胸腺内注射异基因脾细胞诱导移植心免疫耐受的实验研究

目的通过大鼠同种异体心脏异位移植,探讨胸腺内注射异基因脾细胞对移植心的影响.方法用供体脾细胞(SC)在心脏移植前21d预处理受体鼠,术后1周每日腹腔注射环孢素A(CsA)10mg/kg.检测移植心存活时间、混合淋巴细胞反应(MLR)及细胞介导的细胞毒试验(CML).结果胸腺注射脾细胞抗原联合短期应用CsA组的移植心平均存活时间较其他组显著延长(P＜0.05),移植心耐受的受体鼠中MLR增殖活跃,产生免疫耐受的受体鼠的T细胞对供体鼠的靶细胞无明显的细胞毒作用.结论胸腺内注射供体脾细胞抗原预处理受体同时联合短期应用CsA,可诱导产生移植心脏的免疫耐受,且诱导移植耐受的抗原量以2.5×107脾细胞为好.     

小鼠腹部同种异体心脏移植模型的建立及改进

目的 :建立并改进小鼠腹部同种异体心脏移植模型。 方法 :在放大 2 6倍视野下用 10 0线将小鼠供体心脏的升主动脉和肺动脉分别与受体腹主动脉和下腔静脉行端侧吻合 ,术后观察移植心存活时间并做病理检查。结果 :手术成功率达 90 % ,平均取心时间和血管吻合时间分别为 (5 .9± 0 .97)min和 (38.5± 5 .5 )min ;Balb/c小鼠 昆明小鼠移植心平均存活时间为 (6 .2± 1.0 3)d ,昆明小鼠 昆明小鼠移植心存活时间超过 2 0d。 结论 :小鼠心脏移植模型与大鼠模型相比 ,技术操作难度大 ,术者需更长时间的训练 ,可作为大鼠心脏移植模型的补充 ,是利用纯系鼠进行移植研究的廉价选择     

小鼠腹部心脏移植模型的建立及技术改进

目的:探讨小鼠腹部心脏移植模型的建立及技术改进。方法:SPF级近交系雄性BALB/c、C57小鼠各50只,体重均在20-30g,C57小鼠作为供体,BALB/c小鼠为受体,利用改进方法行供体升主动脉与受体腹主动脉,供体肺动脉与受体下腔静脉吻合术建立小鼠腹部心脏移植模型,术后观察移植心脏的存活时间和急性排斥反应情况。结果:手术成功率80%,总手术时间(90±10)min;受体手术时间(72±3)min;动脉吻合时间(21.5±2.5)min;静脉吻合时间(20.5±5.5)min。移植术后未用任何免疫抑制剂,小鼠供心存活时间为(7.9±0.7)d,供心停跳后,移植心脏病理排斥反应分级为Ⅱ-Ⅲ级。结论:改进的腹部心脏移植方法简单,手术时间短,手术成功率高。     

不同处理对大鼠移植心脏存活时间的影响

目的 观察供体脾细胞(SPC)与环磷酰胺(CP)联合预处理对大鼠移植心脏存活时间的影响.方法 应用大鼠颈部心脏移植模型,实验分为对照组(未干预组)、CsA组、SPC CP组.CsA组心脏移植后予环孢霉素A(CsA)10 mg/kg,SPC CP组采用供体SPC和CP预处理移植受体,然后行大鼠颈部心脏移植术.观察移植心脏存活情况及组织病理变化.结果 对照组、CsA组、SPC CP组移植心脏存活时间分别为(7.2±2.4)、(15.8±4.3)、(30.4±10.7)天;组织病理检查显示,经SPC PC预处理的移植心脏排斥反应明显减弱.结论 SPC和CP预处理可以诱导受体对移植物的免疫耐受,延长移植心脏的存活期,效果优于CsA.     

