FTY720与ICAM-1单抗对小鼠-大鼠异种心脏移植抗排斥的作用

目的:研究FTY720与ICAM-1单抗(mAb)对小鼠-大鼠异种心脏移植的抗排斥作用.方法:采用小鼠-大鼠腹部心脏移植,观察移植心存活时间、病理检查、CD4和CD8细胞的浸润程度及检测血中IL-2,IFN-γ,IL-4以及IgM抗体水平.结果:对照组移植心平均存活时间为(2.75±0.43)d.单用ICAM-1 mAb组移植心存活时间无明显延长,单用FTY720大剂量组移植心平均存活(4.25±0.71)d(P＜0.01):FTY720与ICAM-1 mAb大剂量联合用药组移植心存活时间平均(10.25±2.1 2)d(P＜0.01).联合用药组的病理反应、T细胞浸润及IL-2,IFN-γ,IgM水平明显减轻或降低;IgM水平与移植物存活时间呈负相关(R=-0.754,P＜0.01).结论:FTY720与ICAM-1 mAb单一用药对异种移植的抗排斥作用不明显,联合用药可有效延长异种心脏移植的存活时间并能抑制异种抗体的产生.     

皮下注射骨髓细胞诱导小鼠皮肤移植后免疫耐受

目的　探讨皮下注射供体骨髓细胞加用环孢素A(CyA)短期免疫抑制的方法 ,诱导小鼠皮肤移植后免疫耐受的可行性。方法　通过尾 尾皮肤移植将 8周龄BABL/c小鼠皮肤移植到同龄C57BL/ 6小鼠上 ,后者分为 5组 ,A组长期应用CyA ,B～E组按不同时间和剂量皮下注射供体骨髓细胞并加用短期CyA腹腔注射 (7～ 1 1d) ,观察C57BL/ 6小鼠移植皮肤综合评分及平均生存时间。结果　B、C两组小鼠 (BM 1× 1 0 5,1× 1 0 6 ,0～ 1 1d隔天注射 ) ,停用CyA后短期出现排斥反应 ,移植皮肤平均存活 2 7d ;D、E两组小鼠 (BM 1× 1 0 7,0、4、8、1 1d注射和BM 1× 1 0 8,0、5、1 0d注射 ) ,停用免疫抑制剂后并未发生早期排斥反应 ,移植皮肤平均存活时间明显延长(48、55d) ,与持续使用CyA的A组 (54d)相近。 结论　在该小鼠皮肤移植模型中 ,供体骨髓细胞皮下注射加短期免疫抑制剂CyA诱导出了受体对同种皮肤移植物暂时性的耐受 ,延长了移植物平均存活时间 ;该耐受的形成与骨髓细胞注射剂量、间隔时间相关 ,大剂量间隙注射更可能诱导免疫耐受。     

CTLA4Ig延长同种异体大鼠耳廓移植存活的实验研究

研究CTLA4Ig对异体复合组织移植的免疫抑制作用。方法 :以BN大鼠为供体 ,Lewis大鼠为受体进行异体耳廓移植 ,术后分组应用不同剂量CTLA4Ig治疗 ,观察移植耳廓的排斥反应及存活时间 ,检测术后血清IL - 2含量变化。结果 :对照组平均存活 (7.8± 1.9)d ,CTLA4Ig 0 .1mg/kg·d治疗组存活 (8.1± 1.6 )d ,与对照组比无明显差异 (P >0 .0 5 ) ;1.0mg/kg·d组与 5 .0mg/kg·d组分别为 (15 .5± 2 .3)d与 (2 8.8± 3.6 )d ,异体耳廓的存活时间显著延长 (P <0 .0 1) ,且IL - 2含量较对照组明显下降。结论 :CTLA4Ig能延长异体耳廓复合组织移植后的存活 ,其疗效与剂量相关。     

