不同小鼠之间异基因骨髓移植免疫耐受的实验研究

目的　研究有效诱导异种骨髓移植耐受的方法和对异基因骨髓移植重建的影响。方法　将C57BL 6J小鼠辐射后 ,尾静脉注射 1× 10 7个BALB c小鼠骨髓细胞 (输入骨髓细胞前 4h ,注射供鼠的活化NK细胞 ) ,观察生存期、体重、病理组织学等指标。结果　经骨髓及NK细胞输注的小鼠能显著提高受体小鼠的生存率 ,减轻移植物抗宿主病 (GVHD)的病理伤害程度。结论　在小鼠异基因骨髓移植初期 ,输入供鼠的NK细胞和骨髓细胞 ,能促进造血重建 ,预防移植物抗宿主病的发生     

供者NK细胞诱导小鼠MHC半相合骨髓移植的免疫耐受

目的：探讨纯化的供鼠NK细胞加入预处理方案与MHC半相合骨髓移植后免疫耐受的关系。 方法：制备（BALB/c^H-2d×C57BL／6^H-2b）CB6F₁^H-2d/b小鼠为受者,C57BL／6^H-2b的小鼠为供者。70只受者小鼠经致死剂量（9.0 Gy）照射后随机分为7组,每组10只。对照组：分别为单纯照射组、MHC半相合GVHD对照组、MHC半相合骨髓细胞移植组、同基因骨髓细胞移植组。实验组：CB6F₁^H-2d/b小鼠在完成照射后1 h内首先经静脉输注纯化后的MHC半相合供者NK细胞,分为1×106、5×105和2×105／只3个组,在照射后4 h移植MHC半相合骨髓细胞。以血像、体重、生存期和病理组织学等变化为观察指标并做组间比较。结果：①生存期：单纯照射对照组为(5.15±0.66)d,GVHD对照组为(15.80±1.93)d,其他组小鼠生存期均大于30 d。②病理学结果,MHC半相合GVHD对照组出现典型的GVHD病理表现,其他各组均无GVHD病理表现。 结论：在MHC半相合骨髓移植模型上证实,移植前将供鼠的纯化NK细胞加入移植预处理方案,能诱导免疫耐受。     

自然杀伤细胞对小鼠异基因骨髓移植中移植物抗宿主病效应的影响

目的:研究自然杀伤细胞(NK)在异基因骨髓移植中对移植物抗宿主病(GVHD)的影响.方法:以近交系小鼠C57BL/6(H-2b)为供鼠、BALB/c(H-2d)为受鼠,在移植物中增加供者的外周T细胞和(或)NK细胞进行异基因骨髓移植,根据临床表现和病理检查,比较不同移植组的存活率和GVHD发生情况.结果:增加1×106供鼠NK细胞的移植组中40%小鼠出现GVHD,增加2×106供鼠NK细胞的移植组中仅30%出现GVHD;与单纯异基因骨髓移植细(80%急性GVHD、20%慢性GVHD)和骨髓 T细胞组(100%急性GVHD)比较,GVHD发生率显著下降(P＜0.01),30、60和120 d存活率显著增高(P＜0.01).结论:在小鼠异基因骨髓移植中,同种异基因反应性NK细胞可抑制GVHD效应,延长存活期.     

移植前输注供体细胞的小鼠单倍体相合骨髓移植实验

目的建立小鼠非清髓性单倍体相合骨髓移植模型,探讨移植前输注供体细胞的造血干细胞植入效果。方法以CB6F1雌性小鼠为受鼠,C57BL/6雄性小鼠为供鼠,移植前3d经尾静脉输注供鼠脾细胞或骨髓细胞3×107,输注细胞后24h和48h分别通过腹腔注射阿糖胞苷0.015g/d,移植前1d予450cGy全身照射（TBI）,移植当天输注供鼠骨髓有核细胞5×107/只。监测受鼠白细胞恢复、Y染色体性别决定基因（SRY）以及外周血供鼠CD3＋细胞嵌合状态。结果单纯给予TBI小鼠均存活,且移植后30d白细胞恢复正常,TBI＋骨髓细胞移植（TBI＋BMT）组移植后14、30、60d时外周血SRY基因PCR检测结果均阳性,60d供体CD3^＋细胞嵌合率达54.4%。移植前输注供体脾细胞组嵌合率最高,移植后60d达93.5%±4.8%,优于移植前输注供体骨髓细胞组（P〈0.05）。结论 450cGy TBI的非清髓性预处理可以成功建立非清髓性单倍体相合骨髓移植模型,移植前输注供体脾细胞可促进造血干细胞植入。     

