Objective: To compare the biological characteristics of human induced pluripotent stem cell-derived platelet exosomes (hiPSC-Plt-Exos) with those of conventional apheresis platelet exosomes (Plt-Exos), specifically focusing on their differential abilities to enhance the proliferation and migration of human umbilical cord mesenchymal stem cells (hUC-MSCs). Methods: Exosomes were isolated from hiPSC-derived Plt and apheresis Plt concentrate using size exclusion chromatography. These exosomes were then characterized through nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and Western blotting. Co-culture experiments into hUC-MSCs were conducted with hiPSC-Plt-Exos and apheresis Plt-Exos, respectively. Their effects on the proliferation and migration of hUC-MSCs were assessed via cell proliferation assays and scratch tests. Results: hiPSC-Plt-Exos and apheresis Plt-Exos exhibited comparable particle sizes, morphological features (such as the characteristic cup-shaped structure), and surface markers (including CD9 and HSP70). Notably, hiPSC-Plt-Exos demonstrated a significantly greater ability to enhance the proliferation and migration of hUC-MSCs compared to apheresis Plt-Exos (P<0.05). These differences provide critical comparative data for their application in various clinical contexts. Conclusion: This study establishes a theoretical foundation for developing precise therapeutic strategies based on hiPSC-Plt-Exos. Furthermore, it underscores the necessity of selecting the appropriate type of exosomes according to the specific disease microenvironment to achieve optimal therapeutic outcomes.

This study aimed at conducting retrospective analysis of the clinical symptoms and genetic mutations in 20 children with Gitelman syndrome treated at the Affiliated Children′s Hospital of Nanjing Medical University from August 2015 to November 2022 and also explored the molecular mechanism of the pathogenic high-frequency mutation D486N in the Chinese population.

Humans ; East Asian People ; Surveys and Questionnaires ; Vitiligo/epidemiology*

【Objective】 To analyze the data of clinical blood transfusion quality control supervision in Shanghai, so as to provide reference for the improvement of clinical blood transfusion quality management in hospitals at all levels. 【Methods】 The data of clinical blood transfusion quality control supervision in hospitals at all levels from 2016 to 2021 were retrospectively analyzed to obtain the characteristics and indicators in the quality management. 【Results】 The overall level of clinical blood transfusion quality management in Shanghai steadily improved from 2016 to 2021 (F=3.82, P<0.01), and the management level of different hospitals varied significantly (F=9.00, P<0.01). In 2021, the full compliance rates of housing facilities, instruments and equipment, diagnostic reports and medical record writing among the third-level indicators of clinical blood transfusion quality management in hospitals at all levels were as follows: 86.49%(32/37), 100% (37/37)and 43.24%(16/37) for tertiary comprehensive hospitals; 61.11%(11/18), 88.89%(16/18) and 50.00% (9/18)for tertiary specialized hospitals; 60.87%(14/23), 78.26%(18/23)and 47.83%(11/23) for secondary comprehensive hospitals, ; 60.00%(9/15), 66.67%(10/15), 40.00%(6/15) for secondary specialized hospitals; 52.38%(11/21), 38.10%(8/21), 42.86%(9/21) for private hospitals. 【Conclusion】 The characteristics of clinical blood transfusion quality management in hospitals at all levels in Shanghai differed significantly, with different strengths and weaknesses. Hospitals should improve blood transfusion management in terms of housing facilities, personnel management, system process as well as diagnostic reports and medical record writing, in order to enhance the clinical blood transfusion quality management.

