兔阴茎海绵体平滑肌细胞的纯化培养及相关鉴定分析

背景：从以往的文献来看，阴茎海绵体平滑肌细胞的原代培养存在着制作时间长，纯度不高以及易被成纤维细胞污染等诸多缺点。 目的: 探索兔阴茎海绵体平滑肌细胞的纯化培养技术及纯度鉴定方法。　 设计、时间及地点：对照实验，于2007-10/2008-03在上海交通大学附属第六人民医院泌尿外科，上海市组织工程研究与开发中心完成。 材料：成熟的雄性新西兰大白兔5只，体质量2.5~2.8 kg。 方法：取雄性新西兰兔新鲜的阴茎组织，利用高浓度的胶原酶消化法结合差速贴壁技术对海绵体平滑肌细胞进行纯化培养。以同期兔成纤维细胞作为对照参考。 主要观察指标：以四甲基偶氮唑盐分析细胞生长特性；以平滑肌肌动蛋白、肌球蛋白、结蛋白免疫荧光鉴定海绵体平滑肌细胞；以流式细胞仪检测P2及P5代细胞α-肌动蛋白、肌球蛋白、结蛋白阳性率变化情况。 结果：培养细胞四甲基偶氮唑盐显示细胞指数增长期为6 d左右，随后进入平台期。α-肌动蛋白、肌球蛋白、结蛋白均呈阳性反应，同期成纤维细胞仅α-肌动蛋白显示阳性结果。第2代细胞表达α-肌动蛋白、肌球蛋白、结蛋白阳性率分别65.3%， 42.2%, 62.3%。经过反复多次的纯化技术至第5代时，上述指标阳性表达率分别上升为92.8%，72.7%，78.1%。　 结论：通过高浓度的酶消化法及差速贴壁技术可获得高纯度的阴茎海绵体平滑肌细胞，肌球蛋白、结蛋白相对于α-肌动蛋白可以成为鉴定海绵体平滑肌细胞的特异性指标。     

脑动静脉畸形血管内皮细胞和平滑肌细胞的体外培养

目的：探讨脑动静脉畸形（AVM）内皮细胞和平滑肌细胞的分离、培养及鉴定方法。方法：手术获得脑AVM标本后,分别采用组织块贴壁法和酶消化法对脑AVM血管内皮细胞、平滑肌细胞进行培养和形态学观察,采用免疫组化分别检测培养的内皮细胞CD31抗原和平滑肌细胞SMA抗原阳性表达。结果：相差显微镜下,培养的内皮细胞呈扁平梭形,胞核椭圆居中;平滑肌细胞呈长梭形。CD31和SMA分别在两种细胞中免疫阳性表达率超过90％。结论：AVM内皮细胞、平滑肌细胞可以获取和培养增殖,为可供研究脑血管畸形血管生物学的体外模型。     

膀胱匀浆上清液在大鼠骨髓间充质干细胞诱导分化为平滑肌样细胞中的作用☆

目的：环境因素对干细胞的分化起到重要的作用。实验拟观察经低浓度二甲亚枫进行预诱导后，大鼠骨髓间充质干细胞在体外经膀胱组织匀浆上清液诱导定向分化为平滑肌样细胞的可行性。 方法：实验于2007-04/2007-09在河北医科大学解剖教研室下属细胞培养室完成。①实验材料：4～6周龄100～150 g健康清洁级SD大鼠1只，雌雄不限，8周龄220~250 gSD大鼠4只，由河北医科大学实验动物中心提供，实验过程中对动物处置符合动物伦理学标准。②实验方法：采用骨髓干细胞培养基和贴壁法从SD大鼠骨髓中分离骨髓间充质干细胞，并在体外扩增、传代。选择8周龄SD大鼠进行膀胱组织上清液的制备。取第4代骨髓间充质干细胞用1%二甲亚砜预诱导8 h后，应用膀胱匀浆上清液诱导7 d。以未进行诱导的骨髓间充质干细胞为阴性对照组。③实验评估：观察细胞形态学的变化，并运用免疫细胞化学检测特异性α-平滑肌肌动蛋白（α-SMA）的表达。 结果：骨髓间充质干细胞经诱导分化后，细胞呈梭形平滑肌样，融合后形成峰谷状排列，并表达平滑肌特异性蛋白标志物α－平滑肌肌动蛋白，诱导分化率为（45.6±3.5）%，与阴性对照组相比差异具有显著性意义（P < 0.05）。 结论：采用此方法成功诱导骨髓间充质干细胞分化为平滑肌样细胞。     

