Characteristics of Ex Vivo Expansion of Endothelial Progenitor Cells

Recently, endothelial progenitor cells (EPCs) were iso- lated from peripheral blood and proved to participate in neovascular formation[1-3]. This will be useful in regener- ating therapeutic vasculogenesis, provide suitable coat- ing for vascular grafts or deliver lethal toxins to tumor vascular beds. But EPCs in peripheral blood is very lim- ited in number, its introduction into transplantation pro- tocols has been hampered by the limited number of pro- genitors contained in blood harvested…     

咪唑安定与异丙酚在经阴道取卵术中的比较

目的：比较咪唑安定联合芬太尼与异丙酚联合芬太尼作为清醒麻醉在经阴道无痛取卵术中应用效果和安全性。方法：将80例体外受精一胚胎移植患者随机分为咪唑安定联合芬太尼组（咪唑安定组，n=40）和异丙酚联合芬太尼组（异丙酚组，n=40），在保持镇静程度相当的前提下观察两组在取卵术中镇痛效果，循环系统变化（血压和心率），呼吸变化（呼吸频率、指测血氧饱和度和呼吸抑制发生率），以及术后遗忘、恶心呕吐不良反应。结果：两组镇痛效果、循环系统变化无差异。咪唑安定组的呼吸抑制、术后呕吐发生率和术后遗忘率分别为5．0％、10．0％和25．0％，异丙酚组分别为25．0％、27．5％和7．5％，两组具有显著性差异（P〈0．05）。结论：无痛阴道取卵术的清醒麻醉方案中，咪唑安定联合芬太尼的副作用较异丙酚联合芬太尼少。     

Effect of L-carnitine on Cardiomyocyte Apoptosis and Cardiac Function in Patients Undergoing Heart Valve Replacement Operation

Summary： The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three cases undergoing heart valve replacement with cardiopulmonary bypass （CPB） were randomly allocated into two groups： L-carnitine group （n=12, 12 g/L L-carnitine was put in the ST. Thomas cardioplegia） and control group （n=11, identical to the L-carnitine group except that normal saline was administered instead of L-carnitine）. Serum cardial troponin I （cTnI） levels, the left ventricular ejection fraction （LVEF）, and cardiac index （CI） were measured perioperatively. A bit of myocardial tissue obtained from right atria was taken before CPB and by the end of intracardiac procedure to undergo electron microscopy examination and estimate apoptosis by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling （TUNEL）. From the end of CPB to 3 days after operation, the serum levels of cTnI in the L-carnitine group was significantly lower than that in the control group （P〈0.05）. Heart color ultrasonogram showed that the CI index and LVEF at 7th day postoperatively in the L-carnitine group were significantly higher than in the control group （P〈0.05）. Compared to the control group, L-carnitine significantly alleviated the morphologic changes of cardiac muscle cells （electron microscopy examination） and decreased the amounts of apoptotic cardiac muscle cells （TUNEL）. Furthermore, the dosage of vasoactive drugs used after operation was significantly less in the L-carnitine group （P〈0.01）. It was concluded that L-carnitine cardioplegia solution could improve cardiac function in patients undergoing heart valve replacement operation and alleviate CPB-mediated apoptosis of cardiac muscle cells.     

基于PID闭环控制算法的麻醉靶控输注给药的研究

基于传统低阶线性房室药代动力学模型的TCI，可以用解析方法求解所需的给药曲线。但是，基于生理药代动力学模型的TCI，因其数学描述一般为高阶非线性方程，解析法难以求解。本研究提出了一种新方法，以人体异丙酚生理药代动力学模型为基础，以听觉诱发电位指数（AEPI）为反馈变量，用比例-积分-微分（PID）闭环控制算法由计算机求解注射给药曲线。将所得的给药曲线应用于临床麻醉，实际测量的AEPI曲线与仿真曲线基本吻合，取得了较好的临床效果。     

细胞移植结合激光肌肉血管重建增强鼠缺血肢体新生血管形成

目的: 研究激光肌肉血管重建（TMR）和血管内皮祖细胞（EPCs）移植相结合能否增强缺血肢体新生血管形成。方法： 密度梯度法分离脐带血单个核细胞并体外培养，免疫组织化学和流式细胞术定量和定性分析。应用DiI标记注射入激光孔道和缺血区的EPCs。结扎裸鼠右侧髂外动脉造成急性肢体缺血模型，随机分为：TMR＋EPCs组：EPCs移植入缺血区肌肉的激光孔道；TMR组： 缺血区肌肉激光打孔；EPCs组：注射EPCs至缺血区肌肉；对照组：缺血肢体模型。超声多谱勒测定缺血和非缺血后肢的股动脉血流获得比值（FAFI），组织化学和免疫组织化学检查缺血肢体肌肉标本。结果： 贴壁细胞表达KDR、CD34、AC133、CD31和vWF，并且吞噬Ac-LDL，有内皮细胞功能，培养7 d的细胞流式细胞术检查CD34（62%±7%）和AC133（57.2%±9.8%）阳性。术后28 d，TMR＋EPCs、EPCs和TMR组FAFI明显高于各自基线水平；TMR＋EPCs和EPCs组FAFI明显高于对照组。TMR+EPCs组新生血管形成明显多于对照组。结论： TMR和EPCs移植结合明显改善了缺血肢体的灌注并增强了缺血肢体新生血管形成。