CD34+细胞体外定向诱导分化的实验研究

目的:探讨造血生长因子不同组合方式对CD34+细胞体外定向诱导分化作用.方法:应用阴性分选策略,以StemsepTM系统从正常人骨髓细胞中分离CD34+造血干/祖细胞(HSC/HPC),在液体培养体系加入不同组合细胞因子对CD34+细胞进行诱导,检测细胞总数、CD71+细胞和CD15+细胞比例及粒单系祖细胞和红系祖细胞扩增数量.结果:液体培养体系中,以FL+Tpo+SCF+IL-3+Epo细胞因子组合对CD34+细胞向红系细胞的诱导分化能力最强,2w后CD71+细胞比例为61.20%±5.31%,BFU-E、CFU-E分别扩增27.12±3.95和30.65±40.26倍.以FL+Tpo+SCF+IL-3+GM-CSF+G-CSF细胞因子组合对CD34+细胞向粒系细胞的诱导分化能力最强,2w后CD15+细胞比例为56.18%±6.57%,CFU-GM扩增29.87±10.52倍.结论:合理组合生长因子,可定向诱导CD34+细胞生成大量血细胞,将有助于满足临床应用的需要.     

脐血单个核细胞和CD34+细胞体外扩增造血干/祖细胞

考察了脐血单个核细胞(MNC)和CD34+富集细胞在SCF+IL-3+IL-6+FL+Tpo细胞因子组合下的体外扩增特性.实验发现CD34+富集细胞具有很高的扩增潜力,通过3周培养总细胞扩增了(883.2±322.4)倍,而MNC仅扩增了(53.3±6.2)倍.对比细胞集落生成和CD34+细胞的扩增发现,MNC的集落密度由最初的(270.9±54.9)CFCs/105cells上升至第7天的(1 496.3±417.7)CFCs/105cells,CD34+细胞百分比则由最初的(0.99±0.18)%上升至第7天的(4.4±1.9)%,而CD34+富集细胞在培养过程中,虽然集落总数和CD34+细胞总数始终呈上升趋势,但是其集落密度和CD34+细胞百分比则始终呈下降趋势.在两种起始细胞培养中,CFU-GM(粒细胞-巨噬细胞集落形成单位)在集落中的含量逐渐增加,BFU-E(爆式红细胞集落形成单位)含量则逐渐降低.在3周的短期培养中,MNC可以得到更多的集落形成细胞(CFC)和CD34+细胞.     

胎儿骨髓基质细胞与外源性细胞因子的协同造血支持作用

目的 :探讨胎儿骨髓基质细胞与外源性细胞因子的协同造血支持作用。方法 :联合应用胎儿骨髓基质细胞与外源性细胞因子如重组人干细胞因子 (rh SCF)、IL - 3、IL - 6、粒巨噬细胞集落刺激因子 (GM- CSF)、粒细胞集落刺激因子 (G- CSF)、促红细胞生成素 (EPO)等先后对成人骨髓单个核细胞及 CD34 + 富集细胞培养 5 d至 2周。结果 :胎儿骨髓基质细胞与上述细胞因子具有良好的协同作用 ,CD34 +富集细胞以胎儿骨髓基质细胞 +SCF+IL- 3+IL- 6 +G- CSF+EPO培养 2周 ,可使细胞总数、粒 -单系造血祖细胞 (CFU- GM)、早期红系造血祖细胞 (BFU- E)及 CD34 +细胞分别扩增 (119.6± 30 .9)倍、(5 4.6± 17.4)倍、(2 5 .2± 4.4)倍、(11.1± 4.2 )倍。结论 :胎儿骨髓基质细胞可协同上述外源性细胞因子支持成人骨髓造血祖细胞的有效扩增     

多种细胞因子组合对脐血干/祖细胞体外扩增的影响

目的　探讨在体外培养液中不同细胞因子组合对脐血 CD34+ 细胞的扩增作用以及扩增后的 CD34+ 细胞的造血功能。方法　用 FL、SCF、TPO、IL - 3、TL - 6组合成不同的实验组 ,对脐血中分离纯化的 CD34+ 细胞经 6d的短期体外扩增 ,扩增后经流式细胞仪分析 ,L TC- IC、祖细胞集落群计数 ,从而求得较好的细胞因子组合组。结果CD34+ 细胞扩增倍数为 3 .1～ 8.6倍 ,16份脐血 CD34+ 细胞数达到 10× 10 6 以上的细胞总数 ;扩增的 CD34+ 细胞再造血功能与原始 CD34+ 细胞无显著差异。FL是扩增组合中不可缺少的细胞因子 ,同时还证实 TPO与其他细胞因子组合有扩增 CD34+ 细胞的作用 ,但单独使用 TPO稍长时间会使 CD34+ 细胞过多向巨核细胞分化。结论　 FST3 6细胞因子组合能使部份单位体积的脐血 CD34+细胞体外扩增达一定数量 ,为干细胞移植于成人提供了一定的实验依据与方法     

