SP94和CD47双修饰外泌体靶向递送PLK1 siRNA治疗肝癌

目的 设计一种基于外泌体高效递送的方法,将治疗性核酸递送到肝癌组织治疗原发性肝癌。方法 构建靶向肝癌的融合表达SP94和CD47的质粒,转染至HEK293T细胞后提取分离外泌体。通过透射电子显微镜及纳米颗粒跟踪分析、蛋白质印迹法等方法对外泌体进行鉴定。小鼠经尾静脉分别注射200μg DiD标记的未修饰外泌体和SP94修饰的外泌体,采用小动物活体成像仪检测并分析外泌体对肝癌组织的靶向作用。将未修饰外泌体和CD47修饰的外泌体分别与巨噬细胞RAW264.7、小鼠肝癌细胞Hepa1-6共孵育,验证细胞对修饰后外泌体的吞噬情况。通过电穿孔法将Polo样激酶1(PLK1)siRNA加载到不同修饰的外泌体中,再与Hepa1-6细胞共孵育,采用流式细胞术检测细胞凋亡水平。原发性肝癌模型小鼠经尾静脉注射加载PLK1 siRNA的修饰外泌体,系统研究并分析其对原发性肝癌的治疗效果。结果 SP94修饰增强了外泌体对肝癌组织的靶向作用,CD47修饰减少了外泌体被巨噬细胞吞噬。SP94和CD47双修饰外泌体递送PLK1 siRNA促进了肝癌细胞凋亡。在原发性肝癌模型小鼠中,SP94和CD47双修饰外泌体加载P...     

外泌体包裹GDF15 siRNA靶向治疗肝癌的研究

目的 在外泌体表面表达肝癌靶向肽SP94,并将生长分化因子15(GDF15)的siRNA包裹至外泌体中，研究其对肝癌的治疗作用。方法 首先设计合成GDF15的siRNA,转染Hepa1-6和H22细胞作为实验组，无靶向的siRNA作为对照组，通过实时定量PCR、蛋白免疫印迹和流式细胞术验证GDF15 siRNA的功能。再构建一个靶向肝癌的SP94-Lamp2b-HA质粒，转染入HEK293T细胞后提取工程化外泌体SP94-外泌体，用SP94-外泌体包裹GDF15 siRNA作为SP94-siRNA-外泌体实验组，空载SP94-外泌体作为空载对照组，通过尾静脉注射法将两组外泌体导入小鼠体内，研究小鼠原位肝癌模型的治疗效果，并对小鼠的生存期进行观察。另外，将SP94-siRNA-外泌体尾静脉注射入健康小鼠体内，观察器官变化情况，对比血液生物化学和炎性因子指标差异。结果 成功合成GDF15 siRNA,在转染Hepa1-6和H22细胞后，GDF15的mRNA和蛋白水平表达明显降低(P<0.05)。在对原位肝癌小鼠的治疗中，与对照组相比，实验组SP94-siRNA-外泌体明显抑制肿瘤的增...     

负载化疗药物的外泌体对肝癌的靶向治疗研究

目的:在小鼠肝癌皮下瘤模型中探究肝癌靶向肽介导负载甲氨蝶呤(MTX)的肝癌细胞来源外泌体(tumor-derived exosome-TEX)的抗肿瘤效果及不良反应.方法:利用超速离心法收集负载MTX的小鼠肝癌细胞来源的外泌体(TEXMTX);利用外泌体特异锚定短肽CP05将肝癌靶向肽SP94修饰在TEXMTX表面,活...     

子痫前期蜕膜巨噬细胞源性外泌体来源miR-146a-5p通过靶向HIF1α抑制滋养细胞的活力和侵袭能力

目的：探究蜕膜巨噬细胞源性外泌体miR-146a-5p对子痫前期滋养细胞的作用及其分子机制。方法：收集子痫前期（preeclampsia,PE）患者和正常妊娠女性蜕膜组织，使用密度梯度法与流式细胞术分选获得巨噬细胞，提取蜕膜巨噬细胞源性外泌体；为了鉴定外泌体，采用透射电镜观察结构，western blot验证外泌体CD63蛋白表达；采用CCK-8检测外泌体对滋养细胞活力的影响；Transwell实验检测滋养细胞迁移变化；qPCR检测外泌体中miR-146a-5p的表达；western blot检测滋养细胞中HIF1α蛋白表达；双荧光素酶报告基因检测miR-146a-5p与HIF1α是否存在结合位点。结果：巨噬细胞外泌体呈现直径约30～130 nm的中间凹陷“饼状”结构形态，CD63高表达，符合外泌体特征。与正常组相比，PE组蜕膜巨噬细胞源性外泌体显著降低滋养细胞增殖与迁移（P<0.001）。PE组蜕膜巨噬细胞源性外泌体中miR-146a-5p表达量显著下降，蜕膜巨噬细胞源性外泌体处理滋养细胞后滋养细胞中HIF1α蛋白表达显著升高，miR-146a-5p和HIF1α之间存在靶向结合...     

