人脐带血干细胞移植可影响急性心肌梗死后心室重构

目的观察人脐带血干细胞（HUCBSC）移植对大鼠急性心肌梗死后左室重构的影响。方法采用Ficoll-Hypague法分离培养HUCBSC;健康雄性Wistar大鼠40只,随机均分为对照组和实验组,分别将脐带血和HUCBSC经心外膜下植入对照组和实验组梗死心肌周围。结果移植术后4周,实验组左心室非梗死区心肌骨桥蛋白基因（OPN mRNA）、Ⅰ型胶原和AngⅡ含量均显著低于对照组（P〈0.05）。Pearson直线相关分析表明,实验组和对照组心肌AngⅡ、Ⅰ型胶原与OPN mRNA三者之间两两均呈正相关（P〈0.05）。结论人脐带血干细胞移植可能通过抑制大鼠心肌Ⅰ型胶原合成,下调心肌AngⅡ和OPN基因表达,减轻左室重构。     

同种异体骨髓单个核细胞移植对大鼠急性心肌梗死后心室重构的影响

目的:探讨大鼠同种异体骨髓单个核细胞(BM-MNCs)急性心肌梗死区内移植对左室重构的影响.方法:健康雄性Wistar大鼠32只,随机分为假手术组(8只)、对照组(12只)、移植组(12只).假手术组单纯开胸但不结扎冠状动脉;对照组和移植组用结扎冠状动脉左前降支的方法建立大鼠心肌梗死模型,分别将制备的培养基和同种异体BM-MNCs悬液心外膜下植入对照组和移植组梗死心肌周围.移植术后4周,超声心动图及血流动力学检查评价左室形态及左室功能,并观察梗死区心肌内移植的BM-MNCs及其周边组织的形态学特点.结果:移植术后4周,与假手术组相比,对照组及移植组左室收缩末期内径(LVEDs)、左室舒张末期内径(LVEDd)和左室舒张末压(LVEDP)均升高(P＜0.01),左室射血分数(LVEF)、左室短轴缩短率(LVFS)、左室收缩压(LVSP)、左室压最大上升速率( dp/dtmax)和左室压最大下降速率(-dp/dtmax)均降低(P＜0.01).移植组LVEDs、LVEDd和LVEDP低于对照组(P＜0.01),LVEF、LVFS、 dp/dtmax和-dp/dtmax高于对照组(P＜0.01).免疫组织化学检查证实移植组心肌梗死区内有BrdU标记阳性的BM-MNCs移植细胞存活.结论:同种异体BM-MNCs移植可以减轻左室重构,改善急性心肌梗死后的心脏功能.     

大鼠急性心肌梗死区同种异体骨髓单个核细胞移植观察

目的:探讨同种异体骨髓单个核细胞(BM-MNCs)在急性心肌梗死区分化增殖潜能及其修复重建心肌作用,为细胞移植治疗急性心肌梗死提供新种子细胞.方法:健康雄性Wistar大鼠20只,随机分为急性心肌梗死对照组(10只)和急性心肌梗死实验组(10只).用结扎冠状动脉左前降支的方法建立大鼠心肌梗死模型,分别将培养基和制备的BM-MNCs悬液心外膜下植入梗死心肌周围,移植术后4周,观察心肌梗死区及其周边区组织形态学特点、心肌梗死面积变化.结果:移植术后4周,实验组与对照组相比心肌梗死面积缩小(P＜0.01);实验组心肌梗死区内有BrdU标记阳性的BM-MNCs移植细胞存活,向心肌源性细胞分化并且诱导了大量的新生毛细血管.结论:同种异体BM-MNCs在细胞水平完成了对心肌梗死区再心肌化和再血管化过程,是治疗急性心肌梗死的理想种子细胞.     

