1.Effect and mechanisms of highly active umbilical cord mesenchymal stem cells on aging spleen in elderly tree shrews
Li YE ; Chuan TIAN ; Xiaojuan ZHAO ; Mengdie CHEN ; Qianqian YE ; Qiang LI ; Zhuyin LIAO ; Ye LI ; Xiangqing ZHU ; Guangping RUAN ; Zhixu HE ; Liping SHU ; Xinghua PAN
Chinese Journal of Tissue Engineering Research 2025;29(19):4000-4010
BACKGROUND:Spleen has the functions of blood storage,hematopoiesis,and immunity.With the increase of age,the structural degeneration and functional decline of spleen lead to the impairment of immune system function,thus accelerating the aging process of the body.The treatment of spleen aging in tree shrews with highly active umbilical cord mesenchymal stem cells has not been reported. OBJECTIVE:To explore the intervention effect and mechanism of highly active umbilical cord mesenchymal stem cells on spleen aging in tree shrews. METHODS:Highly active umbilical cord mesenchymal stem cells were isolated,cultured,and obtained from the umbilical cord tissue of newborn tree shrews by caesarean section.The differentiation abilities of adipogenesis,osteogenesis,and chondrogenesis were detected by three-line differentiation kit.Cell cycle and surface markers were detected by flow cytometry.The second generation of highly active umbilical cord mesenchymal stem cells were transfected with Genechem Green Fluorescent Protein with infection complex values of 100,120,140,160,180,and 200,respectively,to screen the best transfection conditions.After transfection,the fourth generation of highly active umbilical cord mesenchymal stem cells was injected into the tail vein of tree shrews in the elderly treatment group.The young control group and the aged model group were not given special treatment.After 4 months of treatment,the spleen tissue was taken and the structure of the spleen was observed by hematoxylin-eosin staining.β-Galactosidase staining was used to detect the activity of aging-related galactosidase.Immunohistochemical staining was used to detect the expression levels of p21 and p53 proteins.Ki67 and PCNA immunofluorescence staining was used to detect cell proliferation activity.Immunofluorescence staining was used to detect the expression levels of spleen autophagy protein molecules Beclin 1 and APG5L/ATG5.Reactive oxygen species fluorescence staining was used to detect the content of reactive oxygen species in spleen tissue.CD3 immunofluorescence staining was used to detect the change of the proportion of total T lymphocytes.The secretion levels of interleukin 1β and transforming growth factor β1 in spleen were detected by enzyme linked immunosorbent assay.The distribution of highly active umbilical cord mesenchymal stem cells labeled with green fluorescent protein in spleen tissue was observed by DAPI double staining of nucleus. RESULTS AND CONCLUSION:(1)Highly active umbilical cord mesenchymal stem cells grew in a short spindle shape with fish-like growth,with a large proportion of G0/G1 phase,and had the potential to differentiate into adipogenesis,osteogenesis,and chondrogenesis.(2)Multiplicity of infection=140 and transfection for 72 hours were the best conditions for labeling tree shrews highly active umbilical cord mesenchymal stem cells with Genechem Green Fluorescent Protein.(3)Compared with the aged model group,in the aged treatment group,the spleen tissue cells of tree shrews were arranged closely,and the area of white pulp was increased(P<0.01);the boundary between red pulp and white pulp was clear;the proportion of germinal centers did not show statistically significant difference(P>0.05).The activity level of galactosidase related to spleen tissue aging was decreased(P<0.001),and the expression levels of aging protein molecules p21 and p53 were down-regulated(P<0.001).The expression levels of proliferation-related molecules Ki67 and PCNA were up-regulated(P<0.001,P<0.05);expression levels of autophagy-related molecules Beclin 1 and APG5L/ATG5 were up-regulated(P<0.001),and the content of reactive oxygen species decreased(P<0.001),and the proportion of CD3+T cells increased(P<0.05).The secretion level of interleukin 1β in the aging-related secretion phenotype decreased(P<0.001);no significant difference was found in transforming growth factor β1 level(P>0.05).Compared with the young control group,the above indexes were significantly different in the elderly treatment group(P<0.05).(4)Green fluorescent cells labeled with green fluorescent protein were observed in spleen tissue of tree shrews the elderly treatment group by frozen tissue section observation.The results show that intravenous infusion of highly active umbilical cord mesenchymal stem cells can migrate to spleen tissue,inhibit the production of reactive oxygen species,down-regulate the expression of aging-related proteins,induce autophagy,promote cell proliferation,reduce chronic inflammation,and then improve the structure and function of spleen tissue.
