Volume 95  ·  Issue 48  ·  2015

For medical workers in China, 2015 is a memorable year. 100 years ago, Dr. Wu Liande and other sages founded the Chinese Medical Association with patriotism and pride in serving the country. For my country's digestive endoscopy colleagues, 2015 is a year worth remembering. Thirty years ago, Professor Chen Minzhang and other predecessors were far-sighted and worked together to promote the establishment of the digestive endoscopy branch of the Chinese Medical Association. Under the care of Chinese Medical Association, the Digestive Endoscopy Branch has grown and lasted for a long time. At this historical moment, let us recall the development of digestive endoscopy, feel the struggle of the older generation of digestive endoscope people, and continue to write the glory of digestive endoscopy in China.

Male hypogonadism refers to the decreased function of the testes to secrete testosterone and/or produce sperm, which can be divided into hypergonadotropic hypogonadism and hypogonadotropic hypogonadism (HH) according to blood follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels. Exogenous androgen supplementation allows patients to obtain sufficient signs of virilization and normal sexual function, but it will inhibit hypothalamic-pituitary-gonadal (HPG) axis function, thus inhibiting sperm production. Pulse therapy with gonadotropin and gonadotropin-releasing hormone (GnRH) is widely used in HH patients, but the conversion of testosterone to estradiol by aromatase often increases accordingly, which can lead to breast distension and gynecomastia and other adverse reactions^[1]。 Clinically, scholars have applied aromatase inhibitors (AI) to male hypogonadism patients and achieved certain curative effects, which provides a preliminary clinical basis for the use of AI in this disease. This article mainly summarizes the efficacy and safety of AI in the treatment of male hypogonadism patients in recent years.

Gram-negative bacteria are the most common pathogens of bacterial infectious diseases in China. In recent years, the resistance of Gram-negative bacteria to beta-lactam antibiotics has been increasing, and the most important resistance mechanism is the bacterial production of various beta-lactamases. Beta-lactamase inhibitors can inhibit most beta-lactamases and restore the antibacterial activity of beta-lactam antibiotics. Therefore, the position of β-lactam antibiotic/β-lactamase inhibitor mixture in clinical anti-infection is constantly increasing, and it has become an important choice for clinical treatment of various drug-resistant bacterial infections. At present, there are many kinds and specifications of β-lactam antibiotic/β-lactamase inhibitor mixtures in clinical use in China. Clinicians don't know enough about the characteristics of these mixtures, and the problem of irrational clinical use is more prominent. In order to standardize the clinical application of β-lactam antibiotics/β-lactamase inhibitor mixtures and delay the occurrence and development of drug resistance, this consensus is specially formulated.

To analyze the clinicopathological characteristics, treatment protocls and prognostic factors in patients with primary intestinal diffuse large B-cell lymphoma (DLBCL).

The clinical data of 54 patients with DLBCL who were treated in Cancer Hospital of Chinese Academy of Medical Sciences in the period from August 2003 to November 2012 were retrospectively analyzed, and the relevant prognostic factors of DLBCL were analyzed.

Of the 54 patients, there were 43 males and 11 females (male∶female ratio was 3.91∶1), with a median age of onset of 49 (7-76) years. Most patients (64.8%) were in Lugano stage Ⅰ-Ⅱ. Of all the patients, 50 were followed up for a median of 49 (1-118) months. The 1-, 3- and 5-year overall survival (OS) rates were 82.0%, 69.9% and 60.7%, respectively; the 1-, 3- and 5-year progression-free survival (PFS) rates were 68.0%, 58.0% and 53.4%, respectively. Univariate analysis showed that the factors affecting prognosis of DLBCL patients included Lugano stage, B symptom, International Prognostic Index (IPI) score, lactate dehydrogenase level, β ₂-microglobulin level, tumor size, and treatment protocols (all P<0.05). The 5-year OS rate was 67.1% in the patients treated with surgery plus chemoradiotherapy, and 40.0% in those treated with surgery or chemotherapy alone(P<0.05). In the patients treated with chemotherapy combined with rituximab, the 5-year OS rate was higher than in those treated with chemotherapy alone(71.2% vs 47.6%,P<0.05). Multivariate analysis indicated that tumor size (RR=7.686, P=0.022) and lactate dehydrogenase level (RR=10.131, P=0.017) were independent prognostic risk factors affecting OS.

