No abstract

Mesenchymal stem cell (MSC)-derived extracellular vesicles (exosomes) possess regeneration, cell proliferation, wound healing, and anti-senescence capabilities. The functions of exosomes can be modified by preconditioning MSCs through treatment with bio-pulsed reagents (Polygonum multiflorum Thunb extract). However, the beneficial effects of bio-pulsed small extracellular vesicles (sEVs) on the skin or hair remain unknown. This study investigated the in vitro mechanistic basis through which bio-pulsed sEVs enhance the bioactivity of the skin fibroblasts and hair follicle cells. Avian-derived MSCs (AMSCs) were isolated, characterized, and bio-pulsed to produce AMSC-sEVs, which were isolated, lyophilized, characterized, and analyzed. The effects of bio-pulsed AMSC-sEVs on cell proliferation, wound healing, and gene expression associated with skin and hair bioactivity were examined using human skin fibroblasts (HSFs) and follicle dermal papilla cells (HFDPCs). Bio-pulsed treatment significantly enhanced sEVs production by possibly upregulating RAB27A expression in AMSCs. Bio-pulsed AMSC-sEVs contained more exosomal proteins and RNAs than the control. Bio-pulsed AMSC-sEVs significantly augmented cell proliferation, wound healing, and gene expression in HSFs and HFDPCs. The present study investigated the role of bio-pulsed AMSC-sEVs in the bioactivity of the skin fibroblasts and hair follicle cells as mediators to offer potential health benefits for skin and hair.

Background: Bilateral arthroscopic rotator cuff repair (ARCR) is frequently performed in patients with symptomatic bilateral rotator cuff tears. Purpose: To compare patient-reported outcomes and mobility between simultaneous and staged bilateral ARCR. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 51 patients who underwent simultaneous (anesthetized once) and 42 patients who underwent staged (anesthetized twice) bilateral ARCR between January 2014 and January 2018; for the staged group, the interval between procedures was at least 12 months. All operations were performed by the same surgeon, and all patients had minimum 24-month follow up in both shoulders. Patient-reported outcomes and range of motion (ROM) were assessed preoperatively and postoperatively and compared between groups. Outcome measures included the Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score as well as measures of psychological status, health-related quality of life, activities of daily living (ADL), and patient satisfaction with the state of one’s shoulders. Results: The mean follow-up times for the staged and simultaneous ARCR groups were 44.1 months (range, 36-60 months) and 37.5 months (range, 25-59 months), respectively. There were no significant differences in age, tear size, or fatty degeneration of rotator cuff muscles between the groups. The cumulative length of hospital stay in the staged group was significantly longer than in the simultaneous group ( P < .001). At the final follow-up, both groups showed significant improvement in ROM, CMS, and ASES scores ( P < .05). No significant differences between the groups were observed in terms of ROM, CMS, and ASES scores postoperatively. At 24 months postoperatively, psychological status and health-related quality of life in both groups improved significantly ( P < .05), and there were no significant between-group differences. Patients were able to perform most essential ADL. Both groups had high patient satisfaction, but patient satisfaction for the second shoulder of the staged group was lower than that of the simultaneous group ( P = .039). Conclusion: Simultaneous bilateral ARCR was shown to be effective, resulting in similar improvements in clinical outcomes to staged bilateral ARCR at 2-year follow-up. In addition to higher patient satisfaction, simultaneous bilateral ARCR also had a shorter treatment cycle.