层黏连蛋白和Matrigel对人胚胎干细胞源性神经上皮祖细胞向神经分化的影响

目的 比较层黏连蛋白和Matrigel在人胚胎干细胞源性神经上皮祖细胞向神经细胞分化过程中的作用.方法 人胚胎干细胞诱导分化的神经上皮祖细胞,比较其在层黏连蛋白和Matrigel处理的培养皿上贴壁增殖能力,免疫荧光染色检测神经上皮祖细胞标记Nestin和Musashi,神经元标记Tuj1和星型胶质细胞标记GFAP.结果 神经上皮祖细胞在2种细胞外基质上贴壁率相近,但层黏连蛋白组的神经突起形成率和Tuj1阳性细胞比例分别为(97±2)%和(75±5)%,明显高于Matrigel组的(89±3)%和(50±5)%(P<0.05).结论 层黏连蛋白是神经上皮祖细胞向神经元分化的重要细胞外基质.     

GDNF对PD模型大鼠黑质神经祖细胞和神经元前体细胞增殖及分化的影响

目的 探讨胶质细胞系源性神经营养因子（GDNF）对帕金森病（PD）模型大鼠黑质内神经祖细胞和神经元前体细胞增殖和分化的影响.方法 大鼠右侧纹状体内注射6-羟多巴胺（6-hydroxydopamine, 6-OHDA）建立模型,行为学分析筛选PD动物模型.将动物模型分为4组：动物模型对照组（右侧黑质内不注射）;PBS组（右侧黑质内注射PBS）;GDNF组（右侧黑质内注射GDNF）;EGF＋GDNF组（右侧黑质内注射EGF＋GDNF）.动物继续存活21天.免疫组织化学染色方法检测黑质内酪氨酸羟化酶（TH）、Ⅲ型β-微管蛋白（Tuj1）、巢蛋白（Nestin）免疫反应阳性细胞,光镜下观察并进行细胞计数,统计学分析处理数据.用Western blot方法分析黑质TH、Tuj1、Nestin蛋白的表达,蛋白条带用图象处理仪扫描,用LabWorks软件分析处理.结果 在GDNF组及EGF＋GDNF组大鼠出现显著的行为学功能恢复的同时,其TH反应阳性神经元数量和TH蛋白表达均显著高于对照组,且能同时检测到这里有Tuj1反应阳性细胞及Tuj1蛋白表达.但仅在EGF＋GDNF组检测到Nestin反应阳性细胞及Nestin蛋白表达.结论 GDNF能促进PD模型大鼠黑质内神经元前体细胞向多巴胺能神经元方向分化.     

纹状体组织提取液诱导人胚胎神经干细胞向多巴胺能神经元分化的实验研究

目的体外培养人胚胎神经干细胞并诱导其向多巴胺能神经元分化。方法从临床引产的人胚胎（胎龄8～16周）海马组织中分离、培养人胚胎神经干细胞, 对其进行诱导分化。诱导剂采用来源于20周胎龄胚胎的纹状体的组织提取液。实验分为2组：对照组无诱导剂,培养基为撤除生长因子的基础培养基;实验组培养基中加入纹状体组织提取液50μL/mL;于诱导分化的第7天终止诱导分化,采用标记TH的免疫荧光染色方法检测TH阳性细胞量,用RT-PCR方法检测TH-mRNA的表达情况。结果抗TH的免疫荧光染色结果为：对照组与实验组的TH阳性细胞率分别为(0.53±0.17)%和(7.38±0.84)%,两组相比差异有统计学意义（P＜0.05）。RT-PCR结果显示：对照组TH-mRNA表达不明显,实验组明显表达TH-mRNA,实验组与对照组的TH-mRNA表达差异亦有统计学意义（P＜0.05）。结论纹状体组织提取液具有促进人胚胎神经干细胞向多巴胺能神经元分化的作用。     

PD大鼠纹状体提取液诱导中脑神经干细胞分化为多巴胺能神经元的研究

目的研究PD大鼠纹状体提取液诱对中脑神经干细胞的诱导分化作用.方法①体外分离、培养大鼠胚胎的中脑神经干细胞,并诱导其分化,巢素(Nestin)、神经丝-200(NF-200)、胶质纤维酸性蛋白(GFAP)免疫组化染色鉴定.②加入纹状体提取液后,分化细胞用抗酪氨酸羟化酶(TH)免疫组化鉴定,并用流式细胞技术检测分化比例.结果①从大鼠胚胎的腹侧中脑部位分离获得了大量未分化、呈巢状悬浮生长的细胞团,且能分化为神经元和神经胶质细胞.②经纹状体提取液诱导后,能够分化出多巴胺能神经元,分化比例达20%左右.结论纹状体提取液能诱导中脑神经干细胞向多巴胺能神经元的分化.     

