论干细胞研究的医学价值和社会影响

文章分析了干细胞研究成为当代生命科学热点的原因及干细胞技术的应用前景和医学价值，着重从干细胞的来源、人类胚胎的克隆性研究和干细胞治疗等方面探讨了干细胞研究的社会伦理道德问题。     

造血干细胞分化为内皮细胞的研究进展

干细胞技术是近年来发展最为迅速的生物医学技术，在干细胞技术研究应用中，造血干细胞(hematopoietic stem cell，Hsc)移植的临床应用较早，始于20世纪50年代后期，80年代初有了较大突破。造血干细胞的分离纯化、增殖分化性能及体外扩增的研究是近年来研究的热点。然而，在扩增造血干细胞的同时，也明显地加速其分化，这是造血干细胞扩增所面临的一个难题，     

干细胞对脑梗死治疗的研究进展

近年来，生物医学迅猛发展，干细胞具有自我更新和分化的潜能，在特定微环境中可以横向分化，因此干细胞应用研究具有划时代的意义。干细胞应用应符合安全和有效两大原则，安全包括致畸、致突、致癌三大安全评价试验。有效治疗有许多未解决的问题，但由于其广阔的应用前景，仍成为世界科学界研究的热点之一。应用干细胞治疗脑梗死较传统方法有很多优点，如低毒性或无毒性，长期有效；应用自身干细胞移植，避免产生免疫排斥反应等。下面就干细胞治疗脑梗死研究进展进行综述。     

神经干细胞的研究进展

目的阐述神经干细胞的生物学特性及应用前景。方法参阅国内外相关文献就神经干细胞与临床神经系统疾病之间的密切关系作一综述。结果神经干细胞具有分化、增殖的潜能，神经干细胞系的建立为其应用提供了稳定和丰富的细胞来源。结论神经干细胞为神经系统疾病治疗提供了新的途径，具有巨大的潜在应用价值和重大理论研究意义。     

神经干细胞的研究进展及前景展望

目的根据近年来同内外有关神经干细胞的研究近况，探讨神经干细胞生物学特性、分离培养、诱导分化及应用等方面的研究进展。方法 资料来源：成用计算机检索Medline 1990-01／2006-01相关神经干细胞的文献，检索词“neural stem cells”，并限定文献语占种类为English。同时计算机检索CBM1995-01／2006-01相关神经干细胞方面的文献，检索间为“神经干细胞”，并限定语言种类为中文。资料选择：对资料进行初审，选取包括神经干细胞的文献，开始查找全文。纳入标准：神经干细胞。排除标准：综述文献、重复研究、Meta分析类文章。资料提炼：共收集到61篇关于神经干细胞的文献，纳入30篇符合标准的文献。资料综合：随着成体干细胞的研究不断深入，在许多组织内找到了具有分化潜能的干细胞。神经干细胞具有分化、增殖的潜能，神经干细胞系的建立为其应用提供了稳定和丰富的细胞来源，为临床移植治疗神经系统疾病提供实验和理论基础。结果与结论神经干细胞为神经系统疾病治疗提供了新的途径，具有巨大的潜在应用价值和重大理论研究意义。     

干细胞的基础研究及开发应用

介绍了胚胎干细胞、间充质干细胞、造血干细胞、神经干细胞的细胞生物学特征及应用研究的概况，展望了干细胞作为组织工程学、克隆器官、移植及其它应用的细胞来源的发展前景与存在问题。     

神经干细胞移植及体内原位诱导的研究

近10余年来在包括人在内的哺乳动物的脑和脊髓的不同部位分离培养出了神经干细胞，为中枢神经系统疾病的治疗开辟了新的研究方向。目前在动物身上已经进行了许多有关神经干细胞应用的研究，并初步确定了神经干细胞应用于治疗的可行性。本文在总结神经干细胞近几年研究成果的基础上，对神经干细胞移植、刺激在体神经干细胞增殖分化以及利用神经干细胞进行基因治疗等进行综述。     

干细胞研究机构成立联盟

近日，广州12家干细胞技术研发机构成立联盟，将合力协作开展干细胞学科的研发、应用、推广等方面的工作。干细胞与再生医学是生物医学的新兴领域，将对疾病的机制研究和临床运用带来革命性变化。广州市从事干细胞研究的单位有多家，但相互之间联合少，不利于整合资源进行产学研合作，迫切希望成立一个优势互补、紧密结合的联盟。此次由广州和周边地区干细胞技术领域的研究、开发、应用、服务的12家单位，签约采用灵活的联盟运行机制。     

人眼角膜缘干细胞病理学研究

随着角膜缘干细胞基础理论的丰富和发展，角膜缘干细胞的重要作用逐渐被人们所重视，目前对角膜缘干细胞的研究主要集中在干细胞体外培养和临床应用，对角膜缘干细胞进行病理学研究较少。查阅近10年来有关角膜缘干细胞研究文献，结合1999～2003年对8例后巩膜裂伤眼球摘除标本和46例角巩膜缘功能衰竭症手术切除标本进行病理检测，报告如下。     

干细胞研究何去何从

干细胞治疗已成为医疗科技发展新趋势，干细胞研究也在如火如荼地开展。然而，由于受到医疗乱象的掣肘，国家卫生和计划生育委员会（下称”国家卫生计生委”，原卫生部）规定．白2012年7月1日起不再审批新的干细胞治疗方案。2013年3月，国家卫生计生委下发《干细胞临床试验研究管理办法（试行）》、《干细胞临床试验研究基地管理办法（试行）》和《干细胞制剂质量控制和临床前研究指导原则（试行）》征求意见稿。上述举措是否能有效整顿干细胞临床研究和应用的乱象，使中国的干细胞技术发展走上正轨？     

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.