腺病毒介导的血管内皮生长因子体外转染心肌细胞的研究

目的:构建携带人血管内皮生长因子(VEGF)基因的重组腺病毒载体,并转染体外培养的心肌细胞,检测VEGF的表达.方法:将人源性的VEGF165cDNA正向插入到腺病毒载体PDC315,构建重组质粒,通过脂质体共转染293细胞,经同源重组获得携带人VEGF165基因的重组腺病毒,通过PCR扩增法鉴定所构建的腺病毒,扩增并测定滴度后,体外转染培养的心肌细胞,利用ELISA、Western印迹分析等方法检测VEGF在心肌细胞中的表达.结果:人VEGF165cDNA成功地正向插入到PDC315载体中,以重组病毒基因组DNA为模板,同时扩增出了610bp的VEGF165cDNA基因片段,证实了所构建病毒的正确性,病毒滴度为2.8×108 pfu/ml,Ad VEGF165体外转染心肌细胞3 d后,在培养细胞的上清液及细胞内检测到了VEGF的表达.结论:成功构建了表达人VEGF 165基因的腺病毒载体,体外转染心肌细胞后能够满意表达VEGF,为基因治疗心肌缺血奠定基础.     

人血管内皮细胞生长因子165重组腺病毒的构建及其在真核细胞中的表达

目的:体外构建人血管内皮生长因子165(hVEGF165)的腺病毒表达载体,并检测其在HEK293细胞中的表达。方法:从重组质粒pcDNA3/hVEGF165中获得hVEGF165,经酶切及测序鉴定,将hVEGF165基因亚克隆到穿梭质粒pAdTrack-CMV,重组穿梭质粒经酶切线性化后,与pAEdasyl质粒在大肠杆菌BSJ183中进行同源重组,线性化后转染HEK293细胞进行包装扩增获取重组病毒上清,同时应用RT-PCR及ELISA法检测hVEGF165的表达。结果:目的基因的测序结果与人VEGF165序列(Genbank)相符。转染后经RT-PCR和ELISA检测证实转染重组质粒组hVEGF165 mRNA及蛋白表达,而转染空质粒组及未转染组没有检测到hVEGF165的表达。结论:本研究构建了人VEGF165重组腺病毒表达载体pAd-hVEGF165,并能成功地在HEK293细胞中表达。     

hBcl-2和hVEGF165双基因共表达重组腺病毒载体的构建及鉴定

目的构建hBcl-2和hVEGF165双基因共表达的重组腺病毒载体,为后续基因转染和动物实验提供实验基础。方法通过RT-PCR从A549细胞中分别获得hBcl-2和hVEGF165基因片段,并克隆到pMD-19T载体。将目的基因hBcl-2、IRES元件和hVEGF165依次定向克隆到腺病毒穿梭载体质粒pAd-Track-CMV上。线性化重组穿梭质粒后通过电穿孔转化含有腺病毒骨架质粒pAd-easy-1的感受态大肠杆菌BJ5183构建重组腺病毒载体质粒。脂质体转染线性化的重组腺病毒载体质粒于HEK293细胞以包装制备重组腺病毒。重组腺病毒经PCR鉴定之后进一步扩增、纯化。通过荧光计数确定病毒感染滴度。结果克隆的hBcl-2和hVEGF165基因测序正确,酶切重组穿梭载体质粒和腺病毒载体质粒得到特异酶切产物,重组腺病毒载体质粒转染HEK293细胞3 d后观察到GFP的表达,重组腺病毒的PCR得到hBcl-2和hVEGF165基因的PCR产物,滴度测定为5×109pfu/mL。结论成功构建制备了高滴度的hBcl-2和hVEGF165双基因共表达的重组腺病毒载体,为联合基因治疗心肌梗死的研究提供实验基础。     

