Effect of Guhong injection combined with atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction

Objective:To explore the effect of Guhong Injection combined with atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction.Methods:To select 90 patients with acute cerebral infarction in our hospital,divided into control group(48 cases)and observation group(48 cases)randomly.Patients in the control group were treated with alteplase on the basis of routine symptomatic treatment,and the observation group was treated with Guhong injection on the basis of the control group.Before and after treatment,the serum levels of related factors were detected and compared between the two groups.Results:Before treatment,there were no significant differences in serum related factors(ET-1,PAO,H-FABP,VEGF,S100β,BDNF,CEC,Fibulin-5,vWF,P-selectin,t-PA,PAI-1)between the two groups;After treatment,the serum levels of ET-1,PAO,H-FABP,S100β,CEC,Fibulin-5,vWF,P-selectin,PAI-1 in the observation group were significantly lower than those in the control group,and the serum levels of VEGF,BDNF and t-PA were higher than those in the control group,there were significant differences between the two groups.Conclusion:Guhong injection was added to patients with acute cerebral infarction on the basis of routine symptomatic treatment and ateplase,could significantly improve the level of serum related factors,it was more conducive to the control of symptoms and rehabilitation of patients,the effect was definite,it was worth further study and application in clinic.

Genomic DNA Isolation by Phenol/Chloroform Extracting Method from Sheep Blood Clot

[ Objective] The aim was to establish the method of extracting genomic DNA from sheep blood clot on the basis of the improvement of method for extracting genomic DNA from tissues. [Method]The genomic DNA with complete primary structure and high purity was obtained from the sheep blood clot after the steps of cutting the sheep blood clot with ophthalmic scissors, cell lysis with tissue DNA extracts and digested by proteinase K, extracting with phenol/chloroform and precipitating with ethanol were performed. [ Result] The concentration of the extracted DNA was 159.90 ±0.70 ng/μl and the ratio of the A260/A280 was 1.80 ＋0.01. The sheep microsatellite locus of BM203 was amplified by using the extracted DNA from the sheep blood clot as template of PCR, and the PCR result was perfect. [Conclusion]This method is simple and feasible, the quantity and quality of the extracted DNA can satisfy the demands for the subsequent researches. It is worth to extending and using for reference.

Century Clot在大咯血输血中的指导价值研究

目的 探讨Century Clot在大咯血输血中的指导价值。方法 选取收治60例大咯血患者。随机分为研究组和对照组各30例,除原有治疗方案外,研究组行centuryclot指导输血;对照组行凝血四项及血常规指导输血。比较两组咯血停止时间、治疗后总咯血量及输血总量,比较两组治疗前后的凝血功能(包含TT、PT、APTT以及FIB)及凝血功能监测的准确率。结果 研究组咯血停止时间短于对照组,总咯血量及总输血量低于对照组(P<0.05)。治疗前,两组凝血功能无明显差异(P>0.05);治疗后,两组TT、PT及APTT水平均低于治疗前,且研究组均低于对照组(P<0.05);治疗后,两组FIB均高于治疗前,且研究组高于对照组(P<0.05)。研究组误诊率及漏诊率均低于对照组,但差异无统计学意义(P>0.05),准确率高于对照组(P<0.05)。结论 通过Centuryclot指导大咯血患者输血,不仅可精准止血,还可以有效改善患者凝血功能,减少咯血量及节约血制品。

Intraclot Recombinant Tissue-type Plasminogen Activator Reduces Perihematomal Edema and Mortality in Patients with Spontaneous Intracerebral Hemorrhage

