Impact of an autologous oxygenating matrix culture system on rat islet transplantation outcome

Disruption of the pancreatic islet environment combined with the decrease in oxygen supply that occurs during isolation leads to poor islet survival. The aim of this study was to validate the benefit of using a plasma-based scaffold supplemented with perfluorodecalin to improve islet transplantation outcome.Rat islets were cultured in three conditions: i) control group, ii) plasma based-matrix (P-matrix), and iii) P-matrix supplemented with emulsified perfluorodecalin. After 24 h culture, matrix/cell contacts (Integrinβ1, p-FAK/FAK, p-Akt/Akt), survival (caspase 3, TUNEL, FDA/PI), function, and HIF-1α translocation were assessed. Afterwards, P-matrices were dissolved and the islets were intraportally transplanted. Graft function was monitored for 31 days with glycaemia and C-peptide follow up. Inflammation was assessed by histology (macrophage and granulocyte staining) and thrombin/anti-thrombin complex measurement.Islet survival correlated with an increase in integrin, FAK, and Akt activation in P-matrices and function was maintained. Perfluorodecalin supplementation decreased translocation of HIF-1α in the nucleus and post-transplantation islet structure was better preserved in P-matrices, but a quicker activation of IBMIR resulted in early loss of graft function.“Oxygenating” P-matrices provided a real benefit to islet survival and resistance in vivo. However, intraportal transplantation is not suitable for this kind of culture due to IBMIR; thus, alternative sites must be explored.     

Severe chronic active Epstein–Barr virus infection associated with multiple necrotic lesions in the liver

We report an atypical presentation of a chronic active Epstein–Barr virus (EBV) infection with multiple nodular coagulation necrosis in the liver, that appeared as hypodense areas on a CT scan. The patient, a 26-year-old man, was hospitalized following over 2 years of intermittent fever, weight loss and liver abnormalities after contracting infectious mononucleosis. We diagnosed his illness as a chronic active EBV infection (CAEBV) because of the high antibody titers against EBV and the histological evidence of organ disease with demonstration of EBV mRNA. A liver biopsy revealed EBV-infected T-cell infiltration with hemophagocytosis and marked hepatocytolytic necrosis. The patient developed multiple coagulation necrosis with well-defined borders surrounding T-cell aggregation in the liver 8 months later. He died of respiratory failure due to interstitial pneumonitis. The analysis of EBV-genome termini demonstrated a clonal proliferation of T-cells harboring EBV, but no T-cell antigen receptor (TCR) gene rearrangement was observed. We speculate that the pathogenesis of this disease was an atypical expression of organ damage as a result of an aberrant T-cell response to EBV infection.     

Effect of Gua Sha therapy on patients with diabetic peripheral neuropathy: A randomized controlled trial

ObjectiveTo examine the effect of Gua Sha therapy in the treatment of diabetic peripheral neuropathy (DNP).DesignAn open-label randomized controlled study was conducted with usual care as the control (60 subjects in Gua Sha group and 59 subjects in usual care group). Outcome measures included Toronto Clinical Scoring System (TCSS), Vibration Perception Threshold (VPT), Ankle Brachial Index (ABI), and fasting plasma glucose (FPG). There were 12 consecutive sessions of Gua Sha, one session per week.ResultsAfter the first cycle of Gua Sha intervention, only performance of sensory function measured by the VPT, and peripheral artery disease symptoms by the ABI were statistically significant differences between the two groups (both P values < 0.01), and the total TCSS score and the FPG level were no group differences (P = 0.14, and 0.25, respectively). At the eight-week and 12-week post intervention assessment, Gua Sha therapy significantly reduced severity of neuropathy symptoms, improved performance of sensory function, reduced peripheral artery disease, and better controlled plasma glucose by comparing with the control group (all P values < 0.01). The changes of mean scores of TCSS, VPT, ABI and the plasma glucose levels in the Gua Sha group showed a significant change from baseline to week 12, indicating that Gua Sha therapy induced progressive improvement in the management of DPN symptoms, sensory function, peripheral artery disease and glucose levels. No serious adverse events were reported in either arm. Gua Sha therapy in this study was effective, safe and well tolerated by patients.ConclusionGua Sha therapy appears to be effective at reducing the severity of DPN in a clinically relevant dimension, and at improving other health outcomes in patients with DPN. While this study found that Gua Sha therapy is a promising treatment in reducing the symptoms of patients with DPN, further, larger sample studies are required to confirm the effects of Gua Sha therapy in patients with DPN.     

