Greater hypertrophy in right than left ventricles is associated with pulmonary vasculopathy in sinoaortic-denervated Wistar-Kyoto rats

1. Biventricular hypertrophy has been described in a high blood pressure variability (BPV) model of sinoaortic-denervated (SAD) rats without systemic hypertension. To explore the possible involvement of the lung in SAD-induced right ventricular hypertrophy (RVH), we examined lung morphology, in addition to systemic haemodynamics and ventricle morphology, in Wistar-Kyoto rats 32 weeks after SAD. 2. In Wistar-Kyoto rats 32 weeks after SAD, there existed a substantial elevation in BPV, with no change in the average level of arterial pressure. Biventricular hypertrophy following SAD was characterized by a greater hypertrophy in right than left ventricles; both absolute and normalized right ventricular weights were significantly increased by 22 and 27％, respectively, and only normalized left ventricular weight was significantly increased by 12％. No infarcts were found in any ventricles examined. 3. In the lung, the most prominent change following SAD was pulmonary vasculopathy, including wall thickening, perivascular fibrosis and cell infiltration. In pulmonary arteries with an internal diameter of 70-130 microm, the external diameter, wall thickness and wall thickness to internal diameter ratio were increased in SAD compared with control rats. 4. There was no correlation between right and left ventricular weights. In contrast with BPV-correlated left ventricular weight, right ventricular weight was correlated with the wall thickness of the pulmonary artery, but not with BPV. 5. These findings suggest that greater RVH following SAD is associated with pulmonary vasculopathy, but is not secondary to the left ventricular problems or high BPV.     

Interleukin-6 expression after renal transplantation

BACKGROUND: Interleukin-6 (IL-6) is an inflammatory cytokine that plays a role in transplant rejection. We tested the hypothesis that IL-6 levels in serum or urine could be of value in predicting acute and chronic allograft rejection. Furthermore, we examined whether or not such levels reflected IL-6 expression in the kidney. METHODS: We measured IL-6 and IL-6 soluble receptor (IL-6sR) in serum and urine of 145 transplant patients and 20 normal controls. In parallel, we studied 108 renal biopsies. IL-6 was measured with a bioassay system using an IL-6 dependent cell line. IL-6sR was measured with enzyme-linked immunosorbent assay. The biopsies were examined for IL-6 and IL-6 receptor (IL-6R) expression with immunohistochemistry. RESULTS: Rejection episodes occurring within 2 months of transplantation were accompanied by elevated IL-6 concentrations in serum (17 +/- 4.8 pg/ml, P < 0.05) and urine (114 +/- 27 pg/ml, P < 0.005), compared to controls. These values returned towards baseline (0-5 pg/ml) after successful rejection treatment. The sensitivity of urine measurements was much higher (93%) than serum (54%). The specificity in serum (70%) and urine (60%) was reduced by infection, acute tubular necrosis, and antithymocyte globulin treatment. Serum and urine IL-6sR values did not correlate with rejection. In biopsy tissue, IL-6 and IL-6R were both elevated during rejection. Especially, mononuclear cells within the interstitial infiltrate stained positive. However, the amount of IL-6 positive cells did not correlate with peripheral IL-6 concentrations. CONCLUSIONS: Urine but not serum IL-6 values are sensitive indicators of rejection; however, they are confounded by infection, acute tubular necrosis, and certain antirejection treatments. These features limit their usefulness.      

Subgroup effects despite homogeneous heterogeneity test results

Background  

Statistical tests of heterogeneity are very popular in meta-analyses, as heterogeneity might indicate subgroup effects. Lack of demonstrable statistical heterogeneity, however, might obscure clinical heterogeneity, meaning clinically relevant subgroup effects.     

