2012年 · 第125卷第01期

ST-segment elevation myocardial infarction (STEMI)is usually caused by acute occlusion of an infarct-related coronary artery (IRA),resulting from rupture or erosion of an atherosclerotic plaque and subsequent platelet aggregation and thrombosis.1-3Prompt reperfusion is the key aspect of the optimal management,4-7 and timely expert primary percutaneous coronary intervention (PCI) becomes the best reperfusion strategy with respect to improvement in survival and reduction of combined clinical endpoints in the treatment of STEMI.8-11 Given the high thrombotic risk of patients with STEMI,pretreatment with a high clopidogrel loading dose before primary PCI was advised to reduce distal thrombotic embolization and angiographic no-reflow and improve clinical outcomes.12,13 The use of adjunctive intravenous glycoprotein (GP) Ⅱb/Ⅲa inhibitors following oral dual-antiplatelet therapy enhances thrombus disaggregation by inhibiting fibrinogen binding to the active receptor complex and subsequently disrupting platelet cross-linking,14 and improves IRA patency and myocardial perfusion,14 and has been recommended as class Ⅱa (at the time of primary PCI) or Ⅱb (before primary angiography and PCI)indication in the recent practice guidelines for the management of patients with STEMI.9,10 Tirofiban (a small-molecule platelet GP Ⅱb/Ⅲa inhibitor) seems even more attractive,because of its consistent and rapidly reversible platelet inhibition at increased dose and efficient penetration into the platelet-fibrin thrombus.15 In a broad population of largely unselected patients undergoing primary PCI for STEMI,tirofiban was associated with a noninferior complete resolution of ST-segment elevation (an indirect measure of myocardial reperfusion after PCI14,16) compared with abciximab,17 and was well tolerated and effective in reducing ischemic acute coronary syndrome complications in patients with mild-to-moderate renal insufficiency.18 Previous studies have shown that an upstream low dose of tirofiban favorably ameliorates IRA patency and reperfusion of the infarct area compared with down-stream use,19 and routine initiation of high-bolus dose of tirofiban could further improve clinical outcome after primary PCI.20 These observations highlight that further platelet aggregation inhibition besides high-dose clopidogrel is mandated in patients with STEMI undergoing primary PCI。

Abstract：Background Patients with xanthogranulomatous cholecystitis sometimes exhibit imaging and intraoperative findings that are similar to those of advanced gallbladder cancer,thus these patients are easily misdiagnosed.The present study aimed to investigate the characteristics of xanthogranulomatous cholecystitis masquerading as gallbladder cancer that could potentially aid in the correct diagnosis of this condition.Methods The clinical,serological,radiological and operative features of twelve patients with obviously wall-thickening or mass-forming xanthogranulomatous cholecystitis were retrospectively analyzed.Additionally,the patient preoperative features were compared to those of 36 patients with advanced gallbladder cancers.Results Twelve patients with xanthogranulomatous cholecystitis exhibited one to three episodes of acute cholecystitis within 0.5 to 7 months prior to admission to the hospital.Five of these patients exhibited concomitant choledocholithiasis,whereas no concomitant choledocholithiasis was identified in patients with advanced gallbladder cancer.The incidence of abdominal pain (x2=6.588,P=0.010),acute cholecystitis (x2=29.176,P=0.000),acute cholangitis (x2=6.349,P=0.012),choledocholithiasis (x2=16.744,P=0.000),carcinoembryonic antigen test (P=0.007),CA125 (P=0.001),and diffuse gallbladder wall thickening (x2=6.031,P=0.014),continued mucosal line (x2=15.745,P=0.000),homogeneous enhancement of mucosal line (x2=19.947,P=0.000),submucosal hypoattenuated nodules or band (x2=18.607,P=0.000) in computed tomography demonstrated statistically significant differences between cases of xanthogranulomatous cholecystitis and gallbladder cancer.Furthermore,all the twelve patients with xanthogranulomatous cholecystitis exhibited at least one positive computed tomography imaging feature aside from past acute cholecystitis episode,and no patient with advanced gallbladder cancer simultaneously exhibited past acute cholecystitis episode and at least one positive computed tomography imaging feature.Conclusions The accurate preoperative diagnosis of xanthogranulomatous cholecystitis includes an integrated review of past acute cholecystitis episode,choledocholithiasis,and positive computed tomography imaging features.Besides,we present an algorithm for intraoperative diagnosis。

