脂多糖刺激脐带间充质干细胞上调 IL-1Ra分泌的研究?

目的：探讨脂多糖(lipopolysaccharide,LPS)激活 Toll 样受体4(Toll-like receptor 4,TLR4)对脐带间充质干细胞(umbilical cord mesenchymal stem cells,UC-MSCs)分泌白介素1受体拮抗剂(interleukin-1 receptor antagonist,IL-1Ra)的影响。方法采用组织块法从脐带华通胶组织中分离培养 UC-MSCs;流式细胞术检测UC-MSCs表面标志物 CD14、CD34、CD29和 CD105的表达;TLR4配体 LPS 以不同剂量和时间刺激 UC-MSCs,采用 qPCR 法和 ELISA 法检测 IL-1Ra 的 mRNA 和蛋白质表达水平。结果原代组织培养7~10 d,组织周边有贴壁细胞爬出,呈长梭形;UC-MSCs 表面标志物 CD29和 CD105呈阳性表达,而 CD14和 CD34呈阴性表达;LPS 刺激 UC-MSCs 后,IL-1Ra 在基因及蛋白质水平的表达均显著增加,差异有统计学意义(P <0.05),并呈剂量与时间依赖性。结论LPS 刺激 UC-MSCs 可上调 IL-1Ra 的分泌。     

慢病毒载体介导的人磷脂磷酸水解酶3基因在人脐带间充质干细胞中的表达

目的 体外分离和培养人脐带间充质干细胞（umbilical cord mesenchymal stem cell,UC-MSCs）,并将含有人磷脂磷酸水解酶3（human lipid phosphate phosphatases 3,hLPP3）的慢病毒载体转染UC-MSCs,探讨hLPP-3在UC-MSCs中的表达.方法 从脐带中分离单细胞,经细胞形态学、流式细胞仪（FACS）检测、细胞分化潜能判定,鉴定UC-MSCs的生物学特性.同时将hLPP-3基因克隆入慢病毒载体,包装出病毒上清,以不同拷贝数转染UC-MSCs,用免疫印迹和实时定量PCR技术分别测定不同转染组hLPP-3的蛋白及mRNA表达水平.结果 成功在体外分离和培养了UC-MSCs,并诱导其向脂肪、骨、软骨细胞分化.流式细胞仪检测结果显示脐带MSC表达CD90、CD73及CD105,而不表达CD14、CD34、CD45、CD19、HLA-DR、CD11b及CD106蛋白.用含hLPP-3-GFP融合基因的慢病毒载体转染UC-MSCs,实时定量PCR检测发现,hLPP-3的mRNA转录水平与转染拷贝数有关,转染拷贝数越高,hLPP-3的表达量越高;转染后1个月,免疫印迹发现hLPP-3-GFP依然维持高表达.结论 成功地在体外分离和培养了UC-MSC,并用含有hLPP-3基因的慢病毒载体转染UC-MSCs,通过转染拷贝数在一定水平上调控了UC-MSC中hLPP-3 mRNA的转录水平和蛋白表达量.     

人脐带华通氏胶间充质干细胞的分离、培养、鉴定及冻存、复苏

目的：探讨从人脐带华通氏胶（Wharton’s jelly,WJ）中分离、培养、鉴定间充质干细胞（mesenchymal stemcells,MSCs）及其冻存、复苏的方法。方法：采用植块法分离、培养间充质干细胞,流式细胞仪检测P3代细胞免疫表型,鉴定其向成骨、成脂方向诱导分化的能力;将P1细胞冻存6个月后复苏,鉴定复苏后细胞的特性。结果：植块法容易从人脐带华通氏胶中获得间充质干细胞;组织块贴壁后6 d可见组织块周围细胞爬出,原代培养14~18 d细胞融合70%~80%;P3代细胞强烈表达CD73、CD90、CD105,不表达CD14、CD34、CD45、CD79a和HLA-DR;成骨诱导分化后10 d,可见明显钙结节;成脂诱导14 d,有明显的脂滴出现,油红O染色阳性。冻存再复苏细胞活力达80%,细胞免疫表型及成骨、成脂诱导显示与冻存前细胞呈相同的特性。结论：组织块培养法可从人脐带华通氏胶中分离、培养出纯度较高间充质干细胞,冻存、复苏不改变其特性。     

