人早孕绒毛组织的体外原代培养和人滋养细胞株的建立

目的:建立快速、有效的绒毛滋养细胞体外原代培养的方法以及建立人滋养细胞株和初步评价。方法:采用胰酶和胶原酶I混合消化法消化绒毛组织,用胰蛋白酶消化传代体外培养,通过光镜、透射电镜和免疫荧光激光共聚焦方法对培养出的细胞进行形态和骨架评价。结果:显微镜下可见细胞呈多边形,细胞平铺生长,有细胞融合后形成的合体滋养层细胞;透射电镜下可见细胞表面的微绒毛丰富;胞质丰富,内质网扩张明显,有丰富的糖原颗粒、髓样小体和明显的脂滴,以及细胞间紧密的桥粒样结构连接;直接免疫荧光双标记染色检测到角蛋白18和波形蛋白均为阳性。结论:采用胰酶和胶原酶I混合消化法可获得较纯的滋养细胞,通过光镜、透射电镜和免疫荧光激光共聚焦检测细胞外形和骨架,确定该体外传至56代的细胞株为滋养细胞株。     

语前聋患儿国产人工耳蜗植入效果分析

目的 观察语前聋患儿植入诺尔康-晨星人工耳蜗(Nurotron-Venus cochlear implant,Nurotron-Venus CI)后的听觉言语发育情况及其安全性和稳定性.方法 回顾性分析郑州大学第一附属医院行Nurotron-Venus CI植入的78例语前聋患儿的临床资料,患儿植入年龄为13~96月,按植入年龄将患儿分为 A组(13~24月,16 例)、B 组(25~36月,13 例)、C组(37~48月,16 例)、D 组(49~72月,18 例)、 E 组(73~96月,15 例);在患儿术前及开机后1、3、6、12个月采用有意义听觉整合量表(meaningful auditory integration scale,MAIS)(C、D、E组)、婴幼儿有意义听觉整合量表(infant-toddler meaningful auditory integration scale,IT-MAIS )(A、B组)进行听觉能力评估,开机后1、3、6、12个月使用有意义言语使用量表(meaningful use of speech scale,MUSS)进行言语能力评估.术后行X线耳蜗平片检查明确电极位置及形态,定期随访了解术后相关并发症及佩戴人工耳蜗时间和使用情况.结果 所有患儿术前及开机后1、3、6、12月IT-MAIS或MAIS得分分别为1.67±1.19、6.60±5.12、11.86±5.44、17.41±5.04、22.87±5.46分,术后1、3、6、12月MUSS得分分别为5.01±3.26、8.38±3.58、11.88±3.88、16.58±4.95分,随着植入时间延长得分不断上升(均P<0.05);不同年龄组IT-MAIS或MAIS得分比较:术前A组低于C、D、E组,开机后1、3月A、B组低于E组,开机后6月A组低于C、D、E组,B组低于E组(均为P<0.05);不同年龄组MUSS得分比较:开机后1月B组低于E组,开机后3月A、B、C组低于E组,开机后6月A组低于C、D、E组,B组低于E组,开机后1年A组低于C、D、E组(均为P<0.05).所有患儿在开机后1、3、6、12月MUSS与IT-MAIS或MAIS得分相关系数分别为0.918、0.808、0.881、0.756(均为P<0.05),两者呈正相关.78例患儿术后耳蜗位X线平片均显示电极位置正常,形态良好;2例患儿出现处理器故障,其余CI整体工作状态良好.结论 语前聋患儿国产人工耳蜗植入后1年内,所有患儿的听觉言语能力随时间延长不断提高;小龄组患儿听觉言语得分在术后早期低于大龄患儿;听觉能力在开机后12月时已无差异,但小龄组患儿的言语能力仍低于大龄患儿;听觉整合能力越强,言语使用能力越强;Nurotron-Venus CI安全、效果可靠.     

