系统性红斑狼疮患者树突状细胞亚型水平与疾病活动指数的相关性

目的检测系统性红斑狼疮患者树突状细胞亚型水平,探讨与疾病活动指数的相关性。方法使用免疫荧光染色、流式细胞仪检测髓系树突状细胞(MDC)亚型CD11c 和淋巴系树突状细胞(PDC)亚型CD123 的表达,并与SLEDAI、ds-DNA、C3、C4进行相关性分析。结果显示SLE患者和活动期患者外周血中CD11c 和CD123 表达(0.21±0.12);(0.19±0.13)较正常对照组(0.36±0.07)和(0.29±0.9)明显降低(P<0.05)。在SLE病人中,活动期组(0.16±0.11);(0.13±0.06)和静止期组(0.26±0.13);(0.23±0.16)患者外周血CD11c 和CD123 百分率差异存在显著性(P<0.05)。CD11c 和CD123 水平与SLEDAI、ds-DNA具有明显相关性(r=-0.408、-0.436、-0.474、-0.528;P分别为0.018、0.013、0.009和0.003),与C3、C4无明显相关性。结论SLE患者外周血树突状细胞亚型明显降低,并且与SLEDAI相关明显,可作为观察狼疮活动的客观指标。     

慢性肾功能衰竭患者外周血单核细胞向树突状细胞分化能力的研究

目的了解慢性肾功能衰竭患者外周血单核细胞向树突状细胞(DC)分化的能力.方法采用流式细胞仪检测细胞表面标记表达,混合淋巴细胞反应评价细胞的抗原递呈能力.结果慢性肾功能衰竭患者外周血单核细胞能向DC分化,分化而成的DC表达CD11c,CD40,CD80,CD83的阳性率显著低于正常人(P＜0.05),刺激淋巴细胞增殖的能力显著弱于正常人(P＜0.01).结论慢性肾功能衰竭患者外周血单核细胞向DC分化的能力减弱,分化而成的DC具有较弱的抗原递呈能力.     

口腔癌患者外周血树突状细胞的生物学特性

目的:研究口腔癌患者外周血树突状细胞(DC)的形态、表型和功能性变化及其临床意义. 方法: 口腔癌患者(实验组)及正常人(对照组)15例外周血单个核细胞经GM-CSF,IL-4及TNF-α诱导培养, 获取成熟DC, 光镜和电镜观察细胞的形态,流式细胞仪检测细胞表型如CD1a,CD83,CD80,CD86和HLA-DR等分子的表达变化,用噻唑蓝(MTT)法检测DC与自体和同种异体的混合淋巴细胞反应(MLR)中对淋巴细胞增殖的刺激能力. 结果: 正常人及口腔癌患者的外周血单个核细胞经体外7 d诱导培养,均诱导出具有典型形态和表型的DC,其中实验组细胞的CD83,CD1a表达率分别为49.3±9.5和48.1±7.3,与对照组两者表达率62.1±7.9和60.2±6.8相比,差异有统计学意义(P＜0.05),CD86,CD80和HLA-DR的表达率分别为85.5±8.7,83.2±8.1和78.3±5.4,与对照组三者表达率89.2±6.7,87.7±7.2和82.3±4.1相比无明显统计学差异(P＞0.05);实验组DC细胞CD83,CD1a,CD86,CD80和HLA-DR表达的平均荧光指数(MFI)分别为4.80±2.13,3.96±1.15,12.33±6.75,19.63±8.12和39.44±7.9, 均低于对照组,但差异无统计学意义(P＞0.05);口腔癌患者来源的DC在体外具有诱导同种异体和自体外周血T细胞增殖的能力. 结论: 口腔癌患者外周血单核细胞来源可诱导成为具有功能性的成熟DC,该细胞可应用于口腔癌的免疫治疗.     