The study aimed to investigate the impact of intraclot recombinant tissue-type plasminogen activator （rt-PA） on perihematomal edema （PHE） development in patients with intracerebral hemorrhage （ICH） treated with minimally invasive surgery （MIS） and the effects of intraclot rt-PA on the 30-day survival. We reviewed the medical records of ICH patients undergoing MIS between October 2011 and July 2013. A volumetric analysis was done to assess the change in PHE and ICH volumes at pre-MIS （T1）, post-MIS （T2） and day 10-16 （T3） following diagnostic computed tomographic scans （To）. Forty-three patients aged 52.8±11.1 years with （n=30） or without rt-PA （n=13） were enrolled from our institutional ICH database. The median rt-PA dose was 1.5 （1） mg, with a maximum dose of 4.0 mg. The ratio of clot evacuation was significantly increased by intraclot rt-PA as compared with controls （77.9%±20.4% vs. 64%±15%; P=0.046）. From TI to T2, reduction in PHE volume was strongly associ- ated with the percentage of clot evacuation （p=0.34; P=-0.027）. In addition, PHE volume was positively correlated with residual ICH volume at the same day （p ranging from 0.39-0.56, P〈0.01）. There was no correlation between the cumulative dose of rt-PA and early （T2） PHE volume （p=0.24; P=0.12） or de- layed （T3） PHE volume （p=0.19; P=0.16）. The 30-day mortality was zero in this cohort. In the selected cohort of ICH patients treated with MIS, intraclot rt-PA accelerated clot removal and had no effects on PHE formation. MIS aspiration and low dose of rt-PA seemed to be feasible to reduce the 30-day mor- tality in patients with severe ICH. A large, randomized study addressing dose titration and long-term outcome is needed.

用Sonoclot分析仪测评体外循环后凝血功能的改变

目的用Sonoclot凝血和血小板功能分析仪观察心脏直视手术体外循环前、后凝血功能的改变。方法选择20例体外循环下心脏手术患者,麻醉前及首次鱼精蛋白中和肝素后10 min取静脉血用Sonoclot分析仪检测全血凝血和血小板功能,并进行激活全血凝固时间(ACT)测定。结果体外循环前后ACT差异无显著性(P=0.27),而使用玻璃珠作为促凝剂的检测试剂盒(gb-ACTKit)术后明显高于术前(P<0.01),凝血速率(CR)术后明显降低(P=0.01),血小板功能(PF)降低但无显著差异(P=0.50)。结论Sonoclot分析仪能够早期检测体外循环后凝血功能的改变,是一种较为敏感的床边检测方法。

Promising way to address massive intragastric clotting in patients with acute upper gastrointestinal bleeding:A case report

BACKGROUND Massive intragastric clotting(MIC) makes endoscopic therapy difficult in patients with acute upper gastrointestinal bleeding. Literature data on how to address this problem are limited. Here, we report on a case of massive stomach bleeding with MIC that was successfully treated endoscopically using an overtube of singleballoon enteroscopy.CASE SUMMARY A 62-year-old gentleman with metastatic lung cancer was admitted to the intensive care unit due to tarry stools and hematemesis of 1500 mL of blood during hospitalization. Emergent esophagogastroduodenoscopy revealed massive blood clots and fresh blood in the stomach with evidence of active bleeding.Bleeding sites could not be observed even by changing the patient’s position and aggressive endoscope suction. The MIC was successfully removed using an overtube connected with a suction pipe, which was inserted into the stomach with an overtube of a single-balloon enteroscope. An ultrathin gastroscope was also introduced through the nose into the stomach to guide the suction. A massive blood clot was successfully removed, and an ulcer with oozing bleeding at the inferior lesser curvature of the upper gastric body was revealed, facilitating endoscopic hemostatic therapy.CONCLUSION This technique appears to be a previously unreported method to suction MIC out of the stomach in patients with acute upper gastrointestinal bleeding. This technique could be considered when other methods are not available or if they fail to remove massive blood clots in the stomach.

Influence of styptic fiber on clotting time in rabbits

Objective To explore the influence of styptic fiber on clotting time in rabbits so as to provide experiment data for its development.Methods Onto 0.1 mL aliquots of citrated anti-coagulant rabbit blood placed in a surfacial plate 25 ul of 0.2 mol·L-1 CaCl2 solution was dropped,and mixed well with glass stirrer;the resulting mixture was immediately capped with a piece of styptic fiber(test product group)or absorptive gelatin sponge(positive control group)of 2 cm diameter.Then,the surficial plate was rinsed with 30ml of purified water at 5,10,20,30,40 and 50 min after capping;the rinsings were allowed to stand for 1 h and were subjected to OD determination at a wavelength of 541 nm.The above procedure was repeated twice,the average value of the twice experiments was taken for evaluation of the hemostatic effect of test product.For negative control group,all procedures except for capping were same as the test product group.The haemostatic effect was judged by percent OD relative to OD at 0 min in negative control group(OD 0 min)(OD 0 min was considered as 100%);if OD value at a time was less than 80% of OD 0 min,it should be designated as primary clotting time(PCT),less than 20% as complete clotting time(CCT).Results The measured PCT was 20min for both negative and positive control groups;CCT was 50,30 and 5 min for negative control,positive control and test product groups,respectively,showing the test styptic fiber had a CCT 8 times shorter than untreated blood,10 times shorter than negative control and 6 times shorter than positive control.Conclusions The test styptic fiber has powerful hemostatic effect.