组织块法分离人脐带间充质干细胞的研究

目的：应用组织块法分离人脐带间充质干细胞（hUC-MSCs）并对其生物学特性进行研究。同时探讨在不同储存条件下的脐带是否对组织块法的分离成功率产生影响。方法：无菌条件下采集足月儿的脐带,应用组织块法分离hUC-MSCs,通过流式细胞术观察其免疫学、生长特性。脐带在常温条件和冷冻条件下储存后进行组织块法分离,观察细胞生长情况。结果：应用组织块法能获得贴壁生长的hUC-MSCs,流式细胞仪分析结果显示细胞高表达常见MSC表面分子CD105、CD73及HLA-ABC;低表达造血细胞表面标记CD34、CD45及HLA-DR。常温储存条件下,随着处理时间的延长,获得原代细胞数量下降;组织冷冻后可以获得hUC-MSCs。结论：组织块分离法可以获得贴壁生长的hUC-MSCs,并成功传代扩增;脐带采集后24 h内处理,hUC-MSCs获得数量及分离成功率高;随着处理时间延长,hUC-MSCs获得数量减少,分离成功率降低。     

3种人类间充质干细胞体外增殖能力和成脂能力的比较

目的: 从人足月胎儿的脐带组织和胎盘组织中分离、培养间充质干细胞（MSCs）,观察人脐带组织MSCs（UC-MSCs）、胎盘组织MSCs（PL-MSCs）和胚胎组织MSCs（FT-MSCs）体外增殖能力和成脂分化潜能,为干细胞进一步应用于临床提供实验依据。方法: 无菌条件下获取人足月胎儿脐带组织和胎盘组织,通过Ⅰ型胶原酶酶解法分离出UC-MSCs和PL-MSCs,FT-MSCs由中科生物工程有限公司提供,取第3或4代MSCs进行检测。倒置显微镜观察细胞形态;活细胞计数法检测细胞增殖能力;流式细胞术测定UC-MSCs、PL-MSCs和FT-MSCs细胞周期并鉴定细胞表面标志物的表达阳性率。取3种组织来源的第3代MSCs进行成脂诱导,诱导18 d进行油红O染色,观察并比较3种不同组织来源MSCs的成脂能力。结果：从3种不同组织中均可获取梭形贴壁的MSCs,表面标记物CD44、CD73、CD90和CD105均呈阳性表达,CD14、CD34和CD45均为阴性表达;FT-MSCs增殖能力明显强于UC-MSCs和PL-MSCs（P<0.01）,FT-MSCs、UC-MSCs和PL-MSCs的增殖指数（PI）分别为(36.66±1.30)%、(18.23±1.10)%和(10.03±1.20)%,3种MSCs的PI比较差异均有统计学意义(P<0.01)。3种MSCs经过成脂诱导液诱导后,油红O染色结果均为阳性,但是UC-MSC s体外成脂能力(油红O染色阳性率)明显强于FT-MSCs和PL-MSCs(P<0.01)。结论：3种不同组织来源MSCs在形态和细胞表面标记物等方面相似,FT-MSCs具有更强的增殖能力和增殖活性,UC-MSCs具有更强的体外成脂潜能。     

脐带间质干细胞移植对G raves病小鼠调节性B细胞的影响

目的：探讨脐带间质干细胞（UC-MSCs）治疗Graves病（GD）小鼠的作用机制。方法32只小鼠随机分为正常对照组（G0组）、GD对照组（G1组）和UC-MSCs治疗组（G2组）。留取小鼠血清,化学发光法检测血清游离甲状腺素（FT4）水平,酶联免疫吸附法检测甲状腺刺激抗体（TSAb）浓度。取甲状腺,制备石蜡切片行苏木精-伊红染色。取脾脏,部分制成单个核细胞悬液,行三标记免疫荧光染色、流式细胞分析CD1dhiCD5＋CD19＋Bregs比例;部分脾脏提取总RNA ,实时荧光定量PCR检测Bregs相关细胞因子白细胞介素-10（IL-10）mRNA和转化生长因子-β（TGF-β）mRNA的表达水平。结果26周时G2组血清中 TSAb浓度与脾脏组织中CD19＋B细胞较G1组明显降低（P＜0．05）,B细胞中CD1dhiCD5＋CD19＋ Bregs所占比例和脾组织IL-10 mR-NA、TGF-βmRNA表达量较G1组却明显上升（P＜0．05）,且在移植前、后血清TSAb浓度差与脾脏中CD1dhiCD5＋ CD19＋ Bregs所占比例变化呈显著负相关,与IL-10、TGF-βmRNA的表达量变化呈显著正相关。结论 UC-MSCs可能通过上调Bregs表达而发挥治疗作用。     

