脐血CD34+细胞巨核系定向诱导分化的研究

目的研究TPO与SCF、IL-11协同在体外促进入脐血CD34+细胞向巨核系增殖分化的效应.方法利用流式细胞仪分离纯化脐血CD34+细胞,在含血清液体培养体系中、细胞因子诱导下培养14 d.采用流式细胞术测定不同时间点培养体系中CD41+细胞的比例;同时采用甲基纤维素半固体集落培养测定CFU-MK的数量.结果经14 d培养,TPO+SCF+IL-11组可使CD41+细胞和CFU-MK数量分别扩增40.83±12.41倍、7.86±2.63倍,明显高于TPO组的28.69±8.27倍、4.48±1.25倍.结论在体外SCF和IL-11可以协同增强TPO诱导脐血CD34+细胞向巨核系增殖分化的作用.     

脐血巨核祖细胞的体外扩增

目的联合血小板生成素(TPO)、白细胞介素-11(IL-11)和肝素用脐血CD34 细胞定向扩增巨核祖细胞.方法采用免疫磁珠法(MACS)分选CD34 细胞,用TPO、IL-11和肝素定向扩增巨核祖细胞,巨核祖细胞集落分析(CFU-MK)测定巨核祖细胞扩增倍数,流式细胞术检测巨核祖细胞分化过程中不同细胞组群(CD34 、CD41a 、CD61 、CD34 CD41a 和CD41a CD61 )的变化,免疫组织化学染色(CD41a)和透射电镜观察巨核细胞形态及超微结构,血小板体外活化实验及非肥胖性糖尿病/严重联合免疫缺陷鼠异种体内移植实验评价扩增的巨核祖细胞功能.结果单用TPO 7 d时,CD34 CD41a 细胞扩增(4.0±1.7)倍;与IL-11联用后扩增到(10.5±4.8)倍;再加入肝素后扩增达(29.9±6.4)倍,TPO IL-11 肝素组扩增倍数为TPO组、TPO IL-11组的7.5、2.85倍,与两组相比差异均有显著性(P＜0.05).TPO IL-11 肝素组巨核祖细胞中大集落(＞50个细胞/集落)达(106.8±26.9)倍,较TPO、TPO IL-11组均有明显增加(P＜0.05).将扩增第7天的巨核细胞静脉输注于经放射预处理的非肥胖性糖尿病/严重联合免疫缺陷鼠,可明显加速其血小板及白细胞的恢复并提高小鼠生存率.电镜显示扩增的巨核细胞有一定的界膜发育等成熟特征,体外血小板活化实验证实,扩增的巨核细胞在体外可产生血小板,有正常巨核细胞功能.结论TPO、IL-11和肝素组合的培养体系可有效扩增脐血巨核祖细胞.     

从脐血单个核细胞定向诱导巨核细胞的生成

采用 SCF、TPO、IL- 3、IL- 6、IL- 1细胞因子 ,从脐血单个核细胞定向诱导巨核细胞的形成。比较了 SCF+ TPO+ IL- 1、SCF+ TPO+ IL- 3、SCF+ TPO+ IL- 63种细胞因子组合对刺激巨核细胞生成的作用 ,经体外培养 8d后 ,CD41 + 细胞占培养物的比例分别达到 ( 5 .64± 0 .77) %、( 5 .73± 1 .2 4 ) %和 ( 2 0 .1± 2 .5 3) % ;每 1 0 4个细胞可形成巨核祖细胞集落形成单位 ( CFU- MK)为( 1 3.7± 5 .7)个、( 1 5 .0± 3.6)个和 ( 93.7± 1 6.0 )个。在 SCF+ TPO+ IL- 6体系中增加 IL- 6的浓度 ,可提高培养液中 CD41 + 细胞的纯度。当 IL- 6的浓度从 1 0μg/L增加到 5 0μg/L时 ,CD41 + 细胞的比例可从 ( 2 0 .1± 2 .5 3) %提高到 ( 2 6.81± 3.2 0 ) % ,但每 1 0 4个细胞形成 CFU- MK数目却从( 93.7± 1 6.0 )个减少到 ( 4 5± 8.6)个 ;这说明 IL- 6对巨核细胞的刺激主要作用在其发育的后期。采用 SCF+ TPO+ IL- 3+ IL - 6细胞因子组合 ,由 1× 1 0 6个单个核细胞培养一周后可诱导出 ( 1 .61±0 .5 8)× 1 0 5个 CD41 + 细胞 ,占培养物的比例可达到 ( 1 8.8± 1 .64) % ,每 1 0 4个细胞形成 CFU- MK数目可达到 ( 1 2 1 .8± 1 0 .3)个。这一结果为进一步体外大量扩增巨核细胞提供了基础     

