BACKGROUND:Glioma is the most common brain tumor. IDH mutations occur frequently in glioma, indicating a more favorable prognosis. We aimed to explore energy metabolism-related genes in glioma to promote the research and treatment. METHODS:Datasets were obtained from TCGA and GEO databases. Candidate genes were screened by differential gene expression analysis, then functional enrichment analysis was conducted on the candidate genes. PPI was also carried out to help determine the target gene. GSEA and DO analysis were conducted in the different expression level groups of the target gene. Survival analysis and immune cell infiltrating analysis were performed as well. RESULTS:We screened 34 candidate genes and selected GLUD1 as the target gene. All candidate genes were significantly enriched in 10 KEGG pathways and 330 GO terms. GLUD1 expression was higher in IDH-mutant samples than IDH-wildtype samples, and higher in normal samples than tumor samples. Low GLUD1 expression was related to poor prognosis according to survival analysis. Most types of immune cells were negatively related to GLUD1 expression, but monocytes and activated mast cells exhibited significantly positive correlation with GLUD1 expression. GLUD1 expression was significantly related to 119 drugs and 6 immune checkpoint genes. GLUD1 was able to serve as an independent prognostic indicator of IDH-mutant glioma. CONCLUSION:In this study, we identified an energy metabolism-related gene GLUD1 potentially contributing to favorable clinical outcomes of IDH-mutant glioma. In glioma, GLUD1 related clinical outcomes and immune landscape were clearer, and more valuable information was provided for immunotherapy.

This study aimed to explore the influence of circFOXM1/miR-218-5p molecular axis in the proliferation, apoptosis and migration of glioma cells. The levels of circFOXM1 and miR-218-5p in glioma and adjacent tissues were tested by qRT-PCR. Cultured human glioma U251 cells were randomly split into groups: si-NC, si-circFOXM1, miR-NC, miR-218-5p, si-circFOXM1+anti-miR-NC, si-circFOXM1+anti-miR-218-5p. MTT method, plate clone formation, flow cytometry and Transwell experiments were utilized for detecting the proliferation, clone formation, apoptosis and migration of glioma cells. Dual-luciferase reporter experiment authenticated the targeted relation of circFOXM1 and miR-218-5p. Western blot tested the levels of E-cadherin and N-cadherin. CircFOXM1 was upregulated while miR-218-5p was low expressed in glioma tissues versus normal tissues. After circFOXM1 silence or miR-218-5p overexpression, miR-218-5p level was increased, and cell apoptosis rate and E-cadherin expression were enhancive, whereas cell proliferation, cell clone formation and migration abilities, and N-cadherin level were reduced. CircFOXM1 could affect miR-218-5 level by negative regulation. Furthermore, miR-218-5p silence could reverse the stimulative influence of si-circFOXM1 on apoptosis rate, and E-cadherin level, and the repressive effect on cell viability, cell number of colony formation and migration, and N-cadherin expression. Inhibition of circFOXM1 expression could block the proliferation, clone formation, and migration and induce apoptosis of glioma cells by upregulating miR-218-5p.

