粒—巨噬细胞集落刺激因子和人类急性髓细胞白血病

GM－CSF与AML的生长急性髓细胞白血病（AML）属克隆性疾病，这意味着白血病起源于单一的病态变异的祖细胞，象正常造血祖细胞一样，白血病前体细胞是受多种造血生长因子刺激的，例如AML相细胞需要白细胞介素3（IL3）、粒－巨噬细胞集落刺激因子（GM－CSF）或粒细胞集落刺激因子（G－CSF）才能继续生存和增殖。现已明确认识到GM－CSF是对人类AML细胞最有活性的造血生长因子之一，人类AML细胞在其表面表达有特殊的GM－CSF受体，平均每个细胞拥有150－200个高亲合力受体。另外，大约有2000个低亲合力受体。高亲合力受体最有可…     

rhGM-CSF联合rhIL-4诱导慢性粒细胞白血病细胞来源的树突状细胞

目的 用rhGM-CSF联合rhIL－4将慢性粒细胞白血病（CML）原代细胞诱导成树突状细胞（DC），探索白血病免疫治疗的新途径。方法 分离初诊CML患者外周血单个核细胞（PBMNC），用rhGM-CSF联合rhIL－4共同培养7d；流式细胞仪（FACS）检测细胞因子诱导前后细胞表面HLA－DR、CD1a、CD80和D86的表达，电镜观察细胞形态。结果 经7d的诱导，HLA－DR、CD1a、CD80和CD86的表达明显上调；电镜观察到典型的DC 形态特征。结论 rhGM-CSF联合rhIL－4可成功将CML原代细胞诱导成CML－DC，可望用于CML的免疫治疗。     

联用重组的IL-3、GM-CSF对阿糖胞苷诱导的HL-60细胞凋亡的影响

为研究在阿糖胞苷（Ara－C）的作用下，基因重组的人白细胞介素3（rh－IL－3）、粒单祖细胞集落刺激因子（rh－GM－CSF）对白血病细胞凋亡的影响，选用了HL－60白血病细胞系，采用DNA电泳、流式细胞仪检测、单克隆抗体C－myc、bcl－2抗原表达的分析以及白血病细胞集落的培养观察方法，观察了0～36h8个不同时相凋亡率与其他指标的变化，表明Ara－C凋亡的作用随药物孵育时间的延长而逐渐增强，凋亡率从0h的1．5％升至36h后的36．4％，而IL－3和GM－CSF能使这种作用明显提高，使凋亡率从7．6％升至19．6％，并能增强Ara－C对白血病细胞的杀灭，引起HL－60细胞C－myc抗原表达下降，而bcl－2抗原表达变化不大，同时发现这两种细胞因子对正常造血细胞影响较小，这为临床上白血病诱导缓解期联用rh－IL－3、rh－GM－CSF和细胞毒药物，提高缓解率，提供了理论依据。     

恶性血液病患者CD54表达及其与临床特征、疗效的关系

目的 探讨细胞间黏附分子－1（CD54）在恶性血液病的表达。方法 用免疫荧光方法检测19例急性髓系白血病，34例急性淋巴细胞白血病，10例慢性粒细胞白血病，15例多发性骨髓瘤，21例非霍奇金淋巴瘤和16例正常人骨髓单个核细胞表达CD54。结果 （1）除多发性骨髓瘤，慢性凿细胞性白血病外，急性髓性白血病细胞，非霍奇金淋巴瘤，急性淋巴细胞白血病患骨髓单个核细胞表面CD54表达低于正常人。（2）CD54在急性早幼粒细胞白血病（M3）表达高于在其它类型急性髓系白血病细胞表达，在T－急性淋巴细胞白血病表达明显低于B－急性淋巴细胞白血病表达。（3）高白细胞数，中枢神经系统白血病，脾肿大表达水平下降（P＜0．05）。（4）CD54的表达在急性淋巴细胞白血病完全缓解组明显高于未缓解组，P＜0．01。随着病情缓解CD54表达可升至正常范围。结论 不同的恶性血液病，黏附分子CD54表达不同，并与细胞类型，临床特征及疗效有关。     

细胞因子联合亚硒酸钠对白血病细胞凋亡的影响

目的 探讨rhGM—CSF／IL—3联合Na2SeO3对白血病细胞诱导凋亡的作用。方法 采用白血病骨髓细胞，应用MTT法检测rhGM—CSF／IL—3联合Na2SeO3对白血病细胞生长和增殖的作用；用形态学、DNA琼脂糖电泳、流式细胞术研究细胞因子与化疗药物对白血病细胞诱导凋亡的作用。结果 细胞因子、药物对白血病细胞的生长、增殖有抑制作用；而rhGM—CSF／IL—3联合Na2SeO3对白血病细胞增殖有明显的抑制作用和诱导细胞凋亡的作用。结论 细胞因子联合化疗药物对白血病细胞具有抑制细胞增殖和诱导细胞凋亡的协同作用。     

