肾功能衰竭大鼠超顺磁性氧化铁标记骨髓间充质干细胞肾脏移植MR活体示踪的研究

目的应用磁性氧化铁纳米粒子和多聚左旋赖氨酸（poly-L-lysine，PLL）的偶联物Fe2O3-PLL标记大鼠骨髓间充质干细胞（MSCs），MR活体示踪经肾动脉移植入肾功能衰竭（简称肾衰）大鼠肾脏的标记细胞。方法制备Fe2O3-PLL，分离、纯化并培养大鼠骨髓MSCs，Fe2O3-PLL标记细胞，普鲁士蓝染色显示细胞内铁。肌内注射甘油所致肾衰的大鼠分为2组，分别经左肾动脉移植入标记细胞（6只）和未标记细胞（5只），移植后即刻及第1、3、5、8天应用MRI对移植细胞进行活体示踪，并与肾脏组织切片普鲁士蓝染色和HE染色对照。结果MSCs的Fe2O3-PLL标记率近100％，普鲁士蓝染色显示蓝色铁颗粒位于MSCs胞质内。标记细胞移植后肾衰大鼠肾脏皮质区信号强度明显下降，T2＊WI信号改变最明显，而肾髓质及肾盂信号较细胞移植前无明显变化，信号改变随着时间的延长逐渐减轻一直持续到移植后第8天。组织学分析见绝大多数标记细胞分布于肾皮质肾小球内，与MRI信号改变区域基本一致。未标记细胞移植后未见肾脏信号改变。结论Fe2O3-PLL可以有效标记大鼠骨髓MSCs，临床应用型1．5T磁共振仪可对经肾动脉移植入肾衰大鼠肾脏的标记细胞进行初步活体示踪。     

血管内皮祖细胞局部移植防治血管内皮损伤后再狭窄形成的实验研究

目的 探讨血管内皮祖细胞(EPC)局部移植防治血管成形术后再狭窄形成的可行性.方法 分离、鉴定并培养新西兰大白兔外周血(EPC),用2.5 F球囊扩张并损伤兔右侧颈动脉血管内皮,对损伤血管进行局部EPC移植.共作细胞移植兔13只,其中3只移植荧光标记EPC;对照组8只,局部灌注生理盐水.细胞移植后4 d,对2只荧光标记细胞移植兔取移植细胞后受损伤血管行病理组织学检查,其余实验兔4周后对损伤血管行病理组织学检查.结果 荧光标记细胞移植后4 d,病理学检测显示损伤血管内皮有强荧光表达;4周后,细胞移植组血管壁轻度增厚,对照组血管壁增厚明显,血管腔明显狭窄.两组间血管壁厚度差异有统计学意义(P＜0.01).结论 介入法局部移植同种异体血管内皮祖细胞可防治血管成形术后再狭窄的形成.     

纳米磁粒子复合物标记对内皮祖细胞生物学特性影响的实验研究

目的 探讨超顺磁性纳米磁粒子复合物Fe2O3-多聚赖氨酸(PLL)标记外周血内皮祖细胞(EPCs)后对细胞生物学特性的影响,为标记细胞的体内外MRI提供实验基础.方法 合成Fe2O3-PLL复合物.分离兔外周血单个核细胞,贴壁法筛选出EPCs,25 mg/L的Fe2O3-PLL标记EPCs,普鲁士蓝染色、电子显微镜观察细胞内铁,四氮噻唑蓝(MTT)比色试验比较未标记、标记细胞间生长曲线的差异,流式细胞分析检测标记、未标记细胞的细胞周期变化、细胞凋亡、表面标记物表达情况,实时定量聚合酶链反应(PCR)检测标记、未标记细胞的内皮型一氧化氮合酶(eNOS)、KDR、血管性假血友病因子(vWF)基因在mRNA水平上的差异,激光共聚焦显微镜下观察并分析标记、未标记细胞的Ca2+浓度、膜流动性变化.实验所得数据,计量资料多组比较采用方差分析,两组间比较采用两样本t检验.结果 Fe2O3-PLL对细胞的标记率接近100%,铁颗粒位于细胞质内.25 mg/LFe2O3-PLL标记细胞,其生长曲线、细胞周期[G0-G1期为(93.74±3.52)%]、细胞凋亡[早期凋亡率为(12.89±1.81)%]与未标记细胞[细胞周期为(94.57±3.66)%,细胞凋亡率(11.67±1.18)%]相比,差异无统计学意义(t值分别为0.283、0.977、P值均>0.05);eNOS、KDR、vWF基因的相对表达量及CD34、CD106、CD146、KDR等细胞表面标记物的表达水平相比差异也无统计学意义(P值均>0.05);对Ca2+通道影响小,细胞膜流动性无明显变化.结论 25 mg/L的Fe2O3-PLL对兔外周血EPCs的标记率接近100%,并且对细胞的生物学特性无明显影响,可用于进一步MRl的研究.     

