乙肝病毒标志物阳性血清感染胎盘滋养层细胞的体外研究

目的提供血清中的HBV病毒能进入体外培养的滋养层细胞(HPT-8)的依据。方法用HBV阳性血清体外感染HPT-848h,设感染组和对照组。ELSIA检测细胞培养上清中HBsAg、HBeAg,PCR检测细胞培养上清和细胞中HBVDNA,细胞免疫组织化学法检测细胞中HBsAg、HBcAg,免疫荧光定量PCR检测细胞培养上清中HBVDNA的含量。结果ELISA检测PBS洗8次后第1、2代感染细胞的培养上清的HBsAg、HBeAg均呈阳性;PCR在感染细胞第1、2代的培养上清中检测到HBVDNA特异的片断;第1、2代感染细胞中检测出了rcDNA,第1代感染细胞中检测出了cccDNA;免疫组化检测感染组第2代细胞中HBsAg阳性;荧光定量PCR检测感染细胞第1、2代培养上清中HBVDNA的滴度分别为8×104拷贝/ml和4.6×103拷贝/ml,第3代<103拷贝/ml。结论血清中的HBV病毒能进入HPT-8,但在HPT-8内很难复制、繁殖。     

乙型肝炎病毒感染正常人肾小管上皮细胞的实验研究

目的探讨正常人肾小管上皮细胞（HKC）对乙型肝炎病毒（HBV）的易感性。方法（1）体外培养的HKC传至6孔板中,接种密度为1×10^6个／ml,孵育24h后分受感染和阴性对照两组。受感染组加入0．5mlHepG2．2．15细胞上清液（已知该体外培养的细胞系可随细胞传代释放HBV病毒颗粒）;阴性对照组加入015mI10％FCS—DMEM／F-12培养液。两组HKC继续孵育72h,消化、离心沉淀,PBS清洗,实时荧光定量聚合酶链反应（FQ—PCR）检测两组HKC中的HBVDNA。（2）将HKC细胞传代并接种至2个6孔板中盖玻片上制作细胞爬片,接种密度为1×10^6个／ml,24h后行HBV感染实验。然后将两个6孔板分别作为：（1）受感染组：往六孔板中加入制备好的感染用HepG2．2．15细胞上清液2ml;（2）阴性对照组：往六孔板中加入2mI10％FCS—DMEM／F－12培养液。将HepG2．2．15细胞分别传代并接种至6孔板中盖玻片上制作细胞爬片,接种密度为1×10^6个／ml,24h后作为阳性对照组：往六孔板中加入2ml10％FCS—DMEM培养液继续孵育72h,原位杂交检测各组中的HBVDNA。结果实时荧光定量聚合酶链反应检测到受感染组HKC的基因组中HBVDNA的存在,受感染组HKC原位杂交检测HBVDNA阳性,呈核型。结论体外培养的正常HKC对HBV易感。     

乙型肝炎病毒对肾小管上皮细胞直接作用的实验研究

目的：探讨乙型肝炎病毒（HBV）在体外对人肾小管上皮细胞（HKC）的直接致病作用。方法：①HBV体外感染HKC：培养的HKC传至6孔板中，接种密度为1×10^6个／ml，孵育24h后分受感染和阴性对照两组。受感染组加入0．5ml HepG2．2．15细胞上清液（含有HBV）；阴性对照组加入0．5ml 10％FCS—DMEM／F—12培养液。两组HKC继续孵育72h，消化，离心沉淀，PBS清洗，实时荧光定量聚合酶链反应（FQ—PCR）检测两组HKC中的HBV DNA含量。②HBV对体外培养的HKC细胞直接作用：HKC细胞传至24孔板中，接种密度为1×10^5个／ml，受感染组分三个亚组，分别加入100μl、200μl和300μl的感染用HepG2．2．15细胞上清液；阴性对照组为接种HKC后加入培养液常规培养；阳性对照组为HepG2．2．15细胞上清液。各组的每孔终体积均为2ml，每组设3复孔。孵育72h后收集各孔上清液，ELISA法检测转化生长因子β1（TGF-β1）的表达。结果：①受感染组HKC的基因组中检测到HBV DNA。②受感染组的三个亚组细胞培养上清的TGF-β1与阴性对照组比较差异均有显著性。结论：HBV可感染HKC并促进其分泌TGF-β1。     