Insulin or blood purification treatment for hypertriglyceridaemia-associated acute pancreatitis: A systematic review and meta-analysis

Background/objectivesHypertriglyceridaemia increases risks from acute pancreatitis (HTG-AP) over other aetiologies, but optimal management for HTG-AP remains undefined. We performed a systematic review and meta-analysis of studies of insulin-based treatment (IT) versus blood purification treatment (BPT) for HTG-AP.MethodsSearches were conducted to identify randomised trials and observational studies published between 1946 and 2022 that compared IT and BPT for HTG-AP reporting baseline and post-treatment serum triglyceride (TG) levels with clinical outcomes. The primary outcome was serum TG reduction (Δ-TG) from baseline while secondary outcomes included complications, length of stay, adverse events, and cost.ResultsFifteen (1 randomised, 2 prospective case-controlled, and 12 retrospective cohort) studies were analysed comprising 909 cases with HTG-AP. Pooled results demonstrated IT was significantly less efficient than BPT in Δ-TG at 24 h (WMD -666.06, 95% CI -1130.18 to ?201.94, P = 0.005; 12 studies), at 48 h (WMD -672.60, 95% CI -1233.44 to ?111.77; 8 studies), and overall Δ-TG by day 7 (WMD -385.81, 95% CI -711.07 to ?60.54; 8 studies) (both P = 0.02). IT, however, was associated with significantly fewer adverse events (OR 0.09, 95% CI 0.03 to 0.27, P < 0.0001; 7 studies) and significantly reduced cost (WMD -2.50, 95% CI -3.61 to ?1.39, P < 0.00001; 3 studies). Other secondary outcomes were not significantly different between the two regimens (all P ≥ 0.11). In subgroup analysis Δ-TG at 24 h and overall Δ-TG became insignificant, while other results were unaffected.ConclusionOur findings support the general use of IT for inpatient management of HTG-AP, restricting BPT to those predicted or found to respond poorly to IT.     

Comments on Nigel Wiseman’sA Practical Dictionary of Chinese Medicine (II) —On the use of Western medical terms to express the concepts of traditional Chinese medicine

Mr. Wiseman believes that Western medical terms chosen as equivalents of Chinese medical terms should be the words known to all speakers and not requiring any specialist knowledge or instrumentation to understand or identify, and strictly technical Western medical terms should be avoided regardless of their conceptual conformity to the Chinese terms. Accordingly, many inappropriate Western medical terms are selected as English equivalents by the authors of the Dictionary, and on the other hand, many ready-made appropriate Western medical terms are replaced by loan English terms with the Chinese style of word formation. The experience gained in solving the problems of translating Western medical terms into Chinese when Western medicine was first introduced to China is helpful for translating Chinese medical terms into English. However, the authors of the Dictionary adhere to their own opinions, ignoring others’ experience. The English terms thus created do not reflect the genuine meaning of the Chinese terms, but make the English glossary in chaos. The so-called true face of traditional Chinese revealed by such terms is merely the Chinese custom of word formation and metaphoric rhetoric. In other words, traditional Chinese medicine is not regarded as a system of medicine but merely some Oriental folklore. The paper was written on the basis of an e-mailing discussion with the participation of FANG Ting-yu (Beijing Traditional Chinese Medical University), LIU Gan-zhong (Sino-Japanese Friendship Hospital), LU Wei-bo (China Academy of Traditional Chinese Medicine). WANG Kui (World Association of Traditional Chinese Medical Societies), WANG Tai (Medical College, Qinghai University), and ZHANG Qing-rong (Liaoning Traditional Chinese Medical College)