Abstract：Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome characterized by pain in the perineum,pelvis,suprapubic area,or external genitalia and variable degrees of voiding and ejaculatory disturbance.The analgesic effect of extracorporeal shock wave treatment (ESWT) was an interesting phenomenon with an unclear mechanism discovered by chance in the applications for urolithiasis,on which ESWT has become an increasingly popular therapeutic approach as an alternative option for the treatment of a number of soft tissue complaints.In this study,we aimed to evaluate the feasibility and efficacy of ESWT in non-inflammatory (ⅢB) CP/CPPS.Methods Men diagnosed with ⅢB CP/CPPS were randomized to either ESWT (group 1,n=40) or the control (group 2,n=40).Group 1 received 20 000 shock wave impulses in 10 sessions over a two-week period,whereas group 2 received only a sham procedure.The total scores and sub-domain scores of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) for both groups were assessed at baseline,mid-treatment,end-point,and 4-week and 12-week follow-up visits.Results The mean total NIH-CPSI score of group 1 was significantly decreased from baseline at all post-treatment time points (P ＜0.01 for all).Decreases in pain domain and quality of life (QOL) scores were also significant.In group 2,no significant decreases of total NIH-CPSI score and pain domain score were found at all post-treatment time points.At the end-point of treatment,71.1％ of group 1 exhibited perceptible improvement in total NIH-CPSI compared with 27.0％ of group 2 (P ＜0.001); additionally,28.9％ of group 1 exhibited clinically significant improvement compared with 10.8％ of group 2 (P ＜0.01).Moreover,a greater number of patients in group 1 at 4-week and 12-week follow-up were rated as responders (perceptible and clinically significant response) compared with group 2.Conclusion ESWT exhibits a potentially therapeutic role in the treatment of CP/CPPS。

Abstract：Background The prevalence of malocclusion in modern population is higher than that in the excavated samples from the ancient times.Presently,the prevalence of juvenile malocclusion in the early stage of permanent teeth is as high as 72.92％ in China.This study aimed to observe and evaluate the prevalence and severity of malocclusions in a sample of Xia Dynasty in China,and to compare these findings with the modern Chinese population.Methods The material consisted of 38 male and 18 female protohistoric skulls of Xia Dynasty 4000 years ago.Of 86 dental arches,29 cases had the jaw relationships.Tooth crowding,diastema,individual tooth malposition and malocclusion were studied.Results Of the samples,23.3％ showed tooth alignment problems including crowding (8.1％),diastema (9.3％),and individual tooth malposition (5.8％).The prevalence of malocclusion was 27.6％,mainly presented as Angle Class Ⅰ.Conclusions It is indicated that over thousands of years from Neolithic Age (6000-7000 years ago) to Xia Dynasty (4000 years ago),the prevalence of malocclusion did not change significantly.The prevalence of malocclusion of Xia Dynasty samples was much lower than that of modern population。

Abstract：Background The success and complication rates of atrial fibrillation (AF) ablation may be related to regional differences in left atrial (LA) wall thickness.The purpose of this study was to investigate the transmural LA wall thickness in various regions.Methods We measured LA wall thickness in 36 human heart specimens using calipers at three planes including left pulmonary veins (PVs) vestibule plane,right PVs vestibule plane and the middle plane between the two.In each plane,eight points were selected,including superior,middle and inferior levels at anterior and posterior wall,roof and bottom.Results The anterior and posterior wall thickness displayed gradient from superior to inferior level (anterior wall:(2.73±1.01) mm,(2.08±0.91) mm and (1.54±0.69) mm; posterior wall: (1.74±0.68) mm,(1.48±0.39) mm and (1.27:±0.42)mm).At the roof,LA wall thickness was thickest in middle plane ((2.01±1.02) mm) and was thinnest in left PVs vestibule plane ((1.29±0.41) mm).The posterior wall thickness in left PVs vestibule plane was thinner than in the other two planes (P ＜0.05-0.001),and was thinner in right PVs vestibule plane than in middle plane (P ＜0.01-0.001).Whereas in anterior wall,the wall thickness in left PVs vestibule plane was thicker than in middle and right PVs vestibule plane.Conclusions Significant variations exist for mean LA wall thickness at different regions which are often targeted during circumferential pulmonary venous ablation (CPVA).Appreciating these differences may have significant implications in catheter ablation of AF。

