安心颗粒联合血栓抽吸对急诊冠脉介入术后心肌灌注影响的研究

目的 在接受急诊冠脉介入术（PCI）的急性ST段抬高型心肌梗死患者中,评价术前使用安心颗粒联合血栓抽吸术对心肌灌注的影响。方法 160例接受急诊冠脉介入术的急性ST段抬高型心肌梗死患者被随机分为安心颗粒组（术前顿服安心颗粒8.8 g,术后安心颗粒4.4 g/次,每日2次）和对照组。所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀。术后观察心肌呈色分级（MBG）、心电图ST段回落百分比、肌钙蛋白(cTnI)和肌酸激酶同工酶(CK-MB)峰值、左室射血分数(LVEF)、主要不良心脏事件(MACE)。结果 安心颗粒组术后的MBG分级较高(P<0.05),达到MBG 3级的患者比例较多(P<0.05),术后ST段回落百分比>70%的患者数较对照组多(P<0.05),cTnI(P<0.01)和CKMB(P<0.05)峰值时间提前。术后第30天,安心颗粒组患者的左室射血分数明显高于对照组(P<0.01)。第(30±1)天时,2组患者主要不良心脏事件发生人数无显著性差别(P>0.05)。结论 急诊冠脉介入术前使用安心颗粒,联合血栓抽吸术,能改善心肌灌注和泵功能,但对短期内主要不良心脏事件无影响。      

创伤刺激、肾上腺素和地塞米松对小鼠应激能力的影响

目的 比较创伤刺激和使用肾上腺素、地塞米松或两药合用对小鼠应激能力的影响.方法 分别采用剪尾法及游泳法结合血糖水平测定观察小鼠应激状态的变化;进一步在给予地塞米松、不同浓度肾上腺素及两药合用条件下,测定血糖水平和游泳力竭时间,观察药物对小鼠应激能力的影响.结果 剪尾组血糖水平与生理盐水对照组间比较,差异无统计学意义(P>0.05);给予一定剂量肾上腺素的小鼠,其血糖水平明显高于创伤刺激组和对照组小鼠,差异有统计学意义(P<0.05);在各种药物使用的比较中,较高浓度肾上腺素组游泳力竭时间明显短于地塞米松组和对照组,差异有统计学意义(P<0.05);较高浓度肾上腺素组、两药合用组游泳后血糖水平均明显高于地塞米松组和对照组,差异有统计学意义(P<0.05);低浓度肾上腺素组游泳后血糖水平也明显高于对照组,差异有统计学意义(P<0.05).结论 与对照组相比,剪尾创伤并不足以引起显著的以血糖升高为特点的应激反应;给予肾上腺素及肾上腺素与地塞米松合用虽均显著升高血糖水平但会降低小鼠的运动应激能力.     

Anti-obesity effect and UHPLC-QTOF-MS/MS based metabolite profiling of Solanum nigrum leaf extract

Objective:To evaluate the antioxidant potential and pancreatic lipase inhibitory action of optimized hydroethanolic extracts of Solanum nigrum.Methods:Optimized extraction for maximum recovery of metabolites was performed using a combination of freeze-drying and ultrasonication followed by determination of antioxidant and antiobesity properties.The ultra-high performance liquid chromatography equipped with mass spectrometry was used to analyze metabolite profiling of Solanum nigrum.Computational studies were performed using molecular docking and electrostatic potential analysis for individual compounds.The hypolipidemic potential of the most potent extract was assessed in the obese mice fed on fat rich diet.Results:The 80%hydroethanolic extract exhibited the highest extract yield,total phenolic contents,total flavonoid contents along with the strongest 2,2-diphenyl-1-picrylhydrazyl scavenging activity,total antioxidant power,and pancreatic lipase inhibitory properties.The 80%hydroethanolic extract not only regulated the lipid profile of obese mice but also restricted the weight gain in the liver,kidney,and heart.The 80%hydroethanolic extract also reduced alanine transaminase and aspartate transaminase concentrations in serum.The effects of plant extract at 300 mg/kg body weight were quite comparable with the standard drug orlistat.Conclusions:Solanum nigrum is proved as an excellent and potent source of secondary metabolites that might be responsible for obesity mitigation.     

高铁蛋白血症与早期糖脂代谢异常的关系

目的 探讨高铁蛋白血症与血糖、血脂代谢紊乱的关系.方法 收集杭州市第一人民医院"健康"体检者382例,根据铁蛋白水平,以310μg/L为限分为高铁蛋白组(A组)与低铁蛋白组(B组),分别测定血脂谱,空腹血糖(FBG)、尿酸(UA)、血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)、平均红细胞血红蛋白浓度(MCHC),超声检查脂肪肝,对两组间的数据进行统计学分析.结果 两组间TG、LDL、HDL、ApoAl、ApoB、FBG、UA、Hb、RBC、HCT、MCHC有显著差异,铁蛋白与TG、TC、LDL、ApoB、Hb、RBC、HCT呈正相关,与HDL、ApoA1呈负相关,A组脂肪肝的发生率较B组明显升高.结论 铁蛋白可能是早期糖脂代谢异常的标志物之一.     