2.Calcium phosphate combined with recombinant human bone morphogenetic protein-2 in repair and reconstruction of tibial infectious bone defects
Xufeng JIA ; Miao LONG ; Guangping HUANG ; Qing ZHONG ; Zhaoyao ZHANG ; Yuxin QI ; Peng TIAN ; Ping LI ; Yuchi CHEN
Chinese Journal of Tissue Engineering Research 2024;28(17):2625-2630
BACKGROUND:Although the clinical application of Masquelet technology has achieved extensive success,the research on optimizing all aspects of Masquelet technology is still being carried out.The focus of doctors is to speed up bone healing and shorten bone healing time after bone grafting. OBJECTIVE:To observe the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 in repairing tibial infectious bone defects. METHODS:Thirty-one patients with tibial infectious bone defects were selected from The People's Hospital of Jianyang City from June 2017 to June 2022.They were treated with the Masquelet membrane induction technique.During the second stage of operation,they were divided into a control group(n=15)and a study group(n=16)according to different bone graft materials.Patients in the control group were implanted with autologous bone/allogeneic bone particles,and those in the study group were implanted with calcium phosphate combined with recombinant human bone morphogenetic protein-2/autologous bone particles.Six months after the second stage operation,peripheral blood inflammatory indexes such as white blood cell count,C-reactive protein,and erythrocyte sedimentation rate were detected.Imaging bone healing time,bone healing X-ray score,bone defect healing classification,and adjacent joint function were recorded.The presence of nail track infection,implant absorption,pain,and infection in the bone extraction area were observed. RESULTS AND CONCLUSION:(1)White blood cell count,erythrocyte sedimentation rate,and C-reactive protein levels of the two groups 6 months after the second stage operation were significantly lower than those before the first stage operation(P<0.05).There was no significant difference in each index between the two groups(P>0.05).(2)Bone healing time in the study group was shorter than that in the control group(P<0.05).(3)The Samantha X-ray score of the study group 6 months after the second stage operation was higher than that of the control group(P<0.05).The excellent and good rate of bone defect healing and adjacent joint function of the study group was higher than that of the control group(P<0.05).There was no significant difference in the recurrence rate and complication rate between the two groups(P>0.05).(4)These findings indicate that the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 during the second stage operation of the Masquelet membrane induction technique in the treatment of tibial infectious bone defect is good and safe.
3.Preparation and characterization of curcumin nanomicelles and evaluation of in vitro hepatoprotective activity against alcohol liver disease
Luhui LI ; Guangping GENG ; Lei XU ; Zhikun ZHANG ; Xiaohui PU
China Pharmacy 2024;35(10):1203-1208
OBJECTIVE To prepare and characterize curcumin nanomicelles (hereinafter referred to as Cur/mPEG-PBLA micelles), and to evaluate the in vitro hepatoprotective activity against alcohol liver disease (ALD). METHODS Cur/mPEG-PBLA micelles were prepared with the dialysis method using methoxy-poly(ethylene glycol)-poly(β-benzyl-L-aspartate) (mPEG-PLGA) as the carrier. The appearance and microscopic morphology of Cur/mPEG-PBLA micelles were observed, and particle size, polydispersity index, Zeta potential, encapsulation efficiency and drug loading content were all detected. The in vitro release, pH stability, thermal stability, dilution stability, storage stability, plasma stability tests, and hemolysis experiments were all performed. The cell model of ALD was established with anhydrous ethanol intervention using human liver cancer cells and normal liver cells as objects, Cur reference solution as reference, to evaluate in vitro preventive and ameliorative effects of Cur/mPEG- PBLA micelles on ALD. RESULTS The prepared Cur/mPEG-PBLA micelles exhibited a pale-yellow milky light, with a spherical shape and uniform distribution. The average particle size was about 140 nm, and the polydispersity index was less than 0.3. Zeta potential was (-8.15±0.05) mV; the encapsulation efficiency was (73.26±3.16)%, and the drug loading content was (4.87± 0.42)%. The cumulative release of Cur reference substance was close to 80% at 10 h; the cumulative release of Cur/mPEG-PBLA micelles at 8 h was 28.94% and only 48.25% at 48 h. pH stability and thermal stability of Cur/mPEG-PBLA micelles were better than those of Cur reference solution; Cur/mPEG-PBLA micelles showed good dilution stability, storage stability and plasma stability, and would not cause hemolysis. Cur reference solution and Cur/mPEG-PBLA micelles had varying degrees of in vitro preventive and ameliorative effects on ALD in two types of cells; after 48 h of application, the above effects of Cur/mPEG-PBLA micelles were significantly better than those of Cur reference solution at the same mass concentration (P<0.05). CONCLUSIONS Cur/mPEG-PBLA micelles can improve pH stability and thermal stability of Cur, delayits degradation rate, and have better in vitro hepatoprotective activity against ALD.
