[Research advances in the treatment of liver failure with mesenchymal stem cell-derived exosomes]

Liver failure is a serious clinical syndrome in which multiple pathogenic factors exceed the liver's self-repair capability, resulting massive hepatocellular necrosis, rapid disease progression and high mortality. Liver transplantation is the most effective method for the treatment of liver failure, but it has disadvantages, such as insufficient liver donor and high cost. The clinical efficacy of mesenchymal stem cells in liver failure have been validated, but its application has been limited to certain extent. Cell-free-based therapies, especially mesenchymal stem cell-derived exosomes, has become a research hotspot in recent years. This paper reviews the research advances in the treatment of liver failure with the use of mesenchymal stem cell-derived exosomes.

The value of soluble suppression of tumorigenesis-2 (sST2) in the maintenance of hemodialysis patients with heart failure

BACKGROUND

Patients with end-stage renal disease are prone to develop heart failure (HF). The N-terminal pro-brain natriuretic peptide (NT-proBNP, BNP) is regarded as the gold standard for diagnosing HF. However, its prognostic sensitivity in patients with end-stage renal disease is sub-optimal. Soluble suppression of tumorigenesis-2 (sST2) has been well studied in HF but rarely in patients with maintenance hemodialysis (MHD). This study aimed to evaluate the value of sST2 in predicting HF in MHD patients.

METHODS

Twenty-three patients with New York Heart Association (NYHA) class III-IV were included in the HF group and 88 NYHA class I-II patients in the non-heart failure (NHF) group. sST2 and laboratory indexes were compared between the two groups.

RESULTS

The HF group, compared with the NHF group, presented with higher sST2, more advanced age, higher incidence of coronary heart disease (CHD), left ventricle end-diastolic diameter (LVEDD), and pulmonary artery pressure (PAP), and unchanged parathyroid hormone (iPTH). The HF group also had lower ejection fraction (EF), uric acid, inorganic phosphorus, 25-OH VitD3, and serum albumin. Multivariate logistic regression indicated that age, BNP, and sST2 were independent risk factors of HF in MHD patients. Spearman analysis defined that sST2 was positively correlated with PAP (r =0.283, p =0.003) and C-reactive protein (r =0.354, p <0.001); and negatively correlated with sex (r =-0.255, p =0.007), albumin (r =-0.366, p <0.001), uric acid (r =-0.213, p =0.025), 25-OH VitD3 (r =-0.216, p =0.04), calcium (r =-0.219, p =0.021), and inorganic phosphorus (r =-0.256, p =0.007). Receiver operating characteristic curve analysis determined a positive association between BNP and sST2 (r =0.373, p <0.001), with the area under the curve (AUC) of BNP being 0.822 (sensitivity: 0.783, specificity: 0.830) and the AUC of sST2 being 0.841 (sensitivity: 0.913, specificity: 0.761). The AUC of sST2 was 0.841, and the cut-value was 42.840 (sensitivity: 0.913, specificity: 0.761).

CONCLUSION

sST2 can predict HF in MHD patients and facilitate early diagnosis and prevention of HF in MHD patients. HIPPOKRATIA 2022, 26 (1):19-24.

[Advances in the study of mesenchymal stem cells for end-stage liver disease]

End-stage liver disease refers to the advanced stage of liver disease caused by various chronic liver damage. Orthotopic liver transplantation is the most important final treatment option, but liver transplantation is still limited by many factors at present. Stem cell transplantation therapy has attracted widespread attention as a potential treatment for end-stage liver disease. This article reviews the research progress of mesenchymal stem cell therapy in end-stage liver disease.

[DJ-1 alleviates oxidative stress injury by activating the Nrf2 pathway in rats with cerebral ischemia-reperfusion injury]

OBJECTIVE

To investigate the antioxidant effect of DJ-1 (Park7) in rats with cerebral ischemia/reperfusion (IR) injury and its potential mechanism.

OBJECTIVE

A total of 108 SD rats were randomly divided into sham-operated group, middle cerebral artery occlusion (MCAO) group, Scramble group, DJ-1 siRNA group, negative control (NC) group and DJ-1 overexpression group. Except for those in the sham group, all the rats were subjected to MCAO to establish models of cerebral IR injury. In DJ-1 siRNA and DJ-1 overexpression group, a DJ-1 siRNA and an adeno-associated virus vector carrying DJ-1 gene was injected into the lateral ventricle of the rats, respectively. In each group, neurological scores and brain water content were determined after the operation, and pathological changes of the brain tissue and neuronal injury in the cortical infarction area were assessed using HE and Nissl staining. Oxidative stress in the brain tissues was analyzed by detecting superoxide dismutase (SOD) and malondialdehyde (MDA). The expression levels of DJ-1, Nrf2, Ho-1 and NQO1 in the brain tissue were detected with Western blotting, and the expression and nucleation of Nrf2 was determined by immunofluorescence staining.