新生大鼠胸腺内接种同种和异种脾细胞对移植心脏存活的影响

目的 :诱导新生大鼠免疫耐受。方法 :将Wistar大鼠或豚鼠脾淋巴细胞通过胸腺途径分别注射给新生SD大鼠 ,8～ 10周龄时分别行同种Wistar大鼠或异种豚鼠供心移植 ,观察移植心存活的时间及病理学改变。结果 :胸腺内注射Wistar大鼠脾淋巴细胞者接受Wistar供心移植 ,供心存活时间显著延长 ,平均存活 >6 0 4d(P <0 0 0 1) ;而胸腺内接种豚鼠脾淋巴细胞者接受豚鼠供心移植 ,供心平均存活仅 9 8d(P >0 0 5 )。结论 :单一胸腺内接种同种脾细胞可以诱导新生大鼠的免疫耐受 ,但不能诱导异种免疫耐受     

中华眼镜蛇毒因子清除补体建立异种心脏移植急性血管性排斥反应模型

目的　采用纯化中华眼镜蛇毒因子 (CVF)清除补体 ,建立豚鼠 -大鼠非协调性异种心脏急性血管性排斥反应 (AVR)模型。　方法　供者豚鼠和受者 SD大鼠各 38只 ,分为 3组 : 组 (超急排组 ,n=2 0 ) ,受者不进行任何预处理 ; 组 (小剂量 CVF组 ,n=1 0 ) ,受者移植前 1 d经腹腔注射 CVF2 0 0 μg/ kg,移植后每日注射 1 0 0 μg/kg直至供心停搏 ; 组 (大剂量 CVF组 ,n=8) ,受者移植前 1 d经腹腔注射 CVF4 0 0 μg/ kg,移植后每日注射 2 0 0μg/ kg直至供心停搏。观察供心存活时间 ,供心停跳后行病理组织学检查。　结果　 组和 组供心平均存活时间分别为 (4 1± 2 ) h和 (4 0± 3) h明显长于 组 [(1 7± 2 ) min,P<0 .0 1 ], 组与 组间差异无显著性 (P>0 .0 5 )。病理检查 : 组呈超急性排斥反应 (HAR)改变 ,而 、 组呈 AVR改变 ; 、 组移植物炎症细胞浸润数明显多于 组(P<0 .0 1 ) ,移植物补体 C3沉积明显少于 组 (P<0 .0 1 )。　结论　适当剂量纯化 CVF具有良好的清除大鼠补体C3作用 ,克服豚鼠—大鼠非协调性异种心脏移植物 HAR的发生 ,延长其存活时间 ,建立以炎症细胞浸润为主的异种移植 AVR模型     

基因转移CTLA4-Ig对异种胰岛移植排斥反应的影响

目的 探讨基因转移细胞毒性T淋巴细胞相关抗原4免疫球蛋白(CTLA4-Ig)对异种胰岛移植排斥反应的影响.方法 用携带基因CTLA4-Ig的重组腺病毒转染人胰岛细胞,植人糖尿病大鼠肾胞膜下,建立人-大鼠异种胰岛移植模型,观察糖尿病大鼠移植后血糖变化、生存情况及移植物病理形态学改变,检测移植物CTLA4-Ig、胰岛素的表达和移植大鼠IL-2、TNF-α的水平变化.结果 (1)糖尿病大鼠胰岛移植后2 d血糖降至正常,对照组和转染组血糖平均分别在移植后8 d和25 d升高.(2)转染组移植物存活时间(28±6)d,较对照组(10±2)d显著延长(t=10.52,P＜0.01).(3)移植大鼠生存时间:转染组(48±8)d显著长于对照组(21±6)d(t=12.23,P＜0,01).(4)对照组在移植后1周内,IL-2、TNF-α水平均急尉上升,较移植前显著升高(P＜0.01);转染组则较移植前下降.(5)转染组移植物可见CTLA4-Ig和胰岛索的表达.结论 基因转移CTLA4-Ig可抑制异种胰岛移植排斥反应,延长移植大鼠和移植物的存活时间.     