多种细胞因子组合对脐血干/祖细胞体外扩增的影响

目的　探讨在体外培养液中不同细胞因子组合对脐血 CD34+ 细胞的扩增作用以及扩增后的 CD34+ 细胞的造血功能。方法　用 FL、SCF、TPO、IL - 3、TL - 6组合成不同的实验组 ,对脐血中分离纯化的 CD34+ 细胞经 6d的短期体外扩增 ,扩增后经流式细胞仪分析 ,L TC- IC、祖细胞集落群计数 ,从而求得较好的细胞因子组合组。结果CD34+ 细胞扩增倍数为 3 .1～ 8.6倍 ,16份脐血 CD34+ 细胞数达到 10× 10 6 以上的细胞总数 ;扩增的 CD34+ 细胞再造血功能与原始 CD34+ 细胞无显著差异。FL是扩增组合中不可缺少的细胞因子 ,同时还证实 TPO与其他细胞因子组合有扩增 CD34+ 细胞的作用 ,但单独使用 TPO稍长时间会使 CD34+ 细胞过多向巨核细胞分化。结论　 FST3 6细胞因子组合能使部份单位体积的脐血 CD34+细胞体外扩增达一定数量 ,为干细胞移植于成人提供了一定的实验依据与方法     

造血细胞生长因子对脐血CD34+细胞短期体外扩增的作用

目的 探讨造血细胞生长因子(HGF)的不同组合对脐血CD34 细胞短期体外扩增的作用．方法 用免疫磁珠法分高纯化脐血CD34 细胞，培养于无血清培养液中。加入不同的细胞因子，于第4，7，10，14天检测CD34 细胞百分率和有核细胞(NC)总数。结果 和对照组相比，各组的NC扩增倍数随着培养时间的延长虽不同程度的增加，干细胞在FL、TPO，GM-CSF、SCF、IL-6、G-CSF、EPO和IL-3等因子作用下，NC扩增倍数在培养第14天达高峰，为328．96倍；而CD34 细胞扩增倍数在培养第7天达最高峰，但在FL、TPO、GM-CSF、SCF，IL-6、G-CSF等因子作用下，CD34 细胞扩增倍数最大，7d后达25．23倍，而后随着培养时间的延长而逐渐下降。结论 脐血CD34 细胞在HGF作用下，扩增时间以7-10d为最佳。     

人脐血造血干细胞在转瓶中的悬浮培养

考察经分离纯化后的人脐血CD34+富集细胞在转瓶中的扩增特性,细胞因子为SCF+IL-3+IL-6。实验发现,无论24孔板静态培养还是转瓶悬浮培养,孔板和转瓶内总细胞数分别扩增了(658.7±98.0)倍和(107.3±15.0)倍,说明CD34+具有很大的扩增潜能。对比两种培养体系下细胞集落扩增倍数发现,培养初期孔板内的集落形成能力要大于转瓶,但到培养后期,孔板内集落形成能力下降速度远大于转瓶。孔板中的CFU-GM(粒细胞-巨噬细胞集落形成单位)扩增倍数在第14天为(5.6±0.4)倍,第21天为(1.7±0.5)倍,转瓶中在第14天为(2.1±0.7)倍,第21天为(1.8±0.5)倍。对比两者的CD34+扩增情况,孔板在第14天CD34+含量达到最大值,而到第21天则大大降低,而转瓶内CD34+含量仍可保持在原第14天的水平,转瓶内的CD34+细胞的扩增也比孔板保持较长时间。     