Primary intestinal DLBCL is a highly heterogeneous malignancy. Surgery combined with chemoradiotherapy and rituximab may help improve the overall prognosis of DLBCL patients.

To explore the effect of CD4⁺ CD28^null T cell on occurrence and progression of atherosclerosis in patients with type 2 diabetes.

A total of 188 patients who were diagnosed as type 2 diabetes in the department of endocrinology were selected in this study.The carotid atherosclerosis was detected using color Doppler ultrasound.The patients with intima-media thickness > 1.1 mm or plaques were classified as the carotid atherosclerosis group (95 cases), the others were classified as the control group (93 cases). According to the intima-media thickening and plaques, carotid atherosclerosis group was divided into three subgroups: the thickening group (30 cases), the plaque group (28 cases) and the thickening + plaque group (37 cases). Percentage of CD4 ⁺ CD28^null T cell in peripheral blood was detected using a flow cytometry, and thus compared and analyzed between the carotid atherosclerosis group and the control group.The relationships between percentage of CD4⁺ CD28^null T cell and age, C-reactive protein (CRP), blood sugar, blood lipids, the body mass index (BMI), waist circumference, hip circumference, diastolic blood pressure, systolic blood pressure and other data were also analyzed.

Percentage of CD4⁺ CD28^null T cell of the carotid atherosclerosis group was significantly higher than that of the control group (4.07%±3.21% vs 2.99%±2.34%, P<0.01). Percentage of CD4⁺ CD28^null T cell of the thickening+ plaque group was higher than that of the plaque group and thickening group (both P<0.05), and percentage of CD4⁺ CD28^null T cell of the plaque group was higher than the thickening group (P<0.05). Logistic regression analysis indicated that CRP, FPG and percentage of CD4⁺ CD28^null T cell were the independent risk factors of atherosclerosis in patients with type 2 diabetes.Furthermore, multiple linear regression analysis showed that percentage of CD4⁺ CD28^null T cell was linear correlated to CRP (P<0.01).

The type 2 diabetes patients with atherosclerosis had a higher percentage of CD4⁺ CD28^null T cell, which was increased with the atherosclerosis progression.CD4⁺ CD28^null T cell may affect arterial intimal thickening and plaque formation via mediating inflammatory response in the patients with type 2 diabetes.

To explore the prognostic role of free triiodothyronine (FT₃) on all-cause mortality and heart failure (HF) hospitalization in patients receiving cardiac resynchronization therapy (CRT).

In this single-center retrospective cohort study, a total of 202 chronic heart failure (CHF) patients who had CRT implantation from January 2010 to December 2014 were enrolled. Clinical outcomes were defined as all-cause mortality (including heart transplantation) and new heart failure (HF) hospitalization. Patients were divided into three groups according to FT₃ tertiles: FT₃≤ 4.08 pmol/L group (n=67), FT₃ 4.09-4.71 pmol/L group (n=68) and FT₃ > 4.71 pmol/L group ( n=67). Kaplan-Meier analyses were performed for each outcome. Cox proportional-hazards regression analyses were used to evaluate the independent prognosis of FT₃ in CRT treated patients.

