骨髓源间充质干细胞在异基因小鼠免疫器官内的分布及其免疫功能调节作用

目的：探讨骨髓源间充质干细胞(Bone marrow mesenchymal stem cells，BMSC)在异基因小鼠免疫器官内的分布及其免疫调节作用。方法：以CM-Dil荧光染料示踪BMSC的体内分布情况，并辅以PCR检测Y染色体的方法进一步鉴定；体外实验采用MTT法、ELISA和FACS等方法检测BMSC的免疫调节作用。结果：BMSC可进入并较长期(30天)存在于异基因小鼠免疫器官内；在体外，BALB／C小鼠的BMSC对由ConA诱导的BALB／C和C57BL／6(B6)和BXSB小鼠的T细胞增殖均有抑制作用；而对前两种小鼠由12S诱导的B细胞增殖和分泌k方面表现为促进作用，对BXSB小鼠由IPS诱导的B细胞增殖和k分泌有抑制作用。BALB／C小鼠的BMSC对BALB／C和B6小鼠由ConA诱导的IL-4生成细胞的数量无明显影响，却可降低由ConA诱导的两种品系小鼠的IFN-γ生成细胞的数量；但对于BXSB小鼠却不同，BALB／C的BMSC可降低由ConA诱导的BXSB小鼠的IL-4生成细胞的数量，而提高由ConA诱导的IFN-γ生成细胞的数量。结论：异基因BMSC不但可进入受体的免疫器官，且可较长期(30天)存在；另外，BMSC对同基因正常、异基因正常和异基因自身免疫病的个体均有一定程度的免疫调节作用。     

Genetically engineered negative signaling molecules in the immunomodulation of allergic diseases

PURPOSE OF REVIEW: This review summarizes current knowledge regarding the control of human mast cell and basophil signaling and recent developments using a new therapeutic platform consisting of a human bifunctional gamma and epsilon heavy chain (Fc gamma-Fc epsilon) protein to inhibit allergic reactivity. RECENT FINDINGS: Crosslinking of Fc gamma RIIb to Fc epsilon RI on human mast cells and basophils by a genetically engineered Fc gamma-Fc epsilon protein (GE2) leads to the inhibition of mediator release upon Fc epsilon RI challenge. GE2 protein was shown to inhibit cord blood-derived mast cell and peripheral blood basophil mediator release in vitro in a dose-dependent fashion, including inhibition of human IgE reactivity to cat. IgE-driven mediator release from lung tissue was also inhibited by GE2. The mechanism of inhibition in mast cells included alterations in IgE-mediated Ca mobilization, spleen tyrosine kinase phosphorylation and the formation of downstream of kinase-growth factor receptor-bound protein 2-SH2 domain-containing inositol 5-phosphatase (dok-grb2-SHIP) complexes. Proallergic effects of Langerhan's like dendritic cells and B-cell IgE switching were also inhibited by GE2. In vivo, GE2 was shown to block passive cutaneous anaphylaxis driven by human IgE in mice expressing the human Fc epsilon RI and inhibit skin test reactivity to dust mite antigen in a dose-dependent manner in rhesus monkeys. SUMMARY: The balance between positive and negative signaling controls mast cell and basophil reactivity, which is critical in the expression of human allergic diseases. This approach using a human Fc gamma-Fc epsilon fusion protein to co-aggregate Fc epsilon RI with the Fc gamma RII holds promise as a new therapeutic platform for the immunomodulation of allergic diseases and potentially other mast cell/basophil-dependent disease states.     

