HBV无症状携带者树突状细胞的分化及功能研究

目的 研究HBV无症状携带者树突状细胞的分化及功能.方法 抽取健康对照者(A组)、HBV无症状携带者(B组)外周静脉血,经密度梯度离心法分离获得PBMC,用TNF-α、IL-10分别和rhIL-4、rhGM-CSF刺激培养,获得:成熟树突状细胞(mDC)、不成熟树突状细胞(imDC).rhIL-4、rhGM-CSF刺激培养获得树突状细胞(DC)作组内对照.imDC组加入TNF-α刺激,检验imDC的稳定性.流式细胞仪检测各组反映树突状细胞成熟度的各种分子.结果 A、B组内mDC细胞膜表达HLA-DR,HLA-ABC分子,分泌的IL-12p70与imDC、DC、imDC+TNF-α组相比明显增加;A、B组间mDC的HLA-DR,HLA-ABC表达无显著性差异,IL-12p70分泌差异有统计学意义(P<0.01).imDC的HLA-ABC、HLA-DR低表达,IL-12p70分泌也较低,与本组内DC比较结果差异有统计学意义(P<0.01);A、B组间imDC的HLA-DR,HLA-ABC低表达,IL-12p70分泌差异无统计学意义.imDC加入TNF-α后HLA-ABC、HLA-DR仍低表达,IL-12p70分泌低于本组内DC,结果差异有统计学意义(P<0.01);A、B组间结果无显著性差异.结论 在A、B组,TNF-α均有效促进DC成熟为mDC,IL-10均抑制DC的成熟,不受A、B组细胞来源影响.mDC分泌大量IL-12p70,并在B组低于A组,说明B组mDC存在一定的功能不足.     

中性粒细胞诱导适应性免疫应答过程中树突状细胞成熟活化

目的 探讨T辅助（Th）1细胞免疫应答过程中,中性粒细胞（PMN）对树突状细胞（DC）的调节作用。方法 将脂多糖（LPS）刺激的中性粒细胞（LPS-PMN）和未成熟树突状细胞（imDC）共培养,流式细胞术检测DC表面CD40和CD86,酶联免疫吸附试验（ELISA）检测白细胞介素12（IL-12）、肿瘤坏死因子α（TNF-α）。将与LPS—PMN共培养后DC（PMN-DC）提纯,与FITC标记的卵清蛋白（FITC-OVA）培养,检测其吞噬功能。将PMN-DC与D011．10T细胞和OVA17肽共培养,计活细胞数,胞内染色测干扰素γ（IFN-γ）、白细胞介素4（IL-4）。结果 LPS-PMN可刺激imDC CD40和CD86上调并分泌IL-12、肿瘤坏死因子（TNF）-α,且这种能力能被抗TNF-α单抗所抑制。与imDC对照,PMN—DC吞噬功能下降,能显著刺激D011．10T细胞增殖,分泌高水平IFN-γ、少量IL-4。结论 LPS-PMN具有促使imDC成熟活化,刺激其分泌细胞因子,发挥其在Th1免疫应答中抗原呈递,促进Th1分化的作用。     

小鼠骨髓源半成熟树突状细胞的培养与初步鉴定

目的探索培养与鉴定小鼠骨髓来源半成熟树突状细胞(smDC)的可行方法。方法分离、纯化6周龄C57BL/6小鼠骨髓单核细胞,以含10%胎牛血清、2 ng/ml重组小鼠粒细胞-巨噬细胞集落刺激因子(GM-CSF)和20ng/ml重组小鼠白细胞介素(IL)-4的RPMI-1640培养基培养9 d;再以肿瘤坏死因子-α(TNF-α)(40 ng/ml)刺激24 h获得smDC,同时以脂多糖(1μg/ml)刺激和不加刺激培养24 h获得成熟DC(mDC)和未成熟DC(iDC)。扫描电子显微镜、流式细胞术、ELISA检测iDC、smDC和mDC的形态、细胞表面标志及细胞因子的表达。建立体外淋巴细胞反应模型,采用细胞计数试剂盒检测smDC对异基因淋巴细胞的活化作用。结果smDC的体积介于iDC和mDC之间、多呈类圆形或圆形,胞体直径约为15μm,树突长度多在5~10μm。smDC、iDC与mDC均高表达CD11c,smDC表达CD40、CD80、CD86及MHC-Ⅱ介于iDC和mDC之间。smDC分泌IL-1β、IL-6和IL-12显著低于mDC(P<0.01)、分泌IL-12显著低于iDC(P<0.05),分泌IL-1β、IL-6与iDC比较差异无显著性(P>0.05);smDC、iDC与mDC分泌IL-10差异无显著性(P>0.05)。smDC对异基因淋巴细胞激活作用显著低于mDC和阳性对照(P<0.01),而与阴性对照和iDC差异无显著性(P>0.05)。结论smDC可能是一个功能和形态上相对独立的DC亚群,体外利用GM-CSF、IL-4和TNF-α诱导骨髓单核细胞是获得smDC的有效方法。     

