胶原-纤维蛋白混合凝胶对关节软骨细胞合成Ⅱ型胶原的影响

目的：以胶原蛋白和人血纤维蛋白混合物为载体在体外进行关节软骨细胞三维立体培养,构建人工软骨组织,研究载体对软骨细胞在其中的表达及合成Ⅱ型胶原的影响。方法：取2周龄的新生兔关节软骨,经消化,将获得的软骨细胞与牛Ⅰ型胶原、人血冻干纤维蛋白原、凝血酶按一定比例混合,制成软骨培养物并在体外培养。培养第3周时,取材进行Masson染色、Ⅱ型胶原寡核苷酸探针原位杂交和Ⅱ型胶原的免疫组化观察。 结果：体外培养3周,培养物内细胞大部分存活, Masson染色形成软骨陷窝,同源性细胞簇出现,细胞周围有蓝色物质环绕存在,原位杂交证实其软骨细胞表达Ⅱ型胶原mRNA,免疫组化证实软骨细胞分泌Ⅱ型胶原。 结论：用胶原蛋白和人血纤维蛋白为载体支架体外培养软骨细胞,可促进关节软骨细胞合成分泌Ⅱ型胶原,Ⅱ型胶原是软骨组织最主要的细胞外基质成分。     

兔关节软骨细胞在纤维蛋白胶中体外培养

目的：研究关节软骨细胞在纤维蛋白胶中三维培养时的表现。方法：（１）通过硫酸铵沉淀法从兔血液中提取纤维蛋白原并制备纤维蛋白胶;（２）在纤维蛋白胶凝成的纤维蛋白中立体培养关节软骨细胞,观察其表现并测定生长曲线、倍增时间;（３）通过透射电镜、ＡＢ－ＰＡＳ染色、Ⅱ型胶原免疫组化检查等,了解细胞生长及软骨基质的分泌情况。结果：（１）关节软骨细胞在纤维蛋白中大部分保持卵圆形、小部分如贴壁细胞状;（２）细胞倍增     

胶原凝胶复合CPPf/PLLA支架与软骨细胞的相容性研究

目的研究软骨细胞与胶原凝胶复合CPPf／PLLA支架的细胞相容性,为软骨组织工程提供适宜的种子细胞载体。方法将胶原凝胶包埋的软骨细胞整合入CPPf／PLLA三维支架并进行体外培养,采用倒置相差显微镜和扫描电镜观察细胞在支架上粘附、生长和增殖等情况,从组织学和Ⅱ型胶原免疫组化对复合组织进行评价。结果软骨细胞能良好地在支架上粘附、生长和增殖,新形成的组织为透明软骨样组织、细胞外基质有Ⅱ型胶原分布。结论胶原凝胶复合CPPf／PLLA支架具有良好的细胞相容性,可作为软骨细胞栽体。     

BMP-2诱导肌源性干细胞转化为软骨样细胞的体外实验研究

目的 体外定向诱导大鼠肌源性干细胞(MDSCs)向软骨细胞转化,并对诱导细胞进行鉴定.方法 用差速贴壁的方法对SD大鼠MDSCs进行分离和培养.用骨形态发生蛋白2(BMP2)将MDSCs进行诱导分化,9 d后取出标本,行甲苯胺蓝染色检测软骨基质的分泌,免疫组织化学检测软骨特异性Ⅱ型胶原表达.RT-PCR检测Ⅱ型胶原和聚集蛋白聚糖(aggrecan)的mRNA表达.结果 5 d后镜下见细胞形态由梭形向多边多角形转化.9 d后诱导组甲苯胺蓝染色阳性,Ⅱ型胶原免疫组化检测阳性,RT-PCR检测Ⅱ型胶原和aggrecan mRNA呈阳性表达.结论 BMP-2可诱导MDSC向软骨细胞转化.     