Abstract：Background Pediatric patients are susceptible to lung injury.Acute lung injury in children often results in high mortality.Partial liquid ventilation (PLV) has been shown to markedly improve oxygenation and reduce histologic evidence of injury in a number of lung injury models.This study was designed to examine the hypothesis that PLV would attenuate the production of local and systemic tumor necrosis factor (TNF)-α in an immature piglet model of acute lung injury induced by oleic acid (OA).Methods Twelve Chinese immature piglets were induced acute lung injury by OA.The animals were randomly assigned to two groups of six animals,(1) conventional mechanical ventilation (MV) group and (2) PLV with 10 ml/kg FC-77 group.Results Compared with MV group,the PLV group had better cardiopulmonary variables (P ＜0.05).These variables included heart rate,mean blood pressure,blood pH,partial pressure of arterial oxygen (PaO2),PaO2/inspired O2 fraction (FiO2) and partial pressure of arterial carbon dioxide (PaCO2).PLV reduced TNF-α levels both in plasma and tissue compared with MV group (P ＜0.05).Conclusion PLV provides protective effects against TNF-a response in OA-induced acute lung injury in immature piglets。

Abstract：Background The role played by the nitric oxide (NO) signaling pathway in the aqueous humor dynamics is still unclear.This study was designed to investigate the expression and distribution of NO synthase (NOS) isoforms and guanylate cyclase (GC) in human ciliary body,trabecular meshwork and the Schlemm's canal.Methods Twelve eyes after corneal transplantation were used.Expression of three NOS isoforms (i.e.neuronal NOS (nNOS),inducible NOS (iNOS) and endothelial NOS (eNOS)) and GC were assessed in 10 eyes by immunohistochemical staining using monoclonal or polyclonal antibody of NOS and GC.Ciliary bodies were dissected free and the total proteins were extracted.Western blotting was performed to confirm the protein expression of 3 NOS isoforms and GC.Results Expression of 3 NOS isoforms and GC were observed in the ciliary epithelium,ciliary muscle,trabecular meshwork and the endothelium of the Schlemm's canal.Immunoreactivity of nNOS was detected mainly along the apical cytoplasmic junction of the non-pigmented epithelium (NPE) and pigmented epithelial (PE) cells.Protein expressions of 3 NOS isoforms and GC were confirmed in isolated human ciliary body by Western blotting.Conclusions The expression of NOS isoforms and GC in human ciliary body suggest the possible involvement of NO and cyclic guanosine monophosphate (cyclic GMP,cGMP) signaling pathway in the ciliary body,and may play a role in both processes of aqueous humor formation and drainage。

Abstract：Background Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common paroxysmal supraventricular tachyarrhythmias.The aim of the study was to prospectively compare the characteristics of radiofrequency catheter ablation of AVNRT guided by a magnetic navigation system with the conventional procedure.Methods Patients with AVNRT diagnosed by electrophysiological tests were randomized into two groups.In the conventional technique group (CMT),a common 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. In the magnetic navigation system guidance group (MNS), a magnetic 4-mm-tip quadrapolar temperature-controlled ablation catheter was used.The following parameters were collected and compared between the two groups: ablation procedure time,patient fluoroscopy time,operator fluoroscopy time,energy delivery numbers,maximal energy per deployment,success rate,complication rate and operative cost.Results Forty patients were enrolled and randomized into CMT and MNS groups.The age,gender,tachycardia history and basic cardiovascular diseases of the two groups were comparable (P ＞0.05).All procedures were conducted successfully without complications.No tachycardia recurred during the follow-up period of (9.3±2.6) months.In the MNS group,the patient and operator fluoroscopy times ((11.5±4.3) min,(4.2±1.5) min),energy delivery numbers (3.2±0.9),and maximal energy per deployment ((16.9±3.4) W) were shorter or lower than those of the CMT group ((14.3±6.2) min,(13.6±3.5) min,6.3±2.1,(23.7±1.3) W,respectively) (P ＜0.05).But the operative cost for the MNS group was higher than that of the CMT group (P ＜0.01 ).Conclusion Magnetic navigation system guided radiofrequency catheter ablation of AVNRT has the advantages of shorter fluoroscopy time and lower energy delivery numbers and maximal energy per deployment compared to the present conventional ablation technique。

