CTGF和TIMP1双基因体外联合转染恒河猴腰椎间盘细胞对II型胶原和蛋白多糖的影响

目的 建立恒河猴腰椎间盘细胞体外培养模型,研究腺相关病毒（adeno-associated virus,AAV）介导的结缔组织生长因子（connective tissue growth factor,CTGF）和基质金属蛋白酶组织抑制因子1(tissue inhibitor of metalloproteinases 1,TIMP1) 双基因体外联合转染恒河猴椎间盘细胞较单基因对II型胶原和蛋白多糖合成的影响的变化,以探讨体外延缓椎间盘细胞退变的方法。方法 应用酶消化法培养恒河猴腰椎间盘髓核细胞,以感染复数（MOI） 为106的rAAV2-CTGF-IRES-TIMP1及rAAV2-CTGF、rAAV2-TIMP1分别感染髓核细胞,应用Western blot鉴定和RT-PCR检测II型胶原及蛋白多糖mRNA的表达,35S整合法性行蛋白多糖合成率的测定,SP-ABC免疫组化法检测Ⅱ型胶原含量。结果 rAAV2-CTGF-IRES-TIMP1双基因及rAAV-CTGF、rAAV-TIMP1单基因能够转染恒河猴椎间盘髓核细胞并在其内表达细胞因子。与对照组相比,CTGF可以促进II型胶原及蛋白多糖的合成,TIMP1可以促进蛋白多糖的合成,对II型胶原的合成未见到明显作用;双基因联合感染可以显著促进髓核细胞蛋白多糖和II型胶原的合成。结论 CTGF和TIMP1 单基因转染均可以促进蛋白多糖的合成,CTGF 对 II型胶原的合成亦有促进作用;双基因联合感染可以明显促进蛋白多糖和II型胶原的合成,其效果优于单基因,为多基因治疗椎间盘退变奠定了良好的基础。     

干细胞移植延缓椎间盘退变及磁共振示踪研究

目的:评价超顺磁性氧化铁纳米粒子标记的骨髓间充质干细胞(BMMSCs)在椎间盘退变早期植入椎间盘后细胞外基质的表达情况,并用磁共振进行干细胞示踪。方法:采取体外细胞培养技术,体外纯化扩增兔BMMSCs,并用氧化铁纳米粒子进行标记,于退变手术当时植入手术节段椎间盘内。分别于2、4、6、8周用间苯三酚分光光度法测定蛋白多糖含量的变化,免疫组化法测定Ⅱ型胶原的含量变化,用磁共振扫描对标记干细胞在椎间盘内分布进行示踪。所得数据进行统计学处理。结果:8周内实验组髓核蛋白多糖和Ⅱ型胶原的含量明显较模型组高,差异有统计学意义,但与正常组比较差异无统计学意义。结论:兔BMMSCs移植可以延缓甚至阻止髓核退变。     

兔ADSCs与NPCs共培养后再移植对椎间盘退变影响

目的探讨兔脂肪间充质干细胞(ADSCs)与髓核细胞(NPCs)共同培养后再植入兔腰椎间盘对Ⅱ型胶原和蛋白多糖的影响。方法体外分别提取分离培养兔ADSCs与NPCs。诱导分化兔ADSCs向成骨、成脂方向分化,鉴定兔ADSCs。将兔ADSCs与NPCs共同培养,诱导兔ADSCs向NPCs方向分化。新西兰大白兔30只,分为实验组和对照组,分别将兔ADSCs与NPCs共同培养后的细胞悬液、PBS缓冲液注入针刺抽吸后的椎间盘。4、8周后,采用间苯三酚分光光度法检测两组兔椎间盘髓核蛋白多糖表达的变化,采用反转录-聚合酶链反应对Ⅱ型胶原和蛋白多糖的基因表达进行半定量分析。结果 ADSCs可诱导向成骨、成脂方向分化,与NPCs共同培养后由梭形、多角形变为成纤维细胞样。对照组髓核Ⅱ型胶原和蛋白多糖表达低于实验组,差异有显著性(t=6.50～13.04,P<0.05)。结论兔脂肪组织可成功提取分离ADSCs,ADSCs与NPCs共同培养后移植可延缓兔椎间盘退变。     

