系统性红斑狼疮外周血单个核细胞生长激素受体和mRNA表达的研究

目的　探讨SLE患者外周血单个核细胞 (PBMC)的生长激素受体 (GHR)的表达与系统性红斑狼疮 (SLE)的关系。方法　采用放射性受体配基结合试验 (RLBA)及反转录 聚合酶链反应(RT PCR)研究外周血淋巴细胞GHR变化。结果　SLE活动期患者PBMC的GHR的特异性结合率 (SB) (3 4± 2 0 ) %、总结合率 (TB) (13 8± 5 7) %和静止期患者SB (1 3± 1 2 ) % ,TB (11 4±4 6 ) %均高于正常对照组SB (1 0± 1 0 ) % ,TB (8 3± 0 9) % (P <0 0 1) ;SLE活动期患者PBMC的mRNA的表达水平 (0 77± 0 6 6 )高于静止期患者 (0 4 5± 0 2 8) (P <0 0 5 )和正常对照组PBMC的mRNA的表达 (0 31± 0 2 2 ) (P <0 0 1)。结论　SLE患者PBMC的GHR高表达与SLE的病情活动性相关。     

淋巴细胞计数联合HBV-DNA定量检测在早期诊断重症肝炎及判断预后中的意义

目的　探讨淋巴细胞计数联合HBV -DNA定量检测在预示重症肝炎趋势、诊断早期重症肝炎及判断预后中的意义。方法　选择初诊慢性乙型肝炎 (中度 ) 65例 ,根据病情最终演变情况分成慢性乙型病毒性肝炎 (重度 )组和重症肝炎组 ,观察两组淋巴细胞计数和HBV -DNA负荷量变化情况。结果　慢性乙型病毒性肝炎 (重度 )组患者中仅有 4例患者血淋巴细胞计数在病情演变中出现低于正常值情况 ,但患者血HBV -DNA负荷量较高。重症肝炎组中 17例患者在病情演变为重症肝炎前血淋巴细胞计数出现低于正常值情况 ,仅 1例患者始终正常 ,但患者HBV -DNA负荷量均为阴性。重症肝炎组和慢性乙型肝炎 (重度 )组淋巴细胞计数平均值分别为 0 .8± 0 .12× 10 9/L和 1.3± 0 .34× 10 9/L ,两组比较有显著差异 (P <0 .0 5 )。 18例重症肝炎患者在淋巴细胞减少平均 7.7± 2 .1天后出现明显重症肝炎临床症状和体征。结论　淋巴细胞计数联合HBV -DNA定量检测有助于预测慢性乙型病毒性肝炎 (中度 )的发展趋势、在早期诊断重症肝炎中有重要意义     

白细胞过滤对体外循环心脏手术病人血细胞计数的影响

目的　探讨心肺再灌注前及再灌注早期循环血白细胞过滤对体外循环 (CPB)心脏手术病人血细胞计数的影响。方法　连续选取 5 2例二尖瓣或二尖瓣和主动脉瓣双瓣置换术病人 ,随机分成实验组 (EG)和对照组 (CG)。实验组在动脉旁路上并行安装PallLG - 6白细胞滤器 ,白细胞滤器开放时间在心肺复灌前 5～ 10min至CPB结束 ;对照组仅用CPB常规动脉滤器。观察围术期循环血细胞计数的改变。结果　①实验组过滤后血液白细胞计数、中性粒细胞计数和比例与过滤前相比呈显著降低 ;②心肺复灌前实验组与对照组比较 :白细胞计数分别为 (4 2 82± 1 714 )× 10 9/L和(6 880± 2 997)× 10 9/L、中性粒细胞计数分别为 (2 188±1 184 )× 10 9/L和 (4 115± 2 2 4 3)× 10 9/L、单核细胞计数分别为 (0 15 9± 0 137)× 10 9/L和 (0 30 9± 0 198)× 10 9/L ,P<0 0 1,心肺复灌后上述白细胞计数在实验组和对照组均呈显著性升高 ;③血液淋巴细胞和血小板计数在所有观察时点两组间均无显著差异。结论　再灌注前及再灌注早期循环血白细胞过滤的效果表现在其使用的早期 ,主要体现在中性粒细胞和单核细胞的计数显著降低。     

