目的 探讨以肺间质改变为主的不典型肺结核的CT特征。方法 收集2018 年1月—2018 年12月期间44例经我院临床及实验室确诊的以肺间质改变为主的不典型肺结核的CT影像学资料,进行归纳总结,分析其影像特点。结果 44例以肺间质改变为主的不典型肺结核其中14例患者在肺叶的分布呈局限性分布,其中主要分布于右肺上叶占13例;30例呈弥漫性分布;以间质改变为主的局限性分布及弥漫性分布的不典型肺结核均以细网织影、微结节、细支气管壁增厚、小叶间隔增厚为主要表现,树芽征、磨玻璃影在弥漫性分布中相对常见,其合并空洞、支气管扩张、纵膈淋巴结肿大钙化、胸膜炎、肺大疱的比例高于局限性分布患者;以肺间质改变为主的不典型肺结核呈局限性分布(14例)的患者预后良好,13例呈显著吸收,1例吸收良好;弥漫性分布(30例)的患者中,18例显著吸收,其中6例未吸收或吸收欠佳。结论 以肺间质为改变为主的非典型肺结核具有其特征性,了解其CT特点有助于提高临床诊断及更好的评价治疗预后。

Objective To discuss value of the CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes and improve the early diagnosis of pulmonary tubeculosis. Methods The CT imaging data of 44 patients with atypical pulmonary tuberculosis with interstitial changes was collected from January 2018 to December 2018,and the imaging characteristics were analyzed. Results In 44 cases of atypical pulmonary tuberculosis,14 cases of atypical pulmonary tubeculosis were the localized distribution,13 cases were mainly in the right upper lobe,and 30 cases were diffuse distribution. The atypical pulmonary tuberculosis of the localized and diffuse distribution mainly with interstitial changes was characterized by tine reticular shadow,micnodule,thickening of bronchiole wall and thickening of interlobular Septa. Tree-bud sign and ground-glass shadow were common in diffuse distribution,and the proportions of cavity,bronchiectasis,mediastinal lymphadenopathy calcification,pleurisy and bullae were higher than that in localized distribution. The atypical pulmonary tuberculosis patients with localized pulmonary interstitial changes (14 cases) have a favourable prognosis,13 cases with significant absorption,1 case with favourable absorption,and 18 cases with the atypical pulmonary tuberculosis patients with diffuse pulmonary interstitial changes (30 cases) with significant absorption,6 cases with no absorption or poor absorption. Conclusion The atypical pulmonary tuberculosis with interstitial changes has its characteristics,and the CT features is helpful to improve the clinical diagnosis and better evaluation of treatment prognosis.

目的 通过分析孤立性蝶窦病变的临床特点,进一步提高早期诊断率及治疗疗效。方法 回顾性分析2019年1月—2019年8月在我科手术的孤立性蝶窦病变的9例患者临床资料,总结分析蝶窦病变的临床症状、鼻窦影像学表现及鼻内镜手术疗效。结果 蝶窦病变平均发病年龄约59.1岁,1例为双侧真菌性蝶窦炎,只有1例首诊于耳鼻喉科,8例患者就诊于神经内科,都以头痛为首发症状,1例鼻流清亮液体,鼻腔异味2例,鼻塞、脓涕1例,嗅觉功能减退1例。不同类型的蝶窦病变影像学表现不同,临床症状不同,绝大多数患者以头痛为首发症状。所有患者均在全身麻醉下行鼻内镜手术。术后随访至少3月以上,术后症状完全消失,无复发病例。结论 头痛是孤立性蝶窦病变最常见的临床特点,鼻窦影像学检查是重要的诊断手段,鼻内镜下经嗅裂蝶筛隐窝进路开放蝶窦是最有效的治疗手段。