细胞因子FL、TPO对脐带血造血干细胞的扩增作用

目的:通过体外分离培养人新鲜脐带血(Umbilical cord blood,UCB)造血干细胞(Hematopoietic stem cell,HSC),探讨不同细胞因子组合对HSC的扩增作用.方法:采用Ficoll淋巴细胞分离液密度梯度离心法分离UCBHSC,加入不同组合的细胞因子,检测有核细胞(Nuclear cell,NC)总数和CD34 细胞数.结果:未加细胞因子的对照组培养初期细胞即已破裂溶解,加入不同细胞因子组合的实验组的NC细胞总数和CD34 细胞数随着培养时间的延长均呈现不同程度的增加,于第14天达到高峰,而含有细胞因子FL、TPO的组合,NC细胞数和CD34 细胞数均比较高.结论:体外HSC培养,加入细胞因子对细胞增殖有明显的作用,而细胞因子FL、TPO协同作用能比较好的扩增早期造血干细胞.     

造血生长因子对脐血单个核细胞的体外增殖效应

目的 :探讨不同造血生长因子组合对人脐血造血细胞的体外增殖效应 .方法 :采用免疫荧光染色和祖细胞集落测定 ,观察人脐血单个核细胞 (MNC)经多种造血生长因子的不同组合作用 2wk后其有核细胞、CD34+ 细胞和祖细胞数量的变化 ,并用脾结节形成实验和骨髓祖细胞培养等观察其在小鼠体内的短期造血能力 .结果 :脐血MNC分别与A(SCF /IL 3/IL 6 /G CSF/GM CSF) ,B(SCF/IL 3/IL 6 /FL/EPO) ,C(SCF/IL 3/IL 6 /EPO ) ,3种造血生长因子组合悬浮培养 2wk ,有核细胞、CD34+ 细胞和祖细胞数量增加 .有核细胞总数在B组因子作用下增加最显著 [(2 6± 5 )倍 ],而CD34+ 细胞数量在A组因子作用下增加最明显 [(8± 2 )倍 ].3种因子组合对不同种类祖细胞的增殖效应不同 ,其中A组因子主要刺激早期混合系祖细胞CFU Mix扩增 [(11± 2 )倍 ],B组因子主要刺激粒单系祖细胞CFU GM扩增 [(2 2± 3)倍 ],C组因子主要刺激早期红系祖细胞BFU E扩增 [(13± 4 )倍 ].此外 ,给受照小鼠输注A组因子作用后的人脐血细胞 ,13d在小鼠脾脏形成脾结节 (CFU S) ,30d从小鼠骨髓检出造血祖细胞(CFU GM和CFU E) ,造血细胞数量与从输注新鲜脐血细胞的小鼠体内检出的结果无显著性差异 (P >0 .0 5 ) .结论 :造血细胞生长因子对人脐血单个核细胞具有体外     

脐血造血干/祖细胞体外扩增的实验研究

目的探讨因子组合FL+TPO+SCF+IL-6对脐血CD34 +细胞的体外扩增效应.方法采用Mini-MACS分离纯化出CD34+细胞, 在无基质接触的液体悬浮培养体系培养,通过间接免疫荧光染色、流式细胞仪技术、集落形成试验等动态测定细胞扩增情况.结果培养4周后,FL+TPO+SCF+IL-6组细胞总数、集落形成数均比扩增前显著增加(P＜0.05),并且能维持一定比例的CD34+、Th y-1+细胞;SCF+IL-3+IL-6+GM-CSF+EPO组在第2周时集落形成数已降低,第4周时集落形成数、CD34+细胞基本检测不到.结论与经典因子组合SCF+IL-3+IL-6+G M-CSF+EPO相比,因子组合FL+TPO +SCF+IL-6能在较长时间内有效扩增脐血造血干/祖细胞, 是一个优化组合方案.     