PDGF-B与IL-1α对大鼠动脉平滑肌细胞MMP表达影响的实验研究

目的:探讨血小板源性生长因子-B(PDGF)与白介素-1α(IL-1α)对动脉平滑肌细胞基质金属蛋白酶(MMP)-2、9及基质金属蛋白酶的组织抑制因子(TIMP)-1表达的影响。方法:通过免疫组化与RT-PCR方法,研究体外原代培养的大鼠主动脉平滑肌细胞在使用PDGF-B及IL-1α的情况下,MMP-2、9及TIMP-1表达的情况。结果:正常大鼠动脉平滑肌细胞有MMP-2与TIMP-1的表达,但没有MMP-9的表达,单独使用PDGF-B与IL-1α不能诱导MMP-9的表达,但是同时使用即可诱导其表达。结论:在病理情况下,PDCF-B与IL-1α协同作用诱导MMP-9表达,降解胶原蛋白,这可能是颅内动脉瘤形成机制中的重要途径之一。     

PDGF-B与IL-1α对大鼠动脉平滑肌细胞MMP-1 mRNA表达影响的实验研究

目的 探讨血小板源件生长因子-B（PDGF-B）与白介素-1α（IL-1α）对动脉平滑肌细胞基质金属蛋白酶（MMP）-1、2及基质金属蛋白酶的组织抑制因子（TIMP）-1表达的影响。方法 通过RT-PCR方法，研究体外原代培养的大鼠主动脉平滑肌细胞在使用PDGF-B及IL-1α的情况下，MMP-1、2及TIMP-1 mRNA表达的情况。结果 正常大鼠动脉平滑肌细胞有MMP-2与TIMP-1 mRNA的表达，但没有MMP-1m RNA的表达，单独使用PDGF-B或IL-1α不能诱导MMP-1的表达，但是同时使用即可诱导其表达。结论 在病理情况下，PDGF-B与IL-1α协同作用诱导MMP-1表达，降解胶原蛋白，推测是颅内动脉瘤生长塑形机制中的重要途径之一。     

人脑动静脉畸形血管平滑肌细胞的培养和鉴定

目的:建立一个稳定的人脑动静脉畸形血管平滑肌细胞的培养体系。方法:取手术切除的人脑动静脉畸形组织块以酶消化法接种于铺有胶原底层的培养瓶中进行原代及传代培养,并对其进行形态学观察、免疫组化染色及透射电镜等一系列细胞定性研究。结果:接种后6-8 d后可见少量细胞贴壁,所获培养细胞经免疫组化、透射电镜鉴定证实为血管平滑肌细胞,而且细胞纯度较高,细胞可以连续传代18代。结论:应用酶消化法可获得纯化的血管平滑肌细胞,细胞可以连续传代培养。培养动静脉畸形血管平滑肌细胞可应用于体外作进一步的深入研究。     