Correlation of fibrinogen level and absorbance change in both PT and APTT clotting curves on BCSXP

Objective： To investigate the correlation of fibrinogen level and absorbance change in both PT and APTT clotting curves on BCSXP Analyzer. Methods：A serial of standard fibrinogen and 250 patient plasma samples with different qualities（normal, hemolysis, icterus, and lipemia） were run on BCSXP for assays PT, APTT and Fibrinogen. The absorbance change（DeltaA） from baseline to plateau in clotting curve was retrieved and analyzed on its correlation with the Fibrinogen result. Influence of plasma quality and PT/ APTT result on this correlation was also studied respectively. Results：Both PT-DeltaA and APTT-DeltaA showed good linear regres- sion with fibrinogen level in the sample, with R2 close to 0.90 in both standard and patient samples. Hemolysis（H）, itcterus（I） and lipemia（L） of the sample with valid clotting curves were found to have no significant difference in this correlation from normal（N） sample（R2： 0.83H, 0.92I, 0.81L and 0.79N in PT; 0.89H, 0.95l, 0.91L and 0.89N in APTT） in either PT or APTT curve. PT or APTT result also has little impact on this correlation（0.71 in range 7 - 10 sec, 0.56 inl0 - 20 sec, and 0.70 in 20 sec-; R2 in APTT： 0.88 in 20-30 sec, 0.92 in 30-40 sec, and 0.95 in 40 sec-）. Conclusion：The absorbance change in either PT or APTT clotting curve correlates well with the fibrinogen level in plasma, which is independent of plasma quality PT or APTT results. The absorbance change can be used as an alternative way to roughly estimate fibrinogen level in either PT or APTT clotting curve when the result of clauss-based fibrinogen measurement is not available.

A Case of Adverse Reaction to Booster Dose of COVID-19 Vaccination: Could D-Dimer Elevation Suggest Increased Clotting Risk?

We report the clinical case of a 40-year-old Italian woman, who soon after her booster vaccination with mRNA-1273 after the two previous vaccinations with BNT162b2, developed severe headache, high fever, and Musculo-skeletal pain. She went to the emergency department, where computerized tomography (CT) scans of chest and brain were performed, resulting in both negative for pathologic findings. On the contrary, white blood count was strongly lowered and D-dimer severely elevated. She improved after treatment with enoxaparin and the blood analyses returned in the normal range after ten days. This case supports the hypothesis that COVID-19 vaccines could increase blood clotting in some predisposed subjects. Therefore, we believe that robust and well-designed clinical trials, considering the evaluation of D-dimer levels, should be performed to eliminate any doubts on this issue.

Experimental Results of the Fibrin Clot Use to Accelerate the Regeneration of Damaged Bone in the Rat Lower Jaw

Morphological and radiological methods were used to study regeneration of the damaged bone of rat mandibles after application of plateletenriched fibrin clot. A bone hole was artificially created, and in the natural course of regeneration, the hole was immediately filled with blood and there a blood clot formed. After one week of healing, separate islands of young bone tissue appeared. After two to three weeks, the opening in the mandible was completely replaced by the young bone tissue. When a similar bone hole was filled with autological fibrin clot, the blood clot did not form. But after one week the entire hole was filed with newlyformed fused bone tissue. By the second week after the use of fibrin clot, the bone hole had further healed and bone callus was formed.

Laser induced clot formation in blood treated by EDTA

Patients under systemic (ethylenediaminetetraacetic acid) EDTA are at risk of hemorrhage for any accidental trauma even the superficial ones. This research is a trial to use 980 nm wavelength laser light to provide coagulation for such patients in a local region without collateral thermal damage. Material and Method: 980 nm Diode laser operating in a continuous mode (CW) was incident on human blood treated with EDTA inDurhamtubes. The used parameters were (2.25, 3, 3.75 and 6.75) W output power for variable exposure times (1, 3, 9 and 27) s. Results: A homogenous clot was performed at 4327.84 J/cm2 deposited energy density with the absence of any thermal stress in the blood. Conclusion: 980 nm laser wavelength provides a local photochemical bond break of the anticoagulant enhancing blood coagulation for medically compromised patients.

