基于NF-κB/Twist 1通路二甲双胍对GDM大鼠子代胎鼠Ⅱ型肺泡上皮细胞EMT的作用机制

目的 探讨共表达PD-1/ICOS信号转换受体通过增强靶向CD19的嵌合抗原受体T细胞（CD19-CAR-T细胞）增殖能力提高其对弥漫大B细胞淋巴瘤（DLBCL）产生的抗肿瘤活性。方法 慢病毒感染法构建CD19-CAR-T细胞（bbz）以及共表达PD-1/ICOS信号转换受体的CD19-CAR-T细胞（PD-1/ICOS-bbz）;流式细胞术检测长期共孵育后T细胞CD69的表达;通过细胞计数检测CAR-T细胞的增殖情况;LDH法检测CAR-T细胞对靶细胞的细胞毒性;活体成像检测小鼠体内肿瘤细胞的生长情况;流式细胞术检测外周血中T细胞的比例。结果 成功构建bbz及PD-1/ICOS-bbz;长期共孵育后,PD-1/ICOS-bbz较bbz CD69表达水平更高,增殖能力及对靶细胞的细胞毒性均显著提高（P＜0.01）;PD-1/ICOS-bbz可以完全清除小鼠体内的淋巴瘤细胞,且PD-1/ICOS-bbz较bbz而言可以显著延长小鼠生存期（P＜0.01）,同时PD-1/ICOS-bbz较bbz具有更强的体内增殖能力(P＜0.05)。结论 PD-1/ICOS-bbz较传统的二代CAR-T细胞具有更强的抗肿瘤活性,有望成为一种潜在的弥漫大B细胞淋巴瘤的治疗方案。     

钠碘转运体报告基因共表达对嵌合型受体T细胞体外增殖及杀伤能力的影响

目的 探讨钠碘转运体（NIS）报告基因的共表达对嵌合型受体T（CAR-T）细胞体外增殖和杀伤活性的影响。方法 慢病毒感染法制备CAR-T细胞（仅表达CD19 CAR的T细胞）、NIS-T细胞(仅表达NIS报告基因的T细胞)和NIS-CAR-T细胞（共表达NIS和CD19 CAR的T细胞）,然后按T细胞蛋白表达情况分为4组∶T细胞组（未转染的T细胞）、CAR-T组、NIS-T组、NIS-CART组。流式细胞术检测各组NIS和CAR转染率。各组细胞常规培养24、48、72 h,CCK-8法检测增殖能力。各组T细胞为效应细胞,Nalm6肿瘤细胞为靶细胞,按效靶比0.5∶1、1∶1、2∶1、4∶1共培养24、48、72 h,乳酸脱氢酶细胞毒性检测法（LDH）检测各组细胞对肿瘤细胞的杀伤率,酶联免疫吸附试验（ELISA）法检测共培养上清液中各组细胞因子人干扰素-γ（IFN-γ）和人肿瘤坏死因子-β（TNF-β）释放水平。摄碘实验检测表达NIS蛋白各组细胞的NIS功能。结果 CAR-T细胞、NIS-CAR-T细胞的CAR转染率分别为91.91%、99.41%,NIS-T细胞、NIS-CAR-T细胞的NIS转染率分别为47.83%、50.24%。常规培养24、48、72 h CAR-T细胞与NIS-CAR-T细胞增殖率差异无统计学意义（P>0.05）。0.5∶1、1∶1、2∶1和4∶1效靶比作用24 h时CAR-T细胞杀伤率（%）均高于NIS-CAR-T细胞（P<0.05）,作用48 h和72 h时两组杀伤率差异均无统计学意义（P>0.05）。CAR-T细胞与NIS-CAR-T细胞均存在IFN-γ和TNF-β释放现象,释放水平均高于对照组（P<0.05）。NIS-T细胞与NIS-CAR-T细胞均具有特异性摄碘能力,二者间摄碘能力差异无统计学意义（P>0.05）,但均高于对照组T细胞（P<0.05）。结论 NIS报告基因的共表达不影响CAR-T细胞中CAR转染率,对细胞增殖和杀伤活性无抑制现象。     

