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Gorman EA, Rynne J, Gardiner HJ, Rostron AJ, Bannard-Smith J, Bentley AM, Brealey D, Campbell C, Curley G, Clarke M, Dushianthan A, Hopkins P, Jackson C, Kefela K, Krasnodembskaya A, Laffey JG, McDowell C, McFarland M, McFerran J, McGuigan P, Perkins GD, Silversides J, Smythe J, Thompson J, Tunnicliffe WS, Welters IDM, Amado-Rodríguez L, Albaiceta G, Williams B, Shankar-Hari M, McAuley DF, O'Kane CM. Repair of Acute Respiratory Distress Syndrome in COVID-19 by Stromal Cells (REALIST-COVID Trial): A Multicenter, Randomized, Controlled Clinical Trial. Am J Respir Crit Care Med 2023; 208:256-269. [PMID: 37154608 DOI: 10.1164/rccm.202302-0297oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
Rationale: Mesenchymal stromal cells (MSCs) may modulate inflammation, promoting repair in coronavirus disease (COVID-19)-related acute respiratory distress syndrome (ARDS). Objectives: We investigated the safety and efficacy of ORBCEL-C (CD362 [cluster of differentiation 362]-enriched, umbilical cord-derived MSCs) in COVID-19-related ARDS. Methods: In this multicenter, randomized, double-blind, allocation-concealed, placebo-controlled trial (NCT03042143), patients with moderate to severe COVID-19-related ARDS were randomized to receive ORBCEL-C (400 million cells) or placebo (Plasma-Lyte 148). The primary safety and efficacy outcomes were the incidence of serious adverse events and oxygenation index at Day 7, respectively. Secondary outcomes included respiratory compliance, driving pressure, PaO2:FiO2 ratio, and Sequential Organ Failure Assessment score. Clinical outcomes relating to duration of ventilation, lengths of ICU and hospital stays, and mortality were collected. Long-term follow-up included diagnosis of interstitial lung disease at 1 year and significant medical events and mortality at 2 years. Transcriptomic analysis was performed on whole blood at Days 0, 4, and 7. Measurements and Main Results: Sixty participants were recruited (final analysis: n = 30 received ORBCEL-C, n = 29 received placebo; 1 participant in the placebo group withdrew consent). Six serious adverse events occurred in the ORBCEL-C group and three in the placebo group (risk ratio, 2.9 [95% confidence interval, 0.6-13.2]; P = 0.25). Day 7 mean (SD) oxygenation index did not differ (ORBCEL-C, 98.3 [57.2] cm H2O/kPa; placebo, 96.6 [67.3] cm H2O/kPa). There were no differences in secondary surrogate outcomes or in mortality at Day 28, Day 90, 1 year, or 2 years. There was no difference in the prevalence of interstitial lung disease at 1 year or significant medical events up to 2 years. ORBCEL-C modulated the peripheral blood transcriptome. Conclusion: ORBCEL-C MSCs were safe in subjects with moderate to severe COVID-19-related ARDS but did not improve surrogates of pulmonary organ dysfunction.