TLR7激动剂Imiquimod减弱转染IL-10的小鼠髓样树突状细胞的负向调节功能

目的:观察Toll样受体7(Toll like receptor 7,TLR7)激动剂Imiquimod 对白细胞介素10(interleukin 10,IL-10)转染小鼠骨髓来源的树突状细胞(bone-marrow derived dendritic cell,mDC)免疫功能影响?方法:转染IL-10至小鼠mDC,TLR7激动剂Imiquimod刺激48 h,利用流式细胞仪检测DC表面标志MHCⅡ?CD80?CD86及FasL等分子的表达;ELISA检测细胞产生IL-6?肿瘤坏死因子α(TNF-α)?结果:IL-10抑制mDC表达MHCⅡ?CD80?CD86分子,降低其分泌IL-6?TNF-α,促进其表达FasL,而TLR7激动剂刺激增加了IL-10转染mDC表达MHCⅡ?CD80?CD86分子,促进其产生IL-6?TNF-α,抑制FasL表达?结论:TLR7激动剂可逆转IL-10诱发的DC免疫应答低下?     

不同方法对未成熟树突状细胞体外诱生的研究

目的筛选最佳体外诱生大鼠未成熟树突状细胞(imDC)的方法。方法用低剂量(0.2ng/mL)粒细胞巨噬细胞集落刺激因子(recombination rat GM-CSF,rrGM-CSF)体外诱导imDC;用常规剂量(5ng/mL)的GM-CSF加大鼠白细胞介素-4(recombinationratIL-4,rrIL-4)(5ng/L)体外诱导imDC;rrGM-CSF rrIL-4再加大鼠白细胞介素-10(recombination rat IL-10,rrIL-10)(10ng/mL)体外诱导imDC;第13天收获细胞,观察形态;流式细胞仪检测表面抗原;混合淋巴细胞培养(MLR)检测DC刺激同种异体T淋巴细胞的能力,培养上清白细胞介素-12(IL-12)的浓度和细胞增殖情况等方面进行考察,对比筛选。结果低剂量GM-CSF组和IL-10组DC与GM-CSF IL-4组DC相比,符合imDC的特点;GM-CSF IL-4组DC表现成熟DC的特点,但细胞增殖情况低剂量GM-CSF组明显低于GM-CSF IL-4 IL-10组,两组相比差别具有显著性。结论GM-CSF IL-4 IL-10组是最佳诱导imDC的方法。     

成熟与未成熟小鼠树突状细胞的生物免疫学特性研究

目的 研究小鼠骨髓成熟树突状细胞(mDC)与未成熟树突状细胞(imDC)的生物免疫学特性.方法 体外诱导培养小鼠骨髓imDC,经肿瘤坏死因子-α(TNF-α)刺激获得mDC.用小鼠CD11c免疫磁珠纯化DC.电镜观察DC的细胞形态.流式细胞术(FCM)检测细胞表面分子MHCⅡ、CD80、CD86的表达.用细胞增殖检测试剂(CCK-8)检测混合淋巴细胞反应(MLR)中DC刺激同种异基因T细胞的增殖能力.实时荧光定量PCR(QPCR)检测DC上细胞因子mRNA的表达.ELISA检测DC培养上清中的细胞因子表达.结果 电镜观察:imDC比mDC细胞突起少、短.胞质内有更多吞饮泡及溶酶体.FCM检测imDC上MHC-Ⅱ(27.2％)、CD80(27.6％)、CD86(29.5％)的表达水平均显著低于mDC MHC-Ⅱ(97.7％)、CD80(97.2％)、CD86(96.4％).MLR中相同反应比例imDC刺激T细胞的增殖能力,1∶5(1.63±0.04),1∶10(1.50±0.08),1∶20(1.28±0.07),1∶40(1.19±0.04),显著低于mDC 1∶5(2.21±0.09),1∶10(1.92 ±0.02),1∶20(1.64±0.01),1∶40(1.45±0.06),两组间差异均有统计学意义(均P＜0.01).QPCR检测imDC上IL12p35(0.66±0.13)、IL12p40(0.57±0.10)、IFN-γ(0.74±0.08)mRNA相对表达量(mDC为对照)显著低于mDC(1.00±0.00,P＜0.05),而TGF-β(1.35±0.09)显著高于mDC(1.00±0.00,P＜0.05).ELISA法检测imDC分泌IL12p70(6 ±4)、IFN-γ(56±15)显著低于mDC IL12p70(120±22)、I FN-γ(90±15,P＜0.05),而TGF-β(176±23)显著高于mDC TGF-β(55±18,P＜0.05).结论 imDC低表达共刺激分子、MHC-Ⅱ和Th1类细胞因子,高表达TGF-β,不能活化T细胞,具有耐受原性.mDC高表达共刺激分子、MHC-Ⅱ和Th1类细胞因子,可激活初始T细胞,具有免疫原性.     