骨髓间充质干细胞定向分化为心脏瓣膜构成细胞及鉴定

背景：心脏瓣膜的组成成分中不是只有内皮细胞发挥作用,成纤维细胞、平滑肌细胞等均参与心脏瓣膜基质成分构建。 目的：建立可以在体外获得大量内皮细胞、平滑肌细胞、成纤维细胞的简便方法,并对获得细胞进行形态观察及表面标志鉴定。 方法：全髓贴壁法获取大鼠原代骨髓间充质干细胞,体外培养、扩增,第3代细胞在特定条件下分别向内皮细胞、血管平滑肌细胞、成纤维细胞方向诱导分化,每日于倒置显微镜下观察细胞生长情况,并对诱导分化的细胞行免疫细胞化学检测。 结果与结论：骨髓间充质干细胞在特定条件下诱导培养后,诱导后的细胞分别具有内皮细胞、平滑肌细胞和成纤维细胞的特点。提示骨髓间充质干细胞在体外可以定向分化为内皮细胞、平滑肌细胞、成纤维细胞。     

大鼠骨髓间充质干细胞表达心肌基因表型的时间依赖效应

背景：前期实验已经证实30%心肌培养上清是诱导大鼠骨髓间充质干细胞分化为心肌样细胞的最佳浓度。 目的：在前期实验基础上,观察30%心肌培养上清条件下诱导骨髓间充质干细胞分化为心肌样细胞的时间依赖效应。 设计、时间及地点：对比观察,于2007-08/2008-06在徐州市心血管病研究所完成。 材料：健康成年SD大鼠,体质量180~220 g。 方法：分离大鼠骨髓间充质干细胞和心肌细胞并在体外培养纯化。以1×108 L-1的细胞密度种植心肌细胞,培养72 h后收集上清。将骨髓间充质干细胞的DMEM/F12培养基换为含有30%M199心肌细胞培养上清作为实验组,对照组仍将细胞接种在DMEM/F12培养基上继续培养。 主要观察指标：30%心肌细胞培养上清诱导7,14,21 d后,应用免疫细胞化学技术检测骨髓间充质干细胞中α-平滑肌肌动蛋白、β-肌动蛋白和心肌特异性肌钙蛋白T的表达。 结果：30%心肌细胞培养上清诱导骨髓间充质干细胞后,细胞的形态没有改变,但与对照组相比,α-平滑肌肌动蛋白、 β-肌动蛋白和心肌特异性肌钙蛋白T的表达均呈阳性,其中以第14天的蛋白表达量最高(P < 0.01)。 结论：30%心肌细胞培养上清诱导骨髓间充质干细胞分化为心肌样细胞的最佳诱导时间是14 d。 关键词：骨髓间充质干细胞;心肌微环境;分化;心肌样细胞     

小鼠胚胎干细胞来源平滑肌细胞的鉴定及其功能分析

背景：胚胎干细胞来源的平滑肌细胞是血管组织工程潜在的细胞来源之一,但这些细胞是否具有成熟平滑肌细胞的表型和功能仍不清楚。 目的：对小鼠胚胎干细胞分化的平滑肌细胞进行表型鉴定及功能分析。 设计、时间及地点：细胞学体外观察,于2007-05/2008-12在解放军沈阳军区总医院全军心血管病研究所完成。 材料：清洁级孕12.5 d昆明小鼠1只用于制备饲养层细胞,SD大鼠1只用于制备主动脉平滑肌细胞。小鼠胚胎干细胞系R1、小鼠微血管内皮细胞系由美国ATCC公司提供,转染pSPIE载体的胚胎干细胞R1由本实验室制备。 方法：①诱导分化及筛选：用转染pSPIE载体的胚胎干细胞R1制备拟胚体,拟胚体悬浮培养5 d后贴壁培养1 d,第7天加入全反维甲酸诱导分化4 d,第 11天用10 mg/L嘌呤霉素对诱导分化后的细胞筛选2 d。②表型鉴定：对筛选到的平滑肌细胞进行SM α-actin、SM22α、SM-MHC免疫荧光染色,以大鼠原代主动脉平滑肌细胞、未经筛选的第10天分化细胞作为对照,进行Western Blot分析。③收缩功能：10-5 mol/L卡巴可处理筛选到的平滑肌细胞 30 min。④体外成血管功能：将等量的内皮细胞和筛选到的平滑肌细胞混合,在Matrigel上培养。 主要观察指标：平滑肌细胞标志物的表达,平滑肌细胞的收缩,平滑肌细胞向内皮管腔样结构的募集。 结果：分化的平滑肌细胞主要分布于贴壁生长的拟胚体的外周部位,胚胎干细胞来源的平滑肌细胞3种标志物SM α-actin、SM22α、SM-MHC免疫荧光染色均呈阳性表达,Western Blot结果显示其SM α-actin、SM22α表达水平与大鼠原代主动脉平滑肌细胞相似,高于未经筛选的第10天分化细胞。筛选到的平滑肌细胞在10-5 mol/L卡巴可刺激下出现明显收缩,且能够募集到内皮管腔样结构周围。 结论：小鼠胚胎干细胞来源的平滑肌细胞具有与成熟平滑肌细胞相似的表型和功能。     