解剖学课程资源的开发

课程资源是指供给课程活动、满足课程活动需要的一切,包括构成课程目标、内容的来源和保障课程活动进行的教学设备和材料[1].随着医学的迅猛发展,医学知识不断更新,解剖学作为医学专业的主干课程,开发、整合解剖学课程资源,使其具有前瞻性、有效性、实用性,并进一步优化学生的知识结构,成为解剖学教学研究的新课题.对此,我们进行了探索与实践.     

Comparing different domains of analysis for the characterisation of N-glycans on monoclonal antibodies

With the size of the biopharmaceutical market exponentially increasing,there is an aligned growth in the importance of data-rich analyses,not only to assess drug product safety but also to assist drug development driven by the deeper understanding of structure/function relationships.In monoclonal antibodies,many functions are regulated by N-glycans present in the constant region of the heavy chains and their mechanisms of action are not completely known.The importance of their function focuses analytical research efforts on the development of robust,accurate and fast methods to support drug development and quality control.Released N-glycan analysis is considered as the gold standard for glycosylation characterisation;however,it is not the only method for quantitative analysis of glycoform heterogeneity.In this study,ten different analytical workflows for N-glycan analysis were compared using four monoclonal antibodies.While observing good comparability between the quantitative results generated,it was possible to appreciate the advantages and disadvantages of each technique and to summarise all the observations to guide the choice of the most appropriate analytical workflow according to application and the desired depth of data generated.     

治疗肺癌巧用"原子弹"

二战时期,美国科学家率先研制成功原子弹,它是一种利用核裂变原理制成的核武器,在爆炸的同时会放出强烈的核辐射,危害生物组织。1945年美国向日本的广岛、长崎各投放了一枚原子弹,其杀伤     

葫芦里卖的什么药?——"哑谜医疗"的前世今生

在中国古代,老百姓对于医生的言行心生疑虑,有一个经典的发问: "不知他葫芦里卖的什么药?"以表达对医生、医学的不安与不满."不过,这种疑虑似乎还只是表现在药物属性上,真药还是假药?贵药或贱药?价格是否诚实?是否贱药贵卖?……如今这种知情诉求可是大大拓展了,不仅关心药物的疗效与毒副作用,还要关心诊断、预后、护理细节、康复举措,还有费用标准与合理性.     

院前急救程序

院前急救是急诊医疗体系的重要组成部分,院前急救处理正确与否直接关系到患者的生死存亡.有效的现场急救,要求医务人员须严格按预定的急救规范进行,这不仅有利于提高急救质量,对解决医疗纠纷、保险等也有重大意义.本栏目倡导尽量使用最新的药物、器械诊治;各操作程序方案的设置力求符合最新理论,并注重可操作性、科学性和实用性.     

女医生擅离职守救灾对焉 院领导照章处以辞退错否

事件回放 娄继英原是重庆某医院住院部的助理医师,汶川地震发生后,她主动请缨到灾区去服务,但未获医院批准.5月19日,娄继英毅然与其他志愿者奔赴灾区做医护志愿者.然而,当她回到重庆后,却被医院告知,由于她连续旷工3日,医院为严肃劳动纪律,决定对其按自动离职处理.     

人神经干细胞移植治疗小脑萎缩

目的:探索入神经干细胞(neural stem cell,NSC)移植治疗小脑萎缩(cerebellar atrophy,CA)的有效性.方法:8～10周龄人胚胎的小脑细胞在体外稳定扩增后,借助立体定向技术将其植入经MRI证实的21例CA患者的小脑齿状核内,将NSC(3×107/0.3 ml)缓慢注入小脑齿状核(此前注入地塞米松0.5 mg/0.1 ml).本组男8例,女13例,年龄19～71岁(平均46岁).结果:人胚胎小脑神经细胞可以在体外扩增,扩增的细胞可达1×107倍.移植病例未见明显的移植排斥反应.CA患者移植术后3个月临床症状改善的有效率为61.9%,术后6个月有效率为85.7%;随访12～28个月(平均18个月),有效率达90.4%.结论:应用体外扩增的人NSC可以治疗CA,而且临床安全、有效.     

