Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major coh...Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major cohort for stem cell-based therapies.However,the regenerative potential of stem cells significantly decreases with advanced age and deteriorating health status of the donor.Therefore,the efficacy of autologous stem cell therapy is significantly compromised in older patients.To overcome these limitations,alternative strategies have been used to restore the age-and disease-depleted function of stem cells.These methods aim to restore the therapeutic efficacy of aged stem cells for autologous use.This article explores the effect of donor age and health status on the regenerative potential of stem cells.It further highlights the limitations of stem cell-based therapy for autologous treatment in the elderly.A comprehensive insight into the potential strategies to address the“age”and“disease”compromised regenerative potential of autologous stem cells is also presented.The information provided here serves as a valuable resource for physicians and patients for optimization of stem cellbased autologous therapy for aged patients.展开更多
Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone...Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone regeneration promotion effect of allo-BMSCs in 3D-printed autologous bone particle(ABP)scaffolds.First,we concurrently printed scaffolds with polycaprolactone,ABPs,and allo-BMSCs for appropriate support,providing bioactive factors and seed cells to promote osteogenesis.In vitro studies showed that ABP scaffolds promoted allo-BMSC osteogenic differentiation.In vivo studies revealed that the implantation of scaffolds loaded with ABPs and allo-BMSCs into canine skull defects for nine months promoted osteogenesis.Further experiments suggested that only a small portion of implanted allo-BMSCs survived and differentiated into vascular endothelial cells,chondrocytes,and osteocytes.The implanted allo-BMSCs released stromal cell-derived factor 1 through paracrine signaling to recruit native BMSCs into the defect,promoting bone regeneration.This study contributes to our understanding of allo-BMSCs,providing information relevant to their future application.展开更多
BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resol...BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.展开更多
BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an e...BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an equally ample effort to employ clinical studies for studying the ASD causes and cell therapies.Stem cells have yielded so far mixed results in clinical trials,and at patient level the results varied from impressive to no improvement.In this context we have administered autologous cord blood(ACB)and a non-placebo,material intervention repre-sented by an individualized combination of supplements(ICS)to ASD children.METHODS CORDUS clinical study is a crossover study in which both oral ICS and intravenous ACB were sequentially administered to 56 children;ACB was infused as an inpatient procedure.Treatment efficacy was evaluated pre-treatment and post-treatment at 6 months by an independent psychotherapist with Autism Treatment Evaluation Checklist,Quantitative Checklist for Autism in Toddlers and a 16-item comparative table score,after interviewing the children’s parents and therapists.Before and after each intervention participants had a set of blood tests including inflammatory,metabolic and oxidative markers,and the neuronal specific enolase.RESULTS No serious adverse reactions were noted during and after cord blood or supplement administration.ACB improved evaluation scores in 78%of children with age 3–7-years(n=28),but was much less effective in kids older than 8 years or with body weight of more than 35 kg(n=28;only 11%of children improved scores).ICS yielded better results than ACB in 5 cases out of 28,while in 23 kids ACB brought more improvement than ICS(P<0.05);high initial levels of inflammation and ferritin were associated with no improvement.Ample individual differences were noted in children's progress,and statistically significant improvements were seen after ACB on areas such as verbalization and social interaction,but not on irritability or aggressive behavior.CONCLUSION ACB has superior efficacy to ICS in ASD;high inflammation,ferritin,age and body weight predict less improvement;more clinical studies are needed for studying ACB efficacy in ASD.展开更多
BACKGROUND Cytomegalovirus(CMV)reactivation is a potentially severe complication in immunocompromised patients,yet its incidence and impact in recipients of autologous hematopoietic stem cell transplantation(AHSCT)rem...BACKGROUND Cytomegalovirus(CMV)reactivation is a potentially severe complication in immunocompromised patients,yet its incidence and impact in recipients of autologous hematopoietic stem cell transplantation(AHSCT)remain insufficiently documented.AIM To assess the frequency,timing,and outcomes of CMV reactivation in patients undergoing AHSCT at Aziza Othmana Hospital.METHODS We conducted a retrospective descriptive study of all patients who underwent AHSCT between January 2022 and December 2024 and had at least one posttransplant plasma viral load(VL)assessment.CMV VL was quantified by realtime polymerase chain reaction using TaqMan probes(GeneProof®)with a sensitivity threshold of 150 IU/mL.RESULTS Among 277 AHSCT recipients,17(6.1%)experienced CMV reactivation.Their median age was 43 years,with a sex ratio of 0.46(male/female).Underlying diseases included large B-cell lymphoma(n=5),multiple myeloma(n=3),and Hodgkin’s lymphoma(n=4).The median time to reactivation was 26 days post transplant(11 days after neutrophil recovery).Median peak VL was 1325 IU/mL(range:150-641000 IU/mL).Six patients required antiviral therapy(median peak VL:30150 IU/mL),while 11 had spontaneous resolution(median peak VL:1320 IU/mL).Two patients died in the context of CMV reactivation.CONCLUSION CMV reactivation occurs in a noteworthy proportion of AHSCT recipients and may lead to severe outcomes.Routine VL monitoring in the early post-transplant period is crucial,and preemptive therapy should be initiated once clinically relevant VL thresholds are reached to prevent progression to CMV disease and associated mortality.展开更多
Bioengineered organs have been seen as a promising strategy to address the shortage of transplantable organs.However,it is still difficult to achieve heterogeneous structures and complex functions similar to natural o...Bioengineered organs have been seen as a promising strategy to address the shortage of transplantable organs.However,it is still difficult to achieve heterogeneous structures and complex functions similar to natural organs using current bioengineering techniques.This work introduces the methods and dilemmas in organ engineering and existing challenges.Furthermore,a new roadmap for organ engineering,which uses a modular strategy with autologous bioreactors to create organ-level bioengineered constructions,is summarized based on the latest research advances.In brief,different functional modules of natural organs are constructed in vitro,and autologous bioreactors in vivo are utilized to facilitate inter-module assembly to form a complete bioengineered organ capable of replacing natural organ functions.There are bioengineered organs,such as biomimetic tracheas,which have been successfully fabricated following this roadmap.This new roadmap for organ engineering shows prospects in addressing the shortage of transplantable organs and has broad prospects for clinical applications.展开更多