OBJECTIVE

Compared with those in MCAO group, the neurological scores (P < 0.001) and brain water content (P < 0.001) were significantly increased in DJ-1 siRNA group. Intracerebral injection of DJ-1 siRNA following MCAO obviously aggravated neuron injury in cerebral ischemia region, further reduced SOD activity and increased MDA content (P < 0.001), and significantly lowered the expression levels of Nrf2 and its downstream proteins HO-1 and NQO1 (P < 0.001). Intracerebral injection of the adenoviral vector for DJ-1 (P=0.003) overexpression significantly upregulated the levels of Nrf2 (P=0.006) and its downstream proteins HO-1 (P=0.004) and NQO1 (P=0.014).

OBJECTIVE

As an important neuroprotective factor, DJ-1 alleviates oxidative stress induced by cerebral IR injury in rats by activating the Nrf2 pathway.

[Hepatic echinococcus granulosus: a clinicopathological analysis of thirteen cases]

Objective: To investigate the clinicopathologic characteristics of hepatic echinococcus granulosus (HEG). Methods: Thirteen cases of HEG were collected from Linzhi People's Hospital between January 2017 to October 2020, and their clinicopathologic features, ultrasound classification, immunophenotype and histochemical data were analyzed, retrospectively and the relevant literature was reviewed. Results: Thirteen patients (5 male patients, 8 female patients) were included in this cohort, and the mean age was 40 years. The most common clinical presentation was mild abdominal distention and pain (9/13). Based on WHO-IWGE ultrasound standardized classification, these cases were classified into 5 types, including type CL (1 case), type CE1 (2 cases), type CE2 (4 cases), type CE3 (3 cases) and type CE4 (3 cases). Gross examination revealed a solitary cyst localized in the liver, varying from 2.7 to 13.5 cm in diameter, and most of them(10/13)were more than 10 cm. Histopathologically, these cysts possessed a thin inner germinal layer and outer adventitial layer, and a central cavity filled with a clear"hydatid"fluid. The germinal layer was continuous and generated brood capsules and protoscoleces. The laminated membranes were clearly demonstrated by elastic fiber and Gomori's stains. Inside the"mother"cyst, there were a varying number of"daughter"vesicles of variable sizes. The inflammatory reaction around the cyst consisted of eosinophils, mononuclear cells immediately next to the cyst layer and sometimes formed granuloma and giant cells resembling the Langhan's type giant cells. The lymphoid cells were positive for CD20 and CD3. The CD68 immunohistochemistry clearly demonstrated epithelioid cells of granuloma in two cases. Moreover, immunohistochemistry revealed plasma cells were locally positive for CD38, IgG and IgG4, but not meeting the criteria for IgG4 related lesion. Conclusions: Hepatic echinococcus granulosus is a zoonotic parasitic disease prevalent in pastoral areas such as Tibet. It is important to understand its clinical features, ultrasound characteristics and histological morphology.

LncRNA CASC2 inhibits cell proliferation, metastasis and EMT through miR-18a/SOCS5 axis in cholangiocarcinoma

OBJECTIVE

Cholangiocarcinoma (CCA) is one of the tumors with high malignancy of the liver and bile system, whose development and prognosis mechanisms are still not clear. Here, a preliminary illustration was made on the expression and function of long non-coding RNA (lncRNA) CASC2 and the relevant mechanism of its function.

PATIENTS AND METHODS

Expression of CASC2 in CCA tissues and cells were examined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Cell proliferation ability was detected using colony formation and Cell Counting Kit-8 (CCK-8) assays while cell invasion and migration abilities were measured using transwell and Matrigel assays. Using bioinformatic analysis, underlying downstream molecules of CASC2 were predicted and by Dual-Luciferase assay and Western blot.

RESULTS

It was found that CASC2 was expressed at a significantly lower level in CCA tissues and cell lines. The overexpression of CASC2 inhibited QBC939 cell proliferation, invasion and migration when the knockdown of CASC2 accelerated HUCCT1 cell growth and metastasis. Besides, miR-18a was identified as a direct target for CASC2, and SOCS5 as target for miR-18a. Moreover, CASC2 functioned as a sponge of miR-18a to promote the SOCS5 expression, then, slowed down the epithelial-to-mesenchymal transition (EMT) progression.

