膀胱移行上皮细胞的体外培养研究

目的：探索并建立大鼠膀胱移行上皮细胞的体外培养方法，为膀胱癌相关研究提供实验依据。方法：获取Wistar大鼠膀胱粘膜，采用Dispase酶消化法收集上皮细胞。动态观察细胞形态变化、生长增殖情况；对培养细胞进行细胞周期检测及超微结构观察，并行免疫组织化学鉴定。结果：培养细胞为二倍体移行上皮细胞，无成纤维细胞混杂生长。免疫组织化学证实角蛋白染色阳性。结论：膀胱移行上皮细胞体外培养为体外研究提供了理想的模型。     

尿道粘膜上皮细胞的分离培养和鉴定

目的：为采用组织工程技术构建尿道粘膜组织提供实验依据。方法：取雄性新西兰幼兔尿道粘膜组织小块,酶消化成单细胞悬液,接种后静置培养、传代。动态观察细胞形态变化及生长增殖情况。细胞进行常规组化染色、免疫组化染色及流式细胞仪检查,并观察超微结构。结果：整个上皮细胞生长期内无成纤维细胞混杂生长,均为单一的上皮细胞,并证实为二倍体细胞。细胞可传11－13代,成活50－60d。结论：新西兰幼兔尿道粘膜上皮细胞可在体外培养,在一定时间内保持增殖能力。     

皮肤烧伤增强小鼠肠道上皮细胞的凋亡

已有研究表明皮肤烧伤后肠道粘膜上皮细胞增殖加强,但粘膜重量下降,因而烧伤后肠道粘膜上皮细胞死亡更为显著。通过利用小鼠烧伤模型,体外观察烧伤后肠道粘膜上皮和细胞凋亡和增殖的变化,旨在验证烧伤小鼠肠道粘膜上皮和细胞凋亡增强的假设。 实验用63只成年雄性C57BL6小鼠,3只作为正常对照,余随机分为假伤组和烧伤组,均麻醉、剔毛、置于致伤模具中,利用蒸汽     

兔包皮上皮细胞的分离培养和鉴定

目的:收集兔的小块包皮组织,分离培养上皮细胞,并传代增殖,为组织工程化尿道构建提供细胞来源.方法:取雄性家兔包皮小块组织,酶消化成单细胞悬液,接种后静置培养、传代.并定期观察细胞形态变化及生长增殖情况,免疫组化染色,细胞计数及MTT测定以判断细胞增殖能力.结果:分离消化后的上皮细胞生长良好,经免疫组化测定为正常上皮细胞,并传代3代,细胞数量达到植入生物支架并生长的需要.结论:家兔的包皮上皮细胞可在体外培养增殖并传代,并达到相应细胞数量.     

人体尿道粘膜上皮细胞的连续培养

目的：探讨人尿道粘膜上皮细胞体外培养技术，为构建组织工程化尿道提供种子细胞。方法：取尿道下裂患者尿道粘膜，经中性蛋白酶和胰蛋白酶消化，获取粘膜上皮细胞接种于含8％胎牛血清培养基中连续培养，观察细胞形态变化及生、增殖过程。结果：体外培养细胞长满后呈上皮细胞特有的铺路石样外观，体外可连续传9-10代，生长期50-60d。细胞角质蛋白免疫组织化学染色阳性，透射电镜下可见上皮细胞间特有的桥粒结构。结论：尿道粘膜上皮细胞可在体外连续培养，4代以内的培养细胞可用于组织工程化尿道的构建。     

以L929细胞为滋养层的尿道黏膜上皮细胞体外培养

目的 探索尿道黏膜上皮细胞体外培养的技术和方法，为进一步采用组织工程技术构建尿道黏膜组织奠定基础，并为尿道黏膜的生理、药理、毒理学及微生态研究提供实验模型。方法 取刚离乳的雄性新西兰幼兔尿道黏膜组织，分别以DispaseⅠ消化液和混合消化液消化成单细胞悬液，以差速贴壁法排除成纤维细胞，接种后以L929细胞为滋养层细胞进行培养，定期换液，细胞生长、增殖至80％～90％融合时传代。细胞进行常规HE染色、流式细胞仪检测，以扫描电镜、透射电镜观察其超微结构。再分别设立实验组(n=20)、阳性对照组(正常尿道黏膜组织石蜡切片，n=20)及阴性对照组(成纤维细胞铺片，n=20)行免疫组织化学染色。结果 原代培养10天左右细胞逐渐生长融合成片，如铺路石状，细胞大小均一。上皮细胞为二倍体细胞，生长期内均为单一的上皮细胞，无成纤维细胞混杂生长，细胞可传11～13代，成活50～60天。结论 新西兰幼兔尿道黏膜上皮细胞可在体外进行培养，在一定时间内保持增殖活力，为构建组织工程化尿道奠定了基础，且为尿道黏膜的体外研究提供了实验模型。     

