大鼠子宫宫腔粘连模型的建立及评价指标

子宫内膜损伤是导致宫腔粘连的最主要原因,建立有效的子宫内膜损伤动物模型是研究此类疾病发生、发展和治疗反应等不可或缺的支撑条件。通过宫腔注射95%的乙醇制造大鼠(Rattus norvegicus)子宫内膜损伤模型,检测胚胎植入数目来分析子宫内膜损伤对大鼠生育情况的影响,观察大鼠子宫内膜厚度、腺体数量和纤维化面积,分析乙醇处理对子宫内膜的影响;检测细胞角蛋白(CK-19)和波性蛋白(Vimentin)的表达水平,分析上皮细胞和间质细胞的增殖分化及子宫内膜损伤程度。结果显示,正常组大鼠子宫比损伤组更为平滑且有韧性,与正常组相比,损伤组大鼠生育率显著降低(P0.01),子宫内膜厚度变薄(P0.01)、腺体数量显著减少(P0.01),纤维化面积显著增大(P0.01),CK-19和Vimentin表达量显著下调。结果提示已成功建立大鼠子宫内膜损伤动物模型。     

子宫内膜异位症大鼠模型的建立及其病理学改变

目的构建子宫内膜异位症（内异症）大鼠动物模型,为阐明内异位症发病机理以及寻找有效的治疗方法提供理想的动物模型。方法取性成熟雌性Sprague-Dawley（SD）大鼠30只,通过手术将大鼠自体子宫组织移植到子宫旁韧带上,建立诱发型内异症大鼠动物模型。术后8周,再次剖腹观察异位组织的存活情况、病灶大小、与周围组织的粘连程度以及病理学变化。结果25只大鼠有明显的异位病灶。所有病灶都与周围组织有不同程度的粘连,病灶外观呈囊泡状。光镜观察见大部分异位子宫内膜形态和结构与在位子宫内膜基本相同,但内膜细胞、间质细胞、腺体,与在位内膜相比较少。少数病灶只有上皮组织或只有问质组织。结论自体子宫移植法可成功建立内异症大鼠模型。     

来源于脂肪间充质干细胞的外泌体促进宫腔粘连大鼠子宫内膜再生和生育能力恢复的机制研究

目的：本研究旨在鉴定来源于脂肪间充质干细胞的外泌体（ADSC-exo）,并探索其在宫腔粘连（Intrauterine adhesion,IUA）大鼠模型中的治疗潜力。方法：从6-8周龄的雌性Sprague-Dawley大鼠获得腹股沟脂肪组织,并且分离ADSC。而流式细胞术分析用于鉴定ADSC的细胞表面标志物（CD 90、CD105、CD34和CD45）的表达。与透射电子显微镜观察外泌体形态,蛋白质免疫印迹法分析外泌体表面标记蛋白（CD63和Alix）的表达。苏木精伊红染色和马松染色分别分析子宫组织的形态和纤维化情况。进行功能测试评估IUA大鼠的妊娠率、着床胚胎数和受孕时间。结果：ADSC-exo呈典型的杯状形态,Alix和CD 63阳性表达,主要集中在109.5 nm处。在IUA模型中,ADSC-exo能增强整合素β3、LIF和VEGF的表达,并且能促进子宫内膜再生和胶原重塑,及维持正常子宫结构。ADSC-exo可以改善再生子宫内膜容受性。结论：ADSC-exo能促进子宫内膜再生和生育力恢复。本研究的结果提示严重宫腔粘连和不孕症采用ADSC-exo子宫内局部给药治疗是一种潜在的有效方案...     