基于多链结构的CD30 CAR-T细胞的抗肿瘤作用研究

目的 基于衔接蛋白DAP12的多链嵌合抗原受体T细胞(CAR-T)开发靶向CD30的CAR-T细胞药物,研究CD30 CAR-T对霍奇金淋巴瘤肿瘤细胞的体外和体内临床前药效。方法 通过基因合成和分子克隆技术,设计构建靶向CD30的CAR质粒,进行慢病毒包装,将得到的慢病毒转染T细胞,其中靶向CD30的多链CAR-T为CD30-KIRS2/Dap12-BB组,单链二代CAR-T为CD30-41BBζ组,未做病毒侵染的T细胞为NTD组,利用流式细胞术检测CAR阳性率情况,通过乳酸脱氢酶(LDH)释放检测细胞的杀伤活性,采用酶联免疫吸附试验(ELISA)检测细胞因子干扰素γ(IFN-γ)的分泌水平,进一步通过小鼠异种移植瘤模型检测CD30 CAR-T在小鼠体内抗肿瘤活性。结果 靶向CD30的多链CAR-T和单链二代CAR-T进行对比,研究发现多链CAR-T与单链CAR-T的杀瘤作用相似。但值得注意的是,多链CAR-T的IFN-γ分泌水平更高(P<0.001)。更重要的是,在小鼠的肿瘤模型实验中,多链CAR-T实现了肿瘤的完全消退。结论 靶向CD30的多链CAR-T在抗肿瘤活性方面优于传...     

人源间变性大细胞淋巴瘤BALB/c小鼠建模的免疫学机制

目的 建立人源间变性大细胞淋巴瘤（ALCL） BALB/c小鼠模型,探讨成瘤的免疫学机制.方法 BALB/c小鼠环磷酰胺（CTX）预处理,Karpas-299细胞右腋下注射;流式细胞术检测各组小鼠外周血淋巴细胞亚群比例.结果 ①成功建立人源间变性大细胞淋巴瘤BALB/c小鼠模型.②成瘤组与CTX组相比,CD3＋、CD8＋和CD19＋细胞减少（P＜0.05）;未成瘤组与CTX组相比,CD8＋、CD19＋细胞减少,CD20＋细胞增多（P＜0.05）;成瘤组CD3＋、CD8＋细胞较CTX组和未成瘤组均减少（P＜0.05）;未成瘤组CD20＋细胞较CTX组和成瘤组均增多（P＜0.05）.③注射CTX第3天,BALB/c小鼠CD3＋细胞增多,CD19＋细胞减少（P＜0.05）;第10天CD8＋、CD19＋、CD20＋细胞较注射CTX前减少（P＜0.05）;第17天和第24天,CD8＋、CD19＋、CD20＋细胞仍低于注射CTX前（P＜0.05）,但较第10天有逐渐回升趋势（P＞0.05）.结论 CTX所致机体免疫抑制在ALCL成瘤起始阶段起决定性作用,ALCL的生长可能与CD3＋、CD8＋细胞减少有关.     

表达高亲和PD-1突变体和嵌合抗原受体的双效CBNK细胞的构建及其生物学特性评价

目的 开发一种共表达PD-L1高亲和受体PD-1（HAPD1）和嵌合抗原受体（CAR）的新型双效 CBNK（HAPD1-CAR-CBNK）细胞,进一步提高肿瘤免疫治疗的疗效。方法 首先构建可同时表达高亲和PD-1（HAPD1）的靶向CD19的CAR的双效慢病毒载体,并包装慢病毒感染从脐血中分离扩增的单个核细胞获得双效脐血CAR-NK细胞。检测分析感染效率、细胞扩增能力、表面标志物表达率;然后通过体外共培养检测细胞在不同效靶比条件下对靶细胞杀伤效率以及不同扩增时期细胞的杀伤效率。最后在免疫缺陷小鼠（24只）体内验证双效CBNK细胞在体内对靶细胞的杀伤能力。结果 HAPD1和CAR基因利用慢病毒载体可高效转导至CBNK细胞（[18.63±1.88）%],病毒感染对细胞扩增倍数有一定影响（10.97±2.77 vs 24.84±3.17,P<0.05）,但对细胞表面标志物表达没有显著影响（P?0.05）;双效NK细胞在效靶比为5:1和10:1时的靶细胞杀伤效力高于普通CAR-CBNK细胞（[ 68.38±8.08)% ,（79.11±7.42）% vs（49.65±13.60）%,（59.78±9.32）%,P<0.05）。病毒感染后第9~12天双效NK细胞具有最强靶细胞杀伤能力。体内实验进一步证实,双效NK细胞移植28 d后动物白细胞中肿瘤细胞比例低于普通CAR-CBNK细胞移植组（[ 19.21±3.07）% vs（29.08±3.15）%,P<0.05]。结论 本研究成功构建了一种共表达HAPD1和CAR双效CBNK细胞,并在体外和体内实验证实其高效的靶细胞杀伤能力,为肿瘤免疫细胞治疗提供了一个新的有效方案。     