关节软骨脱细胞支架材料的制备

目的:探讨脱细胞关节软骨支架材料的制备方法,制备软骨理想的组织工程支架材料。方法:实验于2005-12/2006-08在兰州大学第二医院骨科研究所实验室完成。实验方法:利用冷冻干燥、化学去污剂等方法制备脱细胞的兔关节软骨。在无菌状态下取青紫蓝兔的新鲜兔关节软骨,剪成3.5mm×3.5mm,厚度0.2～2.0mm,在冷冻干燥器中冻干12h。在10g/L Triton X-100、Tris-HCl液内加入蛋白酶抑制剂-苯甲基黄酰氟,持续振荡48h后标本以双蒸馏水连续冲洗后置于DNase I酶和RNase A酶混合液中消化。置于10g/L Triton X-100、Tris-HCl液中洗脱。实验评估:①大体观察:肉眼观察脱细胞后关节软骨的外观形态。②组织学观察:将制备的脱细胞关节软骨行石蜡包埋切片,行苏木精-伊红染色、Massion三色染色并在光镜下观察。③扫描电镜观察:将制备的脱细胞关节软骨以戊二醛-锇酸双固定后,行扫描电镜观察。结果:①脱细胞后关节软骨外观形态:肉眼下可见正常关节软骨呈白色或淡黄色,脱细胞后关节软骨色呈灰白,半透明状,无光泽,外形与软骨相似并且仍维持了关节软骨的结构。②脱细胞后关节软骨的组织学变化:苏木精-伊红染色显示,软骨细胞消失,软骨巢分辨不清,在巢内没有蓝染的核物质,核细胞碎屑,只有红染为残留的细胞外基质。Massion三色染色显示,脱细胞后关节软骨内主要含有胶原纤维。③脱细胞后关节软骨的超微结构:扫描电镜下显示,脱细胞后关节软骨陷窝呈蜂窝状,未见到残余的细胞核、细胞器,残余的空穴高低不平。结论:经冷冻干燥、化学去污剂等方法可完整去除软骨中的细胞成分,保留胶原纤维等细胞外基质。     

人骨髓间充质干细胞分化为软骨细胞的诱导条件

目的:分析人骨髓间充质干细胞分离、纯化、体外扩增及其向软骨细胞分化的条件,为人骨髓间充质干细胞用于修复损伤的软骨组织提供依据。方法:实验于2005-03/2006-04在南昌大学医学院生化与分子生物学教研室完成。实验材料:无菌条件下采集无血液系统疾病和家族遗传史的28～65岁成人骨髓8份,进行骨髓间充质干细胞分离与培养,骨髓采集经患者及医院同意,并签署知情同意书。实验方法:取第3代对数生长期骨髓间充质干细胞,实验组使用特定的、内含2mg/L胰岛素、3mg/L转铁蛋白、1mmol/L丙酮酸、100nmol/L地塞米松和10μg/L转化生长因子β1的低糖DMEM培养基诱导人骨髓间充质干细胞向软骨细胞分化,对照组细胞以低糖DMEM基础培养液培养。倒置显微镜下观察细胞形态,诱导7,14d采用半定量RT-PCR方法检测细胞软骨特异性Ⅱ型胶原表达,蕃红花O-亮绿染色分析蛋白多糖粘多糖含量,观察细胞分化情况。结果:①光镜观察成人骨髓间充质干细胞的形态变化:培养7d细胞集落明显,集落中央为数个至数十个圆形细胞,周围变形细胞围绕中央细胞呈放射状生长。培养14d细胞呈平行状或旋涡状排布,细胞排列紧密。②骨髓间充质干细胞向软骨细胞的诱导分化:实验组细胞生长较对照组慢,培养7d后细胞大多呈椭圆形或三角形,部分细胞伸出似触角突起,培养14d细胞变形较明显,排列较为紧密,细胞突起多见,突起间相连,呈较明显软骨细胞形态特征。③骨髓间充质干细胞的番红花-O染色:实验组骨髓间充质干细胞蕃红花O-亮绿呈深染色,对照组人骨髓间充质干细胞呈阴性染色。④RT-PCR检测软骨特异性的Ⅱ型胶原COL2A1 mRNA表达:实验组诱导培养7,14d人骨髓间充质干细胞有Ⅱ型胶原COL2A1 mRNA表达,400～500bp条带间可见明显的荧光条带,诱导培养14d时表达更明显。对照组未见Ⅱ型胶原COL2A1 mRNA表达。结论:采用直接贴壁培养法成功分离和培养出人骨髓间充质干细胞,并将人骨髓间充质干细胞诱导分化成软骨细胞,该软骨细胞具有软骨细胞的形态、生化特征。     