HBV感染人胎盘滋养层细胞机制的初步探讨

目的 采用透射电镜观察HBV体外感染人胎盘滋养层细胞的超微结构变化.方法 HBV体外感染人胎盘滋养层细胞.ELISA检测培养上清中HBsAg,PCR检测细胞培养上清和滋养层细胞中的HBV DNA.HBV荧光定量PCR检测细胞培养上清中HBV DNA量(拷贝/ml).透射电镜观察滋养层细胞的超微结构.结果 感染组滋养层细胞培养上清中HBsAg在PBS清洗后12 h时A值为0.942,96 h时上升为1.264.PCR检测感染组细胞培养上清和感染组细胞HBV DNA均为阳性.PBS彻底清洗后0、12、36、60、84 h感染组细胞培养上清的HBV DNA分别为:＜103,3×104,6×105,5×105,3×105拷贝/ml.透射电镜观察到感染组滋养层细胞膜附近存在包涵素(Clathrin)形式的内吞小体形成,并且发现内吞小体内存在病毒颗粒样结构.在感染组细胞粗面内质网内发现HBsAg特异性的纤维丝状结构.结论 HBV可能经包涵素依赖的细胞内吞形式进入滋养层细胞,进而实现感染细胞或通过胞释作用将病毒排至细胞的对侧而实现穿越滋养层细胞屏障.     

采用永磁悬浮的永久性左心室辅助装置

研制出一台采用永磁轴承的左心室辅助装置（LVAD）。该装置包括一个定子和一个转子，采用径向驱动方式；转子包括驱动磁钢和叶轮，电机定子线圈和泵壳组成定子。装置设计采用了一种特殊结构的永磁轴承。转子的位置测量表明，转子稳定悬浮的前提条件是必须有较高的转速（大于3250r／min）且流量大于1L/min。用猪血为介质所做的液动力测试表明，当转速达到3500r／min～4000r／min时，血泵输出流量达到4L/min～6L/min，输出压力达到100mmHg。该装置重200g，最大处直径为40mm。     

新鲜羊膜致I型超敏反应的变应原性研究

研究新鲜人羊膜的变应原性及其致敏后发生I型超敏反应的可能性。建立豚鼠全身主动过敏实验模型。分新鲜羊膜组、新鲜蛋清组(阳性对照)和PBS液组(阴性对照),每组10只豚鼠。观察豚鼠在致敏期和激发后的反应,采用化学荧光法检测外周血组胺含量,血液流变分析系统检测4项血液流变学指标(全血高切变率黏度、全血低切变率黏度、血浆黏度、红细胞聚集指数)。致敏期间各组豚鼠的体重变化无明显差别(P>0.05);激发后羊膜组豚鼠与阴性组表现一致,无异常反应;羊膜组外周血组胺含量及4项血液流变学指标均与阴性对照无明显差别(P>0.05),与阳性对照有显著性差异(P<0.01)。经规范化无菌处理后的新鲜羊膜,一般不具有变应原性,不会引起I型超敏反应。     

Pregnancy following treatment of symptomatic myomas with laparoscopic bipolar coagulation of uterine vessels

BACKGROUND: Laparoscopic bipolar coagulation of uterine vessels (LBCUV) has been employed for women with symptomatic uterine myomas, but its effect on subsequent pregnancy has not been characterized. METHODS: Four-hundred and twenty-three women entered the study between March 1999 and December 2001. Of these, 142 women (33.6%) were under the age of 40 years at the time of LBCUV, 36 of whom (36/142, 25.3%) were sexually active without contraception. In a prospective study of 142 patients (<40 years old) undergoing LBCUV for symptomatic myomas, 15 women became pregnant (17 total pregnancies) and were evaluated by physical and ultrasound examinations. RESULTS: The volume of the dominant myoma was 117.4 +/- 118.4 and 36.8 +/- 56.8 cm(3) before and after LBCUV respectively. Volume of the dominant myoma after pregnancy was 46.2 +/- 76.7 cm(3) (mean +/- SD). There was a significant difference in myoma volume before and after LBCUV (P = 0.002), but no significant difference in myoma volume when comparing post-partum size with post-LBCUV size (P = 0.269). Pregnancy outcomes included seven miscarriages in the first trimester and one premature rupture of membrane (PPROM). Although the other pregnancies were regarded as uncomplicated, only two women were delivered of normal neonates as the other seven pregnancies were terminated secondary to patient request. CONCLUSIONS: The pregnancy and term pregnancy rates in sexually active women without contraception were 41.6% (15/36) and 5.6% (2/36) respectively. Because a relatively high rate (7/17, 41.2%) of early miscarriages was observed, we recommend that this procedure be employed only for women who do not desire additional children.     

