人骨髓间充质干细胞体外成骨分化过程中成骨相关基因的动态表达

目的：系统研究人骨髓间充质干细胞（hBMSCs）体外成骨诱导分化过程中成骨相关基因的表达变化。方法：应用密度梯度离心法分离hBMSCs,取第2代细胞通过流式检测及多向诱导分化方法进行干细胞鉴定;应用RT-PCR法对hBMSCs在体外成骨诱导不同时间点的成骨相关基因表达进行检测。结果：第2代hBMSCs表达间充质干细胞表面标志CD44、CD90,具有成脂和成骨分化潜能。成骨相关基因在诱导早期部分表达,中期均有表达,基因表达大部分在14天达高峰,与矿化相关的基因表达在21天达高峰。结论：hBMSCs体外成骨诱导过程中成骨相关基因呈动态表达,其表达时序与成骨细胞生理发育基本相似。     

体外培养的人脂肪间充质干细胞生物学特性的研究

目的:了解体外培养的人脂肪间充质干细胞的生物学特性及其体外成脂和成骨的能力.方法:体外培养人脂肪间充质干细胞并传代计数,行成骨和成脂诱导,流式细胞仪检测其细胞增殖周期与表面分子.结果:人脂肪干细胞经过体外培养均一的阳性表达CD44、CD106,而CD49d、CD34、CD45和HLA-DR表达阴性.细胞周期分析表明:G0/G1、S和G 2/M所占比例分别为79.1%、19.7%和1.3%.分离细胞在诱导体系下可以向成骨和成脂方向分化.结论:脂肪间充质干细胞具有特殊的生物学特点,体外能够向成骨和成脂方向分化.     

脐血间充质干细胞的分离培养鉴定及诱导分化研究

目的：分离培养人脐血间充质干细胞（human umbilical cord blood-derived mesenchymal stem cells,hUCB-MSC）,体外观察其生长特性,并在特定条件下诱导分化,探讨其成脂成骨分化能力.方法：采用沉降法和密度梯度离心结合贴壁培养法自脐血中分离间充质干细胞,倒置显微镜下观察其形态及生长情况;流式细胞仪分析细胞周期并检测细胞表面标志物;用茜素红染色和油红0染色分别鉴定其成骨成脂分化能力.结果：纯化的hUCB-MSC贴壁生长,呈均一梭形,具有较强的增值能力,流式细胞仪分析P3代hUCB-MSC稳定表达间充质干细胞表面抗原标志CD73,CD105和CD90等,不表达造血标志CD34和CD45;成骨诱导后3周后细胞茜素红染色阳性;成脂诱导3周后细胞油红0染色阳性.结论：本实验分离的hUCB-MSC具有较强的增殖能力,表达间充质干细胞的表面标记,具有成骨成脂分化潜能.     

人脐血间充质干细胞的分离培养及其多向分化潜能的实验研究

目的 研究人脐血间充质干细胞(MSCs)分离培养的生物学特性及其向成骨、成脂诱导分化的能力.方法 从人脐血中分离扩增MSCs,显微镜下观察其形态及生长情况,绘制生长曲线,电镜下观察超微结构,流式细胞仪检测细胞表面标志物;成骨、成脂诱导后以碱性磷酸酶(ALP)染色、茜素红染色鉴定MSCs成骨分化潜能,油红O染色鉴定成脂分化潜能.结果 人脐血MSCs为成纤维细胞样,漩涡状贴壁生长排列,传至第110代细胞形态无明显变化;电镜下显示为低分化细胞;细胞表面不表达CD34和CD45,强表达CD29、CD44和CD90;成骨诱导后可检测到ALP表达及钙化结节形成;成脂诱导后可检测到脂滴形成.结论 人脐血中可分离出MSCs,与其他来源的MSCs具有类似的生物学特性及多向分化潜能,脐血有可能成为骨组织工程种子细胞的来源.     

人增生性瘢痕成纤维细胞的间充质干细胞表型及多向分化潜能

目的 探讨人增生性瘢痕来源的成纤维细胞的细胞表型及分化潜能,以进一步研究其在增生性瘢痕形成中的作用.方法 从手术切除的增生性瘢痕中提取并分离培养成纤维细胞,以倒置显微镜观察其细胞形态及生长特点.待细胞培养传代至第3代,采用Vi-CELL细胞计数仪检测细胞生长情况,流式细胞仪检测成纤维细胞间充质干细胞表型标志CD73、CD44、CD105、CD90、CD34、CD45、CD14的表达情况;通过免疫细胞化学检测该细胞CK19、Oct 4、Vementin的表达情况及免疫荧光检测α-平滑肌肌动蛋白;诱导分化检测细胞向成骨、成软骨和成脂细胞方向分化能力.结果 细胞原代培养初期贴壁散在分布,生长曲线显示细胞1 ～2d生长较慢,从3～5d左右细胞生长较快,6～7d细胞进入平台期;第2代第5天细胞多为长梭形,呈放射状、漩涡状排列.细胞流式结果显示细胞表型CD90、CD44、CD105、CD73呈高表达,CD45、CD34、CD14不表达;免疫细胞化学检测间充质细胞标记物Vementin、多能干细胞标志物Oct 4均呈阳性表达,免疫荧光检测α-平滑肌肌动蛋白呈阳性表达,上皮细胞标志物CK19呈阴性表达,多向诱导分化实验该细胞可向成骨、成软骨和成脂细胞分化,具有多向分化潜能.结论 人增生性瘢痕来源成纤细胞具有间充质干细胞样生物学特性,该生物学特性可能在增生性瘢痕的形成以及创面修复中发挥至关重要的作用.     

