碱性成纤维细胞生长因子对国产多孔钽-软骨细胞复合物软骨细胞表型维持及去分化的影响

目的 对比不同浓度碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)对国产多孔钽-软骨细胞复合物维持软骨细胞表型和去分化作用的影响.方法 分离培养3周龄新西兰幼兔膝关节软骨细胞,Ⅱ型胶原免疫细胞化学染色、番红O (Safranin O)染色鉴定软骨细胞;取第3代软骨细胞分为5组:A组(1 ng/mL bFGF-多孔钽-软骨细胞),B组(10 ng/mL bFGF-多孔钽-软骨细胞),C组(50 ng/mL bFGF-多孔钽软骨细胞),D组(多孔钽-软骨细胞)及E组(软骨细胞);MTT法检测不同浓度bFGF对多孔钽-软骨细胞生长及增殖状态的影响;扫描电镜观察bFGF-多孔钽-软骨细胞复合物细胞形态及生长;Ⅰ、Ⅱ、Ⅸ、Ⅹ型胶原免疫细胞化学染色检测软骨细胞表型变化及去分化状态;real time-PCR检测软骨细胞Ⅱ、Ⅹ型胶原mRNA表达.结果 Ⅱ型胶原免疫细胞化学染色及Safranin O染色均呈阳性反应,证实所分离培养的细胞为软骨细胞;1、10、50 ng/mL bFGF均可促进软骨细胞增殖,各实验组(A～D组)软骨细胞增殖与对照组(E组)相比,差异有统计学意义,其中10 ng/mL bFGF-多孔钽-软骨细胞增殖最为明显(P＜0.05);组间比较差异有统计学意义(P＜0.05);扫描电镜观察:各组软骨细胞在多孔钽表面及孔隙内生长、黏附,早期呈不等的球形,24 h后胞质延展并向周围伸出多条突起,相互连接、延展向孔隙内部生长,细胞间相互融合并覆盖支架材料;Ⅰ、Ⅱ、Ⅸ和Ⅹ型胶原免疫细胞化学染色显示10 ng/mL bFGF-多孔钽-软骨细胞组(B组)Ⅱ和Ⅸ型胶原表达高于对照组(E组,P＜0.05),组间差异也有统计学意义(P＜0.05);而Ⅰ和Ⅹ型胶原表达则低于对照组(E组,P＜0.05);real time-PCR检测软骨细胞Ⅱ、Ⅹ型胶原mRNA表达显示:各实验组(A～D组)Ⅱ型胶原mRNA的表达高于对照组(E组,P＜0.05),而Ⅹ型胶原mRNA表达量则低于对照组(E组,P＜0.05).结论 bFGF能维持多孔钽-软骨细胞复合物软骨细胞表型,抑制去分化,加强软骨细胞分泌功能.     

胶原-纤维蛋白混合凝胶对关节软骨细胞合成Ⅱ型胶原的影响

目的：以胶原蛋白和人血纤维蛋白混合物为载体在体外进行关节软骨细胞三维立体培养,构建人工软骨组织,研究载体对软骨细胞在其中的表达及合成Ⅱ型胶原的影响。方法：取2周龄的新生兔关节软骨,经消化,将获得的软骨细胞与牛Ⅰ型胶原、人血冻干纤维蛋白原、凝血酶按一定比例混合,制成软骨培养物并在体外培养。培养第3周时,取材进行Masson染色、Ⅱ型胶原寡核苷酸探针原位杂交和Ⅱ型胶原的免疫组化观察。 结果：体外培养3周,培养物内细胞大部分存活, Masson染色形成软骨陷窝,同源性细胞簇出现,细胞周围有蓝色物质环绕存在,原位杂交证实其软骨细胞表达Ⅱ型胶原mRNA,免疫组化证实软骨细胞分泌Ⅱ型胶原。 结论：用胶原蛋白和人血纤维蛋白为载体支架体外培养软骨细胞,可促进关节软骨细胞合成分泌Ⅱ型胶原,Ⅱ型胶原是软骨组织最主要的细胞外基质成分。     

