HLA-DR抗原在慢性乙型肝炎和肝细胞癌中的表达及其意义

目的　探讨HLA DR抗原在慢性乙型肝炎和肝细胞癌 (HCC)中的表达及其意义。方法采用免疫组化技术对 2 0例正常肝组织、36例慢性乙型肝炎和 44例HCC中HLA DR抗原的表达进行检测。结果　正常肝组织中肝细胞未见HLA DR抗原表达。慢性乙型肝炎肝细胞HLA DR抗原表达阳性率为 2 7.8% ,其中 ,中度和重度肝炎HLA DR抗原阳性率明显高于轻度肝炎 (阳性率分别为 37.5 %和 2 0 % ,χ2 =13.6 ,P <0 .0 1)。HCC中肿瘤细胞HLA DR抗原表达阳性率为 43.2 %。HLA DR抗原表达与癌周淋巴细胞浸润 (χ2 =0 .5 1,P >0 .0 5 )和转移 (χ2 =2 .9,P >0 .0 5 )无关 ,但与癌组织分化程度有关 (χ2 =4.9,P <0 .0 5 )。结论　HLA DR抗原的异常表达在慢性乙型肝炎免疫损伤、免疫保护和HCC发生、发展中起重要作用     

类风湿性关节炎巨噬细胞活化的机理

类风湿性关节炎(RA)的免疫应答机理目前仍不清楚,可能是与不断进行的、自体混合淋巴组织反应在关节产生淋巴因子,包括γ-IFN在局部活化巨噬细胞(Mφ)有关。γ-IFN是一种体外Ⅱ类MHC分子表面表达的一种强诱导物,HLA-DR表达的增加是类风湿关节一种特有的免疫组织学特征。为了估计RA中γ-IFN对Mφ的致活作用,本文采用敏感的放射免疫技术研究了RA淋巴细胞自然产生的和致有丝分裂原诱导产生的γ-IFN。作者研究了平均年龄52岁(男19、女23)的42名RA患者周围血淋巴细胞(PBC),同时从11名患者中取关节液     

干扰素和肿瘤坏死因子对人脐静脉内皮细胞表达HLA-Ⅱ类抗原的影响

采用cell-ELISA法对IFN-α、γ及rTNFα单独或协同影响人脐静脉内皮细胞（HUVEC）表达HLA-Ⅱ类抗原作了定量观察。结果表明,IFNγ直接刺激 HUVEC可依浓度和时间依赖的方式提高其 HLA-Ⅱ类抗原表达量,而rTNFα、IFNα单独处理HUVEC无效。当rTNFα和IFNγ同时诱导时,对HUVEC表达HLA-DR、DP、DQ均表现抑制作用。但是,当先用IFNγ诱导HUVEC 24h后,再加入rTNFα则发现DR、DP、DQ的表达升高,起促进作用。     

TRAIL及其受体DR5与动脉粥样硬化关系的初步研究

目的探讨肿瘤坏死因子(INF)相关的凋亡诱导配体(TRAIL)及其受体DR5与动脉粥样硬化(AS)之间的关系。方法冠心病(CAD)组61例,正常对照组22例。应用酶联免疫吸附法测定血浆可溶性TRAIL(sTRAIL)和可溶性DR5(sDR5)水平。免疫组织化学测定冠状动脉TRAIL和DR5蛋白表达情况。结果CAD组血浆sTRAIL和sDR5水平均显著性升高(P<0.001,P<0.05)。3支血管病变组和双支血管病变组血浆sTRAIL和sDR5水平均分别显著高于单支血管病变组和正常对照组(P<0.01,P<0.01,P<0.01,P<0.05)。TRAIL和DR5主要表达于平滑肌细胞的胞质,TRAIL还可表达于AS中的巨噬细胞。AS组冠状动脉的TRAIL和DR5表达明显高于非AS组(P<0.01,P<0.05)。结论TRAIL及其受体DR5可能参与了AS的进展,其浓度越高,冠状动脉病变越重。     