肝癌外泌体LINC ROR对巨噬细胞炎症反应的影响

目的探究肝癌细胞分泌的外泌体中长链非编码RNA（long intergenic non-coding RNA）LINC ROR对巨噬细胞功能的调节作用。方法差速离心分离得到肝癌细胞PLC/PRF/5上清中的外泌体。电镜和纳米颗粒追踪分析仪检测外泌体形态特征和粒径分布。激光共聚焦荧光显微镜观测外泌体与巨噬细胞的空间相对位置。实时荧光定量PCR技术检测LINC ROR 在外泌体中的表达水平。 ELISA法检测巨噬细胞中LINC ROR 小干扰RNA（siRNA）基因沉默后在脂多糖刺激下促炎症因子白细胞介素（IL）-1β的表达水平。结果肝癌细胞分泌的外泌体呈圆状,直径为100 nm左右,同时观测到巨噬细胞能接收肝癌细胞来源的外泌体。相对于正常肝细胞来源的外泌体,肝癌细胞PLC/PRF/5来源的外泌体中高表达LINC ROR。巨噬细胞中LINC ROR基因沉默后,在脂多糖诱导的炎症反应下,巨噬细胞促炎症因子IL-1β的表达水平明显增强。结论肝癌细胞分泌的外泌体中LINC ROR能对邻近巨噬细胞的炎症反应产生调控作用。     

工程外泌体靶向技术及在周围神经损伤修复领域的潜能

外泌体具有良好的稳定性、生物相容性、生物屏障渗透性,以及低免疫原性和低毒性,在治疗和靶向药物递送应用上具有巨大潜力。通过基因工程设计将靶向配体插入外泌体表面,将可以实现靶向患病组织或器官并发挥治疗作用。本文综述了外泌体的产生与功能,当前药物加载到外泌体中的方式及靶向技术。此外,还讨论了工程外泌体在周围神经损伤修复领域的潜能,为周围神经损伤的靶向治疗提供新的方案。     

靶向脑胶质瘤的Ang外泌体递送系统的构建

目的 构建可以精准靶向胶质母细胞瘤(glioblastoma, GBM)的外泌体。方法 构建靶向GBM的Ang-Lamp2b-HA质粒，将Ang-Lamp2b-HA质粒和对照pcDNA3.1载体质粒分别转染入HEK293T细胞后提取工程化外泌体Ang-exo和对照未修饰外泌体Unmod-exo,使用蛋白免疫印迹技术观察两组外泌体标志蛋白表达情况，使用扫描电镜和纳米颗粒分析仪观察两组外泌体形态学表征。建立基于Transwell系统的bEnd.3/LN229体外血脑屏障模型，上下腔室分别接种bEnd.3细胞和LN229细胞，生成完整屏障后，分别在上腔室中加入已染色的Ang-exo和Unmod-exo,通过共聚焦激光扫描显微镜观察两组外泌体在下腔室中胶质瘤细胞荧光强度，验证Ang-exo穿透血脑屏障能力和靶向的能力。已染色的Ang-exo和Unmod-exo外泌体分别通过尾静脉注射入荷瘤小鼠模型，通过活体动物成像和离体器官成像观察两组外泌体在荷瘤小鼠体内荧光分布变化，验证其穿透血脑屏障能力和靶向效果。将Ang-exo与生理盐水分别尾静脉注射入健康小鼠体内，观察比较器官变化情况，对比血液生物化...     

