Awareness and prevalence of stress induced oral ulcers among clinical medical and dental students in university of Benin:a cross-sectional study

Background:Awareness of clinical medical and dental students towards stress induced oral ulcer,to determine the most prevalent stress induced oral ulcers among the study population,and the relationship between perceived stress level and prevalence of stress induced oral ulcer.Methods:A descriptive cross-sectional study,involving clinical Medical and Dental students in College of Medical Sciences,University of Benin.Participants were in their 400,500,and 600 levels respectively with a sample size of 226 calculated using the Cochran formula for sample size determination.Data were collected using self-administered questionnaire.Results:Two hundred and twenty-six respondents were interviewed in this survey.The age of the participants varied from 21-30 years,with mean age of 25.5%.Majority of the respondents(66.4%)were aware of stress induced oral ulcer.The prevalence of stress induced oral ulcer in this study was 12.8% with recurrent aphthous ulcers accounting for a prevalence of 35.5% of all stress induced oral ulcers.Conclusion:Findings from this study shows about 66.4%of clinical Medical and Dental students were aware of stress induced oral ulcer.The prevalence of stress induced oral ulcer in this study was 12.8%and was seen more in males than females,with recurrent aphthous ulcer been the most prevalent stress induced oral ulcer among the study population with a prevalence of about 35.5%.

A Comprehensive Review of Exosomes with Therapeutic Potential in Cancer and Coeliac Disease

The aim of this review was to evaluate the therapeutic potential of exosomes, extracellular vesicles secreted by cells. They have emerged as potential therapeutic transporters for several diseases. This review provides an overview of exosomes’ therapeutic potential in cancer therapy and autoimmune conditions such as Coeliac Disease. The therapeutic effect is that the phospholipid-binding protein ANXA1 improves its anti-inflammatory properties. The review also analyzes the intricate processes of exosome production and composition ability to transport biomolecules such as proteins, microRNAs, and lipids, which promote intercellular communication and alter recipient cell behavior. Exosomes, linked to neurological disorders, cardiovascular disease, and cancer, present the means of targeted drug administration due to their innate specificity. Through genetic engineering and chemical modifications, exosomes can be tailored for specific purposes, demonstrating their versatility in targeted therapy. With ongoing research uncovering their therapeutic potential, exosomes present a promising frontier in novel medical treatments across various health conditions.

Impact of Action Observation Therapy along with Usual Physiotherapy Intervention of Individual with Alzheimer’s Disease

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairments in the initial stage, which lead to severe cognitive dysfunction in the later stage. Action observation therapy (AOT) is a multisensory cognitive rehabilitation technique where the patient initially observes the actions and then tries to perform. The study aimed to examine the impact of AOT along with usual physiotherapy interventions to reduce depression, improve cognition and balance of a patient with AD. A 67 years old patient with AD was selected for this study because the patient has been suffering from depression, dementia, and physical dysfunction along with some other health conditions like diabetes and hypertension. Before starting intervention, a baseline assessment was done through the Beck Depression Inventory (BDI) tool, the Mini-Cog Scale, and the Berg Balance Scale (BBS). The patient received 12 sessions of AOT along with usual physiotherapy interventions thrice a week for four weeks, which included 45 minutes of each session. After four weeks of intervention, the patient demonstrated significant improvement in depression, cognition, and balance, whereas the BDI score declined from moderate 21/63 to mild 15/63 level of depression. The Mini-Cog score improved from 2/5 to 4/5, and the BBS score increased from 18/56 to 37/56. It is concluded that AOT along with usual physiotherapy intervention helps to reduce depression, improve cognition and balance of people with AD.

Anthropometric studies on medical students of Nepal and Sri Lanka:height and weight

