大鼠骨骺干细胞的分离鉴定及其永生化细胞株的构建

[目的]分离、鉴定大鼠骨骺干细胞并建立永生化的大鼠骨骺干细胞株,为细胞移植和转基因治疗提供稳定的细胞来源.[方法]采用Percoll不连续密度梯度离心法分离骨骺干细胞,利用电穿孔转染技术将含有猿肾病毒40大T抗原基因（SV40Tag）的质粒pCMVSV40T/PUR转染骨骺干细胞,经嘌呤霉素筛选,抗性克隆扩大培养.应用FGFR-3抗体和PCNA抗体进行免疫细胞化学染色,观察细胞的形态及其生长状况并绘制细胞生长曲线.用免疫细胞化学法和RT-PCR检测SV40Tag在转染细胞中的表达.[结果]转染后获得一个阳性细胞克隆,免疫细胞化学结果显示FGFR-3抗体染色阳性.SV40Tag抗体染色和RT-PCR结果显示SV40Tag已稳定转染入骨骺干细胞.转染细胞经扩大培养,命名为永生化骨骺干细胞.[结论]成功纯化大鼠骨骺干细胞并构建了SV40Tag永生化的骨骺干细胞株.     

猿肾病毒40大T抗原基因永生化大鼠神经前体细胞株的构建

目的建立猿肾病毒40大T抗原基因(SV40Tag)永生化大鼠神经前体细胞株,为细胞移植治疗和转基因治疗提供稳定的细胞来源。方法利用脂质体介导的基因转染技术将含有SV40Tag的质粒pCMVSV40T/PUR转染原代培养的新生大鼠神经前体细胞,经嘌呤霉素筛选,阳性克隆扩大培养并连续传代。应用巢蛋白抗体进行细胞鉴定,5%胎牛血清诱导细胞分化后,应用免疫细胞化学法检测其分化能力,观察细胞的形态及其生长状况,绘制细胞生长曲线。用RT-PCR、Southern印迹杂交和免疫细胞化学法检测SV40Tag在转染细胞中的表达。结果转染细胞经筛选培养后获得1 个阳性细胞克隆,免疫细胞化学结果显示细胞的巢蛋白和微管相关蛋白2染色为阳性,增殖能力较强。5%胎牛血清可诱导转染细胞分化为微管相关蛋白2阳性和胶质纤维酸性蛋白阳性细胞。Southern印迹杂交结果显示转染细胞基因组中存在SV40Tag cDNA,并可检测到SV40Tag mRNA及其蛋白的表达。转染细胞经扩大培养,命名为永生化神经前体细胞。贴壁培养的神经前体细胞,群体倍增时间为(22.9±2.7)h,传代、冻存和复苏对细胞形态及生长无明显影响。结论成功地构建了SV40Tag永生化的大鼠神经前体细胞株。     

猿肾病毒40介导的人前软骨干细胞永生化的实验研究

目的 构建猿肾病毒40大T抗原基因(SV40Tag)介导的永生化人前软骨干细胞株,为下一步基因打靶研究其分化分子机制提供稳定的细胞来源. 方法采用脂质体介导的基因转染技术将含有SVd0Tag的质粒pCMVSV40T/PUR转染人前软骨干细胞(PSCs),经嘌呤霉素筛选,阳性克隆扩大培养并连续传代.用免疫组化、RT-PCR、Southern印迹杂交法对转染细胞进行鉴定,并检测SV40Tag在转染细胞中的表达及其与基因组的整合情况. 结果 筛选获得的阳性克隆扩大培养,命名为永生化前软骨干细胞(IPSCs),能连续传代培养,细胞生长迅速.免疫组化和RT-PCR证实IPSCs成纤维生长因子受体-3阳性,并可检测到SV40Tag mRNA及其蛋白的表达.Southern印迹杂交显示IPSCs基因组中存在SV40Tag cDNA. 结论 成功构建了SV40Tag介导的永生化人前软骨干细胞株.     

