人胚胎发育过程中胚胎组织肝干细胞免疫表型的变化

目的:观察人胚胎发育不同时期胚胎肝组织中细胞免疫表型及其变化,探讨人肝干细胞的来源、分化与迁移规律.方法:用常规病理H-E染色和免疫组织化学方法观察30例4～35周龄胚胎肝组织中几种细胞的肝胆标记(AFP、GST-π、CK7、CK19)和造血干细胞标记(CD34、c-kit)的表达及变化.结果:AFP阳性表达始于4周龄胚胎肝,至16～24周龄达到高峰,之后表达逐渐减少,仅部分胆管板和少数界板细胞阳性;GST-π阳性表达始于6周龄后的胚胎肝肝索细胞和8周龄后胆管板细胞,但26周龄后仅部分胆管板细胞及少数界板细胞阳性.CK19在6～11周龄肝索细胞内阳性表达达到最高峰,之后表达逐渐减少但胆管板细胞始终阳性;CK7仅限于14周龄之后的胆管板细胞和胆管上皮内表达.8周龄胚胎肝胆管板中开始可见CD34和c-kit阳性细胞,肝索和门静脉附近间充质内也可见少数表达CD34和c-kit的单个核细胞;但21周龄后CD34和c-kit阳性细胞仅见于胆管板及汇管区间充质内而肝索内少见.结论:4～16周龄胚胎肝细胞主要由具有双向分化潜能的肝干细胞组成;16周龄胚胎肝内大部分肝索细胞开始表现出向肝细胞定向分化的特点,而作为未来Hering管细胞来源的胆管板则仍含有肝干细胞;胚胎肝内部分肝干细胞可能来源于造血系统;这些与前期研究提出的"肝流域假设"中涉及肝干细胞所在及来源的假设相吻合.     

胆汁淤积致肝内胆管上皮细胞间质表型转变的病理学分析

目的 探讨胆汁性肝纤维化时胆管上皮细胞发生间质表型转变的特点.方法 制作胆管结扎所致大鼠肝纤维化模型,利用HE染色、免疫组化和免疫荧光等方法,检测术后1周和2周时肝内胆管细胞的上皮和间质标志物的表达情况.结果 大鼠胆管结扎后胆汁淤积,引起肝内汇管区胆管细胞显著增生以及围胆管成纤维细胞和纤维基质增加.免疫组化结果显示,假手术组和胆管结扎组大鼠胆管细胞均表达上皮细胞标志蛋白CK19,但胆管结扎组肝内胆管细胞也表达间质细胞标志物Vimentin和FSP1/S100A4.胆管结扎1周时,汇管区内新生小胆管呈Vimentin强阳性,2周时增生胆管周围许多细胞也呈Vimentin阳性.但两组大鼠胆管细胞均不表达肌成纤维细胞标志物α-SMA,α-SMA阳性细胞主要分布于汇管区胆管细胞周围.结论 在胆汁性肝纤维化进程中胆管细胞增生并发生一定程度的上皮一间质表型转变,可能促进了肝纤维化的发生.     

妇产科概论 免疫学

070788人胚胎发育过程中胚胎组织肝干细胞免疫表型的变化/徐军…∥第二军医大学学报·—2007,28(2)·—117~121目的:观察人胚胎发育不同时期胚胎肝组织中细胞免疫表型及其变化,探讨人肝干细胞的来源、分化与迁移规律。方法:用常规病理H-E染色和免疫组织化学方法观察30例4~35周龄胚胎肝组织中几种细胞的肝胆标记(AFP、GST-π、CK7、CK19)和造血干细胞标记(CD34、c-kit)的表达及变化。结果:AFP阳性表达始于4周龄胚胎肝,至16~24周龄达到高峰,之后表达逐渐减少,仅部分胆管板和少数界板细胞阳性;GST-π阳性表达始于6周龄后的胚胎肝肝索细…     