系统性红斑狼疮患者外周血CD137及其配体表达的变化

目的 探讨T细胞亚群表面协同刺激分子CD137及其在单核细胞表面的配体CD137L表达与系统性红斑狼疮（SLE）发病机制的关系。方法 采用流式细胞仪检测技术对SLE患者和正常人外周血T细胞亚群表面CD137及单核细胞表面CD137L的表达进行分析。 结果 与正常人相比,SLE患者CD4＋T细胞和CD8＋T细胞表达共刺激分子CD137增高,单核细胞表达共刺激分子CD137L增加;SLE患者外周血CD4＋T细胞表达的CD137与24 h尿蛋白定量、球蛋白、SLE病情活动指数(SLEDAI)呈正相关性,与C3呈负相关性;CD8＋T细胞表达的CD137的与24 h尿蛋白定量、SLEDAI呈正相关性。结论 共刺激分子CD137和CD137L表达异常在SLE发病机制中可能有重要作用。     

糖尿病肾病患者外周血单核细胞向树突状细胞分化能力的研究

目的通过对糖尿病肾病患者外周血单核细胞向树突状细胞（DC）分化的能力的研究。探讨糖尿病肾病外周血DC亚群的状况及其活性，为监测、调节患者机体免疫状态及评估替代治疗的疗效提供新方法。方法男性糖尿病患者76例，其中合并肾病患者39例，女性糖尿病患者38例，其中合并肾病患者17例，采用干化学法将其分成正常蛋白尿组（尿蛋白阴性），微量蛋白尿组（30mg／dL〈尿蛋白≤100mg／dL），大量白蛋白尿组（尿蛋白〉100mg／dL），男、女性正常对照组各30例。取外周静脉血以生化分析法测空服血糖（FPG）、糖化血红蛋白（HbA1c）、体重指数（BMI）、以流式细胞仪检测单核细胞表面标志表达。混合淋巴细胞反应评价细胞的抗原递呈能力。结果糖尿病正常蛋白尿组外周血单核细胞向DC分化。分化成的DC表达CD1a．CD11c、CD40与正常人差异无显著性（P〉0．05）。糖尿病微量蛋白尿组和大量蛋白尿组外周血单核细胞分化成的DC表达CD1a、CD11c和CD40显著低于正常人（P〈0．01），但表达CD123明显增高；分化成的DC分泌IFN—α明显增多，而分泌IL-12明显减少。结论糖尿病无合并肾病患者外周血单核细胞向DC分化的能力接近正常人；糖尿病肾病患者外周血单核细胞向DC分化的能力显著低于正常人，分化而成的DC能递呈抗原。但亚群比例失调。     

鼻咽癌病人外周血树突状细胞的表型及功能检测

目的:观察鼻咽癌病人树突状细胞(DC)经体外分离诱导分化后表型变化和呈递功能的情况.方法:在体外分离并诱导成熟HLA-A2基因型鼻咽癌病人自身的DC,运用流式细胞仪检测DC的表型变化,然后分别负载EB病毒抗原LMP-2的HLA-A2限制型两个表位肽段CLGGLLTMV(CLG)和LTAGFIFL(LTA),诱导自身的CD8 T细胞.培养两周后,运用酶联免疫斑点法(ELISPOT)检测经DC诱导后CD8 T细胞的免疫应答情况.结果:分离鼻咽癌患者外周血DC,培养7 d后用流式细胞仪检测DC的各项表型:CD80、CD86、CD83、HLA-DR等,呈现分化成熟的表型特征.上述各种表型的细胞百分率分别为(33.92±21.42)%、(90.20±12.10)%、(32.89±23.47)%、(90.37±12.82)%, 并且与正常人的DC的表达无明显差异.培养成熟的DC呈递肽段CLG及LTA给自身CD8 T细胞,T细胞识别肽段并能应答的细胞数增加,呈递前分别为(2.67±1.97)2×104CD8 T细胞和(5.33±1.86)2×104CD8 T细胞,呈递后为(42.67±33.79)2×104CD8 T细胞和(25.67±18.25)2×104 CD8 T细胞,呈递前、后比较差异有统计学意义(P＜0.05).同时与正常T细胞的应答能力无明显差别.结论:鼻咽癌病人外周血DC可经外周血分离培养,诱导扩增后能分化成熟并能有效呈递肿瘤抗原肽段,产生特异性CTL,对鼻咽癌病人的免疫治疗具有潜在的应用价值.     

