Acute liver failure:A systematic review and network meta-analysis of optimal type of stem cells in animal models

BACKGROUND The therapeutic effects of various stem cells in acute liver failure(ALF)have been demonstrated in preclinical studies.However,the specific type of stem cells with the highest therapeutic potential has not been determined.AIM To validate the efficacy of stem cells in ALF model and to identify the most promising stem cells.METHODS A search was conducted on the PubMed,Web of Science,Embase,Scopus,and Cochrane databases from inception to May 3,2022,and updated on November 16,2022 to identify relevant studies.Two independent reviewers performed the literature search,identification,screening,quality assessment,and data extraction.RESULTS A total of 89 animal studies were included in the analysis.The results of traditional meta-analysis showed that stem cell therapy could significantly reduce the serum levels of alanine aminotransferase[weighted mean difference(WMD)=-181.05(-191.71,-170.39)],aspartate aminotransferase[WMD=-309.04(-328.45,-289.63)],tumor necrosis factor-alpha[WMD=-8.75(-9.93,-7.56)],and interleukin-6[WMD=-10.43(-12.11,-8.76)]in animal models of ALF.Further subgroup analysis and network meta-analysis showed that although mesenchymal stem cells are the current research hotspot,the effect of liver stem cells(LSCs)on improving liver function is significantly better than that of the other five types of stem cells.In addition,the ranking results showed that the possibility of LSCs improving liver function ranked first.This fully proves the great therapeutic potential of LSCs,which needs to be paid more attention in the future.CONCLUSION LSCs may have a higher therapeutic potential.Further high-quality animal experiments are needed to explore the most effective stem cells for ALF.

Thrombolysis during extended cardiopulmonary resuscitation for autoimmune-related pulmonary embolism

BACKGROUND: Massive pulmonary embolism(MPE) and acute myocardial infarction are the two most common causes of cardiac arrest(CA). At present, lethal hemorrhage makes thrombolytic therapy underused during cardiopulmonary resuscitation, despite the potential benefits for these underlying conditions. Hypercoagulability of the blood in autoimmune disorders(such as autoimmune hemolytic anemia) carries a risk of MPE. It is critical to find out the etiology of CA for timely thrombolytic intervention.METHODS: A 23-year-old woman with a 10-year medical history of autoimmune hemolytic anemia suffered from CA in our emergency intensive care unit. ECG and echocardiogram indicated the possibility of MPE, so f ibrinolytic therapy(alteplase) was successful during prolonged resuscitation.RESULTS: Neurological recovery of the patient was generally good, and no fatal bleeding developed. MPE was documented by CT pulmonary angiography.CONCLUSIONS: A medical history of autoimmune disease poses a risk of PE, and the causes of CA(such as this) should be investigated etiologically. A therapy with alteplase may be used early during cardiopulmonary resuscitation once there is presumptive evidence of PE. Clinical trials are needed in this setting to study patients with hypercoagulable states.

电纺胶原膜的制备及其生物学评价

以六氟异丙醇为溶剂,采用喷雾静电纺丝技术将胶原（CoL）溶液与不同浓度的戊二醛（GA）共纺,通过原位交联技术获得GA-CoL共纺膜,对其进行了机械性能和生物学评价.结果表明,GA浓度为9wt%时,GA-CoL共纺膜的纤维直径集中在450-750nm,分布均匀,且CoL三螺旋结构保存完好,共纺膜断裂强度最高,为1.21±0.03MPa,断裂延伸率最大,为6.48%,共纺膜接触角为45.4o.共纺膜对细胞增殖的影响与对照组（纯CoL纺丝膜）没有显著差异（P〉0.05）.

Efficacy of a novel endotoxin adsorber polyvinylidene fluoride fiber immobilized with L-serine ligand on septic pigs

A novel adsorber,polyvinylidene fluoride matrix immobilized with L-serine ligand (PVDF-Ser),was developed in the present study to evaluate its safety and therapeutic efficacy in septic pigs by extracorporeal hemoperfusion.Endotoxin adsorption efficiency (EAE) of the adsorber was firstly measured in vitro.The biocompatibility and hemodynamic changes during extracorporeal circulation were then evaluated.One half of 16 pigs receiving lipopolysaccharide (Escherichia coli O111:B4,5 μg/kg) intravenously in 1 h were consecutively treated by hemoperfusion with the new adsorber for 2 h.The changes of circulating endotoxin and certain cytokines and respiratory function were analyzed.The 72 h-survival rate was assessed eventually.EAE reached 46.3% (100 EU/ml in 80 ml calf serum) after 2 hcirculation.No deleterious effect was observed within the process.The plasma endotoxin,interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) levels were decreased during the hemoperfusion.Arterial oxygenation was also improved during and after the process.Furthermore,the survival time was significantly extended (>72 h vs.47.5 h for median survival time).The novel product PVDF-Ser could adsorb endotoxin with high safety and efficacy.Early use of extracorporeal hemoperfusion with the new adsorber could reduce the levels of circulating endotoxin,IL-6,and TNF-α,besides improve respiratory function and consequent 72 h-survival rate of the septic pigs.Endotoxin removal strategy with blood purification using the new adsorber renders a potential promising future in sepsis therapy.

Validation of Reliable Reference Genes for Accurate Normalization in RT-qPCR Analysis of Codonopsis pilosula

Objective To identify reliable reference genes（RGs） for normalization of real-time PCR（RT-q PCR） data in Codonopsis pilosula. Methods The expression profiles of 10 candidate RGs（GAPDH, ACT, α-TUB, β-TUB, UBQ, CYP, EF-1α, NAC, F-box and PP2A） were examined in C. pilosula during the phenological period. The raw materials examined included roots, stems, leaves, and flower buds at flowering and boll-forming stages, five growth stages of untreated and treated roots with plant growth retardant. The best-suited RGs were accessed using ge Norm, NormF inder, Best Keeper, and Ref Finder algorithms. Results The best-ranked references genes differed across the samples. GAPDH and PP2A were the most suitable for expression analysis in untreated tissues while GAPDH, α-TUB, and PP2A were ranked as the three most stably expressed genes in untreated roots, while NAC and CYP were the most stably expressed genes in stressed（i.e., treated） roots. The expression of UGPase, a key enzyme for CPP biosynthesis, was determined to further validate the selected RGs. Conclusion A total of 10 RGs can be used as reference genes of C. pilosula, however the appropriate one should be used as it may chance.