Nutritional status of a population or an individual could be assessed by clinical,biochemical and anthropometric means.It is widely used in the monitoring of growth and assessment of the nutritional status of children and adults.Even though a large number of anthropometric studies is done in Nepal and Sri Lanka,on various projects related to the nutritional aspects,but only few have been done on anthropometry and due to lack of information on anthropometric data of Nepalese and Sri Lankan medical students,the present study was initiated at Nepal Medical college and Faculty of Medicine,University of Peradeniya,Sri Lanka.The aim of the study was to measure height and weight of medical students of Nepal Medical College and Faculty of Medicine,University of Peradeniya.A total of 1228(males 681;females 547)medical students participated in the study.The ratio of male to female was 1.24:1.The height was measured,to the nearest 0.1 cm without shoes,using a measuring tape affixed to the wall.The weight was recorded using weighing scale,with minimum clothes and without shoes to the nearest 0.1kg.Two tail unpaired t’test was performed to compare mean values.The percentile values were obtained using Microsoft excel for Windows 98.The age of the students varied from 18-26 years with a mean±SD of 20.77±1.17 and 20.90±1.10 in males and females respectively.The heights of the male and female medical students werel.65±0.08 and 1.61±0.08 and the weight was 59.70±9.26 and 55.54±9.16 respectively.The percentile values obtained for height and weight were compared with National Centre for Health statistics(NCHS) standards.The 50th percentile value of males height and weight corresponded to the 20th percentile and below the 20th percentile values respectively of the NCHS standard.The 50th percentile value of female’s height and weight corresponded to less than 10th and 15th percentiles respectively.The height and weight of only 9 males and 8 females were above the 50th percentile value of NCHS standards.The study reveals that the Nepalese medical students and Sri Lankan medical students are underweight and shorter compared to western standards.

Advanced glycation end products:Key mediator and therapeutic target of cardiovascular complications in diabetes

The incidence of type 2 diabetes mellitus is growing in epidemic proportions and has become one of the most critical public health concerns.Cardiovascular complications associated with diabetes are the leading cause of morbidity and mortality.The cardiovascular diseases that accompany diabetes include angina,myocardial infarction,stroke,peripheral artery disease,and congestive heart failure.Among the various risk factors generated secondary to hyperglycemic situations,advanced glycation end products(AGEs)are one of the important targets for future diagnosis and prevention of diabetes.In the last decade,AGEs have drawn a lot of attention due to their involvement in diabetic pathophysiology.AGEs can be derived exogenously and endogenously through various pathways.These are a nonhomogeneous,chemically diverse group of compounds formed nonenzymatically by condensation between carbonyl groups of reducing sugars and free amino groups of protein,lipids,and nucleic acid.AGEs mediate their pathological effects at the cellular and extracellular levels by multiple pathways.At the cellular level,they activate signaling cascades via the receptor for AGEs and initiate a complex series of intracellular signaling resulting in reactive oxygen species generation,inflammation,cellular proliferation,and fibrosis that may possibly exacerbate the damaging effects on cardiac functions in diabetics.AGEs also cause covalent modifications and cross-linking of serum and extracellular matrix proteins;altering their structure,stability,and functions.Early diagnosis of diabetes may prevent its progression to complications and decrease its associated comorbidities.In the present review,we recapitulate the role of AGEs as a crucial mediator of hyperglycemia-mediated detrimental effects in diabetes-associated complications.Furthermore,this review presents an overview of future perspectives for new therapeutic interventions to ameliorate cardiovascular complications in diabetes.

Pattern, Precipitants and Short Term Outcome of Heart Failure Patients Managed at Federal Medical Centre Nguru, a Tertiary Health Centre in Yobe State Northeastern Nigeria

Heart Failure (HF) is a syndrome characterized by typical symptoms (e.g. breathlessness, ankle swelling and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles and peripheral oedema) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Clinical studies investigating the aetiological patterns of heart failure in Sub-Saharan Africa (SSA) revealed that hypertension, cardiomyopathy and rheumatic heart disease account for more than two-thirds of cardiac disease cases. The objective of this study therefore is to assess the pattern, precipitating factors and short term outcome of heart failure among patients admitted into our hospital. Method: The study was a prospective cross-sectional type conducted among in patients with heart failure in the medical ward of the hospital. Results: A total of three and fifty four (354) subjects were recruited into the study, comprising one hundred and twenty nine males (36.4%) and two hundred and twenty five (63.4%) females. Majority of the patients were admitted in NYHA functional class IV. This however improved to class II at discharge though few were discharged in NYHA class III. Heart failure secondary to progressive hypertensive heart disease was the most common (39.0%) followed by peripartum cardiomyopathy (22.6%) while idiopathic dilated cardiomyopathy (11.0%) and rheumatic heart disease (7.3%) were the third and fourth causes of heart failure respectively. The most common precipitating factor for heart failure in this study was chest infection (44.9%). In conclusion, the study revealed that progressive hypertensive heart disease was the leading cause of heart failure, followed by peripartum cardiomyopathy while idiopathic dilated cardiomyopathy and rheumatic heart disease were ranked third and fourth causes of heart failure respectively. Though myocardial infarction is on the increase, it was found to be the fifth cause of heart failure. The study also identified the following precipitants of heart failure in decreasing order of occurrence: chest infection, non-adherence to prescription, and urinary tract infection.