4.Study on Mechanism of Xiaojin Pills in Treatment of Breast Cancer Based on Network Pharmacology and Experimental Verification
Delian NIU ; Dongyin LIAN ; Qin HU ; Lihua SUN ; Ying CHEN ; Hongping HOU ; Guangping ZHANG ; Jianrong LI ; Zuguang YE ; Bo PENG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(2):41-49
Objective To explore the molecular mechanism of Xiaojin Pills in the treatment of breast cancer using an integrated network pharmacology and experimental verification.Methods The chemical components and potential targets of Xiaojin Pills were obtained from TCMSP,TCM-ID,ETCM and SwissTargetPrediction databases.Breast cancer related targets were collected from GeneCards,OMIM and KEGG databases.The overlapped targets were imported into STRING database to analysis a protein-protein interaction(PPI).The key targets of PPI networks were screened based on node topology parameter values through Cytoscape 3.8.0.DAVID database was used to analyze the GO and KEGG pathway enrichment to build drug-chemical components-key targets-signaling pathway network.The breast cancer cell lines MDA-MB-231 and SK-BR-3 were used to study the effects of Xiaojin Pills extract on cell apoptosis,migration and invasion,and to verify the key pathway obtained by enrichment analysis.Results Totally 181 chemical components in Xiaojin Pills were obtained,including quercetin,myricetin,pinocembrin and β-sitosterol.615 potential targets were identified for the anti-breast cancer effects of Xiaojin Pills.After overlapping,170 key targets against breast cancer were identified based on the topological analysis,which included SRC,ERK1/2,AKT1,EGFR,etc.KEGG analysis enriched pathways including pathways in cancer,MAPK signaling pathway,endocrine resistance,PI3K-AKT signaling pathway,EGFR tyrosine kinase inhibitor resistance,apoptosis,and HIF-1 signaling pathway,which may play important roles in the therapeutic effects of Xiaojin Pills against breast cancer.GO enrichment was involved in protein phosphorylation,inflammatory response,negative regulation of apoptosis,and positive regulation of ERK1 and ERK2 cascades.Cell experiments showed that Xiaojin Pills further induced mitochondria-dependent apoptosis by inhibiting the activation of MAPK and PI3K-AKT pathways.At the same time,the expressions of ZO-1 and β-catenin increased,and the epithelial-mesenchymal transformation process was reversed to inhibit the metastasis of breast cancer cells.Conclusion The key targets and signaling pathways of Xiaojin Pills in the treatment of breast cancer are studied through network pharmacology combined with in vitro experiments,which provided a basis for further study of its pharmacodynamic material basis,mechanism of action and clinical application.