同种异体骨髓单个核细胞移植对急性心肌梗死后大鼠心肌细胞凋亡及相关基因表达的影响

目的:探讨大鼠同种异体骨髓单个核细胞(bone marrow mononuclear cells,BM-MNCs)急性心肌梗死区内移植对大鼠心肌细胞凋亡及相关基因表达的影响.方法:健康雄性Wistar大鼠24只,用结扎冠状动脉左前降支的方法建立大鼠心肌梗死模型后,分别将制备的培养基(对照组)和BM-MNCs悬液(移植组)由心外膜下植入梗死心肌周围.移植术后4周,超声心动图评价左室形态及功能,采用TUNEL法检测心肌细胞凋亡,免疫组化法检测心肌细胞中Bcl-2、Fas、FasL蛋白的表达水平,同时观察梗死区心肌内移植BM-MNCs及其周边区组织形态学特点.结果:移植术后4周,移植组左室收缩末期内径和左室舒张末期内径明显低于对照组(P＜0.01),左室射血分数、左室短轴缩短率明显高于对照组(P＜0.01).TUNEL结果显示:移植组心肌细胞凋亡指数(AI)明显低于对照组(P＜0.05).免疫组化结果显示:与对照组相比,移植组心肌细胞中Bcl-2蛋白平均光密度值显著升高(P＜0.05),Fas、FasL蛋白平均光密度值显著降低(P＜0.05),同时观察到移植组心肌梗死区内有BrdU标记阳性的BM-MNCs移植细胞存活.结论:同种异体BM-MNCs移植可以抑制心肌梗死后心肌细胞凋亡的发生,改善急性心肌梗死后的心脏功能,其机制可能与其调节Bcl-2、Fas、FasL的表达有关.     

同种异体骨髓干细胞移植对急性心肌梗死后大鼠心肌细胞凋亡基因的影响

目的探讨同种异体骨髓单个核细胞（BM—MNCs）对急性心肌梗死后心肌细胞凋亡基因的影响。方法健康雄性Wistar大鼠40只,随机分为对照组（20只）和实验组（20只）。分别将培养基和BM—MNCs悬液经心外膜下种植对照组和实验组梗死心肌周围。结果术后4周,实验组左心室非梗死区心肌细胞凋亡指数、TNF-α含量和PDCD5mRNA均显著低于对照组（P均〈0．05）。Pearson直线回归分析表明,两组左心室非梗死区心肌组织中TNF—α含量、心肌细胞凋亡指数和PDCD5mRNA表达三者之间两两均呈正相关（P均〈0．05）。结论BM—MNCs移植可能通过抑制TNF—α表达而降低PDCD5基因促凋亡作用,从而降低心肌细胞凋亡指数,抑制急性心肌梗死后心肌细胞凋亡。     

趋化因子和CD34+干细胞联合移植对梗死后大鼠左室重塑影响的实验研究

目的 探讨趋化因子SDF-1联合同种异体CD34+干细胞移植对心肌梗死后大鼠左室重塑的影响.方法 wistar雄性大鼠38只,随机分成3组:SDF-1联合干细胞移植组(13只);急性心肌梗死对照组(13只):假手术组(12只).移植组和对照组结扎左冠状动脉前降支造成急性心肌梗死模型.另选同种异体大鼠13只,粒细胞集落刺激因子(G-CSF)动员后免疫磁珠法分离外周血CD34+干细胞,在梗死模型制作后7 d,经静脉联合趋化因子SDF-1注入到移植组大鼠体内,对照组和假手术组注入等量磷酸盐缓冲液(PBS).分别于心梗术前、干细胞移植术后1周和4周行心脏超声检查,术后4周检测心肌组织血管紧张素Ⅱ(AngⅡ)和胶原含量.结果 心肌梗死后4周,与对照组比较,移植组左室射血分数(LVEF)、左室短轴缩短率(FS)明显提高(P<0.01),左室收缩末直径(LVESD)、左室舒张末直径(LVEDD)明显减小(P<0.01);移植组心肌组织AngⅡ、胶原含量也有不同程度下降(P<0.05).结论 经静脉联合移植趋化因子SDF-1和外周血干细胞是安全可行的,它能有效地改善心功能,抑制心室重塑,为造血干细胞在心血管疾病中的应用提供理论依据.     