骨髓基质干细胞扩增体系研究

目的 比较三种不同培养体系对人骨髓基质干细胞(h BMSCs)增殖能力、表面标志和分化潜能的影响,探索h BMSCs适合的培养体系。方法 获取h BMSCs,分别用DMEM、DMEM+碱性成纤维细胞生长因子(b FGF)和无动物组份的间充质干细胞培养基(Mesenchymal Stem Cell Medium-animal component free,MSCM-acf)进行培养,反复传代至第6代,分别计数每种培养体系每个代次的细胞得率。取第4~6代细胞,用流式细胞仪对细胞表面标志进行检测,同时对各组第6代细胞分别向成软骨、成脂和成骨方向进行诱导分化。结果 培养至第2代后,MSCM-acf培养体系细胞得率显著大于其他两组;流式细胞分析结果表明,MSCM-acf培养体系表面阳性标志CD73、CD90和CD105均大于99%,总的阴性标志表达小于2%,优于其他两组,尤其是DMEM+b FGF培养体系;三组均保留了多向分化潜能,添加b FGF的培养体系成软骨分化明显优于其他两组,MSCM-acf培养体系成脂和成骨分化优于其他两组。结论 MSCM-acf培养体系可以实现h BMSCs干性维持下的大量扩增,是h BMSCs较为理想的培养体系。     

人瘢痕疙瘩成纤维细胞的干细胞特性研究

目的探讨人瘢痕疙瘩成纤维细胞是否具有间充质干细胞的生物学特性,从细胞分子学角度为进一步研究瘢痕疙瘩的发病机制提供基础研究资料。方法以人瘢痕疙瘩标本为研究对象,通过组织块贴壁法获得成纤维细胞,用流式细胞术检测细胞表面标志CD29、CD34、CD44及CD90的表达;采用免疫细胞化学法检测细胞波形蛋白、Oct4的表达;将体外诱导细胞向成骨细胞、成软骨细胞、成脂肪细胞方向分化。结果采用组织块贴壁法,从瘢痕疙瘩标本中获得成纤维细胞;经流式细胞术检测瘢痕疙瘩成纤维细胞呈高表达CD29、CD44、CD90等间充质干细胞表面标志;经免疫细胞化学法检测瘢痕疙瘩成纤维细胞的波形蛋白、Oct4呈阳性表达;体外诱导分化结果:瘢痕疙瘩成纤维细胞可向成骨细胞、成软骨细胞和成脂肪细胞分化,具有多向分化潜能。结论人瘢痕疙瘩成纤维细胞具有间充质干细胞的生物学特性,可能是瘢痕疙瘩发生、发展的重要因素。     

5-氮杂胞苷和地塞米松对大鼠骨髓间充质干细胞分化作用的实验研究

[目的]探究5-氮杂胞苷和地塞米松对大鼠骨髓间充质干细胞(mesenchymal stem cells,MSCs)成骨分化能力的影响。[方法]SD大鼠骨髓间充质干细胞体外扩增和传代培养,流式细胞术鉴定细胞表面标志,取3代细胞随机分为空白组、激素组、激素+5-氮杂胞苷组,相应药物干预3 d后成骨诱导分化14 d,RT-PCR和Western blot检测Runx2和PPARγ的表达。[结果]所取得骨髓间充质干细胞纯度和均一性好,细胞表面标记CD90高表达,CD34、CD45低表达。第3代细胞经药物干预和成骨诱导后,与空白组相比,激素组Runx2基因表达降低,PPARγ基因升高,5-氮杂胞苷+激素组结果与激素组相反(P<0.05)。[结论]激素能抑制骨髓间充质干细胞成骨分化,促进成脂分化,5-氮杂胞苷能干预激素的这种作用,提高骨髓间充质干细胞分化潜能。     

脂肪来源干细胞的可塑性

脂肪组织为中胚层来源,其中含有成熟的脂肪细胞和未分化的脂肪干细胞,以及微血管内皮细胞和少量的平滑肌细胞。具有干细胞特点的脂肪干细胞可以通过酶消化及离心等方法,从脂肪组织中分离获得。脂肪组织来源的干细胞(Adipose tissue derived stem cells,ADSCs)与骨髓基质干细胞(Bone marrow stem cells,BMSCs)相似,具有多向分化能力和自我更新能力。本文将就ADSCs的多向分化潜能,即分化的可塑性作一综述。1与可塑性相关的细胞表面标志人ADSCs与BMSCs具有相似表面标志[1],也表达CD105、CD166和STRO-1这三个标志多向分化潜能的关键…     

猪脂肪干细胞体外多向分化潜能的实验研究

目的探讨猪脂肪干细胞(Adipose-Derived Stem Cells,ADSCs)在体外是否具有多向分化潜能。方法从猪项背部皮下脂肪组织中获取ADSCs,经过体外培养扩增至第2代分别进行成软骨细胞、成骨细胞和成脂肪细胞诱导分化,通过免疫荧光和RT-PCR对其相关表型进行检测。结果猪ADSCs在体外成软骨诱导分化2周后有特异软骨基质Ⅱ型胶原和Aggrecan表达,RT-PCR检测显示有Ⅱ型胶原、Aggrecan和Sox-9mRNA的表达;体外成骨诱导分化2周后有与成骨相关的OPN、OCN和ONN表达;体外成脂肪诱导2周后,经油红染色显示细胞内有脂滴形成。结论猪ADSCs在体外具有向成软骨细胞、成骨细胞和成脂肪细胞分化的潜能。     

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.     

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.     

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.     

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.     

Immunomodulation in Transplantation with Photopheresis

Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.