丝素蛋白无纺网支架体外构建组织工程化软骨

目的:探讨丝素蛋白无纺网作为耳廓软骨细胞外支架构建组织工程化软骨的可行性。方法:取成年新西兰兔耳廓软骨,酶消化法获取软骨细胞,体外培养扩增后取原代细胞接种到制备好的丝素蛋白无纺网支架上,体外复合培养。每天倒置显微镜下观察细胞黏附、生长、增殖情况,于复合培养第3、7、10天时取材进行扫描电镜观察;于复合培养第1、2、4、6周取材进行组织学评价,同时取材通过RT-PCR方法检测复合物上软骨细胞Ⅱ型胶原mRNA的表达情况。结果:48 h后软骨细胞已黏附于丝素蛋白纤维上,72 h后细胞开始分泌少量细胞外基质;电镜下观察显示软骨细胞及分泌的薄层细胞外基质主要分布于支架材料表面。组织学观察显示2周时支架浅层已有一定厚度软骨组织,可见少量类软骨陷窝,4周和6周时支架浅层软骨组织增厚,软骨陷窝增多,但支架内部软骨细胞数目少,细胞呈星形或梭形,细胞分泌的基质也很少。RT-PCR检测显示在各检测时间点均有Ⅱ型胶原mRNA的表达。结论:兔耳廓软骨细胞在丝素蛋白无纺网支架上已初步形成软骨样组织,但培养条件应进一步优化。     

低强度半导体激光对软骨细胞生物刺激效应的研究

目的了解低强度半导体激光对软骨细胞胶原合成和蛋白多糖分泌影响。方法选取3周龄新西兰白兔分离培养软骨细胞,在含2．5％新生牛血清的培养液中培养,采用波长为650nm,功率5mw的半导体激光（semiconductor laser irradiation,SLI）照射第四代软骨细胞,每次照射时间为5min,每天照射1次共6d,收集激光照射后第2、4、6、8、10和12天的细胞培养液,用氯胺T法检测羟脯氨酸（Hrp）的含量,了解细胞合成胶原的能力;并进行Safranin O染色,以确定软骨细胞的表型及了解蛋白酶的分泌情况。结果在营养缺乏培养状态中,半导体激光对软骨细胞具有明显的光生物调节作用：①两因素重复测定资料的方差分析结果显示,半导体激光照射后软骨细胞合成胶原的能力在逐步增加,而对照组在培养至第2周开始Hrp含量明显下降;②照射组软骨细胞SafraninO染色以红染为主．与对照组比较蛋白多糖分泌明显增多。结论半导体激光照射可通过促进胶原和蛋白多糖等细胞外基质的分泌,从而促进兔软骨细胞在营养缺乏的媒介中的增殖。     

利用软骨细胞外基质来源的多孔支架与骨髓基质干细胞体外长期培养组织工程化软骨的试验研究

研究背景 关节软骨损伤临床常见,但损伤后自我修复能力极差,目前的修复方法均有其局限性。在先前的研究中,我们研制了关节软骨细胞外基质来源的多孔支架（Cartilage ECM-derived porous scaffold, CEDPS）并观察了并在裸鼠体内异位构建软骨。但在进一步可能的临床应用之前,应进一步评估其体外培养组织工程软骨的特点及可行性。 方法 本研究利用关节软骨细胞外基质来源的支架及骨髓基质干细胞体外长时间培养构建软骨组织。粉碎人关节软骨,脱细胞处理后差速离心法收集细胞外基质悬液,采用冷冻干燥技术制备三维多孔支架。扫描电镜及Micro-CT观察其微观结构,并进行细胞毒性试验,组织学观察,生化成分定量检测其胶原、氨基葡聚糖（GAG）、DNA含量,生物力学方法测量其干性及覆水状态下压缩弹性模量;骨髓基质干细胞经含TGF-β1, bFGF的条件培养基成软骨诱导后鉴定,种植到支架上,荧光显微镜及扫描电镜观察细胞黏附情况,Dead/Live免疫荧光染色观察支架内部细胞活性,体外培养1,3周后观察大体形态和组织学形态变化,同时行II型胶原免疫组织化学分析。 结果 制备的CEDPS支架无细胞碎片残留,软骨细胞外基质特异性染色阳性,具有相互贯通的三维孔隙结构;支架生化成分定量检测：总胶原含量为708.2?44.7μg/mg,GAG含量为254.7?25.9μg/mg;支架纵向压缩弹性模量E = 1.226?0.288MPa,覆水后压缩弹性模量E = 0.052?0.007MPa。体外培养的BMSCs-CEDPS复合体形成了类软骨样组织,Dead/Live染色表明支架内部均为活细胞,电镜检查结果表明细胞广泛均匀的分布在支架内部,呈圆形或椭圆形,在支架上增殖显著,细胞基质分泌明显。组织学结果表明蕃红花“O”、Ⅱ型胶原免疫组化染色阳性,表明随着培养时间的增加,细胞在支架中增殖显著,细胞外有大量基质分泌。 结论 CEDPS支架在生化组成和结构上与软骨细胞外基质成分类似,去细胞彻底,具有良好的生物力学特性,是一种较为理想的软骨组织工程支架载体;成软骨诱导的BMSCs与CEDPS支架在体外可初步构建类软骨样组织。     

