侵袭性和非侵袭性垂体腺瘤成纤维细胞的生长及凋亡比较

目的分析比较侵袭性和非侵袭性垂体腺瘤原代细胞培养中成纤维细胞的增殖及凋亡的差别,探讨成纤维细胞在垂体腺瘤侵袭性生长中的作用。方法分别对10例侵袭性和10例非侵袭性垂体腺瘤组织进行原代和传代细胞培养,对成纤维细胞进行形态学及细胞增殖速度观察, 免疫组织化学染色法检测成纤维细胞Ⅰ型胶原和波形蛋白的表达,比较两组成纤维细胞的DNA合成代谢,流式细胞仪(FCM)检测两组成纤维细胞凋亡。结果侵袭性垂体腺瘤原代细胞培养过程中,第1～2天即可见到成纤维细胞,到第8天左右几乎长满单层,非侵袭性垂体腺瘤原代细胞培养过程中,第10天左右才可见到极少数的成纤维细胞生长,1个月后长满单层,成纤维细胞呈Ⅰ型胶原及波形蛋白阳性表达,侵袭组成纤维细胞的DNA合成量明显高于非侵袭组成纤维细胞(t= 28．28,P<0．05),侵袭组细胞凋亡占细胞总数的(1．4±0．4)％,非侵袭组凋亡细胞占总数的 (5．8±1．2)％,两组差别有统计学意义(t=11．00,P<0．05)。结论侵袭性垂体腺瘤中的成纤维细胞增殖快,凋亡少,垂体腺瘤的侵袭性生长可能与成纤维细胞的增殖有关。     

改良“贴壁法”颈椎后纵韧带骨化成纤维细胞的培养

目的改良颈椎后纵韧带骨化（ossification of posterior longitudinal ligament,OPLL）成纤维细胞的培养方法。方法采集OPLL患者和非OPLL患者的后纵韧带组织,用＂贴壁法＂进行体外原代培养,传代后常规苏木素伊红染色,倒置显微镜观察成纤维细胞形态,波形蛋白免疫组化鉴定。结果分离的成纤维细胞可在体外迅速贴壁生长、增殖,波形蛋白免疫组化染色为阳性。结论改良＂贴壁法＂可以较好、较快的获得稳定培养的OPLL成纤维细胞,为研究OPLL的发病机理等提供生物学基础。     

大鼠骨髓间充质干细胞的分离、培养及表型鉴定

目的 建立大鼠骨髓间充质干细胞分离及培养的方法,探讨体外培养骨髓间充质干细胞的生物学特性.方法 采用密度梯度离心法结合贴壁筛选法分离纯化大鼠骨髓间充质干细胞,传代扩增,测定生长曲线,镜下连续观察细胞的形态变化.流式细胞仪鉴定其表面抗原 CD29、CD34、CD44和CD45的表达情况.结果 原代骨髓间充质干细胞呈集落状生长,细胞呈梭形、纺锤形,呈放射状生长,传代后呈均一的成纤维细胞样.骨髓间充质干细胞生长性状相对稳定,1、3、5代细胞生长曲线基本一致.流式细胞仪鉴定表明,骨髓间充质干细胞CD44、CD29表达呈阳性,CD45、CD38表达呈阴性.结论 采用密度梯度离心法结合贴壁培养法能获得纯度较高的骨髓间充质干细胞,并且在体外培养条件下可大量增生,形成形态均一的细胞集落,可以作为组织工程中种子细胞的来源.     

组织工程骨-软骨复合组织种子细胞的获取与培养

目的:探索体外培养组织工程骨-软骨复合组织种子细胞的条件,并观察其部分生物学活性。方法:采用机械-酶消化法对3周龄新西兰大白兔耳软骨和关节软骨消化来获得软骨细胞,采用全骨髓贴壁法来获得骨髓间充质干细胞,对两种细胞进行原代和传代培养,通过倒置相差显微镜观察细胞形态、绘制生长曲线、免疫组化染色等对细胞进行生物学特性分析。结果:原代培养的软骨细胞以多角形或三角形为主,传代3次以后出现去分化。形态学和免疫组化显示细胞3代以内可以保持表型稳定,具有较强的增殖及分泌细胞外基质的能力,而且耳软骨及关节软骨细胞在实验中没有表现出明显的生物学差别。采用贴壁筛选法获得的BMSCs呈长梭形或多边形,生长曲线呈"S"形,Ⅱ型胶原免疫组化染色阳性,细胞生长增殖能力旺盛。结论:体外分离培养的软骨细胞和骨髓间充质干细胞符合组织工程要求,能够作为骨-软骨复合组织的种子细胞。     

人胚胎嗅球嗅鞘细胞的体外培养

目的探讨人胚胎嗅球嗅鞘细胞的分离和培养方法。方法：选取家属同意下引产的4-5月胎儿，分离原代嗅球成鞘细胞，利用差速贴壁法结合无血清饥饿培养法对细胞进行纯化，计算其纯度。结果通过差速贴壁法结合无血清饥饿培养法，可获得纯度70％-80％嗅鞘细胞．显微镜下观察细胞形态，以双极和三极细胞为主，亦有少许多极及梭形细胞。结论应用差速贴壁法与无血清饥饿培养法分离培养人胚嗅球成鞘细胞是一种较为稳定可靠的方法。     

原代培养和纯化人垂体腺瘤细胞的研究

垂体腺瘤约占颅内肿瘤的10%～15%,而其中侵袭性垂体腺瘤又占垂体腺瘤的5%～85%.相对一般垂体腺瘤而言,侵袭性垂体瘤常侵犯海绵窦、蝶窦、鞍上、斜坡等周围结构,无法做到彻底切除,且易复发[1].我们对人垂体腺瘤细胞进行了体外原代培养,利用无血清培养技术得到了纯化的垂体腺瘤细胞.     