Objective By analyzing the clinical characteristics of solitary sphenoid sinus disease,the early diagnosis rate and therapeutic effect can be further improved. Methods The clinical data of 9 patients with isolated sphenoid sinus lesions operated on in our department from January 2019 to August 2019 were retrospectively analyzed,and the clinical symptoms,imaging features of the sinuses and the efficacy of nasal endoscopic surgery were summarized and analyzed. Results The average age of onset of sphenoid sinus lesions was 59.1 years old,1 case was bilateral fungal sphenoid sinusitis,only 1 case was first diagnosed in the department of otolaryngology,8 cases were treated in the department of neurology,all with headache as the first symptom,1 case had clear rhinorrhea,2 cases had nasal odor,1 case had nasal obstruction,1 case had purulent nose,and 1 case had anosmia. The imaging manifestations and clinical symptoms of different types of sphenoid sinus lesions were different,and headache was the first symptom of most patients. All patients underwent nasal endoscopic surgery under general anesthesia. The patients were followed up for at least 3 months after the operation,and the symptoms completely disappeared without recurrence. Conclusion Headache is the most common clinical feature of isolated sphenoid sinus lesions. Imaging examination of the sinus is an important diagnostic method,and endoscopic opening of the sphenoid sinus through the sphenoidal cleft via sphenoidal recess is the most effective treatment method.

目的 探究Harris-Benedict(HB)公式用于估算机械通气的危重症患者能量代谢的准确性,以及不同BMI分组对其影响。方法 使用间接能量测定法测量患者的静息能量(ICREE),通过HB公式计算其静息能量代谢估算值(HBREE)。将80例患者按BMI分为4组,并通过配对样本t检验对ICREE与HBREE进行比较,Pearson分析用于分析ICREE与HBREE的相关性。结果 共纳入80例机械通气的危重症患者。除肥胖组外的其余各组病人,ICREE均高于HBREE(均P＜0.01),HB公式的准确率为23.75%。ICREE与HBREE相关性差(r=0.331,P＜0.01)。当各组使用校正系数对HB公式进行调整后,ICREE与HBREE差异无统计学意义,准确率提高至38.8%。结论 使用HB公式不能很好地反应危重症患者的实际能量代谢。BMI可能是影响HB公式准确性的重要因素。依据不同BMI分组,使用相应校正系数可提高HB公式的准确性。

Objective To explore the accuracy of the Harris-Benedict (HB) formula used to estimate the energy metabolism in critically ill patients undergoing mechanical ventilation and the effects of different BMI groups on it. Methods Indirect calorimetry was used to measure the resting energy of the patient,and the estimated resting energy metabolism was calculated by the HB formula. 80 patients were divided into four groups according to BMI. ICREE and HBREE were compared by paired sample t test. Pearson analysis was used to analyze the correlation between ICREE and HBREE. Results This study included 80 critically ill patients undergoing mechanical ventilation.Except for the obese group,ICREEE was higher than HBREE in all patients and the remaining groups of patients. The accuracy rate of the HB formula was 23.75%. The correlation between ICREE and HBREE is poor(r=0.331,P＜0.01). There was no statistical difference between ICREEE and HBREE and the accuracy rate increased to 38.8% after the Harris-Benedict equation was adjusted by using the correction factor. Conclusion Using the HB formula can not reflect the actual energy metabolism of critically ill patients well. BMI may be an important factor affecting the accuracy of HB formula. The accuracy of the HB equation can be improved by using different correction factors according to different BMI groupings.

目的 本研究旨在探讨压迫止血法在减少实时超声引导经皮肾穿刺术后并发症中的价值。方法 选取2011年9月1日—2016年12月31日于我院行超声引导下经皮肾穿刺术患者405例。按肾穿刺后是否行立即行压迫止血法分2组,非压迫止血法为对照组(A组),压迫止血法为研究组(B组)。记录患者术前血压、凝血四项、血红蛋白、血小板等指标。记录穿刺次数及每次穿刺所取标本长度。术后24 h复查穿刺点出血情况及肾周血肿情况。穿刺术后24 h内监测血尿情况。结果 与非采用压迫止血法超声定位经皮肾穿刺术后(A组)相比,压迫止血法术后(B组)并发症发生率较低, A组肉眼血尿发生率为8.8 %,B组为4 %,差异有统计学意义(P=0.048);A组24 h肾周血肿发生率为 62.1%,B组为49.8%,差异有统计学意义(P=0.042)。结论 实时超声引导下经皮肾穿刺后立即行压迫止血法,可有效减少术后肾周血肿和血尿。