晚期激活抗原-4在CD34+造血干/祖细胞宫内移植早期归巢中的作用

目的 探讨黏附分子晚期激活抗原-4(VLA-4)在脐血CD34+造血干/祖细胞小鼠宫内移植早期归巢中的作用.方法 用密度剃度离心的方法分离脐血CD34+细胞,经SCF和Il-6扩增24h,在BALB/c母鼠怀孕第15天经胎鼠腹腔注射CD34+细胞,每只胎鼠约注射1×105个细胞.用PKH26标记细胞的方法追踪早期归巢情况.在VLA-4阻断实验中,CD34+细胞注射前用20μg/ml抗VLA-4单抗孵育30 min.分别于注射后48h用流式细胞仪检测小鼠胎肝细胞中的人CD45+细胞.结果 SCF+IL-6扩增后脐血CD34+细胞VLA-4表达由原来的(26.34±5.37)%增高至(65.67±8.72)%(P＜0.01).扩增的细胞经胎鼠腹腔移植48h后,在胎肝中可以见到PKH26标记的CD34+细胞,流式细胞仪检测胎肝中人CD45+细胞百分率为(26.54±9.56)%.CD34+细胞移植前经抗VLA-4单抗预处理后胎肝中人CD45+细胞检出率显著降低(3.57±1.25)%,P＜0.01.结论 VLA-4对CD34+造血干/祖细胞宫内移植早期归巢有重要作用.     

IL-11基因修饰的基质细胞对造血细胞体外扩增的影响

目的　研究造血因子白介素 11(IL 11)基因修饰的基质细胞对造血细胞体外扩增的影响。方法　采用逆转录病毒载体将IL 11基因转入基质细胞HFCL ,用Northernblot检测基质细胞HFCLIL 11基因的表达 ,用流式细胞仪检测IL 11基因修饰的HFCL支持的脐血CD3 4 + 造血细胞体外扩增中表型为CD3 4 + CD3 8- 早期祖细胞和表型为CD3 4 + CD41+ 巨核系定向祖细胞的比例。结果　基质细胞HFCL能够表达逆转录病毒介导的IL 11基因 ,并且在这种IL 11基因修饰的基质细胞支持下 ,脐血CD3 4 + 造血细胞经过7d扩增 ,扩增细胞中表型为CD3 4 + CD3 8- 的早期祖细胞和表型为CD3 4 + CD41+ 巨核系祖细胞的比例分别为 (1.62± 0 .2 3 ) %、(9.9±1.1) % ,高于未转基因HFCL的 (0 .8± 0 .2 3 ) %、(6.5± 1.8) % ,而在相同条件下细胞因子支持的扩增细胞中则分别为 (0 .19±0 .14 ) %、(6.0± 1.1) %。结论　基质细胞能够表达经逆转录病毒载体介导的IL 11基因 ,而且经IL 11基因修饰的基质细胞能显著促进CD3 4 + CD3 8- 的早期祖细胞和CD3 4 + CD41+ 巨核系祖细胞扩增。     

脐血造血细胞体外扩增巨核细胞的研究

目的探讨在体外用不同的细胞因子组合在不同的培养时间对脐血CD 34+细胞向巨核系分化以及扩增的作用.方法细胞因子分为TPO(T)、TPO+SCF+IL-6+IL-3(TS36)、TPO+SCF+IL-6+IL-3+FL(TSF 36)等3组.将脐血CD 34+细胞在体外经14 d的诱导分化和扩增,在扩增后通过流式细胞仪、集落培养和免疫组化等方法检测培养物中CD41+细胞百分率、扩增倍数和巨核祖细胞集落形成单位(CFU-MK)产率和扩增倍数以发现较好的细胞因子组.并比较了TSF 36组细胞因子在第7 d和第14d时的CD 41+细胞百分率及CFU-MK产率及它们的扩增倍数.结果CD 41+细胞占培养细胞的比率3组细胞因子在14 d分别为77.5±3.5%、14.4±3.2%、21.3±1.7%;CD 41+细胞扩增倍数3组细胞因子分别为75.2±13.2倍、212.4±70.8倍、378.6±74.7倍;每104个细胞可形成CFU-MK分别为56.7±7.0个、22.0±3.0个、24±4.0个;扩增倍数分别为5.9±2.3倍、14.6±0.6倍、19.5±2.4倍.TSF 36组细胞因子在扩增CFU-MK和CD 41+细胞方面均有最强的作用,其第14 d的CD 41+细胞百分率及CFU-MK产率均低于第7 d,但扩增倍数均高于第7 d.结论TSF 36细胞因子组合能使脐血CD34+细胞向巨核系进行分化和大量扩增,其巨核细胞扩增倍数第14 d高于第7 d,但巨核细胞纯度降低.这一结果进一步为临床应用巨核细胞体外扩增回输提供了实验基础.     

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.