恒河猴成肌细胞移植后骨髓肌HLA—DR表达及其意义

目的 研究成肌细胞移植的宿主及移植物抗原ＨＬＡ－ＤＲ的表达和分布。方法 应用差速贴壁及克隆及培养人胚成肌细胞，通过针注移植人６只福建恒河猴肱二头肌组织中，动态活检移植物部位肌组织，应用免疫组织化学技术（ＳＰ法）观察培养成肌细胞称植物后成肌细胞以及司河猴骨骼肌ＨＬＡ－ＤＲ表达及分布。结果 移植前的成肌细胞和恒河猴肌细胞不表达ＨＡＬ－ＤＲ；移植后，植入的成肌细胞和宿主肌纤维膜呈不同程度地表达出ＨＬＡ－     

差速贴壁及克隆化培养人胚成肌细胞及其移植恒河猴的实验性研究

６个水囊引产４～５个月龄人胚肢体肌组织，采用０．１％Ⅱ型胶原酶和０．１２５％胰蛋白酶二步消化法，分离肌卫星细胞，在含胎肌条件培养液（ＨＦＭＥ）的培养基中，差速贴壁及克隆纯化，电镜及Ｄｅｓｍｉｎ免疫细胞化学鉴定纯度后，Ｒｕｂｂｅｒｐｏｌｉｃｅ刮除收集，按１．６×１０６个细胞／ｋｇ体重，间隔０．５ｃｍ点均匀移植于恒河猴肱二头肌组织中。结果表明，该方法培养的成肌细胞纯度达９６％以上，移植后血清肌浆酶ＬＤＨ及ＣＰＫ与移植前相近（Ｐ＞０．０５），肌组织活检未见明显坏死，表明成肌细胞移植无宿主肌纤维损伤作用；移植后１周ＣＤ４／ＣＤ８比值大于２，补体Ｃ４短暂下降，但Ｔａｃ各值未超过移植前，２周后ＣＤ４／ＣＤ８比值恢复到正常水平，表明恒河猴对移植人的成肌细胞有排异反应，但可以耐受。移植后１周肌组织中可以检出Ｄｅｓｍｉｎ（＋）成肌细胞生长及移植后２周的ＡＯ（＋）的嗜碱性再生肌纤维，此后早期呈ＨＬＡ－ＤＲ（＋）的ＣＤ３（＋）、ＣＤ８（＋）细胞几尽消退。     

移植肾HLA－DR抗原表达的变化及意义

回顾分析４０例９９次同种异体肾移植患者及２８例正常肾组织ＨＬＡ－ＤＲ抗原表达的变化。发现移植肾的ＨＬＡ－ＤＲ抗原不仅表达有所增强，而且表达的范围亦有所变化。移植后ＨＬＡ－ＤＲ抗原表达的形态学改变分三类：（１）弥漫性增加；（２）局灶节段增加；（３）基本正常。其表达有阳性及弱阳性之分，亦受所取组织之影响，在鉴别肾移植排斥时应注意分析。作者认为在排斥反应未逆转时ＤＲ抗原持续强阳性表达，急性排斥时其表达亦增强，但在慢性排斥中ＤＲ表达的意义尚需进一步观察     

肌源性肌病患者骨骼肌细胞HLA-DR的表达

探讨免疫机制在不同肌源性肌病病变过程中的作用。方法应用免疫组化ＳＰ法系统观察７５例神经肌肉疾病患者和外科手术无肌病患者的正常骨骼肌细胞人类白细胞抗原ＤＲ位点的表达。结果ＨＬＡ－ＤＲ定位于肌细胞膜,１８例进行性肌营养不良症（ＰＭＤ）肌组织中ＨＬＡ－ＤＲ阳性表达４例（２２．２％）,位于ＨＬＡ－ＤＲ阳性的单核细胞聚集区域,均为弱阳性（＋,１５例多发性肌炎（ＰＭ）和１０例皮肌炎（ＤＭ）肌组织中肌细胞ＨＬＡ     

恒河猴异种脑移植的免疫反应

目的探讨脑内神经细胞移植免疫排斥反应的特点和程度。方法以未发育成熟的人胚脑皮质神经细胞悬液为供体，以恒河猴为宿主，进行脑内异种移植。结果移植后１～２周，恒河猴外周血中ＣＤ３＋、ＣＤ４＋、ＣＤ８＋Ｔ－淋巴细胞数量和可溶性白介素２受体（ｓＩＬ－２Ｒ）增高，移植后３～４周血清中ＩｇＧ、ＩｇＭ、ＩｇＡ增高，补体Ｃ３降低，Ｃ４正常。病理检查移植组织局部以淋巴细胞为主的炎症细胞浸润，其中部分淋巴细胞呈ＣＤ３、ＣＤ４、ＣＤ８和ＨＤＬ－ＤＲ阳性，移植物内血管内皮细胞下Ｉｇｓ／Ｃ３呈阳性反应，４周以后炎症细胞消退，细胞免疫和体液免疫各指标均恢复正常，部分神经细胞仍然存活。结论移植早期（４周内）宿主产生一定程度的急性免疫反应，以细胞免疫为主，体液免疫参与作用，但宿主能够产生免疫耐受。     