Objective To discuss how to reduce the post-biopsy complications of real-time ultrasound-guided percutaneous renal biopsy by manual compression. Methods A total of 405 ultrasound-guided biopsies were performed in 404 patients in our hospital, between September 2011 and January 2017, were recruited to this study. They were divided into 2 groups, group A biopsy without manual compression, and group B biopsy with manual compression. All patients' records were retrospectively reviewed and both pre and post biopsy information, as well as complications were collected. Results The gross hematuria rate is 8.8 % (16 patients) in group A, but in group B, the rate is 4 %. The perirenal hematoma rate at 24 h after biopsy in group A detected by ultrasound is 62.1% (113 patients), and 49.8% (116 patients, P vs group A=0.042) in group B. Conclusion Manual compression to the puncture site reduced complications like perirenal hematoma and gross hematuria after real-time ultrasound-guided renal biopsy.

目的 分析超声引导下经皮肾穿刺活检术对弥漫性肾病进行病理诊断的临床应用价值。方法 回顾性分析我院275例弥漫性肾病患者经超声引导下行经皮肾穿刺活检术进行诊断的情况,针对上述患者的穿刺活检情况、穿刺满意度、取材成功率、并发症发生状况、弥漫性肾病病理分型结果以及术后诊断更正的情况进行分析。结果 275例患者穿刺满意度、取材成功率、并发症总发生率分别为94.91%,100%、10.91%。275例患者术后并发症的发生与年龄、穿刺次数、肾实质厚度、术前血肌酐水平有关。275例患者以膜性肾病、IgA肾病居多,分别占比23.27%、18.55%。275例患者术后诊断更正率为19.79%。结论 超声引导下经皮肾穿刺活检术是一种安全有效的弥漫性肾病诊断方法,其术后并发症发生率较低且较轻。在弥漫性肾病病理分型诊断中以膜性肾病、IgA肾病的发病率较高。超声引导下经皮肾穿刺活检术可早期诊断弥漫性肾病的病理类型,为确定治疗方案提供可靠依据,改善肾脏疾病的预后。

Objective To analyze the clinical value of ultrasound-guided percutaneous renal biopsy for pathological diagnosis of diffuse renal disease. Methods Retrospective analysis of 275 patients with diffuse renal disease in our hospital underwent ultrasound-guided percutaneous renal biopsy for diagnosis. According to the above-mentioned patients' biopsy status,puncture satisfaction,success rate of material extraction,complications,and diffuse results of pathological typing of nephropathy and correction of postoperative diagnosis were analyzed. Results The satisfaction rate of puncture,the success rate of material extraction and the total incidence of complications were 94%,100%,and 10.91%,respectively. The incidence of postoperative complications in 275 patients was related to age,number of punctures,thickness of renal parenchyma,and preoperative serum creatinine levels. Membrane nephropathy and IgA nephropathy were the most common in 275 patients,accounting for 23.27% and 18.55% respectively. The correction rate of postoperative diagnosis in 275 patients was 19.79%. Conclusion Ultrasound-guided percutaneous renal biopsy is a safe and effective method for diagnosing diffuse nephropathy,and the incidence of postoperative complications is low and mild. Membrane nephropathy and IgA nephropathy have a higher incidence in the diagnosis of diffuse nephropathy. Ultrasound-guided percutaneous renal biopsy may early diagnose the pathological type of diffuse renal disease,provide a reliable basis for determining the treatment plan,and improve the prognosis of renal disease.