5.Genome-wide molecular characterization of a rare group A rotavirus equine-like DS-1-like G3P 8 in China
Guangping XIONG ; Yuhang WEI ; Rui PENG ; Jiaxin FAN ; Xiaoping TANG ; Zhimiao HUANG ; Mengjie DONG ; Ruyi CHE ; Dandi LI
Chinese Journal of Experimental and Clinical Virology 2024;38(1):29-36
Objective:A genome-wide molecular characterization of FJ21351116, a strain of G3P[8]-E2 2021 collected in Fujian, China, was performed.Methods:Whole genome sequencing of FJ21351116 was performed using a high-sensitivity group A rotavirus whole genome sequencing method. Genomic characteriza-tion of the virus was assessed by nucleic acid sequence analysis using MEGA 11.0, Geneious 9.0.2 and DNASTAR software. Neutralization epitopes of VP7 and VP4 (VP8*) were analyzed using BioEdit v. 7.0.9.0 and PyMOL v. 2.5.2.Results:In this study, FJ21351116 was shown to be a G3-P[8]-I2-R2-C2-M2-A2-N2-T2-E2-H2 genotype, and the result of phylogenetic tree showed that the VP7, VP4, VP3, and NSP2-NSP5 genes of the FJ21351116 strain were related to the equine-like DS-1-like G3P[8] genes that have been detected in Japan in recent years. VP6, VP1, VP2, and NSP1 genes are closely related to G2P[4] in most countries, especially in Singapore, suggesting that this strain was formed by genetic reassortment during the evolution of equine-like G3P[8] and G2P[4]. Evolutionary relationships between the VP7/VP4 genes of FJ21351116 and Rotarix and RotaTeq vaccines suggest that the multiple mutations in both VP7 and VP4 (VP8*) neutralizing antigenic epitopes and vaccine amino acid sites. It is hypothesized that the Rotarix and RotaTeq vaccines may be less effective against equine DS-1-like G3P[8] RVA, and the sequence differences with Rotarix are higher than those with RotaTeq.Conclusions:In this study, we found a rare case of DS-1-like G3P [8] RVA strain in China. Currently, horse-like DS-1-like G3P [8] RVA is relatively rare in China and may be poorly protected by vaccine strains, emphasizing the importance of continuous monitoring of RVA strains and the development of efficient and full-coverage RVA vaccines.
6.Mechanism of Nephrotoxicity Induced by Ecliptasaponin A Based on Computational Toxicology
Han LI ; Ling SONG ; Yunhang GAO ; Tengfei CHEN ; Suzhen MU ; Weiya CHEN ; Guangping ZHANG ; Wang HUO
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):72-80
ObjectiveTo predict the potential nephrotoxic components in traditional Chinese medicine health food products based on the Traditional Chinese Medicine Toxicity Alert System and Basic Toxicology Database (TCMTAS-BTD), screen and validate the predicted components by cell and animal experiments, and decipher the mechanism of nephrotoxicity by network pharmacology. MethodTCMTAS-BTD was utilized to predict the toxicity of 3 540 compounds found in the catalogue of traditional Chinese health food ingredients. In the cell experiment, the top 5 compounds with high toxicity probability were screened by measurement of cell proliferation and viability (CCK-8) and high-content screening. ICR mice were randomized into a control group, a low-dose (2.91 mg·kg-1·d-1) ecliptasaponin A, and a high-dose (29.1 mg·kg-1·d-1) ecliptasaponin A group, with 10 mice in each group, and treated continuously for 28 days. During the experiment, the general conditions of the rats were observed, and the kidney index was calculated. The levels of serum creatinine (SCr) and blood urea nitrogen (BUN) in the serum as well as the content of malondialdehyde (MDA) and superoxide dismutase (SOD) in the renal tissue were measured. The pathological changes of the kidney were observed. Network pharmacology was employed to predict the potential pathways of nephrotoxicity. Finally, the pathway-associated proteins were validated by Western blot. ResultThe top 5 compounds with high probability of nephrotoxicity were ecliptasaponin A, chrysophanol, rutaecarpine, tanshinoneⅠ, and geniposidic acid. In the cell experiment, CCK-8 results showed that 10 μmol·L-1 ecliptasaponin A, 60 μmol·L-1 chrysophanol, 40 μmol·L-1 rutaecarpine, and 20 μmol·L-1 tanshinone I altered the viability of HK-2 cells. High-content analysis showed that 10 μmol·L-1 ecliptasaponin A, chrysophanol, rutaecarpine, and tanshinone Ⅰ reduced the cell number (P<0.05, P<0.01). The animal experiment showed that the mice in the high-dose ecliptasaponin A group presented slow movement, slow weight gain (P<0.01), increased kidney index (P<0.01), elevated SCr, BUN, and MDA levels (P<0.01), and lowered SOD level (P<0.01). Mild histopathological changes were observed in the high-dose ecliptasaponin A group. The network pharmacology results showed that the key targets of nephrotoxicity induced by ecliptasaponin A were mainly enriched in the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway, prostatic cancer and lipid and atherosclerosis pathways. Western blot results verified that high dose of ecliptasaponin A raised the phosphorylation levels of PI3K and Akt (P<0.01). ConclusionOn day 28 of administration, 29.1 mg·kg-1 ecliptasaponin A was found to induce renal injury in rats. The mechanism may be related with the PI3K/Akt signaling pathway, which implied that excessive and prolonged usage of Ecliptae Herba may increase the incidence of adverse drug reactions.