The investigation of medical and psychosocial problems of geriatric population in the urban area of Madhya Pradesh in India

Globally, there are an estimated 605 million people aged 60 years and above. Improvements in health care facilities have brought longevity, which is considered to be one of the greatest achievements of the 20th century. Objectives: To assess the morbidity pattern in geriatric people. Methodology: A community based cross sectional study. Results: Out of 208 aged 91 (43.7%) were males, 117 (56.25%) were females. Maximum number of males and females were from the age group 60 - 64 years. 117 (56.25%) had chronic problems and 15 (7.2%) acute. Musculo skeleton problem was the commonest (63%) complaint both in males and females, followed by cardio vascular problem (44%). Diabetes mellitus was more common in males than females and hypertension was more common in females than males. Chronic bronchitis was the commonest respiratory disorder in males (8.7%). Total 20 (9.6%) had psychological problems (depression), psychological problems more common in males 11 (12%) than females 9 (7.7%) Conclusion: The present study showed that chronic morbidity in elderly was significantly higher (56.3%) than acute (7.2%), most commonly affected system by chronic morbidity was musculo-skeletal followed by cardio vascular (CVS) and gastrointestinal (GIT). Psychological problems were more common in males (12%) than in females (7.7%). Psychological problems were more in lower socio-economic class-(V) than higher Class [1].

Validation of short version of evidence-based practice instruments among nurses in clinical practice:Evidence-based practice beliefs,implementation,and organizational culture

Objective:The objective of the study is to validate the short version of evidence-based practice(EBP)instruments among nurses in clinical practice.Methods:An institutional-based cross-sectional research design was used and a stratified sampling technique to select 285 nurse clinicians.The study utilized a structured questionnaire comprising of demographic data from the participants and three validated scales:the shortened versions of the EBP Beliefs Scale,the EBP Implementation Scale,and the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice(OCRSIEP)survey.With the use of descriptive statistics,the data were analyzed and presented in frequencies and percentages,while inter-item correlation coefficient(ICC)and the Kaiser-Meyer-Olkin measure of sampling adequacy were used to confirm the validity of using factor analysis.Results:Findings revealed the mean scores of the EBP Beliefs Scale ranged from 1.50 to 1.61,EBP Implementation Scale ranged from 1.84 to 1.94,and the OCRSIEP Scale ranged from 1.93 to 2.19.All the three shortened scales accordingly had good internal reliability,29.30±9.93 out of 80 for the EBP Beliefs Scale,19.56±7.37 out of 72 for the EBP Implementation Scale,and 66.32±20.35 out of 125 for the OCRSIEP Scale.Conclusion:This study has generated a valid Short Version of EBP reliable instrument that is psychometrically robust that can be used by nurses and clinicians to evaluate EBP in clinical settings since the results presented as a whole confirmed the high reliability and factorial validity.

Synergistic Mixture of Cyperus esculentus, Phoenix dactylifera and Cocos nucifera Aqueous Extract: Its Liver and Kidney Benefits in Male Albino Rat Model