Purification and Identification of a Clotting Protein from the Hemolymph of Chinese Shrimp (Fenneropenaeus chinensis)

The clotting protein(CP) plays important and diverse roles in crustaceans,such as coagulation and lipid transportation.A clotting protein was purified from the hemolymph of Chinese shrimp Fenneropenaeus chinensis(named as Fc-CP) with Q sepharose HP anion-exchange chromatography and phenyl sepharose HP hydrophobic interaction chromatography.Fc-CP was able to form stable clots in vitro in the presence of hemocyte lysate and Ca2+,suggesting that the clotting reaction is catalyzed by a Ca2+-dependent transglutaminase in shrimp hemocytes.The molecular mass of Fc-CP was 380 kDa under non-reducing conditions and 190 kDa under reducing conditions as was determined with SDS-PAGE.CP exists as disulfide-linked homodimers and oligomers.The N-terminal amino acid sequence of Fc-CP was identical to that of shrimps including Penaeus monodon,Farfantepenaeus paulensis and Litopenaeus vannamei;and similar to that of other decapods.The purified Fc-CP was digested with trypsin and verified on an ABI 4700 matrix-assisted laser desorption/ionization tandem time-of-flight(MALDI-TOF/TOF) mass spectrometry.Our results will aid to better understanding the coagulation mechanism of shrimp hemolymph.

Blood Flow Through a Catheterized Artery Having a Mild Stenosis at the Wall with a Blood Clot at the Centre

The blood flow through a catheterized artery having a mild stenosis at the wall together with a blood clot at the centre is studied in the current investigation.Stenosis can occur in vessels carrying blood to brain(i.e.,Carotid arteries),Renal arteries that supply blood to kidneys etc.The flow is refined in such vessels by application of catheter.We have used a Newtonian viscous fluid model and also distinct shapes of stenosis,(i.e.,symmetric and non-symmetric shapes)are considered for this study.The entropy generation togetherwith viscous dissipation is also taken into account for a complete description of heat transfer mechanism.Exact solutions are calculated for the problem subject to given“no slip conditions”.The results are discussed graphically.The velocity quickly increases for a non-symmetric stenosis as compared to a symmetric stenosis.When the height of mild stenosis increases and the channel becomes narrow then the velocity increases in the centre but it decreases with the stenosed wall.However,as the height of blood clotσincreases then the velocity of blood flow reduces with the wall having clot but it remains almost same with the stenosed wall.Streamlines are plotted to visualize the flow pattern.The trapping is symmetric for a symmetric stenosis shape but it changes to non-symmetric trapping when we have a non-symmetric shape of stenosis.

H∞-Feedback Control of Heparin-Controlled Blood Clotting Network for Cardiac Surgeries

This paper presents a solution methodology for H∞-feedback control design problem of Heparin controlled blood clotting network under the presence of stochastic noise. The formulaic solution procedure to solve nonlinear partial differential equation, the Hamilton-Jacobi-Isaacs equation with Successive Galrkin’s Approximation is sketched and validity is proved. According to Lyapunov’s theory, with solutions of the nonlinear PDEs, robust feedback control is designed. To confirm the performance and robustness of the designed controller, numerical and Monte-Carlo simulation results by Simulink software on MATLAB are provided.

Determination of Rennet Clotting Time by Texture Analysis Method

In this study, texture analysis method was used for the determination of rennet flocculation time (tfloc) and rennet clotting time (tclot) of rennet-induced reconstitued milk samples with different CaCl2 concentrations. The rennet flocculation time (RFT) and rennet clotting time (RCT) were also determined by using the Berridge test and sensory evaluation. The hardness value versus renneting time curves derived from texture analysis gave a good modified exponential relationship for each CaCl2 concentration and the curves were used to calculate flocculation time and clotting time parameters. It was found that the parameters (tfloc and tclot) appeared strongly correlated with RFT and RCT, respectively. Texture analysis was proved as a suitable method to control the rennet-induced coagulation and determine the rennet clotting time. It was also determined that enrichment of milk with CaCl2 leaded to a decrease in flocculation and clotting times and an increase in rate of clotting and gel hardness.

