GDNF基因活化的细胞外基质对大鼠坐骨神经缺损的修复作用

目的 探讨GDNF基因活化的细胞外基质对神经元、再生轴突和靶肌肉的保护作用.方法 通过化学萃取获得大鼠坐骨神经细胞外基质,复合上编码GDNF的质粒DNA,构建成基因活化的细胞外基质支架.90只成年Wistar大鼠按随机数字法分为3组:GDNF基因活化的细胞外基质桥接组(A组,n=30), ECM桥接组(B组,n=30),自体神经桥接组(C组,n=30),12周时用激光共聚焦显微镜等形态学方法及电生理学等方法来评价再生神经功能.结果 GDNF基因活化的细胞外基质能作为局部的基因缓释系统来释放GDNF,高效表达12周以上;再生轴突数达(2 117±294),坐骨神经指数恢复到(30.92±2.98)%.结论 GDNF基因活化的细胞外基质可以促进大鼠坐骨神经功能的恢复,有希望成为自体神经移植的替代品.     

GDNF基因修饰的雪旺细胞对大鼠坐骨神经缺损的修复作用

目的应用携带胶质细胞源性神经营养因子基因的逆转录病毒载体质粒(pLXSN-GDNF)对体外培养的雪旺细胞进行基因修饰,并结合细胞外基质凝胶及生物可降解聚乳酸-聚羟基乙酸共聚物(PLGA)管构建神经移植复合体,用于大鼠坐骨神经缺损的修复,同时对其促轴突再生及神经元保护作用予以检测评价.方法 40只成年Wistar大鼠随机分为4组:A组(n=10) 细胞外基质凝胶-PLGA管桥接组;B组(n=10)雪旺细胞-细胞外基质凝胶-PLGA管桥接组;C组(n=10) GDNF基因修饰的雪旺细胞-细胞外基质凝胶-PLGA管桥接组;D组(n=10)自体神经桥接组.损伤各组12周时应用神经电生理及甲苯胺蓝染色和透射电镜观测神经再生情况,辣根过氧化物酶神经逆行示踪技术用于脊髓前角运动神经元再生评价.结果 12周时再生神经运动传导速度检测、甲苯胺蓝染色轴突形态计量学分析、透射电镜超微结构观察以及脊髓前角运动神经元再生评价结果提示:C组优于A、B组,而与D组相比无明显差异.结论雪旺细胞的转基因处理可能弥补单纯细胞移植神经营养因子含量的不足,而可能达到与自体神经移植相似的效果.     

骨髓基质细胞移植对大鼠损伤脊髓GDNF mRNA表达的影响

目的:研究骨髓基质细胞(BMSCs)移植对大鼠损伤脊髓胶质细胞源性神经营养因子(GDNF)表达的影响.方法:将大鼠36只随机分为移植组和对照组,每组3个时相点,每个时相点每组6只动物.移植或手术后24,72 h和7 d,用RT-PCR方法对GDNF的表达进行半定量分析.结果:移植组GDNF mRNA 24,72 h和7 d时都明显高于单纯损伤组(P＜0.05).结论:BMSCs移植可使损伤脊髓表达GDNF增强.     

神经干细胞移植对大鼠脊髓损伤后GDNF基因表达的影响及意义

目的:探讨神经干细胞(NSC)移植对大鼠脊髓损伤后胶质细胞源性神经营养因子(GDNF)表达的影响及其意义。方法:NSC提取自新生Wistar大鼠的海马区,经培养、鉴定。制作大鼠脊髓损伤(SCI)模型,于伤后第7d移植NSC。实验分为3组:NSC移植组(A组)、DMEM填充组(B组)、正常对照组(C组)。应用RT-PCR法和免疫组化法观察细胞移植后不同时间点GDNF基因的表达变化。结果:RT-PCR结果分析,移植术后第1,3,5d,A组GDNF mRNA的表达量明显高于B组,差别有显著性意义(P<0.05)。组化结果分析,移植术后第7,14,28d GDNF的表达量明显高于B组,差别有显著性意义(P<0.05)。结论:NSC在移植后可上调神经营养因子GDNF基因的表达,是修复脊髓损伤的机制之一。     

