1
|
Wang F, Cheng XY, Zhang YT, Bai QR, Zhang XQ, Sun XC, Ma QH, Zhao XF, Liu CF. Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson's disease. Open Life Sci 2024; 19:20220834. [PMID: 38465343 PMCID: PMC10921471 DOI: 10.1515/biol-2022-0834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 03/12/2024] Open
Abstract
Parkinson's disease (PD) is a ubiquitous brain cell degeneration disease and presents a significant therapeutic challenge. By injecting 6-hydroxydopamine (6-OHDA) into the left medial forebrain bundle, rats were made to exhibit PD-like symptoms and treated by intranasal administration of a low-dose (2 × 105) or high-dose (1 × 106) human neural stem cells (hNSCs). Apomorphine-induced rotation test, stepping test, and open field test were implemented to evaluate the motor behavior and high-performance liquid chromatography was carried out to detect dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), serotonin, and 5-hydroxyindole-3-acetic acid in the striatum of rats. Animals injected with 6-OHDA showed significant motor function deficits and damaged dopaminergic system compared to the control group, which can be restored by hNSCs treatment. Treatment with hNSCs significantly increased the tyrosine hydroxylase-immunoreactive cell count in the substantia nigra of PD animals. Moreover, the levels of neurotransmitters exhibited a significant decline in the striatum tissue of animals injected with 6-OHDA when compared to that of the control group. However, transplantation of hNSCs significantly elevated the concentration of DA and DOPAC in the injured side of the striatum. Our study offered experimental evidence to support prospects of hNSCs for clinical application as a cell-based therapy for PD.
Collapse
Affiliation(s)
- Fen Wang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou215004, China
- Institute of Neuroscience, Soochow University, Suzhou, 215123, China
| | - Xiao-Yu Cheng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou215004, China
| | - Yu-Ting Zhang
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou215004, China
- Institute of Neuroscience, Soochow University, Suzhou, 215123, China
| | - Qing-Ran Bai
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, 200333, China
| | - Xiao-Qi Zhang
- Shanghai Angecon Biotechnology Co., Ltd, Shanghai, 201318, China
| | - Xi-Cai Sun
- Shanghai Angecon Biotechnology Co., Ltd, Shanghai, 201318, China
| | - Quan-Hong Ma
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou215004, China
- Institute of Neuroscience, Soochow University, Suzhou, 215123, China
| | - Xiong-Fei Zhao
- Shanghai Angecon Biotechnology Co., Ltd, Shanghai, 201318, China
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou215004, China
- Institute of Neuroscience, Soochow University, Suzhou, 215123, China
| |
Collapse
|
2
|
Guo Y, Zhu H, Wang Y, Sun T, Xu J, Wang T, Guan W, Wang C, Liu C, Ma C. Miniature-swine iPSC-derived GABA progenitor cells function in a rat Parkinson's disease model. Cell Tissue Res 2023; 391:425-440. [PMID: 36645476 DOI: 10.1007/s00441-022-03736-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 12/20/2022] [Indexed: 01/17/2023]
Abstract
Induced pluripotent stem cells (iPS cells) are considered a promising source of cell-based therapy for the treatment of Parkinson's disease (PD). Recent studies have shown forebrain GABA interneurons have crucial roles in many psychiatric disorders, and secondary changes in the GABA system play a directly effect on the pathogenesis of PD. Here, we first describe an efficient differentiation procedure of GABA progenitors (MiPSC-iGABAPs) from miniature-swine iPSCs through two major developmental stages. Then, the MiPSC-iGABAPs were stereotactically transplanted into the right medial forebrain bundle (MFB) of 6-hydroxydopamine (OHDA)-lesioned PD model rats to confirm their feasibility for the neural transplantation as a donor material. Furthermore, the grafted MiPSC-iGABAPs could survive and migrate from the graft site into the surrounding brain tissue including striatum (ST) and substantia nigra (SN) for at least 32 weeks, and significantly improved functional recovery of PD rats from their parkinsonian behavioral defects. Histological studies showed that the grafted cells could migrate and differentiate into various neurocytes, including GABAergic, dopaminergic neurons, and glial cells in vivo, and many induced dopaminergic neurons extended dense neurites into the host striatum. Moreover, over 50% of the grafted MiPSC-iGABAPs could express GABA, and these GABAergic neurons might be responsible for modifying the balance of excitatory and inhibitory signals in the striatum to promote behavioral recovery. Thus, the present study confirmed that the MiPSC-iGABAPs can be used as an attractive donor material for the neural grafting to remodel basal ganglia circuitry in neurodegenerative diseases, avoiding tumorigenicity of iPSCs and the nonproliferative and nondifferentiated potential of mature neurons.