CLOT EXPRESS

CLOT ROYALE是CLOT年度最重头的系列，除了之前看过的一系列联名产品及夏日必备，秋冬的产品也陆续出现．而且陈冠希还亲自上身示范。

Rotational Intravascular Multidirectional Ultrasound Catheter for Sonothrombolysis of Retracted Clots:An in Vitro and in Vivo Study

Thromboembolism in blood vessels poses a serious risk of stroke,heart attack,and even sudden death if not properly managed.Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach for the effective treatment of thromboembolism.Recent reports have highlighted the potential of intravascular sonothrombolysis as a safe and effective treatment modality for deep vein thrombosis(DVT).However,its efficiency has not been validated through in vivo testing of retracted clots.This study aimed to develop a miniaturized multidirectional transducer featuring two 4-layer lead zir-conate titanate(PZT-5A)stacks with an aperture size of 1.4 mm
1.4 mm,enabling both forward-and side-looking treatment.Integrated into a custom two-lumen 10-French(Fr)catheter,the capability of this device for intravascular sonothrombolysis was validated both in vitro and in vivo.With low-dose tissue plasminogen activators and nanodroplets,the rotational multidirectional transducer reduced the retracted clot mass(800 mg)by an average of 52%within 30 min during in vitro testing.The lysis rate was significantly higher by 37%than that in a forward-viewing transducer without rotation.This improvement was particularly noteworthy in the treatment of retracted clots.Notably,a long-retracted clot(>10 cm)was successfully treated within 40 min in vivo by creating a flow channel with a diameter>4 mm in a porcine DVT model.In conclusion,these findings strongly suggest the potential of this technique for clinical applications in sonothrombolysis,offering a feasible solution for effectively treating thromboembolism,particularly in challenging cases involving retracted clots.

In vitro and in silico studies on fibrinolytic activity of nattokinase： A clot buster from Bacillus sp.

BACKGROUND： Nattokinase （NK） is a serine protease enzyme of the subtilisin family. It exhibits a strong fibrinolytic activity. The fibrinolytic enzymes from Bacillus sp. have attracted interest as thrombolytic agents because of their efficiency in the fibrinolytic process including plasmin activation. METHODS： In the present study, VIT garden soil was collected and subjected to isolation process in order to screen for the NK production. Screening for NK enzyme was performed by radial caseinolytic assay. The production of NK enzyme was done in two different production medium for comparative studies. The NK enzyme was purified by gel permeation chromatography. The activity of the purified NK was checked by clot lysis and casein digestion assay. To investigate the structural basis of NK and fibrinogen interaction and also to identify the best binding mode, molecular dynamics and docking studies were performed. RESULTS： Based on the morphological and biochemical characterization, the isolate was identified as Bacillus sp. The overall purification fold of NK was about 3 with the specific activity of 664U/mg and 9.9% yield. Homogeneity of the purified enzyme was analyzed and confirmed by the single band obtained in SDS-PAGE. Molecular weight of the purified protease was estimated as 25 kDa. Purified NK enzyme exhibited 97% of effective clot lysis activity. The NK was docked in to the knob region of the fibrinogen at its binding site using Dock server. A total of 26 residues of fibrinogen and 29 residues of NK constitute the interface region. However, 9 residues offibrinogen （THR238, MET264, LYS266, ARG275, THR277, ALA279, ASN308, MET310, and LYS321） and 8 residues ofNK （GLY61, SER63, THR99, PHE189, LEU209, TYR217, ASN218, and MET222） are involved in intact binding. CONCLUSIONS： A significant amount of NK enzyme was obtained from Bacillus sp. The docking analysis revealed that the NK and fibrinogen adopt an extended binding pattern and interacts with the crucial residues to exhibit their activity.