Objective:To investigate the relationship between white blood cells, neutrophil-lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR) and monocyte-lymphocyte ratio(MLR) with patients suffering from first episode depression.Methods:This retrospective study was conducted among inpatients of Hebei General Hospital from January 2021 to December 2021.Ultimately, 193 patients with first-episode depression were enrolled.According to the score of Hamilton depression scale-24 (HAMD-24), the patients were divided into mild-moderate depression group(20≤HAMD-24<35 score, n=98) and severe depression group (HAMD-24 score ≥35, n=95). White blood cells and the counts of each cell subtype were detected and the NLR, MLR and PLR were calculated.SPSS 25.0 statistical software was used to analyze the data.Mann-Whitney U test was used to compare differences in the two groups and Binary Logistic regression analyses were performed to recognize the predictive factors of the severity of first episode depression. Results:(1) The white blood cells and NLR in the severe depression group were significantly higher than those in the mild-moderate depression group (white blood cells: 5.77(2.05)×10 9/L vs 5.11(1.31)×10 9/L; NLR: 1.86 (1.04) vs 1.57(0.55), P<0.05). There were no significant differences in PLR and MLR between the two groups ( P>0.05). (2)Multiple regression analysis of NLR, white blood cells and HAMD-24 score showed that there were significant differences in the effect of different white blood cells and NLR levels on HAMD-24 score( B=1.398, P=0.003; B=2.624, P=0.001). (3)Binary Logistic regression revealed that white blood cell count and NLR were risk factors for the severity of depression patients( OR were 1.612 and 2.336, respectively, P<0.05). Conclusion:The results suggest that white blood cells and NLR may be relate with the severity of first episode depression.

The study utilized a cross-sectional design. Data was retrieved from the American Academy of Family Physicians fellowship training directory, including program names, areas of focus, program length, and program descriptions. The collected data was categorized and analyzed based on areas of focus and training duration. The program descriptions were also analyzed qualitatively using Nvivo12 software. A total of 532 programs were included in the study:295 programs (55.5%) were ACGME-certified, while 237 programs (44.5%) were not. The majority of programs, 468 (87.9%), were clinically oriented, while 64 programs (12.1%) were non-clinical. Among ACGME-certified programs, the largest number of programs were in sports medicine (121 programs), followed by geriatrics (52 programs). Among non-certified programs, the largest number of programs was in obstetrics (66 programs), accounting for 27.8% of all non-certified programs. Qualitative research found that fellowship programs were diverse, reflecting the societal demands of healthcare service. Moreover, a significant emphasis was placed on empowering teaching and research abilities.The family medicine fellowship programs in the United States cover a wide range of disciplines and meet both the professional interests of doctors and the needs of patients. As China continues to implement its tiered medical system, it can learn from the experience of the United States and develop general practice subspecialty training programs, thereby improving the service capacity of general practitioners and improve the quality of healthcare.