大鼠脂肪间充质干细胞的鉴定及肝内移植的研究

目的:从脂肪组织中获取间充质干细胞(ADMSCs)并验证其多向分化潜能,探讨ADMSCs在肝再生中的作用。方法:获取大鼠脂肪组织,用胶原酶消化法获取干细胞,并进行体外扩增、传代,取第3代细胞分别用不同诱导培养液进行成骨、成脂诱导,诱导后通过细胞形态学和特殊染色观察诱导效果。用PKH26标记细胞,制作部分肝切除模型,将标记的自体ADMSCs经门静脉植入体内,2周后切下取肝脏制成冰冻切片,荧光显微镜观察植入细胞在肝脏的定位,免疫荧光染色观察其白蛋白的表达。结果:从脂肪组织中分离出的细胞能在体外大量扩增,能被诱导分化为成骨细胞、脂肪细胞,ADMSCs移植2周后,可见PKH26标记细胞散在分布于肝内,免疫荧光染色显示标记细胞白蛋白染色阳性。结论:大鼠脂肪组织中可以获取具有多向分化潜能的间充质干细胞,该细胞在肝再生环境中能向肝细胞分化,参与肝再生。     

宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连的临床研究

摘要 目的：探讨宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连的效果及对患者子宫内膜血流参数和血清基质金属蛋白酶-9（MMP-9）、转化生长因子-β1（TGF-β1）水平的影响。方法：选取2017年3月至2019年3月我院收治的宫腔粘连患者106例进行前瞻性随机对照研究,以随机数字表法将患者分为研究组（n=53）和对照组（n=53）。两组均采取宫腔镜下冷刀分离术,对照组术后置入COOK球囊,并在术后当天给予人工周期治疗,研究组在对照组基础上予以P8仿生物电刺激辅助治疗,均治疗3个月。对比两组疗效、月经改善情况、治疗后1年妊娠情况、粘连复发情况和治疗前、治疗1个月后、3个月后粘连评分、子宫内膜容积、子宫内膜厚度、子宫内膜血流参数［阻力指数（RI）、搏动指数（PI）］、血清MMP-9、TGF-β1水平。结果：研究组治疗3个月后总有效率、月经改善率分别为92.45%、94.34%,高于对照组的75.47%、79.25%（P＜0.05）;研究组治疗1个月后、3个月后粘连评分和RI、PI低于对照组,子宫内膜容积、子宫内膜厚度高于对照组（P＜0.05）;研究组治疗1个月后、3个月后血清MMP-9水平高于对照组,TGF-β1水平低于对照组（P＜0.05）;研究组治疗后1年妊娠率44.23%高于对照组25.00%,粘连复发率15.38%低于对照组32.69%（P＜0.05）。结论：宫腔镜下冷刀分离术后P8仿生物电刺激辅助治疗宫腔粘连可减轻宫腔粘连程度,改善子宫内膜容积、厚度、血流情况,调节血清MMP-9、TGF-β1表达,改善月经情况,进而提高疗效和妊娠率,减少粘连复发。     

标记滞留细胞技术结合干细胞标记物检测小鼠子宫内膜干细胞

目的通过标记滞留细胞技术检测昆明小鼠子宫内膜干细胞的存在及其分布情况;观察P63和Musashi-1在不同周龄小鼠子宫内膜的表达以及两者与标记滞留细胞的关系,探讨P63和Musashi-1作为子宫内膜干细胞特异性标记物的可能性。方法出生3天雌性昆明小鼠皮下注射BrdU,分别在1w、2w、3w、4w、6w、8w和10w处死小鼠取其子宫。采用免疫组化法分别检测BrdU、P63和Musashi-1在各周龄小鼠子宫内膜的表达情况。结果标记后1w的小鼠,子宫内膜绝大部分的上皮和基质细胞都被BrdU标记。随着小鼠周龄的增加,子宫内膜BrdU阳性细胞百分率逐渐降低。至第8w时,仅在基质中有极少量的BrdU阳性细胞,主要位于基质与肌层交界处。早期小鼠子宫内膜组织中P63和Musashi-1阳性细胞数量较多,随着子宫内膜的逐渐发育成熟,P63和Musashi-1的表达逐渐减少,其表达规律及分布与标记滞留细胞基本一致。结论 (1)小鼠子宫内膜标记滞留细胞主要位于基质内膜与肌层交界处,这些细胞的分布与推测的子宫内膜干细胞的分布部位相符。(2)P63和Musashi-1是较特异的干细胞标记物。     

