Adoptive transfer of neonatal T lymphocytes rescues immunoglobulin production in mice with severe combined immune deficiency

Mice with the autosomal recessive severe combined immune deficiency (scid) mutation lack mature lymphocytes because of defective joining of T cell receptor and immunoglobulin (Ig) gene segments. Penetrance of this mutation is incomplete since 10-25% of SCID mice produce some T or B lymphocytes. This "leaky" phenotype could be due to a reversion of the mutation in some mice or to a constant, low frequency of functional lymphocytes generated in all SCID mice with variable survival of such cells. We report here that all SCID mice can be stimulated to produce functional B cells by the transfer of normal neonatal, but not adult, T cells. T cell-induced rescue of C.B-17scid B cells results in high levels of Ig expressing the Ighb allotype of the SCID recipient. These results show that all SCID mice generate some functional B cells, the majority of which do not survive in the absence of a subset of T cells present in high frequency in the neonate.     

Rejection of bone marrow allografts by mice with severe combined immune deficiency (SCID). Evidence that natural killer cells can mediate the specificity of marrow graft rejection

C.B-17 scid (H-2d) mice are homozygous for the gene that causes severe combined immune deficiency (SCID). These mice have no T or B cell function, yet display normal natural killer (NK) activity. Irradiated SCID mice were challenged with marrow grafts to determine if antibodies are necessary for marrow allograft rejection. SCID mice rejected H-2/Hh-1 allogeneic marrow grafts. Moreover, this rejection capability could be adoptively transferred using SCID marrow as a source of NK progenitors infused into irradiated B6 (H-2b) hosts. We conclude that NK cells can mediate marrow allograft reactivity in the absence of immunoglobulin. It follows that NK cells probably have specific receptors for Hh antigens.     

An expanded population of natural killer cells in mice with severe combined immunodeficiency (SCID) lack rearrangement and expression of T cell receptor genes

Mice with severe combined immunodeficiency syndrome (SCID) exhibit an impairment in both T and B cell maturation, whereas myelopoiesis remains unaffected. We report here that spleens from SCID mice have undergone phenotypic expansion of cells bearing the NK-2 and asialo GM1 markers (70-80%) characteristic of NK cells and this expansion is accompanied by a 3-4-fold enrichment in NK cytolytic activity over their normal C.B-17 littermates. Furthermore, the NK cells from SCID mice do not rearrange or express T cell receptor alpha or beta genes, or a third T cell rearranging gene, gamma. These findings suggest that (a) T cell receptors are not necessary for NK-mediated cytolysis, and (b) either NK cells constitute an entirely distinct lineage or NK cell function is acquired in pre-T cells prior to the expression of T cell receptor genes.     

Unexpected effects of the severe combined immunodeficiency mutation on murine lymphomagenesis

Strain C.B17 scid/scid (SCID) mice, which lack functional T and B lymphocytes, show heightened susceptibility to the induction of thymic lymphomas by x-irradiation. Susceptibility is highest in thymus-chimeric SCID-BL mice (thymectomized SCID mice bearing a C57BL thymus graft). All SCID-BL lymphomas originate in the cells of the thymic graft (C57BL type) and lack murine leukemia virus expression. Both SCID and SCID-BL lymphomas are phenotypically CD4-8+ and/or CD4+8+, but only the SCID-BL tumors express CD3. Injection of C57BL or BALB/c bone marrow into irradiated SCID-BL mice prevents lymphoma development, but SCID marrow is completely ineffective. The results suggest that the scid condition enhances the activity of a putative lymphomagenic agent induced in the bone marrow by x-irradiation and that C57BL thymic cells are highly sensitive targets. Moreover, the failure of SCID bone marrow to protect against lymphomagenesis vs. the efficacy of marrow from immunocompetent donors points to involvement of T or B lineage cells in this process.     