氧相关HRE启动子控制下表达hVEGF165基因重组2型腺相关病毒的获得及鉴定

目的包装及鉴定低氧反应元件（HRE）启动子控制下缺氧诱导目的基因hVEGF165基因表达的2型重组腺相关病毒。方法磷酸钙三质粒共转染方法将pAAV—HRE9-VEGF165、pAAV—Rep／cap、pHelper质粒转染HEK293T细胞，制备2型重组腺病毒相关病毒（rAAV2）。分离培养S—D大鼠心肌细胞，转染rAAV，细胞固定后做免疫细胞荧光染色，检测细胞内血管内皮细胞生长因子（VEGF165）蛋白的表达。结果pAAV—HRE9-VEGF165质粒经测序鉴定，结果与NCBIGenBank公布的人VEGF165 eDNA核苷酸序列（AB021221）完全一致，含HRE启动子及目的基因hVEGF165的2型重组非复制型腺相关病毒包装成功，可感染原代培养的大鼠心肌细胞，缺氧可诱导VEGF165蛋白表达。结论成功包装并鉴定了rAAV—HRE9-hVEGF165载体，可有效转染心肌细胞，VEGF165基因的适时表达，为缺血性心肌疾病的“分子搭桥”治疗提供了更可能的安全性。     

含不同启动子的腺病毒载体介导的人β2肾上腺素能受体基因在心肌细胞的表达

目的：观察不同的启动因子cmv,mlc-2v对腺病毒载体介导的人β2肾上腺素能受体（β2－AR）基因在大鼠心肌细胞中表达,方法：分别构建cmv,mlc-2v启动子并携带人β20－AR基因的重组腺病毒Adcmvβ2AR,Admlc,β2AR,用以感染心肌细胞,并检测心肌细胞对人β2－AR基因的表达及cAMP的含量,结果：经RT－PCR,Western免疫印迹分析证帝感染的心肌细胞均表达人β2－AR,放射性配基检测显示含mlc-2v启动子Admlcβ2AR感染的心肌细胞β2－AR密度低于含cmv启动子的A β2AR感染组（P＜0．01）,经10umol/L异丙肾上腺素作用,感染组的心肌细胞内cAMP含量明显高于对照组,感染组间存在明显差异（P＜0．01）,结论：含不同启动子的腺病毒载休感染心肌细胞后均可表达具有生物活性的人β2－AR,但两者存在差异。     

携hVEGF165基因的重组腺病毒载体的构建及鉴定

目的　构建携带人血管内皮生长因子 16 5 (hVEGF165)基因的重组腺病毒载体。方法　将hVEGF165cDNA亚克隆到腺病毒中间载体pACCMV·pLpA ,再与pJM17共转染人胚肾 2 93细胞 ,获得载hVEGF165基因的复制缺陷型重组腺病毒 ,感染体外培养的兔主动脉血管平滑肌细胞 (VSMC) ,通过RT PCR和Westernblot检测VEGF表达情况 ,并观察表达产物VEGF对人脐静脉内皮细胞 (HUVEC)增殖的影响。结果　重组腺病毒感染VSMC 4 8h后有VEGFmRNA转录及蛋白质的表达 ,并呈剂量依赖性地促进HUVEC增殖。结论　构建的重组腺病毒载体在VSMC中能够有效表达目的基因 ,且能有效促进HUVEC增殖 ,为hVEGF165基因的实际应用奠定了基础。     

人血管内皮生长因子165基因腺病毒载体的构建及其在C17.2神经干细胞的表达

[目的]构建含有人血管内皮生长因子165(VEGF165)基因的重组腺病毒载体并观察其在C17.2神经干细胞的表达,为下一步脑缺血的转基因细胞移植治疗提供基础.[方法]将VEGF165基因克隆至腺病毒穿梭质粒pAdTrackCMV,获得重组质粒pAdTrack VEGF165,经酶切线性化后,与腺病毒骨架质粒pAdEasy共同转染大肠杆菌BJ5183同源重组获得重组腺病毒质粒,将线性化的重组腺病毒质粒转染293细胞包装获得有感染能力但复制缺陷的重组腺病毒pAdCMV VEGF165,转化体外培养的C17.2神经干细胞.通过RT-PCR、原位杂交、免疫组化、Western blot法检测其在C17.2神经干细胞中的表达.[结果]重组腺病毒AdCMV VEGF165在293细胞中包装成功,病毒滴度达2×1011efu/mL.病毒上清液经ELISA检测VEGF165表达的量为(1135±138)ng/L.重组腺病毒转染神经干细胞后有稳定表达.[结论]成功构建pAd VEGF165重组腺病毒,获得了稳定表达VEGF165的神经干细胞克隆,为下一步脑缺血的转基因细胞移植治疗提供了基础.     