Background: The synergistic mixture of Cyperus esculentus, Phoenix dactylifera and Cocos nucifera (STCD) aqueous extract is a common drink in Port Harcourt, Nigeria. It is assumed to have various health benefits. However, the synergistic mixture of the content has not been studied scientifically, hence the need to evaluate its effect on the liver and kidney being part of the body’s metabolic organs. Aim: This study evaluated the synergistic mixture of Cyperus esculentus, Phoenix dactylifera and Cocos nucifera (STCD) aqueous extract in male albino rats. Methods: Acute toxicity LD50 of STCD was carried out, afterwards, fifteen male albino rats were grouped into three groups with 5 rats in each group;Control, 200 mg/kg, 400 mg/kg STCD. The rats were administered STCD orally 24 hourly, for 21 days, with feed and water ad libitum. At the end of the experiment, blood samples were collected for biochemical analysis of the liver and kidney biomarkers, while the liver and kidney tissues were harvested for histopathological examination using standard laboratory methods. Descriptive statistics were computed and expressed as Mean ± SD. One-way ANOVA and Turkeys test was performed. P value ≤0.05 was considered statistically significant. Results: Acute toxicity LD50 of STCD was observed to be ≥2404.2 mg/kg body weight. An increase in the percentage body weight difference of 8.39% and 2.86% was observed for 200 and 400 mg/kg STCD groups. Also, the liver weight was observed to increase in 400 mg/kg (3.92 ± 1.42) in comparison to the control group (3.48 ± 1.61), a decrease in the kidney weight was observed in all groups administered STCD in comparison to the control group. Administration of STCD at both 200 and 400 mg/kg revealed a decrease in the concentration of the hepatic biomarkers AST, ALT, ALP, TP, Albumin, Total and conjugated bilirubin. The kidney biomarker Urea was observed to decrease in concentration for 200 mg/kg STCD (4.60 ± 1.83) and 400 mg/kg STCD (4.76 ± 0.74) when compared to the control group (6.32 ± 2.74). A decrease in Creatinine was observed in 200 mg/kg (91.80 ± 34.69) and 400 mg/kg (98.60 ± 15.53) in comparison to the control group (117.60 ± 42.88). The histological examination of the liver of rats administered STCD revealed structural normal central vein, hepatocytes and portal tract. The kidney examination revealed normal glomeruli and normal tubule. Conclusion: The findings of this study opine that STCD improved the health of both the liver and kidney as evidenced via the biomarkers and histological examinations of the liver and kidney. This study therefore recommends the intake of STCD at moderate doses for improved liver and kidney function due to its bioactive compounds and nutritional content.

Deoxyribonucleic Acid-Polymerase Chain Reaction Status of HIV Exposed Infants in a Sub Regional Prevention of Mother-to-Child Transmission of HIV Programme during the Period 2009-2020

Introduction: Transitioning to more efficacious Antiretrovirals for HIV infected pregnant women and infant prophylaxis has reduced Mother to child transmission of HIV significantly. This study aimed to determine HIV infection status in HIVexposed infants who had their first DNA polymerase chain reaction test in our molecular Laboratory. Subjects, Materials and Methods: Dried Blood Spots for HIV DNA results from 5 states between 2009 and 2020 were analyzed in the PCR laboratory of the Federal Teaching Hospital, Gombe. Results: Nine thousand eight hundred and twenty-three Human Immunodeficiency Virus Deoxyribonucleic acid polymerase Chain Reaction results were analysed;4937 (50.2%) were males. During the study period, there was an overall declining trend in the mother-to-child transmission rate from 3.8% in 2009 to 1.0% in 2020. 6120 (62.3%) of HIV + mothers received Highly active antiretroviral therapy HAART before pregnancy. 7845 (76.2%) of the infants received Nevirapine prophylaxis. Dried blood spot samples were collected from 4077 (41.5%) at 6 - 8 weeks. 8438 (85.9%) received cotrimoxazole. 9469 (96.4%) were ever breastfed. Of the 9823 HIV DNA PCR results, 255 (2.6%) were positive while 69/4077 (1.7%) and 109/2662 (4.1%) were positive for HIV DNA at 6 - 8 weeks and > 12 weeks respectively. (p = 0.001). 86/747 (11.5%) of infants whose HIV-positive mothers received no ARVS were HIV DNA positive. (p = 0.001). 106/884 (12.0%) of infants who had no Antiretroviral prophylaxis had positive HIV DNA results;7/413 (1.7%) with Zidovudine/Nevirapine prophylaxis had positive results. (p = 0.001). 246/9469 (2.6%) of infants that were ever breastfed were positive for HIV DNA;11/354 (3.0%) that never breastfed had positive HIV DNA. Conclusion: Lack of maternal/infant ARVs and prolonged breastfeeding increased the risk of infant HIV infection.

Prevalence of Cesarean Section at Georgetown Public Hospital Corporation, Guyana: An Institution-Based Cross-Sectional Study

The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC.