神经中间丝蛋白Nestin在胎肝中的表达

目的 采用免疫组织化学方法标记不同发育时期人胚胎肝干细胞中巢蛋白(Nestin)的表达,探讨肝干细胞新的表面标志蛋白。方法 取材不同发育时期胎儿肝脏,固定并制成石蜡切片,ABC法标记神经前体细胞的特异性表面标记Nestin在胎肝干细胞中的表达。结果 汇管区周边界板处卵圆样干细胞表达Nestin阳性,Nestin阳性细胞呈单层紧密排列成管,呈鞘样包绕着早期汇管区,部分包绕着初级汇管区,随着次级汇管区的成熟,Nestin阳性卵圆样干细胞逐渐局限于赫令管周围;此外胚胎发育不同时期可见Nestin阳性单个核样细胞散布在肝实质内。结论 肝脏内有Nestin表达阳性的干细胞存在,其功能、来源需要进一步深入研究。     

瘦素蛋白在小鼠日本血吸虫病肝纤维化组织中的表达及意义

目的 观察小鼠感染日本血吸虫后不同时期肝脏瘦素蛋白的表达,探讨瘦素在日本血吸虫病肝纤维化发生、发展中的意义.方法 日本血吸虫尾蚴皮肤敷贴法感染小鼠构建日本血吸虫病肝纤维化模型,于感染后不同时间取肝组织标本.HE和VG染色对肝组织进行病理学检查,半定量分析肝纤维化程度;采用免疫组织化学SP法动态观察瘦素及肝星状细胞(hepatic stellate cell,HSC)标记物α-平滑肌肌动蛋白(α-SMA)的表达情况.结果 模型组肝胶原含量随病程发展呈进行性增多,肝纤维化程度随病程发展呈进行性加重;α-SMA阳性细胞于炎症早期在汇管区已有表达,随病程进展进行性增加,α-SMA阳性表达主要位于胶原纤维所在部位;瘦素阳性表达出现的时间、部位和进程类似于α-SMA阳性表达情况.相关分析表明,α-SMA蛋白表达与胶原含量呈正相关(r=0.956,P＜0.01),而与肝纤维化程度也呈正相关(r=0.804,P＜0.01) ;与瘦素蛋白呈正相关(r=0.836,P＜0.01);瘦素蛋白与胶原含量呈正相关(r=0.758,P＜0.01),而与肝纤维化程度也呈正相关(r=0.823,P＜0.01).结论 HSC是日本血吸虫病肝纤维化发生发展过程中的关键细胞,而瘦素在该过程中发挥重要的促肝纤维化作用,可望成为新的治疗靶点.     

神经中间丝蛋白Nestin在胎肝中的表达

目的 采用免疫组织化学方法标记不同发育时期人胚胎肝干细胞中巢蛋白(Nestin)的表达，探讨肝干细胞新的表面标志蛋白。方法 取材不同发育时期胎儿肝脏，固定并制成石蜡切片，ABC法标记神经前体细胞的特异性表面标记Nestin在胎肝干细胞中的表达。结果 汇管区周边界板处卵圆样干细胞表达Nestin阳性，Nestin阳性细胞呈单层紧密排列成管，呈鞘样包绕着早期汇管区，部分包绕着初级汇管区，随着次级汇管区的成熟，Nestin阳性卵圆样干细胞逐渐局限于赫令管周围；此外胚胎发育不同时期可见Nestin阳性单个核样细胞散布在肝实质内。结论 肝脏内有Nestin表达阳性的干细胞存在，其功能、来源需要进一步深入研究。     

Wnt3诱导小鼠肝前体细胞上皮-间质转化

目的 探讨wnt3对小鼠肝前体细胞(14-19)发生上皮-间质转化的影响。方法 分别将空载体Ad-GFP和表达wnt3的腺病毒Ad-GFP-wnt3转入小鼠肝前体细胞中,显微镜下观察细胞形态变化。细胞划痕实验和细胞迁移实验观察14-19细胞迁移能力。实时荧光定量PCR和蛋白质印迹分析分别检测14-19细胞中上皮标记物和间质标记物的表达改变。结果 显微镜下可见高表达wnt3的14-19细胞由不规则多边形变为长梭形。细胞划痕实验和细胞迁移实验结果显示,高表达wnt3的14-19细胞迁移能力明显提高,与空载体转染细胞相比差异具有统计学意义(P<0.01)。　实时荧光定量PCR和蛋白质印迹结果显示,间质标记物N-cadherin、vimentin和twist1的mRNA和蛋白水平表达上调,相反上皮标记物E-cadherin的mRNA水平和蛋白水平表达下调,　与空载体转染细胞相比差异具有统计学意义(P<0.01)。结论 Wnt3能够促使小鼠肝前体细胞发生上皮-间质转化,提示其可能参与了肝纤维化的发展进程。     