免疫细胞在小鼠→大鼠心脏移植排斥反应中的作用

目的 :探讨T细胞、巨噬细胞 (MΦ)和自然杀伤细胞 (NK)细胞在小鼠→大鼠心脏移植反应中的作用 .方法 :动物随机分 4组 :对照组、环孢素A(CsA)组、环磷酰胺 (CyP)组和CsA +CyP组 .排斥后取移植心脏作病理学检查 .用免疫组织化学法检测CD4 ,CD8,CD5 7和CD6 8在移植物中的沉积 .结果 :单用CsA (2 .6± 1.5 )d或CyP(3.2± 1.6 )d均不能显著延长异种移植物的存活时间 ,联用CsA和CyP使移植心脏存活 (4 .7± 1.4 )d (P <0 .0 5 ) .病理检查发现被排斥心脏中大量细胞浸润 ,所有被排斥心脏中均有大量NK细胞和MΦ浸润 ,但未见CD4 +和CD8+T细胞浸润 .结论 :NK和MΦ在小鼠→大鼠心脏移植反应中起重要作用 ,而与T细胞无明显相关 .     

供体凋亡细胞输注对大鼠胰岛移植物功能的影响

目的 研究供体凋亡细胞预输注对大鼠胰岛移植后胰岛移植物功能的影响.方法 应用STZ制备SD大鼠糖尿病模型,以直线加速器照射诱导供体Wistar大鼠脾细胞凋亡.经阴茎背静脉输注供体凋亡脾细胞,7d后于糖尿病SD大鼠双侧肾包囊进行同种异体胰岛移植,通过测定血糖变化、血清胰岛素水平以及胰岛移植物存活时间来观察胰岛移植物的功能状态.结果 预输注供体凋亡脾细胞能显著延长同种异体胰岛移植物存活时间(中位生存时间达31 d),并较长时间地维持受体鼠血清胰岛素处于较高水平.结论供体凋亡细胞预输注能够显著延长同种异体胰岛移植物的存活时间,能够较长时间维持胰岛移植物的正常功能状态.     

胸腺内注射异基因骨髓细胞对大鼠异位心脏移植影响的研究

本文采用同种大鼠颈部异位心脏移植模型研究受体胸腺内注射异基因骨髓细胞对移植心脏存活时间的影响及免疫学功能变化。实验分 4组。对照组 (Control组 )、环磷酰胺组 (CP组 )、单纯胸腺内注射异基因骨髓细胞组 (IT组 )、胸腺内注射异基因骨髓细胞辅以短期环磷酰胺组(IT +CP组 )。结果显示 :移植心脏存活时间最长的是IT +CP组为 68 3± 13 4d ,CP组移植心脏存活时间为 18 3± 2 4d ,两组间移植心脏存活时间差异显著 (P <0 0 1) ,而二者分别与Control组比较差异显著 (P <0 0 1,P <0 0 5) ,Control组、IT组移植心脏存活时间较短 ,分别为 8 5±1 4d、 7 8± 1 2d ,受体接受实验处理因素 1个月后免疫功能测定表明 :各组大鼠脾细胞的淋巴细胞转化试验无明显差异 (P >0 0 5)。IT +CP组大鼠脾细胞对供体脾细胞的单向混合淋巴细胞培养有明显抑制作用 (P <0 0 1) ,对供体靶细胞的细胞介导的细胞毒试验呈明显抑制作用 (P<0 0 1) ,说明受体对供体产生特异性免疫无反应性 ,即免疫耐受。     

