Roles of reinforced nerve conduits and low-level laser phototherapy for long gap peripheral nerve repair

Peripheral nerve injuries are common in clinical practice because of traumas such as crushing and sectioning. Lesions of the nerve structure result in lost or diminished sensitivity and/or motor activity in the innervated territory. The degree of lesion depends on the specific nerve involved, the magnitude and type of pres- sure exerted, and the duration of the compression. The results of such injuries commonly include axonal degeneration and retro- grade degeneration of the corresponding neurons in the spinal medulla, followed by very slow regeneration （Rochkind et al., 2001）. The adverse effects on the daily activities of patients with a peripheral nerve injury are a determining factor in establishing the goals of early recovery （Rodriguez et al., 2004）.

Photodynamic therapy of cancer-Challenges of multidrug resistance

Photodynamic therapy(PDT)of cancer is a two-step drug device combination modality,which involves the topical or systemie administration of a photosensitizer followed by light ilumnination of cancer site.In the presence of oxygen molecules,the light illmnination of photosensitizer(PS)can lead to the generation of cytotoxic reactive oxygen species(ROS)and consequently destroy cancer.Similar to many other anticancer therapies,PDT is also subject to intrinsic cancer resistance mediated by mutidrug resistance(MDR)mechanisms.This paper will review the recent progress in understanding the interaction between MDR transporters and PS uptalke.The strategies that can be used in a clinical setting to owercome or bypass MDR will also be discussed.

Tripterygium wilfordii multiglycoside-induced hepatotoxicity via inflammation and apoptosis in zebrafish

Tripterygium wilfordii multiglycoside(GTW)is a commonly used compound for the treatment of rheumatoid arthritis(RA)and immune diseases in clinical practice.However,it can induce liver injury and the mechanism of hepatotoxicity is still not clear.This study was designed to investigate GTW-induced hepatotoxicity in zebrafish larvae and explore the mechanism involved.The 72 hpf(hours post fertilization)zebrafish larvae were administered with different concentrations of GTW for three days and their mortality,malformation rate,morphological changes in the liver,transaminase levels,and histopathological changes in the liver of zebrafish larvae were detected.The reverse transcription-polymerase chain reaction(RT-PCR)was used to examine the levels of microRNA-122(miR-122)and genes related to inflammation,apoptosis,cell proliferation and liver function.The results showed that GTW increased the mortality of zebrafish larvae,while significant malformations and liver damage occurred.The main manifestations were elevated levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST),significant liver atrophy,vacuoles in liver tissue,sparse cytoplasm,and unclear hepatocyte contours.RT-PCR results showed that the expression of miR-122 significantly decreased by GTW;the mRNA levels of inflammation-related genes il1β,il6,tnfα,il10,cox2 and ptges significantly increased;the mRNA level of tgfβsignificantly decreased;the mRNA levels of apoptosis-related genes,caspase-8 and caspase-9,significantly increased;the mRNA level of bcl2 significantly decreased;the mRNA levels of cell proliferation-related genes,top2αand uhrf1,significantly reduced;the mRNA levels of liver function-related genes,alr and cyp3c1,significantly increased;and the mRNA level of cyp3a65 significantly decreased.In zebrafish,GTW can cause increased inflammation,enhanced apoptosis,decreased cell proliferation,and abnormal expression of liver function-related genes,leading to abnormal liver structure and function and resulting in hepatotoxicity.

Treg cells in pancreatic lymph nodes： the possible role in diabetogenesis and βcell regeneration in a TID model

Previously, we established a model in which physiologically adequate function of the autologous β cells was recovered in non-obese diabetic （NOD） mice after the onset of hyperglycemia by rendering them hemopoietic chimera. These mice were termed antea-diabetic. In the current study, we addressed the role of T regulatory （Treg） cells in the mechanisms mediating the restoration of euglycemia in the antea-diabetic NOD model. The data generated in this study demonstrated that the numbers of Treg cells were decreased in unmanipulated NOD mice, with the most profound deficiency detected in the pancreatic lymph nodes （PLNs）. The impaired retention of the Treg cells in the PLNs correlated with the locally compromised profile of the chemokines involved in their trafficking, with the most prominent decrease observed in SDF-1. The amelioration of autoimmunity and restoration of euglycemia observed in the antea-diabetic mice was associated with restoration of the Treg cell population in the PLNs. These data indicate that the function of the SDF-1/CXCR4 axis and the retention of Treg cells in the PLNs have a potential role in diabetogenesis and in the amelioration of autoimmunity and β cell regeneration in the antea-diabetic model. We have demonstrated in the antea-diabetic mouse model that lifelong recovery of the β cells has a strong correlation with normalization of the Treg cell population in the PLNs. This finding offers new opportunities for testing the immunomodulatory regimens that promote accumulation of Treg cells in the PLNs as a therapeutic approach for type 1 diabetes （TID）.

Integrated therapeutic plasma exchange and traditional Chinese medicine treatment in a patient with severe COVID-19:A case report

This report presents the case of a 59-year-old man with severe COVID-19 that gradually progressed to cytokine release syndrome and then acute respiratory distress syndrome;he was successfully treated via integration of therapeutic plasma exchange and traditional Chinese medicine.The patient initially presented with a sore throat,severe muscle aches,productive cough and fever.On the worsening of symptoms,remdesivir was administered.However,as the symptoms continued to worsen and a cytokine release syndrome was suspected,oxygen was provided through a high-flow nasal cannula(50 L/min)and therapeutic plasma exchange was performed to prevent worsening of the acute respiratory distress syndrome.On the same day,a course of traditional Chinese medicine was introduced in consultation with the infectious house staff.The patient’s symptoms gradually improved;the levels of C-reactive protein and D-dimers reduced,and the patient was weaned to a simple oxygen mask and eventually to room air.This is the first reported case of the integration of these treatments.Together,they prevented the patient from requiring intubation,played a role in cytokine management,and also improved the clinical symptoms,including productive purulent sputum,cough,frequent stool passage and intermittent fever,with no adverse effects.As a result,the patient was discharged within two weeks of the integration of these treatments.Therefore,the integration of therapeutic plasma exchange and traditional Chinese medicine is an effective therapy for patients with severe COVID-19.