Objective To study the mechanism of immune hyporesponsiveness of allograft rejection induced by transfusion nonpufsed allopeptide syngeneic immature dendritic cell (imDC) generated from recipient bone marrow progenitors and to explore a possible strategy for liver allograft protection in clinic. Methods Forty experimental rats were randomly divided into 4 group: control group, cyclosporine A (CsA) group, mature DC (mDC) group and imDC group. In control group, Wistar rats only received liver transplantation. In CsA group, Wistar rats underwent liver transplantation plus CsA treatment 〔10 mg/（kg·d)〕. In mDC group, recipient-derived mDC 1×106 were infused intravenously through the penile vein to Wistar rats. In imDC group, ImDC with the dose of 1×106 were injected into Wistar rats via the dorsum vein of penile. In each group, five recipients were killed on the 10th day after transplantation, the other five recipients were left to observe survival time. The levels of ALT, AST, TBIL, IL-2, IFN-γ, IL-4 and IL-10 were detected. The acute rejection and the expression of FasL/Fas in the grafts were detected by HE and immunohistochemical staining. Western blot was used to detect Scurfin protein expression of CD4+ CD25+ T cells. Results The median survival time of the liver allografts in CsA group and imDC group were significantly longer than that in control group and mDC group ( P ＜ 0.05). The levels of ALT and TBIL in control group and mDC group were significantly higher than those in CsA group and imDC group ( P ＜ 0.05). Compared with CsA group and imDC group, the levels of IL-2 and IFN-γ were higher but the levels of IL-4 and IL-10 were lower in control group and mDC group ( P ＜ 0.01). Slightly or no rejection reaction was found in CsA group and imDC group ( P ＜ 0.05). The Scurfin protein expressions of CD4+ CD25+ T cells of imDC group were significantly higher than those of other three groups. Conclusion Application of nonpufsed allopeptide syngeneic recipient-derived imDC is an effective way to induce immune hyporesponsiveness by blocking indirect recognition in rat liver transplantation model. Survival span is significantly prolonged by its protective effect. The mechanism of immune hyporesponsiveness induced by imDC transfusion might be involved in some aspects: T cell apoptosis, immune deviation of Thl/Th2 cytokine net and inhibition of T lymphocytes responsiveness by regulatory T cells.
Objective To determine whether lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU affects expressions of bcl-2, bax and caspase-3 in gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa. Methods Twenty-eight patients with gastric cancer in our department were divided into lymph node-targeted chemotherapy (LNTC) group and control group from October 2005 to August 2006. The patients were treated with carbon nanoparticles absorbing 5-FU before operation in LNTC group and those were operated directly in control group. The gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa were collected after operation. The expressions of bcl-2, bax and caspase-3 in those tissues were determined by immunohistochemical technique. Results In LNTC group, the positive expression rate of bcl-2 in gastric cancer tissues and metastatic lymph nodes was significantly lower than those in control group (28.6% vs . 78.6% , 25.0% vs . 70.0% , P ＜ 0.05), the positive expression rate of bax (85.7% vs . 28.6% , 80.0% vs . 30.0% ) and caspase-3 (57.1% vs . 14.3% , 55.0% vs . 15.0% ) in gastric cancer tissues and metastatic lymph nodes was significantly higher than those in control group ( P ＜ 0.05). The positive expression rate of bcl-2, bax and caspase-3 in normal gastric mucosa was not significantly different between two groups ( P ＞ 0.05). Conclusion The lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU can down-regulate the expression of bcl-2 and up-regulate the expression of bax and caspase-3 in gastric cancer tissues and metastatic lymph nodes, and therefore by affecting the expression levels of these apoptosis molecules may be one of the ways to induce tumor cell apoptosis.
Abstract: Objective To investigate the feasibility of the bone marrow mesenchymal stem cells (BMSCs) as the seed cells for construction of small diameter blood vessels and its induced mechanisms. Methods The bone marrow cells were obtained from hind femur and tibia of male Sprague-Dawley（SD） rats with a body weight of 100 g. The cells were purified by whole bone marrow primary culture before repeated passage in vitro amplification. Cell morphology was observed, and expressions of CD34, CD90, and CD105 cell factors were examined by flow cytometry to identify whether they were the BMSCs. Then, the BMSCs obtained were divided into the experiment group and the control group. The cells in the experiment group were induced to differentiate into the vascular smooth musclelike cells by the Dulbecco’s modified Eagle’s mediumlow glucose(DMEM-LG) plus alltrans retinoic acid and dbcAMP, while the cells in the control group were cultured by the normal DMEM-LG. We observed the morphological characteristics of the BMSCs and detected the expressions of smooth muscle-α actin (SM-α-actin), calponin, and vascular smooth muscle myosin heavy chain(SMMHC) by immunofluorescence and flow cytometry with the fifth generations cells after induction. Results The cells obtained through primary culture appeared spindleshaped and showed characteristic swirling growth. The surface marker CD34 was negative, while CD90 and CD105 were positive. After induction, the cells in the experiment group grew slowly and were slightly ovalshaped. The expression of SM-α-actin, calponin, and SMMHC was significant in the experiment group. In the control group, cell morphology and cell growth were similar to the those of BMSCs in the experiment group, but the expression of SM-α-actin, calponin, and SMMHC was negative. Conclusion The BMSCs can be induced to differentiate into the phenotype of vascular smooth musclelike cells by alltrans retinoic acid，the induced cells which can act as seed cells for tissue engineering construction of small diameter blood vessels.