Hsp7O-H22肿瘤细胞肽复合物与树突状细胞成熟的关系

探讨热休克蛋白70（Hsp70)-H22肽复合物与小鼠骨髓来源的树突状细胞（dendritic cell,DC)成熟之间的关系。采用GM－CSF、IL－4刺激培养小鼠骨髓细胞，增殖产生大量DCs；从H22肝癌细胞中获取肿瘤细胞肽，体外与Hsp70进行结合，结合产物修饰DC，通过细胞因子检测试剂盒和流式细胞仪对修饰的DCs上清液和DCs膜表面分子进行检测。发现Hsp70-H22肽复合物修饰的DCs大量分泌IL－12、TNF－α、IL－1β等细胞因子，并且高表达主要组织相容性Ⅱ类抗原（MHCⅡ类）、CD80、CD40等分子，而单独的Hsp70或H22肽则不具有此作用。结果提示：Hsp70-H22肽复合物可诱导DC成熟，这种成熟的DC分泌的因子和表达的分子对于抗肿瘤免疫是非常有意义的。     

B7转染白血病细胞K562的作用研究

目的：探讨共刺激信号分子B7转化人白血病细胞株K562后,转化细胞的生物学性状变化及介导的免疫作用。方法：构建重组真核表达质粒pcDNA3．1B7,转化人白血病细胞株K562,获得单个细胞克隆,观察K562－B7的生长周期,绘制生长曲线,检测K562－B7诱导T细胞分泌IL－2的情况。结果：pcDNA3.1B7可在K562中稳定表达,K562－B7的生长增殖速度比野生型K562慢。在体外,K562－B7可诱导PMNC分泌IL－2,24h上清液中IL－2含量比B7阴性K562高1倍左右。结论：B7基因转入白血病细胞株K562后,细胞本身增殖能力降低,且K562－B7可活化CD4^ T细胞分泌细胞因子IL－2,提高宿主抗肿瘤免疫能力。     

苦参联合胎肝低分子抑瘤物抗白血病有其机制

目的：探讨苦参（SF）、胎肝低分子抑瘤物（LMW－NTS）联合用药对正常人骨髓粒－巨噬系造血祖细胞（CFU－GM）和急性髓性白血病细胞的影响及其作用机制。方法：采用CFU－GM集落培养、细胞液体培养、Wrigh-giemsa染色、^3H-TdR掺入实验、DNA片段凝胶电泳和RT－PCR等方法，观察SF和LMW－NTS联用对白血病的作用。结果：SF和LMW－NTS联用，明显提高抑制白血病细胞增殖的能力，促进白血病细胞的凋亡，诱导白血病细胞中原癌基因c-Myc的下调，抑制正常造血祖细胞CFU－GM的作用明显低于抑制白血病细胞的作用。结论：联合用药抗白血病的效果，较单用苦参或胎肝低分子抑瘤物明显提高。     

人外周血中树突状细胞的诱导及鉴定

目的：从健康人外周血诱导高纯度树突状细胞（dendritic cell,DC)方法：用贴壁法从健康人外周血获取单核细胞，对传统的诱导方法加以改进，经GM－CSF（100ng/ml)和IL－4（500U/ml)持续诱导7天，在此期间不再补充新的细胞因子，新鲜培养基和促成熟因子，以获取高纯度DC，结果：经上述方法处理后，从健康人外周血中诱导出了大量高纯度DC，其能高表达HLA－I，Ⅱ类分子，共刺激分子和粘附分子，显示出成熟DC的特征，这些DC能强烈诱导同种体淋巴细胞的增殖，其内吞能力在第3天达最高，之后明显下降，结论：本研究所建立的从外周血获取大量成熟DC的方法经济，简便，为DC的深入研究和临床应用奠定了基础。     

多潜能造血祖细胞向红系分化中GM-CSF受体和红细胞生成素受体的表达

目的：了解多潜能造血祖细胞向红系分化过程中造血因子受体的改变。方法；应用受体结合实验和Northern杂交技术分别测定了依赖Epo和GM－CSF增殖的造血相细胞株UT－7在Epo存在下向红系分化过程中Epo受体（EpoR）和GM－CSF受体（GM－CSF－R）及其mRNA的表达水平。结果；UT－7分化至红系阶段Epo－R表达明显上调，而高亲合力和中亲和力GM－CSF－R明显下调。结论：UT－7分化至红系阶段丧失对GM－CSF反应性是由于Epo促使GM－CSF－R-α和β亚单位表达下调所致。提示增加Epo－R和减少GM－CSF－R表达是Epo诱导髓系相细胞向红系分化的重要原因。     

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.