系统性红斑狼疮患者外周血单个核细胞环氧合酶同工酶mRNA的表达

目的　探讨原生型环氧合酶 (COX 1)和诱生型环氧合酶 (COX 2 )在系统性红斑狼疮(SLE)患者外周血单个核细胞 (PBMC)中的表达水平及其在SLE发病机制中的作用及其意义。方法　应用逆转录 聚合酶链反应 (RT PCR)检测了 34例活动期SLE患者和 30名正常人PBMC中COX 1和COX 2mRNA的表达水平。结果　活动期SLE患者COX 1和COX 2的阳性表达率与正常对照组相比差异无显著性 (P >0 0 5 ) ;活动期SLE患者PBMC中COX 2mRNA的平均表达水平 (0 6 6±0 2 7)明显高于正常对照组 (0 43± 0 16 ) ,差异有非常显著性 (P <0 0 1) ;活动期SLE组COX 1的平均表达水平与正常对照组处于同一表达水平 ,差异性无统计学意义 (P >0 0 5 )。结论　活动期SLE患者外周血单个核细胞中COX 2mRNA的表达增加 ,通过诱导前列腺素 (PGs)的产生参与SLE的发病过程。为特异性COX 2抑制剂应用于SLE的治疗提供了理论依据。     

肠易激综合征患者外周血T淋巴细胞亚群分析

目的　肠易激综合征 (IBS)的发病机制是否与炎症免疫有关 ,有待于进一步证实。调查IBS患者血中T淋巴细胞计数及其亚群比例 ,旨在探讨IBS发病新机制。方法　对符合罗马Ⅱ诊断标准的 30例IBS患者及 30名健康对照者的外周血淋巴细胞总数用AC 92 0全血细胞分析仪检查分析 ,采用免疫荧光法并用SimulSET自动软件分析方法进行T淋巴细胞亚群检测。结果　患者外周血淋巴细胞的平均值为 (2 .1± 0 .5 )× 10 9/L ,健康对照组为 (2 .2± 0 .6 )× 10 9/L ,两组差异无显著性 (P >0 .0 5 ) ;T淋巴细胞亚群分析 ,IBS患者外周血CD8值明显高于健康对照组 (P <0 .0 5 ) ,CD4值明显低于健康对照组 ,CD4/CD8比值下降 (P <0 .0 5 ) ,CD3 值与健康对照组相比差异无显著性 (P >0 .0 5 )。结论　IBS患者外周血淋巴细胞总数正常 ,但CD8升高 ,CD4下降 ,CD4/CD8比值下降 ,CD3 正常 ,提示腹泻型IBS可能与免疫下降有关     

北京首批重症急性呼吸综合征患者临床特征及预后分析

目的　探讨重症急性呼吸综合征 (SARS)临床特征 ,分析其预后影响因素。方法　以北京地区首批 34例SARS患者为研究对象 ,观察其临床特征及辅助检查 ,并对 1例死亡患者尸检。结果　患者年龄平均 (33 4± 13 4 )岁 ;潜伏期 2～ 14d ,中位数 4d。发热 (10 0 % )、心悸 (91 7% )、肌痛(79 2 % )、头痛 (70 8% )、腹泻 (73 9% )、咳嗽 (5 8 3% )为主要临床表现。初诊时白细胞计数平均 (4 6± 1 4 )× 10 9/L ,淋巴细胞平均 0 2 7± 0 11,淋巴细胞绝对计数 (1 2 3± 0 4 6 )× 10 9/L ,6 8 4 %病例低于正常。ALT、乳酸脱氢酶、血沉水平升高者分别占 76 2 %、2 8 6 %、4 7 8% ,血清铁、血清白蛋白水平降低者分别为 6 3 2 %、38 1%。 32例有胸部X线检查异常 ,2例CT扫描发现异常。尸检 :肺脏和淋巴组织受累明显。多因素分析显示 ,不良预后独立影响因素是高龄。结论　发热、淋巴细胞和血清铁降低及胸部影像学检查可早期诊断SARS ;年龄为该病预后的独立预测因素。     