CONCLUSIONS

CASC2 was downregulated in CCA tissues and cells. It could inhibit cell proliferation, invasion, migration and EMT via sponging miR-18a/SOCS5 axis. This might provide a novel target for CCA diagnosis and treatment.

[Clinical observation and analysis on the effect of orthokeratology in myopic anisometropic children]

Objective: To evaluate the clinical effects of orthokeratology lens on children with myopic anisometropia. Methods: Retrospective case series study. The data of 226 myopic anisometropia children, (10.83±1.56)years old, including 95 males and 131 females, fitted with orthokeratology(OK) lens in Beijing Tongren Hospital from June 2017 to June 2019 were collected. According to the lens wearing condition and baseline anisometropia, they were divided into four groups: group A1 with an average age of (10.68±1.66) years (bilateral OK lens wearing with low anisometropia, 1.0 D≤SE difference<2.5 D, 50 males and 61 females), group A2 with an average age of (11.24±1.38) years (bilateral OK lens wearing with moderate and high anisometropia, SE difference≥2.5 D, 10 males and 23 females), group B1 with an average age of (10.79±1.51) years (unilateral OK lens wearing with low anisometropia, 1.0 D≤SE difference<2.5 D, 17 males and 21 females) and group B2 with an average age of (10.97±1.60) years (unilateral OK lens wearing with moderate and high anisometropia, SE difference≥2.5 D, 18 males and 26 females). After wearing OK lens for one year, the changes of axial length(AL) and AL difference were observed and statistically analyzed. Results: (1) AL changes: after wearing OK-lens for one year, AL of each eye increased. In group A1, the AL of the more myopic eyes and the less myopic eyes increased by (0.20±0.21) mm and (0.24±0.22) mm respectively, and the difference was statistically significant (t=-3.208, P=0.002); in group A2, the AL growth of the more myopic eyes and the less myopic eyes were (0.04±0.11) mm and (0.17±0.14) mm, and the difference was statistically significant (t=-5.545, P<0.001). In group B1, the AL elongation of the more myopic eyes and the less myopic eyes were (0.14±0.21) mm and (0.39±0.23) mm, and in group B2, the AL growth of the more myopic eyes and the less myopic eyes were (0.11±0.14) mm and (0.54±0.24) mm, with statistically significant differences(t=-6.533, -11.643; all P<0.001). There was a linear correlation between AL elongation and age of the more myopic eyes and the less myopic eyes in group A1(corrected R²=0.208, 0.237) and group A2 (corrected R²=0.169, 0.360). There was no linear correlation of the more myopic eyes and the less myopic eyes between AL change and age or baseline myopia in group B1 (F=0.514, 1.205;P=0.602, 0.312) and group B2 (F=0.841, 0.056; P=0.439, 0.946). (2)Change of AL difference: after wearing OK lens for one year, the changes of AL difference in groupA1, A2, B1 and B2 were (-0.04±0.14) mm,(-0.13±0.13) mm,(-0.26±0.24) mm and (-0.43±0.25) mm, and the decrease of AL difference in moderate and high anisometropia groups were greater than that in low anisometropia groups (t =-3.211, -3.180; P=0.002, 0.002).There was a linear correlation between the reduction of AL difference and baseline anisometropia in group A1, A2 and B2 (corrected R²=0.099, 0.149, 0.230), and there was no linear relationship between the decrease of AL difference and the baseline anisometropia in group B1 (F=0.014, P=0.908). Conclusions: Orthokeratology could effectively control the progression of myopia and to treat anisometropia. The effect of myopia control was better in the older binocular OK lens wearers, and for the patients with greater baseline anisometropia, the treatment effect of anisometropia was better.

Analysis and evaluation of tomographic gamma scanning image reconstruction algorithm

Tomographic Gamma Scanning (TGS) is a nondestructive analysis technique for accurately measuring the content of radioactive material in sealed containers. It has important applications in the fields of nuclear safety assurance and the measurement and analysis of radioactive waste drums. As the key of TGS technique, the quality of the emission image reconstruction algorithm will directly affect the accuracy of measurement results. In this paper, a computer simulation platform for TGS technique is established. The application of four emission image reconstruction algorithms in TGS technique is systematically studied by using 6 · 6 · 6 sample voxel model. Three representative sample media and radioactive source distribution models are established and the applicability of the four reconstruction algorithms is analyzed and evaluated in the presence and absence of detector noise interference. Computer simulation and experimental results show that ML-EM algorithm is the most applicable in the process of TGS image reconstruction.