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1.
Objective: To study the efficacy and safety of autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia. Methods: Fifty Type 2 diabetic patients with lower limb ischemia were enrolled and randomized to either transplanted group or control group. Patients in both group received the same conventional treatment. Meanwhile, 20 ml bone marrow from each transplanted patient were collected, and the mesenchymal stem cells were separated by density gradient centrifugation and cultured in the medium with autologous serum. After three-weeks adherent culture in vitro, 7.32×10^8-5.61×10^9 mesenchymal stem cells were harvested and transplanted by multiple intramuscular and hypodermic injections into the impaired lower limbs. Results: At the end of 12-week follow-up, 5 patients were excluded from this study because of clinical worsening or failure of cell culture. Main ischemic symptoms, including rest pain and intermittent claudication, were improved significantly in transplanted patients. The ulcer healing rate of the transplanted group (1 5 of 18, 83.33%) was significantly higher than that of the control group (9 of 20, 45.00%, P=0.012).The mean of resting ankle-brachial index (ABI) in transplanted group significantly was increased from 0.61±0.09 to 0.74±0.11 (P〈0.001). Magnetic resonance angiography (MRA) demonstrated that there were more patients whose score of new vessels exceeded or equaled to 2 in the transplant patients (11 of 15) than in control patients (2 of 14, P=0.001). Lower limb amputation rate was significantly lower in transplanted group than in the control group (P=0.040). No adverse effects was observed in transplanted group. Conclusion: These results indicate that the autologous transplantation of bone marrow mesenchymal stem cells relieves critical lower limb ischemia and promotes ulcers healing in Type 2 diabetic patients.  相似文献   

2.
Background Diabetic lower limb ischemia is a serious complication of diabetes mellitus. This study was conducted to investigate the effectiveness of distal arterial bypass treatment in diabetic patients with lower limb ischemia. Methods From July 2000 to July 2004, 96 lower limbs of 82 diabetic patients (type 2) with severe lower limb ischemia were treated in Xuan Wu Hospital. Arterial bypass with femoro-popliteal polytetrafluoroethylene (PTFE) and graft-tibial autologous grafts was performed on 31 limbs (32.3%). Popliteal-tibial artery bypass alone was performed on 22 limbs (22.9%). Combined lilac artery stenting, femoro-popliteal artery PTFE graft bypass, and graft-tibial artery autologous graft bypass was performed on 12 limbs (12.5%), and femoro-tibial artery graft bypass was performed on 10 limbs (10.4%). Popliteal-tibial-pedal artery graft bypass was performed on 7 limbs (7.3%). Results Arterial grafts in 92 limbs of 79 patients were patent on discharge. Three patients with 4 ischemic limbs (3.7%) died of respiratory failure 12 hours, 3 days and 7 days after operation respectively. Early operation success rate was 96.3% (79/82). Graft patency rate of patients on discharge was 95.8% (92/96). The short-term total effectiveness rate was 83.3% (80/96). Foot ulcer healing rate was 35.7% (10/28). 97.4% (75/77) patients were followed up for a mean of 13.5 months. The long-term total effective rate was 80.7% (71/88). The total amputation rate was 4.5% (4/88). Mortality was 4.5%. The total graft patency rate was 90.9% (80/88). Conclusion In the treatment of diabetic foot, distal lower limb arterial bypass can help to avoid amputation or lower the amputation level, and may promote foot ulcer healing and improve patient's quality of life.  相似文献   