Collapse
Affiliation(s)
- Yu Guo
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Huan Zhu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Yuanyuan Wang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Tingting Sun
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Jiajia Xu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Tie Wang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Weijun Guan
- Institute of Beijing Animal Science and Veterinary, Chinese Academy of Agricultural Sciences, Beijing, 100193, China
| | - Chunjing Wang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China
| | - Changqing Liu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China. .,Department of Neuroscience, University of Connecticut Health Center, Farmington, CT, 06030, USA.
| | - Caiyun Ma
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, 233000, China.
| |
Collapse
|
3
|
Guo Y, Wang YY, Sun TT, Xu JJ, Yang P, Ma CY, Guan WJ, Wang CJ, Liu GF, Liu CQ. Neural progenitor cells derived from fibroblasts induced by small molecule compounds under hypoxia for treatment of Parkinson's disease in rats. Neural Regen Res 2022; 18:1090-1098. [PMID: 36254998 PMCID: PMC9827776 DOI: 10.4103/1673-5374.355820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Neural progenitor cells (NPCs) capable of self-renewal and differentiation into neural cell lineages offer broad prospects for cell therapy for neurodegenerative diseases. However, cell therapy based on NPC transplantation is limited by the inability to acquire sufficient quantities of NPCs. Previous studies have found that a chemical cocktail of valproic acid, CHIR99021, and Repsox (VCR) promotes mouse fibroblasts to differentiate into NPCs under hypoxic conditions. Therefore, we used VCR (0.5 mM valproic acid, 3 μM CHIR99021, and 1 μM Repsox) to induce the reprogramming of rat embryonic fibroblasts into NPCs under a hypoxic condition (5%). These NPCs exhibited typical neurosphere-like structures that can express NPC markers, such as Nestin, SRY-box transcription factor 2, and paired box 6 (Pax6), and could also differentiate into multiple types of functional neurons and astrocytes in vitro. They had similar gene expression profiles to those of rat brain-derived neural stem cells. Subsequently, the chemically-induced NPCs (ciNPCs) were stereotactically transplanted into the substantia nigra of 6-hydroxydopamine-lesioned parkinsonian rats. We found that the ciNPCs exhibited long-term survival, migrated long distances, and differentiated into multiple types of functional neurons and glial cells in vivo. Moreover, the parkinsonian behavioral defects of the parkinsonian model rats grafted with ciNPCs showed remarkable functional recovery. These findings suggest that rat fibroblasts can be directly transformed into NPCs using a chemical cocktail of VCR without introducing exogenous factors, which may be an attractive donor material for transplantation therapy for Parkinson's disease.
Collapse
Affiliation(s)
- Yu Guo
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Yuan-Yuan Wang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Ting-Ting Sun
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Jia-Jia Xu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Pan Yang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Cai-Yun Ma
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China,National Germplasm Resource Center for Domestic Animals, Institute of Animal Science, Chinese Academy of Agricultural Science, Beijing, China
| | - Wei-Jun Guan
- National Germplasm Resource Center for Domestic Animals, Institute of Animal Science, Chinese Academy of Agricultural Science, Beijing, China
| | - Chun-Jing Wang
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China
| | - Gao-Feng Liu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China,Correspondence to: Chang-Qing Liu, ; Gao-Feng Liu, .
| | - Chang-Qing Liu
- School of Laboratory Medicine, School of Life Sciences, Bengbu Medical College, Bengbu, Anhui Province, China,Department of Neuroscience, University of Connecticut Health Center, Farmington, CT, USA,Correspondence to: Chang-Qing Liu, ; Gao-Feng Liu, .