自体肾上腺髓质脑内移植治疗震颤麻痹——脑脊液内单胺类神经介质的变化

观察了10例经自体肾上腺髓质脑内移植治疗震颤麻痹(PD)患者手术前后脑脊液(CSF)中多巴胺(DA)、去甲肾上腺素(NE),5-羟色胺(5-HT),5-羟吲哚乙酸(5-HIAA)等单胺类物质含量的改变,发现患者经手术后,在症状明显改善的同时,DA术后与术前相比,除第1周无显著性差异外(p>0.05),术后第2、4,6、8周均有明显上升(p<0.01),说明此种手术可以提高脑内DA的含量,进而说明脑内DA含量与PD病因的相关性,而NE、5-HT及5-HIAA的含量手术前后均未发现明显改变,但这并不能说明这些物质与该病因无关。     

Optimization of Process Parameters and Analysis of Microstructure and Properties of 18Ni300 by Selective Laser Melting

In this research, we studied the influence of process parameters on the quality of selective laser melting of 18Ni300 maraging steel. The effects of laser power and scanning speed on the relative density and hardness of 18Ni300 were studied by single-factor experiment and the orthogonal experimental method. The relative optimal process parameters of 18Ni300 were obtained when the layer thickness was 0.03 mm, and the hatch space was 0.1 mm. The microstructures and mechanical properties of the samples formed under different process parameters were characterized. The results showed that the optimal hardness and relative density of the sample were 44.7 HRC and 99.98% when the laser power was 230 W and the scanning speed was 1100 mm/s, respectively; the microstructure of the material was uniform and dense, exhibiting few pores. Some columnar crystals appeared along the boundary of the molten pool due to vertical epitaxial growth. The orientation of fine grains at the boundary of the molten pool was random, and some coarse columnar crystals in the molten pool exhibited a certain orientational preference along the <001> orientation. In the case of optimal process parameters, the SLM-formed 18Ni300 was composed of 99.5% martensite and 0.5% retained austenite; the indentation hardness was distributed in the range of 3.2–5 GPa. The indentation modulus was between 142.8–223.4 GPa, exhibiting stronger fluctuations than the indentation hardness. The sample’s mechanical properties showed obvious anisotropy, while the tensile fracture characteristics exhibited necking. The tensile fracture morphology was ductile, and large equiaxed dimples and holes could be observed in the fiber area, accompanied by tearing characteristics.     

三维支架中骨髓间充质干细胞及软骨细胞和脂肪源性成熟基质细胞的成软骨效应

背景：软骨修复的关键是种子细胞在三维支架中的定向分化,但细胞放入三维支架中很难有透明软骨表现。 目的：考察3种种子骨髓间充质干细胞,软骨细胞和脂肪源性成熟基质细胞在支架中的成软骨特性。 方法：抽取羊骨髓,胰酶消化后获得原代骨髓间充质干细胞细胞、软骨细胞和脂肪源性成熟基质细胞,单层培养扩增。取P1骨髓间充质干细胞,P3软骨细胞和P3脂肪源性成熟基质细胞种植入不同比例(10%,20%,50%,80%,100%)的胶原/透明质酸支架中, 在无血清培养液中三维培养。2周后,用SO染色和免疫组织化学染色分析,观察硫酸软骨素和Ⅱ型胶原合成情况。 结果与结论：种子细胞在三维支架中特定条件下有成软骨效应,骨髓间充质干细胞在含20%透明质酸的胶原/透明质酸支架扩增少于3代有成软骨效应,软骨细胞传代数更高仍然有成软骨效应,但脂肪源性成熟基质细胞成软骨效应能力较弱。结果提示,在同样条件下骨髓间充质干细胞、软骨细胞较脂肪源性成熟基质细胞有更好的成软骨性能。 关键词：骨髓间充质干细胞;软骨细胞;组织工程;软骨;脂肪干细胞 doi:10.3969/j.issn.1673-8225.2010.16.004     