Patients in FT₃≤ 4.08 pmol/L group tended to be older, with more women patients, and had lower estimated glomerular filtration rate (eGFR), hemoglobin and serum sodium concentration. They were also less frequently subjected to smoking, alcohol consumption and were less likely prescribed with renin-angiotensin-aldosterone system inhibitors. Also, this group had highest proportion of NYHA class Ⅳ patients. Kaplan-Meier analyses demonstrated that FT₃ 4.09-4.71 pmol/L group was associated with a significantly better survival (P=0.022) and less new hospitalizations for HF event (P=0.020). Cox regression analyses indicated that FT₃ 4.09-4.71 pmol/L was an independent protective factor for both all-cause mortality (HR=0.220, 95%CI: 0.069-0.700, P=0.011) and HF hospitalization (HR=0.490, 95%CI: 0.241-0.996, P=0.049). Left ventricular end diastolic diameter (LVEDd) enlargement was an independent risk factor of all-cause mortality(HR=1.043, 95%CI: 1.004-1.083, P=0.031).

Patients in FT₃ 4.09-4.71 pmol/L group had the lowest risk of all-cause mortality and HF hospitalization after CRT implantation.

To investigate the expression of methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) in hepatocellular carcinoma (HCC) tissues and its correlation with clinical parameters.

Fluorogenic quantitative-polymerase chain reaction (FQ-PCR) was used to measure the MTHFD2 mRNA expression. The MTHFD2 protein expression was detected by immunohistochemical staining in cancerous tissues and adjacent noncancerous counterparts. The relationship of MTHFD2 expression, clinicopathological parameters and the prognosis of hepatocellular carcinoma was subsequently analysed.

The MTHFD2 mRNA expression in cancerous tissues was higher than that in adjacent noncancerous counterparts (31/47) (P<0.05). The positive rate of MTHFD2 protein in cancerous tissues was significantly higher than that in adjacent noncancerous counterparts (69.5% vs. 33.9%) (P<0.05). MTHFD2 overexpression was found to correlate with clinical pathological parameters such as tumor metastasis, recurrence and poor prognosis (P<0.05). The patients with overexpressed MTHFD2 had shorter tumor-free survival time.

Overexpression of MTHFD2 in HCC may be a risk factor of tumor metastasis and recurrence. MTHFD2 could be a new biomarker for prognosis of HCC.

To evaluate efficacy of the 1 mg overnight dexamethasone suppression test (1 mg overnight DST) in the diagnosis of subclinical Cushing's syndrome, and to explore the best diagnostic cut-off value.

The clinical data of patients with adrenal incidentaloma in Chinese PLA General Hospital from 1995 to 2013 were gathered.The data of subclinical Cushing's syndrome(SCS) and non-functional adrenal adenoma (NFA) was retrospectively analyzed.The ROC curve was used to evaluate the efficacy of the 1 mg overnight DST and to explore the best cut-off value with high sensitivity and specificity.

There were 447 patients with NFA (224 male and 223 female), and the mean age was 53±11 years old.49 patients were with SCS (19 male and 30 female), and the mean age was 47±12 years old.The area under the ROC of serum cortisol level after 1 mg overnight DST was 0.967 (95%CI: 0.942-0.993). The best cut-off value of serum cortisol after 1 mg overnight DST was 63.65 nmol/L , with a sensitivity of 100.0% and a specificity of 88.8% .The best cut-off value of the suppression ratio of serum cortisol was 85.64%, with a sensitivity of 83.3% and a specificity of 84.6%.

The best criterion for 1 mg overnight DST in the diagnosis of SCS was serum cortisol level , and the recommend cut-off point was 63.65 nmol/L, with both a higher sensitivity and specificity.The suppression ratio of serum cortisol after 1 mg overnight DST was also considered as a suitable criterion in the diagnosis of SCS.

To evaluate the use of percutaneous mechanical thrombectomy in the treatment of acute deep venous thrombosis.

Eight cases of acute deep venous thrombosis were reviewed who had received percutaneous mechanical thrombectomy from January to July, 2015 in Beijing Tsinghua Changgung Hospital. All cases were diagnosed as iliofemoral venous thrombosis, 2 cases with vena cava thrombosis. All cases received anticoagulation treatment for 3 to 6 months and pressure treatment after the procedure. Every patient was scheduled to follow up at 1, 3, 6 months, respectively.