特异性人工抗原提呈细胞体外激活CD19嵌合抗原受体T细胞的构建

目的 构建CD19特异性人工抗原提呈细胞(aAPC)用于体外激活扩增CD19嵌合抗原受体(CAR)修饰T细胞(CD19-CAR-T),并考察其杀伤效应.方法 通过慢病毒介导的方法制备以NIH3T3为细胞骨架、表达共刺激分子CD86和/或CD137L的CD19特异性aAPC (NIH3T3-CD 19/86、NIH3T3-CD19/86/137L).采用照射的CD19特异性aAPC与CD 19-CAR-T细胞按一定比例混合培养激活扩增CD19-CAR-T细胞,台盼蓝染色法检测并绘制CD 19-CAR-T细胞生长曲线;流式细胞术检测CD19-CAR-T细胞CAR表达变化及分化表型;生物发光细胞毒性法检测扩增的CD19-CAR-T细胞体外靶特异杀伤效应.结果 流式检测结果显示NIH3T3-CD19/86和NIH3T3-CD19/86/137L细胞表面分别高表达CD19、CD86和/或CD137L分子;NIH3T3-CD19/86和NIH3T3-CD19/86/137L细胞都能够高效扩增CD 19-CAR-T细胞,NIH3T3-CD19/86/137L细胞具有更好的扩增效应,其与CD19-CAR-T细胞混合培养14d后,扩增的T细胞数量明显高于NIH3T3-CD19/86细胞组(P＜0.05);同时,与刺激前相比NIH3T3-CD 19/86和NIH3T3-CD19/86/137L细胞刺激扩增的T细胞中CD19-CAR-T细胞比例显著增加(P＜0.05);扩增的CD 19-CAR-T细胞具有靶特异杀伤效应,能够特异性杀伤CD19阳性靶细胞;流式检测显示NIH3T3-CD19/86/137L扩增的CD19-CAR-T细胞含有约20％作用中心记忆性T细胞.结论 成功制备CD19特异性aAPC,其可在体外特异性扩增功能性CD 19-CAR-T细胞,为初步建立制备高质量临床级CD19-CART细胞的方法提供了技术支撑.     

伊布替尼联合CD19嵌合抗原受体T细胞治疗难治复发弥漫大B细胞淋巴瘤的临床研究

目的 评估伊布替尼联合CD19 CAR-T细胞方案与CD19 CAR-T细胞方案治疗复发难治弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)患者的疗效和安全性.方法 回顾性分析2018年1月—2019年1月在同济大学附属同济医院血液科26例接受CD19 CAR-T细胞治疗的D...     

过表达IL-12的恶性黑色素瘤细胞在肿瘤免疫微环境重建过程中抑制T细胞表面PD-1的表达

目的 探讨过表达IL-12的恶性黑色素瘤细胞B16对肿瘤免疫微环境重建过程中T细胞表面PD-1表达水平的影响。方法 利用慢病毒感染小鼠黑色素瘤细胞B16以构建稳定过表达IL-12的B16细胞株;利用qRT-PCR、ELISA检测IL-12的表达情况;通过平板细胞克隆形成实验验证转染病毒对B16细胞增殖能力的影响;利用ELISA检测B16/IL-12细胞在体内表达IL-12的能力;将健康的C57BL/6小鼠随机分为2组,分别接种B16细胞及B16/IL-12细胞,14 d后用流式细胞术检测肿瘤引流区淋巴结中高表达PD-1的T细胞比例;利用650cGy剂量的放射线照射C57BL/6小鼠以构建免疫重建模型,并将造模后的小鼠随机分为2组,分别接种B16细胞及B16/IL-12细胞,将未接受放疗处理的小鼠作为对照组接种B16细胞,记录各组小鼠肿瘤生长情况,接种细胞14 d后用流式细胞术分别检测肿瘤引流区淋巴结以及肿瘤组织中PD-1+T细胞比例。结果 B16/IL-12细胞相比于B16细胞显著增加IL-12的表达（P<0.001）;转染IL-12过表达慢病毒并未对B16细胞增殖能力造成显著影响（P>0.05）;接种B16/IL-12细胞的何瘤小鼠在其肿瘤组织中含有更高水平的IL-12（P<0.01）;常规荷瘤小鼠模型中,B16/IL-12组小鼠较B16组小鼠具有更低比例的CD4+PD-1+T细胞（P<0.01）,而CD8+T细胞群中,PD-1表达水平差异不显著（P>0.05）;免疫重建小鼠模型中,接种B16细胞的小鼠肿瘤引流区淋巴结和肿瘤组织中的CD4+PD-1+T细胞（P<0.05）及CD8+ PD-1+T细胞比例（P<0.01）均高于正常B16组小鼠,接种B16/IL-12细胞的免疫重建小鼠肿瘤引流区淋巴结及肿瘤组织中的CD4+PD-1+T细胞比例（P<0.01）和CD8+ PD-1+T细胞比例（P<0.001）相比于接种B16细胞的免疫重建小鼠均有显著降低;在小鼠肿瘤生长过程中,接种B16/IL-12细胞的免疫重建小鼠的肿瘤生长受到明显抑制（P<0.001）。结论 肿瘤区域过表达IL-12后可减少免疫重建过程中肿瘤区域T细胞表面PD-1 的表达,达到良好的肿瘤控制效果。     