背景与目的:基质细胞衍生因子1α(SDF-1α)是一种定向诱导细胞迁移的趋化因子,研究显示,间充质干细胞(MSCs)在受损组织中可以沿着SDF-1梯度迁移到损伤部位并参与组织修复,然而目前尚缺乏SDF-1α诱导脂肪来源干细胞(ASCs)对糖尿病缺血下肢进行组织修复的体内研究.因此,本研究探讨SDF-1α促进大鼠脂肪来源干细胞(rASCs)向糖尿病大鼠缺血下肢肌肉组织迁移及对组织修复的影响.方法:取SD大鼠脂肪组织分离培养rASCs,行细胞形态观察,鉴定成脂、成软骨及成神经分化能力,并使用带绿色荧光蛋白(GFP)的腺病毒转染和标记rASCs.将大鼠用STZ法构建糖尿病模型,并结扎大鼠的右下肢股动脉造成下肢缺血后,随机分为两组,通过尾静脉向两组大鼠体内注射rASCs,其中一组在患肢中段部位肌肉处注射SDF-1α蛋白(SDF-1α+rASCs组),另一组则用同样方式注射等量磷酸盐缓冲溶液(rASCs组).治疗后的第1、2周行大鼠双下肢血流量检测,计算及比较各组大鼠的缺血下肢-健侧下肢血流比值.在第4周时处死大鼠,取缺血部位的肌肉组织行HE染色,观察不同治疗方法组中肌肉组织的排列情况.以因子Ⅷ(FⅧ)作为微血管的标记,行免疫荧光染色,荧光显微镜下观察组织中FVIII及GFP的分布情况.结果:所培养的细胞呈长梭形或多角形样生长,并可向脂肪、软骨、神经细胞多向分化,鉴定为rASCs.糖尿病下肢缺血大鼠下肢血流量检测结果显示,在治疗后第1周SDF-1α+rASCs组的缺血下肢-健侧下肢血流比值明显高于rASCs组(0.33±0.03vs.0.26±0.02,P--0.016),治疗后第2周可发现上述差异进一步扩大(0.60±0.02vs.0.47±0.01,P=0.050).HE染色结果显示,在治疗后第4周SDF-1α+rASCs组大鼠的肌肉组织排列更为整齐.免疫荧光结果显示,SDF-1α+rASCs组的骨骼肌组织中rASCs的数量在治疗后第4周明显高于rASCs组(P＜0.05),还能观察到红色荧光(FⅧ)与绿色荧光(rASCs)的重叠.结论:通过提高缺血部位的SDF-1α的浓度能够有效增加迁移至患处的rASCs数量,从而获得优化rASCs改善患肢血流灌注,促进肌肉组织修复的明显效果.此外,rASCs分化为血管内皮细胞可能是rASCs促进缺血肌肉修复的关键机制之一.

目的 探讨淫羊藿苷(ICA)优化大鼠脂肪干细胞(rASCs)促进超长随意皮瓣存活的作用及机制.方法 选择6周龄雌性健康无特定病原体(SPF)级SD大鼠作为实验动物.提取rASCs并鉴定其多向分化能力及表面标志物.通过蛋白免疫印迹(WB)实验检测不同浓度ICA(0、0.1、1、10μM)对rASCs中血管生成因子[血管内皮生长因子(VEGF)、血小板源性生长因子?BB(PDGF?BB)、成纤维细胞生长因子?2(FGF?2)、胰岛素样生长因子?2(IGF?2)]表达的影响.设置rASCs组(予未处理的rASCs)、ICA+rASCs组(予1μM ICA预处理的rASCs)及空白对照组(予等体积PBS),每组3只大鼠,根据分组在皮瓣蒂部注射相应细胞悬液.于治疗后7、14、28 d评估皮瓣存活情况.治疗后28 d取皮瓣组织行组织学及WB实验,检测组织中微血管密度(MVD)、胶原含量及各血管生成因子的表达情况.结果 rASCs具有成脂、成骨和成软骨分化的能力,CD29及CD44呈高表达,不表达CD45.WB结果提示ICA处理能显著提高rASCs中血管生成因子的表达(P<0.05).动物实验结果显示,与空白对照组比较,rASCs组及ICA+rASCs组治疗后7 d、14 d的皮瓣存活面积比更高(P<0.05);在治疗后28 d,仅ICA+rASCs组的皮瓣存活面积比显著高于空白对照组(P<0.05).组织学实验结果显示,与空白对照组相比,rASCs组和ICA+rASCs组的皮瓣组织结构排列更为紧密,MVD、胶原含量显著提高(P<0.05).WB结果显示,rASCs组和ICA+rASCs组的VEGF、PDGF?BB和FGF?2蛋白表达水平均显著高于空白对照组(P<0.05),且ICA+rASCs组的VEGF、PDGF?BB蛋白表达水平较rASCs组更高,差异有统计学意义(P<0.05).结论 ICA能够提高rASCs血管生成因子的表达水平,这可能是其优化rASCs促进大鼠超长随意皮瓣存活的机制.