人神经干细胞临床移植治疗帕金森病

目的:探索人神经干细胞移植治疗帕金森病(Parkinson disease,PD)的有效方法.方法:5～11周人胚胎的前脑细胞在体外稳定扩增,并向多巴胺神经元转化,通过立体定向手术将其植入PD患者的纹状体;2000年11月至2002年11月,采用此方法治疗50例PD患者.结果:人胚胎前脑细胞可在体外扩增并维持不分化状态1年以上,扩增的细胞可达原始细胞数量的1×107倍,并可向多巴胺能神经元转化;PD患者临床移植手术后随访8～30个月(平均24个月),有效率为92％,未见明显的免疫排斥反应.结论:应用体外长期扩增的人类神经干细胞移植治疗PD是可行和有效的.     

人胎脑神经干细胞的体外分离、培养与鉴定

目的探索人胎脑神经干细胞的体外分离培养条件,从而在体外大量增殖神经干细胞,并观察神经干细胞增殖和分化的特点。方法采用含碱性成纤维细胞生长因子（bFGF）和表皮细胞生长因子（EGF）的无血清培养技术,从14周自愿水囊引产人胎脑海马皮质中分离出神经干细胞,并进行培养、传代、分化观察,应用免疫荧光细胞化学技术对培养的细胞及其分化的细胞进行鉴定。结果从14周人胎脑皮质中成功分离出具有自我更新和多分化潜能的神经干细胞,在无血清培养时细胞呈悬浮状态生长,形成神经球,该细胞具有连续增殖能力,可传代培养,表达神经巢蛋白抗原（Nestin）;在含血清培养时诱导神经干细胞分化,分化后的细胞表达神经元细胞和胶质细胞的特异性抗原。结论在含有EGF和bFGF的无血清培养液中,从人胎脑能分离培养出具有自我复制和分化潜能的神经干细胞,并能在体外扩增,可进一步用于基础及临床研究。     

体外培养经皮移植自体骨髓间充质干细胞治疗四肢骨不连

目的:探讨体外培养经皮移植自体骨髓间充质干细胞(MSCs)治疗四肢骨折骨不连的效果。方法:12例四肢骨折骨不连患者采用体外培养经皮移植自体MSCs治疗。结果:9例获得了骨性愈合,骨折愈合平均时间为5个月(4~7月),X线显示骨折线消失,骨痂形成。骨折愈合率为75%(9/12)。结论:体外培养经皮移植自体MSCs治疗四肢骨折骨不连创伤小、安全、并发症少,临床效果满意。     

Biological effect of velvet antler polypeptides on neural stem cells from embryonic rat brain

Background Velvet antler polypeptides (VAPs), which are derived from the antler velvets, have been reported to maintain survival and promote growth and differentiation of neural cells and, especially the development of neural tissues. This study was designed to explore the influence of VAPs on neural stem cells in vitro derived from embryonic rat brain. Methods Neural stem cells derived from E12-14 rat brain were isolated, cultured, and expanded for 7 days until neural stem cell aggregations and neurospheres were generated. The neurospheres were cultured under the condition of different concentration of VAPs followed by immunocytochemistry to detect the differentiation of neural stem cells. Results VAPs could remarkablely promote differentiation of neural stem cells and most neural stem cells were induced to differentiate towards the direction of neurons under certain concentration of VAPs. Conclusion Neural stem cells can be successfully induced into neurons by VAPs in vitro, which could provide a basis for regeneration of the nervous system.     

Experimental Study on Treatment of Glioma by Embyonic Neural Stem Cell Transplnation in Rats

The neural stem cells in Wistar rats were cultured in vitro,purified,and transplanted into C6 glioma model in order to observe their biological characters and provide a basic foundation for treatment of neurological diseases by neural stem cell transplantation.The cells at hippocampal area from gestation 15-day rats were cultured in vitro,and frozen and preserved in liquid nitrogen.C6 tumor-bearing models(n=25) and neural stem cells transplantation models(n=35) were established.When the tumor grew to 3 to 4 weeks,5 rats in each group were randomly selected for MRI examination.At different intervals,the rats were perfused and sampled for HE staining,GFAP and BrdU immunohistochemical staining.The results showed that after resuscitation of neural stem cells at 1-4 passages,the cell viability was 40%-63% with the difference being not significant.The cells could proliferate,passage,and most cells transplanted into glioma model survived.The mean survival time in neural stem cell transplantation group and control was 4.28 and 3.88 weeks respectively,and the average tumor size in the former was smaller than in the latter.It was concluded that embryonic neural stem cells in rats could proliferate and differentiate,and after resuscitation the biological characteristic and viability of the cells were not influenced.Neural stem cells had inhibitory effects on the growth of glioma cells and could prolong the survival of rat model.     

