Volume 85  ·   Issue 36  ·  2005

In the history of the development of Chinese medical journals, there are still few journals that write about 90 Spring and Autumn Periods, and among them, only the journals of the Chinese Medical Association are founded by Chinese physicians- -<It is an honor and pride to celebrate the 90th birthday of this journal as the editor of Chinese Medical Journal.

From the establishment of the molecular model of DNA double helix structure to the proposal of the central rule, important research achievements in the field of life science have been produced frequently. With the completion of the genome project of human and other model organisms, life science research will usher in a new era. After the whole genome sequencing, we are presented with vast DNA sequence information. How to understand it, that is, analyze all possible coding genes and their physiological functions, and systematically expound the expression regulation rules of these genes at the whole genome level, and then reveal the mystery of life will be the most challenging biological topic faced by human beings in the post-genome era.

Tissue and organ defects or dysfunctions are the main causes of human diseases and deaths.How to solve this problem fundamentally has become an international frontier topic actively explored in the field of life sciences.Since the beginning of this century,the research of tissue engineering has made leaps and bounds.All kinds of relatively simple tissue construction and defect repair research have been successful in higher mammals, and some of the results have been applied in clinic.This brings good opportunities for the further development and application of tissue engineering in this century.However, as a new discipline,its in-depth development has also exposed many new problems and challenges [1,2]. This paper discusses the opportunities and challenges faced by the development of tissue engineering in the 21st century from the three basic elements of tissue engineering.

With the completion of the human genome sequencing draft in 1990s, life science has entered the post-genome era. Modern biotechnology has had a profound influence on the development of life science. Nutrient metabolism and support, as an important part of life science, are more closely integrated with modern biotechnology, and the progress made has affected the treatment mode and health of human diseases. Now, we will talk about our views and experiences on the development status and development direction of nutrient metabolism and support in the post-genome era.

Since Thomson et al. [1] reported that they successfully cultured and proliferated human embryonic stem cells in vitro in 1998, the research on stem cells has been extensively carried out and developed rapidly. Scientists have optimistically predicted that the clinical application of stem cells and their derivatives tissues and organs is one of the great scientific and technological achievements of human beings in the 21st century. In April 2004, Science magazine successively reported that Japanese scholars completed the fatherless reproduction of mammals for the first time in the world, that is, the genetic materials of two different egg cells were combined to breed healthy mice [2]; Korean scholars used "somatic cell nuclear transfer" (SCNT) technology to complete the establishment of human embryonic stem cell lines [3]; The research on stem cells is also in a rapid development stage in China, and some research achievements at international level have been obtained. However, there is not a single multi-center clinical controlled study on stem cells in the medical circles at home and abroad, and the research and clinical application of stem cells is still a long road and difficult.

Stem cells are a kind of cells with self-infinite replication and multidirectional differentiation ability, including embryonic stem cells and adult stem cells. In recent years, due to the improvement of cell isolation and culture technology and the deepening of understanding of stem cell characteristics, the research of stem cells has developed rapidly, showing a good prospect of clinical application.

Autologous stem cell transplantation for the treatment of lower extremity ischemic diseases is a new technology that has appeared in recent years, and it has shown attractive prospects, but there are also many problems.

hematopoietic stem cell (HSC) is one of the most well-studied adult stem cells at present, and HSC transplantation has been successfully applied in clinical practice, and has achieved great social and economic benefits. However, the lack of cell sources, the need to take immunosuppressive agents for life after transplantation and a series of serious complications brought by it greatly limit the extensive development of this technology in clinical practice. embryonic stem cell (ES) has become an important source of seed cells in future regenerative medicine because of its infinite proliferation ability and "differentiation totipotency" in vitro. Clone embryos are obtained by somatic-cell nuclear transfer (SCNT) technology, and ES cell lines with genetic specificity are established, and ES cells are induced to differentiate into HSC in vitro, which can be applied to clinical transplantation, which can not only avoid many ethical problems, facilitate obtaining sufficient source of functional cells, but also avoid immune response after transplantation, improve the success rate of transplantation, Therefore, the clinical application of ES cells may first make a breakthrough in HSC transplantation.

At present, 17 million people die of cardiovascular diseases in the world every year, and more than half of them die of acute myocardial infarction. Although recanalization therapy can save the ischemic myocardium, it can't regenerate the infarcted myocardial cells. How to regenerate necrotic myocardium or non-functional myocardium and reproduce its diastolic and contractile functions has always been the peak that scientists need to climb urgently. Since the 1990s, the emergence and maturity of stem cell technology have brought new dawn to the treatment of this kind of diseases, and the exploration of this therapeutic measure has become one of the focus of cardiovascular research in the world. At present, various types of stem cells are used to try to regenerate infarcted myocardium, and the coexistence of positive and negative research results makes the public and scientists feel confused. Which type of stem cells can regenerate infarcted myocardium? By comparing the experimental and clinical efficacy of different types of stem cells in the treatment of myocardial infarction, this paper discusses the possible development direction of stem cell transplantation in the treatment of myocardial infarction in the future.