c-kit+ stem cells and thymocyte precursors in the livers of adult mice

Livers of the adult mice contain c-kit+ stem cells that can reconstitute thymocytes, multiple lineage cells, and bone marrow (BM) stem cells. Transfer of 1 x 10(7) hepatic mononuclear cells (MNC) and 5 x 10(4) hepatic c-kit+ cells of BALB/c mice induced DP thymocytes within a week in four Gy-irradiated CB17/-SCID mice, but 2 wk were required for BM cells or BM c-kit+ cells to produce DP thymocytes. Moreover, B cell-depleted BM cells or liver MNC of SCID mice that had been rescued by hepatic MNC of BALB/c mice again reconstituted thymus and B cells of other irradiated SCID mice. CD3- IL-2R beta- populations of both BM cells and hepatic MNC of C57BL/6 (B6) mice could generate T cells with intermediate TCR (mostly NK1.1-) in the liver of irradiated B6 SCID mice before thymic reconstitution (extrathymic T cells). Furthermore, transfer of liver c-kit+ cells of B6-Ly 5.1 mice into irradiated B6 SCID (Ly5.2) mice revealed that liver c-kit+ cells can reconstitute myeloid and erythroid lineage cells. These results strongly suggest that the liver contains pluripotent stem cells and serves an important hematopoietic organ even into adulthood.     

Early manifestation of alteration in cardiac function in dystrophin deficient mdx mouse using 3D CMR tagging

Background

Duchenne muscular dystrophy (DMD) is caused by the absence of the cytoskeletal protein, dystrophin. In DMD patients, dilated cardiomyopathy leading to heart failure may occur during adolescence. However, early cardiac dysfunction is frequently undetected due to physical inactivity and generalized debilitation. The objective of this study is to determine the time course of cardiac functional alterations in mdx mouse, a mouse model of DMD, by evaluating regional ventricular function with CMR tagging.

Methods

In vivo myocardial function was evaluated by 3D CMR tagging in mdx mice at early (2 months), middle (7 months) and late (10 months) stages of disease development. Global cardiac function, regional myocardial wall strains, and ventricular torsion were quantified. Myocardial lesions were assessed with Masson''s trichrome staining.

Results

Global contractile indexes were similar between mdx and C57BL/6 mice in each age group. Histology analysis showed that young mdx mice were free of myocardial lesions. Interstitial fibrosis was present in 7 month mdx mice, with further development into patches or transmural lesions at 10 months of age. As a result, 10 month mdx mice showed significantly reduced regional strain and torsion. However, young mdx mice showed an unexpected increase in regional strain and torsion, while 7 month mdx mice displayed similar regional ventricular function as the controls.

Conclusion

Despite normal global ventricular function, CMR tagging detected a biphasic change in myocardial wall strain and torsion, with an initial increase at young age followed by progressive decrease at older ages. These results suggest that CMR tagging can provide more sensitive measures of functional alterations than global functional indexes in dystrophin-related cardiomyopathies.     

A severe combined immunodeficient (SCID) mouse model for infection with Entamoeba histolytica

We used severe combined immunodeficient (SCID) mice to study resistance to invasive infection with Entamoeba histolytica. Seven of seven SCID mice developed liver abscesses when challenged intrahepatically with virulent HM1:IMSS strain E. histolytica trophozoites. Only one of seven similarly challenged immunocompetent congenic C.B-17 mice developed an abscess. Adoptive transfer of polyclonal rabbit anti-E. histolytica antiserum, but not preimmune rabbit serum, completely protected 7 of 12 SCID mice from intrahepatic challenge with ameba. These results demonstrate that lymphocyte-based immunity is important in protection against amebic liver abscess, and that anti-E. histolytica antibody can protect against amebic infection in this system. The SCID mouse may provide a powerful model for studying the components of protective immunity to invasive amebiasis.     

Acute rejection of murine bone marrow allografts by natural killer cells and T cells. Differences in kinetics and target antigens recognized

Lethally irradiated C.B-17 +/+, C.B-17 scid/scid (severe combined immunodeficiency, SCID), BALB/c-nu/nu (nude), and C57BL/6 (B6) mice were challenged with H-2-homozygous or H-2-heterozygous totally allogeneic bone marrow cell (BMC) grafts. Some of the irradiated mice were immunized simultaneously with large numbers of irradiated marrow and spleen cells syngeneic with the viable BMC transferred. Irradiated SCID and nude mice, devoid of T cells but with normal NK cell function, were able to reject H-2-homozygous BMC grafts within 4 d. However, they were unable to reject H-2-heterozygous BMC allografts by 7 d even if they were immunized. B6 and C.B-17 +/+ mice were able to reject H-2 heterozygous BMC allografts by 7-8 d, but not as early as 4 d, if they were immunized. The rejection of H-2-homozygous BMC on day 4 was inhibited by administration of anti-NK-1.1 antibodies, but not by anti-Lyt-2 antibodies. Conversely, the rejection of H-2-heterozygous allogeneic BMC on day 8 was prevented by anti-Lyt-2 but not by anti-NK-1.1 antibodies. The data indicate that both NK cells and Lyt-2+ T cells can mediate rejection of allogeneic BMC acutely, even after exposure of mice to lethal doses of ionizing irradiation. NK cells appear to recognize Hemopoietic histocompatibility (Hh) antigens on H-2 homozygous stem cells. The inability of SCID and nude mice to reject H-2 heterozygous totally allogeneic BMC indicate that NK cells do not survey donor marrow cells for self H-2 antigens and reject those cells that express nonself H-2 antigens. The T cells presumably recognize conventional H-2 antigens (probably class I) under these conditions.     

