Background: Mesenchymal stem cells (MSCs), including adipose-derived mesenchymal stem cells (ADSCs), have been shown to attenuate organ damage in acute respiratory distress syndrome (ARDS) and sepsis; however, the underlying mechanisms are not fully understood. In this study, we aimed to explore the potential roles and molecular mechanisms of action of ADSCs in histone-induced endothelial damage.Methods: Male C57BL/6 N mice were intravenously injected with ADSCs, followed by histones or a vehicle. The mice in each group were assessed for survival, pulmonary vascular permeability, and histological changes. A co-culture model with primary human umbilical vein endothelial cells (HUVECs) exposed to histones was used to clarify the paracrine effect of ADSCs. Overexpression and inhibition of miR-126 ADSCs were also examined as causative factors for endothelial protection.Results: The administration of ADSCs markedly improved survival, inhibited histone-mediated lung hemorrhage and edema, and attenuated vascular hyper-permeability in mice. ADSCs were engrafted in the injured lung and attenuated histone-induced endothelial cell apoptosis. ADSCs showed endothelial protection (via a paracrine effect) and Akt phosphorylation in the histone-exposed HUVECs. Notably, increased Akt phosphorylation by ADSCs was mostly mediated by exosomes in histone-induced cytotoxicity and lung damage. Moreover, the expression of miR-126 was increased in exosomes from histone-exposed ADSCs. Remarkably, the inhibition of miR-126 in ADSCs failed to increase Akt phosphorylation in histone-exposed HUVECs.Conclusion: ADSC-derived exosomes may exert protective effects on endothelial cells via activation of the PI3K/Akt pathway.

The number of patients suffering from colorectal cancer (CRC) has been increasing. CRC is known to be curable if detected and treated early. Colonoscopy is currently one of the best screening methods for CRC because it can observe and treat disorders in the large intestine. However, operating the colonoscope is technically demanding for doctors because the insertion of the instrument into the large intestine requires considerable training and skill. To address this issue, we propose a novel self-propelled robot with flexible paddles for the intestinal tract. In this device, the torque is transmitted from a motor outside the patient body to a worm gear at the tip of the colonoscope by a flexible shaft. The worm gear is engaged with two spur gears, and flexible paddles fixed to these spur gears contact the wall of the large intestine to provide the propulsive force. We constructed a force transmission model of the robot to confirm the suitability of the design. The prototype of the self-propelled robot was fabricated by a 3D printer, and its locomotion in a simulated rubber intestine was evaluated. The velocity of the robot was faster than the required speed of 6.5 mm/s. The propulsive force was approximately 1 N; thus, the effectiveness of the robotic principle was confirmed. The mechanical locomotion design, its fabrication, and analysis results are reported in this paper.

Aim: Sarcopenia has been increasingly reported as a prognostic factor for outcome in settings such as cirrhosis, liver transplantation, and emergent surgery. We aimed to elucidate the significance of sarcopenia in severe blunt trauma patients.Methods: We retrospectively analyzed 84 patients emergently admitted to the intensive care unit at Kyushu University Hospital (Fukuoka, Japan) from May 2012 to April 2015. We assessed the amount of skeletal muscle present according to computed tomography and its relevance to ventilation‐free days, patients' length of stay in the intensive care unit, and 28‐day mortality.Results: Twenty‐five (29.7%) patients were defined as sarcopenic. Sixteen (19.7%) patients required 15 days or more in the intensive care unit. The major reason was a prolonged ventilation requirement due to flail chest (n = 7) or pneumonia (n = 3). Sarcopenic patients' stays in intensive care were significantly longer than those of non‐sarcopenic patients (18.7 versus 6.4 days, respectively; P < 0.001). Univariate and multivariate analyses showed sarcopenia to be a significant risk factor for prolonged intensive care unit stay.Conclusion: Sarcopenia is a risk factor that predicts prolonged intensive care unit stay in high‐energy blunt trauma patients.