睾丸支持细胞的基本生物学特性

目的通过了解睾丸支持细胞(Sertoli cells,SC)的基本生物学特性,探讨SC鉴定的良好方法。方法联合应用复合胶原酶及差速贴壁法从睾丸组织中分离、培养SC,光镜和电镜下观察细胞的形态、MTT法测定细胞的生长曲线,观察其在体外培养条件下的增殖特性;利用免疫细胞染色及免疫荧光染色的方法,检测Fas配体(FasL)的表达,观察其免疫功能;应用吖啶橙荧光染色进行细胞鉴定。结果联合应用复合胶原酶及差速贴壁法分离、培养的细胞在光镜下呈长柱状及三角形,增殖能力强,电镜下胞核中可见特异性卫星小体,胞质中细胞器丰富,免疫细胞染色及免疫荧光染色证实其高表达FasL,吖啶橙荧光染色可见胞核中含有大量异染色质,核仁明显,证实其为SC。结论复合胶原酶及差速贴壁法分离的SC具有良好的增殖能力及免疫功能,电镜、吖啶橙荧光染色是鉴定SC方便、有效的方法。     

人骨髓间充质干细胞体外分离、培养及鉴定的实验研究

目的观察体外培养人骨髓间充质干细胞(MSCs)的形态和生长规律,以证实人MSCs是一种理想的种子细胞,以及为进一步深入研究提供基础理论依据。方法对人骨髓淋巴细胞分离液采用密度梯度离心法和差异贴壁法进行分离、提纯MSCs。观察原代、传代细胞的结构、生长情况,对第2代MSCs表面抗原进行测定。结果MSCs原代培养第14～16d时细胞融合成单层,传代细胞保持原代细胞的形态特征。超微结构显示:第2代MSCs细胞核形态不规则,部分核可见多个核仁,胞质内细胞器形态分化幼稚。细胞的生长曲线显示:传代第3d起呈对数生长,第5d达到高峰,10代后无明显克隆出现。P1代克隆形成率为25.83%±2.93%,P5代为14.67%±1.63%,P10代为4.67%±0.52%。MSCs的表型特征显示细胞均一性较好,MSCs表达CD29,CD44,但不表达CD34,CD45。结论用淋巴细胞分离液密度梯度离心和贴壁筛选法,可分离、纯化人MSCs,方法简单、经济,易应用;MSCs增殖能力强,可在体外大量扩增,能满足组织工程的要求,是理想的种子细胞之一。     

不同方法分离的大鼠骨髓间充质干细胞增殖活性和成脂分化能力的比较

目的：通过比较密度梯度离心和贴壁筛选两种方法所获MSCs的增殖活性和成脂分化能力，探索MSCs体外分离和纯化的较好方法。方法：应用密度梯度离心和贴壁筛选两种方法分离纯化骨髓MSCs，并通过MTT法检测其增殖活性，用第三代MSCs进行成脂诱导，以观察两种方法所获MSCs的成脂分化能力。结果：密度梯度离心法所获MSCs纯度高，呈纺缍形或小三角形，增殖快，约7～10天融合；贴壁筛选法分离的原代细胞中红细胞。破骨细胞等杂质细胞较多，增殖速度相对较慢，且经数次传代仍有较多杂质细胞存在，经成脂诱导后，两种方法所获MSCs表现出相似的成脂能力，油红O染色细胞计数值与光密度值比较两组无显著差异（P值〉0．05）。结论：密度梯度离心法是体外分离和纯化MSCs较好的方法，所获细胞增殖活性高，与贴壁筛选法所获MSCs具有相似的成脂分化能力。     

简易快速获得大量高纯度大鼠Leydig细胞

目的 建立一种简易快速获得高纯度睾丸间质内莱迪希(Leydig)细胞的分离方法.方法 联合应用复合胶原酶消化、400目(30 μm)不锈钢滤网过滤和差速贴壁法获得雄性Wister大鼠睾丸间质内的Leydig细胞.分离细胞经3β-羟类固醇脱氢酶(3β-HSD)特异性酶学染色、免疫细胞化学检测和流式细胞学进行细胞表型鉴定和纯度分析.将分离细胞进行原代及传代培养,部分细胞同时给予人绒毛膜促性腺激素(HCG)刺激,观察传代后细胞生长情况,并测定HCG刺激组和非刺激组各代细胞培养上清睾酮水平,评价分离细胞的增殖能力、睾酮分泌功能及对HCG的反应.有血清和无血清2种条件培养液培养原代分离细胞,倒置相差显微镜及电镜观察细胞老化和凋亡状况,优化Leydig细胞的培养条件.结果 应用差速贴壁方法每克睾丸组织(湿重)可获得Leydig细胞(1.5±0.8)×106个,3β-HSD特异性酶学染色、免疫细胞化学检测均呈阳性反应.流式细胞学检测证实3β-HSD阳性细胞率为(95.2±3.7)%.传代后未见明显的细胞增殖,但仍可检测到3β-HSD表达.原代及传代细胞均具有睾酮生成功能,HCG刺激后睾酮分泌水平均明显上升,但原代细胞一定水平的睾酮分泌可持续6 d以上,传代后细胞仅持续48 h.结论 应用差速贴壁法可以获得大量高纯度有活性的Leydig细胞,并可以进行传代培养,且传代前后短期内均可分泌睾酮.该方法简单易行,细胞得率高.     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.