NK细胞对小鼠H-2单倍体相合骨髓移植后GVHD及造血重建的影响

目的:研究自然杀伤(NK)细胞在单倍体相合骨髓移植中对移植物抗宿主病(GVHD)及造血重建的影响. 方法: 以近交系Balb/c(H-2d)×C57BL/6(H-2b)杂交F1代小鼠(H-2d/b)为供鼠、Balb/c(H-2d)为受鼠,在移植物中增加供者的外周T细胞和(或)NK细胞进行半相合骨髓移植,根据临床表现、病理检查及外周血白细胞(WBC)数,比较不同移植组GVHD发生及造血重建情况. 结果: 骨髓 T细胞组中90%的小鼠出现GVHD,外周血WBC平均在移植后4 wk恢复正常;而骨髓 T 低浓度NK细胞组中20%小鼠出现GVHD, 外周血WBC平均在移植后3 wk恢复正常;骨髓 T 高浓度NK细胞组中仅10%出现GVHD,外周血WBC也平均在移植后3 wk恢复正常. 后两组较骨髓 T细胞组GVHD发生率显著下降(P＜0.01),外周血WBC恢复时间显著提前(P＜0.01). 结论:在小鼠单倍体相合骨髓移植中,同种反应性NK细胞可降低GVHD发生率,促进造血重建.     

单倍型骨髓移植小鼠移植物抗宿主病模型的建立及移植物抗宿主病靶器官T细胞受体克隆检测

目的:建立单倍型骨髓移植小鼠模型,观察单倍型骨髓移植小鼠移植物抗宿主病(GVHD)靶器官的组织病理表现及器官特异性T细胞受体克隆表达.方法:建立单倍型异基因移植小鼠GVHD模型,进行移植前后GVHD靶器官的病理分析,同时应用RT-PCR扩增小鼠肝脏、皮肤、结肠、肾脏等组织移植前、后T细胞受体β链可变区(TCRBV)20个家族的基因序列,通过基因扫描判断TCRBV家族的克隆表达和CDR3克隆的性质.结果:单倍型骨髓移植小鼠在移植后14 d临床开始出现典型的GVHD表现.移植后24 d受鼠肝脏、皮肤、远端回肠等均出现典型的GVHD病理表现,在其T细胞受体谱型图上出现了分属TCRBV家族的单克隆或寡克隆增生的T细胞,而肾脏等非GVHD靶器官中浸润的淋巴细胞为多克隆的T细胞增生.结论:单倍型骨髓移植小鼠在移植后14 d出现典型的GVHD表现,GVHD靶器官出现的T细胞单克隆及寡克隆增生可能与GVHD的发生相关.     

非清髓性骨髓移植对移植物抗宿主病的影响

目的探讨非清髓性预处理方案对大鼠异基因骨髓移植模型移植物抗宿主病(GVHD)的影响.方法Wistar大鼠为供鼠,SD大鼠为受鼠,受鼠分两组,分别予以不同的预处理方案,A组受鼠自移植前4～1 d,腹腔注射氟达拉宾(1 mg/kg),移植前4 h接受2Gy的全身照射;B组受鼠仅在移植当天分别接受6 Gy的全身照射.各实验组受鼠均在移植当天经尾静脉输注供鼠骨髓细胞3.8×107;对照组大鼠输注等量的生理盐水,观察各组大鼠GVHD反应.结果移植前接受氟达拉宾和2 Gy全身照射预处理的大鼠生存期较长,且 GVHD 临床和病理评分也较低.结论非清髓性骨髓移植预处理方案可有效预防GVHD,拓宽临床进行异基因骨髓移植的适用范围.     