The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clin...The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines.This review aims to elucidate the available approaches for TMJ reconstruction,with a particular emphasis on recent groundbreaking advancements.The current spectrum of TMJ reconstruction integrates diverse surgical techniques,such as costochondral grafting,coronoid process grafting,revascularized fibula transfer,transport distraction osteogenesis,and alloplastic TMJ replacement.Despite the available options,a singular,universally accepted‘gold standard’for reconstructive techniques or materials remains elusive in this field.Our review comprehensively summarizes the current available methods of TMJ reconstruction,focusing on both autologous and alloplastic prostheses.It delves into the differences of each surgical technique and outlines the implications of recent technological advances,such as 3D printing,which hold the promise of enhancing surgical precision and patient outcomes.This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ,thereby improving the quality of life for patients with end-stage TMJ disorders.展开更多
Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery...Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.展开更多
To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical...To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical community have resulted in a lack of documented suc-cesses.This report presented the efficacious intervention in a pa-tient presenting with polytraumatic injuries involving the thoracic and abdominal regions,namely right-sided hemothorax,contusion and hematoma of the right lung,splenic rupture,lateral damage to the common bile duct,disruption of the left portal vein branch and left hepatic duct,incisions in the hepatic segments IV,V,VI,VII,and VIII,laceration of the right adrenal gland,rupture of the right hepatic venous trunk and retro-hepatic inferior vena cava(RHIVC),and pancreatic hematoma.展开更多
BACKGROUND Despite advances in treatment,the prognosis for patients with high-risk pediatric solid tumors remains dismal.Tandem autologous stem cell transplantation(ASCT)offers promise for improving outcomes in these ...BACKGROUND Despite advances in treatment,the prognosis for patients with high-risk pediatric solid tumors remains dismal.Tandem autologous stem cell transplantation(ASCT)offers promise for improving outcomes in these patients.This study aimed to examine the efficacy and prognostic factors of tandem ASCT in pediatric patients with high-risk solid tumors.AIM To determine the survival outcomes and prognostic factors in pediatric patients with high-risk solid tumors undergoing tandem ASCT.METHODS A total of 40 pediatric patients with high-risk solid tumors treated from March 2015 to August 2022 were included in this retrospective study.The diagnoses of the patients included neuroblastoma,germ cell tumors,atypical teratoid/rhabdoid tumor,medulloblastoma,and pineoblastoma.After induction chemotherapy,all patients received tandem ASCT and were allocated into two groups(group A and group B)based on high-dose chemotherapy regimens.Prognostic relevance was evaluated by examining patient characteristics,such as sex,age,lactate dehydrogenase levels,primary site,the number of metastatic sites,and bone marrow involvement.RESULTS The median follow-up duration since the first ASCT was 24 months(range:1-91 months),with 5-year overall survival(OS)and event-free survival(EFS)rates of 73%and 70%,respectively,for the entire cohort.The 3-year OS rates were 67%for group A and 87%for group B(P=0.29),with corresponding 3-year EFS rates of 67%and 79%(P=0.57).Among neuroblastoma patients,the 5-year OS and EFS were 69%and 63%(P=0.23).Univariable analysis revealed a notable association of age≥36 months and elevated lactate dehydrogenase level at diagnosis with poorer OS.Despite acute adverse effects,all patients demonstrated good tolerance to the treatment,with no occurrences of transplant-related mortality.CONCLUSION Tandem ASCT demonstrates promising survival outcomes for patients with high-risk solid tumors,particularly neuroblastoma,with manageable toxicity and no transplant-related mortality.展开更多
Objective:To explore the clinical value of autologous skull transplantation in the treatment of skull defects.Methods:Sixty-six patients who underwent skull defect reconstruction treatment in our hospital from January...Objective:To explore the clinical value of autologous skull transplantation in the treatment of skull defects.Methods:Sixty-six patients who underwent skull defect reconstruction treatment in our hospital from January 2022 to March 2024 were selected and divided into an autologous skull transplantation group(n=31)and an artificial bone transplantation material group(n=35)based on different bone transplantation materials.The two groups of patients were followed up for 12 months to observe the bone healing and the incidence of postoperative complications.Results:After 9 months of treatment,the bone healing performance of the autologous skull transplantation group was better than that of the artificial bone transplantation material group(P<0.05).By the end of the last follow-up,the incidence of bony postoperative complications in the autologous skull transplantation group was lower than that in the artificial bone transplantation material group(P<0.05).Conclusion:Autologous skull repair for skull defects has good biocompatibility,can promote bone healing,and reduce the incidence of postoperative complications.展开更多
Autologous stem cell transplantation(ASCT)and chimeric antigen receptor T-cell(CAR-T)therapy represent pivotal treatments for hematologic malignancies,each with distinct strengths and limitations.ASCT reduces tumor bu...Autologous stem cell transplantation(ASCT)and chimeric antigen receptor T-cell(CAR-T)therapy represent pivotal treatments for hematologic malignancies,each with distinct strengths and limitations.ASCT reduces tumor burden through myeloablative conditioning but remains susceptible to relapse,while CAR-T therapy precisely targets malignant cells but encounters challenges,including cytokine release syndrome(CRS),immune effector cell-associated neurotoxicity syndrome(ICANS),and limited persistence.Emerging evidence suggests that combining ASCT with CAR-T therapy yields synergistic effects.ASCT reshapes the immune microenvironment,lowers immunosuppressive cells and CRS risk,while CAR-T eliminates residual disease and promotes immune recovery.Clinical trials in relapsed/refractory B-cell lymphomas and multiple myeloma demonstrate complete remission rates(CRR)of 72%-100%and two-year progression-free survival(PFS)rates of 59%-83%,with severe CRS/ICANS incidences below 10%.However,the precise mechanisms underlying this synergy,optimal timing of CAR-T infusion after ASCT,and ideal dosing regimens require further definition.Future research should prioritize large-scale,randomized controlled trials and establish standardized protocols for toxicity management to maximize therapeutic benefits.By integrating the complementary strengths of ASCT and CAR-T,this combination strategy represents a promising approach for improving outcomes in high-risk hematologic malignancies;however,additional studies are necessary to validate its efficacy and expand its clinical applicability.展开更多
Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on pre...Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on previous clinical research results and combined with the ten core treatment principles of SMIS,this guideline systematically elaborates on the indications,contraindications,preoperative evaluation,surgical operation standards,postoperative management,and efficacy evaluation system of ASGS-SMIR.This surgery achieves effective repair of large-area mucosal defects and stenosis prevention in the esophagus through the technical process of“skin flap harvesting,mesh processing,sleeve suture,and stent fixation”.The purpose of this guideline is to promote the standardized and normalized application of this technique and provide guidance for clinical practice.展开更多
BACKGROUND Skin is the largest organ in the human body and plays crucial roles in human health.Efficient and rapid healing of burn wounds is of great significance.While stem cell therapies have offered potential metho...BACKGROUND Skin is the largest organ in the human body and plays crucial roles in human health.Efficient and rapid healing of burn wounds is of great significance.While stem cell therapies have offered potential methods to treat burn wounds,relatively few have had success in clinical practice.AIM To investigate the effect of the combined application of collagen III and adiposederived stem cells(ASCs)on vascular regeneration in skin wound healing.METHODS Burn wounds were created in 18 adult male Sprague-Dawley rats,and they were randomly divided into two groups.In the treatment group,each rat was injected with 4×10^(6) Zs-Green-labeled autologous ASCs suspended in collagen III.In the control group,each rat was injected with collagen III.Each rat received six injections.Images of the wounds were acquired every 3 days.RESULTS Multiple injections of autologous ASCs improved wound closure rate more efficiently compared to the control group.Moreover,autologous ASCs do not survive long-term during the skin wound healing process.CONCLUSION This study demonstrated that multiple injections of autologous ASCs combined with collagen III accelerated burn wound healing by increasing collagen deposition and improving angiogenesis.展开更多
BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous plat...BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.展开更多
Knees are the most commonly impacted weight-bearing joints in osteoarthritis(OA),affecting millions of people worldwide.With increasing life spans and obesity rates,the incidence of knee OA will further increase,leadi...Knees are the most commonly impacted weight-bearing joints in osteoarthritis(OA),affecting millions of people worldwide.With increasing life spans and obesity rates,the incidence of knee OA will further increase,leading to a significant increase in the economic burden.Conventional treatment modalities utilized to manage knee OA have limitations.Over the last decade,the role of various autologous peripheral blood-derived orthobiologics(APBOs)for the treatment of knee OA has been extensively investigated.This editorial provided an overview and focused on defining and shedding light on the current state of evidence based on the most recent published clinical studies concerning the use of APBO for the management of knee OA.While numerous studies have demonstrated promising results for these preparations,a notable gap exists in the comparative analysis of these diverse formulations.This absence of head-to-head studies poses a considerable challenge for physicians/surgeons in determining the optimal preparation for managing knee OA and achieving sustained longterm results.Thus,more adequately powered,multicenter,prospective,doubleblind,randomized controlled trials with longer follow-ups are needed to establish the long-term efficacy and to aid physicians/surgeons in determining the optimal APBO for the management of knee OA.展开更多
Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the pre...Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the present study, we investigated the histological and morphometric changes after large volumes of fat were grafted within the subcutaneous cellular tissue. An experimental study was designed using four 3-month-old male pigs. One hundred cc of decanted fat tissue was transferred into the right leg. Volume augmentation achieved by auto lipo-injecting within the subcutaneous cellular tissue persisted up to two months. Although there is a reduction in cell number and size, an increased amount of extracellular matrix and the presence of oily cysts and microcalcifications were observed. <strong>Conclusion:</strong> The volume augmentation, which is achieved by autologous fat transfer in large quantities in subcutaneous cellular tissue, can remain for months.展开更多
Background: Allogeneic blood transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential ri...Background: Allogeneic blood transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential risk associated with allogeneic blood transfusion has heightened interest in the use of autologous blood transfusion. In the present study, the serum concentrations of neopterin, interferon-gamma (IFN-γ), T lymphocyte subsets (CD3^+, CD4^+, CD8^+, CD4^+/CD8^+) and a possible association between these variables were investigated. The purpose was to further evaluate the effect of autologous versus allogeneic blood transfusion on immunological status in patients undergoing surgery for gastric cancer. Methods: Sixty ASA Ⅰ~Ⅱ(American Society of Anesthesiologists) patients undergoing elective radical resection for stomach cancer were randomly allocated to receive either allogeneic blood transfusion (n=30) or autologous blood transfusion (n=30). Serum concentrations of the neopterin, IFN-γ and T lymphocyte subsets in the recipients were measured before induction of anesthesia, after operation, and on the 5th postoperative day. Results: Both two groups, serum neopterin, IFN-γ, percentages of T-cell subsets (CD3^+, CD4^+), and CD4^+/CD8^+ ratio had significantly decreased after operation, but decreased more significantly in group H (receiving allogeneic blood transfusion) than those in group A (receiving autologous whole blood transfusion) (P〈0.05). On the 5th postoperative day,serum neopterin, IFN-γ, CD3^+, CD4^+ T-cells, and CD4^+/CD8^+ ratio returned to the baseline values in group A. In contrast, the above remain decreasing in group H, where there were no significant relations between serum neopterin and IFN-γ. Conclusion:Perioperative surgical trauma and stress have an immunosuppressive impact on gastric cancer patients. Allogeneic blood transfusion exacerbates the impaired immune response. Autologous blood transfusion might be significantly beneficial for immune-compromised patients in the perioperative period, clearly showing its superiority over allogeneic blood transfusion.展开更多