A GENETIC STUDY OF SUSCEPTIBILITY TO EXPERIMENTAL TUBERCULOSIS IN MICE INFECTED WITH MAMMALIAN TUBERCLE BACILLI

A study has been made of the genetic aspects of the difference between two inbred strains of mice (C57B1/6 and Swiss) in response to experimental infection with mammalian tubercle bacilli. Males and females, 4 to 6 weeks of age were inoculated intravenously with 0.2 ml of a 1/50 culture dilution of Mycobacterium tuberculosis var. bovis (Vallée strain) grown in tween albumin medium. Mean survival time for C57B1 animals was 28.1 ± 0.6 days and for Swiss, 55.3 ± 0.6 days postinfection. The characteristic survival time of the two strains was reversed in mice receiving a smaller infective dose. The age of mice at the time of inoculation also affected the results of infection: both C57B1 and Swiss, inoculated at 12 months of age, died at the same rate, but when inoculated at older ages, C57B1 survived slightly longer. Bacteriologic studies demonstrated that there was no significant difference between the two mouse strains with regard to the numbers of viable units of tubercle bacilli recovered from various organs during the 2 week period following infection with a 10^–3 culture dilution of Vallée. Moreover, the standard infective inoculum (1/50 culture dilution) did not activate corynebacterial pseudotuberculosis in C57B1 mice, a strain known to be latently infected with Corynebacterium kutscheri, rapid multiplication of tubercle bacilli occurred, but no corynebacteria were recovered. When C57B1 and Swiss strains were crossed, survival tests after infection with the standard inoculum demonstrated that mice of the F₁ generation were more resistant than either parent. Whether the overdominance was due to a new combination of parental genes for resistance or to heterosis was not determined. The increased litter size of the F₁ mice, an evidence of increased vigor, supports the view that heterosis was involved. In backcrosses to the resistant strain (Swiss), survival time gradually became stabilized at approximately the parental level. In the 1st backcross to the susceptible strain (C57B1), survival times fell into two classes indicating segregation of genes, with perhaps dominance of genes from the Swiss. After repeated backcrosses to C57B1, mice of the 4th backcross generation had a survival time essentially the same as that of the original parental strain. On the basis of having obtained progeny characterized by the original parental susceptibilities after genetic tendencies had been intermingled by crossbreeding, it was concluded that hereditary factors influenced the response of mice to experimental infection with M. tuberculosis. The number of genes was not determined.     

Analgesic effects of dietary caloric restriction in adult mice

Nociception was studied in male mice, mostly of the C57BL/6 strain, during continuous or prolonged restriction of caloric intake (60% of ad-libitum) from midlife to senescence (up to 105 weeks). Restricted mice showed fewer licking or biting responses 20-60 min after hind paw injection of 5% formalin at 46 and 70 weeks, but not at 93 weeks. Also, they showed longer response latencies around 46 weeks of age in the 52 degrees C hot-plate test, which partial tail amputation failed to affect, although it did produce at least 2 weeks of chronic neuropathic hypersensitivity in ad libitum controls. Injection of collagen subcutaneously at 36-42 weeks led to chronic hyperalgesia in the DBA/1 but not the C57BL/6 strain, measured weekly by the barely nociceptive 50 degrees C hot-plate test to minimize damage. This collagen-induced arthritic hyperalgesia was then gradually and reversibly blocked during 9-15 weeks of caloric restriction starting at 53-58 weeks. In longitudinal trials on normal mice, performed every 2-4 weeks between 42 and 105 weeks with the 50 degrees C hot-plate, caloric restriction led to altered latencies (higher relative to controls) only in the last 10-20 weeks, perhaps because it delayed the onset of age-related peripheral neuropathies. In conclusion, long-term caloric restriction leads to significant hypoalgesia in pre-senescent mice subjected to above-threshold pain of widely different durations, the effect disappearing at later ages unless spontaneous neuropathies become influential. A reduction in cumulative food intake thus appears to generate antinociceptive signals in adult male mice, perhaps serving specifically to promote riskier behavior during prolonged food shortages.     