In recent years, it has been found that nerve regeneration is a physiological phenomenon in the adult mammalian brain. Neurons generated by adult neural stem cells have corresponding electrophysiological functions whether in vitro or in vivo, and can regenerate and repair nerves after injury [1-3]. Moreover, genetically modified stem cells can also be used in gene therapy of nervous system diseases, and express exogenous neurotransmitters, neurotrophic factors and metabolic enzymes, which provide a new therapeutic approach for many refractory nervous system diseases.

Objective to investigate the effect of selective cyclooxygenase-2 (COX-2) inhibitor NS-398 on the signal transduction pathway of Stat5 and PPAR δ in colon cancer cell line SW480, in order to clarify the mechanism of selective COX-2 inhibitor against colorectal cancer independently of COX-2. Methods The expression of COX-2 mRNA in colon cancer cell line SW480 was detected by RT-PCR. The expression of Stat5 and PPAR δ signal transduction pathway was detected by Western blot, the cell proliferation was detected by tetramethylazolium salt (MTT) assay, and the cell cycle and apoptosis were detected by flow cytometry. Results No COX-2 mRNA expression was detected in colon cancer cell line SW480. After 72 h with NS-398 (75 μ mol/L), the cell ratio of G1 phase increased from 31.2% to 40.6%, and the cell ratio of S phase decreased from 52.8% to 41.2%, and the cell proliferation was inhibited.

Objective to investigate the prognosis and related factors of fertility-preserving therapy in patients with three different types of ovarian malignant tumors. Methods The survival rate, recurrence and uncontrolled rate and fertility status of 189 patients with ovarian malignant tumor treated with preservation of fertility were retrospectively analyzed.Among the 189 patients, 136 were germ cell tumor (OGCT), 31 were sex cord stromal tumor (OSCST) and 22 were epithelial carcinoma (EOC). The median follow-up time of the patients in OGCT, OSCST and EOC groups was 50, 46 and 45 months, respectively.Results The 5-year survival rate of the patients in OGCT, OSCST and EOC groups was 94.0% (131/134), 77.1% (26/30) and 64.7% (16/21), and the recurrence and uncontrolled rate were 29.9% (40/134), 20.0% (6/30) and 47.6% (10/21), respectively. During the follow-up period, 46 patients delivered. Standardized chemotherapy was an independent factor affecting the survival rate and recurrence and uncontrolled rate of OGCT. For OSCST, FIGO staging and standardized chemotherapy are the factors affecting survival rate, recurrence and uncontrolled rate, respectively. Comprehensive staging surgery and FIGO staging are the factors affecting survival rate, recurrence and uncontrolled rate of EOC. Conclusion Fertility-preserving therapy should be individualized for OSCST and EOC, while for OGCT, it is not limited by FIGO staging.

Objective to investigate the clinical effect of early surgical resection of optic nerve sheath meningioma and protecting the vascular nerves of the orbital apic.Methods the clinical data of 21 patients with optic nerve sheath meningioma resected by cranio-orbital approach were retrospectively analyzed. The first symptom was visual impairment in 13 cases, including blindness in 6 cases and exophthalmos in 8 cases.Neuroimaging examination showed that 15 cases of tumor (flat type) surrounded the optic nerve longitudinally and showed "double track sign", of which 5 cases invaded the cranium; Six cases of tumor (nodular type) showed round shape without "double track sign", all of which were confined to the orbit. The follow-up was 2 months to 6 years after operation. Results 15 cases of tumor were totally resected, 6 cases were partially resected, 17 cases of oculomotor nerve and 18 cases of abductor nerve were preserved after operation; The visual acuity was successfully preserved in 2 patients with small tumors after early surgery, and there was no recurrence after 4 years and 5 years of follow-up, respectively. Two patients were followed up with recurrence (both large tumors). Conclusion Early surgical resection of optic nerve sheath meningioma has the advantages of preserving other nerve vessels in the orbital apex while completely removing the tumor, and the visual acuity of some eyes can also be preserved.

Public health emergencies refer to major infectious diseases, mass diseases of unknown origin, major food and occupational poisoning and other events that seriously affect public health that suddenly occur, cause or may cause serious damage to public health [1]. Public health emergencies can cause strong reactions in the area where they occur and outside the area, which directly relates to public health, economic development and social stability.