| |
Collapse
|
4
|
Zhu H, Sun T, Wang Y, Wang T, Ma C, Wang C, Liu C, Guo Y. [Directed differentiation of porcine induced pluripotent stem cells into forebrain GABAergic neuron progenitors]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:820-827. [PMID: 34238733 DOI: 10.12122/j.issn.1673-4254.2021.06.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To establish an efficient protocol for directed differentiation of miniature-swine induced pluripotent stem cells (iPSCs) into GABAergic progenitors in a chemically defined system. OBJECTIVE We adopted a two-stage protocol for inducing the differentiation of porcine iPSCs. In the first stage, embryoid bodies (EBs) derived from porcine iPSCs after 3 days of suspension culture were induced in neural induction medium (containing SB431542, DMH1 and FGF2) till day 12 to differentiate into primitive neuroepithelia cells (NECs). In the second stage, the primitive NECs were induced in neural induction medium (containing Pur and B27) to obtain neural rosettes, which further differentiated into GABAergic neuron progenitors on day 21. After labeling with CM-DiI, the progenitor cells were stereotactically transplanted into the substantia nigra (SN) of 6-OHDA-lesioned PD model rats, and the cell survival, migration and differentiation in vivo were observed. OBJECTIVE Porcine iPSCs could be passaged stably on the feeder cell layer and expressed the pluripotent stem cell markers OCT4, Nanog, SSEA1and TRA-160. Karyotype analysis demonstrated the absence of contamination by cells from other species. On day 12 of induced differentiation, the cells formed adherent colonies containing NECs in the form of neural rosettes, which expressed the neuroepithelial markers PAX6, SOX2 and Nestin and the neurite marker beta Ⅲ Tubulin (Tuj1). After induction for 21 days, the NECs differentiated into GABAergic neural progenitors highly expressing NKX2.1 and FOXG1. Eight weeks after transplantation, the iPSCs-iGABA progeniters survived in the striatum of the PD rats, where they differentiate into GABAergic neurons and TH+ neurons and significantly improved dyskinesia of the rats. OBJECTIVE The miniature-swine iPSCsderived GABA progenitors may serve as promising donor cells for neural grafting for treatment of neurodegenerative diseases.
Collapse
Affiliation(s)
- H Zhu
- School of Laboratory Medicine Bengbu Medical College, Bengbu 233000, China
| | - T Sun
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - Y Wang
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - T Wang
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - C Ma
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - C Wang
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - C Liu
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - Y Guo
- School of Laboratory Medicine Bengbu Medical College, Bengbu 233000, China
| |
Collapse
|
5
|
Jiang LL, Li H, Liu L. Xenogeneic stem cell transplantation: Research progress and clinical prospects. World J Clin Cases 2021; 9:3826-3837. [PMID: 34141739 PMCID: PMC8180210 DOI: 10.12998/wjcc.v9.i16.3826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 03/23/2021] [Indexed: 02/06/2023] Open
Abstract
Organ transplantation is the ultimate treatment for end-stage diseases such as heart and liver failure. However, the severe shortage of donor organs has limited the organ transplantation progress. Xenogeneic stem cell transplantation provides a new strategy to solve this problem. Researchers have shown that xenogeneic stem cell transplantation has significant therapeutic effects and broad application prospects in treating liver failure, myocardial infarction, advanced type 1 diabetes mellitus, myelosuppression, and other end-stage diseases by replacing the dysfunctional cells directly or improving the endogenous regenerative milieu. In this review, the sources, problems and solutions, and potential clinical applications of xenogeneic stem cell transplantation will be discussed.