小鼠肝癌细胞外泌体对树突状细胞成熟与功能的影响

目的 探讨小鼠肝癌细胞(Hepa1-6)来源的外泌体对树突状细胞成熟和功能的影响.方法 提取小鼠Hepa1-6细胞的外泌体,用透射电镜来鉴定外泌体的外形,Western blot方法测定外泌体的标志蛋白CD63和TSG101的表达,使用小鼠Hepa 1-6细胞外泌体冲击树突状细胞(DCs),DCs成熟相关表面分子CD40、CD80、CD83、CD86、MHC-Ⅱ的表达使用流式细胞术检测;将小鼠T淋巴细胞和小鼠Hepa1-6细胞外泌体致敏的DCs一起孵育5d,使用CFSE染色标记和流式法来测定共孵育T细胞的分裂增殖情况.结果 透射电镜可以观察到从Hepa1-6细胞的上清液中收集到的外泌体,表现为圆形或类圆形膜性囊泡样结构,符合外泌体的典型特征;Western blot检测表明小鼠Hepa1-6细胞来源的外泌体表达CD63、TSG101标志性蛋白,不表达细胞色素C;从小鼠Hepa1-6细胞提取来的外泌体致敏DCs,可上调表面MHC-Ⅱ类分子、成熟标志分子CD83和共刺激分子CD40、CD80、CD86(P ＜0.05).且随着外泌体浓度的增加,DC表面分子表达增高;同时可促进T淋巴细胞的增殖(P＜0.05).结论 小鼠Hepa 1-6细胞提取的外泌体可促进DC2.4的朝向成熟表型分化,并促进T细胞的增殖.     

经HIV包膜蛋白gp120刺激的T细胞外泌体促进巨噬细胞M2极化

目的：本研究旨在探讨经HIV膜蛋白gp120处理后人T淋巴细胞系（H9）外泌体对巨噬细胞极化的影响。方法：采用CCK8试剂盒检测gp120处理后人T淋巴细胞H9活力；采用ELISA法检测H9细胞上清液中炎症因子水平；通过电镜和Western blot实验鉴定外泌体特征；PHK67染色观察外泌体进入巨噬细胞情况；最后通过ELISA和免疫荧光检测巨噬细胞极化标记物，分析gp120处理后T细胞外泌体对巨噬细胞极化的影响。结果：HIV gp120蛋白抑制人T淋巴细胞H9增殖并促进炎症因子释放。成功提取人T淋巴细胞H9外泌体，电镜下为中间凹陷的膜结构，高表达标记蛋白CD9、CD63、CD81。PHK67染色结果显示H9细胞外泌体可进入巨噬细胞。经gp120处理的H9细胞外泌体可促进巨噬细胞向M2型极化。结论：HIV膜蛋白gp120处理人T淋巴细胞H9分泌的外泌体能够促进巨噬细胞M2极化，可能是gp120在免疫调节中的新机制。     

人骨髓间充质干细胞分泌的外泌体调控恶性胶质瘤相关巨噬细胞的极化

  目的  探究人骨髓间充质干细胞分泌的外泌体对肿瘤相关巨噬细胞极化的影响，并初步探讨其对胶质瘤发生发展的影响。  方法  利用试剂盒提取人骨髓间充质干细胞分泌的外泌体，通过扫描电镜及Western blot 鉴定外泌体。将胶质瘤细胞分为SHG449:SHG449细胞不做特殊处理；SHG449+M0组:SHG449细胞与M0型巨噬细胞共培养；SHG449+M0+exosome组:SHG449细胞与M0型巨噬细胞共培养后，加入标记有PKH-67的外泌体使其进入M0型巨噬细胞。  结果  （1）人骨髓间充质干细胞分泌的外泌体成功提取，且进入M0型巨噬细胞；（2）外泌体进入胶质瘤细胞SHG449诱导极化的巨噬细胞后细胞形态转化，且M2型巨噬细胞活化标志物Arginase、CD206以及CCL22，TGF-β表达下降（Arginase:P < 0.01，CD206:P < 0.05， CCL22:P < 0.05，TGF-β:P < 0.01），M1型活化标志物iNOS，CD68以及IL-1β，TNF-α表达上升（iNOS:P < 0.01，CD68:P < 0.01，L-1β:P < 0.000 1，TNF-α:P < 0.001）；（3）被外泌体诱导极化的巨噬细胞导致胶质瘤细胞增殖能力下降（P < 0.05），凋亡能力上升（P < 0.000 1）。  结论  人骨髓间质细胞分泌的外泌体可抑制肿瘤相关巨噬细胞向M2表型转化，并诱导其向M1表型转化，调节肿瘤免疫微环境，从而达到抑癌的作用。     

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.