恶性肿瘤患者外周血淋巴细胞体外扩增后亚群的变化

目的:观察23例恶性肿瘤患者外周血淋巴细胞在体外经扩增培养后总CD3 、CD3 CD4 、CD3 CD8 淋巴细胞及CD3-CD16 56 (NK细胞)、CD3 CD16 56 (NKT细胞)的变化,初步观察淋巴细胞体外扩增培养后回输患者的生物安全性。方法:体外大规模诱导和扩增恶性肿瘤患者外周血淋巴细胞及单个核细胞,然后应用流式细胞术测定扩增前后CD3 、CD3 CD4 、CD3 CD8 、CD3-CD16 56 、CD3 CD16 56 细胞在淋巴细胞中所占百分比的变化。结果:CD3 、CD3 CD8 、CD3 CD16 56 细胞比例较培养前明显增加(P<0.01),而CD3 CD4 和CD3-CD16 56 细胞比例则明显的降低(P<0.01)。所有患者细胞回输治疗后无明显的毒副反应。结论:在本研究体系下体外诱导扩增培养肿瘤患者自体外周血NK细胞及致敏淋巴细胞效率较高,细胞毒性细胞比例增高较大,具有良好的生物安全性。     

人外周血淋巴细胞体外扩增培养前后19种细胞表型研究

目的:观察35例恶性肿瘤患者外周血淋巴细胞在体外经扩增培养后19种细胞表型的变化。方法:体外诱导扩增恶性肿瘤患者外周血淋巴细胞及单个核细胞,应用流式细胞术测定扩增前后CD3 等19种不同表型细胞百分比的变化。结果:经体外扩增培养后,CD3 、CD3 CD8 、CD3 CD16-CD56 、CD3 CD16 CD56-、CD3 CD16 CD56 ,CD45RO 细胞及其亚型CD8 CD45RO 、CD8 CD28-细胞比例较培养前明显增加(P<0.01);而CD19 、CD3 CD4 、CD3-CD16-CD56 、CD3-CD16 CD56-、CD3-CD16 CD56 ,CD45RA 细胞及其亚型CD4 CD45RA 、CD8 CD45RA ,CD4 CD45RO ,CD28 细胞及其亚型CD8 CD28 细胞比例则明显的降低(P<0.01)。结论:培养扩增后细胞具有直接杀伤肿瘤细胞的细胞毒活性。     

异源淋巴细胞免疫治疗后反复妊娠丢失患者的外周血NK细胞变化

目的 观察异源淋巴细胞免疫治疗后反复妊娠丢失(RPL)患者的外周血自然杀伤(NK)细胞变化情况.方法 选取2012年1月至2013年12月期间在我院门诊就诊的反复妊娠丢失并具备免疫治疗适应证的患者30例(RPL组),采用流式细胞术分析异源淋巴细胞免疫治疗后其外周血NK细胞及亚群的变化,并以26例正常妇女做为健康对照组进行比较.结果 异源淋巴细胞主动免疫治疗前,RPL组患者外周血CD3-CD56+NK细胞比例明显高于健康对照组,差异有统计学意义(P<0.05),而其余亚群比例CD3+CD56+、CD56dimCD16+、CD56brightCD16-、CD56+CD69+比较则差异均无统计学意义(P>0.05);经过治疗后,患者外周血CD3-CD56+NK细胞比例从治疗前的(17.07±8.19)降为治疗后的(10.02 ± 7.32),差异有统计学意义(P<0.05),而其余亚群比例治疗前后比较差异均无统计学意义(P>0.05).结论 异源淋巴细胞免疫治疗可能通过降低CD3-CD56+NK细胞比例促进再次妊娠的成功.     