大鼠异基因骨髓移植急性移植物抗宿主病模型的建立

目的建立较稳定的异基因骨髓移植急性移植物抗宿主病动物模型,为异基因骨髓移植后的急性移植物抗宿主病(aGVHD)的相关研究提供实验参照。方法以雄性SD大鼠为供鼠,雌性Wistar大鼠为受鼠,受体大鼠随机分成A、B、C、D、E 5组,移植当天所有受鼠均接受8.5 GY的全身照射(TBI),于照射后4~6 h内,A组回输等量培养液,B组经尾静脉输注供鼠骨髓细胞(2×108个/kg),C、D、E组分别回输供鼠骨髓细胞(2×108个/kg) 不同比例的脾细胞。观察各组大鼠生存期、外周白细胞计数、及有无aGVHD的临床及病理表现。结果A组大鼠于15d内全部死亡,外周血白细胞计数明显减低,骨髓病理示造血组织减少,提示死于造血衰竭。B、C、D、E组大鼠外周血白细胞计数均有明显恢复,B组大鼠8只存活超过50 d,C、D、E组大鼠均于50 d观察期内死亡,并有aGVHD的临床表现及病理表现,但C组大鼠aGVHD的程度较轻且时间不集中,其中D、E组大鼠可于相对集中的时间内观察到典型aGVHD临床及病理。结论TBI预处理的方式是可行的,单纯输入异基因骨髓细胞不能引起明显的aGVHD,骨髓细胞与脾细胞1∶1及1∶1.5混合组均可作为异基因骨髓移植后理想的aGVHD动物模型。     

不同成分淋巴细胞输注对荷瘤小鼠异基因骨髓移植的影响

目的:建立荷瘤小鼠非清髓异基因骨髓干细胞移植模型,探讨不同成分的供者淋巴细胞输注(DLI)对移植效果的影响及抗肿瘤机制. 方法: 受者鼠为Balb/c(H-2Kd)小鼠,供者鼠为C57bl/6(H-2Kb)小鼠,受者小鼠腹腔接种小鼠肝癌细胞株H22细胞,观察腹水生成情况及生存状况. 于接种瘤细胞后d5给予全身照射预处理,随后给受者小鼠尾静脉输注供者鼠的骨髓细胞,建立荷瘤小鼠的MHC不相合亚移植模型. 依据不同DLI将荷瘤鼠受者鼠随机分为A,B,C,D,E组,每组10只. A,B,C,D组均给予预处理,A组预处理后于移植d1,7给予供者小鼠全脾细胞0.5×107个;B组分别于移植d1,7给予去除CD8 细胞供者鼠脾细胞0.5×107个;C组于移植d1,7给予去除CD4 细胞供者鼠脾细胞0.5×107个;D 组只接受预处理不作移植及DLI;E组为对照组,既不作预处理,也不接受骨髓细胞移植及DLI. 观察各组成瘤率、生存期、嵌合状态、造血恢复情况及移植物抗宿主病(GVHD). 结果:所有小鼠均产生腹水,成瘤率100%;生存期C组最长为(35.6±3.1)d,B组为(23.7±10.9)d,B,C两组相比有统计学差异(P＜0.05);接受移植的A,B,C组嵌合率均高于0.80,只接受预处理的D组鼠白细胞计数自行恢复正常;GVHD评分C组与B组有明显差异(P＜0.05). 结论:建立非清髓荷瘤小鼠异基因骨髓干细胞移植模型条件适宜,说明去除CD4 细胞的DLI能够有效地减轻GVHD反应,延长荷瘤鼠生存期;去除CD8 细胞的DLI会加重GVHD反应,影响移植.     

H-2半相合小鼠CD34+细胞和TK+T细胞移植建立急性GVHD模型

目的建立H-2半相合小鼠CD34 细胞和TK T细胞混合移植急性GVHD模型.方法自亲代雄性代鼠骨髓分离CD34 细胞,同时取脾脏T细胞转染tk基因,两者移植雌性F1受鼠,每只输入CD34 细胞和TK T细胞分别为1.0×105和1.0×107.单纯照射组和CD34 细胞组作对照.结果CD34 TK T细胞组均发生急性GVHD,生存时间13.3±1.2天,受鼠死亡前外周血白细胞1.76±0.25×109/L,病理表现与单纯照射组明显不同.单纯照射组小鼠生存时间6.5±0.8天,与CD34 TK T细胞组比较,P＜0.05.CD34 细胞组和CD34 TK T细胞组小鼠外周血检查可见Y染色体.结论H-2半相合CD34 细胞和TK T细胞混合移植能建立急性GVHD模型.     

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 Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.