rAAV2载体介导GFP基因转染树突状细胞

目的:在诱导人骨髓CD34 细胞分化成树突状细胞(dendritic cells,DCs)的基础上,探讨2型重组腺相关病毒(Type 2 recombinant adeno-associated virus,rAAV2)载体介导绿色荧光蛋白(green fluorescent protein,GFP)基因转染DCs的条件.方法:采用免疫磁珠法分离纯化人骨髓来源的CD34 细胞.在含有IL-4和GM-CSF的培养体系中体外诱导CD34 细胞生成DCs,于第5天加入TNF-α诱导DCs成熟,在不同时间用rAAV2载体介导GFP基因转染未成熟和成熟的DCs.通过电子显微镜和流式细胞仪鉴定树突状细胞,荧光显微镜及流式细胞仪检测GFP的表达.结果:人骨髓CD34 细胞经诱导分化后,在光镜及透射电镜下均可观察到DCs的形态特征,流式细胞仪检测到DCs表型;荧光显微镜及流式细胞仪检测细胞培养第3天、第5天和加入TNF-α后的rAAV2-GFP转染率分别为0.45%,13.54%和0.25%.结论:本实验中所采用的培养体系可成功将人骨髓CD34 细胞诱导分化成DCs,rAAV2/GFP转染DCs效率随细胞诱导分化时间的延长而增高,且转染未成熟DCs的效率高于转染成熟DCs.     

脐血CD34+造血干细胞来源的树突状细胞体外培养体系的优化

目的：优化脐血CD34^＋造血干细胞（HPC）来源的树突状细胞（DCs）诱导培养方法，为体外研究CD34^＋HPC诱导产生功能性树突状细胞（DCs）的影响因素奠定基础。方法：淋巴细胞分离液（Ficoll）分离获得脐血单个核细胞，免疫磁珠阳性分选CD34^＋HPC，并用流式细胞术鉴定CD34^＋HPC纯度：比较GT（GM-CSF＋TNF—α）方案和GTI（GM—CSF＋TNF—α＋IL-4）方案及GTI方案中TNF—α．和IL-4不同时段加入对诱导培养产生的DCs成熟的影响：通过激光共聚焦显微镜观察细胞形态，流式细胞仪分析细胞表型及3H—TdR检测DCs激发异体T细胞增殖能力。结果：免疫磁珠阳性分选CD34＋HPC纯度可达90％以上：将CD34＋HPC按GT方案和GTI方案进行培养，均可诱导产生DCs．但经GT方案诱导的DCsCD14表达较高，CD80、CD86、CD83、CD1a表达不如经GTI方案诱导的高；而GTI方案中，以TNF—α．0h加入、IL-448h加入诱导培养的DCs各表型表达相对较佳．并具有激发异体T细胞增殖能力。结论：CD34^＋HPC经过合适的培养体系能够诱导分化为功能性DCs，以GM—CSF与TNF-α 0h加入、IL-448h加入的GM—CSF＋TNF—α＋IL-4方案更为可取。     

2型腺相关病毒转导人骨髓CD34+细胞与间充质干细胞

目的:探讨2型重组腺相关病毒(AAV2)载体能否有效转导人骨髓CD34 细胞与间充质干细胞。方法:构建、包装、纯化携带绿色荧光蛋白基因的2型重组腺相关病毒(rAAV22/GFP),转染骨髓CD34 造血干/祖细胞和间充质干细胞,转导后48 h在荧光显微镜下观察GFP的表达,并比较羟基脲(HU)处理前后rAAV2/GFP对CD34 细胞的转染效率。结果:rAAV2/GFP对CD34 细胞的转染效率为5.3%±1.7%。经羟基脲预处理后达13.2%±2.8%,rAAV2/GFP对间充质干细胞的转染效率为23%±3.6%。结论:rAAV2对间充质干细胞的转染效率高于骨髓CD34 细胞,羟基脲预处理可以明显提高rAAV2对CD34 细胞的转染效率。     