细胞因子诱导的杀伤细胞治疗妇科恶性肿瘤的近期疗效观察

目的 观察回输体外培养的自体细胞因子诱导的杀伤细胞（cytokine-induced killer cells, CIK）治疗妇科恶性肿瘤的近期临床疗效。方法 取8例妇科恶性肿瘤患者外周血,体外培养诱导出CIK细胞,将CIK细胞回输给患者,对比其回输前及回输后2个月的免疫功能、血清CA-125值、卡氏评分及临床症状变化,评价其近期临床疗效。 结果 回输后,外周血CD4+/CD8+比值增加(P<0.05), CD3-CD16+CD56+ 细胞所占百分比增加(P<0.05), CD4+CD25+细胞所占百分比降低(P<0.05);5例患者血清CA-125值下降;1例患者卡氏评分上升;5例患者自觉有临床症状缓解;无一例出现回输不良反应。结论 回输自体CIK细胞对治疗妇科恶性肿瘤有一定的近期疗效。     

恶性肿瘤患者化疗前后免疫学指标的变化及临床应用探讨

目的观察恶性肿瘤患者化疗前后外周血免疫学指标的变化,并探讨其临床应用。方法应用流式细胞仪检测100例恶性肿瘤患者化疗前后外周血T淋巴细胞亚群(CD3+、CD4+、CD8+),B淋巴细胞(CD19+)及NK细胞(CD3-/CD16+56+)的表达率。结果所有患者化疗后CD3+、CD4+、CD4+/CD8+表达高于化疗前,NK细胞明显降低,差异有统计学意义(P0.05);B淋巴细胞(CD19+)化疗前后的变化差异无统计学统计学意义(P0.05)。结论有效的化疗能够改善恶性肿瘤患者的T淋巴细胞免疫功能。     

胸腺五肽对胃癌患者化疗前后淋巴细胞亚群的影响及其临床意义

目的探讨胃癌患者免疫功能的状态及胸腺五肽(Thymopentin-5,TP-5)对胃癌化疗后淋巴细胞亚群的影响。方法40例进展期胃癌患者随机分为单纯化疗组和联合化疗组(联合应用TP-5),并设正常对照组。采用流式细胞术检测化疗前1天及化疗后7天患者外周血CD3+CD4+T细胞,CD3+CD8+T细胞,CD3-CD16+56+NK细胞,CD4+/CD8+比值。应用SAS 8.2软件进行统计学分析。结果1.胃癌患者外周血CD3+细胞,CD3+CD4+T细胞,CD3-CD16+56+NK细胞数量少,CD4+/CD8+比值低,CD3+CD8+T细胞数量多,与C组对照有统计学意义(P<0.05)。2.单纯化疗组化疗后患者外周血CD3+细胞,CD3+CD4+T细胞,CD3-CD16+56+NK细胞数量进一步减少,CD4+/CD8+比值再降低,CD3+CD8+T细胞数量升高,与化疗前相比有统计学意义(P<0.05);联合化疗组患者化疗后外周血CD3+细胞,CD3+CD4+T细胞,CD3-CD16+56+NK细胞,CD3+CD8+T细胞数量,CD4+/CD8+比值,与化疗前相比无统计学意义(P>0.05)。结论胃癌患者细胞免...     

急性髓系白血病T淋巴细胞亚群及NK细胞的变化及其临床意义

目的:探讨检测外周血T淋巴细胞亚群及NK细胞活性对AML患者的病情监测、疗效评价及预后判断的价值。方法:37例AML患者分别采用DA、HA、MA等方案全身化疗,28天为一疗程,在治疗前、化疗结束后2周及下一疗程前采血行T淋巴细胞亚群及NK细胞检测。结果:AML患者CD3 、CD4 、CD4 /CD8 及CD16 56 明显低于正常对照组(P<0.05),化疗2周后CD3 、CD8 、CD4 、CD4 /CD8 及CD16 56 活性均低于化疗前(P<0.05),且高危组变化更显著,治疗有效组升高较无效组明显(P<0.05)。结论:检测外周血T淋巴细胞亚群及NK细胞活性有助于AML患者的病情监测、疗效评价及预后判断。     