3.
Background In bone marrow transplant patients, the microenvironment in bone marrow is damaged after chemotherapy or radiotherapy. Subsequent to allogenic hematopoietic stem cell transplantation in patients with clinically successful engraftments, the source of mesenchymal stem cells (MSCs) remains controversial. To further verify the stimulatory effect of the simultaneous transplantation of cells from second donors on engraftment success for hematopoietic stem cell transplantation in support of donor MSCs engraftments, the aim of this study is to monitor the dynamics of the engraftment of bone marrow-derived MSCs in patients after transplantation with mismatched-sex hematopoietic stem and third-party cells. Methods In this study, the hematopoietic stem cells from 32 clinical donors of different sexes that resulted in successful engraftments were selected for transplantation and were classified into three groups for research purposes: group A consisted of 14 cases of transplantation with bone marrow and recruited peripheral hematopoietic stem cell transplantation, group B contained 8 cases of simultaneous re-transfusion of MSCs from the second donor, and group C contained 10 cases of simultaneous re-transfusion of umbilical blood from the second donor. The bone marrow from 32 patients with successful engraftments of hematopoietic transplantation were selected and sub-cultured with MSCs. Flow cytometry (FCM) was used to measure the expression of surface antigens on MSCs. Denaturing high-performance liquid chromatography (DHPLC) in combination with polymerase chain reaction amplification of short tandem repeats (STR- PCR) was used to measure the engraftment status of fifth-generation MSCs in patients. Fluorescence in situ hybridization (FISH) revealed the sex origin of the fifth-generation MSCs in 32 patients. Dynamic examinations were performed on patients receiving donor transplantations. Results The progenies of fifth-generation MSCs were successfully cultured in 32 cases. The results of FCM demonstrated that the expression levels of CD14+ and CD45+ cells were lower than 0.04% in the fifth-generation MSCs. The analysis using DHPLC and FISH showed similar results. One patient from group B also received a temporary transplantation of MSCs from the donor. The MSCs in the remaining 31 patients all originated from the patients themselves. Conclusions After transplantation, the MSCs present in patients originated from the host. In patients transplanted with MSCs from a second donor, the phenomenon of temporary chimerization of MSCs was observed.  相似文献   

4.
5.
Background Polycythemia vera (PV) is a malignant disorder of hemaopoietic stem cells which is characterized by clonal hyperproliferation and a low rate of apoptosis. This study was to assess endogenous erythroid colony (EEC) formation in the bone marrow of PV patients and determine its clinical significance.Methods The bone marrow mononuclear cells of 26 patients with PV, 2 patients with secondary erythrocytosis (SE), and 19 normal controls were cultured by Marsh‘ s method for EEC evaluation,and the clinical significance was evaluated.Results EECs appeared in 25 patients with PV but not in 2 patients with SE and 19 normal controls.The number of EECs and the EEC ratio [ EEC/erythropoietin ( EPO)-dependent colony forming uniterythroid (CFU-E)] in PV patients positively correlated with hemoglobin (Hb) levels. Their EEC number did not correlate with white blood cell (WBC) counts, platelet (PLT) counts, or leukocyte alkaline phosphatase (LAP) scores. Their EEC did not correlate with serum EPO levels. Fifteen patients with PV were treated with hydroxyurea ( Hu ) and/or interferon-alpha (IFN-α). Their EEC ratio before treatment positively correlated with the treatment time required for complete remission (CR) and negatively correlated with the time before relapse. The EEC numbers of 7 PV patients treated with Hu/IFN-α decreased after the blood cell counts dropped to normal levels. There was a positive correlation between the EEC ratio and the incidence of attacks of vascular thrombosis in PV patients. The numbers of apoptosised bone marrow mononuclear cells in PV patients were lower than those in normal controls. The EEC numbers of PV patients negatively correlated with the rate of apoptosis of bone marrow mononuclear cells.Conclusions EEC formation is characteristic in PV patients. EEC number in PV patients positively correlates with Hb levels, the time required for CR, and the incidence of attacks of vascular thrombosis. EEC number negatively correlates with the time before relapse. Bone marrow suppressive treatment might decrease EEC number. Thus, EEC number is a sensitive and specific parameter reflecting the abnormal hematopoietic clone burden induced by polycythemia vera. EEC number is an important diagnostic parameter for PV patients.  相似文献   

