基因疫苗pcDNA-AChRα211免疫小鼠建立重症肌无力动物模型

目的：用基因疫苗pcDNA-AChRα211，免疫C57BL／6小鼠建立实验性自身免疫性重症肌无力模型（EAMG）。方法：将人乙酰胆碱受体α亚基N端的主要免疫区（AChRα211）的基因片段插入到穿梭载体pcDNA3．0中，构建基因疫苗pcDNA-AChRα211。大量提纯质粒pcDNA-AChRα211后肌肉注射C57BL／6小鼠。用ELISA法检测小鼠血清中抗AChRα211，的IgG（ACh-RAb），并用PCR方法检测外源基因在小鼠各组织器官中的分布情况。结果：双酶切鉴定和序列测定表明构建了含正确目的基因阅读框的重组质粒pcDNA-AChRα211，ELISA分析表明该基因疫苗免疫的C57BL／6小鼠血清中含有AChRAb，且免疫三个月后在小鼠的肌肉、肝、脾、肾中仍可检测到目的基因AChRα211的存在。结论：重组质粒pcDNA-AChRα211作为基因疫苗能够诱导实验性自身免疫性重症肌无力。     

临床用间充质干细胞的质量控制研究

干细胞是一类具有自我更新和分化潜能的细胞.间充质干细胞(MSCs)是属于中胚层的一类多潜能干细胞,主要存在于结缔组织和器官间质中,如骨髓、脂肪、脐带、羊膜组织,间充质干细胞具有强大的增殖能力和免疫调节功能,在适宜的体内或体外环境下具有分化为肌细胞、肝细胞、成骨细胞、软骨细胞、基质细胞等多种细胞的能力.间充质干细胞由于具备多向分化和免疫调节功能,因此在治疗一些退行性和自身免疫性疾病等方面具有广阔的临床应用前景.     

Human umbilical cord-derived mesenchymal stem cells treatment for refractory uveitis: a case series

AIM: To evaluate therapeutic outcomes of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) treatment in patients with refractory uveitis. METHODS: A retrospective and noncomparative review was performed on four patients with refractory uveitis from December 2013 to December 2017. HUC-MSCs were administered intravenously at a dose of 1×106 cells/kg. Clinical response, relapse rate, change of visual acuity, and other metrics were evaluated. RESULTS: All four patients presented with responses to HUC-MSCs treatment, with three males and one female. The numbers of uveitis attacks per year after the HUC-MSCs treatment (0, 2, 0, 0 respectively) all decreased compared with the numbers before the treatment (3, 6, 4, 4 respectively). The oral steroid and immunosuppressive agents were tapered in all patients without recrudescence of ocular inflammation, and three patients discontinued their oral medicine at the last visit. The best corrected visual acuity (BCVA) of 3 patients was improved to varying degrees, and the BCVA of 1 patient remained at 20/20 (Snellen chart) from the first to the last consultation. CONCLUSION: The study provides an effective therapy of HUC-MSCs in maintaining remission in patients affected by uveitis refractory to previous immunosuppressant treatments.     

腰麻-硬膜外联合阻滞用于分娩镇痛的药物比较研究

目的:观察3种不同药物用于腰麻-硬膜外联合阻滞(CSEA)分娩镇痛的效果、安全性以及对产程和母婴的影响,以探讨最佳的配伍和药物剂量,为临床分娩镇痛提供指导和借鉴。方法:选择要求分娩镇痛产妇300例随机分为3组:单纯罗哌卡因组(R组)、单纯舒芬太尼组(S组)、罗哌卡因+芬太尼组(RF组);另选择100例未采用任何镇痛方式的产妇作为对照组。观察并记录各组镇痛效能及对产程和母婴的影响。结果:①镇痛3组均获得良好的镇痛效果。RF组与S组起效时间明显短于R组(P<0.01);RF组与S组首剂持续时间明显长于R组(P<0.01);RF组与S组的起效时间和首剂持续时间无显著性差异(P>0.05);RF组局麻药总用量明显少于R组(P<0.01)。②3组镇痛前后各时点产妇的MBP(平均动脉压)、HR(心率)、RR(呼吸频率)、SpO2(血氧饱和度)无显著性差异(P>0.05)。③第一产程活跃期时间,镇痛3组均短于对照组,有显著性差异(P<0.01);第二产程时间及第三产程时间,各组之间无显著性差异(P>0.05);各组之间的器械助产率及剖宫产率无显著性差异(P>0.05)。④新生儿1min及5min Apgar评分,各组之间无显著性差异(P>0.05)。⑤S组有12例、RF组有17例发生皮肤瘙痒,但症状轻微,无需应用拮抗药;其余不良反应的发生率各组之间差异无统计学意义(P>0.05)。结论:3种给药方案均可安全有效应用于分娩镇痛。选择0.15%罗哌卡因复合2μg/ml芬太尼用于腰麻-硬膜外联合阻滞分娩镇痛疗效确切、起效更快、作用时间更长。由于局麻药用量减少,因此,对运动神经的影响更小、不良反应少,产妇易于接受,满意率高,是无痛分娩的一种理想麻醉方法。     

