Exosomes are double phospholipid membrane vesicles that are synthesized and secreted by a variety of cells, including T cells, B cells, dendritic cells, immune cells, are extracellular vesicles. Recent studies have revealed that exosomes can play a significant role in under both physiological and pathological conditions. They have been implicated in regulation of inflammatory responses, immune response, angiogenesis, tissue repair, and antioxidant activities, particularly in modulating immunity in autoimmune diseases (AIDs). Moreover, variations in the expression of exosome-related substances, such as miRNA and proteins, may not only offer valuable perspectives for the early warning, and prognostic assessment of various AIDs, but may also serve as novel markers for disease diagnosis. This article examines the impact of exosomes on the development of AIDs and explores their potential for therapeutic application.

Lower extremity chronic total occlusion (CTO) is the most severe manifestation of peripheral artery disease (PAD), with high amputation and mortality rates. As a minimal invasive reconstruction therapy, endovascular therapy (EVT) plays an important role in limb salvage for CTO in current clinical practice. The complexity of CTO lesions leads to a high risk for complications and a low success rate of EVT. Therefore, establishing a grading or scoring system to predict the success rate of revascularization strategy will be helpful in developing appropriate treatment strategies and assessing benefits and risks. This paper summarizes the most popular CTO scoring systems, such as PACSS grading, PARC grading, TAC grading, CTOP classification, Infrapop-CTO scoring, and J-BTK CTO scoring. PACSS grading and PARC grading are suitable for evaluating the severity of vascular calcification including iliofemoral segment, femoral-popliteal segment, and below-the-knee artery segment. TAC grading is suitable for grading calcification below the knee lesions; with low intervention success rate in a high calcification grading. CTOP classification was developed by analyzing the effect of morphological characteristics of proximal and distal fibrous caps of lower extremity CTO lesions on the outcome of EVT. The success rate of antegrade intervention is lower in type IV. The Infrapop-CTO score and J-BTK CTO score can predict successful anterograde crossing of infrapopliteal CTO lesions, with low intervention success rate in high score. Both scoring systems use three variables, namely, shape of proximal stump, calcification, and occlusion length.

Objective:To compare and analyze the efficacy of supraumbilical longitudinal auxiliary incision and left lower abdominal oblique auxiliary incision during laparoscopic radical resection of rectal cancer.Methods:The data of 196 patients with rectal cancer treated in the Second Affiliated Hospital of Xiamen medical college from January 2015 to December 2020 were analyzed retrospectively. Different abdominal auxiliary incisions were used for grouping. The control group (101 cases) used the oblique auxiliary incision of the left lower abdomen, and the observation group (95 cases) used the longitudinal auxiliary incision of the upper umbilical cord. The intraoperative indicators (operative time, intraoperative blood loss, auxiliary incision length, distance between anastomotic teeth and dentate line), postoperative indicators (first postoperative exhaust time, postoperative pain score, fluid intake time, first out of bed time and hospital stay) and operative complications between the two groups were compared.Results:The first postoperative exhaust time ((56.8±4.3) h vs. (70.3±5.8) h, t=4.796) and the first postoperative out of bed time ((38.81±2.04) h vs. (47.93±2.63) h, t=5.113) in the observation group were significantly shorter than those in the control group, and the pain scores at 24 hours ((2.01±0.22) vs.(2.43±0.40), t=5.882) and 48 hours pain score ((2.23±0.44) vs. (3.14±0.72), t=6.58) after operation were significantly lower than those in the control group (all P<0.05). The incidence of incision hernia in the observation group was significantly lower than that in the control group (5.3% (5/95) vs.9.9% (10/101), χ 2=4.29)( P<0.05). Conclusion:Compared with the left lower abdominal oblique auxiliary incision,the supraumbilical longitudinal auxiliary incision in laparoscopic radical resection of rectal cancer can not only significantly reduce the postoperative pain scores and recover the postoperative intestinal function as soon as possible, but also significantly reduce the incidence of postoperative incision hernia.