小肠黏膜下层无细胞基质作为阴道平滑肌细胞载体的可行性

摘要 背景：目前国内外用于阴道组织工程研究的主要支架材料聚乙醇酸存在降解过快等缺陷。天然脱细胞支架材料尤其是小肠黏膜下层逐渐成为组织工程研究的重点。 目的：探索用猪小肠黏膜下层基质作为组织工程学阴道细胞载体的可行性。 方法：取新西兰雌兔,分离出阴道平滑肌组织块,组织块+酶消化法原代培养阴道平滑肌细胞。体外培养传代后作为种子细胞接种于自制猪小肠黏膜下层基质体外联合培养,倒置显微镜动态观察细胞形态及生长增殖情况,分别于1,2,3,4周时取标本,行组织学检查。 结果与结论：①体外成功培养出阴道平滑肌细胞,倒置显微镜下,见培养的阴道平滑肌细胞呈现长梭状,细胞集结于培养皿上形成典型的“峰和谷”样构型。②黏膜下层无细胞基质外观呈白色,半透明,有一定韧性。苏木精-伊红染色未见细胞成分存在。③阴道平滑肌细胞-肠黏膜下层标本切片苏木精-伊红染色后,光镜下可见细胞成分逐渐增多,由表浅向深层部位生长。④阴道平滑肌细胞-肠黏膜下层标本切片采用抗兔平滑肌α-肌动蛋白单克隆抗体免疫组化染色后,均可见抗兔α-Actin的阳性细胞。结果初步证明了猪小肠黏膜下层基质可作为一种平滑肌细胞载体。 关键词：阴道平滑肌细胞;组织工程;猪小肠黏膜下层;细胞载体;支架材料 doi:10.3969/j.issn.1673-8225.2010.47.001     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.     

Special Pharmacokinetic Considerations in Children

Summary: Pediatric patients have greater degrees of pharmacokinetic variability and unpredictability than adults. This variability results from the effects of pharmacogenetics, age and growth, prior and current comedication, and disease. Newborns with seizures have the least predictable dosage requirements, and their needs change as drug-eliminating mechanisms mature in the neonatal period. Infants have the highest relative capacities to eliminate antiepileptics of any age group and require the largest relative doses. In addition to age-related trends, children demonstrate the same drug-specific, pharmacokinetic phenomena that adults do, including nonlinear phenytoin elimination, nonlinear valproate binding, and autoinduction of carbamazepine. Intercurrent illness and drug interactions further modify the age-related pharmacokinetic patterns in children and make dosage requirements even more unpredictable. Recent studies have shown that febrile illness can affect drug elimination, sometimes decreasing drug levels by 50% or more. Intermittent treatment with benzodiazepines administered either orally or rectally can be an important adjunct and help minimize this type of problem for children with marginally controlled epilepsy. Intermittent benzodiazepines are also helpful for children who have febrile seizures and who need only occasional antiepileptic protection.