羊膜载体复合膜负载骨髓间充质干细胞促愈创面的研究

目的 探讨骨髓间充质干细胞(MSCs)促进创面愈合的作用和用于创面修复的可行性,为组织工程化皮肤提供新的种子细胞来源.方法 自体来源的骨髓,经体外培养并纯化MSCs,应用5-溴脱氧尿嘧啶(BrdU)标记技术进行标记,以羊膜载体复合膜为载体植入兔背部左侧全层皮肤缺损创面(治疗组),右侧全层皮肤缺损创面仅植以羊膜载体复合膜(对照组).于术后1,2周观察创面收缩率,记录愈合时间;术后4,5周切取创面中央再生皮肤组织,行病理和BrdU免疫组织化学染色检测,进行比较.结果 创面收缩率,治疗组>对照组(P<0.05),愈合时间,治疗组<对照组(P<0.05).常规病理检测治疗组再生皮肤表皮层明显增厚,细胞数目显著增多.免疫组化检测,在治疗组再生皮肤附件毛囊内层以及表皮基底层可见BrdU阳性标记细胞.结论 MSCs自体移植在一定程度上可以显著提高创面愈合的质量,为皮肤损伤由解剖重建到功能修复的完美愈合提供了新的治疗思路.     

骨髓间充质干细胞修复兔皮肤缺损创面的实验研究

目的研究骨髓间充质干细胞(MSCs)参与皮肤缺损创面修复重建表皮的可能性,为组织工程化皮肤提供新的种子细胞来源。方法自体来源的骨髓MSCs应用5-溴脱氧尿嘧啶(BrdU)标记后,以Ⅰ型胶原为载体植入兔背部左侧全层皮肤缺损创面(治疗组),右侧全层皮肤缺损创面仅植以Ⅰ型胶原作为对照组。于术后6、12天观察创面收缩率,记录愈合时间;术后4、5周切取创面中央再生皮肤组织,行常规病理和BrdU免疫组织化学染色检测,进行对比研究。结果创面收缩率,治疗组>对照组(P<0.05);愈合时间,治疗组<对照组(P<0.05)。常规病理检测治疗组再生皮肤表皮层明显增厚,细胞数目显著增多;免疫组化检测,在治疗组再生皮肤附件毛囊内层以及表皮基底层、棘层可见BrdU阳性标记细胞。结论骨髓间充质干细胞在全层皮肤缺损创面可能分化为表皮细胞参与表皮重建并具有促进创面愈合的作用。     

黑色素细胞与骨髓间充质干细胞复合构建组织工程化皮肤

目的 探讨构建含有黑色素细胞组织工程化皮肤的方法.方法 从人包皮组织中获取黑色素细胞,从人骨髓中获取骨髓间充质干细胞(BMSCs),以二者为种子细胞,按照1:10的比例混和培养,并与I型胶原膜复合体外构建组织工程化皮肤,对裸鼠创面进行修复.通过大体标本观察、4,6-联脒-2-苯基吲哚(DAPI)体内示踪标记、HE染色、免疫组织化学检测及透射电镜观察等方法,观察组织工程化皮肤修复裸鼠皮肤创面缺损及黑色素细胞的分布情况.结果 裸鼠创面皮肤生长良好,DAPI体内示踪标记、免疫组织化学检测S-100蛋白及透射电镜观察可以发现黑色素细胞以正常的组织结构形式分布于创面皮肤.结论 黑色素细胞与BMSCs通过适当的比例及体外条件培养,与I型胶原膜复合可以在体外构建出具有黑色素细胞的组织工程化皮肤.     

骨髓问充质干细胞对大鼠损伤汗腺的修复性研究

目的探讨皮肤汗腺受损后骨髓间充质干细胞对其的修复效果。方法大鼠骨髓间充质干细胞体外分离、培养、标记。机械损伤大鼠脚掌汗腺,干细胞治疗组于创面周围皮下注入MSCs,对照组注射相同剂量PBS,分别比较两组的创面愈合率及再生上皮的厚度,观察MSCs参与受损汗腺修复的情况。结果7d时干细胞治疗组的创面愈合率及14d时的表皮再生厚度均优于对照组（P〈0．05）;BrdU标记的MSCs参与了损伤汗腺导管部的修复。结论骨髓间充质干细胞有利于创伤皮肤的修复并可能参与损伤汗腺的修复。     

骨髓间充质干细胞促进损伤汗腺修复的实验研究

目的探讨骨髓间充质干细胞(marrow mesenchymal stem cells,MSCs)分化为创面皮肤汗腺细胞的可能性及其参与创面修复的可能机制。方法无菌条件下取雄性Wistar大鼠(6只)股骨骨髓细胞,分离、纯化、体外扩增培养MSCs后,应用溴脱氧尿嘧啶(BrdU)标记技术标记细胞。雄性Wistar大鼠(30只)正常喂养1周后按随机数字表法分为2组:模型组和对照组(各15只),模型组大鼠背部正中,制备1cm×1cm全层皮肤缺损创面。从对照组和模型组大鼠尾静脉输注BrdU标记的MSCs(5×106 mL-1)0.1mL;术后第7天与第10天切取创面组织,采用PowerVisionTM免疫组织化学染色法检测BrdU。结果在创面皮下汗腺导管周围发现BrdU阳性细胞,且汗腺中也有呈现BrdU阳性的细胞。结论创面愈合过程中,MSCs归巢并参与创面修复;在创面微环境下,MSCs可分化为汗腺细胞,并参与创面修复。     