7.Ganmai Dazao Tang Treats Breast Cancer-related Depression via MAPK/NF-κB Signling Pathway
Jieyuan LIU ; Yanli WANG ; Delian NIU ; Mengting LI ; Lijinchuan DONG ; Xinmin LIU ; Hongping HOU ; Guangping ZHANG ; Ying CHEN ; Bo PENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):170-178
ObjectiveTo investigate the therapeutic effect of Ganmai Dazao Tang on breast cancer-related depression and explore the mechanism of the decoction in regulating immune inflammation and neurotransmitters via the mitogen-activated protein kinase (MAPK)/nuclear factor-κB (NF-κB) pathway. MethodBALB/c mice were randomized into control, model, fluoxetine (5 mg·kg-1·d-1), and low- and high-dose (crude drug 20 and 40 g·kg-1, respectively) Ganmai Dazao Tang groups (n=10). The mouse model of 4T1 orthotopic transplantation-induced breast cancer-related depression-like behavior was established. The depression-like behavior of mice was assessed by the tail suspension test and the forced swimming test. RT-qPCR was employed to determine the mRNA levels of interleukin (IL)-17A, forkhead box P3 (FoxP3),IL-1β, IL-6, and tumor necrosis factor-α (TNF-α) in the cerebral cortex. Flow cytometry was employed to measure the proportions of immune cell subsets in the spleen and thymus. HPLC-MS/MS was employed to measure neurotransmitter levels in the cerebral cortex. Western blotting was employed to detect the activation of the MAPK/NF-κB pathway. ResultCompared with the model group, administration of Ganmai Dazao Tang at a dose of 40 g crude drug·kg-1 continuously for 4 weeks shortened the immobility time of modeled mice in the tail suspension and forced swimming tests (P<0.05), down-regulated the mRNA levels of IL-1β, IL-17A, and TNF-α (P<0.05), increased the proportions of T cells, CD4+ T cells, B cells, helper T 17 (Th17) cells, and regulatory T (Treg) cells, and reduced the proportion of CD8+ T cells (P<0.05). Furthermore, it lowered the levels of 5-hydroxyindoleacetic acid (5-HIAA) and kynurenine (Kyn), decreased the kynurenine/tryptophan (Kyn/Trp) ratio (P<0.05), increased the content of 5-hydroxytryptamine (5-HT), and down-regulated the protein levels of phosphorylated extracellular signal-regulated kinase (p-ERK), phosphorylated p38 MAPK, and phosphorylated nuclear factor-κB p65 (P<0.05). ConclusionGanmai Dazao Tang can down-regulate the expression of inflammatory cytokines such as IL-1β, IL-17A, and TNF-α, restore 5-HT metabolism and Kyn/Trp balance, increase the 5-HT content, and reduce the activation of p38 MAPK, ERK, and the MAPK-mediated NF-κB signaling pathway to reduce neuroinflammation in the treatment of cancer-related depression.