血管内皮生长因子基因转染自体骨髓血管内皮祖细胞治疗下肢缺血的实验研究

目的:利用血管内皮生长因子(vascular endothelial growth factor,VEGF165)基因转染体外诱导的血管内皮祖细胞(endothelial progenitor cells,EPCs),并移植到下肢缺血的高脂血日本大耳兔体内,观测其促进血管新生、改善肢体缺血的效果。方法:①制作高脂血兔,梯度离心法分离兔骨髓单个核细胞(MNCs),用内皮细胞专业培养基(EGM-2)诱导培养EPCs,并用双荧光染色法及免疫组化等方法进行鉴定。②脂质体介导携带EGFP标记的VEGF165质粒转染EPCs,用激光共聚焦显微镜检测VEGF蛋白的表达,用流式细胞仪检测转染率。③制作兔单侧下肢缺血模型,并将其随机分为A、B、C 3组,分别移植EPCs、VEGF165基因转染后的EPCs及EGM-2培养基,多种方法检测移植效果。结果:①诱导出的梭形细胞,经FITC-UEA-I和DiI-acLDL荧光双染证实为正在分化的EPCs,同时经免疫组化法证实其Flk-1和Ⅷ因子的表达。②激光共聚焦显微镜下见绿色荧光蛋白表达,证实VEGF165转染成功,经流式细胞仪检测得到转染率约22.5%。③DSA及免疫组化检查显示VEGF165基因转染后的EPCs移植后改善肢体缺血的效果优于其他2组。结论:VEGF基因转染EPCs后能改进EPCs质量,移植后促血管新生能力增强,其效果优于未转染组。     

体外标记内皮祖细胞小鼠缺血性脑梗死模型局部移植后向病灶侧迁移的MRI实验研究

目的探讨多聚左旋赖氨酸(PLL)与超顺磁性氧化铁纳米微粒(Feridex)的复合物(SPIO-PLL)体外标记骨髓源性内皮祖细胞(endothelial progenitor cells,EPCs)的可行性,观察标记细胞脑内移植至小鼠缺血性脑梗死模型后的迁移情况。方法体视显微镜下线栓小鼠右侧大脑中动脉制备缺血性脑梗死模型30只,随机分成缺血对照组(6只)、生理盐水移植组(6只)、磁性标记EPCs移植组(12只)和未标记EPCs移植组(6只),采用立体定向方法进行脑内移植。对移植后小鼠的神经系统行为和运动功能进行评估,MR在体观察EPCs的迁移情况,普鲁氏蓝检测EPCs的分布。结果移植后1周神经系统行为学评分显示移植组动物改善不明显,磁性标记EPCs脑内移植后1周MR T2WI、GRE-T2*WI显示移植区低信号改变并沿胼胝体向病灶侧迁移,普鲁氏蓝染色示部分移植的标记细胞沿胼胝体向损伤侧迁移。结论移植EPCs短期内不能有效地促进缺血性小鼠神经行为功能的恢复,SPIO-PLL标记能够在体评价细胞移植后的脑内迁移。     

细胞移植术治疗兔下肢缺血模型的影像学评价

目的:利用血管内皮生长因子(VEGF_(165))基因转染体外诱导的血管内皮祖细胞(EPCs)治疗慢性下肢缺血兔模型,探讨CTA、DSA及多普勒超声检查对缺血下肢侧支循环形成评价的敏感性,并比较各种检查方法的差异性。方法:①制作高脂血兔,梯度离心法分离兔骨髓单个核细胞(MNCs),用内皮细胞专业培养基(EGM-2)诱导培养EPCs,脂质体介导转染携带增强型绿色荧光蛋白EGFP标记的VEGF_(165)质粒转染EPCs,流式细胞仪检测整体转染率。②制作兔单侧下肢缺血模型,随机分为A、B、C组,分别移植注射未转染EPCs(EPCs组)、VEGF_(165)转染的EPCs(EPC/VEGF组)、EGM-2培养基(EGM-2组),多种方法检测移植效果。结果:①自兔骨髓诱导出的梭形贴壁细胞为EPCs。②流式细胞仪检测其总体转染率约22.5%。③DSA、CTA、多普勒超声及免疫组化显示移植基因修饰后的EPCs组比未转染EPCs组能更好地促进缺血肢体新生血管形成,改善缺血肢体血运。DSA较CTA对新生血管显示更清晰,各处理组内对2种检查结果进行比较,结果均具有统计学意义(P0.05)。结论:CTA、DSA及多普勒超声均能客观评价缺血下肢侧支循环建立情况,DSA对新生血管的显示上优于CTA,但DSA为有创检查,技术要求高,CTA为无创性检查,对缺血下肢评价时宜首选CTA检查,超声多普勒用于对治疗效果的长期随访。     