猿肾病毒40大T抗原基因永生化大鼠星形胶质细胞株的构建

目的 构建永生化大鼠星形胶质细胞，为转基因细胞移植镇痛提供细胞载体。方法 采用差速粘附法体外分离和培养大鼠大脑皮层星形胶质细胞。利用脂质体将含有猿肾病毒40大T抗原(SV40Tag)基因的质粒pCMVSV40T／PUR转染培养的大鼠星形胶质细胞。经嘌呤霉素1．5μg／ml筛选后，挑选阳性细胞克隆扩大培养并连续传代。PCR、RT-PCR及免疫组化检测阳性细胞克隆中SV40Tag基因的整合情况及其表达，并对传代细胞的胶质原纤维酸性蛋白(GFAP)进行检测。结果 成功获得体外培养的大鼠星形胶质细胞，GFAP阳性表达；筛选获得阳性细胞克隆，连续传代培养近50代；PCR、RT-PCR产物经1．5％琼脂糖凝胶电泳分析显示558bp处有一特异性扩增条带，与阳性对照条带相同，而未转染pCMVSV40T／PUR的细胞无扩增条带，回收片段经测序、比对与SV40Tag的基因序列一致(100％)；同时转染的阳性细胞克隆SV40Tag和GFAP免疫染色阳性。结论 成功地构建了SV40Tag基因永生化的大鼠星形胶质细胞株。     

转导人端粒酶逆转录酶基因致人骨髓间充质干细胞永生化并向软骨细胞诱导分化的研究

目的 建立永生化人骨髓间充质干细胞系并向软骨细胞诱导分化,以供软骨组织工程基础研究及临床应用.方法 原代培养人骨髓间充质干细胞(hMSC),用含有人端粒酶逆转录酶(hTERT)基因的逆转录病毒转染hMSC,G418筛选得到阳性克隆,体外连续培养,检测端粒酶的表达及活性.TGF-β1和地塞米松对转化后的hMSC-hTERT细胞诱导,使其向软骨细胞分化,并用原位杂交和免疫组化检测II型胶原.结果 外源性hTERT在转染细胞中稳定表达并传至第50代,永生化的hMSC细胞经TGF-β1和地塞米松诱导在体外分化为软骨细胞.结论 外源性hTERT基因可以有效地在体外使hMSC永生化,永生化的hMSC细胞经诱导可在体外分化为软骨细胞,从而作为软骨组织工程研究的细胞来源.     

破骨细胞转基因永生化问题的初步探讨

目的：通过转基因技术建立破骨细胞永生化细胞系，方法：经1，25（OH）2D3诱导，获得小鼠骨髓来源的破骨前体细胞，脂质体法（Fugene6）将猿猴病毒40（SV40）和绿色荧光蛋白（GFP）质粒分别转染入破抽前体细胞，G418筛选抗性克隆；同时将GFP转染入逆转录病毒包装细胞（P167）中，作为方法对照，继而，用含有GFP的逆转录病毒感染破骨前体细胞，G418筛选抗性克隆。结果：获得小鼠骨髓来源的破骨前体细胞，Fugene6转染SV40和GFP到破骨前体细胞后，G418筛选未获得阳性克隆，但GFP转染PT67细胞获得阳性克隆和含有GFP的逆转录病毒。将含有GFP的逆转录病毒感染破骨前体细胞，G418筛选未获得阳性克隆，结论：通过破骨细胞转基因永生化，建立破骨或破骨前体系细胞系的方法是一个非常有意义的研究课题，但是难度较大。可以初步认为：脂质体和逆转录病毒载体的方法不是破骨细胞转基因的最佳方法。     