Technical success were achieved in all cases with restoring of good flow in previous lesions. Grade Ⅲ (complete) lysis was achieved in 2 cases and grade Ⅱ(50%-99% ) lysis in 6 cases, swelling legs were mostly fade away. Of all study follow up , only one case with mild post-thrombotic syndrome after six months.

Percutaneous mechanical thrombectomy is safe and effective in the treatment of acute deep venous thrombosis.

To evaluate the efficacy of Botulinum-A toxin injection into bladder to treat neurogenic incontinence in patients with spinal cord injury and compare effectiveness of two different doses (200 U and 300 U).

Between January 2009 and October 2014, A total of 60 adult patients with spinal cord injury above the sacral (mean age, 32 years; male 56, female 4) were selected in Beijing Bo'ai Hospital of China Rehabilitation Research Center. All the patients kept voiding diary and underwent urodynamic examination before operation. All the patients were allocated with a random number table into 200 U Botulinum-A toxin injection group or 300 U group (bothn=30). In the 200 U group, 200 U of Botulinum-A toxin were dissolved in 10 ml of normal saline, which was injected into 20 different sites (0.5 ml for each site) of bladder wall, including 10 outside the bladder trigone and the remaining 10 inside trigone. In the 300 U group, 300 U of Botulinum-A toxin were dissolved in 15 ml of normal saline, which was injected into 30 different sites (0.5 ml for each site) in bladder outside of the bladder trigone using a flexible cystoscopic needle. The evaluation of the effects and follow-up included voiding diary, urodynamic testing and observation of adverse and toxic effects.

At baseline, mean urinary incontinence frequencies were (15.2±3.2) episodes/day and (16.2±2.9) episodes/day in 200 U and 300 U group, which reduced to (2.9±1.2) episodes/day and (2.5±1.4) episodes/day, respectively in week 4 (P<0.05). However, continence rate was not significantly different between the two dose groups [63% (19/30) vs 70% (21/30),P>0.05]. The effect of botulinum-A toxin started to be observed from the 1^st posttreatment week on average. Obvious improvements in maximum cystometric capacity, end-filling maximum detrusor pressure, and bladder compliance were observed at week 4 as shown by urodynamics (all P<0.05), but with no significant difference between the 200 U and 300 U groups. In the follow-up period of (6.3±1.2) months, no toxic or adverse effects were observed after injection in the two groups.

The regimen of Botulinum-A toxin 200 U injection involving trigone of the bladder can achieve a short-term effect comparable with that of the standard 300 U injection excluding trigone. It may be an effective and safe treatment for neurogenic incontinence in spinal cord injury patients.

To investigate the distribution and clinical significance about venous anastomosis of superficial cerebral vein in normal adult.

The digital subtraction angiography (DSA) images of the venous phase from 50 normal adults were retrospectively analyzed, and the morphology of venous anastomosis of superficial cerebral veins was observed and measured. While venous anastomosis of superficial cerebral veins of 15 (30 sides) cadaveric heads was observed through blood vessel perfusion.

Trolard vein and Labbe vein were the main venous anastomosis of superficial cerebral veins. A total of 55 Trolard veins were found out of 50 sides DSA venous phase images, including left 27, right 28; 34 Trolard veins, left 18, right 16, were found from the 30 sides of the brain hemispheres. 51 Labbe veins, left 25, right 26, were found from the 50 sides DSA venous phase images, and 31 Labbe veins, left 15, right 16, were found from the 30 sides of the brain hemispheres.

Venous anastomosis of superficial cerebral veins is variable. The DSA venous phase image is consistent with the microscopic anatomy, and the preoperative DSA examination is beneficial for the protection of venous anastomosis of superficial cerebral veins.

To investigate the risk factors of cerebral metastasis of breast cancer and to provide guidance for the early diagnosis and treatment of brain metastases.