左旋精氨酸对兔肺缺血再灌注损伤的保护作用

目的 :观察左旋精氨酸对在体兔肺缺血再灌注损伤的影响。方法 :复制在体兔肺缺血再灌注损伤模型。 30只日本雄性大耳兔 ,随机分为三组 :假手术组 ,缺血再灌注组 (IR组 )和左旋精氨酸 +缺血再灌注组(Larg组 )。对比观察各组血浆SOD活力 ,NO、MDA含量 ,肺组织湿干重比 (W /D) ,肺损伤组织学定量评价指标 (IQA)及光镜和电镜下的组织形态学改变。结果 :缺血再灌注后Larg组血浆NO含量和SOD活力较S组、IR组明显升高 (P <0 .0 1) ,MDA、W/D、IQA较IR组明显降低 (P <0 .0 5 ,P <0 .0 5 ,P <0 .0 1) ;IR组镜下见有肺组织水肿 ,肺泡损伤严重 ,内皮细胞线粒体水肿或空泡化 ,毛细血管内炎性细胞浸润 ;而Larg组肺组织上述改变明显减轻。结论 :在体兔肺缺血前预先用L Arg处理 ,可减轻随后的缺血再灌注损伤 ;其机制之一可能与L Arg抗氧自由基作用有关     

Financial protection of patients through compensation of providers: The impact of Health Equity Funds in Cambodia

Public providers have no financial incentive to respect their legal obligation to exempt the poor from user fees. Health Equity Funds (HEFs) aim to make exemptions effective by giving NGOs responsibility for assessing eligibility and compensating providers for lost revenue. We use the geographic spread of HEFs over time in Cambodia to identify their impact on out-of-pocket (OOP) payments. Among households with some OOP payment, HEFs reduce the amount paid by 35%, on average. The effect is larger for households that are poorer and mainly use public health care. Reimbursement of providers through a government operated scheme also reduces household OOP payments but the effect is not as well targeted on the poor. Both compensation models raise household non-medical consumption but have no impact on health-related debt. HEFs reduce the probability of primarily seeking care in the private sector.     

Lymph node non-Hodgkin's lymphoma incidentally discovered during a nephrectomy for renal cell carcinoma

We report the case of a left laparoscopic nephroureterectomy with the incidental discovery of a non-Hodgkin’s lymphoma in one of the lymph nodes of the renal hilum. A laparoscopic nephroureterectomy was decided on for a 64-year-old man. Renal cell carcinoma in the kidney and one lymph node of the renal hilum with non-Hodgkin’s lymphoma was found. Chemotherapy was not started for the lymphoma discovery. There are no signs of relapse after two years of follow up. Coexistence in the same patient is an extremely rare condition. We review the literature about this issue to clarify this association.     

氯胺酮对人肺癌A549细胞生长的影响及相关机制研究

目的:探讨麻醉类药物氯胺酮和吗啡对人肺癌A549细胞生长的影响及相关作用机制?方法:体外培养肺癌细胞系A549,细胞培养24 h后,随机分为3组:对照组(NC组,加0.9% NaCl处理)?氯胺酮组(K1?K2?K3组,分别加氯胺酮100?200?400 ?滋g/mL处理)和吗啡组(M1?M2?M3组,分别加吗啡25?50?100 ?滋g/mL处理)?持续作用24 h后,Transwell小室培养体系测定肿瘤细胞的迁移率;双荧光素酶报告基因法测定NF-κB转录活性;48 h后MTT法测定细胞增殖抑制率;Western blot技术测定NF-κB P65的蛋白表达;QPCR技术检测细胞内IL-1β和COX-2的mRNA表达?结果:①与NC组比较,M1?M2组表现为促进A549细胞迁移(P < 0.05),M3组作用不明显;K1?K2?K3组表现为抑制A549细胞迁移(P < 0.05);②与NC组比较,M1?M2组表现为促进A549细胞增殖(P < 0.05),M3组作用不明显;K2?K3组表现为抑制A549细胞增殖(P < 0.05),K1组不明显;③与NC组比较,M1?M2?M3组表现为促进IL-1β?COX-2的mRNA表达(P < 0.05);K2?K3组表现为抑制IL-1β?COX-2的mRNA表达(P < 0.05),K1组不明显;④与NC组比较,M1?M2?M3组表现为促进P65的转录和蛋白表达(P < 0.05),K1?K2?K3组表现为抑制P65的转录和蛋白表达(P < 0.05)?结论:与阿片类药物不同,氯胺酮通过NF-κB信号通路及其下游因子IL-1β和COX-2抑制人肺腺癌细胞A549的迁移和增殖,可能更适用于肺癌患者的术后镇痛?