大鼠蛛网膜下腔移植超顺磁性氧化铁纳米离子标记永生化神经前体细胞后的磁共振成像追踪

目的观察大鼠蛛网膜下腔移植超顺磁性氧化铁纳米粒子（SPIO）标记永生化神经前体细胞后的磁共振成像追踪。方法用SPIO-多聚赖氨酸复合物（SPIO-PLL）标记永生化神经前体细胞。采用普鲁士蓝染色鉴定SPIO-PLL标记永生化神经前体细胞的效率，采用MTT法检测标记前后细胞活力，用免疫细胞化学法对标记后1周的细胞进行抗巢蛋白、微管相关蛋白和胶质纤维酸性蛋白（GFAP）染色，检测标记细胞的分化能力。蛛网膜下腔置管成功的SD大鼠10只，随机分为2组（n=5），标记细胞组和未标记细胞组，蛛网膜下腔分别移植标记后2d的永生化神经前体细胞和未标记细胞，移植后30min及移植后1周用MRI对蛛网膜下腔的细胞进行活体追踪，用组织切片进行普鲁士蓝染色和抗猿肾病毒40大T抗原染色。结果SPIO可以高效率地标记永生化神经前体细胞，普鲁士蓝染色显示SPIO—PLL标记永生化神经前体细胞质内出现细小的天蓝色铁颗粒，SPIO-PLL标记对永生化神经前体细胞的活力没有明显的影响，标记后1周，抗巢蛋白、微管相关蛋白染色阳性，GFAP染色阴性。标记细胞组移植后30min及移植后1周MRI活体检查发现标记细胞在磁共振成像上呈明显的低信号改变，脊髓组织学切片结果普鲁士蓝、抗猿肾病毒40大T抗原染色阳性；未标记细胞组磁共振成像上无明显低信号改变。结论利用MRI技术可以对蛛网膜下腔移植后的标记细胞进行活体追踪。     

生长分化因子5基因转染诱导骨髓基质干细胞分化的研究

目的 探讨人生长分化因子5(GDF5)基因转染对骨髓基质干细胞(BMSCs)生长及分化的影响.方法 采用脂质体介导法将GDF5基因导人人BMSCs,通过MTT法和流式细胞仪分别检测细胞增殖能力和细胞周期,在光镜和电镜水平观察细胞形态,用逆转录多聚酶链反应(RT-PCR)和免疫细胞化学方法榆测GDF5和Ⅱ型胶原mRNA和蛋白质的表达.柠檬酸铅法检测细胞碱性磷酸酶活性,RT-PCR法检测骨钙素mRNA表达.结果 GDF5在转染细胞内得到稳定表达,转染细胞的增殖能力和细胞周期与未转染细胞基本一致.光镜下转染细胞中多角形细胞相对增多,排列方式不规则.电镜下转染细胞核呈不规则形,细胞器丰富.转染细胞Ⅱ型胶原mRNA和蛋白表达阳性,骨钙素mRNA表达阴性.结论 GDF5基因脂质体法转染BMSCs成功,转染细胞仍保持正常生长增殖特性.GDF5可诱导BMSCs向软骨表型分化,GDF5基因修饰的BMSCs可作为软骨组织上程的候选种子细胞.     

Sox9基因真核表达载体的构建及其诱导大鼠骨髓基质细胞定向分化为骨骺干细胞

[目的] 从永生化骨骺干细胞中克隆Sox9基因并构建真核表达载体,并探讨Sox9诱导骨髓基质细胞向骨骺干细胞分化的可能性.[方法]以RT-PCR方法获得Sox9全长,插入pGEM-T Easy克隆载体中,测序正确后与pEGFP-IRES2表达载体酶切后连接,复合质粒以脂质体法转染骨髓基质细胞,观察转染效率,Sox9和 FGFR-3的表达.流式细胞术鉴定细胞表型,MTT法检测细胞增殖活性.[结果]成功的完成了Sox9的扩增和表达载体的构建 ,重组载体转染骨髓基质细胞后能检测到Sox9、FGFR-3的表达,增殖活性与骨骺干细胞无异.[结论]成功构建了Sox9真核表达载体,其能诱导骨髓基质细胞分化为骨骺干细胞并具有其特性.     