Human Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes home preferentially to and induce selective regressions of autologous EBV- induced B cell lymphoproliferations in xenografted C.B-17 scid/scid mice [published erratum appears in J Exp Med 1996 Sep 1;184(3):1199]

C.B-17 scid/scid (severe combined immunodeficiency [SCID]) mice inoculated with peripheral blood lymphocytes from Epstein-Barr virus (EBV)-seropositive donors, or with EBV-transformed lymphoblastoid B cell lines (EBV-LCL), develop lethal human EBV+ B cell lymphoproliferative disorders (EBV-LPD) with characteristics similar to those arising in immunodeficient patients. Using this model, we examined the capacity of human effector cells to control human EBV-LPD. SCID mice received rabbit anti-asialo GM1 antiserum to abrogate endogenous natural killer-cell function. Preliminary experiments showed that adoptive transfer of peripheral blood mononuclear cells (PBMC), purified T cells, interleukin (IL) 2-activated PBMC or anti-CD3- activated T cells derived from EBV-seropositive donors did not result in improved survival of treated mice (in vivo effector/target ratio 2:1 to 1:1). In contrast, EBV-specific cytotoxic T lymphocytes (CTL), derived from EBV-seropositive donors and expanded in vitro, exhibited strong EBV-specific and HLA-restricted activity both in vitro and in vivo. SCID mice inoculated intraperitoneally with autologous but not with HLA-mismatched EBV-LCL had significantly improved survival relative to untreated mice after inoculation of EBV-specific CTL either intraperitoneally (P<0.001) or intravenously (P<0.001) (in vivo effector/target ratio 1:1). SCID mice bearing large subcutaneous EBV+ tumors and treated intravenously with 10(7) EBV-specific CTL achieved complete tumor regression. Both CTL- and CTL-plus-IL-2-treated mice survived significantly longer than untreated animals or animals treated with IL-2 alone (P = 0.0004 and P<0.02, respectively). SCID mice bearing two subcutaneous EBV+ tumors, one autologous and the other HLA mismatched to the EBV-specific CTL donor, had regression of only the autologous tumor after intravenous infusion of 10(7) EBV-specific CTL. Moreover, we could demonstrate preferential homing of PKH26-labeled EBV- specific CTL to autologous but not to HLA-mismatched EBV+ tumors as early as 24 h after intravenous adoptive transfer. Immunophenotypic analyses also demonstrated preferential infiltration of T cells into the autologous EBV+ tumor in SCID mice bearing both the autologous and either fully HLA-mismatched or genotypically related haplotype-sharing EBV+ tumors. The human T cells infiltrating EBV+ tumors were CD3+ and, predominantly, CD8+CD4-. Our results indicate that EBV-specific CTL preferentially localize to and infiltrate EBV+ tumors bearing the appropriate HLA antigens and thereafter induce targeted regressions of disease.     

瑞舒伐他汀联合依折麦布对老年急性脑梗的降脂效果与安全性研究

【目的】研究瑞舒伐他汀联合依折麦布对老年急性脑梗死血脂未达标患者的降脂效果和安全性。【方法】入选89例急性脑梗死患者,A 组46例给予瑞舒伐他汀（10 mg／d）联合依折麦布（10 mg／d）治疗,B 组43例给予瑞舒伐他汀（10 mg／d）治疗,治疗2周及12周后观察两组患者血脂水平及肝功能,肌酶变化并进行比较。【结果】治疗2周后两组患者低密度脂蛋白胆固醇（LDL‐C）平均下降比例分别为32．7％和17．3％;而治疗12周后平均下降比例分别为48．4％和27．2％,组间比较 A组下降较 B 组更早更快,差异有显著统计学意义（均 P ＜0．001）,且和 B 组相比肝功能,肌酶等无变化,治疗12周后 A 组达标率56．5％（26例）,B 达标率20．9％（9例）,差异有显著统计学意义（ P ＝0．002）。治疗12周后总胆固醇（TC）下降约45％和28％,与 B 组比较差异有显著统计学意义（ P ＝0．003）。治疗12周后三酰甘油（TG）下降,而高密度脂蛋白胆固醇（HDL‐C）升高,但与治疗前比较均无统计学意义。【结论】瑞舒伐他汀联合依折麦布对老年急性脑梗死患者不增加肝毒性和肌毒性且能使 LDL‐C 达标时间缩短,达标率升高。     