Objective Intracerebral hemorrhage(ICH)refers to predominant,sporadic,and non-traumatic bleeding in the brain parenchyma.The PI3K/AKT/mTOR signaling pathway is an important signal transduction pathway regulated by enz...Objective Intracerebral hemorrhage(ICH)refers to predominant,sporadic,and non-traumatic bleeding in the brain parenchyma.The PI3K/AKT/mTOR signaling pathway is an important signal transduction pathway regulated by enzyme-linked receptors and has many biological functions in mammals.It plays a key role in neuronal metabolism,gene expression regulation,and tissue homeostasis in the healthy and diseased brain.Methods In the present study,the role of the PI3K/AKT/mTOR pathway inhibitor chrysophanol(CPH)(10 mg/kg and 20 mg/kg,orally)in the improvement of ICH-associated neurological defects in rats was investigated.Autologous blood(20µL/5 min/unilateral/intracerebroventricular)mimics ICH-like defects involving cellular and molecular dysfunction and neurotransmitter imbalance.The current study also included various behavioral assessments to examine cognition,memory,and motor and neuromuscular coordination.The protein expression levels of PI3K,AKT,and mTOR as well as myelin basic protein and apoptotic markers,such as Bax,Bcl-2,and caspase-3,were examined using ELISA kits.Furthermore,the levels of various neuroinflammatory cytokines and oxidative stress markers were assessed.Additionally,the neurological severity score,brain water content,gross brain pathology,and hematoma size were used to indicate neurological function and brain edema.Results CPH was found to be neuroprotective by restoring neurobehavioral alterations and significantly reducing the elevated PI3K,AKT,and mTOR protein levels,and modulating the apoptotic markers such as Bax,Bcl-2,and caspase-3 in rat brain homogenate.CPH substantially reduced the inflammatory cytokines like interleukin(IL)-1β,IL-6,and tumor necrosis factor-α.CPH administration restored the neurotransmitters GABA,glutamate,acetylcholine,dopamine,and various oxidative stress markers.Conclusion Our results show that CPH may be a promising therapeutic approach for overcoming neuronal damage caused by the overexpression of the PI3K/AKT/mTOR signaling pathway in ICH-induced neurological dysfunctions in rats.展开更多
Objective: To study the efficacy and safety of autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia. Methods: Fifty Type 2 diabetic patients with lower limb ...Objective: To study the efficacy and safety of autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia. Methods: Fifty Type 2 diabetic patients with lower limb ischemia were enrolled and randomized to either transplanted group or control group. Patients in both group received the same conventional treatment. Meanwhile, 20 ml bone marrow from each transplanted patient were collected, and the mesenchymal stem cells were separated by density gradient centrifugation and cultured in the medium with autologous serum. After three-weeks adherent culture in vitro, 7.32×10^8-5.61×10^9 mesenchymal stem cells were harvested and transplanted by multiple intramuscular and hypodermic injections into the impaired lower limbs. Results: At the end of 12-week follow-up, 5 patients were excluded from this study because of clinical worsening or failure of cell culture. Main ischemic symptoms, including rest pain and intermittent claudication, were improved significantly in transplanted patients. The ulcer healing rate of the transplanted group (1 5 of 18, 83.33%) was significantly higher than that of the control group (9 of 20, 45.00%, P=0.012).The mean of resting ankle-brachial index (ABI) in transplanted group significantly was increased from 0.61±0.09 to 0.74±0.11 (P〈0.001). Magnetic resonance angiography (MRA) demonstrated that there were more patients whose score of new vessels exceeded or equaled to 2 in the transplant patients (11 of 15) than in control patients (2 of 14, P=0.001). Lower limb amputation rate was significantly lower in transplanted group than in the control group (P=0.040). No adverse effects was observed in transplanted group. Conclusion: These results indicate that the autologous transplantation of bone marrow mesenchymal stem cells relieves critical lower limb ischemia and promotes ulcers healing in Type 2 diabetic patients.展开更多
文摘Regenerative medicine is a promising therapeutic avenue for previously incurable diseases.As the risk of chronic and degenerative diseases significantly increases with age,the elderly population represents a major cohort for stem cell-based therapies.However,the regenerative potential of stem cells significantly decreases with advanced age and deteriorating health status of the donor.Therefore,the efficacy of autologous stem cell therapy is significantly compromised in older patients.To overcome these limitations,alternative strategies have been used to restore the age-and disease-depleted function of stem cells.These methods aim to restore the therapeutic efficacy of aged stem cells for autologous use.This article explores the effect of donor age and health status on the regenerative potential of stem cells.It further highlights the limitations of stem cell-based therapy for autologous treatment in the elderly.A comprehensive insight into the potential strategies to address the“age”and“disease”compromised regenerative potential of autologous stem cells is also presented.The information provided here serves as a valuable resource for physicians and patients for optimization of stem cellbased autologous therapy for aged patients.
基金supported by the Science and Technology Development Fund of the Fourth Military Medical University(No.2016XB051)the Military Medical Promotion Plan of the Fourth Military Medical University(No.2016TSA-005)+2 种基金the Science and Technology Program of Guangzhou(No.201604040002)the Youth Development Project of Air Force Medical University(No.21QNPY072)the Xijing Hospital Booster Program(No.XJZT24CZ10).
文摘Autologous bone marrow-derived mesenchymal stem cells(BMSCs)have been shown to promote osteogenesis;however,the effects of allogeneic BMSCs(allo-BMSCs)on bone regeneration remain unclear.Therefore,we explored the bone regeneration promotion effect of allo-BMSCs in 3D-printed autologous bone particle(ABP)scaffolds.First,we concurrently printed scaffolds with polycaprolactone,ABPs,and allo-BMSCs for appropriate support,providing bioactive factors and seed cells to promote osteogenesis.In vitro studies showed that ABP scaffolds promoted allo-BMSC osteogenic differentiation.In vivo studies revealed that the implantation of scaffolds loaded with ABPs and allo-BMSCs into canine skull defects for nine months promoted osteogenesis.Further experiments suggested that only a small portion of implanted allo-BMSCs survived and differentiated into vascular endothelial cells,chondrocytes,and osteocytes.The implanted allo-BMSCs released stromal cell-derived factor 1 through paracrine signaling to recruit native BMSCs into the defect,promoting bone regeneration.This study contributes to our understanding of allo-BMSCs,providing information relevant to their future application.