人子宫内膜各型胶原蛋白及纤维粘连蛋白随月经周期变动的研究

本实验对人正常子宫内膜月经周期中Ⅰ、Ⅲ、Ⅳ和Ⅴ型胶原蛋白及纤维粘连蛋白的变动状况进行了免疫组织化学的观察,目的是进一步探讨为接受胚泡着床,子宫内膜方面的准备状况。本实验使用的是因良性疾息被摘除的子宫。切片标本应用ＬＳＡＢ免疫组织化学方法对细胞外基质中的各型胶原蛋白及纤维粘连蛋白随月经周期变动的情况进行了观察。结果显示胶原蛋白及纤维粘连蛋白主要分布在上皮组织的基底膜中。胶原蛋白和纤维粘连蛋白在分泌初期明显减少的结果说明细胞外基质的确有明显随月经周期变化而变化的现象。提示子宫内膜中的胶原蛋白及纤维粘连蛋白的周期性变化对胚泡着床是有重要的作用。因此我们认为,胶原蛋白及纤维粘连蛋白是否能伴随月经周期而进行周期性变化是检查是否有真正正常月经周期的指标之一。本研究将对着床,抗着床机理及某些不孕症的治疗提供新的探讨方向。     

TGF-β1诱导的Postn、α-SMA和CollagenⅠ在宫腔粘连内膜组织中高表达与粘连严重程度相关

骨膜蛋白（periostin, Postn）与转化生长因子-β1（transforming growth factor-beta1,TGF-β1）信号通路活动密切相关,并参与多种纤维化疾病的病理形成,但在宫腔粘连（intrauterine adhesions,IUAs）形成过程中的作用机制尚不清楚。为了解Postn与纤维标志物（α-平滑肌肌动蛋白：alpha smooth muscle actin,α-SMA,Ⅰ型胶原：CollagenⅠ）在宫腔粘连发病中的作用,本研究收集宫腔粘连（实验组）轻、中、重度各20名患者的内膜组织,非宫腔粘连者20名（对照组）,利用实时荧光定量PCR技术、Western印迹技术和免疫组化染色证明：Postn与α-SMA、CollagenⅠ在mRNA和蛋白质表达水平的趋势一致,且与宫腔粘连严重程度呈正相关;实验组Postn、α-SMA 和 CollagenⅠ较对照组明显升高,其中以中、重度宫腔粘连患者内膜组织Postn、α-SMA和CollagenⅠ表达有非常显著的统计学差异（P＜0.01）。同时,为探究TGF-β1与Postn等纤维标志物的关系,利用重组人转化生长因子TGF-β1刺激原代子宫内膜基质细胞后,Western印迹结果显示,TGF-β1与Postn、α-SMA和CollagenⅠ蛋白质表达变化呈现剂量和时间依赖关系。上述结果证实,内膜纤维化是宫腔粘连的主要特征,由Postn等纤维产物参与形成,且与粘连程度相关。推测该病理过程可能与内膜损伤后,TGF-β1促使子宫内膜基质细胞成纤维分化、诱导Postn持续高表达有关。     

骨髓间充质干细胞移植对大鼠脑缺血再灌注损伤Livin和Caspase-3表达的影响

目的探讨骨髓间充质干细胞（BMSCs）移植对大鼠脑缺血再灌注损伤海马区凋亡相关基因Livin和Caspase-3表达及神经元细胞凋亡的影响。方法实验动物分为假手术组、模型组和BMSCs组,进行神经功能评分,应用TTC法检测脑梗死体积,追踪PKH26标记的移植BMSCs,应用免疫组化方法和Western blot检测Livin、Caspase-3蛋白表达,应用TUNEL法检测细胞凋亡。结果 PKH26标记的BMSCs在海马区有表达。与模型组比较,BMSCs组神经功能评分显著降低（P〈0.05）,脑梗死体积显著减少（P〈0.05）。BMSCs组与模型组相比Livin蛋白表达显著增高（P〈0.05）,Caspase-3蛋白表达明显下降（P〈0.05）,神经元细胞凋亡指数显著降低（P〈0.05）。结论 BMSCs对脑缺血再灌注损伤具有保护作用,其作用机制可能与上调Livin表达,下调Caspase-3表达,抑制细胞凋亡有关。     