人骨形态发生蛋白2促兔椎间盘细胞aggrecan和Ⅱ型胶原的合成作用

目的:研究人骨形态发生蛋白2(BMP-2)对体外培养兔腰椎间盘髓核细胞Ⅱ型胶原和软骨聚集蛋白多糖(aggrecan)的影响。方法:兔髓核细胞体外分离培养,分别利用Antonopulos和Miamine法检测对照组和不同剂量hBMP-2(10,100和1000ng/ml)组胶原和蛋白多糖表达水平。RT-PCR检测细胞Ⅱ型胶原和aggrecan mRNA的表达水平。结果:加入BMP-2后可见随剂量增加胶原和蛋白多糖表达量逐渐增加,并存在剂量依赖关系(P<0.01)。在6dRT-PCR结果显示BMP-2组aggrecan和Ⅱ型胶原mRNA的表达高于对照组,并且随剂量增高aggrecan和Ⅱ型胶原mRNA的表达量逐渐增加。结论:BMP-2可促进体外培养兔腰椎间盘细胞合成代谢,随剂量增加胶原和蛋白多糖表达量逐渐增加,并存在剂量依赖关系,提示hBMP-2可能对退变椎间盘具有修复功能。     

兔椎间盘髓核细胞体外培养自然退变的观察

目的 观察体外培养的兔髓核细胞不同代数之间细胞形态、NOS活性、NO含量、细胞总蛋白含量的变化;制作兔髓核细胞体外培养的退变模型.方法 酶消化及自然传代法分离培养体外兔椎间盘髓核细胞,HE染色光镜观察髓核细胞形态;利用分光光度法检测P1、P3代细胞培养液中NOS活性和NO含量,考马斯亮蓝法检测细胞总蛋白含量.结果 ①成功建立了兔椎间盘髓核细胞的体外培养模型;②随着传代次数的增加,细胞内一氧化氮合酶(nitric oxide synthase,NOS)活性和NO分泌增加,但细胞总蛋白含量却降低,差别具有统计学意义.结论 通过体外培养兔髓核细胞并进行自然传代,随着传代次数的增加,髓核细胞呈现自然退变现象,为髓核细胞退变机理的研究提供了细胞学基础.     

骨髓间充质干细胞的体内示踪及其修复椎间盘退变的实验研究

目的: 探讨骨髓间充质干细胞(marrow mesenchymal stromal cells,MSCs)的标记与体内示踪方法,及其治疗椎间盘退变的可行性.方法:取兔MSCs行体外培养,并在体外纯化扩增,用超顺磁性氧化铁(superparamagnetic iron oxide,SPIO)磁粒子标记后分别于1、3、5、7 d用MTT法检测细胞活性.将标记后的细胞植入退变的椎间盘内.分别于2、4、6、8周用间苯三酚分光光度法测定蛋白多糖含量的变化,免疫组化法测定Ⅱ型胶原含量的变化,用MR扫描对标记干细胞在椎间盘内分布进行示踪.所得数据进行统计学处理.结果:MTT法结果显示,SPIO对MSCs的生物活性无影响,MSCs能被SPIO有效标记.运用MR扫描可观察到其在体内的分布,并发现干细胞向周边发生了迁徙.8周内实验组髓核蛋白多糖和Ⅱ型胶原的含量高于模型组,差异有统计学意义.结论:SPIO可有效地标记MSCs并行体内活体示踪,且不影响细胞活性,是理想的示踪剂.SPIO标记后的MSCs移植能增加髓核中细胞外基质的含量,从而延缓椎间盘退变.     

