Objective To review the advance in the experimental studies and evaluate the potential therapeutic application of the mesenchymal stem cells(MSCs). Methods The related articles published in China and theother countries during the recent years were extensively reviewed and analyzed. Results The MSCs were widely used in the cell-transplantation therapy and the tissue engineering because of their pluripotency of differentiation into various kinds of cells. They were also frequently used in the gene therapy because they could stably express the transfected objective genes. Because of their immunomodulatory function, the MSCs could also be used in the immunotherapy. Conclusion The MSCs are the stem cells, which have characteristics of renewing themselves, having multipotency, and being easy to undergo amplification in vitro.The MSCs are ideal target cells for the cell therapy, tissue engineering, gene therapy, and immunotherapy.
Breast cancer is one of the most common malignant tumors in women. The systematic therapy of breast cancer may affect the endometrium and ovarian function, such as abnormal endometrial hyperplasia and abnormal uterine bleeding caused by ovulation disorders. If we do not consider the patients suffering from breast cancer, we can use progesterone drugs to stop bleeding, regulate menstruation, and protect the endometrium. But there is no consistent conclusion on the safety of progesterone drugs in breast cancer patients. This article reviews the security of progesterone drugs in breast cancer survivors from the perspective of basic and clinical research. At present, whether the use of progesterone drugs in breast cancer survivors increases the risk of disease may be related to the type, dosage, and method of use of progesterone drugs. At the same time, it is also related to the type of breast cancer the patient has. Based on the available data, it is safe to use natural progesterone or dydrogesterone for the short term in patients with breast cancer. More studies are needed to evaluate other approaches.
Objective To review the advances in gene expression of marrow stromal cells(MSCs) in biological characteristic, differentiation, gene therapy, supporting hematopoiesis, inflammation reaction in wound repair.Methods The related articles in recent years were extensively reviewed.Results MSCs can express not only specific mRNA of mesodermal cells but also that of endodermal and ectodermal cell types on various differentiation conditions. When transfected or transducted, MSCs can steadily express many therapeutic transgenesin vitro or in vivo as well. Furthermore, they have the ability to support hematopoietic system and participate in the process of inflammation in wound repair.Conclusion MSCs are stem cells which have the characteristicof self renewing, multipotency and easy to expand in vitro. MSCs are ideal target cells for cell and gene therapies.
ObjectiveTo explore the therapeutic effect and its possible mechanisms of somatostatin combined with antibiotics on acute cholecystitis through the detection of serum tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) in rabbits. MethodsForty-five rabbits were randomly averagely classified into three groups following the establishment of acute cholecystitis model: control group, blank group， and experimental group. The rabbits in control group received cefazolin sodium and metronidazoie by intravenous injection twice a day. The rabbits in experimental group got a hypodermic injection of somatostin (20 μg/kg) twice a day besides antibiotics, while these drugs were replaced by equal volume of normal saline for the rabbits in control group. The concentrations of serum TNFα and CRP were detected by enzyme-linked immunosorbent assay and histomorphological and electron microscopic changes of gallbladder in rabbits were observed on 3 d after administer. ResultsThe concentrations of serum TNF-α of rabbits in experimental group 〔(401.6±48.7) pg/ml〕 were significantly lower than those in control group 〔(767.3±67.4) pg/ml〕 and blank group 〔(806.7±61.2) pg/ml〕, P=0.000 and P=0.000, while the difference between the latter two groups was not significant (P=0.196). The concentrations of serum CRP of rabbits in experimental group 〔(16.2±1.1) mg/L〕 were significantly lower than those in control group 〔(55.4±1.2) mg/L〕 and blank group 〔(72.8±8.9) mg/L〕, P=0.000 and P=0.000, and which was higher in blank group compared with control group (P=0.018). The Histopathological results showed that gallbladder wall emerged mulifocality mucosal fluid necrosis, lamina propia hyperemia, bulk neutrophil infiltration and sequent alleviation of reaction in the rabbits of experimental group when compared with the rabbits of blank group and control group. Electron microscopic results demonstrated that the intercellular junction of gallbladder kept relative integrity and the swelling and vacuolar degeneration of mitochondria and endoplasmic reticulum obviously relieved. ConclusionsSomatostatin can significantly reduce the concentrations of serum TNF-α and CRP in the model of rabbits acute cholecystitis, which may protect the mucous membrane of gallbladder from the inflammation reaction.
Objective To explore the effect of endovascular treatment guided by ultrasonography combined with portosystemic shunts on the patients with Budd-Chiari Syndrome （BCS）.Methods The clinical data of 136 patients with BCS treated by balloon angioplasty and stent implantation guided by Doppler ultrasonography in our hospital from January 1995 to January 2011 were retrospectively analyzed.After balloon angioplasty,53 patients were treated by inferior vena cava （IVC） stent implantation and 31 patients with hepatic venous occlusion underwent portosystemic shunts （PSSs） at one week after endovascular treatment.The long-and short-term effects after treatment were studied.Results After endovascular procedures,the IVC pressure of patients significantly decreased （P＜0.01）,while IVC diameter, flow velocity in the lesion,and right atrial pressure of patients showed significant increase（P＜0.01）.Slight heart dysfunction appeared in 13 cases of patients.After shunting,acute pancreatitis occurred in 3 cases, and 1 patient died of upper gastrointestinal hemorrhage on the 10 d after PSSs.Doppler ultrasonography for IVC and shunt vessels showed：the swollen liver and spleen lessened on 3d after endovascular procedures.The swollen liver lessened 2-7cm （mean 5.5cm）,swollen spleen lessened 3-8cm （mean 5.8cm）, and the time of ascites disappearance was 3-60d （mean 14d）.All the patients were followed up for 1 month to 15 years with an average of 3 years.Restenosis of the distal part of stent was found in 1 patient in 2 years after operation, hepatic vein occlusion occurred in 1 case in 1 year after treatment,hepatocellular carcinoma occurred in 1 patient in 3 years after stent implantation,and 1 patient died of C type hepatitis after 1 year,and 5 out of 6 cases of patients with infertility had babies after 1 year.All patients had no stent migration or occlusion of shunts and the symptoms of portal hypertension were obviously relieved.Conclusions Endovascular treatment guided by Doppler ultrasonography is a convenient,safe,and effective method for BCS.Portosystemic shunts are commended to patients with hepatic venous occlusions.The above mentioned methods provide a feasible and effective means for IVC stenosis and short segment occlusion with hepatic vein occlusion of BCS.