6.
Objective To provide a more effective microsurgical treatment for obstructive lymphedema. Methods Sixty models of rabbits with lymphedema in right hindlimb were devided into three groups: 20 for fascial flap transplantation (group A ), 20 for no treatment (group B) and 20 for anastomosis of lymph vessels and vein (group C) as control. For group A, the posterior branch of medial vein in the normal hindlimb was cut down together with the fascial strip ( about 3 cm wide) around it and concomitant lymph vessels, then transferred through the block region of the affected limb. The two broken tips of the vein were anastomosed respectively to normal veins beside the block region. Subcutaneous tissue and skin were sutured at last. For group B, no treatment was carried out. But traditional anastomosis of lymph vessels and vein was used for group C. Postoperative variation of volume was observed and lymphoscintigraphy was made. Results The volume curve of the affected limb in group A kept declining after 2 weeks and nearing to that of the normal hindlimb in group B but away from that of the affected limb in group B. The curve of donor limb in group A was similar to that of the normal limb of group B, which meant no secondary lymphedema occurred in donor limb. The volume of the affected limb of group A had significant difference to that of group C at postoperative 24 weeks, which meant the effect of group A was better than C. The lymphatic drainage of the affected limb of group A was obviously better than B and C in lymphoscintigraphic image. Deposit of nuclein was lessened. Conclusion It was verified that the transplantation of vein-lymph vessels-fatty fascial flap had following advantages: decreased technical difficulty, better long-term effect, almost no chronic lymphedema occurred in donor site, extensive adaptation.  相似文献   

7.
Objective:To investigate the feasibility of minimal invasive repair of cartilage defect by arthroscope-aided microfracture surgery and autologous transplantation of mesenchymal stem cells. Methods: Bone marrow of minipigs was taken out and the bone marrow derived mesenchymal stem cells (BMSCs) were isolated and cultured to passage 3. Then 6 minipigs were randomly divided into 2 groups with 6 knees in each group. After the articular cartilage defect was induced in each knee, the left defect received microfracture surgery and was injected with 2.5 ml BMSCs cells at a concentration of 3×107 cells/ml into the articular cavity; while right knee got single microfracture or served as blank control group. The animals were killed at 8 or 16 weeks, and the repair tissue was histologically and immunohistochemically examined for the presence of type Ⅱ collagen and glycosaminoglycans (GAGs) at 8 and 16 weeks. Results: Eight weeks after the surgery, the overlying articular surface of the cartilage defect showed normal color and integrated to adjacent cartilage. And 16 weeks after surgery, hyaline cartilage was observed at the repairing tissues and immunostaining indicated the diffuse presence of this type Ⅱ collagen and GAGs throughout the repair cartilage in the treated defects. Single microfracture group had the repairing of fibrocartilage, while during the treatment, the defects of blank group were covered with fewer fiber tissues, and no blood capillary growth or any immunological rejection was observed. Conclusion: Microfracture technique and BMSCs transplantation to repair cartilage defect is characterized with minimal invasion and easy operation, and it will greatly promote the regeneration repair of articular cartilage defect.  相似文献   

8.
Objective To investigate the therapeutic effectiveness of intracoronary implantation of autologous bone marrow mononuclear cells (BM-MNC) in miniswine model of reperfused myocardial infarction.
Methods Sixteen miniswine myocardial ischemic reperfusion injury models made by ligation of the distal one third segment of left anterior descending artery for 90 minutes were randomized into 2 groups. In BM-MNC group (n = 9), (3.54 ± 0.90)× 10^8 BM-MNC were intracoronary injected, and in the control group (n = 7), phosphate buffered saline was injected by the same way. Echocardiographic and hemodynamic results, vessel density, and myocardial infarction size were evaluated and compared before and 4 weeks after cell transplantation.
Results In BM-MNC group, there were no differences between before and 4 weeks after transplantation in aspects of left ventricular ejection fraction (LVEF), interventricular septal thickness, left ventricular lateral and anterior septal wall thickness, cardiac output, or +dp/dtmax. In control group, LVEF, interventricular septal thickness, left ventricular lateral and anterior septal wall thickness, cardiac output, and +dp/dtmax decreased significantly 4 weeks after transplantation (P 〈 0.05). Left ventricular end-diastolic pressure and -dp/dtmax did not change significantly before and after cell transplantation in both groups. Capillary density in BM-MNC group was greater than that in control group [(13.39 ± 6.96)/high power field vs. (3.50 ± 1.90)/high power field, P 〈 0.05]. Infarction area assessed by tetrazolium red staining and the infarction percentage decreased in BM-MNC group compared with those in control group (P 〈 0.05).
Conclusions Transplantation of BM-MNC into myocardium with ischemic reperfusion injury increases capillary density and decreases infarction area. It has significantly beneficial effect on cardiac systolic function rather than on diastolic function.  相似文献   