异基因造血干细胞移植后小鼠共刺激分子表达与急性移植物抗宿主病的关系

目的 探究异基因造血干细胞移植后小鼠共刺激分子表达及其与急性移植物抗宿主病（aGVHD）发病的关系。方法 供体为5只C57BL/6J（H2KD^-H2KB⁺）雄性小鼠,受体为30只CB6F1（H2KD⁺H2KB⁺）雌性小鼠。将受体小鼠随机分为单纯照射组、骨髓移植组和aGVHD组,每组10只。单纯照射组：受体小鼠接受γ射线照射后不注射任何细胞;骨髓移植组：受体小鼠接受γ射线照射后注射5×10⁶个供体来源去T淋巴细胞的骨髓有核细胞;aGVHD组：受体小鼠接受γ射线照射后,同时注射5×10⁶个供体来源去T淋巴细胞的骨髓有核细胞和3×10⁷个供体来源脾细胞。采用log-rank生存曲线分析各组小鼠移植后生存情况。分别在移植后7、14、21、28 d采用流式细胞术检测骨髓移植组和aGVHD组小鼠外周血CD4⁺T淋巴细胞和CD8⁺T淋巴细胞表面共刺激分子细胞毒性T淋巴细胞相关抗原4（CTLA-4）、程序性死亡蛋白1（PD-1）、可诱导共刺激分子（ICOS）和CD28的表达情况,以及移植后21 d两组小鼠脾组织CD4⁺T淋巴细胞内白细胞介素（IL）-17、γ干扰素、IL-4的表达情况,并在移植后21 d采用3,3''-二氨基联苯胺（DAB）染色检测两组小鼠结肠组织共刺激分子配体的表达情况。结果 单纯照射组受体小鼠均在γ射线照射后19 d内死亡;骨髓移植组小鼠在γ射线照射后均未出现aGVHD症状,30 d内均存活;aGVHD组小鼠在γ射线照射后出现aGVHD症状的时间为14（11~18）d,生存时间为22（13~30）d。随着时间的推移,aGVHD组小鼠外周血CD4⁺和CD8⁺T淋巴细胞表面CTLA-4、PD-1表达在移植后均呈下降趋势,ICOS、CD28表达均呈上升趋势。在移植后28 d时aGVHD组小鼠外周血CD4⁺和CD8⁺T淋巴细胞表面CTLA-4、PD-1表达均低于骨髓移植组,ICOS、CD28表达均高于骨髓移植组,差异均有统计学意义（P均<0.05）。DAB染色结果示,骨髓移植组结肠组织CD80、ICOS配体（ICOSL）、PD-1配体（PD-L1）表达均为阴性,aGVHD组结肠组织CD80、ICOSL、PD-L1阳性表达率分别为40%、80%、80%。与骨髓移植组比较,aGVHD组小鼠脾组织CD4⁺T淋巴细胞内IL-17、γ干扰素表达均增加,IL-4表达减少,差异均有统计学意义（P均<0.05）。结论 异基因造血干细胞移植小鼠发生aGVHD后,共刺激分子CTLA-4表达随时间推移逐渐降低。CTLA-4、ICOS、PD-1均可能通过调节辅助性T细胞（Th）1、Th2、Th17等T淋巴细胞亚群分布参与aGVHD的发生、发展。     

CAR-T细胞免疫治疗实体瘤的研究进展

近年来过继性细胞免疫疗法因效果显著而得到广泛认可,尤其是CD19特异嵌合抗原受体（CAR）的自体T细胞治疗恶性血液瘤取得成功。本文总结实体肿瘤存在肿瘤免疫微环境、靶点不均一以及免疫抑制性受体等原因导致CAR-T无法有效治疗,提出改进CAR-T细胞以提高T细胞浸润、共表达细胞因子与酶以及修饰相关受体等方式提高CAR-T抗实体肿瘤活性,为后续CAR-T细胞治疗实体肿瘤研究奠定理论基础。     

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.