目的 分析彩色多普勒超声在小儿阴囊急症诊断中的应用价值。方法 于2019年1月—2019年12月选取院内收治的100例以阴囊急症就诊的患儿作为研究对象,使用彩色多普勒超声对所有患儿进行诊断,分析患儿的超声影像学特点,并对彩色多普勒超声的诊断结果与手术和病理结果进行对比。结果 急性睾丸扭转患儿的影像学形态以睾丸肿胀(90.63%)、阴囊壁水肿(75.00%)、鞘膜积液(68.75%)、睾丸实质回声异常(59.38%)和附睾增大(53.13%)为主,其中睾丸肿胀和睾丸实质回声异常的患儿例数明显高于其他疾病类型(P＜0.05);急性睾丸附件扭转患儿的影像学形态以睾丸外结节(96.30%)、附睾增大(74.07%%)、阴囊壁水肿(70.37%)和鞘膜积液(51.85%)为主,其中睾丸外结节的患儿例数高于其他疾病类型(P＜0.05);急性附睾炎患儿的影像学形态以阴囊壁水肿(82.61%)、附睾增大(73.91%)和鞘膜积液(52.17%)为主;急性睾丸炎患儿的影像学形态也以阴囊壁水肿(83.33%)、附睾增大(83.33%)、和鞘膜积液(55.56%)为主,急性附睾炎和急性睾丸炎患儿的影像学形态相比差异无统计学意义(P＞0.05);急性睾丸扭转患儿的睾丸内血流分布主要为减少或消失和精索扭转,与其他疾病类型患儿相比差异有统计学意义(P＜0.05);急性睾丸附件扭转患儿的睾丸内血流分布主要为正常,与其他疾病类型患儿相比差异有统计学意义(P＜0.05);急性附睾炎和睾丸炎患儿的睾丸内血流分布主要为增加,与其他疾病类型患儿相比差异有统计学意义(P＜0.05),急性附睾炎和急性睾丸炎患儿的睾丸内血流分布情况相比差异无统计学意义(P＞0.05);彩色多普勒超声在阴囊急症中的总诊断率为97%,与手术病理结果相比无差异(P＞0.05),在急性睾丸扭转中的诊断符合率为96.88%,在急性睾丸附件扭转中的诊断率为96.30%,在急性附睾炎中的诊断符合率为95.65%,在急性睾丸炎中的诊断率为100.00%,不同疾病类型阴囊急症患儿中的诊断率与手术病理结果相比均无差异(P＞0.05)。结论 彩色多普勒超声在小儿阴囊急症的诊断中发挥出了较好的临床诊断效果,在不同疾病类型阴囊急症中的诊断符合率均相对较高,应当作为小儿阴囊急症早期筛查的主要影像学方法,值得广泛应用及推广。

Objective To analyze the value of color Doppler ultrasound in the diagnosis of scrotal emergency in children. Methods From January 2019 to December 2019,100 children admitted to the hospital with scrotal emergency were selected as the research objects. All patients were diagnosed by color Doppler ultrasound and the characteristics of ultrasound imaging were analyzed. The diagnostic results of color Doppler ultrasound were compared with surgical and pathological results. Results The imaging morphology of children with acute testicular torsion was testicular swelling (90.63%),scrotal wall edema (75.00%),hydrocele (68.75%),abnormal testicular parenchymal echo (59.38%),and enlarged epididymis (53.13%) mainly. The numbers of children with testicular swelling and abnormal testicular parenchymal echo were higher than other disease types (P<0.05); the imaging morphology of children with acute testicular attachment reversal was extratesticular nodules (96.30%) and enlarged epididymis (74.07 %%),scrotal wall edema (70.37%),and hydrocele (51.85%) were predominant,and the numbers of children with extra testicular nodules were higher than other disease types (P<0.05); acute epididymis morphology of scrotal wall edema (82.61%),enlarged epididymis (73.91%),and hydrocele (52.17%) in children with inflammation are mainly; the morphology of scrotal wall edema in children with acute orchitis (83.33%) also,epididymis enlargement (83.33%),and hydrocele (55.56%) were the main factors. There was no significant difference in imaging morphology between children with acute epididymitis and acute orchitis (P> 0.05); Testicular blood flow distribution in children with acute testicular torsion was mainly reduced or disappeared and spermatic cord twisted,the difference was statistically significant compared with children with other disease types (P<0.05); blood distribution in the testis of children with acute testicular accessory torsion was mainly normal,compared with children with other disease types. The difference was statistically significant (P<0.05); the distribution of blood flow in the testis of children with acute epididymitis and orchitis was mainly increased,and the difference was statistically significant compared with children with other disease types (P<0.05). There was no significant difference in testicular blood flow distribution between children with inflammation and acute orchitis (P> 0.05);The overall diagnosis rate of color Doppler ultrasound in scrotal emergency was 97%,and there was no significant difference compared with the surgical pathological results (P> 0.05). The diagnostic coincidence rate in acute testicular torsion was 96.88%,and in acute testis, the diagnostic rate of attachment reversal was 96.30%,the diagnostic coincidence rate in acute epididymitis was 95.65%,the diagnostic rate in acute orchitis was 100.00%. Compared with the diagnosis rates and surgical pathology results in children with scrotal emergency of different disease types,there were no significant differences (P> 0.05). Conclusion Color Doppler ultrasound has a good clinical diagnosis effect in the diagnosis of scrotal emergencies in children,and the diagnostic coincidence rate in different types of scrotal emergencies is relatively high. It should be used as the main early screening for scrotal emergencies. The imaging method is worthy of wide application and promotion.