Clinical data of postoperative patients with breast cancer were collected in our hospital from 2005 to 2009. All the patients were divided into two groups, with or without brain metastasis. The risk factors of brain metastases of patients with breast cancer were analyzed by the logistic regression.

Eight hundred and twenty four early postoperative patients with breast cancer were enrolled. The median follow-up time was 68 months and 199 cases had brain metastasis. The univariate logistic regression results showed that higher grade of tumor, <35 years, premenopausal, clinical stage Ⅲ, HER-2 positive and ER negative, no adjuvant chemotherapy, no adjuvant normal therapy were the risk factors of brain metastasis. The multivariate logistic regression result showed that higher grade of tumor, <35 years, premenopausal, clinical stage Ⅲ, HER-2 positive, ER negative were the risk factors. The mathematical model was used to predict the probability of occurrence of brain metastasis. ROC curve were draw by the value of predict probability as test variable and the brain metastasis status as state variables. The AUC value of this predictive model was 0.743±0.018. The specificity and sensitivity are relative high.

Age <35 years, premenopausal, clinical stage Ⅲ, HER-2 positive and ER negative were independent risk factors for brain metastases. This model has the predictive value for the occurrence of brain metastases from breast cancer.

To study the phenotypic alteration of intestinal dendritic cells (DC) in a rat model of irritable bowel syndrome (IBS) and the change of mitogen-activated protein kinase (MAPK) signaling pathway, in order to explore the potential mechanism of ERK1/2 pathway mediation in abnormal DC immune response.

IBS rat model was established by combining neonatal maternal separation and colorectal distension in 10 SD rats, and 10 healthy rats served as controls. Visceral sensitivity was evaluated with abdominal withdrawal reflex (AWR). Mesenteric lymph node DC (MLNDC) was isolated and purified by magnetic label-based technique after modeling. Expression of surface major histocompatibility complex (MHC)-Ⅱ in control rats was determined by flow cytometric analyses. Western-blot was used to determine the expression of MHC-Ⅱ, p-p38, p38, phosphorylated extracellular regulated protein kinase (p-ERK1/2), ERK1/2, phosphorylated c-Jun N-terminal kinase (p-JNK), and JNK in MLNDC.

Visceral sensitivity was significantly higher in the IBS group than in the control group. The purity of the OX62 positivity MLNDC following magnetic sorting was about 85.57%±7.67%. MLNDC in the control group expressed high level of MHC-Ⅱ. The expression of MHC-Ⅱ and p-ERK1/2 in MLNDC in the IBS group were higher than those in the control group (1.05±0.13 vs 0.67±0.18, t=-2.973, P=0.041; 3.21±0.48 vs 2.34±0.85, t=-3.130, P=0.035); while there was no significant difference in the expressions of p-JNK and p-p38 compared with the control groups (0.95±0.17 vs 0.76±0.36, t=0.808, P=0.464; 1.07±1.13 vs 1.19±0.91, t=0.137, P=0.897).

The intestinal DC in IBS rats show a upregulated expression of MHC-Ⅱ, which may be related to the activation of intracellular ERK1/2 pathway.

To verify whether FN1 and ZNF438 are the androgen receptor(AR) target genes in LNCaP-AI cells and investigate the effects of AR exerts on FN1 and ZNF438 gene expression.

ChIP-PCR and agarose gel electrophoresis were performed to verify the fact that AR acted on FN1 and ZNF438 gene. Subsequently, LNCaP-AI cells were treated with dihydrotestosterone(DHT)and lentivirus transfection to down-regulate AR expression. The expression of FN1 and ZNF438 gene in mRNA and protein levels were analyzed by RT-qPCR and Western blot.