8.Construction and Experimental Validation of Chemically-induced Cough Model Based on Cough Waveforms
Yunhang GAO ; Ling JIA ; Han LI ; Ling SONG ; Cong GUO ; Tengfei CHEN ; Hongping HOU ; Weiya CHEN ; Guangping ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):230-236
ObjectiveTo construct a cough model induced by chemical stimuli by whole-body plethysmography (WBP) for counting coughs based on cough waveforms, and use this model to explore the antitussive effect of GK-A. MethodDifferent chemical stimuli were used to induce coughs in mice or guinea pigs. Respiratory waveforms were monitored by WBP, and the recognizable and typical cough waveforms were selected for cough counting. Guinea pigs were induced to cough with different concentrations of citric acid or capsaicin, and cough waveforms were used to optimize the stimulation conditions. The optimized guinea pig model of cough was validated with dextromethorphan, and the optimized guinea pig model of capsaicin-induced cough was used to evaluate the antitussive effect of GK-A. ResultWBP could count the coughs induced by capsaicin and citric acid in guinea pigs by recognizable and typical respiratory waveforms. The optimized stimulation conditions were capsaicin concentration of 100 µmol·L-1 and nebulization for 2 min. The validation results showed that compared with the model group, the dextromethorphan group of guinea pigs had reduced coughs (P<0.05) and prolonged cough latency (P<0.01). GK-A prolonged the cough latency (P<0.05) and reduced coughs (P<0.05) in the mouse model of ammonia-induced cough. In the guinea pig model of capsaicin-induced cough, GK-A prolonged cough latency (P<0.05), reduced coughs (P<0.05), and decreased substance P (SP) content in the guinea pig serum (P<0.05, P<0.01). ConclusionA guinea pig model of capsaicin-induced cough was successfully established based on cough waveform counting, which provided an objective and accurate cough counting method. GK-A has antitussive effects, possibly by inhibiting the neuropeptide SP.
9.Prognostic values of parameters from hypothermic machine perfusion after static cold storage on short-term outcomes of kidney transplantation
Tianying XING ; Jiangtao WU ; Qi WANG ; Guangping LI ; Ying HUANG ; Tongwen OU
Chinese Journal of Organ Transplantation 2024;45(8):543-549
Objective:To evaluate the prognostic values of parameters from hypothermic machine perfusion (HMP) after static cold storage (SCS) on short-term outcomes of kidney transplantation.Method:From February 2023 to October 2023, the authors retrospectively reviewed the clinical and HMP data of recipients undergoing adult deceased donor kidney transplantation at Xuanwu Hospital, Capital Medical University. HMP resistance and renal arterial anatomical variants were utilized for subgroup analysis. The primary endpoints were delayed graft function (DGF) and whether or not creatine level normalized. The secondary endpoints were the lowest creatine level within 1 month post-kidney transplantation, reduction extent of creatinine level, duration for creatine level to decline to the lowest and duration for creatinine normalization. Single and multiple variable analyses were utilized for examining the correlation between HMP parameters and short-term postoperative outcomes.Result:A total of 157 recipients were included for analysis. Mean serum creatinine level was (870.0±283.9) μmol/L and mean trough creatinine level within 1 month postoperatively (118.5±63.5) μmol/L. Sixteen recipients (10.2%) had delayed graft function (DGF) and creatinine failed to normalize in 10 receipients (6.4%). Average time for creatinine to decline to the lowest level within 1 month was (14.5±7.6) d (3~30 d) and average time for creatinine to normalize (6.4±5.8) d (1~30 d). Multiple variable regression analysis revealed that terminal resistant index was independently correlated with multiple events, including DGF ( P<0.01), whether or not creatinine level normalized within 1 month ( P=0.001), reduction extent of creatinine level ( P<0.01) and duration for creatinine normalization ( P=0.024) . Conclusion:Parameters of HMP after SCS are capable of predicting the short-term outcomes of kidney transplantation. Terminal resistant index is an independent risk factor for several prognostic events.
10.Summary of the 19 th Chinese Symposium of Burns and Wounds
Yanling LYU ; Yu MO ; Guangping LIANG ; Gaoxing LUO ; Yizhi PENG ; Dan SUN ; Kaizhen QIU ; Luyao WU ; Tingting LI ; Zhixin LIU
Chinese Journal of Burns 2024;40(7):699-700
The 19 th Chinese Symposium of Burns and Wounds was successfully held in Foshan of Guangdong Province from June 20 th to 22 nd in 2024. There were more than 700 delegates attending the academic event. The theme of the congress was expansion, integration and standardization, which could promote academic exchanges, multi-disciplinary fusion, and standardization of clinical treatment of burns and wounds. A total of nearly 200 famous experts and scholars had their speeches on the two-day keynote forum and special academic seminars including critical care, wound repair, scar prevention and treatment, rehabilitation nursing, and disciplinary integration sessions. The congress ended successfully with abundant fruits and friendship.

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