应用骨髓干细胞和自制胶原-壳聚糖构建组织工程心瓣膜

目的探讨应用骨髓基质干细胞(bone mesenchymal stem cells,BMSCs)诱导分化的内皮细胞为种子细胞,以胶原-壳聚糖复合物为支架材料,运用组织工程学的原理和方法体外构建组织工程心脏瓣膜(tissue engineering heart valve,TEHV)的可行性。方法兔主动脉壁体外分离、培养、传代平滑肌细胞、成纤维细胞,将培养的成纤维细胞、平滑肌细胞与兔骨髓基质干细胞诱导分化的内皮细胞按顺序种植在预湿处理的胶原-壳聚糖复合支架上,通过组织学及倒置显微镜、扫描电镜观察内皮细胞、成纤维细胞、平滑肌细胞在支架上生长、增殖和基质分泌情况。结果 HE染色示内皮细胞能够在胶原-壳聚糖复合支架黏附、伸展、增殖,在TEHV表面长成连续的细胞层;扫描电子显微镜示TEHV表面光滑,细胞生长良好,细胞层完整,且瓣膜表面的内皮细胞具有合成和分泌前列环素(PGI2)的功能。结论以兔主动脉壁体外分离、培养、传代的平滑肌细胞、成纤维细胞和BMSCs诱导分化的内皮细胞为种子细胞,依次种植在胶原-壳聚糖复合支架上可以构建TEHV,且内皮细胞能够分泌PGI2。     

精氨酸-甘氨酸-天冬氨酸肽固定去细胞瓣构建组织工程瓣膜的实验研究

目的：研究促黏附分子精氨酸-甘氨酸-天冬氨酸（RGD）肽对去细胞瓣组织工程心脏瓣膜（TEHV）构建的影响：方法：酶＋去污剂法制备去细胞瓣天然支架，应用化学交联剂Sulfo-LC-SPDP，使GRGDSPC肽与之稳定纳合，然后表面种植大鼠肌成纤维细胞以构建TEHV文验组采用GRGDSPC肽固定去细胞瓣，对照组则为未处理去细胞瓣．体外培养1周后取瓣叶，作苏木精-伊红（H-E）染色和扫描电镜观察，检测羟脯氨酸和DNA含量，逆转录-聚合酶链反应（RT-PCR）方法检测瓣膜Ⅰ型胶原、赖氨酰氧化酶（LOX）mRNA表达：结果：与对照组比较，实验组形态学显示细胞紧密联合且胞外基质丰富，羟脯氨酸和DNA含量值增高，Ⅰ型胶原、LOX mRNA表达增强：结论：RGD肽表面修饰去细胞瓣，提高天然支架细胞黏附性，促进种子细胞生长、繁殖与细胞外基质分泌，有利TEHV构建。     

骨髓间充质干细胞和猪去细胞瓣膜支架构建组织工程瓣膜

目的 探讨运用组织工程技术以骨髓间充质干细胞和去细胞猪心脏瓣膜支架构建组织工程心脏瓣膜的方法.方法 体外培养、扩增自体骨髓间充质干细胞并鉴定,接种于以曲拉通-脱氧胆酸钠、RnaseⅠ和DnaseⅠ去细胞的猪心脏瓣膜支架上,形成细胞材料复合物,体外培养7 d,将该复合物移植于裸鼠腹腔,4周后行组织学检测.结果 骨髓间充质干细胞具有与成纤维细胞相似的生物学特性,表达ASMA,Vimentin抗原,去细胞瓣膜去细胞彻底,骨髓间充质干细胞可在支架表面良好生长,形成表面光滑的细胞层,分泌细胞外基质,生长好.在裸鼠体内可继续扩增,形成多层细胞.结论 运用组织工程技术以骨髓间充质干细胞和去细胞猪心脏瓣膜可生成初级组织工程瓣膜.     

骨髓基质干细胞构建组织工程心脏瓣膜的初步研究

目的：探讨用骨髓基质干细胞(BMSCs)和脱细胞天然嚣唾支集体外构建组织工程心脏瓣膜(TEHV)的可行性。方法：髂嵴穿刺抽取狗骨髓液，Percoll密度梯度离心法获取BMSCs．DMEM培养液体外培养扩增，免疫组化染色及流式细胞术分析鉴定分化细胞表型。采用去污剂和酶消化法制作脱细胞猪主动脉瓣膜支架，将BMSCs分化细胞接种于瓣膜支架上构建TEHV。分别行石蜡包埋切片H-E染色、免疫组化染色、扫描电镜及透射电镜检查观察TEHV的组织学结构并鉴定细胞类型。结果：BMSCs分化细胞呈梭形，α-SMA及Vimentin染色阳性，其α-SMA表达与血管壁肌成纤维细胞相近。异种瓣膜支架细胞去除完全，纤维支架结构保留完整。石蜡切片示：BMSCs在脱细胞支架上呈复层生长，α-SMA阳性。扫描电镜示TEHV表面光滑，细胞层完整．透射电镜示其细胞成分为有活性的分泌型细胞．呈梭形，复层生长。结论：BMSCs的自然分化细胞具有肌成纤维细胞的特性，种植于脱细胞瓣膜支架上构建TEHV简便可行。TEHV的在体改建尚需进一步研究。     