基金Supported by The New Faculty Research Grant of Pusan National University,2023The Research Grant of the Chungbuk National University in 2023.
文摘BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and hyperpigmentation.Although cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this condition.CASE SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months earlier.There had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was initiated.One month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in discoloration.CONCLUSION Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.
文摘BACKGROUND Cellular therapies have started an important new therapeutic direction in autistic spectrum disorder(ASD),and the ample diversity of ASD pathophysiology and the different types of cell therapies prompt an equally ample effort to employ clinical studies for studying the ASD causes and cell therapies.Stem cells have yielded so far mixed results in clinical trials,and at patient level the results varied from impressive to no improvement.In this context we have administered autologous cord blood(ACB)and a non-placebo,material intervention repre-sented by an individualized combination of supplements(ICS)to ASD children.METHODS CORDUS clinical study is a crossover study in which both oral ICS and intravenous ACB were sequentially administered to 56 children;ACB was infused as an inpatient procedure.Treatment efficacy was evaluated pre-treatment and post-treatment at 6 months by an independent psychotherapist with Autism Treatment Evaluation Checklist,Quantitative Checklist for Autism in Toddlers and a 16-item comparative table score,after interviewing the children’s parents and therapists.Before and after each intervention participants had a set of blood tests including inflammatory,metabolic and oxidative markers,and the neuronal specific enolase.RESULTS No serious adverse reactions were noted during and after cord blood or supplement administration.ACB improved evaluation scores in 78%of children with age 3–7-years(n=28),but was much less effective in kids older than 8 years or with body weight of more than 35 kg(n=28;only 11%of children improved scores).ICS yielded better results than ACB in 5 cases out of 28,while in 23 kids ACB brought more improvement than ICS(P<0.05);high initial levels of inflammation and ferritin were associated with no improvement.Ample individual differences were noted in children's progress,and statistically significant improvements were seen after ACB on areas such as verbalization and social interaction,but not on irritability or aggressive behavior.CONCLUSION ACB has superior efficacy to ICS in ASD;high inflammation,ferritin,age and body weight predict less improvement;more clinical studies are needed for studying ACB efficacy in ASD.
文摘BACKGROUND Cytomegalovirus(CMV)reactivation is a potentially severe complication in immunocompromised patients,yet its incidence and impact in recipients of autologous hematopoietic stem cell transplantation(AHSCT)remain insufficiently documented.AIM To assess the frequency,timing,and outcomes of CMV reactivation in patients undergoing AHSCT at Aziza Othmana Hospital.METHODS We conducted a retrospective descriptive study of all patients who underwent AHSCT between January 2022 and December 2024 and had at least one posttransplant plasma viral load(VL)assessment.CMV VL was quantified by realtime polymerase chain reaction using TaqMan probes(GeneProof®)with a sensitivity threshold of 150 IU/mL.RESULTS Among 277 AHSCT recipients,17(6.1%)experienced CMV reactivation.Their median age was 43 years,with a sex ratio of 0.46(male/female).Underlying diseases included large B-cell lymphoma(n=5),multiple myeloma(n=3),and Hodgkin’s lymphoma(n=4).The median time to reactivation was 26 days post transplant(11 days after neutrophil recovery).Median peak VL was 1325 IU/mL(range:150-641000 IU/mL).Six patients required antiviral therapy(median peak VL:30150 IU/mL),while 11 had spontaneous resolution(median peak VL:1320 IU/mL).Two patients died in the context of CMV reactivation.CONCLUSION CMV reactivation occurs in a noteworthy proportion of AHSCT recipients and may lead to severe outcomes.Routine VL monitoring in the early post-transplant period is crucial,and preemptive therapy should be initiated once clinically relevant VL thresholds are reached to prevent progression to CMV disease and associated mortality.
基金supported by the National Natural Science Foundation of China(NSFC)(Nos.81770091,82000099)the National Key Research and Development Program of China(Nos.2024YFC3044600,2022YFC2407400)+6 种基金the Clinical Research Plan of Shanghai Hospital Development Center(multi-center clinical research project for major diseases)(No.SHDC2020CR1021B)the scientific and technological innovation action plan of Science and Technology Commission of Shanghai Municipality(No.20DZ2253700)the Science and Technology Commission of Shanghai Municipality(Nos.20YF1440900,21YF1438500,21S31905200)the Clinical Research Foundation of Shanghai Pulmonary Hospital(Nos.FKLY20007,SKPY2021005)Shanghai Pulmonary Hospital Innovation Team(Nos.FKXY2306,FKCX1906,FKXY1902)Shanghai Pulmonary Hospital Grant(No.FKCY1903)Ningbo Top Medical and Health Research Program(No.2022030208)。
文摘Bioengineered organs have been seen as a promising strategy to address the shortage of transplantable organs.However,it is still difficult to achieve heterogeneous structures and complex functions similar to natural organs using current bioengineering techniques.This work introduces the methods and dilemmas in organ engineering and existing challenges.Furthermore,a new roadmap for organ engineering,which uses a modular strategy with autologous bioreactors to create organ-level bioengineered constructions,is summarized based on the latest research advances.In brief,different functional modules of natural organs are constructed in vitro,and autologous bioreactors in vivo are utilized to facilitate inter-module assembly to form a complete bioengineered organ capable of replacing natural organ functions.There are bioengineered organs,such as biomimetic tracheas,which have been successfully fabricated following this roadmap.This new roadmap for organ engineering shows prospects in addressing the shortage of transplantable organs and has broad prospects for clinical applications.
