pcDNA3.1-VEGF165转染BMSCs构建组织工程骨修复骨缺损的实验研究

目的：依据组织工程的原则,首先将pcDNA3.1-血管内皮生长因子（vascular endothelial growth factor, VEGF）165质粒转染至骨髓间充质干细胞（bone marrow stromal cells ,BMSCs）,然后将其与纳米羟基磷灰（nano-hydroxyapatite,n-HA) /羧甲基壳聚糖（carboxymethyl chitosan,CMCS）支架材料复合构建组织工程骨,观察该组织工程骨在兔桡骨骨缺损模型处的成骨能力及降解速度。 方法：采用化学共沉淀法制备纳米羟基磷灰石,以京尼平（Genipin）为交联剂,通过粒子沥滤结合冷冻干燥工艺制备纳米羟基磷灰石/羧甲基壳聚糖复合支架材料。采用扫描电镜观察其微观结构;三点弯曲法测试其力学性能;通过细胞形态分析测试其体外细胞毒性;激光共聚焦显微镜观察其荧光性能。根据设计的引物反转录合成VEGF165,pcDNA片段,构建pcDNA3.1-VEGF165质粒。骨髓间充质干细胞取自兔骨髓,培养、传代,采用电转法将 pcDNA3.1- VEGF165转至 BMSCs 然后与 n-HA/CMCS支架材料复合构建组织工程骨;建立动物模型将其植入兔桡侧,通过大体观察,X射线,HE染色及三点弯曲强度评价其成骨能力及降解速度。 结果：京尼平交联的n-HA/CMCS支架材料微观结构、力学性能与天然松质骨相似,可满足支架材料的要求;与戊二醛做交联剂所得支架相比,本研究所得支架生物毒性更小,更利于细胞的吸附与增殖,并且使用京尼平交联是支架材料具有自发荧光特征;成功构建出 pcDNA3．1-VEGFl65质粒,将其转至 BMSCs,并与n-HA/CMCS 复合构建组织工程骨。大体标本观察表明复合材料植入骨缺损处可见骨缺损处愈合良好,植入材料大部分已转化为自体骨组织仅少许未降解。X射线观察显示实验侧可见明显骨痂生成,骨髓腔形成,骨髓腔基本贯通。HE染色结果表明实验组骨缺损愈合,皮质骨形成,皮质主要由编织骨组成,部分由新生的骨单位构成,髓腔再通。 结论： pcDNA3.1-VEGF165转染BMSCs复合n-HA/CMCS支架材料具有生物相容性好、无毒副作用、促进局部微血管形成、加快骨缺损修复的作用,其降解速度与骨生长速度基本匹配;使用京尼平交联的支架不同于其他骨组织工程支架材料,其具有自发荧光特征。通过激光共聚焦显微镜可以清楚地观察到支架和细胞的界面,细胞的粘附特征,以及支架的微结构和降解时微结构特征变化。综上可知本研究所得复合骨是一种潜在的性能优良的骨修复材料。     

异种生物骨衍生材料与大鼠骨髓基质细胞黏附的体外实验研究

目的:探寻良好的骨组织工程支架材料.方法:以新西兰大白兔的四肢长骨制备一种生物骨衍生材料,将此材料与大鼠骨髓基质细胞(BMSCs)联合培养,通过光镜及电镜对联合培养过程进行动态观察. 结果:生物骨衍生材料具有三维立体多孔隙结构,并有良好的生物相容性和材料-细胞界面.结论:异种生物骨衍生材料是一种有临床应用前景,适用于组织工程骨构建的支架材料.     

hVEGF基因修饰的SD大鼠BMSCs与胶原膜BME-10X复合物的成骨能力研究

目的：观察人血管内皮生长因子（hVEGF165）基因的骨髓基质细胞（BMSCs）与胶原膜BME‐10X复合的相容性及该复合物移植在体内的成骨情况,为其能否修复牙周骨质缺损提供依据。方法在体外将hVEGF165基因转染的SD大鼠BM SCs种植于胶原膜BM E‐10X复合膜上,使用激光共聚焦扫描显微镜、荧光显微镜、扫描电镜及组织学方法进行观察,并将该复合物植入裸鼠皮下,于4、8周处死裸鼠取材制成组织切片,H‐E染色后观察异位体内成骨和血管生成的情况。结果复合物培养24 h后见目的细胞在胶原膜中贴附、伸展,各层BM E‐10X胶原膜上均有数量不等的细胞附着。转染细胞在胶原膜表面复层生长,并进入内部间隙中。复合物植入裸鼠皮下后,可见新生胶原纤维、类骨质样结构和新生血管的形成。结论 hVEGF165基因转染 BMSCs 在胶原膜BM E‐10X上生长良好,细胞‐胶原复合物在裸鼠体内具有异位成骨及促进新生血管形成能力。     