Abstract：Background Left ventricular hypertrophy (LVH) and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke.Hypertension is the major cause of LVH.Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown.The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population.Methods The study was a community-based cross-sectional study,and comprised 4270 hypertension patients with integrated clinical and echocardiographic data.Left ventricular mass was measured by transthoracic echocardiography.LVH was diagnosed by using the criteria of over 49.2 g/m27 for men and 46.7 g/m2.7 for women.LV geometric patterns (normal,concentric remodeling,concentric or eccentric hypertrophy) were calculated according to LVH and relative wall thickness.Logistic regression model was used to determine the odds ratio (OR) and 95％ confidence intervals (CI) of the risk factors of LVH.Results The prevalence of LVH was 42.7％ in 4270 hypertensive patients,with 37.4％ in males and 45.4％ in females,respectively.The prevalence of concentric remodeling,concentric or eccentric hypertrophy was 24.7％,20.2％,and 22.6％,respectively.In Logistic regression model,female (OR 1.3,95％CI 1,1-1.5,P ＜0.01),age (OR 1.02,95％CI 1.01-1.03,P ＜0.01),body mass index (OR 1.2,95％CI 1.15-1.20,P ＜0.01),systolic blood pressure (OR 1.02,95％CI 1.01-1.03,P ＜0.01),and serum triglyceride (OR 1.10,95％ CI 1.00-1.20,P＜0.01) were risk factors of LVH.Female,age,body mass index,systolic blood pressure and serum triglycedde were also risk factors of left ventricular geometric abnormality.Conclusions The echocardiographic LVH is the major complication of patients with hypertension in rural area of China,especially for women.To effectively treat hypertension,weight loss and control of serum triglyceride may help to prevent LVH in hypertensive population。

Abstract：Background Mechanical asynchrony is an important parameter in predicting the response to cardiac resynchronization therapy,but detailed knowledge about cardiac timing in healthy persons is scarce.Therefore,in the current study,we sought to investigate the physiological status of interventricular synchronicity using pulse wave flow and tissue Doppler imaging in a healthy Chinese population.Methods Eighty-eight healthy volunteers underwent standard flow and tissue Doppler echocardiographic examinations.Ventricular inflow and outflow pulse wave flow Doppler patterns were recorded together with annulus pulse tissue Doppler imaging.Time intervals from the beginning of the QRS complex to the onset,peak and end of each wave were measured.Results The onsets of systole between left and right ventricles were highly synchronized by both imaging modalities.However,the left ventricle reached the peak flow ejection and peak mechanical contraction earlier than the right ventricle,(165.61±26.23) ms vs.(204.3±34.55) ms (P ＜0.01) and (133.62±26.19) ms vs.(191.25±38.47) ms (P ＜0.01).Time to peak early diastolic relaxation was earlier in the left ventricle than in the right heart,(500.23±56.52) me vs.(524.94±47.42) ms (P ＜0.01).Conclusions Left and right ventricles were well synchronized at the onsets of systole and diastole even though interventricular peak systolic and peak early diastolic dyssynchrony was observed in healthy people by pulse wave Doppler imaging.In addition,diastolic timing events were slightly affected by age and gender。