基金supported by NSFC(82370932)Research and Develop Program of West China Hospital of Stomatology Sichuan University(RD-03-202102,LCYJ2019-20)Natural Science Foundation of Sichuan Province(2023NSFSC1512,2024NSFSC1588)。
文摘The reconstruction of the temporomandibular joint presents a multifaceted clinical challenge in the realm of head and neck surgery,underscored by its relatively infrequent occurrence and the lack of comprehensive clinical guidelines.This review aims to elucidate the available approaches for TMJ reconstruction,with a particular emphasis on recent groundbreaking advancements.The current spectrum of TMJ reconstruction integrates diverse surgical techniques,such as costochondral grafting,coronoid process grafting,revascularized fibula transfer,transport distraction osteogenesis,and alloplastic TMJ replacement.Despite the available options,a singular,universally accepted‘gold standard’for reconstructive techniques or materials remains elusive in this field.Our review comprehensively summarizes the current available methods of TMJ reconstruction,focusing on both autologous and alloplastic prostheses.It delves into the differences of each surgical technique and outlines the implications of recent technological advances,such as 3D printing,which hold the promise of enhancing surgical precision and patient outcomes.This evolutionary progress aims not only to improve the immediate results of reconstruction but also to ensure the long-term health and functionality of the TMJ,thereby improving the quality of life for patients with end-stage TMJ disorders.
文摘Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.
基金supported by a grant from the Climbing Project for Medical Talent of Zhongnan Hospital,Wuhan University(PDJH202215).
文摘To the Editor:Theoretically,autologous liver transplantation is posited as a treatment for patients experiencing traumatic liver rupture.How-ever,the procedural complexity and its infrequent application by the medical community have resulted in a lack of documented suc-cesses.This report presented the efficacious intervention in a pa-tient presenting with polytraumatic injuries involving the thoracic and abdominal regions,namely right-sided hemothorax,contusion and hematoma of the right lung,splenic rupture,lateral damage to the common bile duct,disruption of the left portal vein branch and left hepatic duct,incisions in the hepatic segments IV,V,VI,VII,and VIII,laceration of the right adrenal gland,rupture of the right hepatic venous trunk and retro-hepatic inferior vena cava(RHIVC),and pancreatic hematoma.
基金Guangzhou Municipal Science and Technology Bureau,Municipal School and College Joint Funding Project,No.2024A03J1240.
文摘BACKGROUND Despite advances in treatment,the prognosis for patients with high-risk pediatric solid tumors remains dismal.Tandem autologous stem cell transplantation(ASCT)offers promise for improving outcomes in these patients.This study aimed to examine the efficacy and prognostic factors of tandem ASCT in pediatric patients with high-risk solid tumors.AIM To determine the survival outcomes and prognostic factors in pediatric patients with high-risk solid tumors undergoing tandem ASCT.METHODS A total of 40 pediatric patients with high-risk solid tumors treated from March 2015 to August 2022 were included in this retrospective study.The diagnoses of the patients included neuroblastoma,germ cell tumors,atypical teratoid/rhabdoid tumor,medulloblastoma,and pineoblastoma.After induction chemotherapy,all patients received tandem ASCT and were allocated into two groups(group A and group B)based on high-dose chemotherapy regimens.Prognostic relevance was evaluated by examining patient characteristics,such as sex,age,lactate dehydrogenase levels,primary site,the number of metastatic sites,and bone marrow involvement.RESULTS The median follow-up duration since the first ASCT was 24 months(range:1-91 months),with 5-year overall survival(OS)and event-free survival(EFS)rates of 73%and 70%,respectively,for the entire cohort.The 3-year OS rates were 67%for group A and 87%for group B(P=0.29),with corresponding 3-year EFS rates of 67%and 79%(P=0.57).Among neuroblastoma patients,the 5-year OS and EFS were 69%and 63%(P=0.23).Univariable analysis revealed a notable association of age≥36 months and elevated lactate dehydrogenase level at diagnosis with poorer OS.Despite acute adverse effects,all patients demonstrated good tolerance to the treatment,with no occurrences of transplant-related mortality.CONCLUSION Tandem ASCT demonstrates promising survival outcomes for patients with high-risk solid tumors,particularly neuroblastoma,with manageable toxicity and no transplant-related mortality.
文摘Objective:To explore the clinical value of autologous skull transplantation in the treatment of skull defects.Methods:Sixty-six patients who underwent skull defect reconstruction treatment in our hospital from January 2022 to March 2024 were selected and divided into an autologous skull transplantation group(n=31)and an artificial bone transplantation material group(n=35)based on different bone transplantation materials.The two groups of patients were followed up for 12 months to observe the bone healing and the incidence of postoperative complications.Results:After 9 months of treatment,the bone healing performance of the autologous skull transplantation group was better than that of the artificial bone transplantation material group(P<0.05).By the end of the last follow-up,the incidence of bony postoperative complications in the autologous skull transplantation group was lower than that in the artificial bone transplantation material group(P<0.05).Conclusion:Autologous skull repair for skull defects has good biocompatibility,can promote bone healing,and reduce the incidence of postoperative complications.
基金supported by funding from the National KeyR&D Program of China(No.2022YFC2502604)the National Natural Science Foundation of China(No.82470194)+1 种基金the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2024-I2M-3-021)the ChenXiaoping Foundation for the development of Science and Technology of Hubei Province(No.CXPJJH122001-2221)。
文摘Autologous stem cell transplantation(ASCT)and chimeric antigen receptor T-cell(CAR-T)therapy represent pivotal treatments for hematologic malignancies,each with distinct strengths and limitations.ASCT reduces tumor burden through myeloablative conditioning but remains susceptible to relapse,while CAR-T therapy precisely targets malignant cells but encounters challenges,including cytokine release syndrome(CRS),immune effector cell-associated neurotoxicity syndrome(ICANS),and limited persistence.Emerging evidence suggests that combining ASCT with CAR-T therapy yields synergistic effects.ASCT reshapes the immune microenvironment,lowers immunosuppressive cells and CRS risk,while CAR-T eliminates residual disease and promotes immune recovery.Clinical trials in relapsed/refractory B-cell lymphomas and multiple myeloma demonstrate complete remission rates(CRR)of 72%-100%and two-year progression-free survival(PFS)rates of 59%-83%,with severe CRS/ICANS incidences below 10%.However,the precise mechanisms underlying this synergy,optimal timing of CAR-T infusion after ASCT,and ideal dosing regimens require further definition.Future research should prioritize large-scale,randomized controlled trials and establish standardized protocols for toxicity management to maximize therapeutic benefits.By integrating the complementary strengths of ASCT and CAR-T,this combination strategy represents a promising approach for improving outcomes in high-risk hematologic malignancies;however,additional studies are necessary to validate its efficacy and expand its clinical applicability.