体外家兔骺板软骨细胞和复合支架材料构建人工骺板软骨

目的：探讨采用复合支架材料构建人工骺板软骨的可行性。方法:分离获得骺板软骨细胞,加入0.3% Ⅰ型胶原酸性溶液、1 000 U·mL^-1凝血酶溶液及20 g·L^-1人血冻干纤维蛋白原混匀,成为胶冻样软骨组织培养物。定期取培养块固定,常规石蜡切片,行HE染色、甲苯胺蓝染色及免疫组化检查。结果：新制成的以胶原-纤维蛋白混合凝胶为支架材料的软骨细胞培养物呈浅粉红色胶冻样 ,细胞均匀分布于其中。培养3 d后悬浮物呈乳白色,透光度降低。逐渐缩小至直径约7 mm大小,硬度逐渐增加。HE染色见软骨细胞位于软骨陷窝内,软骨细胞培养物有一定层次感,但没有象骺板样排列成柱状。甲苯胺蓝染色显示胞体周围有丰富的软骨基质。免疫组织化学染色可见Ⅱ型胶原阳性细胞。结论：利用混合支架构建的人工骺板软骨在大小及可塑性等方面结果较满意。     

利用PLGA细胞支架再生人关节软骨的实验研究

目的：研究人关节软骨细胞在PLCA三维支架上的贴附和生长情况，利用组织工程技术培养工程化关节软骨。方法：制作PLGA三维细胞支架。分离培养成人关节软骨细胞，体外扩增后种植到PLGA支架中。在体外和裸鼠体内分别培养软骨细胞一支架复合物，分期终止培养，进行组织学染色、扫描电镜、Ⅱ型胶原免疫组织化学及cDNA探针原位杂交检测。结果：体外培养发现，软骨细胞支架材料内贴附生长良好，长期培养仍保持软骨细胞特性，棵鼠体内培养8周后可形成软骨样组织。结论：PLGA三维支架适合软骨细胞贴附生长和分泌软骨外基质，可作为软骨组织工程的细胞载体。利用组织工程的方法可获得适于移植的工程化关节软骨。     

新型快速成形的三维多孔支架材料构建组织工程软骨

目的:探讨以骨髓基质细胞(BMSC)为种子细胞,以快速成形的生物相容性材料为支架构建组织工程软骨的可行性.方法:成年兔BMSC在成软骨培养液中诱导培养,使之具有软骨细胞表型后,接种于快速成形的生物相容性三维支架材料聚乳酸/聚羟乙酸共聚物(poly-lactic-co-glycolic acid,PLGA),经体外培养扩增2 wk后植入自体肌袋,术后8 wk取材,进行组织学、甲苯胺蓝染色及II型胶原免疫组织化学观察.结果:成年兔BMSC在体外可诱导为软骨细胞,接种于三维支架材料培养后,扫描电境观察见细胞在支架上可大量扩增;接种细胞的支架植入自体肌袋8 wk,可形成软骨样组织,甲苯胺蓝染色及II型胶原免疫组化染色阳性.结论:具有软骨细胞表型的BMSC接种于快速成形的三维支架材料在体内非关节环境可形成软骨样组织.     

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.