软骨前体细胞的分离鉴定及IL-1β对其成软骨分化的影响

目的对正常软骨中的软骨前体细胞进行分离、鉴定,并对不同浓度IL-1β对软骨前体细胞的成软骨分化影响进行研究。方法取正常成年新西兰大白兔的软骨细胞,通过纤连蛋白粘连分离出软骨前体细胞,采用流式细胞仪对其细胞表型进行鉴定,倒置相差显微镜观察其克隆增殖,并行成骨、成脂、成软骨三系分化观察。培养软骨前体细胞团并分为4组,分别加入普通H-DMEM培养基(A组)、成软骨诱导分化培养基(B组)、成软骨诱导分化培养基+0.1 ng/mL IL-1β(C组)、成软骨诱导分化培养基+1.0 ng/mL IL-1β(D组),培养3周行组织学、生物化学、实时荧光定量PCR等检测,观察IL-1β的影响。结果在正常软骨细胞中存在软骨前体细胞,经鉴定有干细胞表型阳性表达,有与干细胞相似的克隆增殖能力及分化能力。HE染色示,C、D组中细胞团块较B组明显减小,细胞呈肥大样改变。番红O、Ⅱ型胶原及Ⅹ型胶原染色示,B组较A组染色深,C、D组均浅于B组,D组浅于C组。生物化学成分测定示,C、D组的总胶原、糖胺聚糖(glycosaminoglycan,GAG)相对含量及GAG/DNA比值均显著低于B组,D组显著低于C组,差异均有统计学意义(P0.05);C、D组DNA相对含量均显著高于B组(P0.05),但C、D组间差异无统计学意义(P0.05)。实时荧光定量PCR检测示,C、D组Ⅱ型胶原、Ⅹ型胶原、Sox-9 mRNA相对表达量均显著低于B组,D组显著低于C组,差异均有统计学意义(P0.05);而C、D组Runx-2和MMP-13mRNA相对表达量均显著高于B组,D组显著高于C组,差异均有统计学意义(P0.05)。结论在正常软骨组织中存在一种有干细胞特性的软骨前体细胞,其有克隆和潜在分化的能力。IL-1β对软骨前体细胞成软骨分化有抑制作用,并有促进成骨分化的可能。     

Reduction of Plasma Fibrinogen, Immunoglobulin G, and Immunoglobulin M Concentrations by Immunoadsorption Therapy with Tryptophan and Phenylalanine Adsorbents

Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

The multiply injured child

Blunt trauma is the principal cause of childhood death in many developed countries. This review outlines the differences between adults and children with respect to resuscitation and treatment of orthopaedic injuries in a child with polytrauma. Recent advances in techniques of fracture stabilization are reported.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.     

The analgesic effect of racemic ketamine in patients with chronic ischemic pain due to lower extremity arteriosclerosis obliterans

Background : Ketamine in sub-dissociative doses has been shown to have analgesic and phantom-Limb pain, where conventional treatment has often failed. Chronic ischemic pain due to lower extremity arteriosclerosis obliterans often responds poorly to analgesics, and the pain-generating mechanisms are not well understood.
Methods : Eight patients with rest pain in the lower extremity due to arteriosclerosis obliterans were given sub-dissociative doses of 0.15, 0.30, or 0.45 mg/kg racemic ketamine and morphine 10 mg as a 5-min infusion on four separate days in a cross-over, double-blind, randomised protocol. Plasma levels of (S)- and (R)-ketamine and their nor-metabolites were analysed with an enantioselective high-performance liquid chromatography (HPLC) method. Pain levels were evaluated with a visual analogue scale (VAS).
Results : Individual pain levels were highly variable during and after all the infusions but the pooled pain levels showed a dose-dependent analgesic effect of ketamine with a transient but complete pain relief in all patients at the highest dose (0.45 mg/ kg). Side-effects, mainly disturbed cognition and perception, were pronounced and dose-dependent. Morphine 10 mg had an analgesic peak at 20 min and 5/8 patients had complete pain relief. The remaining 3 patients also had high baseline pain scores, indicating a higher analgesic potency for the 0.30 and 0.45 mg/ kg ketamine doses than for morphine 10 mg.
Conclusion : We have demonstrated a potent dose-dependent analgesic effect of racemic ketamine in clinical ischemic pain. Due to a narrow therapeutic window, this analgesic effect is probably best utilised in combination with other analgesics.     