CD4~+T淋巴细胞Kv1.3通道在大鼠动脉粥样硬化中的作用

目的:探讨大鼠动脉粥样硬化(AS)模型中CD4+T淋巴细胞电压门控钾通道(Kv)Kv1.3的表达、功能及其在AS中的作用。方法:采用高脂饮食法建立大鼠动脉粥样硬化模型,流式细胞术分析淋巴细胞的比例,采用免疫磁珠法分离CD4+T淋巴细胞,研究脾组织CD4+T淋巴细胞Kv1.3mRNA表达、细胞内钙离子浓度及细胞因子分泌的变化。结果:(1)AS组脾组织CD4+T淋巴细胞占总T淋巴细胞比例较对照组明显升高(74.93%±2.15%vs67.80%±2.54%,P0.05)。(2)经刀豆蛋白A(ConA)刺激,AS组T淋巴细胞增殖程度明显高于对照组(1.1321±0.1750vs0.7971±0.0955,P0.05)。(3)AS组脾组织CD4+T淋巴细胞在ConA刺激状态下胞内钙离子浓度明显高于对照组(H=82,P0.05)。(4)AS组脾组织CD4+T淋巴细胞在刺激48h后较刺激24h后细胞因子(IL-2,TNF-α)分泌显著增加。(5)AS组脾组织CD4+T淋巴细胞Kv1.3mRNA表达明显高于对照组(3.670±1.579vs1)。结论:AS组脾组织CD4+T淋巴细胞比例高于对照组,CD4+T淋巴细胞Kv1.3mRNA表达增多,提示高表达Kv1.3的CD4+T淋巴细胞可能在AS的发生发展中发挥重要的作用。     

干扰素γ与抗CD20单克隆抗体对骨髓瘤细胞增殖影响的体外研究

目的：体外研究干扰素γ能否增加多发性骨髓瘤(MM)瘤细胞表面CD20的表达、增强抗CD20单克隆抗体美罗华抗骨髓瘤的作用。方法：将浓度为(0～800)U／ml的重组人干扰素γ(hrγ-IFN)，联合浓度为(0～20)U／ml的美罗华，分别与14例初治(初治组)和16例复发难治(难治组)的MM患者瘤细胞在半固体甲基纤维素培养体系中培养，观察它们对瘤细胞集落形成的影响，并用流式细胞仪测定上述不同浓度hrγ-IFN处理前后瘤细胞表面CD20的表达。结果：hrγ-IFN浓度分别≥50 U／ml或≥100 U／ml可明显增加初治组或难治组瘤细胞表面CD20的表达；单用≥50 U／ml或≥100 U／ml的hrγ-IFN对初治组或难治组瘤细胞集落形成有抑制作用，而单用≥16 U／ml的美罗华只对初治组瘤细胞集落形成有轻度抑制；≥50 U／ml的hrγ-IFN联合≥12 U／ml的美罗华，或≥100 U／ml的hrγ-IFN联合≥16 U／ml的美罗华，对初治组或难治组瘤细胞集落形成的抑制大于单用同浓度的hrγ-IFN或美罗华。结论：体外hrγ-IFN能抑制MM瘤细胞集落形成，并可通过增加瘤细胞表面CD20的表达而增强美罗华对瘤细胞集落形成的抑制作用。     

强的松对小儿原发性肾病综合症患者PBMC HLA表达的调节作用

目的: 初步探讨糖皮质激素对外周血单个核细胞(PBMC)人类白细胞抗原(HLA)表达的调控作用.方法: 肾病综合征(NS)患儿PBMC体外经IFN-γ联合PHA 刺激诱导活化,用不同浓度强的松干预,采用流式细胞术检测其PBMC组成性、活化后和强的松处理后HLA-Ⅰ/Ⅱ类分子和HLA-DR7分子的表达量并与正常对照组进行分析比较.结果: (1)体外培养NS患儿及正常人PBMC组成性表达HLA-Ⅰ、Ⅱ类分子和HLA-DR7分子,且NS患儿高于正常人(尤以HLA-Ⅱ类分子突出,为正常人的11.78倍,P＜0.01);(2)体外经 IFN-γ联合PHA活化后HLA-Ⅰ/类分子和DR7分子表达增加(P＜0.01);(3)经不同浓度强的松处理后,HLA-Ⅰ/类分子和DR7分子比活化后表达减少(P＜0.01);(4)经不同浓度强的松预处理后,与活化组比较HLA-Ⅰ、Ⅱ类分子和HLA-DR7表达减少(P＜0.01),对NS患儿的抑制率要高于正常人,并且HLA-Ⅱ类分子表达的抑制作用表现出剂量依赖性(P＜0.01).结论: NS患儿体内存在异常活化的T细胞;糖皮质激素对IFN-γ诱导活化的PBMC HLA表达有抑制作用.     