Effects of low molecular weight heparin on clot rate and activated clotting time： an in vitro study

Background Due to lack of point-of-care testing, the use of low-molecular-weight heparin （LMWH） therapy in some special patients is restricted. This study was designed to explore the effects of LMWH on clot rate （CR） and activated clotting time （ACT）, and to search for an appropriate method for bedside monitoring of anticoagulant activity of LMWH. Methods Thirty-two healthy volunteers were selected from the staff of Beijing Tongren Hospital. CR and ACT were measured with different reagents （glass beads, diatomite, kaolin and magnetic bar） on blood samples spiked with increasing concentrations of LMWH （dalteparin, 0.2-1.8 IU/ml）. Correlations between concentrations of LMWH and values of CR and ACT were analysed based on the data obtained and regression analysis was performed to establish a regression equation. Results With the increase in doses of dalteparin, CR values reduced gradually. The values of CR of four reagents （glass beads, diatomite, kaolin and magnetic bar） were 20.4-4.5 IU/min, 27.4-6.9 IU/min, 27.5-7.9 IU/min and 7.8-0.1 IU/min respectively and an linear relationship was observed between the CR values and dalteparin concentrations （P〈0.05）. The values of ACT were 173-615 seconds, 130-270 seconds, 123-226 seconds, 337-1411 seconds respectively, which showed a linear regression between the ACT values and dalteparin concentrations （P〈0.01）. Differences in slope of the regression curves of ACT were observed with all the reagents tested （glass beads 248.2 s/IU, diatomite 74.8 s/IU, kaolin 58.2 s/IU and magnetic bar 1112.2 s/IU, P〈0.01）. While the minimum concentration of dalteparin was 0.2 IU/ml, 0.4 IU/ml, 1.4 IU/ml and 0.2 IU/ml separately, the ACT values of the four coagulants （glass beads, diatomite, kaolin and magnetic bar） were beyond the normal limit and showed a noticeable increase respectively （P〈0.01）. Conclusions This study showed that there was an excellent linear relationship between the CR and ACT values and dalteparin concentrations for all the four reagents （glass beads, diatomite, kaolin and magnetic bar） in vitro. The sensitivity of different coagulation reagents to LMWH different. Choosing a suitable reagent, both CR and ACT were possible to be used as a convenient bedside test for LMWH.

术后腹腔粘连形成机制及间充质干细胞外泌体的治疗前景

背景:术后腹腔粘连的形成是一个复杂的过程,预防术后粘连是临床上亟待解决的问题。目的:旨在从细胞及分子水平分析粘连的发生机制,为间充质干细胞外泌体预防和治疗粘连提供理论依据。方法:以“腹腔粘连,盆腔粘连,术后粘连,上皮间充质转化,间充质干细胞,干细胞外泌体,间充质干细胞外泌体”为中文检索词,以“Abdominal adhesion,pelvic adhesion,postoperative adhesion,epithelial mesenchymal transformation,mesenchymal stem cell,stem cell exosomes,mesenchymal stem cell exosomes”为英文检索词,检索PubMed、中国知网和中国生物医学文献数据库,筛选各数据库建库至2023年8月发表的术后腹腔粘连及间充质干细胞外泌体干预研究的相关文章,并进行系统的整理分析,最终纳入54篇文献进行综述。结果与结论:(1)任何腹膜炎症、机械损伤、组织缺血和异物植入等病理因素均可引起腹膜表面的损伤,引起术后腹腔粘连;腹腔粘连的形成过程包括腹膜间皮细胞修复、炎性反应、纤溶系统及凝血途径等过程的相互作用,涉及多种细胞因子及信号通路,包括Wnt/β-catenin通路能诱导纤维化和血管生成,并与转化生长因子β/Smads信号通路相互协同,能刺激成纤维细胞增殖,引起腹膜纤维化;同时,核转录因子kB信号通路上调细胞炎症因子的表达,促进成纤维细胞增生,组织纤维化的过程中发挥关键作用。(2)干细胞的旁分泌功能是目前以再生医学为基础的分子干预腹腔粘连的重要方向,可以参与作用于腹腔粘连中的多种复杂细胞因子及信号通路。(3)相对于传统治疗腹腔粘连的方法,间充质干细胞外泌体具有生物活性、使用安全、无需特殊培养和扩增、更低的免疫原性及较长的稳定性等优势,能通过多种途径引导一种正常的修复和愈合。(4)间充质干细胞外泌体在以往研究中均被证明可以参与调节粘连形成的上述各过程,在临床研究中显示出潜在的应用前景,但需要进一步临床研究以探索适当的间充质干细胞外泌体治疗方案,来解决临床转化的问题。