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Affiliation(s)
- Ellen A Gorman
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
| | - Jennifer Rynne
- Centre for Inflammation Research, The University of Edinburgh, Edinburgh, United Kingdom
| | - Hannah J Gardiner
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
| | - Anthony J Rostron
- Sunderland Royal Hospital, South Tyneside and Sunderland National Health Service Foundation Trust, Sunderland, United Kingdom
- Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Andrew M Bentley
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester, United Kingdom
| | - David Brealey
- University College Hospital London, London, United Kingdom
| | | | - Gerard Curley
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mike Clarke
- Northern Ireland Clinical Trials Unit, Belfast, United Kingdom
| | - Ahilanadan Dushianthan
- University Hospital Southampton, Southampton, United Kingdom
- National Institute for Health and Care Research Southampton Biomedical Research Centre, University of Southampton, Southampton, United Kingdom
| | - Phillip Hopkins
- King's Trauma Centre, King's College Hospital, London, United Kingdom
| | - Colette Jackson
- Northern Ireland Clinical Trials Unit, Belfast, United Kingdom
| | - Kallirroi Kefela
- Department of Critical Care, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Anna Krasnodembskaya
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
| | - John G Laffey
- Regenerative Medicine Institute at CÚRAM Centre for Research in Medical Devices, University of Galway, Galway, Ireland
| | - Cliona McDowell
- Northern Ireland Clinical Trials Unit, Belfast, United Kingdom
| | - Margaret McFarland
- Department of Critical Care, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Jamie McFerran
- Northern Ireland Clinical Trials Unit, Belfast, United Kingdom
| | - Peter McGuigan
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
- Department of Critical Care, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Gavin D Perkins
- Critical Care Unit, University Hospitals Birmingham, Birmingham, United Kingdom
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jonathan Silversides
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
- Department of Critical Care, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Jon Smythe
- National Health Service Blood and Transplant, Oxford, United Kingdom
| | - Jacqui Thompson
- National Health Service Blood and Transplant, Birmingham, United Kingdom
| | | | - Ingeborg D M Welters
- Intensive Care Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom
- Institute of Life Course Medical Sciences, University of Liverpool, Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom
| | - Laura Amado-Rodríguez
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Guillermo Albaiceta
- Centro de Investigación Biomédica en Red-Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, Oviedo, Spain
- Departamento de Biología Funcional, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain; and
| | - Barry Williams
- Independent Patient and Public Representative, Sherborne, United Kingdom
| | - Manu Shankar-Hari
- Centre for Inflammation Research, The University of Edinburgh, Edinburgh, United Kingdom
| | - Daniel F McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
- Department of Critical Care, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Cecilia M O'Kane
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
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7
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Ferreira-Baptista C, Queirós A, Ferreira R, Fernandes MH, Gomes PS, Colaço B. Retinoic acid induces the osteogenic differentiation of cat adipose tissue-derived stromal cells from distinct anatomical sites. J Anat 2023; 242:277-288. [PMID: 36056547 PMCID: PMC9877480 DOI: 10.1111/joa.13758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 02/01/2023] Open
Abstract
Mesenchymal stromal cells-based regenerative orthopedic therapies have been used in cats as a promising and innovative therapeutic approach to enhance the repair of bone defects. Adipose tissue-derived stromal cells (ADSCs) can be obtained from two main sites-subcutaneous and visceral-with established differences regarding structure, composition, cell content, and functionality. However, in cats, to the best of the authors' knowledge, no studies have been conducted to compare the functional activity of the ADSCs isolated from the two sites, and the impact of these differences on the induced osteogenic potential. Additionally, retinoic acid has been recently regarded as a new osteogenic inducer within cells of distinct species, with undisclosed functionality on cat-derived cell populations. Thus, the present study aimed to evaluate the functional activity of ADSCs isolated from the subcutaneous and visceral adipose sites (SCAT and VAT, respectively) of the cat, as well as the effects of two osteogenic-inducing conditions-the classic dexamethasone, β-glycerophosphate and ascorbic acid-supplemented media (Dex + β + AAM), and Retinoic Acid-supplemented media (RAM). The adipose tissue of subcutaneous and visceral origin was isolated, characterized, and ADSCs were isolated and grown in the presence of the two osteogenic-inducing conditions, and characterized in terms of proliferation, metabolic activity, morphology, and osteogenic activity. Our results demonstrated a distinct biological profile of the two adipose tissue sites regarding cell size, vascularization, and morphology. Further, osteogenic-induced ADSCs from both sites presented an increased expression of alkaline phosphatase activity (ALP) and cytochemical staining, as compared with control. Overall, RAM induced higher levels of ALP activity than Dex + β + AAM, supporting an increased osteogenic activation. Additionally, VAT was the tissue with the best osteogenic potential, showing higher levels of ALP expression, particularly with RAM. In conclusion, different characteristics were found between the two adipose tissue sites-SCAT and VAT, which probably reflect the differences found in the functionality of isolated ADSCs from both tissues. Furthermore, for cat, VAT shows a greater osteogenic-inductive capacity than SCAT, particularly with RAM, which can be of therapeutic relevance for regenerative medicine applications.