Abstract： Objective To assess the effects of three different palliative procedures including modified BlalockTaussig (B-T) shunt, Waterston shunt, and reconstruction of right ventricularpulmonary artery (RV-PA) continuity for pulmonary atresia with ventricular septal defect (PAVSD). Methods We retrospectively analyzed the clinical data of 93 patients with PAVSD who had undergone palliative surgical procedures including modifie BT shunt, Waterston shunt, and RVPA econstruction in Fu Wai Hospital from September 1998 to September 2008. There were 53 males and 40 females, aged from 14.0 days to 14.4 years, with the body weight ranged from 3.6 to 33.0 kg (9.9±6.3 kg). According to International Congenital Heart Surgery Nomenclature and Database Project, these patients were categorized into 2 groups: 64 of type Ⅰ and 29 of type Ⅱ. The most common associated anomaly is rightsided aortic arch (except for ventricular septal defect). The application of the three kinds of palliative surgical procedures in staged management of PAVSD and the followup results were statistically analyzed. Results The corrective rate of the three palliative procedures were 28.12% (18/64) for modified BT shunt, 7.14%(1/14) for Waterston shunt, and 66.67% (10/15) for RV-PA reconstruction, respectively. RV-PA reconstruction had a significantly higher corrective 〖CM(1585mm〗rate than the other two surgical procedures (P=0.016). The percutaneous oxygen saturation (SpO2) increased by 4%59% and Nakata index by 31-104 mm2/m2. No tortuous pulmonary artery was found under echocardiogram or angiocardiography after palliative operation. The perioperative mortality of both surgical stages was 10 patients. Twostage radical surgery was successfully performed for 25 patients, among whom 20 were followed up till May 2009. During the followup, one died suddenly, 15 were classified as New York Heart Association (NYHA) Ⅰ, and 4 as NYHA Ⅱ. Conclusion The surgical management of PAVSD needs to be improved continuously. Compared with shunting procedures, the RVPA reconstruction is a better palliative operation method, and the modified B-T shunt is preferred in younger patients.
Objective To investigate the operative characteristic and results of the modified Fontan procedure, and improve the application of Fontan procedure in the clinic. Methods From Sep. 1992 to June 2006, 77 cases (aged 2.5 years to 20.0 years) with a wide range of complicated congenital heart diseases underwent the modified Fontan procedure.Right atriumpulmonary artery connection were performed in 21 cases, intraatrium fenestrated baffle or conduit total cavopulmonary connection were performed in 28 cases, extracardiac conduit total cavopulmonary connection were performed in 24 cases, atrium wall lateral tunnel total cavopulmonary anastomosis were performed in 2 cases, extracardiac pericardialtube total cavopulmonary anastomosis was performed in 1 case, and extracardiac direct total cavopulmonary connection was performed in 1 case. Results In early postoperative period, there were 1 case of successful reoperation and 5 death, the cause of death were heart failure (3 cases), arrhythmia (1 case) and cerebral hemorrhage (1 case). The early survival rate was 93.5%(72/77), with 92.0% free from failure. The eject fractions of left ventricle (LVEF) after operation were increased than those before operation （68.5%±4.0% vs.62.0%±4.5%,P=0.032） and left ventricular enddiastolic diameter (LVEDD) were decreased than those before operation （52.5±7.8mm vs.62.5±11.0mm, P=0.013）. A total of 63 cases (87.5%) were followed up from 1 to 15 years after operation. In late postoperative period, there were 4 cases of death, and 1 of successful re-operation. Late survival rate was 88.3%, with 86.0% free from failure. Conclusion In the treatment for complicated congenital heart diseases, the modified Fontan procedure could result in good early and longterm outcome, and the choices for surgical procedure are various.
Objective To improve the method of hard tissue slicing for research of bone tissue engineering.Methods The method of hard tissue slicing especially the key techniqueslice mounting had been studied and improved. Results The experiments showed that our research improved techniques in hard tissue slicing not only in keeping the characteristics of hard tissue slicing, easily stain with HE, Masson, immunohistochemistry, and distinguishing the differences among tissues easily, but also in overcoming the shortcoming of issue shedding easy to happen in the general hard tissue slicing. Conclusion The improved techniquesin hard tissue slicing is a more useful hard tissue slicing techniques.
3D printing technology has a promising prospect of medical use and clinical value, and may play an important role in the field of thoracic and cardiovascular surgery, such as preoperative diagnosis, surgical planning, surgical approach alternatives and organ replacement. This review focuses on the development of 3D printing technology in recent years and its use and prospect in the field of thoracic and cardiovascular surgery including surgical teaching and simulation, personalized prosthesis implantation, and artificial organ transplantation.
Mini health technology assessment (mini-HTA) is a decision support tool based on the principle and method of evidence-based medicine and traditional HTAs. It systematically reviews healthy technologies and provides references for decision makers at the hospital level in terms of introducing relevant health technologies. In order to provide a new insight to the decision makers, this paper briefly introduces the features of mini-HTA.
The reporting checklist of health technology assessment (HTA) was a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA) to be used to guide the reporting of HTA. Experiential evidence showed that the tool was effective to improve the reporting quality of HTA and also could be used as a reference in performing HTA and translating the research evidence into decision-making. This paper introduced the background, developing process and main contents of the checklist, so as to improve the reporting quality of HTA in China.