Objective:To explore the clinical characteristics of pneumocystis carinii pneumonia (PCP) after kidney transplantation.Methods:From January 2020 to January 2022, clinical data were retrospectively reviewed for 13 renal transplant recipients with pneumocystis pneumonia diagnosed by metagenomics next generation sequencing (mNGS). There were 3 females and 10 males with an age range of (46±10) years.The median time of postoperative onset was 10(2-21) months; The major clinical manifestations included fever ( n=11), cough ( n=7), expectoration ( n=6) and dyspnea ( n=11). Paired t-test was employed for analyzing the laboratory results at admission and discharge. Results:The diagnosis was confirmed by the detection of NGS in alveolar lavage fluid or venous blood.The levels of G test, LDH test, total T lymphocyte absolute count (CD3+ Abs), inhibitory/cytotoxic T lymphocyte count (CD3+ CD8+ Abs) and auxiliary/induced T lymphocyte absolute count (CD3+ CD4+ Abs) were (543.27±440.49) pg/ml, (529.98±222.43)U/L and (191.92±119.42)/μl, (87.33±50.59)/μl and (106.92±87.42)/μl at admission and (69.58±50.21) pg/ml, (285.38±46.62 U/L), (888.58±672.99)/μl, (336.83±305.21)/μl and (520.08±388.76)/μl at discharge.The differences were statistically significant ( P<0.001, P=0.002, 0.006, 0.017, 0.005). All of them received compound sulfamethoxazole and caspofungin.Except for one death due to septic shock after 21-day treatment, 12 cases were cured. Conclusions:mNGS test is one of the important tool for an early diagnosis of PCP.Combined use of compound sulfamethoxazole and caspofungin is an effective anti-infective regimen.And immune function monitoring is vital for adjusting antibiotic and immunosuppressive regimens.

Resveratrol (RSV) is known to possess anticancer properties in many types of cancers like breast cancer, in which POLD1 may serve as a potential target. However, the anticancer mechanism of RSV on triple negative breast cancer (TNBC) remains unclear. In the present study, the antitumor effects and mechanism of RSV on TNBC cells were analyzed by RNA sequencing (RNA-seq), which was then verified via cell counting kit-8 (CCK8), immunofluorescence, immunohistochemistry, Western Blot (WB), flow cytometry, and hematoxylin-eosin (HE) staining. According to the corresponding findings, the survival rate of MDA-MB-231 cells gradually decreased as RSV treatment concentration increased. The RNA-seq analysis results demonstrated that genes affected by RSV treatment were mainly involved in apoptosis and the p53 signaling pathway. Moreover, apoptosis of MDA-MB-231 cells induced by RSV was observed to be mainly mediated by POLD1. When treated with RSV, the expression levels of full length PARP1, PCNA, and BCL-2 were found to be significantly reduced, and the expression level of Cleaved-PARP1 as well as Cleaved-Caspase3 increased significantly. Additionally, the mRNA expression of POLD1 was significantly reduced after treatment with RSV, and the protein expression level was also inhibited by RSV in a concentration-dependent manner. The prediction of domain interaction suggested that RSV may bind to at least five functional domains of the POLD1 protein (6s1m, 6s1n, 6s1o, 6tny and 6tnz). Furthermore, after RSV treatment, the anti-apoptotic index (PCNA, BCL-2) of MDA-MB-231 cells was found to decrease while the apoptosis index (caspase3) increased. Moreover, the overexpression of POLD1 reduced the extent of apoptosis observed in MDA-MB-231 cells following RSV treatment. Moreover, animal experimental results showed that RSV had a significant inhibitory effect on the growth of live tumors, while POLD1 overexpression was shown to antagonize this inhibitory effect. Accordingly, this study’s findings reveal that RSV may promote the apoptosis of TNBC cells by reducing the expression of POLD1 to activate the apoptotic pathway, which may serve as a potential therapy for the treatment of TNBC.

Severe burns are acute wounds caused by local heat exposure, resulting in life-threatening systemic effects and poor survival. However, the specific molecular mechanisms remain unclear. First, we downloaded gene expression data related to severe burns from the GEO database (GSE19743, GSE37069, and GSE77791). Then, a gene expression analysis was performed to identify differentially expressed genes (DEGs) and construct protein-protein interaction (PPI) network. The molecular mechanism was identified by enrichment analysis and Gene Set Enrichment Analysis. In addition, STEM software was used to screen for genes persistently expressed during response to severe burns, and receiver operating characteristic (ROC) curve was used to identify key DEGs. A total of 2631 upregulated and 3451 downregulated DEGs were identified. PPI network analysis clustered these DEGs into 13 modules. Importantly, module genes mostly related with immune responses and metabolism. In addition, we identified genes persistently altered during the response to severe burns corresponding to survival and death status. Among the genes with high area under the ROC curve in the PPI network gene, CCL5 and LCK were identified as key DEGs, which may affect the prognosis of burn patients. Gene set variation analysis showed that the immune response was inhibited and several types of immune cells were decreased, while the metabolic response was enhanced. The results showed that persistent gene expression changes occur in response to severe burns, which may underlie chronic alterations in physiological pathways. Identifying the key altered genes may reveal potential therapeutic targets for mitigating the effects of severe burns.

