胶原凝胶真皮构建及其性质测定

目的为了改进组织工程化人工皮肤的生物学性能。方法改进Hansburgh和Middelkoop制备人工真皮的方法,应用I型胶原酶和中性蛋白酶Dispase分离得到新生儿真皮成纤维细胞,并将其种植于胶原溶胀液,成功构建凝胶真皮,并检测了其力学及生物学性能。结果胎儿真皮成纤维细胞在凝胶真皮中增殖速度快、活性高、分泌细胞外基质丰富。结论凝胶真皮的生物学性能优于传统胶原海绵人工真皮。     

组织工程皮肤用真皮支架细胞相容性的比较研究

目的研究几种真皮支架的细胞相容性，为构建组织工程皮肤提供资料。方法取胶原海绵、明胶海绵、PEGA和PHBV共4种真皮支架，与小鼠成纤维细胞和ES源表皮样干细胞体外培养，观察前者对后者粘附率的影响，及对成纤维细胞增殖的影响，评价真皮支架的细胞相容性。结果成纤维细胞和ES源表皮样干细胞在4种支架材料上均能粘附存活，成纤维细胞能增殖，但在胶原海绵、PHBV和PLGA支架上的增殖率明显高于明胶海绵。结论几种真皮支架的细胞相容性较好，可用于新型组织工程皮肤的构建。     

应用胶原蛋白构建组织工程皮肤的实验研究

目的 探讨以胶原蛋白为支架构建组织工程皮肤的体外培养理想方法.方法 体外分离、培养、鉴定角朊细胞和成纤维细胞;利用本室自制胶原蛋白,制备胶原凝胶和胶原海绵两种组织工程支架;在成功构建人工真皮的基础上,种植角朊细胞,构建人工复合皮肤,并进行组织学及免疫组化检查.结果 制备的胶原海绵孔径平均100～150μm,孔隙率89%,组织相容性良好;两种皮肤替代物免疫组化染色显示Ⅳ型胶原、纤维连接蛋白(FN)和层粘连蛋白(Laminin)阳性,HE染色可见均具有表皮和真皮双层结构,厚度约3mm,在形态结构上与正常皮肤相似.结论 培养的人角朊细胞和成纤维细胞种植于胶原蛋白支架上气-液界面培养可构建出具有类似天然皮肤结构的组织工程皮肤.     

人和猪脱细胞真皮体外构建活性真皮替代物的对比研究

目的 观察异体和异种脱细胞真皮支架(ADM)对体外构建的活性人工真皮生物学活性的影响.方法 体外培养、扩增人皮肤成纤维细胞后,按2.5×105个/cm2密度分别接种于异体(人)脱细胞真皮(hADM)、异种(猪)脱细胞真皮(pADM)支架表面进行复合培养.动态观测细胞生长情况及活性真皮替代物的组织结构,并观测复合培养3、6、10 d培养上清中IL-6、透明质酸(HA)的变化.结果 人皮肤成纤维细胞在人和猪的脱细胞真皮支架上粘附、生长良好,均可形成细胞膜片并向支架内生长.在接种人皮肤成纤维细胞后,hADM组和pADM组培养上清液中均可检测出逐渐增高的IL-6和HA.复合培养第6、10天,hADM组和pADM组均显著高于单层成纤维细胞培养组(P＜0.05),但两组间并无统计学差异.结论 人皮肤成纤维细胞接种于hADM和pADM进行体外复合培养后均可构建具有生物学活性的人工真皮,就成纤维细胞的生物学活性而言.二者之间并无差别.     

壳多糖-胶原-糖胺聚糖凝胶人工皮肤的制备

目的 研制一种新型的凝胶类人工皮肤。方法 制备壳多糖－胶原－糖胺聚糖（GAGs)－成纤维细胞真皮替代物（DE），随后在“成熟”的DE表面接种KC，先浸没培养，再气液界面培养，构建完整的人工皮肤。对人工皮肤行组织学分析。结果 人工真皮浸没培养将发生一定程度的收缩，接种角质形成细胞将促进其收缩。液气界面培养一定时间后的人工皮肤有结构致密的真皮和分化良好的表皮。结论 我们制作的壳多糖－胶原－GAGs凝胶人工皮肤是有满意真皮表结构的新型人工皮肤。     

以牛Ⅰ型胶原作为人工皮肤支架的研究

目的 探索以牛Ⅰ型胶原作为人工皮肤支架的可行性.方法 将牛型Ⅰ胶原用醋酸溶解后,采用-70℃预冻,再采用真空干燥的方法获得作为人工真皮的胶原海绵支架.结果 得到膜状的胶原海绵支架,其切面可见胶原纤维相互连接成多孔网状结构,孔径大致相同.结论 牛Ⅰ型胶原是一种良好的细胞外基质,可以用来构建人工皮肤的真皮支架.     

