site,Chinese medicine intervention and depression family history.Conclusion Patients with lesions in the frontal & temporal lobes and depression family history were most prone to post-stroke depression.

ObjectiveTo investigate the treatment and safety of interferon ? plus Ribovirin for chronic hepatitis C after kidney transplantation. MethodsFive patients with chronic hepatitis C after kidney transplantation were administered with interferon ? (50 ?g) subcutaneously once a week, plus Ribovirin (600 mg) orally once daily. The levels of HCV-RNA, ALT and serum creatinine in patients’ serum were monitored monthly. ResultsFour in 5 patients presented normal ALT and negative HCV-RNA in serum 12 weeks after treatment, and obtained sustained viral response 24 weeks after interferon ? plus Ribovirin therapy. During treatment, renal graft rejection did not occur. The most frequent side-effects were the decrease of leukocyte and hemoglobin, myalgia and fever, but did not influence the course of treatment. ConclusionCombination of interferon ? with Ribovirin can be a valid therapeutic option in renal transplant recipients with hepatitis C, and shows no influence on the renal function.

A total of 88 patients with chronic heart failure were divided into 2 groups: the carvedilol group( n =40) and the control group( n =48). Patients in 2 groups were all treated with routine regime,the experimental group also received carvedilol treatment.Before and 7 months after treatment, their left ventricular ejection fractions (EF%) and the rate of left ventricular drawing back on short axis contration were recorded to evaluate the effects of carvedilol. The values of EF% and short axis were higher in both groups after 7 months follow up ( P

Objective To assess response of rectal carcinoma to preoperative chemoradiation therapy(CRT)using DWI and tumor ADC values,and to investigate the value of ADC in predicting and monitoring therapeutic effect of CRT.Methods Twenty-six patients with primary rectal carcinoma undergoing preoperative CRT were recruited to the study.DWI was performed on a 1.5 T MR scanner in all patients at the time point of pre-therapy,the end of the 1st,2nd week of therapy and pre-operation,respectively.ADC values of the tumors were calculated on the workstation.Randomized block design was applied to analyze change in ADCs following treatment Results All patients were divided into T-downstaging group(n=12)and T-non-downstaging group(n=14).In T-downstaging group,the mean tumor ADC values were(1.10±0.13)×10~(-3),(1.32±0.19)×10~(-3),(1.35±0.13)×10~(-3),(1.32±1.00)×10~(-3) mm~2/s at the time point of pretreatment,week 1,week 2,pre-operation,respectively(F=16.420,P＜0.01).The mean tumor ADC value in T-non-downstaging had a slight increase from(1.16±0.16)×10~(-3) mm~2/s to(1.23±0.13)×10~(-3) mm~2/s at the time of week 1(P＞0.05).The ADC value in T-non-downstaging group continuously increased to(1.30±0.16)×10~(-3) mm~2/s at the end of the 2nd week of CRT(F=5.023,P＜0.01)and appeared statistical difference.The evolution of tumor ADC values in the two groups was significantly different.Early increases in tumor ADC were observed in T-downstaging group.Regarding the increase percentage of ADC value at 1st week as a diagnostic marker of tumor downstaging,when it was set as 11.6%,the sensitivity,specificity,positive predictive value and negative predictive value is 75.0%,78.6%,75.0% and 78.6% respectively,the area under curve(Az)was 0.774(95% confidence interval:0.583 to 0.964).Conclusions An early significant increase of mean tumor ADC value in rectal carcinoma has a potential to predict therapeutic effect of CRT.One week after beginning CRT is an early time point to monitor therapy efficacy.