CDMP1诱导成纤维细胞向成软骨细胞表型分化的实验研究

目的 应用软骨形态发生蛋白-1(CDMP1)生长因子，体外诱导真皮成纤维细胞向成软骨细胞表型分化，探讨其作为组织工程化软骨种子细胞的可行性方法取成人真皮成纤维细胞，体外扩增至第2代，以加入cDMP1生长因子(100ng／mL)的含10％胎牛血清的F-12培养液诱导，每3d换液1次，进行单层培养，对照组为不加CDMP1培养的成纤维细胞-7d后，免疫荧光检测Ⅱ型胶原分泌，RT-PCR检测Aggrecan、Ⅱ型胶原mRNA表达。结果 诱导后成纤维细胞细胞形态由梭形向软骨细胞样多角形、多边形转变。Ⅱ型胶原免疫荧光检测表达阳性，RT-PCR检测Aggrecan、Ⅱ型胶原mRNA表达阳性。结论 成纤维细胞在CDMP1生长因子诱导下能向成软骨细胞表型分化，并能分泌软骨细胞特异性基质，有可能成为软骨组织工程新的种子细胞来源。     

CDMP1诱导成纤维细胞向成软骨细胞表型分化的实验研究

目的应用软骨形态发生蛋白-1(CDMPI)生长因子,体外诱导真皮成纤维细胞向成软骨细胞表型分化,探讨其作为组织工程化软骨种子细胞的可行性.方法取成人真皮成纤维细胞,体外扩增至第2代,以加入CDMPl生长因子(100ng/mL)的含10%胎牛血清的F-12培养液诱导,每3 d换液1次,进行单层培养,对照组为不加CDMPl培养的成纤维细胞.7 d后,免疫荧光检测Ⅱ型胶原分泌,RT-PCR检测Aggrecan、Ⅱ型胶原mRNA表达.结果诱导后成纤维细胞细胞形态由梭形向软骨细胞样多角形、多边形转变.Ⅱ型胶原免疫荧光检测表达阳性,RT-PCR检测Aggrecan、Ⅱ型胶原mRNA表达阳性.结论成纤维细胞在CDMPI生长因子诱导下能向成软骨细胞表型分化,并能分泌软骨细胞特异性基质,有可能成为软骨组织工程新的种子细胞来源.     

兔骨髓基质细胞在诱导条件下的成骨特性

目的 观察兔骨髓基质细胞的生长特点及诱导条件下的成骨能力。方法 使用密度梯度离心分离兔骨髓基质细胞进行培养，保留贴壁细胞传代，观察在培养液中添加地塞米松，维生素C，β－甘油磷酸钠条件下骨髓基质细胞生长及成骨分化情况。结果 骨髓基质细胞呈成纤维细胞样表现，增殖能力强。诱导条件下第2代细胞的碱性磷酸酶活性明显增高，10－12d达到最高峰，并且出现矿化结节。结论 使用本实验方法，获得的骨髓基质细胞成骨能力肯定，增殖能力强，可作为骨组织工程的种子细胞。     

骨髓间充质干细胞的分离培养及定向诱导软骨细胞的实验研究

目的　体外培养大鼠骨髓间充质干细胞并向软骨细胞表型分化 ,探讨其作为组织工程软骨种子细胞的可行性。方法　取成年大鼠股骨骨髓 ,体外培养、纯化。取第三代成年大鼠骨髓间充质干细胞 ,实验组用HG DMEM无血清培养液诱导 ;对照组用含 1 0 %胎牛血清的HG DMEM培养液自然分化。形态学观察 ,免疫组化检测Ⅱ型胶原分泌。结果　大鼠骨髓间充质干细胞为均一的成纤维细胞样。实验组与对照组Ⅱ型胶原免疫组化阳性率有显著差异 (P <0 .0 1 )。结论　成年大鼠骨髓间充质干细胞在特定的培养基能向软骨细胞方向转化 ,作为软骨组织工程种子细胞具有可行性     

皮肤成纤维细胞构建组织工程肌腱的实验研究

近年来，研究者们应用类似于骨髓基质干细胞的细胞作为组织工程肌腱的种子细胞，未获明显进展。皮肤成纤维细胞和肌腱细胞均来源于中胚层，细胞形态相似。如果成纤维细胞能取代肌腱细胞，作为种子细胞应用于肌腱组织工程则可望解决种子细胞缺乏的难题。作者曾应用成纤维细胞作为种子细胞修复肌腱缺损取得初步成功，但缺乏长期观察结果。本研究旨在长期观察皮肤成纤维细胞构建的组织工程肌腱，并与肌腱细胞作为种子细胞的组织工程肌腱进行比较。     

小鼠骨髓基质干细胞的培养及常见的组化染色方法

目的:研究小鼠骨髓基质干细胞的培养条件及其成为组织工程种子细胞的可能性.方法:取小鼠股骨骨髓进行骨髓基质干细胞的原代培养,通过相差显微镜、光镜及扫描电镜观察,了解骨髓基质干细胞的生长情况及其特点.结果:刚接种的干细胞散在分布,胞体透亮,1～2 d后开始贴壁,1周后开始形成成纤维细胞样集落,大约2周长成单层,碱性磷酸酶染色阳性,细胞可分泌胶原,可形成钙结节.结论:小鼠骨髓基质干细胞可在体外进行培养增殖并具有组织工程种子细胞的特点.     

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.