Ocular myositis--a diagnostic dilemma

Dear Editor,Orbital myositis is a relatively rare entity but is the next most common cause of extra ocular muscle disease after thyroid associated orbitopathy(TAO)[1-2].It was first described by Gleason in 1903 as an orbital pseudotumour and then renamed in 1930[3].It usually affects young females than males.Extraocular muscles differ from skeletal muscles by a smaller unit size and higher motor neuron discharge,higher blood flow and volume of mitochondria fractions that allow inflammatory cells to reach and circulate easier,causing inflammation[4].Clinical findings include moderate to severe orbital pain,painful diplopia increased with eye movement,exophthalmos,swollen eyelids,conjunctival hyperemia or chemosis usually.Contrast enhanced magnetic resonance imaging(CEMRI)is the most sensitive modality which discloses enhancement or thickening of inflamed extraocular muscle.

Antimicrobial activity of Sapindus mukorossi and Rheum emodi extracts against H pylori: In vitro and in vivo studies

AIM: To evaluate the antibacterial activity of Sapindus mukorossi (S. mukorossi) and Rheum emodi (R. emodi). METHODS: Powders of S. mukorossi and R. emodi were extracted successively with petroleum ether, benzene, chloroform and ethanol and were concentrated in vacuum. The disk diffusion method was used for in vitro studies and in vivo studies were performed on male Wister rats. Thirty resistant clinical isolates of H pylori, as determined by their antibiotic sensitivity patterns by E-test, along with two Gram +ve (S. aureus, B. subtilis) and two Gram -ve (E. coli, P. vugaris) organisms were screened for their susceptibility patterns against these extracts. RESULTS: In our screening, all 30 resistant isolates and the other four organisms (two Gram +ve S. aureus, B. subtilis and two Gram -ve, E. coli, P. vugaris) were sensitive to the test compounds. It was found that ethanol and chloroform extracts of S. mukorossi and ethanol and benzene extracts of R. emodi inhibited H pylori at very low concentrations. In the in vitro study, the isolates showed a considerable zone of inhibition at very low concentrations (10 μg/mL) for both the extracts. In the in vivo study, the H pylori infection was cleared with minimal doses of extracts of S. mukorossi (2.5 mg/mL) and R. emodi (3.0 mg/mL) given orally for seven days. CONCLUSION: We can conclude from this study that the extracts of S. mukorossi and R. emodi inhibited the growth of pylori in vitro and, in in vivo studies, the H pylori infection cleared within seven days at very low concentrations. We also found that H pylori did not acquire resistance against these herbal extracts even after 10 consecutive passages.

Role of the renin angiotensin system in diabetic nephropathy

Diabetic nephropathy has been the cause of lot of mor bidity and mortality in the diabetic population.The renin angiotensin system(RAS) is considered to be involved in most of the pathological processes that result in diabetic nephropathy.This system has var ious subsystems which contribute to the disease pat ho logy.One of these involves angiotensin Ⅱ(Ang Ⅱ) which shows in c reased activity during diabetic nephropathy.This causes hypertrophy of various renal cells and has a pres sor effect on arteriolar smooth muscle resulting in increas ed vascular pressure.Ang Ⅱ also induces inflamm ation,apoptosis,cell growth,migration and differentiation.Monocyte chemoattractant protein-1 production responsible for renal f ibrosis is also regulated by RAS.Polymorphism of angiotensin converting enzym e(ACE) and Angiotensinogen has been shown to have effects on RAS.Available treatment modalities have proven effective in controlling the progression of nephropathy.Various drugs(based on antagonism of RAS) are currently in the market and others are still under trial.Amongst the approved drugs,ACE inhibitors and ang iot ensin receptor blockers(ARBs) are widely used in clinical practice.ARBs are shown to be superior to ACE inhibitors in terms of reducing proteinuria but the combined role of ARBs with ACE inhibitors in diabetic nephropathy is under debate.