目的:探讨淫羊藿苷(ICA)对乳腺癌细胞MCF-7的作用,以及ICA对表皮生长因子(EGF)诱导的MCF-7细胞上皮间质转化(EMT)的作用及机制.方法:CCK-8法检测ICA对乳腺癌细胞MCF-7存活能力的影响并确定后续试验的干预浓度;设立空白对照组、EGF刺激组、EGF+ICA组;划痕实验、Transwell迁移及侵袭实验检测EGF及ICA+EGF对MCF-7细胞迁移及侵袭能力的影响;Western Blot检测AKT、p-AKT、N-cadherin、E-cadherin、Vimentin蛋白表达水平.结果:ICA对乳腺癌细胞MCF-7有杀伤作用,且呈浓度依赖性;各组MCF-7细胞24h愈合率由高到低依次为:EGF刺激组＞EGF+ICA组＞空白对照组(P＜0.01);各组穿过膜的细胞数由高到低依次为:EGF刺激组＞EGF+ICA组＞空白对照组.与空白对照组比较,EGF刺激组p-AKT、N-cadherin、Vimentin蛋白表达量显著增加(P＜0.01),E-cadherin蛋白表达量显著减少(P＜0.01).与EGF刺激组比较,EGF+ICA组p-AKT、N-cadherin、Vimentin蛋白表达量显著减少(P＜0.01),E-cadherin蛋白表达量显著增加(P＜0.01).结论:ICA能够抑制乳腺癌细胞MCF-7的增殖.同时ICA还可以抑制EGF所诱导的EMT过程,可能是通过下调PI3K/AKT信号通路实现的.

Advanced platelet-rich fibrin (A-PRF) is an autogenous biological material obtained from peripheral blood. A-PRF extract (A-PRFe) contains a high concentration of various cytokines that are increasingly appreciated for their roles in improving stem cell repairing function during tissue regeneration. However, the optimal A-PRFe concentration to stimulate stem cells is unknown. This study aimed to identify the optimal concentrations of A-PRFe to promote adipogenic and osteogenic differentiation of human adipose-derived stem cells (ASCs). We produced A-PRFe from A-PRF clots by centrifuging fresh peripheral blood samples and isolated and identified ASCs using surface CD markers and multilineage differentiation potential. Enzyme-linked immunosorbent assay (ELISA) showed the concentrations of several cytokines, including b-FGF, PDGF-BB, and others, increased gradually, peaked on day 7 and then decreased. Cell proliferation assays showed A-PRFe significantly stimulated ASC proliferation, and proliferation significantly increased at higher A-PRFe doses. The degree of adipogenic and osteogenic differentiation increased at higher A-PRFe concentrations in the culture medium, as determined by oil red O and alizarin red staining. Reverse transcription polymerase chain reaction (RT-PCR) showed that expression levels of genes related to adipogenic/osteogenic differentiation (PPARγ2, C/EBPα, FABP4, Adiponectin, and ALP, OPN, OCN, RUNX2), paracrine (HIF-1α, VEGF, IGF-2) and immunoregulation (HSP70, IL-8) function were higher in groups with a higher concentration of A-PRFe than in lower concentration groups. This study demonstrates that A-PRFe is ideal for use in ASC applications in regenerative medicine because it improves biological functions, including proliferation, adipogenic/osteogenic differentiation, and paracrine function in a dose-dependent manner.

