骨髓间充质干细胞静脉移植治疗大鼠脊髓损伤

背景：干细胞移植可以重建中枢神经系统的结构和功能,近年来引起了广泛的关注。 目的：尾静脉移植骨髓间充质干细胞观察其对大鼠脊髓损伤修复的影响并探讨其机制。 方法：密度梯度离心法结合贴壁筛选法分离骨髓间充质干细胞。将成年雌性Wistar大鼠以动脉瘤夹钳夹法制备大鼠脊髓损伤模型后随机分为细胞移植组和对照组,分别干预。 结果与结论：细胞移植组大鼠BBB后肢功能评分恢复优于对照组(P < 0.05)。自损伤后第30天开始,细胞移植组大鼠运动诱发电位潜伏期及体感诱发电位P1波潜伏期的恢复均优于对照组(P < 0.05),并持续至实验结束。细胞移植组大鼠脊髓内在损伤中心及头、尾端距离脊髓损伤中心1 cm处均可见阳性细胞。说明尾静脉注射移植骨髓间充质干细胞可以促进脊髓损伤大鼠神经功能恢复,其机制可能与移植细胞迁移到损伤部位,分化为神经元样和神经胶质细胞样细胞,并分泌或促进宿主分泌神经营养因子有关。     

电梯性晕厥一例报告

1病例报告患者女,42岁。主因半年来反复晕厥3次,于2010年6月11日就诊于我院。半年前,一次于服用降血压药1h后乘上升电梯中,突感头晕、出汗、眼前发黑、双下肢无力,随即瘫     

中青年与老年大疱性类天疱疮患者的临床比较

目的探讨年龄<60岁的中青年大疱性类天疱疮(BP)患者与年龄≥60岁的老年BP患者的临床及实验室检查差异,从而指导临床实践。方法对资料完整的136例BP患者进行回顾性分析,以年龄60岁为界分为中青年患者组和老年患者组,对两组临床特点及实验室检查进行比较。结果中青年患者皮损面积严重及累及黏膜的发生率高于老年患者(P<0.05),而瘙痒出现率低于老年患者(P<0.05);中青年患者白细胞升高、中性粒细胞升高、血清IgE升高的发生率明显高于老年患者(P<0.05),尿蛋白阳性、肝酶异常及白蛋白降低的发生率低于老年患者(P<0.05),两组免疫荧光的阳性率差异无统计学意义(P>0.05);中青年组联合免疫抑制剂的发生率及治疗中合并症的发生率均小于老年患者(P<0.05),两组控制皮损所需糖皮质激素用量无显著差别。结论年龄<60岁的中青年BP患者的临床症状严重,易于诊断,对临床治疗的效果优于老年患者。     

抗血小板治疗患者起搏器围术期不同抗栓治疗策略的临床对比研究

目的探讨长期口服阿司匹林进行抗血小板治疗的患者起搏器围术期的抗栓治疗策略。方法 2010年1月~2014年1月连续入住河北大学附属医院的长期服用阿司匹林并且安装永久起搏器的老年患者112例,分为3组:A组36例,围术期不停用阿司匹林;B组42例,起搏器术前3~5d停用阿司匹林,术后12h恢复;C组34例,术前停用阿司匹林3~5d,以低分子肝素桥接替代治疗,术前12h停用,术后12h恢复。结果 A、B、C组渗血的发生率分别为5.6%,7.1%,23.5%(P=0.044),囊袋血肿发生率分别为2.8%,2.4%,17.6%(P=0.025),C组渗血和囊袋血肿发生率明显高于A组和B组,A组与B组比较无统计学差异(P0.05)。所有患者均未发生大出血事件。B组和C组平均住院时间显著较A组长[(10.5±3.0)d和(11.6±2.9)d vs(7.5±2.3)d,P=0.000];住院期间3组患者均无囊袋感染及缺血事件发生。结论起搏器置入围术期持续应用阿司匹林治疗出血风险无明显增加,肝素桥接替代治疗明显增加出血发生率并延长住院时间。     

脂肪间充质干细胞移植治疗慢性阻塞性肺疾病

BACKGROUND:Chronic obstructive pulmonary disease is progressive respiratory disease characterized by airflow limitation. OBJECTIVE:To investigate the therapeutic effect of adipose-derived mesenchymal stem cell transplantation in rats with chronic obstructive pulmonary disease. METHODS:Sixty healthy male Sprague-Dawley rats were randomly divided into control, model and treatment groups (n=20 per group). Rat models of chronic obstructive pulmonary disease were made in the model and treatment group, while no treatment was done in the control group. After modeling, rats in the treatment group were given tail vein injection of CM-Dil-labeled adipose-derived mesenchymal stem cells, and rats in the model and control groups given the same amount of normal saline. Rat pulmonary ventilation function, inflammatory factor level and pathological changes of the lung were detected at 14 days after cell transplantation. RESULTS AND CONCLUSION:After modeling, reduced lung function was found in rats with chronic obstructive pulmonary disease, but the cell transplantation significantly improved this reduction (P < 0.05). Compared with the model group, significantly reduced indexes were visible in the treatment group (P < 0.05), including the total number of white blood cells, the number of macrophages and neutrophils, levels of interleukin-8, tumor necrosis factor α and C-reactive protein in the bronchoalveolar lavage fluid as well as serum level of malondialdehyde, while serum superoxide dismutase activity was increased significantly in the treatment group (P < 0.05). In the treatment group, emphysema-like changes were mitigated and CM-Dil-labeled adipose-derived mesenchymal stem cells were capable of homing to the lung tissue of rats with chronic obstructive pulmonary disease and survived. All these findings show that adipose-derived mesenchymal stem cell transplantation can improve lung function of rats with chronic obstructive pulmonary disease, and reduce inflammatory response, which has for certain some therapeutic effects.     

