Mesenchymal stem cells (MSCs) are multipotent stem cells characterized by their robust proliferative capacity, homing ability, differentiation potential, and low immunogenicity in vitro. MSCs can be isolated from a variety of tissues, primarily including but not limited to bone marrow, adipose tissue, umbilical cord, placenta, and dental pulp. Although there have been a large number of clinical studies on the treatment of diseases by MSCs and MSCs-derived exosomes (MSCs-EXO), the large-scale clinical application of MSCs and MSCs-EXO have been limited due to the heterogeneity of the results among various studies. This review provides a detailed description of the classification and characterization of MSCs and MSCs-EXO, as well as their extraction methods. Furthermore, this review elaborates on three key mechanisms of MSCs and MSCs-EXO: paracrine mechanisms, immunomodulatory and anti-inflammatory effects, as well as their promotion of tissue regeneration. This review also examines the role of MSCs and MSCs-EXO in cardiovascular diseases, neurological disorders, autoimmune diseases, musculoskeletal disorders, and other systemic diseases over the past five years, while discussing the challenges and difficulties associated with their clinical application. Finally, we systematically summarized and analyzed the potential causes of the various heterogeneous results currently observed. Additionally, we provided an in-depth discussion on the challenges and opportunities associated with the clinical translation of disease treatment approaches based on MSCs, MSCs-EXO, and engineered exosomes.

Background: Hydrocephalus caused by spontaneous intracerebral hemorrhage (ICH) is an independent risk factor with adverse effects on the progression of the disease. Until now, the choice of intraventricular catheter placement and intraventricular fibrinolysis (IVF) has been mainly based on the personal experience of the neurosurgeon. Objective: We will introduce the clinical effect of the new external ventricular drainage (EVD), an independent innovation of our medical center, on ICH patients, hoping to inspire more neurosurgeons to apply our method. Methods: In this open retrospective study, We analyzed the clinical data, radiological manifestations, and prognostic scores of 10 patients with the spontaneous intracerebral hemorrhage who received transfrontal lateral ventricle puncture and drainage under laser navigation in our hospital. Results: A total of 10 patients with an average age of 58.10±9.97 years were enrolled for emergency surgery. All operations were completed according to the consensus specifications. It took 11.25±3.81 days for the intracranial pressure to return to normal. On admission, patients had a median GCS of 10. The median preoperative GCS was 8. The median GCS at discharge score was 15. At discharge, the median NIHSS score was 4. After 6 months of follow-up, patients had a median NIHSS score of 4. At discharge, the median ADL score of patients was 85. After 6 months of follow-up, the median ADL score of the patients was 95. Conclusion: In treating patients with ICH, the emergency treatment of transfrontal external ventricular drainage combined with OMMAYA sac implantation under laser navigation is a surgical method worthy of further study.

Objective To investigate dynamic changes in brain functional connectivity (FC) in patients with prolonged disorders of consciousness (pDOC) during and after Xingnao Kaiqiao(XNKQ) acupuncture therapy using functional near-infrared spectroscopy (fNIRS). Methods 36 patients with pDOC were enrolled. After one patient was excluded because of data quality issues, the final analysis included 35 patients who completed the acupuncture intervention with fNIRS monitoring. fNIRS assessments of changes in oxygenated hemoglobin (HbO) concentration were conducted before, during, and after XNKQ acupuncture sessions. Intra- and interregional FC analyses were performed across eight predefined regions. FC analysis was performed by extracting HbO time series before, during, and after acupuncture. Results Compared with the baseline FC, FC was significantly greater during acupuncture. Subgroup analysis revealed increased FC during acupuncture in patients with unresponsive wakefulness syndrome (UWS). In contrast, no such increase was detected in individuals in the minimally conscious state (MCS) or in the sham acupuncture group. The intraregional FC in the left frontal lobe (LFL), right frontal lobe (RFL), left temporal lobe (LTL), and left dorsolateral prefrontal cortex (LDLPFC) markedly increased during acupuncture. FC remained elevated in the LFL, RFL, LTL, right temporal lobe (RTL), and right primary motor cortex (RPMC) after acupuncture. The interregional FC between the LFL-LTL, LFL-RFL, LFL-RTL, RFL-LTL, RFL-RTL, and LTL-RTL was significantly greater during acupuncture. These enhancements persisted after acupuncture for LFL-LTL, LFL-RFL, RFL-LTL, RFL-RTL, and LTL-RTL FC. In the UWS subgroup, the intraregional FC in the LFL, RFL, LTL, RTL, and LDLPFC, as well as the interregional FC between the LFL and LTL, increased during acupuncture. After acupuncture, FC was increased in the LFL, LTL, and RPMC. In the MCS subgroup, FC in the RFL was elevated after acupuncture. Additionally, interregional FC between the LFL and RFL increased both during and after acupuncture, and connectivity between the RFL and LFL also increased following acupuncture. Conclusion XNKQ acupuncture selectively increases FC in consciousness-related networks, particularly within frontal and temporal cortices, with sustained effects postintervention. These findings support the therapeutic potential of XNKQ for pDOC patients through targeted reorganization of higher-order cognitive networks, providing neurophysiological evidence for its clinical application.