Intravenous endotoxin does not increase tissue extravasation of albumin in rats

Background : It is unclear whether activation of the inducible nitric oxide synthase (iNOS) increases or decreases the extravasation of plasma.
Methods : Chloralose anaesthetised male Wistar rats received E. coli lipopolysacharide (LPS), 3 mg kg^-1 i.v., or the corresponding volume of saline, 3 or 5 h before the end of the experiment. Mean arterial pressure (MAP) and heart rate (HR) were recorded. Tissue clearance of radio-labelled albumin, during the last 2 h of each experiment, was determined by a double-isotope method. In separate animals, the serum concentration of nitrite and nitrate was determined, 5 h after LPS or the solvent.
Main Results : LPS initially decreased MAP and lastingly increased HR. In the 3-h LPS animals (n=8), tissue plasma clearance was lower in the heart and calf muscle and increased only in diaphragm, compared to corresponding control animals (n=8). In the 5-h LPS rats, clearance was lowered (n=8) in the entire gastrointestinal tract and in testes, compared to controls (n=8). The serum nitrite/nitrate concentration was higher in animals given LPS (n=6) than in controls (n=6).
Conclusion : After LPS, tissue clearance of albumin was not increased in any major tissue, in spite of increased serum levels of NO end products. Apparently, after activation of iNOS, the augmented release of NO is not necessarily associated with increased albumin extravasation.     

Adrenaline markedly improves thoracic epidural analgesia produced by a low-dose infusion of bupivacaine, fentanyl and adrenaline after major surgery: A randomised, double-blind, cross-over study with and without adrenaline

Background: Basic pharmacological research indicates that there are synergistic antinociceptive effects at the spinal cord level between adrenaline, fentanyl and bupivacaine. Our clinical experience with such a mixture in a thoracic epidural infusion after major surgery confirms this. The objectives of the present study were to evaluate the effects on postoperative pain intensity, pain relief and side effects when removing adrenaline from this triple epidural mixture. Methods: A prospective, randomised, double-blind, cross-over study was carried out in 24 patients after major thoracic or abdominal surgery. Patients with only mild pain when coughing during a titrated thoracic epidural infusion of about 10 ml · h^?1 of bupivacaine 1 mg · ml^?1, fentanyl 2 μg · ml^?1, and adrenaline 2 μg · ml^?1 were included. On the 1^st and 2^nd postoperative days each patient was given a double-blind epidural infusion, at the same rate, with or without adrenaline. The effect was observed for 4 h or until pain when coughing became unacceptable in spite of a rescue analgesic procedure. Rescue analgesia consisted of up to two epidural bolus injections per hour and i.v. morphine if necessary. All patients received rectal paracetamol 1 g, every 8 h. Fentanyl serum concentrations were measured with a radioimmunoassay technique at the start and end of each study period. Main outcome measures were extent of sensory blockade and pain intensity at rest and when coughing, evaluated by a visual analogue scale, a verbal categorical rating scale, the Prince Henry Hospital pain score, and an overall quality of pain relief score. Results: The number of hypaesthetic dermatomal segments decreased (P <0.001) and pain intensity at rest and when coughing increased (P <0.001) when adrenaline was omitted from the triple epidural mixture. This change started within the first hour after removing adrenaline. After 3 h pain intensity when coughing had increased to unacceptable levels in spite of rescue analgesia (epidural bolus injections and i.v. morphine). Within 15–20 min after restarting the triple epidural mixture with adrenaline, pain intensity was again reduced to mild pain when coughing. Serum concentration of fentanyl doubled from 0.22 to 0.45 ng · ml^?1 (P <0.01), and there was more sedation during the period without adrenaline. Conclusions: Adrenaline increases sensory block and improves the pain-relieving effect of a mixture of bupivacaine and fentanyl infused epidurally at a thoracic level after major thoracic or abdominal surgery. Serum fentanyl concentrations doubled and sedation increased when adrenaline was removed from the epidural infusion, indicating more rapid vascular absorption and systemic effects of fentanyl.