流产术后并发宫腔粘连的危险因素分析及宫腔镜联合雌孕激素的干预效果研究

目的:分析流产术后并发宫腔粘连的危险因素,并探讨宫腔镜联合雌孕激素对宫腔粘连的干预效果,以期为宫腔粘连的防治提供依据。方法:选取2016年1月至2017年2月于我院接受流产术后并发宫腔粘连的患者100例作为粘连组,另选取同期于我院接受流产术后未发生宫腔粘连的患者100例作为未粘连组。比较粘连组和未粘连组患者基本资料、既往史情况、手术指标,并采用多因素Logistic回归分析流产术后并发宫腔粘连的危险因素。进一步将粘连组按照随机数字表法分成对照组(n=50)和观察组(n=50),对照组患者进行雌孕激素治疗,观察组患者进行宫腔镜联合雌孕激素治疗。比较观察组与对照组患者治疗3个周期后首次月经情况以及临床疗效。结果:粘连组孕次、产次、吸宫时负压、吸宫时间以及合并盆腔炎时间均高于未粘连组,差异均有统计学意义(P0.05)。经多因素Logistic回归分析可得,吸宫时负压≧500 mm Hg、吸宫时间≧15 min为流产术后并发宫腔粘连的危险因素(P0.05)。观察组治疗3个周期后首次月经量减少发生率、首次月经中期子宫内膜厚度≤8 mm发生率低于对照组,治疗有效率高于对照组(P0.05)。结论:吸宫时负压≧500 mm Hg、吸宫时间≧15 min均属于流产术后并发宫腔粘连的独立危险因素,临床应根据以上危险因素采取相应预防措施,以减少宫腔粘连的发生。而对于已发生宫腔粘连的患者,采用宫腔镜联合雌孕激素治疗具有较好的干预效果,值得在临床上推广应用。     

Human amniotic mesenchymal stem cells promote endometrium regeneration in a rat model of intrauterine adhesion

Human amniotic transplantation has been proposed to improve the therapeutic efficacy of intrauterine adhesions (IUAs). Human amniotic mesenchymal stem stromal cells (hAMSCs) can differentiate into multiple tissue types. This study aimed to investigate the mechanism by which hAMSCs transplantation promotes endometrial regeneration. The rat models with IUA were established through mechanical and infective methods, and PKH26-labeled hAMSCs were transplanted through the tail vein (combined with/without estrogen). Under three different conditions, hAMSCs differentiated into endometrium-like cells. HE and Mason staining assays, and immunohistochemistry were used to compare the changes in rat models treated with hAMSCs and/or estrogen transplantation. To define the induction of hAMSCs to endometrium-like cells in vitro, an induction medium (cytokines, estrogen) was used to investigate the differentiation of hAMSCs into endometrium-like cells. qRT-polymerase chain reaction (PCR) and western blotting were performed to detect the differentiation of hAMSCs into endometrium-like cells. A greater number of glands, fewer endometrial fibrotic areas, and stronger expression of vascular endothelial growth factor and cytokeratin in the combined group (hAMSCs transplantation combined with estrogen) than in the other treatment groups were observed. hAMSCs could be induced into endometrium-like cells by cytokine treatment (TGF-β1, EGF, and PDGF-BB). Transplantation of hAMSCs is an effective alternative for endometrial regeneration after injury in rats. The differentiation protocol for hAMSCs will be useful for further studies on human endometrial regeneration.     

Biologic properties of gadolinium diethylenetriaminepentaacetic acid-labeled and PKH26-labeled human umbilical cord mesenchymal stromal cells

Background aimsThis study was conducted to characterize gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA)-labeled and PKH26-labeled human umbilical cord mesenchymal stromal cells (HuMSCs) and to track them with magnetic resonance imaging (MRI) in vitro and in vivo.MethodsHuMSCs were isolated from umbilical cords and expanded in vitro. Cells were sequentially labeled with Gd-DTPA and PKH26. The labeling efficiency was determined by spectrophotometry measurements, and the longevity of Gd-DTPA maintenance was measured with MRI. The influence of double labeling on cellular biologic properties was assessed by cell proliferation, viability, differentiation, cycle and apoptosis. Transplantation of double-labeled HuMSCs or placebo was performed in 39 female Sprague-Dawley rats. Leak point pressure and maximal bladder capacity were measured in animals 6 weeks after injection.ResultsThe T1 values and signal intensity on T1-weighted imaging of labeled cells were significantly higher than the control group (P < 0.05). The signal intensity on T1-weighted imaging of labeled cells was retained >14 days in vitro and in vivo. There was no significant difference in the cell cycle, cell apoptosis, cell proliferation and cell viability between labeled and unlabeled HuMSCs (P > 0.05). After double labeling, HuMSCs were still capable of differentiating into osteoblasts and adipocytes. Periurethrally injected HuMSCs in the rats significantly improved leak point pressure and maximal bladder capacity.ConclusionsHuMSCs were successfully labeled with Gd-DTPA and PKH26. This labeling method is reliable and efficient and can be applied for tracking cells in vitro and in vivo without altering cellular biologic properties.     