组织工程化皮肤移植后真皮演变的观察

目的　探索应用组织工程技术修复全层皮肤缺损后真皮的演变过程。方法　选用长枫杂交仔猪为实验动物 ,取腹部 2cm× 2cm全厚皮肤 ,酶消化法获取皮肤表皮细胞与成纤维细胞 ,体外经原代培养 ,将处于对数生长期的表皮细胞、成纤维细胞分别与PluronicF 12 7混匀成细胞悬液后 ,种植聚羟基乙酸 (polyglycolicacid ,PGA)形成细胞 生物材料复合物 ,用于修复自体动物背部直径 4cm全层皮肤缺损 ,以单纯生物材料 (PGA +Pluron ic)充填的创面作为阴性对照。分别于修复术后 1,2 ,4 ,8周取材 ,通过组织学和电镜等方法对新生组织进行评价。结果　第 1周实验组分表皮与真皮两部分 ,真皮内有少量胶原合成 ,成纤维细胞量多 ,内质网扩张 ;第 2周真皮较前增厚 ,胶原合成量增加。第四周真皮内的成纤维细胞数量减少 ,胶原量较前增多。第八周真皮内成纤维细胞的数量明显较前减少 ,部分成纤维细胞呈凋亡样改变 ,组织工程化皮肤的真皮结构与正常皮肤接近。结论　成纤维细胞 PGA Pluronic复合物移植后逐渐演变为正常真皮     

4种支架构建复合式口腔黏膜的组织学特点

目的利用4种不同支架材料构建复合式口腔黏膜,并比较其组织结构特点。方法体外培养人口腔黏膜的成纤维细胞和角质形成细胞,在4种支架材料中加入成纤维细胞,培养7d后,在支架表面加入角质形成细胞,培养4d后,移至气-液界面继续培养7d。苏木精-伊红染色镜下观察构建的复合式口腔黏膜的组织形态学特点。结果 4种支架均可构建形成复层上皮。其中,上皮层与脱细胞真皮基质材料(de-epidermised dermis,DED)结合紧密,形成的人工黏膜有明显的上皮钉突。不同于以往报道,上皮层与Alloderm结合并不十分紧密。以胶原凝胶为基质形成的人工口腔黏膜最厚,有明显分层。以胶原海绵-胶原凝胶为基质形成的复层上皮在部分区域长入至胶原海绵的空隙中。结论以DED和胶原凝胶为支架构建的口腔黏膜更接近于天然结构,而后者脆性较大,限制了其临床应用的可能。     

ES细胞源表皮样干细胞与胶原海绵体外构建组织工程化皮肤

 【目的】 探讨以ES细胞源表皮样干细胞构建组织工程皮肤的方法，为构建新的组织工程皮肤奠定基础。【方法】 先把成纤维细胞放置于胶原海绵真皮支架内，体外培养2d，再放置ES细胞源表皮样干细胞，体外培养3d，观察其形态和进行免疫组化检测。【结果】 成纤维细胞与ES细胞源表皮样干细胞均在真皮支架内黏附，免疫组化表明ES细胞源表皮样干细胞仍呈Bl整合素强阳性和CK15、CK19阳性。【结论】 结果提示ES细胞源表皮样干细胞在体外构建的组织工程化皮肤内仍维持未分化状态。     

ES细胞源表皮样干细胞与胶原海绵体外构建组织工程化皮肤

【目的】 探讨以ES细胞源表皮样干细胞构建组织工程皮肤的方法，为构建新的组织工程皮肤奠定基础。【方法】 先把成纤维细胞放置于胶原海绵真皮支架内，体外培养2d，再放置ES细胞源表皮样干细胞，体外培养3d，观察其形态和进行免疫组化检测。【结果】 成纤维细胞与ES细胞源表皮样干细胞均在真皮支架内黏附，免疫组化表明ES细胞源表皮样干细胞仍呈Bl整合素强阳性和CK15、CK19阳性。【结论】 结果提示ES细胞源表皮样干细胞在体外构建的组织工程化皮肤内仍维持未分化状态。     

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.