淋巴细胞对系统性红斑狼疮患者粒巨噬细胞集落形成单位抑制活性的研究

目的　探讨系统性红斑狼疮 (SLE)患者B、T淋巴细胞对SLE及正常人骨髓粒巨噬细胞集落形成单位 (GM CFU)的影响。方法　分别用SLE患者及正常人B、T及B +T淋巴细胞加入半固体甲基纤维素培养体系中 ,观察它们分别对 16例SLE患者及 12名正常人GM CFU产率的影响。结果　加入SLE患者B、T淋巴细胞后 ,分别可见 75 0 %和 37 5 %的SLE患者GM CFU形成减少 ,产率为 (10 9± 71)个 /10 5细胞和 (137± 34 )个 /10 5细胞 ,与未加淋巴细胞组比较差异均有显著性(P <0 0 1,P <0 0 5 ) ,同时加入SLE患者B和T淋巴细胞时 87 5 %的SLE患者GM CFU产率减少 ,为 (98± 31)个 /10 5细胞 ,与分别加入SLE患者B或T淋巴细胞组比较均有明显差异 (P <0 0 5 ,P <0 0 1) ;SLE患者B及B +T淋巴细胞分别对 5 8 4%、6 6 7%的正常人骨髓GM CFU形成有抑制作用 ,产率为 (2 0 3± 6 7)、(199± 92 )个 /10 5细胞 ,明显低于未加淋巴细胞组 (P均 <0 0 1) ,而正常人淋巴细胞对SLE患者GM CFU的产率与未加淋巴细胞组比较差异无显著性 (P均 >0 0 1)。结论　SLE患者B淋巴细胞无论对大部分SLE患者或大部分正常人骨髓GM CFU的形成有抑制作用 ,SLE患者的B +T淋巴细胞对SLE患者和正常人骨髓GM CFU的抑制有协同作用 ,SLE患者的B淋巴细胞的异常可能是SL     

鞘内联合注射甲氨蝶呤加地塞米松治疗狼疮中枢受累

目的　探讨鞘内联合注射甲氨蝶呤加地塞米松在治疗系统性红斑狼疮 (SLE)中枢神经系统 (CNS)病变中的作用。方法　对 2 4例常规剂量糖皮质激素治疗无效的CNS、SLE患者予鞘内联合注射甲氨蝶呤加地塞米松各 10～ 2 0mg ,对其临床疗效及副作用进行观察 ,并对鞘内注射治疗前后CNS、SLE住院死亡率进行比较。结果　 2 2例CNS、SLE临床症状体征缓解 ,有效率 91 7% ;鞘内注射前脑脊液压力、蛋白及白细胞分别为 (2 0 2± 15 5 )mmH2 O、(145 2± 876 )mg/L及 (2 5 1± 14 3)× 10 6/L ,而鞘内注射后分别下降为 (12 9± 10 8)mmH2 O、(6 0 8± 383)mg/L及 (6 8± 2 1)× 10 6/L ,P均 <0 0 5 ;4例出现一过性不良反应 ,如双下肢烧灼感、头痛及一过性大小便失禁 ;鞘内注射前后CNS、SLE住院死亡率分别为 30 2 (2 9/ 96例 )及 4 0 % (3/ 75例 ) ,P <0 0 1。结论　鞘内联合注射甲氨蝶呤加地塞米松是治疗CNS、SLE的一种有效方法 ,值得进一步临床研究。     