9.
Background Nonmyeloablative allogeneic bone marrow transplantation has been used since the 1990s as a new hematological stem cell transplantation strategy for treating hematological diseases. The purpose of this study was to explore the graft-versus-leukemia (GVL) effects of donor lymphocyte infusions (DLIs) after nonmyeloablative allogeneic bone marrow transplantations, while assessing the declines in treatment-associated morbidity, mortality, and graft-versus-host disease (GVHD).Methods A total of 615 (H-2k) mice were injected with L615 tumor cells and received 500 cGy (60Coγ-ray) irradiation three days later, followed by an allogeneic bone marrow transplantation (allo-BMT). The allo-grafts consisted of 3×10(7) bone marrow cells and 1×10(7) spleen cells from BALB/C (H-2d) donor mice. Two days after the allo-BMT, the recipient mice were given 200 mg/kg of cyclophosphamide. Subsequently, recipient mice were infused with either donor spleen cells [2×10(7)] on day 14 or 21, or donor spleen cells [5×10(7)] pretreated with hydrocortisone and cyclosporin A (CsA) in vitro on day 14 post-BMT.Results The median survival time of mice that received DLI on day 21 and pretreated DLI on day 14 post-BMT was longer than that of controls and the day 14 DLI group (P<0.01). No evidence of severe GVHD was observed in the day 21 DLI group nor in the day 14 treated DLI group. Mixed chimerism was confirmed in the day 14 DLI group, the day 14 treated DLI group, and the day 21 DLI group on the thirteenth day post-transplantation; full donor chimerism was observed two weeks after DLI.Conclusion Donor lymphocyte infusion after nonmyeloablative bone marrow transplantation may reduce transplantation-associated morbidity and mortality while strengthening graft-versus-leukemia effects.  相似文献   

10.
OBJECTIVE:To explore the effect of kidney-reinforcing,blood-activating and stasis-removing recipes on adhesion molecule expression of bone marrow mesenchymal stem cells(MSCs) from patients with chronic aplastic anemia(CAA).METHODS:We used threeTraditional Chinese Medicine recipes,namely a kidney-reinforcing recipe(KRR),blood-activating and stasis-removing recipe(BASRR),and kidney-reinforcing,blood-activating and stasis-removing recipe(KRBASRR),and a normal saline control to prepare herbal medicine serum in Sprague Dawley rats.Thirty CAA patients were enrolled in the experimental group,including 17 kidney-Yang deficient patients and 13 kidney-Yin deficient patients.Ten healthy individuals were included in the control group.MSCs were isolated from bone marrow samples,and the cell density was observed to measure their proliferation ability by microscopy on days 2,7,and 14 after isolation.In addition,the expression of adhesion molecules of bone marrow MSCs(CD106,CD49d,CD31 and CD44) were detected by flow cytometry after 48 h of treatment with the four different herbal medicine serums.RESULTS:The proliferation of MSCs from kidney-Yang deficient and kidney-Yin deficient patients was weaker than that of MSCs from the control group.The expression of all adhesion molecules of bone marrow MSCs from CAA patients was obviously lower than that in the control group(P< 0.01).The expression of CD49d and CD31 in MSCs from patients with a kidney-Yin deficiency was lower than in those with a kidney-yang deficiency(P< 0.05 and P<0.01,respectively).For kidney-Yang deficient patients,CD31 expression in the KRBASRR group was significantly higher than that in the BASRR group(P<0.01),while CD44 in the KRBASRR group was significantly higher than that in both KRR and BASRR groups(P<0.01).For kidney-Yin deficient patients,CD106 and CD49d expression in the KRBASRR group was obviously higher than that in the KRR group(P<0.05),while CD31 and CD44 expression in the KRBASRR group was significantly higher than that in both KRR and BASRR groups(P< 0.05 and P<0.01,respectively).CONCLUSION:The bone marrow microenvironment in CAA patients is abnormal.The effect of KRBASRR may be better than that of KRR and BASRR for kidney-Yang deficient and kidney-Yin deficient patients by improving the expression levels of MSC adhesion molecules.  相似文献   