Thymus-grafted SCID mice show transient thymopoiesis and limited depletion of V beta 11+ T cells

To seek direct evidence for the notion that stem cells in the thymus need to be constantly replenished from the bone marrow (BM), fetal (day 15) thymuses from normal BALB/c mice were grafted into T and B cell-deficient C.B-17 SCID mice (both H-2d, I-E+). The thymus grafts in these mice showed normal thymopoiesis for the first 3 wk postgrafting but then developed sudden atrophy with near complete loss of CD4+8+ cells by 4-5 wk. Such atrophy was not seen when the thymus-grafted mice were cotransplanted with normal BM cells. The lymph nodes of SCID mice receiving thymus grafts alone contained mature T cells but virtually no B cells. This lack of B cells was associated with aberrant I-E-restricted V beta deletion: the depletion of V beta 3+ and V beta 5+ T cells was near complete, whereas V beta 11+ cells showed only marginal depletion.     

Mature murine B and T cells transferred to SCID mice can survive indefinitely and many maintain a virgin phenotype

To seek information on the potential lifespan of normal B and T lymphocytes, lymph node (LN) cells from unprimed mice were transferred to H-2-identical severe combined immunodeficiency (SCID) hosts. At a population level, the donor B and T cells survived for at least 10 mo post-transfer with no reduction in their numbers. In terms of antibody production, LN-injected SCID mice remained responsive to several different antigens and contained unprimed precursors of memory cells for greater than or equal to 6 mo post-transfer. Most of the B and T cells recovered from LN-injected SCID mice expressed the typical virgin phenotype of mature lymphocytes from young mice. These findings suggest that many of the transferred lymphocytes might have remained in interphase as virgin cells from the time of injection. This did not apply to all of the transferred cells, however, because 20-40% of CD4+ cells from long-term SCID hosts displayed a memory phenotype, 7% incorporated 2-bromodeoxyuridine over 5 d, and total numbers of B and T cells increased gradually (twofold) over a 10-mo period. Collectively, the data favor the view that the pool of mature B and T cells in adult mice is largely self sufficient: some of the cells proliferate, presumably in response to environmental antigens, but many mature cells can remain quiescent for prolonged periods. Input of new cells from the primary lymphoid organs continues, but at a much reduced rate relative to young life.     

K562-DC融合瘤苗刺激的CIK/NK细胞在荷瘤NOD/SCID小鼠体内的杀瘤活性

目的 探讨经K562细胞-树突细胞(DC)融合瘤苗刺激的脐血源性细胞因子诱导的杀伤(CIK)/自然杀伤(NK)细胞在荷瘤NOD/SCID小鼠体内的杀伤效能及其安全性.方法 通过不同细胞因子的组合分别诱导脐血单个核细胞(MNC)成为DC和CIK/NK细胞,通过聚乙二醇(PEG)将灭活K562细胞与DC融合形成K562-DC融合瘤苗.以10:1比例在CIK/NK细胞培养体系中加入K562-DC融合瘤苗,制备K562-DC融合瘤苗刺激的CIK/NK细胞.小鼠均经尾静脉接种K562细胞1×106诱导荷瘤鼠;于接种肿瘤细胞后24 h按不同分组分别经尾静脉输注K562-DC融合瘤苗刺激的CIK/NK细胞1×107、CIK/NK细胞1×107,同时设相应的非荷瘤鼠对照.比较各组小鼠的生存率、存活时间;用流式细胞术检测小鼠外周血、肝、肺组织中人CD13+细胞和外周血人CD56+细胞.结果 在接种1×106K562细胞后未经处理的小鼠39 d内全部死亡,8只鼠中肉眼可见瘤块的小鼠5只,其中位于肝脏的4只、脾脏的1只.接种K562细胞后接受K562-DC瘤苗刺激的CIK/NK细胞治疗的8只小鼠第65天时死亡1只,抗瘤有效率为87.5%;接受CIK/NK细胞治疗小鼠死亡2只,时间分别为接种K562细胞后第56天及第62天,抗瘤有效率为75.0%,均未发现肉眼可见瘤块.该两组小鼠存活时间分别为(69.4±1.8)d、(67.2±5.3)d,两组间差异无统计学意义(P＞0.05),均高于未予治疗的荷瘤对照组[(30.4±4.6)d](P＜0.01),荷瘤后接受K562-DC瘤苗刺激的和未经瘤苗刺激的CIK/NK细胞治疗的两组其余小鼠存活均超过70 d.经CIK/NK细胞治疗的两组存活小鼠外周血,肝、肺组织中人CD13+细胞率差异无统计学意义,均显著低于荷瘤未治疗组(P＜0.01),而治疗的两组存活小鼠外周血人CD56+细胞率与输注不同CIK/NK细胞的非荷瘤对照组相比差异无统计学意义(P＞0.05).结论 经过灭活肿瘤细胞预孵育的脐血源性CIK/NK细胞接种在动物体内具有抗瘤活性,无致瘤性.     