PF-5274857阻断香烟烟雾诱导的上皮-间质转化的作用

目的 探讨Smoothened（Smo）抑制剂PF-5274857在香烟烟雾(CS)诱导所致的上皮-间质转化（EMT）转变中的作用, 为口腔鳞状细胞癌的临床治疗和预防提供依据。方法 以支气管上皮细胞株Beas-2b建立体外CS诱导EMT模型,实验分为预防实验和治疗实验两部分进行。预防实验:用3 μmol/L PF-5274857预刺激Beas-2b细胞2 h后用CS溶液培养8 d;治疗实验:CS培养8 d后用3 μmol/L PF-52748573处理Beas-2b细胞4 d。通过Western blot、免疫荧光检测细胞蛋白中EMT标志物E-钙黏蛋白（E-cadherin）、波形蛋白（vimentin）、α平滑肌肌动蛋白（α-SMA）的含量及位置变化,小室迁移实验测定治疗实验中细胞迁移能力改变。结果 PF-5274857预刺激2 h,间质标志物vimentin和α-SMA蛋白表达降低,上皮标志物E-cadherin表达升高。而已被CS诱导产生EMT改变的Beas-2b细胞经PF-5274857治疗4 d后部分恢复E-cadherin表达,并且vimentin和α-SMA蛋白表达降低,其升高的迁移能力也降低。 结论 PF-5274857可以预防和治疗由CS引起的Beas-2b细胞EMT。     

埃兹蛋白在转化生长因子-β诱导的支气管上皮细胞间充质转化中的作用

目的探讨埃兹蛋白(ezrin)在支气管上皮细胞(16HBE)间充质转化(EMT)中的作用。方法建立转化生长因子-β(TGF-β)诱导的16HBE的EMT模型;RT-PCR和Western blot法检测16HBE中ezrin m RNA和蛋白表达;通过慢病毒sh RNA抑制ezrin表达,观察细胞形态,检测细胞EMT的生物标志分子上皮钙黏着蛋白(E-cadherin)、波形蛋白(vimentin)和α-平滑肌动蛋白(alpha smooth muscle actin,α-SMA)的m RNA和蛋白表达水平;加入外源性ezrin蛋白,细胞免疫荧光、RT-PCR及Western blot法检测其对EMT标志物的影响。结果 TGF-β能下调16HBE中ezrin的m RNA和蛋白表达。经ezrin敲减后,同TGF-β刺激表现相同,16HBE也由典型的铺路石样变为梭形,同时其E-cadherin表达下降,vimentin和α-SMA表达增加;加入重组蛋白ezrin后,16HBE的E-cadherin表达增多,vimentin和α-SMA表达下降。结论 TGF-β可能通过下调ezrin表达促进16HBE发生EMT。     

化学致癌剂3''''-甲基-4-DAB影响巢蛋白Nestin在SD大鼠肝卵圆细胞中的表达

目的：采用免疫组化方法标记大鼠肝卵圆细胞中巢蛋白Nesin的表达，探讨肝卵圆细胞新的表面标记蛋白。方法：用化学致癌剂3’-甲基4-二甲基氨偶氮苯(3’-Methy-4-dimethylaminoazobenzen，3’-me-DAB)喂养SD大鼠4周，取大鼠肝脏，用免疫组化法标记神经前体细胞的特异性表面标记物巢蛋白Nestin在大鼠肝卵圆细胞中的表达。结果：汇管区靠近界板处卵圆细胞表达Nestin阳性，Nestin阳性细胞成簇状分布或呈双层排列成管状，主要集中在赫令氏管周围并见Nestin阳性细胞向肝小叶内迁移，散在分布于肝细胞索。结论：大鼠肝内存在Nestin表达阳性的卵圆细胞，Nestin可能是肝卵圆细胞新的标记蛋白。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.