CVF在大鼠移植心脏缺血再灌注损伤中的保护作用研究

目的 研究中华眼镜蛇毒因子(cobra venom factor, CVF)对同种大鼠移植心脏缺血再灌注损伤的保护作用机制.方法 近交系雄性B/N大鼠为供体,Lewis大鼠为受体,建立腹腔异位心脏移植模型.实验组术前给予CVF尾静脉注射,观察移植心的存活时间,并设B/N大鼠同系对照组.免疫组化法测定各组术后第1、3、5 天移植心脏的C3沉积,并观察移植心的病理变化.结果 接受CVF 20 μg/kg,2 d 1次,尾静脉给药的大鼠,移植心存活时间明显延长,平均达(11.69±0.72)d,而对照组为(6.65±0.35)d(P＜0.01),组织内C3沉积较对照组同期明显减轻,病理损害程度减轻,优于同期对照组.结论 CVF消耗补体显著延长移植心脏存活时间,能明显减轻近交系大鼠移植心脏缺血再灌注损伤.     

脾切除延长大鼠异种移植心脏存活时间的实验研究

目的:采用小鼠至大鼠心脏移植模型,研究脾切除联用免疫抑制剂对异种移植物存活时间的影响。方法:动物随机分为组,分别采用脾切除、来氟米特()或二者联用以观察对异种移植心脏存活时间的影响。法检测血清。7LefELISAIgG用免疫组织化学法检测。IgG结果:单行脾切除使移植心脏存活(±)天4.401.14(P,脾切除联用使移植心脏存活<0.05)CsA(±)天与组比较,4.750.95(IIP。脾切除联用显著延长移植心脏存活时间达(±)天,且显著降低受体血清>0.05)Lef8.202.17水平和移植物中沉积IgGIgG(P。加用不能显著增加脾切除联用的效果。<0.05)CsALef结论:脾切除可显著延长小鼠至大鼠移 植心脏存活时间。脾切除和具有协同免疫抑制作用,可降低移植后受体血清水平及移植物中沉积,延长异种移植物LefIgGIgG的存活时间。     

血清血管内皮细胞生长因子和大鼠心脏移植急性排斥反应的关系

目的观察血管内皮细胞生长因子在大鼠心脏移植急性排斥期中的血清表达及与排斥反应的关系。方法实验分为对照组和CSA组(n=14)。采用颈部心脏移植术式建立模型,手术后分别经胃管给予生理盐水及CSA干预。常规监测排斥反应发生情况。每组7只用于观察移植物存活时间,7只用于动态抽取血液标本,样本采用双抗体夹心法检测血清VEGF表达水平。结果CSA组移植心存活时间(21.1±2.9)d长于对照组(12.4±2.3)d(P<0.01)。对照组血清VEGF表达强度强于CSA组(P<0.05)。结论VEGF的表达和移植心的炎性浸润以及急性排斥有密切关系。     

心胸腺联合移植诱导大鼠同种异体移植免疫耐受

目的:研究心胸腺联合移植对大鼠同种异体移植心脏的抗排斥作用.方法:应用显微外科技术行心胸腺联合移植,通过移植心存活时间、病理学检查、CD4 ,CD8 T细胞的浸润及检测血中和移植心中IL-2和IL-4水平,观察移植胸腺的作用.结果:对照组移植心平均存活(6.0±0.76)d,保留胸腺的大鼠行心胸腺联合移植其移植心平均存活(6.88±0.64)d(P＜0.05);胸腺切除后行心胸腺联合移植可明显延长移植心的存活达(14.13±5.82)d(P＜0.01),短期应用环孢素则可使移植心长期存活:在移植心获长期存活组其移植心及胸腺的病理改变及CD4 ,CD8 T细胞的浸润均很轻微,且其血清及移植心组织中的IL-2降至较低水平,而IL-4则维持在较高水平.结论:无论保留或切除受体胸腺,心胸腺联合移植均有利于移植心的存活,而且胸腺切除后心胸腺联合移植对移植心有更显著的保护作用,短期应用免疫抑制剂则可诱导大鼠对同种异体移植心脏的耐受.     

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.