不同年龄段人骨髓间充质干细胞生物学特性的研究

本研究通过对不同年龄段人骨髓间充质干细胞(mesenchymalstemcell,MSC)的研究探讨MSC生物学特点与年龄的关系,从而为临床寻找合适供体,迅速获取所需MSC提供实验依据。骨髓供体按年龄分为4组:A组(胚胎)、B组(0-20岁)、C组(20-40岁)和D组(40岁以上)。观察各组骨髓MSC的生长、增殖、分化特点;用流式细胞仪检测细胞表面标志,用ELISA方法检测培养上清造血相关因子的水平;进行核型分析及成瘤试验;评价不同年龄段供体骨髓MSC在临床造血干细胞移植中的应用价值。结果显示:各组骨髓均可培养出MSC,各组MSC表面标志无显著差异;各组MSC均具有向脂肪细胞和成骨细胞分化的能力;原代培养B组骨髓MSC含量较多,贴壁时间早,传代时间短,P0至P1时间为5.5天,传至P10需33天,8×106MNC培养至P10时MSC数达(5.19±2.15)×1010;A、C、D组P0至P1时间分别为15、7和13天,传至P10分别需50、60和72天,8×106MNC培养传代至P10时MSC数分别为(4.98±2.08)×1010、(1.86±0.47)×1010、(0.64±0.22)×1010。A组MSC较细长,细胞融合后生长无接触抑制,P15增殖速度开始减缓;B、C、D组MSC形态相似,有生长接触抑制B组P10开始增殖减缓,C、D组P8开始增殖减缓;B组MSC培养上清中SCF、FLT3L、IL6及SDF1水平高于其它各组。各组间细胞的增殖指数无显著差异。核型分析均为正常核型,成瘤实验为阴性。结论:MSC增殖生长特性与年龄密切相关;根据临床造血干细胞移植的需要,0-20岁年龄组骨髓是短时间内获取足够细胞数的理想供体,分泌HGFs水平亦占优势;0-20岁组骨髓MSC的生物学特性优于其他各组,可以作为MSC的供源。     