基金National Key Research and Development Program of China(2022YFC2503600)。
文摘Autologous Skin-Grafting Surgery after Super Minimally Invasive Resection(ASGS-SMIR)is a novel endoscopic repair technique developed under the guidance of the Super Minimally Invasive Surgery(SMIS)concept.Based on previous clinical research results and combined with the ten core treatment principles of SMIS,this guideline systematically elaborates on the indications,contraindications,preoperative evaluation,surgical operation standards,postoperative management,and efficacy evaluation system of ASGS-SMIR.This surgery achieves effective repair of large-area mucosal defects and stenosis prevention in the esophagus through the technical process of“skin flap harvesting,mesh processing,sleeve suture,and stent fixation”.The purpose of this guideline is to promote the standardized and normalized application of this technique and provide guidance for clinical practice.
基金Supported by the Natural Science Foundation of Hunan Province,China,No.2021JJ40638the Research Foundation of Education Bureau of Hunan Province,China,No.22B0897General Funding Project of Hunan Provincial Health Commission,China,No.202202055404.
文摘BACKGROUND Skin is the largest organ in the human body and plays crucial roles in human health.Efficient and rapid healing of burn wounds is of great significance.While stem cell therapies have offered potential methods to treat burn wounds,relatively few have had success in clinical practice.AIM To investigate the effect of the combined application of collagen III and adiposederived stem cells(ASCs)on vascular regeneration in skin wound healing.METHODS Burn wounds were created in 18 adult male Sprague-Dawley rats,and they were randomly divided into two groups.In the treatment group,each rat was injected with 4×10^(6) Zs-Green-labeled autologous ASCs suspended in collagen III.In the control group,each rat was injected with collagen III.Each rat received six injections.Images of the wounds were acquired every 3 days.RESULTS Multiple injections of autologous ASCs improved wound closure rate more efficiently compared to the control group.Moreover,autologous ASCs do not survive long-term during the skin wound healing process.CONCLUSION This study demonstrated that multiple injections of autologous ASCs combined with collagen III accelerated burn wound healing by increasing collagen deposition and improving angiogenesis.
文摘BACKGROUND Lower limb atherosclerotic occlusive disease(LAOD)is a common complication in diabetic patients,leading to significant symptoms and reduced quality of life.AIM To investigate the efficacy of autologous platelet-rich gel(APRG)as an innovative treatment for LAOD,focusing on clinical outcomes such as symptom relief,flow values,ankle-brachial index(ABI),walking distance,and claudication severity.METHODS This retrospective study involved an analysis of electronic medical records(EMR)from 150 patients diagnosed with LAOD.Participants were assigned to either a treatment group(n=80)or a control group(n=70).Both groups received standard care and underwent dressing changes.In addition,the treatment group was given APRG.Primary outcomes included changes in pain levels,wound healing rates,flow values assessed by plethysmography,ABI measurements,walking distance,and claudication severity.Statistical analyses were conducted to determine the significance of the results.RESULTS The APRG group showed significant improvements after 12 weeks,including a 70%reduction in pain,a 65%increase in wound healing rates,and an average walking distance increase of 150 meters.Flow values improved by 20%,with significant enhancements in ABI measurements(P<0.01).Additionally,patient satisfaction was higher,and 60%of patients reported improved claudication severity,confirming the efficacy of APRG in enhancing clinical outcomes for lower LAOD.CONCLUSION The APRG demonstrates significant efficacy in managing LAOD in diabetic patients,improving key clinical parameters including flow values,ABI,walking distance,and claudication.These findings support the need for further prospective studies to validate long-term efficacy and optimize treatment strategies.
文摘Knees are the most commonly impacted weight-bearing joints in osteoarthritis(OA),affecting millions of people worldwide.With increasing life spans and obesity rates,the incidence of knee OA will further increase,leading to a significant increase in the economic burden.Conventional treatment modalities utilized to manage knee OA have limitations.Over the last decade,the role of various autologous peripheral blood-derived orthobiologics(APBOs)for the treatment of knee OA has been extensively investigated.This editorial provided an overview and focused on defining and shedding light on the current state of evidence based on the most recent published clinical studies concerning the use of APBO for the management of knee OA.While numerous studies have demonstrated promising results for these preparations,a notable gap exists in the comparative analysis of these diverse formulations.This absence of head-to-head studies poses a considerable challenge for physicians/surgeons in determining the optimal preparation for managing knee OA and achieving sustained longterm results.Thus,more adequately powered,multicenter,prospective,doubleblind,randomized controlled trials with longer follow-ups are needed to establish the long-term efficacy and to aid physicians/surgeons in determining the optimal APBO for the management of knee OA.
文摘Nowadays, fat transfer is an accepted technique that has been popularized in clinical practice, during which large volumes of fat are strategically relocated to increase and improve the contour of the body. In the present study, we investigated the histological and morphometric changes after large volumes of fat were grafted within the subcutaneous cellular tissue. An experimental study was designed using four 3-month-old male pigs. One hundred cc of decanted fat tissue was transferred into the right leg. Volume augmentation achieved by auto lipo-injecting within the subcutaneous cellular tissue persisted up to two months. Although there is a reduction in cell number and size, an increased amount of extracellular matrix and the presence of oily cysts and microcalcifications were observed. <strong>Conclusion:</strong> The volume augmentation, which is achieved by autologous fat transfer in large quantities in subcutaneous cellular tissue, can remain for months.