软骨形态发生蛋白1诱导真皮成纤维细胞表达软骨细胞表型的实验研究

目的应用软骨形态发生蛋白(CDMP)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.方法取包皮环切术后丢弃真皮组织共3例,成纤维细胞体外培养扩增至第二代,以1×104/cm2密度接种,12 h后加入细胞诱导液(10%胎牛血清F-12培养液,CDMP1终浓度为100 ng/ml)单层培养,未加的成纤维细胞培养用CDMP1为对照.诱导7 d后观察细胞形态变化,Image Plus图像分析软件计算细胞长宽比例.激光共聚焦显微镜分别观察诱导前后细胞内Ⅰ、Ⅱ、Ⅲ型胶原表达及分布,Western印迹检测诱导前后细胞Ⅱ型胶原蛋白表达.反转录聚合酶链式反应(RT-PCR)检测诱导后成软骨相关的Sox9、聚集蛋白聚糖与Ⅱ、Ⅸ型胶原mRNA表达;同时检测与成骨相关的X型胶原、碱性磷酸酶(AKP)mRNA表达.培养第二代细胞以2×107个细胞/ml细胞密度进行离心管法培养,诱导14 d后行阿辛蓝与Ⅱ型胶原免疫组化染色.结果诱导后可见单层培养的成纤维细胞形态由长梭形向软骨细胞样多角形转变,Image Plus图像分析软件计算细胞诱导后的长宽比例为(1.40±0.15),较诱导前(7.40±1.30)差异有显著意义(P＜0.05);与正常软骨细胞(1.29±0.24)差异无显著意义.免疫荧光激光共聚焦观察发现诱导后细胞内出现Ⅱ型胶原表达,Ⅰ、Ⅲ型胶原表达呈阳性.RT-PCR检测成软骨相关的Sox9,聚集蛋白聚糖,Ⅱ、Ⅸ型胶原mRNA表达阳性;X型胶原、AKP未检测到mRNA阳性表达.Western印迹检测细胞诱导后Ⅱ型胶原蛋白表达阳性.离心管培养诱导7 d后阿辛蓝染色示糖胺聚糖(GAG)均匀分布于基质中,免疫组化染色示基质中Ⅱ型胶原表达阳性.结论第二代成人真皮成纤维细胞在CDMP1生长因子诱导下可向成软骨细胞表型分化,并能分泌软骨细胞特异性基质,有望成为软骨组织工程新的种子细胞来源.     

转化人关节软骨细胞的Ⅱ型胶原表型诱导

目的 用离心管聚集体培养（Aggregate culture)诱导转化人关节细胞的Ⅱ型胶原。方法 将体外长期培养的第30，40，50代转化软骨细胞消化后进行离心管培养，比较细胞在单层培养，离心管聚集体培养，以及在普通培养基，RAI诱导培养基下[2型骨形态发生蛋白（BMP－2）＋抗坏血酸盐（Ascorbate) 胰岛素（insulin)]，Ⅰ，Ⅱ，Ⅲ型胶原的表达和胞外基质发生情况。结果 在单层培养条件下，转化软骨细胞只表达Ⅰ型胶原，而在BAI诱导培养基及离心管聚集体培养下转化软有细胞表达的Ⅱ型胶原和大量胞外基质。结论 离心管聚集体培养是诱导转化软骨细胞Ⅱ型胶原的有效方式。     