以GFP为标记的肝癌细胞RNA转染树突状细胞的体外效应

目的:探讨GFP作为标记观察肝癌细胞RNA转染DCs效果的可行性及肿瘤细胞RNA转染DCs制备疫苗的可行性. 方法:绿色荧光蛋白质粒载体 pGFP-C3稳定转染肝癌细胞HepG2,Trizol法提取筛选后细胞HepG2-GFP总RNA;分离肝癌患者外周血单核细胞体外诱导DCs细胞,总RNA转染DCs,荧光显微镜下观察转染效果,流式细胞仪检测转染前后DCs表型变化;ELISA法检测转染前后上清中IL-12变化情况;MTT法检测效应细胞对靶细胞的杀伤率. 结果:pGFP-C3稳定转染肝癌细胞HepG2后可得到稳定表达GFP的细胞HepG2-GFP,荧光显微镜下呈绿色荧光;总RNA转染的DCs荧光显微镜下呈绿色荧光,CD80(13.2%上升至86.7%),HLA-DR(38.9%上升至97.9%),CD83(0.9%上升至97.1%),CD86(31.2%上升至92.5%)表达明显升高,上清IL-12分泌量ng/L显著增高(61.3±8.1→287.4±29.3,P＜0.05);诱导的CTL能够对肝癌细胞株HepG2起特异性杀伤作用. 结论:GFP可以作为肿瘤细胞RNA转染树突状细胞的观察标记,肿瘤细胞RNA转染DCs可作为一种有效的肿瘤疫苗.     

结肠癌细胞总RNA电穿孔法体外转染成熟树突状细胞

目的：探讨结肠癌细胞总RNA电穿孔法转染成熟树突状细胞（mDCs）的转染效率及对树突状细胞(DCs）特征和功能的影响,为DCs核酸肿瘤疫苗的制备及其在临床应用奠定基础。方法： 用重组人粒细胞-巨噬细胞集落刺激因子（rhGM-CSF）、重组人白细胞介素4（rhIL-4）将人外周血单核细胞(PBMC)诱导成未成熟树突状细胞（imDCs）,肿瘤细胞坏死因子-α（TNF-α）作用24 h刺激其成熟。实验设为imDCs组和mDCs组。Trizol法提取特异表达癌胚抗原(CEA)的结肠癌细胞SW480总RNA,电穿孔法将总RNA转染mDCs,设为RNA转染DCs组。流式细胞术检测各组细胞表面分子标志变化和转染DCs组的CEA蛋白表达情况。ELISA法检测各组细胞IL-12分泌水平。结果：rhGM-CSF、rhIL-4、TNF-α能将PBMC诱导成具有典型毛刺样突起形态学特征的DCs。imDCs组DCs表面CD1a表达呈阳性,CD80弱阳性,CD83阴性。mDCs组DCs表面CD1a、CD83、CD80表达均呈阳性。RNA转染DCs组DCs表面CD1a、CD83、CD80表达均呈阳性。总RNA转染mDCs后4 h检测到CEA蛋白表达。mDCs组、RNA转染DCs组IL-12分泌量与imDCs组比较均显著升高（P＜0.01), 而mDCs组与RNA转染DCs组比较差异无显著性（P>0.05)。结论：结肠癌细胞总RNA可通过电穿孔法转染mDCs并表达CEA蛋白,电穿孔不改变mDCs的表面分子特征及功能。     

携带CML28基因的2型重组腺相关病毒的构建及体外转染树突状细胞

 目的 构建携带肿瘤抗原CML28基因的2型重组腺相关病毒（recombinant adeno-associated virus,rAAV2/CML28）,检测其体外转染人树突状细胞（dendritic cells,DCs）后对DCs的影响和目的基因CML28的表达。方法 将CML28基因克隆到2型重组腺相关病毒载体系统（AAV Helper-Free System）中的真核表达质粒pAAV-IRES-hrGFP,将酶切和DNA测序鉴定后的重组表达质粒pAAV-CML28-hrGFP与AAV Helper-Free System 中的病毒包装辅助质粒pAAV-RC和pHelper以磷酸钙法共转染AAV-293细胞,制备携带CML28基因的重组腺相关病毒rAAV2/CML28。rAAV2/CML28转染体外培养的DCs,RT-PCR法检测CML28的表达,流式细胞术检测DCs的表面分子和rAAV2/CML28转染DCs的效率。结果 流式细胞术证实构建并包装了rAAV2/CML28,该病毒对DCs的转染效率接近30%,病毒转染DCs检测到CML28的表达以及高水平的HLA-DR、CD80、CD83和CD86表达。结论 成功构建了携带CML28基因的重组腺相关病毒rAAV2/CML28,该病毒介导目的基因在DCs内表达,DCs的成熟没有因病毒转染受到不良影响,为应用CML28转基因DCs诱导CML28特异性抗肿瘤免疫研究奠定了基础。     