干细胞生长因子协同血小板生成素体外扩增脐血巨核前体细胞的研究

目的探讨在干细胞生长因子(SCF)和血小板生成素(TPO)组合作用下,人脐血CD34~ 细胞体外扩增为巨核前体细胞的效果。方法采用经免疫磁珠纯化系统收集的人脐血CD34~ 细胞与SCF TPO组合体外培养,研究该组合对巨核前体细胞的扩增效果。结果在SCF和TPO组合的作用下,脐血CD34~ 细胞(6例)显著地向巨核前体细胞(CD61 CD41~ 细胞)扩增。CD61~ CD41~ 细胞构成比在培养第7天达到峰值(15．57±4．95)％,第14天为(9．06±2．72)％；存第14天,CD61~-CD41~ 细胞总数和巨核系细胞集落形成单位(CFU- MK)达到高峰,为较理想的培养时间。经过体外扩增,总细胞数、CD34~ 细胞数、CD61~ CD41~ 细胞和CFU-MK均显著增加。结论在SCF和TPO组合的作用下,脐血CD34~ 细胞可有效地扩增为巨核前体细胞。     

GM-CSF体外促进多倍体巨核细胞的生成

在TPO IL-3的细胞因子组合中添加不同浓度GM-CSF，从脐血CD34^ 细胞定向诱导巨核细胞的形成，以此考察GM-CSF对巨核细胞体外扩增和成熟的作用。比较了TPO IL-3、TPO IL-3 GM-CSF(5、20、100μg／L)的4种细胞因子组合对巨核细胞扩增及形成多倍体的作用。结果发现：在TPO IL-3的细胞因子组合中添加GM-CSF有利于总细胞的扩增，对巨核细胞的纯度没有显著的影响。体外培养14d后，培养物巨核细胞中多倍体(≥8N)巨核细胞比例明显提高，从中可以看出GM-CSF能促进巨核细胞多倍体的形成。     

不同细胞因子对脐血CD34+细胞扩增的影响

目的探讨不同细胞因子促进脐血CD34 细胞扩增的效应,为下一步的临床应用奠定基础。方法采用EasySep免疫磁珠阳性选择系统分离脐血中CD34 细胞,在无血清、无基质细胞培养体系中添加不同细胞因子培养2周,分组:A组,SCF FL TPOB组,SCF FL TPO IL-3C组,SCF FL TPO G-CSF。结果CD34 细胞数目于培养后7d达到峰值,3组间差异无显著性;B组扩增至14d时细胞总数达(384.40±17.48)倍,显著高于另外2组。扩增7d后的脐血细胞经体外培养可形成造血集落。结论体外扩增脐血CD34 细胞理想的细胞因子组合为SCF TPO FL,以7d为宜。     

脐血CD34+细胞向巨核细胞的分化扩增及基因的表达变化

目的研究脐血CD34+细胞向巨核细胞的诱导分化及体外扩增,并观察此过程中巨核细胞特异性基因表达的变化。方法免疫磁珠法分离获得CD34+细胞培养在无血清无基质培养基中,采用TPO+SCF+IL 3+IL 6、 TPO+SCF+IL 3、 TPO+SCF三种不同因子组合对其诱导分化及扩增。收集3、7、10、14?d的扩增产物,运用荧光显微镜检测巨核细胞的表面标志;流式细胞术（FCM）检测巨核细胞的凋亡;对巨核细胞进行DNA含量检测以及荧光定量PCR检测特异性基因表达的变化。结果分离获得的CD34+细胞在体外可以有效扩增,随培养时间的延长,CD34+/CD41+细胞数第7天达最高值,之后逐渐下降;而CD41+、CD42b+、CD61+细胞随培养时间的延长表达量逐渐增高。DNA含量检测发现,随着培养天数的增加,多倍体细胞所占的百分比增加。三种因子组合中TPO+SCF+IL 3+IL 6组扩增效率最高。荧光定量PCR显示转录因子GATA 1、NF E2、TXS、GPIIb和HPRT在第7天表达量最高,之后下降。凋亡转录因子APAF 1随培养天数的延长表达量增加。结论脐血CD34+细胞在体外可向巨核细胞诱导分化及扩增,其基因表达的变化也支持这一结论。     

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.