淋巴细胞趋化因子受体mRNA在系统性红斑狼疮患者外周血单个核细胞的表达

目的探讨淋巴细胞趋化因子受体(XCR1)mRNA在系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMC)中的表达,及其与疾病的相关性。方法收集93例确诊的SLE患者和30名健康对照组,收集PBMC,提取RNA。应用反转录-聚合酶链反应(RT-PCR)方法检测研究对象XCR1mRNA表达水平。结果!"XCR1mRNA在PBMC中表达水平,患者组(1.57±0.84)与正常对照组(0.19±0.14),两者差异无统计学意义(P>0.05)。活动期(2.09±1.38)与对照组比较,两者差异有统计学意义(t=2.392,P=0.02);活动期与非活动期(0.31±0.24)比较,差异有统计学意义(t=3.091,P=0.003);非活动期与对照组比较,差异无统计学意义(P>0.05)。"#SLE患者组XCR1mRNA水平与疾病活动度评分(SLEDAI)关系:SLE患者组PBMC中XCR1mRNA表达水平与SLEDAI作直线相关性分析,XCR1mRNA水平与SLEDAI(r=0.540,t=5.445,P=0.000)呈正相关。"$SLE患者PBMC中XCR1mRNA表达与临床表现及实验室检查相关性:SLE抗SSA抗体阳性患者(17/68,1.4±1.2)比阴性患者(51/68,3.5±4.9),其XCR1mRNA表达水平降低,差异有统计学意义(t=2.78,P=0.007)。结论XCR1mRNA表达水平在PBMC中活动期SLE患者比非活动期及对照组增高,与疾病的活动性(SLEDAI)正相关,非活动期与对照组差异无统计学意义。SLE抗SSA抗体阳性患者比阴性患者,其XCR1mRNA表达水平降低,两组均较健康对照组增高。提示XCR1参与疾病的发展,与疾病的活动性相关,XCR1可能参与抗SSA抗体的形成过程,造成组织损伤。     

干细胞移植后合并巨细胞病毒感染时淋巴细胞亚群变化

目的　研究异基因外周血干细胞移植 (PBSCT)后早期巨细胞病毒 (CMV)活动性感染时淋巴细胞亚群变化及其意义 ,探讨活动性CMV感染对免疫的影响。方法　根据CMV感染情况 ,将 2 7例早期PBSCT受者分为症状性感染、无症状活动性感染以及同期未出现活动性感染 3组 ,5 1例正常人作为对照组 ,用流式细胞仪测定其淋巴细胞表面CD3 、CD4、CD8、CD16、CD56、CD19、CD2 8的表达 ,比较各组间的差异。结果　PBSCT后早期CD+ 4 T和B细胞数量显著低于正常人 (P值均 <0 0 1) ;2 7例受者中无活动性CMV感染 5例、无症状活动性CMV感染 10例和症状性CMV感染 12例。上述 3组病人的平均CD+ 4 T细胞计数 (× 10 6/L)分别为 32 8± 2 0 3、2 39± 2 18和 199± 92 ;CD+ 8T细胞计数 (× 10 6/L)分别为 4 0 0± 380、2 6 7± 2 0 6和 6 0 3± 4 6 1;CD+ 4 CD+ 2 8的功能细胞亚群的比例分别为 (89 2± 8 9) %、(84 2±10 1) %和 (6 3 5± 11 4 ) % ;自然杀伤 (NK)细胞比例分别为 (16 2± 11 1) %、(2 9 3± 9 9) %和 (19 2±10 2 ) %。与无活动性CMV感染者相比 ,无症状CMV活动性感染者除NK细胞升高外 (P <0 0 1) ,其他指标差异无显著性 ;而症状性CMV感染者和无症状CMV感染者相比 ,其CD+ 4 T细胞数量显著减少(P <0 0 1) ,CD+ 8T     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.