脱钙骨基质支架构建组织工程骨的实验研究

目的以同种异体骨脱钙骨基质(demineralized bone matrix,DBM)为支架材料,复合体外诱导培养的人骨髓间充质干细胞(human mesenchymal stem cells,hMSCs),构建组织工程骨并通过裸鼠皮下异位成骨实验及裸鼠皮下致瘤性实验验证其成骨效果及安全性.方法贴壁法培养hMSCs,体外诱导培养扩增,以1.857×106/ml的密度与DBM复合构建组织工程骨,体外培养,并在扫描电镜下观察细胞与材料复合情况,进行组织学观察.同时进行了裸鼠皮下异位成骨实验.结果细胞与支架复合后3 d,细胞与DBM表面及孔隙可实现良好复合;复合后5 d,扫描电镜观察到细胞基质分泌旺盛,充满支架孔隙.裸鼠皮下成骨实验证明其成骨效果良好.结论以本实验中使用的细胞培养方法扩增、诱导分化的种子细胞生物安全性好,自制的DBM具有良好的生物相容性,可为种子细胞生长提供较好的三维空间,按照标准化工艺流程制备的组织工程骨安全、有效.     

复合BMSCs的异种骨移植材料异位成骨研究

目的:制备兔脱钙骨基质(DBM),研究复合骨髓间充质干细胞(BMSCs)的DBM的异位成骨能力。方法:制备DBM材料,将体外培养的ICR小鼠BMSCs与DBM复合培养后构建的组织工程骨植入ICR小鼠股部肌袋中,以单纯DBM植入组为对照,术后7d及28d行X线检测,并于术后7,14,28d取植入材料作组织学检测、钙含量测定。结果:DBM与BMSCs复合体植入后7d即有成骨细胞出现,随着时间增加成骨细胞增多,术后28d即有较成熟骨质形成,移植物钙含量随时间推移逐渐增高。单纯植入DBM术后14d出现少量成骨细胞,术后28d出现少量类骨质,钙含量持续处于较低水平。结论:DBM与BMSCs复合后具有很好的异位成骨能力,DBM是组织工程骨研究较理想的支架材料。     

移植过表达人VEGF165的BMSCs促进放疗损伤大鼠模型的组织修复

背景 骨髓间充质干细胞（BMSCs）的多向分化潜能在组织再生的研究应用中显示出了极大的潜力,同时血管内皮生长因子165（VEGF165）能够促进血管的生成从而促进组织的再生。本研究用VEGF165基因修饰BMSCs移植的方法来恢复放疗大鼠损伤模型的组织修复能力。 方法 从大鼠胫骨分离获取BMSCs;用脂质体将hVEGF165转染至BMSCs;以60Coγ射线照射大鼠右后肢,总吸收剂量为30 Gy,总共40只,照射结束后第1天,将实验分为四组（n=10）：不注射组作为未治疗对照组（组1）,空转染BMSCs组（组2）、未转染BMSCs组（组3）及hVEGF165-BMSCs组（组4）,分别注射照射区组织,共治疗2次,间隔2周。治疗结束1周后行血管造影及血管染色体视学图像分析,对后肢肌肉标本行血管、肌肉显微结构观察、RT-PCR、Western Bloting及免疫组化染色。 结果 结果表明分离得到的BMSCs具有多向分化能力;转染后的BMSCs高表达hVEGF165基因和蛋白;组2、3、4的血管数量、密度、平均管径、平均截面积各项指标及MyoD、myogenin、α-SMA蛋白、CD31蛋白表达均高于组1。hVEGF165mRNA及蛋白的表达及上述指标在注射hVEGF165转染的BMSCs（组4）均高于组2和组3。 结论 过表达VEGF165基因的BMSCs通过促进血管新生和肌纤维的再生有效地增强了组织的修复能力,过表达VEGF165基因的BMSCs具有潜在的临床应用价值。     