目的 探讨子午流注开穴法对薄型子宫内膜患者妊娠结局的影响。方法 将同期在门诊行B超监测排卵、指导受孕的薄型子宫内膜患者80例随机分为两组,每组各40例,观察组采用子午流注开穴法及药物治疗,对照组则单纯给予药物治疗。比较两组治疗前后的子宫内膜厚度、子宫内膜形态、子宫内膜血流搏动指数(PI)、血流阻力指数(RI)及临床妊娠率(PR)。结果 两组治疗后子宫内膜厚度与同组治疗前均有不同程度的改善(P<0.05),治疗后子宫内膜厚度两组间比较差异有统计学意义(P<0.05)。观察组治疗后A型子宫内膜的比例较治疗前增加,差异有统计学意义(P<0.05);与对照组比较,差异有统计学意义(P<0.05)。观察组临床妊娠率为27.5%,对照组临床妊娠率为10%,两组相比较差异有统计学意义(P<0.05)。结论 子午流注开穴法在薄型子宫内膜患者中的应用有效促进子宫内膜容受性的建立,从而改善其妊娠结局。

Objective To explore the effects of selection points by earth meridian ebb-flowing rule on infertile women suffering from thin endometrium. Methods 80 patients with thin endometrium who were monitored ovulation and guided pregnancy under B-mode ultrasound were randomly divided to two groups: the observation group and the control group, 40 patients for each group. The observation group was treated with selection points by earth meridian ebb-flowing rule and medication, while the control group was treated with medication only. The endometrial thickness, endometrial morphology, endometrial blood flow Pulsation Index (PI), Resistance Index (RI) and Clinical Pregnancy Rate (PR) before and after treatment were compared between the two groups. Results After treatment, the endometrial thickness was improved in both groups, which was statistical significant between the two groups(P<0.05). The proportion of type A endometrium in the observation group was increased compared with that before treatment and the control group, the difference was statistical significant(P<0.05). The clinical pregnancy rate was 27.5% in the observation group and 10% in the control group, and the difference between the two groups was statistically significant(P<0.05). Conclusion The application of selection points by earth meridian ebb-flowing rule in patients with thin endometrium may effectively promote the establishment of endometrial receptivity and improve the pregnancy outcome.

