人脐带华通氏胶间充质干细胞的分离、培养、鉴定及冻存、复苏

目的：探讨从人脐带华通氏胶（Wharton’s jelly,WJ）中分离、培养、鉴定间充质干细胞（mesenchymal stemcells,MSCs）及其冻存、复苏的方法。方法：采用植块法分离、培养间充质干细胞,流式细胞仪检测P3代细胞免疫表型,鉴定其向成骨、成脂方向诱导分化的能力;将P1细胞冻存6个月后复苏,鉴定复苏后细胞的特性。结果：植块法容易从人脐带华通氏胶中获得间充质干细胞;组织块贴壁后6 d可见组织块周围细胞爬出,原代培养14~18 d细胞融合70%~80%;P3代细胞强烈表达CD73、CD90、CD105,不表达CD14、CD34、CD45、CD79a和HLA-DR;成骨诱导分化后10 d,可见明显钙结节;成脂诱导14 d,有明显的脂滴出现,油红O染色阳性。冻存再复苏细胞活力达80%,细胞免疫表型及成骨、成脂诱导显示与冻存前细胞呈相同的特性。结论：组织块培养法可从人脐带华通氏胶中分离、培养出纯度较高间充质干细胞,冻存、复苏不改变其特性。     

脐带华通胶间充质干细胞的分离培养及鉴定

目的 探讨人脐带华通胶间充质干细胞体外分离、培养方法 ,并通过成脂成骨诱导及表面标记物的检测进行鉴定.方法 剔除脐带动脉、静脉和外膜,取遗留的华通胶组织,将其剪成细小的碎块,用浓度为0.2%的Ⅱ型胶原酶消化,提取脐带华通胶间充质干细胞,流式细胞仪检测细胞表面抗原CD44、CD90、CD105、CD73、HLA-ABC、CD34、CD45及HLA-DR,成骨细胞、成脂细胞分化诱导.结果 脐带华通胶经胶原酶消化后,可提取大量间充质干细胞,流式细胞仪检测脐带华通胶干细胞不表达造血干细胞的表面特征,而表达间充质干细胞的标志,例如CD44、CD90、CD105及CD73,并且干细胞HLA-ABC阳性表达,CD34、CD45及HLA-DR呈阴性.组织化学染色显示茜素红、碱性磷酸酶及油红染色强阳性.结论 该方法 可较好地分离脐带华通胶间充质干细胞.将为实验研究和临床应用提供一种新的干细胞来源.     

人脐带源间充质干细胞的培养及生物学性状

目的 建立从脐带分离培养间充质干细胞的方法,并研究其生物学特性.方法 脐带经剪碎置于?MEM培养基中培养至细胞爬出,细胞生长达80%培养皿底后传代,整个过程用倒置显微镜观察细胞形态,绘制生长曲线,用免疫荧光方法测定细胞免疫表型并研究其冻存及复苏.结果 脐带组织经直接贴壁培养法可培养出成纤维样细胞,免疫表型分析CD44和CD20阳性,冻存复苏后细胞存活率在90%以上,增殖能力强,和未冻存过的传代细胞具有同样的生长特性.结论 脐带组织培养可获得大量间充质干细胞,为间充质干细胞应用于科学研究和临床治疗提供了新的细胞来源.     

人脐带华通胶间充质干细胞的体外分离培养及鉴定

目的 研究由脐带华通胶组织(Wharton's jelly)在体外分离、培养、扩增获得脐带间充质干细胞(umbilical cord derived mesenchymal stem cells,以下简称UC MSCs)的方法,并进行UC- MSCs的各项鉴定.方法 脐带华通胶组织采用胶原酶以及胰酶序贯消化法分离得到UC-MSCs,用流式细胞仪分析其表型特征,向成骨、成脂以及成神经元细胞诱导分化并鉴定.结果 由人脐带华通胶可以有效获得间充质干细胞.原代细胞培养24～48 h内细胞开始贴壁生长,5～7 d左右可以传代培养,在2～3周时间内可以迅速扩增至107到108数量级.各项分化鉴定试验证实UC-MSCs具有多向分化潜能,能分化成骨、成脂细胞以及神经元细胞.UC-MSCs在体外培养传至20～30代仍保持稳定的细胞表面标记.结论 由人脐带华通胶可以有效地获得间充质干细胞,这种UC-MSCs能在体外长期传代培养,生物学特性稳定,具有多向分化的潜能,是今后细胞治疗很有前景的种子细胞.     

无血清培养基分离培养脐带间充质干细胞的研究

目的探讨应用无血清培养体系分离培养脐带间充质干细胞,明确其成骨生物学特性,为临床应用奠定实验基础。方法在无血清干细胞培养体系下,利用组织块贴壁培养法分离培养,扩增脐带间充质干细胞,在倒置显微镜进行形态学观察,流式细胞检测鉴定其表面标记CD34、CD44、CD90及CD45的表达,成骨诱导液培养2～3周后观察其细胞形态学变化,茜素红染色鉴定其成骨情况。结果脐带组织块接种后第1次更换培养液12h后,有少量梭形的细胞从脐带组织边缘爬出,培养5～6d左右成单层状生长,12d左右梭形状细胞呈现复层生长趋势,细胞表面标记CD44、CD90均呈阳性为间充干细胞来源,CD34、CD45均呈阴性为非造血干细胞来源;细胞经成骨诱导2～3周后具有良好的分化成骨能力。结论利用无血清的人间充质干细胞专用培养基培养体系,脐带组织培养法能够分离培养出大量的脐带间充质干细胞,避免了培养中异种蛋白的混入而降低临床排异反应。     