血管内皮生长因子基因重组腺病毒载体的构建

目的 :构建携带人血管内皮生长因子基因的重组腺病毒载体。方法 :将人源性的 VEGF1 6 5c DNA正向插入到穿梭质粒 p HCMVSP1A的 CMV启动子之下 ,构建重组质粒 ,通过脂质体与 p JM17共转染 2 93细胞 ,经同源重组获得携带人 VEGF1 6 5基因的重组腺病毒 ,通过 PCR扩增法鉴定所构建的腺病毒 ,扩增、纯化并测定滴度。结果 :人VEGF1 6 5c DNA成功地正向插入到 p HCMVSP1A载体中 ,以重组病毒基因组 DNA为模板 ,同时扩增出 5 76 bp的VEGF1 6 5c DNA基因片段和 86 0 bp的腺病毒骨架基因片段 ,证实了所构建病毒的正确性 ,病毒滴度为 2 .5× 10 9pfu/ m l。结论 :成功构建了表达人 VEGF1 6 5基因重组腺病毒载体 ,使 VEGF基因的高效转染成为可能     

小鼠降钙素基因相关肽基因重组腺病毒载体的构建及其在心肌细胞的表达

目的:利用AdEasy腺病毒载体系统,构建小鼠降钙素基因相关肽(calcitonin gene-related peptide,CGRP)基因重组腺病毒载体,并验证其在心肌细胞中的表达.方法:采用RT-PCR方法扩增出含有小鼠CGRP全长cDNA的基因片段,并将其插入PUC57载体,经EcoRⅤ和SalⅠ双酶切,将小鼠CGRP基因亚克隆至穿梭质粒pShuttle-CMV,形成重组质粒pShuttle-CMV-CGRP.经PmeⅠ酶切线性化后,在大肠杆菌BJ5183中与腺病毒骨架质粒pAdEasy-1同源重组产生重组腺病毒质粒AdEasy-pShuttle-CGRP.重组腺病毒质粒在XL-Gold 细胞中扩增,经PacⅠ酶切线性化后,转染人胚肾293细胞进行重组腺病毒的包装,并经氯化铯纯化得到重组腺病毒AdEasy-pShuttle-CGRP.用纯化后的重组腺病毒转染原代培养的乳鼠心肌细胞,荧光显微镜下观察转染效果.通过尾静脉导入重组腺病毒7 d后,放免法测定心肌中CGRP的表达量.结果:测序证实PUC57 -CGRP重组质粒中含有小鼠CGRP基因的cDNA;重组穿梭质粒pShuttle-CMV-CGRP经双酶切鉴定后可见约7.5 kb和423 bp片段;重组腺病毒质粒AdEasy-pShuttle-CGRP经Pac Ⅰ酶切可见长约3 kb与30 kb DNA片断.转染293细胞进行包装,7 d后细胞出现病变效应,回收病毒重复感染293细胞,在荧光显微镜下可见绿色荧光蛋白表达.提取病变293细胞中重组腺病毒进行目的基因的PCR鉴定为阳性.构建好的重组腺病毒经纯化后具有很高的滴度,并且成功转染了原代培养的乳鼠心肌细胞.通过放免法证实,该载体可以显著增加小鼠心脏中CGRP的表达.结论:成功构建携带CGRP基因的重组腺病毒载体,该重组腺病毒载体AV-CGRP可以显著增加心脏中CGRP的表达量,为进一步研究CGRP基因治疗奠定了基础.     

靶向hVEGF165基因shRNA质粒表达载体的构建及筛选

目的 构建编码hVEGF165 mRNA的shRNA质粒表达载体,并筛选出基因沉默效果最明显的shRNA质粒表达载体.方法 以hVEGF165 mRNA编码区中第5和第7外显子序列作为RNA干扰靶点,分别构建3个shRNA质粒表达载体和1个阴性对照质粒表达载体并通过PCR进行鉴定.经鉴定后分别转染稳定表达hVEGF165基因的BHK细胞,实时荧光定量PCR和Western blotting分别从mRNA和蛋白质水平检测抑制效果.结果 构建的质粒表达载体PCR鉴定均可扩增出预期条带,构建成功.靶向hVEGF165基因的shRNA对所转染稳定表达hVEGF165基因的BHK细胞中hVEGF165基因mRNA和蛋白质表达均有抑制作用,其中shRNA2最为明显.结论 成功构建了靶向hVEGF165基因的shRNA质粒表达载体,其中抑制效果最为明显的shRNA质粒表达载体为pDC316-EGFP-U6-shRNA2质粒.     

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.     

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…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.