树突状细胞在慢性乙型肝炎和肝癌治疗中的应用前景

目的:综述树突状细胞在慢性乙型肝炎和肝癌治疗中的应用前景。资料来源:应用计算机检索PUBMED2001-01/2005-12期间的相关文章,检索词为"dendritic cells,chronic type B hepatitis,hepatoma,therapy",并限定文章语言种类为English。同时计算机检索万方数据库2001-01/2005-12期间的相关文章,检索词为"树突状细胞,慢性乙肝,肝癌,治疗",并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与树突状细胞在慢性乙型肝炎和肝癌治疗中的应用相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到56篇相关文献,30篇文献符合纳入标准,排除的26篇文献为内容陈旧或重复。符合纳入标准的30篇文献中,15篇涉及树突状细胞与慢性乙型肝炎的治疗,10篇涉及树突状细胞与肝癌的治疗,5篇涉及存在的问题与展望。资料综合:慢性乙型肝炎和肝癌的发生发展与病毒的持续感染和机体的免疫功能障碍有关,树突状细胞是机体中功能最强的抗原提呈细胞,在诱导T细胞抗病毒和抗肿瘤免疫中起核心作用。①树突状细胞与慢性乙型肝炎的治疗:许多证据表明由树突状细胞介导的细胞毒T淋巴细胞反应,通过杀伤感染的肝细胞和释放抗病毒的细胞因子来清除乙型肝炎病毒。②树突状细胞与肝癌的治疗:研究证明,经肿瘤抗原致敏的树突状细胞能明显增强特异性细胞毒T淋巴细胞对肝癌细胞的杀伤活性。结论:树突状细胞与慢性乙型肝炎和肝癌的发生发展密切相关。在乙型肝炎和肝癌治疗中,如能激发、增强机体对乙型肝炎病毒和肝癌细胞的主动免疫排斥反应,可有助于清除体内的病毒和肿瘤,达到抗病毒和抗肿瘤治疗的目的。     

调配骨水泥经皮椎体成形术注入治疗老年骨质疏松性椎体压缩骨折的疗效及其生物相容性

目的：总结经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床效果,并观察骨水泥材料与宿主的生物相容性反应. 方法：①患者对象：阳江市中医医院2003-02/2005-12收治的骨质疏松症性椎体压缩性骨折患者26例（32个椎体）,在C形臂X射线机透视下,行经皮椎弓根途径椎体成形术治疗.其中65岁以下的8例患者（8椎体）在硬膜外麻醉下行体位及手法复位后再行经皮椎体成形术治疗.②骨水泥注入方法及途径：调配骨水泥为英国CORIN公司生产的低黏滞度聚甲基丙烯酸甲酯,在骨水泥中加入尹索显或欧乃派克,粉∶液∶造影剂比例为3∶2∶1.应用1 mL专用注射器（美国COOK公司产品）经穿刺针将处于黏稠阶段的骨水泥注入椎体,当骨水泥达椎体后壁即停止注射.如果单侧穿刺骨水泥分布未超过椎体中线,则同时行另一侧椎弓根穿刺.③效果评估：观察椎体高度的恢复,采用目测类比评分法评估疼痛缓解程度,并发症发生情况与材料及宿主的反应. 结果：26例均完成手术进入结果分析.①每椎体注射骨水泥3.5～8.0 mL,平均4.5 mL,24 h后即离床活动.②手法复位后行经皮椎体成形术者,椎体高度椎体高度恢复到正常的75%～90%,随访≥12个月无椎体高度丢失.③术前目测类比评分为8.1（5.6～9.5）分,术后为2.7（1.2～4.8）分.23例患者腰痛术后24 h内消失,3例陈旧性骨折患者腰痛术后部分缓解.④并发骨水泥椎旁渗漏4例4椎体,未发现特殊的材料和宿主反应;前引流静脉渗漏2例2椎体,无临床症状;穿剌针抽出脑脊液1例,改行另侧穿刺成功. 结论：①经皮椎体成术治疗老年骨质疏松性椎体压缩骨折具有微创、见效快、疗效肯定的优点.②体位及手法复位后行经皮椎体成术,能大部分恢复椎体高度,适合于年龄相对较轻,椎体楔形压缩较多的患者.③只要操作熟练,单侧椎弓根穿刺即能达到临床目的.④骨水泥材料与宿主之间呈现较好的生物相容性.     