With the development of the 3rd-generation high-throughput sequencing technology and tissue engineering, recent studies show that many long-chain non-coding RNAs (LncRNAs) have played an important role in osteogenic differentiation of mesenchymal stem cells (MSCs). LncRNAs, which are involved in the regulation of mechanical regulation, further regulate bone-related cell functions and play a regulatory role at multiple levels, including transcription, post-transcriptional and epigenetic. LncRNAs may be involved in the osteogenic differentiation and bone remodeling of MSCs, the regulation of bone-related cell functions as a mechanical response molecule, as well as the pathological process of skeletal diseases.

BACKGROUND: Spinal cord injury is a damage to the spinal cord with a high morbidity that can be divided into primary and secondary injury. Secondary injury does more harm to the body than primary injury, which can be regulated and improved through proper interventions. In addition to the drugs, surgical decompression and other traditional treatments, hypothermia is an important physical intervention that has been shown to regulate secondary injury following spinal cord injury, and hold neuroprotective effect.OBJECTIVE: To introduce different hypothermia treatments for spinal cord injury and the effect on the disordered environment after spinal cord injury, as well as summarize the latest progression. METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles addressing the application of hypothermia in spinal cord injury published from January 2001 to June 2016, using the keywords of therapeutic hypothermia or low temperature, spinal cord injury in Chinese and English, respectively. RESULTS AND CONCLUSION: Hypothermia is divided into systematic and local hypothermia, and the former is simple and convenient, but it may lead to complications. Local hypothermia can quickly reach the target temperature, to make deep hypothermia at injury site and stablize the core temperature in the body, but it is invasive, and the necessary time of locating and maintaining effective temperature is a challenge. In general, hypothermia can improve the disordered microenvironment after spinal cord injury, reduce inflammatory infiltration, regulate the expression of relative genes and proteins, and promote the proliferation and differentiation of endogenous nerve cells. There are basic and clinical studies on hypothermia neuroprotection against spinal cord injury from various aspects; thereafter, hypothermia is a promising treatment strategy for spinal cord injury.

Based on the known IRAK4 inhibitors MK-32 and AU-5,we designed and synthesized 12 pyridine-based target compounds by adopting open-ring and hybrid strategies,and combining molecular docking technology.The bioassays determined by radioisotope labeling demonstrated that the target compounds displayed good inhibitory activity against IRAK4.Among them,the IC50 value of 5 compounds was less than 1 μmol/L,suggesting that these compounds may be candidates for further investigation.

BACKGROUND:Peripheral nerve defect due to limb dysfunction has always been the difficulty faced by the medical profession. Ideal materials and processing technology for constructing a tissue engineering scaffold targeting peripheral nerve repair are stil in research stage. OBJECTIVE:To review the research progress in peripheral nerve repair using col agen/silk fibroin nerve conduits. METHODS:In this paper, the first author retrieved the PubMed and CNKI from 2003 to 2016 to search articles regarding methods of constructing artificial nerve scaffolds and selection of raw materials. Data from these articles were col ected, summarized and analyzed. RESULTS AND CONCLUSION:Forty-six articles were included for final analysis. Col agen and its degradation products trigger no inflammatory response in the host because of high biocompatibility and biodegradability. However, its use is largely limited by its rapid degradation and poor physical performance. Silk fibroin has a high flexibility and biocompatibility, and exhibits a slow degradation in vivo. As a rapid prototyping technique, three-dimensional printing can print various forms of scaffolds within a short time, characterized as high-quality pore structure and large-scale production. Given these, the col agen/silk fibroin nerve conduit prepared using the three-dimensional printing technology can maintain the biocompatibility and even improve the mechanical properties of the raw materials. Until now, more investigations on nerve repair using col agen or silk fibroin have been done, and we have never stopped improving the production process of these scaffolds. Therefore, the col agen/silk fibroin scaffold prepared using the three-dimensional printing technology is expected to become the main candidate for the repair of peripheral nerve defects.