HBV体外感染人胎肝细胞的鉴定方法研究

目的通过HBV体外感染22周龄原代培养人胎肝细胞,比较常用检测指标的敏感性和特异性.方法利用HBV阳性血清感染体外培养的原代人胎肝细胞.应用ELISA法检测培养上清中的HBsAg和HBeAg,免疫组化法检测细胞核中的HBcAg,荧光定量PCR法检测上清和细胞中HBV DNA,巢式PCR法检测细胞中cccDNA.结果胎肝细胞核中的HBcAg于感染后第2天出现阳性,培养上清和细胞中HBVDNA定量自第4天起检出,上清中HBsAg和HBeAg于第5～6天出现阳性;细胞中HBV cccDNA自第8～9天出现阳性.结论HBV在原代培养人22周龄的胎肝细胞中能够稳定复制和表达,各种检测指标的灵敏性和特异性不一,免疫组化法检测细胞核中的HBcAg敏感性好,特异性可.     

HBV感染胎盘滋养细胞的体外研究

目的：对早孕绒毛的滋养细胞进行原代培养,利用HBV感染血清对滋养细胞进行体外感染,探讨细胞在体外培养条件下对HBV的感染率及HBV在细胞中的复制状态．方法：利用胰蛋白酶和胶原酶联合消化培养法原代培养早孕胎盘中的滋养细胞,并进行免疫组化鉴定,获得纯度较高的滋养细胞后进行体外的HBV感染,通过细胞免疫化学染色、ELISA及PCR法分别检测细胞上清中的HBsAg,细胞中的HBVDNA及cccDNA．结果：原代培养的滋养细胞,细胞生长良好,特异性角蛋白一7阳性,纯度高．原代滋养细胞在与HBV阳性血清共同孵育后均未出现明显的细胞病变,感染后24h和48h在滋养层细胞细胞浆中可见HBsAg的阳性表达,被感染细胞呈散在分布．感染后48h起可检测到弱阳性的HBsAg及HBVDNA,感染后细胞内未检测出cccDNA．结论：利用联合酶消化法建立了胎盘中滋养细胞的体外培养系统．HBV能够在体外感染原代培养的滋养细胞,对被感染细胞的生长无明显影响．HBV可能不在滋养细胞中复制．     

臭氧溶液对HBV体外感染的HepG2细胞的抗病毒作用

目的:建立乙型肝炎病毒(HBV)体外感染人肝癌HepG2细胞的实验模型,并研究臭氧溶液对感染了HBV后的HepG2细胞的抗病毒作用。方法:乙肝阳性血清与HepG2细胞共孵育建立体外感染模型,采用倒置相差显微镜检测细胞形态,MTT法检测细胞成活率,ELISA法检测HBsAg和HBeAg表达水平,HBV荧光定量PCR检测HBV DNA表达量。结果:体外感染了HBV DNA的HepG2细胞能持续稳定分泌HBsAg和HBeAg,并能产生HBV DNA,通过低浓度臭氧溶液作用后,细胞形态无明显差异,细胞成活率无明显影响(P>0.05),HBsAg和HBeAg均转阴(P<0.01),HBV DNA拷贝量亦明显降低(P<0.01)。结论:较低浓度臭氧溶液对感染了HBV的HepG2细胞有明显的抗病毒作用,对细胞并无损伤。     

HBV的宫内传播与人绒毛膜滋养层细胞的HBV感染和凋亡关系的研究

目的检测HBV感染后人绒毛膜滋养层细胞的HBV标志物的表达和细胞的形态学变化,探讨HBV对滋养层细胞的感染与HBV宫内传播的关系。方法将HBV感染的血清与原代培养的人早孕绒毛膜滋养层细胞及传代细胞JEG-3共同孵育8～48h,通过倒置显微镜观察细胞的形态及细胞间连接,细胞免疫荧光方法检测滋养层细胞中HBsAg的表达,荧光定量PCR方法检测细胞中的HBVDNA,TUNEL方法检测滋养层细胞的凋亡。结果滋养层细胞与HBV感染的血清共同孵育后,滋养层细胞的形态及细胞间连接无明显变化;但通过免疫荧光方法检测到滋养层细胞中HBsAg的阳性表达,并通过荧光定量PCR方法检测到滋养层细胞中HBVDNA的存在;同时,细胞凋亡检测结果表明,与HBV感染的血清共同孵育后,滋养层细胞的凋亡数量明显增加。结论HBV可以感染体外培养的滋养层细胞;HBV感染可以诱导滋养层细胞凋亡,滋养层细胞的感染和凋亡可能与HBV的宫内传播机制有关。     