Enhanced differentiation potential of human amniotic mesenchymal stromal cells by using three-dimensional culturing

The therapeutic potential of human amniotic mesenchymal stromal cells (hAMSCs) remains limited because of their differentiation towards mesenchymal stem cells (MSCs) following adherence. The aim of this study was to develop a three-dimensional (3-D) culture system that would permit hAMSCs to differentiate into cardiomyocyte-like cells. hAMSCs were isolated from human amnions of full-term births collected after Cesarean section. Immunocytochemistry, immunofluorescence and flow cytometry analyses were undertaken to examine hAMSC marker expression for differentiation status after adherence. Membrane currents were determined by patch clamp analysis of hAMSCs grown with or without cardiac lysates. Freshly isolated hAMSCs were positive for human embryonic stem-cell-related markers but their marker profile significantly shifted towards that of MSCs following adherence. hAMSCs cultured in the 3-D culture system in the presence of cardiac lysate expressed cardiomyocyte-specific markers, in contrast to those maintained in standard adherent cultures or those in 3-D cultures without cardiac lysate. hAMSCs cultured in 3-D with cardiac lysate displayed a cardiomyocyte-like phenotype as observed by membrane currents, including a calcium-activated potassium current, a delayed rectifier potassium current and a Ca²⁺-resistant transient outward K⁺ current. Thus, although adherence limits the potential of hAMSCs to differentiate into cardiomyocyte-like cells, the 3-D culture of hAMSCs represents a more effective method of their culture for use in regenerative medicine.     

PKH26 labeling of extracellular vesicles: Characterization and cellular internalization of contaminating PKH26 nanoparticles

PKH lipophilic dyes are highly fluorescent and stain membranes by intercalating their aliphatic portion into the exposed lipid bilayer. They have established use in labeling and tracking of cells in vivo and in vitro. Despite wide use of PKH-labeled extracellular vesicles (EVs) in cell targeting and functional studies, nonEV-associated fluorescent structures have never been examined systematically, nor was their internalization by cells. Here, we have characterized PKH26-positive particles in lymphoblastoid B exosome samples and exosome-free controls stained by ultracentrifugation, filtration, and sucrose-cushion-based and sucrose-gradient-based procedures, using confocal imaging and asymmetric-flow field-flow fractionation coupled to multi-angle light-scattering detector analysis. We show for the first time that numerous PKH26 nanoparticles (nine out of ten PKH26-positive particles) are formed during ultracentrifugation-based exosome staining, which are almost indistinguishable from PKH26-labeled exosomes in terms of size, surface area, and fluorescence intensity. When PKH26-labeled exosomes were purified through sucrose, PKH26 nanoparticles were differentiated from PKH26-labeled exosomes based on their reduced size. However, PKH26 nanoparticles were only physically removed from PKH26-labeled exosomes when separated on a sucrose gradient, and at the expense of low PKH26-labeled exosome recovery. Overall, low PKH26-positive particle recovery is characteristic of filtration-based exosome staining. Importantly, PKH26 nanoparticles are internalized by primary astrocytes into similar subcellular compartments as PKH26-labeled exosomes. Altogether, PKH26 nanoparticles can result in false-positive signals for stained EVs that can compromise the interpretation of EV internalization. Thus, for use in EV uptake and functional studies, sucrose-gradient-based isolation should be the method of choice to obtain PKH26-labeled exosomes devoid of PKH26 nanoparticles.     