新生豚鼠神经干细胞的分离培养、鉴定及标记

目的 从新生豚鼠海马中分离培养神经干细胞，为神经干细胞移植治疗感音神经性耳聋的实验研究创造条件。方法 分离新生豚鼠海马组织，用含碱性成纤维生长因子（bFGF）和表皮生长因子（EGF）无血清培养技术培养神经干细胞，免疫组化技术检测其巢蛋白（Nestin）的表达。采用荧光染料DAPI标记神经干细胞。结果 从新生豚鼠海马组织分离出的细胞中可获得呈集落样生长的神经干细胞团，并能表达Nestin；荧光染料的标记效率可达93．4％，细胞传代8次后荧光亮度仍无明显衰减。结论 从新生豚鼠海马分离的细胞具有明显的增殖能力，荧光染料的标记可获得较高的标记效率，可作为神经干细胞移植治疗感音神经性耳聋实验研究的供体细胞。     

神经干细胞在体外诱导向胆碱能神经元定向分化后移植治疗脊髓损伤

目的 研究神经干细胞向胆碱能神经元定向分化后对脊髓横断损伤的修复作用.方法 采用GFP转基因孕鼠(E 12～14d)的海马分离、培养神经干细胞并诱导其向胆碱能神经元方向分化.SD成年大鼠以显微剪横断脊髓制成SCI模型.将SD大鼠18只分为3组:A组注入DMEM/F12培养液;B组注入神经于细胞的细胞液,C组注入在体外定向诱导为胆碱能神经元的细胞液;3组实验动物均于细胞移植后采用B B B评分法定期评估运动功能.于移植后第8周末,取出相应的脊髓阶段,行ChAT免疫组织化学染色,光镜观察.结果 从海马分离的细胞群具有自我更新能力,表达nestin,胎鼠骨骼肌提取液可以诱导这些细胞中的11.8%分化成为胆碱能神经元,与对照组差异明显.B组和C组所有大鼠BBB评分在移植细胞3周以后明显高于A组(P＜0.05),C组所有大鼠BBB评分在移植细胞4周以后明显高于B组(P＜0.05).在移植第8周末,冰冻切片中可见ChAT染色阳性细胞.结论 神经干细胞可以在体外诱导向胆碱能神经元定向分化,定向分化后移植应用在脊髓横断损伤治疗中,可明显改善运动功能.     

转基因神经干细胞移植治疗暂时性脑缺血的实验研究

目的探讨转染血管内皮细胞生长因子(VEGF)基因的神经干细胞在宿主缺血区的基因表达情况,以及对神经功能的保护作用.方法用脂质体介导法将VEGF121基因转染到大鼠神经干细胞中.经RT-PCR及免疫荧光染色检测转基因神经干细胞及其分化细胞的基因表达情况.建立大鼠大脑中动脉梗塞模型(tMCAO),并将其随机分成(1)对照组,(2)细胞悬液PBS移植组,(3)神经干细胞移植组,(4)转基因神经干细胞移植组,前3组每组10只大鼠,第4组20只大鼠.立体定向法将BrdU标记的转基因神经干细胞移植到tMCAO大鼠的纹状体缺血半暗区.移植后2～12周进行神经损害严重程度评分(NSS)并与其他3组比较.用免疫荧光染色方法观察移植后1周转基因神经干细胞在脑内的基因表达情况和移植后12周转基因神经干细胞在脑内的分化、迁徙情况.结果转基因神经干细胞及其分化的子代细胞均有VEGF121的表达并持续2周左右.移植后2、4、6、8、10、12周(4)组大鼠的NSS评分分别为5.8±1.5、5.0±1.0、4.6±1.0、4.0±0.7、4.0±1.0、3.8±0.4,均低于其他3组.其中第8周显著低于(1)、(2)组(均P=0.008),第12周显著低于(1)、(2)、(3)组(均P=0.000).转基因神经干细胞移植后1周在宿主脑内迁徙并表达VEGF基因产物,移植后12周在宿主脑内存活、迁徙,部分分化成神经元.结论转染VEGF基因的神经干细胞移植后在缺血早期表达基因产物,并对宿主局部血管和神经结构具有保护作用.转基因神经干细胞移植是治疗脑缺血性疾病的可行途径.     

体外培养的人胚胎脑皮层神经干细胞的生长特性

目的从胎龄10～12周的人工流产胚胎脑皮层分离、培养神经干细胞后观察其生长特性.方法分别分离、鉴定孕10～12周人工流产的人胚胎脑皮层及孕16d Wistar大鼠脑皮层来源的神经干细胞,并在体外培养增殖.通过普通及电子显微镜观察、生长情况测定等方面的比较来观察其生长特性.结果不同来源的神经干细胞均保持着未分化状态,能够自我更新以及具有多向分化潜能.但来源于人胚胎脑皮层的神经干细胞生长速度明显较慢,且其生长需多种细胞因子的联合刺激.结论人胚胎脑皮层神经干细胞体外培养存在生长速度慢,分裂相所占比例低,群体倍增时间长以及其生长需多种细胞因子的联合刺激等问题.