刺五加皂苷对体外培养大鼠脊髓运动神经元缺氧损伤的保护作用

目的:观察刺五加皂苷(acanthopanax senticosus saponins, ASS)对脊髓运动神经元缺氧损伤有无保护作用,并探讨其可能机制.方法:对胚鼠运动神经元进行原代分离培养,免疫组化鉴定后建立缺氧诱导的神经元凋亡模型.取运动神经元培养在24孔板中,每组10孔,分为4组:对照组,无缺氧损伤;缺氧损伤组;ASS保护组,缺氧前24 h加入50 μg/ml的ASS;神经胶质细胞源性神经营养因子(GDNF)保护组,缺氧前24 h加入0.1 μg/ml的GDNF.倒置显微镜及电镜下观察细胞形态学变化;MTT法测定神经元细胞活性;检测细胞外液LDH释放量来观察ASS对神经元细胞膜稳定性的影响.提取细胞匀浆液,Western印迹法检测分析ASS对缺氧的运动神经元HIF-1α表达的影响.结果:形态学观察显示ASS、GDNF保护组神经元缺氧损伤较缺氧损伤组明显减轻.ASS保护组神经元的细胞活性(0.21±0.028)比缺氧损伤组(0.15±0.012)高(P<0.05),而LDH的释放量(28.6±1.309)比缺氧损伤组(40.7± 1.885)低(P<0.01);缺氧损伤组的神经元HIF-1α的相对表达量(0.72±0.027)比对照组(0.16±0.003)高(P<0.01),但ASS保护组HIF-1α的表达(1.15±0.016)最高(P<0.01).ASS对大鼠脊髓运动神经元缺氧损伤的保护作用与GDNF相仿.结论:ASS可以提高体外缺氧损伤的运动神经元的细胞活性,对细胞的缺氧损伤有明显的保护作用,其保护作用的发挥,可能与增强细胞膜的稳定性及提高细胞HIF-1α的表达有关.     

缝线粘附重组pcDNA3-GDNF-GFP质粒对周围神经损伤后神经元保护的实验

目的 研究周围神经损伤后新的修复方法和胶质细胞源性神经营养因子（GDNF）对坐骨神经损伤大鼠脊髓神经元的保护作用.方法 50只雌性Wistar大鼠制成右侧坐骨神经缺损动物模型,随机分为实验组和对照组.实验组使用粘附pcDNA3-GDNF-GFP的缝线,对照组使用粘附pcDNA3的缝线进行坐骨神经的缝合修复.术后1周、8周使用激光共聚焦显微镜检测GDNF在脊髓神经元的表达;术后12周行脊髓神经元尼氏染色和右侧坐骨神经电生理检查.结果 实验组神经元有绿色荧光表达,证明转染成功;尼氏染色发现神经元数目多于对照组,实验组神经的传导速度、动作电位的峰值及潜伏期分别是19.82±1.90 m/s、3.47±0.32 mV、0.36±0.03 ms,明显高于对照组.结论 使用携pcDNA3-GDNF-GFP重组质粒的缝线修复损伤的周围神经,可以对脊髓神经元产生营养保护作用并促进周围神经的再生.     

磷脂酶Cδ3和RhoA在大鼠损伤脊髓中的表达

目的 观察磷脂酶Cδ3(PLCδ3)和RhoA在大鼠损伤脊髓中的表达.方法 75只雄性Wistar大鼠随机分为3组(n=25):模型组用改良Allen's打击法制作脊髓损伤模型;假手术组只切除椎板,不损伤脊髓;对照组不做任何处理.在术后1、3、7、14、28 d每组随机取5只大鼠,取损伤灶附近脊髓,用HE染色观察脊髓损伤及神经元死亡情况,采用免疫荧光方法和Western blot检测损伤后脊髓中PLCδ3、RhoA、胶质纤维酸性蛋白和神经元标记物NeuN的表达.结果 脊髓损伤后PLCδ3在神经元和星形胶质细胞中表达持续下调,RhoA在残存的神经元和星形胶质细胞表达上调,脊髓损伤后第3天开始升高,第7天达高峰,持续增高至第28天.损伤灶周围星形胶质细胞的增生与活化和RhoA同步,出现神经元的进行性坏死.结论 脊髓损伤后神经元和胶质细胞中PLCδ3表达下调可能导致RhoA表达上调,而参与神经元的死亡和星形胶质细胞的增生和活化,促进脊髓损伤胶质瘢痕形成,影响神经功能恢复.     