Objective to induce the differentiation of rhesus monkey skin stem cells into conjunctival epithelial cells in vitro and explore the plasticity of skin stem cells. Methods Rhesus monkey skin stem cells were cultured in vitro and purified with type IV collagen. Before and after purification, the proportion of β 1 integrin and keratin 15 positive cells was detected by flow cytometry. The purified skin stem cells were identified by immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR). The skin stem cells were transfected with green fluorescent protein gene, and the fluorescent cells were selected after 24 hours, and co-cultured with human conjunctival epithelial cells for 10 days. Then, the specific antigens of conjunctival epithelial cells, mucin 4 and keratin 4, were identified by cellular immunofluorescence and RT-PCR. Results the proportion of skin stem cells cultured in vitro was nearly 90% after purification. The positive results of β 1 integrin and keratin 15 were detected by immunofluorescence and RT-PCR. After transfection with green fluorescent protein gene for 24 h, the cells showed green fluorescence. After co-culture with conjunctival epithelial cells for 10 days, the positive results of mucin 4 and keratin 4 were detected by immunofluorescence and RT-PCR. Conclusion The purified skin stem cells of primate rhesus monkey can be induced to differentiate into conjunctival epithelial cells under suitable conditions.

Objective to investigate the induction conditions and differentiation rules of embryonic stem cells (ES cells) to BE differentiated into bile duct epithelial cells (BE cells) in vitro. Methods ES cells were selected, and the expressions of cytokeratin 7 (CK7), cytokeratin 19 (CK19) and γ-glutamyl transpeptidase (GGT) were detected by immunocytochemistry, and their expression time and spatial distribution were observed. Results On the 10th day of ES cell differentiation, a circular structure appeared in the differentiated community of embryonic somatic cells, and CK7 and GGT were expressed, and CK19 was expressed on the 13th day of differentiation, and the expressions of the three increased with the prolongation of culture time; Conclusion ES cells can differentiate into BE cells and form bile duct-like structures under specific culture conditions and the action of cell growth factors.

A 61-year-old male was admitted to the hospital on 23 May 2005 due to abdominal pain for two and a half years, low back pain, double hydronephrosis, retroperitoneal soft tissue shadow and abdominal aortic aneurysm for one and a half years. In October 2002, the patient developed abdominal distension and dull pain in the lower abdomen without obvious trigger, without special treatment. In September 2003, he developed lower waist and hip pain, intermittent fever, body temperature fluctuated from 37℃ to 37.5℃, blood erythrocyte sedimentation rate (ESR) fluctuated from 35 to 56 mm/h, creatinine (Cr) 18 mg/L, urea nitrogen (BUN) 80 mg/L; B-mode ultrasound examination showed "mild hydrops in both kidneys and dilated upper ureters", kidney diagram showed "serious impairment of left kidney function and moderate impairment of right kidney function", and abdominal CT showed "retroperitoneal soft tissue density shadow, surrounding the surrounding blood vessels and left ureter" (Figure 1). The symptoms were not improved after oral Chinese medicine to protect the kidney.

Apoptosis is an important basic function of all multicellular tissues.The biochemical and morphological changes of apoptosis are highly conserved among different species from nematodes to humans [1], which are of great significance for embryonic development and the maintenance of normal cell homeostasis. However, excessive apoptosis can induce degenerative changes, such as immune deficiency and neurodegenerative diseases [1, 2]. Therefore, the correct regulation of apoptosis process is of great significance to the body.

The function of testis depends on the continuous proliferation of spermatogonial stem cells. These cells adhere to the basement membrane of seminiferous tubules and are embedded between supporting cells. After homologous expansion, they form differentiated spermatogonial chains. The differentiated spermatocytes form spermatocytes after two meiosis, and the latter form mature sperm after metamorphosis. During the whole spermatogenesis process, spermatogonial stem cells exhibit great cell population expansion ability in all germ cell types. In addition, DNA deletion is likely to occur during DNA replication and meiosis. As the starting point of carrying genetic material, spermatogonial stem cell pool is of great significance for the change of genome integrity. It can be seen that spermatogonial stem cells provide a path for the research of germ cell genetic engineering. As a member of stem cell family, spermatogonial stem cells have the potential of immortalization and pluripotency, and are precursors of sperm formation. In recent years, the research on spermatogonia stem cells has been deeper and deeper [1]. With the breakthrough in methodology, especially spermatogonia stem cell transplantation, spermatogonia stem cells have shown a broad application prospect.

