Objective To systematically review the efficacy of oxygen therapy for diabetic foot ulcers (DFUs). MethodsThe PubMed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCT) on the efficacy of different oxygen therapies for DFUs from inception to April 1, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Statistical analysis was performed using R software, and GraphPad Prism was used for graphical representations. ResultsA total of 61 RCTs involving 4 306 DFUs cases were included in the analysis. The oxygen therapies examined primarily included hyperbaric oxygen, topical oxygen, and ozone therapy. The surface under the cumulative ranking curve (SUCRA) indicated that hyperbaric oxygen therapy ranked highest for healing rate, area reduction rate, and healing time (SUCRA values were 0.957, 0.868, and 0.869, respectively). However, hyperbaric oxygen therapy also ranked higher for amputation rate and adverse events (SUCRA values were 0.616 and 0.718, respectively). Further subgroup analysis revealed that hyperbaric oxygen therapy maintained the highest ranking in area reduction rate across subgroups defined by publication language and treatment duration. ConclusionHyperbaric oxygen therapy shows advantages in terms of healing rate, area reduction rate, and healing time for DFUs, but it is also associated with higher amputation rates and adverse events. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To assess the efficacy and safety of laparoscopic staging and surgery for patients with cervical cancer. Methods We searched The Cochrane Library, MEDLINE, EMbase, CBM (from inception to 2009). Randomized controlled trials (RCTs) were identified according to the inclusion and exclusion criteria, and then the quality of included trials was accessed, and the data were extracted. Meta-analysis was performed by RevMan 5.0.2 software. Results Two RCTs involving 120 participants were included. The results of meta-analyses showed laparoscopic surgery, compared with open surgery, shortened postoperative ileus time (MD= –18.20, 95%CI –22.20 to –14.20, Plt;0.001), reduced the postoperative pain (MD= –1.30, 95%CI –1.86, to –0.74, Plt;0.001) and shortened the overall hospital stay (MD= –1.30, 95%CI –1.59 to –1.01, Plt;0.001). Currently, no evidence supported the superiority of laparoscopic surgery on duration of surgery, number of harvested lymph node and intraoperative blood loss over open surgery. Moreover, the laparoscopic surgery neither increased nor decreased the risk of postoperative complications. Conclusion The laparoscopic staging and surgery could shorten the recovery time of gastrointestinal function, shorten hospital stay, reduce pain in patients, but have no advantages in postoperative complications, operative time, number of lymph node biopsy, and intraoperative blood loss, compared with open surgery. However, the evidence is not b enough because of the low quality of the included studies. Thus, more high-quality RCTs are required in future.
Objective To systematically evaluate risk prediction models for acute exacerbation of chronic obstructive pulmonary disease (COPD), and provide a reference for early clinical identification. Methods The literature on the risk prediction models of acute exacerbation of COPD published by CNKI, VIP, Cochrane, Embase and Web of Science database was searched in Chinese and English from inception to April 2022, and relevant studies were collected on the development of risk prediction models for acute exacerbations of COPD. After independent screening of the literature and extraction of information by two independent researchers, the quality of the included literature was evaluated using the PROBASTA tool. Results Five prospective studies, one retrospective case-control study and seven retrospective cohort studies were included, totally 13 papers containing 24 models. Twelve studies (92.3%) reported the area under the receiver operator characteristic curve ranging 0.66 to 0.969. Only five studies reported calibrated statistics, and three studies were internally and externally validated. The overall applicability of 13 studies was good, but there was a high risk of bias, mainly in the area of analysis. Conclusions The existing predictive risk models for acute exacerbations of COPD are unsatisfactory, with wide variation in model performance, inappropriate and incomplete inclusion of predictors, and a need for better ways to develop and validate high-quality predictive models. Future research should refine the study design and study report, and continue to update and validate existing models. Secondly medical staff should develop and implement risk stratification strategies for acute exacerbations of COPD based on predicted risk classification results in order to reduce the frequency of acute exacerbations and to facilitate the rational allocation of medical resources.