FN1 and ZNF438 gene enrichment of AR-ChIP group were 7.274±0.290 and 6.843±0.078, significantly higher than the IgG-ChIP group of 1.004±0.113 and 1.000±0.014 (t_(FN1)=34.91, t_(ZNF438)=128.377, P<0.05). Differences were statistical significance. After DHT stimulation, the expression of FN1 and ZNF438 gene in mRNA and protein levels were 0.434±0.050 and 0.069±0.042, significantly lower than the control group of 1.000±0.016 and 1.025±0.277 (t_(FN1)=18.532, t_(ZNF438)=5.905, P<0.05). Differences were statistical significance. Moreover, after AR down-regulation, the expression of FN1 and ZNF438 gene in mRNA and protein levels were 17.579±4.415 and 1.895±0.424, significantly higher than the control group of 1.028±0.445 and 1.041±0.190(t_(FN1)=6.461, t_(ZNF438)=3.184, P<0.05). Differences were statistical significance.

FN1 and ZNF438 gene are AR negatively regulated target genes in LNCaP-AI cells. The study might provide a new sight to further explore the mechanism of LNCaP-AI cells grow in androgen-depleted conditions.

To study the therapeuticeffects and mechanismsof androgen and simvastatin on osteoporosis in castrated rats.

Fifty 12-month-old male SD rats were divided into five groups randomly: castrated group (A), sham operated group(B), androgen group (C), simvastatin group(D), androgen+ simvastatin group(E). Each group has 10 rats. In this study, osteoporosis model was established by castration.All the groups were given testis and epididymis resection except sham operatedgroup.The drugs were administrated on 9 weeks after operation.C, D and E group were treated by the differentdrugs lavage for 12 weeks. A and B group were given normal saline at the same time. Lumbar spine bone mineral densities(BMD) of rats were measured on pre-operation, before administration, 6 weeks and 12 weeks after administration.All rats were sacrificed on 12 weeks after administration.Serum osteocalcin(BGP), interleukin-6(IL-6) and Ca²⁺ were measured.Bone histologywasobserved.

After the treatment by simvastatin or androgen for 12 weeks, BMD of the group C and group Dwas significantlyhigher than that of group A(P<0.01). After the treatment by simvastatin and androgen for 6 weeks, BMD of the group E was significantlyhigher than that of group A, C and D(P<0.05). The level of serum BGP in group Awassignificantlylowerthan that ingroup B(P<0.05)and the level of serum BGP in group E was significantly higher than that in group B(P<0.05). The serum IL-6 in eachtreated group were significantly lower than thatin group A(P<0.05).

The combination of simvastatin and androgen could inhibit bone absorption and promote bone formation, which could improve the osteoporosis.

To investigate the effects of calcitriol on airway remodeling and airway epithelial cell apoptosis in a murine model of bronchial asthma.

Twenty-four SPF female Balb/c mice were randomly allocated into three groups according to a random digits table with 8 mice in each group: the control group, the chronic asthma group and the calcitriol intervention group.(1) The chronic asthma group: the mice were sensitized by intraperitoneal injection of Ovalbumin (OVA, 20 μg) and aluminium hydroxide (50 μl) on days 1 and 14.From day 21, the mice were challenged by inhalation of 1% OVA solution (10 ml, 30 min/time, three times a week for consecutively 8 weeks). (2) The calcitriol intervention group: the mice were sensitized and challenged as above, and were given calcitriol 100 ng through intraperitoneal injection 30 min before every inhalation.(3) The control group: the mice were sensitized and challenged by saline instead of OVA.The mice were sacrificed 24 hours after the last challenge, and the left lung were removed, fixed with paraformaldehyde, embedded with paraffin and sectioned.HE staining, Alcian blue and Periodic acid Schiff (AB-PAS) staining, Masson staining, and α-smooth muscle actin (α-SMA) immunohistochemistry staining were conducted.Bronchial basement membrane perimeter (Pbm), total bronchial wall area and positive areas of AB-PAS staining, Masson staining, and α-SMA staining were determined with image analysis software.The results were standardized with the basement membrane perimeter.Paraffin sections of mice lung tissue were detected with terminal transferase deoxyuridine triphosphate (dUTP) nick end labeling enzyme mediated method (TUNEL) for apoptosis of airway epithelial cells and with immunohistochemistry staining for expression of B cell lymphoma/lewkmia-2 (Bcl-2) in the airway epithelium.