组织工程尿道粘膜的体外构建

目的:利用组织工程方法在体外构建形成尿道粘膜结构。方法:酶消化法获得猪膀胱尿路上皮细胞(UC),以免疫荧光和RT-PCR方法进行UC鉴定。制备膀胱脱细胞基质移植物(BAMG)作为支架材料,以苏木精-伊红染色、Masson染色、免疫组化和扫描电镜进行评价。经过体外培养和扩增后,将P3代UC接种在BAMG上。结果:BAMG支架上的UC经过体外培养1周后即可形成沿基膜排列的复层上皮结构。扫描电镜显示细胞-材料复合良好,免疫组化检测支架上的UC广谱角蛋白表达阳性。结论:运用组织工程方法能够在体外快速进行尿道粘膜上皮结构的初步构建,为进一步临床修复诸如尿道下裂、尿道狭窄等尿道缺损奠定技术基础。     

人类肥大乳房乳腺上皮细胞的原代培养

目的 探讨人类肥大乳房乳腺上皮细胞的原代培养方法.方法 采用胶原酶消化培养法,在体外进行人类肥大乳房乳腺上皮细胞的分离培养,用倒置显微镜观察、细胞爬片、HE染色和细胞角蛋白免疫组织化学染色的方法对分离培养的细胞进行形态学观察和鉴定.结果 倒置显微镜下观察细胞形态呈鹅卵石型或多角型,部分形态不规则,增殖的过程中形成岛屿状闭合型的细胞群,细胞之间连接紧密.细胞HE染色可见细胞胞质呈粉红色或浅紫色,细胞核呈蓝紫色,圆形或椭圆形,核中可见深蓝色的染色体.免疫组化鉴定结果显示,培养的细胞胞浆内可见棕黄色的细胞角蛋白着色,表达上皮细胞特异的细胞角蛋白18.结论 应用酶消化法和条件培养液可以获得纯度较高的人类肥大乳房乳腺上皮细胞.     

猪气管上皮细胞的分离、培养和鉴定

目的 探索猪气管上皮细胞体外适宜的生长、增殖条件,以期为组织工程化气管内壁上皮化提供种子细胞.方法 无菌切取猪颈段气管,细菌蛋白酶消化.以明胶作为铺层,接种、培养.待细胞贴壁后,进行光镜观察、广谱角蛋白免疫组化检测、免疫荧光鉴定.结果 光镜观察可见细胞呈铺路石样生长.角蛋白检测和免疫荧光检测均呈阳性,而阴性对照组和空白对照组呈阴性.结论 以明胶作为铺层可以培养出活力较好、纯度高的气管上皮细胞.     

人肛瘘管壁上皮细胞的体外分离培养和鉴定

目的:寻找建立人肛瘘管壁上皮细胞体外分离、培养及鉴定细胞起源的技术方法.方法:通过组织块法分离并原代培养人肛瘘管壁组织上皮细胞,观察上皮细胞形态并对培养细胞进行细胞化学鉴定.结果:分离后的上皮细胞在24～36 h贴壁,在7～9 d进入对数期生长期.细胞鉴定角蛋白免疫细胞化学染色为阳性,波形蛋白免疫细胞化学染色为阴性.结论:该方法获得的肛瘘管壁上皮细胞能够在体外稳定培养,可以为细胞分子水平上研究肛瘘瘘管愈合机制提供可靠的细胞模型.     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.     

Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery

Background: The efficacy of intraoperative salvage and washing of wound blood and the predictors of allogeneic red cell transfusions in prosthetic hip surgery are insufficiently known.
Methods: In 96 patients, undergoing primary or revision surgery, salvaged and washed red cells and, if necessary, allogeneic blood were used to keep haematocrit not lower than 33%. The bleeding of red cells during hospital stay was calculated from the red cell balance. The preoperative red cell reserve (millilitres of red cells in excess of a haematocrit of 33%) was estimated and the difference between this volume and the total bleeding of red cells was retrospectively used to classify patients with regard to the need for red cells. Stepwise regression analysis was used to define patient-related variables associated with allogeneic blood transfusion.
Results: Preoperative knowledge of the type of operation (primary, revision), the preoperative red cell reserve, and the body mass could predict roughly half of the need for banked blood (r²=0.45). Only one-third of the total bleeding of red cells was retransfused. For complete avoidance of allogeneic blood, autotransfusion was most effective in patients with a moderate need (0–4 u). However, 32% of such patients required allogeneic blood.
Conclusions: Autotransfusion has a limited efficacy to decrease the need for allogeneic blood, and other blood-saving methods should be added for this purpose. It is difficult to predict the need for allogeneic blood preoperatively.     