核因子-κB圈套寡核苷酸转染对小鼠成熟树突状细胞生物学特性的影响

目的 探讨核因子KB圈套寡核苷酸(NF-κB decoy ODN)转染对小鼠成熟树突状细胞(DCs)生物学特性的影响.方法 体外诱导Balb/c小鼠骨髓细胞生成未成熟DCs(imDCs),经抗原OVA以及LPS孵育后成为OVA冲击的骨髓来源成熟nCs(mDCs),流式细胞仪检测DCs表面分子CDllc以及MHC-Ⅱ的表达予以鉴定;将NF-KB decoy ODN体外转染小鼠骨髓来源成熟DCs,同时设立阴性对照组(转染NF-KB"变异"ODN)以及未转染组,EMSA检测转染后NF-KB的活性变化;流式细胞仪检测各组DCs表面共刺激分子(CIMO、CDSO、CD86)的表达;混合淋巴细胞反应观察各组DCs对OVA致敏的T淋巴细胞增殖的影响.结果 成功培养出骨髓来源成熟DCs;NF-κB decoy ODN转染DCs的NF-KB活性明显降低(P<0.05),DCs表面CD40、CDS0共刺激分子的表达与阴性对照组、未转染组比较无明显改变(P0.05),而CD86的表达与其他各组比较明显降低(P<0.05);在混合淋巴细胞反应中,NF-KB decoy ODN转染DCs对T细胞的增殖有抑制作用(P<0.05),而阴性对照组与未转染组的DCs具有强烈的激发T细胞增殖的能力(P<0.05).结论 NF-KB decoy ODN转染DCs可能通过CD86的表达降低显著抑制抗原特异性T细胞活化,该改良的DCs有可能用于哮喘的免疫治疗.     

不同成熟状态小鼠树突状细胞的体外诱导

目的：体外诱导小鼠骨髓来源的不同成熟状态树突状细胞(dendritic cells，DCs)。方法：rmGM—CSF体外培养小鼠骨髓细胞，5～6d后，利用磁性细胞分离器(MACS)分离CD11C^ 细胞，部分细胞加入rmTNFα继续培养1～2d，通过流式细胞仪检测分别检测细胞表面标志，同种混合淋巴细胞反应检测细胞的体外刺激能力。结果：小鼠骨髓细胞经rmGM-CSF培养5～6d，再经过MACS分离可获得大量未成熟DCs，细胞表面出现少量短而粗的突起，低水平表达MHCI／分子和共刺激分子CD80、CD86及CI40，刺激同种CD4^ T细胞的混合淋巴细胞反应能力较弱：加入rmTNFα继续培养可获得成熟DCs，细胞表面出现大量细长突起，细胞表面高水平表达MHC Ⅱ分子和共刺激分子CD80、CD86及CI40，刺激同种CI4^ T细胞的混合淋巴细胞反应能力较强。结论：通过rmGM-CSF或rmGM-CSF rmTNFα体外培养体系可以获得大量未成熟DCs或成熟DCs，为进一步研究DCs的生物学功能提供实验基础。     

重组绿色荧光蛋白腺相关病毒载体转染293细胞和CD34^＋细胞

目的研究重组绿色荧光蛋白腺相关病毒载体分别转染293细胞(人胚肾细胞)和人CD34^ 细胞后绿色荧光蛋白的表达情况。方法用CS-3000血细胞分离机分离骨髓单个核细胞，免疫磁性分离仪纯化CD34^ 细胞，重组绿色荧光蛋白腺相关病毒载体分别转染两种细胞，并通过荧光显微镜、流式细胞仪对绿色荧光蛋白的表达进行分析。结果荧光显微镜下两种细胞均可见绿色荧光蛋白表达，流式细胞仪于一定时间内检测293细胞的基因转导效率最高为32．8％，CD34^ 细胞的基因转导效率最高为25％．在所观察的时间内，转染率呈先升高后降低趋势。结论重组绿色荧光蛋白腺相关病毒载体能转染293和CD34^ 细胞，绿色荧光蛋白基因可作为良好的报告基因，为将来的干细胞基因治疗打下良好基础。     

慢性粒细胞白血病患者骨髓中不同细胞诱生树突状细胞的体外研究

目的:体外诱导慢性粒细胞白血病(CML)患者骨髓单个核细胞(BMMNCs)、CD34+细胞、单核细胞为树突状细胞(DCs),并对其形态、表型及其刺激T细胞增殖作用进行比较。方法:利用GM-CSF、IL-4、TNF-α体外定向诱导生成树突状细胞,利用流式细胞仪对所诱生的细胞进行细胞形态及表型检测,用D-FISH方法检测所诱生DCs的白血病源性。并应用MTT法检测所诱生的DCs刺激T细胞增殖的能力。结果:CML患者BMMNCs、CD34+细胞、单核细胞体外均可诱导生成bcr/abl融合基因阳性的DCs,前者DCs产量明显高于后二者,但均具有刺激自体及异体T细胞增殖的能力,且三者无显著性差异。结论:来源于CML患者骨髓的BMMNCs、CD34+细胞、单核细胞均可诱生成CMLDCs,对T细胞均具有刺激增殖能力,但BMMNCs所诱生的DC主要来源于未成熟的中性粒细胞。     

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.