Objective To summarize the probability of pulmonary embolism （PE） induced by lower extremity deep venous thrombosis （DVT） and investigate the role of vena cava filter （VCF） in preventing from PE. Methods The clinical data of 1 058 patients with lower extremity DVT from January 2005 to January 2012 were analyzed retrospectively. Results The PE rate was 3.21% （34/1 058） and the death rate was 1.42% （15/1 058） in 1 058 patients with lower extremity DVT. The VCF was implanted in 171 of 1 058 patients. The VCFs of 151 patients were implanted from femoral vein， 20 patients were implanted from jugular vein. The PE rates were 3.61% （32/887） and 1.17% （2/171） and the death rates were 1.69% （15/887） and 0 （0/171） in patients without VCF and with VCF， respectively. Both of them occurred in the first ten days. PE could keep as long as 35 d. The PE rate and death rate in the patients without VCF were significantly higher than those in the patients with VCF （P＜0.01）. The PE rates and death rates in both lower extremities DVT were higher than those in patients with the right and left ones （P＜0.05）， which in the right lower extremity were higher than those in the left one （P＜0.05）. The PE rate and death rate in the patients with lower extremity DVT combined with vena cava thrombosis were significantly higher than those in the patients with central type （P＜0.05）， which in the central type were significantly higher than those in the peripheral type （P＜0.05）， there were no significant differences between peripheral type and mixed pattern. The follow-up time was from 1 month to 7 years with （39±19） months， the patency rate of VCF was 98.7%. There were no filter migration， declination， and failure of expansion. Conclusions VCF can prevent from PE effectively， but the indications must be controlled.
Objective To compare the clinical efficacy between total enteral nutrition and enteral nutrition combined with parenteral nutrition after pancreaticoduodenectomy. Methods A total of 70 patients who underwent pancreaticoduodenectomy in our hospital from July 2012 to July 2015 were collected prospectively, and all patients were divided into 2 groups randomly: enteral nutrition group and combined nutrition group. Patients in enteral nutrition group received total enteral nutrition, and patients in combined nutrition group received enteral nutrition combined with parenteral nutrition. Compared the nutritional indicators, other related indexes, and morbidity between the 2 groups. Results ① The nutritional indexes. Compared with before treatment, the body mass index (BMI), white blood cell count, serum albumin level, serum albumin level, and total lymphocyte count at 1 week and 2 weeks after treatment improved (P<0.05). At the same time point (before treatment, 1 week after treatment, and 2 weeks after treatment), there was no significant in the BMI, white blood cell count, serum albumin level, serum albumin level, and total lymphocyte count between the 2 groups (P>0.05). ② Other related indexes. The anal exhaust time, defecation time, and hospital stay of the patients in the combined nutrition group were shorter than those of enteral nutrition group, and the cost of treatment in combined nutrition group was less than that of the enteral nutrition group (P<0.05). ③ Morbidity. There was no significant difference in the total morbidity between the combined nutrition group〔11.4% (4/35)〕 and enteral nutrition group 〔20.0% (7/35)〕,P>0.05. Conclusion Total enteral nutrition and enteral nutrition combined with parenteral nutrition after pancreaticoduodenectomy both can obtain well curative effect, but enteral nutrition combined with parenteral nutrition can make the patients recover faster with lower cost, which is suitable for promotion.
ObjectiveTo investigate the regulatory effect of miRNA-21-5p (miR-21) on spinal fibroblasts, and to explore the mechanism of miR-21 related pathological process of spinal cord injury.MethodsSpinal cord fibroblasts were identified by immunofluorescence. Spinal fibroblasts damage model was established by scratch method. Quantitative real-time polymerase chain reaction (RT-PCR) was used to determine the relative expression of miR-21 and fibrosis-related genes in spinal cord fibroblasts after injury. The expression of miR-21 in spinal cord fibroblasts was up-regulated and down-regulated by using miR-21 mimics/inhibitor, and the expression levels of apoptosis and proliferation-related proteins were detected by Western Blot (WB).ResultsThe expression of miR-21 and fibrosis-related genes were increased after spinal cord fibroblast scratch (P<0.05). Up-regulation of the miR-21 can increase the expression of apoptosis-related genes in fibroblasts (P<0.05), and vice versa. The proliferation of fibroblasts was consistent with the expression of miR-21, while the apoptosis of fibroblasts was contrary to the expression of miR-21.ConclusionsmiR-21 enhanced the fibrosis and proliferation, inhibited the apoptosis of spinal cord fibroblasts after mechanical injury. This indicates that miR-21 is closely related with the formation of fibrotic scar after spinal cord injury, which also providesa potential therapeutic target for spinal cord injury.