HBV全基因组克隆转染细胞系的建立

目的:建立HBV体外细胞培养体系. 方法:构建HBV全基因克隆质粒pcDNA3-3HBV,稳定转染HepG2细胞,G418筛选. ELISA检测细胞上清液HBsAg,HBeAg的表达,免疫组化检测细胞内HBcAg的表达,RT-PCR检测细胞S基因mRNA的表达,PCR检测细胞上清液DNA. 结果:成功构建了HBV全基因克隆质粒pcDNA3-3HBV,稳定转染HepG2后,培养上清HBsAg,HBeAg阳性,细胞内HBcAg呈核浆型分布,且以浆型分布为主. RT-PCR证实有HBV S基因 mRNA 的表达,上清中HBV S及前S基因阳性,荧光定量PCR检测显示培养上清中HBV 滴度达1×108拷贝/L. 结论:重组质粒pcDNA3-3HBV能在HepG2细胞中表达、转录、复制,该细胞培养体系能产生较高水平的HBV.     

TNF-α对HBV体外感染人胎盘绒毛膜滋养层细胞的促进作用

目的:研究TNF-α对HBV体外感染人胎盘绒毛膜滋养层细胞的促进作用,建立HBV与人胎盘绒毛滋养层细胞相互作用的稳定体外感染模型.方法:绒毛膜癌细胞系JEGⅢ细胞作为滋养层细胞模型,分别在促感染因子TNF-α存在和不存在情况下,与HBV阳性血清(2×1012HBV DNA/L)共同孵育.感染后24 h,PBS充分洗涤感染体系,直至最后一遍洗液HBsAg阴性.加新鲜培养液继续培养,每隔12 h,收集培养标本,分别用Western blott,透射电镜,ELISA,和PCR检测培养物中HBV标志物.结果:在TNF-α不存在的感染环境下,细胞标本中HBV标志物呈阴性或弱阳性.而在TNF-α存在的感染环境下,细胞标本中HBV标志物呈阳性或强阳性,感染效率大大增强(P<0.01).但各时间点之间的感染效率差异不显著.结论:在TNF-α存在的环境下,HBV体外可以成功感染滋养层细胞.该体外细胞感染模型是深入研究HBV宫内传播机制的关键.     

DMSO、地塞米松对于HBV感染HepCHLine-4细胞能力的影响

目的 评价二甲基亚砜（DMSO）、地塞米松对于乙型肝炎病毒（HBV）感染HepCHLine-4细胞能力的影响。方法 HBV感染前将HepCHLine 4细胞分为DMSO处理组（A组）、地塞米松处理组(B组)、DMSO及地塞米松处理组(C组)和对照组(D组)。含胎牛血清100mL/L 的细胞培养基中,A组添加20mL/L DMSO,B组添加5×10-5 mol/L 地塞米松,C组添加20mL/L DMSO及5×10-5 mol/L地塞米松,D组不添加上述两种试剂。用相应培养基培养各组细胞4d以备病毒感染。将HBV病毒颗粒加入各组细胞中于37℃中孵育24h。电化学发光法检测感染后各组细胞培养上清中HBsAg和HBeAg的滴度;荧光定量PCR检测感染后各组细胞培养上清的HBV DNA。结果 DMSO处理组HBsAg和HBeAg的滴度相对较高;地塞米松处理组HBV DNA值相对较高;DMSO及地塞米松处理组HBsAg和HBeAg的滴度及HBV DNA值均较高,其最高值分别是125.790 IU/mL, 4.784 S/Co, 5.930×105 copies/ mL;对照组HBsAg和HBeAg的滴度及HBV DNA值均较低,其最高值分别是85.490 IU/mL,1.896 S/Co,3.729×104 copies/mL。 结论 DMSO、地塞米松有提高HepCHLine 4细胞被HBV自然感染能力的趋势。     

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.     

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.     

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.