脐带间充质干细胞对干燥综合征患者外周血的免疫调控研究

目的:研究脐带间充质干细胞(UC-MSCs)对干燥综合征(SS)患者外周血的免疫调节作用。方法:取新生儿脐带组织分离并培养UC-MSCs,流式细胞术检测UC-MSCs的细胞表面标记;选取20例疾病活动期的SS患者,收集静脉血提取外周血单个核细胞(PBMC),将SS患者的PBMC与UC-MSCs共培养,CCK-8法检测细胞存活率,筛选最优共培养细胞比例进行后续实验;流式细胞术检测共培养后SS患者PBMC中淋巴细胞亚群的变化情况。结果:UC-MSCs可降低SS患者PBMC中的外周血CD3⁺ T细胞、CD3⁺CD8⁺ T细胞以及CD19⁺ B细胞的比例,而CD16⁺ CD56⁺ NK细胞比例、CD3⁺ CD4⁺T细胞比例、CD4⁺/CD8⁺无明显变化。结论:UC-MSCs可以调节SS患者的免疫功能,从而对SS有一定的治疗作用。     

人脐血和脐带源MSCs分离培养难易及生物学特征的对比研究

目的 比较从人脐血和脐带中分离培养间充质干细胞（MSCs）的难易及两种不同来源MSCs的生物学特性,寻找最佳MSCs来源.方法 采用密度梯度离心法和组织块法分离培养人脐血MSCs和脐带MSCs.流式细胞术检测脐血和脐带源MSCs表面分子表型;采用丹参联合生长因子的方法诱导两种不同来源的MSCs向神经细胞分化.结果 脐带 MSCs原代分离培养成功率可达88%,而脐血MSCs分离培养成功率只有24%;脐带MSCs和脐血MSCs倍增时间分别为22h和38h;流式细胞术检测结果显示：两者具有相似的免疫表型,均表达黏附分子和基质细胞标记,不表达造血细胞标记、内皮细胞标记和HLA-DR;两种来源的MSCs在体外均可分化为樟经元样细胞.结论 脐带源 MSCs在生长速度、培养成功率上远高于脐血源 MSCs,在细胞表型及分化能力方面无差别.脐带 MSCs 是一种理想的 MSCs 来源.     

人脐带华通胶间充质干细胞的体外分离培养及鉴定

目的 研究由脐带华通胶组织(Wharton's jelly)在体外分离、培养、扩增获得脐带间充质干细胞(umbilical cord derived mesenchymal stem cells,以下简称UC MSCs)的方法,并进行UC- MSCs的各项鉴定.方法 脐带华通胶组织采用胶原酶以及胰酶序贯消化法分离得到UC-MSCs,用流式细胞仪分析其表型特征,向成骨、成脂以及成神经元细胞诱导分化并鉴定.结果 由人脐带华通胶可以有效获得间充质干细胞.原代细胞培养24～48 h内细胞开始贴壁生长,5～7 d左右可以传代培养,在2～3周时间内可以迅速扩增至107到108数量级.各项分化鉴定试验证实UC-MSCs具有多向分化潜能,能分化成骨、成脂细胞以及神经元细胞.UC-MSCs在体外培养传至20～30代仍保持稳定的细胞表面标记.结论 由人脐带华通胶可以有效地获得间充质干细胞,这种UC-MSCs能在体外长期传代培养,生物学特性稳定,具有多向分化的潜能,是今后细胞治疗很有前景的种子细胞.     

人脐带间充质干细胞分离培养建立及其生物学特性观察

目的:建立从人的脐带组织中分离和培养脐带间充质干细胞(UC-MSCs)的方法,并探讨UC-MSCs的生物学特性。方法:分别采用原代贴壁培养法和酶消化法(胶原酶Ⅱ和胰酶)分离培养UC-MSCs,瑞氏染色观察细胞形态,流式细胞术检测第3代以后的UC-MSCs表面特异标志物表达,MTT法检测P7细胞增殖情况。UC-MSCs同外周血单个核细胞共培养后,用MTT法测定细胞增殖率,Hoechst与PI双染色,观察UC-MSCs对健康人淋巴细胞增殖的影响。结果:原代贴壁培养法1周左右可见成纤维样细胞从组织块边缘爬出,成簇生长;酶消化法3~5天可见成纤维样细胞均匀生长。传代培养后,UC-MSCs均呈长梭形、旋涡状生长;细胞核大,核仁清晰;免疫表型:CD29阳性率为(95.71±2.23)%,CD31和CD34阳性率分别为(2.47±0.54)%和(3.24±0.34)%;第7代UC-MSCs仍具有较强的分裂增殖能力。UC-MSCs对淋巴细胞的增殖反应具有抑制作用,呈细胞数量剂量依赖性,而淋巴细胞对UC-MSCs的生长未见影响。结论:从人脐带中成功分离培养的细胞具有UC-MSCs生物学特性。     

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…     

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.     

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.     

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.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.