11.
目的:探讨自体骨髓单个核细胞移植与中药合用对下肢缺血的治疗作用.方法:治疗对象为23例严重下肢缺血患者.术前用集落细胞刺激因子使患者骨髓处于增生活跃状态,抽取骨髓液后分离单个核细胞,细胞总量达到1×109以上.移植采用缺血肢体多点注射.移植后1 d起服益气活血中药.观察患者手术前后肢体疼痛、冷感评分、踝/肱指数(ankle/brachial index,ABI)以及溃疡创面情况.结果:治疗后患肢疼痛及冷感评分逐渐降低,治疗1个月后与治疗前比较有显著性差异(P<0.05);ABI在治疗后逐渐升高,治疗后1个月平均升高了0.15.而足部溃疡面积改善不明显.结论:自体骨髓单个核细胞移植结合中药治疗可以迅速改善下肢缺血患者的疼痛及冷感,能有效改善局部的血液循环.  相似文献   

12.
目的:探讨自体骨髓干细胞移植治疗下肢严重缺血患者的临床疗效。方法:对我院2009年2月~2012年3月收治的106例下肢严重缺血患者,从髂骨处抽取自体骨髓血,分离出单个核细胞,再制成细胞悬液。通过股动脉插管,在球囊阻断动脉血流的情况下将干细胞悬液注射到缺血的下肢动脉。结果:治疗后患者的疼痛明显减轻,与治疗前相比差异具有统计学意义(MH=95,P<0.05);治疗后冷感评分明显低于治疗前(P<0.05);而跛行距离、踝肱指数、经皮氧分压均较治疗前明显增加(P<0.05)。所有患者术后随访8个月,未见明显不良反应发生。结论:自体骨髓干细胞移植是治疗下肢严重缺血的一种简单、安全、有效的手段,值得临床广泛推广和应用。  相似文献   

13.
糖尿病足的自体干细胞移植治疗   总被引:4,自引:0,他引:4  
目的:观察自体干细胞移植治疗糠尿病足的可行性及安全性。方法:分别采集患者自体骨髓250~300ml或外周单个核细胞混悬液150ml,Ficoll分离液进一步分离,配制成单个核细胞混悬液,流式细胞仪计数CD+34细胞数,行下肢缺血部位多点肌肉注射进行移植,观察至少12周,进行临床评估。结果:自体干细胞移植后,患者下肢疼痛、冷感、间歇性跛行、皮肤温度、踝肱指数(ABI)及数字减影血管造影(DSA)治疗前后均有显著性差异。移植过程无不良反应发生。结论:采用自体干细胞移植治疗糖尿病足是可行的、安全的。  相似文献   

14.
目的 对比观察内皮祖细胞(EPCs)和骨髓单个核细胞移植治疗糖尿病大鼠下肢动脉缺血的动脉变化.方法 将雄性Wistar大鼠30只诱导成糖尿病模型,其中25只成模,成模鼠结扎左下肢股动脉制造下肢缺血模型,此后随机分成3组,分别给于生理盐水(A组,n=7),内皮祖细胞(B组,n=9),骨髓单个核细胞(C组,n=9),沿股动脉走向、多点肌肉注射.继续喂养28 d后行下肢动脉造影检测下肢血流.结果 动脉造影结果显示EPCs移植治疗组缺血侧下肢动脉显影血管数多于对照组(P<0.05); EPCs移植治疗组血管数多于骨髓间充质干细胞移植治疗组,但无统计学差异.结论 EPCs移植治疗对糖尿病大鼠下肢缺血效果明确.  相似文献   