Abstract：Background Intravenous leiomyomatosis is a rare neoplasm,and its cardiac extension is often overlooked or misdiagnosed.The purpose of this study was to explore the imaging features of intravenous leiomyomatosis with cardiac extension,especially the value of magnetic resonance imaging in differential diagnosis.Methods Between July 2005 and August 2008,4 cases of intravenous leiomyomatosis with cardiac extension were resected in Cangzhou Central Hospital.Three cases had echocardiography performed,two had post contrast scans of CT performed,and two had MRI performed.Between July 2005 and May 2010,25 cases of histopathologically proven other kinds of tumors involving the inferior vena cava and right atrium were compared for discussion of differential diagnosis.Results Intravenous leiomyomatosis with cardiac extension demonstrated a hyperechoic elongated mobile mass extending from the inferior vena cava to the right atrium with or without evidence of protruding into the right ventricle on echocardiography.The lesion was enhanced heterogeneously on post contrast scans of CT and was of relatively lower density compared to the enhanced blood in the inferior vena cava and right atrium,with common iliac vein and the ipsilateral internal iliac and ovarian veins involved in some cases.The untreated uterus myoma demonstrated enlargement of the uterus with heterogeneous contrast enhancement.On MRI,the lesion looked like a luffa vegetable sponge on FIESTA coronal images and a sieve pore on T2-weighted axial images.All four tumors were removed successfully,and follow up of one to four years revealed no recurrence.The 25 cases of histopathologically proven other kinds of tumors involving inferior vena cava and right atrium had their own imaging features different from those seen on intravenous leiomyomatosis with cardiac extension.With reference to their medical history,differential diagnosis can often be made.Conclusion The imaging appearance of intravenous leiomyomatosis has some unique features,and the luffa vegetable sponge and sieve pore like appearance on MRI may be helpful for differential diagnosis。

Abstract：Objective To review the recent developments in the mechanisms of glucocorticoids induced osteonecrosis of femoral head (ONFH) and introduce a new theory of ONFH.Data sources Both Chinese- and English-language literatures were searched using MEDLINE (1997-2011),Pubmed (1997-2011 ) and the Index of Chinese-language Literature (1997-2011 ).Study selection Data from published articles about mechanisms of glucocorticoids induced ONFH in recent domestic and foreign literature were selected.Data extraction Data were mainly extracted from 61 articles which are listed in the reference section of this review.Results Glucocorticoids are steroid hormones secreted by the adrenal cortex that play a pivotal role in the regulation of a variety of developmental,metabolic and immune functions.However,high dose of exogenous glucocorticoids usage is the most common non-traumatic cause of ON FH.Glucocorticoids can affect the metabolisms of osteoblasts,osteoclasts,bone marrow stromal cells and adipocytes which decrease osteoblasts formation but increase adipocytes formation and cause ONFH finally.Conclusions Glucocorticoids affect the differentiation of mesenchymal stem cells,through activating or inhibiting the related transcript regulators of osteogenesis and adipogenesis.At last,the size and volume of mesenchymal stem cells derived adipocytes will increase amazingly,but the osteoblasts will be decreased obviously.In the meantime,the activity of the osteoclasts will be activated.So,these mechanisms work together and lead to ONFH。

Abstract：Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years (mean 57 years).Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days (mean 5 days).All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively (mean 22 months).The fractures healed within 10-18 weeks after operation (mean 12 weeks).During the last follow-up,the mean palmar tilt was (7.0±0.9)° and the mean ulnar variance was (21.0±4.2)°,showing significant difference when compared with preoperation ((-5.0±1.2)° and (8.0±3.8)°).The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5％.Conclusions The clinical effect of distal radius fracture treated with open reduction and internal plate fixation was relatively satisfactory.Meticulous operation procedure and individual rehabilitation strategy contribute to the wrist joint functional recovery。

Abstract：Background A novel circular pulmonary vein ablation catheter (PVAC) has been introduced for pulmonary vein isolation (PVI).Accurate delineation of left atrium-pulmonary vein (LA-PV) anatomy is important for this technique.The aim of this study was to test whether the 3-dimensional rotational angiography (3D RTA) of the left atrium can facilitate PVI using PVAC technique.Methods Twenty patients with paroxysmal atrial fibrillation (AF) were enrolled in this study.The 3D RTA was reconstructed and registered with live fluoroscopy in all the patients.AF ablation was performed with a PVAC catheter in the navigation of registered 3D RTA.Results The 3DRTA image was successfully reconstructed and registered with live fluoroscopy in all patients (100％).The LA-PV anatomy was delineated clearly in all patients.Navigation of the PVAC inside the registered 3D RTA,ensured accurate placement within the atrium to perform ablation,and the PVAC was correctly placed inside the PV ostium to verify the PVI.All the PVs were isolated.Total procedural time was (87.5±12.1) minutes,and fluoroscopy time was (20.1±6.3) minutes.Follow-up after (7.1±1.5) months showed freedom from AF in 70％ (14/20) patients.No PV stenosis was observed.Conclusions Intraprocedure reconstructed and registered 3D RTA can clearly delineate the LA-PV anatomy in real-time.The results demonstrate the feasibility and reliability of combining use of 3DRA and PVAC in AF ablation procedures。