Objective:To evaluate the effect of acupuncture with invigorating viscera and purging fu, replenishing qi and nourishing yin for the T2DM patients with qi and yin deficiency syndrome.Methods:A total of 59 patients who met the inclusion criteria from January 1, 2019 to December 31, 2020 in the Endocrinology Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine were divided into the acupuncture group with 30 cases and a control group with 29 cases, according to the random number table method. The control group received conventional hypoglycemic treatment. And the acupuncture group was treated with acupuncture on the basis of the control group treatment. Both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment, respectively. Serum IL-6 was measured by ELISA, serum CRP by immunoturbidimetry, and serum fasting blood glucose (FPG), 2 hPG, HbAlc, TC, TG, HDL-C, LDL-C levels by spectrophotometry. The BMI, clinical effect rates were calculated.Results:The total effective rate was 96.7% (29/30) in acupuncture group and 75.9% (22/29) in control group, and the difference was statistically significant ( χ2=5.96, P<0.01). After treatment, the scores of fatigue, dryness of mouth and pharynx, spontaneous sweating and night sweating, shortness of breath and lazy speech in acupuncture group were significantly lower than those in the control group ( t values were 6.02, 4.31, 4.34, 3.63, respectively, all Ps<0.01). The serum CRP level in acupuncture group was significantly lower than that of the control group at 21, 48 d after treatment ( t values were -4.36, -3.75, respectively, all Ps<0.01), and IL-6 level was significantly lower than that of the control group at 14, 21, 28 d after treatment ( t values were -2.92, -5.35, -8.71, respectively, all Ps<0.01). After treatment, the serum TC [(4.62±0.68) mmol/L vs. (5.56±0.72) mmol/L, t=5.16], TG [(1.48±0.42) mmol/L vs. (2.12±0.89) mmol/L, t=3.55], LDL-C [(2.48±0.84) mmol/L vs.(3.02±0.95) mmol/L, t=2.32] in the acupuncture group were significantly lower than those in the control group ( P<0.05), HDL-C [(1.39±0.27) mmol/L vs. (1.26±0.22) mmol/L, t=-2.02] in the acupuncture group was significantly higher than that of the control group ( P<0.05). The serum FPG level at 21 d [(6.12±0.67) mmol/L vs. (6.57±0.61) mmol/L, t=-4.96], 28 d [(5.78±0.52) mmol/L vs. (6.49±0.58) mmol/L, t=-2.70] in acupuncture group were significantly lower than those in the control group ( P<0.01). The 2h PG level at 14 d after treatment [(10.23±1.06) mmol/L vs. (11.76±1.34) mmol/L, t=-4.87], 21 d [(9.05±0.98) mmol/L vs. (10.53±1.24) mmol/L, t=-5.10], 28 d [(7.45±0.69) mmol/L vs. (9.31±0.78) mmol/L, t=-9.71] in the acupuncture group were significantly lower than those in the control group ( P<0.01), and HbA1c level were decreased 14 d [(7.93±0.86)% vs. (8.52±0.97)%, t=-2.47], 21 d [(7.63±0.85)% vs. (8.15±0.92)%, t=-2.26], 28 d [(6.47±0.51)% vs. (7.51±0.62)%, t=-7.05] significantly lower than those in the control group ( P<0.01), BMI [(22.13±1.57) kg/m 2vs. (24.16±1.82) kg/m 2, t=-4.59] 28 d after treatment was significantly lower than that of the control group ( P<0.01). Conclusion:Acupuncture therapy of nourishing viscera and purging fu, nourishing qi and nourishing yin can regulate the disorder of glucose and lipid metabolism in patients with T2DM and syndrome of qi and yin deficiency.

Objective:To investigate the protective effect of spironolactone on myocardial injury in septic rats and to provide a novel measure for the diagnosis and treatment of sepsis myocardial injury.Methods:Totally 120 male Sprague-Dawley rats were randomly divided into the sham group, cecal ligation and perforation group (CLP group), and spironolactone group. The sham group was only exposed to the cecum by laparotomy. CLP was performed to induce sepsis in the CLP group and spironolactone group. The cecal perforation was ligated and the contents of the intestine were squeezed out. The spironolactone group was administered spironolactone by gavage with a dose of 20 mg/(kg·d) per rat. The sham and CLP groups were given the same dose of saline. The experiment period was 7 days. After the rats were sacrificed, blood was collected and myocardial tissue was removed. The changes of serum TNF-α, IL-6, cTnI and CK-MB levels were detected by ELISA. Cardiac structure and function were detected by echocardiography. The relative apoptosis of left ventricular myocytes in rats was detected by TUNEL staining. The levels of TNF-α, IL-6, Bcl2-associated X protein (Bax), B cell lymphoma 2 (Bcl2) and Caspase 3 in the left ventricle tissue were detected by immunohistochemistry.Results:Compared with the CLP group, the levels of TNF-α and IL-6 in serum and left ventricular tissue were significantly decreased ( P<0.05) and serum levels of cTnI and CK-MB were significantly down-regulated ( P<0.05). Heart rate (HR) and left ventricular diastolic dimension (LVDd) were significantly reduced ( P<0.05), and ejection fraction (EF) and left ventricular fractional shortening (FS) increased significantly ( P<0.05). Ventricular muscle apoptosis was improved ( P<0.05),the level of apoptosis-related protein Bcl2 was increased and the Bax and Caspase3 expression were significantly down-regulated ( P<0.05).The expression of Bcl2 protein, EF and FS in the CLP group were significantly lower than those in the sham group( P<0.05), and the remaining indexes were significantly higher than those in the sham group( P<0.05). Conclusions:Spironolactone can treat sepsis-induced myocardial injury by reducing inflammatory response caused by sepsis, reducing myocardial damage, alleviating ventricular muscle apoptosis, and improving ventricular structure and function.