大鼠髓系来源的树突状细胞的体外诱导及功能鉴定

目的探讨建立合适的大鼠骨髓源性未成熟树突状细胞(imDC)的培养方法,并对其生物学特性进行评价。方法分别以不同剂量的粒细胞-巨噬细胞集落刺激因子(GM-CSF)和白介素(IL)-4诱导分化获得大鼠骨髓源性树突状细胞(DC),比较收获率及特异性标记蛋白(OX62)阳性的DC数量,获得最佳细胞因子浓度。并用流式细胞仪分析DC表型,混合淋巴细胞反应(MLR)检测其刺激同种T细胞增殖能力,ELISA法测定MLR上清IL-12、γ-免疫反应性纤维结合素(IFN-γ)水平。结果 GM-CSF 5 ng/ml可诱导出更高的收获率及OX62的阳性率。GM-CSF 5 ng/ml培养7 d的DC,表达中等水平的主要组织相容性(抗原)复合物Ⅱ类(MHC II)和低水平的CD86;其分泌少量IL-12;刺激同种T细胞增殖能力极低。脂多糖(LPS)刺激后MHCⅡ、CD86表达明显增加;分泌IL-12和IFN-γ增加;刺激同种T细胞增殖能力增强。结论 GM-CSF 5 ng/ml为诱导大鼠骨髓源性imDC的最佳剂量,培养7～9 d可以获得足够数量和纯度的imDC。     

OpG ODN对不同来源树突状细胞活化的影响

目的 比较CpG ODN-1826对BALB／C小鼠骨髓来源树突状细胞(BMDC)和脾脏来源树突状细胞(SDC)的活化作用。方法 用CpG ODN-1826体外刺激树突状细胞(DC)，流式细胞术检测CD80阳性率，ELISA检测IL-12(p70)分泌水平，MTT法检测活化DC刺激T细胞增殖的能力。结果 CpG ODN-1826体外可不同程度激活BMDC和SDC，诱导DC上调CD80的表达和分泌高水平IL-12，促进DC刺激T淋巴细胞增殖。CpG ODN-1826刺激的BMDC膜表面CD80表达水平明显高于SDC，其分泌IL-12的水平亦高于SDC。结论 CpG ODN-1826可促进小鼠骨髓来源和睥脏来源DC的功能成熟，CpG ODN-1826刺激活化BMDC的作用明显强于刺激活化SDC。     

人骨髓间充质干细胞抑制单核细胞来源的树突状细胞的成熟和功能

目的研究人骨髓间充质干细胞(MSC)的免疫调节作用以探讨防治异基因造血干细胞移植中移植物抗宿主病(GVHD)的可能途径。方法将培养第5天的人单核细胞来源的树突状细胞(DC)以每孔1×106密度种于24孔培养板,与等体积3~6代MSC上清混合培养48h,加脂多糖(100ng/m l)、肿瘤坏死因子α(TNF-α,10ng/m l)促DC成熟,观察试验组与对照组树突状细胞免疫表型的变化及其分泌细胞因子白细胞介素(IL)-10、IL-12的变化,并通过混合淋巴细胞反应检测树突状细胞刺激淋巴细胞增殖能力的变化。结果流式免疫分型显示与对照组相比,树突状细胞成熟表面标志CD83、协同刺激分子CD80表达降低,酶联免疫吸附试验(ELISA)测定IL-12浓度混合培养组减少41.7%(P<0.05),IL-10浓度无变化,刺激淋巴细胞增殖能力混合培养组降低(P<0.01)。结论骨髓间充质干细胞上清可抑制单核细胞来源的树突状细胞的成熟和功能,诱导免疫耐受。     

CpG ODN对不同来源树突状细胞活化的影响

目的比较CpG ODN-1826对BALB/C小鼠骨髓来源树突状细胞(BMDC)和脾脏来源树突状细胞(SDC)的活化作用.方法用CpG ODN-1826体外刺激树突状细胞(DC),流式细胞术检测CD80阳性率,ELISA检测1L-12(p70)分泌水平,MTT法检测活化DC刺激T细胞增殖的能力.结果CpG ODN-1826体外可不同程度激活BMDC和SDC,诱导DC上调CD80的表达和分泌高水平IL-12,促进DC刺激T淋巴细胞增殖.CpG ODN-1826刺激的BMDC膜表面CD80表达水平明显高于SDC,其分泌IL-12的水平亦高于SDC.结论CpG ODN-1826可促进小鼠骨髓来源和脾脏来源DC的功能成熟,CpG ODN-1826刺激活化BMDC的作用明显强于刺激活化SDC.     

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…