Purpose There has been a resurgence of interest in the tumor stroma in recent years. Whether the relative abundance of various stromal cells can be used as a classification system for muscle-invasive bladder cancer (MIBC) remain elusive.Methods We applied single-cell RNA-sequence (scRNA-seq) data from two MIBCs to identify stromal cell (CD45 negative cells) clusters and the marker gene set of each cell cluster. The single sample gene set enrichment analysis method is used to estimate the relative abundance of the cell clusters in each MIBC sample from The Cancer Genome Atlas. Subsequently, k-means clustering was performed to cluster the MIBCs. Prognosis, oncogenic pathway enrichment score, epithelial-mesenchymal transition (EMT) score, gene mutation frequency, and tumor infiltrating lymphocytes (TILs) were compared among the stromal component-based types of MIBC.ResultsIn the scRNA-seq analysis, a total of nine cell clusters mainly composed of four types of cells were identified. Cell clusters 0, 1, 2, 3, 4, and 7 were considered as bladder epithelial cells, the cells in clusters 5 and 8 were mainly recognized as stem cells and fibroblasts, and the cell cluster 6 was recognized were endothelial cells. The 408 MIBC samples were classified into three types. Type 1 and 3, the “stromal-sufficient” type I and II with higher stromal cells, and Type 2, the “stromal-desert” type with lower stromal cells. The stromal-desert type had significantly better overall survival. As the tumor progresses, the stromal component of the stromal-desert type increases and change into the stromal-sufficient type. Increased stromal cells may come from EMT. The enrichment scores of multiple oncogenic pathways in stromal-sufficient types were significantly higher than those in stromal-desert type. More TILs were found in stromal-sufficient type, but their function may be inhibited by stromal cells. In addition, the three stromal types of MIBC may have specific gene mutation characteristics.Conclusions We proposed a novel stromal component-based classification system to divided into MIBC three phenotype. The three types of MIBC differ in various biological characteristics. The progress of MIBC may be summarized as the process of gradually increasing stromal components and constructing a microenvironment suitable for cancer cells.

OBJECTIVE:To explored the effect of stromal cell-derived factor 1α (SDF-1α) on promoting the migration ability of rat adipose derived stem cells (rADSCs) by constructed the rADSCs overexpression SDF-1α via adenovirus transfection.METHODS:rADSCs were isolated from adipose tissue of 6-week-old SPF Sprague Dawley rats. Morphological observation, multi-directional differentiations (osteogenic, adipogenic, and chondrogenic inductions), and flow cytometry identification were performed. Transwell cell migration experiment was used to observe and screen the optimal concentration of exogenous SDF-1α to optimize the migration ability of rADSCs; the optimal multiplicity of infection (MOI) of rADSCs was screened by observing the cell status and fluorescence expression after transfection. Then the third generation of rADSCs were divided into 4 groups: group A was pure rADSCs; group B was rADSCs co-cultured with SDF-1α at the best concentration; group C was rADSCs infected with recombinant adenovirus-mediated green fluorescent protein (Adv-GFP) with the best MOI; group D was rADSCs infected with Adv-GFP-SDF-1α overexpression adenovirus with the best MOI. Cell counting kit 8 (CCK-8) and Transwell cell migration experiment were preformed to detect and compare the effect of exogenous SDF-1α and SDF-1α overexpression on the proliferation and migration ability of rADSCs.RESULTS:The cell morphology, multi-directional differentiations, and flow cytometry identification showed that the cultured cells were rADSCs. After screening, the optimal stimulating concentration of exogenous SDF-1α was 12.5 nmol/L; the optimal MOI of Adv-GFP adenovirus was 200; the optimal MOI of Adv-GFP-SDF-1α overexpression adenovirus was 400. CCK-8 method and Transwell cell migration experiment showed that compared with groups A and C, groups B and D could significantly improve the proliferation and migration of rADSCs ( P<0.05); the effect of group D on enhancing the migration of rADSCs was weaker than that of group B, but the effect of promoting the proliferation of rADSCs was stronger than that of group D ( P<0.05).CONCLUSION:SDF-1α overexpression modification on rADSCs can significantly promote the proliferation and migration ability, which may be a potential method to optimize the application of ADSCs in tissue regeneration and wound repair.