OBJECTIVE: To explore the mechanism of Flos Puerariae and Semen Hoveniae in treatment of alcoholic liver injury (ALI) based on network pharmacology and molecular docking. METHODS: The information of chemical constituents and targets of Flos Puerariae and Semen Hoveniae was collected from TCMSP and Swiss databases, and the threshold values of oral bioavailability (OB) ≥ 30%, drug likeness (DL) ≥0.18 were used to screen the potential active compounds. The GeneCard and DrugBank databases were used to obtain the targets corresponding to ALI. The common targets were queried using Venn Diagram, and the network of PPI and Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed through DAVID and Reactome database. Autodock Vina software was used for molecular docking of potential ingredients and key targets. RESULTS: A total of 21 potential active compounds and 431 therapeutic targets were gathered in Flos Puerariae and Semen Hoveniae, which involved 273 biological functions, 90 KEGG pathways and 362 Reactome pathways. The GO functions involved protein binding, ATP binding, etc.; the KEGG pathways mainly included PI3K-Akt signaling pathway and TNF signaling pathway; the Reactome pathways contained signal transduction and immune system, etc. The results of molecular docking showed that 21 potential active ingredients had good affinity with the core targets Akt1, TP53 and IL-6. CONCLUSIONS The network pharmacology and molecular docking analysis demonstrate the synergetic effect of Flos Puerariae and Semen Hoveniae with multi-compounds, multi-targets and multi-pathways in the treatment of ALI; and also predict the possible medicinal substance, key targets and pathways, which provides clues for the new drug development and mechanism research.
Animals ; Computer Simulation ; Drugs, Chinese Herbal/therapeutic use* ; Lepidoptera/chemistry* ; Liver/drug effects* ; Liver Diseases, Alcoholic/therapy* ; Molecular Docking Simulation ; Phosphatidylinositol 3-Kinases/metabolism* ; Plant Extracts/therapeutic use* ; Rhamnaceae/chemistry* ; Signal Transduction/drug effects*

Objective:To analyze the metabolism of blood glucose and lipid in breast cancer patients after the first chemotherapy.Methods:Breast cancer patients who received chemotherapy for the first time from December 2016 to January 2020 were collected in our hospital, and their blood glucose and lipid levels were monitored. Patients were grouped according to different treatment plans. Non-parametric rank sum test was used for statistical analysis on SPSS software.Results:There were 1 356 female breast cancer patients were enrolled, blood glucose and lipid levels were compared before and after chemotherapy. Our results showed that baseline medium blood glucose was 5.2 mmol/L, lower than 5.3 mmol/L after chemotherapy ( P<0.05). The baseline triglyceride (TG) was 1.2 mmol/L, lower than 1.6 mmol/L after chemotherapy ( P<0.05). The baseline small dense low-density lipoprotein (sdLDL) was 0.7 mmol/L, lower than 0.8 mmol/L after chemotherapy ( P<0.05). The baseline high density lipoprotein (HDL) was 1.3 mmol/L, higher than 1.2 mmol/L after chemotherapy ( P<0.05). Patients′ menstrual status and body mass index were related with blood glucose, TG, LDL and sdLDL (all P< 0.05). Conclusions:Abnormal metabolism of blood glucose and lipid are observed in breast cancer patients after the first chemotherapy. More awareness of cardiovascular disease in breast cancer patients might ensure their overall clinical benefits.