VEGF165真核表达载体的构建及其在鼠膀胱平滑肌细胞的表达

目的 构建血管内皮生长因子(VEGF165)真核表达载体pcDNA3.1(-)/VEGF165,转染鼠膀胱平滑肌细胞并检验其生物学活性.方法 将VEGF165 cDNA克隆于真核表达载体pcDNA3.1(-),构建真核表达载体pcDNA3.1(-)/VEGF165;并转染入鼠膀胱平滑肌细胞,采用RT-PCR和免疫荧光染色检测VEGF165基因在鼠膀胱平滑肌细胞中的表达,并用MTT法检测转染后细胞上清液中VEGF165的生物学活性.结果 和结论将构建的真核表达载体pcDNA3.1(-)/VEGF165转染入鼠膀胱平滑肌细胞后,VEGF的表达增高,转染后细胞上清液具有促使内皮细胞增殖的生物学活性.     

VEGF基因转染结合脱蛋白骨修复股骨头坏死的实验研究

目的:构建pcDNA3.1/VEGF165质粒及联合脱蛋白骨基因治疗早期股骨头缺血性坏死.方法:将含人VEGF165全长cDNA序列的克隆载体pUC18/VEGF165与pcDNA3.1( )载体构建成重组真核表达质粒pcDNA3.1/VEGF165;69只AVNFH造模成功后的新西兰大白兔随机分成3组.第一组,将脱蛋白骨复合pcDNA3.1/VEGF165质粒植入坏死的股骨头内;第二组植入DPB;第三组仅在股骨头内钻一隧道.股骨头标本术后3天,1,2,4,8和16周获取.RT-PCR检测VEGF165mRNA的表达,Western blot检测VEGF165蛋白的表达,组织形态学分析血管发生和股骨头修复.结果:成功构建pcDNA3.1/VEGF165;第一组VEGF165 mRNA和蛋白表达术后1周达到高峰,时间持续超过3周.血管形成术后2,4周增加,骨形成术后2,4和8周增加,与另两组相比差异呈显著性(P＜0.01).结论:VEGF165基因转染可促进局部血管的早期形成,DPB-VEGF复合物可增加骨形成.脱蛋白骨联合VEGF165基因治疗为骨坏死的修复提供了理论基础.     

BMP-2及VEGF双基因骨髓干细胞复合磷酸钙支架生物相容性的体外实验研究

目的制备BMP-2及VEGF双基因骨髓干细胞复合磷酸钙支架,探讨所制备支架材料的生物相容性。方法以磷酸钙粉为原料制备多孔磷酸钙支架材料(CPC),对所得支架材料采用双基因转染的鼠骨髓间充质干细胞(MSCs)复合共制备成双基因修饰磷酸钙支架材料,采用扫描电子显微镜及万能测试机对材料的表征及物理性能进行评价;复合共培养2周后计算细胞在支架材料上的黏附率,利用倒置相差显微镜及扫描电镜下观察细胞在材料内的黏附和生长情况,分别采用MTT法、碱性磷酸酶活性测定(ALP)及茜素红染色检测MSCs在支架材料上的增殖、分化及矿化情况。结果制备的双基因修饰磷酸钙支架材料具有良好孔隙结构和一定强度;双基因转染的MSCs在支架表面附着良好,细胞增殖测定、细胞ALP及茜素红染色检测显示该材料对MSCs生长和功能表达未见明显抑制作用,生物相容性良好。结论双基因修饰磷酸钙支架材料具有良好孔隙结构和较好力学强度;双基因转染的MSCs可以在其上进行良好的黏附、生长、增殖、分化以及矿化,具有良好的生物相容性。     

异种生物衍生骨与兔骨髓间充质干细胞的体外黏附实验研究

目的:探寻良好的骨组织工程支架材料。方法:以市售新鲜猪股骨制备一种生物骨衍生材料,将材料与兔骨髓间充质干细胞(BMSCs)复合培养,扫描电镜下对复合培养过程进行动态观察。结果:异种生物衍生骨具有三维立体多孔结构,并有良好的生物相容性和材料细胞界面。结论:异种生物衍生骨是一种具有临床应用前景、适用于构建组织工程骨的支架材料。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.