Objective To evaluate the hemostasis effect of 915 MHz microwave in the hepatic artery and portal vein injury in vivo dog liver.Methods After manufactured model of the hepatic artery and portal vein injury,915MHz microwave percutaneous coagulation therapy and drug injections were performed under the guidance of contrast-enhanced ultrasound (CEUS),the hemostatic effect,amount of bleeding and histologic findings were compared between the two groups.Results 915 MHz microwave coagulation had better hemostatic effect than drug injection,the amount of bleeding was significantly less than the injection method,and the pathological results showed that the vessel wall necrosis and surrounding tissue coagulation were more obvious than the injection.Conclusions CEUS guided 915 MHz microwave has a significant role in hemostasis,so the 915 MHz microwave percutaneous coagulation therapy of the hepatic artery and portal vein injury in vivo dog liver has important clinical auxiliary significance.

Objective To investigate the feasibility and promising applications of percutaneous transhepatic lymphosonography in detecting sentinel lymph nodes(SLNs).Methods Twenty five rabbits with VX2 tumor were included in this study.0.05 ml SonoVue was injected into the liver parenchyma at 12,3,6,9 points around the VX2 tumor.The situation of contrast-enhanced lymph-vessel emited from injected point and lymph nodes in hepatic portal or around tumor was observed,and then the position of the lymph nodes were detected with the help of the mark on the surface of the portal vein,caput pancreatis,collum vesicae biliaris.Methylene blue (MB) was injected in the same way as above.The injected points were massaged for five minutes,and then executed the experimental rabbits.The lymph nodes enhanced and all the lymph node dyed or not were taked out for recorded and pathologic examination.Results 34 SLNs were conformed by operation and pathological diagnosis in all the rabbits.All SLNs were confirmed pathologically,28 lymph nodes which were checked out by percutaneous transhepatic lymphosonography were all SLNs.In all the 31 lymph nodes which were checked out by MB,25 lymph nodes were SLNs and the rest were the second degree lymph nodes.The detection rate of percutaneous transhepatic lymphosonography (82.4％) and the MB (91.2％) showed no significant difference(P =0.169).There were 6 SLNs enhanced uniformitily in which 2 SLNs encroach by cancer cell and 22 enhanced asymmetrically in which 21 SLNs encroach by cancer cell.The sensitivity,specificity and accuracy of percutaneous transhepatic lymphosonography to detcect the SLNs benign or malignancy was 95.5％ (21/28),66.7％(4/6) and 89.3 ％ (25/28).Conclusions Percutaneous transhepatic lymphosonography is a reliable and noninvasive method to detect and estimate the SLNs of hepatic cancer.

Objective To evaluate the effect of 915 MHz microwave percutaneous coagulation of splenic artery injury in vivo experimental.Methods The manufacture model of the splenic artery injury were made and divided into two groups:group A (peripheral splenic artery injury) and group B (central type of splenic artery injury),915 MHz,2450 MHz microwave coagulation therapy and drug injections were performed under the guidance of ultrasound contrast.The hemostatic effect,operating time,total therapy time,amount of bleeding,amount of fluid infusion and histologic findings were compared.Results The treatment time of 915 MHz microwave[group A(4.65 ± 5.45),group B (9.38 ± 5.62) s] was less than those of 2450 MHz microwave[group A(86.36 ± 6.34) s,group B(127.72 ± 5.34) s] and drug injection [group A(128 ± 4.85)s,group B(182 ± 7.28)s],on the other hand,the amount of bleeding and fluid volume was less than that of rest methods.Conclusions Contrast-enhanced ultrasound guided 915 MHz microwave has significant hemostatic effect compared with the other two methods,915 MHz microwave percutaneous coagulation therapy has important significance to splenic artery injury in clinical.