ObjectiveTo investigate the expressions and significance of chemokines factor receptors 4 (CXCR4) and chemokines factor receptors 7 (CXCR7) in gastric cancer tissues. MethodsSixty-five patients with gastric cancer who treated in our hospital from January 2011 to June 2013 were retrospectively collected as gastric cancer group, and 20 patients with gastric ulcer were retrospectively collected as control group at the same time. The expressions of CXCR4 and CXCR7 in gastric cancer tissues and normal gastric tissues were measured by immunohistochemistry, and then the relation-ship among expressions of CXCR4/CXCR7 in gastric cancer tissues and clinicopathological features of patients with gastric cancer was explored, as well as its effect on survival. ResultsPositive expression rates of CXCR4 and CXCR7 were identi-fied in 80.00% (52/65) and 84.62% (55/65) of the gastric cancer group, and 5.00% (1/20) and 10.00% (2/20) in control group respectively, and the positive expression rates of CXCR4 and CXCR7 in gastric cancer group were significantly higher than those of control group respectively (χ2=36.65, P<0.01; χ2=38.55, P<0.01). The positive expression rate of CXCR4 in gastric cancer tissues was related with degree of differentiation, T staging, and TNM staging (P<0.05), positive expression rate of CXCR4 in patients with poor differentiation, T3-4 staging, and TNM Ⅲ-Ⅳ staging were higher than corresponding patients with moderate/high degree of differentiation, T1-2 staging, and TNM Ⅰ-Ⅱ staging. The positive expression rate of CXCR7 in gastric cancer tissues was related with degree of differentiation, T staging, and N staging (P<0.05), positive expression rate of CXCR7 in patients with poor differentiation, T3-4 staging, and N1-3 staging were higher than corrsponding patients with moderate/high degree of differentiation, T1-2 staging, and N0 staging. The survival situation was worse in patients with positive expression of CXCR4 and CXCR7 than corresponding patients with negative expression (P=0.01, P=0.01) respectively. ConclusionsCXCR4 and CXCR7 are related to gastric cancer genesis and development. Furthermore, the expressions of CXCR4 and CXCR7 could be used as markers to predict prognosis of gastric cancer. The regulation of CXCR4/chemokine ligand 12 (CXCL12) axis and CXCR7/CXCL12 axis may provide a new targeted therapy for patients with gastric cancer.
ObjectiveTo summarize the characteristics, diagnosis, and treatment of acral glomus tumor in order to improve the level of diagnosis and treatment. MethodsThe clinical data from 70 cases of acral glomus tumor treated between June 2004 and October 2013 were analyzed retrospectively. There were 11 males and 59 females with an average age of 41 years (range, 18-67 years). The disease duration ranged from 4 months to 30 years, with a median duration of 5 years. Sixty-nine cases had solitary tumors and only 1 patient had more than 1 lesion. The tumors were located on the finger in 66 patients (67 fingers) and the toe in 4 patients (4 toes); among them, the subungual glomus tumor happened in 44 patients (44 fingers and 1 toe). All patients suffered from paroxysmal pain and pinpoint pain with positive Love's pin test, and 29 patients (28 fingers and 1 toe) had positive cold sensitivity. Fifty-two patients (48 fingers and 4 toes) were found to have glomus tumor according to the high-frequency color doppler ultrasonography. X-ray films revealed depression on the phalanx in 16 patients (14 fingers and 2 toes). ResultsNo patient suffered from delayed incision healing, and infection after surgical treatment. The follow-up time was from 1 month to 9 years and 2 months with a median follow-up time of 20 months. The clinical symptoms disappeared after surgery with no dysfunction or recurrence. ConclusionThe diagnosis of acral glomus tumor is easy because of the typical symptoms:paroxysmal pain, pinpoint pain, and cold sensitivity. High-frequency color doppler ultrasonography may play an important role in the preoperative assessment of glomus tumors with accurate localization.
ObjectiveTo investigate the specific microRNA (miRNA) in osteogenic and chondrogenic differentiations of C3H10T1/2 cells. MethodsC3H10T1/2 cells were induced to differentiate into osteoblasts and chondrocytes.Specific miRNA more than 2 fold change and 2 average normalized probe signal between C3H10T1/2 and C3H10T1/2-derived osteoblast,and between C3H10T1/2 and C3H10T1/2-derived chondrocytes were screened out by miRNA microarray,and verified by real-time fluorescence quantitative PCR (RT-qPCR). ResultsAlkaline phosphatase expression of osteogenic induced group was significantly higher than that of control group at 7 days after induced (P<0.05).RT-qPCR results showed the expressions of Runx2,serine protease (Sp7),collagen type I,and osteopontin (OPN) genes were significantly increased at 7,14,and 21 days after induced when compared with before induced (P<0.05).Western blot results showed the expressions of Runx2,Sp7,collagen type I,and OPN proteins of osteogenic induced group were significantly higher than those of control group at 21 days after induced (P<0.05).The expressions of SOX9,collagen type Ⅱ,Aggrecan,and Has2 were significantly increased at 5,10,and 15 days after induced when compared with before induced (P<0.05).The expressions of SOX9,collagen type 2,Aggrecan,and Has2 proteins of chondrogenic induced group were significantly higher than those of control group at 15 days after induced (P<0.05).Totally,10 osteogenic and 3 chondrogenic miRNA more than 2 fold change and 2 average normalized probe signal were screened out by miRNA microarray.RT-qPCR results of these specific miRNAs were similar to microarray results except miR-455-3p. ConclusionSpecific miRNAs are screened out by microarray and it is a good foundation for the future study on miRNA functional verification and target gene prediction.