Hepatoprotective activity of Sapindus mukorossi and Rheum emodi extracts: In vitro and in vivo studies

AIM: To study the hepatoprotective capacity of Sapindus mukorossi (S. mukorossi) and Rheum emodi (R. emodi) extracts in CCl4 treated male rats. METHODS: The dried powder of S. mukorossi and R. emodi was extracted successively with petroleum ether, benzene, chloroform, and ethanol and concentrated in vacuum. Primary rat hepatocyte monolayer cultures were used for in vitro studies. In vivo, the hepatoprotective capacity of the extract of the fruit pericarp of S. mukorossi and the rhizomes of R. emodi was analyzed in liver injured CCl4-treated male rats. RESULTS: In vitro: primary hepatocytes monolayer cultures were treated with CCl4 and extracts of S. mukorossi & R. emodi. A protective activity could be demonstrated in the CCl4 damaged primary monolayer culture. In vivo : extracts of the fruit pericarp of S. mukorossi (2.5 mg/mL) and rhizomes of R. emodi (3.0 mg/mL) were found to have protective properties in rats with CCl4 induced liver damage as judged from serum marker enzyme activities. CONCLUSION: The extracts of S. mukorossi and R. emodi do have a protective capacity both in vitro on primary hepatocytes cultures and in in vivo in a rat model of CCl4 mediated liver injury.

Newer perspectives of coronary artery disease in young

Coronary artery disease(CAD) occurring in less than 45 years of age is termed as young CAD.Recent studies show a prevalence of 1.2% of CAD cases in this age group.Ethnic wise south Asians especially Indians are more vulnerable to have CAD in young age group with a prevalence of 5% to 10%.Conventional risk factors such as smoking,diabetes,hypertension,obesity and family history seems to be as important as in older CAD subjects.But the prevalence of these risk factors seems to vary in younger subjects.By far the most commonly associated risk factor is smoking in young CAD.Several genes associated with lipoprotein metabolism are now found to be associated with young CAD like cholesterol ester transfer protein(CETP) gene,hepatic lipase gene,lipoprotein lipase gene,apo A1 gene,apo E gene and apo B.Biomarkers such as lipoprotein(a),fibrinogen,D-dimer,serum Wnt,gamma glutamyl transferase,vitamin D2 and osteocalcin are seems to be associated with premature CAD in some newer studies.In general CAD in young has better prognosis than older subjects.In terms of prognosis two risk factors obesity and current smoking are associated with poorer outcomes.Angiographic studies shows predominance of single vessel disease in young CAD patients.Like CAD in older person primary and secondary prevention plays an important role in prevention of new and further coronary events.

Characterization of hepatic progenitors from human fetal liver using CD34 as a hepatic progenitor marker

AIM: To enrich putative hepatic progenitors from the developing human fetal liver using CD34 as a marker. METHODS: Aborted fetuses of 13-20 wk were used for the isolation of liver cells. The cells were labeled with anti CD34; a marker used for isolating progenitor population and the cells were sorted using magnetic cell sorting. The positive fractions of cells were assessed for specific hepatic markers. Further, these cells were cultured in vitro for long term investigation. RESULTS: Flow cytometric and immunocytochemical analysis for alphafetoprotein (AFP) showed that the majority of the enriched CD34 positive cells were positive for AFP. Furthermore, these enriched cells proliferated in the long term and maintained hepatic characteristics in in vitro culture. CONCLUSION: The study shows that aborted human fetal liver is a potential source for isolation of hepatic progenitors for clinical applications. The study also demonstrates that CD34 can be a good marker for the enrichment of progenitor populations.

Protection of Cactus Polysaccharide against H_2O_2-induced damage in the rat cerebral cortex and hippocampus Differences in time of administration