胶质细胞源性神经营养因子对脊髓损伤后皮质脊髓束再生的保护作用

目的:观察外源性胶质细胞源性神经营养因子(GDNF)对大鼠损伤脊髓皮质脊髓束再生的影响.方法:利用Nystrm法制备大鼠胸髓压迫损伤模型.蛛网膜下腔置管至损伤局部,连续1周给予GDNF.应用辣根过氧化物酶 (HRP)顺行追踪技术和胶质纤维酸性蛋白(GFAP)、神经中丝(NF)免疫组化活性的变化来评价外源性GDNF对伤区皮质脊髓束和轴突再生的影响.结果:脊髓损伤后4周GDNF治疗组GFAP表达较对照组明显减少,NF标记轴突数显著多于对照组,皮质脊髓束部分再生并通过损伤区至远端0.5 cm.结论:外源性GDNF局部给药能减少胶质细胞增生,促进脊髓损伤大鼠皮质脊髓束轴突再生和神经骨架蛋白的修复.     

绿色荧光蛋白腺病毒表达载体在肌源性干细胞移植修复脊髓损伤实验中的应用

目的:观察绿色荧光蛋白腺病毒表达载体在肌源性干细胞移植修复脊髓损伤实验中的应用。方法:40只成年SD大鼠随机分为移植组(n=20)和对照组(n=20),均进行脊髓半切损伤。伤后9d,移植组于伤处移植体外转染GFP基因的大鼠MDSCs,而对照组仅注射等量PBS,于移植后1、2、3、4周用BBB评分方法测大鼠的运动功能,同时进行损伤脊髓取材、快速冰冻切片进行荧光显微镜观察。结果:移植后1周两组动物运动功能恢复无明显差异;移植后2、3、4周与对照组比较,移植组显著提高运动功能;荧光显微镜观察经绿色荧光蛋白基因标记的肌源性干细胞在损伤脊髓组织局部生长良好,并且有沿着脊髓神经束向头尾两侧迁移的趋势。结论:携带绿色荧光蛋白基因的腺病毒表达载体的细胞标记方法是安全可靠、简便有效的生物示踪标记方法,可以用于标记细胞移植实验研究。     

脂质体介导胶质细胞源性神经营养因子基因转染对大鼠脊髓损伤后神经功能的影响

目的　探讨阳离子脂质体介导的胶质细胞源性神经营养因子 (GDNF)基因体内转染对大鼠脊髓损伤后后肢运动功能恢复的影响。方法　雄性成年SD大鼠 30只 ,随机均分为绿色荧光蛋白 (GFP)对照组及GDNF治疗组。采用改良Nystr m法经后路压迫大鼠胸段脊髓模型 ,以直接注射法将脂质体DC Chol和重组质粒 pEGFP GDNFcDNA混合后注入大鼠损伤脊髓。HE染色观察伤后 4周伤段脊髓残存组织的面积 ,采用斜板试验和运动功能评分观察大鼠后肢运动功能的恢复情况。结果　大鼠脊髓损伤后 1～ 4周 ,GDNF治疗组后肢运动功能评分明显高于GFP对照组 ,两组间差异有显著性 (P <0 .0 5 )。伤后 4周 ,GDNF组伤段残存脊髓组织的面积大于对照组 (P <0 .0 1)。结论　脂质体介导GDNF基因体内转染能明显减少脊髓损伤后伤区的坏死和萎缩 ,并促进大鼠后肢运动功能的恢复     

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.