ObjectiveTo observe the effect of exosomes secreted by retinal pigment epithelial (RPE) cells which damaged by blue light to Nod-like receptor protein (NLRP3).MethodsCultured ARPE-19 cells were divided into 2 groups; one group of RPE cells were exposed to blue light irradiation for 6 hours, the other group was cultured in routine environment. Total exosomes were extracted from the two groups by differential ultracentrifugation in low-temperature, and examined by transmission electron microscope to identify their forms. The exosomes were then incubated with normal ARPE-19 cells. The expression level of CD63, interleukin (IL)-1β, IL-18 and caspase-1 on the exosome surface were measured by Western blotting. The expressions of NLRP3 mRNA in RPE cells were detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR).ResultsBlue light damaged the cellular morphology. Transmission electron microscopy showed that the exosomes were 50-200nm in diameter and like double-concave disks. Blue light damaged cell-derived exosomes had significantly higher expression of IL-1β (t=18.04), IL-18 (t=12.55) and caspase-1 (t=14.70) than the control group (P＜0.001). ARPE-19 cells cultured with blue light damaged cell-derived exosomes also had significantly higher expression of IL-1β (t=18.59), IL-18 (t=23.95) and caspase-1 (t=35.27) than control exosomes (P＜0.001). RT-PCR showed that the relative expression of NLRP3 mRNA of PRE cells in experimental group and control group were 1.000±0.069 and 0.2±0.01, respectively, the difference was significant (t=12.20, P＜0.001).ConclusionThe expression IL-1β, IL-18 and caspase-1 and NLRP3 mRNA were upregulated by exosomes secreted by blue light damaged-RPE cells.
Objective To investigate the protocols of combined culture of human placenta-derived mesenchymal stem cells (HPMSCs) and human umbilical vein endothelial cells (HUVECs) from the same and different individuals on collagen material, to provide the. Methods Under voluntary contributions, HPMSCs were isolated and purified from human full-term placenta using collagenase IV digestion and lymphocyte separation medium, and confirmed by morphology methods and flow cytometry, and then passage 2 cells were cultured under condition of osteogenic induction. HUVECs were isolated from fresh human umbilical vein by collagenase I digestion and subcultured to purification, and cells were confirmed by immunocytochemical staining of von Willebrand factor (vWF). There were 2 groups for experiment. Passage 3 osteoblastic induced HPMSCs were co-cultured with HUVECs (1 ∶ 1) from different individuals in group A and with HUVECs from the same individual in group B on collagen hydrogel. Confocal laser scanning microscope was used to observe the cellular behavior of the cell-collagen composites at 1, 3, 5, and 7 days after culturing. Results Flow cytometry showed that HPMSCs were bly positive for CD90 and CD29, but negative for CD31, CD45, and CD34. After induction, alizarin red, alkaline phosphatase, and collagenase I staining were positive. HUVECs displayed cobble-stone morphology and stained positively for endothelial cell marker vWF. The immunofluorescent staining of CD31 showed that HUVECs in the cell-collagen composite of group B had richer layers, adhered and extended faster and better in three-dimension space than that of group A. At 7 days, the class-like microvessel lengths and the network point numbers were (6.68 ± 0.35) mm/mm2 and (17.10 ± 1.10)/mm2 in group A, and were (8.11 ± 0.62) mm/mm2 and (21.30 ± 1.41)/mm2 in group B, showing significant differences between the 2 groups (t=0.894, P=0.000; t=0.732, P=0.000). Conclusion Composite implant HPMSCs and HUVECs from the same individual on collagen hydrogel is better than HPMSCs and HUVECs from different individuals in integrity and continuity of the network and angiogenesis.
ObjectiveTo observe the effect of exosomes derived from human umbilical cord blood mesenchymal stem cells (hUCMSC) on the expression of vascular endothelial growth factor (VEGF) A in blue light injured human retinal pigment epithelial (RPE) cells. MethodshUCMSC were cultured with exo-free fetal bovine serum for 48 hours, and then the supernatants were collected to isolate and purify exosomes by gradient ultracentrifugation method. Transmission electron microscopy was used to identify the morphology of exosomes. Surface specific maker protein CD63 and CD90 were detected via Western blot. Cultured ARPE-19 cells were divided into normal control group, blue light injured group and hUCMSC exosomes treated group. Cells were exposed to the blue light at the intensity of (2000±500) Lux for 12 hours to establish the light injured models. The cells of hUCMSC exosomes treated group were treated by different concentrations of exosomes for 8, 16, 24 hours. The mRNA and protein of VEGF-A were determined by real time-polymerase chain reaction and Western blot. Immunofluorescence assay were used to detect the expression levels of VEGF-A. ResultshUCMSC exosomes were successfully isolated, they exhibited round or oval shape and their diameter ranged from 50 to 100 nm with membrane structure through electron microscope. hUCMSC exosomes expressed the common surface marker protein CD63 and the surface marker protein CD90 of hUCMSC. The protein and mRNA level of VEGF A in the blue light injured group increased significantly compared to that in normal control group (t=-16.553, -19.456; P < 0.05). After treating with low, middle and high concentration of hUCMSC exosomes for 8, 16 and 24 hours, the protein and mRNA level of VEGF A of injured RPE were significantly decreased (P < 0.05). With the treated time and concentration of hUCMSC exosomes improved, the protein and mRNA level of VEGF A of injured RPE gradually decreased (P < 0.05). Immunofluorescence assay showed the protein level of VEGF-A of injured RPE gradually decreased with the same concentration of hUCMSC exosomes treated over time. ConclusionhUCMSC exosomes can effectively down-regulate the mRNA and protein level of VEGF-A in blue light injured RPE, the effect depends on the concentration and treated time of hUCMSC exosomes.