同种异基因骨髓细胞移植诱导嵌合体小鼠生成

采用C57BL/J和BALB/c两种小鼠进行骨髓细胞移植。移植前受体小鼠经 6 0Gy6 0 Coγ射线照射。用细胞染色法和流式细胞术分析了射线对小鼠淋巴细胞的损伤强度和照射后移植了骨髓细胞的小鼠在不同时间内的淋巴细胞亚群变化。结果表明 ,(1 ) 6 0Gyγ射线照射受体鼠 ,能杀伤 95 5 %的外周淋巴细胞 ,但是不影响自身H 2Kb 分子在淋巴细胞表面表达的百分数。残留细胞中CD3+ T细胞、NK1 1 + 淋巴细胞、CD3+ /NK1 1 + 淋巴细胞的阳性率分别由照射前的 40 44%增加到45 30 %、 1 1 3 %增加到 37 41 %和 1 0 7%增加到 5 86 % (P≤ 0 0 1 ) ;(2 )小鼠的淋巴细胞数量从照射后 30d开始恢复 ,到1 90d达到正常值 ;(3 )照射后进行同种异基因骨髓细胞移植后的第 60天 ,受体淋巴细胞表面自身H 2Kb 抗原表达下降 ,CD3+ /NK1 1 + 淋巴细胞百分数增加。随H 2Kb 的抗原表达的恢复 ,CD3+ /NK1 1 + 淋巴细胞百分数下降 ;(4)在细胞移植的第 1 90天 ,受体小鼠 (黑色 )表型呈现出供体鼠 (白色 )颜色特征。在嵌合体小鼠外周淋巴细胞中 ,有 2 5 %为供体H 2Kd 阳性细胞 ,CD3+ /NK1 1 + 淋巴细胞百分数为 1 88% ,明显高于正常值 (P≤ 0 0 1 )。以上结果表明 ,6 0Gy6 0 Coγ射线照射能诱导免疫耐受 ,其耐受性的形成可能与最初保     

胰岛素依赖型糖尿病患者外周血单核细胞膜表面HLA-Ⅱ类抗原、白细胞介素2受体和铁传递蛋白受体的表达

本文作者用间接免疫荧光法检测了10例胰岛素依赖型糖尿病(IDDM)患者外周血单核细胞膜表面HLA-DR、DQ、DP抗原、白细胞介素2受体(IL-2R)、铁传递蛋白受体(TfR)的表达。术中应用了相应的单克隆抗体和FITC标记的第二抗体。结果表明,IDDM患者单核细胞膜表面HLADQ抗原、IL-2R和TfR的表达明显高于正常对照组,而HLA-DR、DP抗原的表达在IDDM组与正常对照组之间差异无显著性。推测HLA-DQ、IL-2R和TfR的异常表达在IDDM的发病机制中可能起一定作用。     

老年哮喘患者外周血淋巴细胞内IFNγ与IL4的变化

目的了解老年哮喘患者在不同病期外周血淋巴细胞表达IFN-γ、IL-4的变化.方法应用流式细胞仪,测定哮喘急性发作期、缓解期和健康老年人外周血淋巴细胞表达IFN-γ、IL-4的百分率.结果 CD3+CD8+淋巴细胞IFN-γ表达率,急性发作期组(10.5±4.6%)低于缓解期组(17.5±3.8%,p<0.05)和对照组(18.4±5.9%,p<0.05);IL-4表达率急性发作期组(2.6±2.2%)高于缓解期组(1.3±0.9%,p<0.05)和对照组(1.5±0.8%,p<0.05);CD3+、CD8+淋巴细胞IFN-γ表达率,急性发作期组(31.4±10.3%)显著高于缓解期组(20.2±12.3%,p<0.05)和对照组(21.3±10.4%,p<0.05).结论向Th2偏移的Th1/Th2失衡,可能与老年哮喘患者病情发展有关.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.