高频电刀对家兔活体肌肉组织的作用

目的 :探讨高频电刀对肌肉组织结构的作用。方法 :用高频电极在不同输出功率时测定大白家兔活体肌肉组织的电流强度 ,灼伤中心区汽化深度和汽化表面积 ,光镜和电镜下观察创面下 0～ 6mm深度的组织结构变化。结果 :随着电流输出功率的增强 ,肌肉组织的电流强度 ,中心区汽化深度和汽化表面积也随之增加 ,创面深部组织显微和超微结构发生了热凝固性改变 ,损伤程度随着离中心区距离的延长而减弱 ,但在 6mm深处仍有较明显的损伤性改变。结论 :用高频电刀操作时应注意对深部肌肉组织的损伤性作用 ,为减少损伤应注意操作时的电流强度和电灼时间。     

动物实验模型中多极导管心室除颤系统电除颤对心脏功能的影响

评价新型的双极和三极导管自动心室除颤系统电除颤对左心室收缩和舒张功能的影响。动物麻醉后,在X光机指导下,分别在10只犬心脏内装置双极导管自动除颤系统（组Ⅰ）;在10只猪心脏内装置三极导管自动除颤系统（组Ⅱ）;并行电除颤试验。使用食管超声心动图在电除颤前后记录二维、M型和多谱勒超声图像。组I动物接受4次电除颤,电量为64J;组Ⅱ接受平均8次电除颤,电量为210J。结果显示：左室收缩面积分数、左室等容舒张时间和二尖瓣血流E波与A波速度比值以及时间-流速积分比值等反映左室舒缩功能的指标在两组动物除颤后均无显著改变。研究表明：两种经静脉导管自动心室除颤系统中反复低能量心内膜电除颤对左室舒缩功能无明显损伤作用;研究结果为经静脉多极导管自动心室除颤系统在临床的应用和电生理研究提供了可靠的实验数据。     

用电子自旋共振成像观测氮氧自由基的透皮特性

在自行研制的电子自旋共振成像(Electron spin resonance imaging, ESRI)系统上建立了活体皮肤电子自旋共振成像的实验模型.观测了氮氧自由基化合物2,2,6,6-四甲基哌啶-1-氧(2,2,6,6-tetramethyl-1-piperidinyloxy,TEMPO)穿透小鼠皮肤组织的动态过程和浓度分布情况.成像结果显示TEMPO化合物对不同方法处理后的皮肤组织的透皮特性有明显差别.TEMPO水溶液难以穿透皮肤,而溶解在二甲基亚枫(Dimethyl sulfoxide,DMSO)中的脂溶性TEMPO溶液可以渗入并穿透皮肤.皮肤表层的角质蛋白对TEMPO有明显的阻隔性, 而且化合物渗入或透过皮肤组织的量具有较强的时间依赖性.本研究结果提示ESRI技术为动态研究某些特殊结构化合物的透皮特性提供了科学有效的分析手段.     

前路椎体次全切在治疗颈椎后纵韧带骨化中的应用

目的：探讨颈前路椎体次全切治疗颈椎后纵韧带骨化的手术减压范围。方法：采用前路椎体次全切植骨融合术治疗颈椎后纵韧带骨化56例，其中完全切除骨化者47例，用“漂浮法”处理者9例，并针对不同个体及病变特点采用不同的减压范围。结果：54例获得3个月-6a随访，平均28个月。植骨均于术后3-5个月内获得骨性融合。JOA评分由术前8．5分提高到术后14．1，平均改善率74％，优良率80．2％。结论：行椎体次全切术治疗颈椎后纵韧带骨化时应针对不同个体及病变特点采用不同的足够的减压范围，可以减少并发症，并获得较佳的疗效。