目的 本研究通过已建立的稳定表达人血小板CD36的HEK293T细胞系,制备鼠源的抗人CD36单克隆抗体并进行特性鉴定。方法 利用已经建立的稳定表达人血小板CD36的HEK293T细胞系对CD36(-/-)C57小鼠进行免疫,取脾脏与小鼠骨髓瘤细胞融合,筛选出阳性克隆。纯化单克隆抗体后,利用Western blot检测抗体结合活性。利用小鼠IgG类/单抗亚型鉴定试剂鉴定单克隆抗体的抗体亚型。通过流式细胞检测和血小板抗原单克隆抗体特异性免疫固定检测(MAIPA)鉴定其诊断应用价值。结果 经筛选后得到一株杂交瘤细胞,抗体亚型为IgG2a,轻链为κ链,Western blot试验表明该单克隆抗体特异性识别人血小板CD36抗原。MAIPA结果显示,与商业化单克隆抗体FA6-152相比,该单克隆抗体灵敏度更高。结论 成功制备了一种鼠抗人CD36单克隆抗体,为临床鉴定CD36抗体,筛选CD36阴性献血员提供了新的工具,也为今后进一步研究CD36在血液免疫疾病中作用机制提供了实验基础。

Objective In this study, by the established HEK293T cell line with stable expression of human platelet CD36, murine anti-human CD36 monoclonal antibody was prepared and characterized. Methods The established HEK293T cell line with stable expression of human platelet CD36 was used to immunize CD36 (-/-) C57 mice, and the spleen was fused with mouse myeloma cells to screen for positive cloning.After the purification of monoclonal antibody, the antibody binding activity was detected by Western blot.Mouse rapid antibody isotyping reagent was used to identify the subtype of monoclonal antibody.Its diagnostic value was evaluated by flow cytometry and monoclonal antibody-specific immobilization of platelet antigen (MAIPA). Results After screening, a high-producing hybridoma cell was obtained, the subtype of monoclonal antibody was IgG2a and the light chain was κ chain. Western blot analysis showed that the monoclonal antibody could specifically recognize CD36 antigen of human platelet. MAIPA results showed that the monoclonal antibody was more sensitive than the commercial monoclonal antibody FA6-152. Conclusion It is concluded that a mouse anti-human CD36 monoclonal antibody with biological activity has been obtained, which provides a new tool for the clinical identification of CD36 antibody and the screening of CD36 negative blood donors, and also provides an experimental basis for further research on the mechanism of CD36 in blood immune diseases.

目的 研究NR3C1(核受体亚科3,C组,成员1)又称糖皮质激素受体(GR)表达量对前列腺癌恶性程度的影响及其与前列腺癌生化复发的相关性。方法 通过组织芯片免疫组化染色检测的方法检验NR3C1在不同恶性程度前列腺癌组织的表达情况,结合Taylor数据库分析NR3C1表达水平与前列腺癌临床病理特征关系,再采用Kaplan-Meier法分析NR3C1对前列腺癌生化复发生存率的影响,最后用Cox回归分析临床病理特征与生化复发的相关性。结果 组织芯片免疫组化结果显示NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.028)。结合Taylor公用数据库分析,NR3C1在前列腺癌组织中的表达低于癌旁组织(P＜0.001),NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.005),NR3C1低表达与PSA复发(P=0.028)和转移(P=0.003)相关。Kaplan-Meier结果提示:NR3C1高表达组患者术后的生化复发生存率更高(P=0.043),总体生存率没有明显区别(P=0.872)。单因素分析结果显示:NR3C1(P=0.002),病理分期(P＜0.001),Gleason评分(P＜0.001),是否转移(P=0.012)是前列腺癌生化复发的影响因素。多因素分析结果显示:高Gleason 评分(P=0.017)和转移(P<0.001)均为生化复发危险因素。结论 NR3C1影响前列腺癌的发病进程,检验NR3C1的表达情况,能预测前列腺癌患者生化复发的概率,可协助判断前列腺癌预后。