人胎儿血造血干/祖细胞的生物学特性及其移植实验

背景:造血干细胞来源目前包括骨髓干细胞、外周血干细胞和脐带血干细胞,寻找新的干细胞来源以满足临床移植需要一直是人们的希望。从妊娠第5周起,肝脏中发育成完善的血窦系统,此后造血干细胞就可以随血液流动迁移。目的:观察人胎儿血造血干/祖细胞的生物学特性并对其进行非肥胖糖尿病/重症联合免疫缺陷小鼠移植。设计:对照实验。单位:广西医科大学第一附属医院血液科。对象:①细胞来源:21例胎儿血标本取自胎龄为18～29周[(24.2±3.2)周]死亡胎儿及21例足月脐带血标本取自广西医科大学第一附属医院产科2002-10/2003-02。所取的血标本均取得其家属的知情同意。②实验动物:非肥胖糖尿病/重症联合免疫缺陷小鼠12只,6～7周龄,雌性,无菌饲养于超净工作台中。方法:采用流式细胞术,检测胎儿血的造血干/祖细胞表面标志,包括CD34,CD38,HLA-DR及CD90,同时与21例足月儿脐血作比较。并将人胎血单个核细胞移植给6只经亚致死量照射的非肥胖糖尿病/重症联合免疫缺陷小鼠,5周后观察其植入情况,采用流式细胞术检测小鼠骨髓中人白细胞的含量,以及采用聚合酶链反应检测小鼠骨髓中的人Cart-1基因。主要观察指标:①胎血和脐血造血干/祖细胞表面标志的表达情况。②将胎血细胞移植给非肥胖糖尿病/重症联合免疫缺陷小鼠的植入情况。结果:①人胎血中CD34 细胞的百分率显著高于足月脐血[(2.2588±0.7209)%,(1.5729±0.4783)%,P=0.0004],CD34 CD38-细胞和CD34 CD90 细胞的百分率也均显著高于足月脐血[(1.2986±0.4706)%,(0.8710±0.4095)%,P=0.0016;(0.9300±0.4692)%,(0.5600±0.3658)%,P=0.0324]。②6例胎血中的4例可顺利重建经亚致死量照射的非肥胖糖尿病/重症联合免疫缺陷小鼠的造血,移植后5周在小鼠骨髓中仍可检测到人的白细胞和人Cart-1基因。结论:人胎儿血中有比足月脐血更高含量的造血干/祖细胞,其单个核细胞能植入非肥胖糖尿病/重症联合免疫缺陷小鼠骨髓,并重建髓、淋巴系全面造血。胎儿血有望成为多能造血干细胞来源。     

他汀类药物致肝损害的不同处理方法比较

目的 探讨他汀类药物致肝损害的不同临床处理方法对患者的影响.方法 80例患者随机分为发生他汀类药物肝损害后减至最小维持量继续治疗组(A组)及发生他汀类药物肝损害后立即停药组(B组).观察两组患者肝功能、血脂变化及近期主要心脏事件发生情况.结果 本研究中80例患者,无胆汁淤积性黄疸、肝功能衰竭及死亡病例.A组患者在治疗后4周治愈22例(55.0％)、好转17例(42.5％)、恶化1例(2.5％),8周治愈33例(82.5％)、好转7例(17.5％)、恶化0例,12周治愈37例(92.5％)、好转3例(7.5％)、恶化0例;B组患者在停药后4周治愈23例(57.5％)、好转17例(42.5％)、恶化0例,8周治愈35例(87.5％)、好转5例(12.5％)、恶化0例,12周治愈38例(95.0％)、好转2例(5.0％)、恶化0例.两组患者在治疗后4周、8周、12周比较在治愈、好转、恶化例数差异无统计学意义(P＞0.05).A组患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平在治疗期间与基线比较持续降低(P＜0.01).B组患者TG、TC、LDL-C水平与基线比较无明显变化(P＞0.05).A、B两组患者TG、TC、LDL-C在组间、不同时点以及组间和不同时点的交互作用差异均有统计学意义(P＜0.01).3个月随访总的主要心脏事件(包括非致死性心肌梗死、心绞痛和靶血管重建)A组低于B组,但是差异无统计学意义(25.0％ vs37.5％,P＞0.05).结论 他汀类药物致肝损害患者采取减至最小维持量继续治疗及立即停药的方法均安全可行,采取减至最小维持量继续治疗可维持降脂作用,并且近期心脏事件发生率有下降趋势.     

胎儿外耳长度超声测量观察面的分析

目的探讨产前超声测量胎儿外耳长度的最佳观察面及方法。方法对90例孕17～28周胎儿进行左右外耳长度测量,并进行对比分析;筛选160例妊娠37～40+6周正常发育的胎儿,通过胎儿外耳旁矢状切面(A)、外耳冠状切面(B)、外耳轮廓的三维超声立体成像(C)测量其外耳长度,并与出生后新生儿外耳长度进行对比分析。结果 17～28周中孕期胎儿左、右外耳长度比较,差异无统计学意义。胎儿外耳长度观察面A和C的外耳长度与出生后外耳长度在妊娠37～38+6周间比较差异无统计学意义(P>0.05),在妊娠39～40+6周间比较差异有统计学意义(P<0.05)。胎儿外耳观察面B的长度与出生后外耳长度在妊娠37～40+6周间比较差异均有统计学意义(P<0.01)。结论胎儿外耳观察面A和C可作为产前超声测量胎儿外耳长度的标准观察面,为产前筛查胎儿外耳畸形提供良好依据,具有广泛的临床应用价值。