目的 观察自体富血小板纤维蛋白(PRF)提取液复合德莫林对患者手术后切口愈合及瘢痕形成的影响.方法 选取2015年1月～2017年12月于南宁市第一人民医院就诊的腹部、颈部、乳腺开放性手术患者各40 例,按照配伍分组将三种手术患者分为A、B、C、D 四组,每组腹部、颈部、乳腺开放性手术患者各10 例,A 组采用自体PRF 提取液复合德莫林涂抹切口、B组采用PRF提取液涂抹切口、C组采用德莫林喷剂涂抹切口、D组采用生理盐水清洗切口.从患者外周静脉血提取出PRF,分别在第1、3、7、14、28天收集PRF分泌的上清液进行细胞因子检测;比较各组不同部位术后切口愈合时间、切口疼痛级别、瘢痕面积.结果 PRF凝胶分泌上清液中所包含的各种细胞因子第1～7天浓度逐渐升高,第7天达峰值,随后浓度逐渐降低;A组颈部、乳腺、腹部切口愈合时间、切口疼痛级别均短于B、C、D组,各组与对照组比较,差异有统计学意义(P＜0.05);A组颈部、乳腺、腹部术后切口瘢痕增生程度低于B、C、D 组,差异有统计学意义(P＜0.05);B 组颈部、乳腺及腹部术后切口瘢痕增生程度低于C、D组,差异有统计学意义(P＜0.05);C组颈部、乳腺及腹部术后切口瘢痕增生程度低于D组,差异有统计学意义(P＜0.05).结论 PRF凝胶提取液中包含多种细胞因子,提取液复合德莫林对减少患者术后切口愈合时间、切口疼痛级别、瘢痕面积起到协同作用.

Augmenting the biological function of adipose-derived stromal cells (ASCs) is a promising approach to promoting tissue remodeling in regenerative medicine. Here, we examined the effect of ginsenoside Rg1 on the paracrine activity and adipogenic differentiation capacity of human breast ASCs (hbASCs) in vitro. hbASCs were isolated and characterized in terms of stromal cell surface markers and multipotency. Third-passage hbASCs were cultured in basic media only or basic media containing different concentrations of G-Rg1 (0.1–100 μM). Cell proliferation was assessed by CCK-8 assay. Paracrine activity was assessed using ELISA. Gene expression was measured by qRT-PCR. Adipogenic differentiation capacity was evaluated by Oil red O staining. We found that hbASCs differentiated into adipocytes, osteoblasts, and chondrocytes in appropriate induction culture medium. hbASCs showed expression of CD29, CD44, CD49d, CD73, CD90, CD105, and CD133 but not CD31 and CD45 surface markers. G-Rg1 increased hbASC proliferation and adipogenic differentiation capacity at lower concentrations (0.1–1 μM) and had the opposite effects at higher concentrations (10–100 μM), while enhanced paracrine activity was observed in all experimental groups compared with control group, and the activation effect of lower concentration G-Rg1 was greater than at higher concentration. These results indicate that G-Rg1 can enhance the proliferation, paracrine activity, and adipogenic differentiation capacity of hbASCs within a certain concentration range. Therefore, the use of G-Rg1 may be beneficial to ASC-assisted fat graft regeneration and soft tissue engineering.

目的 目前对于Ⅳ期男性乳腺癌原发灶手术切除考虑谨慎,但原发灶手术有可能够提高生存率.分析手术与否与Ⅳ期男性乳腺癌预后获益有何相关,并分析其获益因素,为男性乳腺癌诊治提供依据.方法 提取美国国立癌症研究所数据库(Surveillance,Epidemiology,and End Results,SEER)1990-01-01-2009-12-31共344例Ⅳ期男性乳腺癌患者数据,采用t检验和χ2检验进行单变量描述性分析,Cox比例风险模型进行单因素分析及多因素分析,以确定与生存的独立因素.Log-rank检验并绘制Kaplan-Meier生存曲线分析手术对预后的影响.结果 单因素分析发现,原发部位手术能够使Ⅳ期男性乳腺癌得到生存获益(手术与非手术比较,P<0.001),患者诊断年龄(>65岁/≤65岁,HR=1.580,95％CI:1.268～1.971,P<0.001)与雌激素受体(阳性/阴性,HR=1.965,P<0.001)和孕激素受体(阳性/阴性,HR=1.312,P<0.001)是影响Ⅳ期男性乳腺癌预后的主要保护因素;多因素分析发现,患者年龄、雌激素受体状态、手术与否是显著影响患者预后,均P<0.001.结论 Ⅳ期男性乳腺癌患者接受原发灶手术后提高了患者的生存率,其中雌激素受体/孕激素受体阳性患者有生存优势,可为今后男性乳腺癌诊治的参考.

