Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

Cholangiocarcinoma originates from bile duct epithelial cells. It has an insidious onset, a high degree of malignancy, a poor prognosis and a high recurrence rate. Exosomes are nanoscale vesicles with a bilayer membrane structure, containing abundant biomolecules such as DNA, RNA, proteins and lipids. Exosomes are important carriers for the exchange of substances and information between cells and are involved in a variety of pathophysiological processes. In addition, exosomes have great potential in the diagnosis and treatment of various diseases. This article reviews the role of exosomes in the occurrence and development of cholangiocarcinoma and their potential value in the diagnosis and treatment of cholangiocarcinoma.

Exosomes are extracellular vesicles that regulate various signaling pathways in the body by mediating the release of proteins, nucleic acids and lipids, thus playing an important role in pathophysiological processes such as inflammation, tumor, immunity and nervous system. More and more studies have shown that exosomal non-coding RNA (ncRNA) plays a crucial role in pancreatic diseases. This article reviews the role of exosome ncRNA in the occurrence, diagnosis and treatment of pancreatic diseases such as acute pancreatitis and pancreatic cancer, in order to provide a reference for clinical practice.

Objective To investigate toe-brachial index ( TBI) in the diagnosis of peripheral artery disease ( PAD) and its risk factors in the patients with type 2 diabetes.Methods TBI was examined in the 238 patients with type 2 diabetes.The patients were divided into the group with low TBI ( TBI≤0.7 ) and the group with normal ABI ( TBI>0.7 ) .The two groups were compared for clinical parameters.Results Thirty two patients (13.4%)with abnormal ABI (TBI≤0.7) showed older age [(63.8 ±9.9) yrs vs (54.9 ±10.8) yrs, P =0.000] , lower diastolic blood pressure [(70.5 ±6.9) mmHg vs (74.9 ±9.1) mmHg, P =0.003], more frequency of hypertension (56.3%vs 38.3%, P =0.043), coronary artery heart disease (28.7%vs 10.7%, P =0.020) and cere-bral vascular disease (15.6%vs 4.4%, P =0.025).Step-wise analysis screened that age and diastolic blood pressure were the inde-pendent risk factors for TBI .Conclusions Aging and hypertension were the risk factors in the patients with abnormal TBI in type 2 di-abetes.TBI was an easy and economical method for diagnosing PAD in patients with type 2 diabetes.

OBJECTIVETo investigate the clinical and pathologic characteristics of anti-glomerular basement membrane(GBM) disease with normal renal function.

METHODSThe clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed.

RESULTSSix (17.1%) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2+-3+ along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerular capillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin[(77.97±20.62 vs.(99.67±19.80 g/L P=0.024], lower titers of anti-GBM antibody[(224.34 ± 145.79 vs.(80.23 ± 85.73 EU/ml P=0.027], and lower ratio of glomeruli with crescents[(0.58±0.29 vs.(0.17±0.27 ,P=0.005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria.

CONCLUSIONAnti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis.

Adult ; Anti-Glomerular Basement Membrane Disease ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

ObjectiveTo explore the possible mechanisms of Wuling Jun Power by the DNA microarray technique.MethodsAn experimental depression model was established by exposing the mouse to a chronic mild stress procedure. The total RNA was extracted reverse-transcripted and hybrided to the mouse 1-2 cDNA microarray (Clontech). The difference of expression profiles between control model, Wuling Jun powder and fluoxetine-treated groups were analyzed by the Image 2-1 Software.Results130 genes were significantly altered in stress group compared with the control groups. Among them, 116 genes were up-regulated and 14 genes were down-regulated. Meanwhile, 85 genes significantly changed in the Wuling Jun powder treated group with 34 genes up-regulated and 51 genes down-regulated compared with the model groups. For the Fluoxetine-treated group, 133 genes significantly changed with 35 genes up-regulated and 98 genes down-regulated compared with the model groups. These genes were associated with many aspects of life including receptor activity, protein kinases, inflammatory factors, transferrin, neurogenesis and so on.ConclusionMultiple genes were affected by the stress exposure. Altered changes of some genes were normalized by Wuling Jun powder and Fluoxetine treatment. In general, the mechanisms of Wuling Jun powder and Fluoxetine are similar, but also with minor difference.

Mycoplasmas, the smallest free-living, self-replicating bacteria with diameters of 200 to 800 nm, have been reported to be associated with human diseases. It is well known that the mycoplasma lipoprotein/peptide is able to modulate the host immune system, whose N-terminal structure is an important factor in inducing immunity and distinguishing Toll-like receptors (TLRs). However, there is still no clear elucidation about the pathogenic mechanism of mycoplasma lipoprotein/peptide and the signaling pathway. Some researchers have focused on understanding the structures of these proteins and the relationships between their structure and biological function. This review provides an update on the research in this field.
Lipoproteins ; chemistry ; metabolism ; Models, Biological ; Mycoplasma ; chemistry ; metabolism ; Toll-Like Receptors ; chemistry ; metabolism

ObjectiveTo characterize the neural progenitor cell in the human amnion mesenchyme and epithelial layer with specific mark proteins of neural stem cell.MethodsExpressions of specific mark proteins of neural stem cell including nestin, glial fibrillary acidic protein (GFAP), musashi-1, vimentin and PSA-NCAM in human amnion tissue and cultured amniotic cells were determined by immunohistochemistry and immunofluorescence staining.ResultsExpressions of pluripotent neural stem cell specific makers (nestin, musashi-1, vimentin and PSA-NCAM) were detected in the human amnion mesenchyme and epithelial layer. In addition, cultured amniotic cells were expressed several neural stem cell specific markers including nestin, GFAP and PSA-NCAM. Nestin+ and GFAP+ double positive cells were identified in the human amnion tissue and cultured amniotic cells by immunohistochemistry and immunofluorescence staining.ConclusionSpecific mark proteins of neural stem cell are expressed in human amnion tissue and cultured amniotic cells.

ObjectiveTo study the influence of Jiuqiang Naoliqing (JNQ) on the expression of calcitonin gene related peptide(CGRP)and Synapsin Ⅰ in brain of the spontaneous hypertension rats (SHR). MethodsThe rats were randomly divided into 4 groups: Wistar group, SHR group, lower dose of JNQ treated SHR group and higher dose of JNQ treated SHR group. The expression of CGRP and Synapsin Ⅰ in the dentate gyrus, CA1 subfield of hippocampus and cortex were determined by immunohistochemistry after treatment for 3 weeks. ResultsCompared with the Wistar group, the expression of CGRP and Synapsin Ⅰ in the dentate gyrus, CA1 subfield of hippocampus and cortex of SHR group significantly decreased. The treatment with lower dose of JNQ significantly enhanced the expression of CGRP in cortex(P<0.05 vs SHR).The treatment with higher dose of JNQ significantly enhanced not only the expression of CGRP in the dentate gyrus, CA1 subfield of hippocampus and cortex, but also that of Synapsin Ⅰ in the CA1 subfield of hippocampus selectively in comparison with SHR group. ConclusionJNQ may improve the micro circulation in brain by up regulating the expression of CGRP and enhance the modulating function of central nervous system by up regulating the expression of Synapsin Ⅰ in spontaneous hypertension rats.