基金Project supported by the Health Department of Zhejiang Province(No. 2004A040)the Education Department of Zhejiang Province (No. G20030486), China
文摘Background: Allogeneic blood transfusion-induced immunomodulation (TRIM) and its adverse effect on the prognosis of patients treated surgically for cancer remain complex and controversial. However, the potential risk associated with allogeneic blood transfusion has heightened interest in the use of autologous blood transfusion. In the present study, the serum concentrations of neopterin, interferon-gamma (IFN-γ), T lymphocyte subsets (CD3^+, CD4^+, CD8^+, CD4^+/CD8^+) and a possible association between these variables were investigated. The purpose was to further evaluate the effect of autologous versus allogeneic blood transfusion on immunological status in patients undergoing surgery for gastric cancer. Methods: Sixty ASA Ⅰ~Ⅱ(American Society of Anesthesiologists) patients undergoing elective radical resection for stomach cancer were randomly allocated to receive either allogeneic blood transfusion (n=30) or autologous blood transfusion (n=30). Serum concentrations of the neopterin, IFN-γ and T lymphocyte subsets in the recipients were measured before induction of anesthesia, after operation, and on the 5th postoperative day. Results: Both two groups, serum neopterin, IFN-γ, percentages of T-cell subsets (CD3^+, CD4^+), and CD4^+/CD8^+ ratio had significantly decreased after operation, but decreased more significantly in group H (receiving allogeneic blood transfusion) than those in group A (receiving autologous whole blood transfusion) (P〈0.05). On the 5th postoperative day,serum neopterin, IFN-γ, CD3^+, CD4^+ T-cells, and CD4^+/CD8^+ ratio returned to the baseline values in group A. In contrast, the above remain decreasing in group H, where there were no significant relations between serum neopterin and IFN-γ. Conclusion:Perioperative surgical trauma and stress have an immunosuppressive impact on gastric cancer patients. Allogeneic blood transfusion exacerbates the impaired immune response. Autologous blood transfusion might be significantly beneficial for immune-compromised patients in the perioperative period, clearly showing its superiority over allogeneic blood transfusion.
基金The authors express their gratitude to Chairman,Mr.Parveen Garg and Director,Dr.G.D.Gupta,ISF College of Pharmacy,Moga(Punjab),India,for their great support.
文摘Objective Intracerebral hemorrhage(ICH)refers to predominant,sporadic,and non-traumatic bleeding in the brain parenchyma.The PI3K/AKT/mTOR signaling pathway is an important signal transduction pathway regulated by enzyme-linked receptors and has many biological functions in mammals.It plays a key role in neuronal metabolism,gene expression regulation,and tissue homeostasis in the healthy and diseased brain.Methods In the present study,the role of the PI3K/AKT/mTOR pathway inhibitor chrysophanol(CPH)(10 mg/kg and 20 mg/kg,orally)in the improvement of ICH-associated neurological defects in rats was investigated.Autologous blood(20µL/5 min/unilateral/intracerebroventricular)mimics ICH-like defects involving cellular and molecular dysfunction and neurotransmitter imbalance.The current study also included various behavioral assessments to examine cognition,memory,and motor and neuromuscular coordination.The protein expression levels of PI3K,AKT,and mTOR as well as myelin basic protein and apoptotic markers,such as Bax,Bcl-2,and caspase-3,were examined using ELISA kits.Furthermore,the levels of various neuroinflammatory cytokines and oxidative stress markers were assessed.Additionally,the neurological severity score,brain water content,gross brain pathology,and hematoma size were used to indicate neurological function and brain edema.Results CPH was found to be neuroprotective by restoring neurobehavioral alterations and significantly reducing the elevated PI3K,AKT,and mTOR protein levels,and modulating the apoptotic markers such as Bax,Bcl-2,and caspase-3 in rat brain homogenate.CPH substantially reduced the inflammatory cytokines like interleukin(IL)-1β,IL-6,and tumor necrosis factor-α.CPH administration restored the neurotransmitters GABA,glutamate,acetylcholine,dopamine,and various oxidative stress markers.Conclusion Our results show that CPH may be a promising therapeutic approach for overcoming neuronal damage caused by the overexpression of the PI3K/AKT/mTOR signaling pathway in ICH-induced neurological dysfunctions in rats.
基金the Clinical Research Fund of Southwest Hospital at Third Military Medical University (SWH2005A109)
文摘Objective: To study the efficacy and safety of autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia. Methods: Fifty Type 2 diabetic patients with lower limb ischemia were enrolled and randomized to either transplanted group or control group. Patients in both group received the same conventional treatment. Meanwhile, 20 ml bone marrow from each transplanted patient were collected, and the mesenchymal stem cells were separated by density gradient centrifugation and cultured in the medium with autologous serum. After three-weeks adherent culture in vitro, 7.32×10^8-5.61×10^9 mesenchymal stem cells were harvested and transplanted by multiple intramuscular and hypodermic injections into the impaired lower limbs. Results: At the end of 12-week follow-up, 5 patients were excluded from this study because of clinical worsening or failure of cell culture. Main ischemic symptoms, including rest pain and intermittent claudication, were improved significantly in transplanted patients. The ulcer healing rate of the transplanted group (1 5 of 18, 83.33%) was significantly higher than that of the control group (9 of 20, 45.00%, P=0.012).The mean of resting ankle-brachial index (ABI) in transplanted group significantly was increased from 0.61±0.09 to 0.74±0.11 (P〈0.001). Magnetic resonance angiography (MRA) demonstrated that there were more patients whose score of new vessels exceeded or equaled to 2 in the transplant patients (11 of 15) than in control patients (2 of 14, P=0.001). Lower limb amputation rate was significantly lower in transplanted group than in the control group (P=0.040). No adverse effects was observed in transplanted group. Conclusion: These results indicate that the autologous transplantation of bone marrow mesenchymal stem cells relieves critical lower limb ischemia and promotes ulcers healing in Type 2 diabetic patients.