Abstract：Background The percutaneous transcatheter closure of secundum atrial septal defect (ASD) is increasingly a widespread alternative to surgical closure.The aim of this study was to assess long-term results of percutaneous closure of secundum-type atrial septal defect (ASD Ⅱ).Methods Between January 2001 and December 2005,61 patients underwent a successful percutaneous closure of ASD Ⅱ; including 25 male and 36 female.All were included in the patient study and were followed up to monitor by electrocardiogram and echocardiography,at intervals of 3 days,3 months,6 months,1 year,2 years,and 5 years after operation.Results Three days after percutaneous transcatheter septal closure (PTSC),the right atrium diameter,right ventricular end-diastolic left-right diameter and right ventricutar end-diastolic volume (RVEDV) decreased significantly (P ＜0.05).Right ventricular end-diastolic anteroposterior diameter (RVEDD),right ventricular end-systolic volume (RVESV) and right ventricular ejection fraction (RVEF) also decreased (P＜0.01).During the period from 3 to 6 months,the size of the right atrium and right ventricle returned to normal range.Three days after PTSC,the left ventricular end-diastolic diameter (LVEDD),left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left ventricular-systolic volume (LVSV) and left ventricular ejection fraction (LVEF) were significantly increased (P ＜0.05).At 1 year,the size of the left atrium,left ventricle and left cardiac function returned to normal range (P ＜0.01).There were no deaths or significant complications during the study.At five year follow-up,all defects were completely closed and remained closed thereafter.Conclusion Transcatheter closure of ASD Ⅱ effectively eliminated the abnormal shunt and,subsequently improved the dimensions of each chamber and cardiac function。

A female papillary thyroid cancer patient with diffuse micronodular pulmonary metastases was confirmed only by post radioactive iodine (RAI) therapy whole body scan (RxWBS).Her diagnostic iodine-131 whole body scan (DxWBS),chestCT and 18FDG PET/CT scan were all negative.Attention and pitfalls of this case concerning surgical and RAI dosemanagement are against current international guidelines on thyroid cancer。

Abstract：Background Human interleukin-10 (hlL-10) is a cytokine synthesis inhibitory factor,which is involved in various immune responses.The purpose of this study was to construct an adenoviral vector carrying the hlL-10 gene for expression of biologically active hlL-10 in rat bone marrow mesenchymal stem cells (rMSCs).Methods A pSNAV2.0-hlL10 plasmid was used as a template to obtain a hlL-10 cDNA fragment that was subcloned by restriction enzyme digestion and ligation into a pDC316-IRES-EGFP-lacZ alpha plasmid carrying an enhanced green fluorescent protein (EGFP) marker gene.The pDC316-hlL-10-IRES-EGFP plasmid was linearized by Pmel digestion and used to transfect HEK293 packaging cells using the adenovirus packaging system AdMax.Virus particles were amplified by repeatedly infecting HEK293 cells with the seed virus and then purified by ion exchange.After the number of virus particles and titer was determined,rMSCs were infected with the adenoviral vector.The infection rate was determined by fluorescence microscopy and flow cytometry,and hlL-10 protein expression in rMSCs was measured by Western blotting.Results The virus particle concentration,OD260/280 value and virus titer of the amplified and purified recombinant adenovirus were 3.2×1011 VP/ml,approximately 2.0,and 1.1×1010 TCID50/ml,respectively.Bright green fluorescence was observed by fluorescence microscopy and flow cytometry in the recombinant adenovirus-infected rMSCs.GFP expression was considered the multiplicity of infection (MOI) and was time-dependent.The infection rate was 92.9％ at 100 MOI.Conclusions A bicistrenic recombinant adenoviral vector for hlL-10 and EGFP gene expression were successfully constructed.The infection rate of rMSCs by the adenovirus was high (92.9％ at 100 MOI) and the target gene hlL-10 was highly expressed in cells.The present study provides an experimental basis for further research of immunosuppressive therapy using hlL-10.The expression level of hlL-10 protein as detected by Western blotting was also MOI- and time-dependent。