目的 系统评价糠酸莫米松和丙酸氟替卡松分别治疗变应性鼻炎的疗效与安全性.方法 计算机检索Cochrane Library,PubMed,EMbase,CNKI,CBM,VIP,WANFANG数据库,纳入有关随机对照试验,检索时间均从建库至2018年1月,按照Cochrane系统评价方法进行文献数据提取和质量评价,采用RevMan 5.3软件进行Meta分析.结果 纳入6个随机对照试验,共930例患者.Meta分析结果显示,糠酸莫米松与丙酸氟替卡松相比,治疗前后鼻塞[SMD=-0.30,95％CI(-0.56,-0.03),P=0.03]、流鼻涕[SMD=-0.28,95％CI(-0.54,-0.02),P=0.04]差异显著;打喷嚏[SMD=-0.04,95％CI(-0.31,0.22),P=0.75]、鼻痒[SMD=-0.19,95％CI(-0.51,0.13),P=0.25]、不良反应发生率[OR=0.90,95％CI(0.61,1.32),P=0.58]、生活质量评分(t=1.23,P=0.224)差异均不显著.结论 糠酸莫米松改善变应性鼻炎患者鼻塞、流鼻涕症状疗效优于丙酸氟替卡松,改善喷嚏、鼻痒疗效及不良反应与丙酸氟替卡松无显著性差异,但受纳入研究数量和质量的限制,尚待更多高质量研究予以验证.

Background/Aims: The rejuvenation properties of nanofat grafting have been described in recent years. However, it is not clear whether the clinical efficacy of the procedure is attributable to stem cells or linked to other components of adipose tissue. In this study we isolated nanofat-derived stem cells (NFSCs) to observe their biological characteristics and evaluate the efficacy of precise intradermal injection of nanofat combined with platelet-rich fibrin (PRF) in patients undergoing facial rejuvenation treatment. Methods: Third-passage NFSCs were isolated and cultured using a mechanical emulsification method and their surface CD markers were analyzed by flow cytometry. The adipogenic and osteogenic nature and chondrogenic differentiation capacity of NFSCs were determined using Oil Red O staining, alizarin red staining, and Alcian blue staining, respectively. Paracrine function of NFSCs was evaluated by enzyme-linked immunosorbent assay (ELISA) at 1, 3, 7, 14, and 28 days after establishing the culture. Then, the effects of PRF on NFSC proliferation were assessed in vitro. Finally, we compared the outcome in 103 patients with facial skin aging who underwent both nanofat and intradermal PRF injection (treatment group) and 128 patients who underwent hyaluronic acid (HA) injection treatment (control group). Outcomes in the two groups were compared by assessing pictures taken at the same angle before and after treatment, postoperative recovery, incidence of local absorption and cysts, and skin quality before treatment, and at 1, 12, 24 months after treatment using the VISIA Skin Image Analyzer and a SOFT5.5 skin test instrument. Results: NFSCs expressed CD29, CD44, CD49d, CD73, CD90, and CD105, but did not express CD34, CD45, and CD106. NFSCs also differentiated into adipocytes, osteoblasts, and chondrocytes under appropriate induction conditions. NFSCs released large amounts of growth factors such as VEGF, bFGF, EGF, and others, and growth factor levels increased in a time-dependent manner. At the same time, PRF enhanced proliferation of NFSCs in vitro in a dose-dependent manner, and the growth curves under different concentrations of PRF all showed plateaus 6d after seeding. Facial skin texture was improved to a greater extent after combined injection of nanofat and PRF than after control injection of HA. The nanofat-PRF group had a higher satisfaction rate. Neither treatment caused any complications such as infection, anaphylaxis, or paresthesia during long-term follow-up. Conclusion: NFSCs demonstrate excellent multipotential differentiation and paracrine function, and PRF promotes proliferation of NFSCs during the early stage after seeding. Both nanofat-PRF and HA injection improve facial skin status without serious complications, but the former was associated with greater patient satisfaction, implying that nanofat-PRF injection is a safe, highly effective, and long-lasting method for skin rejuvenation.