The mice in the chronic asthma group and calcitriol intervention group showed characteristic airway inflammation and airway remodeling of asthma.The ratios between the total bronchial wall area and positive areas of AB-PAS staining, Masson staining and α-SMA staining and the basement membrane perimeter in the calcitriol intervention group were (14.12±2.13), (3.72±0.57), (4.31±0.65) and (3.27±0.46) μm ²/μm, respectively, all of them were significantly lower than (19.24±1.70), (5.23±0.90), (7.63±1.55) and (5.40±0.69) μm²/μm in the chronic asthma group and higher than (7.79±1.01), (0.05±0.03), (1.37±0.25) and (1.40±0.24) μm²/μm in the control group (allP<0.01). The airway epithelial cell apoptosis index in the calcitriol intervention group was significantly lower than that in the chronic asthma group and higher than the control group [(14.89±1.75)% vs (29.73±5.74)% and (0.45±0.38)%, bothP<0.01]. The relative expression of Bcl-2 in the calcitriol intervention group was significantly higher than that in the chronic asthma group and lower than the control group (0.114±0.009 vs 0.091±0.023 and 0.160±0.021, bothP<0.05).

Calcitriol attenuates airway remodeling and reduces the apoptosis of airway epithelial cells in a murine model of chronic asthma.The mechanism of calcitriol in reducing apoptosis of airway epithelial cells is by regulation of expression of the important molecule Bcl-2 protein in mitochondrial apoptotic pathway.

According to the bronchoscopic manifestations, bronchial tuberculosis is classified into 7 types^[1]。 The treatment of granuloproliferative bronchial tuberculosis is difficult and the prognosis is poor. In this study, on the basis of systemic anti-tuberculosis therapy, we investigated the effect of bronchoscopic cryoscopy combined with local injection of isoniazid + rifampicin + dexamethasone in the treatment of granuloproliferative bronchial tuberculosis.

Pulmonary fibrosis is a pulmonary disease characterized by interstitial pulmonary fibrosis with decreased pulmonary function and respiratory failure, and is the end outcome of many pulmonary diseases. The patient's condition is serious, the mortality rate is high, and there is still a lack of effective therapeutic drugs in clinic^[1,2]。 Pulmonary fibrosis is characterized by injury and activation of alveolar epithelial cells, interstitial inflammation, fibroblast proliferation, collagen deposition in extracellular matrix, and autoimmune abnormalities^[3,4]。 Therefore, regulating abnormal autoimmune inflammation, targeting abnormally proliferating fibroblasts, and inducing functional lung epithelial cell repair are the key links to effectively control the progression of pulmonary interstitial fibrosis.

Stem cells are a class of cell populations with self-renewal ability and multidirectional differentiation potential, which have been applied in tissue engineering and regenerative medicine neighborhoods^[1,2]。 According to different sources, stem cells can be divided into embryonic stem cells and adult stem cells^[3]。 Embryonic stem cells have potential socio-ethical controversies that hinder their use^[4]。 Although adult stem cells can be derived from bone marrow, peripheral blood, fat, dental pulp, and hair follicles^[5]But there are problems such as difficulty in obtaining materials, greater trauma and limited quantity^[6]。 Therefore, exploring a new source of stem cells is a hot topic in biomedical research.

Comrade Lin Chuanjia, an outstanding member of the Communist Party of China, a famous expert in children's health care in China, one of the founders of children's health care in China, and a professor of pediatrics in Beijing Children's Hospital, died at 3: 40 on November 7, 2015 in the First Hospital of Peking University at the age of 100 due to ineffective treatment.