系统性红斑狼疮患者外周血调节性T细胞与Th17细胞失衡的研究

目的 通过检测系统性红斑狼疮(systemic lupus erythematosus,SLE)患者外周血CD4+ CD25high调节性T细胞(regulaory T cells,Treg)与Th17细胞的比例,来探讨Treg/Th17细胞的失衡在SLE发病中的作用.方法 采用流式细胞仪检测52例SLE患者(其中活动组38例)及22名健康对照者的外周血CD4+ CD25highT细胞、Th17细胞的比例,并分析与疾病活动指数(systemic lupus erythematosus activity index,SLEDAI)的相关性.结果 SLE患者外周血CD4+ CD25highT细胞和Th17细胞占CD4+T细胞的比例与对照者相比,差异无统计学意义(P＞0.05),且与SLEDAI无相关性.CD4+ CD25highT细胞与Th17细胞的比率在活动组SLE中下降尤为明显(P＜0.05),且与SLEDAI呈明显的负相关(P＜0.05).结论 活动性SLE患者外周血Treg与Th17细胞的比率明显下降,并与疾病活动密切相关,说明两群细胞的失衡可能在SLE的发生和发展中起重要作用.     

SLE患者CD24-CD20hiCD11c+B细胞与mTORC1通路的相关性分析

目的 分析特异B细胞与mTORC1信号通路中PI3K、AKt、mTOR mRNA表达量的相关性。方法 收集2020年1月-2021年6月在厦门二院门诊或住院SLE患者40例及健康人40例的外周血、临床资料,用流式检测SLE患者特异表型的B细胞,对该B细胞的表达比例和临床活动指标进行相关性分析;用q PCR法测mTORC1信号通路中PI3K、A Kt、mTOR基因的表达水平,并分析其与该特异B细胞的相关性。结果 初发未治SLE患者外周血中存在高比例的CD24-CD20hiCD11c+特异性B细胞;特异性B细胞的表达比例与抗dsDNA定量、SLEDAI积分、24 h尿蛋白定量正相关(P <0.05);特异性B细胞的表达比例与补体C3、补体C4负相关(P <0.05);SLE组PI3K、AKt、mTOR mRNA的表达显著高于健康(P <0.05);特异性B细胞的表达比例与PI3K、AKt、mTOR mRNA的表达量呈正相关。结论 SLE患者外周血中CD24-CD20hiCD11c+特异性B细胞的比例显著增高,该特异性B细胞的表达比例可能与抗dsDNA定量、SLEDAI积分...     

类风湿关节炎外周血和关节液树突状细胞的膜分子表达及功能研究

目的研究类风湿关节炎（rheumatoid arthritis,RA）患者树突状细胞（dendritic cell,DC）的膜分子表达水平和功能的变化,探讨DC在RA发病机制中的作用。方法应用流式细胞术、混合淋巴细胞培养测定诱导DC细胞表面分子表达、对同种异体T细胞功能情况,诱导成熟后DC表面分子表达与临床活动及预后相关指标ESR、CRP、RF、Stoke指数的相关性。结果RA外周血来源DC表达CD83、CD209、CD80、HLA—DR较正常人外周血来源DC增高（P〈0．05）,RA关节液来源DC较RA外周血来源DC表达CD83、CD209、CD86、CD80明显增高（P〈0．05）。RA关节液组较RA和正常人外周血DC对同种异体T细胞的刺激明显增强。RA患者外周血诱导成熟DC表型CD83、CD209与stoke评分指数呈正相关。结论提示RA时关节内免疫反应可能与局部DC分化、成熟能力增强有关,后者可通过激活T细胞引起自身免疫反应,造成滑膜组织损伤。RA患者DC表面共刺激分子表达水平的增高可能与患者免疫亢进及所致的免疫损伤有关。     

人类系统性红斑狼疮血清对内皮(逆)穿越模型中树突状细胞表型成熟的影响

目的：研究人类系统性红斑狼疮(systemic lupus erythematosus，SLE)血清对正常人单核细胞(monocyte，Mo)分化形成的树突状细胞(dendritic cell，DC)的表型成熟的影响。方法：分离正常人外周血单个核细胞(PBMC)，加入内皮细胞穿越模型中，分别以正常人血清和SLE血清加入培养体系中，36h后收集2次穿越内皮单层得到的，经形态学鉴定的DC细胞，流式细胞术测DC的CD80、CD86、HLA—DR的表达情况。结果：SLE血清诱导的DC其CD80的表达水平明显低于正常人血清刺激组，而二者均高表达CD86、HLA—DR。结论：DC的表型成熟和血清环境有一定关系。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.