血管内皮祖细胞与血管新生的研究进展

血管内皮祖细胞（endothelial progenitor cells,EPCs）是一类能分化为成熟血管内皮细胞的前体细胞,不仅参与人胚胎血管生成,同时也参与出生后血管新生和内皮损伤后的修复过程.大量的研究显示,动员和移植的EPCs可提高缺血组织的血管新生能力,促进损伤血管的修复和再内皮化,这为治疗以坏死性血管炎为主要病理改变的一类疾病带来了新的希望.因此EPCs已成为目前的研究热点之一,本文就血管内皮祖细胞与血管新生的关系及其在治疗性血管新生中应用的研究进展作一综述.     

内皮祖细胞MRI示踪研究进展

研究表明内皮祖细胞(endothelial progenitor cells,EPCs)与很多疾病有关,如血管损伤、动脉粥样硬化和肿瘤等,对于诸多疾病的诊断和治疗有着良好的应用前景[1-2].随着研究的进一步深入,EPCs的来源、动员、归巢和分化等生物学行为成为研究EPCs与疾病相互作用机制的主要内容,如何在活体有效地评价EPCs的生物学行为则自然地成为医学影像学而临的一项重要课题.近年来,分子影像学的快速发展使得在细胞和分子水平活体无创地监测疾病过程成为可能,其中的一项重要研究内容是细胞成像[3-4].在MR细胞成像研究中,对EPCs的MRI示踪做了一些初步的探索,简要综述如下……     

脑梗死大鼠脑内移植超顺磁性氧化铁颗粒标记神经干细胞后的MR示踪研究

目的探讨超顺磁性氧化铁颗粒（SP10）标记的胎鼠神经干细胞（NSCs）在脑梗死模型大鼠脑内移植后，MR示踪观察的可行性。方法大鼠脑梗死模型24只，按随机数字表法分为3组：第1组大鼠同侧尾状核移植SP10和5-溴脱氧尿核苷（BrdU）双标记的NSCs；第2组对侧尾状核移植双标记的NSCs；第3组对侧尾状核移植未标记的NSCs。移植后1、3、5、7周后进行MR示踪观察，选择T2WI和梯度回波（GRE）序列，成像后相应时间点每组处死2只大鼠，取脑组织冰冻切片后进行普鲁士蓝染色及BrdU染色。结果移植后1周MRI显示：移植标记细胞组在注射点处可见类圆形低信号影，未标记细胞组注射点未见异常信号影；3周后，第1组梗死皮层下可见线状低信号影；移植5周后，第2组沿胼胝体走行可见扇形低信号影，尖端指向病灶。GRE序列显示标记细胞较清晰，而T2WI显示梗死病灶和大鼠脑正常结构较清晰。相应时间点相应部位普鲁士蓝染色及BrdU染色可见阳性细胞，与MRI结果相符。结论超顺磁性氧化铁颗粒和BrdU双标记的神经干细胞移植至大鼠脑内后可迁移到病灶区；MR成像能够在活体内连续示踪观察神经干细胞的迁移及分布情况。     

pSVPoMcat微基因修饰雪旺氏细胞移植对损伤脊髓前角神经元的保护作用研究

目的：探讨pSVPoMcat微基因修饰雪旺氏细胞移植对损伤脊髓前角神经元的保护作用。方法：采用大鼠脊髓半横切损伤模型，将实验动物分为3组：pSVPoMcat微基因修饰雪旺细胞移植组（A组），单纯雪旺氏细胞移植组（B组），损伤对照组（C组）。对脊髓切片行Nissl染色，酸性磷酸酶（ACP）组织化学染色及原位末端标记（TUNEL）法染色，并用联合行为记分（CBS）观察大鼠神经功能恢复情况。结果：A、B、C三组前角神经元存活率呈显著性差异（A＞B＞C，P＜0．01）；A组ACP变化幅度明显降低（A＜B＜C）；细胞凋亡率为C＞B＞A。大鼠神经功能恢复也出现了相同的变化趋势。结论：pSVPoMcat微基因修饰雪旺氏细胞移植对脊髓损伤前角神经元有保护作用并促进大鼠损伤脊髓功能的恢复。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）