IGF-1,OP-1在椎间盘退变中的作用分析

目的 观察IGF-1(胰岛素样生长因子-1)、OP-1(成骨蛋白-1)在大鼠尾椎椎间盘退变中的作用.方法 利用Lindblom折尾加压法建立鼠尾椎椎间盘退变模型,将外源性IGF-1,OP-1在不同时间、不同部位分两次向同一退变尾椎椎间盘髓核内注射.4周后取材,光镜下观察椎间盘形态、厚度,软骨陷窝中细胞密度,分析AB-PAS染色标本髓核中蛋白多糖的MOD值.免疫组织化学SP法检测鼠尾椎椎间盘软骨板内细胞PCNA表达情况,计算阳性表达率.结果 ①HE染色:与对照组比较,OP-1组内层纤维环胶原增粗,排列整齐,陷窝中细胞密度高.两实验组髓核完整性较好,无明显缺失.②AB-PAS染色:与对照组相比,IGF-1,OP-1组椎间盘厚度均增加,髓核的MOD值增加,两实验组比较无明显差异.③免疫组织化学染色:OP-1组软骨细胞PCNA阳性表达率高于IGF-1与对照组.结论 ①鼠尾椎椎间盘内注射生长因子可以刺激细胞增殖,增加胶原和蛋白多糖释放,从而促进退变椎间盘的修复;②在PGs合成方面,两生长因子效果无明显差异,OP-1促进细胞增殖、胶原合成、逆转退变过程的效果优于IGF-1.     

胶原及蛋白多糖含量测定在诊断颈椎间盘突出症中的应用

研究胶原,蛋白多糖含量变化在诊断颈椎间盘突症中作用,为探讨该病发生机理提供有意义依据。方法：共收集正常颈椎间３６例,颈椎间盘突出症突出髓核３９例,提取并测定其胶原,蛋白多糖含量。结论髓核中胶原,蛋白多糖含量变化与颈椎间盘突症的发生相关,可直接反映间盘退变病理过程。     

胶原及蛋白多糖含量测定在诊断颈椎间盘突出症中的应用

目的：研究胶原、蛋白多糖含量变化在诊断颈椎间盘突出症中作用,为探讨该病发生机理提供有意义依据。方法：共收集正常颈椎间盘３６例,颈椎间盘突出症突出髓核３９例,提取并测定其胶原、蛋白多糖含量。结果：突出髓核中胶原含量高于正常组,而蛋白多糖含量低于正常组（Ｐ＜０．０５）。结论：髓核中胶原、蛋白多糖含量变化与颈椎间盘突出症的发生相关,可直接反映间盘退变病理过程。     

BMSCs-Pluronic F-127水凝胶复合体移植治疗椎间盘退变的实验研究

目的:探讨兔BMSCs-Pluronic F-127凝胶复合体移植治疗椎间盘髓核缺损退变的效果,为临床应用提供实验依据。方法:6只1月龄健康新西兰白兔,雌雄不限,各取骨髓2 ml,分离培养BMSCs。取第3代骨髓间充质干细胞(BMSCs),与Pluronic F-127水凝胶混匀,制备成BMSCs-Pluronic F-127水凝胶复合体。将18只新西兰大白免建立椎间盘髓核缺损退变动物模型,并随机分为3组(n=6)。正常对照组仅分离暴露椎间盘,不作任何处理;移植治疗组将25μl BMSCs-Pluronic F-127水凝胶复合体注入缺损椎间盘中心;缺损退变组仅注射入0.01 mol.L-1PBS液25μl。8周后处死动物,取出脊柱,应用MRI测量各椎间盘的信号强度和邻近椎旁肌肉的信号强度,计算信噪比;取出相应椎间盘行阿尔辛蓝过碘雪夫(AB-PAS)染色及Ⅱ型胶原免疫组织化学染色,切片行灰度值测定和分光光度计测定蛋白多糖含量。结果:3组椎间盘信噪比差异有统计学意义(P<0.05)。AB-PAS染色显示,正常对照组及移植治疗组椎间盘染色明显,椎间盘结构清晰;缺损退变组椎间盘结构紊乱,髓核组织和外周纤维化分界不清...     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.