同种异体骨髓间充质干细胞在大鼠心脏的迁移及分化

目的探讨同种异体骨髓间充质干细胞(MSC)在大鼠心脏定居存活情况、同种异体移植是否可行。正常心脏微环境与梗死心脏微环境对骨髓间充质干细胞(MSC)迁移、分化的影响。方法雌性Wistar大鼠35只,①正常心脏MSC移植组(10只);②急性心肌梗死对照组(AMI,10只);③心肌梗死MSC移植组(10只);④单个核细胞治疗组(5只)。结扎左冠状动脉前降支造成心肌梗死模型。分离纯化来自雄性Wistar大鼠的骨髓MSC,于冠脉结扎后1～3h植入到雌性正常大鼠和心肌梗死大鼠心脏组织,模拟同种异体细胞移植治疗。于细胞移植后10周取心脏检测各种指标。结果(1)经纯化的大鼠MSC在同种异体大鼠心脏可定居、生存,而未经纯化的单个核细胞移植在同种异体大鼠心脏未见存活;(2)在正常心脏微环境中,带蓝色荧光的供体MSC细胞核呈小岛屿状分布,与宿主心肌纤维排列无关;而在心肌梗死模型大鼠心脏微环境中,蓝色细胞核分布广泛,呈椭圆形,似心肌细胞核,其排列方向与宿主心肌纤维排列方向一致,免疫组化检测胞浆心肌特异蛋白染色阳性。结论纯化的MSC具有免疫耐受特性,无需加用免疫抑制剂,可进行同种异体移植;同种异体MSC在正常心脏微环境中不发生迁移、分化;而在急性梗死大鼠心脏中具有向缺血梗死区迁移并分化为心肌样细胞的特点。     

急性心梗后自体骨髓单个核细胞移植对梗死心肌结构影响的实验研究

目的:探讨自体骨髓单个核细胞移植对梗死心肌基本结构及心肌收缩力的影响.方法:贵州香猪24只,随机分为对照组和实验组,每组12只.抽取骨髓3 ml,按照Ficoll密度梯度离心方法分离出骨髓单个核细胞,PKH26 Red红色荧光标记.开胸结扎左冠状动脉前降支后,实验组将荧光标记后的自体骨髓单个核细胞分别注射至结扎的左冠状动脉前降支和远端多点注入急性心肌梗死区域;对照组以同样方法注射PBS.术后3,6周取标本,组织切片染色,观察组织基本结构;体外药物刺激离体肌条,检测心肌收缩情况.结果:VG染色显示实验组胶原纤维融合较少,组织结构排列基本处于有序状态.实验组心肌收缩力明显高于对照组(P＜0.001),且随时间推移恢复程度增加(P＜0.05).结论:自体骨髓单个核细胞梗死心肌移植可以增加心肌细胞的收缩力,调节组织内胶原纤维的含量和组成,防止心室重构,从而起到对心肌基本结构的保护作用.     

三种途径移植自体BM-MNCs对猪急性心肌梗死后心功能影响的对比研究

目的对比研究心肌内、冠脉内及静脉内3种途径移植自体骨髓单个核细胞（BM-MNCs）对猪急性心肌梗死后心功能的影响。方法3种途径移植后4周观察小血管密度及心功能变化情况。结果（1）3种途径BM-MNCs移植后4周小血管密度均明显高于各自的对照组（P〈0.01）;心肌内移植BM-MNCs组与冠脉内移植BM-MNCs组相比小血管密度无统计学差异,但明显高于静脉内移植BM-MNCs组（P〈0.01）。（2）3种途径BM-MNCs移植后4周 LVEF及FS均明显高于各自对照组但组间比较无统计学差异;心肌内移植组和冠脉内移植组LVEDd均明显低于对照组,而静脉内移植组LVEDd虽低于对照组但无统计学差异（P〉0.05）。结论3种途径移植BM-MNCs均有助于促进缺血心肌血管新生,改善左心室收缩功能,其中心肌内直接注射和冠脉内注射效果相似,静脉注射较前两种途径移植效果差;心肌内与冠脉内移植BM-MNCs组有减轻心室重构的作用,但在静脉移植组该作用不明显。     

骨髓间质干细胞促进急性心肌梗死大鼠的血管新生及其抗纤维化作用

目的探讨骨髓间质干细胞(bone mesenchymal stem cell,BMSCs)促进急性心肌梗死(acute myocardial infraction,AMI)大鼠的血管新生及抑制大鼠心肌间质纤维化形成的作用。方法制做大鼠AMI模型,并于术后24 h从尾静脉移植同种异体BMSCs。在移植后21天用超声心动图检测BMSCs移植大鼠的左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)和射血分数(EF)。收取BMSCs移植大鼠的心脏标本,用新生血管标志物第Ⅷ因子相关抗原免疫组织化学染色法检测心肌毛细血管密度;用免疫组化检测其心肌间质Ⅰ,Ⅲ型胶原沉积情况。结果与对照组相比,BMSCs移植组心脏功能改善,毛细血管密度增加,心肌间质Ⅰ,Ⅲ型胶原沉积减少。结论BMSCs移植能改善AMI大鼠心脏功能,促进血管新生,减轻其心肌间质纤维化。     

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.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.