食蟹猴脐带间充质干细胞的分离与鉴定

目的建立食蟹猴脐带间充质干细胞的分离培养方法。方法新鲜食蟹猴脐带剪碎为糊状,用含10%胎牛血清的DMEM/F12培养液培养,观察细胞形态特征,流式细胞技术分析细胞抗原标志的表达,并检测其体外多向分化潜能。结果运用组织贴块法可以从新鲜脐带中分离到贴壁生长、阳性表达CD29、CD44、CD90的成纤维细胞样细胞。这些细胞在体外诱导培养后可分别检测到脂滴、骨和软骨细胞。结论运用组织贴块培养法可用含10%胎牛血清的DMEM/F12培养液从食蟹猴脐带中分离到间充质干细胞。     

成人脂肪间充质干细胞冻存的实验研究

目的 探寻成人脂肪间充质干细胞冻存和复苏的条件,观察冻存前后脂肪间充质干细胞的形态学特征以及向心肌细胞诱导分化的潜能.方法 自成人脂肪组织分离培养脂肪间充质干细胞,流式细胞仪检测细胞表面分子.将脂肪间充质干细胞于液氮中低温冻存,经3个月后复苏,倒置相差显微镜及透射电子显微镜下观察细胞形态.5-氮杂胞苷进行诱导,免疫荧光技术检测心肌特异性肌钙蛋白-Ⅰ.比较冻存前后脂肪间充质干细胞的形态学特征及诱导转化率.结果 脂肪间充质干细胞较幼稚,冻存前后光镜下的形态及电镜下的超微结构无明显差别,脂肪间充质干细胞呈CD29阳性表达,HLA-DR阴性表达.冻存前后脂肪间充质干细胞经5-氮杂胞苷诱导后第28天均可表达心肌特异性肌钙蛋白-Ⅰ,诱导转化率无差异.结论 脂肪间充质干细胞可耐受低温冻存,复苏后细胞的形态学特征以及诱导分化潜能无明显变化.     

低温冻存对人脐带间充质干细胞生物学特性的影响

目的比较人脐带间充质干细胞(human umbilical cord mesenchymal stem cells,UC-MSCs)冻存前与复苏后的生物学特性,为规模化储备UC-MSCs提供试验支持。方法采用胶原酶消化法从脐带中分离UC-MSCs,贴壁培养传代,将第3代UC-MSCs利用程控降温仪冷冻,置于-196℃液氮中冻存6个月后复苏,比较冻存前和复苏后UC-MSCs的细胞形态、生长曲线、免疫表型及多向分化潜能等生物学特性。结果复苏后UC-MSCs仍呈成纤维样形态生长,生长曲线与冻存前相似;免疫表型仍高表达CD73、CD90、CD105,不表达CD34、CD45、CD40、CD80、CD86、CD154、HLA-DR;在特定的体外诱导条件下,仍可以向骨、脂肪、软骨分化。结论冻存复苏后UC-MSCs的生物学特性仍保持稳定。     

低温冻存对兔脂肪间充质干细胞部分生物学特性的影响

目的 研究低温冻存对兔脂肪间充质干细胞部分生物学特性的影响。方法 采用组织块法分离培养兔脂肪间充质干细胞。用倒置显微镜观察原代细胞的细胞形态,流式细胞仪检测兔脂肪间充质干细胞的免疫表型。取第3代兔脂肪间充质干细胞置于-196℃液氮保存半年,37℃复苏并传至第7代。实验分为两组,实验组为冻存复苏后传至第7代的兔脂肪间充质干细胞,对照组为未冻存的第7代兔脂肪间充质干细胞,用MTT绘制其生长曲线;添加成脂、成骨诱导液进行诱导,油红O、茜素红染色和碱性磷酸酶活性检测分别进行鉴定。结果 体外培养的兔脂肪间充质干细胞呈梭形纤维样细胞形态,生长力旺盛。流式细胞仪检测显示,第3代兔脂肪间充质干细胞强表达CD44、CD90,阴性表达造血细胞相关的表面标志CD45。两组细胞生长曲线呈典型的“S”形,无统计学差异（P>0.05）;成脂诱导14 d后,油红O染色呈阳性;成骨诱导2周时茜素红染色阳性,ALP表达活性随成骨诱导时间延长不断增加且无统计学差异（P>0.05）。结论 冻存后的兔脂肪间充质干细胞体外生长及多向分化潜能未发生显著变化。     

人脂肪源性间充质干细胞的分离培养和鉴定

目的:分离培养并鉴定人脂肪源性间充质干细胞(hAD-MSC).方法:采用贴壁法从人脂肪组织分离获得hAD-MSC,并从表面分子表达和定向分化两个方面进行鉴定.结果:成功从脂肪组织中分离获得间充质干细胞,该群细胞贴壁生长,形态类似成纤维细胞样;具有较强的体外增殖能力和自我更新能力;一致性好,纯度高,99％的细胞阳性表达CD105、CD90、CD13、CD44分子;CD117、CD34、CD45和HLA-DR阴性表达,阳性率低于2％;可向脂肪和成骨细胞定向分化.结论:分离所得细胞符合间充质干细胞基本特点,可确定为hAD-MSC.     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.