恒河猴和人骨骼肌肌酶组织化学和超微结构的比较

目的观察恒河猴和人骨骼肌形态学的相同性及差异性，方法应用肌活检，ＨＥ染色和电镜观察恒河猴和人骨骼肌超微结构，并通过线粒体ＡＴＰ酶和ＮＡＤＨ－ＴＲ酶细胞化学染色观察恒河猴和人骨骼肌细胞类型的差异。结果，恒河猴肌纤维直径小于人，粗细肌丝发达，与人类显著不同的是恒河猴肌纤维ＩＩ型和更为发达（９６％以上）结论恒河猴骨骼肌组织适合于作为人类基因治疗和功能性细胞移植实验的靶组织。     

人胚胸腺组织培养及其移植恒河猴的实验研究

应用组织培养，发现人胚胸腺组织贴块法培养呈典型的３个过程，培养１周后胸腺基质细胞（ＴＳＣ）大量生长，其胞浆ｃｙｔｏｋｅｒａｔｉｎ呈弱阳性表达，电镜观察了ＴＳＣ细胞胞浆含有典型的张力微丝束，ＴＳＣ细胞培养上清液能促进肿瘤浸润淋巴细胞（ＴＩＬ）的体外增殖和表型转化。胸腺共悬浮培养能使胸腺上皮成分集中，ＨＬＡ－ＤＲ阳性细胞比例下降，用１２号针头对恒河猴三角肌行移植实验，结果表明移植是安全的，且胸腺上皮组     

人白细胞DR抗原和第Ⅷ因子相关抗原在骨肉瘤血管内皮细胞中的表达

目的 检测骨肉瘤血管内皮细胞中人白细胞ＤＲ抗原（ＨＬＡ－ＤＲ）和第Ⅷ因子相关抗原（ＦⅧＲＡｇ）的表达,及其对骨肉瘤生物学行为的影响。应用：应用ＨＬＡ－ＤＲ的ＦⅧＲＡｇ单克隆抗体对８０例骨肉瘤进行免疫组织化学染色。结果 骨肉瘤血管内皮细胞几乎不表达ＨＬＡ－ＤＲ,而ＦⅧＲＡｇ呈高表达。结论：骨肉瘤血管内皮细胞主要表现为凝血功能面几乎丧失免疫功能,其与骨肉瘤的转移和预后有密切关系。     

过敏性接触性皮炎皮损部位细胞HLA—DR和CD45Ro抗原的表达

目的：观察ＨＬＡ－ＤＲ和ＣＤ４５Ｒｏ抗原法在过敏性接触性皮炎（ＡＣＤ）患皮损细胞上的表达。方法：ＡＣＤ患１８例，正常对照３例，应用免疫组织化学方法，结果：ＡＣＤ皮损单一核细胞以Ｔ细胞为多，角朊细胞（ＫＣ）在ＡＣＤ中可异常表达ＨＬＡ－ＤＲ，且在表皮损害严重部位有ＨＬＡ－ＤＲ，ＫＣ数增多，ＨＬＡ－ＤＲ，ＫＣ数与对应对真皮中ＨＬＡ－ＤＲ＾＋Ｔ细胞数呈正相关，结论：（１）ＨＬＡ－ＤＲ＾＋ＫＣ数增多伴有     

HLA－DR在大肠癌的表达及其与转移和预后的关系

应用免疫组织化学方法对８３例不同分期的大肠癌及其正常粘膜组织和１２例大肠腺瘤进行Ⅱ类抗原ＨＬＡ－ＤＲ表达的研究。结果大肠癌ＨＬＡ－ＤＲ表达的阳性率为４７％，大肠腺瘤为１６．６％，而正常粘膜未见表达；ＨＬＡ－ＤＲ的表达与大肠癌的转移呈正相关，ＨＬＡ－ＤＲ表达强者其转移发生率低；ＨＬＡ－ＤＲ的表达与大肠癌的Ｄｕｋｅ＇ｓ分期及浸润深度有关，与细胞分化、肿瘤大小及位置无关；ＨＬＡ－ＤＲ是大肠癌的一个预后指标，表达阳性者其预后较好。     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.