BACKGROUND： Pharmacological research has shown that cactus polysaccharide （CP） has anti-oxidant, anti-inflammatory, anti-tumor, anti-aging, and immune-stimulating activities. It may also provide protective effects against oxidative stress injuries in the rat brain. OBJECTIVE： To validate the effects of CP on H2O2-induced oxidative stress injuries in the rat cerebral cortex and hippocampal slices 30 minutes prior to injury, as well as 30 minutes and 2.5 hours after injury. DESIGN： A randomized controlled experiment. SETTINGS： Department of Pharmacology, Tongji Medical College, Huazhong University of Science and Technology; Department of Pharmacology, College of Medical Science, Yangtze University. MATERIALS： A total of 50 male Sprague Dawley （SD） rats, normal grade and weighing 200 300 g, were provided by the Laboratory Animal Center of Tongji Medical College, Huazhong University of Science and Technology. The protocol was performed in accordance with ethical guidelines for the use and care of animals. Cactus polysaccharide, a dried needle crystal, was extracted from Opuntia milpa alta at the Chemistry and Environment Engineering School of Yangtze University. The following chemicals and instruments were used： 2,3,5-triphenyl tetrazolium chloride （Sigma, St Louis, Missouri, USA）; lactate dehydrogenase （LDH）, superoxide dismutase （SOD）, glutathione （GSH）, and total antioxidant competence （T-AOC） assays （Jiancheng-Bioeng Institute, Nanjing）; McIllwain tissue chopper （Mickle Laboratory Engineering, USA）; and ELISA reader and Magellan software （TECAN, Austria）. METHODS： This experiment was performed at the Department of Pharmacology, Medical College of Yangtze University, between March and June 2006. All rats were sacrificed after anesthesia. The cerebral cortex and hippocampus were dissected. Several cerebral cortex and hippocampus slices were selected as controls, while other sections were co-incubated with H2O2 for 30 minutes to induce an oxidative stress injury. The experimental slices were randomly divided into 3 groups： model group, low-dose group, and high-dose group. Slices from the low- and high-dose group were incubated with CP 30 minutes prior to injury, as well as 30 minutes and 2.5 hours after injury. The number of cerebral cortex and hippocampus slices at each time point was greater than 10 and 7, respectively. The control group slices were incubated with artificial cerebrospinal fluid （aCSF） for 3 hours. The model group slices were incubated with aCSF for 30 minutes, followed by 30 minutes of aCSF with H2O2 incubation to establish the oxidative stress injury model. Thereafter, the slices were re-incubated with aCSF for 2 hours. The slices in the low- and high-dose group were co-incubated with 0.33 mg/L CP or 1.67 mg/L CP, respectively. CP was applied either for 30 minutes prior to the H2O2 treatment, co-incubated with H2O2 for 30 minutes, or applied 2 hours after H2O2 treatment. MAIN OUTCOME MEASURES： Brain slice activity was determined by TTC staining. Biochemical markers, such as LDH, SOD, GSH, and T-AOC, were analyzed in clear supernatant liquid to study the pharmacological mechanisms. RESULTS： （1） Effects of CP on H2O2-injured brain slices： TTC absorption level at 490 nm decreased with a 30-minute CP administration before and after injury. The TTC absorption values in the low- and high-dose group were significantly lower than the control group （P 〈 0.05 - 0.01 ）. CP administration prior to insult had greater neuroprotective effects on brain slices than administration during the insult. CP Administration after insult had no obvious protective effects on the brain slices. There was no significant difference in TTC absorption levels between administration after 2.5 hours and the model group （P 〉 0.05）. （g） Effects of CP on substances released from H2O2-induced injury slices were as follows： following incubation with 2 mmol/L H2O2 for 30 minutes, LDH release was significantly increased from the rat cortical and hippocampal brain slices. T-AOC and GSH were decreased, which is in accordance with the TTC assay for evaluating the degree of slice injury. Prior administration of 0.33 mg/L CP and 1.67 mg/L CP decreased LDH release and enhanced T-AOC and GSH release in a dose-dependent manner. After H2O2-induced damage for 30 minutes, the release of SOD increased to some extent. SOD levels were further raised by pre-incubation with 0.33 mg/L CP or 1.67 mg/L CP, compared to the model group （P 〈 0.05）. CONCLUSION： CP can protect rat cerebral cortex and hippocampal slices from H2O2-induced injury, This protective effect is dose-dependent. CP administration before injury is more effective than during or after injury.

Targeted therapy of gastrointestinal stromal tumours

Gastrointestinal stromal tumours(GISTs) are mesen-chymal neoplasms originating in the gastrointestinal tract, usually in the stomach or the small intestine, and rarely elsewhere in the abdomen. The malignant potential of GISTs is variable ranging from small lesions with a benign behaviour to fatal sarcomas. The majo-rity of the tumours stain positively for the CD-117(KIT) and discovered on GIST-1(DOG-1 or anoctamin 1) expression, and they are characterized by the presence of a driver kinase-activating mutation in either KIT or platelet-derived growth factor receptor α. Although surgery is the primary modality of treatment, almost half of the patients have disease recurrence following surgery, which highlights the need for an effective adjuvant therapy. Traditionally, GISTs are considered chemotherapy and radiotherapy resistant. With the advent of targeted therapy(tyrosine kinase inhibitors), there has been a paradigm shift in the management of GISTs in the last decade. We present a comprehensive review of targeted therapy in the management of GISTs.