骨髓间充质干细胞-聚乳酸聚乙醇酸共聚复合物支架修复组织损伤的实验研究

目的 探讨骨髓间充质干细胞-聚乳酸聚乙醇酸共聚复合物（PLGA）的构建及对损伤组织的修复效果。方法 （1）分离培养新西兰幼兔骨髓间充质干细胞（MSC）,4,6联脒-2苯基吲哚（DAPI）标记后接种于PLGA支架上。扫描电镜和免疫荧光显微镜观察不同时间段MSC在支架上的生长情况。（2）分别将MSC-PLGA复合物及PLGA支架移植于新西兰大白兔背部皮肤创面。术后观察创面愈合情况,5周后取移植物行HE染色、VG染色及细胞角蛋白AE1／AE3免疫荧光组化检测。结果 MSC在支架上生长良好,细胞数量随时间增长而逐渐增加,第10天细胞达到90％融合。MSC-PLGA复合物所修复创面,随着聚合材料的降解,逐渐形成新生皮肤,HE染色及VG染色示新生皮肤与正常皮肤结构相似,且荧光显微镜下可见胞核呈蓝色荧光的角化层细胞及毛囊细胞,其胞浆同时表达角蛋白。PLGA支架所修复创面则新生皮肤仅见少量毛囊,并见增厚的纤维瘢痕。结论 骨髓间充质干细胞复合PLGA聚合物是良好的移植替代物。     

骨髓间充质干细胞移植增强大鼠子宫切口再生修复

目的：探讨骨髓间充质干细胞（MSCs）移植在大鼠子宫创伤后再生修复中的作用.方法：建立大鼠瘢痕子宫模型.取Ad-GFP标记的大鼠MSCs,于子宫切口内注射进行原位移植,2周后取瘢痕处子宫肌组织,行HE常规染色,血管内皮生长因子（VEGF）、转化生长因子-β1（TGF-β1）免疫组织化学染色,α-SMA荧光标记,检测MSCs在切口局部的定向分化情况,并定量检测切口局部肌层的生物力学.结果：瘢痕子宫模型成功建立.MSCs移植后子宫切口的破裂阈值增强（P＜0.05）,切口局部VEGF表达上调,TGF-β1表达下调（均P＜0.01）,α-SMA荧光标记提示MSCs在子宫肌层局部出现平滑肌定向分化.结论：MSCs移植增强了子宫切口的再生愈合,提高了切口局部的机械张力,有望减少再次妊娠时子宫破裂的风险.     

兔骨髓间充质干细胞定向诱导移植修复关节软骨的实验研究

目的：通过诱导兔骨髓间充质干细胞（MSCs）,观察干细胞向软骨细胞的分化效果。方法：纯化兔骨髓间充质干细胞;用含转化生长因子β1的诱导液培养骨髓间充质干细胞;以MTT测定诱导细胞的增殖活性;免疫组化检测Ⅱ型胶原蛋白的表达;诱导后的细胞移植于白兔膝关节内,X线摄片观察软骨修复形成情况。结果：诱导液可有效诱导MSCs向软骨细胞表型转化,且骨髓间充质干细胞向软骨细胞分化所需的特异性细胞外基质——Ⅱ型胶原明显升高,移植后效果明显。结论：兔骨髓间充质干细胞定向诱导后移植修复关节软骨是有效的。因此骨髓间充质干细胞有可能成为软骨组织工程较理想的种子细胞来源。     

骨髓间充质干细胞迁移到皮肤损伤部位的现象观察

目的 探讨骨髓间充质干细胞(MSCs)在皮肤创伤刺激下,能否从骨髓迁移到皮肤创面.方法 抽取小型香猪的骨髓,分离纯化MSCs,培养扩增后,经DAP1标记回植到骨髓中,制作皮肤创面,7,14 d,观察皮肤组织中是否有阳性细胞以及实验组和对照组的差别.结果 将MSCs经DAPI标记回植后,实验组7 d DAPI染色阳性的细胞较多,14 d阳性细胞减少.而对照组阳性细胞稀少,在7,14 d的皮肤组织切片中无差别.结论 MSCs在皮肤创伤刺激下,可以从骨髓迁移到皮肤创面.     

真皮间充质干细胞治疗皮肤缺损创面的研究进展

大面积深度烧伤、严重创伤及外科手术切除体表恶性组织等均会造成体表皮肤组织的广泛缺损。在目前的临床医疗手段治疗后,创面虽然愈合,但丧失了皮肤的正常结构和外观,严重影响患者的生存质量。近年来,组织工程化人工皮肤的构建和应用为临床的大面积皮肤缺损的修复治疗提供了新的途径和方法。组织工程化皮肤的关键技术之一是种子细胞的选择,目前研究较多的种子细胞有骨髓间充质干细胞、表皮干细胞和真皮间充质干细胞（dermis-delved mesenchymal stem cells,DMSC）。本文就真皮间充质干细胞治疗皮肤缺损的研究进展作一综述。     

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.