小鼠孤雌胚胎干细胞直接向神经细胞诱导分化的实验研究

目的探讨小鼠孤雌胚胎干细胞在体外不经过拟胚体(EB）阶段，直接诱导分化为神经细胞的可行性。方法采用阶段诱导的方法，首先由孤雌胚胎干细胞向神经前体细胞定向分化，通过巢蛋白(nestin)免疫荧光细胞化学染色对神经前体细胞进行鉴定。在此基础上，撤除丝裂原，加入5%胎牛血清，观察已分化的神经前体细胞能否进一步分化为神经细胞，并对分化出的细胞进行免疫荧光细胞化学鉴定。结果经选择培养基培养3?d后的孤雌干细胞绝大多数可诱导为神经前体细胞，nestin呈阳性。加入血清进一步诱导，可分化出β-Ⅲ-tubline阳性的神经细胞。结论小鼠孤雌胚胎干细胞在体外不经EB培养阶段，可直接诱导分化为神经细胞，并且前期可得到大量的神经前体细胞。     

大鼠胚胎脊髓源性神经干细胞的培养和分化

目的探讨大鼠脊髓源性胚胎神经干细胞体外分离培养增殖及分化,为进一步的实验研究提供基础。方法取孕14~16 d的SD大鼠胚胎脊髓在条件培养基中培养增殖传代分化,用神经干细胞特异性抗体—巢蛋白(Nestin)鉴定克隆细胞,用特异性的单克隆抗体鉴定克隆球诱导分化后的细胞。用Brdu免疫荧光对神经干细胞传代能力检测。结果获得了大量能自我增殖并分化的神经干细胞,分化后主要产生神经元特异性微管相关蛋白染色阳性的神经元质纤维酸性蛋白阳性的星型胶质细胞和少突胶质细胞三种神经组织细胞。Brdu免疫荧光显示神经球中绝大多数细胞为Brdu阳性细胞,其细胞核中可见荧光标记物。结论大鼠胚胎脊髓能分离、培养出神经干细胞,并能诱导分化为神经元、星型胶质细胞和少突胶细胞。     

丙泊酚对大鼠胚胎神经干细胞增殖及分化的影响

目的探讨丙泊酚对体外培养大鼠胚胎神经干细胞(NSCs)增殖及分化的影响。方法采用孕14～16 d Wistar大鼠,进行NSCs原代培养并用Nestin鉴定,按以下给药分成六组:空白对照组(control)、脂肪乳对照组(introlipid)、丙泊酚不同浓度组[5、25、50、100μmol/l],用5-溴脱氧尿(Brdu)掺入法观察丙泊酚对胚胎神经干细胞增殖的影响。胚胎神经干细胞诱导分化过程中加入50μmol/l丙泊酚,采用NeuN、GFAP免疫组化法观察丙泊酚对胚胎神经干细胞分化的影响。结果分离培养的神经干细胞95%以上呈Nestin阳性,不同浓度丙泊酚组Brdu阳性细胞百分数没有差异,丙泊酚NeuN阳性细胞百分数(23.1±0.9%)明显高于对照组(13.4±0.8%)(P<0.05),而GFAP细胞阳性细胞数与对照组相比没有明显差异。结论临床相关剂量丙泊酚对体外培养大鼠神经干细胞增殖没有影响,但能诱导神经干细胞向神经元细胞分化。     

GFP转基因鼠神经上皮干细胞纹状体内移植的实验研究

目的：观察GFP转基因鼠胚胎神经上皮干细胞的体外培养及脑内移植后的存活与分化状况。 方法：将GFP转基因鼠的胚胎神经上皮干细胞置于无血清培养基内纯化扩增,用巢蛋白免疫组织化学染色鉴定神经干细胞,将扩增后的含GFP基因的神经干细胞在立体定位仪下,定向移植到大鼠的纹状体内。术后不同时期取材、切片,在荧光显微镜下观察移植细胞的存活状况,行微管相关蛋白（MAP-2）、胶质纤维酸性蛋白（GFAP）以及酪氨酸羟化酶（TH）免疫组织化学染色鉴定移植细胞的分化状况。结果： GFP转基因鼠神经管来源的神经上皮干细胞在无血清培养基内能增殖形成神经球,呈巢蛋白阳性。纹状体内移植2周、4周均可见明显的呈绿色荧光的移植细胞,显示细胞存活良好。免疫组织化学染色显示移植细胞在不同间隔时间可分化为MAP-2、GFAP及TH阳性细胞。结论： GFP转基因鼠来源的具有GFP标记的胚胎神经上皮干细胞可在体外培养扩增,移植到大鼠纹状体内存活良好并能分化成神经元、神经胶质细胞,且能定向分化为多巴胺能神经元。     

纹状体组织块诱导胚胎干细胞定向分化的实验研究

目的：探讨由胚胎干细胞向多巴胺能神经元方向分化的最佳诱导条件。方法：本实验采用纹状体组织炔与胚胎干细胞联合培养的方法，通过形态学观察和酪氨酸羟化酶(TH)免疫细胞化学染色对分化细胞进行鉴定。结果：14％左右的胚胎干细胞诱导分化为多巴胺能神经元，而且分化神经元具有投射神经元的典型特征。结论：纹状体组织炔不仅能诱导胚胎干细胞向多巴胺能神经元方向分化，还可影响轴突和／或树突的投射方向和分支模式。     

胚胎神经上皮干细胞体外克隆增殖与分化的实验研究

目的观察胚胎神经上皮干细胞在体外克隆增殖和诱导分化的情况。方法取孕11 d大鼠的胚胎,经分离获得神经管上皮细胞,在无血清培养基内克隆、增殖、传代。取不同时期的神经球进行神经干细胞的鉴定和诱导分化,并通过免疫组织化学染色鉴定分化的结果。结果胚胎神经上皮干细胞在体外能够克隆、增殖,形成的神经球呈nestin阳性,在分化培养基内可分化为星型胶质细胞和神经元。结论胚胎神经上皮干细胞可在体外进行单细胞克隆和诱导分化。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.