Balloon-assisted endoscopic submucosal dissection for treating small intestinal lipomas: Report of two cases

BACKGROUNDMost small intestinal lipomas are treated surgically, and some require repeated surgeries for multiple lipomas. However, application of endoscopic submucosal dissection (ESD) technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine, medical equipment limitations, and the lack of relevant experience among endoscopists.CASE SUMMARYTwo patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloon-assisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas. The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas, with a complete resection rate of 100% (4/4), without intraoperative or postoperative bleeding, perforation, or other complications. After 3-6 mo of postoperative follow-up, the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.CONCLUSIONBalloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.     

Management of pseudomyxoma peritonei

INTRODUCTION Pseudomyxoma peritonei (PMP) is a rare disease[1]. It refers to a progressive disease process within the peritoneum which originates from the appendix or ovaries and is characterised by the production of copious amounts of mucinous fluid resu…     

脐带间充质干细胞移植治疗大鼠重症肌无力的研究

脐带间充质干细胞因其来源广泛,易扩增,低免疫原性等特点被人们越来越多地应用于疾病治疗的研究中。本研究旨在为重症肌无力疾病探求一种新的应用干细胞的治疗方法。将脐带间充质干细胞(UCMSC)移植到重症肌无力大鼠中,应用免疫荧光法观察人源化细胞的分布,ELISPOT法观察MSC对B细胞原位分泌抗体的影响,Transwell试验检测分泌IFN-γ的水平。结果发现,经静脉输注的UCMSC能快速的迁移到炎症部位和局部淋巴结,而且在淋巴结的髓质区也可以检测到人源化的细胞。体外原位检测乙酰胆碱受体(AchR)抗体分泌的试验发现,当MSC与淋巴结来源的淋巴细胞充分接触,能有效地抑制AchR抗体的产生。Transwell试验显示,UCMSC与CD4T细胞直接接触,能有效地降低IFN-γ的产生,在一定程度上缓解重症肌无力体内的Th1/Th2细胞失衡的免疫状态。结论 :在重症肌无力大鼠中,MSC可能通过相互接触或/和释放细胞因子而调节机体的免疫反应,这为重症肌无力提供了一种潜在的治疗新途径。     

鳖甲煎改良方对大鼠肝纤维化的防治作用

目的:研究鳖甲煎改良方对大鼠肝纤维化(HF)的防治作用及对TGF-β1和Sman3/7蛋白表达的影响,探讨其机制.方法:SD♂大鼠90只,随机取10只作为正常对照组(A组),其余大鼠用皮下注射40%CCl4橄榄油油剂3mL/kg诱导大鼠肝纤维化模型8wk,于第2周时随机处死5只大鼠证实HF形成后,将剩下的大鼠随机分为肝纤维化模型组(B组)、鳖甲煎改良方高剂量组[C组,28.4g/(kg·d)]、中剂量组[D组,14.2g/(kg·d)]、低剂量组[E组,7.1g/(kg·d)]、复方鳖甲软肝片组[F组,0.6g/(kg·d)],每组15只.C、D、E、F组给予10mL/(kg·d)相应药液灌胃治疗,A、B组同时给予等剂量的生理盐水灌胃处理.8wk后采血测定血清丙氨酸氨基转移酶(ALT)、草氨酸氨基转移酶(AST)、白蛋白和球蛋白含量;取肝组织作HE染色观察肝纤维化程度变化;Westernblot方法检测TGF-β1、Smad3和Smad7蛋白的表达.结果:8wk后,与B组比较,C、D、E组和F组肝小叶结构破坏明显减轻,肝纤维化程度分级较B组明显好转;ALT和AST含量显著降低(P<0.01),白蛋白含量显著增...