腺病毒介导CTLA4-FasL基因转移诱导大鼠心脏移植物长期存活的作用

目的　探讨腺病毒介导细胞毒T淋巴细胞相关抗原 (CTLA4 ) FasL基因转移延长异基因大鼠心脏移植物存活的作用及其相关机制。方法　供体DA大鼠心脏移植给受体LEW大鼠后 ,经门静脉注入 5× 10 9空斑形成单位 /毫升 (pfu/ml)CTLA4 FasL腺病毒 (AdCTLA4 FasL) ;随后 ,通过每天触摸受体大鼠腹壁 ,记录心脏移植物存活时间。受体大鼠尾静脉取血 ,用酶联免疫吸附法(ELISA)测定CTLA4 FasL融合蛋白的体内表达 ;通过过继性转移试验、混合淋巴细胞反应 (MLR)及白细胞介素 (IL) 2逆转实验、细胞毒T细胞 (CTL)活性测定、辅助性T淋巴细胞前体 (HTLp)和细胞毒T淋巴细胞前体 (CTLp)频数测定及辅助性T细胞 (TH) 1/ 2型细胞因子检测 ,探讨耐受机制。结果　经AdCTLA4 FasL处理的受体大鼠 ,异基因心脏移植物平均存活时间达 (71 0± 2 3 7)d(n =6 ) ,而对照的未处理组、绿色荧光蛋白 (EGFP)腺病毒处理组和细胞毒T淋巴细胞相关抗原 4免疫球蛋白 (CTLA4Ig)腺病毒处理组平均存活时间分别为 (5 7± 0 5 )d(n =6 )、(5 2± 0 4 )d(n =6 )和 (4 5 7± 12 4 )d(n =6 ) ,差异具有显著意义 (均P <0 0 5 )。心脏移植物长期存活的受体大鼠对供体抗原的低应答可以被过继转移 ;MLR活性特异性降低 ,且不被外源性IL 2逆转 ;CTL活     

IDO基因转染延长同种异基因大鼠移植心脏的存活

目的:了解逆转录基因载体介导的吲哚胺-2,3-加双氧酶(IDO)基因转染能否延长同种异基因大鼠移植心脏的存活时间及机理。方法:把同种异基因大鼠心脏移植模型(Lewis→BN)分成4组,A组为对照组,同种异基因大鼠心脏移植(Lewis→BN);B组:IDO基因转染后的供体心脏移植给受体大鼠;C组:空载体转染供体心脏,再移植给受体大鼠;D组:同种异基因大鼠心脏移植 CsA组(CsA5mg/kg/d×7天)。观察记录移植心脏的存活时间及术后6天组织病理学检查明确排斥反应的诊断和分级,RT-PCR检测术后6天移植心脏TNF-α的mRNA表达,FCM检测外周血活化的T细胞(CD3 CD25 )、有核细胞CD86 表达等方法探讨其机理。结果:A、B、C、D组移植心脏平均存活时间为7.2±0.45、13.2±2.16、7.1±0.62和15.6±3.21天,其中B、D组术后6天CD3 CD25 、有核细胞CD86 表达、供心组织急性排斥反应的强度和TNF-α的mRNA表达较A、C组显著降低(P<0.05),A、C组具有典型重度急性排斥反应特征而B、D组最轻。结论:逆转录基因载体介导的IDO基因转染能够延长移植心脏存活时间的作用,其机理包括抑制反应性T细胞、抑制有核细胞共刺激信号CD86表达、抑制心肌组织表达TNF-α等。     

建立小鼠异位心脏移植模型

目的:建立小鼠腹腔异位心脏移植模型.方法:选用建康C57近交系小鼠和BALB/c近交系小鼠,参考大鼠心脏移植Ono式模型,并加以改良.同系移植组(n=20)供、受体均采用BALB/c小鼠;同种异品系移植组(n=20)供体为C57近交系小鼠,受体为BALB/c近交系小鼠.结果:成功建立了小鼠腹腔异位心脏移植模型,供心热缺血时间为(0.9±0.05)min,冷缺血时间为(34.8±0.7)min,手术成功率为90%.同系移植组小鼠心脏移植物获得长期存活(＞100 d);同种异品系移植组小鼠心脏移植物存活期为(7.5±0.1)d.结论:提高供心的摘取技术及受体的血管吻合技术是手术成功的关键.     

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.