Collapse
Affiliation(s)
- Lin-Li Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hui Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lei Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
6
|
Harris JP, Burrell JC, Struzyna LA, Chen HI, Serruya MD, Wolf JA, Duda JE, Cullen DK. Emerging regenerative medicine and tissue engineering strategies for Parkinson's disease. NPJ Parkinsons Dis 2020; 6:4. [PMID: 31934611 PMCID: PMC6949278 DOI: 10.1038/s41531-019-0105-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 11/25/2019] [Indexed: 02/07/2023] Open
Abstract
Parkinson's disease (PD) is the second most common progressive neurodegenerative disease, affecting 1-2% of people over 65. The classic motor symptoms of PD result from selective degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc), resulting in a loss of their long axonal projections to the striatum. Current treatment strategies such as dopamine replacement and deep brain stimulation (DBS) can only minimize the symptoms of nigrostriatal degeneration, not directly replace the lost pathway. Regenerative medicine-based solutions are being aggressively pursued with the goal of restoring dopamine levels in the striatum, with several emerging techniques attempting to reconstruct the entire nigrostriatal pathway-a key goal to recreate feedback pathways to ensure proper dopamine regulation. Although many pharmacological, genetic, and optogenetic treatments are being developed, this article focuses on the evolution of transplant therapies for the treatment of PD, including fetal grafts, cell-based implants, and more recent tissue-engineered constructs. Attention is given to cell/tissue sources, efficacy to date, and future challenges that must be overcome to enable robust translation into clinical use. Emerging regenerative medicine therapies are being developed using neurons derived from autologous stem cells, enabling the construction of patient-specific constructs tailored to their particular extent of degeneration. In the upcoming era of restorative neurosurgery, such constructs may directly replace SNpc neurons, restore axon-based dopaminergic inputs to the striatum, and ameliorate motor deficits. These solutions may provide a transformative and scalable solution to permanently replace lost neuroanatomy and improve the lives of millions of people afflicted by PD.
Collapse
Affiliation(s)
- James P. Harris
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Justin C. Burrell
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA USA
| | - Laura A. Struzyna
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA USA
| | - H. Isaac Chen
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Mijail D. Serruya
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA USA
| | - John A. Wolf
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
| | - John E. Duda
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Parkinson’s Disease Research, Education, and Clinical Center (PADRECC), Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
| | - D. Kacy Cullen
- Center for Brain Injury & Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
- Center for Neurotrauma, Neurodegeneration & Restoration, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA USA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA USA
| |
Collapse
|
7
|
Zhang J, Zhang L, Chen Y, Shi H, Huang X, Wang Y, Wang Y, Wei Y, Xue W, Han J. Effect and mechanism of mGluR6 on the biological function of rat embryonic neural stem cells. Biosci Biotechnol Biochem 2019; 83:1027-1034. [PMID: 30739574 DOI: 10.1080/09168451.2019.1578639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Here, we investigated the effects and molecular mechanisms of metabotropic glutamate receptor 6 (mGluR6) on rat embryonic neural stem cells (NSCs). Overexpression of mGluR6 significantly promoted the proliferation of NSCs and increased the diameter of neutrospheres after treatment for 24 h, 48 h and 72 h. Overexpression of mGluR6 promoted G1 to S phase transition, with significantly decreased cell ratio in G1/G0 phase but significantly increased cell ratio in S phase. Additionally, mGluR6 overexpression for 48 h decreased the early and late apoptosis significantly. Moreover, overexpression of mGluR6 significantly increased the expression of p-ERK1/2, Cyclin D1 and CDK2, while the expression of p-p38 was significantly decreased. On the contrary, these effects of mGluR6 overexpression were reversed by mGluR6 knockdown. In conclusion, mGluR6 promotes the proliferation of NSCs by activation of ERK1/2-Cyclin D1/CDK2 signaling pathway and inhibits the apoptosis of NSCs by blockage of the p38 MAPK signaling pathway.
Collapse
Affiliation(s)
- Jing Zhang
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Lu Zhang
- b Department of Foreign Languages , Ming De College of Northwestern Polytechnical University , Xi'an , P.R. China
| | - Yani Chen
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Haiyan Shi
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Xiaoyong Huang
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Yanfeng Wang
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Yu Wang
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Yameng Wei
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Wanjuan Xue
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| | - Jiming Han
- a Department of Clinical Medicine , Medical College of Yan'an University , Yan'an , P.R. China
| |
Collapse
|