缺氧对肾小管上皮细胞分泌外泌体的影响

目的    观察缺氧对肾小管上皮细胞分泌外泌体的影响,探讨外泌体在缺氧致肾脏损伤中的作用及机制。 方法    （1）常氧（21% O₂）及缺氧（1% O₂）分别处理大鼠肾小管上皮细胞（NRK-52E）48 h,收集细胞上清液并使用高速梯度离心法分离外泌体。采用透射电镜、纳米示踪分析、Western印迹、蛋白浓度定量鉴定并比较两组外泌体的基本特性。（2）在共培养实验中,以不同浓度（1、10、50、100、300 mg/L）的常氧外泌体、缺氧外泌体分别干预脂多糖（LPS）诱导的大鼠原代腹腔巨噬细胞,使用实时荧光定量PCR与酶联免疫吸附试验（ELISA）法分别检测巨噬细胞白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）、诱导型氮氧化物合酶（iNOS）水平;使用Western印迹法检测巨噬细胞磷酸化（p）STAT/STAT及细胞因子信号传导抑制蛋白1（SOCS1）的蛋白表达;最后,使用实时荧光定量PCR法检测常氧外泌体与缺氧外泌体中炎性反应相关微RNA（microRNA,miR）的表达差异。 结果    （1）离心得到的囊泡具有外泌体典型的结构,粒径小于150 nm,表达外泌体标志蛋白CD63,说明分离得到外泌体。缺氧对肾小管上皮细胞分泌的外泌体形态、粒径分布比例无明显影响,但提高了外泌体的分泌量。（2）缺氧外泌体相比于常氧外泌体促进了LPS诱导的M1型巨噬细胞IL-6、TNF-α、iNOS 的表达和分泌（均P＜0.01）,同时提高STAT的磷酸化水平并减少SOCS1的蛋白表达（均P＜0.01）;对炎性反应相关microRNA检测发现缺氧外泌体中miR-155、miR-27a表达量较常氧外泌体明显升高（P＜0.05）。 结论    缺氧可改变外泌体的生物学功能,表现为协同促进LPS诱导的M1型巨噬细胞的表型转化,这可能是慢性肾脏病微炎性反应状态持续的原因之一。     

In Vitro Function and Durability Assessment of a Novel Polyurethane Heart Valve Prosthesis

Abstract While flexible-leaflet, central-flow prosthetic heart valves promise relief from anticoagulation therapy, they continue to be restricted by inadequate durability. In consequence, a novel trileaflet valve, made entirely from polyurethane, has been developed. A batch of 6 consecutively manufactured polyurethane valves was subjected to hydrodynamic function and accelerated fatigue testing. Computerized data acquisition and control systems have been introduced to improve valve testing methodologies. In terms of hydrodynamic function, the polyurethane valve demonstrates transvalvular pressure gradients similar to those for a bioprosthetic valve (Carpentier-Edwards) and levels of retrograde flow significantly less than those for either the bioprosthetic valve or a bileaflet mechanical valve (St Jude Medical). The equivalent of 10 years of cycling without failure has been exceeded by all 6 polyurethane valves in accelerated fatigue tests with 2 valves remaining intact after 674 million cycles (equivalent to approximately 17 years) in continuing tests. Highspeed photography revealed considerable differences in leaflet motion between valves cycled at accelerated and physiological rates.     

Negative pressure ventilation vs. spontaneous assisted ventilation during rigid bronchoscopy: A controlled randomised trial

Background: Ventilation during interventional rigid bronchoscopy (IRB) under general anaesthesia (jet ventilation, positive pressure ventilation and spontaneous assisted ventilation) may offer some difficulties. This study compares the effectiveness during IRB of intermittent negative pressure ventilation (INPV) and spontaneous assisted ventilation (SAV). Methods: Thirty-eight patients submitted to IRB were randomised into two groups: SAV or INPV. All patients received a total intravenous anaesthesia; INPV patients were paralysed. Pre-and intra-operative arterial blood gases and O₂ flow through a rigid bronchoscope were assessed. The endoscopist applying a subjective score evaluated the operating conditions. Results: Patients of the INPV group, as compared to the SAV group, required a lower dosage of fentanyl (2.6 ± 1.8 (μg · kg^?1· h^?1 vs. 6.6 ± 4.8 μg · kg^?1· h^?1), a lower O₂ supply (3.3 ± 2.8 1/min vs. 11.6 ± 3.4 1/min), a shorter recovery time (5.4 ± 2.9 min vs. 9.8 ± 7.1 min) and no manually assisted ventilation (0 ± 0 vs. 1 ± 1.1 nd?/procedure). Intraoperative PaCO₂ was higher in the SAV (8.1 ± 1.3 kPa) than in the INPV group (5.0 ± 1.6 kPa) and intraoperative pH differed in the two groups (7.26 ± 0.05, SAV vs. 7.47 ± 0.08, INPV). Operating conditions, as assessed by a subjective score, were considered better with INPV than with SAV (4.9 vs. 4.3). Conclusions: As compared to SAV, INPV in paralysed patients during IRB reduces administration of opioids, shortens recovery time, prevents respiratory acidosis, excludes the need for manually assisted ventilation, reduces 02 need and affords optimal surgical conditions. INPV appears a safe, non-invasive and effective ventilatory management during IRB.