三羟基异黄酮对关节软骨细胞合成胶原和蛋白多糖的影响

目的 通过对体外培养软骨细胞的实验研究,探寻受体酪氨酸激酶抑制剂对软骨细胞在细胞分子水平的影响及其可能机制。方法 对软骨细胞进行原代及传代培养,通过对培养细胞形态学及甲苯胺蓝染色观察,选择适合传代软骨细胞,应用三羟基异黄酮干预后1、2、3、4天RT-PCR、ICC及甲苯胺蓝染色观察法比较药物干预对体外培养软骨细胞Ⅰ、Ⅱ型胶原的转录和翻译水平及蛋白多糖的表达变化。结果 20 μg/mL及25 μg/mL三羟基异黄酮干预可以抑制Ⅰ型胶原表达,同时增加Ⅱ型胶原及蛋白多糖的表达。结论 三羟基异黄酮可以抑制脂多糖刺激诱导的软骨细胞反分化,对体外培养关节软骨细胞的正常表型具有一定的保护作用,其保护作用与三羟基异黄酮浓度呈现一定的相关性。     

软骨细胞体外分离培养与鉴定的实验研究

目的探讨兔关节软骨细胞分离、培养和鉴定的方法，建立软骨细胞的体外培养体系。方法4周龄新西兰白兔采用机械-酶消化法，分离膝关节软骨细胞接种培养以及传代培养．倒置相差显微镜观察细胞形态，甲苯胺蓝及Ⅱ型胶原免疫组化对细胞进行鉴定。结果成功建立了体外培养软骨细胞的实验方法。原代培养的软骨细胞呈多角形，传代3次后出现反分化。形态学、免疫化学染色显示细胞培养3代以内可以保持表型的稳定。甲苯胺蓝及Ⅱ型胶原染色阳性。细胞传至5代后．出现“成纤维细胞样”。结论本研究建立了简单易行的软骨细胞分离、培养方法；初代、第2代、第3代细胞生长良好，适合于实验研究；软骨细胞5代培养后．细胞袁型发生改变。     

成人脂肪来源干细胞定向诱导分化为软骨细胞的实验研究

[目的] 诱导脂肪组织来源干细胞(ADSCs)定向分化为软骨细胞并进行鉴定,为软骨组织工程获取大量种子细胞做准备.[方法] 对患者抽脂术的脂质部分进行分离培养及传代,采用四氮唑复合物(MTT)法测定细胞活性并描绘细胞增殖曲线,通过流式细胞仪将培养的细胞行干细胞鉴定,将第4代的ADSCs向软骨细胞定向诱导分化并行阿新蓝染色鉴定;免疫组化检测成软骨方向诱导后的ADSCsⅡ型胶原的表达.[结果] ADSCs体外增殖速度快,并且保持稳定的倍增率直至13～15代;流式细胞仪分析提示该细胞具有干细胞特性;通过定向分化技术,ADSCs可向软骨细胞分化,阿新蓝染色及Ⅱ型胶原表达均呈阳性,说明定向分化后的细胞具备正常软骨细胞的功能.[结论] 成功诱导ADSCs向软骨细胞定向分化,为软骨组织工程提供了可靠的种子细胞.     

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.     

多聚左旋赖氨酸促进大鼠肢芽细胞软骨分化的研究

目的:探讨多聚左旋赖氨酸(PL)对大鼠肢芽细胞向软骨细胞分化的促进作用及其可能机制。方法:取大鼠肢芽细胞在含不同剂量PL的培养液中培养4 d,根据培养细胞所形成的软骨集落形成情况、与阿尔新蓝结合量和Ⅱ型胶原的表达情况,判断PL促进肢芽细胞向软骨细胞分化现象;根据不同时间添加PL来推断其发挥最大作用的时间;用免疫组化检测神经钙粘附蛋白的表达。结果:PL促进培养中大鼠肢芽细胞软骨集落的形成的最佳剂量可能为10μg/mL;PL发挥最大作用的时间为培养的第24 h内;免疫组化显示:5μg/mL组中Ⅱ型胶原和神经钙粘附蛋白的表达增强。结论:PL在一定浓度范围内以剂量依赖性方式促进大鼠肢芽细胞向软骨细胞分化且可能是通过增强神经钙粘附蛋白的表达来完成的。     

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。     

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.     

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.