15.
自体骨髓干细胞移植治疗糖尿病足8例   总被引:2,自引:0,他引:2  
目的 观察自体骨髓干细胞移植治疗糖尿病足的效果.方法 选择2009年11月~2011年5月武警广西总队医院采用自体骨髓干细胞移植治疗的糖尿病足患者8例.观察患者术后6个月内下肢疼痛、冷感、间歇性踱行、踝肱压指数(ABI)及溃疡愈合情况.结果 ①移植后患者下肢疼痛、麻木、冷感、间歇性跛行明显减轻;8例糖尿病足患者中7例创面全部愈合,其中Ⅱ级2例、Ⅲ级4例、Ⅳ级1例;愈合时间10~46 d,平均27 d.②干细胞移植治疗后6个月患者ABI明显升高[(0.26±0.18)比(0.45±0.19)],差异有统计学意义(f=2.462,P< 0.05).结论 自体骨髓干细胞移植治疗糖尿病足是一种有效的方法.  相似文献   

16.
关万宁 《河北医学》2010,16(6):679-681
目的:评价骨肿瘤病变切除后应用深低温冷冻同种异体骨移植联合自体骨髓单核细胞移植修复骨缺损的治疗效果;方法:回顾性分析2004年1月至2009年1月在我院骨科骨肿瘤病变的124例患者,其中采用同种异体骨联合自体骨髓单核细胞移植植骨61例(联合骨髓单核细胞移植组);单纯同种异体骨植骨63例(单纯植骨组);结果:联合骨髓单核细胞移植组移植骨界限模糊时间和消失时间均短于单纯植骨组。术后6、12、24个月时联合骨髓单核细胞移植组骨密度明显高于单纯植骨组。结论:同种异体骨联合自体骨髓单核细胞移植,组织抗原性减弱,能明显促进骨融合和骨缺损的愈合。  相似文献   

17.
目的比较血管腔内成形术(PTA)联合自体外周血干细胞(APBSC)移植与单纯应用两种方法治疗糖尿病足的效果。方法2006年8月至2010年12月我院收治住院并明确诊断为糖尿病足的患者45例,随机分为联合组14例、PTA组21例和APBsc组10例,联合组行PTA术后给予患肢外周血干细胞移植,PTA组患者行单纯PTA术.APBSC组患者行APBSO移植治疗。记录各组1、3、6个月的治疗效果。结果联合组6个月内疗效明显优于PTA组和APBSO组(P〈0.05);6个月内PTA组复发率呈上升趋势.APBSC组则呈下降趋势;于患肢缺血早期进行干细胞移植疗效明显优于晚期(P〈0.05)。结论PTA与APBSO都是治疗糖尿病足的安全、有效的手段,PTA术后行APBSC移植效果优于单纯应用一种方法。  相似文献   

18.
目的探讨体外培养的自体骨髓间充质干细胞治疗兔下肢肢体缺血的治疗效果.方法将体外培养扩增后获得的自体骨髓干细胞悬液分别注射于家兔右下肢缺血模型的股动脉周围的大腿肌肉群内.术后3、6周后通过血管造影术及病理学方法,检测患肢侧支循环和血管新生情况.结果体外培养的自体骨髓间充质干细胞治疗兔下肢肢体缺血取得了满意的疗效.结论体外培养的自体骨髓间充质干细胞不能治疗下肢缺血性疾病的一种有效方法.  相似文献   

19.
目的:评价自体骨髓单个核细胞移植治疗严重慢性下肢缺血性疾病的效果和安全性。方法:2003年12月至2005年12月应用自体骨髓单个核细胞移植术治疗42例严重慢性下肢缺血性疾病,其中下肢动脉硬化闭塞症(ASO)22例、血栓闭塞性脉管炎(TA0)5例、糖尿病足14例、下肢狼疮性动脉炎1例。术前多数患肢有轻重不同的静息痛,踝肱指数(ABI)均在0.6以下。随访时检查跛行距离、ABI、双下肢放射性核素扫描等客观指标。结果:患者手术1个月后开始随访,其中显著有效11例(26%)、有效16例(38%)、无效15例(36%),总有效率64%。糖尿病足、TAO、下肢狼疮性动脉炎3种疾病总有效率80%,ASO有效率50%,无手术并发症。结论:自体骨髓单个核细胞移植术能够增加患肢血流灌注,改善某些严重慢性下肢缺血性疾病的症状和体征。  相似文献   

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