Objective We study the role of NR3C1 (nuclear receptor subfamily 3,group C,member 1) in PCa progression,and the correlation between its expression level and the biochemical recurrence of PCa. Methods Immunohistochemistry was used to detect the expression of NR3C1 in PCa tissues of different degrees of malignancy. The associations of NR3C1 expression and clinical pathological features were analyzed using the Taylor dataset. Kaplan-Meier was used to detect the relationship between NR3C1 expression and biochemical recurrence survival rate in PCa. Cox-regressive analysis was used to detect the relationship between clinical pathological features and biochemical recurrence. Results Immunohistochemistry analysis showed the expression of NR3C1 was higher in which its Gleason Score was lower(P=0.028). Base on the Taylor dataset,the expression of NR3C1 was higher in the adjacent benign tissues than that in PCa(P＜0.001). The expression of NR3C1 was higher in which its Gleason Score was lower(P=0.005). Furthermore,low NR3C1 expression was associated with PSA failure(P=0.028) and Metastasis(P=0.003). Kaplan-Meier showed the biochemical recurrence-free time of PCa patients in low NR3C1 expression groups reduced(P=0.043). The overall survival time of PCa patients was not correlated to NR3C1 expression levels(P=0.872). Single factor analysis showed the biochemical recurrence is associated with NR3C1 expression(P=0.002),pathological stage(P＜0.001),Gleason score(P＜0.001), Metastasis status(P=0.012). Multivariate analysis by Cox regression further identified the high Gleason Score(P=0.017) and Metastasis status (P<0.001)were hazards of the biochemical recurrence. Conclusion Our study showed that the expression of NR3C1 critically connected with the process of PCa,which indicated that we can predict the probability of the biochemical recurrence and determine the prognosis of prostate cancer by detecting the expression of NR3C1 in PCa patients.

目的 探讨骨髓间充质干细胞源性微泡(BMSC-MV)修复大鼠早发性卵巢功能不全的自噬机制。方法 大鼠骨髓分离培养骨髓间充质干细胞;超速离心法从骨髓间充质干细胞培养液中分离微泡;腹腔注射顺铂溶液制备早发性卵巢功能不全(POI)模型,制备后3 d尾静脉取血ELISA检测血清雌二醇(E2)及卵泡刺激素(FSH);尾静脉注射BMSC-MV移植治疗POI大鼠模型,移植后28 d尾静脉取血ELISA检测E2、FSH及抗苗勒管激素(AMH),同时取卵巢组织检测自噬相关蛋白LC3及P62。结果 模型对照组及微泡移植组在模型制备后3 d的E2 含量低于正常对照组,FSH 含量高于正常对照组(P<0.001);微泡移植组在移植后28 d的E2、AMH含量高于模型对照组(P<0.001),FSH含量低于模型对照组(P<0.001);微泡移植组的LC3较模型对照组表达升高,而P62表达降低(P<0.001)。结论 BMSC-MV介导自噬修复大鼠早发性卵巢功能不全。

Objective To investigate the autophagy mechanism of bone marrow mesenchymal stem cell-derived microvesicle (BMSC-MV) in repairing premature ovarian dysfunction in rats. Methods The whole bone marrow adherence method was used to isolate,culture and identify BMSCs of SD rats. Microvesicles were isolated from bone marrow mesenchymal stem cell by ultracentrifugation. Premature ovarian insufficiency (POI) model was prepared by intraperitoneal injection of cisplatin solution,and serum estradiol (E2) and follicular stimulating hormone (FSH) were detected by ELISA from tail vein 3 days after preparation. Rat model of POI was treated with BMSC-MV transplantation by tail vein. Blood from tail vein was collected 28 days after transplantation to detect E2,FSH and AMH by ELISA. Meanwhile,ovarian tissues were collected to detect autophagy-related proteins LC3 and P62. Results The E2 content of the model control group and the microvesicle transplantation group was lower than that of the normal control group,and the FSH content was higher than that of the normal control group (P<0.001). The content of E2 and AMH in the microvesicle transplantation group at 28 days after transplantation was higher than that in the model control group (P<0.001),and the content of FSH was lower than that in the model control group (P<0.001). Compared with the model control group,LC3 expression in the microvesicle transplantation group was increased,while P62 expression was decreased (P<0.001). Conclusion BMSC -MV mediate autophagy to repair premature ovarian insufficiency in rats.