富血小板血浆促进牵拉成骨的矿化过程

BACKGROUND: The platelet-rich plasma contains various growth factors that could enhance the regeneration of certain tissues. OBJECTIVE: To observe the effect of platelet-rich plasma on the mineralization process during distraction osteogenesis in rabbits. METHODS: Thirty-two adult Japanese white rabbits were randomly divided into four groups (n=8 per group). The upper 1/3 tibial osteotomy at the posterior limb was performed in all rabbits, and the 1 cm limb lengthening models were prepared, followed by the local injection of 500 μL platelet-rich plasma at 5, 15 and 25 days. The controls received no treatment. At 37 days after modeling, the rabbits were killed and newly formed callus was removed to undergo hematoxylin-eosin staining, and the frontal X-ray film of tibia was obtained. RESULTS AND CONCLUSION: Lane-Sandhu radiographic scoring showed that the scores in the injection groups at 15 and 25 days after modeling were obviously better than those in the control group and the injection at 5 days after modeling. Lane-Sandhu histological scoring revealed that the scores in the injected groups at 15 and 25 days after modeling were significantly higher than those in the control group and group at 5 days after modeling (P < 0.05), which highest at 25 days. These results suggest that local injection of platelet-rich plasma can promote bone mineralization during distraction osteogenesis effectively, especially in the middle period of distraction osteogenesis. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

五味子多糖对人胶质瘤U251细胞增殖的影响

目的探讨五味子多糖对人胶质瘤U251细胞增殖的影响。方法人胶质母细胞瘤株U251置于胎牛血清中培养,分为观察组和对照组。观察组应用五味子多糖作用于人胶质瘤U251细胞,对照组未应用任何药物作用于人胶质瘤U251细胞。四甲基偶氮唑蓝比色(MTT)法观察800μg/ml五味子多糖对人胶质瘤U251细胞增殖的影响。RT-PCR观察800μg/ml五味子多糖对人胶质瘤U251细胞周期素(cyclin)B1 mRNA、原癌基因(c-Myc)mRNA的影响。Western印迹观察800μg/ml五味子多糖对人胶质瘤U251细胞cyclin B1、c-Myc蛋白的影响。结果培养48 h后,观察组不同浓度用药组OD570值均低于对照组,且随着用药浓度的上升,五味子多糖对人胶质瘤U251细胞的增殖抑制作用逐渐加强趋势。观察组cyclin B1 mRNA、c-Myc mRNA相对表达量均低于对照组(P0.05)。观察组cyclin B1、c-Myc蛋白表达量均低于对照组(P0.05)。结论五味子多糖能够有效抑制人胶质瘤U251细胞增殖,这可能与五味子多糖抑制cyclin B1与c-Myc的表达作用有关。     

老年中低位直肠癌患者手助腹腔镜与开腹直肠癌根治术的疗效比较

目的探讨手助腹腔镜全直肠系膜切除术在老年中低位直肠癌患者治疗中的疗效。方法 2012年6月至2013年12月行手助腹腔镜及开腹全直肠系膜切除术治疗的老年中低位直肠癌患者80例,应用手助腹腔镜下全直肠系膜切除术治疗41例(腹腔镜组),常规开腹全直肠系膜切除术治疗39例(开腹组);对两组患者的手术学指标进行统计分析与评价。结果两组患者均顺利完成保肛手术,且无术中死亡病例,腹腔镜组无中转开腹者。腹腔镜组患者术中出血量及术后排气时间均少于开腹组(P0.05),而手术时间、淋巴结清扫个数及术后并发症比较无明显差异(P0.05)。结论手助腹腔镜全直肠系膜切除术可以达到与传统开腹全直肠系膜切除术相同的疗效,相比传统开腹及全腹腔镜直肠癌根治术,手助腹腔镜直肠癌根治术在一定程度上更适合老年患者。     

负重状态对下腰椎椎体间旋转中心的影响

BACKGROUND: Epidemiologic reports have indicated that excessive weight-bearing exercise is one of important risk factors for lumbar degeneration, but the effects of weight-bearing activity on normal lumbar motion pattern are still not clear. OBJECTIVE: To measure the changing characteristics and rules of position at the center of rotation of the lower lumbar spine during a weight-lifting activity of normal person. METHODS: Fourteen asymptomatic subjects with a mean age of (25±5) years were recruited for this study. The L4-5 and L5-S1 segments of each subject were CT-scanned to construct 3D models using dual X-ray imaging system and spiral CT examination combined technology in the aid of computer software. The physiological load and lumbar spinal 3D motion under the loading condition were reproduced when matching the flexion, neutrality and extension in the dual X-ray imaging system and on dual oblique lumbar X-ray image. Coordinate systems were established at the vertebral body of L4-S1 to obtain the center of rotation during flexion-to-neutral, neutral-to-extension and the full flexion-extension motion. RESULTS AND CONCLUSION: (1) Under physiological load, the center of rotation of L4-5 of normal person was located about 1.0 mm anterior to the central axis of the vertebral body, and the center of rotation of L5-S1 was located about 0.7 mm anterior to the central axis of the vertebral body. (2) With weight loading, the center of rotation of both two segments shifted backward about 0.5 mm. There was no statistical difference between these two loading conditions. (3) When the center of rotation in flexion and extension was calculated respectively, the moving range of the center of rotation at both L4-5 and L5-S1 became larger due to taking loads of 10 kg (P < 0.05). In flexion, the center of rotation at L5-S1 significantly shifted forward during a weight-lifting activity (P < 0.05). (4) These results confirm that compared with non-weight-bearing condition, the trajectory of the center of rotation was found to be increased when taking loads, especially during the flexion-to-neutral motion.