人外周血与脐带血来源自然杀伤细胞大体系扩增培养比较

目的探讨人外周血、脐带血来源的细胞因子诱导的自然杀伤(NK)细胞在体外大体系扩增培养的增殖能力及细胞表型分析。方法无菌采集健康志愿者外周血、孕产妇脐带血,用淋巴细胞分离液分离单个核细胞,加入白细胞介素-2(IL-2)体外诱导NK细胞,细胞计数法检测比较其增殖能力,流式细胞术检测诱导后NK细胞的表型。结果加入IL-2诱导体外培养15 d后,外周血、脐带血来源的NK细胞扩增倍数分别为187.87±7.57和165.80±9.24,外周血来源的NK细胞扩增倍数高于脐带血来源的(P<0.05)。培养前,流式细胞术检测外周血、脐带血不同来源单个核细胞中CD3~-CD16~+CD56~+表型的NK细胞所占比例分别为(18.37±3.16)%和(13.29±2.41)%,差异无统计学意义(P>0.05);诱导培养15 d后,外周血、脐带血不同来源单个核细胞中CD3~-CD16~+CD56~+表型的NK细胞所占比例分别为(91.32±5.38)%和(84.26±4.11)%,较诱导前均显著升高(P<0.05);外周血来源CD3~-CD16~+CD56~+表型的NK细胞所占比例稍高于脐带血来源,但差异无统计学意义(P>0.05)。结论经细胞因子IL-2诱导后,外周血和脐血来源诱导的NK细胞的增殖能力、CD3~-CD16~+CD56~+表型细胞所占比例均有较大提高。     

新疆地区健康成人外周血NK细胞体外扩增技术的研究

目的探索用免疫磁珠分选高纯度CD3-CD56+CD16+CD19-CD45+NK细胞并研究体外保持NK细胞活性及体外扩增技术。方法应用免疫磁珠阴性分选法(MACS)分离出高纯度的CD3-CD56+CD16+CD19-CD45+NK细胞,置于含10%胎牛血清的RPMI1640培养基中,分别加入500、1 000、6 000U/mL 3种不同浓度的细胞因子IL-2,组成不同培养体系进行体外扩增。采用细胞计数法、流式细胞术免疫表型分析方法,比较3种细胞因子刺激组及对照组培养的NK细胞数量及纯度的变化。结果免疫磁珠阴性分选后所得的高纯度CD3-CD56+CD16+CD19-CD45+NK细胞纯度由分选前的(29.66±2.31)%提高到(95.37±1.93)%,培养7d后,空白对照组NK细胞纯度降低为(61.82±2.58)%,而加入细胞因子IL-2的3组NK细胞纯度均无明显差异(P>0.05)。18d后,空白对照组的NK细胞纯度降低至(4.28±1.56)%,而浓度为6 000U/mL的实验组纯度为(93.72±2.29)%,与加入细胞因子IL-2前比较,差异无统计学意义(P>0.05)。NK细胞中加入3种不同浓度细胞因子IL-2组500、1 000、6 000U/mL未见明显扩增,差异无统计学意义(P>0.05)。结论经免疫磁珠分选法分选获得的NK细胞,在体外使用10%胎牛血清的RPMI1640培养基培养,添加刺激因子IL-2后,可有效提高NK细胞的存活率,为今后NK细胞的研究与免疫治疗提供了一种简单、有效保持NK细胞纯度的方法。     

结直肠癌术后患者化疗前后外周血NKT及NK细胞表达分析

目的观察结直肠癌术后患者化疗前后外周血淋巴细胞亚群的变化,评估患者免疫功能状态变化。方法纳入浙江省肿瘤医院2016年1～12月住院的结直肠癌根治术后Ⅱ～Ⅲ期患者74例,健康对照组为25例同期我院就诊的非恶性肿瘤患者,采用流式细胞术分析辅助化疗第1、6、8周期前1 d外周血淋巴细胞亚群比例。结果结直肠癌根治术后患者外周血中CD3+(P=0.1532)、CD3+CD4+(P=0.1107)、CD3+CD8+(P=0.2576)T细胞与健康对照组比较无差异(P0.05),而CD3+CD56+NKT细胞(P=0.0210)及CD3-CD56+NK细胞(P=0.0045)较健康对照者显著升高(P0.05)。术后辅助化疗6周期前NK、NKT细胞比例均无显著变化,P0.05。8周期前NKT细胞比例无显著变化(P0.05),NK细胞比例仅轻度下降(19.10±4.63 vs 20.31±4.66,P=0.046)。结论结直肠癌根治术后患者NK及NKT细胞比例较健康人显著升高,且辅助化疗后表达率保持稳定。     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…