The patient was a 29-year-old female, married for 1 1/2 years, had no contraceptive measures, had regular menstruation, had never given birth, had 0 pregnancy and 0 delivery, and had no special past history. After 63 days of menopause, the urine pregnancy test was positive, and there was no discomfort. Real-time vaginal ultrasound examination showed no gestational sac in the uterus, the endometrium was about 8 mm thick, and a mixed mass of 21 mm adjacent to the right ovary was detected. Doppler showed that the peripheral blood flow was abundant, and it was suspected that it was "right fallopian tube pregnancy". After 48 hours, the serum β-human chorionic gonadotropin (β-hCG) was tested, and it increased from 2150 IU/L to 2980 IU/L, and progesterone was 15 ng/L. After ultrasound examination, the bilateral ovaries were normal, the mass adjacent to the right ovary increased to 26 mm, the blood supply was abundant, the resistance index was 0.33, and there was no accumulation in the pelvic cavity. Ectopic pregnancy was extremely likely and growing rapidly. Immediate treatment was needed to avoid massive bleeding and life-threatening.

In all patients with peroneal muscular atrophy (CMT), CMT1 type accounts for about 70% of the total, while 70% of autosomal dominant CMT1 patients and 90% of sporadic cases are caused by a fragment containing PMP22 gene in 17p11.2 region (1.5 Mb in size, occasionally<This type is called CMT1A. The second most common type is X-linked CMT, accounting for about 14% of all CMT types [2].

As a modern molecular drug therapy, hepatocellular carcinoma gene therapy has brought new prospects for the treatment of hepatocellular carcinoma. However, the current research results of hepatocellular carcinoma gene therapy are not satisfactory, and the lack of good gene transfer vector is an important reason [1]. It is necessary to improve the existing ideas and provide a new gene transfer strategy targeting hepatocellular carcinoma cells.

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease characterized by progressive airflow restriction. At present, there is no effective treatment for this disease. Roflumilast is a newly discovered phosphodiesterase-4 inhibitor. Klaus et al. conducted a phase three, multicenter, double-blind, randomized controlled study to evaluate the efficacy and safety of Roflumilast. The research results were published in the journal Lancet (Lancet, 2005, 366:563-571).

Recently, a medical team composed of Dr. Liu Yufen from Genome Research Center of Yangming University, Taiwan, China, Chen Weiming, Director of Fracture and Trauma Department of Taipei Veterans General Hospital, and Professor Cai Shifeng from Institute of Genetics of Yangming University completed the gene mapping and selection of hereditary form of osteonecrosis. Their research confirmed that heredity is also one of the causes of avascular femoral head necrosis, and found the causal gene, which solved the mystery of "the cause of avascular femoral head necrosis is unknown".

Very little is known about human genetic susceptibility to bacterial pathogen infection. Tuberculosis caused by Mycobacterium tuberculosis still has a high prevalence and mortality rate worldwide, with more than 8 million new cases of tuberculosis and 2 million deaths every year. Schurr, a molecular geneticist from the Host Resistance Research Center of McGill University Health Center in Canada, estimates that 2 billion people are infected with Mycobacterium tuberculosis, accounting for about 1/3 of the world's total population. However, only 5% ~10% of the infected people suffer from tuberculosis in their lifetimes, and 90% ~95% of the infected people are in dormant state and do not develop the disease in their lifetimes. Among the infected people, about half of the patients occur within 2 years after infection, which is rapidly occurring tuberculosis, called primary tuberculosis, which is especially common in children and is its main form; However, the slow progression of clinical symptoms after 2 years of infection is called secondary infection or reactivation. The mechanism of this rate difference from infection to onset is still unknown. He spent 5 years studying this, and on August 23, 2005<Their latest research results were published in PNAS, 2005, 102:12183-12188.

coronary artery dilatation (CAD) refers to the enlargement of coronary artery diameter more than 1.5 times that of adjacent normal coronary arteries. The incidence of CAD is low, and can cause angina pectoris and even myocardial infarction. Two patients with severe dilatation of three coronary arteries complicated with myocardial infarction are reported.

Three cases of thrombocytopenia after interventional occlusion in children with patent ductus arteriosus were treated in our hospital from October 2004 to March 2005. The reports are as follows.

The 11th annual conference of the International Society for Liver Transplantation was held in Los Angeles, USA from July 20 to 23, 2005. Experts and scholars from all over the world attended the conference. More than 300 papers were exchanged during the conference, which mainly discussed the treatment of HCV infection and liver cancer by transplantation.

Editor's Note: In the course of running a journal for nearly a century, the contents reported by Chinese Medical Journal have recorded the development course of Chinese medicine, and at the same time, it fully reflects the policy of running a journal that Chinese Medical Journal has always insisted on serving scientific research, teaching and clinical practice, and embodies the purpose of running a journal wholeheartedly for the development of Chinese medical cause. From its founding in November 1915 to the end of 2004, it published 84 volumes, 872 issues, and published 24 699 articles, involving 34 451 authors and 2729 institutions (including 333 colleges and universities, 1761 medical institutions and 303 scientific research institutions), and the authors' institutions involved 155 cities and 20 countries in mainland China.