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Affiliation(s)
- Carla Ferreira-Baptista
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal.,BoneLab - Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal.,REQUIMTE/LAQV, University of Porto, Porto, Portugal.,REQUIMTE/LAQV, Department of Chemistry University of Aveiro, Aveiro, Portugal
| | | | - Rita Ferreira
- REQUIMTE/LAQV, Department of Chemistry University of Aveiro, Aveiro, Portugal
| | - Maria Helena Fernandes
- BoneLab - Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal.,REQUIMTE/LAQV, University of Porto, Porto, Portugal
| | - Pedro Sousa Gomes
- BoneLab - Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, University of Porto, Porto, Portugal.,REQUIMTE/LAQV, University of Porto, Porto, Portugal
| | - Bruno Colaço
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal.,REQUIMTE/LAQV, University of Porto, Porto, Portugal.,CECAV-Animal and Veterinary Research Centre UTAD, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Vila Real, Portugal
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9
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Liu Y, Li Y, Zang J, Zhang T, Li Y, Tan Z, Ma D, Zhang T, Wang S, Zhang Y, Huang L, Wu Y, Su X, Weng Z, Deng D, Kwan Tsang C, Xu A, Lu D. CircOGDH Is a Penumbra Biomarker and Therapeutic Target in Acute Ischemic Stroke. Circ Res 2022; 130:907-924. [PMID: 35189704 DOI: 10.1161/circresaha.121.319412] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide. Prediction of penumbra existence after AIS is crucial for making decision on reperfusion therapy. Yet a fast, inexpensive, simple, and noninvasive predictive biomarker for the poststroke penumbra with clinical translational potential is still lacking. We aim to investigate whether the CircOGDH (circular RNA derived from oxoglutarate dehydrogenase) is a potential biomarker for penumbra in patients with AIS and its role in ischemic neuronal damage. METHODS CircOGDH was screened from penumbra of middle cerebral artery occlusion mice and was assessed in plasma of patients with AIS by quantitative polymerase chain reaction. Magnetic resonance imaging was used to examine the penumbra volumes. CircOGDH interacted with miR-5112 in primary cortical neurons was detected by fluorescence in situ hybridization, RNA immunoprecipitation, and luciferase reporter assay. ADV-mediated CircOGDH knockdown ameliorated neuronal apoptosis induced by COL4A4 (Gallus collagen, type VI, alpha VI) overexpression. Transmission electron microscope, nanoparticle tracking analysis, and Western blot were performed to confirm exosomes. RESULTS CircOGDH expression was dramatically and selectively upregulated in the penumbra tissue of middle cerebral artery occlusion mice and in the plasma of 45 patients with AIS showing a 54-fold enhancement versus noncerebrovascular disease controls. Partial regression analysis revealed that CircOGDH expression was positively correlated with the size of penumbra in patients with AIS. Sequestering of miR-5112 by CircOGDH enhanced COL4A4 expression to elevate neuron damage. Additionally, knockdown of CircOGDH significantly enhanced neuronal cell viability under ischemic conditions. Furthermore, the expression of CircOGDH in brain tissue was closely related to that in the serum of middle cerebral artery occlusion mice. Finally, we found that CircOGDH was highly expressed in plasma exosomes of patients with AIS compared with those in noncerebrovascular disease individuals. CONCLUSIONS These results demonstrate that CircOGDH is a potential therapeutic target for regulating ischemia neuronal viability, and is enriched in neuron-derived exosomes in the peripheral blood, exhibiting a predictive biomarker of penumbra in patients with AIS.
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Affiliation(s)
- Yanfang Liu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yufeng Li
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Jiankun Zang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Tianyuan Zhang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yaojie Li
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Zefeng Tan
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Dan Ma
- Departments of Chemistry and Biological Sciences, University of Southern California, Los Angeles (D.M.)
| | - Tao Zhang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, China. (T.Z.)
| | - Shiyong Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China. (S.W.)
| | - Yusheng Zhang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Lian Huang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yousheng Wu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Xuanlin Su
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Zean Weng
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Die Deng
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Chi Kwan Tsang
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Anding Xu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Dan Lu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
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