体外培养肾小球系膜细胞转化生长因子β1和血管紧张素Ⅱ表达与过氧化物酶体增殖物激活受体α激动剂的影响

目的:观察过氧化物酶体增殖物激活受体α(Peroxisome proliferators-actived receptor-alpha,PPARα)激动剂对体外培养的肾小球系膜细胞的作用。方法:实验于2005-12/2006-05在泸州医学院附属医院传染免疫实验室完成。实验分组:将培养的大鼠HBZY-1肾小球系膜细胞株分为6组,将高糖作为刺激因子,PPARα激动剂WY14643作为干预因素。分别设①正常组:5.6mmol/L葡萄糖。②高糖组:30mmol/L葡萄糖;③高糖 10,100,500μmol/LWY14643组:30mmol/L葡萄糖 10,100,500μmol/L WY14643。④高糖 WY14643溶剂组:30mmol/L葡萄糖 250μmol/L二甲亚砜 250μmol/L无水乙醇。实验评估:①采用反转录-聚合酶链反应半定量法测定各组肾小球系膜细胞PPARαmRNA和血管紧张素ⅡmRNA表达。②采用免疫细胞化学法检测各组转化生长因子β1蛋白表达。结果:①肾小球系膜细胞PPARαmRNA表达:高糖组肾小球系膜细胞PPARα表达低于正常组(分别为0.21±0.14,0.97±0.25),差异有显著性意义(t=7.742,P<0.05);10,100,500μmol/L WY14643组肾小球系膜细胞PPARα表达高于高糖组(分别为0.52±0.06,0.92±0.22,0.94±0.34,0.21±0.14),差异有显著性意义(t=4.438,7.182,7.213,P<0.05)。②转化生长因子β1表达和血管紧张素ⅡmRNA表达:高糖组肾小球系膜细胞转化生长因子β1、血管紧张素ⅡmRNA表达高于正常组(分别为25.76±0.24,16.43±0.38;0.79±0.23,0.46±0.13),差异有显著性意义(t=4.029,3.563,P<0.05);10,100,500μmol/LWY14643组肾小球系膜细胞转化生长因子β1、血管紧张素ⅡmRNA表达低于高糖组(分别为20.18±0.15,18.59±0.37,16.46±0.31,25.76±0.24;0.43±0.16,0.21±0.09,0.19±0.05,0.79±0.23),差异有显著性意义(P<0.05)。结论:转化生长因子β1、血管紧张素Ⅱ是糖尿病肾病发病的重要致病因子;PPARα激动剂减少转化生长因子β1、血管紧张素Ⅱ的表达可能与其增加PPARα的表达有关。     

中国肝癌肝移植的现状与展望

肝癌行肝移植治疗的指征、效果和相关问题一直存在争论,国际上已经有数个通用的肝癌肝移植标准,如Milan标准、Pittsburgh标准、UCSF标准等等,中国的移植学家们也在纷纷探讨适合中国的肝癌肝移植标准.本文收集并分析近年来国内外的文献,结合本移植中心460例肝移植的病例,对肝癌的分期标准、晚期肝癌行肝移植的指征进行了探讨,笔者认为影响我国肝癌肝移植的主要因素有:供肝的来源、术后乙肝及肿瘤的复发及相关社会因素等.