PKH26 as a fluorescent label for live human umbilical mesenchymal stem cells

To determine whether PKH26 labeling affects the morphologies, phenotypes, proliferation, and secretion abilities of human umbilical mesenchymal stromal cells (HUMSCs) were investigated. Isolated HUMSCs were labeled with PKH26, and cell morphology was observed under microscope. Cell cycle, apoptotic cell death, expression of PKH26, and the proliferation rate were evaluated. Additionally, fluorescence intensity of PKH26 labeling at different passage times was quantified. There were no detectable differences in cell morphology, cell growth, and proliferation rate after PKH26 labeling. In addition, fluorescence intensity of PKH26 labeling was gradually reduced with increase of the passage times. The PKH26 labeling disappeared after passage six times. In summary, PKH26 labeling is a safe and effective way to label live HUMSCs.     

再生胰腺提取物诱导人羊膜间充质干细胞定向分化为胰岛素分泌细胞

利用天然生物诱导剂大鼠再生胰腺提取物(Rgenerating pancreatic extract,RPE)定向诱导人羊膜间充质干细胞(Human amniotic mesenchymal stem cells,hAMSCs)向胰岛素分泌细胞分化。切除大鼠60%胰腺刺激胰腺再生,而后制备RPE,以终浓度为20 mg/L的RPE诱导hAMSCs。实验通过形态学鉴定、双硫腙染色、免疫荧光分析、RT-PCR基因检测和高糖刺激胰岛素分泌等实验鉴定细胞诱导结果。实验结果显示P3代hAMSCs经RPE诱导后形态变化明显,诱导15 d后细胞呈簇状生长,经双硫腙染色可见棕红色细胞团;免疫荧光染色结果显示诱导细胞呈胰岛素阳性表达;RT-PCR实验证明诱导细胞阳性表达人胰岛相关基因Pdx1和insulin;高糖刺激实验证明培养液中有胰岛素成分产生,且分泌量随刺激时间的延长先增加而后趋于稳定。实验结果表明hAMSCs在体外经RPE诱导可以分化为胰岛素分泌细胞。     

Effects of low temperature and lactate on osteogenic differentiation of human amniotic mesenchymal stem cells

A functional relationship between the growth and the progression of events associated with osteogenic differentiation of human amniotic mesenchymal stem cells (hAMSCs) has been a fundamental question, which remains unclear. This study is aimed at investigating the effects of low temperature and lactate individually, and in combination on the growth and osteogenic differentiation of hAMSCs. It was shown that the growth of hAMSCs in growth medium was inhibited by both low-cultivation temperature and lactate. By extending culture period at low temperature, cell growth declined gradually, while the ALP expression and calcium deposition increased progressively. However, the growth of hAMSCs induced in osteogenic medium at 37°C was markedly enhanced by additional lactate. The ALP expression and calcium deposition, on the contrary, were significantly depressed. Furthermore, the synergistic actions of long-term low temperature and lactate resulted in more intense inhibition on both cell growth and osteogenic differentiation. Therefore, these findings may imply the co-contribution of the culture environment on the selective manipulation on the growth capacity and osteogenic differentiation potential of hAMSCs.     

Human mesenchymal stem cells and renal tubular epithelial cells differentially influence monocyte-derived dendritic cell differentiation and maturation

Mesenchymal stem cells (MSCs) possess immunosuppressive properties. But also fully differentiated human renal tubular epithelial cells (RTECs) are able to modulate T-cell proliferation in vitro. In this study we compared two MSC populations, human adipose derived stem cells (ASCs) and human amniotic mesenchymal stromal cells (hAMSCs), and RTECs regarding their potential to inhibit monocyte-derived dendritic cell (DC) differentiation and maturation in indirect co-culture.In the presence of hAMSCs and RTECs, monocytes stimulated to undergo DC differentiation were inhibited to acquire surface phenotype of immature and mature DCs. In contrast, ASCs showed only limited suppressive capacity. Secretion of IL-12p70 was suppressed in hAMSC co-cultures and high IL-10 levels were detected in all co-cultures. Prostaglandin E₂ was found in ASC and hAMSC co-cultures, whereas soluble human leukocyte antigen-G was highly elevated only in RTEC co-cultures. Thus, inhibition of DC generation by MSCs and RTECs might be mediated by different soluble factors.